VAAFT - Videoassisted anal fistula treatment: A new approach for anal fistula

AbstractIntroductionAnal fistula is an epithelised path between the rectum or anal canal and the perianal region. The use of laparoscopic surgery with a minimally invasive procedure has led to the development of video-assisted surgical treatment of anal fistula.ObjectiveTo describe the surgical technique VAAFT as a new approach to fistula.ConclusionThis is a safe and reproducible procedure. It enables the study of the entire fistula, obtaining the identification of accessory paths, cavitations and of the inner hole. More studies should be published for a better analysis of this technique, as well as to have a long-term outcome with new publications

Placental and Umbilical Cord Anomalies Diagnosed by Two- and Three-Dimensional Ultrasound

The aim of this review is to present a wide spectrum of placental and umbilical cord pathologies affecting the pregnancy. Placental and umbilical cord anomalies are highly associated with high-risk pregnancies and may jeopardize fetal well-being in utero as well as causing a predisposition towards poor perinatal outcome with increased fetal and neonatal mortality and morbidity. The permanent, computerized perinatology databases of different international centers have been searched and investigated to fulfil the aim of this manuscript. An extended gallery of prenatal imaging with autopsy correlation in specific cases will help to provide readers with a useful iconographic tool and will assist with the understanding and definition of this critical obstetrical and perinatological issue

PRESSURIZED WATER PRETREATMENT TO INCREASE SUGAR PRODUCTION FROM GREEN COCONUT

Pretreatment of lignocellulosic industrial waste is necessary to promote the cellulose accessibility. Thus, this study evaluated the production of green coconut sugars during pressurized hydrothermal pre-treatment and enzymatic hydrolysis of the pretreated biomass. Pretreatment of the green coconut shell was carried out at 70 °C, 150 bar and water flow rate of 1 mL/min for 4 h. Samples from the system output stream were analyzed by HPLC and Folin Ciocalteu method. The solid fraction was characterized (chemical composition, XRD and FTIR) and subjected to enzymatic hydrolysis. The liquid fractions of pretreatment provided a defined profile of released glucose, xylose, phenolic components and acetic acid over time. After 40 min, most of fermentable sugars were released, forming a liquor with a sugar content above 10 g/L. Post-treated biomass showed a reduction of cellulose (26 % to 17 %) and hemicellulose (23 % to 18 %) and an increase in lignin content (32 % to 44 %). Despite this new chemical composition of the biomass, the pretreated material had lower crystallinity indexes and modifications in its chemical groups. This favored cellulosic conversion from 15 % to 55 %, producing 63.5 % more glucose than the untreated green coconut shell during enzymatic hydrolysis. Thus, the pressurized pre-treatment favored the fermentable sugar production from the green coconut shell, and there is also the possibility of utilizing the sugars present in the pre-treatment liquor

Assessment of ultrasound and Doppler parameters in the third trimester of pregnancy as predictors of adverse perinatal outcome in unselected pregnancies

Objectives: The aim of the study was to investigate ultrasound and Doppler parameters in the third trimester of pregnancy as possible predictors of adverse perinatal outcome in unselected pregnancies. Material and methods: We performed a retrospective cross-sectional study including unselected pregnant women be­tween 27 and 36 + 6 weeks of gestation. The following ultrasound and Doppler parameters were assessed: estimated fetal weight (EFW) [g], EFW percentile, placental maturity grade (Grannum classification), single vertical deepest pocket (SVDP) of amniotic fluid [cm], amniotic fluid index (AFI) [cm], mean uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, middle cerebral artery (MCA) PI, MCA peak systolic velocity (PSV) [cm/s], and cerebroplacental ratio (CPR). Adverse perinatal outcome was defined as Apgar score of < 7 at 1 min, birth weight of < 2500 g at delivery, and gestational age of < 37 weeks at delivery. The unpaired t test was used to compare the groups. Results: AFI (p = 0.01), mean UtA PI (p = 0.04) and mean UA PI (p = 0.03) were significantly different with regard to the Apgar score at 1 min. EFW, EFW percentile, SVDP of amniotic fluid, AFI, mean UtA PI, UA PI, and MCA PI were significantly different (p < 0.001) in terms of birth weight. Placental maturity grade (p = 0.02), SVDP of the amniotic fluid (p < 0.001), AFI (p < 0.001), mean UtA PI (p < 0.001), UA PI (p = 0.001), and MCA PI (p < 0.001) were significantly different as far as gestational age at delivery is concerned. Conclusion: Ultrasound and Doppler parameters may predict adverse perinatal outcomes in unselected pregnancies in the third trimester of pregnancy

Extract from leaf of Psidium guajava L depresses the guinea pig atrial contractility by interfering with potassium and calcium channels

