Genome sequencing of Cladophialophora exuberans, a novel candidate for bioremediation of hydrocarbon and heavy metal polluted habitats.

Cladophialophora exuberans is a filamentous fungus related to black yeasts in the order Chaetothyriales. These melanized fungi are known for their 'dual ecology', often occurring in toxic environments and also being frequently involved in human infection. Particularly Cladophialophora exuberans, C. immunda, C. psammophila, and Exophiala mesophila have been described with a pronounced ability to degrade aromatic compounds and xenobiotic volatiles, such as benzene, toluene, ethyl-benzene, and xylene, and are candidates for bioremediation applications. The objective of the present study is the sequencing, assembly, and description of the whole genome of C. exuberans focusing on genes and pathways related to carbon and toxin management, assessing the tolerance and bioremediation of lead and copper, and verifying the presence of genes for metal homeostasis. Genomic evaluations were carried out through a comparison with sibling species including clinical and environmental strains. Tolerance of metals was evaluated via a microdilution method establishing minimum inhibitory (MIC) and fungicidal concentrations (MFC), and agar diffusion assays. Heavy metal bioremediation was evaluated via graphite furnace atomic absorption spectroscopy (GFAAS). The final assembly of C. exuberans comprised 661 contigs, with genome size of 38.10 Mb, coverage of 89.9X and a GC content of 50.8%. In addition, inhibition of growth was shown at concentrations of 1250 ppm for copper and at 625 ppm for lead, using the MIC method. In the agar tests, the strain grew at 2500 ppm of copper and lead. In GFAAS tests, uptake capacities were observed of 89.2% and 95.7% for copper and lead, respectively, after 21 experimental days. This study enabled the annotation of genes involved in heavy metal homeostasis and also contributed to a better understanding of the mechanisms used in tolerance of and adaptation to extreme conditions.

[ARBOALVO: territorial stratification for definition of areas for prompt response by surveillance and timely control of urban arbovirus infections]. / ARBOALVO: estratificação territorial para definição de áreas de pronta resposta para vigilância e controle de arboviroses urbanas em tempo oportuno.

The study aimed to present the methodological proposal entitled "Prompt Response", modelled in the cities of Belo Horizonte (Minas Gerais State) and Natal (Rio Grande do Norte State), Brazil. The proposal aims to identify and demarcate priority areas for timely targeting of surveillance activities, aiming to reduce the intensity and velocity in the spread of epidemics in endemic urban areas. The methodology uses three variables that represent the necessary causes for the production and reproduction of dengue: notified cases (virus), Aedes eggs (vector), and population (host). This was an ecological study that used data from three information planes aggregated in finer temporal and spatial scales of 3 to 4 weeks and 400 to 600-meter grids, respectively. The prompt response areas were defined by Scan statistical analysis with definition of simultaneous spatial clusters for the three planes via the SaTScan program. In Natal, the areas defined as prompt response occupied, on average, 15.2% of the city's territory and concentrated 67.77% of the dengue cases in the period following demarcation of the prompt response areas. In Belo Horizonte, the observed proportions were 64.16% of cases in 23.23% of the territory. These results were obtained in two cities with different socioenvironmental and geographic realities and distinct epidemiological profiles, indicating that the methodology can be applied to different urban realities, allowing control programs to concentrate on reduced portions of the territory and impacting a high percentage of cases in timely fashion.

