Schinopsis brasiliensis Engl. (braúna) is a tree species of the Anacardiaceae family. It is native to Brazil, Paraguay, and Bolivia. It is a candidate for agro-industrial system that can be used to produce phytotherapeutics and bioproducts. However, to comprehensively understand the characteristics of plant within the framework of sustainable development for agro-industries, exploring the chemical and phenotypic diversity of samples from various microenvironments across different collection periods is essential. Accordingly, herein, the influence of different environmental factors and sample collection durations on braúna samples was investigated over several years using multivariate statistical analyses associated with nuclear magnetic resonance (NMR) spectroscopy. Bark samples from different areas and environmental data from different locations were analyzed. Distinct chemical profiles were observed across reserve, forest, and management areas, all marked by elevated sugar levels suggesting water stress adaptation. High radiation and low rainfall correlated with increased sugar and amino acids. Each microenvironment responded uniquely to these environmental conditions. Consequently, plant samples from different microenvironments collected over different periods were observed to respond differently to environmental factors, such as solar radiation and temperature. We correlated the metabolomic data with climatic data evaluating the influence of abiotic factors on the production of metabolites in braúna bark samples. Engl (braúna family Brazil Paraguay Bolivia agroindustrial agro industrial bioproducts However agroindustries, agroindustries industries, industries agro-industries essential Accordingly herein NMR (NMR spectroscopy analyzed reserve forest adaptation acids conditions Consequently temperature

ABSTRACT Water reservoirs were built in the semi-arid region to mitigate the effects of drought and water scarcity. However, these reservoirs are subject to variables that impact the volume and quality of the stored water, with the contribution of such nutrients as Total Nitrogen (TN) and Total Phosphorus (TP) being one of the main factors in intensifying the eutrophication process. The aim of this study was to quantify the principal inputs and outputs of nutrients (N and P) and calculate the nutrient balance, in order to verify the influence of seasonality on the import and export of these nutrients in surface reservoirs of the semi-arid region of Brazil. Seven campaigns were carried out between 2015 and 2016, with water samples collected at five points in the Pereira de Miranda reservoir and four in the General Sampaio reservoir. The inflow of nutrients was greater when the inflow rate of the water was higher. The balance showed the accumulation of 22.8 tons of TN and 2.8 tons of TP in the Pereira de Miranda reservoir, and 13 tons of TN and 1.5 tons of TP in the General Sampaio. These reservoirs are therefore retaining nutrients, acting as a storage site for nutrients transported by surface runoff in the basin of the Curu River. This increase in storage occurred mainly during the rainy season, when nutrient retention by the reservoirs impaired water quality, resulting in eutrophication, and making it difficult to meet the uses for which the reservoirs were intended. semiarid semi arid scarcity However (TN (TP process N P Brazil 201 2016 higher 228 22 8 22. 28 2 2. 1 15 5 1. River season intended 20

This study evaluates the residence time (RT) and total phosphorus (TP) in a small hypereutrophic lake in the city of Fortaleza, Brazil. The results indicate that RT predicted by a complete-mix model is very similar (R² = 0.83) to that simulated with a 2-D hydrodynamic model (CE-QUAL-W2). Simple power-laws were fitted to describe RT and TP concentration at the lake inlet as functions of lake inflow, yielding correlations of R² = 0.84 and 0.70, respectively. The combination of these correlations with a complete-mix approach provided a comprehensive model that predicted TP values measured at the lake outlet reasonably well (R² = 0.60). In addition, a direct empirical correlation between simulated TP concentration and precipitation was also obtained. The simulations indicate a nearly periodic behaviour of RT and TP, with the seasonal variations being much higher than the interannual ones. Finally, an application of the model showed that a reduction of 99% of the input TP load was required to reach 100% compliance with the required water quality standards; this could be achieved by connecting the residences to the sewage network. The methodology proposed in this research can be easily applied to other lakes in the Brazilian northeast and extended to other tropical regions around the globe.

