Postoperative serum magnesium levels as a predictor for the need for calcium replacement after total thyroidectomy: a prospective study

ABSTRACT Objective: Our aim was to assess the ability of serum magnesium (Mg), measured on the first postoperative day (Mg1PO), to predict the need for calcium (Ca) replacement in patients undergoing total thyroidectomy (TT). Subjects and methods: Eighty patients undergoing TT, with Mg1PO and PTH dosage in the first (PTH1h) and eighth (PTH8h) hours after TT, were evaluated for the need for Ca replacement. Data were evaluated by uni/multivariate logistic regression and Receiver Operating Characteristic (ROC) curve. Results: 32 patients (40%) required Ca replacement. Median PTH1h, PTH8h and Mg1PO were higher in the no replacement group: 17 versus (vs) 3 pg/mL (p < 0.001), 18.2 vs 3.0 pg/mL (p < 0.001) and 2 vs 1.6 mg/dL (p < 0.001), respectively. Mg1PO was the isolated predictor for this replacement (odds ratio = 0.0004, 95% confidence interval: 0.000003-0.04; p = 0.001), with the cut-off value of 1.8 mg/dL showing sensitivity and specificity of 78.1% and 87.5%, respectively. Conclusions: In this group of patients, serum Mg1PO was the isolated predictor for the need for Ca replacement.

Auditory middle latency responses and hearing skills in adults / Potencial evocado auditivo de média latência e habilidades auditivas em adultos

ABSTRACT Purpose: to compare the Auditory Middle Latency Response in adults, one group with and another group without altered auditory skills. In addition, the aim was to compare cut-off values of 30% and 50% for the Ear Effect in terms of sensitivity and specificity. Methods: the sample comprised 32 individuals of both genders with no hearing loss who were divided into Group 1 (16 individuals with no alterations in auditory skills) and Group 2 (16 individuals with alterations in auditory skills). All participants received an audiological evaluation and measurement of Brainstem and Auditory Middle Latency Potentials. Results: when Group 1 and Group 2 were compared, a statistically significant difference was only observed in Na and Pa amplitude of waves A1C3 and A2C3. In the analysis of sensitivity and specificity of the Auditory Middle Latency Response, a cut-off value of 50% gave a better balance between sensitivity and specificity. Conclusion: adults presented with altered auditory abilities had smaller response amplitudes in the Na and Pa components of the waves generated in the left hemisphere. A cut-off value of 50% gave a better discrimination of the Ear Effect for identifying subjects with altered auditory skills.

RESUMO Objetivo: comparar a latência e a amplitude dos componentes Na, Pa, Nb e Pb do Potencial Evocado Auditivo de Média Latência em adultos com e sem alterações em habilidades auditivas, bem como analisar a sensibilidade e a especificidade dos valores de corte de 30% e 50% para o Efeito de Orelha. Métodos: compuseram a amostra 32 indivíduos de ambos os sexos e sem perda auditiva, sendo subdivididos em Grupo 1 (16 indivíduos sem alterações em habilidades auditivas) e Grupo 2 (16 indivíduos com alterações em habilidades auditivas). Todos os participantes foram submetidos a uma avaliação audiológica e aos Potenciais Evocados Auditivos de Tronco Encefálico de Média Latência. O teste ANOVA foi utilizado na análise dos dados, considerando significantes os valores de p menores ou iguais a 0,05. Resultados: foi observada diferença estatisticamente significante apenas na amplitude de Na e Pa, quando Grupo 1 e Grupo 2 foram comparados. Esta diferença foi observada nas ondas A1C3 e A2C3. Na análise de sensibilidade e especificidade do Potencial Evocado Auditivo de Média Latência, observou-se que o valor de corte de 50% apresentou um melhor equilíbrio entre os critérios de sensibilidade e especificidade. Conclusão: os indivíduos adultos com alterações nas habilidades auditivas apresentaram menor amplitude de resposta nos componentes Na e Pa das ondas geradas no hemisfério esquerdo. O valor de corte de 50% apresentou um melhor equilíbrio na análise do Efeito de Orelha para a contribuição no diagnóstico de alterações de habilidades auditivas.

