Life cycle phases: Literature review and new classification proposal for application in healthcare

ABSTRACT Introduction: Although uncommon in dentistry, the concept of the life cycle holds great importance for dental professionals in identifying crucial intervention opportunities and determining the optimal timing for treatments and procedures. Objective: To carry out a review of the literature on life cycle classifications and their distinct phases, evaluating their applicability in healthcare. Methods: A literature review was performed, searching for articles in PubMed, SciELO, National Health Library (BvB), and Google Scholar databases, as well as relevant books. The keywords "life cycle," "life stages," "human development," "age groups," and "biological age" were used. Relevant articles were selected by analyzing their titles and abstracts, and read in full to confirm their inclusion in the research. Results: Nine distinct life cycle classifications were found, each with unique criteria. Conclusion: Based on the comprehensive literature review, a novel classification was proposed (The 10-phase Life Cycle), which encompasses dental, growth, physiological aging, sociocultural, and behavioral characteristics, aiming to enhance communication among healthcare professionals, particularly those engaged in the growth, development, and aging processes of human beings.

RESUMO Introdução: Embora incomum na Odontologia, o conceito de ciclo vital é de grande importância para ajudar os profissionais dessa área a identificar oportunidades cruciais para intervenções e para determinar o momento ideal para tratamentos e procedimentos. Objetivo: Realizar uma revisão da literatura sobre as classificações do ciclo vital e suas distintas fases, avaliando sua aplicabilidade na área da saúde. Métodos: Foi realizada uma revisão da literatura, buscando artigos nas bases de dados PubMed, SciELO, Biblioteca Nacional de Saúde (BvB) e Google Acadêmico; além de livros relevantes. Foram utilizadas as palavras-chave "ciclo vital", "estágios de vida", "desenvolvimento humano", "faixas etárias" e "idade biológica". Os artigos relevantes foram selecionados por meio da análise de seus títulos e resumos e lidos na íntegra para confirmar sua inclusão na pesquisa. Resultados: Nove classificações distintas de ciclo vital foram encontradas, cada uma com critérios únicos. Conclusão: Com base nessa revisão abrangente da literatura, é proposta uma nova classificação (o ciclo vital de 10 fases) que engloba características dentárias, de crescimento, envelhecimento fisiológico, socioculturais e comportamentais, com o objetivo de melhorar a comunicação entre os profissionais da área de saúde, particularmente aqueles envolvidos nos processos de crescimento, desenvolvimento e envelhecimento do ser humano.

Discovery of new Schistosoma mansoni aspartyl protease inhibitors by structure-based virtual screening

BACKGROUND Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma, with a limited treatment, mainly based on the use of praziquantel (PZQ). Currently, several aspartic proteases genes have already been identified within the genome of Schistosoma species. At least one enzyme encoded from this gene family (SmAP), named SmCD1, has been validated for the development of schistosomicidal drugs, since it has a key role in haemoglobin digestion by worms. OBJECTIVE In this work, we integrated a structure-based virtual screening campaign, enzymatic assays and adult worms ex vivo experiments aiming to discover the first classes of SmCD1 inhibitors. METHODS Initially, the 3D-structures of SmCD1, SmCD2 and SmCD3 were generated using homology modelling approach. Using these models, we prioritised 50 compounds from 20,000 compounds from ChemBridge database for further testing in adult worm aqueous extract (AWAE) and recombinant SmCD1 using enzymatic assays. FINDINGS Seven compounds were confirmed as hits and among them, two compounds representing new chemical scaffolds, named 5 and 19, had IC50 values against SmCD1 close to 100 μM while presenting binding efficiency indexes comparable to or even higher than pepstatin, a classical tight-binding peptide inhibitor of aspartyl proteases. Upon activity comparison against mammalian enzymes, compound 50 was selective and the most potent against the AWAE aspartic protease activity (IC50 = 77.7 μM). Combination of computational and experimental results indicate that compound 50 is a selective inhibitor of SmCD2. Compounds 5, 19 and 50 tested at low concentrations (10 uM) were neither cytotoxic against WSS-1 cells (48 h) nor could kill adult worms ex-vivo, although compounds 5 and 50 presented a slight decrease on female worms motility on late incubations times (48 or 72 h). MAIN CONCLUSION Overall, the inhibitors identified in this work represent promising hits for further hit-to-lead optimisation.

