POLUIÇÃO POR RESÍDUOS SÓLIDOS NO BAIXO SÃO FRANCISCO, NORDESTE DO BRASIL

A grandiosidade do rio São Francisco sempre despertou no ribeirinho a errônea ideia de que suas águas seriam capazes de absorver tudo o que é descartado em suas águas. Atualmente, o despejo inadequado do resíduo sólido é um dos grandes problemas mundiais. A presença de resíduos sólidos no Baixo São Francisco é abordada utilizando técnicas de censos visuais e o mergulho livre. O presente trabalho fornece informações das margens do rio nas orlas histórica de Penedo (AL) e portuária de Néopolis (SE), além da Praia do Pontal do Peba, Piaçabuçu (AL), próxima a foz do rio, com a finalidade de analisar quali-quantitativamente os resíduos sólidos presentes, assim como a percepção dos ribeirinhos sobre o problema. Para a análise quali quantitativa, realizou-se a coleta do lixo em 30 transectos, 30x2 m², paralelos às margens. O lixo foi recolhido e classificado em 11 categorias (garrafas plásticas, embalagens plásticas, vidros, metais, tecidos, materiais de pesca, madeira manufaturada, borrachas, isopor, espumas e papel) e pesado. Foram recolhidos 103,4 Kg de resíduos sólidos, sendo 59,6 Kg na praia do Pontal do Peba, 33,2 Kg na orla do centro histórico de Penedo e 30,6 Kg nas proximidades do porto de Neópolis. Dentre estas categorias, os resíduos plásticos dominaram. Para análise da percepção, foram aplicados 30 questionários em cada localidade, onde foi observado que acidentes envolvendo o lixo são comuns, que os ribeirinhos consideram o rio poluído e que são responsáveis pela presença dos resíduos sólidos, apontando a educação ambiental como a principal saída para minimizar o problema

Left ventricular systolic dysfunction in Marfan syndrome is related to aortic distensibility

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2019.Background: The cardiovascular involvement in Marfan syndrome (MS) is characterized mainly by dilatation and reduced distensibility of the ascending aorta. Left ventricular (LV) dysfunction has been detected in MS and a primary cardiomyopathy has been suggested but the pathophysiology is unclear. The purpose of this study was to evaluate the LV function in patients with MS and to assess the relationship with the aortic distensibility, as possible underlying mechanism. Methods: We studied 53 patients with MS (27.0 ± 11 years, 29 men) without valvular or hypertensive heart disease and a control group of 26 healthy subjects (29 ± 9 years, 17 men). All underwent echocardiography and cardiac magnetic resonance (CMR) and the following indexes were analyzed: a) Echo: mitral flow velocities E/A ratio and deceleration of mitral E; E’ velocity obtained from the medial and lateral mitral ring; E/E’ ratio b) CMR: LV volumes indexed to BSA and ejection fraction (EF); global longitudinal strain (GLS, Circle cvI42); maximal size and distensibility of proximal ascending aorta. Distensibility was calculated from maximal (systolic) and minimum (diastolic) area of maximal proximal ascending aorta (cross-sectional images from SSFP sequence) using the formula=(maximum area-minimum area)/[ minimum area x (systolic BP-diastolic BP)]. Results: 17 from 53 patients with MS had increased LV end-diastolic volume, 14 decreased EF (<50%) and 22 decreased GLS. Compared with the control group, patients with MS showed increased LV end-diastolic volume (85.0 ± 5.2vs 80.1 ± 5.3ml/m2, p = 0.04), lower GLS (17.1 ± 1.9 vs 18.9 ± 2.2, p = 0.01) lower LVEF (53.0 ± 7.1% vs 56.0 ± 5.4%, p = 0.03) and higher E/E’ value (9.2 ± 1.3 vs. 6.2 ± 0.8, p = 0.01) as well as larger dimensions of proximal aorta (39 ± 2.2cm vs 32 ± 0.8,p = 0.010) and lower aortic distensibility (3.4 ± 1.9 vs. 4.4 ± 1.7 dynes cm-1, p = 0.03). In the group of patients, a correlation was found between the aortic distensibility and the LVEF (r = 0.47, p = 0.045) and GLS (r = 0.65, p = 0.02), but not with the other variables. Aortic distensibility was an independent predictor of LV dysfunction using a cutoff of 50% for LVEF and 19% for GLS. Conclusion: In our population of patients with MS, we found changes in the LV function, which were related with aortic distensibility, possibly sharing a common pathway. The prognostic significance of these findings is under evaluation.info:eu-repo/semantics/publishedVersio

Overuse: medical novelty or age-old phenomenon?

