RESUMO
PURPOSE: The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. METHODS: A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated. RESULTS: Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m2 (range 21.3-48.0 kg/m2) with higher mean BMI rates of 30.3 kg/m2 in the IHs group (range 22-48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. Mean console time was 148.3 (range 75-277 min) and 192.6 min (range 66-301 min) in the PVHs and IHs groups respectively. There were no intraoperative complications or conversions. Average length of stay was 1.5 days. Four patients were readmitted within 30 days of surgery. There were no reoperation or cases of intraparietal herniation in this cohort. No hernia recurrence was verified during the mean 230.7 days of follow up in both groups. CONCLUSION: We present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes.
Assuntos
Hérnia Ventral , Hérnia Incisional , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Feminino , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Humanos , Hérnia Incisional/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Telas CirúrgicasRESUMO
SETTINGS: Amazonas is facing increasing challenges in tuberculosis (TB) control, with nearly 3000 cases per year, and multidrug-resistant TB (MDR-TB) may jeopardise the TB control programme. OBJECTIVE: To assess the number of MDR-TB cases in the Amazonas and to improve estimates of the burden of TB. DESIGNS: The Brazilian National Mandatory Disease Reporting System (SINAN) and the Brazilian Epidemiological Surveillance System of Multidrug Resistance (TBMR) were searched for MDR-TB cases in the State of Amazonas from 2000 to 2011. RESULTS: Eighty-one MDR-TB cases were notified. The rates of primary MDR-TB, initial MDR-TB during the first treatment regimen and acquired MDR-TB were respectively 3.8%, 13.7% and 82.7%; 26.9% of previously treated patients had ⩾ 4 treatment cycles. The MDR-TB cases reported 263 contacts, only 35.0% of whom were examined. The cure and death rates among the 81 patients with MDR-TB were respectively 45.7% and 25.9%. CONCLUSIONS: The number of MDR-TB cases seems incompatible with the high TB prevalence in the Amazonas. Most patients were unaware of contact with TB patients. TB is endemic in the Amazonas. This highlights the need for improving resistance investigation among all TB cases.
Assuntos
Antituberculosos/uso terapêutico , Controle de Doenças Transmissíveis/organização & administração , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Avaliação das Necessidades , Prevalência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Tuberculose Resistente a Múltiplos Medicamentos/diagnósticoRESUMO
The occurrence of Mahanarva fimbriolata (Stal) in the state of São Paulo, Brazil, is observed in September and its control has been carried out through the use of Metarhizium anisopliae (Metsch.) Sorok. With the aim of evaluating the efficiency of the fungi isolates the present work was conducted on natural populations of M. fimbriolata in a mechanically harvested commercial sugarcane crop. The isolates IBCB 348, IBCB 408, IBCB 410 and IBCB 425 were used at a concentration of 1.5 × 10(12) conidia/ha (2 kg/ha of fungus grown on rice). A completely randomized block design was laid out with five treatments and four replicates, with each replicate consisting of 7 lines of 100 m length, and with 1.5 m spacing. At 30 days after spraying, the isolates IBCB 408 and IBCB 425 showed a control effectiveness for nymphs of 63 and 62%, respectively, and for adults it was 100%. At 60 days after application, the isolated IBCB 425 was the most efficient for controlling the nymphs (48.4%). In general, there was no statistical difference between the strains with respect to the capacity for controlling M. fimbriolata populations. It was observed that only a single application of M. anisopliae is not effective for maintaining the population of M. fimbriolata below the economic injury level.
No Estado de São Paulo, Mahanarva fimbriolata (Stal) é observada a partir de setembro e, atual-mente, o controle está sendo realizado com a aplicação do fungo Metarhizium anisopliae (Metsch.) Sorok. O objetivo deste trabalho foi comparar a eficiência de isolados de M. anisopliae em controlar populações naturais de M. fimbriolata em cultivos comerciais de cana-de-açúcar colhida mecanicamente. Os isolados IBCB 348, IBCB 408, IBCB 410 e IBCB 425 do fungo foram aplicados na concentração de 1,5 × 10(12) conídios/ha, utilizando-se 2 kg de arroz + fungo. As suspensões de conídios foram preparadas pela lavagem do arroz+fungo em água. O delineamento experimental foi em blocos casualizados com 5 tratamentos e 4 repetições, sendo cada repetição composta por 7 linhas de 100 m de comprimento e espaçamento de 1,5 m. Decorridos 30 dias da pulverização, observaram-se que os isolados IBCB 408 e IBCB 425 apresentaram eficiência de controle de ninfas de 63 e 62%, respectivamente, e para os adultos a eficiência foi de 100%. Aos 60 dias da aplicação, o isolado IBCB 425 foi o mais eficiente para controlar as ninfas (48,4%). De maneira geral, não ocorreu diferença estatística entre os isolados quanto à capacidade de controle das populações de M. fimbriolata. Observou-se que apenas uma única aplicação de M. anisopliae não é eficiente para a manutenção da população de M. fimbriolata abaixo do nível de dano econômico.
