Correlation between splenomegaly and thrombocytopenia in hepatosplenic schistosomiasis

RACIONAL: Sabe-se que tanto a leucopenia quanto a plaquetopenia têm relação direta com a esplenomegalia, mas não existem estudos correlacionando de forma direta ou precisa o tamanho do baço com o número de plaquetas. Ainda há controvérsia se a plaquetopenia observada em pacientes com doenças hepáticas crônicas está mais relacionada à esplenomegalia ou à própria hipertensão portal. OBJETIVO: Correlacionar o nível sérico das plaquetas nos períodos pré e pós-operatório imediato com peso e volume do baço em pacientes portadores da forma hepatoesplênica da esquistossomose com indicação para tratamento cirúrgico da hipertensão portal. MÉTODO: Foram analisados os prontuários de pacientes portadores da forma hepatoesplênica da esquistossomose mansônica submetidos a tratamento cirúrgico da hipertensão portal. Foram incluídos portadores com a doença confirmada pelo diagnóstico anatomopatológico da biópsia hepática realizada no período intra-operatório. Foram excluídos todos os doentes que apresentavam antecedentes de etilismo crônico, hepatite viral, evidências clínico-laboratoriais de insuficiência hepática ou alterações histopatológicas compatíveis com cirrose hepática. Foram avaliados: o tamanho e volume do baço; o nível sérico de plaquetas; o número de plaquetas. RESULTADOS: Foram identificados 141 pacientes que preenchiam os critérios de inclusão do total de 160 prontuários analisados. A idade média foi de 39,03 ± 12,74 anos (15 a 74 anos), sendo 84 homens (59,5%) e 57 mulheres (40,5%). O peso médio do baço foi de 966,27 ± 464,61 g (120 a 2700 g). O volume elíptico médio foi de 966,68 ± 499,12 cm3 (236,13 a 2782,36 cm³. Houve correlação estatisticamente significativa entre o peso e o volume elíptico do baço (p<0,0001). O número médio de plaquetas no período pré-operatório foi 76,84 ± 43,64 x10³/mm³, abaixo dos valores considerados normais (150 - 400 x10³/mm³). Observou-se correlação estatisticamente significante entre o número e valor logarítmico das plaquetas no período pré-operatório tanto com peso (p<0,01) quanto com o volume elíptico (p<0,05) do baço. O número de plaquetas no pós-operatório imediato esteve correlacionado de modo inverso com o peso do baço retirado (p=0,0297); o valor logaritmo das plaquetas também se correlacionou com o peso. Não se conseguiu, através do modelo empregado, prever o valor sérico das plaquetas baseando-se no peso e volume esplênicos. CONCLUSÃO: As variações do nível sérico de plaquetas tanto no pré como no pós-operatório, em pacientes portadores da forma hepatoesplênica da esquistossomose mansônica, apresentam-se diretamente correlacionadas às variações de peso e volume do baço. A esplenomegalia foi diretamente responsável pela variação do número de plaquetas.BACKGROUND: It is known that both leukopenia and thrombocytopenia were significantly correlated with splenomegaly, but there is no studies correlating directly or precisely the size of the spleen with the number of platelets. It is controversial whether the thrombocytopenia observed in patients with chronic liver disease is more related to splenomegaly or portal hypertension itself. AIM: To correlate the serum level of platelets in pre and postoperative weight and volume of the spleen in patients with hepatosplenic schistosomiasis with indication for surgical treatment of portal hypertension. METHODS: The medical records of patients with hepatosplenic schistosomiasis mansoni who underwent surgical treatment of portal hypertension were revised. Were included patients with the disease confirmed by pathologic diagnosis of liver biopsy performed during surgery, and excluded all patients who had a history of chronic alcoholism, viral hepatitis, clinical and laboratory evidence of hepatic or histopathological changescompatible with liver cirrhosis. Evaluation of the size and volume of the spleen, the serum level of platelets, the platelet count was done. RESULTS: Were identified 141 patients who met the inclusion criteria of the 160 charts analyzed. The mean age was 39.03 ± 12.74 years (15 to 74 years) and 84 men (59.5%) and 57 women (40.5%). The average weight of the spleen was 966.27 ± 464.61 g (120-2700 g). The elliptical volume averaged 966.68 ± 499.12 cm³ (from 236.13 to 2782.36 cm³. There was a statistically significant correlation between weight and volume of elliptical spleen (p<0.0001). The average number of platelets in preoperative period was 76.84 ± 43.64 x10³/mm³ below normal values (150-400 x10³/mm³). There was a statistically significant correlation between the numbers and logarithmic value of platelets in both preoperative with weight (p<0.01) with the elliptical volume (p<0.05) spleen. The number of platelets in the immediate postoperative period was correlated inversely with the weight of the spleen removed (p=0.0297 ), the logarithm value of platelets is also correlated with weight. The model used did not predict the serum concentrations of platelets based on weight and spleen volume. CONCLUSION: The variations in serum levels of platelets in both pre and postoperative period in patients with hepatosplenic schistosomiasis were directly correlated to changes in weight and volume of the spleen. Splenomegaly was directly responsible for the variation in the number of platelets

