Influência da cobertura vegetal de inverno e da adubação orgânica e, ou, mineral sobre as propriedades físicas de uma Terra Roxa Estruturada

O presente trabalho objetivou avaliar a influência da cobertura vegetal de inverno, constituída de uma associação de aveia preta (Avena strigosa Schreb) com nabo forrageiro (Raphanus sativus L.), da adubação orgânica com esterco de aves, da adubação orgânica e mineral e da adubação mineral sobre propriedades físicas do solo, numa Terra Roxa Estruturada do estado de Santa Catarina. As análises foram realizadas em amostras de solo coletadas em agosto de 1994 e janeiro de 1995, nas profundidades de 0-10, 10-20 e 20-30 cm, em um experimento iniciado em 1990. Verificou-se uma redução na estabilidade de agregados maiores que 4,76 mm, quando se fez uso de adubação orgânica, bem como aumento na estabilidade de agregados das classes de diâmetro 4,76 a 2,00 e 2,00 a 1,00 mm. Na camada de solo de 0-10 cm, observou-se que o adubo orgânico aumentou a macroporosidade e diminuiu a densidade do solo, enquanto a adubação orgânica e mineral reduziu a macroporosidade e aumentou a microporosidade e a densidade do solo

Chronic Subdural Hematoma Associated with Voiding Dysfunction

We report the case of a 73-year-old male who presented with a chronic subdural hematoma that compressed the frontal lobe, an area known to be active in detrusor control, and caused contralateral hemiparesis and urgency incontinence. Urodynamically, he had a small bladder capacity and high amplitude overactive detrusor contractions with an intact sphincteric response. We concluded that the effect of intracranial lesions on voiding depends upon the site rather than the type of the pathology. Further in-depth studies are needed to clarify the effect of intracranial lesions, and accordingly the function of different brain regions and their influence on voiding.</jats:p

Voiding Dysfunction due to Chronic Viral Encephalitis in a Young Woman

We record a case of a 37-year-old female with acute viral encephalitis, frequency and urgency incontinence. Video urodynamics showed small bladder capacity, sensory urgency, high residual urine and a Christmas tree appearance of the bladder. MRI showed inflammation and edema in the area of the thalamus and internal capsule in the early stage, then cavitation and gliosis in the same regions in the late stage.</jats:p

Efeito de esterco bovino sobre os rendimentos de espigas verdes e de grãos de milho The effect of cattle manure on yield of green corn ears and maize grains

Avaliaram-se os efeitos de doses de esterco bovino (0; 8; 16; 24; 32 e 40 t ha-1) sobre os rendimentos de espigas verdes e de grãos de duas cultivares de milho (Centralmex e AG-9012). O trabalho foi realizado em Mossoró (RN), de setembro a dezembro/99, com irrigação por aspersão. Utilizou-se esquema de parcelas subdivididas no delineamento de blocos completos casualizados com três repetições. As doses de esterco foram aplicadas às parcelas e as cultivares, às subparcelas. O rendimento de milho verde foi avaliado pelo número e peso totais de espigas verdes empalhadas e pelo número e peso de espigas comercializáveis, empalhadas e despalhadas. O rendimento de grãos foi avaliado pelo peso dos grãos corrigido para 15,5% de umidade. Análises do solo, realizadas aos 120 dias após o plantio, constataram que o esterco aumentou a retenção e a disponibilidade de água e os teores de fósforo, potássio e sódio, na camada do solo de 20-40 cm, mas não influenciou o pH e os teores de cálcio, soma de bases e de matéria orgânica. Tanto o rendimento de espigas verdes como o rendimento de grãos aumentaram com o aumento da dose de esterco, exceto o número e o peso totais de espigas verdes da cultivar Centralmex. A cultivar AG-9012 foi superior à cultivar Centralmex quanto aos rendimentos de espigas verdes e de grãos. A receita líquida, calculada com a comercialização de espigas empalhadas comercializáveis, foi maior na ausência de esterco para a cultivar AG-9012 e com a aplicação de 8 t ha-1para a Centralmex.<br>The effect of different levels of cattle manure (0; 8; 16; 24; 32 and 40 t ha-1) on yield of green corn ears and grains of two maize cultivars was evaluated (Centralmex and AG-9012). The study was carried out at Mossoró, Rio Grande do Norte State, Brazil, from September to Dezember 1999 using sprinkler irrigation. The experimental design was complete random blocks arranged in splitplot with three replications. The manure was applied to main plots and cultivars in the subplots. The green corn yield was evaluated by total number and weight of green ears with husk and by marketables ears, with husk and without husk. The grain yield was evaluated by grain weight corrected for 15,5% humidity. The soil analysis, carried out 120 days after planting, indicated that the manure increased the water retention, water availability and the potassium, sodium and phosphorus contents, however, did not influence pH, calcium, sum of bases and organic matter contents. The manure levels x cultivars interaction was significant for number of marketable ears with husk only. All evaluated traits increased with the increase of manure levels. The cultivar AG-9012 was superior to the cultivar Centralmex for the evaluated traits. The net income, obtained with the sale of marketable ears with husk, was higher when no manure was applied for AG-9012. For the cultivar Centralmex, the net income was higher with 8 t ha-1 cattle manure application

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P &lt; 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P &lt; 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P &lt; 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P &lt; 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P &lt; 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Surgical site infection after gastrointestinal surgery in children: An international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods: In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results: Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P < 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P < 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -9·4 (95 per cent c.i. -11·9 to -6·9) per cent; P < 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries