Bulk and surface theoretical investigation of Nb-doped δ-FeOOH as a promising bifunctional catalyst.

The development of bifunctional catalysts is of great interest in fine chemistry, since they are capable of promoting multicatalytic reactions involved in several important industrial processes. Iron oxyhydroxides have been identified as low-cost bifunctional catalysts. However, their applications are limited due to their weak acid character. Thus, elaborated modifications of these systems can significantly contribute to increasing their activities and selectivity. This work consists in the study, through DFT calculations, of the properties of the bulk and the surface of feroxyhyte (δ-FeOOH) doped with niobium, as a potential bifunctional catalyst. We identified the formation of stronger van der Waals interactions among the doped δ-FeOOH layers, which can increase the thermal stability of the catalyst. In addition, evidence has been found that the insertion of Nb increases Brönsted acidity and gives rise to new Lewis acid sites on the catalyst surface.

Molecular Docking, Metal Substitution and Hydrolysis Reaction of Chiral Substrates of Phosphotriesterase.

During World War II, organophosphorus compounds with neurotoxic action were developed and used as the basis for the development of structures currently used as pesticides in the agricultural industry. Among the nerve agents, Tabun, Sarin, Soman and VX are the most important. The factor responsible for the high toxicity of organophosphorus (OP) is the acetylcholinesterase inhibition. However, one of the characterized enzymes capable of degrading OP is Phosphotriesterase (PTE). This enzyme has generated considerable interest for applications of rapid and complete detoxification. Due to the importance of bioremediation methods for the poisoning caused by OP, this work aims to study the interaction mode between the PTE enzyme and organophosphorus compounds, in this case, Sarin, Soman, Tabun and VX have been used, which are potent acetylcholinesterase inhibitors, taking into account the enantiomers "Rp" and " Sp" of each compound, with the Sp-enantiomers presenting the higher toxicity. With that, we were able to demonstrate the existence of the stereochemical preference by PTE in these compounds. With the purpose of increasing the speed of the hydrolysis mechanism, we have proposed a modification in the enzyme active site structure, where Zn(2+) ions were substituted by Al(3+) ions. To analyze the stability of Al(3+) ions in the wild-type PTE active site, MD simulations were also performed. This mutation brought relevant results; in this case, there was a reduction of the reaction energy barrier for all the compounds, mainly for VX in which the reaction presented lower activation energy values, and consequently, a faster hydrolysis process.

Urethral extrusion of a peritoneal catheter in a patient with a neobladder: a rare complication of shunt insertion.

The insertion of a ventriculoperitoneal shunt (VPS) is considered the standard of care for several forms of hydrocephalus. Abdominal complications are most common with this procedure, comprising up to 30% of all shunt-related problems. Conversely, visceral perforation or extrusion of the shunt apparatus is rare. Herein we report a rare complication of VPS insertion in which the peritoneal catheter was spontaneously extruded through the urethra of a patient with a neobladder. We further discuss the pathogenesis, diagnosis, and treatment of this condition.

Management of Wilms' tumor with intracardiac extension.

We review our experience and the literature in treating 4 patients with Wilms' tumor (WT) with intracardiac extension among 92 patients with this neoplasm. Cardiopulmonary bypass with circulatory arrest and profound hypothermia was used. There were 3 boys (3 years, 4 years 5 months, and 15 years) and 1 girl (6 years). The follow-up periods were 8 months, 3 years, 2 years 6 months, and 15 years, respectively. We had no surgical complications and conclude that the preoperative diagnosis is extremely important. These patients must be transferred to institutions where concomitant cardiac procedures can be performed. In treating patients with WT, Doppler ultrasound must be used preoperatively in all cases, not only those in which clinical and radiologic signs of intravascular involvement are found. We propose that preoperative chemotherapy should be used, as it shrinks the thrombus and causes desirable adherence of the thrombus to the venous wall, reducing the probability of thromboembolism during the surgical procedure. We also find this method safer than in our 1st case, where neither cardiac arrest nor hypothermia was used. Our results agree with the literature that intracardiac extension of WT does not worsen its prognosis when a rational surgical approach is used.