Acute effects of different intervals between repeated sprints on performance responses in amateur futsal athletes / Efeitos agudos de diferentes intervalos entre sprint repetidos sobre as respostas de desempenho em atletas amadores de futsal

ABSTRACT Objective: Verify the influence of different break times between sprints on the performance of amateur futsal athletes. Methods: 10 individuals, men, amateur futsal athletes (Age: 21.5 ± 1.6; Weight: 72.4 ± 6.88; Height: 1.72 ± 0.05; BMI: 24.3 ± 1.2; Fat%: 13.7 ± 3.3, VO2peak: 49.1 ± 10.5) participated in the study. Individuals were randomly selected to perform sessions with sprints (10 sets 20 m) with different pause times of 15 (S15), 30 (S30) and 60 (S60) seconds. For performance analysis, the speed (km / h) applied to each sprint was used and monitored by a device with a photocell (CEFISE Biotecnologia Esportiva®). Results: There was an interaction between speed and interval time (p = 0.000). For condition S15, a greater reduction in performance was observed (p ≤ 0.05), while for S30 and S60, no significant reduction in performance was observed (p > 0.05). The data for the area under the curve showed a significant difference (p = 0.000), where the interval of 60 s (S60) was longer compared to the values of 30 (S30) (p = 0.000) and 15 s (S15) (p = 0.000). However, there were no significant differences between the 30 and 15 s data (p = 0.248). Conclusion: A shorter time (15 s) interval between repeated sprints can significantly affect performance compared to longer breaks (30 and 60 s), but all the conditions tested here can be positive for the improvement of performance, mainly in sports that demand fast and efficient motor actions such as futsal.

RESUMO Objetivo: Verificar a influência dos diferentes tempos de intervalo entre os sprints no desempenho dos atletas de futsal amadores. Métodos: 10 indivíduos, homens, atletas de futsal amadores (Idade: 21,5 ± 1,6; Peso: 72,4 ± 6,88; Altura: 1,72 ± 0,05; IMC: 24,3 ± 1,2; Gordura%: 13,7 ± 3,3, VO2peak: 49,1 ± 10,5) participou no estudo. Os indivíduos foram selecionados aleatoriamente para realizar sessões com sprints (10 conjuntos 20 m) com diferentes tempos de pausa de 15 (S15), 30 (S30) e 60 (S60) segundos. Para análise do desempenho, a velocidade (km/h) aplicada a cada sprint foi utilizada e monitorizada por um dispositivo com uma fotocélula (CEFISE Biotecnologia Esportiva®). Resultados: Houve uma interação entre velocidade e tempo de intervalo (p = 0,000). Para a condição S15, observou-se uma maior redução no desempenho (p ≤ 0,05), enquanto para S30 e S60, não se observou qualquer redução significativa no desempenho (p > 0,05). Os dados para a área sob a curva mostraram uma diferença significativa (p = 0,000), onde o intervalo de 60 s (S60) foi mais longo em comparação com os valores de 30 (S30) (p = 0,000) e 15 s (S15) (p = 0,000). No entanto, não houve diferenças significativas entre os dados de 30 e 15 s (p = 0,248). Conclusão: Um intervalo de tempo mais curto (15 s) entre sprints repetidos pode afetar significativamente o desempenho em comparação com os intervalos mais longos (30 e 60 s), mas todas as condições aqui testadas podem ser positivas para a melhoria do desempenho, principalmente nos desportos que exigem ações motoras rápidas e eficientes, tais como o futsal.

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

ABSTRACT Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Subjects and methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusions: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.

Aplicabilidade e considerações clínicas do Sistema Contralateral Routing of Signal (CROS): revisão sistemática / Applicability and clinical considerations of the Contralateral Routing of Signal System (CROS): systematic review / Aplicabilidad y consideraciones clínicas del sistema de enrutamiento de señal contralateral (CROS): revisión sistemática

Introdução: O Sistema Contralateral Routing of Signal (CROS) é uma opção de intervenção auditiva com propósito de melhorar a percepção monoaural e minimizar as dificuldades da perda auditiva unilateral. Objetivo: analisar e descrever o público-alvo, o tempo de adaptação, o controle de uso do Sistema CROS, as avaliações utilizadas para medir os seus benefícios, sua efetividade e limitações. Método: Este estudo foi conduzido de acordo com as diretrizes PRISMA. A pesquisa bibliográfica foi realizada através dos bancos de dados científicos online na área da saúde, PubMed e Scopus, foram utilizadas as palavras-chave "Unilateral hearing loss", "Hearing aid", "CROS" e "Contralateral Routing of Signal". Os resultados da pesquisa limitaram-se a artigos científicos experimentais, que abordavam diretamente o sistema CROS, publicados em inglês, português ou espanhol. Resultados: Onze artigos foram selecionados para a revisão do texto completo. Quanto aos usuários do CROS, a faixa etária variou entre nove a 84 anos; prevalência do sexo masculino. Observou-se grande diversidade nas avaliações, sendo realizadas com tempo de uso inferior a 30 dias e superior a seis meses, após adaptação do CROS. Tal avaliação era realizada por meio de questionários não padronizados e avaliações objetivas com estímulos controlados. O uso do CROS proporcionou benefícios na localização sonora, efeito sombra da cabeça e inteligibilidade de fala, porém não mostrou eficácia em situações ruidosas. Conclusão: Por ser um dispositivo, não invasivo, de fácil adaptação e manuseio que traz benefícios imediatos, o CROS deve ser a primeira opção na reabilitação da perda auditiva unilateral.