DRESS syndrome in ophthalmic patients

ABSTRACT Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal adverse drug reaction associated with skin rash, fever, eosinophilia, and multiple organ injury. A number of pharmacological agents are known to cause DRESS syndrome such as allopurinol, anticonvulsants, vancomycin, trimethoprime-sulfamethoxazole, and pyrimethamine-sulfadiazine. Here, we describe two patients who developed DRESS syndrome during ocular treatment. The first case was being treated for late postoperative endophthalmitis with topical antibiotics, intravenous cephalothin, meropenem, and intravitreal injection of vancomycin and ceftazidime before symptoms developed. We were unable to identify the causal drug owing to the large number of medications concurrently administered. The second case presented with DRESS syndrome symptoms during ocular toxoplasmosis treatment. In this case, a clearer association with pyrimethamine-sulfadiazine was observed. As a result of the regular prescription of pharmacological agents associated with DRESS syndrome, ophthalmologists should be aware of the potentially serious complications of DRESS syndrome

Acute iris depigmentation following systemic moxifloxacin

Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) HospitalUNIFESP, EPM, HospitalSciEL

Nutracêuticos na reprodução de touros e garanhões

The industry has made available in the market a series of substances (nutraceuticals) which intent would be to optimize the use of nutrients in some metabolic paths, influencing positively reproductive performance in animals. However, the response to the use of nutraceuticals varies according to the animal. As the organism is highly complex and in order to achieve a perfect activity of the hypothalamic-pituitary-gonadal axis, an ideal interaction in molecular basis is needed, where the nutraceuticals can have their direct action. The aim of this study was to review the function and research results using the main nutraceuticals (&#946; carotene, vitamin A, L-carnitine, omegas 3, 6 and 9 and Gamma-oryzanol) on reproductive characteristics of bulls and stallions.A indústria tem disponibilizado no mercado uma série de substâncias (nutracêuticos) com a intenção de otimizar a utilização de nutrientes em algumas vias metabólicas, influenciando positivamente o desempenho reprodutivo dos animais. No entanto, a resposta ao uso de nutracêuticos varia de acordo com o animal. Como o organismo é altamente complexo e, a fim de alcançar perfeita atividade do eixo hipotálamo-hipófise-gonadal, uma interação ideal na base molecular é necessária, onde os nutracêuticos podem ter sua ação direta. O objetivo neste estudo foi revisar a função e resultados de pesquisas usando os principais nutracêuticos (&#946;-caroteno, vitamina A, L-carnitina, ômegas 3, 6 e 9 e gama-orizanol) sobre as características reprodutivas de touros e garanhões

ESTUDO DE VIABILIDADE DO REUSO AUTOMATIZADO DE ÁGUA DE APARELHOS DE REFRIGERAÇÃO

An automated hydraulic system can contribute to water and financial economics, bringing ecological benefits to the environment. This article presents a proposal for a system for capturing and reusing water from refrigeration appliances. An integration between hydraulics and sensors linked to an Arduino board or microcontroller is demonstrated here. The proposed system monitors the water consumption and manages in which moments the reused water or the sanitation company will be used. Measurements of the volume of water coming from refrigeration appliances, small scale prototypes and three-dimensional models were used as proof of concept, demonstrating the viability of the solution.Um sistema hidráulico automatizado pode contribuir para a economia hídrica e financeira, trazendo benefícios ao ambiente. Este artigo apresenta uma proposta de sistema de captação e reutilização da água oriunda de aparelhos de refrigeração. Utiliza-se aqui a integração entre sistema hidráulico e sensores vinculados a uma placa Arduino ou microcontrolador. O sistema proposto monitora o consumo de água e define em quais momentos será utilizada a água reaproveitada ou da companhia de saneamento. Medições do volume de água advindo dos aparelhos de refrigeração, protótipos em escala reduzida e modelos tridimensionais serviram como prova de conceito, demonstrando a viabilidade da soluçã

A new approach to induce mango shoot maturation in Brazilian semi-arid environment