Phycocyanin is a pigment present in cyanobacteria whose optical characteristics favor its application in clinical, dietary, and environmental aspects. There are reports of studies of these pigments in lakes and reservoirs, which present different analysis methodologies. Based on this information, this work aims to evaluate correlations between phycocyanin and the number of cyanobacteria to optime the methodologies mentioned above. The samples were collected from four reservoirs in the semiarid region of Ceará, and the applied methodology was based on the work of Hórvath (2013). The spectrophotometry and the fluorimetry analyzes were performed in this analysis. The analytical curves for the phycocyanin showed high linearity, and the fluorimetric technique, which was used due to its greater analytical sensitivity. The absorbance coefficient (2.57 mL mg-1 cm-1) was obtained by spectrophotometry, which was lower than that reported in the literature. The correlations found were higher and significant for phycocyanin (r > 0.70) for the reservoirs, while the correlations with chlorophyll were much lower, hence is contrary to what was observed in the literature. It is concluded that the phycocyanin pigment should be used as an indicator in the estimation of cyanobacteria in reservoirs, replacing the use of chlorophyll for the same function.

Abstract Considering the BSSF steelmaking slag generated in a Brazilian steelwork, it would be worth to separate iron and calcium from it, with the objective of increasing its iron content, or producing Fe2O3 and CaO by selective precipitation from cations in aqueous solution. In this way, materials could be produced and used in-house, e.g., sintering plant. This possibility was explored through acid leaching for an industrial sample. A possibility to increase concentration of iron of the slag is to leach it with a 2 mol.L-1 HCl solution; in this condition, 63.6% of the CaO is extracted from the slag to the aqueous solution, and Fe content of the slag increases from 27.4 to 37.1 wt%. Another possibility is to use HCl 5 mol.L-1; in this condition, 86.8% of the Fe and 90.7% of the CaO are transferred to the liquid solution. Then separation of iron and calcium can be achieved by selective precipitation: firstly, adding ammonia to precipitate Fe(OH)3, and then calcinating it to produce Fe2O3 (~ 200 °C); in the following, adding sodium carbonate to precipitate CaCO3, which in turn can be calcinated to produce CaO (~ 900 °C). In this way, Fe2O3 and CaO could be produced.

Resumo Introdução: O exame clínico otorrinolaringológico da via aérea superior tem sido historicamente feito com a ajuda de imagens radiográficas para diagnosticar causas obstrutivas da respiração bucal. Objetivo: O objetivo deste estudo foi comparar as medidas volumétricas em 3D da cavidade nasal, nasofaringe e orofaringe entre crianças com respiração bucal e obstrução respiratória e crianças respiradoras bucais sem obstrução respiratória. Método: Estudo retrospectivo que inclui 25 crianças respiradoras bucais de 5 a 9 anos. As crianças foram avaliadas por exame clínico otorrinolaringológico, nasofibroscopia flexível e tomografia computadorizada multi-slice. Medidas volumétricas obtidas tomograficamente de três regiões anatômicas (cavidade nasal, nasofaringe e orofaringe) foram correlacionadas e comparadas com diagnóstico dicotômico otorrinolaringológico (obstruído vs. não obstruído). Um teste t de amostra independente foi usado para avaliar a associação entre as medidas em 3D das vias aéreas superiores e o diagnóstico otorrinolaringológico de obstrução nas três regiões anatômicas. Os coeficientes de correlação intraclasse inter e intraobservador foram usados para avaliar a confiabilidade das medidas em 3D. Resultados: O coeficiente de correlação intraclasse variou de 0,97 a 0,99. Uma associação foi encontrada entre a hipertrofia de conchas e a redução do volume da cavidade nasal (p < 0,05) e entre a hiperplasia de tonsila faríngea e a redução do volume da nasofaringe (p < 0,001). Não foi encontrada associação entre a hiperplasia da tonsila palatina e a redução do volume da orofaringe. Conclusões: 1) O volume da cavidade nasal estava reduzido nas crianças com diagnóstico de hipertrofia de conchas; 2) O volume da nasofaringe estava reduzido nas crianças com diagnóstico de hiperplasia de tonsila faríngea; e 3) O volume da orofaringe de crianças com respiração bucal e hiperplasia de tonsila palatina foi semelhante ao de crianças respiradoras bucais sem aumento da tonsila palatina. A adoção da mensuração anatômica dos vários compartimentos da via aérea superior complementa o método de avaliação.