O objetivo deste trabalho foi apresentar a proposta metodológica denominada de "Pronta Resposta" modelada nas cidades de Belo Horizonte (Minas Gerais) e Natal (Rio Grande do Norte), Brasil. A metodologia visa identificar e delimitar áreas prioritárias para o direcionamento das ações de vigilância em tempo oportuno, buscando a redução da intensidade e velocidade da dispersão de epidemias em áreas urbanas endêmicas. Para tanto, a metodologia utiliza três variáveis, que representam as causas necessárias para a produção e reprodução da dengue: casos notificados (vírus), ovos de Aedes (vetor) e população (hospedeiro). Trata-se de um estudo ecológico que utilizou os dados dos três planos de informações agregados em escalas temporais e espaciais mais finas, de três a quatro semanas e grades de 400 a 600 metros respectivamente. As áreas de pronta resposta foram definidas por meio de análise estatística de varredura Scan, com definição de clusters espaciais simultâneos para os três planos por meio do programa SaTScan. Os resultados observados foram: na cidade de Natal, as áreas definidas como pronta resposta ocuparam em média 15,2% do território do município e concentraram 67,77% dos casos de dengue do período posterior ao utilizado na delimitação das áreas de pronta resposta, e em Belo Horizonte, os números observados foram de 64,16% dos casos em 23,23% do território. Esses resultados foram obtidos em duas cidades com realidades socioambientais e geográficas diferentes e com perfis epidemiológicos também distintos, apontando que a metodologia pode ser aplicada em diferentes realidades urbanas, criando a possibilidade de os programas de controle atuarem em porções reduzidas do território e impactar num alto percentual de casos em tempo oportuno.

El objetivo del trabajo fue presentar la propuesta metodológica, denominada de "Resposta Rápida", modelada en las ciudades de Belo Horizonte (Minas Gerais) y Natal (Rio Grande do Norte), Brasil. Esta última tiene como meta identificar y delimitar áreas prioritarias para la ejecución de acciones de vigilancia en el momento oportuno, buscando la reducción de la intensidad y velocidad de la dispersión de epidemias en áreas urbanas endémicas. Para tal fin, la metodología utiliza tres variables, que representan las causas necesarias para la producción y reproducción del dengue: casos notificados (virus), huevos de Aedes (vector) y población (huésped). Se trata de un estudio ecológico que utilizó los datos de los tres planos de información agregados en escalas temporales y espaciales más finas, de 3 a 4 semanas y tablas de 400 a 600 metros respectivamente. Las áreas de respuesta rápida se definieron a través del análisis estadístico de exploración Scan, con definición de clústeres espaciales simultáneos para los tres planos mediante el programa SaTScan. Los resultados observados fueron: en la ciudad de Natal, las áreas definidas como de respuesta rápida ocuparon de media un 15,2% del territorio del municipio y concentraron un 67,77% de los casos de dengue del período posterior al utilizado en la delimitación de las áreas de respuesta rápida y, en Belo Horizonte, los números observados fueron un 64,16% de los casos en un 23,23% del territorio. Estos resultados se obtuvieron en dos ciudades con realidades socioambientales y geográficas diferentes y con perfiles epidemiológicos también distintos, apuntando que la metodología se puede aplicar en diferentes realidades urbanas. Dando la posibilidad de que los programas de control actúen en secciones reducidas del territorio e impactar en un alto porcentaje de casos en el momento oportuno.

Arboalvo: estratificação territorial para definição de áreas de pronta resposta para vigilância e controle de arboviroses urbanas em tempo oportuno / Arboalvo: territorial stratification for definition of areas for prompt response by surveillance and timely control of urban arbovirus infections / Arboalvo: estratificación territorial para la definición de áreas de respuesta rápida para la vigilancia y control de arbovirosis urbanas en el momento oportuno

O objetivo deste trabalho foi apresentar a proposta metodológica denominada de "Pronta Resposta" modelada nas cidades de Belo Horizonte (Minas Gerais) e Natal (Rio Grande do Norte), Brasil. A metodologia visa identificar e delimitar áreas prioritárias para o direcionamento das ações de vigilância em tempo oportuno, buscando a redução da intensidade e velocidade da dispersão de epidemias em áreas urbanas endêmicas. Para tanto, a metodologia utiliza três variáveis, que representam as causas necessárias para a produção e reprodução da dengue: casos notificados (vírus), ovos de Aedes (vetor) e população (hospedeiro). Trata-se de um estudo ecológico que utilizou os dados dos três planos de informações agregados em escalas temporais e espaciais mais finas, de três a quatro semanas e grades de 400 a 600 metros respectivamente. As áreas de pronta resposta foram definidas por meio de análise estatística de varredura Scan, com definição de clusters espaciais simultâneos para os três planos por meio do programa SaTScan. Os resultados observados foram: na cidade de Natal, as áreas definidas como pronta resposta ocuparam em média 15,2% do território do município e concentraram 67,77% dos casos de dengue do período posterior ao utilizado na delimitação das áreas de pronta resposta, e em Belo Horizonte, os números observados foram de 64,16% dos casos em 23,23% do território. Esses resultados foram obtidos em duas cidades com realidades socioambientais e geográficas diferentes e com perfis epidemiológicos também distintos, apontando que a metodologia pode ser aplicada em diferentes realidades urbanas, criando a possibilidade de os programas de controle atuarem em porções reduzidas do território e impactar num alto percentual de casos em tempo oportuno.

