Dario Palhares

Comparative Anatomy of the Bark of Stems, Roots and Xylopodia of Brosimum Gaudichaudii (Moraceae)

Brosimum gaudichaudii Trec. occurs in the Atlantic and Amazon forests, and is the only species of Brosimum commonly found in Cerrado vegetation. It is of pharmaceutical interest due to the large accumulation of furocoumarins such as psoralens in the bark of roots and xylopodia. This work describes the bark anatomy of sterns, roots, and xylopodia. Although the external bark morphology of stern and subterranean system are different, anatomically they are similar, with both having wavy and fused rays at the outer region of the phloem and a gradual transition between pervious (non-collapsed) and collapsed phloem. Tbe stern and bark periderms have three to seven layers of cells. The bark of younger stern regions is different from the bark of older parts of the stern. Younger stern parts have higher abundance of laticifers in the phloem, and gelatinous fibers arranged in bundles. Compared with the younger regions, older sterns have fewer laticifers and the gelatinous fibers are scattered in the phloem. The root and the xylopodium bark are structurally similar to each other, with a higher abundance of laticifers than sterns. Starch was found in the roots, but not in sterns.

Limitação terapêutica para crianças portadoras de malformações cerebrais graves

Brain malformations may present themselves in different forms, from mild to severe, which can be lethal within a few hours after birth. Based on a systematic review of literature, it was verified that, although theoretically suspending or withholding treatment are ethically similar, in practice, such equivalence is not perceived either by doctors and nursing assistants or by the general population, who tend to more comfortably accept the withholding rather than the withdrawal of treatments. The dialogue with parents is the procedure that legitimizes medical initiatives when proposing therapeutic limitation. In conclusion, severe brain malformations result in an end of life context, in which bioethical principles of palliative care apply and in which the limitation of respiratory support is the main dilemma to be faced in the final moments of patients’ lives.within a few hours after birth. Based on a systematic review of literature, it was verified that, although theoretically suspending or withholding treatment are ethically similar, in practice, such equivalence is not perceived either by doctors and nursing assistants or by the general population, who tend to more comfortably accept the withholding rather than the withdrawal of treatments. The dialogue with parents is the procedure that legitimizes medical initiatives when proposing therapeutic limitation. In conclusion, severe brain malformations result in an end of life context, in which bioethical principles of palliative care apply and in which the limitation of respiratory support is the main dilemma to be faced in the final moments of patients’ lives.

Suspensão de nutrição enteral a pacientes em coma persistente

Withdrawal of enteral nutrition in patients with persistent coma Persistent vegetative state is a clinical condition defined as a long period, from six months to one year, in a coma, which is only possible with the use of medical technology. In some countries, it is lawful for legal guardians to request the suspension of enteral nutrition for these patients, which certainly leads to death within a few days. There is a need for terminology that differentiates between therapeutic limitation, neglect and euthanasia. Therapeutic limitation arises at the moment of acute intercurrences affecting chronic terminal patients, while euthanasia is a request for controlled death. It is concluded, therefore, that the intentional withdrawal of nutritional support for these patients is an act of euthanasia.Persistent vegetative state is a clinical condition defined as a long period, from six months to one year, in a coma, which is only possible with the use of medical technology. In some countries, it is lawful for legal guardians to request the suspension of enteral nutrition for these patients, which certainly leads to death within a few days. There is a need for terminology that differentiates between therapeutic limitation, neglect and euthanasia. Therapeutic limitation arises at the moment of acute intercurrences affecting chronic terminal patients, while euthanasia is a request for controlled death. It is concluded, therefore, that the intentional withdrawal of nutritional support for these patients is an act of euthanasia.

Seed structure and initial development of Byrsonima basiloba Juss. (Malpighiaceae)

Byrsonima basiloba Juss. es un arbusto de rapido crecimiento que produce frutos comestibles y jugosos. Esta investigacion estudio la morfologia y anatomia de las semillas y plantas jovenes de este arbusto. Su endocarpio duro contiene una semilla por loculo. La semilla esta compuesta por una testa y un tegumento con un endospermo residual. El embrion es de color marfil, con cotiledones largos circinados, anisofilos, foliaceas con apices inconexos. El eje embrionario es corto, recto, con epicotilo corto y radicula, y con una tapa de raiz rudimentaria, y ocupa una pequena porcion de la semilla. En la plantula es posible diferenciar claramente la protoderma del procambium y del meristema primario. Inmediatamente por encima del promeristema se encuentran el parenquima cortical, la epidermis con pelo, y el cilindro vascular ya parcialmente diferenciado, asi como los vasos del xilema con engrosamiento helicoidal, por lo que se puede concluir que la diferenciacion de los tejidos de esta especie se produce muy temprano. La region de cuello, que se origina del xilopodium en la planta adulta, no muestra ningun cambio en el color, siendo oblicua al eje del vastago. Los cotiledones y eofilos son anfistomaticos. La descripcion anatomica puede ayudar con la identificacion taxonomica de las especies, como tambien proporcionar una guia para el futuro, en cuanto a protocolos de cultivo in vitro.

Clinical Circadian Behaviour of Infantile Allergic Rhinitis

Objectives: In a week, not every day the patient with allergic rhinitis will have symptoms; also, in a year, not every month the patient will have complaints. Therefore, the clinical evaluation of allergic rhinitis in children should take in consideration the frequency of symptoms and the circadian cycle.

Debate bioético respecto de la necesidad de los gimnasios de contar con certificados médicos para deportistas amateur

Sports Medicine comprises two branches: one, related to professional athletes and the other, related to the general population vis a vis sports and physical activity. The bioethical conflicts involving professional athletes are different from those of amateur practitioners. There is a constant deliberation related to the requirement of medical evaluation before admission to a gym. There are regional laws that make the medical certificate an obligatory document. It is observed that in the creation of these laws, the arguments are guided by a way to transfer responsibility from the gym to the physician who has attended the client. In a sense, the laws that indiscriminately require medical certificates subvert the ethics of the medical practice because the medical officer is not capable to assure that a given patient has no medical issue; instead the medical work is to try to identify the cause to a complaint. The gyms provide clients with orientation and supervision by providing them with qualified professionals. Although the need for medical certificates for everybody is unethical, a detailed medical evaluation is needed for gym clients who may present clinical manifestations during exercise or have some specific clinical conditions.

Debate bioético sobre a necessidade de atestados médicos para os desportistas amadores em ginásios

Sports Medicine comprises two branches: one, related to professional athletes and the other, related to the general population vis a vis sports and physical activity. The bioethical conflicts involving professional athletes are different from those of amateur practitioners. There is a constant deliberation related to the requirement of medical evaluation before admission to a gym. There are regional laws that make the medical certificate an obligatory document. It is observed that in the creation of these laws, the arguments are guided by a way to transfer responsibility from the gym to the physician who has attended the client. In a sense, the laws that indiscriminately require medical certificates subvert the ethics of the medical practice because the medical officer is not capable to assure that a given patient has no medical issue; instead the medical work is to try to identify the cause to a complaint. The gyms provide clients with orientation and supervision by providing them with qualified professionals. Although the need for medical certificates for everybody is unethical, a detailed medical evaluation is needed for gym clients who may present clinical manifestations during exercise or have some specific clinical conditions.

Cultivo in vitro de Brosimum gaudichaudii Tréc. (Moraceae)

The objective of this research was to evaluate the organogenic potential of internodes, leaf discs and roots of Brosimum gaudichaudii using 12 different combinations of the plant growth regulators 6-benzylaminopurine and naphthalene acetic acid in MS medium (half strength), solid medium (6.5 g agar) and sucrose medium (20 g.L-1). Regardless the hormonal combination tested, we observed the formation of friable calluses (2 - 20 mm wide) in 90% of the internode explants. However, the treatments were not able to induce callus or buds on roots and leaf discs. The anatomical analysis revealed meristemoid formation in the outer and inner regions of the calluses. The results may serve as the basis for further testing of callus induction in this species.

Epilepsy and social security: general aspects of the insured claimants and medical decisions.

BACKGROUND Epilepsy affects adults at productive age and interferes with their ability to work. However, the granting of social security benefits to these patients has not received sufficient attention. This article aims to provide a profile of individuals with a previous diagnosis of epilepsy that file claims for social security benefits and a profile of the medical advisory decisions that support the concession of these benefits. PARTICIPANTS A sample of thirty individuals with illness-related problems due to epilepsy was selected from the claimants that receive Social Security Incapacity/Sickness benefits. METHODS An exploratory data analysis of the 188 Social Security medical files of the thirty claimants was performed using the clinical and epidemiological information and the medical advisory criteria. RESULTS The mean age of the claimants was 39 years and most of them were males in jobs that do not require a lot of schooling. The first claim was filed within an average of four years of employment. On average, each worker files a claim every three months, which entitles him/her to receive incapacity/sickness benefits for seventeen months. The frequency of seizures and the medications used by the claimants were registered in 60% of the medical files. In addition, the description of the physical and neurological exam was incomplete in 50% of the files. Furthermore, 60% of the files did not include the argument or the clinical evidence that was used to justify the concession of a benefit. CONCLUSION The medical advisory decisions on epileptic workers tend to be inconsistent, overly lenient and generally lacking in clinical evidence. The disparities among the granted benefits indicate the need for the National Social Security System to review and draft specific guidelines for epilepsy.

Enfoque ético de situaciones de agresión que involucran a pacientes dependientes y a médicos

Resumen es: Con frecuencia los trabajadores del sector de asistencia en salud afrontan el comportamiento agresivo de los pacientes. Cuando esta involucrado un pacien...