Prevalência de feminicídios na Grande Vitória envolvendo região craniofacial no período de pandemia do vírus Sars-CoV-2 / Feminicide prevalence in Grande Vitória involving the craniofacial region during the pandemic of the Sars-CoV-2 virus

Introdução: feminicídio é o homicídio que envolve violência doméstica e familiar, menosprezo ou discriminação ao fato da vítima ser mulher. Em 2020, foi decretada pandemia do vírus SARS-CoV-2 e como forma de reduzir a disseminação foi adotado o isolamento social, expondo muitas mulheres a um maior risco de violência doméstica. Estudos apontam que a maioria dos traumatismos relacionados à violência contra mulher ocorrem na face, ressaltando a importância de estudar os casos de feminicídio envolvendo a região bucomaxilofacial. Objetivo: verificar a prevalência de feminicídio, envolvendo lesões em região craniofacial, no período anterior (2018 e 2019) e durante (2020 e 2021) a pandemia da coronavírus. Métodos: foi realizada análise descritiva, por meio da frequência numérica e percentual do número de feminicídios envolvendo a região craniofacial no período de 2018 a 2021. Resultados: o número de laudos analisados de feminicídio ocorridos na Grande Vitória foi 47, sendo 24 antes e 23 durante a pandemia. Averiguou-se também que em 68,83% dos casos houve a presença de lesão craniofacial, principalmente em região do crânio e extraoral. Conclusão: não ocorreu variação significativa na prevalência de feminicídio antes e durante a pandemia do vírus SARS-CoV-2 na região da Grande Vitória, no Estado do Espírito Santo

Introduction: femicide is homicide that involves domestic and family violence, contempt or discrimination against the fact that the victim is a woman. In 2020, pandemic of SARS-CoV-2 virus was declared and, to reduce the spread of the disease, social isolation was adopted, exposing many women to a greater risk of domestic violence. Studies indicate that most traumas occur on the face, highlighting the importance of studying cases of femicide involving the oral and maxillofacial region. Purpose: to verify the prevalence of femicide, involving lesions in the craniofacial region, in the period before (2018 and 2019) and during (2020 and 2021) the coronavirus pandemic Methods: a descriptive analysis was carried out, through the numerical frequency and percentage of the number of femicides involving the craniofacial region in the period from 2018 to 2021. Results: the number of reports of femicide analyzed in Vitória was 47, with 24 before and 23 during the pandemic, with no significant variation. It was also found that in 68.83% of the total cases there was the presence of craniofacial lesion, mainly in the skull and extraoral region. Conclusion: there was no significant variation in the prevalence of femicide before and during the SARS-CoV-2 virus pandemic in the Grande Vitória region, in the state of Espírito Santo

Predicting mortality in neonates with gastroschisis in a Southeastern state of Brazil

SUMMARY OBJECTIVE: This study aimed to verify risk factors associated with gastroschisis mortality in three neonatal intensive care units located in the state of Espírito Santo, Brazil. METHODS: A retrospective cohort study of neonates with gastroschisis was performed between 2000 and 2018. Prenatal, perinatal, and postsurgical variables of survival or nonsurvival groups were compared using chi-square statistical test, t-test, Mann-Whitney U test, and logistic regression. Tests with p<0.05 were considered statistically determined. RESULTS: A total of 142 newborns were investigated. Mean maternal age, gestational age, and birth weight were lower in the group of nonsurvival (p<0.05). Poor clinical conditions during admission, complex gastroschisis, closure with silo placement, the use of blood products, surgical complications, and short bowel syndrome were more frequent in the nonsurvival group (p<0.05). Complex gastroschisis [adjusted odds ratio (OR) 3.74, 95% confidence interval (95%CI) 1.274-11.019] and short bowel syndrome (adjusted OR 7.55, 95%CI 2.177-26.225) increased the risk of death. Higher birth weight inversely reduced the risk for mortality (adjusted OR 0.99, 95%CI 0.997-1.000). CONCLUSION: Complex gastroschisis and short bowel syndrome increased the risk of death, with greater birth weight being inversely correlated with the risk of mortality. The findings of this research can contribute to the formulation of protocols to improve the quality and safety of care in order to reduce neonatal mortality associated with gastroschisis.

Could be FOXO3a, miR-96-5p and miR-182-5p useful for Brazilian women with luminal A and triple negative breast cancers prognosis and target therapy?