Abstract Introduction: Imaging studies have hystorically been used to support the clinical otorhinolaryngological evaluation of the upper respiratory tract for the diagnosis of obstructive causes of oral breathing. Objective: The objective of this study was to compare 3D volumetric measurements of nasal cavity, nasopharynx and oropharynx of obstructed mouth-breathing children with measurements of non-obstructed mouth-breathing children. Methods: This retrospective study included 25 mouth-breathing children aged 5-9 years evaluated by otorhinolaryngological clinical examination, flexible nasoendoscopy and full-head multi-slice computed tomography. Tomographic volumetric measurements and dichotomic otorhinolaryngological diagnosis (obstructed vs. non-obstructed) in three anatomical regions (the nasal cavity, nasopharynx and oropharynx) were compared and correlated. An independent sample t-test was used to assess the association between the 3D measurements of the upper airways and the otorhinolaryngological diagnosis of obstruction in the three anatomical regions. Inter- and intra-observer intraclass correlation coefficients were used to evaluate the reliability of the 3D measurements. Results: The intra-class correlation coefficients ranged from 0.97 to 0.99. An association was found between turbinate hypertrophy and nasal cavity volume reduction (p < 0.05) and between adenoid hyperplasia and nasopharynx volume reduction (p < 0.001). No association was found between palatine tonsil hyperplasia and oropharynx volume reduction. Conclusions: (1) The nasal cavity volume was reduced when hypertrophic turbinates were diagnosed; (2) the nasopharynx was reduced when adenoid hyperplasia was diagnosed; and (3) the oropharynx volume of mouth-breathing children with tonsil hyperplasia was similar to that of non-obstructed mouth-breathing children. The adoption of the actual anatomy of the various compartments of the upper airway is an improvement to the evaluation method.

Abstract: This paper investigates phosphorus dynamics in a highly polluted system composed of a drainage channel followed by a shallow reservoir in the city of Fortaleza, Brazilian semiarid. During the dry season, significant non-point source loads of total phosphorus originated from residences unconnected to sewers were identified along the channel, resulting in an increasing flow rate of untreated sewage towards the reservoir. During the rainy season, as a consequence of dilution, phosphorus concentrations decreased by about 5-fold. The results also revealed that the reservoir was acting similarly to a waste stabilization pond, with phosphorus removal efficiency of about 33%. Assuming one-dimensional flow for the channel and complete mixing for the reservoir, it was possible to adjust phosphorus decay coefficients of kc = 2.2 day-1 and kr = 22.8 year-1, respectively, which were higher than their corresponding values available in the literature. This was attributed mainly to the relatively high temperatures and shallow water depths. The results also revealed an inverse dependence of kc and kr on water and wind velocity, with potential thresholds of respectively 0.3 and 5.0 m/s for resuspension of bed sediments and internal phosphorus loading.

Resumo Introdução: A hiperplasia adenotonsilar (HAT) e a rinite alérgica (RA) consistem nas causas mais comuns de obstrução de vias aéreas superiores em crianças. Tais afecções, ao comprometer a via aérea superior, podem ocasionar hipoventilação alveolar crônica, vasoconstrição pulmonar e hipertensão pulmonar, em alguns casos irreversível. Objetivo: Este estudo transversal objetivou avaliar a prevalência de hipertensão arterial pulmonar em dois grupos de crianças respiradoras orais (RO): com HAT e rinite alérgica isolada, de 2 a 12 anos, por meio de exame ecodopplercardiográfico. Método: Foram selecionados e submetidos à ecodopplercardiografia 54 pacientes com HAT com indicação de adenoidectomia e/ou tonsilectomia e 24 pacientes com rinite alérgica persistente. A pressão sistólica da artéria pulmonar (PSAP) foi determinada pela regurgitação tricúspide e a pressão média da artéria pulmonar (PMAP) foi calculada a partir da PSAP. Determinações similares foram feitas em 25 respiradores nasais (RN). Resultados: As médias da PMAP e da PSAP foram maiores nos grupos de RO do que nos RN (17,62 ± 2,06 [HAT] e 17,45 ± 1,25 [RA] vs. 15,20 ± 2,36 [RN] mmHg; p < 0,005; e 25,61 ± 3,38 [HAT] e 25,33 ± 2,06 [RA] vs. 21,64 ± 3,87 [RN] mmHg; p < 0,005; respectivamente) e a média do tempo de aceleração do traçado do fluxo pulmonar (TAc) foi maior nos RN que nos grupos de RO (127,24 ± 12,81 [RN] vs. 114,06 ± 10,63 ms [HAT] e 117,96 ± 10,28 [RA] MS [RA]; p < 0,0001). Conclusão: Nenhuma criança respiradora oral (HAT e RA) preencheu os critérios de HP, embora tanto os portadores de HAT quanto de RA isolada apresentaram evidências significativas de aumento da pressão arterial pulmonar pela ecodopplercardiografia em relação aos respiradores nasais. Não se observou diferença entre os grupos HAT e RA.

