Daily Formative Assessment in Undergraduate Medical Training: construction and presentation of an instrument / Avaliação diária de atitudes e profissionalismo na Graduação Médica: apresentação de um instrumento

The objective is to present a daily attitudes and professionalism assessment instrument for medical students in theoretical-practical activities. The development of the instrument was based on the manuals of the program for student integration with the community, on the program's pedagogical project, and on the National Curricular Guidelines for Undergraduate Programs in Medicine, and was carried out by professors. These were consulted in weekly 50-minute meetings held between August and November 2016. At the end of the process, a version of the instrument was consolidated with five items and six descriptors to discriminate learning situations that enable competency-based assessment from the simplest to the most complex level. With the use of the instrument, points considered important in medical training in theoretical-practical activities cannot be overlooked (AU).

Objetiva-se apresentar um instrumento de avaliação diária de atitudes e profissionalismo para estudantes de Medicina em atividades teórico-práticas. A elaboração do instrumento foi baseada nos manuais do programa de integração do aluno com a comunidade, projeto pedagógico do curso e nas Diretrizes Curriculares Nacionais da Graduação em Medicina, realizada por docentes. Os docentes foram consultados em reuniões com duração de 50 minutos, com periodicidade semanal, entre agosto e novembro de 2016. Ao final do processo foi consolidada uma versão do instrumento com cinco itens e seis descritores para discriminação de situações de aprendizagem que permitem a avaliação da competência de um nível mais simples até o mais complexo. Com a utilização do instrumento elaborado não se deixa de avaliar pontos considerados importantes para a formação médica em atividades teórico-prática (AU).

Molecular diagnosis of cutaneous leishmaniasis in an endemic area of Acre State in the Amazonian Region of Brazil

Abstract INTRODUCTION This study proposes to identify the Leishmania species found in the skin lesions of cutaneous leishmaniasis (CL) patients from Brasiléia municipality (Acre). METHODS Skin biopsy imprints or biopsy fragments were assayed via kDNA-PCR/RFLP and FRET-real-time PCR. RESULTS Of individuals with suspected CL, 18 were positive for Leishmania kDNA. Leishmania (Viannia) braziliensis (61.1%) and Leishmania (Viannia) guyanensis (5.5%) were identified in the positive samples. CONCLUSIONS These results are congruent with the previous reports in Acre and Bolivia, revealing L. braziliensis as the most prevalent species. L. guyanensis identification also corroborates with the epidemiology of the disease in the Amazon Basin.

A interação entre as pessoas com síndrome de Down e seus irmãos: um estudo exploratório / The interaction between people with Down syndrome and their siblings: an exploratory study

Resumo A presença de uma pessoa com deficiência provoca transformações na família que exigem, de cada membro, redefinição de papéis. O irmão, como todos os outros membros, passa por processos de frustração, aceitação, culpa e mudanças. Nesse sentido, objetivou-se (a) analisar a interação entre o irmão com desenvolvimento típico e o com síndrome de Down; (b) identificar que informação e reação os irmãos com desenvolvimento típico possuem sobre o diagnóstico da síndrome de Down; (c) verificar se houve ou não modificações no contexto familiar e em suas próprias vidas após o nascimento do irmão com síndrome de Down. A pesquisa, realizada por meio de entrevistas, teve como participantes sete sujeitos com desenvolvimento típico, irmãos de pessoas com síndrome de Down. O estudo demonstrou que os irmãos, assim como os demais agentes familiares, passam por processos de aceitação, confusão e por várias outras complexidades com a qual a deficiência está atrelada, mas que estas não são tão marcantes quanto aos de seus pais. Um indicativo apontado no estudo se refere à importância de grupos de apoio para irmãos, que visem trabalhar questões como preconceito e sentimentos aversivos perante a deficiência. Aqueles com desenvolvimento típico precisam de informações corretas, bem como apoio, visando favorecer a interação entre irmãos.

Abstract The presence of a disabled person causes transformations in the family that demand a redefinition of the role of each member. Siblings, like all other members, experience frustration, acceptance, guilt and adaptation. In this respect, an attempt was made to; (a) analyze the interaction between a sibling with standard development and a sibling with Down syndrome; (b) identify what information and reaction the siblings with standard development have regarding the diagnosis of Down syndrome; (c) verify whether or not there were changes in the family context and also changes in their own lives after the birth of the sibling with Down syndrome. The survey was conducted through interviews, the participants being seven children with standard development having siblings with Down syndrome. The study showed that the siblings, as well as the other family members, experience processes of acceptance, confusion and other complex emotions related to the disability, albeit they are not as marked as those experienced by their parents. A fact revealed in this study is the importance of support groups for siblings, seeking to handle issues such as prejudice and adverse feelings towards disability. The siblings with standard development must have correct information, as well as support, in order to foster healthy interaction between siblings.

Pharmacobotanical study of Baccharis pentaptera

AbstractBaccharis L. sect. Caulopterae, Asteraceae, comprises thirty species in Brazil that show stems represented by cladodes, which are very similar in morphology. These species are popularly known as “carqueja” in Brazil and Argentina and are used in popular medicine as diuretic and stomachic. The aim of this work was to examine the morpho-anatomical characters of cladodes of Baccharis pentaptera (Less.) DC. for diagnosis purposes. The plant material was prepared by light and scanning electron microscopy. B. pentaptera shows opposite and spread wings in the two-winged cladode axis and irregular arrangement in the three-winged cladode. The wings have a uniseriate epidermis with palisade parenchyma next to both sides of epidermis. The spongy parenchyma crossed by minor collateral vascular bundles is observed in the central region of wings. The glandular trichomes are capitate and biseriate and the non-glandular trichomes are uniseriate and flagelliform with 2–3 cells that extend from the base. In caulinar axis, there are uniseriate epidermis, chlorenchyma alternating with angular collenchyma and perivascular fiber caps adjoining the phloem which is outside the xylem. Prismatic and styloid crystals are verified in the perimedullary zone. These combined characters can assist the diagnosis of Baccharis species sect. Caulopterae.

Gochnatia polymorpha: macro-and microscopic identification of leaf and stem for pharmacognostic quality control

Gochnatia polymorpha (Less.) Cabrera, Asteraceae, is popularly known as cambará and cambara-de-folha-grande in Brazil. It is used in traditional medicine to treat respiratory and gastrointestinal disorders. Pharmacological studies revealed anti-inflammatory, antispasmodic, antibacterial and antiviral activities. The goal of this paper was to carry out morphological and anatomical studies in order to describe the aerial parts of G. polymorpha. The botanical material was collected, fixed, and prepared according to usual light and scanning electron microtechniques. The leaves are simple, oblong-lanceolate to elliptical-lanceolate in form with mucronate acute apex, rounded base, entire or slightly toothed margin, and short petiole. In transection, the epidermis is uniseriate along the leaf blade. A subepidermal layer next to the adaxial side is present. Anomocytic stomata are seen only on the abaxial surface. Capitate glandular trichomes and T-shaped non-glandular trichomes occur on the leaves. The mesophyll is dorsiventral and minor collateral vascular bundles are enclosed by a sheath of thick walled parenchymatic cells. The midrib is biconvex and the petiole has a circular shape. The epidermis of the stem consists of a single layer of cells with glandular and nonglandular trichomes. The vascular cylinder shows typical structure and perivascular fiber caps are next to the phloem.

Actinomicose ovariana em paciente não usuária de dispositivo intrauterino / Ovarian Actinomycosis in a non-IUD user

Neste relato é descrito caso de Actinomicose ovariana, estendendo-se ao epíploon, em mulher de 49 anos não usuária de DIU, com dor abdominal, febre, diarreia, massa abdominal palpável e irritação peritoneal, que foi submetida à laparotomia exploradora, seguida de ooferectomia unilateral, devido a abscesso tubo ovariano esquerdo.

Here we report the case of ovarian Actinomycosis extending to the omentum, in a non-IUD user, a 49-year-old woman with abdominal pain, fever, diarrhea, palpable abdominal mass and peritoneal irritation, who underwent laparotomy followed by unilateral oophorectomy due to left tube ovarian abscess.

Anatomical characters of the medicinal leaf and stem of Gymnanthemum amygdalinum (Delile) Sch.Bip. ex Walp. (Asteraceae)

Gymnanthemum amygdalinum (Delile) Sch.Bip. ex Walp. (Asteraceae), better known by its former name Vernonia amygdalina Delile, is a small shrub used in folk medicine as an antipyretic, laxative, antimalarial and anthelmintic. Studies have demonstrated that different vegetal extracts possess antioxidant, antimicrobial and antiparasitic activities. Among the bioactive metabolites, there are sesquiterpene lactones, saponins, polyphenols and flavonoids. This study investigated the leaf and stem microscopic characters of G. amygdalinum, aiming to expand the knowledge on this medicinal species and indicate anatomical structures. Plant material was fixed and sectioned by freehand and using a microtome. The sections were either stained or underwent standard histochemical tests. Scanning electron microscopy was performed to investigate epidermal relief. The leaf is amphistomatic with anomocytic stomata. There are striate cuticle, glandular and non-glandular trichomes and dorsiventral mesophyll. In transverse section, the midrib and the petiole have a plano-convex shape. Both show several collateral vascular bundles and few crystals of calcium oxalate. In the stem, the epidermis persists and the phellogen has a peripheral origin. It presents typical endodermis and sclerenchymatic caps adjoining the phloem. The aspects that contribute to characterizing the species are stomata on both leaf surfaces, midrib and petiole features, the endodermis and sclerenchymatic caps in the stem, as well as the different types of trichome on both aerial organs.