Abstract FOXO3a dysregulation is frequently implicated in tumorigenesis, and its inhibition can occur by several molecular mechanisms. Among these, post-transcriptional suppression by miRNAs has been associated with various cancers initiation. Here, we assessed the expression profiles of the most relevant miRNAs for breast tumorigenesis, using Luminal A (LA) and Triple-Negative (TN) breast cancer from Brazilian patients, by the quantitative real time-PCR method. Their potential prognostic role for the patients was also evaluated. We identified the miRNAs miR-96-5p and miR-182-5p, de-scribed as negative regulators of FOXO3A, with differential expression both in LA and TN tumors when compared to normal tissue. The miR-96-5p and miR-182-5p miRNAs were upregulated in LA (7.82 times, p < 0.005; 6.12 times, p < 0.005, respectively) and TN breast cancer samples (9.42 times, p < 0.0001; 8.51 times, p < 0.0001) compared to normal tissues. The samples with higher miR-96-5p and miR-182-5p expression (FR ≥ 4) were submitted for FOXO3a immunostaining. Reduced protein detection was observed in all of the tumors compared to normal tissues. The most prominent miRNA expression and FOXO3a protein suppression were observed in TN samples (p < 0.001), indicating the relevant role of these molecules in this tumor biology and clinical behavior. Our results corroborate the literature regarding to the relevance of FOXO3a in the breast cancer, and they open new perspectives for alternative target therapy options for Brazilian patients expressing both FOXO3a and its regulatory miRNAs.

Influence of birthplace on gastroschisis outcomes in a state in the southeastern region of Brazil

Abstract Objective: To characterize the influence of birthplace on outcomes of patients with gastroschisis admitted to three hospitals in a state in Brazil's southeastern region, according to condition inborn (born in a reference center) or outborn (born outside the reference center). Methods: Retrospective multicenter cohort study of patients with gastroschisis. The sample size utilized was of patients admitted in three hospitals with a diagnosis of gastroschisis ICD 10 Q79.3 between January 2000 to December 2018. Patients were divided into two groups, inborn and outborn. Characteristics of prenatal, perinatal and postoperative were compared using statistical tests. The level of significance adopted was P-value < 0.05. Results: In total, 144 cases of gastroschisis were investigated. The outborn patients group had higher rates of absence of antenatal diagnosis (p = 0.001), vaginal delivery (p = 0.001), longer time between birth and abdominal wall closure surgery (p = 0.001), to silo removal (p = 0.001), to first enteral feeding (p = 0.008), for weaning from mechanical ventilation (p = 0.034), used less peripherally inserted central catheter (PICC) and required more venous dissections (p = 0.001), and lower mean of serum sodium (p = 0.015). There were no differences in mortality rates and length of hospital stay between the inborn and outborn groups. Conclusion: Although outborn patients with gastroschisis were less likely to have an antenatal diagnosis and were more prone to a longer time to undergo surgical and feeding procedures, and to spend more time in mechanical ventilation, these disadvantages seemed not to reflect on the death rate and the length of hospital stay of patients from this group.

The mutational repertoire of uterine sarcomas and carcinosarcomas in a Brazilian cohort: A preliminary study

OBJECTIVES: The present study aimed to contribute to the catalog of genetic mutations involved in the carcinogenic processes of uterine sarcomas (USs) and carcinosarcomas (UCSs), which may assist in the accurate diagnosis of, and selection of treatment regimens for, these conditions. METHODS: We performed gene-targeted next-generation sequencing (NGS) of 409 cancer-related genes in 15 US (7 uterine leiomyosarcoma [ULMS], 7 endometrial stromal sarcoma [ESS], 1 adenosarcoma [ADS]), 5 UCS, and 3 uterine leiomyoma (ULM) samples. Quality, frequency, and functional filters were applied to select putative somatic variants. RESULTS: Among the 23 samples evaluated in this study, 42 loss-of-function (LOF) mutations and 111 missense mutations were detected, with a total of 153 mutations. Among them, 66 mutations were observed in the Catalogue of Somatic Mutations in Cancer (COSMIC) database. TP53 (48%), ATM (22%), and PIK3CA (17%) were the most frequently mutated genes. With respect to specific tumor subtypes, ESS showed mutations in the PDE4DIP, IGTA10, and DST genes, UCS exhibited mutations in ERBB4, and ULMS showed exclusive alterations in NOTCH2 and HER2. Mutations in the KMT2A gene were observed exclusively in ULM and ULMS. In silico pathway analyses demonstrated that many genes mutated in ULMS and ESS have functions associated with the cellular response to hypoxia and cellular response to peptide hormone stimulus. In UCS and ADS, genes with most alterations have functions associated with phosphatidylinositol kinase activity and glycerophospholipid metabolic process. CONCLUSION: This preliminary study observed pathogenic mutations in US and UCS samples. Further studies with a larger cohort and functional analyses will foster the development of a precision medicine-based approach for the treatment of US and UCS.

Hypothalamic transcriptional expression of the kisspeptin system and sex steroid receptors differs among polycystic ovary syndrome rat models with different endocrine phenotypes

OBJECTIVES: Polycystic ovary syndrome is a heterogeneous endocrine disorder that affects reproductive-age women. The mechanisms underlying the endocrine heterogeneity and neuroendocrinology of polycystic ovary syndrome are still unclear. In this study, we investigated the expression of the kisspeptin system and gonadotropin-releasing hormone pulse regulators in the hypothalamus as well as factors related to luteinizing hormone secretion in the pituitary of polycystic ovary syndrome rat models induced by testosterone or estradiol. METHODS: A single injection of testosterone propionate (1.25 mg) (n=10) or estradiol benzoate (0.5 mg) (n=10) was administered to female rats at 2 days of age to induce experimental polycystic ovary syndrome. Controls were injected with a vehicle (n=10). Animals were euthanized at 90-94 days of age, and the hypothalamus and pituitary gland were used for gene expression analysis. RESULTS: Rats exposed to testosterone exhibited increased transcriptional expression of the androgen receptor and estrogen receptor-β and reduced expression of kisspeptin in the hypothalamus. However, rats exposed to estradiol did not show any significant changes in hormone levels relative to controls but exhibited hypothalamic downregulation of kisspeptin, tachykinin 3 and estrogen receptor-α genes and upregulation of the gene that encodes the kisspeptin receptor. CONCLUSIONS: Testosterone- and estradiol-exposed rats with different endocrine phenotypes showed differential transcriptional expression of members of the kisspeptin system and sex steroid receptors in the hypothalamus. These differences might account for the different endocrine phenotypes found in testosterone- and estradiol-induced polycystic ovary syndrome rats.

EZH2 Protein Expression and Tumor Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer / Expressão da proteína EZH2 e resposta tumoral à quimioterapia neoadjuvante no câncer de mama localmente avançado

Abstract Introduction Neoadjuvant chemotherapy (NAC) is the standard treatment for locally advanced breast cancer. However, some tumors will not respond to this treatment due to histological and molecular features. The protein EZH2 (enhancer of zest homolog 2) is a histone methyltransferase that is correlated with poorly differentiated breast carcinomas and aggressive tumor behavior. Purpose The present study evaluated the association between EZH2 expression and response to NAC, and its correlation with HER2 overexpression, estrogen and progesterone receptors (ER, PR) and Ki-67 proliferation index. Methods A total of 60 patients with locally advanced breast cancer treated with NAC were selected for this study. Twenty-three paraffin blocks had not enough material for tissue resection, and were not evaluated. A tissue microarray based in immunohistochemistry (IHC) analysis of EZH2 was performed for the remaining 37 specimens. Patients were divided into two groups based on response to NAC. Results EZH2 expression was significantly associated with markers of poor prognosis such as ER negativity (p = 0.001), PR negativity (p = 0.042) and high Ki-67 proliferation index (p = 0.002). High EZH2 expression was not correlated with the response to NAC. Conclusions Our data suggested that EZH2 protein expression may not correlate with the clinical response to NAC. Other studies with more patients are needed to confirm this observation.

Resumo Introdução A quimioterapia neoadjuvante é o tratamento padrão para os cânceres de mama localmente avançados. Entretanto, apenas uma porcentagem desses tumores irá responder ao tratamento, devido a características histológicas e moleculares. A proteína EZH2 (enhancer of zest homolog 2) é uma histona metiltransferase associada a tumores mal diferenciados e de comportamento agressivo. Objetivo O presente estudo teve como objetivo avaliar a associação entre a expressão da proteína EZH2 e a resposta à quimioterapia neoadjuvante, além da correlação dessa proteína com hiper-expressão de HER2, receptores de estrogênio e progesterona, e o marcador de proliferação Ki-67. Métodos Um total de 60 pacientes com câncer de mama localmente avançado tratadas com quimioterapia neoadjuvante foram selecionadas para esse estudo. Vinte e três blocos de parafina não continham material suficiente para ressecção e não foram avaliados. Foi realizado microarray baseado em análise imuno-histoquímica da proteína EZH2 para as 36 pacientes restantes. As pacientes foram divididas em dois grupos baseado na resposta à quimioterapia neoadjuvante. Resultados A expressão da proteína EZH2 foi significativamente associada com marcadores de pior prognóstico, como negatividade para receptor de estrogênio (p = 0,001) e progesterona (p = 0,042), além de alto Ki-67 (p = 0,002). Entretanto, a alta expressão da EZH2 não se correlacionou com a resposta à quimioterapia neoadjuvante. Conclusões Nossos dados sugerem que a expressão da proteína EZH2 pode não estar relacionada com a resposta clínica à quimioterapia neoadjuvante. Outros estudos com maior número de pacientes são necessários para confirmar esses achados.

Cumulative trauma disorders, overweight and obesity among Brazilian dentists

This study aimed to assess the prevalence of cumulative trauma disorders (CTD), overweight and obesity and the association between them, among public health dentists. Methods: The study included 150 dentists working at various public health system units in Recife, PE, Brazil. A Brazilian version of the Nordic Musculoskeletal Symptoms Questionnaire was used. Obesity and overweight were observed across the BMI (body mass index) recommended by the World Health Organization. A descriptive analysis was carried out using SPSS 13.0 software. Results: Among respondents, 79.3% were female with a mean age of 44.42 years. The presence of musculoskeletal symptoms was reported by 138 (92%) of participants, 129 of whom linked the symptoms to their work activity. The cervical region was the most involved, accounting for 104(14.3%) of the total 723 affected areas. Overweight was observed in 32% of the professionals and obesity in 13%. Of the 150 participants, 30 (20%) received a medical diagnosis of CTD and of these, 13 (43.3%) had a high BMI. The 40-49-year-old age group was most affected by CTDand females were more affected than males, accounting for 22.7% of professionals interviewed. There was no significant association between the presence of CTD and overweight/obesity (p>0.05). Conclusions: However, given the multifactorial nature of occupational diseases, it is likely that overweight and obesity may act as a predisposing factor in these diseases, interacting and enhancing the effects of other important risk factors for the occurrence of work-related musculoskeletal disorders.

Nível de evidência e grau de recomendação dos artigos sobre a acurácia diagnóstica da ultrassonografia na síndrome do túnel do carpo / Level of evidence and grade of recommendation of articles on the diagnostic accuracy of ultrasonography in carpal tunnel syndrome

OBJETIVO: Este trabalho teve como objetivo avaliar a qualidade dos artigos relacionados com a acurácia diagnóstica da ultrassonografia na síndrome do túnel do carpo idiopática e relacionada com o trabalho. MATERIAIS E MÉTODOS: Realizou-se busca em bases de dados eletrônicas, selecionando-se relatórios de revisões sistemáticas, ensaios clínicos randomizados e estudos observacionais. Após quatro etapas de análise, desde a triagem inicial até a avaliação pelo instrumento elaborado pelo Critical Appraisal Skills Programme, os artigos foram classificados em níveis de evidência, com seus respectivos graus de recomendação. RESULTADOS: Dos 68 artigos inicialmente encontrados, apenas 4 preencheram os critérios de qualidade propostos neste estudo. A mensuração da área transversal do nervo mediano foi o critério mais importante para o diagnóstico de síndrome do túnel do carpo (ponto de corte entre 9 e 10 mm²: sensibilidade = 82-86,3 por cento; especificidade = 48-87 por cento). Os quatro artigos obtiveram nível de evidência "1b" e grau de recomendação "A". CONCLUSÃO: A avaliação ultrassonográfica em pacientes com suspeita clínica de síndrome do túnel do carpo pode ser realizada como teste de primeira linha, com boa relação custo-benefício, reduzindo a necessidade de exames eletrodiagnósticos.

OBJECTIVE: The present study was aimed at assessing the quality of articles related to diagnostic accuracy of ultrasonography both in idiopathic and occupational carpal tunnel syndrome. MATERIALS AND METHODS: A search was undertaken in electronic databases, selecting reports on systematic reviews, randomized clinical trials and observational studies. After four stages of analysis, from an initial screening to the evaluation by means of the assessment scale developed by the Critical Appraisal Skills Programme, the articles were classified according to levels of evidence, with their respective grades of recommendation. RESULTS: Among 68 articles initially identified, only 4 have met all the methodological quality criteria proposed in the present study. Measurement of the cross-sectional area of the median nerve was the most important criterion for the diagnosis of carpal tunnel syndrome (cut-off point between 9 and 10 mm²: sensitivity = 82-86.3 percent; specificity = 48-87 percent). The four articles were given level of evidence "1b" and grade of recommendation "A". CONCLUSION: The sonographic evaluation of patients with clinical suspicion of carpal tunnel syndrome can be cost-effectively performed as a first-line test, reducing the need for electrodiagnostic testing in these patients.

GLUT1 expression in malignant tumors and its use as an immunodiagnostic marker

OBJECTIVE: To analyze glucose transporter 1 expression patterns in malignant tumors of various cell types and evaluate their diagnostic value by immunohistochemistry. INTRODUCTION: Glucose is the major source of energy for cells, and glucose transporter 1 is the most common glucose transporter in humans. Glucose transporter 1 is aberrantly expressed in several tumor types. Studies have implicated glucose transporter 1 expression as a prognostic and diagnostic marker in tumors, primarily in conjunction with positron emission tomography scan data. METHODS: Immunohistochemistry for glucose transporter 1 was performed in tissue microarray slides, comprising 1955 samples of malignant neoplasm from different cell types. RESULTS: Sarcomas, lymphomas, melanomas and hepatoblastomas did not express glucose transporter 1. Fortyseven per cent of prostate adenocarcinomas were positive, as were 29 percent of thyroid, 10 percent of gastric and 5 percent of breast adenocarcinomas. Thirty-six per cent of squamous cell carcinomas of the head and neck were positive, as were 42 percent of uterine cervix squamous cell carcinomas. Glioblastomas and retinoblastomas showed membranous glucose transporter 1 staining in 18.6 percent and 9.4 percent of all cases, respectively. Squamous cell carcinomas displayed membranous expression, whereas adenocarcinomas showed cytoplasmic glucose transporter 1 expression. CONCLUSION: Glucose transporter 1 showed variable expression in various tumor types. Its absence in sarcomas, melanomas, hepatoblastomas and lymphomas suggests that other glucose transporters mediate the glycolytic pathway in these tumors. The data suggest that glucose transporter 1 is a valuable immunohistochemical marker that can be used to identify patients for evaluation by positron emission tomography scan. The function of cytoplasmic glucose transporter 1 in adenocarcinomas must be further examined.

PCR detection of multiple human herpesvirus DNA in saliva from HIV-infected individuals in Teresina, State of Piauí, Brazil / Detecção por PCR do DNA de vários herpesvírus humanos na saliva de indivíduos infectados pelo HIV em Teresina, Estado do Piauí, Brasil

INTRODUCTION: Human herpesviruses are frequently associated with orofacial diseases in humans (HSV-1, EBV, CMV and HHV-8), some can also cause systemic disease (CMV and HHV-8). The transmission of these viruses occurs by contact with infected secretions, especially saliva. Human immunodeficiency virus infection is associated with an increased risk of HHVs and related diseases. METHODS: This work aimed to detect HSV-1, EBV, CMV and HHV-8 DNA in saliva of HIV-infected patients from Teresina, northeast Brazil, by PCR and compare these findings with age and sex matched HIV-seronegative individuals. RESULTS: No difference in prevalence was verified between HHV detection in the saliva of HIV-seropositive individuals and controls. The individual frequencies of these viruses in these two populations were different. HIV seropositivity correlated positively with the presence of CMV (OR: 18.2, p= 0.00032) and EBV (OR: 3.44, p= 0.0081). No association between CD4 counts and the prevalence of HHVs in the saliva was observed; however, a strong association was determined between seropositivity and the presence of multiple HHV DNAs in saliva (OR: 4.83, p = 0.0028). CONCLUSIONS: These findings suggest the asymptomatic salivary shedding of HHVs is a common event between HIV-seropositive and seronegative individuals from Teresina, Piauí, Brazil, and, especially for HIV-seropositive patients, saliva is a risk factor for the acquisition/transmission of multiple HHVs.

INTRODUÇÃO: Alguns herpesvírus humanos são frequentemente associados a doenças orofaciais em humanos. A transmissão destes vírus ocorre através do contato com secreções contaminadas, especialmente a saliva. A infecção pelo vírus da imunodeficiência humana é considerada um fator de risco para a aquisição de HHVs e doenças correlatas. MÉTODOS: Este trabalho teve como objetivo detectar por PCR o DNA de HSV-1, EBV, CMV e HHV-8 na saliva de pacientes infectados com HIV em Teresina, nordeste do Brasil, e comparar os dados obtidos com o grupo controle (indivíduos HIV negativos). RESULTADOS: Não há diferença na prevalência de detecção de HHVs na saliva de indivíduos HIV soropositivos e soronegativos. No entanto, as frequências individuais de detecção dos diferentes HHVs são diferentes entre estas duas populações. A soropositividade para HIV apresentou correlação positiva com a presença de CMV (OR: 18,2, p = 0,00032) e EBV (OR: 3,44, p = 0,0081). Não foi verificada nenhuma associação entre a contagem de CD4 e prevalência de HHVs na saliva, no entanto existe uma forte associação entre a soropositividade e a detecção do DNA de vários HHVs na saliva (OR: 4,83, p = 0,0028). CONCLUSÕES: Estes resultados sugerem que a transmissão salivar de HHVs é um evento comum entre os indivíduos HIV soropositivos e soronegativos de Teresina, Piauí, Brasil, e, especialmente para os pacientes soropositivos, a saliva é um fator de risco para a aquisição/transmissão de múltiplos HHVs.

Perfil funcional de locomoção em um grupo de pacientes com lesão medular atendidos em um centro de reabilitação / Perfil funcional de locomoción en un grupo de pacientes con lesión medular atendidos en un centro de rehabilitación / Functional ambulation profile in a group of spinal cord injured patients attended at a rehabilitation center

OBJETIVO: descrever o perfil de locomoção de um grupo de pacientes com lesão medular (LM), correlacionando-o com as características da amostra. MÉTODOS: setenta pacientes (50 com LM traumática e 20 com LM não-traumática). Instrumentos: Classificação Funcional da Marcha Modificada (CFMM), WISCI-II, Escala de Ashworth Modificada (EAM), Classificação AIS, Lower Extremities Muscle Score (AIS-LEMS). Estatística: descritiva, comparação entre grupos, testes de correlação considerando p<0,05. RESULTADOS: a média da idade dos pacientes foi de 36 anos; 72,9 por cento dos pacientes eram homens; tempo médio de lesão: 4,7 anos; AIS: 38,6 por cento A, 10 por cento B, 22,8 por cento C, 28,6 por cento D; Nível de lesão: 32,8 por cento cervical, 52,9 por cento torácico, 14,3 por cento lombossacro. Causas mais frequentes: PAF 30 por cento; acidente automobilístico 18,6 por cento; CFMM: CR 34,3 por cento; marcha terapêutica 20 por cento; domiciliar 12,8 por cento; comunitária 32,9 por cento. WISCI-II: 7,5. AIS-LEMS: 13,4. Houve diferença entre os grupos LM traumática e não-traumática quanto à idade, sexo, AIS, AIS-LEMS, CFMM e WISCI-II. Correlações significativas: AIS correlacionou-se positivamente com CFMM, WISCI-II, AIS-LEMS. Nível de lesão correlacionado negativamente com EAM. AIS-LEMS positivamente com a AIS, CFMM, WISCI-II e negativamente com apoio e órteses na deambulação. O tempo de lesão e a presença de dor incapacitante não se correlacionaram com as variáveis estudadas. CONCLUSÕES: o grupo de LM traumática era composto por pacientes mais jovens e com maior prevalência de lesão completa. A idade se correlacionou com o uso de aparelhos de auxílio à marcha e órteses. O desempenho funcional da marcha esteve ligado à AIS e ao AIS-LEMS, sendo que a marcha comunitária necessitou de um AIS-LEMS de pelo menos 32 pontos.

OBJECTIVE: to describe the locomotion profile of a group of spinal cord injured (SCI) patients and its correlation with the sample features. METHODS: seventy patients (50 with traumatic SCI and 20 non-traumatic) were assessed. Instruments: Modified Functional Ambulation Classification (MFAC), Walking Index for Spinal Cord Injury II (WISCI-II), Modified Ashworth Scale (MAS), American Spinal Injury Association Impairment Scale (AIS) and AIS Lower Extremities Muscle Score (AIS-LEMS). Statistics: descriptive, comparison between groups, correlation tests (considering p<0,05). RESULTS: average values were: age: 36 years, 72.9 percent males, average time of lesion 4.7 years. AIS A, 38.6 percent; AIS B, 10 percent; AIS C, 22.8 percent; AIS D, 28.6 percent. Level of lesion: 32.8 percent cervical, 52.9 percent thoracic, 14.3 percent lumbar. More prevalent etiologies: gunshot wounds 30 percent and car accidents 18 percent. MFAC: Non-ambulation, 34.3 percent; Therapeutic ambulation 20 percent, Household ambulation 12.8 percent, community ambulation (32.9 percent); WISCI-II: 7.5, AIS-LEMS: 13.4. There were differences between traumatic and non-traumatic groups concerning age, sex, AIS, AIS-LEMS, MFAC and WISCI-II. Significant correlations: AIS positively correlated to MFAC, WISCI-II and AIS-LEMS. Level of lesion negatively correlated to MAS. AIS-LEMS positively correlated to AIS, MFAC, WISCI-II and negatively correlated to support and orthosis during ambulation. Time of lesion and presence of disabling pain were not correlated to the studied variables. CONCLUSIONS: traumatic SCI group was composed by younger patients with higher prevalence of complete lesion. Age was correlated to the use of orthosis and walking devices. Functional performance of gait was correlated with AIS and AIS-LEMS, and a AIS-LEMS of at least 32 points was needed to achieve community gait.

OBJETIVO: describir el perfil de locomoción de un grupo de pacientes con lesión medular (LM), correlacionándolo con las características de la muestra. MÉTODOS: setenta pacientes (50 con LM traumática y 20 con LM no traumática). Instrumentos: Clasificación Funcional de la Marcha Modificada (CFMM), WISCI-II, Escala de Ashworth Modificada (EAM), Clasificación AIS, AIS Lower Extremities Muscle Score (AIS-LEMS). Estadística: descriptiva, comparación entre grupos, testes de correlación considerando un p<0,05. RESULTADOS: el promedio de la edad de los pacientes fue de 36 años, 72,9 por ciento hombres, tiempo promedio de lesión de 4,7 años; 38,6 por ciento A, 10 por ciento B, 22,8 por ciento C, 28,6 por ciento D; nivel de lesión de 32,8 por ciento cervical, 52,9 por ciento torácico y 14,3 por ciento lumbo sacro. La causa más frecuente fue PAF 30 por ciento, accidente automovilístico con 18,6 por ciento. CFMM: CR 34,3 por ciento marcha terapéutica 20 por ciento, domiciliar 12.8 por ciento, comunitaria 32,9 por ciento WISCI-II: 7,5. AIS-LEMS: 13,4. Hubo diferencia entre los grupos LM traumático y no traumático según la edad, sexo, AIS, AIS-LEMS, CFMM y WISCI-II. Correlaciones significativas: AIS positivamente con CFMM, WISCI-II, AIS-LEMS. Nivel de lesión negativamente con apoyo y ortesis en la ambulación. El tiempo de lesión y la presencia de dolor discapacitante no se correlacionaron con las variables estudiadas. CONCLUSIONES: el grupo de LM traumático era compuesto por pacientes más jóvenes y con mayor prevalencia de lesión completa. La edad se correlacionó con el uso de aparatos de auxilio para la marcha y ortesis. El desempeño funcional de la marcha se correlacionó con AIS y el AISLEMS, siendo que la marcha comunitaria necesitó de un AISLEMS de por lo menos 32 puntos.

Cirurgia de transplante autógeno pela técnica imediata / Autogenous transplantation surgery through the immediate technique

O transplante dentário envolve a implantação de um dente autólogo, simultaneamente extraído, em novo alvéolo. O momento ideal para a realização deste procedimento se dá, quando o dente atinge de metade a três quartos do comprimento radicular, e o forame apical está aberto. Esse trabalho avalia um transplante autógeno utilizando a técnica convencional. Selecionou-se para tanto paciente do gênero masculino, com 15 anos de idade, com indicação de exodontia dos dentes 37 e 38. Durante exame clínico e radiográfico, observou-se que o dente 37 achava-se impactado no 36, provocando sua erupção incompleta, com possibilidade de reabsorção radicular. Propôs-se, então, o transplante dentário o qual foi realizado com o consentimento dos responsáveis legais. Após o bloqueio anestésico, incisão, descolamento do retalho, odontosecção, exodontia do 37 e limpeza, fez-se a exodontia do dente 38 que foi posicionado no alvéolo do 37, sem traumatizar a região apical permanecendo submucoso. Três meses mais tarde, teve início a erupção espontânea. Após três anos de controle clínico e radiográfico, ficou constatado que o dente transplantado estava em boas condições. Radiograficamente, as imagens sugeriram reparação, rizogênese e desenvolvimento radicular. O transplante dental, quando corretamente indicado, é uma boa alternativa terapêutica para reabilitação bucal em pacientes jovens.

A dental transplant involves, simultaneously, an autogenous tooth extraction and implant in another alveolus. The ideal moment for this procedure is when the tooth reaches between ½ and ¾ of the root length and the apical foramen is still open. This study evaluates a clinical case of an autogenous transplant using the immediate technique. A 15-year-old male patient needing extraction of teeth 37 and 38 was selected for the study. The clinical and radiographic examinations showed tooth 37 impacted on tooth 38 tooth, causing its incomplete eruption and indicating root reabsorption. During the surgical procedures tooth 37 was extracted and cleaned, after which tooth 38 was implanted in the alveolus of tooth 37 and also extracted. Afterwards, the 38 tooth was placed inside the 37 tooth alveolus, remaining in the submucosa. The foliar sac remained in place without causing trauma to the apical region. Three months later spontaneous eruption took place. After three years of clinical and radiographic follow-up, , the transplanted tooth presented a healthy condition, with the images showing bone repair and formation and development of the root. A dental transplant, when correctly indicated, turns out to be a good alternative to oral rehabilitation in young patients.

Antimicrobial activity and chemical investigation of Brazilian Drosera

The antimicrobial activity of three different extracts (hexanic, ethyl acetate, methanol) obtained from Brazilian Drosera species (D. communis, D. montana var. montana, D. brevifolia, D. villosa var. graomogolensis, D. villosa var. villosa, Drosera sp. 1, and Drosera sp. 2 ) were tested against Staphylococcus aureus (ATCC 25923), Enterococcus faecium (ATCC23212), Pseudomonas aeruginosa (ATCC27853), Escherichia coli (ATCC11229), Salmonella choleraesuis (ATCC10708), Klebsiella pneumoniae (ATCC13883), and Candida albicans (a human isolate). Better antimicrobial activity was observed with D. communis and D. montana var. montana ethyl acetate extracts. Phytochemical analyses from D. communis, D. montana var. montana and D. brevifolia yielded 5-hydroxy-2-methyl-1,4-naphthoquinone (plumbagin); long chain aliphatic hydrocarbons were isolated from D. communis and from D. villosa var. villosa, a mixture of long chain aliphatic alcohols and carboxylic acids, was isolated from D. communis and 3b-O-acetylaleuritolic acid from D. villosa var. villosa.

Análise da virulência de isolados de Paracoccidioides brasiliensis, contendo seqüências conhecidas do gene PbGP43: ptodução e caracterização de isoformas recombinantes de gp43 / Virulence in mice of Paracoccidioides brasiliensis isolates bearing know PbGP43 genotypes: production and characterization of recombinant isoforms of gp43

O Para coccidioides brasiliensis é o fungo dimórfico térmico causador da paracoccidioidomicose (PCM) no homem. A glicoproteína gp43 é o principal antígeno diagnóstico do fungo, mas também elicita imunidade celular protetora em camundongos imunizados e é um potencial fator de virulência devido à sua propriedade adesiva. Em nosso laboratório foi previamente reportando um importante polimorfismo na sequência do exon 2 do PbGP43, o qual definiu 6 grupos genotipos (A a F). Dentre os 17 isolados fúngicos estudados Pb2, Pb3 e Pb4 apresentaram as seqüências mais polimórficas com 14 a 15 substituições. Esses isolados foram obtidos de pacientes com PCM crõnica e expressam proteína mais básica. Nós testamos a virulência de Pb2, Pb3 e Pb4 (genotipo A) em comparação com isolados carregando os outros genotipos D, E e F, incluindo Pb18. A infecção foi realizada em camundongos 1310.A pelas vias intraperitoneal (i.p.) com fungo adaptado in vitro, intratraqueal (i.t.) e intravenosa (i.v.) com fungos repuperados de órgãos. Esses três isolados provocaram baixa mortalidade e foram recuperados baixos números de leveduras dos animais infectados após os diferentes períodos de estudo. Pb3 adaptado in vivo causou infecção maior após 30 e 60 dias, no entanto a doença regrediu aos 120 dias. A resposta antigp43 elicitada por Pb2, Pb3 e Pb4 foi rica em IgG2a, IgG2b e IgG3, sugerindo uma tendência a resposta tipo Th1 (com IgG2a>IgG2b>IgG3). Esse resultado foi de acordo com uma maior presença de INF e menos IL-10 nos animais inoculados com Pb3. Os outros isolados provocaram doença progressiva e maior produção de anticorpos IgG1 e IgA, característicos de resposta Th2...

Avaliação do consumo alimentar de vitamina A de crianças assistidas em creches comunitárias, Teresina (PI), Brasil / Dietary assessment of vitamin A of the children attended at day care community, Teresina (PI), Brazil

Este trabalho teve o objetivo de avaliar a adequação de vitamina A nas refeições oferecidas em creches comunitárias do município de Teresina, identificando-se também os principais alimentos fontes da vitamina consumidos pelas crianças na creche e no domicílio. Os dados foram coletados entre 1997/1998, pelo método da pesagem direta dos alimentos e por meio do questionário de freqüência de consumo alimentar de vitamina A. O consumo diário de alimentos fontes de vitamina A foi baixo, não alcançando 50 por cento do recomendado. Verificou-se uma baixa freqüência de consumo de vegetais fontes de vitamina A na alimentação destas crianças, sendo a presença de preconceitos alimentares um fator que dificulta o acesso da criança ao consumo alimentar da vitamina...

Ciclo de vida e motivaçöes financeiras (com especial atençäo aos idosos brasileiros) / Life cicle and financial motivations (with special attention to Brazilian old-aged)

Tem como objetivo descrever o processo de acumulação e desacumulação de riqueza financeira ao longo do ciclo de vida. Dá especial ênfase à demanda de ativos por parte dos idosos brasileiros. Faz uma resenha da literatura sobre as motivações para a demanda de ativos ao longo prazo das unidades familiares. Busca avaliar empiricamente a relevância dessas motivações no contexto brasileiro.