Mioclonía espinal: ¿un misterio anestésico? Se acepta el reto / Spinal myoclonus: is it an anesthetic mystery?

El objetivo es presentar un estudio descriptivo relacionado con un caso de de mioclonía espinal (ME) sin precedentes conocidos, tras una anestesia subaracnoidea. Los ME son espasmos no generalizados repentinos, breves e involuntarios que pueden ser un efecto adverso de la administración de fármacos a través de las vías neuroaxiales. Se presenta el caso de una mujer de 67 años, ASA II, propuesta para cirugía de reemplazo de cadera, con exámenes preoperatorios normales en la que 7 minutos después de la anestesia subaracnoidea con 10 mg de bupivacaína al 0,5% no se observó bloqueo motor, y la paciente se quejó de dolor insoportable en las piernas y en el perineo, asociando con movimientos mioclónicos bilaterales, asimétricos y arrítmicos en las extremidades inferiores. El dolor se resolvió tras 48 horas de anestesia general y perfusión de rocuronio, entre otras medidas terapéuticas. Tras el diagnóstico diferencial, la bupivacaína intratecal parece ser la causa más probable de ME, con respecto a la ausencia de trastornos neurológicos y electrolíticos, traumatismo directo de la médula espinal, intercambio de fármacos y examen perioperatorio normal, imágenes y pruebas de laboratorio. Es obligatorio revisar siempre las historias anestésicas de los pacientes y reconocer, tratar y reportar complicaciones anestésicas raras

The goal is to present a descriptive study related an unprecedent case of spinal myoclonus (SM) following subarachnoid anesthesia (SA). SM are sudden, brief, involuntary non-generalized spasms that can be an adverse effect of drug administration via neuraxial routes. Female, 67y, ASA II, proposed for hip replacement surgery, with normal preoperative exams. 7min after SA with 10mg of bupivacaine 0,5%, no motor blockade observed, and patient complained of unbearable pain in legs and perineum and bilateral, asymmetrical and arrhythmic myoclonic movements in the lower limbs. The latter solved after 48h of general anesthesia and rocuronium perfusion, amongst other therapeutics. Accordingly, intrathecal bupivacaine appears to be the SM most likely cause, regarding the absence of neurologic and electrolyte disorders, spinal cord direct trauma, drug exchange and normal perioperative examination, imaging and laboratory testing.It is mandatory to always take the patients' anaesthetic histories and recognize, treat and report rare anaesthetic complications

Prevalence of food allergy in infants and pre-schoolers in Brazil

BACKGROUND: Food allergy is an increasing problem in public health, especially in childhood. Its incidence has increased in the last decade. Despite this, estimates of the actual incidence and prevalence are uncertain. The aim of this study was to estimate the prevalence of food allergy in infants and pre-schoolers. METHODS: The parents of 3897 children completed questionnaires on the occurrence of any reaction to food. Children with parentally reported reactions were selected for further examination including a clinical interview, physical examination, allergic tests, and if necessary, oral food challenge to conclude the diagnosis of FA. RESULTS: The estimated prevalence of allergy in children aged 4-59 months was 0.61%, being, 1.9% in infants and 0.4% in pre-schoolers. Among the 604 patients physicians evaluated with parent-reported FA, 24 (4%) had a confirmed diagnosis of food allergy, and 580 (96%) were excluded in the remaining. Of these, approximately half (51/52.6%) of 97 infants and (128/48%) of 487 pre-schoolers already performed the diet exclusion suspected food for a period of time. CONCLUSION: This study shows that high overall prevalence of parental belief of current food allergy however the same was not observed in the in physician-diagnosed food allergy. The prevalence of food allergy was lower than that observed in the literature. This study alerts health professionals to the risk entailed by overestimation of cases of food allergy and unnecessary dietary exclusion, which may result in impairment in growth and development of children, especially in their first years of life

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Prevalence of parent-reported food allergy in infants and preschoolers in Brazil

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Efectos del ultrasonido de alta potencia en la adiposidad localizada / Effects of high power ultrasound in localized subcutaneous adiposity

