Retinol status and associated factors in mother-newborn pairs.

BACKGROUND: Vitamin A deficiency is still considered to be a nutritional problem during pregnancy, lactation and early childhood. The present study aimed to assess the vitamin A status of women and their newborns in the Brazilian Northeast and to determine the association between retinol in the maternal serum, umbilical cord blood and colostrum. METHODS: Vitamin A status in 65 pairs of women and newborns was assessed from samples of the mother's serum, umbilical cord serum and colostrum using high-performance liquid chromatography. The inadequacy of the vitamin A status of mothers and infants was identified if the retinol values were <0.7 µmol L- 1 in maternal serum or umbilical cord blood or <1.05 µmol L-1 in colostrum. RESULTS: The prevalence of inadequate maternal vitamin A status was 21.5% (95% CI: 11.5%-31.5%) and 13.8% [95% confidence interval (CI) = 5.4%-22.2%] based on maternal serum and colostrum, respectively. Among newborns, 41.5% (95% CI = 29.3%-53.5%) presented a low status of vitamin A based on cord serum. Multiple linear regression analysis identified that maternal serum retinol is a predictor of umbilical cord retinol (P = 0.005). Retinol in maternal serum was lower in mothers who were less educated (P = 0.04) and colostrum retinol was higher in older (P = 0.04) and multiparous (P = 0.002) mothers. CONCLUSIONS: Vitamin A deficiency is a common problem among mothers attended in public hospitals in Northeast Brazil and maternal retinol concentrations are associated with retinol status in newborns. Maternal age, parity and educational level were related to the maternal vitamin A status.

Laparoscopic pediatric pyeloplasty using the Flexdex® articulating needle driver: step-by-step video.

Ureteropelvic junction (UPJ) stenosis is the most common cause of pathological neonatal hydronephrosis. UPJ obstruction may be treated conservatively in some cases, but surgery is indicated if symptoms occur or renal function deteriorates. Pyeloplasty is the procedure of choice for UPJ stenosis. Pyeloplasty can be performed by open laparoscopic or robotic technique. The laparoscopic technique is safe and may be associated with shorter length of hospital stay and reduced complications. Lately, robotic pyeloplasty has been performed with similar results, adding the benefits of easier suturing maneuverability, but with increased costs. Flexdex® is a laparoscopic articulating needle driver that improves maneuverability and ergonomics. In this video, a laparoscopic pyeloplasty with the Flexdex® needle drive is described. The case was treated without any intraoperative complications and with no significant blood loss, and the patient was discharged the day after the procedure. After 90 days of follow-up, there were no complications reported.

Application and stability of cathodes with manganese dioxide nanoflowers supported on Vulcan by Fenton systems for the degradation of RB5 azo dye.

This work describes the electrochemical degradation of Reactive Black 5 (RB5) by two methods: electrochemical and photo-assisted electrochemical degradation with and without a Fenton reagent. Two anodes were used, Pt and boron-doped diamond (BDD, 2500 ppm), and the cathode was 3% MnO2 nanoflowers (NFMnO2) on a carbon gas diffusion electrode (GDE). An electrochemical cell without a divider with a GDE with 3% w/w NFMnO2/C supported on carbon Vulcan XC72 was used. The decolorization efficiency was monitored by UV-vis spectroscopy, and the degradation was monitored by Total Organic Carbon (TOC) analysis. For dissolution monitoring, aliquots (1 mL) were collected during the degradation. After 6 h of H2O2 electrogeneration, the manganese concentration in the RB5 solution was only 23.1 ±â€¯1.2 µg L-1. It was estimated that approximately 60 µg L-1 (<0.2%) of manganese migrated from the GDE to the solution after 12 h of electrolysis, which indicated the good stability of the GDE. The photoelectro-Fenton-BDD (PEF-BDD) processes showed both the best color removal percentage (∼93%) and 91% of mineralization. The 3% NFMnO2/C GDE is promising for RB5 degradation.

Effect of RRR-α-tocopherol supplementation on serum of breastfeeding women up to 60 days after delivery: a randomised controlled trial.

