Targeting KRAS in Pancreatic Ductal Adenocarcinoma: The Long Road to Cure.

Pancreatic ductal adenocarcinoma (PDAC) remains an important cause of cancer-related mortality, and it is expected to play an even bigger part in cancer burden in the years to come. Despite concerted efforts from scientists and physicians, patients have experienced little improvement in survival over the past decades, possibly because of the non-specific nature of the tested treatment modalities. Recently, the discovery of potentially targetable molecular alterations has paved the way for the personalized treatment of PDAC. Indeed, the central piece in the molecular framework of PDAC is starting to be unveiled. KRAS mutations are seen in 90% of PDACs, and multiple studies have demonstrated their pivotal role in pancreatic carcinogenesis. Recent investigations have shed light on the differences in prognosis as well as therapeutic implications of the different KRAS mutations and disentangled the relationship between KRAS and effectors of downstream and parallel signaling pathways. Additionally, the recognition of other mechanisms involving KRAS-mediated pathogenesis, such as KRAS dosing and allelic imbalance, has contributed to broadening the current knowledge regarding this molecular alteration. Finally, KRAS G12C inhibitors have been recently tested in patients with pancreatic cancer with relative success, and inhibitors of KRAS harboring other mutations are under clinical development. These drugs currently represent a true hope for a meaningful leap forward in this dreadful disease.

Efficacy and Safety Associated With Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma: A Meta-analysis.

Importance: Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular carcinoma (HCC). The overall effect of ICIs compared with standard therapies in unresectable HCC requires more research. Objective: To estimate the efficacy and safety associated with ICIs compared with standard therapies in patients with unresectable HCC. Data Sources: PubMed, Cochrane Library, Web of Science, Latin American and Caribbean Health Sciences Literature, and American Society of Clinical Oncology and European Society of Medical Oncology meeting proceedings were systematically searched. Reference lists from studies selected by electronic searching were manually searched to identify additional relevant studies. The search included literature published or presented from February 2010 to February 2020. Study Selection: From December 2019 to February 2020, independent reviewers evaluated each database, scanning the title, abstract, and keywords of every record retrieved. Full articles were further assessed if the information given suggested that the study was a randomized clinical trial (RCT) comparing ICIs vs standard therapies in the treatment of unresectable HCC. Data Extraction and Synthesis: The full text of the resulting studies and extracted data were reviewed independently according to PRISMA guidelines. Summary hazard ratios (HRs) of overall survival (OS) and progression-free survival (PFS) were calculated by a random-effects model. The likelihood of ICIs being associated with overall response rate (ORR) and treatment-related adverse events (TRAEs) was expressed by odds ratios (ORs) using a random-effects model. Main Outcomes and Measures: The main outcomes were OS, PFS, ORR, and TRAEs. Results: Of 1836 studies yielded by the search, 3 were retained, totaling 1657 patients (985 treated with ICIs vs 672 receiving standard treatment). Two studies evaluated ICIs as monotherapy, and 1 study investigated the combination of ICIs with bevacizumab. Compared with standard therapies (sorafenib in first-line therapy or placebo in second-line therapy), ICIs were associated with significantly improved OS (HR, 0.75; 95% CI, 0.62-0.92; P = .006), PFS (HR, 0.74; 95% CI, 0.56-0.97; P = .03), and ORR (OR, 2.82; 95% CI 2.02-3.93; P < .001). The probability of grade 3 or 4 TRAEs was lower with ICIs than with sorafenib (OR, 0.44; 95% CI, 0.20-0.96; P = .04). Conclusions and Relevance: This meta-analysis found superior efficacy and safety associated with ICIs compared with standard therapies and highlights the survival benefit associated with the combination of antiangiogenic therapy with ICIs in first-line systemic therapy of unresectable HCC.

Emerging and Experimental Agents for Anal Cancer: What is New?

Squamous cell carcinoma of the anal canal (SCCA) is an HPV-related malignancy with rising incidence in the past few decades in the US, characterized by high rates of complete response to chemoradiotherapy with curative intent. However, in a long-term follow-up, a meaningful subgroup of patients with locally advanced disease presents disease recurrence, which demands treatments with high morbidity and important impact in the quality of life. In metastatic or unresectable disease, palliative chemotherapy is the standard of care, but it is still associated with a dismal prognosis. Novel agents are urgently needed in the systemic therapy of SCCA. From a translational standpoint, there are many hurdles to overcome, since PI3KCA mutation is the most frequent genetic abnormality and actionable mutations are rarely found in SCCA, as well as it is characterized by low tumor mutational burden and low rates of high-frequency microsatellite instability. But the latest studies of immunotherapeutic approaches have produced promising findings and this therapeutic strategy is the major path being followed in the ongoing clinical trials. The latest advances in the systemic therapy of SCCA have provided the framework for the conception of new clinical trials. Therefore, carboplatin plus paclitaxel have become the backbone for novel agents. Immune checkpoint inhibitors (ICIs), mainly anti-PD-1 monoclonal antibodies, such as retifanlimab, nivolumab, and atezolizumab have been studied in Phase III trials with chemotherapy in first-line therapy. Likewise, ICIs have been evaluated in locally advanced and refractory disease. Novel technologies, such as bispecific antibodies, and immunotherapeutic approaches, such as vaccines and adoptive T-cell therapies, have also been tested in ongoing clinical trials. Immunotherapy may bring practice-changing advances in the systemic therapy of SCCA in the next few years and it might play a larger role in the therapeutic management of this challenging disease.

