OBJECTIVES: Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor that differs from conventional hepatocellular carcinoma in several aspects. The aim of this study was to describe the clinical, surgical and histopathological features of fibrolamellar hepatocellular carcinoma and to analyze the factors associated with survival. METHODS: We identified 21 patients with histopathologically diagnosed fibrolamellar hepatocellular carcinoma over a 22-year period. Clinical information was collected from medical records and biopsies, and surgical specimens were reviewed. RESULTS: The median age at diagnosis was 20 years. Most patients were female (67%) and did not have associated chronic liver disease. Most patients had a single nodule, and the median tumor size was 120 mm. Vascular invasion was present in 31% of patients, and extra-hepatic metastases were present in 53%. Fourteen patients underwent surgery as the first-line therapy, three received chemotherapy, and four received palliative care. Eighteen patients had “pure fibrolamellar hepatocellular carcinoma,” whereas three had a distinct area of conventional hepatocellular carcinoma and were classified as having “mixed fibrolamellar hepatocellular carcinoma.” The median overall survival was 36 months. The presence of “mixed fibrolamellar hepatocellular carcinoma” and macrovascular invasion were predictors of poor survival. Vascular invasion was associated with an increased risk of recurrence in patients who underwent surgery. CONCLUSION: Fibrolamellar hepatocellular carcinoma was more common in young female patients without chronic liver disease. Surgery was the first therapeutic option to achieve disease control, even in advanced cases. Vascular invasion was a risk factor for tumor recurrence. The presence of macrovascular invasion and areas of conventional hepatocellular carcinoma were directly related to poor survival.

Theoretical-reflexive research, whose aim is to analyze the clarity of concept stimulus in the Roy Model, for best comprehension in nursing practice. It was developed in three phases: 1- Search of studies that utilized the Roy Model; 2- Conducted reading for comprehension of the concept stimulus and 3- Analysis of clarity of the concept. The three studies were conducted at master level. The analysis of the studies shows deficiency in the clarity of the concept stimulus, being predominant the ambiguity in the classification and differentiation of the focal and contextual stimuli, without the existence of consistency and uniformity. The need arises to deepen the theories of nursing for adequate application in the areas of research: nursing education and practice, optimizing and improving its use, as well as, enabling the comprehension of determined concepts that are not sufficiently clear. The worries that arise among the nurses will provide a more profound approach to the study, enabling the advance of theories, as well as new findings, leading to necessary changes.

Pesquisa teórico-reflexiva, objetivando analisar a clareza do conceito estímulo no modelo de Roy, para maior compreensão na prática de enfermagem. Desenvolvido em três etapas: 1ª- Levantamento de estudos que utilizaram o Modelo de Roy; 2ª - Leitura dirigida para a compreensão do conceito estímulo e 3ª - Análise da clareza do conceito. Foram utilizados três estudos, em nível de mestrado. A análise dos estudos demonstra deficiência na clareza do conceito estímulo, predominando ambigüidade na classificação e diferenciação dos estímulos focais e contextuais, não existindo consistência e uniformidade. Evidencia-se a necessidade do aprofundamento nas teorias de enfermagem, para a aplicação adequada nas áreas de pesquisa, ensino e prática, otimizando e aprimorando seu uso, além de possibilitar a compreensão de determinados conceitos, não suficientemente claros. As inquietações surgidas entre os enfermeiros poderão proporcionar o aprofundamento nos estudos, possibilitando o avanço das teorias, assim como novos achados, direcionando as mudanças necessárias.

