Torsion of the inferior vena cava: An unprecedented variant of post-pneumonectomy syndrome.

Post-pneumonectomy syndrome (PPS) is a rare complication after pneumonectomy defined by mediastinum shift toward the vacated pleural space with compression of the distal trachea or mainstem bronchi, resulting in dyspnea. This report describes a 32-year-old woman who presents with limiting symptoms of progressive dyspnea and chest pain 2 years after a right pneumonectomy. In computed tomography scan, there was no evidence of airway compression but suggested torsion of the inferior vena cava with preload compromise, confirmed during the surgical mediastinum repositioning using a transesophageal echocardiography-guided approach. This case report presents this unprecedented variant of PPS syndrome, highlighting the diagnostic and peri-operative management challenges.

Fuel consumption rate and emissions variability in waste collection services routes: case study of Cascais Ambiente.

In the design waste collection systems, it is common practice to use a constant specific fuel consumption (e.g. litres per amount of waste collected or distance travelled). This is also the approach used in many cases for fleet management, namely, for decision-making on more fuel-efficient equipment acquisition. However, the specific fuel consumption is not constant and there are spatial and temporal variations. Accounting for this variability becomes relevant if a more refined cost or environmental optimization is intended. The present research effort evaluates the energy intensity of the waste collection service in the Cascais municipality, reporting the differences and the magnitude of the variability for the mixed waste collection service. Statistically significant differences are found between the circuits, the trucks, months of the year and days of the week. It is discussed that extrapolating average fuel consumption rates for decision-making in new waste collection systems may be prone to substantial error.

Renal Involvement in Pediatric Patients with COVID-19: An Up-to-date Review.

BACKGROUND: In pediatric patients, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has been mostly associated with mild symptoms. However, as in adults, renal involvement has been reported in children and adolescents with Coronavirus Disease 2019 (COVID-19). OBJECTIVE: This review aimed to report data about renal involvement in pediatric COVID-19 patients. The focuses were on the pathophysiology of acute kidney injury in Pediatric Inflammatory Multisystem Syndrome Temporally Associated (PIMS-TS) with SARS-CoV-2 and the possible impact of SARS-CoV-2 infection upon kidney function, as well as data concerning patients with previous kidney diseases, including Nephrotic Syndrome and Chronic Renal Disease. The implications for COVID-19 outcomes in pediatric patients were also discussed. METHODS: This integrative review searched for articles on renal involvement in pediatric COVID-19 patients. The databases evaluated were PubMed and Scopus. RESULTS: The emergence of PIMS-TS with SARS-CoV-2 has shown that pediatric patients are at risk of severe COVID-19, with multi-organ involvement and dysfunction. In addition to intense inflammation, several systems are affected in this syndrome, collectively creating a combination of factors that results in acute kidney injury. Several studies have proposed that kidney cells, including the podocytes, might be at risk of direct infection by SARS-CoV-2, as high levels of ACE2, the virus receptor, are expressed on the membrane of such cells. Some cases of glomerular diseases triggered by SARS-CoV-2 infection and relapses of previous renal diseases have been reported. CONCLUSION: Further studies are necessary to establish risk factors for renal involvement in pediatric COVID-19 and to predict disease outcomes.

Características da oclusão e prevalência de más oclusões em crianças atendidas na Universidade Federal de Goiás / Characteristics of the occlusion and prevalence of malocclusion in children treated at the Federal University of Goiás

Objetivo: Avaliar as características da oclusão e a prevalência das más oclusões em crianças atendidas na Faculdade de Odontologia da Universidade Federal de Goiás. Material e Método: Foram avaliados 116 modelos de estudo de crianças entre 4 e 12 anos de idade atendidas no período entre janeiro de 2007 e julho de 2010. Os modelos foram avaliados por um único examinador, analisando a faixa etária, gênero, trespasse horizontal e vertical, relação transversal posterior e as relações de caninos e de molares. As informações coletadas foram submetidas à análise estatística descritiva. Resultados: A prevalência de más oclusões na amostra foi de 88,8%, sendo mais frequente nas meninas. A relação de caninos em normoclusão bilateral (57,76%) e a relação dos molares em Classe I (38,79%) foram mais frequentes. A condição normal do trespasse vertical e horizontal foi mais prevalente. No entanto, o trespasse horizontal aumentado esteve presente em 26,72% da amostra e a mordida aberta anterior em 21,5%. A mordida cruzada posterior esteve presente em 37,93% das crianças. Conclusões: A maioria das crianças atendidas apresentou algum tipo de má oclusão. No entanto, quando as características avaliadas foram consideradas isoladamente, prevaleceram as condições de normalidade.

Aim: To evaluate the characteristics of occlusion and the prevalence of malocclusion in children treated at the School of Dentistry, Federal University of Goiás. Material and Method: It was evaluated 116 dental casts of children between 4 and 12-yearold treated in the period between January 2007 and July 2010. The casts were evaluated by an only examiner, examining age, gender, overjet and overbite, posterior transverse relationship and the relations of canines and molars. The data were subjected to descriptive statistical analysis. Results: The prevalence of malocclusion in the sample was 88.8%, being more common in girls. The bilateral canines normo-occlusion (57.76%) and the molars Class I (38.79%) were more frequent. The assessments of overjet and overbite showed a higher prevalence of normal conditions. However, the increased overjet was present in 26.72% of the sample and anterior open bite in 21.5%. The posterior crossbite was present in 37.93% of children. Conclusions: Most children attended had some type of malocclusion. However, when the characteristics were considered separately, the normal conditions showed prevalent.