BACKGROUND: Maternal supplementation is a viable strategy to combat vitamin E deficiency in newborns, although a protocol for maternal vitamin E supplementation has not been defined. The present study assessed the effect of maternal supplementation in a single dose on the serum of postpartum women up to 60 days after delivery. METHODOLOGY: Fifty healthy breastfeeding women were recruited at two maternity hospitals both located in Natal, RN, Brazil. The participants were randomly allocated to a control group and a treatment group in a 1 : 1 ratio. Serum was collected 1, 20, 30 and 60 days after delivery. Immediately after the first collection, the treatment group received a single dose of 400 IU of RRR-α-tocopherol. α-Tocopherol was quantified by high-performance liquid chromatography. The usual dietary vitamin E intake was determined using four 24-h recalls, and intake adequacy was assessed based on the estimated average requirements for lactating women (16 mg day-1 ). RESULTS: The mean dietary vitamin E intakes of the both groups were similar (P > 0.05) and inadequate. The serum levels of α-tocopherol assessed at 1, 20, 30 and 60 days indicated adequate vitamin E status in both the control group (1194.6, 907.7, 910 and 748.6 µg dL-1 , respectively) and treatment group (1183.7, 956.0, 935.9 and 766.4 µg dL-1 , respectively). The comparison at each day showed no difference between treatments (P > 0.05). CONCLUSIONS: A single vitamin E supplement did not change the mean serum level of α-tocopherol in breastfeeding women; thus, it does not improve their vitamin E status in the first 60 days after delivery.

Association Between Dyspnea and Severity of Liver Disease in Patients in the Pre-transplantation Period-A Pilot Study.

BACKGROUND: Liver transplantation is indicated at the end stage of chronic liver failure, and severity of disease will determine the precocity of this happening. At this stage, the presence of chronic dyspnea is one of several manifestations of progression of the disease, which leads the patient to inactivity. A rehabilitation program can positively influence the evolution of liver transplant recipients. The objective of this study was to establish an association between the perception of dyspnea and the severity of liver disease in patients at a single center of a Brazilian liver pre-transplantation clinic. METHODS: Measurements were performed at a liver pre-transplantation clinic. The severity of liver disease was assessed with the use of the Model for End-Stage Liver Disease (MELD) score, and dyspnea was assessed with the use of a modified Medical Research Council scale of dyspnea (mMRC). RESULTS: Men had a higher prevalence of viral hepatitis. Dyspnea was reported only during intense exercise. Duration of disease and MELD score showed medians of 49 months and 20, respectively. CONCLUSIONS: We found no correlation between mMRC and the MELD score. In addition, no correlation was found between duration of disease and MELD score or mMRC.

Tumour cell and stromal features in metastatic and non-metastatic non-small cell lung carcinomas.

AIMS: Tumour cell behaviour depends on the interactions between nuclear genetic changes in the malignant cells and a stroma favourable for growth, invasion and metastasis. To evaluate such interactions, we studied the relationship between tumour cell and stromal features for proliferative factors, p53, microvessel density and metalloproteinases, controlled for the extent of the primary lesion (T1 to T4), in early (non-metastatic) and late (metastatic) non-small cell lung carcinomas (NSCLC). METHODS AND RESULTS: Variables were examined for differences and correlations in the frequency of p53, AgNOR, CD34 and MMP-9 expression in primary lesions and metastases of NSCLC using a general linear model. The patients included 58 males and 22 females (mean age 62 +/- 9 years) with 19 T1 (23.8%), 40 T2 (50.0%), 14 T3 (17.5%) and seven T4 (8.8%). In late disease, AgNOR and p53 were statistically related to the extent of the primary lesion, whereas in early disease AgNOR tended to be increased in tumours without metastasis, while p53 expression tended to decrease progressively in tumours with metastasis. Microvessel density in late disease was of no statistical significance, whereas in early disease strong CD34 expression was seen in tumours with metastasis, being at its maximum in T3 primary lesions. The best marker for the extent of the lesion and its progression was MMP-9, with greater expression by tumours with metastasis than those without. CONCLUSIONS: Different tumour cell and stromal interactions control metastasis and therefore the biological risk of NSCLC. A panel of molecular markers, such as p53, MMP-9 and CD34 could help to identify subgroups of patients that could benefit from adjuvant therapy.

[Facial paralysis. Neuro-muscular reconstruction techniques]. / Paralisia facial. Técnicas de reconstrução neuro-muscular.

Several surgical procedures have been proposed through the years for the treatment of facial paralysis. The multiplicity and diversity of techniques portray the complexity and challenge represented by this pathology. Two basic dynamic options are available: -Reconstruction of nerve continuity through direct micro suture, with interposition grafts or nerve transpositions. -Regional muscular transposition, most often using the temporalis. Facial reanimation with the temporalis transfer has withstood the test of time and still is a reference technique. In a few weeks, good results can be obtained with a single and rather simple surgical procedure. Functional free flaps have been used with increasing frequency in the last two decades, most often combining a cross-facial nerve graft followed by a gracilis free flap nine months later. With this method there is a potential for restoration of spontaneous facial mimetic function. Apparently there is a limit in microsurgical technique and expertise beyond which there is no clear improvement in nerve regeneration. Current research is now actively studying and identifying nerve growth factors and pharmacological agents that might have an important and complementary role in the near future.

