New isolates of ectomycorrhizal fungi and the growth of eucalypt

O objetivo deste trabalho foi avaliar a eficiência de isolados fúngicos ectomicorrízicos na colonização radicular, na absorção de fósforo e no crescimento de mudas de Eucalyptus dunnii. Os inóculos de dez isolados de Chondrogaster angustisporus, Hysterangium gardneri, Pisolithus spp. e Scleroderma spp. foram produzidos em uma mistura turfa-vermiculita suplementada com meio de cultura líquido. As plantas foram cultivadas em substrato semelhante com macro e micronutrientes. Os tratamentos foram distribuídos em casa de vegetação em delineamento inteiramente casualizado. Após três meses, as plântulas com inoculação dos isolados – UFSC-Sc68 (Scleroderma sp.), UFSC-Ch163 (Chondrogaster angustisporus) e UFSC-Pt188 (Pisolithus microcarpus) – tiveram os maiores valores de matéria seca e de fósforo na parte aérea. Esses valores foram superiores ou equivalentes aos observados nas plantas sem inoculação, adubadas com 16 vezes mais fósforo. Esses isolados foram selecionados para futuros estudos, a fim de se estabelecerem técnicas de produção de inoculantes, para serem usados em programas de reflorestamento em condições de viveiros e campo.The objective of this work was to evaluate the efficiency of ectomycorrhizal isolates on root colonization, phosphorus uptake and growth of Eucalyptus dunnii seedlings. Inocula of ten ectomycorrhizal isolates of Chondrogaster angustisporus, Hysterangium gardneri, Pisolithus spp., and Scleroderma spp. were aseptically produced in a peat-vermiculite mixture supplemented with liquid culture medium. Plants grew in a similar substrate supplemented with macro- and micro-nutrients; treatments were randomly distributed in a greenhouse. After three months, seedlings inoculated with three isolates – UFSC-Sc68 (Scleroderma sp.), UFSC-Ch163 (Chondrogaster angustisporus), and UFSC-Pt188 (Pisolithus microcarpus) – had a phosphorus shoot content and a shoot dry matter higher or equivalent to those of noninoculated controls which had been fertilized with a 16-fold phosphorus amount. These isolates were selected for new studies for establishing inoculum production techniques, in order to be applied in reforestation programmes under nursery and field conditions

LIVER TRANSPLANTATION IN LIVER CIRRHOSIS DUE TO HEPATITIS C: A CRITICAL ANALYSIS OF ITS ADVANTAGES, CHALLENGES AND IMPACT ON PATIENTS' QUALITY OF LIFE.

