Numerical study of sodalime and PDMS hemisphere photonic structures for radiative cooling of silicon solar cells.

This paper numerically explores the capability of an all-photonic approach to enhance radiative cooling, UV and sub-bandgap reflection, and light trapping as a path to improve solar cells efficiency. The structure is based on hemispheres and a flat surface placed on a silicon photovoltaic cell. The study considers two materials commonly used in panel covers: soda-lime glass and polydimethylsiloxane (PDMS). A numerical approach based on the rigorous coupled-wave analysis method and an electrical-thermal model predicts maximum power improvements of 18.1% and 19.7% when using soda-lime and PDMS hemispheres, respectively, as well as a cell's temperature reduction of 4 °C, compared to a glass encapsulated solar cell.

Excitation and detection of acoustic phonons in nanoscale systems.

Phonons play a key role in the physical properties of materials, and have long been a topic of study in physics. While the effects of phonons had historically been considered to be a hindrance, modern research has shown that phonons can be exploited due to their ability to couple to other excitations and consequently affect the thermal, dielectric, and electronic properties of solid state systems, greatly motivating the engineering of phononic structures. Advances in nanofabrication have allowed for structuring and phonon confinement even down to the nanoscale, drastically changing material properties. Despite developments in fabricating such nanoscale devices, the proper manipulation and characterization of phonons continues to be challenging. However, a fundamental understanding of these processes could enable the realization of key applications in diverse fields such as topological phononics, information technologies, sensing, and quantum electrodynamics, especially when integrated with existing electronic and photonic devices. Here, we highlight seven of the available methods for the excitation and detection of acoustic phonons and vibrations in solid materials, as well as advantages, disadvantages, and additional considerations related to their application. We then provide perspectives towards open challenges in nanophononics and how the additional understanding granted by these techniques could serve to enable the next generation of phononic technological applications.

Highly-Scattering Cellulose-Based Films for Radiative Cooling.

Passive radiative cooling (RC) enables the cooling of objects below ambient temperature during daytime without consuming energy, promising to be a game changer in terms of energy savings and CO2 reduction. However, so far most RC surfaces are obtained by energy-intensive nanofabrication processes or make use of unsustainable materials. These limitations are overcome by developing cellulose films with unprecedentedly low absorption of solar irradiance and strong mid-infrared (mid-IR) emittance. In particular, a cellulose-derivative (cellulose acetate) is exploited to produce porous scattering films of two different thicknesses, L ≈ 30 µm (thin) and L ≈ 300 µm (thick), making them adaptable to above and below-ambient cooling applications. The thin and thick films absorb only ≈ 5 % ${\approx}5\%$ of the solar irradiance, which represents a net cooling power gain of at least 17 W m-2 , compared to state-of-the-art cellulose-based radiative-cooling materials. Field tests show that the films can reach up to ≈5 °C below ambient temperature, when solar absorption and conductive/convective losses are minimized. Under dryer conditions (water column = 1 mm), it is estimated that the films can reach average minimum temperatures of ≈7-8 °C below the ambient. The work presents an alternative cellulose-based material for efficient radiative cooling that is simple to fabricate, cost-efficient and avoids the use of polluting materials.

Ulceración esofágica por ingestión de doxiciclina / Doxycycline induced esophageal ulceration

La ulceración esofágica por ingestión de doxiciclina es una de las causas más frecuentes de lesión esofágica. Ha sido subdiagnosticada y escasamente reconocida en dermatología. El dolor retroesternal, la odinofagia de aparición brusca y el antecedente de ingesta de doxiciclina u otros fármacos son características que facilitan su diagnóstico. Puede presentar complicaciones serias, como hemorragias, estenosis y mediastinitis.

Esophageal ulceration due to ingestion of doxycycline is one of the most frequent causes of esophageal injury. It has been underdiagnosed and scarcely recognized in dermatology. Retrosternal pain, sudden odynophagia and a history of doxycycline or other drugs intake are some of the characteristics that lead to diagnosis. It may cause severe complications such as bleeding, stenosis and mediastinitis.

A Self-Assembled 2D Thermofunctional Material for Radiative Cooling.

