Evidence of combined flower thermal and drought vulnerabilities portends reproductive failure under hotter-drought conditions.

Despite the abundant evidence of impairments to plant performance and survival under hotter-drought conditions, little is known about the vulnerability of reproductive organs to climate extremes. Here, by conducting a comparative analysis between flowers and leaves, we investigated how variations in key morphophysiological traits related to carbon and water economics can explain the differential vulnerabilities to heat and drought among these functionally diverse organs. Due to their lower construction costs, despite having a higher water storage capacity, flowers were more prone to turgor loss (higher turgor loss point; ΨTLP) than leaves, thus evidencing a trade-off between carbon investment and drought tolerance in reproductive organs. Importantly, the higher ΨTLP of flowers also resulted in narrow turgor safety margins (TSM). Moreover, compared to leaves, the cuticle of flowers had an overall higher thermal vulnerability, which also resulted in low leakage safety margins (LSM). As a result, the combination of low TSMs and LSMs may have negative impacts on reproduction success since they strongly influenced the time to turgor loss under simulated hotter-drought conditions. Overall, our results improve the knowledge of unexplored aspects of flower structure and function and highlight likely threats to successful plant reproduction in a warmer and drier world.

A bitter future for coffee production? Physiological traits associated with yield reveal high vulnerability to hydraulic failure in Coffea canephora.

The increase in frequency and intensity of drought events have hampered coffee production in the already threatened Amazon region, yet little is known about key aspects underlying the variability in yield potential across genotypes, nor to what extent higher productivity is linked to reduced drought tolerance. Here we explored how variations in morphoanatomical and physiological leaf traits can explain differences in yield and vulnerability to embolism in 11 Coffea canephora genotypes cultivated in the Western Amazon. The remarkable variation in coffee yield across genotypes was tightly related to differences in their carbon assimilation and water transport capacities, revealing a diffusive limitation to photosynthesis linked by hydraulic constraints. Although a clear trade-off between water transport efficiency and safety was not detected, all the studied genotypes operated in a narrow and/or negative hydraulic safety margin, suggesting a high vulnerability to leaf hydraulic failure (HF), especially on the most productive genotypes. Modelling exercises revealed that variations in HF across genotypes were mainly associated with differences in leaf water vapour leakage when stomata are closed, reflecting contrasting growth strategies. Overall, our results provide a new perspective on the challenges of sustaining coffee production in the Amazon region under a drier and warmer climate.

Metabolic shifts during fruit development in pungent and non-pungent peppers.

Fruit pungency is caused by the accumulation of capsaicinoids, secondary metabolites whose relation to primary metabolism remains unclear. We have selected ten geographically diverse accessions of Capsicum chinense Jacq with different pungency levels. A detailed metabolic profile was conducted in the fruit placenta and pericarp at 20, 45, and 60 days after anthesis aiming at increasing our understanding of the metabolic changes in these tissues across fruit development and their potential connection to capsaicin metabolism. Overall, despite the variation in fruit pungency among the ten accessions, the composition and metabolite levels in both placenta and pericarp were uniformly stable across accessions. Most of the metabolite variability occurred between the fruit developmental stages rather than among the accessions. Interestingly, different metabolite adjustments in the placenta were observed among pungent and non-pungent accessions, which seem to be related to differences in the genetic background. Furthermore, we observed high coordination between metabolites and capsaicin production in C. chinense fruits, suggesting that pungency in placenta is adjusted with primary metabolism.

Acclimation of hydraulic and morphological traits to water deficit delays hydraulic failure during simulated drought in poplar.

The capacity of trees to tolerate and survive increasing drought conditions in situ will depend in part on their ability to acclimate (via phenotypic plasticity) key hydraulic and morphological traits that increase drought tolerance and delay the onset of drought-induced hydraulic failure. However, the effect of water-deficit acclimation in key traits that determine time to hydraulic failure (THF) during extreme drought remains largely untested. We measured key hydraulic and morphological traits in saplings of a hybrid poplar grown under well-watered and water-limited conditions. The time for plants to dry-down to critical levels of water stress (90% loss of stem hydraulic conductance), as well as the relative contribution of drought acclimation in each trait to THF, was simulated using a soil-plant hydraulic model (SurEau). Compared with controls, water-limited plants exhibited significantly lower stem hydraulic vulnerability (P50stem), stomatal conductance and total canopy leaf area (LA). Taken together, adjustments in these and other traits resulted in longer modelled THF in water-limited (~160 h) compared with well-watered plants (~50 h), representing an increase of more than 200%. Sensitivity analysis revealed that adjustment in P50stem and LA contributed the most to longer THF in water-limited plants. We observed a high degree of trait plasticity in poplar saplings in response to water-deficit growth conditions, with decreases in stem hydraulic vulnerability and leaf area playing a key role in delaying the onset of hydraulic failure during a simulated drought event. These findings suggest that understanding the capacity of plants to acclimate to antecedent growth conditions will enable better predictions of plant survivorship during future drought.