Investigación teórico-reflexiva cuyo objetivo fue analizar la claridad del concepto estímulo según el modelo de Roy, para mayor comprensión en la práctica de enfermería. Desarrollada en tres etapas: 1ª- Levantamiento de estudios que utilizaron el Modelo de Roy; 2ª - Lectura dirigida hacia la comprensión del concepto estímulo y 3ª - Análisis de la claridad del concepto. Fueron utilizados tres estudios, a nivel de maestrado. El análisis de los estudios demuestra deficiencia en la claridad del concepto estímulo, predominando ambigüedad en la clasificación y diferenciación de los estímulos focales y contextuales, sin consistencia y uniformidad. Se evidencia la necesidad de profundizar en las teorías de enfermería, para su aplicación adecuada en las áreas de investigación, enseñanza y práctica, optimizando y mejorando su uso, además de posibilitar la comprensión de determinados conceptos no suficientemente claros. Las inquietudes surgidas entre los enfermeros podrán motivar un abordaje más profundo de los estudios, posibilitando el avance de las teorías, así como nuevos descubrimientos, dirigiendo los cambios necesarios.

O presente trabalho apresenta uma contribuição aos estudos de modelagem climática com ênfase na variabilidade pluviométrica sazonal da Amazônia oriental, durante as estações de verão e outono (DJF e MAM). Baseado nos resultados das simulações regionais do RegCM3 para um período de 26 anos (1982/83 a 2007/08) e usando domínio em alta resolução espacial (30 Km) e dois diferentes esquemas de convecção (Grell e MIT), foi investigado o desempenho do modelo em simular a distribuição regional de precipitação sazonal na Amazônia oriental, com referência a um novo conjunto de dados observacional compilado com informações de uma ampla rede integrada de estações pluviométricas. As análises quantitativas evidenciaram que o RegCM3 apresenta erros sistemáticos, sobretudo aqueles relacionados com viés seco no Amapá e norte/nordeste do Pará usando ambos os esquemas Grell e MIT, os quais apontam que o modelo não reproduz as características da ZCIT sobre o Atlântico equatorial. As simulações usando MIT, também apresentaram viés úmido no sudoeste/sul/sudeste do Pará e norte do Tocantins. Além disso, através da técnica de composições, também foi investigado o desempenho do RegCM3 em reproduzir os padrões espaciais anômalos de precipitação sazonal em associação aos episódios ENOS, e as fases do gradiente térmico sobre o Atlântico intertropical. Os resultados demonstraram que o modelo conseguiu representar realisticamente bem o padrão espacial das anomalias pluviométricas acima (abaixo) do normal em grande parte da Amazônia oriental, durante os conhecidos cenários favoráveis, i.e., condições de La Niña e gradiente de aTSM para o Atlântico sul (desfavoráveis, i.e., El Niño e gradiente de aTSM para o Atlântico norte).

This paper presents a contribution on the climate modelling studies with emphasis on seasonal rainfall variability in eastern Amazonia, during the austral summer and autumn seasons (DJF and MAM). Based on RegCM3 regional climate simulations for a 26 years period (1982/83 to 2007/08) using high resolution domain scale (30 km) and two different convection schemes (Grell and MIT), it was investigated the model performance to simulate the regional pluviometric distribution in eastern Amazon, with reference to a new observational data base containing regional aspects extracted from a dense rain gauge station network. The quantitative analysis showed that RegCM3 presents systematic errors, especially those related to the dry bias in the Amapá and north/northeast of Pará using both schemes Grell and MIT, which indicate that the model does not reproduce ITCZ characteristics over equatorial Atlantic. The simulations using MIT also indicated wet bias in the southwest/south/southeast of Pará and north of Tocantins. Moreover, through composites technique, it was also investigated RegCM3 response to reproduce the anomalous spatial rainfall patterns in association with ENSO episodes and interhemispheric SSTa gradient phases across the intertropical Atlantic. The results showed that the model represented realistically well the spatial pattern related to the rainfall anomalies above (below) than normal in most of eastern Amazonia, during the known favourable scenarios, i.e., La Niña and south Atlantic SSTa gradient (unfavourable, i.e., El Niño and north Atlantic SSTa gradient).