The study aimed to present the methodological proposal entitled "Prompt Response", modelled in the cities of Belo Horizonte (Minas Gerais State) and Natal (Rio Grande do Norte State), Brazil. The proposal aims to identify and demarcate priority areas for timely targeting of surveillance activities, aiming to reduce the intensity and velocity in the spread of epidemics in endemic urban areas. The methodology uses three variables that represent the necessary causes for the production and reproduction of dengue: notified cases (virus), Aedes eggs (vector), and population (host). This was an ecological study that used data from three information planes aggregated in finer temporal and spatial scales of 3 to 4 weeks and 400 to 600-meter grids, respectively. The prompt response areas were defined by Scan statistical analysis with definition of simultaneous spatial clusters for the three planes via the SaTScan program. In Natal, the areas defined as prompt response occupied, on average, 15.2% of the city's territory and concentrated 67.77% of the dengue cases in the period following demarcation of the prompt response areas. In Belo Horizonte, the observed proportions were 64.16% of cases in 23.23% of the territory. These results were obtained in two cities with different socioenvironmental and geographic realities and distinct epidemiological profiles, indicating that the methodology can be applied to different urban realities, allowing control programs to concentrate on reduced portions of the territory and impacting a high percentage of cases in timely fashion.

El objetivo del trabajo fue presentar la propuesta metodológica, denominada de "Resposta Rápida", modelada en las ciudades de Belo Horizonte (Minas Gerais) y Natal (Rio Grande do Norte), Brasil. Esta última tiene como meta identificar y delimitar áreas prioritarias para la ejecución de acciones de vigilancia en el momento oportuno, buscando la reducción de la intensidad y velocidad de la dispersión de epidemias en áreas urbanas endémicas. Para tal fin, la metodología utiliza tres variables, que representan las causas necesarias para la producción y reproducción del dengue: casos notificados (virus), huevos de Aedes (vector) y población (huésped). Se trata de un estudio ecológico que utilizó los datos de los tres planos de información agregados en escalas temporales y espaciales más finas, de 3 a 4 semanas y tablas de 400 a 600 metros respectivamente. Las áreas de respuesta rápida se definieron a través del análisis estadístico de exploración Scan, con definición de clústeres espaciales simultáneos para los tres planos mediante el programa SaTScan. Los resultados observados fueron: en la ciudad de Natal, las áreas definidas como de respuesta rápida ocuparon de media un 15,2% del territorio del municipio y concentraron un 67,77% de los casos de dengue del período posterior al utilizado en la delimitación de las áreas de respuesta rápida y, en Belo Horizonte, los números observados fueron un 64,16% de los casos en un 23,23% del territorio. Estos resultados se obtuvieron en dos ciudades con realidades socioambientales y geográficas diferentes y con perfiles epidemiológicos también distintos, apuntando que la metodología se puede aplicar en diferentes realidades urbanas. Dando la posibilidad de que los programas de control actúen en secciones reducidas del territorio e impactar en un alto porcentaje de casos en el momento oportuno.

Environmental Detection of SARS-CoV-2 Virus RNA in Health Facilities in Brazil and a Systematic Review on Contamination Sources.

