RESUMO
Persistent organic pollutants (POPs) were determined in Gymnura altavela liver samples from one of the most impacted estuarine environments in the Atlantic Ocean (Guanabara Bay, Brazil). PCBs were the predominant compounds (91.2%) averaging 6773 ± 4659 ng.g-1 lipid weight (lw). DDT, Mirex, HCH and HCB concentrations were 633 ± 715, 6.2 ± 9.3, 3.4 ± 1.4 and 0.5 ± 0.5 ng.g-1 lw, respectively. Recent DDT input in the estuary was minimum, as verified by the p,p'-DDE/∑DDT ratio (0.67). The prevalence of industrial compounds was highlighted by the ΣDDT/ΣPCB ratio (0.08). A negative correlation detected between disc width and PCBs, Mirex and HCH concentrations may be a consequence of maternal offloading. High POP concentrations in G. altavela liver samples from Guanabara Bay suggests that PCBs, in particular, may pressure the conservation of this threatened with extinction tropical estuarine batoid species.
Assuntos
Hidrocarbonetos Clorados , Bifenilos Policlorados , Poluentes Químicos da Água , Animais , Oceano Atlântico , Brasil , Espécies em Perigo de Extinção , Monitoramento Ambiental , Hidrocarbonetos Clorados/análise , Poluentes Orgânicos Persistentes , Bifenilos Policlorados/análise , Poluentes Químicos da Água/análiseRESUMO
Calcaneal fractures are the most common tarsal fractures and their treatment is still debated today. We intend in this update to highlight the points of controversy and clarify the consensus, especially in the treatment of intra-articular fractures, as well as to describe the management of major complications.
Las fracturas de calcáneo son las más frecuentes del tarso y su tratamiento sigue siendo hoy en día objeto de debate. Pretendemos en esta actualización destacar los puntos de controversia, así como clarificar los consensos, especialmente en el tratamiento de las fracturas intraarticulares, así como describir el manejo de las principales complicaciones.
Assuntos
Calcâneo , Fraturas Ósseas , Calcâneo/lesões , Consenso , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Humanos , Resultado do TratamentoRESUMO
Hallux rigidus is the most frequent arthrosis of the foot and ankle and the second most important condition involving the first metatarsophalangeal joint after hallux valgus. If left untreated, it may cause important alterations in gait, mobility and activities of daily living. The purpose of this review article is to describe a complete treatment algorithm for all grades of this condition, after a thorough bibliographic review.
Assuntos
Algoritmos , Hallux Rigidus/cirurgia , HumanosRESUMO
High-energy tibial pylon fractures represent some of the most severe injuries of the ankle joint and currently represent a challenge for the orthopedic surgeon. These are usually polytraumatized patients and before admitting them into the traumatology unit, spinal cord, pelvic or thoracoabdominal injuries should be ruled out. Due to the special anatomy of the area, its thin skin cover and subcutaneous location, soft tissues are usually severely affected and this is key when choosing the time for a surgical intervention. Although the definitive treatment of these injuries is controversial, the so called two-stage treatment seems to predominate in order to minimize soft tissue iatrogenic injuries applying the concept of orthopedic damage control of the limb. We present the preliminary results of 10 patients operated with this method at our center.
Assuntos
Traumatismos do Tornozelo/terapia , Fixação de Fratura/métodos , Fraturas Fechadas/terapia , Fraturas da Tíbia/terapia , Fatores de Tempo , Traumatismos do Tornozelo/etiologia , Traumatismos do Tornozelo/cirurgia , Parafusos Ósseos , Fixadores Externos , Fíbula/lesões , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Fraturas Fechadas/classificação , Fraturas Fechadas/etiologia , Fraturas Fechadas/cirurgia , Humanos , Imobilização , Fixadores Internos , Traumatismo Múltiplo , Estudos Retrospectivos , Lesões dos Tecidos Moles/etiologia , Lesões dos Tecidos Moles/cirurgia , Lesões dos Tecidos Moles/terapia , Fraturas da Tíbia/classificação , Fraturas da Tíbia/etiologia , Fraturas da Tíbia/cirurgia , CicatrizaçãoRESUMO
Symptomatic involvement of the gastrointestinal (GI) tract as a prominent symptom in Langerhans' cell histiocytosis (LCH) is uncommon, occurring in less than 1 to 5 percent of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7 percent), protein-losing enteropathy (33.3 percent) and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management
Assuntos
Feminino , Humanos , Pré-Escolar , Sistema Digestório/patologia , Histiocitose de Células de Langerhans/patologia , Enteropatias Perdedoras de Proteínas/patologia , Biópsia , Evolução Fatal , Hipoaldosteronismo/complicações , Enteropatias Perdedoras de Proteínas/diagnósticoRESUMO
Symptomatic involvement of the gastrointestinal (GI) tract as a prominent symptom in Langerhans' cell histiocytosis (LCH) is uncommon, occurring in less than 1 to 5% of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7%), protein-losing enteropathy (33.3%) and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management.
Assuntos
Sistema Digestório/patologia , Histiocitose/patologia , Enteropatias Perdedoras de Proteínas/patologia , Biópsia , Pré-Escolar , Evolução Fatal , Feminino , Humanos , Hipoaldosteronismo/complicações , MasculinoRESUMO
We report the case of a 3-year-old girl with stage I Wilms' tumor of favorable histology. During the course of chemotherapy 5 months post-diagnosis, an abdominal ultrasonogram revealed hypoechoic areas consistent with hepatic tumor recurrence. A liver biopsy performed to rule out recurrence of the malignancy was suggestive of toxocariasis and the diagnosis was confirmed by serologic testing. Although the patient had few classic signs of visceral larva migrans, her eosinophilia and family social history should have suggested this possibility. This case demonstrates that hepatic toxocariasis should be considered in evaluating hepatic hypoechoic lesions in a child, even when features typical of the disease are absent.