Late Stillbirth: a Ten Year Cohort Study

Introduction: Late fetal death is a desolating event that inspite the effort to implement new surveillance protocols in perinatal continues to defy our clinical pratice. Objective: To examine etiological factors contributing to main causes and conditions associated with fetal death in late pregnancies over a 10-year period. Methods: Retrospective cohort analysis of 208 late singleton stillbirth delived in a tertiary-perinatal referral maternity over a 10-year period. Clinical charts, laboratory data and feto-placental pathology findings were systematically reviewed. Results: The incidence of late fetal demise was 3.5 per 1000 pregnancies. No significant trend in the incidence of stillbirth was demonstrated during the study period. Stillbirth was intrapartum in 12 (5.8%) cases and 72 (35%) were term pregnancies. Fourteen percent of cases were undersurveilled pregnancies. Mean gestacional age at diagnosis was 34 weeks. The primary cause of death was fetal, it was present in 59 cases, 25% were considered small for gestational age. Stillbirths were unexplained in 24.5% of cases. Maternal medical disorders were identified in 21%. Hypertensive disorders were frequent and associated with early gestacional age (p = 0.028). Conclusion: There was no change in the incidence of late stillbirth during the 10 years under evaluation. The incidence was 3.5 ‰ which was identical to that described in developed countries. About one quarter of the stillbirths was unexplained. The most frequent maternal pathology was chronic hypertension

Emprego da compostagem para destinação final de suínos mortos e restos de parição.

A destinação final de carcaças de suínos. Formulação de uma nova alternativa. Processos em fluxo contínuo. Processos em batelada. Quanto ao volume das carcaças. Quanto à velocidade de decomposição das carcaças. Compostagem: uma solução para destinação de carcaças. Quanto ao grau de tecnologia. Quanto à estrutura física. Quanto às reações que ocorrem na compostagem. Requisitos para a compostagem de carcaças. Dimensionamento da célula de compostagem. Passos para a compostagem de carcaças. Como resolver os problemas mais comuns.bitstream/item/82371/1/CiT26.pd

Um Caso Raro de Tumor Abdominopélvico: Paraganglioma

Paragangliomas are rare tumors, with a reported incidence of 2–8 per million. They are chromaffin cell tumors that develop from the neural crest cells and may be divided in tumors derived from the parasympathetic or sympathetic ganglia. We report a case a of a 32-year-old nulliparous woman, referred to our Infertility Clinic. Abdomino-pelvic ultrasound identified a large abdominopelvic tumor, without ovarian origin (both ovaries were identified and had normal morphology). Magnetic Resonance Imaging suggested a right adnexal multicystic, vascularized mass close to iliac vessels and questioning an ovarian origin. At exploratory laparotomy, a 10 cm encapsulated and vascularized mass was found beginning just below right renal artery and extending to the level of the broad ligament. This mass was totally excised and histopathology was consistent with Paraganglioma

Acute Sheehan's Syndrome Presenting as Central Diabetes Insipidus

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome

Mitigação e adaptação das cidades às alterações climáticas: vulnerabilidades socioambientais e conflitos jurídicos na tutela das Áreas Urbanas de Preservação Permanente no Brasil

This paper aims to understand the relationships between socio-environmental vulnerability in Brazilian urban areas in the current context of climate change and the legal protection of urban Areas of Permanent Preservation (APP, in the acronym in Portuguese). We seek to identify and interpret how the composition formed by (i) norms currently in force in Brazilian law, (ii) instruments of environmental and land-use planning public policies, and (iii) jurisprudence on normative conflicts related to the discipline of urban PPAs. By means of a literature review and critical analysis of the legislation, other public policy instruments and jurisprudential precedents, we aimed to understand how this composition is aligned with initiatives to mitigate and adapt to climate change and to reduce socio-environmental vulnerabilities resulted from or aggravated by it, with a focus on the situation of populations that live precariously in risk areas. As a result, we have identified a complex and not very harmonious composition of norms applicable to these protected areas in the urban context. However, the current understanding of jurisprudence and the current legislative activity have evolved positively in relation to the necessary actions of adaptation to climate change and reduction of socio-environmental vulnerabilities, although important improvements are still necessary for effective protection and restoration, whenever possible, of urban APP.info:eu-repo/semantics/publishedVersio

Implant Site Nexplanon Reaction?

Nexplanon (Schering-Plough Limited/Merck Sharp & Dohme Limited (MSD)) is a long active reversible contraceptive method that provides effective contraception for 3 years. It consists of a single, flexible, rod-shaped implant, containing 68 mg etonogestrel. It is 4 cm long, consists of an ethylene vinyl acetate copolymer, a non-absorbable material, and also contains 15 mg of barium sulfate, which makes it visible by X-ray. We describe a case of a 39-year-old woman who experienced a local reaction to the barium sulfate in Nexplanon. She was given medical treatment, but only the removal of the implant resolved the symptoms. After removal there was gradual improvement and 72 h later the patient was asymptomatic. Allergic reaction to barium sulfate is extremely rare: until now, there have only been two cases associated with Nexplanon described in the literature

Association of albumin or protamine to lipoplexes: enhancement of transfection and resistance to serum

The successful application of gene therapy depends on the availability of carriers to efficiently deliver genetic material into target cells. Such efficacy is strongly related to key parameters including serum resistance and protection of DNA.The complexes were tested in terms of their biological activity, in the absence or presence of serum, by following transfection activity. Interaction with plasma proteins was evaluated by immunoblotting, while cytotoxicity was assessed by the Alamar Blue assay. Extent of DNA protection was determined both by using ethidium bromide intercalation and DNase I digestion assays.Our results show that, depending on the charge ratio and on the lipid composition, albumin and protamine can be used (either individually or co-associated) to generate cationic liposome/DNA complexes fulfilling in vivo requirements, while exhibiting high levels of transfection activity. In the present work a novel cationic lipid was tested. It was demonstrated that 1-palmitoyl-2-oleoyl-sn-glycero-3-ethylphosphocholine (EPOPC):cholesterol (Chol) liposomes constitute a very promising carrier for gene delivery as illustrated by their enhancing effect on transfection, as compared with DOTAP-containing liposomes. Moreover, the biological activity of EPOPC-containing complexes is significantly improved upon association of albumin, even in the presence of 60% serum (namely for the 4/1 lipid/DNA charge ratio). Nevertheless, our studies also show that transfection activity mediated by DOTAP-containing complexes can be significantly enhanced upon pre-condensation of DNA with protamine.Co-association of HSA and protamine to lipoplexes ensures a high degree of DNA protection and results in high levels of transfection activity even in the presence of serum. Copyright © 2004 John Wiley & Sons, Ltd

Determinação do sexo da Tuvira Gymnotus sp. através da análise de imagem de ultra-som

A tuvira (Gymnotus sp.) é um peixe muito conhecido no Pantanal por ser amplamente utilizado como isca viva pela pesca esportiva. Visto os problemas inerentes à sua coleta na natureza, como degradação ambiental e as condições desumanas de trabalho, faz-se necessário buscar alternativas para sua produção, como a criação em cativeiro. Entretanto, ainda não há uma técnica simples e não invasiva para a sexagem deste peixe. Deste modo, este trabalho tem por objetivo verificar a possibilidade de se utilizar a ultra-sonografia na determinação do sexo da tuvira. Foram avaliados 100 reprodutores coletados nos viveiros de reprodutores, os quais foram submetidos à análise individual de ultra-som utilizando-se um aparelho portátil (ALOKA C.O. LTD. Modelo SSD-500) com um transdutor plano de 5 MHz. Após a análise e interpretação das imagens o sexo foi determinado pelo consenso de dois observadores.bitstream/CPAP/56062/1/BP77.pdfFormato eletrônico