External apical root resorption after orthodontic treatment: analysis in different chronological periods

ABSTRACT Introduction: External apical root resorption (EARR) is characterized by the definitive loss of tooth root structure, with a higher incidence in lateral and central maxillary incisors. Objective: To identify, in different chronological periods, the incidence of EARR in the maxillary incisors (MI) of patients orthodontically treated with or without premolars extraction. Methods: Periapical radiographs before and after orthodontic treatment of 1,304 MIs from 326 patients (205 women and 121 men) were evaluated for EARR, divided into five groups, according to the chronological period in which treatments were started: G90) from 1990 to 1994, G95) from 1995 to 1999, G00) from 2000 to 2004, G05) from 2005 to 2009, G10) from 2010 to 2015. The evaluation was performed in each group, in patients who underwent maxillary first premolars extraction and those who did not. For statistical analysis, Fisher's exact test was used, with a significance level of p < 0.05. The EARR was measured using the adapted Levander and Malmgren classification. Results: Incidence of EARR was higher in MIs of patients treated with maxillary premolar extraction (p < 0.05) in two chronological periods (G00 and G10), also being influenced by orthodontic treatments with longer duration, and due to possible individual genetic factors. Conclusion: Even with the limitations of a retrospective study, the lack of a defined EARR pattern in the MIs at different chronological periods was larger in the experimental group, due to the sum of factors such as premolars extraction, prolonged orthodontic treatment, possible genetic characteristics, and root shape, without the influence of the sex and age.

RESUMO Introdução: A reabsorção radicular apical externa (RRAE) é caracterizada pela perda definitiva da estrutura dentária na região radicular, com maior incidência em incisivos centrais e laterais superiores. Objetivo: Identificar, em diferentes períodos cronológicos, a incidência de RRAE em incisivos superiores (IS) de pacientes tratados ortodonticamente com e sem extração de pré-molares. Métodos: Por meio de radiografias periapicais antes e após o tratamento ortodôntico, 1.304 IS de 326 pacientes (205 mulheres e 121 homens) foram avaliados quanto à RRAE, divididos em cinco grupos, de acordo com o período cronológico em que os tratamentos foram iniciados: G90) de 1990 a 1994; G95) de 1995 a 1999; G00) de 2000 a 2004; G05) de 2005 a 2009; e G10) de 2010 a 2015. Em cada grupo, foi realizada avaliação nos pacientes submetidos à extração dos primeiros pré-molares superiores e nos que não foram. Para análise estatística, foi utilizado o teste exato de Fisher, com p< 0,05; a RRAE foi mensurada por meio da classificação de Levander e Malmgren modificada. Resultados: A incidência da RRAE foi maior em IS de pacientes tratados com extrações de pré-molares (p< 0,05) em dois períodos cronológicos (G00 e G10), além de ter sido influenciada por tratamentos ortodônticos de maior duração e por possíveis fatores genéticos individuais. Conclusão: Mesmo com as limitações de um estudo retrospectivo, a ausência de um padrão definido de RRAE nos IS nos diferentes períodos cronológicos foi maior no grupo experimental, devido à soma de fatores, como extração de pré-molares, tratamento ortodôntico prolongado, possíveis características genéticas e morfologia radicular, sem influência do sexo e da idade.

Competências para a gestão de um repositório institucional: o caso do repositório institucional da Universidade de Coimbra / Competencies for institutional repositories management: the case of the institutional repository of the University of Coimbra / Competencias para la gestión de repositorios institucionales: el caso del repositorio institucional de la Universidad de Coimbra

É num cenário de abertura crescente da ciência, mais amplo e complexo, que se impõem novas competências aos gestores de repositórios. Este estudo visa identificar os papéis e as competências necessárias à gestão e organização de um repositório institucional. Trata-se de um estudo qualitativo com observação participante, suportado pela revisão da literatura, que permitiu refletir sobre o papel dos gestores de repositórios e as competências que devem reunir no âmbito da ciência aberta, tendo como estudo de caso o Estudo Geral, o repositório institucional da Universidade de Coimbra. Embora as funções de um gestor de repositório tenham origem no campo da Ciência da Informação, o conjunto de competências a reunir é amplo e interdisciplinar, destacando-se aquelas ao nível da comunicação científica, das tecnologias digitais, da gestão e da comunicação, da técnica e da gestão de conteúdos.