Objetivo: El objetivo de este estudio fue analizar los efectos de la ultracavitación de alta frecuencia (UCV-AF) sobre la adiposidad localizada abdominal. Material y método: Se realizó un estudio descriptivo sobre 40 pacientes. Para evaluar los efectos del tratamiento sobre el tejido adiposo, se consideraron el peso corporal, la circunferencia abdominal, la plicometría y la ecografía. Se realizaron 8 sesiones de UCV-AF durante 2 meses, frecuencia: 3MHz, con una potencia de 30 vatios, ciclo de trabajo del 100%, durante 15 min. El área de tratamiento fue de 10 cm2. Resultados: Los promedios pre y postratamiento del peso corporal, la circunferencia abdominal, la plicometría y la ecografía fueron 66,88 y 66,85 kg, 86,24 y 81,93 cm, 34,825 y 26,825 mm, y 1,925 mm y 1,692 mm, respectivamente. El análisis estadístico no mostró diferencias significativas en el peso corporal (p < 0,8444, t = 0,1976) pero en la circunferencia, la plicometría y la ecografía las diferencias fueron extremadamente significativas: p < 0,0001, t = 10,594; p < 0,0001, t = 10,241; p < 0,0001, t = 6,030, respectivamente. Conclusiones: El tratamiento UCV-AF provocó una disminución significativa del tejido adiposo abdominal a través de la reducción de la circunferencia, plicometría y en la ecografía, sin generar cambios en el peso corporal

Objective: The aim of this study was to analyze the effects of high frequency ultracavitation (UCV-HF) on localized abdominal fat tissue. Material and method: A descriptive study was conducted on 40 patients. Body weight, abdominal circumference, plicometry and diagnostic ultrasound were used to measure the effects of the treatment on fat tissue. Eight sessions of UCV-HF were applied in a period of 2 months. requency: 3MHz, and 30 watts, a duty cycle of 100%, for 15minutes. The treatment area was 10 cm2. Results: The pre-and post-treatment weight, abdominal circumference, diagnostic ultrasound and plicometry average was 66.88 and 66.85 Kg, 86.24 and 81.93 cm, 34.825 and 26.825 mm, 1.925 and 1.692 mm, respectively. The statistical analysis did not show significant differences in body weight (P < 0.8444, P = 0.1976). However, the differences in the circumference, plicometry and diagnostic ultrasound the difference were extremely significant: P < 0.0001, t = 10.594; P < 0.0001, t = 10.241; P < 0.0001, t = 6.030 respectively. Conclusions: The UCV-HF resulted in a significant decrease of abdominal fat tissue by reducing circumference, plicomety and fat thickness, without significant changes in body weight

Assessing the diversity of the virulence potential of Escherichia coli isolated from bacteremia in São Paulo, Brazil

Most of the knowledge of the virulence determinants of extraintestinal pathogenic Escherichia coli (ExPEC) comes from studies with human strains causing urinary tract infections and neonatal meningitis and animal strains causing avian colibacillosis. In this research, we analyzed the phylogenetic background, the presence of 20 ExPEC virulence factors, and the intrinsic virulence potential of 74 E. coli strains isolated in São Paulo, Brazil, from 74 hospitalized patients (43 males and 31 females) with unknown-source bacteremia. Unlike other places in the world, the bacteremic strains originated equally from phylogroups B2 (35%) and D (30%). A great variability in the profiles of virulence factors was noted in this survey. Nevertheless, 61% of the strains were classified as ExPEC, meaning that they possessed intrinsic virulent potential. Accordingly, these strains presented high virulence factor scores (average of 8.7), and were positively associated with 12 of 17 virulence factors detected. On the contrary, the non-ExPEC strains, isolated from 39% of the patients, presented a generally low virulence capacity (medium virulence factor score of 3.1), and were positively associated with only the colicin cvaC gene. These results show the importance of discriminating E. coli isolates that possess characteristics of true pathogens from those that may be merely opportunistic in order to better understand the virulence mechanisms involved in extraintestinal E. coli infections. Such knowledge is essential for epidemiological purposes as well as for development of control measures aimed to minimize the incidence of these life-threatening and costly infections.

