Epidural Block for Cesarean Section. A Comparative Study between 0.5% Racemic Bupivacaine (S50-R50) and 0.5% Enantiomeric Excess Bupivacaine (S75-R25) Associated with Sufentanil

SummaryBackground and objectivesEpidural 0.5% racemic bupivacaine associated with opioids is a technique used in cesarean sections; however, its toxicity has been questioned. 50% Enantiomeric excess bupivacaine has lower cardio- and neurotoxicity. The efficacy of epidural 0.5% racemic bupivacaine and 0.5% enantiomeric excess bupivacaine associated with sufentanil in parturients undergoing cesarean sections was evaluated.MethodsFifty gravida at term, undergoing elective cesarean section under epidural block, were divided in two groups according to the local anesthetic used: Group I – 0.5% racemic bupivacaine with vasoconstrictor; and Group II – 0.5% enantiomeric excess bupivacaine (S75-R25) with vasoconstrictor. In both groups, the local anesthetic (100 mg) was associated with sufentanil (20 μg), and a total of 24 mL of the solution was used. The following parameters were evaluated: latency of the sensitive blockade; maximal level of the sensitive blockade; degree for motor blockade; time of motor blockade regression; duration of analgesia; maternal side effects; and neonatal repercussions.ResultsLatency, maximal level of sensitive blockade, degree of motor blockade, and duration of analgesia were similar in both groups; the mean time for regression of the motor blockade was significantly smaller in Group II. The incidence of side effects was similar in both groups. Maternal cardiocirculatory changes and neonatal repercussions were not observed.ConclusionsEpidural racemic bupivacaine and 50% enantiomeric excess bupivacaine provided adequate anesthesia for cesarean sections. 50% Enantiomeric excess bupivacaine is a promising alternative for this procedure, since it has faster regression of the motor blockade, which is desirable in obstetric patients

What about vaginal extraction of the kidney? results of an online survey

PURPOSE: We aimed to characterize surgeons opinion about the vaginal extraction of the kidney after transperitoneal laparoscopic nephrectomy. Matherial and Methods: A 9-item questionnaire was published online (Survey Monkey TM) and publicized via email to a multidisciplinary pool of surgeons in Portugal. Data was collected and statistical analysis was performed using IBM SPSS Statistics, Version 21.0. RESULTS: Three hundred and fifty nine inquiries were sent, 154 surgeons completed the questionnaires (response rate of 43.0%). Fifty five point eight percent of the participants would choose the transvaginal approach for themselves or for a close relative. The most stated arguments were a better cosmesis (29.0%) expectancy of lower post operative pain (26.0%) and lower rate of incisional hernias (23.0%). Defenders of the transabdominal procedure justified with an expectancy of lower complication rate (39%), namely impairment of sexual function and fertility (22%). The female gender and the familiarity with transvaginal surgery were the stronger predictors of the option for this approach (70.6% vs 48.5%; p=0,016 and 85.3% vs 46.6%; p <0.001 respectively). CONCLUSIONS: Contrasting with similar surveys published on transvaginal NOTES, the vaginal specimen extraction after conventional laparoscopic nephrectomy was fairly accepted by the inquired surgeons.info:eu-repo/semantics/publishedVersio

Modelagem matemática da dinâmica temporal do HLB.

RESUMO: O Huanglongbing (HLB) e considerado atualmente a mais grave doença da citricultura nacional, devido aos enormes prejuízos econômicos que pode causar. Este trabalho apresenta um modelo matemático epidemiológico para avaliar a evolução temporal da doença considerando o sistema planta (citros) - inseto vetor (Diaphorina citri). Com base na literatura determinou-se faixas de variacao para os parâmetros biológicos do modelo. A partir da criação de cenários de simulação veri&#64257;cou-se numericamente algumas condições que favorecem a evolução da doença.SBIAgro 2011

Astrometry of the main satellites of Uranus: 18 years of observations

We determine accurate positions of the main satellites of Uranus: Miranda, Ariel, Umbriel, Titania, and Oberon. Positions of Uranus, as derived from those of these satellites, are also determined. The observational period spans from 1992 to 2011. All runs were made at the Pico dos Dias Observatory, Brazil. We used the software called Platform for Reduction of Astronomical Images Automatically (PRAIA) to minimise (digital coronography) the influence of the scattered light of Uranus on the astrometric measurements and to determine accurate positions of the main satellites. The positions of Uranus were then indirectly determined by computing the mean differences between the observed and ephemeris positions of these satellites. A series of numerical filters was applied to filter out spurious data. These filters are mostly based on the comparison between the positions of Oberon with those of the other satellites and on the offsets as given by the differences between the observed and ephemeris positions of all satellites. We have, for the overall offsets of the five satellites, -29 (+/-63) mas in right ascension and -27 (+/-46) mas in declination. For the overall difference between the offsets of Oberon and those of the other satellites, we have +3 (+/-30) mas in right ascension and -2 (+/-28) mas in declination. Ephemeris positions for the satellites were determined from DE432+ura111. Comparisons using other modern ephemerides for the solar system -INPOP13c- and for the motion of the satellites -NOE-7-2013- were also made. They confirm that the largest contribution to the offsets we find comes from the motion of the barycenter of the Uranus system around the barycenter of the solar system, as given by the planetary ephemerides. Catalogues with the observed positions are provided.Comment: 13 pages, 21 figure

Development and validation of attitudes measurement scales: fundamental and practical aspects