The regulation of temperature is a major energy-consuming process of humankind. Today, around 15% of the global-energy consumption is dedicated to refrigeration and this figure is predicted to triple by 2050, thus linking global warming and cooling needs in a worrying negative feedback-loop. Here, an inexpensive solution is proposed to this challenge based on a single layer of silica microspheres self-assembled on a soda-lime glass. This 2D crystal acts as a visibly translucent thermal-blackbody for above-ambient radiative cooling and can be used to improve the thermal performance of devices that undergo critical heating during operation. The temperature of a silicon wafer is found to be 14 K lower during daytime when covered with the thermal emitter, reaching an average temperature difference of 19 K when the structure is backed with a silver layer. In comparison, the soda-lime glass reference used in the measurements lowers the temperature of the silicon by just 5 K. The cooling power of this simple radiative cooler under direct sunlight is found to be 350 W m-2 when applied to hot surfaces with relative temperatures of 50 K above the ambient. This is crucial to radiatively cool down devices, i.e., solar cells, where an increase in temperature has drastic effects on performance.

Nanowire forest of pnictogen-chalcogenide alloys for thermoelectricity.

Pnictogen and chalcogenide compounds have been seen as high-potential materials for efficient thermoelectric conversion over the past few decades. It is also known that with nanostructuration, the physical properties of these pnictogen-chalcogenide compounds can be further enhanced towards a more efficient heat conversion. Here, we report the reduced thermal conductivity of a large ensemble of Bi2Te3 alloy nanowires (70 nm in diameter) with selenium for n-type and antimony for p-type (Bi2Te3-ySey and Bi2-xSbxTe3 respectively). The nanowire growth was carried out through electrodeposition in nanoporous aluminium oxide templates with high aspect ratios leading to a forest (109 per centimetre square) of nearly identical nanowires. The temperature dependence of thermal conductivity for the nanowire ensembles was acquired through a highly sensitive 3ω measurement technique. The change in the thermal conductivity of nanowires is largely affected by the roughness in addition to the size effect due to enhanced boundary scattering. The major factor that influences the thermal conductivity was found to be the ratio of the rms roughness to the correlation length of the nanowire. With a high Seebeck coefficient and electrical conductivity at room temperature, the overall thermoelectric figure of merit ZT allows the consideration of such forests of nanowires as efficient potential building blocks of future TE devices.

Using the Biology Card Sorting Task to Measure Changes in Conceptual Expertise during Postsecondary Biology Education.

While there have been concerted efforts to reform undergraduate biology toward teaching students to organize their conceptual knowledge like experts, there are few tools that attempt to measure this. We previously developed the Biology Card Sorting Task (BCST), designed to probe how individuals organize their conceptual biological knowledge. Previous results showed the BCST could differentiate between different populations, namely non-biology majors (NBM) and biology faculty (BF). In this study, we administered the BCST to three additional populations, using a cross-sectional design: entering biology majors (EBM), advanced biology majors (ABM), and biology graduate students (BGS). Intriguingly, ABM did not initially sort like experts any more frequently than EBM. However, once the deep-feature framework was revealed, ABM were able to sort like experts more readily than did EBM. These results are consistent with the conclusion that biology education enables advanced biology students to use an expert-like conceptual framework. However, these results are also consistent with a process of "selection," wherein students who persist in the major may have already had an expert-like conceptual framework to begin with. These results demonstrate the utility of the BCST in measuring differences between groups of students over the course of their undergraduate education.

Impacto de la cirugía de catarata en la calidad de vida de pacientes del Hospital Central de la Policía / Cataract surgery impact in quality of life in patients at Hospital Central de la Policía

Objetivo: evaluar el impacto de la cirugía de catarata en la calidad de vida de los pacientes del Hospital Central de la Policía. Diseño del estudio: estudio cuasi experimental. Métodos: se incluyeron pacientes del servicio de oftalmología del Hospital Central de la Policía con diagnóstico de catarata a quienes se les realizo encuesta de calidad de vida (SF-36) previo a la cirugía, con obtención de consentimiento informado para participar en el estudio y con aprobación de la junta institucional. Luego de la cirugía se aplicó de nuevo la encuesta de calidad de vida a cada paciente a los 3 y 6 meses. Se realizó el análisis univariado y se determinaron las correlaciones existentes entre las variables de interés del estudio y la calidad de vida, se utilizó el paquete estadístico SPSS 22.0 de IBM. Resultados: se incluyeron 41 pacientes a quienes se les realizó cirugía de catarata. El puntaje de calidad de vida promedio paso de 63 antes de la cirugía a 78 y 81 en los 3 y 6 meses respectivamente posteriores a la cirugía demostrando gran mejoría en la calidad de vida de los pacientes. Conclusiones: en cuanto al puntaje de cuestionario SF-36, se encontró aumento del puntaje de calidad de vida posterior a la cirugía de catarata tanto a los 3 y 6 meses, pasando de calidad de vida regular a bueno.

