Cirurgia endoscópica intrarrenal combinada (ECIRS) em posição galdakao-valdívia modificada: um relato de caso / Endoscopic combined intrarenal surgery (ECIRS) in galdakao modified supine valdivia position: a case report

Introdução: A nefrolitíase é uma patologia de alta prevalência. Possui importante morbidade por complicações agudas, relacionadas a obstrução de vias urinárias e quadros de insuficiência renal, bem como quadros infecciosos que podem evoluir à sepsis. Classicamente seu tratamento é cirúrgico e tem-se a nefrolitotomia percutânea (NPC) como padrão ouro para cálculos renais maiores que 2 cm.  Relato de caso: Paciente masculino, 48 anos, com repetidos quadros de infecção urinária. A investigação foi realizada com exames laboratoriais e de imagem. Possui sobrepeso, hipertensão leve, sem outras comorbidades. Apresentando cálculo coraliforme, complexo à esquerda, foi submetido a abordagem endoscópica combinada, ureteroscópica e percutânea em posição supina modificada, com completa extirpação de cálculos, com alta no segundo dia de pós-operatório, retornando em 45 dias para retirada de duplo jota, com boa evolução

Nitrogen application rates, sources, and times affecting chlorophyll content and wheat yield

To achieve high wheat yield, correct management of N fertilization and the use of high yield potential cultivars are necessary. The aim of this study was to evaluate the effects of different application rates and sources of N, applied totally at sowing or in topdressing, on grain yield and yield components of two irrigated wheat cultivars under a no-till system, grown in a Cerrado (Brazilian tropical savanna) region of low altitude. A randomized block design was used in a 5 x 3 x 2 x 2 factorial arrangement with three replications, combining five levels of N (0, 50, 100, 150, and 200 kg ha(-1)), three sources of N (Entec (R), ammonium sulfate, and urea), and two application times (at sowing, near the rows, or in topdressing) in two wheat cultivars (IAC 370 and Embrapa 21). The wheat cultivars had similar grain yields. There was no difference among the sources of N for grain yield and yield components. The N applied totally at sowing did not differ from the traditional application at sowing and in topdressing for production of irrigated wheat in no-tillage. The increase in application rates of N increased the leaf N contents and chlorophyll, plant height, and the number of ears per m(2). Grain yield of the wheat cultivars IAC 370 and Embrapa 21 increased up to the application rates of 134 and 128 kg ha(-1) of N, respectively, regardless of application time and source of N. The positive correlation between chlorophyll leaf content and grain yield in accordance with N fertilization levels indicates that N fertilization in topdressing can be recommended based on SPAD readings of leaf chlorophyll performed at 38 days after wheat plant emergence