INTRODUCTION: Mentions of overuse tend to imply it is a recent phenomenon as if irrationality was brought about by technological advances and the development of new procedures. However, it is possible that physicians have been prone to the same cognitive biases since antiquity, also performing inappropriate and excessive procedures. This raises the question of whether the contemporary issue of overuse is a modern phenomenon or inherited from a multi-millennial medical tradition. OBJECTIVE: To infer an answer to this question by summarizing the medical literature about overuse throughout the history of medicine. METHODS: Medical overuse is defined as futile, low-value procedures characterized by excessive use of methods with a high probability of causing more harm than good to patients. It examines the history of medical literature, with a critical look at procedures that might be characterized as harmful, futile, or with excessive use of diagnostic and therapeutic methods. RESULTS: This analysis revealed evidence that such procedures have been taking place throughout many periods of history. Studies have shown that the current prevalence of inappropriate medical procedures can be as high as 29% in the United States and 80% of cases for some individual services around the world. Lack of reliable data thwarts accurate analysis of the prevalence of overuse before the last decade. CONCLUSIONS: Instead of a recent phenomenon, overuse has permeated medical practice from its beginnings until today, regardless of technological advances, and is possibly inherent to the human species

[thrombolysis In Massive Pulmonary Embolism Based On The Volumetric Capnography].

This is the first report of a patient submitted to chemical thrombolysis due to massive pulmonary embolism (PE) during the postoperative period of neurosurgery, in whom due to the lack of adequate clinical conditions, no imaging assessment was performed. Clinical, gasometric and capnographic data allowed the decision to perform the thrombolysis with safety. The P(a-et)CO2 gradient decreased from 46.4 mmHg to 11.8 mmHg (normal < 5 mmHg) and the end-tidal alveolar dead space fraction decreased from 0.85 to 0.37 (normal < 0.15) from the pre-thrombolysis period to the 7th day post-thrombolysis. We conclude that the volumetric capnography (VC) was useful in the patient's diagnosis and clinical follow-up.95e97-e9

Avaliação da incidência de antracnose, do desempenho e estado nutricional de variedades de mangueira, para cultivo orgânico, na região centro-norte do Estado de São Paulo.

A mudança do perfil do consumidor, aliada aos riscos da contaminação por agrotóxicos, tem levado à busca de alternativas ecologicamente apropriadas para produção de frutas. Os objetivos deste trabalho foram avaliar a incidência de antracnose, o desempenho e estado nutricional de variedades de mangueira conduzidas organicamente na região de Pindorama-SP. Foram utilizadas 17 variedades de mangueira. O experimento foi instalado em delineamento experimental em blocos completos ao acaso, com 17 tratamentos (variedades) e seis repetições. Foi avaliada a severidade de antracnose nas folhas, através de uma escala diagramática, atribuindo-se notas aos sintomas. Foram avaliados o crescimento e o desenvolvimento (altura da planta, perímetro do tronco e da copa) e o estado nutricional, mediante análise foliar, das diferentes variedades utilizadas. Através dos resultados obtidos, podem-se considerar como muito suscetíveis à antracnose as variedades Bourbon, Rocha e Rosa; e resistentes, as variedades IAC 111, Alfa, Beta e Parvin; as variedades de manga apresentaram o mesmo padrão de crescimento; as maiores alturas da planta corresponderam aos maiores diâmetros do tronco e da copa; a variedade Parvin apresentou o melhor desempenho dentre as variedades estudadas, com relação à resistência à antracnose, altura e diâmetro do caule e da copa, podendo ser recomendada ao cultivo orgânico. As variedades Omega e Alfa também apresentaram bom crescimento, podendo ser indicadas para esse cultivo, pelo menos nessa fase inicial; as variedades Surpresa e Rosa não apresentaram bom desempenho, no campo, em relação às demais, não devendo ser recomendadas para o cultivo orgânico, principalmente a variedade Rosa, bastante suscetível à antracnose. As concentrações de N, P e K foram elevadas na fase vegetativa das plantas, comparadas à baixa concentração de Ca; houve carência de Boro em todas as variedades estudadas. A manga Rosa, provavelmente, sofreu toxicidade ao excesso de manganês, ocasionando diminuição em seu desenvolvimento

Matrix Microparticles Of Copaiba Oil (Copaifera Langsdorffii) On Renal Physiology: Patent Review

PURPOSE: to demonstrate the effect of matrix microparticles of Copaifera langsdorffii (aerial parts of copaiba), aiming to evaluate the discussions and results of the works that demonstrate Its function on the kidneys as well as its effectiveness. METHODS: A bibliographic study was carried out by consulting public online databases of patents, such as the United States Patent and Trademark office, World Intellectual Property Organization and the National Intellectual Property Institute; The following keywords were used: copaiba oil, renal function, kidney, kidney stones, matrix microparticles Copaifera langsdorffii and lithiasis. In this study were included patents of invention, innovations and utility models in the period from January 2007 to May 2016. RESULTS: One patent register was included regarding a method for obtaining microparticles and compounds, having antilithiasic, analgesic, antispasmodic, anti-inflammatory, diuretic and antiseptic activity. CONCLUSION: The patent registry survey demonstrates the possibility of beneficial action of matrix microparticles Copaifera langsdorffii on renal physiology, acting as antilithiasis and even with diuretic properties, thus opening up new possibilities of research of this substance on renal physiology

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection