Almost everywhere continuity of conditional expectations

A necessary and sufficient condition on a sequence $\{\mathfrak{A}_n\}_{n\in \mathbb{N}}$ of $\sigma$-subalgebras that assures convergence almost every where of conditional expectations is given

Impuesto a las aguas saborizadas (refrescos): una alternativa para financiar el combate a la diabetes en México

Diabetes is the number one cause of death in people of productiveage in México, generating high economic and social costs at themicro and macroeconomic levels. In 90% of diabetes cases, theyare attributed to obesity, which is directly related to imbalancesin the diet and to a sedentary lifestyle. The average expenditurein soda consumption is equivalent to 12 and 7.5% of the basicfood basket, rural and urban, respectively. The objective ofthis study was to propose an alternative for financing diabetestreatment by imposing a tax on soda consumption. Themethodology consists in estimating the expenditure in diabetestreatment and soda consumption using information from theENSANUT 2006 databases, and performing a sensibility analysiswith different tax sums, and in view of different scenarios forproduct price elasticities. Results indicate that the incomegenerated from a tax of two to three pesos per liter, taking intoaccount a price elasticity between -0.5 and 1.0, might coverthe total cost generated by diabetes treatment in México, anddecrease its consumption in 13% to 19%.La diabetes es la primera causa de muerte en personas en edadproductiva en México, lo que genera elevados costos económicos ysociales a niveles micro y macroeconómicos. El 90% de los casos dediabetes se atribuyen a la obesidad, que se relaciona directamentecon desequilibrios en la dieta y sedentarismo. El gasto promedioen consumo de refresco equivale a 12 y 7.5% de la canasta básicaalimentaria rural y urbana respectivamente. El objetivo de estetrabajo fue proponer una alternativa para financiar el tratamientode diabetes imponiendo un impuesto al consumo de aguas saborizadas.La metodología consiste en estimar el gasto en el tratamientode diabetes y consumo de refresco a partir de las bases de datos dela ENSANUT 2006, y realizar un análisis de sensibilidad con distintosmontos de impuesto y ante distintos escenarios de elasticidadesprecio de los productos. Los resultados indican que el ingreso generadoa partir de un impuesto de entre dos y tres pesos por litro,contemplando una elasticidad precio entre -0.5 y 1.0, permitiríacubrir el gasto total generado por el tratamiento de diabetes enMéxico, y disminuir entre 13% y 19% su consumo

Paracoccidioidomicose acarretando Síndrome Colestática: relato de caso: Paracoccidioidomycosis causing Cholestatic Syndrome: a case report

Introdução: Síndrome Colestática engloba as doenças que acometem as vias biliares resultando em colestase, que é classificada em extra e intra-hepática. Uma causa rara de colestase extra-hepática é a causada pela paracoccidioidomicose, onde há a compressão externa da via biliar pelo comprometimento generalizado de linfonodos. Objetivo: Relatar caso em que uma síndrome colestática é causada por Paracoccidioidomicose, devido obstrução extrínseca da via biliar. Relato do caso: Paciente M. T. M., sexo masculino, 35 anos, procedente de região rural em Presidente Prudente, história de alcoolismo e uso de drogas, com queixa de dor de início insidioso em epigastro e irradiação para hipocôndrio direito, acompanhado de febre e inapetência e evoluindo com icterícia e colúria. Foi submetido a internação com suspeita inicialmente de coledocolitíase e após exames de imagem, compressão extrínseca da árvore biliar extra-hepática de provável etiologia neoplásica. No entanto, após a realização de biópsia foi confirmado diagnóstico de PCM cursando com quadro atípico de colestase. Discussão: A forma de manifestação pode dificultar o diagnóstico imediato de PCM, ao mimetizar outras doenças obstrutivas das vias biliares, mostrando, portanto, a importância como diagnóstico diferencial independentemente da faixa etária, principalmente por ser a principal causa de micose sistêmica no Brasil, ressaltando em especial a investigação em populações de zonas rurais endêmicas

Relato de caso: Tumor neuroendócrino de apêndice cecal: Case report: neuroendocrine Tumor of the cecal appendix