The negative inotropic effect of aqueous fraction (AqF) obtained from the acetic extract of Psidium guajava L leaf was investigated on the guinea pig left atrium. Myocardial force was measured isometrically (27 ± 0.1 o C, 2 Hz). AqF (100 mg/ml) reduced contractility of about 85 ± 9.4 % (n = 4, p < 0.001, Fcalc = 51.70, F(0.01; 4; 21) = 5.09, EC50 = 14.28 ± 3 mg/mL) in a concentration-dependent fashion. This effect was reduced by 20 mM of tetraethylammonium (TEA), increasing EC50 to 50 ± 7 mg/ml (n = 4, p < 0.001, Fcalc = 282.13; F(0.01; 21; 66) = 2.36). AqF (100 mg/ml) shifted to the right the CaCl2 concentration-effect curve, increasing the EC50 from 2170 ± 112 to 2690 ± 132 mM (n = 3, p < 0.001, Fcalc = 220.80 ; F(0.01; 29; 60) = 2.19). L-NAME (100 mM) did not modify the AqF inotropic effect (n = 3, p > 0.05) sugesting that the oxide nitric pathway did not participate of the action mechanism of AqF. We can conclude that AqF depresses the atrial contractile by reducing the calcium entry in myocardial cells and also by openenig potassium channels of cardiac tissue._________________________________________________________________________________________ RESUMO: O efeito inotrópico da fração aquosa (AqF) do extrato acético das folhas de Psidium guajava L. foi investigado em átrio esquerdo de cobaia. A força miocárdica foi medida isometricamente (27 ± 0,1 o C; 2 Hz). A AqF (100 mg/mL) reduziu a contratilidade em até 85 ± 9,4 % (n = 4; p < 0,001; Fcalc = 51,70; F(0,01; 4; 21) = 5,09; CE50 = 14,28 ± 3 mg/mL) de forma dependente da concentração. Este efeito foi reduzido pelo tetraetilamônio (TEA, 20 mM) que também aumentou a CE50 de 14,28 ± 3 mg/mL para 50 ± 7 mg/ mL (n = 4; p < 0,001; Fcalc = 282,13; F(0,01; 21; 66) = 2,36). A AqF (100 mg/mL) deslocou para a direita a curva concentração-efeito do CaCl2 , aumentando a CE50 de 2170 ± 112 para 2690 ± 132 mM (n = 3; p < 0,001; Fcalc = 220,80 ; F(0,01; 29; 60) = 2,19). Por outro lado, o L-NAME (100 mM) não alterou o efeito inotrópico da AqF (n = 3; p > 0,05), sugerindo que a via do óxido nítrico não participa do mecanismo de ação da AqF. Conclui-se que a AqF deprime a contratilidade atrial por reduzir a entrada de cálcio nas células miocárdicas e por abrir canais de potássio deste tecido

Reativação Tectônica Quaternária no Domínio Sul da Província Borborema, NE do Brasil: Integração de Dados Morfométricos, Geológicos e Geofísicos da Bacia do Rio Una

Integração de dados em diferentes escalas foi realizada com o objetivo de identificar possíveis efeitos de reativações tectônicas cenozoicas (pós-rifte), relacionadas ao embasamento adjacente à Bacia Pernambuco, sobre o qual está localizada a bacia hidrográfica do Rio Una. O estudo foi baseado na integração de parâmetros morfométricos do canal do Rio Una, modelados a partir de imagens de radar, dados de geologia de superfície e dados de sísmica de reflexão multicanal 2D adquiridos no canal do rio, próximo às cidades de Barreiros e Palmares. A análise morfométrica se baseou no cálculo da relação declividade vs. extensão (RDE) ao longo do perfil longitudinal do Rio Una. Dados geológicos foram coletados em afloramentos no embasamento próximo aos municípios de Barreiros e Palmares. Também foram investigados os depósitos da Formação Barreiras na região costeira, próximo ao município de São José da Coroa Grande. A análise do perfil longitudinal mostrou que o Rio Una está implantado sobre três superfícies criadas por eventos sucessivos de soerguimento e erosão, as quais controlaram a compartimentação de sua bacia hidrográfica. O estudo do índice RDE mostrou a ocorrência de anomalias de primeira ordem, no médio curso, e de segunda ordem, no médio e baixo curso do rio. As anomalias de primeira e segunda ordem estão localizadas sobre as principais zonas de cisalhamento pré-cambrianas que cortam o embasamento com orientação NE-SW. As anomalias também estão relacionadas a falhas e fraturas mais jovens com direção NW-SE. A interpretação dos dados sísmicos mostrou um arranjo de falhas e fraturas de alto ângulo no embasamento que afetaram depósitos sedimentares de idade quaternária e holocênica. Também foram observadas falhas em depósitos da Formação Barreiras (Mioceno) depositados sobre o embasamento próximo a borda da Bacia Pernambuco. A geometria dos planos de falha é indicativa de estruturas do tipo flor, relacionadas a um regime de reativação transcorrente que está atuando sobre a margem continental, com compressão máxima E-W e extensão N-S. Este regime afetou a morfologia do canal do Rio Una, bem como os depósitos sedimentares associados à sua bacia de drenagem