A scenario of increasing openness of science, which is broader and more complex, requires new competencies of repository managers. This study aims to identify the roles and competencies necessary for the management and organization of an institutional repository. It is a qualitative study with participant observation, supported by the literature review, which allowed us to reflect on the role of repository managers and the skills they must gather in the context of open science, having as a case study the General Study, the repository of the University of Coimbra. Although the functions of a repository manager originate in the field of Information Science, the set of skills to be gathered is broad and interdisciplinary, highlighting the skills in terms of scientific communication, digital technologies, management and communication, technical and content management.

Es en un escenario de creciente apertura de la ciencia, más amplio y complejo, donde se imponen nuevas competencias de los gestores de repositorios. Este estudio tiene como objetivo identificar los roles y competencias necesarios para la gestión y organización de un repositorio institucional. Se trata de un estudio etnográfico, sustentado en la revisión de la literatura, que permitió reflexionar sobre el rol de los gestores de repositorios y las habilidades que deben reunir en el contexto de la ciencia abierta, teniendo como caso de estudio el Estudio General, el repositorio institucional de la Universidad de Coimbra. Si bien las funciones de un gestor de repositorios se originan en el ámbito de la Ciencia de Información, el conjunto de competencias a recopilar es amplio e interdisciplinario, destacando las competencias en materia de comunicación científica, tecnologías digitales, gestión y comunicación, técnica y de gestión de contenidos.

Stereological and morphological analysis of the effects of aging on spermatogenesis in rat testis

Abstract Purpose: To quantify, through stereological and morphometric analysis, spermatogenesis in rats undergoing the natural aging process. Methods: Seventy-two male Wistar rats were divided into 6 equal groups according to age at the time of killing: 3, 6, 9, 12, 18, and 24 months. All the rats were subjected orchiectomy and collection of testicular parenchymal fragments for histological and morphometric analysis. The numerical density of spermatids was calculated using a stereological study, and morphometric analysis was conducted to measure the height of the germinal epithelium and the area of the seminiferous tubules. Results: We found that the 18 and 24 months groups showed a significant reduction in the number of round spermatids. However, the height of the germinal epithelium was not significantly different between the groups. The area of seminiferous tubules was also significantly reduced in the elderly rats compared to that in the young ones. Conclusion: Aging of rats showed a significant reduction in the number of round spermatids and the area of the seminiferous tubules, more pronounced in the rats at 18 and 24 months of life.

In silico repositioning of new drugs against Schistosoma mansoni

Schistosomiasis is a neglected tropical disease caused by parasites of the genus Schistosoma. In Brazil only Schistosoma mansoni causes this disease. The World Health Organization estimated in 2012 approximately 249 million people at risk of acquiring this disease around the world. The main strategy to control this disease is praziquantel treatment of individuals living in endemic areas. The drug praziquantel is used on a large scale in the treatment of schistosomiasis and currently there are reported cases of resistance, indicating the need to discover new drugs. In silico drug repositioning is a time and cost reducing strategy in the search for anti-Schistosoma agents. This work used bioinformatic tools to identify potential schistosomicidal drugs. A list was compiled of S. mansoni potential targets that are part of essential processes in the database TDR and the targets that are part of the tegument were obtained in the scientific literature. The file with S. mansoni targets contained 1,376 targets, and of these only 61 targets associated with 399 drugs had homology with drug targets. After removal of duplicate drugs, drugs found in previous studies and after the analysis of the conservation of the binding site, only 28 S. mansoni targets associated with 102 drugs had 60% or more of the active site conserved. Some of the drugs had activity and are interesting to validate this study such as: artemether, lumefantrine, meloxicam. Among the drugs found 18 drugs were selected to be tested in prospective experimental assays according to the following criteria: low toxicity in vivo, off-patent status, and logP <5.0.

Synthesis and molecular modelling studies of pyrimidinones and pyrrolo[34-d]-pyrimidinodiones as new antiplasmodial compounds