SARS-CoV-2 environmental monitoring can track the rate of viral contamination and can be used to establish preventive measures. This study aimed to detect by RT-PCR the presence of SARS-CoV-2 from inert surface samples in public health settings with a literature review about surface contamination and its burden on spread virus. Samples were collected from health settings in Curitiba, Brazil, between July and December 2020. A literature review was conducted using PRISMA. A total of 711 environmental surface samples were collected from outpatient areas, dental units, doctors' offices, COVID-19 evaluation areas, and hospital units, of which 35 (4.9%) were positive for SARS-CoV-2 RNA. The frequency of environmental contamination was higher in primary care units than in hospital settings. The virus was detected on doctors' personal items. Remarkably, the previously disinfected dental chair samples tested positive. These findings agree with those of other studies in which SARS-CoV-2 was found on inanimate surfaces. Detection of SARS-CoV-2 RNA on surfaces in public health settings, including those not meant to treat COVID-19, indicates widespread environmental contamination. Therefore, the intensification of disinfection measures for external hospital areas may be important for controlling community COVID-19 dissemination.

A Review on COVID-19 Diagnosis Tests Approved for Use in Brazil and the Impact on Pandemic Control

Abstract With the COVID-19 pandemic, many diagnostic tests (molecular or immunological) were rapidly standardised, given the urgency of the situation, many are still in the process of being validated. The main objective of this study was to review the aspects of the diagnostic kits approved in Brazil and their application in the different federative units to gather epidemiological information. In order to achieve these objectives, a survey was carried out on the data available at the regulatory agency (ANVISA) and in the literature. The main countries that have registered products in Brazil are China (51.4%), Brazil (16.6%), South Korea (9.2%), USA (8.8%) and Germany (3.6%). The methodologies of these products are based on the detection of nucleic-acid (15.8%), antigen (13%) and antibody (71.2%). In the immunological tests, it was verified that the sensitivity ranged from 55 to 100% and the specificity from 80 to 100%. The percentage of cases in the samples tested in Brazil is elevated in almost all federative units since eight states showed 40% of positive cases in tested samples, while 18 states displayed between 20 and 40%. In conclusion, this review showed that Brazil is dependent on external technology to respond to pandemics, epidemics and endemics disease and needs to improve its biotechnological scheme to solve further diseases outbreaks.

Environmental Screening of Fonsecaea Agents of Chromoblastomycosis Using Rolling Circle Amplification.

Chromoblastomycosis is a chronic, cutaneous or subcutaneous mycosis characterized by the presence of muriform cells in host tissue. Implantation disease is caused by melanized fungi related to black yeasts, which, in humid tropical climates, are mainly members of the genus Fonsecaea. In endemic areas of Brazil, F. pedrosoi and F. monophora are the prevalent species. The current hypothesis of infection is traumatic introduction via plant materials, especially by plant thorns. However, isolation studies have demonstrated a low frequency of the agents in environmental substrates. The present study aimed to detect F. pedrosoi and F. monophora in shells of babassu coconuts, soil, plant debris, and thorns from endemic areas of chromoblastomycosis in Maranhão state, northern Brazil, using Rolling Circle Amplification (RCA) with padlock probes as a new environmental screening tool for agents of chromoblastomycosis. In addition to molecular screening, the environmental samples were analyzed by fungal isolation using mineral oil flotation. The limit of detection of the RCA method was 2.88 × 107 copies of DNA per sample for the used padlock probes, indicating that this represents an efficient and sensitive molecular tool for the environmental screening of Fonsecaea agents. In contrast, with isolation from the same samples using several selective methods, no agents of chromoblastomycosis were recovered.

Vaccuuming method as a successful strategy in the diagnosis of active infestation by Pediculus humanus capitis.