Introducción: El Sistema Contralateral Routing of Signal (CROS) es una opción de intervención auditiva con el propósito de mejorar la percepción monoaural y minimizar las dificultades de la pérdida auditiva unilateral. Objetivo: analizar y describir el público objetivo, el tiempo de adaptación, el control del uso del Sistema CROS, las evaluaciones utilizadas para medir sus beneficios, su efectividad y limitaciones. Metodo: Este estudio se realizó de acuerdo con las pautas PRISMA. La búsqueda bibliográfica se realizó a través de bases de datos científicas online del área de salud, PubMed y Scopus, utilizando las palabras clave "Unilateral hearing loss", "Hearing aid", "CROS" y "Contralateral Routing of Signal". Los resultados de la investigación se limitaron a artículos científicos experimentales, que abordaron directamente el sistema CROS, publicados en inglés, portugués o español. Resultados: Se seleccionaron once artículos para revisión de texto completo. En cuanto a los usuarios de CROS, la edad osciló entre los nueve y los 84 años; prevalencia masculina. Hub gran diversidad en las evaluaciones, realizadas con tiempos de uso de menos de 30 días y más de seis meses tras la adaptación del CROS. Dicha evaluación se realizó mediante cuestionarios no estandarizados y evaluaciones objetivas con estímulos controlados. El uso de CROS proporcionó beneficios en la localización del sonido, el efecto de sombra de la cabeza y la inteligibilidad del habla, pero no fue efectivo en situaciones ruidosas. Conclusión: Al tratarse de un dispositivo no invasivo, de fácil adaptación y manejo que aporta beneficios inmediatos, CROS debería ser la primera opción en la rehabilitación de la hipoacusia unilateral.

Introduction: The system Contralateral Routing of Signal (CROS) is an option of auditory intervention in order to improve the monaural perception and minimize the difficulties of unilateral hearing loss. Objective: to analyze and describe the target users, the adaptation time and the control use of CROS system, the evaluations utilized to measure its benefits, as well as its effectiveness and limitations. Method: This study was conducted according to the PRISMA guidelines. The bibliographic research was through the scientific data online banks in the health area, PubMed and Scopus, using the keywords "Unilateral hearing loss", "Hearing aid", "CROS" and "Contralateral Routing of Signal". The results of the research were limited to experimental scientific articles, which address directly the CROS system, published in English, Portuguese or Spanish. Results: Eleven studies were selected to review. The age of CROS users ranged from nine to 84 years and male sex prevalence. There was great diversity in the evaluations being carried out. The performance's evaluation date varied between less than 30 days and more than six months after the adaptation. Such assessments were performed using non-standardized questionnaires and objective evaluations with controlled stimuli. The use of CROS provides benefits in sound localization, head shadow effect and speech intelligibility, but it is not effective in noisy situations. Conclusion: CROS should be the first option in unilateral hearing loss rehabilitation for being a non-invasive, easy adaption, handling dispositive and with good benefits to the client.

Frequency-Following Response and Auditory Middle Latency Response: an analysis of central auditory processing in young adults / Frequency-Following Response e Potencial Evocado Auditivo de Média Latência: uma análise frente ao processamento auditivo central de jovens adultos

ABSTRACT Purpose: to compare the latency and amplitude of the Frequency-Following Response and the Auditory Middle Latency Response in typical individuals and those with altered auditory abilities, as well as to investigate the sensitivity and specificity of both assessments in relation to central auditory processing. Methods: 32 individuals of both sexes were distributed into Group 1 (without altered auditory abilities) and Group 2 (with altered auditory abilities). The groups were divided according to behavioral tests of central auditory processing. Individuals in both groups underwent auditory evoked potentials. Student's t-test was used for analysis, considering a 5% significance. Results: in Group 2, V and A had higher latency and lower amplitude and slope. Group 2 also had lower Na and Pa amplitudes in waves A1C3 and A2C3. The Frequency-Following Response showed 93% sensitivity and specificity, while the Auditory Middle Latency Response showed 87% sensitivity and 93% specificity. Conclusion: the individuals presented with altered hearing abilities showed higher latency and lower response amplitude in the Frequency Following Response and Auditory Middle Latency Response compared to typical individuals. The Frequency- Following Response showed a better balance of sensitivity and specificity.