The shoot maturation phase is important for growing mangoes because it precedes the floral induction, when plants are under stress caused by high temperatures and low water availability. Abiotic stress could be alleviated by using plant biostimulant which alters the phytohormone and carbohydrates biosynthesis. Thus, an experiment was conducted to evaluate the use a plant biostimulant containing Ascophyllum nodosum to induce shoot maturation of mango cv. Palmer grown in semi-arid environment. The experimental design consisted of randomized blocks with four treatments, ten replications and five plants per parcel. Treatments consisted of: T1) biostimulant foliar spray + K fertilizer; T2) foliar spray with biostimulant alternating with K fertilizer; T3) individual foliar sprays with magnesium sulfate, potassium sulfate, sulfur and calcium fertilizers, potassium fertilizer and Ethrel®; and T4) Control treatment. The total soluble carbohydrates in leaves, buds and shoots, N, K and S leaf concentrations and fruit production were recorded. The carbohydrate concentrations, nitrogen, sulphur and potassium leaf concentrations and fruit production of mango depend on shoot maturation strategy. Shoot maturation strategy using biostimulant containing Ascophyllum nodosum alternating with K fertilizer from 30 days after PBZ could&nbsp; be recommended for the production of mango cv. Palmer

Coastline changes and sedimentation related with the opening of an artificial channel: the Valo Grande Delta, SE Brazil

The role played by human activity in coastline changes indicates a general tendency of retreating coasts, especially deltaic environments, as a result of the recent trend of sea level rise as well as the blockage of the transfer of sediments towards the coast, especially due to the construction of dams. This is particularly important in deltaic environments which have been suffering a dramatic loss of area in the last decades. In contrast, in this paper, we report the origin and evolution of an anthropogenic delta, the Valo Grande delta, on the south-eastern Brazilian coast, whose origin is related to the opening of an artificial channel and the diversion of the main flow of the Ribeira de Iguape River. The methodology included the analysis of coastline changes, bathy metry and coring, which were used to determine the sedimentation rates and grain-size changes over time. The results allowed us to recognize the different facies of the anthropogenic delta and establish its lateral and vertical depositional trends. Despite not being very frequent, anthropogenic deltas represent a favorable environment for the record of natural and anthropogenic changes in historical times and, thus, deserve more attention from researchers of different subjects.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [06/04344-2]info:eu-repo/semantics/publishedVersio

Traumatismo orofacial e a qualidade de vida relacionada à saúde bucal: uma revisão sistemática

A região orofacial é uma das regiões corporais que mais são acometidas com danos traumáticos, em especial na dentição e nos tecidos moles adjacentes. A análise dos diferentes aspectos da saúde bucal relatadas pelo paciente faz parte da pesquisa sobre qualidade de vida relacionada à saúde bucal (QVRSB), que ajuda a melhorar a prestação de tratamento odontológico. Esta revisão sistemática objetiva analisar os impactos do trauma orofacial sobre a qualidade de vida relacionada à saúde bucal (QVRSB). Foi realizada busca nos bancos de dados PubMed, ScienceDirect, Scopus, Google Scholar e Scielo e com base na ferramenta PRISMA e na aplicação dos critérios de inclusão e exclusão foram selecionados 5 artigos para análise e discussão. Infere-se que a QVRSB dos pacientes é impactada pelas lesões traumáticas orofaciais, tendo relação diretamente proporcional, maior impacto imediatamente após o diagnóstico e de acordo com a gravidade do trauma. A maioria dos estudos limita-se a crianças e adolescentes, contudo, o traumatismo orofacial ocorre em qualquer idade. O questionário “condensed oral health impact profile – 14 (OHIP-14)” e suas adaptações são ferramentas importantes para os estudos sobre a QVRSB. Por fim, os estudos que relacionam a QVRSB e o trauma orofacial são importantes para retirar ensinamentos para a prática clínica dos atendimentos odontológicos

The pace of life for forest trees.

Tree growth and longevity trade-offs fundamentally shape the terrestrial carbon balance. Yet, we lack a unified understanding of how such trade-offs vary across the world's forests. By mapping life history traits for a wide range of species across the Americas, we reveal considerable variation in life expectancies from 10 centimeters in diameter (ranging from 1.3 to 3195 years) and show that the pace of life for trees can be accurately classified into four demographic functional types. We found emergent patterns in the strength of trade-offs between growth and longevity across a temperature gradient. Furthermore, we show that the diversity of life history traits varies predictably across forest biomes, giving rise to a positive relationship between trait diversity and productivity. Our pan-latitudinal assessment provides new insights into the demographic mechanisms that govern the carbon turnover rate across forest biomes