Where do leaf water leaks come from? Trade-offs underlying the variability in minimum conductance across tropical savanna species with contrasting growth strategies.

Plants continue to lose water from their leaves even after complete stomatal closure. Although this minimum conductance (gleaf-res ) has substantial impacts on strategies of water use and conservation, little is known about the potential drivers underlying the variability of this trait across species. We thus untangled the relative contribution of water leaks from the cuticle and stomata in order to investigate how the variability in leaf morphological and anatomical traits is related to the variation in gleaf-res and carbon assimilation capacity across 30 diverse species from the Brazilian Cerrado. In addition to cuticle permeance, water leaks from stomata had a significant impact on gleaf-res . The differential pattern of stomata distribution in the epidermis was a key factor driving this variation, suggesting the existence of a trade-off between carbon assimilation and water loss through gleaf-res . For instance, higher gleaf-res , observed in fast-growing species, was associated with the investment in small and numerous stomata, which allowed higher carbon assimilation rates but also increased water leaks, with negative impacts on leaf survival under drought. Variation in cuticle structural properties was not linked to gleaf-res . Our results therefore suggest the existence of a trade-off between carbon assimilation efficiency and dehydration tolerance at foliar level.

Homicídios femininos no estado do Rio Grande do Norte e suas regiões de saúde no período de 2000 a 2016 / Female homicides in the state of Rio Grande do Norte and its health regions between 2000 and 2016

Resumo Introdução Os homicídios femininos apresentam elevada magnitude e transcendência no Nordeste brasileiro. Objetivo Analisar a evolução temporal da mortalidade por homicídio feminino no estado do Rio Grande do Norte (RN) e suas regiões de saúde nos anos 2000. Método Trata-se de um estudo ecológico que utilizou regressão binomial negativa para a análise de tendência. Resultados A taxa de mortalidade média no período foi de 5,08 óbitos por 100.000 mulheres, com as maiores taxas observadas na Região Metropolitana (5,92 óbitos) e Mossoró (5,60 óbitos). A maior proporção de óbitos ocorreu em solteiras, perpetrados por arma de fogo e localizados no domicílio. Verificou-se uma tendência de aumento da mortalidade em todas as faixas etárias até os 49 anos e na Região Metropolitana de João Câmara. Também se constatou tendência de alta na taxa de mortalidade por homicídios por arma de fogo em todas as regiões de saúde, exceto Caicó e Pau dos Ferros, onde houve estacionariedade nas taxas. Conclusão O estado do Rio Grande do Norte e suas regiões de saúde apresentam taxas de homicídios femininos semelhantes aos países com maior violência contra as mulheres, indicando a necessidade de maiores investimentos na rede de proteção à mulher em situação de violência doméstica.

Abstract Background Female homicides present high magnitude and transcendence in the Northeast region of Brazil. Objective To analyze the temporal evolution of mortality due to female homicide in the state of Rio Grande do Norte and its health regions between 2000 and 2016. Method Ecological study using negative binomial regression for trend analysis. Results The average mortality rate for the period analyzed was 5.08 deaths per 100,000 women, with the highest rates observed in the metropolitan region (5.92) and in the municipality of Mossoró (5.60). Most of the deaths were of unmarried women, with the use of firearms, and occurred at home. There was an upward trend in mortality in all age groups up to age 49 and in the metropolitan region of João Câmara. An upward trend was also observed in the mortality rate of firearm homicides in all health regions of the state, except for Caicó and Pau dos Ferros, where these rates showed a stationary trend. Conclusion The state of Rio Grande do Norte and its health regions show female homicide rates similar to those of countries with the greatest violence against women, indicating the need for greater investments in the protection network for women in situations of domestic violence.

Self-reported adherence among people with epilepsy in Brazil.