Objective: to evaluate the impact of cataract surgery on quality of life of patients in the Central Police Hospital. Methods: a quasi-experimental study. Patients of the ophthalmology department of the Central Police Hospital with a diagnosis of cataract where included and the instrument to measure quality of life was applied (SF-36) before surgery; informed consent was obtained to participate in the study and approval the institutional review board was granted. After surgery the instrument was applied again for each patient at 3 and 6 months. Responses were considered for univariate analysis and correlations, the SPSS 22.0 statistical package was used. Results: 41 patients were included in whom cataract surgery was done. The quality of life score average pace of 63 before surgery to 78 and 81 at 3 and 6 months respectively after surgery showing great improvement in the quality of life of patients. Conclusions: It was evident the improvement on the score of the SF-36 instrument at both 3 and 6 months, ranging form regular quality of life to good quality of life.

Consecuencias de la enfermedad de Parkinson en la calidad de vida / Consequences of Parkinson’s disease on quality of life

La enfermedad de Parkinson (EP), se identifica como una enfermedad neurodegenerativa, que tiende a atacar al Sistema Nervioso Central, dañando severamente regiones neuronales de la sustancia negra. A nivel mundial la EP ocupa la segunda posición como la enfermedad de degeneración neuronal con mayor prevalencia. Los orígenes de la EP resultan multifactoriales, pues al presente se desconoce una única causa biológica o genética que explique su etiología de forma plena y satisfactoria. Se reconocen en la actualidad una variedad de siete tipos de Parkinsonismo, que producen afectaciones en sus distintas etapas, tanto a nivel de los sistemas de serotonina, noradrenalina como acetilcolina. Los drásticos efectos que provoca la EP sobre la Calidad de Vida (CV) de los pacientes, puede ser evaluada científica y cuantitativamente, desde las múltiples pruebas y evaluaciones que han surgido dentro del campo de las ciencias de la salud. Los cuatro síntomas más comunes para el reconocimiento del Parkinsonismo, son la inestabilidad postural, la rigidez corporal, la bradicinesia y los temblores. La EP continúa siendo poco intervenida en sus etapas tempranas de aparición, especialmente en naciones en vías de desarrollo, por lo que se requiere mayor unidad entre disciplinas científicas y sistemas públicos de salud, para mejorar la CV de estas poblaciones...

Parkinson's disease (PD), is identified as a neurodegenerative disease, tending to attack the Central Nervous System, severely damaging neural regions of substantia nigra. Globally PD ranks second as the most prevalent neuronal degeneration disease. The origins of PD are multifactorial, because nowadays a unique biological or genetic cause to explain the etiology of full and satisfactory way is unknown. They now recognize a variety of seven types of Parkinsonism, producing affectations in its various stages, both at the serotonin, norepinephrine and acetylcholine systems. The drastic effects caused by PD on Quality of Life (QoL) of patients, can be evaluated quantitatively and scientifically and from the multiple tests and evaluations that have emerged within the field of health sciences. The four most common symptoms of Parkinsonism recognition are postural instability, body rigidity, bradykinesia and tremors. PD is still little intervened in the early stages of emergence, especially in developing nations, so that greater unity between scientific disciplines and public health systems are required to improve the QoL’s populations...

A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country.

OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for > 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.

Sistema de suporte à decisão clínica para um programa para profilaxia de tromboembolia venosa em um hospital geral de um país de renda média / A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country

OBJETIVO: Determinar o impacto da implantação de um sistema informatizado de suporte à decisão clínica combinado com seminários instrucionais na utilização de profilaxia para tromboembolia venosa (TEV) de forma adequada. MÉTODOS: Estudo transversal em duas fases (antes e depois da implantação de um novo protocolo de profilaxia para TEV) para avaliar o impacto que a estratégia combinada teve na utilização adequada da profilaxia para TEV. O estudo foi conduzido no Hospital Nossa Senhora da Conceição, um hospital geral localizado em Porto Alegre (RS). Foram incluídos pacientes clínicos e cirúrgicos com mais de 18 anos com tempo de hospitalização > 48 h. Nas fases pré e pós-implantação, foram incluídos 262 e 261 pacientes, respectivamente. RESULTADOS: As características de base das duas amostras foram semelhantes, inclusive em relação à distribuição dos pacientes por nível de risco. Comparando-se os períodos pré e pós-implantação, verificou-se que a adequação da profilaxia para TEV aumentou de 46,2% para 57,9% (p = 0,01). Ao se observar populações específicas de pacientes, o uso adequado da profilaxia para TVE aumentou dramaticamente em pacientes com câncer (de 18,1% para 44,1%; p = 0,002) e em pacientes com três ou mais fatores de risco (de 25,0% para 42,9%; p = 0,008), populações essas que mais se beneficiam da profilaxia. CONCLUSÕES: É possível aumentar o uso de profilaxia adequada para TEV em cenários economicamente desfavoráveis através do uso de protocolos informatizados e de profissionais treinados. A subutilização da profilaxia permanece como um problema importante, destacando a necessidade da melhora continuada na qualidade da assistência hospitalar.

OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for > 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.

Emergência de infecção por Trichosporon Asahii em pacientes portadores de insuficiência cardíaca em unidade de terapia intensiva cardiológica: relato de caso e revisão da literatura / Trichosporon asahii an emerging etiologic agent of fungal infection and colonization in heart failure patients in intensive care unit: case report and literature review

JUSTIFICATIVA E OBJETIVOS: As infecções fúngicas por Trichosporon Asahii têm sido cada vez mais freqüentes nas últimas duas décadas. Quadros graves com alta mortalidade são tradicionalmente descritos em pacientes neutropênicos com câncer. Recentemente, a infecção tem ocorrido também em outros grupos de pacientes. O objetivo deste estudo foi descrever a crescente prevalência de Trichosporon asahii em unidade de terapia intensiva cardiológica (UTIC), com perfil de pacientes habitualmente não susceptíveis a tal infecção fúngica, relatar um caso clínico e revisão da literatura. RELATO DO CASO: Paciente do sexo feminino, 85 anos, com antecedentes de hipertensão arterial sistêmica, insuficiência cardíaca (fração de ejeção = 30 por cento) e embolia pulmonar, admitida na UTI depois de parada cardiorrespiratória em fibrilação ventricular durante consulta de rotina. Evoluiu sem seqüela neurológica. O ecocardiograma não revelou alterações em relação ao exame anterior. Não houve alteração dos indicadores de necrose miocárdica. A paciente apresentou falha na extubação traqueal e desmame difícil, necessitando ventilação mecânica prolongada mesmo após traqueostomia. Houve complicações por insuficiência renal aguda e infecções recorrentes (respiratória, urinária e sistêmica), com boa resposta ao tratamento com antibióticos de amplo espectro. Após sete meses de internação na UTI, evoluiu com choque séptico, associado à infecção urinária por Trichosporon asahii, com hemoculturas identificadas pelo mesmo fungo. Iniciado tratamento com anfotericina B lipossomal (5 mg/kg/dia). Apesar do uso associado de vancomicina e imipenem, houve piora clínica progressiva. Hemoculturas colhidas no sétimo dia de uso de antifúngico revelaram-se negativas, porém a urocultura ainda revelou o crescimento de T. asahii. Evoluiu com óbito após 18 dias de tratamento, por falência de múltiplos órgãos. CONCLUSÕES: O aumento da gravidade dos pacientes internados nas UTI e o uso disseminado...

BACKGROUND AND OBJECTIVES: Infection with the non-Candida yeast species Trichosporon have been recognized with increasing frequency over the last two decades. Invasive disease due to trichosporonosis has been reported from neutropenic patients with cancer and the mortality is high. Recently, others groups of patients have become susceptible to this rare fungi. We report the emerging of infection with pathogenic Trichosporon asahii in severely ill heart failure patients in a tertiary cardiological intensive care unit (CICU). We describe our data, and report a fatal case of disseminated trichosporonosis in a patient with heart failure. We also review literature pertaining to T. asahii infections. CASE REPORT: An 85 year-old woman with a history of hypertension, heart failure (ejection fraction (EJ): 30 percent) and pulmonary embolism was admitted to a medical cardiological ICU after cardiac arrest (ventricular fibrillation) resuscitated during a routine consultation. There were no neurological sequelae and the echocardiogram revels no changes, neither the cardiac biomarkers. Ventricular fibrillation was considered secondary to heart failure. The patient had extubation failure and difficult weaning needing long term mechanical ventilation even after tracheostomy. Her hospital course was complicated by acute renal failure and recurrent respiratory, urinary and systemic bacterial infections, which responded to broad-spectrum antibiotics. After a temporary improvement she developed urinary infection and subsequent septic shock. Cultures of urine and blood specimens grew T. asahii. Treatment with liposome amphotericin B (5 mg/kg/day) was started. Despite receiving vancomycin and imipenem, the clinical condition of the patient deteriorates. Blood taken for culture on the seventh day of amphotericin B therapy were negative but urine specimen still grew T. asahii. On the eighteenth day of antifungal therapy, the patient died with multiorgan...