Gymnanthemum amygdalinum (Delile) Sch.Bip. ex Walp. (Asteraceae), espécie mais conhecida pela sinonímia Vernonia amygdalina Delile, é um pequeno arbusto empregado na medicina popular como antipirético, laxativo, antimalárico e anti-helmíntico. Estudos demonstraram que diferentes extratos do vegetal possuem atividades antioxidante, antimicrobiana e antiparasitária. Entre os metabólitos bioativos presentes, citam-se lactonas sesquiterpenoides, saponinas, polifenóis e flavonoides. Este estudo investigou os caracteres microscópicos de folha e caule de G. amygdalinum, a fim de ampliar o conhecimento acerca dessa espécie medicinal e apontar estruturas anatômicas características. O material foi fixado e seccionado à mão livre e em micrótomo. Os cortes foram corados ou submetidos aos testes histoquímicos clássicos. Empregou-se microscopia eletrônica de varredura para investigar a ultraestrutura da superfície epidérmica. A folha é anfiestomática com estômatos anomocíticos. Há cutícula estriada, tricomas glandular e tector e mesofilo dorsiventral. Em secção transversal, a nervura central e o pecíolo têm contorno plano-convexo. Ambos mostram vários feixes vasculares colaterais e poucos cristais de oxalato de cálcio. No caule, a epiderme permanece e o felogênio tem instalação periférica. São observadas endoderme típica e calotas esclerenquimáticas apostas ao floema. Os aspectos que fornecem elementos para a identificação da espécie são a ocorrência de estômatos em ambas as superfícies foliares, a organização da nervura central e do pecíolo, a endoderme e as calotas esclerenquimáticas no caule, além dos diferentes tipos de tricoma nos órgãos aéreos estudados.

Morpho-anatomical analysis of Aspidosperma olivaceum and A. polyneuron, Apocynaceae

The family Apocynaceae includes many medicinal species, such as Aspidosperma olivaceum Müll. Arg. and A. polyneuron Müll. Arg. The first, popularly known as "peroba-branca", is a source of indole alkaloids that are recognized for their antitumor activity. The second, known as "peroba-rosa", is used by some people for treating malaria. To contribute to the knowledge about Brazilian medicinal plants and potential vegetal drugs, a morpho-anatomical analysis of the leaves and stems of these tree species was carried out. The botanical material was fixed, sectioned and stained using standard techniques. Histochemical tests were performed and the material was also analyzed using a scanning electron microscope. Aspidosperma olivaceum and A. polyneuron are morphologically similar, both presenting alternate, simple, elliptic-lanceolate leaves. The leaves are hypostomatic with anomocytic stomata and have non-glandular trichomes. In the stem, there are peripheral phellogen, lignified fibers and some stone cells in the cortex and pith, as well as numerous gelatinous fibers near the phloem. Prismatic calcium oxalate crystals and laticifers are present in the leaves and stems. Unlike A. olivaceum, A. polyneuron also has cyclocytic stomata, predominantly unicellular non-glandular trichomes and a biconvex midrib with a sharper curve on the adaxial side. In addition, A. olivaceum differs because it has some idioblasts with phenolic content.

Morpho-anatomy of the leaf and stem of Eugenia pyriformis

Eugenia pyriformis Cambess., known as uvaia, is a species of Myrtaceae native to Brazil. Its leaves are used in folk medicine to treat gout because they possess the property of inhibiting xanthine oxidase, an enzyme involved in the conversion of xanthine into uric acid. The objective of this work was to study the leaf and stem morpho-anatomy of E. pyriformis, in order to contribute to what is known about the Brazilian flora, and this medicinal plant and potential vegetal drug. Samples of mature leaves and young stems were fixed and sectioned by freehand, or embedded in glycol methacrylate and sectioned with a microtome, and then stained. In addition, microchemical tests and scanning electron microscopy were performed. The leaf is simple, symmetric, elliptic-lanceolate, with an acute apex and base, and an entire margin. The epidermis is uniseriate and coated with a moderately thick cuticle. The stomata are anomocytic and inserted at the same level as the adjacent cells. Unicellular non-glandular trichomes are abundant on the abaxial surface. The mesophyll is dorsiventral. In transverse section, the midrib is plano-convex and the petiole is circular, and both of these structures have a single bicollateral vascular bundle. In the stem, the vascular cylinder consists of external phloem, xylem and internal phloem, traversed by narrow rays. Phenolic compounds, druses and prismatic crystals of calcium oxalate are also present in the leaf and stem.

Centrolobium tomentosum: macro-and microscopic diagnosis of the leaf and stem

Centrolobium tomentosum Guillemin ex Benth., Fabaceae, known as "araribá-rosa", is a large tree that is widespread throughout Brazil. The bark of its stem is used in folk medicine as an astringent and the leaves are employed as a poultice for wounds and bruises. The aim of this study was to contribute to the pharmacognostic quality control of this medicinal species through a macro- and microscopic diagnosis of its leaves and stems. Mature leaves and young stems were collected at Embrapa (Colombo, PR) and analyzed using standard microtechniques. The leaves are opposite or alternate, compound, imparipinnate, oblong-lanceolate and hypostomatic with paracytic stomata. The mesophyll is dorsiventral and the midrib is biconvex with a collateral vascular bundle in a circular arrangement. The petiolule is circular and its vascular system is composed of two major vascular bundles in the middle, with smaller bundles between them. The rachis has a structure similar to the petiole, and these parts have a sclerenchymatic sheath shaped in multiple arcs, which surrounds a collateral vascular bundle that is centrally located. The stem has a uniseriate epidermis with peripheral phellogen and a sclerenchymatic sheath composed of many arcs, which surrounds the phloem. The stems and leaves also have non-glandular and glandular trichomes, phenolic compounds and idioblasts made of calcium oxalate crystals. This manuscript has an important role in the morpho-anatomical diagnosis of the Brazilian flora.