BACKGROUND: Nonadherence rates among people with epilepsy (PWE) are widely variable, ranging from 26% to 95.4%. We aimed to identify nonadherence in Brazil, its determinant factors, its impact on patients' management, and to compare it with other chronic nonparoxysmal diseases. METHODS: A multicenter observational case-control study was conducted between March 2015 and October 2016, and 153 subjects were included. Subjects' clinical-epidemiological data were surveyed with the Morisky-Green test (MGT), Brief Medication Questionnaire (BMQ), and the Liverpool adverse events profile (LAEP). RESULTS: One hundred three PWE and 50 controls with other, nonparoxysmal chronic conditions were interviewed; both groups were matched according to age and socioeducational level. People with epilepsy were aged 36.4 ±â€¯13.9 (range 18-67), 55% were women, mean age at epilepsy onset was 18.1 ±â€¯15.5 years, 51.5% had pharmacoresistant epilepsy, and 48.5% were on monotherapy. 74.8% of patients and 70.0% controls were nonadherent to treatment according to MGT (p = 0.58); and barrier of recall (BMQ) was associated with nonadherence in 78% of PWE and 76% of controls (p = 0.84). Binary logistic regression analysis revealed LAEP (OR 1.05; 95%CI = 1.01-1.09; p = 0.03) and self-reported frequency of forgetfulness on the last three months (OR 19.13; 95%CI = 2.40-152.28; p < 0.01) as the main factors associated with nonadherence. Nonadherent subjects did not have more seizures and did not need emergency treatment more often than adherent ones. CONCLUSION: Three of four PWE were not fully adherent to their treatment. Adherence assessment should be routine in all outpatient visits as well as interventions aimed to improving it. Adverse events are important predictors of adherence, and they should be considered when choosing the initial treatment of epilepsy.

Different ways to die in a changing world: Consequences of climate change for tree species performance and survival through an ecophysiological perspective.

Anthropogenic activities such as uncontrolled deforestation and increasing greenhouse gas emissions are responsible for triggering a series of environmental imbalances that affect the Earth's complex climate dynamics. As a consequence of these changes, several climate models forecast an intensification of extreme weather events over the upcoming decades, including heat waves and increasingly severe drought and flood episodes. The occurrence of such extreme weather will prompt profound changes in several plant communities, resulting in massive forest dieback events that can trigger a massive loss of biodiversity in several biomes worldwide. Despite the gravity of the situation, our knowledge regarding how extreme weather events can undermine the performance, survival, and distribution of forest species remains very fragmented. Therefore, the present review aimed to provide a broad and integrated perspective of the main biochemical, physiological, and morpho-anatomical disorders that may compromise the performance and survival of forest species exposed to climate change factors, particularly drought, flooding, and global warming. In addition, we also discuss the controversial effects of high CO2 concentrations in enhancing plant growth and reducing the deleterious effects of some extreme climatic events. We conclude with a discussion about the possible effects that the factors associated with the climate change might have on species distribution and forest composition.

Conhecimentos da equipe de enfermagem no cuidado intensivo a pacientes em hemodiálise / Knowledge of the nursing team in the intensive care to patients on hemodialysis / Conocimiento del equipo de enfermería en los cuidados intensivos para pacientes en hemodiálisis

Objetivo: descrever os conhecimentos da equipe de enfermagem acerca dos cuidados intensivos a pacientes em tratamento hemodialítico. Método: estudo descritivo e com abordagem qualitativa, realizada por meio de entrevista semiestruturada com 11 profissionais da equipe de enfermagem de uma unidade de terapia intensiva geral, em município do estado de Mato Grosso, no ano de 2016. De acordo com a análise de conteúdo de Bardin, emergiram três categorias: "aprendi com os colegas", "a hemodiálise é coisa séria" e "o conhecimento é para todos". Resultados: os profissionais de enfermagem reconhecem que os conhecimentos acerca dos cuidados aos pacientes em hemodiálise são limitados e foram adquiridos por intermédio de outros colegas. Conclusão: a equipe de enfermagem necessita de medidas educativas, como a educação permanente, para que possam organizar e prestar o cuidado aos pacientes em tratamento hemodialítico fundamentados em conhecimentos técnicos e científicos.(AU)

Objective: to describe the knowledge of the nursing team about the intensive care to patients on hemodialysis. Method: descriptive study with a qualitative approach, carried out by means of semi-structured interviews with 11 professionals from the nursing team in a general Intensive Care Unit, in a municipality of the state of Mato Grosso, in the year 2016. According to the content analysis of Bardin, three categories emerged: "I have learned with colleagues", "Hemodialysis is a serious thing" and "knowledge is for everyone". Results: the nursing professionals recognize that knowledge about the care to patients on hemodialysis is limited and acquired through other colleagues. Conclusion: the nursing team needs educational measures, such as permanent education, so that they can organize and provide care to patients on hemodialysis based on technical and scientific knowledge.(AU)