[Fetal hydronephrosis: postnatal management and follow up]. / Hidronefrose fetal: abordagem pós-natal e seguimento.

OBJECTIVE: Fetal hydronephrosis is being detected with increasing frequency and probably this observation will increase as the quality of ultrasound equipment improves. This study evaluated etiology and postnatal clinical outcomes of prenatally detected hydronephrosis. METHODS: In a period of 13 years 148 infants were referred with fetal hydronephrosis. The initial evaluation, after prophylaxis, included ultrasound and voiding cystography. Sequential evaluation was determined by initial findings. RESULTS: Postnatal predominant diagnosis were pelviureteric junction obstruction (24%) and hydronephrosis without obstruction (18%). Follow up median was 38.7 months. Renal function deteriorated in 13 (8.8%) children and 11 (7.4%) died during follow up. Bad prognosis was associated with urethral obstruction. CONCLUSIONS: Fetal hydronephrosis is a clue of urinary tract anomalies. Urinary tract infections and delay in postnatal diagnosis must be prevented in children with this uropathy.

[Results of intracerebral inoculation of the cerebrospinal fluid of patients with Parkinson disease in experimental animals]. / Resultados das inoculações intracerebrais de líquido cefalorraquiano de parkinsonianos em animais de experimentações.

Intracerebral inoculation of parkinsonian's cerebrospinal fluid were carried out in 720 mice, under strict observation during 48 weeks. The inoculations led to a mortality rate of 157 mice (21.8%), being 31% (76) in the first, 17% (41) in the second, and 16% (40) after the third one. High mortality rates occurred, most prevalent in the first inoculation and during the first 7 weeks. Dendrite tumefaction and disintegration as well as nerve cell swelling were the ultrastructural changes observed in the brain of mice.

[Ultrastructural analysis of the cerebrospinal fluid in patients with Parkinson disease]. / Análise ultra-estrutural do Líquido cefalorraquiano de parkinsonianos.

Ultrastructural cerebrospinal fluid of 20 parkinsonian patients examined by negative staining showed not recognizable structures thought to be of viral origin in 6 cases (30%). However, mortality rate analysis failed to disclose significant differences between the inoculated animals. Either artefact or not, such structures deserve to be reported.

[Ultrastructural aspects of Parkinson disease]. / Aspectos ultra-estruturais da doença de Parkinson.

Brains from four parkinsonian patients and one control patient were analysed by electron microscopy. The most consistent abnormal findings were nerve fibers rarefaction, great interstitial space enlargement, neuropil disruption, mitochondrial tumefaction and degenerative changes. These findings occurred regularly in the brain of parkinsonian patients. Furthermore, except for mitochondrial changes, they were distinctively absent in the control patient, and therefore cannot be attributed to technical problems. Contrary-wise, they clearly reflect chronic neuronal loss. Also noteworthy was the demonstrative of deposits of amorphous substance into mitochondria, axons, cytoplasm and into the interstitial space.

[Accidental hanging during auto-erotic practices]. / Enforcamento acidental no decurso de práticas auto-eróticas.

An unusual case of accidental hanging during autoerotic practices in a 25-year-old male student is described and the autoerotic asphyxia syndrome briefly discussed. The authors stressed the importance of a correct diagnostic of accidental death in these cases.

[Clinical and epidemiological evaluation of Hansen's disease August 1937 to December 1980 in the Sanitary Dermatology Service of the Health Center of Campos, RJ]. / Avaliação clínica e epidemiológica da hanseníase no período de agosto de 1937 a dezembro de 1980, no Serviço de Dermatologia Sanitária do Centro de Saúde de Campos--RJ.

Resulting from the the research that has been performed in the Health Center of Campos--RJ, Sanitary Dermatology Service, a total of 854 cases of Hansen's disease were analysed in its principal clinical and epidemiological aspects, in the period from August 1937 until December 1980.

Anti-brucella agglutinins in bats and "Callithrix" monkeys.

Anti-Brucella agglutinins were found in 5 of 53 (9.4%) vampire bats Desmodus rotundus, captured in the State of Bahia, Brasil. Two specimens of Diphylla ecaudata were negative. Fifty specimens of the small monkey, Callithrix penicillata, were also negative.