Liver cirrhosis caused by hepatitis C is a serious condition that often leads to the need for liver transplantation for patients in advanced stages of the disease. This procedure has been a crucial measure to improve survival and quality of life for these patients. However, its effectiveness and impact are the subject of critical analysis due to the associated challenges, such as the scarcity of donor organs, the risks of postoperative complications and the possibility of recurrence of hepatitis C virus infection in the new liver. Understanding the advantages and challenges of liver transplantation in hepatitis C liver cirrhosis is essential to optimize patient outcomes and quality of life. Objective: To critically analyze the advantages, challenges and impact on the quality of life of patients undergoing liver transplantation due to liver cirrhosis caused by hepatitis C. Methodology: A systematic literature review was carried out following the PRISMA guidelines. The PubMed, Scielo and Web of Science databases were searched for articles published in the last 10 years. The descriptors used were "liver transplant", "liver cirrhosis", "hepatitis C", "advantages", "challenges" and "quality of life". The inclusion criteria were original studies that addressed the topic in humans, written in English, Portuguese or Spanish. Exclusion criteria were animal studies, literature reviews and studies focusing on liver conditions other than hepatitis C. Results: The results highlighted the effectiveness of liver transplantation in improving the survival and quality of life of patients with liver cirrhosis due to hepatitis C. However, challenges persist, including the limited availability of donor organs and the risk of relapse of hepatitis C virus infection. Strategies to mitigate these challenges have been discussed, such as the use of next-generation antiviral therapies. Conclusion: Liver transplantation is a vital intervention for patients with liver cirrhosis caused by hepatitis C, providing significant benefits in terms of survival and quality of life. However, the associated challenges need to be addressed to further improve outcomes and ensure the long-term success of this procedure.Liver cirrhosis caused by hepatitis C is a serious condition that often leads to the need for liver transplantation for patients in advanced stages of the disease. This procedure has been a crucial measure to improve survival and quality of life for these patients. However, its effectiveness and impact are the subject of critical analysis due to the associated challenges, such as the scarcity of donor organs, the risks of postoperative complications and the possibility of recurrence of hepatitis C virus infection in the new liver. Understanding the advantages and challenges of liver transplantation in hepatitis C liver cirrhosis is essential to optimize patient outcomes and quality of life. Objective: To critically analyze the advantages, challenges and impact on the quality of life of patients undergoing liver transplantation due to liver cirrhosis caused by hepatitis C. Methodology: A systematic literature review was carried out following the PRISMA guidelines. The PubMed, Scielo and Web of Science databases were searched for articles published in the last 10 years. The descriptors used were "liver transplant", "liver cirrhosis", "hepatitis C", "advantages", "challenges" and "quality of life". The inclusion criteria were original studies that addressed the topic in humans, written in English, Portuguese or Spanish. Exclusion criteria were animal studies, literature reviews and studies focusing on liver conditions other than hepatitis C. Results: The results highlighted the effectiveness of liver transplantation in improving the survival and quality of life of patients with liver cirrhosis due to hepatitis C. However, challenges persist, including the limited availability of donor organs and the risk of relapse of hepatitis C virus infection. Strategies to mitigate these challenges have been discussed, such as the use of next-generation antiviral therapies. Conclusion: Liver transplantation is a vital intervention for patients with liver cirrhosis caused by hepatitis C, providing significant benefits in terms of survival and quality of life. However, the associated challenges need to be addressed to further improve outcomes and ensure the long-term success of this procedure

RECTAL ADENOCARCINOMA: CLINICAL EVALUATION AND TREATMENT THROUGH ROBOTIC SURGERY

Rectal adenocarcinoma is a malignant neoplasm that develops in the glandular cells of the rectum. Its clinical evaluation and treatment have been objects of considerable interest, especially with the advancement of robotic surgery. The introduction of the robot in colorectal surgery has provided significant advantages, such as better visualization, precision and control of movements, resulting in potential benefits for patients. However, the literature on the effectiveness and outcomes of robotic surgery in the treatment of rectal adenocarcinoma is vast and varied. Objective: to examine and synthesize the available evidence on the clinical assessment and treatment of rectal adenocarcinoma using robotic surgery, focusing on the last 10 years. Methodology: The methodology followed the PRISMA checklist guidelines. We used the PubMed, Scielo and Web of Science databases to identify relevant articles published in the last 10 years. The descriptors used were "rectal adenocarcinoma", "robotic surgery", "clinical evaluation", "treatment" and "results". The inclusion criteria were studies that evaluated robotic surgery in the treatment of rectal adenocarcinoma, published in English or Portuguese. The exclusion criteria were studies unrelated to the topic, studies without access to the full text and studies with duplicate data. Results: The results revealed an increasing trend in the use of robotic surgery for the treatment of rectal adenocarcinoma. Key topics covered included oncological outcomes, postoperative complications, post-treatment quality of life, and comparisons with other surgical approaches. Conclusion: The review highlights the growing evidence supporting the efficacy and safety of robotic surgery in the treatment of rectal adenocarcinoma. However, additional studies are needed to further understand its clinical utility and its long-term impact on patient outcomes.Rectal adenocarcinoma is a malignant neoplasm that develops in the glandular cells of the rectum. Its clinical evaluation and treatment have been objects of considerable interest, especially with the advancement of robotic surgery. The introduction of the robot in colorectal surgery has provided significant advantages, such as better visualization, precision and control of movements, resulting in potential benefits for patients. However, the literature on the effectiveness and outcomes of robotic surgery in the treatment of rectal adenocarcinoma is vast and varied. Objective: to examine and synthesize the available evidence on the clinical assessment and treatment of rectal adenocarcinoma using robotic surgery, focusing on the last 10 years. Methodology: The methodology followed the PRISMA checklist guidelines. We used the PubMed, Scielo and Web of Science databases to identify relevant articles published in the last 10 years. The descriptors used were "rectal adenocarcinoma", "robotic surgery", "clinical evaluation", "treatment" and "results". The inclusion criteria were studies that evaluated robotic surgery in the treatment of rectal adenocarcinoma, published in English or Portuguese. The exclusion criteria were studies unrelated to the topic, studies without access to the full text and studies with duplicate data. Results: The results revealed an increasing trend in the use of robotic surgery for the treatment of rectal adenocarcinoma. Key topics covered included oncological outcomes, postoperative complications, post-treatment quality of life, and comparisons with other surgical approaches. Conclusion: The review highlights the growing evidence supporting the efficacy and safety of robotic surgery in the treatment of rectal adenocarcinoma. However, additional studies are needed to further understand its clinical utility and its long-term impact on patient outcomes