Leaf and stem microscopic identification of Tithonia diversifolia (Hemsl.) A. Gray (Asteraceae)

Tithonia diversifolia (Hemsl.) A. Gray is an Asteraceae shrub, popularly known as Mexican sunflower and cultivated for ornamental and therapeutic uses in different countries. In folk medicine, it is of value for treating diabetes, malaria and infectious diseases. These indications have been corroborated by various pharmacological assays. Given the lack of data on anatomical aspects of T. diversifolia, this work aimed to investigate the leaf and stem microscopic characters of this medicinal plant and potential vegetal drug. Samples of mature leaves and young stems were sectioned and stained. Histochemical tests and scanning electron microscopy were also performed. The leaf has anomocytic stomata on both sides, dorsiventral mesophyll and several collateral vascular bundles arranged as a ring in the midrib. The stem shows angular-tangential collenchyma, an evident endodermis and sclerenchymatic caps adjoining the phloem. The main characters for anatomical identification are the different types of trichome (non-glandular, capitate and non-capitate glandular), the midrib features and the localization of the secretory ducts near the vascular system.

Tithonia diversifolia (Hemsl.) A. Gray é um arbusto da família Asteraceae, popularmente conhecido como girassol-mexicano e cultivado como ornamental e medicinal em vários países. Tradicionalmente, é usado no tratamento de diabetes, malária e doenças infecciosas. Essas indicações têm sido corroboradas por diversos ensaios farmacológicos. Em razão das escassas informações sobre aspectos anatômicos de T. diversifolia, este trabalho objetivou investigar os caracteres microscópicos foliares e caulinares dessa planta medicinal e potencial droga vegetal. Amostras de folhas adultas e caules jovens foram fixadas, seccionadas e coradas. Testes histoquímicos e microscopia eletrônica de varredura foram também realizados. A folha apresenta estômatos anomocíticos em ambas as superfícies, mesofilo dorsiventral e vários feixes vasculares colaterais dispostos em círculo na nervura central. O caule exibe colênquima angular-tangencial, endoderme nítida e calotas esclerenquimáticas apostas ao floema. Os principais caracteres para a identificação anatômica são os diferentes tipos de tricoma (tector, glandular capitado e não capitado), os aspectos da nervura central e a localização dos dutos secretores nas proximidades do sistema vascular.

A relação entre o tamanho tumoral e fatores prognósticos em 241 casos de carcinoma papilar da tireóide / The relation between tumoral size and prognostic factors in241 cases of thyroid papillary carcinoma

Introdução: O carcinoma papilar é a neoplasia mais frequente da tireoide. Em geral, corresponde a lesões indolentes, com excelente prognóstico em longo prazo. Os fatores prognósticos associados ao carcinoma papilar incluem idade, invasão neoplásica extratireoidiana e presença de metástases à distância. Os autores avaliam 241 casos de carcinoma papilífero da tireoide com o objetivo de estimar a relação entre o tamanho tumoral e fatores prognósticos nesta neoplasia. Métodos: No presente estudo, foram analisadas as seguintes variáveis: idade, sexo, topografia, tamanho tumoral, grau de diferenciação, variante histológica, multicentricidade, margens cirúrgicas, invasão angiolinfática, capsular e extratireoidiana, estadiamento e presença de metástases nodais. Foi utilizado o teste de Mann-Whitney para verificar a associação entre o tamanho tumoral e as variáveis. Resultados: A idade média correspondeu a 53,22 anos, sendo encontrados 211 casos no sexo feminino (87,6%). O tamanho tumoral esteve associado a idade (p<0,001), sexo (p<0,001), invasão capsular (p<0,01), extensão neoplásica extratireoidiana (p<0,001), invasão neoplásica angiolinfática (p<0,02) e presença de metástases em linfonodos regionais (p<0,001), não existindo relação com grau e variante histológica (p>0,05). A presença concomitante de tireoidite de Hashimoto e hiperplasia nodular exibiu associação significante (p<0,001). Conclusão: No carcinoma papilífero, o tamanho tumoral representa um dos principais fatores morfológicos relacionados à invasão neoplásica capsular e angiolinfática, extensão extratireoidiana e metástases em linfonodos.

Introduction: Papillary carcinoma is the most common cancer of the thyroid gland. In general the lesions are indolent with an excellent long-term prognosis. The prognostic factors associated with papillary carcinoma include age, extra-thyroid neoplastic invasion, and presence of distant metastases. Here the authors studied 241 cases of papillary thyroid carcinoma in order to estimate the relationship between tumor size and prognostic factors in this malignancy. Methods: The following variables were considered in this study: age; sex; topography; tumor size; differentiation grade; histological variant; multicentricity; surgical margins; angiolymphatic, capsular and extra-thyroid invasion; taging; and nodal metastasis. The Mann-Whitney test was used to determine the association between tumor size and the variables. Results: The mean age was 53.22 years, and 211 cases occurred in females (87.6%). Tumor size was associated with age (p <0.001), gender (p <0.001), capsular invasion (p <0.01), extra-thyroid neoplastic extension (p <0.001), angiolymphatic neoplastic invasion (p <0.02), and presence of regional lymph node metastases (p <0.001), with no relationship to grade and histological variant (p> 0.05). The concomitant presence of Hashimoto’s thyroiditis and nodular hyperplasia were significantly associated (p <0.001). Conclusion: In papillary carcinoma, tumor size represents one of the main morphological factors related to capsular and angiolymphatic invasion, extra-thyroid extension, and lymph nodes metástases.