Immigrant families coping with schizophrenia. Behavioral family intervention v. case management with a low-income Spanish-speaking population.

BACKGROUND: This investigation compared the effectiveness and cross-cultural applicability of behavioural family management (BFM) and standard case management in preventing exacerbation of symptoms and relapse in schizophrenia. METHOD: Forty low-income Spanish-speaking people with a diagnosis of schizophrenia were randomly assigned to receive standard case management or behavioural family management after stabilisation with neuroleptic medication. RESULTS: Survival analyses indicated that among the less acculturated patients BFM was significantly related to greater risk of exacerbation of symptoms. Among the more acculturated patients, risk of exacerbation could be predicted by medication compliance but not by type of intervention. In analyses of symptom severity and functional status at 1-year follow-up, the level of patient acculturation was found to be significantly related to various measures of treatment outcome. CONCLUSION: Sociocultural factors affect responses to different types of intervention. The results did not support earlier findings of a beneficial effect of BFM when applied to a socioculturally diverse population.

[Myocardial revascularization without extracorporeal circulation. Surgical results in 1090 patients]. / Revascularização miocárdica sem circulação extracorpórea. Resultados cirúrgicos em 1090 pacientes.

PURPOSE: To report our experience of 12 years of myocardial revascularization without cardiopulmonary bypass (CPB) and to discuss its expanding surgical indications. METHODS: This technique was employed in 1090 patients, between September/81 and April/93, corresponding to 17.4% of all revascularized patients. Regarding gender, male patients were the majority (73.7%) and ages ranged from 28 to 86 year-old (mean 57). Chronic coronary insufficiency was the main indication (69.4%) and 18.9% of our global experience were operated on during acute ischemia. The average number of grafts per patient was 1.6 and internal mammary artery was utilized in 60.1% of patients. Left anterior descending coronary artery and right coronary artery were the coronary arteries most often treated. RESULTS: Our hospital mortality rate was 2.5% (28/1090) although it was 7% for patients over 70 years. The most common cause of death was cardiogenic shock after failed angioplasty. Postoperative complications included AMI in 4.8%, arrhythmias in 5.5% and pulmonary in 3.2%. Mean of any type of blood derivate utilization was 0.28 units/patients. CONCLUSION: Myocardial revascularization without CPB is a valid alternative in a selected cohort of patients and it is performed with low morbidity and mortality. Nowadays it represents an excellent tactical option for high-risk patients and in failed angioplasties.

[Late development of congestive heart failure in interventricular communication caused by penetrating wound, with pulmonary hypertension resolution after surgical correction]. / Desenvolvimento tardio de insuficiência cardíaca congestiva em comunicação interventricular por ferimento penetrante, com resolução da hipertensão pulmonar após correção cirúrgica.

Male, 33 years-old, with onset of heart failure and edema; he used to be completely asymptomatic but mentioned he underwent previously a pleural drainage, after a hemothorax provoked by a stab wound. His physical examination confirmed he was in heart failure and showed a harsh holosystolic murmur between mitral and tricuspid areas. Cardiac catheterization demonstrated a large apical ventricular septal defect (VSD) and systemic pulmonary arterial pressures. With oxygen there was an increase in the left to right shunt and normal pulmonary vascular resistance. The clinical diagnosis was that of a traumatic VSD provoking pulmonary hypertension although a congenital etiology could not be completely ruled out. At surgery there was a sharp cut at the pericardium and an apical epicardial lesion; the VSD was patch sutured and the patient did well with control of his heart failure. A control hemodynamic study performed within the first postoperative month showed no residual shunt and complete normalization of the pulmonary pressures and resistance.

[Anatomical classification of anterior encephaloceles]. / Classificação anatômica das encefaloceles anteriores.

The authors present an anatomical classification of the anterior encephaloceles. The importance of a topographic knowledge of such anomalies in their diagnosis and treatment is emphasized in order to avoid complications during the investigation of a cranio-facial protrusion.

An overview of medical cost containment in workers' compensation.

