Abstract Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare pathology, with a classic clinical presentation of painless bilateral massive cervical lymphadenopathy. The extranodal manifestations may involve skin, central nervous system, hematological, bones, and airway compromise, among others. Its diagnosis is challenging and requires a complete evaluation of the patient including medical history, physical examination, laboratory testing, imaging and histopathological study to confirm the diagnosis. Treatment should be individualized for each patient, including follow-up, systemic corticosteroids, radiotherapy, chemotherapy, immunomodulators and surgery. We present the case of a 65-year-old patient with a history of RDD located in the lacrimal glands and lymphoma, which begins with progressive bilateral obstruction refractory to medical treatment, for which it is decided to perform surgery, whose histopathological study confirmed RDD.

Resumen La histiocitosis sinusal con linfadenopatías masivas, conocida como enfermedad de Rosai-Dorfman (ERD), es una patología poco frecuente cuya presentación clásica consiste en el desarrollo de grandes adenopatías cervicales bilaterales indoloras. La manifestación extranodal puede involucrar compromiso cutáneo, del sistema nervioso central, hematológico, óseo, de la vía aérea, entre otros. Su diagnóstico es un desafío y requiere una evaluación completa del paciente incluyendo historia clínica, examen físico, exámenes de laboratorio, imágenes y estudio histopatológico que confirme el diagnóstico. El tratamiento debe ser individualizado para cada paciente. Las alternativas incluyen la observación, corticoides sistémicos, radioterapia, quimioterapia, inmunomoduladores y cirugía. Se presenta el caso de una paciente de 65 años con antecedente de enfermedad de Rosai-Dorfman localizada en glándulas lagrimales y linfoma no Hodgkin, que comienza con obstrucción nasal bilateral progresiva refractaria a tratamiento médico, por lo que se decide realizar cirugía, cuyo estudio histopatológico confirmó enfermedad de Rosai-Dorfman.

Resumo Altas doses de antibióticos utilizados em hospitais podem afetar a composição microbiana dos esgotos, selecionando bactérias resistentes. Nesse sentido, avaliamos o perfil de resistência a antibióticos e o fenótipo multirresistente de bactérias isoladas em esgoto de um hospital terciário no interior do estado de São Paulo, Brasil. Para o isolamento de bactérias, foram semeados 10 µL das amostras de esgoto em meios de cultura seletivos e os isolados foram identificados usando o sistema automatizado VITEK-2. O teste de sensibilidade aos antibióticos foi realizado por disco-difusão em ágar. Elevadas porcentagens de resistência foram encontradas para amoxicilina, ampicilina, ceftazidima, clindamicina, vancomicina e o fenótipo multirresistente (MDR) foi atribuído a 60,7% dos isolados. Nossos resultados mostram bactérias classificadas como prioridade crítica/alta pela Lista de Patógenos Prioritários da OMS (Enterococcus e Staphylococcus aureus resistentes à vancomicina e Enterobacteriaceae resistentes aos carbapenêmicos) no esgoto hospitalar. Sendo assim, implementação de tecnologias de desinfecção do esgoto hospitalar reduziriam a carga bacteriana no esgoto que chegará às estações de tratamento de esgoto urbanas, minimizando a contaminação dos ecossistemas hídricos receptores e a disseminação da resistência bacteriana no ambiente.

Abstract High doses of antibiotics used in hospitals can affect the microbial composition of sewers, selecting resistant bacteria. In this sense, we evaluated the antibiotic resistance profile and the multiresistant phenotype of bacteria isolated in sewage from a tertiary hospital in the interior São Paulo state, Brazil. For bacteria isolation, 10 µL of sewage samples were sown in selective culture media and the isolates were identified using VITEK-2 automatized system. The antibiotic sensitivity test was performed by disk diffusion. High percentages of resistance were found for amoxicillin, ampicillin, ceftazidime, clindamycin, vancomycin and the multidrug-resistant phenotype (MDR) was attributed to 60.7% of the isolates. Our results show bacteria classified as critical/high priority by WHO List of Priority Pathogens (Enterococcus and Staphylococcus aureus resistant to vancomycin and Enterobacteriaceae resistant to carbapenems) in hospital sewage. Therefore, the implementation of disinfection technologies for hospital sewage would reduce the bacterial load in the sewage that will reach urban wastewater treatment plants, minimizing superficial water contamination and bacterial resistance spread in the environment.