Abstract Introduction: Adenotonsillar hyperplasia (ATH) and allergic rhinitis (AR) are the most common causes of upper airway obstruction in children. Such diseases, by affecting the upper airways, can cause chronic alveolar hypoventilation, pulmonary vasoconstriction and pulmonary hypertension, which in some cases, are irreversible. Objective: This cross-sectional study aimed to evaluate the prevalence of pulmonary hypertension in two groups of mouth-breathing (MB) 2-12 years old children with ATH and isolated allergic rhinitis, through Doppler echocardiography. Methods: 54 patients with ATH and indications for adenoidectomy and/or tonsillectomy and 24 patients with persistent allergic rhinitis were selected and submitted to Doppler echocardiography. The Systolic Pulmonary Artery Pressure (SPAP) was determined by tricuspid regurgitation and the Mean Pulmonary Artery Pressure (MPAP) was calculated from the SPAP. Similar measurements were carried out in 25 nasal breathing (NB) individuals. Results: The mean MPAP and SPAP were higher in the MB than in the NB group (17.62 ± 2.06 [ATH] and 17.45 ± 1.25 [AR] vs. 15.20 ± 2.36 [NB] mmHg, p < 0.005, and 25.61 ± 3.38 [ATH] and 25.33 ± 2.06 [AR] vs. 21.64 ± 3.87 [NB] mmHg, p < 0.005, respectively) and the mean acceleration time of pulmonary flow trace (Act) was higher in the NB than in the MB group (127.24 ± 12.81 [RN] vs. 114.06 ± 10.63 ms [ATH] and 117.96 ± 10.28 [AR] MS [AR]; p < 0.0001). Conclusion: None of the MB children (ATH and AR) met the PH criteria, although individuals with both ATH and isolated AR showed significant evidence of increased pulmonary artery pressure by Doppler echocardiography in relation to NB individuals. No differences were observed between the ATH and AR groups.

The aim this research is to develop a HS-SPME/GC-MS method to analyze the carbaryl in blood plasma samples of the rural workers, who live round the perimeter of Chapada do Apodi-CE. This was achieved by chromatographic signal of the 1-naftol, degradation product of carbaryl with the intention of evaluating the degree of exposure of the workers to pesticides, causing chromosome abnormalities as already evidence in appropriate literature. Three different types of covered SPME fibers were tested and a full factorial design with central point in two levels. The variables optimized were temperature and ionic strength and temperature was the response in the design. Study was undertaken to determinate the equilibrium time. The thermal degradation of carbaryl in SPME headspace was analyzed by 1H-NMR. Proposed method achieved low limits of detection and quantification (1.5 and 5 ng mL-1, respectively) with good precision and accuracy, using the method of weighted least squares. However, the proposed method can be considered a good alternative way of monitoring carbaryl in blood plasma by analytical signal of 1-naftol. None of the plasma analyzed presented a concentration of 1-naftol compound higher than limit of detection of the method proposed here.

Abstract Introduction This article is related to complications of rhinoplasty and its main causes of reoperations. Objectives The objective of this study is to perform a systematic review of literature on complications in rhinoplasty. Data Synthesis The authors conducted a survey of articles related to key terms in the literature by using three important databases within 11 years, between January 2002 and January 2013. We found 1,271 abstracts and selected 49 articles to this review. Conclusion Themain results showed that the number of primary open rhinoplasty was 7902 (89%) and 765 closed (11%) and the percentage of reoperations in primary open complete rhinoplasties was 2.73% and closed complete was 1.56%. The statistical analysis revealed a value of p = 0.071. The standardization of terms can improve the quality of scientific publications about rhinoplasty. There is no difference between primary open or closed rhinoplasty techniques in relation to reoperations.