Objetivo: describir el conocimiento del equipo de enfermería acerca de los cuidados intensivos para pacientes en hemodiálisis. Método: estudio descriptivo y con abordaje cualitativo, realizado por medio de entrevistas semiestructuradas con 11 profesionales del equipo de enfermería en una unidad de cuidados intensivos generales, en el municipio del estado de Mato Grosso, en el año 2016. De acuerdo con el análisis del contenido de Bardin, emergieron tres categorías: "He aprendido con colegas", "La hemodiálisis es una cosa seria" y que "El conocimiento es para todos". Resultados: los profesionales de enfermería reconocen que los conocimientos acerca de los cuidados a los pacientes en hemodiálisis son limitados y fueron adquiridos por otros colegas. Conclusión: el personal de enfermería necesita de medidas educativas, como la educación permanente, a fin de que puedan organizar y prestar atención a los pacientes en hemodiálisis basado en conocimientos técnicos y científicos.(AU)

Complicações hemodialíticas na Unidade de Terapia Intensiva / Hemodialysis complications in the Intensive Care Unit

Objetivo: caracterizar o perfil sociodemográfico e identificar complicações em pacientes submetidos ao tratamento hemodialítico internados em Unidade de Terapia Intensiva. Método: trata-se de um estudo quantitativo, transversal e descritivo, realizado em Unidade de Terapia Intensiva. Constituiu-se a amostra por 78 prontuários de pacientes que realizaram hemodiálise no ano de 2016. Utilizou-se, para a coleta de dados, um formulário para a caracterização sociodemográfica e clínica. Realizou-se uma análise estatística descritiva, e apresentados em tabelas. Resultados: identificou-se o predomínio de homens, com idade igual ou superior a 60 anos e com diagnóstico inicial de doença renal crônica. Apontou-se que, em 255 sessões de hemodiálise realizadas, as principais complicações foram: hipotensão arterial ­ 94 (36,86%), hipertensão arterial ­ 47(19,10%), arritimias cardíacas ­ 34(13,82%) e coágulos no filtro ou sistema ­ 34 (13,82%). Conclusão: evidenciou-se a necessidade de medidas educativas no intuito de qualificar a tomada de decisão da equipe de Enfermagem e, consequentemente, reduzir as complicações intradialíticas.(AU)

A Structure Shaped by Fire, but Also Water: Ecological Consequences of the Variability in Bark Properties Across 31 Species From the Brazilian Cerrado.

Bark is a structure involved in multiple physiological functions, but which has been traditionally associated with protection against fire. Thus, little is known about how the morpho-anatomical variations of this structure are related to different ecological pressures, especially in tropical savanna species, which are commonly subjected to frequent fire and drought events. Here we evaluated how the structural and functional variations of bark are related to the processes of resilience and resistance to fire, as well as transport and storage of water in 31 native species from the Brazilian Cerrado. Because of their thick bark, none of the trees analyzed were top-killed after a severe fire event. The structural and functional variations of the bark were also associated with water storage and transport, functions related to properties of the inner bark. In fact, species with a thicker and less dense inner bark were the ones that had the highest water contents in the wood, bark, and leaves. Lower bark density was also related to higher stem hydraulic conductivity, carbon assimilation, and growth. Overall, we provide strong evidence that in addition to protection from fire, the relative investment in bark also reflects different strategies of water use and conservation among many Cerrado tree species.

Evidências científicas da alimentação na prevenção e tratamento das doenças cardiovasculares: revisão integrativa / Scientific evidence of feeding in the prevention and treatment of cardiovascular diseases: an integrative review / Evidencias científicas de la alimentación en la prevención y tratamiento de las enfermedades cardiovasculares: revisón integrativa

Diferentes padrões dietéticos modulam múltiplos aspectos do processo aterosclerótico, como níveis lipídicos, resistência à insulina, metabolismo glicídico, pressão arterial, fenômenos oxidativos, função endotelial e inflamação vascular, o que consequentemente interfere na prevalência de eventos cardiovasculares. Este estudo investiga as evidências disponíveis na literatura sobre a alimentação na prevenção e tratamento das doenças cardiovasculares. Trata-se de uma revisão integrativa. A coleta de dados foi realizada no período de abril a junho de 2018 nas bases de dados: Lilacs, Medline, PubMed, Cinahl e Capes. Obteve-se uma amostra de 12 artigos. Os padrões alimentares mais bem estudados foram a Dieta mediterrânea (MedDiet) e a Abordagem dietética para parar a hipertensão (DASH). A MedDiet e a DASH reduzem a pressão arterial, os níveis de lipoproteína de alta densidade e colesterol total, a glicemia e o ganho de peso a longo prazo, retardando a progressão subclínica da aterosclerose, associada ao menor risco de eventos clínicos. As evidências mostram que a relação da alimentação na prevenção e tratamento das doenças cardiovasculares está cada vez mais elucidada. A utilização dessas dietas traz benefícios satisfatórios para a saúde cardiovascular.