Morpho-anatomical characters of the leaf and stem of Mandevilla coccinea (Hook. et Arn.) Woodson, Apocynaceae / Características morfo-anatômicas de folha e caule de Mandevilla coccinea (Hook. et Arn.) Woodson, Apocynaceae

Mandevilla coccinea (Hook. et Arn.) Woodson, Apocynaceae is a herb native to South America employed in folk medicine as an analgesic, anti-inflammatory and to inhibit snake venom effects. This work was carried out to study the morpho-anatomical characters of the leaf and stem in order to advance knowledge on this medicinal plant and on pharmacognostic quality control. The plant material was fixed and prepared according to light and scanning electron microtechniques. Its leaves are simple, alternate and ovate-obovate. The epidermis is uniseriate and coated with a thick and striate cuticle. The stomata are paracytic and occur on both foliar surfaces. The dorsiventral-like mesophyll has a sub-epidermal parenchymatic layer containing phenolic substances and is traversed by minor collateral vascular bundles. The midrib is biconvex and the petiole is concave-convex, both presenting bicollateral vascular bundles in an open arc. The stem is circular in transverse section and the epidermis remains in incipient secondary growth. A sub-epidermal parenchymatic layer containing phenolic substances, a discontinuous sclerenchymatic sheath of non-lignified fibres and cylinders of external phloem, xylem and internal phloem occur. Numerous branched laticifers and idioblasts with phenolic substances are present in the leaf and stem.

Mandevilla coccinea (Hook. et Arn.) Woodson, Apocynaceae, é uma espécie herbácea nativa da América do Sul e empregada na medicina popular como analgésico, antiinflamatório e para inibir os efeitos de veneno de cobra. Este trabalho objetivou estudar os caracteres morfoanatômicos de folha e caule, a fim de fornecer conhecimento dessa espécie medicinal e para o controle de qualidade farmacognóstico. O material foi fixado e preparado de acordo com técnicas usuais de microscopia de luz e eletrônica de varredura. As folhas são simples, alternas e ovado-obovadas. A epiderme é unisseriada e recoberta por uma cutícula espessada e estriada. Os estômatos são paracíticos e ocorrem em ambas as superfícies foliares. O mesofilo tende a ser dorsiventral, apresenta uma camada subepidérmica parenquimática contendo compostos fenólicos e é percorrido por feixes vasculares colaterais de pequeno porte. A nervura central é biconvexa e o pecíolo é côncavo-convexo, ambos apresentando feixes vasculares bicolaterais em arco aberto no parênquima fundamental. O caule tem secção transversal circular e, em estrutura secundária incipiente, a epiderme permanece. Na sequência, encontram-se camada subepidérmica parenquimática contendo compostos fenólicos, bainha esclerenquimática descontínua composta de fibras não lignificadas, além de cilindros de floema externo, xilema e floema interno. Numerosos laticíferos ramificados e idioblastos com substâncias fenólicas estão presentes na folha e no caule.

Morpho-anatomical study of the leaf and stem of pau-alecrim: Holocalyx balansae

Holocalyx balansae Micheli belongs to the Fabaceae family and is called pau-alecrim in Portuguese. In folk medicine, it is indicated to treat heart, hepatic and digestive upsets, as well as being considered anti-septic and diaphoretic. This work aimed to study the morpho-anatomy of the leaf and stem of this native medicinal species, in order to increase knowledge of the Brazilian flora and to contribute to pharmacognostic quality control. Samples of mature leaves and young stems were fixed and either sectioned free-hand or embedded in glycol-methacrylate and sectioned by microtome, then stained. Microchemical tests and scanning electron microscopy were also performed. The leaves are alternate, compound and paripinnate, and the leaflets have a lanceolate shape. Anomocytic and anisocytic stomata are found exclusively on the abaxial surface. The mesophyll is dorsiventral and the midrib, in cross-section, is flat on both sides, showing one collateral vascular bundle, encircled by a sclerenchymatic and crystalliferous sheath. The rachis and petiole present a collateral vascular bundle with a centric arrangement. The stem presents phellogen localized superficially. In the vascular cylinder, there is a sclerenchymatic sheath and continuous phloem and xylem cylinders, both traversed by narrow rays. Prismatic crystals of calcium oxalate are present in the leaf and stem.

