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Introduction: Few studies are available on the acute effects of motor racing on race drivers lactacidemia and blood glucose. Objective: To verify changes in lactacidemia and glycemia of race car drivers in the Old Stock Race category. Method: The concentrations of plasma lactate and glycemia of eight male race car drivers in the Old Stock Race category (OSR) were recorded thirty minutes before the start and ten minutes after the start of the race. The data were obtained during the 4th round of the 2018 Season of the OSR held at the Jos Carlos Pace race track (Interlagos / So Paulo-Brazil). For comparison between moments, paired Students t-test paired on variables with normal distribution was used, with Bonferronis post-test, adopting a 5% significance level, for all analyses. Descriptively the data were compared using the Percentage Delta and presented in graphical and tabular form.Results: It was found that the lactate concentration increased significantly after the race (2.26 + 0.76 vs. 3.56 + 0.97 mmol / L, p = 0.0101). On the other hand, there was no change in blood glucose (122 +15.3 vs. 123 + 19.8 mg / dl, p = 0.8828).Conclusion: The significant increase in lactacidemia after the race indicates that there was an anaerobic muscle requirement during the race. On the other hand, there was no change in the mean blood glucose after the race.Key Words:Motor Racing, Human Performance, Exercise, Experimental Research

De forma a compreender a influência e relação no binómio liderança e satisfação em enfermagem, o objetivo deste estudo foi apresentar uma revisão bibliográfica narrativa acerca do tema e analisar o conhecimento produzido entre a relação liderança e a satisfação na equipa de enfermagem. Método:Trata-se de uma revisão narrativa da literatura. As bases de dados utilizadas foram a EBSCO (CINAHL Complete, MedLine Complete) para responder à pergunta de partida: “Qual o conhecimento relativamente à influência da liderança na satisfação da equipa de enfermagem no período de 2016-2021?". Para obtenção dos artigos, foram utilizados como critérios de inclusão: fontes primárias e revisões da literatura, integrativas, disponíveis na integra, em idioma português, espanhol e inglês, nos últimos cinco anos (2016-2021) e como critérios de exclusão: teses e dissertações, revisões narrativas, artigos duplicados ou noutros idiomas, considerando os seguintes descritores: liderança, satisfação no trabalho e enfermagem, aceites pela DeCS. As pesquisas desenvolveram-se durante o mês de maio de 2021 e selecionaram-se 26 artigos. Após análise dos artigos foram realizadas leituras exploratórias para maior compressão dos assuntos definidos e exploração do material recolhido, foram selecionados 7 artigos.

Estudos envolvendo a dinâmica de nutrientes no solo sob campo nativo submetido a queimas no Sul do Brasil são escassos. O presente trabalho tem por objetivo avaliar as modificações nos atributos químicos do solo oriundas da queima das pastagens nativas. O estudo foi desenvolvido em Lages - SC, num Cambissolo Húmico Alumínico, argiloso e com alto teor de matéria orgânica. Os tratamentos consistiram de duas áreas contíguas, uma de 5,06ha com pastejo e queima, e outra, de 3,4ha, somente submetida ao pastejo. A temperatura do solo, a 1cm de profundidade, da área queimada, foi medida por sonda elétrica. As amostragens de solo, em três camadas (0 fraction three-quarters 2, 2 fraction three-quarters 5 e 5 fraction three-quarters 10cm), foram efetuadas 3 dias antes da queima, imediatamente após a queima e 30, 60, 90, 150, 220 e 350 dias após a queima, para o tratamento queimado; e 3 dias antes da queima, 90 e 220 dias após a queima, para o tratamento não queimado. Avaliaram-se o pH em água e os teores de N-total, N-NO3-+NO2, N-NH4+, Ca+Mg, K, Al e P. A camada superficial do solo (0 fraction three-quarters 2 cm) foi a que mostrou ser mais sensível à ação do fogo, atingindo temperatura máxima de 70masculineC aos 4 minutos. Nessa camada, logo após a queima, ocorreu aumento nos teores de nitrato e diminuição nos teores de amônio. Também a queima aumentou os teores de K, Ca+Mg e os valores de pH e diminuiu os teores de Al+3. De um modo geral, todos os atributos químicos do solo avaliados tenderam aos valores originais a partir dos 90 dias após a queima.