Various dietary patterns modulate many aspects of the atherosclerotic process, such as lipid levels, insulin resistance, glucose metabolism, blood pressure, oxidative phenomena, endothelial function and vascular inflammation, which consequently interferes with the prevalence of cardiovascular events. Thus, this integrative review involved the available evidence in the literature on nutrition concerning the prevention and treatment of cardiovascular diseases. Data collection happened between April and June 2018 in the following databases: Lilacs, Medline, PubMed, Cinahl and Capes. Obtained a sample of 12 articles. Food standards best studied are the Mediterranean diet (MedDiet) and Dietary Approach to stop hypertension (DASH). MedDiet and DASH reduce blood pressure, levels of high-density lipoprotein and total cholesterol, blood glucose and weight gain in the long term, slowing the progression of Subclinical Atherosclerosis, and they are associated with the lowest risk of clinical events. The evidence shows that the role of nutrition in the prevention and treatment of cardiovascular disease is increasingly understood. The use of these diets bring satisfactory benefits for cardiovascular health.

En diversos patrones dietéticos se modulan muchos aspectos del proceso aterosclerótico, tales como los niveles de lípidos, resistencia a la insulina, metabolismo de la glucosa, presión arterial, fenómenos oxidativos, función endotelial e inflamación vascular, lo que interfiere en la prevalencia de eventos cardiovasculares. El presente estudio objetivó investigar las evidencias disponibles en la literatura sobre la alimentación para la prevención y tratamiento de las enfermedades cardiovasculares. Es una revisión integrativa. Los datos se recolectaron en el período entre abril y junio de 2018, en las bases de datos: Lilacs, Medline, PubMed, Cinahl y Capes. Se obtuvo una muestra de 12 artículos. Las normas alimentarias mejor estudiadas fueron la dieta mediterránea (MedDiet) y el enfoque dietético para evitar la hipertensión (DASH). La MedDiet y el DASH reducen la presión arterial, los niveles de lipoproteína de alta densidad y colesterol total, la glucosa en la sangre y el aumento de peso a largo plazo, frena la progresión de aterosclerosis subclínica asociada con el menor riesgo de eventos clínicos. Las evidencias muestran que la relación de la alimentación para la prevención y tratamiento de enfermedades cardiovasculares es cada vez más difundida. El uso de estas dietas aporta beneficios satisfactorios para la salud cardiovascular.

Photosynthesis impairments and excitation energy dissipation on wheat plants supplied with silicon and infected with Pyricularia oryzae.

Considering the effect of silicon (Si) in reducing the blast symptoms on wheat in a scenario where the losses in the photosynthetic capacity of the infected plants is lowered, this study investigated the ability of using the incident light, the chloroplastidic pigments (chlorophylls and carotenoids) alterations and the possible role of carotenoids on the process of light dissipation on wheat plants non-supplied (-Si) or supplied (+Si) with Si and inoculated or not with Pyricularia oryzae. For + Si plants, blast severity was reduced compared to -Si plants. Reductions in the concentration of photosynthetic pigments (total chlorophyll, violanxanthin + antheraxanthin + zeaxanthin, ß-carotene and lutein) were greater for inoculated -Si plants than for inoculated + Si ones. The α-carotene concentration increased for inoculated -Si and +Si plants in comparison to non-inoculated plants limiting, therefore, lutein production. Higher functional damage to the photosystem II (PSII) was noticed for inoculated -Si plants with reductions in the values of maximum quantum quenching, photochemical yield of PSII and electron transport rate, but higher values for quenching non-photochemical. This finding also contributed to reductions in the values of light saturated rate photosynthesis and light saturation point for -Si plants which was attenuated for inoculated + Si plants. Increase in dark respiration values occurred for inoculated plants than for non-inoculated ones. The Si supply to wheat plants, besides reducing blast severity, contributed to their better photosynthetic performance. Moreover, inoculated + Si plants coped with drastic losses of light energy dissipation processes (fluorescence and heat) by increasing the concentration of carotenoids which helped to maintain the structural and functional viability of the photosynthetic machinery minimizing, therefore, lipid peroxidation and the production of reactive oxygen species.