BACKGROUND Malaria is responsible for 429,000 deaths per year worldwide, and more than 200 million cases were reported in 2015. Increasing parasite resistance has imposed restrictions to the currently available antimalarial drugs. Thus, the search for new, effective and safe antimalarial drugs is crucial. Heterocyclic compounds, such as dihydropyrimidinones (DHPM), synthesised via the Biginelli multicomponent reaction, as well as bicyclic compounds synthesised from DHPMs, have emerged as potential antimalarial candidates in the last few years. METHODS Thirty compounds were synthesised employing the Biginelli multicomponent reaction and subsequent one-pot substitution/cyclisation protocol; the compounds were then evaluated in vitro against chloroquine-resistant Plasmodium falciparum parasites (W2 strain). Drug cytotoxicity in baseline kidney African Green Monkey cells (BGM) was also evaluated. The most active in vitro compounds were evaluated against P. berghei parasites in mice. Additionally, we performed an in silico target fishing approach with the most active compounds, aiming to shed some light into the mechanism at a molecular level. RESULTS The synthetic route chosen was effective, leading to products with high purity and yields ranging from 10-84%. Three out of the 30 compounds tested were identified as active against the parasite and presented low toxicity. The in silico study suggested that among all the molecular targets identified by our target fishing approach, Protein Kinase 3 (PK5) and Glycogen Synthase Kinase 3β (GSK-3β) are the most likely molecular targets for the synthesised compounds. CONCLUSIONS We were able to easily obtain a collection of heterocyclic compounds with in vitro anti-P. falciparum activity that can be used as scaffolds for the design and development of new antiplasmodial drugs.

Computational drug discovery for the Zika virus

Few Zika virus (ZIKV) outbreaks had been reported since its first detection in 1947, until the recent epidemics occurred in South America (2014/2015) and expeditiously became a global public health emergency. This arbovirus reached 0.5-1.3 million cases of ZIKV infection in Brazil in 2015 and rapidly spread in new geographic areas such as the Americas. Despite the mild symptoms of the Zika fever, the major concern is related to the related severe neurological disorders, especially microcephaly in newborns. Advances in ZIKV drug discovery have been made recently and constitute promising approaches to ZIKV treatment. In this review, we summarize current computational drug discovery efforts and their applicability to discovery of anti-ZIKV drugs. Lastly, we present successful examples of the use of computational approaches to ZIKV drug discovery.

Efficacy of sertraline against Trypanosoma cruzi: an in vitro and in silico study

Drug repurposing has been an interesting and cost-effective approach, especially for neglected diseases, such as Chagas disease. Methods: In this work, we studied the activity of the antidepressant drug sertraline against Trypanosoma cruzi trypomastigotes and intracellular amastigotes of the Y and Tulahuen strains, and investigated its action mode using cell biology and in silico approaches. Results: Sertraline demonstrated in vitro efficacy against intracellular amastigotes of both T. cruzi strains inside different host cells, including cardiomyocytes, with IC50 values between 1 to 10 µM, and activity against bloodstream trypomastigotes, with IC50 of 14 µM. Considering the mammalian cytotoxicity, the drug resulted in a selectivity index of 17.8. Sertraline induced a change in the mitochondrial integrity of T. cruzi, resulting in a decrease in ATP levels, but not affecting reactive oxygen levels or plasma membrane permeability. In silico approaches using chemogenomic target fishing, homology modeling and molecular docking suggested the enzyme isocitrate dehydrogenase 2 of T. cruzi (TcIDH2) as a potential target for sertraline. Conclusions: The present study demonstrated that sertraline had a lethal effect on different forms and strains of T. cruzi, by affecting the bioenergetic metabolism of the parasite. These findings provide a starting point for future experimental assays and may contribute to the development of new compounds.(AU)

Numeric and volumetric changes in Leydig cells during aging of rats

Abstract Purpose: To analyze the effects of aging in rats on the nuclear volume, cytoplasmic volume, and total volume of Leydig cells, as well as their number. Methods: Seventy-two Wistar rats were divided into six subgroups of 12 rats, which underwent right orchiectomy at 3, 6, 9, 12, 18, and 24 months of age. The weight and volume of the resected testicles were assessed. A stereological study of Leydig cells was conducted, which included measurements of cell number and nuclear, cytoplasmic, and total cell volumes. Results: The weight and volume of the resected testicles showed reductions with age. Only the subgroup composed of 24-month old rats showed a decrease in the nuclear volume of Leydig cells. Significant reductions in the cytoplasmic volume and total volume of Leydig cells were observed in 18- and 24-month old rats. The number of Leydig cells did not vary significantly with age. Conclusions: Aging in rats resulted in reduction of the nuclear, cytoplasmic, and total cell volumes of Leydig cells. There was no change in the total number of these cells during aging.

