The estimated mean intestinal coefficients of Leporinus friderici Bloch, 1794 and L. taeniofasciatus Britski, 1997, from the Upper Tocantins River, central-western Brazil, were 1·25 0·15 and 1·14 0·07, respectively. The external surfaces of the lips have taste buds. The histological structure is composed of four layers: mucosa, submucosa, muscular, and serosa. No muscularis mucosa is detected. The oesophageal epithelium is stratified in L. friderici and pseudostratified in L. taeniofasciatus, the latter with PAS+ basal cells and eosinophilic apical cells. A thick layer of adipose tissue was found within the submucosa. Leporinus taeniofasciatus has a sphincter separating the cardiac and fundic portions of the stomach. In both species, gastric glands are present in the stomach, except in its pyloric portion. The pyloric caeca possess a simple columnar epithelium with brush border and three types of goblet cells. Rodlet cells were found in L. friderici. The three portions of the intestine showed no histological differences. Anatomical and histological features of the digestive tract are consistent with the omnivorous habit of both these species. 2001 The Fisheries Society of the British Isles

BackgroundOral manifestations may be the first signs of hematologic diseases, and may occur due to the disease itself or to treatment.ObjectiveTo evaluate the frequency and types of oral conditions presented by patients on a hematology ward.MethodsData were collected by oral examinations during weekly visits to a hematology ward. Six trained dentists performed the oral assessment based on the principles of oral semiology. All patients who accepted to be examined were included in the study. Patients who were unavailable or unable to have oral examinations were excluded. Data were recorded on protocol forms and in the electronic records of the institution. A descriptive analysis was performed.ResultsSeventy-nine patients were included in the analysis; 50.6% were female and the mean age was 41.49 years. The most common reasons for hospitalization were chemotherapy and complications (81%), relapse (13.9%) and pre-transplant preparation (5%). The most frequent underlying diseases were multiple myeloma (17.7%), acute myeloid leukemia (15.4%) and acute lymphocytic leukemia (11.5%). Oral conditions were found in 36 (45.6%) patients, some of whom presented more than one condition. The most common oral conditions were dry lips (12.6%), mucositis (10.1%), petechiae (8.9%) and candidiasis (7.6%). Of the detected oral conditions, 56.9% were related to the underlying disease or chemotherapy and 20.2% were not related to the disease.ConclusionThis study shows the types and frequency of oral conditions observed in hematological inpatients. Awareness of these conditions is important for prevention and planning the care of patients with hematological diseases.

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Objective: the purpose of this study was to compare the effectiveness of a pre-thickened infant formula (Nan AR) with a conventional homemade formula in the reduction of regurgitation and vomiting in infants with gastroesophageal reflux.Methods: a hundred children, under 12 months, not exclusively breast feeding, were select for the study. Forty-eight were treated with conventional formula with starch and 52 with pre-thickened infant formula.Results: there was no statistically significant difference between the two groups in the improvement or cure of symptoms, each treatment having been effective. Conclusions ResumoObjetivo: o presente estudo foi realizado com o objetivo de comparar a eficácia de uma fórmula infantil pré-espessada (Nan AR) com fórmula convencional, de espessamento caseiro, com amido de milho, na redução de episódios de regurgitações e vômitos de lactentes com refluxo gastroesofágico (RGE).Métodos: foram estudadas 100 crianças, menores de 12 meses de idade, que não faziam uso de leite materno exclusivo. Por sorteio, 48 receberam fórmula convencional, e 52 receberam fórmula infantil pré-espessada (Nan AR), com comparação dos resultados clínicos após 3 meses.Resultados: não houve diferença estatisticamente significativa na melhora ou cura dos sintomas entre os dois grupos, tendo sido ambos os tratamentos eficazes.Conclusões: o espessamento dietético, seja com fórmulas infantis especiais, seja com medidas caseiras, tem eficácia semelhante no tratamento do refluxo gastroesofágico do lactente. O refluxo gastroesofágico (RGE), definido como o fluxo retrógrado involuntário do conteúdo gástrico para o esôfago, constitui uma das três principais causas de consulta em gastroenterologia pediátrica, sendo responsável por 75% das doenças do esôfago 1 . Pode ser fisiológico ou patológico, dependendo das complicações associadas.O RGE fisiológico é comum nos primeiros meses de vida, mas pode ocorrer em qualquer faixa etária. As regurgitações pós-alimentares surgem entre o nascimento e os

Abstract. Herniation of the stomach through the umbilicus is exceedingly rare with only one case reported in the international literature in the past 40 years. One case of a reducible gastric umbilical hernia, not diagnosed by endoscopy, is reported. Diagnosis was made by double-contrast barium examination after 5 years of symptoms and ineffective treatment. Herniation of the stomach is difficult to diagnose by endoscopy and radiological studies can be more sensitive and allow a more specific diagnosis.Key words: Stomach ± Herniation ± Umbilicus ± Barium examination ± Double contrast Correspondence to: R. Sampaio DiscussionA review of the international literature of the past 40 years revealed only one case of umbilical stomach herniation [1]. The patient was a 63-year-old woman with significant gastric outlet obstruction due to compression of the efferent limb at the neck of the hernia. The involved stomach demonstrated a mesenteroaxial twist within the hernia sac causing the efferent limb to be superior to the afferent limb.Endoscopy has a broad range of indications in gastrointestinal disorders and radiological procedures are substituted for or supplanted by endoscopic management in many instances [2]. The unique feature of our case was the inability of endoscopy to diagnose the hernia, perhaps due to spontaneous reduction of the hernia during the performance of the endoscopic examination. However, herniation of the stomach through the umbilical ring when the patient was in the upright position ± and even recumbent position ± was responsible for the patient symptoms. When only frontal views were available, as in the barium small bowel follow-through examination, the abnormality was not correctly diagnosed. Because only a part of the greater curvature of the stomach was herniated, a duodenal diverticulum was suggested.The umbilicus is a common site of herniation. Umbilical hernias are seen mostly in middle-aged or elderly multiparous women. Increased pressure on the anterior abdominal wall associated with pregnancy and obesity causes herniation through naturally weak areas. These hernias occasionally become large and usually contain omentum and large and/or small bowel. They are much more prone to incarceration and strangulation than inguinal hernias and strangulation of colon and omentum is common [1,3]. In most instances the hiatal ring is a small firm defect less than 1 cm in diameter in the aponeurosis. Umbilical hernias are common in infants and close spontaneously without treatment if the aponeurotic defect is 1.5 cm or less in diameter [2]. The rarity of involvement of the stomach in these hernias is explained by the stomach's relatively fixed position in the abdomen caused by its ligamentous attachments. These ligaments include the gastrohepatic ligament along the lesser curvature, the gastrocolic and gastrosplenic ligaments along the greater curvature, and the gastrophrenic ligament along the posterior aspect of the fundus. Also, the esophagus holds the stomach in place superiorly, and the fixed duode...