Avaliação da política de atenção integral à saúde do homem / Evaluation of the policy of integral attention the men's health

Objetivo: Avaliar a Política de Atenção Integral a Saúde do Homem no município de São Luís–Maranhão. Metodologia: Amostra constituída por 10 (dez) enfermeiros coordenadores dos distritos Cohab, Bequimão e Centro. Coleta de dados realizada em março de 2013, dias e horários pré-definidos por conveniência. Resultados: A maioria das unidades de saúde não executa a política de atenção integral a saúde do homem. Os fatores sociais e culturais relacionados a organização do serviço dificultam o acesso do homem ao serviço de saúde de natureza preventiva, destacando-se questões de gênero, como a concepção de invulnerabilidade,a vergonha e o medo de descobrir uma doença incapacitante. As barreiras estão relacionadas ao horário de funcionamento das unidades, número de profissionais insuficientes, redução de ações educativas e ausência de capacitação dos profissionais de saúde. Conclusão: A organização, execução e utilização dos serviços de saúde para o homem não parecem adequados. É de fundamental importância que a política de saúde esteja pactuando com a Política Nacional de Atenção Básica, visto que as unidades básicas de saúde configuram-se como porta de entrada do homem ao sistema de saúde, um novo modelo proposto de atenção à saúde.

Objective: to evaluate the policy of Integral attention to health in São Luis-Maranhão. Methods: the sample consisted of 10 (ten) nurses district coordinators Cohab, Bequimão and Center. Data collection in March 2013, pre-established days and times for convenience. Results: the majority of health units performs the policy of integral attention to health. Social and cultural factors related to organization of the service make it difficult to access health service preventive in nature, with emphasis on gender issues, such as the design of invulnerability, the shame and the fear of discovering a crippling disease. The barriers are related to the hours of operation of the units, number of insufficient professionals, educational activities and lack of training of health professionals. Conclusion: the Organization, execution and utilization of health services for the man doesn't seem appropriate. Is of fundamental importance that health policy is agreed with the National Policy of the basic attention, since the basic health units configured as the gateway of man health system, a new proposed model for health care.

Perfil clínico-epidemiológico dos pacientes tratados com mielomeningocele em um hospital universitário de Curitiba / Clinical and epidemiological profile of patients treated with myelomeningocele at a university hospital in Curitiba

Objetivo: O objetivo deste trabalho é traçar o perfil clínico-epidemiológico dos recém-nascidos portadores de mielomeningocele tratados no serviço de neurocirurgia do Hospital Universitário Evangélico de Curitiba (HUEC) e comparar esses dados com a literatura. Método: Foram revistos os prontuários e descrições de cirurgia de todos os pacientes operados para tratamento de mielomeningocele no período de janeiro de 2007 a junho de 2012, compondo uma amostra de 26 pacientes. Resultados: Os pacientes estudados foram predominantemente do sexo masculino, com lesão ao nível da região lombar. Em 21 pacientes evidenciou-se a presença de hidrocefalia, e outras quatro crianças apresentaram outras malformações do sistema nervoso central. A maioria dos pacientes apresentou bexiga neurogênica, e outros nove recém-nascidos tiveram anormalidades ortopédicas. Conclusão: A mielomeningocele é um evento que cursa com alta morbidade principalmente devido às complicações neurológicas, urológicas, ortopédicas, entre outras, assim é de suma importância tanto estimular a prevenção quanto realizar o diagnóstico e tratamento de forma mais precoce possível.

Objective: The aim of this paper is to map the clinical and epidemiological profile of the newborn with myelomeningocele treated in the neurosurgery service of the Hospital Universitário Evangélico of Curitiba (HUEC) and compare this data with the literature. Method: We reviewed the hospital files, surgical and out-patient notes of all patients operated on for the treatment of myelomeningocele from January 2007 to June 2012, composing a sample of 26 patients. Results: The patients studied were predominantly male with an injury in the lumbar region. In 21 patients revealed the presence of hydrocephalus, and other four children had other malformations of the central nervous system. Most patients had neurogenic bladder, and other nine neonates had orthopedic abnormalities. Conclusion: Myelomeningocele is an event that leads to high morbidity mainly due to neurological, urological, orthopedic and others, so it is of paramount importance both to stimulate the prevention and perform the diagnosis and treatment as early as possible.

Gliomas multiplos: relato de caso e revisão de literatura / Multiples gliomas: case report and literature review

A melhoria no diagnóstico por imagem, aumento da expectativa de vida e métodos diagnósticos menos invasivos como a biópsia estereotática tornaram possíveis um maior número de diagnósticos definitivo de lesões múltiplas cerebrais. Acreditase que o número crescente de gliomas múltiplos (GsMs) registrados seja decorrente de uma melhor investigação diagnóstica ao invés de um aumento no seu número absoluto por qualquer outro motivo. Diagnósticos presuntivos muito utilizados em relação a lesões múltiplas cerebrais em um passado recente,não encontram mais lugar na neurocirurgia atual. A descrição deste caso, bem como a revisão literária, objetiva ao neurocirurgião ter em mente o diagnóstico de GsMs, pois, apresentam características clínicas e radiológicas semelhantes a patologias benignas de excelente prognóstico bem como lesões expansivas também de prognóstico reservado, mas que exigem manejo diferente por parte do médico assistente.