Análise da presença de Helicobacter pylori na secreção da cavidade peritoneal de pacientes com úlcera péptica perfurada admitidos em um hospital terciário / Analysis of the presence of Helicobacter pylori in the secretion of the peritoneal cavity of patients with peptic ulcer perforated admitted in a tertiary hospital

Objetivo: avaliar presença de Helicobacter pylori na secreção peritoneal e no tubo digestivo dos pacientes com úlcera péptica perfurada utilizando teste rápido de urease. Métodos: realizou-se estudo prospectivo, transversal, descritivo, em que se avaliou pacientes atendidos no Setor de Emergência do Hospital Regional Homero de Miranda Gomes de São José (HRHMG), entre fevereiro de 2009 e julho de 2010, portadores de UPP. Coletaram-se, no transoperatório, duas amostras de líquido peritoneal (na proximidade do orifício da úlcera) e outras duas amostras de líquido da cavidade digestiva, uma de cada local sendo encaminhada para cultura e outra injetada em frascos com solução de urease préformada (TUPF). Coletado sorologia para Helicobacter pylori. Resultados: no período do estudo, 14 pacientes foram analisados. A idade média foi de 41,06 anos (DP=13,1). Predominaram pacientes homens (100%), brancos (71,4%), tabagistas (57,2%), IMC < 30 (85,7%), com história prévia de dispepsia (78,6%). O tempo de peritonite pré-operatória foi menor que 24 horas em 85,6% dos casos e o tratamento realizado foi fechamento primário da perfuração com omentoplastia pediculada em todos os pacientes. A sorologia para Helicobacter pylori foi positiva em 84,6% dos pacientes analisados. O TUPF foi positivo em 78,6% das amostras do tubo digestivo e em 42,8% das amostras da cavidade peritoneal. Com relação a estes testes rápidos, 41,6% apresentaram positividade tanto para a amostra do peritônio, quanto para a gástrica/ duodenal, 50% positivaram exclusivamente na amostra da cavidade digestiva e 8,4% exclusivamente na cavidade peritoneal. Dos 11 pacientes que apresentaram sorologia positiva para Helicobacter pylori, 100% apresentaram o TUPF positivo em pelo menos um dos sítios pesquisados. Conclusão: a presença do Helicobacter pylori pode ser avaliada pela realização do teste rápido da urease do fluido coletado em, pelo menos, dois sítios (cavidade peritoneal e cavidade gástrica/duodenal), com igual significância entre os dois métodos. Necessitam maiores estudos para validação deste método.

Objective: to evaluate the presence of Helicobacter pylori in peritoneal secretion and digestive tract of patients with perforated peptic ulcer using urease rapid test d. Methods: we conducted a prospective, cross-sectional, descriptive, which we assessed patients treated at the Emergency Unit of the Hospital Regional de Miranda Gomes Homer of St. Joseph (HRHMG) between February 2009 and July 2010, holders of UPP. Was collected, during surgery, two samples of peritoneal fluid (in the vicinity of the orifice of ulcer) and two samples of fluid from the digestive cavity, one for each location being routed to another culture and injected into vials with a solution of preformed urease (TUPF). Hp collected for serology. Results: during the study period, 14 patients were analyzed. the old me was 41.06 years (SD = 13.1). Most patients were men (100%), white (71.4%), smokers (57.2%), BMI <30 (85.7%), with a history of dyspepsia (78.6%). The time of peritonitis preoperative was less than 24 hours in 85.6% of cases and treatment was fechamendo primary drilling omentoplasty flap from all patients. The H. pylori serology was positive in 84.6% of patients analyzed. The TUPF was positive in 78.6% of the samples of the digestive tract and 42.8% of the samples of the peritoneal cavity. With regard to these rapid tests, 41.6% were positive for both the sample of the peritoneum, as for gastric / duodenal, 50% of the sample only positivaram digestive cavity and only 8.4% in the peritoneal cavity. Of the 11 patients with positive serology for Hp, 100% presented TUPF positive in at least one of the sites surveyed. Conclusion: the presence of Hp can be assessed through the rapid urease test fluid collected in at least two sites (peritoneal cavity and cavity gastric / duodenal), with equal significance between the two methods. Require larger studies to validate this method.

