Fumonisin B1 And Ochratoxin A In Beers Made In Brazil

Samples of beer made in Brazil were analyzed for the presence of fumonisin B1 (FB1) and ochratoxin A (OTA). FB1 was searched for in 58 beer samples from 30 plants located in nine states. The samples were concentrated and cleaned up with strong ion exchange column, derivatized with OPA and analyzed by HPLC with fluorescence detection. The limit of detection was 0.26 ng.mL-1 and the average recovery was 98%. Twenty-five samples contained FB1 ranging from 1 to 40 ng.mL -1. Beer (123 samples) from 36 plants located in 5 states were analyzed for OTA by means of immunoaffinity column cleanup followed by liquid chromatography associated with fluorescence. The detection limit was 0.1 ng.mL-1 and the average recovery was 92%. Five samples contained OTA in concentrations from 1 to 18 ng.mL-1. The results indicate that FB1 and OTA contamination in Brazilian beer is not geographically limited and that beer does not contribute significantly to FB1 intake by consumers. 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Retention systems for extraoral maxillofacial prosthetic implants: a critical review

We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001–13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner’s choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist

Early psychiatric morbidity in a Brazilian sample of acute ischemic stroke patients

OBJECTIVE: Stroke is a major public health problem worldwide, and its neuropsychiatric sequelae are frequent and disabling. Furthermore, there is evidence that these sequelae impair recovery. Brazil has the highest stroke rates in Latin America, but data on the frequency of neuropsychiatric disorders in these patients are scarce. This study aimed to identify mental disorders among in-hospital patients with acute ischemic stroke. METHODS: The Mini International Neuropsychiatric Interview-Plus (MINI-Plus) was applied to 60 patients during the first week of hospitalization. RESULTS: Psychiatric disorders were diagnosed in 55% of the patients. A wide range of neuropsychiatric disorders have been identified, mainly mood and anxiety disorders. Specifically, we identified major depression (26.7%), alcohol abuse or dependence (11.7%), specific phobia (8.3%), generalized anxiety disorder (6.7%), psychosis (5.0%), social phobia (3.3%), adjustment disorder (3.3%) and panic disorder (1.7%). CONCLUSION: Psychiatric comorbidity should be evaluated as part of the rehabilitation of stroke patients and should be carefully examined by physicians

A Bovine Pericardium Rigid Prosthesis For Left Ventricle Restoration: 12 Years Of Follow-up [prótese Rígida De Pericárdio Bovino Para Remodelamento Ventricular Esquerdo: 12 Anos De Seguimento]