Most human epidemiological and clinical studies use visual inspection of the hair and scalp to diagnose Pediculus humanus capitis , however this method has low sensitivity to diagnose active infestations (presence of nymphs and adult lice). Vacuuming the hair and scalp has been used as a diagnostic method, but there are no previous data comparing its effectiveness with visual inspection. The aim of this study was to determine the prevalence of overall infestation (nits and trophic stages), of active infestation by Pediculus humanus capitis , and to evaluate the effectiveness of vacuuming in comparison with the visual inspection. Visual inspection was performed by three examiners and vacuuming of the scalp by one investigator, with an adapted vacuum cleaner. A total of 166 children aged 4 to 10 years old were randomly selected from public schools in Southern Brazil. Considering the positive results obtained by both methods, the prevalence of overall infestation was 63.3%, whereas active infestation was 18.7%. The visual inspection was more effective on diagnosing overall infestation, however, its effectiveness to detect active infestation was lower, ranging from 0.6% (RR=3%, p<0.001) to 6.6% (RR=35%, p=0.001), depending on the number of examiners. The effectiveness of vacuuming to diagnose active infestation was higher than the one of visual inspection, with a prevalence rate of 16.3% (RR=87%, p=0.332). As presented in our study, the vacuuming method was 2.74 to 7.87 times most likely to detect active infestation, thus it could be adopted as a more accurate method to diagnose active pediculosis.

Defecography by digital radiography: experience in clinical practice / Defecografia por radiologia digital: experiência na prática clínica

Abstract Objective: The objective of this study was to profile patients who undergo defecography, by age and gender, as well as to describe the main imaging and diagnostic findings in this population. Materials and Methods: This was a retrospective, descriptive study of 39 patients, conducted between January 2012 and February 2014. The patients were evaluated in terms of age, gender, and diagnosis. They were stratified by age, and continuous variables are expressed as mean ± standard deviation. All possible quantitative defecography variables were evaluated, including rectal evacuation, perineal descent, and measures of the anal canal. Results: The majority (95%) of the patients were female. Patient ages ranged from 18 to 82 years (mean age, 52 ± 13 years): 10 patients were under 40 years of age; 18 were between 40 and 60 years of age; and 11 were over 60 years of age. All 39 of the patients evaluated had abnormal radiological findings. The most prevalent diagnoses were rectocele (in 77%) and enterocele (in 38%). Less prevalent diagnoses were vaginal prolapse, uterine prolapse, and Meckel's diverticulum (in 2%, for all). Conclusion: Although defecography is performed more often in women, both genders can benefit from the test. Defecography can be performed in order to detect complex disorders such as uterine and rectal prolapse, as well as to detect basic clinical conditions such as rectocele or enterocele.

Resumo Objetivo: Este estudo tem por objetivo descrever o perfil da população que se submeteu a exame de defecografia, de acordo com a faixa etária e sexo do paciente, bem como os principais achados e diagnósticos de imagem nesta população. Materiais e Métodos: Estudo retrospectivo e descritivo com 39 pacientes realizado entre janeiro de 2012 e fevereiro de 2014. Os pacientes foram avaliados quanto a idade, sexo e os diagnósticos encontrados. Foram divididos por idade, e as variáveis contínuas são expressas como média ± desvio-padrão. Todas as quantificações possíveis em defecografia foram realizadas neste trabalho, incluindo esvaziamento da ampola retal, descenso perineal e as medidas do canal anal. Resultados: Dos 39 pacientes estudados, todos apresentaram alterações radiológicas, sendo a maioria do sexo feminino (95%). O mais novo tinha 18 anos e o mais velho, 82 anos (idade média de 52 ± 13 anos). Dez pacientes tinham menos de 40 anos, 18 tinham entre 40 e 60 anos e 11 pacientes tinham mais do que 60 anos. Os diagnósticos mais prevalentes foram retocele anterior (77%) e enterocele (38%). Os menos frequentes foram prolapso vaginal (2%), prolapso uterino (2%) e divertículo de Meckel (2%). Conclusão: As mulheres realizam mais exames de defecografia, porém ambos os gêneros se beneficiam deste estudo. A defecografia é capaz de detectar causas complexas de distúrbio da defecação como prolapso vaginal, uterino e retal, e pode ser utilizada em condições clínicas mais simples como a avaliação de retocele ou enterocele.

Defecography by digital radiography: experience in clinical practice.