RESUMO Objetivo: comparar a latência e a amplitude do Frequency-Following Response e do Potencial Evocado Auditivo de Média Latência em indivíduos típicos e com alterações das habilidades auditivas, assim como investigar a sensibilidade e especificidade de ambas as avaliações frente ao processamento auditivo central. Métodos: 32 indivíduos de ambos os sexos foram distribuídos em Grupo 1 (sem alterações de habilidades auditivas) e Grupo 2 (com alteração em habilidades auditivas). Os grupos foram divididos de acordo com testes comportamentais do processamento auditivo central. Os indivíduos de ambos os grupos foram submetidos aos potenciais evocados auditivos. O teste T de Student foi utilizado para a análise, considerando 5% de significância. Resultados: no Grupo 2, V e A apresentaram maior latência e menor amplitude e slope. O Grupo 2 também apresentou menores amplitudes de Na e Pa nas ondas A1C3 e A2C3. O Frequency-Following Response apresentou 93% de sensibilidade e especificidade, enquanto o Potencial Evocado Auditivo de Média Latência apresentou 87% de sensibilidade e 93% de especificidade. Conclusão: os indivíduos com alteração das habilidades auditivas apresentaram maior latência e menor amplitude de resposta no Frequency Following Response e Potencial Evocado Auditivo de Média Latência em relação aos indivíduos típicos. O Frequency-Following Response apresentou melhor equilíbrio de sensibilidade e especificidade.

Thyroglobulin/thyrotropin ratio for predicting long-term response in differentiated thyroid carcinoma: a retrospective study

ABSTRACT Objective: Thyrotropin-stimulated thyroglobulin (STg) after total thyroidectomy is a prognosis marker for differentiated thyroid carcinoma (DTC). As Tg level is influenced by thyrotropin (TSH), perhaps the STg/TSH ratio is also a prognosis marker for these tumours. We aimed to compare STg/TSH ratio and first STg level in differentiated thyroid carcinoma patients for their ability to predict the long-term response to initial treatment. Subjects and methods: This retrospective study evaluated data from 181 DTC patients for first (1st) STg and STg/TSH ratio, at 1-3 months post-total thyroidectomy and before iodine-131 therapy, according to response to initial therapy [Excellent/Indeterminate or Incomplete (Biochemical/Structural)] observed at final evaluation, and with the survival time with excellent/indeterminate response. Results: Cases with incomplete response presented higher STg level [225.13 ± 585.26 ng/mL versus (vs) 20.4 ± 192.9 ng/mL; p < 0.001] and STg/TSH ratio (3.01 ± 7.8 vs 0.27 ± 2.58; p < 0.001). Cutoffs of 5 ng/mL for STg and 0.085 for STg/TSH displayed sensitivities of 76.7% and 76.9%, and specificities of 79.2% and 82.6%, respectively, in predicting response to therapy. Values below these cutoffs were associated with longer survival time in excellent/indeterminate response (140.4 vs 15.9 and 144.6 vs 15.9 months, respectively). Conclusion: STg/TSH ratio has a similar performance to the 1st STg in predicting long-term response to initial therapy.

Identification of patterns related to linkage groups or disequilibrium by factor analysis / Identificação de padrões relacionados a grupos de ligação ou de desequilíbrio por análise de fatores

ABSTRACT: Empirical patterns of linkage disequilibrium (LD) can be used to increase the statistical power of genetic mapping. This study was carried out with the objective of verifying the efficacy of factor analysis (AF) applied to data sets of molecular markers of the SNP type, in order to identify linkage groups and haplotypes blocks. The SNPs data set used was derived from a simulation process of an F2 population, containing 2000 marks with information of 500 individuals. The estimation of the factorial loadings of FA was made in two ways, considering the matrix of distances between the markers (A) and considering the correlation matrix (R). The number of factors (k) to be used was established based on the graph scree-plot and based on the proportion of the total variance explained. Results indicated that matrices A and R lead to similar results. Based on the scree-plot we considered k equal to 10 and the factors interpreted as being representative of the bonding groups. The second criterion led to a number of factors equal to 50, and the factors interpreted as being representative of the haplotypes blocks. This showed the potential of the technique, making it possible to obtain results applicable to any type of population, helping or corroborating the interpretation of genomic studies. The study demonstrated that AF was able to identify patterns of association between markers, identifying subgroups of markers that reflect factor binding groups and also linkage disequilibrium groups.