Os tumores neuroendócrinos são neoplasias raras que podem surgir em várias localizações. Os tumores neuroendócrinos do apêndice cecal são o terceiro tumor neuroendócrino mais frequente no trato gastrointestinal e aparecem principalmente em idades mais jovens. Na sua grande maioria são identificados através do estudo histopatológico na sequência de uma apendicectomia por suspeita de apendicite aguda. Em casos raros podem causar síndrome carcinoide. Atualmente, são utilizados os sistemas de classificação da Organização Mundial de Saúde e da European Neuroendocrine Tumor Society, os quais têm por base a taxa mitótica e/ou o índice proliferativo Ki-67. O tratamento de escolha dos tumores neuroendócrinos do apêndice cecal é a apendicectomia simples e em casos selecionados pode ser necessária a realização de colectomia direita. A apendicectomia simples é o tratamento cirúrgico de rotina e proporciona a cura na maioria dos casos. Os critérios propostos pela European Neuroendocrine Tumor Society para o tratamento desses tumores são de fácil reprodução mesmo os tumores de apêndice cecal sendo neoplasias relativamente raras, porém com um excelente prognóstico

Overactive bladder-18 years - Part II

Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning - as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder - 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.Univ Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUniv Sao Paulo, Dept Urol, BR-05508 Sao Paulo, SP, BrazilFac Med ABC, Dept Urol, Sao Paulo, SP, BrazilUniv Los Andes, Dept Urol, Bogota, ColombiaEscuela Med Mil, Dept Urol, Mexico City, DF, MexicoHosp Clin Jose San Martin, Catedra Urol, Buenos Aires, DF, ArgentinaMae de Deus Ctr Hosp, Dept Urol, Porto Alegre, RS, BrazilUniv Fed Ciencias Saude Porto Alegre, Porto Alegre, RS, BrazilAC Camargo Hosp, Dept Urol, Sao Paulo, SP, BrazilHosp Clinico Fuerza Area Chile, Santiago, ChileInst Mexicano Seguro Social, Mexico City, DF, MexicoHosp Souza Aguiar, Dept Urol, Rio De Janeiro, RJ, BrazilComplejo Med Policial Churruca Visca, Serv Urol, Buenos Aires, DF, ArgentinaCtr Policlin Valencia Vina, Valencia, VenezuelaHosp Pablo Tobon Uribe, Medellin, ColombiaClin Indisa, Serv Urol, Providencia, ChileCtr Reabilitacao & Readaptacao Dr Henriqe Santill, Goiania, Go, BrazilHosp Univ Caracas, Serv Urol, Caracas, VenezuelaUniv Fed Ceara, Div Urol, Fortaleza, Ceara, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilWeb of Scienc

Overactive bladder-18 years - Part I

Overactive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals - including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years.Univ Fed Sao Paulo, EPM, Rua Dr Oscar Monteiro Barros 617-141, BR-05641010 Sao Paulo, SP, BrazilUniv Sao Paulo, Dept Urol, BR-05508 Sao Paulo, SP, BrazilFac Med ABC, Dept Urol, Sao Paulo, SP, BrazilUniv Los Andes, Dept Urol, Bogota, ColombiaEscuela Med, Dept Urol, Mexico City, DF, MexicoHosp Clin Jose San Martin, Catedra Urol, Buenos Aires, DF, ArgentinaMae de Deus Ctr Hosp, Dept Urol, Porto Alegre, RS, BrazilUniv Fed Ciencias Saude Porto Alegre, Porto Alegre, RS, BrazilAC Camargo Hosp, Dept Urol, Sao Paulo, BrazilHosp Clin Fuerza Area Chile, Santiago, ChileInst Mexicano Seguro Social, Mexico City, DF, MexicoHosp Souza Aguiar, Dept Urol, Rio De Janeiro, RJ, BrazilComplejo Med Policial Churruca Visca, Serv Urol, Buenos Aires, DF, ArgentinaCtr Policlin Valencia Vina, Valencia, VenezuelaHosp Pablo Tobon Uribe, Medellin, ColombiaClin Indisa, Serv Urol, Providencia, ChileCtr Reabilitacao & Readaptacao Dr Henriqe Santill, Goiania, Go, BrazilHosp Univ Caracas, Serv Urol, Caracas, VenezuelaUniv Fed Ceara, Div Urol, Fortaleza, Ceara, BrazilUniv Fed Sao Paulo, EPM, Rua Dr Oscar Monteiro Barros 617-141, BR-05641010 Sao Paulo, SP, BrazilWeb of Scienc