RESUMO Objetivo conhecer as características orofaciais de idosos funcionalmente independentes e analisar a associação com a idade, gênero, nível socioeconômico e estado dentário. Método estudo observacional, transversal de caráter analítico com amostra não probabilística. Foi aplicado o instrumento validado “Protocolo de Avaliação Miofuncional Orofacial com Escalas para Idoso” em sujeitos funcionalmente independentes com idade igual ou acima de 60 anos, em boas condições de saúde segundo avaliação geriátrica padronizada, intitulada Protocolo de Avaliação Multidimensional do Idoso. Resultados os idosos apresentaram padrões de normalidade acima de 60% nos parâmetros de aspecto e mobilidade das estruturas. As alterações significantes foram: sulco nasolabial acentuado; bochechas flácidas ou arqueadas; vedamento labial com tensão ou ausência de vedamento e comissuras labiais deprimidas. As alterações de mobilidade foram pequenas, entre 20,6% e 33,8%, com maior prevalência na elevação da língua e lateralização do ar em bochechas infladas e da mandíbula. Não houve relação destes achados perante a progressão da idade e as classes socioeconômicas. As mulheres apresentaram maior chance de exibirem aspecto normal dos lábios e alguma alteração da mobilidade. O número de dentes associou-se com o volume e a configuração dos lábios e a mobilidade da mandíbula. Além disso, o uso de prótese dentária associou-se significativamente com o aspecto do sulco nasolabial e a tensão/configuração das bochechas. Conclusão este trabalho sugere que o sistema oromiofacial encontra-se dentro dos padrões de normalidade na maioria dos idosos funcionalmente independentes. O que ampara a atuação multiprofissional na prevenção, promoção e tratamento da saúde oromiofuncional dos idosos.

ABSTRACT Purpose to understand the main orofacial characteristics of functionally independent elderly individuals and to investigate their association with age, gender, socioeconomic level, and dental status. Methods an observational, cross-sectional, and analytical study was carried out with a non-probabilistic sample. Inclusion criteria: minimum age of 60 years, individual in good health conditions according to a pre-established protocol published by the health care service. In order to collect the data, we used the validated Orofacial Myofunctional Evaluation with Scores for Aged Protocol. Results The elderly individuals presented normal patterns in more than 60% of the appearance and mobility parameters. Significant alterations observed were: pronounced nasolabial sulcus; flaccid or arched cheeks; labial sealing with tension or absence of sealing; and depressed labial commissures. Alterations in mobility were few, between 20.6% and 33.8%, with higher prevalence of alterations when raising the tongue, lateralizing air inflated in cheeks and jaw. There was no relationship between these findings and the progression of age and socioeconomic classes. Women were more likely to show normal appearance of lips and some alterations in lips mobility. The number of teeth was associated with the volume and shape of lips and with jaw mobility. In addition, the use of dental prosthesis was shown to be significantly related to the nasolabial sulcus aspect and the configuration/tension of cheeks. Conclusion This study suggests normal patterns of oromyofacial system in most functionally independent elderly individuals. It supports multidisciplinary action for prevention, promotion, and treatment of the elderly population’s oral functions.

Resumo Introdução: Doenças dos seios paranasais, cavidades nasais e doenças da base do crânio podem ser tratadas com operação endonasal utilizando-se endoscópio rígido nasal. Referências anatômicas são importantes para a segurança durante a realização dessas operações. Objetivo: Medir a distância da parede posterior do seio maxilar à base anterior do crânio de acordo com características sócio-demográficas. Detalhar um ponto de referência anatômico para operações dos seios paranasais e acesso à base anterior do crânio comparando variações anatômicas entre os lados direito e esquerdo, gênero, altura, peso, idade e etnia em cadáveres. Método: Medidas do ângulo de 90º (ponto onde inicia a deflexão da base do crânio para formar a parede anterior do esfenoide, chamado de ângulo de 90º – Δ_90º) aos pontos superior, médio e inferior da parede posterior do seio maxilar. Foram utilizados 60 cadáveres com idade acima de 17 anos, e avaliados com idade, altura, peso IMC, gênero e etnia, comparando-se as medidas dos lados direito e esquerdo. Resultados: As medidas foram maiores que 1,5 cm em todos os cadáveres e não variaram com a idade, altura, peso, gênero e etnia nos lados direito e esquerdo dos cadáveres. Destaca-se falta de associação entre a medida do Δ90º à parede posterior superior; média e inferior do maxilar (categórico ou quantitativo) com as características estudadas. Conclusão: A metodologia empregada definiu o ponto de referência nasal por não variar com as características dos cadáveres.

