Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

AbstractOriginal contributionunderstand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy.BackgroundDuhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation.Objectiveevaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery.Designclinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery.LocationService of Coloproctology – Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included.Resultsa total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2mmHg p < 0.001) and anal squeeze pressures (244.3mL to 161.25 p=0.01), whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively, which became more obtuse, both during rest, straining and during evacuation.Conclusionsthe anatomical and functional changes in the pelvic diaphragm are significant after Duhamel surgery and together, they result in clinical improvement of patients

Analysis of the Decision-Making Process of Judges in Setting the Sentence

The study investigated the decision of judges, referring to the dosimetry of the base-penalty, applied to crimes of robbery and theft. A total of 1063 sentences were used, handed down in 12 criminal courts in Brazil, between 2019 and 2020. Legal factors were parameterized and subjected to statistical analysis. The results indicate the use of automated systems in the decisions made by judges, with bias influence, affecting the legality and constitutionality of sentences

Bio-behavioral survey of syphilis in homeless men in Central Brazil: a cross-sectional study

The objective of this study was to investigate the prevalence and factors associated with syphilis in homeless men in Central Brazil. It is a cross-sectional study conducted with 481 individuals attending four therapeutic communities between October and December 2015. A structured interview was conducted to collect sociodemographic data and risk factors for syphilis. Rapid/point-of-care and VDRL tests were performed to determine exposure to syphilis and the presence of active syphilis, respectively. Poisson regression analysis was used to verify the risk factors associated with the outcomes investigated. Of the study participants, 10.2% were reactive to the rapid test, and 5.4% had active syphilis. At the multiple regression analysis, schooling (adjusted prevalence ratio - APR: 0.89; p = 0.005), history of genital ulcer (APR: 2.59; p = 0.002), STI history (APR: 1.97; p = 0.042), and sexual intercourse under drug effects (APR: 1.60; p = 0.022) were independent factors associated with lifetime syphilis. Also, history of genital ulcer (APR: 2.19; p = 0.019), STI history (APR: 1.74; p = 0.033) and number of sexual partners in the last year (APR: 1.02; p = 0.044) were associated with active syphilis. The prevalence of syphilis among homeless men was rather high, confirming the vulnerability of this group to this infection. These results emphasize the need for educational intervention, improvement of risk reduction programs, availability of diagnostic tests, especially the rapid test, and treatment

Metástase Gástrica de Câncer de Mama: Relato de Caso e Revisão de Literatura

Introdução: O câncer de mama é a neoplasia mais incidente no sexo feminino com 48.930 novos casos estimados em 2006, no Brasil. Os principais sítios de metástases são: ossos, pele, linfonodos, pulmões, pleura, fígado e cérebro. Metástases gástricas são raras e pouco citadas na literatura, sendo o câncer de mama o segundo principal responsável. À endoscopia digestiva alta, apresentam-se mais comumente sob a forma de infiltração intramural difusa, assemelhando-se à linite plástica, e predominam em tumores do tipo lobular. A comparação histológica dos espécimes é obrigatória, porém a imunoistoquímica também pode ser útil. O prognóstico é ruim, visto que a doença metastática raramente se restringe ao estômago. O tratamento é paliativo e inclui quimioterapia, terapia hormonal e radioterapia. Relato de caso: Paciente com câncer de mama em tratamento adjuvante com anastrozol apresentou-se ao serviço com queixa de plenitude gástrica e emagrecimento. Havia massa endurecida em epigástrio, dolorosa à palpação profunda. Ao exame endoscópico, observou-se lesão infiltrante, comprometendo o fundo e metade proximal do corpo gástrico. Foi verificado carcinoma ductal com áreas secretoras de muco e células em "anel de sinete" metastático para o estômago; CK7 positivo, CK20 e receptor hormonal negativos. Sem evidência de doença em outros focos, a paciente foi tratada com seis ciclos de docetaxel, obtendo-se resposta patológica gástrica completa. Discussão: Apesar de rara, a metástase gástrica é causa de considerável morbidade em pacientes com câncer de mama e pode responder ao tratamento sistêmico apropriado