Streptococcus mutans ( S. mutans ) is the major pathogen involved in caries development during the first few years of life. Prebiotics represent a breakthrough approach to maintaining oral health by utilizing naturally beneficial bacteria against harmful bacteria., Aim: To assess the effects of prebiotics supplements on salivary pH and salivary buffer capacity in children with early childhood caries (ECC)., Materials and Methods: This study was performed on 23 samples, aged 3-6 years who received prebiotics supplements for 14 days, followed up to 3 and 6 months. Unstimulated saliva samples were collected to assess salivary pH and salivary buffer capacity using salivary check buffer kit., Statistical Analysis Used: The data showed normal distribution; hence, parametric tests were applied. Repeated measures of analysis of variance were applied to compare the mean at the three different time intervals, followed by paired t- test for pairwise comparison., Results: There was a highly significant difference on comparing the different parameters. Salivary pH was lowest at baseline with a mean value of 6.65 which increased at the 3-6-month follow-up to 7.00 and 7.33. Similarly, salivary buffer capacity which was 4.73 at baseline, increased at 3 months to 8.17, and at 6 months to 10.34., Conclusion: It can be suggested that prebiotics supplements can be adopted as a novel approach in children with ECC as a form of preventive measure to facilitate a better lifestyle., Clinical Significance: These prebiotics when taken for a period of 2 weeks increased the salivary pH as well as salivary buffer capacity when the data was compared at different time intervals emphasizing its importance, especially in children with ECC., How to Cite This Article: Fernandes VA, Mata DB, Nadig B, et al. Effect of Prebiotics Supplements on Salivary pH and Salivary Buffer Capacity in Children with Early Childhood Caries: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(1):54-58., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2024; The Author(s).)

This paper aims to understand the current research scenario through published studies on corporate sustainability, emphasizing the environmental approach. Methodologically, this research develops a systematic literature review based on papers published in the Web of Science database in the last ten years. As a result, there was an upward evolution of research on the searched topic, with one hundred fifteen publications in the last three years compared to one hundred six documents published in the previous seven years. It is also observed that studies published at the beginning of the time frame between 2011 and 2020 were more concerned with the adoption of corporate sustainability, while the most recent research focuses on new approaches and methodologies for its implementation. And, with regard to its implementation, one of the main barriers is the incorrect perception of senior managers that the results from corporate sustainability must be more linked to the economic than to the environmental and social spheres. As relevant aspects, this study observed that new technologies, currently led by the 5th generation mobile network (5G) and Fourth Industrial Revolution (Industry 4.0), can contribute to the insertion of corporate sustainability in the industrial context. It also noted that, despite being recent, COVID-19 was considered by several researchers as an event to be considered in terms of corporate sustainability., Competing Interests: Conflict of interestThe authors have no relevant financial or non-financial interests to disclose and have no conflicts of interest to declare that are relevant to the content of this article., (© The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background & Aims: Creatine is a dietary supplement with potential capacity to stimulate the phosphocreatine pathway and protein synthesis, through the stimulation of the PI3-K/AKT and mTOR cascade, its use in populations with reduced muscle preservation capacity (such as the older adults) can be an interesting and low-cost alternative. The aim of the present study was to evaluate the morphological, stereological and morphometric effects of the use of creatine monohydrate for 8 weeks on the renal, hepatic and muscular tissues of 26-month-old Wistar rats., Methods: Twelve Wistar rats were divided into two groups of six animals each. Group 1 was not supplemented with creatine and received a standard diet consisting of water and chow. Group 2 received the same diet, but was supplemented with creatine monohydrate at a dose of 0.3 mg/kg of body weight diluted in 200 ml of drinking water for 8 weeks., Results: Supplementation reduced muscle mass loss as indicated by the perimeter of the perimysium (group 1: 114.6 μm; group 2: 65.2 μm) and endomysium (group 1: 41,239.3 μm; group 2: 12,437.6 μm) compared to the non-supplemented group. In addition, a larger cross-sectional area was observed in group 2. No significant kidney or liver damage was observed in the supplemented group., Conclusions: The use of creatine is considered safe in the animal model used, as this amine does not cause glomerular reductions or hepatic degeneration., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