A remarkable leaf mine induced by Tachygonus sp.n. (Coleoptera: Curculionidae: Curculioninae: Rhamphini) on Erythroxylum subsessile (Erythroxylaceae) with a description of the new species / Mina foliar singular induzida por Tachygonus sp. n. (Coleoptera: Curculionidae: Tachygoninae) em Erythroxylum subsessile (Erythroxylaceae) com descrição da nova espécie

In this study, we describe and present original data on the bionomics and ecology of Tachygonus erythroxyli Hespenheide, New Species, on Erythroxylum subsessile (Mart.). Thirty individuals of E. subsessile were analysed every two months, from October, 2006 to October, 2007 at the National Park of Restinga de Jurubatiba (PNRJ) Carapebus, Rio de Janeiro, Brazil. Females of T. erythroxyli lay their eggs singly on the upper surface of the host's leaves. The mine of T. erythroxyli is expanded with three bubbles, each one representing one larval instar. These mines occur throughout the year in at least half of the host plants and are markedly more abundant in summer. We obtained three parasitoid species, making a total of 53% of the rate of parasitism. Cirrospilus sp. (Eulophidae) was the most prevalent and represented 88% of the parasitoids. The great abundance of Tachygonus mines, their high frequency in their host plant, and local monophagy of this leaf miner weevil suggest a close association between T. erythroxyli and Erythroxylum subsessile.

No presente estudo, foram descritos e apresentados os primeiros dados sobre bionomia e ecologia de Tachygonus erythroxyli Hespenheide, New Species, em Erythroxylum subsessile (Mart.). Trinta indivíduos de E. subsessile foram amostrados a cada dois meses, de outubro de 2006 a outubro de 2007, no Parque Nacional da Restinga de Jurubatiba (PNRJ), Carapebus-Rio de Janeiro, Brasil. Fêmeas de T. erythroxyli colocam ovos isolados na face superior das folhas do seu hospedeiro. A mina de T. erythroxyli é do tipo expandida e apresenta um formato de três bolhas, sendo que cada bolha corresponde a um estádio da larva. Essas minas ocorrem ao longo de todo o ano em pelo menos metade das plantas hospedeiras, sendo marcadamente mais abundantes no verão. Foram obtidas três espécies de parasitoides que, juntas, demonstraram uma taxa de parasitismo de 53%. Cirrospilus sp. (Eulophidae) foi a mais abundante e representou 88% dos parasitoides. A grande abundância de minas de Tachygonus, a alta frequência em seu hospedeiro e a monofagia local desse besouro minador de folhas sugere uma forte associação entre T. erythroxyli e Erythroxylum subsessile.

Two media method for gamma ray attenuation coefficient measurement of archaeological ceramic samples

This work reports the application of an alternative methodology for the linear attenuation coefficient determination of irregular shape samples, in such a way that it is not necessary to know the sample thickness. Based on this method, indigenous archaeological ceramic fragments from the region of Londrina, north of Parana State in Brazil, were studied. On the other hand, theoretical mass attenuation coefficient values were determined with the XCOM computer code. With the results obtained, it was concluded that the two media method works very well for the linear attenuation coefficient measurement of irregular-shaped ceramic samples, which makes it suitable, especially, for archaeometric studies.

Ocorrencia de Taenia sp. na populacao atendida no laboratorio central do Instituto Adolfo Lutz, Sao Paulo, SP, Brasil (1960/1989) / Occurrence of Taenia sp. in the population seen at the Central Laboratory of the Adolfo Lutz Institute, Sao Paulo, SP, Brazil (1960/1989)

Foram examinados retrospectivamente os relatorios mensais e anuais da Secao de Enteroparasitoses do Laboratorio Central do Instituto Adolfo Lutz, Sao Paulo, SP, no periodo de 1960 a 1989, perfazendo uma serie historica de 30 anos, com 1.519.730 exames protoparasitologicos e 355 identificacoes de proglotes de Taenia. Pelo metodo da sedimentacao espontanea foram diagnosticados 7.663 (0,5 por cento) casos de presenca de ovos de Taenia sp. nas fezes. Das 355 proglotes enviadas para identificacao, 311 (87,60 por cento) estavam em condicoes de serem especificadas, e dessas, 273 (87,80 por cento) eram proglotes de Taenia saginata e 38 (12,22 por cento) de T. solium.