Síndrome compartimental após extravasamento de contraste: Compartment syndrome after contrast extravasation

Introdução: A síndrome compartimental decorrente do extravasamento de contraste pode ter diversas complicações, merecendo atenção para que seja evitada ou uma vez instaurada, tratada. Apresentação do caso: Paciente do sexo feminino, 65 anos de idade, ex-tabagista, hipertensa e portadora de doença aterosclerótico vascular periférica, em uso de Losartana e AAS. Sofreu queda sobre membro superior esquerdo e foi submetida à Tomografia Computadorizada com contraste iodado que extravasou ocasionando náusea, episódios de vômito e dor, edema, parestesia e prurido local, sendo diagnosticada com síndrome compartimental e tratada com fasciotomia. Discussão: A síndrome compartimental decorre do aumento da pressão em um compartimento osteofascial fechado, diversas podem ser as etiologias da compressão dentre elas o extravasamento de contraste iodado usado em Tomografias Computadorizadas, provocando de alterações cutâneas e comprometendo elementos vasculares, nervos e músculos levando a prejuízo tecidual, demandando intervenção rápida para diminuir a extensão dos agravos através da Fasciotomia associada a aspiração do contraste. Conclusão: A Síndrome compartimental causada por extravasamento de contraste iodado pode ter desfechos locais e sistêmicos severos, assim que feito seu diagnóstico deve ter abordagem definitiva o quanto antes para minimizar suas complicações

Síndrome de Patau: Patau syndrome

Introdução: A Síndrome de Patau, ou trissomia do 13, é um distúrbio autossômico. A principal causa dessa síndrome é a não disjunção do cromossomo 13 durante a primeira divisão meiótica e sua incidência é cerca de 1:20.000 a 25.000. Apresentação do caso: Paciente do sexo feminino,37 anos de idade, natural e procedente de Goiânia/Go,casada e dona de casa.G3P2A0C0 com 33 semanas e 2 dias de gestação.Admitida no hospital das Clínicas de Goiânia com quadro de sangramento vaginal em pequena quantidade e dor em baixo ventre há 2 horas.Negou comorbidades, tabagismo, etilismo e uso de drogas ilícitas. Discussão: A Síndrome de Patau está relacionada a várias malformações, sendo as principais do trato gastrointestinal, sistema nervoso central e cardiopatias. Certas anomalias ou malformações são incompatíveis com a vida, mas alguns casos de trissomia parcial do cromossomo 13 podem ter sobrevida mais longa. Portadores dessa anomalia costumam vir a óbito devido a complicações cardiorrespiratórias. A idade materna avançada é o principal fator de risco. O diagnóstico dessa síndrome pode ser feito por ultrassom obstétrico de qualidade. Conclusão: Logo, nota-se que é primordial que as mulheres realizem o pré-natal adequado. E caso apresentem os fatores de risco é importante o aconselhamento genético pré-natal e pré-concepcional para que a mulher e o feto tenham a assistência adequada