An efficient strategy combining the stereocontrol of organocatalysis with the diversity-generating character of multicomponent reactions is described to produce structurally unique, tetrasubstituted cyclopentenyl frameworks. An asymmetric Michael addition-hemiacetalization between α-cyanoketones and α,β-unsaturated aliphatic aldehydes was performed for constructing cyclic hemiacetals, which were next employed as chiral bifunctional substrates in a new diastereoselective intramolecular isocyanide-based multicomponent reaction. This approach furnished a diversity of structurally complex compounds - including peptidomimetics and natural product hybrids in high stereoselectivity (up to >99% ee and up to >99 : 1 dr) and in moderate to high yields., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Electrosynthesis can be considered a powerful and sustainable methodology for the synthesis of small organic molecules. Due to its intrinsic ability to generate highly reactive species under mild conditions by anodic oxidation or cathodic reduction, electrosynthesis is particularly interesting for otherwise challenging transformations. One such challenge is the installation of fluorinated alkyl groups, which has gained significant attention in medicinal chemistry and material science due to their unique physicochemical features. Unsurprisingly, several electrochemical fluoroalkylation methods have been established. In this review, we survey recent developments and established methods in the field of electrochemical mono-, di-, and trifluoromethylation, and perfluoroalkylation of small organic molecules., (© 2021 The Authors. Published by The Chemical Society of Japan & Wiley-VCH GmbH.)

Background: Since February 2020, data on the clinical features of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their clinical evolution have been gathered and intensively discussed, especially in countries with dramatic dissemination of this disease., Objective: To assess the clinical features of Brazilian patients with SARS-CoV-2 and analyze its local epidemiological features., Design and Setting: Observational retrospective study conducted using data from an official electronic platform for recording confirmed SARS-CoV-2 cases., Methods: We extracted data from patients based in the state of Pernambuco who were registered on the platform of the Center for Strategic Health Surveillance Information, between February 26 and May 25, 2020. Clinical signs/symptoms, case evolution over time, distribution of confirmed, recovered and fatal cases and relationship between age group and gender were assessed., Results: We included 28,854 patients who were positive for SARS-CoV-2 (56.13% females), of median age 44.18 years. SARS-CoV-2 infection was most frequent among adults aged 30-39 years. Among cases that progressed to death, the most frequent age range was 70-79 years. Overall, the mortality rate in the cohort was 8.06%; recovery rate, 30.7%; and hospital admission rate (up to the end of follow-up), 17.3%. The average length of time between symptom onset and death was 10.3 days. The most commonly reported symptoms were coughing (42.39%), fever (38.03%) and dyspnea/respiratory distress with oxygen saturation < 95% (30.98%)., Conclusion: Coughing, fever and dyspnea/respiratory distress with oxygen saturation < 95% were the commonest symptoms. The case-fatality rate was 8.06% and the hospitalization rate, 17.3%.

Introduction: Percutaneous nephrolithotomy is the main type of surgery indicated for kidney stones larger than 2 cm. The present study describes a three-needle technique for percutaneous nephrolithotomy on two planes., Surgical Technique: The patient is first placed in the lithotomy position for cystoscopy, which guides the ureteral and urethral catheter. Next, the patient is placed in ventral decubitus for the three-needle technique. With the aid of the nephroscope, the first needle is positioned in the projection of the renal pelvis, the second needle is placed in the most posterior of the inferior calyces and the third needle is aligned with the other two at the most depressible point determined by the surgeon's index finger. After alignment in the topography of the third needle, an incision is made with the scalpel 1-2 cm perpendicular to the aponeurosis of the latissimus dorsi muscle. The second needle is replaced with a peridural needle, which is used to confirm the location of the inferior renal calyx and limit the depth of the Chiba needle inserted in the topography of the third needle, forming a 90° angle with the peridural needle. The Chiba needle enables the passage of the guidewire and subsequent dilatation until the 30F caliber for the passage of the Amplatz dilator, initiating the conventional procedure., Comments: The technique described has been used at our service for 15 years and has the advantages of less morbidity, fewer complications and less use of the nephrostomy tube. The technique is also easy to learn and highly reproducible.

Aims: B 1 - and B 2 -kinin receptors play a major role in several cardiovascular diseases. Therefore, we aimed to evaluate cardiac functional consequences of B 1 - and B 2 -kinin receptors ablation, focusing on the cardiac ROS and NO generation., Main Methods: Cardiac contractility, ROS, and NO generation, and protein expression were evaluated in male wild-type (WT), B 1 - (B 1 -/- ) and B 2 -kinin (B 2 -/- ) knockout mice., Key Findings: Impaired contractility in B 1 -/- and B 2 -/- hearts was associated with oxidative stress through upregulation of NADPH oxidase p22 phox subunit. B 1 -/- and B 2 -/- hearts presented higher NO and peroxynitrite levels than WT. Despite decreased sarcoplasmic reticulum Ca 2+ ATPase pump (SERCA2) expression, nitration at tyrosine residues of SERCA2 was markedly higher in B 1 -/- and B 2 -/- hearts., Significance: B 1 - and B 2 -kinin receptors govern ROS generation, while disruption of B 1 - and B 2 -kinin receptors leads to impaired cardiac dysfunction through excessive tyrosine nitration on the SERCA2 structure., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Nucleosynthetic isotope variability among Solar System objects is often used to probe the genetic relationship between meteorite groups and the rocky planets (Mercury, Venus, Earth and Mars), which, in turn, may provide insights into the building blocks of the Earth-Moon system. Using this approach, it has been inferred that no primitive meteorite matches the terrestrial composition and the protoplanetary disk material from which Earth and the Moon accreted is therefore largely unconstrained. This conclusion, however, is based on the assumption that the observed nucleosynthetic variability of inner-Solar-System objects predominantly reflects spatial heterogeneity. Here we use the isotopic composition of the refractory element calcium to show that the nucleosynthetic variability in the inner Solar System primarily reflects a rapid change in the mass-independent calcium isotope composition of protoplanetary disk solids associated with early mass accretion to the proto-Sun. We measure the mass-independent 48 Ca/ 44 Ca ratios of samples originating from the parent bodies of ureilite and angrite meteorites, as well as from Vesta, Mars and Earth, and find that they are positively correlated with the masses of their parent asteroids and planets, which are a proxy of their accretion timescales. This correlation implies a secular evolution of the bulk calcium isotope composition of the protoplanetary disk in the terrestrial planet-forming region. Individual chondrules from ordinary chondrites formed within one million years of the collapse of the proto-Sun reveal the full range of inner-Solar-System mass-independent 48 Ca/ 44 Ca ratios, indicating a rapid change in the composition of the material of the protoplanetary disk. We infer that this secular evolution reflects admixing of pristine outer-Solar-System material into the thermally processed inner protoplanetary disk associated with the accretion of mass to the proto-Sun. The identical calcium isotope composition of Earth and the Moon reported here is a prediction of our model if the Moon-forming impact involved protoplanets or precursors that completed their accretion near the end of the protoplanetary disk's lifetime.

Purpose: To evaluate functional and anatomical outcomes after aflibercept in patients with diabetic macular edema (DME) with poor response to bevacizumab., Methods: We retrospectively reviewed patients with DME recalcitrant to bevacizumab who were switched to aflibercept between January and December 2015. All patients had a minimal follow-up of three months before the conversion and underwent at least three injections of bevacizumab. Functional outcome consisted in best corrected visual acuity (VA). Anatomical outcomes were demonstrated through central macular thickness (CMT) measured by optical coherence tomography., Results: Forty-nine eyes of 34 subjects were reviewed. Mean VA improved from 0.55 ± 0.32 logMAR to 0.46 ± 0.33 logMAR (p = 0.038). Mean CMT decreased from 473 ± 146 μm to 349 ± 85 μm (p < 0.001). Twelve eyes (24%) demonstrated absence of macular edema after aflibercept. Previous bevacizumab exposure did not correlate with different outcomes. The variation of VA in response to aflibercept was significantly superior in the group with poorer VA before the switch (mean variation of -0.097 ± 0.21 logMAR) when compared to eyes with VA < 0.4 logMAR (mean variation of +0.019 ± 0.090 logMAR; p = 0.036). The same scenario was verified for anatomical outcomes as eyes with poor vision before the switch (≥0.4 logMAR) achieved superior reduction in CMT in response to aflibercept (mean CMT variation of -157 ± 171 μm versus -49.5 ± 39.9 μm; p < 0.01). Pre-switch CMT was a predictor of CMT reduction after switching (B = -0.945; confidence interval 95% -1.1; -0.76; p < 0.001)., Conclusions: Conversion to aflibercept for persistent DME resulted in functional and anatomical improvements and these outcomes were not influenced by previous bevacizumab exposure. Pre-switch CMT was a predictor of anatomical changes after aflibercept.

