ABSTRACT Migration of foreign bodies into the urinary tract is a rare event. In certain instances, to unravel the way that objects arrived in the urinary tract is not easy. We report the case of an accidentally swallowed wooden toothpick that migrated and was found in the left ureterovesical junction, protruding into the bladder. Even though the computed tomography scan is widely employed to evaluate the urinary tract, this resource does not have a good sensitivity for detecting foreign bodies. Our report presents an insight into the best imaging approach if wooden toothpicks are suspected. In the present case, the endoscopic treatment was possible with an uneventful outcome and a complete resolution of symptoms.

Resumo O presente estudo objetivou examinar as características químicas e microbiológicas do leite cru refrigerado coletado em diferentes fazendas e estações. Amostras foram coletadas em doze fazendas produtoras de leite de búfala localizadas na região centro-leste do estado de São Paulo, Brasil, uma vez ao mês entre os anos de 2011 a 2014. Análises de gordura, proteína, lactose, extrato seco e sólidos totais foram realizadas utilizando-se técnica de Infra-vermelho. Análises de resíduos de antimicrobianos foram realizadas através do teste rápido Kit Delvo Test. Análises de contagem de células somáticas e contagem padrão em placas foram conduzidas através de Citometria de Fluxo. Resultados das análises dos componentes químicos, assim como da análise microbiológica de CPP, demonstraram diferenças estatísticas significativas através das estações para estes parâmetros. Em todas as amostras analisadas nenhum resíduo de antimicrobiano foi detectado, indicando que os produtores estão respeitando a legislação sanitária brasileira vigente, bem como para SCC; no entanto, valores acima do permitido foram encontrados para CPP. Diferenças significativas para todos os parâmetros analisados foram encontradas entre as fazendas investigadas, indicando que o incentivo de preço pago pela qualidade do leite cru poderia ser uma alternativa às empresas de processamento de lácteos, favorecendo o rendimento e a qualidade do produto final.

Abstract The present research aimed to examine the chemical and microbiological characteristics of refrigerated raw milk collected from buffalo-only dairy herds from different farms and seasons. Samples were collected from twelve farms producing buffalo milk, located in the Mideast region of São Paulo state, in Brazil, once a month throughout the dairy calendar year from 2011 to 2014. The analysis of fat, protein, lactose, dry extract, and total solids contents were carried out using Infrared Absorption. Residues for antimicrobial analysis were carried out using Delvo Test Kit technique, and both somatic cell count and standard plate count analysis were carried out using Flow Cytometry. The analysis of the chemical components as well as for the microbiological analysis of SPC proved to be statistically significant throughout the period. No antibiotic residues were found in the totality of the sample, hence indicating that the farmers complied with the current sanitary legislation in that country, as well as SCC; however, higher values were found for the SPC. Significant results for all parameters analyzed were found among the farms, indicating that price incentives paid for the quality of raw milk could be an alternative to dairy processing companies, favoring yield and quality of the final product.