Abstract Introduction: Diseases of paranasal sinuses, nasal cavity, and skull base can be treated by endonasal operations using a nasal rigid endoscope. When conducting this kind of surgery, anatomical references are critical for safety. Objective: To measure the distance from the posterior wall of the maxillary sinus to the skull base, according to socio-demographic characteristics, and to detail an anatomical reference point for paranasal sinus operations and for an access to the anterior skull base, comparing anatomical variations between right and left sides, gender, height, weight, age, and ethnicity in cadavers. Methods: Measures were taken from the 90° angle (the starting point where deflection of the skull base begins to form the anterior wall of the sphenoid, also known as Δ90°) to the upper, middle, and lower points of the posterior wall of the maxillary sinus. This study used 60 cadavers aged over 17 years, and evaluated these bodies with respect to age, height, BMI, weight, gender, and ethnicity, comparing measurements of right and left sides. Results: The measurements were >1.5 cm in all cadavers and did not vary with age, height, weight, gender, and ethnicity on their right and left sides. The lack of association between the measurement from Δ90° to the upper, middle, and lower posterior walls of the maxillary sinus (categorical or quantitative) is noteworthy, considering the characteristics studied. Conclusion: The methodology defined the nasal point of reference, considering an absence of variation in the cadavers’ characteristics.

Resumo Neste estudo foram avaliados os efeitos do aumento da vazão fluvial sobre o fitoplâncton e os nutrientes em quatro estuários do Nordeste do Brasil. Para isso, foram coletadas amostras durante um período de forte déficit hidrológico (Nov/2010, período seco), e durante um período chuvoso (maio/2011). Dois estuários estão localizados em áreas urbanas (Ceará - CE e Cocó - CO) e dois têm forte déficit de água doce (Pacoti - PAC e Priangi - PIR). Os efeitos do aumento da descarga fluvial foram diferentes entre os que recebem descargas antrópicas (CO, CE e PIR) e aquele menos impactado (PAC). No CO e CE, o fluxo fluvial no período chuvoso diluiu os nutrientes e controlou as florações fitoplanctônicas. No PIR, o fósforo e o nitrogênio inorgânico decresceram neste período. Foi observado um aumento de todos os nutrientes no PAC, e de NT no PIR, seguidos de um aumento do fitoplâncton. No período chuvoso, espécies dulcícolas de ambientes eutróficos dominaram nos estuários. No período seco, observaram-se florações de Cryptomonas/Rhodomonas (CE) e Synechocystis aquatilis (CO). No período seco, sob a condição de hipersalinidade, predominaram espécies marinhas no PAC e PIR. A Análise de Correspondência Canônica sugeriu a salinidade, a sílica e o NT como os principais responsáveis pela variação do fitoplâncton.

Abstract This study evaluated changes in phytoplankton and nutrients after an increase in river discharge in four estuaries of northeastern Brazil. Samples were taken during a markedly freshwater-deprived period (Nov/2010, dry season), and during a rainy season (May/2011). While two estuaries are located in urban areas (Ceará - CE and Cocó - CO), the others are markedly freshwater-deprived (Pacoti - PAC and Pirangi - PIR). Our findings indicate that increased freshwater had opposing effects on estuaries impacted by anthropogenic discharges (CO, CE and PIR) compared with the other, less impacted (PAC). In CO and CE, the freshwater flow during the rainy period had a nutrient diluting effect and controlled phytoplankton blooms. In PIR, only phosphorus and inorganic nitrogen decreased in the rainy season. In contrast, an increase of all nutrients was observed in PAC, and of TN in PIR, followed by an increase in phytoplankton biomass. In the rainy season, eutrophic freshwater species dominated in all the estuaries. In the dry season, blooms of Cryptomonas/Rhodomonas and Synechocystis aquatilis were, respectively, observed in CE and CO. Also in the dry season, PAC and PIR had a predominance of marine species under a condition of hypersalinity. Canonical correspondence analysis suggested the variation observed for salinity, silica, and TN are the main driver of phytoplankton structure.