As manifestações clínicas do portador de paralisia facial

Introdução: A paralisia facial e um sintoma de um transtorno de base resultante em imobilidade e incapacidade de executar a mímica facial e a expressão emotiva. São várias as etiologias deste acometimento, sendo a classificação em paralisia facial periférica, representada classicamente pela paralisia de Bell e a central, pelo acidente vascular encefálico, adotada para auxiliar na investigação e seguimento clínico adequado. Objetivo: Descrever sobre a paralisia facial, com foco em características clínicas que propiciem ao diagnóstico precoce, medidas terapêuticas e restauração imediata. Metodologia: Revisão narrativa que selecionou artigos disponibilizados na íntegra publicados no recorte temporal de 2008 até 2022. Resultados: Dos 10 artigos incluídos neste estudo, todos realizaram uma ampla análise sobre a temática, a qual propiciou a disseminação de informações atualizadas sobre conceito, diagnóstico diferencial entre duas condições clínicas opostas resultantes em paralisia facial, manifestações, avaliação clínica e manejo adequado. Conclusão: Estudos ainda urgem em ser feitos no intuito de orientar melhor os profissionais e a comunidade a respeito da paralisia facial e a importância que possui o acompanhamento e seguimento precoce. Destarte,

Aspectos anatomopatológicos das neoplasias malignas renais: Anatomopathological aspects of malignant renal neoplasms

As neoplasias renais correspondem ao crescimento exacerbado de células tumorais no interior dos rins, classificadas como benignas ou malignas. Neste estudo será abordado sobre as neoplasias malignas renais, a qual correspondem a maior prevalência e são representadas pelo carcinoma de células renais e o tumor de Wilms, com a finalidade de descrever a respeito dos aspectos anatomopatológicos, disseminando informações para o diagnóstico e manejo precoce. O carcinoma de células renais é mais prevalente no sexo masculino, indivíduos mais velhos, geralmente assintomático, contribuindo para o diagnóstico tardio junto a existência de metástases e terapêutica irresponsiva. Não se trata de uma doença genética, sendo o caráter esporádico o predominante, neste contexto os fatores de risco, sobretudo o tabagismo em seguida de obesidade hemodiálise e doenças genéticas são potenciais desencadeantes da enfermidade. Os exames complementares associado a clínica, junto ao acompanhamento eleva a possibilidade de identificação antes de avanços metastáticos. O tumor de Wilms é típico de crianças, acometendo um ou ambos os rins, normalmente com alguma anomalia genética, sendo os sinais inespecíficos, mas sempre manifestando massa palpável e dor abdominal, a qual os métodos de imagem confirmam o diagnóstico e estimam o prognóstico deste. Neste contexto, elucida-se a transcendência que os aspectos anatomopatológicos das neoplasias malignas renais oferecem para a diagnose precoce, devido a escassez e inespecificidafe das manifestações clínicas. Logo, a junção do perfil de cada neoplasia abordado conduz ao manejo adequado e reduz a incidência de tratamentos agressivos e irresponsivos

A reatividade negativa oriunda da poliquimioterapia imposta na Hanseníase

Introdução: A hanseníase é uma doença infectocontagiosa, que devido às repercussões clínicas e aos dados epidemiológicos é considerada de notificação compulsória. Contudo, esse transtorno quando é precocemente identificado e adequadamente manejado, evita consideravelmente o círculo vicioso de contágio e as manifestações clínicas que tornam a doença tão alvo de estigma. Objetivo: Descrever a reação negativa oriunda da poliquimioterapia imposta na hanseníase. Metodologia: Trata-se de uma revisão narrativa de literatura, fundamentada nas plataformas do Scielo, Pubmed, Lilacs e demais literaturas pertinentes ao tema, utilizando-se os seguintes descritores: Reação Hansênica, Efeitos Adversos e Poliquimioterapia, no período de janeiro de 2023. Resultados e Discussão:  Atualmente, o protocolo terapêutico voltado para a Hanseníase é a poliquimioterapia e possui boa eficácia e tolerância pela maioria dos pacientes.  No advém, a minoria destes apresenta reações adversas que variam de leve a exacerbadas e que devem ser devidamente classificados e orientados para outras opções farmacológica, objetivando impedir que o paciente abandone o tratamento, junto às enormes repercussões oriundas deste, e propiciar melhor qualidade de vida. Conclusão: Estima-se que o tratamento da Hanseníase é algo importante e indispensável para evitar problemas de saúde pública, mas este se baseia em uma alta carga associada de remédios potentes, a qual alguns portadores possuem sensibilidade e se orientados, podem continuar o tratamento até o alcance da cura.&nbsp

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt