ABSTRACT Purpose: We aimed to assess failure rates of salvage interventions and changes in split kidney function (SKF) following failed primary repair of ureteropelvic junction obstruction (UPJO). Materials and Methods: A retrospective review of adult patients at an academic medical center who underwent salvage intervention following primary treatment for UPJO was performed. Symptomatic failure was defined as significant flank pain. Radiographic failure was defined as no improvement in drainage or a decrease in SKF by ≥7%. Overall failure, the primary outcome, was defined as symptomatic failure, radiographic failure, or both. Results: Between 2008-2017, 34 patients (median age 38 years, 50% men) met study criteria. UPJO management was primary pyeloplasty/secondary endopyelotomy for 21/34 (62%), primary pyeloplasty/secondary pyeloplasty for 6/34 (18%), and primary endopyelotomy/secondary pyeloplasty for 7/34 (21%). Median follow-up was 3.3 years following secondary intervention. Patients undergoing primary pyeloplasty/secondary endopyelotomy had significantly higher overall failure than those undergoing primary pyeloplasty/secondary pyeloplasty (16/21 [76%] vs. 1/6 [17%], p=0.015). Among patients undergoing secondary endopyelotomy, presence of a stricture on retrograde pyelogram, stricture length, and SKF were not associated with symptomatic, radiographic, or overall failure. Serial renography was performed for 28/34 (82%) patients and 2/28 (7%) had a significant decline in SKF. Conclusions: Following failed primary pyeloplasty, secondary endopyelotomy had a greater overall failure rate than secondary pyeloplasty. No radiographic features assessed were associated with secondary endopyelotomy failure. Secondary intervention overall failure rates were higher than reported in the literature. Unique to this study, serial renography demonstrated that significant functional loss was overall infrequent.

SUMMARY The objective of this work was to study the effect of the addition of polyphenolic peanut skin extracts (PSE) and oregano essential oil (OEO) on the microbiological, chemical, and sensory properties of frankfurter-type sausages during storage. Seven treatments were prepared: control sample (C: without additives); sausage with commercial additives (F); with OEO (O); with Runner PSE (R); with Virginia PSE (V); with OEO and Runner PSE (OR), and with OEO and Virginia PSE (OV). Consumer tests and general composition analysis were performed on the fresh products (sausages without storage). Sausages were stored at 4 °C during 37 days and samples were extracted at days 0, 12, 23, and 37 for microbiological, chemical (peroxide value and conjugated dienes), and sensory descriptive analysis. All sausages had low fat content (3.36 g/100g) and good colour, flavour and texture acceptance scores by consumers (between 5 7 on a 9-point hedonic scale). The absence of commercial additives (nitrite, nitrate, and other compounds) affected the sausage characteristic colour, reducing the consumer's acceptance. The treatments with natural additives had less microbiological and chemical deterioration compared to control sample. The results suggest peanut skin extracts and oregano essential oil can replace commercial additives as preservatives in sausages.

RESUMEN El objetivo del trabajo fue estudiar el efecto del agregado de extractos polifenólicos de tegumento de maní (EP) y aceite esencial de orégano (AEO) en las propiedades microbiológicas, químicas y sensoriales de salchichas tipo Frankfurt durante el almacenaje. Se prepararon siete tratamientos: salchichas control (sin aditivos), con aditivos comerciales, con AEO, con EP Runner, con EP Virginia, con EP Runner y AEO y con EP Virginia y AEO. Inicialmente, sobre las muestras sin almacenaje, se determinó aceptabilidad por consumidores y composición química general. Las salchichas se almacenaron a 4 °C durante 37 días, y se extrajeron muestras para análisis microbiológico, químico (índice de peróxido, dienos conjugados) y sensorial descriptivo a los días 0, 12, 23 y 37. Todos los tratamientos tuvieron bajos contenidos de lípidos (3.36 g/100g) y buenos resultados de aceptabilidad, con valores entre 5-7 (escala hedónica de 9 puntos). La ausencia de aditivos comerciales (nitrito, nitrato y otros compuestos) afectó el color característico del producto, reduciendo su aceptabilidad. Los tratamientos con aditivos naturales tuvieron menor deterioro microbiológico y químico durante el almacenaje. Los resultados sugieren que los extractos de piel de maní y el aceite esencial de orégano pueden reemplazar a los aditivos comerciales como conservantes en salchichas.

BACKGROUND: A postoperative troponin leak that was previously considered clinically insignificant has been independently associated with 30-day mortality in unselected surgical patients <img border=0 width=32 height=32 src="../../../../../img/revistas/samj/v104n9/18s1.jpg">45 years of age following non-cardiac surgery. OBJECTIVES: To determine whether routine troponin surveillance following non-cardiac surgery and initiation of aspirin and statin therapy in troponin-positive patients is cost-effective. METHODS: Pharmacoeconomic analysis to determine the cost-effectiveness of routine postoperative surveillance for patients aged <img border=0 width=32 height=32 src="../../../../../img/revistas/samj/v104n9/18s2.jpg">45 years undergoing non-cardiac surgery. We compared the total expected cost of hospital care of patients who received routine troponin surveillance and subsequent introduction of statin and aspirin therapy for 30 days in troponin-positive patients with the cost of hospital care of patients who did not receive troponin surveillance. We estimated a 25% relative risk reduction following statin and aspirin therapy for postoperative vascular mortality and non-fatal myocardial infarction. RESULTS: Routine troponin surveillance with initiation of aspirin and statin therapy was cost-effective, with an incremental cost of -R16 724 per event avoided. CONCLUSION: Routine postoperative troponin surveillance in non-cardiac surgical patients <img border=0 width=32 height=32 src="../../../../../img/revistas/samj/v104n9/18s3.jpg">45 years of age requiring a postoperative night in hospital is potentially cost-effective.

Insect-food-plant associations have been shown to be influenced by the chemical, physical and nutritional characteristics of plants. We suggest that among insect larvae that use leaf material to build shelters, food-plant use may be constrained by differences in host leaf structure, illuminating a rarely investigated aspect of insect-plant interactions. To explore the potential effects of leaf structure on shelter building behavior in a Neotropical skipper butterfly, we investigated shelter building patterns on two congeneric food-plants that varied in leaf thickness. Shelter architecture varied significantly between hosts, with thicker leaves requiring longer cuts to construct shelters. The relationship between shelter building behavior and leaf structure is discussed in relation to selection pressures on larval shelters and food-plant choice.

O protozoário Leishmania (L.) chagasi foi transmitido experimentalmente a um hamster pela picada do flebotomíneo Lutzomyia furcata. Os insetos foram infectados através de uma membrana (pele de pinto), utilizando-se formas amastigotas provenientes do baço de um hamster infectado. O baço foi triturado em sangue de coelho. A L. (L.) amazonensis foi transmitida a um hamster pela picada do flebotomíneo Psychodopygus c. carrerai, previamente alimentado em lesão de pele de um outro hamster infectado com o parasita. O exame desse flebotomíneo, através de microscópio eletrônico, revelou um número pequeno de flagelados degenerados, livres no lumen do intestino anterior.

Lutzomyia furcata transmitted Leishmania chagasi to a hamster 10 days after being experimentally fed on an infected spleen. An individual female Psychodopygus carrerai carrerai that had fed on a hamster lesion caused by Leishmania mexicana amazonensis transmitted this parasite 6 days later to another hamster. Transmission electron microscopy of this fly's head revealed a small number of degenerate promastigotes in the foregut, but only a few were attached.

É apresentado um "levantamento ilustrado" dos 30 flebotomíneos mais comumente encontrados no Estado do Pará, Brasil, usando-se características externas, com as medidas do quinto segmento das palpos, cor do tórax e do abdomen, e medidas da cabeça e do cor po. Com isto é possível, na maioria dos casos, levar à identificação até a espécie. Exis_ tem algumas espécies, entretanto, que são mais difíceis de serem identificadas, particu larmente as fêmeas, havendo nestes casos, necessidade de um exame taxonômico mais deta lhado, para que se possa concluir a identificação. Esta orientação ilustrada é particu larmente útil a técnicos de laboratório, estudantes e entomólogos visitantes.

A pictorial field guide to the 30 species of sandfly most commonly encountered in Pará State is presented, based on the easily recognised external characters of the length of the 5th palpal segment, thoracic infuscation, abdominal colour and head and body size. In most cases this allows identification to the species. In others, especially with females, it gives an indication of the species, which may then be confirmed with data from more detailed taxanomix studies. This type of field guide helps in teaching, rapid sorting of flies prior to dissection and in acquainting visitors with the variety of species present in a given area.A rapid technique for the taxonomic sorting of unmounted, freshly killed female sandflies is required, prior to the dissection of large numbers of a particular species. Such a method is useful in areas where numerous species occur in studies on natural flagellate infections, age determination and for ecological studies. With the above points in mind a pictorial field guide has been designed that enables the identification of unmounted, unmacerated specimens of the 30 more commonly encountered species of phleboto-mine sandflies (***) in Pará State, North Brazil. It is based on the easily recognised external characters of the length of the 5th palpal segment, thoracic infuscation, ad-dominal colour and proboscis and body size.Taxonomy of male phlebotomine sandflies is based on the structure of the genitalia and, as most of this is external, a wholly external character key is readily made. Female taxonomy, however, is based on the internal character of the cibarium, pharynx and sperma thecae. In order to produce an external character key we therefore return to an unso phisticated "phlebotometry" (see Martins et al., 1978 p. 3 for review), using relative lengths of the proboscis, palpal segments and body, along with the degree of infuscation. Ihis idea is not new; indeed many sandfly specialists presently use external characters to separate certain species (H. Fraiha, R. P. Lane, P. D. Ready, D. G. Young and R. D. Ward personal communications 1983 & 1984).A key used to separate five anthropophillic sandflies by Biagi (1966), in Mexico, was based mainly on palpal segment length and infuscation. Floch and Abonnenc (1952) stressed the use of relative lengths of palpal segments in their keys to the sandflies of French Guiana, and four members of the shannoni group have been similarly separated according to the degree of infuscation by Morales et al. (1982). The use of thoracic infuscation as a reliable character seems to be gaining favour, having been used by young & Fairchild (1974) and Ready & Fraiha (1981). Indeed Chariotis 1974) showed the usefulness of thoracic infuscation to sepenate 7 anthropophillic species, during studies onvesicular stomatitis in Panama. Identification using external characters is essential for work on viral isolations from sandflies, where bulk samples of whole sandflies are used.Perhaps the major advantage of a simple visual guide is for teaching purposes. Technical staff in this lnstitute are able to identify most of the species they encounter without having to use the standard, more unwieldly (and in many cases unavailable) internal character keys, and the guides presented below have allowed rapid species sorting prior to the dissection of sandflies in our leismaniasis study areas (Ryan et at. ,1985).

Lutzomyia longipalpis foi alimentado através de membrana com uma suspensão de macerado de fígado e baço em sangue desfibrinado de coelho. Este material foi originário de um hamster infectado com Leishmania chagasi, realimentado em hamsters limpos, transmitindo os parasitos em duas ocasiões. Esta mesma colônia de Lu. longipalpis, do Ceará, foi usada para a primeira transmissão há oito anos e 64 gerações atrás e não teve a capacidade vetorial diminuída.

A closed Lutzomyia longipalpis colony, from Ceará has been used to transmit Leishmania chagasi isolated from a fox in Pará state. The last time this colony was successfully used in similar transmission experiments was eight years (64 generations) ago indicating that this colony of Lu. longipalpis has fully maintained its vectorial capacity in spite of such a long period of maintainance in the laboratory.

Os machos do flebótomo Lutzomyia longipalpis apresentam-se sob duas formas, uma que possui um par de manchas claras apenas no tergito 4, enquanto a outra distingue-se por possuir um par adicional de manchas claras no tergito 3. Isolamento reprodutivo foi observado entre populações simpátricas com as duas formas e também entre populações alopátricas da forma com um só par de manchas (Ward et al., 1983). Foram também constatadas diferenças micromorfológicas em estruturas vuticulares nas manchas, que talvez sejam locias de liberação de ferormônios (Lane & Ward, 1984). Machos com um único par de manchas claras são encontrados desde o México até o sul do Brasil, enquanto a forma com duas manchas é achada somente no Maranhão, no norte do Brasil, até Minas Gerais e a fronteira do Brasil com o Paraguai, ao sul. No leste do Brasil as duas formas são simpátricas em algumas localidades e alopátricas em outras. São apresentados detalhes da distribuição conhecida das duas formas baseados na observação de espécimens capturados no Brasil em 1982, ou vistos em coleções de museus ou recebidos de outros laboratórios.

The males of the sandfly Lutzomyia longipalpis occur in two forms, one which bears a single pair of pale spots on tergite 4 and another in which an additional pair of spots characterizes tergite 3. Almost complete reproductive isolation between sumpatric populations of the two forms and between allopatric populations of the one-spot form has been reported (Ward et al., 1983). Micromorphological differences in cuticular structures on the spots have also been observed and may be sites of pheromone release (Lane & Ward, 1984). Detais of the known distribution of the two are based on the examination of new specimens captured in Brazil during 1982, as well as museum collections and specimens from other laboratories. Males with a single pair of pale spots have been found from Mexico to southern Brazil, whilst the two-spot form is found only from the state of Maranhão in North Brazil to Minas Gerais and the border with Paraguay. In the eastern area of Brazil the two forms occur sympatrically in some locations and separately in others.

Foram dissecados Lutzomyia longipalpis, capturados no foco de leishmaniose visceral na ilha de Sao Luis, Maranhao, sendo encontradas 1,8% com infeccao natural por promastigotas.

Dissection of Lutzomyia longipalpis, captured in the São Luis focus of visceral Leishmaniasis revealed a 1.8% promastigote infection rate.