Abstract Background: Hemorrhoid disease (HD) is one of the most common gastrointestinal complaints worldwide, affecting 4.4% of the general population in the United States. Since antiphospholipid syndrome (APS) may lead to intra-abdominal thrombosis, one may expect that this condition can impact the risk for HD development. Additionally, as APS patients are more prone to thrombosis and treatment with anticoagulants may increase risk of bleeding, one may also infer that rates of HD complications may be higher in this scenario. Nevertheless, no data in these regards have been published until now. The objective of the present study is to evaluate frequency of HD and describe its complications rates in antiphospholipid syndrome APS patients. Methods: We consecutively invited patients who fulfilled APS criteria to undergo proctological examination. After examination, patients were divided in two groups, based on the presence of HD, and compared regarding different clinical manifestations and antiphospholipid profile. We performed the analysis of the data, using chi-square and Mann Whitney U when applicable and considering a significance level of 0.05. Multivariate regression analysis included age and variables with p < 0.10 in the bivariate analysis. Results: Forty-one APS patients agreed to undergo proctological examination. All were female and overall median age was 43 (36–49). Seventeen (41.4%) patients were diagnosed with HD, with the following frequency distribution: 7 internal (41.2%), 4 external (23.5%) and 5 mixed hemorrhoids (29.4%). Of the internal hemorrhoids, 5 patients were classified as grade I (71.4%), 1 grade II (14.3%), and 1 grade IV (14.3%). Prior gestation ( p = 0.067) and constipation ( p = 0.067) correlated with a higher frequency of HD. In multivariate analysis, constipation remained as an important risk factor (OR 3.92,CI95% 1.03–14.2, p = 0.037). Five out of 17 patients (29.4%) reported anal bleeding, but it did not correlate with warfarin dose ( p = 0.949). Surgical treatment was indicated for 10 patients (58.8%). Other anorectal findings were anal fissure, plicoma, condyloma and one chlamydial retitis. Conclusion: We found an unexpected high frequency of hemorrhoids in APS patients, with a great proportion requiring surgical treatment.

ABSTRACT A 29-year-old patient with a history of three nasal fillings in the nasal tip with hyaluronic acid five years ago, reason for consultation improvement nasal aesthetics and nasal obstruction. Physical examination showed a slight osteocartilaginous hump, bulbous tip, symmetrical nostrils, no deviation nasal pyramid, no masses or nodules were palpated. After the management of his rhinitis and previous informed consent, when performing open rhinoseptoplasty, a large amount of foreign body type granulation tissue was found in the tip and nasal dorsum, which forced the surgical plan to change. The post-surgical biopsy showed foreign body granuloma by biopolymer derived from silicone. Evolved satisfactorily aesthetically and functionally. The use of nasal fillers has increased in recent years, although there are no facial fillers approved by the FDA for nasal use. The correct use of nasal fillers is a controversial issue. Nasal granulomas by foreign body are late complications that have increased with the use of biopolymers with inadequate doses and techniques. The use of ecotomography has contributed to improve the surgical planning; the deferred histological study has allowed to identify the material used in most cases becoming the gold standard