The objective of this study was to evaluate the efficacy of fibrin adhesive made up of snake venom and bubaline fibrinogen by rat colon anastomosis. Eighty rats were randomly assigned into 2 experimental groups: GI control (anastomosis with extramucous interrupted suture) and GII (repair suture + fibrin glue). The animals were studied at the following 4 times: T0 – preoperative, T1 – 7th day postoperative, T2 – 14th day postoperative, and T3 – 21 st day postoperative. The macroscopic characteristics of the intestinal segment open and closed anastomosis and the bursting strength of the anastomosed segments were observed at each of the above times. The results showed that the anastomosed segments coapted and there was no difference in the bursting strength values between the 2 groups. There was a decrease in the bursting strength values up until the 7 th day postoperative in both groups with its progressive increase at the other times. Although important experimental studies using large animals are needed for a better evaluation of tissue repair processes, this adhesive may become a valuable tool for use in anastomosis.

O presente ensaio refere-se à adubação de Pinus oocarpa Schiede. Foi instalado em solo Latossolo Vermelho Escuro Distrófico originalmente sob vegetação de cerrado, no município de Assis, São Paulo. Através de medições periódicos de altura e DAP (diâmetro à altura do peito) das árvores, foram verificados os efeitos da adubação NPK, calagem, S, B e Zn sob delineamento experimental de blocos casualizados com quatro repetições. Pela análise estatística dos últimos dados de altura e diâmetro, quando as plantas estavam com 3 anos, conclui-se que: a adubação NPK proporcionou um aumento significativo no desenvolvimento das plantas em altura e diâmetro; a adubação NPK + calagem aumentou significativamente a altura; a adubação NPK + calagem + S aumentou significativamente o diâmetro e a aplicação de B e Zn não apresentou efeitos significativos.

The present work deals with the mineral fertilization of Pinus oocarpa Schiede. The experiment took place in a Distrophic Dark-Red Latosol, formerly under "cerrado" vegetation in Assis, State of São Paulo, Brazil. The height and D.B.C. (diameter breast height) of the trees were periodically measured in order to check the effects of NPK, liming, S, B and Zn fertilization under experimental delineation of randomized blocks with four repetitions . By means of statistical analysis of the last height and diameter data on three year-old plants, we can conclude that: NPK fertilization significantly increased the height and diameter of the plants; NPK + liming treatment significantly increased the plants height; NPK + liming + S treatment significantly increased the plants diameter and the application of B and Zn did not exert any effect.

Este trabalho relata os resultados de um ensaio realizado com o objetivo de estudar a fixação de P por um Latossolo Vermelho Escuro-Orto, serie Iracema, de Piracicaba, Estado de São Paulo. O ensaio foi realizado em vasos de plástico, cada um recebendo 500 g de terra e os tratamentos, correspondentes a 0, 100, 200, 400, 600 e 1.200 kg/ha de P2O5 na forma de Ca (H2PO4)2. H2O. Houve 4 repetições de cada tratamento. Seguiu-se um período de incubação de 3 semanas, durante o qual as parcelas permaneceram umidecidas, entre 40 e 70% do poder de retenção de umidade. Depois foram feitos trabalhos necessários do que se concluiu que: a) grande proporção do P fixado permaneceu solúvel em H2SO4 0,05 N; b) o Fe e o Al foram importantes na fixação do P; c) o pré-tratamento do solo com Ca (H2P0(4))2· H2O reduziu-lhe a capacidade de fixação de fosfato.

This paper deals with an experiment carried out in pots with the aim of studying the fixation of P in a Dark Red Latosol, from the Municipality of Piracicaba, State of Sao Paulo, Brazil. The main conclusions were as follows: a) about 90% of the fixed P remained soluble in 0,05N H2SO4 solution; b) Fe and Al contributed to increase the quantities of fixed P; c) the pre-treatment of the soil with Ca(H2PO4)2. H2O decreased its capacity for fixing P.