Traumatismo de crânio por ferimento por arma de fogo: perfil epidemiológico em um hospital de referência de Curitiba e revisão de literatura / Firegun head injuries: epidemiological profile fron a referential university hospital of Curitiba and literature review

Objetivo: verificar dados epidemiológicos de ferimentos por projétil de arma de fogo (FPAF) no período de junho de 2007a agosto de 2008 em hospital referência em trauma, bem como revisão de literatura. Métodos: realizado estudo retrospectivo com ênfase nas variáveis sexo, idade, dia de semana do evento,escala de coma de Glasgow à admissão, trajetória do projétil e evolução do paciente pós injúria por FPAF em crânio ,conforme ficha padronizada pelo serviço de neurocirurgia do referido hospital. Resultados: foram computados 33 casos. Três excluídos, pois, embora em região cefálica, não adentraram cavidade intracraniana. Idade média de acometimento foi de28,75 anos; predomínio do sexo masculino (73,33%); 50%dos casos foram admitidos em Glasgow <6; 60% evoluíram ao óbito; orifício de entrada presente em quadrante anterior direito em 30% dos casos, com porcentagem idêntica em quadrante posterior direito; 30% ocorreram na segunda feira,seguidos de 23,33% no domingo. Conclusão: os dados obtidos neste estudo corroboram literatura mundial. Glasgow abaixo de 6 à admissão e envolvimento ventricular ou multilobar traduzem mau prognóstico. População jovem masculina vitimada durante o final de semana compatível com relatos encontrados em revisão literária.

Céfalo-hematoma subperiosteal gigante ossificado na infância / Ossified giant subperiosteal cephalhematoma in childhood

Hematoma subperiosteal ou céfalo-hematoma, apesar de condição conhecida em neonatos, é rara em adultos e mesmo em crianças maiores, o que levanta a suspeita de uma diferente patogênese entre as duas situações. A cronificação e a ossificação do céfalo-hematoma são condições extremamente infrequentes, com escasso material bibliográfico, e sua presença no adulto é fato inusitado na literatura. Reportamos o caso de um hematoma subperiosteal crônico de grandes proporções, ossificado, com um ano de evolução, tratado cirurgicamente, em um menino de 12 anos de idade com síndrome epiléptica e déficit cognitivo prévios. A revisão e a discussão de sua patogênese e seu tratamento foram realizadas para exposição da condição.

Subperiosteal hematoma or cephalhematoma is a well known condition on newborns, but rare in adults and older children, what may lead to a different pathogenic origin. Chronic or ossificated cephalhematoma are infrequent, with few reports in medical literature. There are no cases reported in adults. It is presented a case of a 12 year-old boy, with previous epileptic syndrome and cognitive deficit, who was admitted because of a large chronic ossified subperiosteal hematoma. It was removed surgically. Revision and discussion of its pathogenesis were prepared for the case presentation.

Teste de tuberculinização em caprinos (Capra hircus) experimentalmente sensibilizados / Tuberculin test in experimentally sensitized goats (Capra hircus)

Foram estabelecidos critérios de interpretação do teste de tuberculinização aplicado ao diagnóstico da tuberculose em grupos de caprinos experimentalmente sensibilizados. Dos 30 animais utilizados, dez foram sensibilizados com Mycobacterium avium - amostra D4 (grupo A) e dez com Mycobacterium bovis - amostra AN5 (grupo B). Dez caprinos não foram sensibilizados e constituíram o grupo controle (grupo C). No teste cervical simples, realizado com tuberculina bovina (M. bovis) e lido às 72 horas pós-tuberculinização (p.t.), as reações positivas foram aquelas em que houve aumento da espessura da dobra de pele igual ou superior a 3,9mm; reações inconclusivas, quando situadas entre 1,8 e 3,8mm, e negativas quando iguais ou menores que 1,7mm. A análise dos resultados do teste cervical comparativo, realizado com o M. avium e M. bovis e lido às 72 horas p.t., indicou reação positiva quando o aumento da espessura da dobra da pele induzida pela tuberculina bovina superou a reação à aviária em pelo menos 2,5mm; reação inconclusiva quando a diferença entre a reação à tuberculina bovina e à tuberculina aviária ficou situada entre 1,9 e 2,4mm; e negativa quando a reação bovina ultrapassou a aviária em até 1,8mm. As 96 horas após a injeção da tuberculina, foi efetuada a avaliação histológica do local das reações tuberculínicas colhendo-se amostras de pele de cinco caprinos dos grupos A e B e de quatro animais do grupo controle; os resultados confirmaram a presença, nos grupos sensibilizados, de infiltrado inflamatório, constituído, preferencialmente, por células mononucleares.