RESUMO
No Estado de São Paulo, Mahanarva fimbriolata (Stal) é observada a partir de setembro e, atualmente, o controle está sendo realizado com a aplicação do fungo Metarhizium anisopliae(Metsch.) Sorok. O objetivo deste trabalho foi comparar a eficiência de isolados de M. anisopliae em controlar populações naturais de M. fimbriolata em cultivos comerciais de cana-de-açúcar colhida mecanicamente. Os isolados IBCB 348, IBCB 408, IBCB 410 e IBCB 425 do fungo foram aplicados na concentração de 1,5 × 1012 conídios/ha, utilizando-se 2 kg de arroz + fungo. As suspensões de conídios foram preparadas pela lavagem do arroz+fungo em água. O delineamento experimental foi em blocos casualizados com 5 tratamentos e 4 repetições, sendo cada repetição composta por 7 linhas de 100 m de comprimento e espaçamento de 1,5 m. Decorridos 30 dias da pulverização, observaram-se que os isolados IBCB 408 e IBCB 425 apresentaram eficiência de controle de ninfas de 63 e 62%, respectivamente, e para os adultos a eficiência foi de 100%. Aos 60 dias da aplicação, o isolado IBCB 425 foi o mais eficiente para controlar as ninfas (48,4%). De maneira geral, não ocorreu diferença estatística entre os isolados quanto à capacidade de controle das populações de M. fimbriolata. Observou-se que apenas uma única aplicação de M. anisopliae não é eficiente para a manutenção da população de M. fimbriolata abaixo do nível de dano econômico.
EFFECTIVENESS OF FOUR ISOLATES OF METARHIZIUM ANISOPLIAE (METSCH.) SOROK. AGAINST THE ROOT SPITTLEBUG, MAHANARVA FIMBRIOLATA (STAL, 1854) (HEMIPTERA: CERCOPIDAE), IN THE FIELD. The occurrence of Mahanarva fimbriolata (Stal) in the state of São Paulo, Brazil, is observed in September and its control has been carried out through the use of Metarhizium anisopliae (Metsch.) Sorok. With the aim of evaluating the efficiency of the fungi isolates the present work was conducted on natural populations of M. fimbriolata in a mechanically harvested commercial sugarcane crop. The isolates IBCB 348, IBCB 408, IBCB 410 and IBCB 425 were used at a concentration of 1.5 × 1012 conidia/ha (2 kg/ha of fungus grown on rice). A completely randomized block design was laid out with five treatments and four replicates, with each replicate consisting of 7 lines of 100 m length, and with 1.5 m spacing. At 30 days after spraying, the isolates IBCB 408 and IBCB 425 showed a control effectiveness for nymphs of 63 and 62%, respectively, and for adults it was 100%. At 60 days after application, the isolated IBCB 425 was the most efficient for controlling the nymphs (48.4%). In general, there was no statistical difference between the strains with respect to the capacity for controlling M. fimbriolata populations. It was observed that only a single application of M. anisopliae is not effective for maintaining the population of M. fimbriolata below the economic injury level.