OBJECTIVE: The objective of this study was to profile patients who undergo defecography, by age and gender, as well as to describe the main imaging and diagnostic findings in this population. MATERIALS AND METHODS: This was a retrospective, descriptive study of 39 patients, conducted between January 2012 and February 2014. The patients were evaluated in terms of age, gender, and diagnosis. They were stratified by age, and continuous variables are expressed as mean ± standard deviation. All possible quantitative defecography variables were evaluated, including rectal evacuation, perineal descent, and measures of the anal canal. RESULTS: The majority (95%) of the patients were female. Patient ages ranged from 18 to 82 years (mean age, 52 ± 13 years): 10 patients were under 40 years of age; 18 were between 40 and 60 years of age; and 11 were over 60 years of age. All 39 of the patients evaluated had abnormal radiological findings. The most prevalent diagnoses were rectocele (in 77%) and enterocele (in 38%). Less prevalent diagnoses were vaginal prolapse, uterine prolapse, and Meckel's diverticulum (in 2%, for all). CONCLUSION: Although defecography is performed more often in women, both genders can benefit from the test. Defecography can be performed in order to detect complex disorders such as uterine and rectal prolapse, as well as to detect basic clinical conditions such as rectocele or enterocele.

OBJETIVO: Este estudo tem por objetivo descrever o perfil da população que se submeteu a exame de defecografia, de acordo com a faixa etária e sexo do paciente, bem como os principais achados e diagnósticos de imagem nesta população. MATERIAIS E MÉTODOS: Estudo retrospectivo e descritivo com 39 pacientes realizado entre janeiro de 2012 e fevereiro de 2014. Os pacientes foram avaliados quanto a idade, sexo e os diagnósticos encontrados. Foram divididos por idade, e as variáveis contínuas são expressas como média ± desvio-padrão. Todas as quantificações possíveis em defecografia foram realizadas neste trabalho, incluindo esvaziamento da ampola retal, descenso perineal e as medidas do canal anal. RESULTADOS: Dos 39 pacientes estudados, todos apresentaram alterações radiológicas, sendo a maioria do sexo feminino (95%). O mais novo tinha 18 anos e o mais velho, 82 anos (idade média de 52 ± 13 anos). Dez pacientes tinham menos de 40 anos, 18 tinham entre 40 e 60 anos e 11 pacientes tinham mais do que 60 anos. Os diagnósticos mais prevalentes foram retocele anterior (77%) e enterocele (38%). Os menos frequentes foram prolapso vaginal (2%), prolapso uterino (2%) e divertículo de Meckel (2%). CONCLUSÃO: As mulheres realizam mais exames de defecografia, porém ambos os gêneros se beneficiam deste estudo. A defecografia é capaz de detectar causas complexas de distúrbio da defecação como prolapso vaginal, uterino e retal, e pode ser utilizada em condições clínicas mais simples como a avaliação de retocele ou enterocele.

Synthesis of nitrolipids. All four possible diastereomers of nitrooleic acids: (E)- and (Z)-, 9- and 10-nitro-octadec-9-enoic acids.

Unsaturated fatty acids are nitrated endogenously to produce nitrated lipids. Recent studies have shown that these nitrated lipids have high chemical reactivity and profound biological implications. We report an efficient, scalable synthesis which is regiospecific and stereoselective for all possible isomers of nitrated oleic acid: (E)- and (Z)-, 9- and 10-octadec-9-enoic acids.

Oxido nitroso: uma boa opçåo como gás para pneumoperitôneo nas colescistectomias por videolaparoscopia sob anestesia geral / Nitrous oxide: good option as pneumoperitoneum gas in videolaparoscopic cholecystectomy under general anesthesia