Background: Myocardial infarction might result in dilated left ventricle and numerous techniques have been described to restore the original left ventricle shape and identify tools for late survival assessment. The aim of this study is to compare our experience with a modified Dor procedure using a rigid prosthesis to the septal anterior ventricular exclusion procedure (SAVE) for left ventricle restoration. The EuroScore index for prediction of late follow up survival was evaluated. Methods: We evaluated 80 patients who underwent left ventricle restoration between 1999 to 2007 and eight patients were excluded with incomplete data. A modified Dor procedure with rigid prosthesis (MD group) was performed on 53 patients and 19 underwent the septal anterior ventricular exclusion procedure (SAVE group). The patients were classified according their left ventricle shape as type I, II or III. Kaplan-Meier and Cox proportional hazard ratio regressions analysis were performed to assess survival after both techniques and expected surgical mortality using EuroScore index ranking after 12 years of follow up. Results: The operative mortality was comparable in both groups ranked by EuroScore index. The groups were comparable for all clinical data, except the MD group had more patients using intra-aortic balloon pumps before surgery, (5.7% vs. 0; P<0.01). Kaplan Meier analysis by left ventricle shape showed comparable survival for all patients, with slightly higher survival for type I. Kaplan Meier analysis of all death showed equivalent survival curves for both techniques after 12 years of follow up (71.5 ± 12.3 vs. 46.6 ±20.5 years; P=0.08). Kaplan Meier analysis of EuroScore index for all patients showed a difference between the three ranked categories, i.e., 0 to 10%, 11 to 49% and higher than 50% expected surgical mortality after 12 years of follow up (70.9 ± 16.2 vs. 67.5 ± 12.7 vs. 53.0 ± 15.5; P=0.003). Conclusion: The MD procedure showed consistent ejection fraction improvements after long term follow up. Survival was comparable for all ventricular types and for the MD and SAVE procedures. The EuroScore index is a useful index for late survival assessment of ventricular restoration techniques.262164172Cooley, D.A., Hallman, G.L., Henly, W.S., Left ventricular aneurysm due to myocardial infarctionexperience with 37 patients undergoing aneurysmectomy (1964) Arch Surg, 88, pp. 114-121Jatene, A.D., Left ventricular aneurysmectomy. Resection or reconstruction (1985) J Thorac Cardiovasc Surg, 89 (3), pp. 321-331Dor, V., Saab, M., Coste, P., Kornaszewska, M., Montiglio, F., Left ventricular aneurysm: A new surgical approach (1989) Thorac Cardiovasc Surg, 37 (1), pp. 11-19Dor, V., Sabatier, M., di Donato, M., Montiglio, F., Toso, A., Maioli, M., Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction: Comparison with a series of large dyskinetic scars (1998) J Thorac Cardiovasc Surg, 116 (1), pp. 50-59Braile, D.M., Mustafa, R.M., Ardito, R.V., Zaiantchick, M., Coelho, W.M., (1991) Correction of the Left Ventricle Geometry with Semi Rigid Bovine Pericardial Prosthesis Rev Bras Cir Cardiovasc, 6 (2), pp. 109-115Isomura, T., Horii, T., Suma, H., Buckberg, G.D., Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: Treat form not disease (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S245-S250. , RESTORE GroupJones, R.H., Velazquez, E.J., Michler, R.E., Sopko, G., Oh, J.K., O'Connor, C.M., Coronary bypass surgery with or without surgical ventricular reconstruction (2009) N Engl J Med, 360 (17), pp. 1705-1717di Donato, M., Castelvecchio, S., Kukulski, T., Bussadori, C., Giacomazzi, F., Frigiola, A., Surgical ventricular restoration: Left ventricular shape influence on cardiac function, clinical status, and survival (2009) Ann Thorac Surg, 87 (2), pp. 455-461Najafi, M., Sheikhvatan, M., Montazeri, A., Sheikhfathollahi, M., Predictors of quality of life among patients undergoing coronary artery bypass surgery (2008) Acta Cardiol, 63 (6), pp. 713-721Messaoudi, N., de Cocker, J., Stockman, B.A., Bossaert, L.L., Rodrigus, I.E., Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac surgery? (2009) Eur J Cardiothorac Surg, 36 (1), pp. 35-39Santarpino, G., Onorati, F., Rubino, A.S., Abdalla, K., Caroleo, S., Santangelo, E., Preoperative intraaortic balloon pumping improves outcomes for high-risk patients in routine coronary artery bypass graft surgery (2009) Ann Thorac Surg, 87 (2), pp. 481-488Nashef, S.A., Roques, F., Michel, P., Gauducheau, E., Lemeshow, S., Salamon, R., European system for cardiac operative risk evaluation (EuroSCORE) (1999) Eur J Cardiothorac Surg, 16 (1), pp. 9-13Dor, V., Sabatier, M., di Donato, M., Maioli, M., Toso, A., Montiglio, F., Late hemodynamic results after left ventricular patch repair associated with coronary grafting in patients with postinfarction akinetic or dyskinetic aneurysm of the left ventricle (1995) J Thorac Cardiovasc Surg, 110 (5), pp. 1291-1299Athanasuleas, C.L., Buckberg, G.D., Stanley, A.W., Siler, W., Dor, V., Didonato, M., RESTORE Group. Surgical ventricular restoration: The RESTORE Group experience (2004) Heart Fail Rev, 9 (4), pp. 287-297Salati, M., di Biasi, P., Paje, A., Santoli, C., Left ventricular geometry after endoventriculoplasty (1993) Eur J Cardiothorac Surg, 7 (11), pp. 574-578Buckberg, G.D., Coghlan, H.C., Torrent-Guasp, F., The structure and function of the helical heart and its buttress wrapping. VI. Geometric Concepts of Heart Failure and Use For Structural Correction (2001) Semin Thorac Cardiovasc Surg, 13 (4), pp. 386-401di Donato, M., Sabatier, M., Dor, V., Gensini, G.F., Toso, A., Maioli, M., Effects of the Dor procedure on left ventricular dimension and shape and geometric correlates of mitral regurgitation one year after surgery (2001) J Thorac Cardiovasc Surg, 121 (1), pp. 91-96Suma, H., Horii, T., Isomura, T., Buckberg, G., A new concept of ventricular restoration for nonischemic dilated cardiomyopathy (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S207-S212. , RESTORE GroupForm versus disease: Optimizing geometry during ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S238-S244. , RESTORE GroupKieser, T.M., The left ventricle: To reconstruct or not: Lessons from the STICH trial (2009) J Thorac Cardiovasc Surg, 138 (3), p. 784Suma, H., Isomura, T., Horii, T., Buckberg, G., Role of site selection for left ventriculoplasty to treat idiopathic dilated cardiomyopathy (2004) Heart Fail Rev, 9 (4), pp. 329-336. , RESTORE GroupDancini, J.L., Rodrigues, J.J., Santos, J.S., Pinto, R.F.A., Burgos, F.J.C., Conforti, C.A., Left ventricular aneurysmectomy: Late followup (1996) Rev Bras Cir Cardiovasc, 1 (11), pp. 23-29Almeida, R.M.S., Lima, J.D., Bastos, L.C., Carvalho, C.T., Loures, D.R., Endoventricular circular patch plasty with septal exclusion: Initial experience (2000) Rev Bras Cir Cardiovasc, 4 (15), pp. 302-307Campagnucci, V.P., Rivetti, L.A., Pinto e Silva, A.M.R., Gandra, S.M.A., Pereira, W.L., Aneurismectomia de ventrículo esquerdo com o coração batendo ininterruptamente: Resultados imediatos (2006) Rev Bras Cir Cardiovasc, 21 (1), pp. 55-61Herrera, C.B., Insalralde, A., Brandi, A.C., Santos, C.A., Herrera, D.D., Soares, M.J.F., Correção de aneurisma de ventrículo esquerdo em paciente chagásico empregando prótese de pericárdio bovino (2000) Rev Bras Cir Cardiovasc, 15 (1), pp. 72-74Sgarbi, C.J., Ardito, R.V., Santos, R.C., Bogdan, R.A.B., Arruda Jr., F.V., Silva, E.M., Correção cirúrgica do aneurisma de ventrículo esquerdo: Comparação entre as técnicas de sutura linear e reconstrução geométrica (2000) Rev Bras Cir Cardiovasc, 15 (4), pp. 293-301Versteegh, M.I., Lamb, H.J., Bax, J.J., Curiel, F.B., van der Wall, E.E., de Roos, A., MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection (2003) Eur J Cardiothorac Surg, 23 (4), pp. 609-613Use of cardiac magnetic resonance imaging in surgical ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S216-S224. , Buckberg GD;RESTORE GroupWalker, J.C., Guccione, J.M., Jiang, Y., Zhang, P., Wallace, A.W., Hsu, E.W., Helical myofiber orientation after myocardial infarction and left ventricular surgical restoration in sheep (2005) J Thorac Cardiovasc Surg, 129 (2), pp. 382-39