Assuntos
Animais , Hemípteros/classificação , Saccharum , Controle Biológico de Vetores , Metarhizium/classificaçãoRESUMO
No Estado de São Paulo, Mahanarva fimbriolata (Stal) é observada a partir de setembro e, atualmente, o controle está sendo realizado com a aplicação do fungo Metarhizium anisopliae(Metsch.) Sorok. O objetivo deste trabalho foi comparar a eficiência de isolados de M. anisopliae em controlar populações naturais de M. fimbriolata em cultivos comerciais de cana-de-açúcar colhida mecanicamente. Os isolados IBCB 348, IBCB 408, IBCB 410 e IBCB 425 do fungo foram aplicados na concentração de 1,5 × 1012 conídios/ha, utilizando-se 2 kg de arroz + fungo. As suspensões de conídios foram preparadas pela lavagem do arroz+fungo em água. O delineamento experimental foi em blocos casualizados com 5 tratamentos e 4 repetições, sendo cada repetição composta por 7 linhas de 100 m de comprimento e espaçamento de 1,5 m. Decorridos 30 dias da pulverização, observaram-se que os isolados IBCB 408 e IBCB 425 apresentaram eficiência de controle de ninfas de 63 e 62%, respectivamente, e para os adultos a eficiência foi de 100%. Aos 60 dias da aplicação, o isolado IBCB 425 foi o mais eficiente para controlar as ninfas (48,4%). De maneira geral, não ocorreu diferença estatística entre os isolados quanto à capacidade de controle das populações de M. fimbriolata. Observou-se que apenas uma única aplicação de M. anisopliae não é eficiente para a manutenção da população de M. fimbriolata abaixo do nível de dano econômico.(AU)
EFFECTIVENESS OF FOUR ISOLATES OF METARHIZIUM ANISOPLIAE (METSCH.) SOROK. AGAINST THE ROOT SPITTLEBUG, MAHANARVA FIMBRIOLATA (STAL, 1854) (HEMIPTERA: CERCOPIDAE), IN THE FIELD. The occurrence of Mahanarva fimbriolata (Stal) in the state of São Paulo, Brazil, is observed in September and its control has been carried out through the use of Metarhizium anisopliae (Metsch.) Sorok. With the aim of evaluating the efficiency of the fungi isolates the present work was conducted on natural populations of M. fimbriolata in a mechanically harvested commercial sugarcane crop. The isolates IBCB 348, IBCB 408, IBCB 410 and IBCB 425 were used at a concentration of 1.5 × 1012 conidia/ha (2 kg/ha of fungus grown on rice). A completely randomized block design was laid out with five treatments and four replicates, with each replicate consisting of 7 lines of 100 m length, and with 1.5 m spacing. At 30 days after spraying, the isolates IBCB 408 and IBCB 425 showed a control effectiveness for nymphs of 63 and 62%, respectively, and for adults it was 100%. At 60 days after application, the isolated IBCB 425 was the most efficient for controlling the nymphs (48.4%). In general, there was no statistical difference between the strains with respect to the capacity for controlling M. fimbriolata populations. It was observed that only a single application of M. anisopliae is not effective for maintaining the population of M. fimbriolata below the economic injury level. (AU)
Assuntos
Animais , Hemípteros/classificação , Saccharum , Metarhizium/classificação , Controle Biológico de VetoresRESUMO
ABSTRACT Migdolus fryanus (Westwood, 1863) (Col: Vesperidae) usually causes great damages to sugar cane crops. The reproductive behavior aspects should be considered important to develop control methods. The flight behavior during mating was studied in sugar cane fields in four municipalities of São Paulo State, Brazil, (Olímpia, Catanduva, Promissão and Teodoro Sampaio), from October 2001 to March 2003. The fluctuation of larvae population has previously been studied in Catanduva, SP, Brazil, during March 2002 and February 2004. In September 2003, the larval infestion was compared in crops of 3 municipalities (Olimpia, Catanduva and Teodoro Sampaio). The reproductive flight occurred at high adult male density, after raining, between October and March. Such flights lasted seven days. The female came out from the soil for mating from 8:00 to 10:00 a.m,. Usually, the male could be found before the female emergence, influenced by the female sex pheromone. The mating lasted five to thirty seconds. Immediately after mating, the female returned to the soil to start oviposition. Larvae were more frequently between June and September (dry season). The highest larval infestation was observed in Teodoro Sampaio, while the lowest one was noted in Catanduva.
RESUMO Infestações por Migdolus fryanus (Westwood, 1863) (Col: Vesperidae) podem resultar em severos prejuízos à cultura da cana-de-açúcar. Na presente pesquisa estudou-se o comportamento de revoada em canaviais de 4 municípios de São Paulo (Olímpia, Catanduva, Promissão e Teodoro Sampaio), entre os meses de outubro de 2001 e março de 2003, realizando-se 3 observações por município em cada ano. Em Catanduva, SP foi estudada a flutuação de larvas por intermédio de abertura de trincheiras no período compreendido entre março de 2002 e fevereiro de 2004. Além disso, no mês de setembro de 2003 foi comparado entre três municípios (Olímpia, Catanduva e Teodoro Sampaio) o índice de infestação de larvas por touceira de cana, em reboleira atacada. As revoadas ocorreram sempre após chuvas, algumas duraram até 7 dias e aconteceram entre os meses de outubro e março. Fêmeas apareceram de forma bem sincronizada entre 8h e 10h da manhã e permaneceram no solo até a chegada do macho. Já os machos foram freqüentes o dia todo, aparecendo primeiro que as fêmeas. A cópula durou entre 5 a 30 segundos. As larvas foram mais freqüentes entre março a setembro e em maior número no período de baixa pluviosidade (julho a setembro). O maior índice por touceira ocorreu em Teodoro Sampaio, média de 3,96/larvas por touceira, e Olímpia, média de 3,88/larvas por touceira que diferiram significativamente de Catanduva, média de 1,6/larva por touceira. Com relação às reboleiras estudadas ocorreu diferença significativa do número de larvas por touceiras apenas em Olímpia, SP.