[Trichosporon asahii an emerging etiologic agent of fungal infection and colonization in heart failure patients in intensive care unit: case report and literature review]. / Emergência de infecção por Trichosporon Asahii em pacientes portadores de insuficiência cardíaca em unidade de terapia intensiva cardiológica: relato de caso e revisão da literatura.

BACKGROUND AND OBJECTIVES: Infection with the non-Candida yeast species Trichosporon have been recognized with increasing frequency over the last two decades. Invasive disease due to trichosporonosis has been reported from neutropenic patients with cancer and the mortality is high. Recently, others groups of patients have become susceptible to this rare fungi. We report the emerging of infection with pathogenic Trichosporon asahii in severely ill heart failure patients in a tertiary cardiological intensive care unit (CICU). We describe our data, and report a fatal case of disseminated trichosporonosis in a patient with heart failure. We also review literature pertaining to T. asahii infections. CASE REPORT: An 85 year-old woman with a history of hypertension, heart failure (ejection fraction (EJ): 30%) and pulmonary embolism was admitted to a medical cardiological ICU after cardiac arrest (ventricular fibrillation) resuscitated during a routine consultation. There were no neurological sequelae and the echocardiogram revels no changes, neither the cardiac biomarkers. Ventricular fibrillation was considered secondary to heart failure. The patient had extubation failure and difficult weaning needing long term mechanical ventilation even after tracheostomy. Her hospital course was complicated by acute renal failure and recurrent respiratory, urinary and systemic bacterial infections, which responded to broad-spectrum antibiotics. After a temporary improvement she developed urinary infection and subsequent septic shock. Cultures of urine and blood specimens grew T. asahii. Treatment with liposome amphotericin B (5 mg/kg/day) was started. Despite receiving vancomycin and imipenem, the clinical condition of the patient deteriorates. Blood taken for culture on the seventh day of amphotericin B therapy were negative but urine specimen still grew T. asahii. On the eighteenth day of antifungal therapy, the patient died with multiorgan failure. CONCLUSIONS: The increasing of severely ill patients, and the use of broad spectrum antibiotics, has predisposed the emerging of invasive infections by rare and new opportunistic fungal pathogens. Severe infection related to T. asahii, until recently restricted to neutropenic patients with cancer, has been frequently identified in heart failure patients with advanced age. The mortality is high. These data highlights the importance of considering this group of patients as a risk group for T. asahii infection.

Hypophosphatemia in children hospitalized within an intensive care unit.

The aims of this study were to estimate the occurrence of hypophosphatemia and to identify potential risk factors and outcome measures associated with this disturbance in children admitted to a pediatric intensive care unit. Data concerning 42 children admitted consecutively to 1 pediatric intensive care unit over a 1-year period were examined. Serum phosphorus levels were measured on the third day of admission, where levels below 3.8 mg/dL were considered indicative of hypophosphatemia. Hypophosphatemia was found in 32 children (76%), and there was a significant association between this disturbance and malnutrition (P = .04). Of the potential risk factors such as sepsis, diuretic/steroid therapy, starvation (over 3 days), and Pediatric Index of Mortality, none discriminated for hypophosphatemia. There were no associations between hypophosphatemia and mortality, length of stay in the pediatric intensive care unit, or time on mechanical lung ventilation. Hypophosphatemia was a common finding in critically ill children and was associated with malnutrition.

Hypophosphatemia in critically ill children.

The purpose of this paper is to review clinical studies on hypophosphatemia in pediatric intensive care unit patients with a view to verifying prevalence and risk factors associated with this disorder. We searched the computerized bibliographic databases Medline, Embase, Cochrane Library, and LILACS to identify eligible studies. Search terms included critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. The search period covered those clinical trials published from January 1990 to January 2004. Studies concerning endocrinological disorders, genetic syndromes, rickets, renal diseases, anorexia nervosa, alcohol abuse, and prematurity were not included in this review. Out of 27 studies retrieved, only 8 involved pediatric patients, and most of these were case reports. One clinical trial and one retrospective study were identified. The prevalence of hypophosphatemia exceeded 50%. The commonly associated factors in most patients with hypophosphatemia were refeeding syndrome, malnutrition, sepsis, trauma, and diuretic and steroid therapy. Given the high prevalence, clinical manifestations, and multiple risk factors, the early identification of this disorder in critically ill children is crucial for adequate replacement therapy and also to avoid complications.