Morfoanatomia de folha e caule de Genipa americana L., Rubiaceae / Leaf and stem morpho-anatomy of Genipa americana L., Rubiaceae

Genipa americana L., conhecida como jenipapo, é uma Rubiaceae nativa do Brasil e as suas folhas são utilizadas pela população como antidiarreico e febrífugo, e o caule como anti-hemorrágico, contra luxações e contusões. Com o objetivo de caracterizar macro e microscopicamente folhas adultas e caules jovens para o controle de qualidade farmacognóstico, essa planta medicinal foi analisada segundo a metodologia clássica de morfoanatomia vegetal. Genipa americana apresenta folhas simples, opostas, de formato obovado a oblanceolado e pecíolos curtos. A epiderme foliar é uniestratificada e revestida por cutícula delgada e levemente estriada. Os estômatos são paracíticos e restritos à superfície abaxial. Há tricomas tectores uni e pluricelulares predominantemente na superfície abaxial. O mesofilo é dorsiventral. Em secção transversal, a nervura central é plano-convexa e o pecíolo é circular, ambos apresentando um feixe vascular colateral em disposição cilíndrica e outros menores. O caule possui felogênio localizado nas camadas subepidérmicas, colênquima anelar e um cilindro floemático externo ao de xilema, sendo ambos percorridos por raios parenquimáticos estreitos. Ocorrem idioblastos contendo compostos fenólicos, areia cristalina e drusas de oxalato de cálcio na folha e no caule.

Genipa americana L., known as jenipapo, is a Rubiaceae species native to Brazil. Its leaves are used by the population as anti-diarrheic and febrifuge, and its stem as anti-hemorrhagic and for trauma injuries. Aiming to identify macro and microscopically mature leaves and young stems for the pharmacognostic quality control, this medicinal plant was investigated according to standard morpho-anatomical techniques. The leaves are simple, opposite, obovate-oblanceolate, presenting short petiole. The epidermis is uniseriate and coated with thin and slightly striate cuticle. The stomata are paracytic and restricted to the abaxial surface. It occurs non-glandular trichomes, uni and multicellular, predominantly on the abaxial surface. The mesophyll is dorsiventral. In cross-section, the midrib is plane-convex and the petiole is circular, both presenting one collateral vascular bundle in centric arrangement and minor ones. The stem shows phellogen installed superficially, annular collenchyma and a phloem cylinder outside the xylem one, both traversed by narrow parenchymatic rays. It is encountered idioblasts containing phenolic substances and calcium oxalate crystal-sand and druses.

Himatanthus lancifolius (Müll. Arg.) Woodson, Apocynaceae: estudo farmacobotânico de uma planta medicinal da Farmacopeia brasileira 1ª edição / Himatanthus lancifolius (Müll. Arg.) Woodson, Apocynaceae: morpho-anatomical study of a medicinal plant described in the Brazilian Pharmacopoeia 1st edition

Himatanthus lancifolius (Müll. Arg.) Woodson é um arbusto nativo do Brasil, latescente, popularmente conhecido como agoniada e utilizado principalmente para distúrbios menstruais. O presente trabalho teve como objetivo caracterizar morfoanatomicamente a folha, o caule e a casca caulinar dessa planta medicinal, a fim de contribuir para o controle de qualidade e a autenticidade dessa espécie. O material vegetal foi fixado e submetido às microtécnicas usuais. A folha é simples, glabra e obovado-lanceolada. A epiderme é uniestratificada, revestida por cutícula estriada e possui estômatos anisocíticos na face abaxial. O mesofilo é dorsiventral. A nervura central é biconvexa e o pecíolo é circular, ambos apresentando feixes vasculares bicolaterais. Laticíferos, amiloplastos e idioblastos fenólicos estão presentes no parênquima fundamental da nervura central e do pecíolo. O sistema vascular do caule é tipicamente bicolateral. Laticíferos e idioblastos fenólicos ocorrem no córtex, no floema e na medula. Esses caracteres morfoanatômicos, em conjunto, podem ser utilizados como parâmetros para o controle de qualidade dessa espécie.

Himatanthus lancifolius (Müll. Arg.) Woodson is a Brazilian native shrub, laticiferous, popularly known as "agoniada" and it is mainly used for uterine disorders. The present work aimed to study the leaf, stem and stem bark morpho-anatomy of this medicinal plant, in order to contribute to its quality control and identification. The plant material was fixed and submitted to standard microtechniques. The leaf is simple, glabrous and obovate-lanceolate. The epidermis is uniseriate, coated with striated cuticle and it has anysocitic stomata on the abaxial surface. The mesophyll is dorsiventral. The midrib is biconvex and the petiole is circular, both presenting bicollateral vascular bundles. Laticiferous ducts, amyloplasts and phenolic idioblasts are found in ground parenchyma of the midrib and petiole. The vascular system of the stem is tipically bicollateral. Laticiferous ducts and phenolic idioblasts are present in the cortex, phloem and pith. These morpho-anatomical characters, all together, can be used as quality control parameters of this species.

Pharmacobotanic characterization of young stems and stem barks of Rauvolfia sellowii Müll. Arg., Apocynaceae / Caracterização farmacobotânica de novos talos e cascas do caule de Rauvolfia sellowii Müll. Arg., Apocynaceae

Rauvolfia sellowii Müll. Arg. (Apocynaceae), a Brazilian native tree rich in indole alkaloids, is known as "pau-pra-tudo" and popularly used as hypocholesterolemic, hypoglycemic and antihypertensive. The aim of this work was to study the anatomy of the young stems and stem barks of this medicinal plant, in order to contribute to the identification of the species as a drug. The plant material was fixed and prepared according to standard microtechniques. The young stems have remaining epidermis, but a suberified peridermis is evident. The phellogen is located in the cortical region, forming suber externally. Underneath the phellogen, lies the phelloderm and collenchymatic region. In the cortex, there are numerous laticifers and some fibers. There is an incomplete sclerenchymatic sheath, consisting of several groups of fibers and stone cells. The stem has internal phloem ordered as isolated groups side by side. Numerous laticifers, calcium oxalate crystals, idioblasts and amyloplasts are found in the cortex, phloem, xylem and pith. The stem bark has many layers of suber and cortical parenchyma, a sheath composed of fibers and stone cells totally lignified, and external phloem. These anatomical characteristic, taken together, can be used as quality control parameters for this species.

Rauvolfia sellowii Müll. Arg. (Apocynaceae), uma árvore nativa brasileira rica em alcaloides indólicos, é conhecida como "pau-pra-tudo" e utilizada popularmente como hipocolesterolêmica, hipoglicêmica e anti-hipertensiva. O presente trabalho teve como objetivo caracterizar anatomicamente o caule jovem e a casca caulinar dessa planta medicinal, a fim de contribuir para a identificação e autenticidade da droga. O material vegetal foi fixado e submetido às microtécnicas usuais. O caule jovem possui epiderme remanescente, porém uma periderme suberificada é observada. O felogênio instala-se na região cortical, formando súber externamente. Subjacentes ao felogênio são observadas a feloderme e uma região colenquimática. No córtex, há numerosos laticíferos e algumas fibras. Há uma bainha esclerenquimática incompleta, constituída de vários grupos de fibras e células pétreas. O caule mostra floema interno organizado em grupos isolados lado a lado. Numerosos laticíferos, cristais de oxalato de cálcio, idioblastos e amiloplastos são encontrados no córtex, no floema, no xilema e na medula. A casca do caule possui várias camadas de súber e parênquima cortical, uma bainha composta de fibras e células pétreas totalmente lignificadas, e floema externo. Estes caracteres anatômicos, quando analisados em conjunto, podem ser utilizados como parâmetros para controle de qualidade desta espécie.

Associação entre metástases em linfonodos axilares e fatores prognósticos e preditivos no carcinoma ductal infiltrante de mama / Association between lymph node metastases and prognostic / predictive factors in breast invasive ductal carcinoma

Introdução: O carcinoma mamário corresponde a uma das neoplasias malignas mais comuns no Brasil, sendo uma causa frequente de óbito por tumores malignos em mulheres. Determinadas características histopatológicas do tumor, como grau, tamanho e presença de metástases, podem ser correlacionadas com o tempo de sobrevida livre de doença. No presente estudo, os autores avaliam a associação entre metástases em linfonodos axilares e fatores prognósticos e preditivos no carcinoma ductal infiltrante de tipo histológico não especial. Métodos: Foram avaliados 106 espécimes de setorectomia ou mastectomia entre janeiro e dezembro de 2008, sendo determinados os seguintes dados: tamanho tumoral, grau histológico, presença de metástases em linfonodos axilares, receptores de estrogênio e progesterona e expressão imuno-histoquímica de cerbB2. Resultados: A idade média correspondeu a 59,33 anos, com 46 casos (43,4%) na categoria T1, 40 casos (37,14%) na categoria T2 e 20 casos (18,87%) no grupo T3. Houve associação estatística entre a presença de metástases em linfonodos axilares em relação à idade (p=0,0025), grau histológico (p=0,014), tamanho tumoral (p=0,0036), receptores de estrogênio (p=0,021) e expressão de cerbB2 (p=0,0043). O tamanho tumoral esteve associado à idade (p=0,0078), grau (p=0,0027), receptores de estrogênio (p=0,0017) e expressão de cerbB2 (p=0,0032). Conclusão: No presente estudo, a presença de metástases nodais esteve associada a fatores prognósticos e preditivos, como tamanho tumoral, idade, grau e receptores de estrogênio, sendo necessária a avaliação desses fatores para determinar um índice prognóstico personalizado para cada paciente

Introduction: Mammary carcinoma represents one of the most common malignant neoplasms in Brazil and is a frequent cause of death from malignant tumors. Features of the tumor, such as grade, size and presence of metastases, can be correlated with the duration of disease-free survival. The aim here was to evaluate the association between axillary lymph node metastases and prognostic and predictive factors in infiltrating ductal carcinoma of no special histological type. Methods: We analyzed 106 specimens obtained by sectorectomy or mastectomy between Jan and Dec 2008 and determined the following data: Tumor size, histological grade, presence of metastases in axillary lymph nodes, estrogen and progesterone receptor expression and cerbB2 immunohistochemistry. Results: The mean age was 59.33 years, with 46 cases (43.4%) in category T1, 40 cases (37.14%) in category T2 and 20 cases (18.87%) in category T3. There was statistical association between the presence of metastases in axillary lymph nodes and age (p = 0.0025), histological grade (p = 0.014), tumor size (p = 0.0036), estrogen receptor (p = 0.021) and cerbB2 expression (p = 0.0043). Tumor size was associated with age (p = 0.0078), grade (p = 0.0027), estrogen receptors (p = 0.0017) and cerbB2 expression (p = 0.0032). Conclusion: In this study the presence of nodal metastases was associated with prognostic and predictive factors such as tumor size, age, grade and estrogen receptors, and these factors should be assessed in determining a customized prognostic index for an individual patient