RESUMO
The presence of hepatitis B virus (HBV) serological markers was investigated in 170 patients (137 male, 33 female) infected with human immunodeficiency virus (HIV) type 1. Antibodies to the hepatitis B core antigen (anti-HBc antibodies) were detected in 115 (68%) patients. Of these 115, 14 (12%) were hepatitis B surface antigen (HBsAg) positive, 60 (52%) presented anti-HBs antibodies, and 41 (35%) were anti-HBc positive only. All 115 of the anti-HBc positive samples were tested for HBV DNA by using two polymerase chain reaction (PCR) assays that amplify the core and pre-S regions of the HBV genome, respectively. HBV DNA was detected in 23 samples: 7 of 14 (50%) HBsAg-positive samples, 12 of 60 (20%) anti-HBs-positive samples, and 4 of 41 (10%) samples positive for anti-HBc only. Six samples (all HBsAg positive) were positive in both PCR assays and 17 samples were HBV DNA positive in only one assay. The mean viral load in HBsAg-positive patients was higher than that observed in HBsAg-negative patients. A number of patients were receiving treatment with lamivudine, a drug that interferes with both HBV and HIV replication. However, neither the rate of HBV DNA positivity nor HBV load was significantly different between patients treated with lamivudine and those not treated with this drug.
Assuntos
DNA Viral/análise , Infecções por HIV/epidemiologia , HIV-1/isolamento & purificação , Hepatite B/epidemiologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Estudos de Coortes , Comorbidade , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Infecções por HIV/diagnóstico , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/análise , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Probabilidade , Fatores de Risco , Testes Sorológicos/métodos , Distribuição por Sexo , Carga ViralRESUMO
The world of surgical laparoscopy is evolving. Laparoscopic prosthetic inguinal hernia repair is gaining rapid and wide acceptance. This experience consisted of 144 hernia repairs in 105 patients (40 bilateral, 31 recurrent, and 33 unilateral nonrecurrent hernias), treated through an extraperitoneal laparoscopic repair. When compared with transabdominal repair, operative time and postoperative recovery were similar, with some advantages related to the avoidance of intraabdominal manipulation and potential related complications. In spite of a relatively short follow-up (up to 40 months), there were no recurrences in this series. Morbidity rate was acceptable (16.1%), mainly reported as minor complications. Anatomical and technical skills to perform the operation are required and achieved through training. Extraperitoneal hernia repair with synthetic mesh is safe and feasible, with the advantages of being associated with less pain, rapid return to full activities, and the already proven milder systemic responses following interventional laparoscopy.
Assuntos
Hérnia Inguinal/cirurgia , Laparoscopia/métodos , Feminino , Humanos , Tempo de Internação , Masculino , Polipropilenos , Complicações Pós-Operatórias , Recidiva , Telas CirúrgicasRESUMO
Groundwater samples collected by piezometers from three cemeteries in geologically distinct areas of S. Paulo and Santos, Brazil, were analysed in order to determine their hygienic and sanitary conditions. Fecal coliformes, fecal streptococci, sulfite reducer clostridia and Salmonella were searched for the purpose of evaluating sanitary conditions, and total coliforms, heterotrophic bacteria, proteolitic and lipolitic microorganisms for evaluating hygienic conditions. In some samples, nitrate levels were also determined. It was discovered that these waters do not present adequate sanitary and hygienic conditions and that, in some cases, nitrate levels were extremely high (75.7 mg/l). In most samples, higher levels of fecal streptococci and sufite reducer clostridia than fecal coliforms were detected, which seems to show that the two former indicators would be more appropriate for evaluating the sanitary conditions of this kind of water. Salmonella were detected in only one of 44 samples analysed and coliphages in none. In the statistical analysis, the correlation matrix showed significant correlations among three fecal pollution indicators, as well as among anaerobic and aerobic heterotrophs and lipolitic bacteria. A direct relationship between the deterioration of water quality and the geological and hydrogeological conditions of the environment studied was observed. When cemeteries are constructed these conditions should, therefore, be taken into consideration.