RESUMO INTRODUÇÃO: A triagem auditiva neonatal nos permite identificar precocemente alterações auditivas. Entretanto, doenças da orelha média podem dificultar o diagnóstico. OBJETIVO: Avaliar o exame de reflectância de potência como um indicador de doença de orelha média e compará-lo com a timpanometria. MÉTODO: Estudo de casos em que foram avaliados 105 neonatos e lactentes que fizeram parte da triagem auditiva em 2013. Foram realizados os seguintes exames: emissões otoacústicas transientes, reflectância de potência e timpanometria. RESULTADOS: Na avaliação das emissões otoacústicas, cerca de 95% passaram. A especificidade da reflectância de potência em todas as frequências pesquisadas variou de 75,3% até 95,9% e da timpanometria em 1.000 Hz variou de 83% até 87,2% e houve concordância entre esses exames. CONCLUSÃO: O resultado do exame de reflectância nas frequências de 2.000 Hz e 3.000 Hz apresentou correlação com os resultados da timpanometria e com as emissões otoacústicas, e foram estas as frequências mais adequadas para a determinação de doença de orelha média pela reflectância de potência. Observou-se que valores da reflectância de potência acima dos padrões sugerem presença de líquido em orelha média, portanto uma alteração condutiva.

ABSTRACT INTRODUCTION: Auditory screening in newborns allows for detection of hearing problems early in life. However, middle ear diseases can make the diagnosis more difficult. OBJECTIVE: To evaluate the power reflectance test as an indicator of the middle ear disease and to compare it to tympanometry. METHODS: Case study evaluating 105 newborns and infants who participated in the audiology screening in 2013. The following exams were performed: transient otoacoustic emissions, power reflectance, and tympanometry. RESULTS: In the optoacoustic emission evaluation, approximately 95% of the subjects passed the test. The specificity of power reflectance in all frequencies studied ranged from 75.3% to 95.9%, and that of tympanometry at 1000 Hz ranged from 83% to 87.2%; there was agreement among these exams. CONCLUSION: The outcome of power reflectance tests at 2000 Hz and 3000 Hz showed a correlation with tympanometry and otoacoustic emissions, and these were the most appropriate frequencies to determine middle ear disease through power reflectance measurement. It was also observed that values of power reflectance above reference levels suggested the presence of fluid in the middle ear, and thus a conductive hearing loss.

RESUMO Introdução: A fluoresceína intratecal tem sido efetiva no diagnóstico topográfico da rinoliquorréia. Entretanto, não há estudos no líquor após o uso de fluoresceína intratecal. Objetivo: Estudo prospectivo visando avaliar o líquor, através de análise química e citológica, após injeção de fluoresceína. Método: Análise prospectiva de 24 punções após injeção intratecal de fluoresceína para diagnóstico topográfico de fístula liquórica, coletado no momento da punção, 24 e 48 horas, divididos pela celularidade: grupo 1, com até 5 células e grupo 2 com mais de 5 células. Resultado: A coloração amarelo-esverdeada do líquor permaneceu após 48 horas em 36%, evidenciando permanência de fluoresceína. Observou-se ausência de mudanças no nível de proteína e glicose entre 0-24 horas e 0-48 horas. No grupo 2, um aumento na contagem celular foi observado entre 24 e 48 horas (p = 0,019). No dois grupos juntos, observou-se um aumento de neutrófilos entre 0 e 48 horas (p = 0,048) e uma diminuição entre 24 e 28 horas (p = 0,05). Conclusão: Fluoresceína intratecal provocou discretas reações meníngeas, como o aumento de células entre 24 e 48 horas e aumento dos dos neutrófilos em 24 horas com uma subsequente dimi nuição em 48 horas sem correlação com sintomas.

ABSTRACT INTRODUCTION: Intrathecal fluorescein has been effective for topographic diagnosis of rhinoliquorrhea. Nonetheless, there are no reports on the study of cerebral spinal fluid (CSF) after use of intrathecal fluorescein. OBJECTIVE: A prospective study attempting to evaluate CSF through chemical and cytological analysis, after injection of fluorescein. METHODS: Prospective analysis of 24 samples of CSF after intrathecal injection of fluorescein for topographic diagnosis of CSF fistulae, collected at the time of puncture and after 24 and 48 h, divided by cellularity: Group 1, up to five cells, and Group 2, with more than five cells. RESULTS: The yellow-greenish color of CSF remained after 48 h in 36%, evidencing permanence of fluorescein. No changes in protein and glucose levels were observed between 0-24 h and 0-48 h. In group 2, an increase in cell count was observed between 24 h and 48 h (p = 0.019). In both groups, there was an increase of neutrophils between 0 and 48 h (p = 0.048) and a decrease between 24 and 48 h (p = 0.05). CONCLUSION: Intrathecal fluorescein provoked discreet meningeal reactions, such as an increase of cells between 24 and 48 h and an increase of neutrophils at 24 h, with a subsequent decrease at 48 h with no correlation with symptomatology.