The aim of the present study was to investigate factors associated with bruxism in children aged from 1 to 13 years with developmental disabilities. A total of 389 dental records were examined. The bruxism analyzed was determined based on parental reports. The following variables were also analyzed: gender, age, International Code of Diseases (ICD), mouth breathing, history of gastroesophageal reflux, use of psychotropic drugs, gingival status, reports of xerostomia, hyperkinesis, pacifier use, thumb sucking and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without bruxism. Variables with a p-value < 0.25 in the bivariate analysis were incorporated into the logistic regression models. Females had a 0.44-fold (95%CI: 0.25 to 0.78) greater chance of exhibiting bruxism than males. Individuals with gastroesophageal reflux had a 2.28-fold (95%CI: 1.03 to 5.02) greater chance of exhibiting bruxism. Individuals with reported involuntary movements had a 2.24-fold (95%CI: 1.19 to 4.24) greater chance of exhibiting bruxism than those without such movements. Exhibiting involuntary movements, the male gender and gastroesophageal reflux are factors associated with bruxism in children with developmental disabilities.

Objective: Report the experience with the Society of Thoracic Surgeons scoring system in a Brazilian population submitted to isolated coronary artery bypass graft surgery., Methods: Data were collected from January-2010 to December-2011, and analyzed to determine the performance of the Society of Thoracic Surgeons scoring system on the determination of postoperative mortality and morbidity, using the method of the receiver operating characteristic curve as well as the Hosmer-Lemeshow and the Chi-square goodness of fit tests. From the 1083 cardiac surgeries performed during the study period 659 represented coronary artery bypass graft procedures which are included in the present analysis. Mean age was 61.4 years and 77% were men., Results: Goodness of fit tests have shown good calibration indexes both for mortality (X2=6.78, P=0.56) and general morbidity (X2=6.69, P=0.57). Analysis of area under the ROC-curve (AUC) demonstrated a good performance to detect the risk of death (AUC 0.76; P<0.001), renal failure (AUC 0.79; P<0.001), prolonged ventilation (AUC 0.80; P<0.001), reoperation (AUC 0.76; P<0.001) and major morbidity (AUC 0.75; P<0.001) which represents the combination of the assessed postoperative complications. STS scoring system did not present comparable results for short term hospital stay, prolonged length of hospital stay and could not be properly tested for stroke and wound infection., Conclusion: Society of Thoracic Surgeons scoring system presented a good calibration and discrimination in our population to predict postoperative mortality and the majority of the harmful events following coronary artery bypass graft surgery. Analysis of larger samples might be needed to further validate the use of the score system in Brazilian populations.

Background: Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life., Methods/design: A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life., Discussion: CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients., Trial Registration: The protocol for this study is registered with the Brazilian Registry of Clinical Trials (ReBEC RBR-7yhr4w and World Health Organization under Universal Trial Number UTN: U1111-1127-9390 [http://www.ensaiosclinicos.gov.br/rg/RBR-7yhr4w/]).

Objective: Cardiac surgeries are sometimes followed by significant blood loss, and blood transfusions may be necessary. However, indiscriminant use of blood components can result in detrimental effects for the patient. We evaluated the short-term effects of implementation of a protocol for the rational use of blood products in the perioperative period of cardiac surgery., Methods: Between April and June 2011, an institutional protocol was implemented in a private hospital specializing in cardiology to encourage rational use of blood products, with the consent and collaboration of seven cardiac surgery teams. We collected clinical and demographic data on the patients. The use of blood products and clinical outcomes were analyzed during hospital stay before and after protocol implementation. The protocol consisted of an institutional campaign with an educational intervention to surgical and anesthesiology teams; the goal was to tailor blood transfusion practice according to clinical goals (anemia with hemodynamic changes and significant ventricular dysfunction) and to make routine the prescription of ε-aminocaproic acid intraoperatively, which is recommended by international guidelines based on scientific evidence., Results: After three months of protocol implementation, the use of ε-aminocaproic acid increased from 31% to 100%. A total of 67% of surgeries before protocol implementation required any blood transfusion, compared with 40% that required any blood transfusion after protocol implementation in subsequent months of the same year (p<0.001). There was no significant difference in clinical outcomes assessed before and after implementation of the protocol., Conclusion: The rational use of blood products associated with infusion of ε-aminocaproic acid has the potential to reduce the number of blood transfusions in perioperative of cardiac surgeries, but it can affect the risk of complications.