Avaliação de impactos ambientais na praia do Atalaia, Salinópolis - PA

As pressões sobre os ecossistemas têm aumentado sistematicamente em uma escala global. Diante disso, as paisagens urbanas têm sido modificadas, através da implantação de projetos urbanos que divulguem imagens favoráveis para a atividade turística, o que propicia impactos ambientais. Diante disto, tal pesquisa justifica-se pelo aumento da expansão urbana desordenada, e ao aumento de ações antrópicas inadequadas que comprometem principalmente a qualidade das águas, como: despejo de esgotos domésticos, resíduos sólidos, óleos de veículos, entre outros agravantes de problemas socioambientais. Diante desta perspectiva, tal pesquisa justifica-se pelo aumento da expansão urbana desordenada, e ao aumento de ações antrópicas inadequadas que alteram principalmente a qualidade das águas locais, como: despejo de esgotos domésticos, resíduos sólidos, óleos de veículos, entre outros agravantes de problemas socioambientais. Neste contexto, o objetivo desta pesquisa tem por escopo determinar a concentração de Oxigênio Dissolvido, pH e Temperatura, para verificar se tais variáveis apresentam-se de forma regular, além de verificar os principais impactos ambientais ocorrentes na praia de Atalaia, Salinópolis-PA. Quanto à metodologia utilizada, ela foi exploratória, observativa, sistemática, direta com abordagem qualitativa. O método aplicado foi o dedutivo.  Foi realizada a amostragem para verificar a concentração do pH, OD (Oxigênio Dissolvido) e Temperatura, além de verificar os principais impactos ambientais. A análise dos dados obtidos indicou que os parâmetros não divergente entre os pontos da coleta das amostras, apresentando simetria no que se refere as normas vigentes. Entretanto, existe a necessidade de construir uma sensibilidade ambiental efetiva capaz de possibilitar modalidades de relação entre sociedade e a natureza, para promover o desenvolvimento sustentável

Activity of arginine-phenylalanine and arginine-tryptophan-based surfactants against Staphylococcus aureus

Aims: This study aimed to evaluate the antibacterial effect of two new cationic surfactants based on phenylalanine-arginine (LPAM) and tryptophan-arginine (LTAM). Materials & methods: Antibacterial activity, mechanism of action and interactions with Staphylococcus aureus enzymes were measured through microbiological, flow cytometry and molecular docking assays, respectively. Results & conclusion: These compounds showed antibacterial activity in the range of 4.06-16.24 μg/ml against planktonic cells and no activity against mature biofilms, since they caused a loss of membrane integrity and increased DNA damage, as revealed by flow cytometry analysis. In silico assays revealed the existence of molecular bonds such as hydrogen bonds, mainly with DNA. Therefore, these compounds have promising pharmacological activity against MRSA strains.The authors would like to thank Central Analítica-UFC/CT-INFRA/MCTI- SISANO/Pró-Equipamentos CAPES for the support.Peer reviewe

Analysis of possible pathways on the mechanism of action of minocycline and doxycycline against strains of Candida spp. resistant to fluconazole

Species of the genus Candida, characterized as commensals of the human microbiota, are opportunistic pathogens capable of generating various types of infections with high associated costs. Considering the limited pharmacological arsenal and the emergence of antifungal-resistant strains, the repositioning of drugs is a strategy used to search for new therapeutic alternatives, in which minocycline and doxycycline have been evaluated as potential candidates. Thus, the objective was to evaluate the in vitro antifungal activity of two tetracyclines, minocycline and doxycycline, and their possible mechanism of action against fluconazole-resistant strains of Candida spp. The sensitivity test for antimicrobials was performed using the broth microdilution technique, and the pharmacological interaction with fluconazole was also analysed using the checkerboard method. To analyse the possible mechanisms of action, flow cytometry assays were performed. The minimum inhibitory concentration obtained was 4-427 µg ml-1 for minocycline and 128-512 µg ml-1 for doxycycline, and mostly indifferent and additive interactions with fluconazole were observed. These tetracyclines were found to promote cellular alterations that generated death by apoptosis, with concentration-dependent reactive oxygen species production and reduced cell viability. Therefore, minocycline and doxycycline present themselves as promising study molecules against Candida spp.This study was supported by grants and fellowships from the research support agencies CNPq, CAPES and FUNCAP/Ceará.Peer reviewe

The unchained dream: the Brazilian cineclubist movement (from the aesthetic engagement to the politics resistance in the leaden years 1928 1988)