The tuberculin skin test was established with the aim to be applied in the diagnosis of tuberculosis in experimentally sensitized goats. Thirty goats were alocated into three groups with ten animals each. The animals in group A were sensitized with Mycobacterium avium sample D4; group B with Mycobacterium bovis sample AN5; and group C (control) was inoculated with saline solution. The results of the simple cervical test after 72h of bovine tuberculin inoculation was interpreted as follow: positive reaction, when there was an increase in the skin fold thickness greater than 3.9mm; suspicious, when from 1.8 to 3.8mm; and negative when less than 1.7mm. The analysis of the results of the comparative cervical test between M. avium and M. bovis and analysed, 72h after tuberculin, indicated positive reactions, when the increase in skin fold thickness induced by M. bovis was greater than that one induced by the avian tuberculin at least 2.5mm; it was considered suspicious when the difference between the bovine and avian tuberculin reactions was from 1.9 to 2.4mm; and negative when this difference was smaller than 1.8mm. The histological evaluation of the local specific tuberculin response, were performed in skin samples collected from five goats in group A, five in group B, and four in group C, the results were the presence of mononuclear inflammatory infiltrate at 96h after tuberculin inoculation.

Efeito da refrigeração sobre o exame hemogasométrico em sangue venoso de ovinos / Effect of refrigeration on the hemogasometric examination of venous blood in sheep

Com o propósito de avaliar o efeito da refrigeração sobre o exame hemogasométrico, foram utilizados 12 ovinos machos, hígidos, da raça Santa Inês, com cerca de quatro meses de idade e peso variando entre 30 e 45 kg. As amostras de sangue destinadas ao exame hemogasométrico foram coletadas em duplicata utilizando-se agulhas descartáveis acopladas à seringas plásticas contendo cerca de 1000UI de heparina sódica. Durante e após a coleta tomou-se o cuidado de evitar a entrada de bolhas de ar no interior da seringa. As amostras não conservadas foram mantidas a temperatura ambiente, entre 23 e 25°C, e aquelas destinadas à refrigeração foram acondicionadas em isopor contendo 3kg de água gelada e 3kg de gelo, mantendo-se assim uma temperatura entre 0 e 4° C. As análises hemogasométricas foram determinadas imediatamente após coleta e com 1, 2, 3, 4, 5, 6, 8, 10, 12 e 24 horas. As análises dos resultados indicaram alterações significativas nas amostras mantidas a temperatura ambiente, caracterizado-se por diminuições, a partir da 4, 8 e 10 horas após coleta, para os valores do pH, BE e StB, respectivamente, e por aumento, a partir da 6 hora, para os valores da PCO(2 subscrito).Com relação as amostras conservadas, não foram evidenciadas variações significativas dos parâmetros ao longo dos tempos de análise. Conclui-se, portanto, que amostras de sangue venoso de ovinos são viáveis, para a realização do exame hemogasométrico, até 24 horas após coleta, desde que mantidas sob adequada refrigeração.

With the objective of evaluating the effect of refrigeration on the hemogasometric exam, venous blood samples were collected from 12 healthy male sheep, Santa Ines breed, with a mean age of 4 months old, and body weight raging from 30 to 45 kg. The blood samples for the hemogasometric examination were collected in two aliquots from each animal, using dispensable needles connected to plastic syringes containing about 1000 IU sodium heparin. During and after the sampling, the care of avoiding the presence of air bubbles in the syringe was attempted. The samples without conservation were kept at room temperature, between 23 an 25°C, and the samples under refrigeration were kept in an box containing 3 L of cold water and 3Kg of ice, to maintain a temperature between 0 and 4°C. The hemogasometric analyses were made immediate1y after collection an after 1, 2, 3, 4, 5, 6, 8, 10, 12 and 24 hours. The results indicated significant alteration in samples kept at room temperature, characterized by decline, starting at 4, 8 and 10 hour post-collection, of the values f pH, BE and StB, respectivelly, and by a raise, since the 6th hour, of the values of PCO(2subscript). No significant variations of the parameters were seen in the refrigerated samples during the study. So, the conclusion is that ovine venous blood samples are viable, for the determination of the hemogasometric evaluation, until 24 hours after the collection, when kept (maintained) under adequate refrigeration.