Purpose – This paper aims to present the fundamental aspects for the development and validation (D&amp;V) of attitudes’ measurement scale, as well as its practical aspects that are not deeply explored in books and manuals. These aspects are the results of a long experience of the authors and arduous learning with errors and mistakes. Design/methodology/approach – The nature of this paper is methodological and can be very useful for an initial reading on the theme that it rests. This paper presents four D&amp;V stages: literature review or interviews with experts; theoretical or face validation; semantic validation or validation with possible respondents; and statistical validation. Findings – This is a methodological paper, and its main finding is the usefulness for researchers. Research limitations/implications – The main implication of this paper is to support researchers on the process of D&amp;V of measurement scales. Practical implications – Became a step-by-step guide to researchers on the D&amp;V of measurement scales. Social implications – Support researchers on their data collection and analysis. Originality/value – This is a practical guide, with tips from seasoned scholars to help researchers on the D&amp;V of measurement scale

Physical-chemical properties of nanocomposites based on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and titanium dioxide nanoparticles

Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) was reinforced with titanium dioxide (TiO2) in concentrations of 1.0%, 2.5% and 5.0% (m/m) to produce nanocomposites by the solvent casting technique. TiO2 was synthesized by a hydrothermal treatment to produce nanoparticles. The nanostructure of the nanoparticles was studied by x-ray diffraction analysis (XRD) and transmission electron microscopy (TEM). The XRD confirmed TiO2 crystalline nanoparticles, with a mixture of anatase and rutile phases. Through TEM analysis, the formation of TiO2 nanorod agglomerates with an average diameter and length of 40 and 12 nm, respectively, was observed. The thermal and mechanical properties of the pure PHBV and nanocomposite films were characterized by differential scanning calorimetry (DSC) and dynamic mechanical analysis. The DSC analysis showed that the glass transition temperature decreased with the inclusion of TiO2 in the PHBV matrix in relation to pure PHBV. The results of biodegradation assays for the PHBV and nanocomposites in an aqueous medium and in soil showed morphological and structural changes for all samples, indicating a high biodegradation rate for this material. The most important conclusion is that the biodegradation of the PHBV was not affected by the addition of nanoparticles, thus enabling the use of nanocomposites in applications requiring biodegradable materials.CNPqFAPESP [2013/14954-6]Fed Univ Sao Paulo Unifesp, Dept Sci & Technol, BR-12231280 Sao Jose Dos Campos, SP, BrazilFed Univ Goias UFG, Dept Chem, BR-75801615 Jatai, Go, BrazilFed Univ Sao Paulo Unifesp, Dept Sci & Technol, BR-12231280 Sao Jose Dos Campos, SP, BrazilFAPESP [2013/14954-6]Web of Scienc

Increased polyclonal immunoglobulin reactivity toward human and bacterial proteins is associated with clinical protection in human Plasmodium infection

BACKGROUND: Polyclonal B-cell activation is well known to occur in Plasmodium infections, but its role in pathogenesis or protection remains unclear. However, protective properties of natural antibodies have previously been demonstrated in other contexts. METHODS: Sera from asymptomatic and symptomatic Plasmodium-infected subjects locally detected in a survey study in the Brazilian Amazon, and from unexposed and exposed but presently uninfected control subjects, were assayed by a standardized quantitative immunoblot method allowing simultaneous detection of IgG or IgM reactivity to a large number of parasite-unrelated proteins. RESULTS: In subjects free of coinfection with hepatitis B virus, IgG reactivity to human brain antigens and Escherichia coli proteins was strikingly enhanced in asymptomatic Plasmodium-infected individuals when compared to such with clinical malaria symptoms, or to uninfected control subjects. This difference was most characteristic for limited exposure times (less than ten years locally, or 20 years in endemic areas). It was more significant than a similar trend found for IgG to Plasmodium falciparum antigens, and unrelated to parasitaemia levels. Asymptomatic subjects with comparatively short exposure characteristically showed relatively elevated IgG versus IgM reactivity. Polyclonal IgG reactivity appears triggered by previous P. falciparum but not Plasmodium vivax malaria. CONCLUSION: The observed difference in polyclonal antibody production seems related to intrinsic activation states of infected individuals, rather than to parasite-antigen specific immune responses. However, it appears influenced by preceding stimuli. This supports the idea that acquired clinical immunity may not exclusively depend on antigen-specific responses, but also on the individual polyclonal reaction

An analysis of rainfall based on entropy theory

The principle of maximum entropy can provide consistent basis for analyzing rainfall and for geophysical processes in general. The daily rainfall data was assessed using the Shannon entropy for a 10-years period from 189 stations in the northeastern region of Brazil. Mean values of marginal entropy were computed for all observation stations and isoentropy maps were then constructed for delineating annual and seasonal characteristics of rainfall. The Mann-Kendall test was used to evaluate the long-term trend in marginal entropy for two sample stations. The marginal entropy values of rainfall were higher for locations and periods with highest amount of rainfall. The results also showed that the marginal entropy decreased exponentially with increasing coefficient of variation. The Shannon theory produced spatial patterns which led to a better understanding of rainfall characteristics throughout the northeastern region of Brazil. Trend analysis indicated that most time series did not have any significant trends

De como ensinar: traços paradigmáticos nos manuais pedagógicos e perspectivas de investigação (1870-2015)

O objetivo do artigo é contribuir para a produção de conhecimento sobre manuais destinados à formação de professores, focalizando particularmente as obras usadas no ensino de disciplinas como a Pedagogia, a Didática, a Metodologia e a Prática de Ensino, em perspectiva ainda pouco explorada na pesquisa educacional. Denominados de manuais pedagógicos, têm sido publicados no Brasil desde 1870 com a intenção de garantir aos futuros professores uma formação especializada. A complexificação da Didática como campo de conhecimento e o fortalecimento das Didáticas Específicas produziram transformações nesse conjunto de obras ao longo dos últimos quarenta anos, demandando revisões conceituais e novas perspectivas de investigação, apontadas pelas autoras nesta síntese realizada a partir dos resultados de suas pesquisas