Use of medical cost-containment strategies in workers' compensation is increasingly common and varies in design and enforcement. An evolution toward managed care is observed, particularly in the private sector.

[Intracranial saccular aneurysm: report of 3 cases in a same family]. / Aneurisma sacular intracraniano. Apresentação de trés casos em uma mesma família.

The authors report the cases of three patients from the same family, all with intracranial saccular aneurysm (left carotid artery, anterior communicating artery, and middle cerebral artery). All three patients were operated on with good recovery and no complications. The authors call attention for some etiopathogenic aspects of familial saccular aneurysms.

Aneurisma sacular intracraniano: apresentaçäo de três casos em uma mesma família / Intracranial saccular aneurysm: report of 3 cases in a same family

Os autores apresentan os casos de três irmäos com diagnóstico de aneurisma sacular intracraniano, fazendo breve revisäo da literatura enfocando possíveis aspectos etiopatogênicos implicados

[Meningioma of the olfactory groove and breast neoplasms: report of 2 cases]. / Meningioma da goteira olfativa e câncer de mama. Relato de dois casos.

Two cases of olfactory groove meningiomas are presented in patients with breast cancer. Predominance of breast cancer and meningiomas in the age decades of the forties and the fifties, presence of steroid hormones receptors in both and prevalence of meningiomas in women are referred as significant correlations. Examination of the breast of women with meningiomas is recommended. Tomographic images are sometimes atypical, and a surgical intervention may be necessary.

Self-reports of spousal violence in a Mexican-American and non-Hispanic white population.

As part of a survey of Los Angeles households, 1,243 Mexican Americans and 1,149 non-Hispanic whites were surveyed about their experiences of spousal violence. Questions to assess violence included both perpetration (whether they had been physically violent toward a partner) and victimization (whether they had been the victim of sexual assault by a partner). Over one-fifth (21.2%) of the respondents indicated that they had, at one or more times in their lives, hit or thrown things at their current or former spouse or partner. Spousal violence rates for Mexican Americans born in Mexico and non-Hispanic whites born in the United States were nearly equivalent (20.0% and 21.6%, respectively); rates were highest for Mexican Americans born in the United States (30.9%). While overall rates of sexual assault were lower for Mexican Americans, one-third of the most recent incidents reported by Mexico-born Mexican-American women involved the husband and approximated rape.

Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles.

The current prevalence of DSM-III psychiatric disorders was assessed using the Diagnostic Interview Schedule (DIS) as part of a Los Angeles household population survey. The Los Angeles prevalence estimates were compared with sex- and age-adjusted estimates from four other US field sites, all of which were part of the Epidemiologic Catchment Area (ECA) program. Overall, few significant differences in household population rates were found between Los Angeles and the other ECA sites. Within the Los Angeles household sample, the current prevalence of disorder among Mexican Americans was compared with that among non-Hispanic whites. Non-Hispanic whites had higher rates of drug abuse/dependence than Mexican Americans; the rates among non-Hispanic whites in Los Angeles were also higher than those found at other ECA sites. Mexican Americans displayed higher rates of severe cognitive impairment, a finding that likely reflects ethnic and educational bias in the measurement of cognitive impairment. Another ethnic difference was found only for one specific age and sex group: Mexican-American women 40 years of age or older had strikingly high rates of phobia.

Expressed emotion and schizophrenic outcome among Mexican-American families.

This study has demonstrated that among low-income, relatively unacculturated Mexican-American households, a high level of expressed emotion on the part of key relatives significantly increases the risk of relapse for remitted schizophrenics who return home to live with their families after hospital discharge. This cross-cultural replication of earlier research findings in London and southern California suggests that critical, hostile, or emotionally overinvolved attitudes and behaviors may be general major stressors that adversely influence the fragile adaptation of schizophrenic individuals in diverse cultural settings. The finding of a lower prevalence of high levels of expressed emotion among Mexican-American compared to Anglo-American and British households lends support to the hypothesis that intrafamilial behaviors may account for different schizophrenic outcomes in different cultures.