Análise epidemiológica e emprego do teste rápido da urease em pacientes com úlcera péptica perfurada / Epidemiological analysis and use of rapid urease test in patients with perforated peptic ulcers

OBJETIVO: Analisar o perfil epidemiológico de pacientes com úlcera péptica gastroduodenal perfurada e verificar se a presença do H. pylori nas secreções peritoneais e intraluminais desses pacientes pode ser avaliada pelo teste rápido da urease. MÉTODOS: Realizou-se estudo prospectivo, transversal, descritivo, com dados de pacientes atendidos em um hospital de abrangência regional, em portadores de úlcera péptica perfurada. Coletou-se, no transoperatório, amostras de líquido peritoneal (na proximidade da perfuração) e da secreção intraluminal, sendo encaminhadas para cultura e teste rápido de urease. RESULTADOS: Quatorze pacientes foram analisados. A média etária foi 41,06 anos, todos homens, brancos (71,4%), tabagistas (57,2%), IMC < 30 (85,7%), com história prévia de dispepsia (78,6%). Sorologia para H. pylori foi positiva em 84,6% dos casos. O teste rápido da urease foi positivo em 78,6% das amostras do tubo digestivo e em 42,8% das amostras da cavidade peritoneal; 41,6% foram positivos em ambos os locais, 50% somente na cavidade digestiva e 8,4% exclusivamente na cavidade peritoneal. Dos 11 pacientes com sorologia positiva para H. pylori 100% apresentaram positividade em pelo menos um dos sítios pesquisados. CONCLUSÃO: Verificou-se que a incidência foi menor que a esperada. Há associação significativa entre a infecção pelo H. pylori e a ocorrência de perfuração. A presença deste patógeno pode ser avaliada tanto pela sorologia quanto pela realização do teste rápido da urease do fluido coletado na cavidade peritoneal e na luz gástrica/duodenal.

OBJECTIVE: To analyze the epidemiological profile of patients with gastroduodenal ulcer perforation and verify if the presence of H. pylori in the peritoneal and intraluminal secretions of these patients can be assessed by rapid urease test. METHODS: We conducted a prospective, descriptive, cross-sectional study with data from patients in a hospital at a regional level, in patients with peptic ulcer. During surgery, we collected peritoneal fluid samples (in the vicinity of the perforation) and intraluminal secretion, sending them for culture and rapid urease test. RESULTS: Fourteen patients were analyzed. The average age was 41.06 years, all men, Whites (71.4%), smokers (57.2%), BMI <30 (85.7%), with a history of dyspepsia (78.6%). Serology for H. pylori was positive in 84.6% of cases. The rapid urease test was positive in 78.6% of the samples of the digestive tract and 42.8% of samples from the peritoneal cavity; 41.6% were positive at both sites, 50% only in the digestive cavity and 8.4% only in the peritoneal cavity. Of the 11 patients with positive serology for H. pylori, 100% were positive in at least one of the sites surveyed. CONCLUSION: It was found that the incidence was lower than expected. There is significant association between infection with H. pylori and the occurrence of perforation. The presence of this pathogen can be assessed both by serology and by the realization of the rapid urease test from fluid collected in the peritoneal cavity and the gastric / duodenal lumen.

Laparoscopia no tratamento do ureter retrocava: relato de caso e revisão da literatura / Laparoscopy in the treatment of retrocaval ureter: a case report and literature review

É apresentado um caso de ureter retrocava em paciente com queixa de dor lombar à direita, tratada após confirmação por tomografia computadorizada de abdome com contraste intravenoso com transposição do ureter direito (ureteroplastia) associada à implantação de cateter duplo J. sem intercorrências. Dessa forma, enfatiza-se a importância dessa malformação como uma das causas de uropatia obstrutiva e o uso de métodos de imagem para diagnosticá-la.

Tumor adenomatoide epididimário: relato de dois casos e revisão da literatura / Adenomatoid tumor of the epididimys: report a two cases and review the literature

Tumores adenomatóides são tumores mesoteliais benignos geralmente encontrados nas estruturas paratesticulares. Relatamos dois casos de tumor adenomatoide no epididímo. Revisamos a literatura sobre tumores epididimários, suas apresentações, métodos e diagn´soticos e tratamento.

Cited Brazilian papers in general surgery between 1970 and 2009

OBJECTIVES: To identify the most cited articles in general surgery published by Brazilian authors. INTRODUCTION: There are several ways for the international community to recognize the quality of a scientific article. Although controversial, the most widely used and reliable methodology to identify the importance of an article is citation analysis. METHODS: A search using the Institute for Scientific Information citation database (Science Citation Index Expanded) was performed to identify highly cited Brazilian papers published in twenty-six highly cited general surgery journals, selected based on their elevated impact factors, from 1970 to 2009. Further analysis was done on the 65 most-cited papers. RESULTS: We identified 1,713 Brazilian articles, from which nine papers emerged as classics (more than 100 citations received). For the Brazilian contributions, a total increase of about 21-fold was evident between 1970 and 2009. Although several topics were covered, articles covering trauma, oncology and organ transplantation were the most cited. The majority of classic studies were done with international cooperation. CONCLUSIONS: This study identified the most influential Brazilian articles published in internationally renowned general surgery journals.