Perfil e prevalência dos tumores primários do sistema nervoso central no Grupo Hospitalar Conceição, de Porto Alegre, RS / Prevalence and histological aspects of primary central nervous system tumors at the Grupo Hospitalar Conceição, Porto Alegre, RS

Introdução: um dos grandes focos da neuropatologia cirúrgica tem sido associar a classificação dos tumores, baseada em achados histopatológicos, com dados clínicos e imuno-histoquímicos a fim de determinar entidades clínico-patológicas. Avanços nas técnicas de neuroimagem permitem, atualmente, determinar com precisão a localização da lesão e a realização de biópsias em múltiplas áreas deste grupo heterogêneo de tumores. Com o objetivo de estimar a associação entre tipo histológico e topografia, os autores descrevem todos os casos de tumores primários do sistema nervoso central avaliados no Hospital Conceição. Metodologia: foram avaliados 912 casos distintos de tumores primários do sistema nervoso central, entre 1995 e 2009, no laboratório de patologia do Grupo Hospitalar Conceição. Os autores descrevem os tipos histológicos encontrados e sua associação com topografia, idade, sexo e achados imuno-histoquímicos. Resultados: os tipos histológicos mais comuns foram o glioblastoma (31,15%), astrocitoma difuso (10,86%) e meningioma (grau I da OMS - 10,75%), com associação destes com a topografia (p=0,001) e a idade dos pacientes (p=0,01). A avaliação imuno-histoquímica foi realizada em 48 casos de neoplasia maligna indiferenciada, sendo que a expressão dos anticorpos determinou a diferenciação tumoral destas lesões, tornando este método fundamental na avaliação deste subgrupo de tumores. Conclusões: o presente estudo sugere a associação entre tipo histológico, idade e topografia em casos de tumores primários do sistema nervoso central

Introduction: One of the major targets of surgical neuropathology has been to associate tumor classification, based on histopathological findings, with clinical and immunohistochemical data in order to determine clinico-pathological entities. Current advances in the neuroimaging techniques allow to accurately determine the location of lesion and to perform biopsies at multiple sites of this heterogeneous group of tumors. In order to assess the association of this histological type with topography, the authors describe all cases of primary tumors of the central nervous system evaluated in the Conceição Hospital. Methods: 912 distinct cases of primary tumors of the central nervous system were evaluated in the laboratory of Pathology of the Grupo Hospitalar Conceição between 1995 and 2009. The authors describe the histological types found and their association with topography, age, sex and immunohistochemical findings. Results: The most common histological types were the glioblastoma (31.15%), diffuse astrocytoma (10.86%) and meningioma (grade I of WHO, 10.75%), with association of these with topography (p=0.001) and patient age (p=0.01). Immunohistochemical evaluation was performed in 48 cases of undifferentiated malignant neoplasia, where antibody expression determined tumor differentiation

Macro and microscopic characters of the aerial vegetative organs of Carqueja: Baccharis usterii Heering

This work aimed to study the macro and microscopic characters of the aerial vegetative organs of Baccharis usterii for quality control purposes. The plant was prepared for light and scanning electron microscopic analyses. The stem consisted of three-winged cladodes with small leaves. In the caulinar axis, these was a uniseriate epidermis, chlorenchyma alternating with angular collenchyma, perivascular fibre caps adjoining the phloem which was outside the xylem, and parenchymatic pith. The wings and the leaves were alike, presenting a uniseriate epidermis, palisade parenchyma next to the both sides of the epidermis and spongy parenchyma traversed by minor collateral vascular bundles in the central region. In the leaf midrib, a single collateral vascular bundle was embedded in the ground parenchyma. Secretory ducts and glandular trichomes occured in the stem and leaf.

Caracteres macro e microscópicos dos órgãos vegetativos aéreos de carqueja: Baccharis usterii Heering. Este trabalho objetivou estudar os caracteres macro e microscópicos dos órgãos vegetativos aéreos de Baccharis usterii, com aplicação no controle de qualidade. O material botânico foi preparado de acordo com técnicas para microscopia óptica e de varredura. O caule consistiu de cladódios trialados, nos quais se inserem pequenas folhas. O eixo caulinar apresentou epiderme unisseriada, clorênquima em alternância com colênquima angular, calotas de fibras perivasculares apostas ao floema, o qual se forma externamente ao xilema, e medula parenquimática. As alas e as folhas mostraram-se semelhantes, apresentando epiderme unisseriada, parênquima paliçádico junto a ambas as faces epidérmicas e parênquima esponjoso na região central, atravessado por feixes vasculares de pequeno porte. Na nervura central da folha, um feixe vascular colateral encontrou-se mergulhado no parênquima fundamental. Dutos secretores e tricomas glandulares ocorreram no caule e na folha