RESUMEN Paciente de 29 años con antecedente de tres rinomodelaciones en la punta nasal con ácido hialurónico hace cinco años, evaluada por deseo de mejora estética nasal y obstrucción nasal. Al examen visual se observó una leve giba osteocartilaginosa, punta bulbosa, narinas simétricas, sin laterorrinea, no se palparon masas ni nodulaciones. Posterior al manejo de su rinitis y previo consentimiento informado, al realizar rinoseptoplastía abierta se encontró gran cantidad de tejido granulatorio tipo cuerpo extraño en la punta y dorso nasal lo que obligó a cambiar el plan quirúrgico. La biopsia diferida confirmó granuloma por cuerpo extraño por biopolímero derivado de la silicona. Evolucionó satisfactoriamente estética y funcionalmente. La rinomodelación ha aumentado en los últimos años, aunque no existen rellenos faciales aprobados por la FDA para uso nasal. La correcta utilización de los rellenos nasales continúa siendo un tema controvertido. Los granulomas nasales por cuerpo extraño son complicaciones tardías que se han incrementado con el uso de biopolímeros con dosis y técnicas inadecuadas. El uso de ecotomografía ha contribuido a mejorar la planificación quirúrgica, así como el estudio histológico diferido ha permitido identificar el material utilizado en la mayoría de los casos convirtiéndose en el estándar de oro.

RESUMO Este estudo investiga a Rodovia Presidente Dutra inaugurada na década de 1950 e sua influência no processo de urbanização do Vale do Paraíba Paulista. Amparado nas constatações de Villaça (2001), que apontou para as vias regionais como vias de urbanização, a Rodovia Presidente Dutra assumiu um papel primordial para o crescimento das cidades. Na década de 1970, tal infraestrutura rodoviária foi um importante vetor do processo de realocação industrial a partir da Grande São Paulo (LENCIONI, 1998). Mais recentemente, a Rodovia foi novamente apontada nas propostas para a adoção dos Vetores Territoriais no Estado de São Paulo. A análise temporal visa, por meio, de mapas axiais explorar a expansão urbana e o sistema viário urbano-regional. Para isso, fez-se o uso de cartas topográfica,s elaboradas para o ano de 1977 e da base de dados das vias urbanas existentes no ano de 2015, obtida do projeto Open Street Map (OSM). A cartografia resultante do índice de integração das vias urbanas proporcionou uma visão espacial do sistema viário intra-urbano revelando indícios de um processo de urbanização dispersa, permitindo assim, evidenciar a Rodovia Presidente Dutra como um elemento estruturador do espaço urbano-regional no Vale do Paraíba Paulista.

ABSTRACT This study investigates the President Dutra Highway, inaugurated in the 1950s, and its influence on the urbanization process of the Paraíba Paulista Valley. Supported on the findings of Villaça (2001), which point to regional roads as urbanization routes, the President Dutra Highway has taken on a primary role for the growth of cities. In the 1970s, the President Dutra Highway was an important vector of the process of industrial relocation from the Greater São Paulo (LENCIONI, 1998). More recently, the President Dutra Highway was again pointed to in the proposals for the adoption of Territorial Vectors in the State of São Paulo. By means of axial maps, the temporal analysis aimed to explore urban expansion and the urban regional road system. To this end, topographical charts created for the year 1977 and the database of urban roads existing in 2015, obtained from the Open Street Map (OSM) project were used. The cartography resulting from the integration index of the urban roads provided a spatial view of the intra-urban road system revealing indications of a dispersed urbanization process, thus evidencing the President Dutra Highway as a structuring element of the urban-regional space in the Paraíba Paulista Valley.

RESUMEN Este estudio investiga la Carretera Presidente Dutra inaugurada en la década de 1950 y su influencia en el proceso de urbanización del Valle del Paraíba Paulista. Amparado en las constataciones de Villaça (2001), que apunta a las vías regionales como vías de urbanización, la Carretera Presidente Dutra asumió un papel primordial para el crecimiento de las ciudades. En la década de 1970, tal infraestructura vial fue un importante vector del proceso de realocación industrial a partir de la Gran São Paulo (LENCIONI, 1998). Más recientemente, la Carretera fue nuevamente apuntada en las propuestas para la adopción de los Vectores Territoriales en el Estado de São Paulo. El análisis temporal busca, por medio de mapas axiales, explorar la expansión urbana y el sistema vial urbano-regional. Para ello, se hizo el uso de cartas topográficas, elaboradas para el año 1977 y de la base de datos de las vías urbanas existentes en el año 2015, obtenida del proyecto Open Street Map (OSM). La cartografía resultante del índice de integración de las vías urbanas proporcionó una visión espacial del sistema viario intraurbano revelando indicios de un proceso de urbanización dispersa, permitiendo así, evidenciar la Carretera Presidente Dutra como un elemento estructurador del espacio urbano-regional en el Valle del Paraíba Paulista.

Resumo Os carabídeos são reconhecidos mundialmente como agentes de controle biológico de pragas agrícolas. O objetivo foi comparar o ciclo de vida de Abaris basistriata Chaudoir (Coleoptera: Carabidae) em três substratos: solo, vermiculita fina, ou guardanapos de papel. O ciclo biológico de A. basistriata apresentou diferentes durações no solo e no papel. A viabilidade dos ovos e a sobrevivência das larvas do primeiro e segundo instares foram semelhantes nos três substratos, enquanto que o terceiro instar e a pupa apresentaram maior sobrevivência no solo quando comparados com vermiculita e papel. O substrato solo foi mais favorável à longevidade do carabídeo. Abaris basistriata mostrou menor período de pré-oviposição e maior período de oviposição e pós-oviposição no solo. A fecundidade e a fertilidade foram maiores quando A. basistriata foi criado no solo. O solo foi o substrato mais favorável para a criação de A. basistriata no laboratório. Estas informações são importantes e podem tornar essa espécie útil para o controlo biológico.

Abstract Carabids are recognized worldwide as biological control agents of agricultural pests. The objective was to compare the life cycle of Abaris basistriata Chaudoir (Coleoptera: Carabidae) on three substrates: soil, fine vermiculite, or paper napkins. The biological cycle of A. basistriata presented different durations in soil and paper. The viability of eggs and larvae survival of the first and second instars were similar on all three substrates, while the third instar and pupa in the soil presented higher survival when compared with vermiculite and paper. The soil substrate was more favorable for the longevity of the carabid beetle. Abaris basistriata showed a shorter pre-oviposition period and a higher oviposition and post-oviposition period in the soil. Fecundity and fertility were higher when A. basistriata was reared on soil. The soil was most favorable substrate for rearing of A. basistriata in the laboratory. This information may make this species useful for the biological control.

ABSTRACT Introduction: Rhinoseptoplasty is a complex and challenging surgery. It addresses nasal aesthetics and functionality. Aim: To describe the experience in rhinoseptoplasty performed by the Nose Committee at our medical center. Material and method: Descriptive study, of the all rhinoseptoplasties performed by the Nose Committee between 2013 and 2015. Results: 265 patients underwent surgery in the 3-year period; 164 (61.8%) were women and the mean age was 29 years (range 13-73). Most were primary surgeries (secondary: 2.6%). An external approach was most commonly used (92.5%). Nasal tip surgery was performed in 253 (95.5%) patients; osteocartilaginous dorsum reduction in 252 (95,1%), and augmentation in only 5 (1,9%). Osteotomies were frequent: paramedian in 229 (86.4%), bilateral percutaneous lateral osteotomies in 217 (81.9%) and unilateral percutaneous lateral in 17 (6.4%). Regarding nasal tip grafts, columellar strut was most often used, in 241 (90,9%) patients, followed by the shield graft in 69 (26,0%). For the dorsum, autospreaders were used in 124 (46.7%), and spreader grafts in 109 (41.1%). Conclusions: Open rhinoseptoplasty was the most commonly used approach. This has shown favorable for residents due to better exposition of nasal anatomy. Only 2.6% were secondary rhinoseptoplasties. We emphasize the use of the columellar strut for nasal tip support as we frequently encounter hispanic noses at our center.

RESUMEN Introducción: La rinoseptoplastía es una cirugía compleja y desafiante. Permite resolver problemas estéticos y funcionales de la nariz. Objetivo: Describir la experiencia en rinoseptoplastías realizadas en el Comité de Nariz en nuestro centro. Material y método: Estudio descriptivo de pacientes sometidos a rinoseptoplastía entre 2013 y 2015. Resultados: Se operaron 265 pacientes en 3 años, 164 (61,8%) fueron mujeres y la edad promedio fue de 29 años (rango 13-73). Las cirugías fueron principalmente primarias (secundarias: 2,6%). El abordaje más utilizado fue abierto (92,5%). Se realizó trabajo de punta nasal en 253 (95,5%) pacientes; resección del dorso osteocartilaginoso en 252 (95,1%), y aumento de éste en sólo 5 (1,9%). Las osteotomías fueron frecuentes: paramedianas en 229 (86,4%), percutánea lateral bilateral en 217 (81,9%) y percutánea lateral unilateral en 17 (6,4%). El vástago columelar fue el injerto de punta más frecuentemente utilizado, en 241 (90,9%) pacientes, seguido del escudo en 69 (26,0%). En el dorso, se utilizaron autoespaciadores en 124 (46,7%) pacientes, y espaciadores en 109 (41,1%). Conclusiones: El abordaje abierto fue el más frecuente, demostrando ser favorable en nuestro centro por la exposición y aprendizaje de nuestros residentes. Se constató 2,6% de cirugías secundarias. Se destaca el uso de vástago columelar para otorgar soporte a la punta nasal dada la alta prevalencia de nariz hispana en nuestro centro.

Abstract Background: Spontaneous rupture of the ureter is rare. It is associated with abdominal pain and should be considered the differential diagnosis in patients with renal colic with no apparent underlying cause. Stone impaction-retention at the ureteral wall has been thought to produce erosion and ulceration. Clinical case: Three cases of spontaneous ureteral rupture with no apparent cause were presented herein. Double-J catheter was placed in two patients and open drainage was carried out in one patient to repair the rupture. Prophylaxis with ceftriaxone was given to prevent infection. The patients progressed satisfactorily. Control computed tomography urography identified no alterations or apparent additional complications. Conclusions: Ureteral rupture is a rare alteration. Urinary retention, lymphoma, and chemotherapy have been suggested as possible causes of spontaneous rupture.

Resumen Antecedentes: La ruptura espontánea del uréter es poco frecuente; se asocia con dolor abdominal y debe considerarse como diagnóstico diferencial en pacientes con cólico renal, sin ninguna causa subyacente aparente. Se ha propuesto que la impactaciónretención de cálculos (litos) en la pared del uréter puede producer erosión y ulceración. Caso clínico: Se describen tres casos de ruptura ureteral espontánea sin causa aparente. El tratamiento en dos pacientes consistió en la colocación de un catéter doble J endoscópico y en un caso se efectuó drenaje abierto para reparar la ruptura. Se prescribió tratamiento profiláctico con ceftriaxona para prevenir infecciones. Los pacientes evolucionaron adecuadamente; la urotomografía de control no mostró alteraciones ni complicaciones adicionales aparentes. Conclusiones: La ruptura ureteral es una lesión poco común; algunos reportes de ruptura espontánea sugieren como principals causas: retención urinaria, linfomas y quimioterapia.

Resumo Dado que a valoração econômica de serviços ecossistêmicos é uma abordagem útil para incentivar a conservação de áreas naturais, tivemos como objetivo estimar o valor monetário dos benefícios fornecidos por uma área protegida no sudeste do Brasil, o Parque Nacional da Serra do Cipó. Calculamos a disposição a pagar dos visitantes pela conservação dos ecossistemas abrangidos pela área protegida, usando o método da valoração contingente. Localizado em uma região que sofre intensa pressão antrópica, o Parque Nacional da Serra do Cipó é composto majoritariamente por campos rupestres, além de outras fitofisionomias do Cerrado. Realizamos 514 entrevistas com os visitantes da região e encontramos uma disposição a pagar média de R$ 7,16 ano–1, o que corresponde ao total de aproximadamente R$ 716.000,00 ano–1. Detectamos que renda per capita, número de dependentes, nível de interesse por temas relacionados ao meio ambiente e local de origem influenciam a probabilidade de o indivíduo estar disposto a contribuir para a conservação do parque, assim como o valor da disposição a pagar declarada. Este estudo atrai atenção dos tomadores de decisão e da sociedade para a importância de se conservar os campos rupestres e outras fitofisionomias do Cerrado.

Abstract Considering that the economic valuation of ecosystem services is a useful approach to support the conservation of natural areas, we aimed to estimate the monetary value of the benefits provided by a protected area in southeast Brazil, the Serra do Cipó National Park. We calculated the visitor’s willingness to pay to conserve the ecosystems of the protected area using the contingent valuation method. Located in a region under intense anthropogenic pressure, the Serra do Cipó National Park is mostly composed of rupestrian grassland ecosystems, in addition to other Cerrado physiognomies. We conducted a survey consisting of 514 interviews with visitors of the region and found that the mean willingness to pay was R$ 7.16 year–1, which corresponds to a total of approximately R$ 716,000.00 year–1. We detected that per capita income, the household size, the level of interest in environmental issues and the place of origin influenced the likelihood that individuals are willing to contribute to the conservation of the park, as well as the value of the stated willingness to pay. This study conveys the importance of conserving rupestrian grassland and other Cerrado physiognomies to decision makers and society.

Neste trabalho revisamos alguns dos sistemas não-lineares mais paradigmáticos e desvendamos algumas das suas surpreendentes interligações. Os problemas de interesse, descrito matematicamente pelas equações de sine-Gordon, Toda e KdV, generalizam modelos físicos conhecidos, como o pêndulo simples, o sistema massa-mola e as ondas lineares em água, respectivamente. Depois de discutirmos as peculiaridades decorrentes da presença de não-linearidades nos modelos, esclarecemos como os sistemas apresentados são relacionados uns aos outros, indicando a existência de uma família de equações que compartilham propriedades como a integrabilidade. Nós mostramos como a equação de KdV pode ser convenientemente discretizada a fim de preservar tais características importantes. Além de apresentarmos as ligações estreitas que esta equação tem com a cadeia de Toda e com a equação sine-Gordon, nós também investigamos outros procedimentos capazes de gerar um sistema integrável discreto a partir do modelo KdV com a discretização de Hirota.

In this report we review some of the most paradigmatic nonlinear systems and unveil some of their suprising interconnections. The problems of interest, described mathematically by the equations of sine-Gordon, Toda and KdV, generalize well known physical models, the simple pendulum, the mass on a spring and the linear waves, respectively. After discussing the differences arising from the presence of nonlinearities in the models, we clarify how the systems presented are related to each other, indicating existence of a family of equations sharing integrability properties. We show how the KdV equation can be conveniently discretized in order to preserve important properties. Besides presenting the close connections this equation has with respect to the Toda lattice and the sine-Gordon equation, we also investigate other procedures capable of generating a discrete integrable system from the KdV model, as the Hirota discretization.

Introduction: The fungal laryngitis is an unusual disease in immunocompetent patients, however should take into consideration in the differential diagnosis of leukoplakias, especially in patients with predisposing factors such as pharyngolaryngeal reflux, use of inhaled, oral or intravenous corticosteroids. Aim: Describe a series of cases of fungal laryngitis in immunocompetent patients with clinical diagnosis and empirical antifungal treatment. In addition, finding the association with predisposing factors keys. Material and method: Retrospective study of 11 patients with diagnosis of fungal laryngitis according to clinical presentation, predisposing factors and findings in the laryngeal videostroboscopy (vocal folds leukoplakias) joined the response to empirical treatment with oral fluconazole. Also an extensive literature review was conducted until 2015. Results: The main predisposing factor was the pharyngolaryngeal reflux (91%) followed by use of corticosteroids (55%). All patients were treated empirically with fluconazole for 14-21 days. 100% of patients responded successfully, with remission of symptoms and laryngeal lesions. Conclusion: Clinical diagnosis and treatment with fluconazole as first-line treatment generate good response rate, provided that the patient's symptoms and signs with the findings in the larynx are correlated.