Controle de danos após trauma torácico contuso com lesão cardíaca em criança - relato de caso / damage control after abdominal trauma

O objetivo é descrever o caso de um traumatismo torácico contuso que cursou com grave lesão da artériapulmonar, tipo laceração, que conduziu o paciente ao choque hipovolêmico refratário às medidas de suporte,sendo adotado o controle de danos torácicos. A cirurgia de controle de danos tem sido muito difundida na literatura que aborda trauma, especialmente quando se trata detrauma abdominal. Entretanto, esse relato pretende demonstrar que também é possível adotar a cirurgia de controle de danos quando se aborda um traumatismo torácico grave em pacientes com pouca reserva fisiológica.

The objective is to describe a case of blunt chest trauma causing severe laceration-type injury in the pulmonary artery, which led the patient to developrefractory hypovolemic shock to the support measures, with the adoption of chest damage control. Damage control surgery has been quite spread in the literature on trauma, especially when dealing with abdominal trauma.Nevertheless, this report is aimed to demonstrate that it is also possible to adopt damage control surgery whentreating severe chest trauma in patients with reduced physiological reserve.

III Fórum Nacional da SBACV: conduta frente ao paciente com claudicaçäo intermitente / The issue of the SBACV 3rd Forum was Intermittent Claudication: the Forum was held in 11 state chapters; of the SBACV, and its conclusions are presented herein

Este artigo apresenta os resultados do III Fórum da SBACV. obtidos através da síntise de discussões realizadas em 11 regionais.As principais conclusões foram: 1-Após avaliaçäo clínica completa, as principais medidas terapêuticas que devem ser adotadas no paciente claudicante säo a intervensäo nos fatores de risco à aterosclerose, combate ao tabagismo, e o incentivo à prática do exercício físico.2-O uso de drogas deve ser considerado uma forma coadjuvante e unuca um tratamento substitutivo ao exercício físico e ao abandono do fumo.3-Como critérios para o acompanhamento da resposta ao tratamento clínico do paciente claudicante foram estabelecidos: avaliaçäo clínica e através de exames laboratoriais, distãncia de marcha, determinaçäo de índices pressóricos com o dopper.4-A ineficácia do tratamento clínico e a claudicaçäo incapacitante foram consenso como indicações para revascularizaçäo...

Angiocardiografia com radionuclídios: método de primeira passagem sincronizada com o ECG, em repouso e com esforço. Parâmetros da normalidade, indicaçöes, critérios para interpretaçäo e diagnóstico da doença arterial coronariana (DAC) / Radionuclide ventriculography: first pass methodology in rest and after stress. Physiological parameters and criteria for diagnosis of coronary artery disease

De 254 pacientes estudados, foram selecionados 39 normais levando em consideraçäo a história e o exame clínico, o ECG e o teste ergométrico e evoluçäo clínica posterior. Vinte e nove eram do sexo masculino e 10 do sexo feminino. A média de idade foi de 45 anos, com variaçäo de 29 a 60 anos. Através da angiocardiografia isotópica após esforço (ARE) desse grupo de controle determinaram-se os padröes normais qualitativos, como movimentos de paredes, perímetros cardíacos, imagens de amplitude, paradoxo e fase, e os seguintes parâmetros quantitiativos: fraçöes de ejeçäo global e regionais, débito cardíaco, volume sistólico, volume diastólico final, taxa de ejeçäo, tempo de ejeçäo e tempo de circulaçäo pulmonar. As indicaçöes da ARE, os parâmetros fisiológicos e os critérios para a interpretaçäo de um exame normal, bem como critérios para considerar a ARE diagnóstica da coronariopatia isquêmica säo considerados. Os restantes 215 pacientes apresentaram clínica e testes com resultados compatíveis com doença cardíaca, se comparados com o desempenho do grupo controle. Os autores finalmente enfatizam o papel da ARE no diagnóstico da cardiopatia isquêmica coronariana