AVALIAÇÃO E EFETIVIDADE DA ANALGESIA EM PESSOAS SUBMETIDAS A HEMODIÁLISE

Objetivo: Avaliar a prevalência de dor crónica e dor intradialítica em pessoas em programa hemodiálise, bem como a eficácia da terapia analgésica. Métodos: Estudo transversal e correlacional. Uma amostra aleatória composta por 183 pessoas submetidos a hemodiálise em duas clínicas e um serviço de nefrologia na região de Lisboa, Portugal. Aplicados Brief Pain Inventory, que analisa a influência da dor na vida da pessoa e Escala Visual Analógica para avaliar a dor intradialítica. Resultados: A amostra foi constituída em sua maioria por homens (59,6%) de nacionalidade portuguesa (78,7%), média de idade de 59,17 anos (± 14,64). A dor crónica ocorre em 56,6% das pessoas e a dor intradialítica em 30,1%. As causas da dor crónica foram musculoesqueléticas (68,7%) e dor associada ao acesso vascular (17,2%). A localização nos membros inferiores foi a mais comum (43,4%). O uso de analgésicos para dor crónica foi elevado (58,2%) e foram ainda utilizados o repouso (24,1%) e massagem/relaxamento (6,3%). O alívio da dor crónica verificou-se em 63% das pessoas, referindo alívio de mais de 50%. Conclusões: A dor de origem musculoesquelética é um sintoma frequente nesta amostra. A utilização de fármacos na gestão da dor crónica foi a estratégia mais aplicada