RESUMO: Padrões empíricos de desequilíbrio de ligação (LD) podem ser utilizados para aumentar o poder estatístico do mapeamento genético. Este trabalho foi realizado com o objetivo de verificar a eficácia da análise de fatores (AF) aplicada a conjuntos de dados de marcadores moleculares do tipo SNP, visando identificar grupos de ligação e blocos de haplótipos. O conjunto de dados SNPs utilizado foi oriundo de um processo de simulação de uma população F2, contendo 2000 marcas com informações de 500 indivíduos. A estimação das cargas fatoriais (loadings) da AF foi feita de duas formas, considerando a matriz de distâncias entre os marcadores (A) e considerando a matriz de correlação (R). O número de fatores (k) a ser utilizado foi estabelecido com base no gráfico scree-plot e com base na proporção da variância total explicada. Os resultados indicam que as matrizes A e R conduzem a resultados similares. Com base no scree-plot considerou-se k igual a 10 e os fatores interpretados como sendo representativos dos grupos de ligação. O segundo critério conduziu a um número de fatores igual a 50, e os fatores interpretados como sendo representativos dos blocos de haplótipos. Isto mostra o potencial da técnica que permite obter resultados aplicáveis ​​a qualquer tipo de população, corroborando a interpretação de estudos genômicos. O trabalho demonstrou que a AF foi capaz de identificar padrões de associação entre marcadores, identificando subgrupos de marcadores que refletem grupos de ligação fatorial e também grupos de desequilíbrio de ligação.

Intragroup differences and similarities in performance on rapid automatized naming tasks in children with ADHD symptoms, children with reading disabilities, and controls

Abstract Introduction Rapid automatized naming (RAN) is the ability to name, as fast as possible, symbols such as letters, digits and figures. The present study aimed to investigate intragroup performance patterns on RAN tasks in children with attention deficit hyperactivity disorder (ADHD) symptoms alone, children with reading disability (RD) alone and controls with typical development. Methods A total of 216 Brazilian children between 8 to 11 years old were selected from public schools located in two Brazilian capitals, namely Porto Alegre and Belo Horizonte, to participate in the study. Mixed 3 (participant group: ADHD symptoms, RD or control group) × 3 (type of stimulus: letters, numbers or figures) ANOVAs were performed using response time and number of errors as dependent variables. Only intragroup comparisons are described in this paper. Results The groups with ADHD symptoms and RD showed similar performance results on naming speed. There were no differences between letters and numbers within each group, but we found slower responses in figure naming compared to the other tasks for both groups. Concerning accuracy, children with ADHD symptoms showed a similar number of errors in all three tasks. These patterns were distinct from the performance of the control group. Conclusion Results suggest a shared deficit in naming speed of alphanumeric stimuli in children with ADHD symptoms and those with RD, and impairments in naming digits correctly in children with ADHD symptoms.

Case for diagnosis. Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder

Abstract: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease, with an indolent evolution and benign course. The classic presentation is a solitary nodule on the face or trunk. The disorder's rarity and clinical and histopathological characteristics, can make the diagnosis difficult. We present the case of a 36-year-old Caucasian woman with a purplish erythematous nodule, hardened, shiny, asymptomatic, on the left nasal ala, which had grown progressively for 45 days. Histopathological examination and immunohistochemistry panel demonstrated alterations consistent with primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was complete remission of the condition within 60 days of treatment with potent occlusive corticosteroids.

Do impensável ao instituído: a ação coletiva dos catadores de materiais recicláveis na cidade de Santa Cruz do Sul / From the unthinkable to the instituted: the collective action of the gatherers of recyclable materials in the city of Santa Cruz do Sul

A inclusão dos catadores na agenda de políticas de gestão de resíduos na cidade de Santa Cruz do Sul, que culminou com a celebração de contratos de prestação de serviços públicos, foi o resultado da ação coletiva realizada pelos catadores articulados no Movimento Nacional dos Catadores de Materiais Recicláveis (MNCR), com o apoio de demais organizações da sociedade e do Estado em nível local. Houve a ocorrência de um processo em que os catadores articulados junto ao MNCR passaram de excluídos a prestadores de serviço de destinação final e coleta seletiva de resíduos neste município. Neste artigo, realizamos a interpretação sociológica desse processo e de seus limites por meio de categorias como estigma, frames de ação coletiva e repertório de conflito presentes na literatura específica sobre relações excludentes e sobre movimentos sociais. Como forma de conferir rigor hermenêutico, será utilizado material empírico do MNCR, e também, referências de estudo da dissertação e da tese de um dos autores. (OLIVEIRA, 2010; 2016) Para descrever os limites da institucionalização no contexto local serão empregados estudos sobre esse conceito e sobre a estagnação da coleta seletiva feita pela Cooperativa dos Catadores de Santa Cruz do Sul (COOMCAT). Ao final, com base na descrição desse processo contencioso, elaboraremos algumas considerações sobre o conflito que se estabelece em torno da gestão de resíduos nesta localidade.(AU)

The inclusion of waste pickers in the waste management policy agenda in the city of Santa Cruz do Sul, which culminated in the conclusion of public service contracts, was the result of the collective action taken by the waste pickers articulated in the National Movement of Recyclable Materials Collectors (MNCR), with the support of local society and state organizations. There was a process in which the collectors articulated with the MNCR went from being excluded to service providers of final disposal and selective waste collection in this municipality. In this paper, we perform the sociological interpretation of this process and its limits through categories such as stigma, collective action frames and conflict repertoires of specific literature on exclusionary relations and social movements. For conferring hermeneutic rigor, empirical material from the MNCR will be used, as well as references from the dissertation and thesis of one of the authors. (OLIVEIRA, 2010; 2016) To describe the limits of institutionalization in the local context, studies on this concept and on the stagnation of selective collection performed by Recyclable Waste Collectors Cooperative of Santa Cruz do Sul (COOMCAT) will be deployed. In the end, based on the description of this contentious process, we will elaborate some considerations about the conflict around the waste management in this locality.(AU)

Fas-ligand and caspase-3 positivity in three cases of histiocytic sarcoma: a different etiopathogenic pathway?

Histiocytic sarcoma (HS) is a rare malignant neoplasia of hematopoietic origin and unknown etiology. We studied three patients with histiocytic sarcoma reviewing the morphological and immunohistochemical aspects. We evaluated in particular, if apoptosis may be unbalanced in this disease. All cases have morphological and immunohistochemical features consistent with the diagnosis of histiocytic sarcoma. The markers CD163, CD68, vimentin, lysozyme, and S-100 were positive in all cases. Similarly, the three samples were positive for Fas-ligand and Caspase-3. It is well-known that neoplasms may induce increased levels of Fas-ligand with the blockade of the apoptosis process. In the context of HS, the increased Fas-ligand expression represents a new area for research. Indeed, it is linked to proinflammatory stimulus and, maybe with the association of an infection.

Intervenções cognitivas e comportamentais para manejo de insônia em pacientes oncológicos / Cognitive and behavioural interventions for insomnia management in cancer patients / Intervenciones cognitivas y conductuales para el manejo de insomnio en pacientes oncológicos

Introdução: A prevalência de insônia em pacientes oncológicos oscila de 30 a 50%. As psicoterapias cognitivo-comportamentais apresentam eficácia comprovada para o tratamento desta condição. Objetivos: Identificar as principais intervenções cognitivas e comportamentais para manejo de insônia no contexto oncológico. Método: Realizar uma revisão sistemática da literatura produzida entre os anos de 2010 e 2015 nas bases: Pubmed Psych Info e Google Scholar. Foram utilizados os seguintes descritores: Insomnia, Cancer, Cognitive Behavioral Therapy, Randomized Controlled Trial. A qualidade metodológica dos artigos encontrados foi avaliada através da escala JADAD. Resultados: Intervenções cognitivo-comportamentais, incluindo Mindfulness, apresentam evidências de eficácia em pacientes oncológicos, com peculiaridades que devem ser consideradas pelos profissionais no momento da escolha da intervenção. Considerações Finais: Há necessidade de maior apropriação das técnicas por parte dos profissionais envolvidos na atenção em saúde mental no contexto oncológico. Ainda, novas pesquisas devem ser realizadas para verificação de eficácia considerando aspectos socioculturais da população brasileira.

Introduction: The prevalence of insomnia in cancer patients ranges between 30 and 50%. Cognitive Behavioral psychotherapies have proven effective for treating insomnia. Objectives: Identify the main cognitive and behavioral interventions for insomnia management in the oncological context. Method: A systematic review of the literature produced between 2010 and 2015 was conducted based on: PsychInfo PubMed and Google Scholar. The following words were researched: Insomnia, Cancer, Cognitive Behavioral Therapy, and Randomized Controlled Trial. Methodological quality was assessed by JADAD scale by two independent evaluators. Results: The results in articles surveyed indicate that cognitive behavioral interventions, including Mindfulness, show evidence of effectiveness in cancer patients with peculiarities that must be considered by professionals when choosing the intervention. Conclusion: There is a need for mental health care professionals to fully grasp the techniques in order to work with oncological patients. More research is to be carried out to verify the effectiveness considering socio-cultural aspects of the Brazilian population.

Introducción: La prevalencia del insomnio en pacientes oncológicos varia de 30 a 50%. Las psicoterapias cognitivo-conductuales presentan una eficacia comprobada para el tratamiento de esta condición. Objetivo: Identificar las principales intervenciones cognitivas y conductuales para el manejo del insomnio en el contexto oncológico. Método: Realizar una revisión sistemática de la literatura producida entre los años 2010 y 2015 en las bases: Pubmed PsychInfo y Google Scholar. Fueron utilizados los siguientes descriptores: "Insomnia", "Cancer", "Cognitive Behavioral Therapy", "Randomized Controlled Trial". La calidad metodológica de los artículos encontrados fue evaluada a través de la escala JADAD. Resultados: Intervenciones cognitivo-conductuales, incluyendo Mindfulness, presentan evidencias de eficacia en pacientes oncológicos, con peculiaridades que deben ser consideradas por los profesionales en el momento de la elección de la intervención. Consideraciones finales: Hay necesidad de mayor apropiación de las técnicas por parte de los profesionales involucrados en la atención en salud mental en el contexto oncológico. Así como, nuevas investigaciones deben ser realizadas con el fin de verificar la eficacia, considerando aspectos socioculturales de la población brasileña.

Lymphoepithelioma-like carcinoma of the skin

Abstract: Primary cutaneous lymphoepithelioma-like carcinoma is a rare disease with low metastatic potential. Its morphologic and pathological features are similar to those of nasopharyngeal lymphoepithelial carcinoma. We report the case of a 60-year-old man with an infrapalpebral pearly papule, measuring 0.6 cm in diameter. The lesion was excised with a clinical hypothesis of basal cell carcinoma or squamous cell carcinoma. Histopathological analysis revealed a malignant neoplasm with syncytial arrangement of cells with vesicular nuclei, associated with dense lymphocytic infiltrate. Immunohistochemistry revealed cytokeratin-positive cells (AE1/AE3) and p63 protein, indicating epithelial histogenesis and squamous differentiation. A negative Epstein-Barr virus test result was achieved by immunohistochemistry. Primary lymphoepithelioma-like carcinoma of the skin is a differential diagnosis of lesions with prominent inflammatory infiltrates.

Mudanças na atividade física de universitários: associação com informações sobre saúde e acesso a locais para prática / Changes in the physical activity of university students: association with health information and access to places for practicing / Cambios en la actividad física de universitarios: asociación con informaciones sobre salud y acceso a lugares para práctica

RESUMO Objetivo Avaliar mudanças no nível de atividade física (NAF) de estudantes durante os dois primeiros anos de graduação e sua associação com o acesso a informações sobre saúde e locais para prática de atividade física. Métodos Participaram do estudo universitários que ingressaram na Universidade Federal do Recôncavo da Bahia no ano 2010 e foram acompanhados durante os dois primeiros anos da graduação. Fatores socioeconômicos, demográficos, massa corporal, estatura, informações sobre saúde e acesso a locais para prática de atividade física foram avaliados pelo autorelato. O NAF foi mensurado através do Questionário Internacional de Atividade Física (IPAQ) e classificado com base nos critérios do Comitê de Pesquisas sobre o IPAQ. Para a análise estatística recorreu-se ao teste qui-quadrado e teste de McNemar (p<0,05). Resultados A amostra que participou de todo o período de seguimento foi composta por 92 universitários (64,1 % do sexo feminino). A proporção de universitários insuficientemente ativos aumentou de 7,6 % para 12,0 % durante os dois primeiros anos de graduação, porém esta mudança não foi significativa (p>0,05). Universitários que não receberam informações sobre cuidados com a saúde durante a graduação foram mais prováveis para permanecerem/se tornarem insuficientemente ativos (p<0,001). Não houve associação entre o NAF e o acesso a locais para prática de atividade física (p>0,05). Conclusão Houve tendência para aumento da proporção de universitários insuficientemente ativos durante o ensino superior. Políticas voltadas para capacitação dos estudantes sobre cuidados à saúde nas Universidades podem auxiliar no aumento da prática de atividade física, contribuindo para a melhoria da saúde dos universitários.(AU)

ABSTRACT Objective To evaluate changes in the physical activity level (PAL) of students within the first two years of studies and their association with access to health information and places for physical activity. Methods The sample included students who were admitted to the Federal University of Reconcavo in Bahia, Brazil, and were observed during their first two years of studies. Socioeconomic and demographic aspects, as well as body mass, height, health information and access to places for physical activity were assessed through a self-report. PAL was measured using the International Physical Activity Questionnaire (IPAQ) and classified based on the criteria of the Research Committee for IPAQ. Chi-square test and McNemar test (p<0.05) were used for statistical analysis. Results The sample that participated during the entire observation period was composed of 92 students (64.1% female). The insufficiently active students ratio increased from 7.6% to 12.0% during the first two years of undergraduate studies, but this difference was not significant (p>0.05). Students who did not receive information about health care during the course of their studies were more likely to remain/become insufficiently active (p<0.001). There was no association between PAL and access to places for physical activity (p>0.05). Conclusion A tendency to an increase in insufficiently active ratio during higher education was observed. Policies aimed at training students about health care in universities may be useful for increasing physical activity, thus contributing to improve the health condition of the students.(AU)

RESUMEN Objetivo Evaluar cambios en el nivel de actividad física (NAF) de estudiantes durante los dos primeros años de graduación y su asociación con el acceso a informaciones sobre salud y locales para práctica de actividad física. Métodos Participaron del estudio, universitarios que ingresaron en la Universidad Federal del Recôncavo de Bahia en el año 2010 y fueron acompañados durante los dos primeros años de la graduación. Los factores socioeconómicos, demográficos, masa corporal, estatura, información sobre salud y acceso a lugares para práctica de actividad física fueron evaluados por el auto relato. El NAF fue medido a través del Cuestionario Internacional de Actividad Física (IPAQ) y clasificado con base en los criterios del Comité de Investigaciones sobre el IPAQ. Para el análisis estadístico se recurrió a la prueba Chi cuadrado y prueba de McNemar (p<0,05). Resultados La muestra que participó de todo el período de seguimiento fue compuesta por 92 universitarios (64,1 % del sexo femenino). La proporción de universitarios insuficientemente activos aumentó del 7,6 % al 12,0 % durante los dos primeros años de graduación, sin embargo este cambio no fue significativo (p>0,05). Los universitarios que no recibieron información sobre el cuidado de la salud durante la graduación fueron más probables para permanecer/ tornarse insuficientemente activos (p<0,001). No hubo asociación entre el NAF y el acceso a lugares para práctica de actividad física (p>0,05). Conclusión Hubo tendencia a aumentar la proporción de universitarios insuficientemente activos durante la enseñanza superior. Las políticas dirigidas a la capacitación de los estudiantes sobre cuidados a la salud en las Universidades pueden auxiliar en el aumento de la práctica de actividad física, contribuyendo a la mejora de la salud de los universitarios.(AU)

Acute lymphoblastic leukemia: primary bone manifestation with hypercalcemia in a child / Leucemia linfoblástica aguda: manifestação óssea primária com hipercalcemia em criança

ABSTRACT Primary bone manifestation associated with hypercalcemia is an infrequent presentation of acute lymphoblastic leukemia (ALL) in children. An 8-year-old girl was admitted with bone and abdomen pain, vomiting, fever, headache, anemia, elevated serum calcium and normal parathyroid hormone levels. Bone radiographs: osteolytic lesions. Bone marrow biopsy showed an infiltration by ALL with immunohistochemical positivity for CD45, CD20, CD79a, TdT and CD10, clinically characterized by hypercalcemia, multifocal osteolytic lesions and single cytopenia. Bone marrow biopsy was a relevant aid in establishing the diagnosis of multifocal osteolytic lesions, associated with hypercalcemia.

RESUMO Apresentação óssea primária associada à hipercalcemia é manifestação clinicolaboratorial infrequente de leucemia linfoblástica aguda (LLA) em crianças. Relatamos o caso de uma criança do sexo feminino, 8 anos, admitida com dores ósseas e no abdômen associadas a vômitos, febre, cefaleia, anemia, hipercalcemia e níveis de paratormônio normais. Radiografias ósseas apresentaram lesões osteolíticas. Biópsia de medula óssea demonstrou infiltração por LLA com positividade imuno-histoquímica para CD45, CD79a, TdT e CD10, clinicamente caracterizada por hipercalcemia, lesões osteolíticas multifocais e citopenia única. A biópsia de medula óssea é importante ferramenta no estabelecimento do diagnóstico de lesões osteolíticas multifocais associada à hipercalcemia.

Endobronchial solitary fibrous tumor

Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that appears primarily in the pleura and rarely in intrapulmonary or endobronchial topography. The authors report the case of a 47-year-old woman who presented obstructive respiratory symptoms for 4 years. The chest computed tomography and bronchoscopy showed an obstructive polypoid lesion located between the trachea and the left main bronchus associated with distal atelectasis of the left lung. A resection of the lesion was performed and, macroscopically, the mass was oval, encapsulated, and firm, measuring 2.3 × 1.7 × 1.5 cm. Histology revealed low-grade mesenchymal spindle cell neoplasm, with alternating cellularity, myxoid areas, and mature adipose tissue outbreaks, as well as blood vessels with irregular walls. The immunohistochemical study was positive for CD34, CD99, and BCL2. The diagnosis was SFT in an unusual topography. The patient's symptoms remitted after tumor excision, and no systemic problems were evident. SFTs primarily affect adults and often follow a benign course; however, their behavior is unpredictable. The presence of necrosis and mitotic activity may portend a poor prognosis. Endobronchial SFTs are rare but should be evaluated and monitored similar to SFTs at other sites, with a long-term follow-up