Hypophosphatemia in critically ill children

Este estudo objetivou realizar revisão da literatura para verificar prevalência, fatores de risco e condições clínicas associadas à hipofosfatemia em crianças gravemente doentes. Para a pesquisa foram utilizadas as bases de dados Medline, Embase, Cochrane Library, Lilacs abrangendo estudos clínicos publicados de janeiro de 1990 a janeiro de 2004. Os termos utilizados para pesquisa foram: critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. Foram excluídos estudos referentes a distúrbios endócrinos, síndromes genéticas, raquitismo, nefropatias, anorexia nervosa, alcoolismo e prematuridade. Dos 27 artigos inicialmente identificados, 8 referiam-se à faixa etária pediátrica, sendo a maioria deles relatos de casos isolados. Nos estudos clínicos selecionados, a prevalência de hipofosfatemia foi superior a 50%. Os principais fatores associados à hipofosfatemia foram realimentação, desnutrição, sepse, trauma, uso de diuréticos e corticoesteróides. Considerando-se a elevada prevalência, as repercussões clínicas e os múltiplos fatores de risco para hipofosfatemia em crianças internadas em unidade de cuidados intensivos, a identificação precoce de pacientes suscetíveis a esse distúrbio é essencial para o tratamento oportuno e prevenção de complicações.

Hiperplasia angiolinfoide con eosinofilia: sobre 4 observaciones / Angiolymphoid hyperplasia with eosinophilia

La hiperplasia angiolinfoide con eosinofilia es una patología infrecuente de origen desconocido, que se caracteriza clínicamente por presentar nódulos ubicados en cabeza o cuero cabelludo de adultos jóvenes. Presentamos cuatro casos clínicos, tres de ellos con lesiones múltiples y uno solitario

Hiperplasia angiolinfoide con eosinofilia: sobre 4 observaciones / Angiolymphoid hyperplasia with eosinophilia

La hiperplasia angiolinfoide con eosinofilia es una patología infrecuente de origen desconocido, que se caracteriza clínicamente por presentar nódulos ubicados en cabeza o cuero cabelludo de adultos jóvenes. Presentamos cuatro casos clínicos, tres de ellos con lesiones múltiples y uno solitario (AU)

Hiperhidrosis primaria localizada axilar y palmo-plantar: un desafío terapéutico, contribución de la toxina botulínica tipo A / Primary localized axillary and palmo-plantar hyperhidrosis: a therapeutic challenge, botulin A toxin contribution

Describimos nuestra experiencia usando Toxina Botulínica A (TXA) para el tratamiento de la hiperhidrosis primaria localizada (HPL): 8 casos de HPL axilar y 3 de HPL palmar. Los resultados en las axilas fueron uniformemente buenos, con evaluaciones objetivas (test de Minor) y subjetivas excelentes. En palmas, el dolor producido por las inyecciones múltiples es un factor limitante que plantea la necesidad de realizar bloqueos neurales. La opción TXB es un aporte importante, dadas las dificultades que se enfrentan en el tratamiento de la HPL y porque la opción quirúrgica, sólo recomendable para casos muy severos y efectuada por grupos especializados, no está exenta de riesgos

Hiperhidrosis primaria localizada axilar y palmo-plantar: un desafío terapéutico, contribución de la toxina botulínica tipo A / Primary localized axillary and palmo-plantar hyperhidrosis: a therapeutic challenge, botulin A toxin contribution

Describimos nuestra experiencia usando Toxina Botulínica A (TXA) para el tratamiento de la hiperhidrosis primaria localizada (HPL): 8 casos de HPL axilar y 3 de HPL palmar. Los resultados en las axilas fueron uniformemente buenos, con evaluaciones objetivas (test de Minor) y subjetivas excelentes. En palmas, el dolor producido por las inyecciones múltiples es un factor limitante que plantea la necesidad de realizar bloqueos neurales. La opción TXB es un aporte importante, dadas las dificultades que se enfrentan en el tratamiento de la HPL y porque la opción quirúrgica, sólo recomendable para casos muy severos y efectuada por grupos especializados, no está exenta de riesgos (AU)