Esta Tese tem por finalidade tratar de questões ligadas ao Movimento Cineclubista brasileiro compreendendo os anos de 1928 a 1988, tendo por objetivo principal demonstrar sua trajetória do engajamento estético à resistência política. O marco cronológico estabelecido, remonta aos anos 1920, com o nascimento do cineclubismo na França e particularmente, com a criação do primeiro cineclube oficial do Brasil, o Chaplin-Club, em 1928. Neste período, o cineclubismo se caracterizava basicamente pelo engajamento estético e, entre nós, muda para uma atitude de resistência política durante os anos de chumbo, um período marcado pelo domínio de uma ditadura civil-militar. A baliza cronológica final é o ano de 1988, quando aconteceu a abertura política no Brasil e a volta do Regime democrático, fenômeno que também afetou o movimento cineclubista, causando-lhe enfraquecimento, sem contudo ser possível falar no fim deste, pois ele se mantém ativo até os dias atuais. Também tem como finalidade demonstrar que no cineclubismo, em seus primórdios, o acento recaía sobre o aprimoramento do cinema, as questões estéticas e a luta para elevar o cinema ao status de uma das belas-artes, a sétima-arte. Visa a demonstrar o processo de mudança do cineclubismo e sua rearticulação após a promulgação do Ato Institucional nº 5, que havia causado a desorganização do movimento em várias regiões do Brasil. Pretende-se expor como ocorreu a conversão de cineclubismo em movimento cineclubista, através da reorganização das Federações e do Conselho Nacional de Cineclubes (CNC), no mesmo sentido almeja-se mostrar que os cineclubes tornaram-se o locus de resistência ao regime ditatorial vigente no país após o Golpe de Estado civil-militar de 1964. Outrossim, procuro mostrar as tensões internas no processo de constituição do movimento cineclubista no Brasil.This thesis is intended to talk about issues related to the Brazilian cineclubist movement comprising the years 1928 to 1988, whose principal objective is showing its trajectory from the aesthetic engagement to the politics resistance. The chronologic goal established brings back the 20s from the 20th century, with the emergence of the cineclubism in France and particularly with the creation of the first official cineclub of Brazil, the Chaplin-Club, in 1928. In this period, the cineclubism was characterized by the aesthetic engagement and it was until the leaden years in the second half from the 60s decade, period marked by the dominance of a civil-military dictatorship. The final chronologic goal is in 1988, when it happened the opening policy in Brazil and the return of democratic rule, phenomenon that also affected the cinecublist movement causing cooling, without being the end of it, because it exists until today. It also intends demonstrating that in the first years of cineclubism, the accent fell on the improvement of cinema, the aesthetic issues and the struggle to raise the cinema to the status of one of the fine arts, the seventh art. It also wants to show the process of changing in the action in the cineclubism and their rearticulation after granting of the Institutional Act No. 5, which had caused its breakdown in several regions of Brazil. It is intended to expose how its conversion from cineclubism to cineclubist movement, from the reorganization of the federations and the National Council of film societies and the National Cineclub Council (CNC in Portuguese), in the same sense aims to show that the cineclubs will become the locus of resistance to the dictatorial regime in force in the country after the coup of 1964 civil-military. In addition is to show internal tensions in the process of Constitution of the cineclubism and the cineclubist movement in Brazil

Relação entre uniformidade da produtividade e indicadores de uniformidade da irrigação em sistema de irrigação por microaspersão em citros

Em irrigação, a uniformidade está relacionada com a capacidade do equipamento em fornecer a mesma quantidade de água em toda a área irrigada. Em sistemas de irrigação localizada, o dimensionamento baseia-se na uniformidade de emissão (UE) pré-estabelecida, que é o resultado conjunto das características do equipamento e de sua configuração hidráulica. Entretanto, este valor desejado de UE pode ou não ser confirmado pelo projeto final, em decorrência da declividade da área e dos diâmetros comerciais da tubulação, que dificilmente coincidem exatamente com aqueles definidos nos cálculos do dimensionamento. Além disso, há uma questão: dimensionar sistemas de irrigação localizada visando obter elevada uniformidade de emissão significa alcançar elevada uniformidade na produção ? Este trabalho teve como objetivo avaliar a relação entre a uniformidade de emissão de projeto e a uniformidade da produção, em sistema de irrigação por microaspersão. A análise de sensibilidade envolveu diferentes declividades, 0%, 3%, 6%, 9% e 12%, e diferentes valores de uniformidade de emissão de projeto, 60% 70%, 75%, 80%, 85%, 90% e 94%. Considerou-se um pomar de citros com dimensões de 400m por 600m, com declividade variável na direção do menor comprimento. As linhas de plantio estavam em nível, na direção da maior dimensão. O espaçamento adotado no pomar era de 7m x 4m. A linha de derivação operava sempre em declive e tinha espaçamento regular entre linhas laterais de 7m, sendo que a primeira estava a 3.5m. Observou-se maiores valores de uniformidade da vazão nos maiores valores de declividade, exceto em 12%. Quando se calculou o coeficiente de variação da produtividade utilizando a função de produção para o fator água, verificou-se uma melhoria da uniformidade em todas...Irrigation uniformity is related to the ability of equipment to provide the same amount of water throughout the irrigated area. In irrigation systems, the design is based on the pre-established emission uniformity (EU) which is the combined result of the equipment characteristics and its hydraulic configuration. However, this desired value of the EU may not be confirmed by the final project, due to the slope of the area and the commercial diameters of the pipe. This study aimed to evaluate the uniformity of design of an irrigation system and its relationship with yield. The sensitivity analysis involved different slopes, 0, 3, 6, 9 and 12%, and different values of emission uniformity, 60, 70, 75, 80, 85, 90 and 94% . The design of trickle irrigation was applied to a citrus orchard with dimensions of 400m x 600m, with variable slope towards the shorter length. The tree rows were leveled in the larger direction and the spacing adopted in the orchard was 7m x 4m. The manifold line was always operating on a slope and had regular spacing between the lateral lines of 7m, the first of which was 3.5m. Higher discharge values were observed in the highest slope values except at 12%. When we calculated the variation coefficient of productivity using the production function for the water factor, there was an improvement of uniformity in all the combinations evaluated. Comparing the index performance evaluation, it was observed they had the same pattern performance in all combinations studied. The lowest values were obtained for the indicator emission uniformity and the largest for distribution uniformity, and the Barragan index had intermediary performance. The variation pressure coefficients ranged from 0.02 to 0.33, the flow variation coefficient ranged from 0.01 to 0.17, and production variation coefficients with 60 days of irrigation ranged from 0.0003 to 0.0125Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq