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Burn injuries are of serious concern worldwide not only because of the physical impact but also because of severe mental and emotional distress and reduced quality of life. The usual management comprises topical and systemic medications, and supportive care; however, conventional therapy may be expensive and insufficient for many cases. Thus, we describe herein a unique case in which a low-level laser was used concomitantly with the conventional approach for the management of head and neck burn wounds and could improve the patient's clinical condition within a short period.

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Over the last decades, stable fly (Stomoxys calcitrans) outbreaks associated with agricultural and/or livestock production systems have become a serious problem in some Brazilian locations. This article presents a survey on the history, evolution and mapping of such outbreaks in Brazil over five decades (1971-2020). Outbreaks (n= 579) were recorded in 285 municipalities from 14 states, mainly associated with by-products from the ethanol industry (82.7%), in natura organic fertilizers (12.6%) and integrated crop-livestock systems (3.1%). Few cases were reported until the mid-2000s, progressively increasing since then. Outbreaks associated with ethanol mills occurred in 224 municipalities, mainly in Southeast and Midwest states, while those associated with organic fertilizers (mainly poultry litter and coffee mulch) affected 39 municipalities, mostly in the Northeast and Southeast states. More recently, outbreaks in integrated crop-livestock systems during the rainy season have occurred in Midwest states. This survey highlights the magnitude of the problem of stable fly outbreaks in Brazil and its relationship with environmental public policies, agricultural production chains and regional trends. Specific public actions and policies are urgently needed to prevent their occurrence and impact in the affected regions.(AU)

Nas últimas décadas, surtos da mosca-dos-estábulos (Stomoxys calcitrans), associados a sistemas de produção agrícola e/ou pecuária, tornaram-se um grave problema em algumas localidades brasileiras. Este artigo apresenta um levantamento sobre a história, evolução e mapeamento desses surtos no Brasil ao longo de cinco décadas (1971-2020). Surtos (n= 579) foram registrados em 285 municípios de 14 estados, principalmente associados a subprodutos da indústria do etanol (82,7%), fertilizantes orgânicos in natura (12,6%) e sistemas de integração lavoura-pecuária (3,1%). Poucos casos foram registrados até meados dos anos 2000, aumentando progressivamente desde então. Surtos associados a usinas de etanol ocorreram em 224 municípios, principalmente no Sudeste e Centro-Oeste, enquanto surtos associados a fertilizantes orgânicos (principalmente esterco aviário e palha de café) afetaram 39 municípios, principalmente nos estados do Nordeste e Sudeste. Mais recentemente, surtos em sistemas de integração lavoura-pecuária, durante a estação chuvosa, têm ocorrido no Centro-Oeste. Este levantamento ressalta a magnitude do problema dos surtos da mosca-dos-estábulos no Brasil e sua relação com políticas públicas ambientais, cadeias produtivas agrícolas e tendências regionais. Ações e políticas públicas específicas são urgentemente necessárias para prevenir sua ocorrência e impacto nas regiões afetadas.(AU)

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This retrospective study reports data obtained by the Federal Police's National Institute of Criminalistics (INC-PF) relating to chemical analysis aimed at identifying explosives used in Automated teller machines (ATMs)/cash safes robberies between 2014 and 2020 in Brazil. 93 Real cases were studied and, based on the analysis carried out on the materials related to these cases, focusing on the type of explosive used, the following distribution profile was obtained: I) explosive mixtures based on chlorates and/or perchlorates (53%); explosive emulsion (22%); black gunpowder (13%); negative/inconclusive (11%) and organic - pentaerythritol tetranitrate (PETN) (1%). These results can contribute to investigations related to diversion/loss of explosives for criminal purposes, indicating, for example, through relationships between prevalence in the use of a certain type of explosive with a certain location, its possible origin (mining industry, explosive industries, fireworks factories, among others). The profile observed in the results can guide the selection of explosives to be studied in future research, as the possibilities are vast. Furthermore, despite the expressive number of occurrences in Brazil in the period of interest of this study, only a small fraction of samples was sent to the forensic chemistry laboratory to identify the explosive involved, which suggests that expanding chemical analysis should be encouraged in this field. In combination with an increase in professional training and collaboration trials between the laboratories, these activities can improve the chemical explosive's profile in Brazil, enabling the search for correlations between occurrences and contributing to the growth and development of this area.

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Hazardous sequences of vulcanian explosions are thought to result from the repeated emplacement and destruction of degassed, highly crystalline magma plugs in the shallow conduit of arc volcanoes. The processes governing the timing and magnitude of these explosions are thought to be related to magma ascent rate and efficiency of degassing and crystallisation. We study a rare suite of time-constrained ballistic bombs from the 2004-2010 period of activity of Galeras volcano to reconstruct magma plug architecture prior to six individual vulcanian explosions. We find that each plug was vertically stratified with respect to crystallinity, vesicularity and melt volatile content, melt composition and viscosity. We interpret this structure as resulting from multiple bubble nucleation events and degassing-driven crystallisation during multi-step ascent of the magma forming the plug, followed by spatially variable crystallisation within the plug under contrasting conditions of effective undercooling created by degassing. We propose that the shallow conduit evolved from more open degassing conditions during 2004-2008 to more closed conditions during 2009-2010. This resulted in explosions becoming smaller and less frequent over time during 2004-2008, then larger and more frequent over time during 2009-2010. This evolution was controlled by changing average ascent rates and is recorded by systematic changes in plagioclase microlite textures. Our results suggest that small volume vulcanian explosions (~ 105 m3) should generally be associated with longer repose times (hundreds of days) and produce ballistics characterised by small numbers of large, prismatic plagioclase microlites. Larger volume vulcanian explosions (~ 106 m3) should be associated with shorter repose times (tens of days) and produce ballistics characterised by high numbers of small, more tabular plagioclase microlites.

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O uso rotineiro do exame coloscópico para avaliação, diagnóstico e procedimentos terapêutico das doenças dos cólons e do reto, bem como para rastreamento e prevenção do câncer colorretal, seja em pessoas jovens portadores de doenças reconhecidamente pré-malignas ou em pessoas acima do 50 anos de idade, tem sido considerado um dos mais bem sucedidos projetos de saúde pública de extensão mundial. A fácil aceitação se deve a três principais fatores: primeiro, à adequação técnica e evolução dos aparelhos e a segurança do exame; segundo, ao desenvolvimento prático das habilidades do examinador e, terceiro, a magnificência da imagem revelando amplo acesso às finas características da mucosa, com critérios abrangentes para o diagnóstico. Nesse contexto, o preparo necessário para o resultado expressivo que se intenta tornou-se a parte pior ou menos tolerável da coloscopia, razão pela qual o que está em discussão atualmente é a necessária busca com o objetivo de se encontrar um método de preparo, rápido, eficiente, barato, agradável e, principalmente seguro. Nos últimos 40 anos, entre as várias fórmulas - mecânicas e farmacológicas - com diferentes associações de drogas laxativas, tem sido possível destacar três produtos que, pelo menos por algum tempo, foram referências mundiais na limpeza dos cólons que antecede a coloscopia. São eles: primeiro, a solução de manitol a 10 por cento - descartado por causa de acidentes explosivos; segundo, as soluções de polietileno glicol (PEG), depreciado por conta da exigência da ingestão oral de grandes volumes, pelos consequentes distúrbios do equilíbrio hidroeletrolítico e pela rejeição por parte do paciente; e, o terceiro, o fosfato de sódio (NaP) que poderia parecer ideal, mas vem recebendo críticas veementes por causa de seus efeitos colaterais, mormente os nefrotóxicos. Não está em jogo a eficácia desses três produtos, mas a segurança que deveria determinar seus usos indiscriminados para propiciar as melhores condições para os mais adequados exames. Estamos diante de um impasse: o manitol, mundialmente proscrito, continua sendo indicado entre nós, sem causar problemas, num esquema posológico diferente do que foi usado no passado e que influenciou os acidentes. Por outro lado, a industria farmacêutica não conseguiu popularizar o PEG; o NaP, fabricado para uso retal, substituiu os antecessores com limpeza eficiente, mas com ações lesivas significativas, principalmente renais. Assim, o que nos resta é resgatar o manitol - demonstrar por meio de um estudo prospectivo, casualizado, que o manitol a 10 por cento ingerido pelo menos até 4 horas antes da coloscopia é totalmente inócuo para o procedimento de diagnóstico e de terapêutica.

The routine of the colonoscopic examination for therapeutic evaluation, for diagnosis, and management of the diseases of the colon and of the rectum, as well as for screening and prevention of the colorectal cancer in young patients bearing premalignant diseases or in those above 50 years of age, as well as for screening and prevention of the colorectal cancer in young patients bearing premalignant diseases or in those above 50 years of age, has been one of the most successful public health projects worldwide71. The easy acceptance is due to three principal factors: first, to the technical adaptation and evolution of the instruments, and the safety of the examination; second one, to the practical development of the examiner skills, and, thirdly, to the magnificence of the image revealing broad access to the fine structures of the mucous membrane, with a large criteria for the diagnosis. In this context, the necessary preparation became the worst part or less tolerable of the colonoscopy. For this reason, it is necessary to look for a method of preparation, quick, efficient, cheap, pleasant, and safe. In the last 40 years, between the commentaries on mechanical and pharmacological methods - with different associations of laxative drugs - it was possible to find three products that, at least during some time, were world-wide references on large bowel cleaning for colonoscopy. They are: first, a 10 percent mannitol solution - it was dropped because of explosives accidents ; second, the polyethylene glycol (PEG) solutions, it was depreciated due to the requirement of large volumes for oral ingestion, due to electrolytic balance disturbance and rejection by the patient, and the third, the sodium phosphate (NaP) that would seem ideal, but that has received criticism because of its side effects, especially the nephrotoxicity. There is no the discussion on the efficiency of these three products, but on the safety with which we might promote their indiscriminate uses to offer the best conditions on performance of the colonoscopy. However, we have an impasse: the mannitol was abandoned, but it keeps on indicated among us, without causing problems, in a scheme that is different from which was used in the past when it influenced the accidents. On the other hand, the pharmaceutical industry did not manage to popularize PEG; the NaP is manufactured for rectal use, it substituted the predecessors with efficient cleaning, but with significantly harmful lesions. So, which remains for us is to rescue the mannitol - for that, we must evidence through a randomized trial that a oral ingestion of 10 percent mannitol solution, at least up to 4 hours before the colonoscopy, is totally harmless on diagnosis and therapeutic procedures.

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