The objective of this study is to identify subtypes of Human Immunodeficiency Virus type 1 (HIV-1) and to analyze the presence of mutations associated to antiretroviral resistance in the protease (PR) and reverse transcriptase (RT) regions from 48 HIV-1 positive treatment naïve patients from an outpatient clinic in Maringá, Paraná, Brazil. Sequencing was conducted using PR, partial RT and group-specific antigen gene (gag) nested PCR products from retrotranscribed RNA. Transmitted resistance was determined according to the Surveillance Drug Resistance Mutation List (SDRM) algorithm. Phylogenetic and SimPlot analysis of concatenated genetic segments classified sequences as subtype B 19/48 (39.6%), subtype C 12/48 (25%), subtype F 4/48 (8.3%), with 13/48 (27.1%) recombinant forms. Most recombinant forms were B mosaics (B/F 12.5%, B/C 10.4%), with one C/F (2.1%) and one complex B/C/F mosaic (2.1%). Low levels of transmitted resistance were found in this study, 2/48 (2.1% to NRTIs and 2.1% for PI). This preliminary data may subsidize the monitoring of the HIV evolution in the region.

Background and Objectives: Osteogenesis Imperfecta is a rare condition, especially in obstetric patients. It has an estimated prevalence of 1/10,000 in the general population, and 1/25,000 to 30,000 in obstetric patients. The objective of this report was to present a rare case of a pregnant woman with Osteogenesis Imperfecta undergoing cesarean section., Case Report: This is a 23 years old gravida on the 38th week, admitted to the maternity ward with loss of amniotic fluid and contractions for four hours, associated with the absence of fetal movements for four days. The patient had a mild form of Osteogenesis Imperfecta without other comorbidities. She was not taking any medication, and she did not have prenatal follow-up. The patient underwent spinal anesthesia in the L(3)-L(4) space, median approach, with a single puncture with a 27G Quincke needle and the administration of hyperbaric 0.5% bupivacaine (10 mg) and morphine (60 microg). She was discharged in the second postoperative day without complaints., Conclusions: Fertility is preserved, especially in those patients with type I of the disease, and pregnancy can be carried to term. Delivery is usually surgical due to pelvic deformities in the gravida, cephalopelvic disproportion, and increased incidence of abnormal fetal presentation. The importance of the anesthesiologist in the surgical team relies on the perioperative management and the choice of the most appropriate anesthetic technique for each patient., (Copyright 2010 Elsevier Editora Ltda. All rights reserved.)

Context: By convention, the posterior palatal seal area is located on the palate between the anterior and posterior vibrating lines. However, there are opposing views on whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion., Aims: The study was carried out to determine whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion by unbiased observers. A second part of the study was formulated to evaluate whether the palpatory method correlated with the nose-blowing method in locating the anterior line of flexion., Materials and Methods: Twenty-three dental undergraduate clinical students were selected as observers. Twenty-three edentulous patients were randomly selected. The students were asked to record the anterior and posterior vibrating line on one patient each using two differently colored marking pencils. Also, the anterior vibrating line was marked by the palpatory method (using T burnisher) using a third colored marking pencil. The marked lines were then transferred onto the previously made impression of modeling plastic., Results: Of the 23 recorders used in the study, 19 could locate separate anterior and posterior lines of flexion. In 4 cases, the anterior and posterior lines of flexion coincided and were not distinct. In 20 cases, the palpatory method produced a line anterior to the line located by the Valsalva maneuver., Conclusions: The anterior and posterior vibrating lines could be located by the undergraduate students as two separate lines of flexion when the appropriate action was elicited for each of them; and the palpatory method produced a line slightly anterior to the anterior vibrating line located by the Valsalva maneuver.

This prospective, randomized controlled trial was undertaken to evaluate the effect of tube decompression of the stomach after surgical procedure on the digestive tract. One hundred and nine patients were randomly allocated to postoperative treatment with (57 patients) or without (52 patients) nasogastric tubes. No significant differences were found between the two groups in the duration of hospitalization, time to begin peroral fluid intake, occurrence of hiccups, vomiting, nausea, parotiditis, nasal septum necrosis, anastomotic leak and wound dehiscence. Moreover, abdominal distension, pyrosis, otalgia, dysphagia, odynophagia and atelectasis occurred more often in intubated patients as shown by chi-square analysis of the data with Yates correction, with the level of significance at p = less than 0.05. Tube decompression of the stomach does not relieve intestinal paralysis after digestive operations. These data seem to indicate that the routine prophylactic use of a nasogastric tube is unnecessary in gastrointestinal operations.