A pioneering RET genetic screening study in the State of Ceará, Brazil, evaluating patients with medullary thyroid cancer and at-risk relatives: experience with 247 individuals

ABSTRACT Objective: Initial diagnosis of medullary thyroid carcinoma (MTC) is frequently associated with advanced stages and a poor prognosis. Thus, the need for earlier diagnoses and detection in relatives at risk for the disease has led to increased use of RET genetic screening. Subjects and methods: We performed RET screening in 247 subjects who were referred to the Brazilian Research Consortium for Multiple Endocrine Neoplasia (BRASMEN) Center in the State of Ceará. Direct genetic sequencing was used to analyze exons 8, 10, 11, and 13-16 in MTC index cases and specific exons in at risk relatives. Afterward, clinical follow-up was offered to all the patients with MTC and their affected relatives. Results: RET screening was performed in 60 MTC index patients and 187 at-risk family members. At the initial clinical assessment of the index patients, 54 (90%) were diagnosed with apparently sporadic disease and 6 (10%) diagnosed with hereditary disease. After RET screening, we found that 31 (52%) index patients had sporadic disease, and 29 (48%) had hereditary disease. Regarding at-risk relatives, 73/187 were mutation carriers. Mutations in RET codon 804 and the rare p.M918V mutation were the most prevalent. Conclusions: Performing RET screening in Ceará allowed us to identify a different mutation profile in this region compared with other areas. RET screening also enabled the diagnosis of a significant number of hereditary MTC patients who were initially classified as sporadic disease patients and benefited their relatives, who were unaware of the risks and the consequences of bearing a RET mutation.

Exercise training program based on minimum weekly frequencies: effects on blood pressure and physical fitness in elderly hypertensive patients / Programa de exercícios físicos baseado em frequência semanal mínima: efeitos na pressão arterial e aptidão física em idosos hipertensos

BACKGROUND: Exercise training (ET) can reduce blood pressure (BP) and prevent functional disability. However, the effects of low volumes of training have been poorly studied, especially in elderly hypertensive patients. OBJECTIVES: To investigate the effects of a multi-component ET program (aerobic training, strength, flexibility, and balance) on BP, physical fitness, and functional ability of elderly hypertensive patients. METHODS: Thirty-six elderly hypertensive patients with optimal clinical treatment underwent a multi-component ET program: two 60-minute sessions a week for 12 weeks at a Basic Health Unit. RESULTS: Compared to pre-training values, systolic and diastolic BP were reduced by 3.6% and 1.2%, respectively (p<0.001), body mass index was reduced by 1.1% (p<0.001), and peripheral blood glucose was reduced by 2.5% (p=0.002). There were improvements in all physical fitness domains: muscle strength (chair-stand test and elbow flexor test; p<0.001), static balance test (unipedal stance test; p<0.029), aerobic capacity (stationary gait test; p<0.001), except for flexibility (sit and reach test). Moreover, there was a reduction in the time required to perform two functional ability tests: "put on sock" and "sit down, stand up, and move around the house" (p<0.001). CONCLUSIONS: Lower volumes of ET improved BP, metabolic parameters, and physical fitness and reflected in the functional ability of elderly hypertensive patients. Trial Registration RBR-2xgjh3.

CONTEXTUALIZAÇÃO: O treinamento físico (TF) é capaz de reduzir a pressão arterial (PA) e prevenir o declínio da capacidade funcional. Entretanto, pouco tem sido estudado sobre os efeitos de menores volumes de treinamento em idosos com hipertensão arterial (HA). OBJETIVOS: Investigar os efeitos de um programa de TF multicomponente (treinamento aeróbico, força, flexibilidade e equilíbrio) na PA, aptidão física e capacidade funcional de idosos com HA. MÉTODOS: Trinta e seis idosos com HA e tratamento clínico otimizado foram submetidos a um programa de exercícios físicos multicomponente, com duas sessões semanais de 60 minutos cada, durante 12 semanas, em uma Unidade Básica de Saúde (UBS). RESULTADOS: Comparados aos valores antes do TF, observou-se redução de 3,6% da PA sistólica (p<0,001), de 1,2% da PA diastólica (p<0,001), de 1,1% do índice de massa corporal (IMC) (p<0,001) e de 2,5% da glicemia periférica em jejum (p=0,002). Observou-se melhora em todos os domínios da aptidão física, como força muscular (testes de levantar da cadeira e flexão de cotovelos, p<0,001); equilíbrio estático (teste de apoio unipodal, p=0,029), capacidade aeróbica (teste de marcha estacionária, p<0,001), com exceção da flexibilidade (teste de sentar e alcançar). Além disso, houve redução no tempo utilizado para realização de dois testes de avaliação da capacidade funcional, o de "calçar meias" e o de "sentar, levantar-se da cadeira e locomover-se pela casa" (p<0,001). CONCLUSÕES: O TF com duas sessões semanais em idosos hipertensos repercutiu na melhora dos indicadores metabólicos, da aptidão física e da capacidade funcional e atuou como auxiliar no controle da PA. Registro de Ensaios Clínicos RBR-2xgjh3.

Características morfológicas da casca do ovo de avestruz / Morphologicals characteristics of the ostrich eggshell

A análise morfológica da casca do ovo da avestruz é importante, pois diversos fatores morfológicos podem estar relacionados com a eclodibilidade do ovo desta espécie no Brasil. Para tanto foram analisadas 60 amostras de ovos aparentemente normais (ovos eclodidos e com morte embrionária). Foram efetuadas observações que permitiram estabelecer: a espessura média da casca do ovo, a porosidade da casca destes ovos, e correlacionar estas variáveis com a eclodibilidade. Os resultados foram analisados estatisticamente mediante o teste de Duncan, o que mostrou que ovos com menor porosidade tem também uma menor eclodibilidade. A porosidade média dos ovos eclodidos é de 19,87 poros/cm², e dos ovos com morte embrionária é de 16,78 poros/cm². Não houve diferença estatística entre a espessura da casca nas regiões estudada, nem interação entre viabilidade e as regiões.

Morphological analysis of the ostrich eggshell is important because several factors can be related to morphological hatchability of eggs of this species in Brazil. Therefore, 60 samples of apparently normal eggs were analyzed (eggs hatched and with embryonic death). The observations were allowed to establish that: the average thickness of the eggshell, the porosity of the shell of the eggs, and correlate these variables with hatchability. The results were statistically analyzed by Duncan's test, which showed that eggs with less porosity also have a lower hatchability. The average porosity of hatched eggs is 19.87 pores/cm², and of eggs with embryonic death is pores/cm2 16.78. There was no statistical difference between the thickness of the shell in the regions studied, no interaction between viability and the regions studied.

Diagnóstico nacional en materia de seguridad y salud en la agricultura / National agricultural and safe security diagnosis

Este documento contiene la siguiente información: datos generales: población económicamente activa, población masculina y femenina, menores trabajadores, población trabajadora y la seguridad social. Agroquímicos: pesticidas importados por año, plaguicidas prohibidos y de uso restringido y plaguicidas más utilizados. Marco institucional: programas de prevención y programas de capacitación. Acciones de otras instituciones, marco normativo, estadísticas de accidentes y enfermedades de trabajo: la situación actual, la siniestralidad, intoxicaciones por plaguicidas, enfermedades profesionales según tipo de actividad y intoxicaciones por plaguicidas