Introduction Positive surgical margins (PSMs) are an adverse factor that may predict a worse outcome in patients submitted to radical prostatectomy (RP). However, not all of these cases will evolve to biochemical (BCR) or clinical (CR) recurrence, therefore relationship between PSMs and these recurrent events has to be correlated with other clinical and pathologic findings to indicate complementary treatment for selected patients. Materials and Methods Of 1250 patients submitted to open retropubic radical prostatectomy (RRP), between March 1991 and June 2008, the outcome of 161 patients with PSMs and of 67 without PSMs as a control group, comprising a total of 228 cases were retrospectively reviewed. A minimum follow-up time of 2 years after surgery was considered. BCR was determined when PSA ≥ 0.2ng/mL. CR was determined whenever there was clinical evidence of tumor. Chi-square test was used to correlate clinical and pathologic variables with PSMs. Time interval to biochemical recurrence was analyzed by the Kaplan-Meier product limit analysis using the log-rank test for comparison between groups. Univariate and multivariate Cox stepwise logistic regression models were used to identify significant predictors of risk of shorter intervals to BCR. Results Prostate circumference margin was the most common site with 78 cases (48.44%). Regarding the outcome of 228 cases from both groups, BCR occurred in 68 patients (29.82%), and CR in 10 (4.38%). Univariate analysis showed statistically significant associations (p < 0.001) between presence of PSMs with BCR, but not with CR (p = 0.05). At follow-up of the 161 patients with PSMs, only 61(37.8%) presented BCR, while 100 (62.8%) did not. BCR correlated with pathologic stage; Gleason score; preoperative PSA; tumor volume in the specimen; capsular and perineural invasion; presence and number of PSMs. CR correlated only with angiolymphatic invasion and Gleason score. Considering univariate analysis of clinical and pathologic factors predicting progression-free survival at 5 years, prostate weight; preoperative PSA; Gleason score; pathologic stage; tumor volume; PSMs; capsular and perineural invasion were correlated with BCR. At multivariate analysis, only Gleason score and percentage of tumor volume correlated as significant independent predictors of BCR. Conclusion At univariate analysis, presence, number and location of PSMs have consistent correlation with BCR after RRP, but at follow-up BCR occurred only in 37.8% of patients with PSMs. However at multivariate analysis, the significant risk factors for BCR were percentage of tumor volume (p = 0.022) and Gleason score (p < 0.005) in the surgical specimen. Angiolymphatic invasion and Gleason score were significantly correlated with CR.

Introduction: phenylketonuria is the most recognized congenital metabolic error. Its early detection and low phwnylalanine diet can prevent mental retardation in these patients. Objective: to evaluate the impact of the early phenylketonuria prevention program in Holguin province from January 1986 to October 2012. Methods: a retrospective descriptive study was made in children who were assisted at the phenylketonuria department of pediatric hospital in Holguin province. The universe of study was 12 patients diagnosed with phenylketonuria. The medical histories provided the necessary information. The metabolic control was evaluated through the serum phanylalanin figures recorded in the medical history, the nutritional status was assessed according to the percentile rates set in Cuba and the intellect coefficient was analyzed with psychometric tests. Results: in this group, 66.6 % (8 patients) presented good metabolic control and 58.3 % (7) showed normal intellect. Of the patients diagnosed with the disease before 1986, three (42.9 %) suffered mild mental retardation and two (28.6 %) were disabled. All the patients diagnosed by this program showed normal intellect and 5 had no symptoms. Four were studying for 80 %. Of the studied patients, 83.3 % (10) were eutrophic. Conclusions: the early diagnosis program has allowed the significant improvement of the health status of the phenylketonuric patients, with stable metabolic control and noticeable integration to the society.

Introducción: la fenilcetonuria es el más conocido de todos los errores congénitos del metabolismo. Su detección precoz y una dieta baja en fenilalanina pueden prevenir el retraso mental en los pacientes. Objetivo: evaluar el impacto del programa de prevención precoz de fenilcetonuria en la provincia de Holguín, en el periodo de enero de 1986 a octubre de 2012. Métodos: se realizó un estudio descriptivo retrospectivo en los niños atendidos en la consulta de fenilcetonuria del Hospital Pediátrico de Holguín. El universo estuvo constituido por los 12 pacientes con el diagnóstico de fenilcetonuria. La información se obtuvo a través de las historias clínicas. Se evaluó el control metabólico mediante los valores de fenilalanina sérica registrados en las historias clínicas, el estado nutricional se valoró mediante las tasas de percentiles establecidas en Cuba y el coeficiente intelectual se analizó mediante test psicométricos. Resultados: el 66,6 % (8 de los pacientes) presentó un control metabólico bueno, y 7 para un 58,3 % un intelecto normal. De los pacientes diagnosticados antes de 1986, 3 presentan un retardo mental ligero (42,9 %) y el 28,6 % está incapacitado (2). El 100 % de los diagnosticados por programa presentan un intelecto normal y 5 no presentan síntomas. Estudian 4 para un 80 %. El 83,3 % de los pacientes estudiados son eutróficos (10). Conclusiones: el programa de diagnóstico precoz ha permitido que el estado de salud de los pacientes fenilcetonúricos mejore en cuantía significativa, con una estabilidad en el control metabólico y una integración apreciable a la sociedad.