Backgoruind and oblectives - Nitrous oxide is less iritating than carbon dioxide when injected into the abdominal cavity, besides inducing less hemodynamic and respiratory changes. The objective of this study was to demonstrate that: a) N2O used as pneumoperitoneum gas is little absorbed by the splancnic circulation; b) Intraperitoneal N2), associated or not with inhaled N2O, does not change PETCO2, and cannot be responsible for postoperative vomiting; c) the association of inhaled and intraperitoneal N2O reduces alfentanil requirement as compared to ventilation with 100 per cent oxygen. Methods - After Institutional approval, thirty two patientes of both sexes, ASA physical status 1 or 2, submmited to laparoscopic cholecystectomy, gave their informed consent to participate. Patients were premedicated with intramuscular midazolan (0.1mg.Kg-1). Monitoring included blood presure, ECG, gas analyser, pulse oximeter, oxygen analyser and peripheral nerve stimulator. Anhestesia was included with droperidol (0.15 mg.Kg-1), alfentanil (40ug.Kg-1), propofol (0.5 mg.Kg-1) in continuous infusion, atracurium (0.5 mg.Kg-1) and 100 per cent oxygen by mask, followed by tracheal intubation. Ventilation was controlled with 7 ml.Kg-1 tidal voleme and the ventilatory rate was adjusted to maintain PETCO2 at 32-36 mmHg, 97-98 per cent HbO2 saturation, 33-35 per cent FlO2 and intratracheal pressure of 10-12 cmH2O. Metropolol, 0.05-1 mgKg-1, was injested after tracheal intubation. The patients were allocated into two groups: Group O, ventilated with 100 per cent O2; Group N, ventilated with N2O 66-67 per cent in O2. Maintenance of anesthesia was done with propofol infusion (35 ug.Kg-1) and intermitent doses of alfentanil in both groups. Alfentanil doses systolic and diastolic arterial pressures and heart rate were registered. The PETCO2 was adjusted to 32-36 mmHg with constant tidal volume and changes in ventilatory rate if necessary. The N2O was insuflated into the abdominal cavity up to obtaining 10-12 mmHg pressure and the initial volume was registered. Samples were colected from the gastric cavity and the N2O concentration was measured in the abdominal cavity at the end of the procedure. In Group O, the expired N2O was monitored to detect absorption by splacnin circulation. In Group N, the time after discontinuation of N2O required for the expires concentration to reach 15 per cent and zero, were registered. Data were statisticaly analyzed with Student's "t" test, ANOVA and chi square test. Results - In Group O, alfentanil doses were higher than in Group N (p<0.001). Initial intraperitoneal insuflation volume of N2O were 1.76 +- 0.47 Land l.92 +- 0.59 L respectively in Groups O and N. In both groups, the N2O concentration in the desinsuflation gas was near 100 per cent and N2O was not detected in the gastric cavity gas. In Group O, N2O was not detected in the expiratory gases. In 3.38 +- 1.09 min the N2o concentration was reduced to 15 per cent and 8.38 +- 3.36 min it was zero in Group N. Conclusions - The authors concluded that: 1- N2O used by peritoneal route is not absorbed by splancnic circulation; 2- the association of inhalation and intraperitoneal N2O does not induce significant hemodynamic or respiratory changes; 3- because it is little absrbed and unlikely to produce explosive mixtures, the authors recommend N2O to be used as pneumoperitoneum gas in laparoscopic cholecistectony

Anastomose do intestino grosso com anel biofragmentável / Anastomosis of the large intestine with biofragmentable ring

A busca de melhores resultados na realizaçäo de anastomose do intestino grosso, numerosos métodos têm sido utilizados ao longo do tempo. Recentemente a utilizaçäo de um anel de ácido poliglicólico para esta finalidade tem sido testado experimental e clinicamente por vários grupos de investigadores em todo o mundo. Realizamos um levantamento bibliográfico relativo à este procedimento em estudos clínicos, prospectivos e randomizados e pudemos constatar que o método é prático e de possível utilizaçäo, com segurança nas anastomoses de intestino grosso e reto intraperitoneal. Num total de 1481 pacientes, nos vários trabalhos, foi utilizado o anel em 745, o grampeador em 190 e a anastomose manual em 546. Os resultados obtidos quanto a deiscência anastomótica, tempo de retorno da funçäo intestinal, início da introduçäo e aceitaçäo da dieta, tempo de hospitalizaçäo, abscessos, sangramentos e complicaçöes da ferida foram semelhantes nos três grupos. Ressalta-se que o tempo dispendido na confecçäo da anstomose foi menor com o grampeador em relaçäo a sutura manual e foi também menor com o uso do anel em relaçäo a sutura manual em alguns estudos