Introducción: La laringitis fúngica es una patología poco planteada en pacientes inmunocompetentes, sin embargo se debería tener en consideración en el diagnóstico diferencial de leucoplaquias en estos pacientes, más aún con factores predisponentes como reflujo faringolaríngeo, tabaquismo crónico y/o uso de corticoides. Objetivo: Presentar una serie de casos de pacientes inmunocompetentes con diagnóstico clínico de laringitis fúngica y tratamiento antimicótico empírico. Describir la asociación con factores predisponentes claves. Material y método: Estudio retrospectivo que incluyó a 11 pacientes con diagnóstico clínico de laringitis fúngica por correlación de la clínica, factores predisponentes y hallazgos en la videoestroboscopía laríngea (leucoplaquias múltiples en los pliegues vocales) sumado a la respuesta a tratamiento empírico con fluconazol oral. Se realizó además una revisión de la literatura disponible hasta el año 2015. Resultados: Todos los diagnósticos fueron clínicos correlacionando síntomas con hallazgo de leucoplaquias características en la laringe. El principal factor asociado fue el reflujo faringolaríngeo (91%) seguido por uso de corticoides (55%). Todos los pacientes fueron tratados con un esquema empírico de fluconazol oral por 14-21 días. El 100% de los pacientes respondió de forma exitosa al uso de este fármaco con remisión de los síntomas y de las lesiones laríngeas. Conclusión: El diagnóstico clínico y tratamiento con fluconazol oral como tratamiento de primera línea generarían buena tasa de respuesta, siempre que se correlacionen los síntomas y signos del paciente con los hallazgos encontrados en la laringe.

Resumo Pachira aquatica Aubl. é frequentemente utilizada como planta ornamental em áreas urbanas no Brasil. O objetivo do trabalho foi conhecer os ácaros associados a P. aquatica com ênfase em Brachytydeus formosa (Cooreman), bem como descrever alguns aspectos morfológicos do seu aparato bucal. O estudo foi realizado em 2012, em Jaboticabal, estado de São Paulo, Brasil. Foram selecionadas dez árvores de P. aquatica para realização do experimento. Cerca de 130 folíolos foram coletados de cada árvore localizados em diferentes quadrantes (norte, sul, leste e oeste) e estratos (superior, médio e inferior). Os folíolos foram colocados em sacos de papel e transportados para o laboratório. Os ácaros foram preparados em lâminas de microscopia óptica. No total foram encontradas onze espécies de ácaros, pertencentes a oito famílias. As espécies encontradas foram B. formosa, Eutetranychus banksi (McGregor), Agistemus sp., Tyrophagus putrescentiae (Schrank, 1781), Brevipalpus phoenicis (Geijskes), Brevipalpus sp., Cheletogenes sp., Iphiseiodes zuluagai Denmark & Muma, Euseius sp., Neoseiulus sp., e apenas um exemplar da família Bdellidae. A espécie predominante foi B. formosa, com 8.142 ácaros igualmente distribuídos nos quatro quadrantes e principalmente nos estratos médio e superior da planta. Ácaros de B. formosa dos folíolos de P. aquatica foram separados para o estudo da morfologia externa do aparato bucal utilizando-se microscopia eletrônica de varredura (SEM).

Abstract Pachira aquatica Aubl. is commonly used as an ornamental plant in urban areas of Brazil. The objective of the study was to investigate the occurrence of mites on P. aquatica, with emphasis on Brachytydeus formosa (Cooreman), and to describe aspects the external features of its mouthpart. The study was conducted in 2012 in Jaboticabal, State of São Paulo, Brazil. Ten trees of P. aquatica were selected for the experiment. Approximately 130 leaflets were collected from each tree, which were located in different quadrants (north, south, east, and west) and strata (upper, middle, and lower). The leaflets were placed in paper bags and transported to the laboratory. The mites were prepared on optical microscope slides. A total of eleven species of mites were found, belonging to eight different families. The species and genera of the organisms included B. formosa, Eutetranychus banksi (McGregor), Agistemus sp., Tyrophagus putrescentiae (Schrank, 1781), Brevipalpus phoenicis (Geijskes), Brevipalpus sp., Cheletogenes sp., Iphiseiodes zuluagai Denmark & Muma, Euseius sp., Neoseiulus sp., and only one specimen from the Bdellidae family. The predominant species was B. formosa, with 8,142 mites equally distributed among the four quadrants and mostly in the middle and upper strata of the plant. B. formosa mites from leaflets of P. aquatica were separated for the study of the external mouthpart morphology by scanning electron microscopy (SEM).

Introduction: This study intends to describe the characteristics of Down syndrome children and relate them to oral health in order to facilitate their treatment in the dental office. Material and methods: A PubMed database research was conducted and limited to articles published in English, Spanish, French and Portuguese, between the years of 1997 and 2012. Results and discussion: The characterization of oral health standards in a population with T21 is necessary to establish priorities (both preventive and curative actions) and it's essential to identify and quantify the needs of the target population when a health care plan is made in order to develop a preventive standard protocol.

Introducción: Este estudio pretende describir las características de los niños con síndrome de Down y relacionarlos con la salud oral, con el fin de facilitar el tratamiento en el consultorio dental. Material y métodos: Fue realizado un estudio de base de datos PubMed limitado a artículos publicados en inglés, español, francés y portugués, entre los años 1997 y 2012. Resultados y discusión: Necesidad de caracterizar los niveles de salud oral en la población con trisomía 21 con el objetivo de identificar y cuantificar las prioridades en términos preventivos y curativos.

This paper presents the case of a patient of six years old female without background or important morbidly in her family, who consults for left-sided proptosis in April of 2011. It performs brain magnetic resonancebeing demonstrated a tumor of theethmoid sinus with commitment to the left orbit that causes exophthalmus. Nasal endoscopic biopsy was compatible with juvenile ossifying fibroma. It was subsequently performed ananthrostomy whitethmoidectomy in two times, with satisfactory results for the patient. Although the Juvenile ossifying fibroma is a rare type of benign lesion, can be very aggressive and have a high recurrence rate in certain occasions, by what should be taken into account to make an early diagnosis and treatment, with a scheduled follow up in the long term.

Se presenta el caso de una paciente de seis años, de sexo femenino sin antecedentes mórbidos ni familiares de importancia, quien consulta por proptosis izquierda en abril de 2011. Se realiza resonancia magnética de cerebro evidenciándose un tumor de seno etmoidal con compromiso de órbita izquierda que ocasiona exoftalmo. La biopsia endoscópica nasal fue compatible con fibroma osificante juvenil. Posteriormente se realiza antrostomía con etmoidectomía en dos tiempos, con resultados satisfactorios para la paciente. Aunque el fibroma osificante juvenil es un tipo de lesión benigna poco frecuente, puede llegar a ser muy agresiva y con una alta tasa de recidiva en ciertas ocasiones, por lo que se debe tener en cuenta para realizar un diagnóstico y tratamiento precoz, con un seguimiento programado a largo plazo.

Choanal atresia is the most common congenital nasal anomaly. When bilateral, it presents with respiratory distress at birth. Unilateral atresia is manifested by respiratory failure and unilateral rhinorrhea, and may go along unnoticed. Diagnosis is suspected in the absence of airflow in the nasal cavity and for the inability to advance a nasogastric tube. Diagnosis is confirmed by endoscopic examination and computed tomography. The definitive treatment is surgical, and there are different techniques and surgical approaches. A review of the literatureis presented, with special emphasis onthepost-surgical treatmentwithstents and Mitomycin-Cview from the evidence.

La atresia de coanas es la anomalía congénita nasal más común. Cuando es bilateral, se presenta con dificultad respiratoria desde el nacimiento. La atresia unilateral se manifiesta con insuficiencia ventilatoria y rinorrea unilateral, pudiendo pasar inadvertida. El diagnóstico se sospecha ante la ausencia de paso de aire en las fosas nasales y la imposibilidad de hacer progresar una sonda nasogástrica. Se confirma mediante examen endoscópico y tomografía computarizada. El tratamiento definitivo es quirúrgico, existiendo diferentes técnicas y vías de abordaje. Se presenta una revisión de la literatura, con especial énfasis en el tratamiento pos-quirúrgico con stents y mitomicina-C a través de una mirada desde la evidencia.