LATE IMPACT OF THE LAPAROSCOPIC TREATMENT OF DEEP INFILTRATING ENDOMETRIOSIS WITH SEGMENTAL COLORECTAL RESECTION.

BACKGROUND: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. AIM: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. METHODS: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. RESULTS: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. CONCLUSION: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.

Solitary Fibrous Tumors of the Orbit and Central Nervous System: A Case Series Analysis.

INTRODUCTION: Solitary fibrous tumor (SFT) is rarely diagnosed in clinical practice. Since its initial descriptions in the central nervous system (CNS) and the orbits, very few case reports and small case series have expanded their clinical and pathological characterization. We sought to describe a cases series of SFT from a single laboratory of neuropathology belonging to a tertiary university hospital. METHODS: Retrospective clinical and histopathological description of eight cases of CNS and orbital SFT diagnosed over a 21-year period of time. RESULTS: Median age was 47.3 years and four were males. Clinical presentation was related to local mass effect in all. Tumors occurred in the orbits (5/62.5%), intracranial dura attached (2), and the spinal medulla (1). The neuropathology showed the presence of hemangiopericytoma type (2), classic type (3), and mixed type (3). Histological anaplasia was present in two cases. Widespread/total immunoreactivity for vimentin, CD34, and Bcl-2 was present in all. Gross total removal was conducted in the majority (6/75%) and subtotal removal in 2 (25%). Three patients were submitted to adjuvant treatment (radiosurgery and radiotherapy). Recurrence occurred in four patients, 13-120 months after surgical intervention. Anaplasia was present in one case of recurrence. CONCLUSION: Our case series confirms the clinical and neuropathological diversity of CNS and orbital SFTs. Studies with longer follow-up periods are necessary to better understand the clinical behavior and prognosis of the SFT in the CNS and orbits.

Late impact of the laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection / Impacto tardio do tratamento laparoscópico da endometriose profunda infiltrativa com ressecção segmentar colorretal

ABSTRACT Background: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. Aim: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. Methods: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. Results: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. Conclusion: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.

RESUMO Racional: A endometriose profunda infiltrativa colorretal pode impactar de maneira importante na qualidade de vida e na fertilidade das pacientes. A ressecção segmentar é uma opção terapêutica com resultados positivos na queda dos sintomas, porém ainda sem efeitos funcionais comprovados. Objetivo: Avaliar o impacto tardio do tratamento laparoscópico da endometriose profunda infiltrativa com ressecção segmentar colorretal. Métodos: Série de casos prospectiva com 46 pacientes submetidas ao tratamento laparoscópico para endometriose profunda infiltrativa com ressecção segmentar colorretal entre 2013 e 2016. Foram analisados sintomas ginecológicos, intestinais e a fertilidade no período pré-operatório, três e 12 meses ou mais após o procedimento. Resultados: Na entrevista pré-operatória, foram levantadas as prevalências de sintomas ginecológicos (87%), intestinais (80,4%) e de infertilidade (45,6%). No 3º mês pós-operatório, observou-se redução significativa da prevalência dos sintomas ginecológicos (p<0,001) e de sintomas intestinais, tenesmo (p=0,001) e disquesia (p=0,002). Após 12 meses ou mais observou-se diminuição significativa da prevalência de dismenorreia (p=0,001), de dispareunia profunda (p=0,041) e de dor pélvica crônica (p=0,011) além de disquesia (p=0,001) em relação ao período pré-operatório. As taxas de gravidez total e espontânea foram de 57,1% e 47,6%, respectivamente. Conclusão: O tratamento da endometriose profunda infiltrativa com ressecção segmentar colorretal proporcionou alívio precoce e tardio dos sintomas ginecológicos e intestinais. Os resultados sugerem impacto positivo sobre a fertilidade em pacientes inférteis.

Efeitos de uma intervenção com pedômetro sobre o risco metabólico em crianças obesas / Effects of an intervention with pedometer on metabolic risk in obese children / Efectos de una intervención con podómetro en el riesgo metabólico en niños obesos

RESUMO Introdução: Nas últimas décadas, a incidência de obesidade na população pediátrica vem aumentando, juntamente com a inatividade física. A obesidade e a inatividade física são componentes predisponentes para o agravo dos fatores de risco metabólico, sendo de fundamental importância seu tratamento visando melhora da saúde dos jovens. Objetivo: Verificar o efeito de 12 semanas de uma intervenção focada na atividade física sobre os fatores de risco metabólico em crianças obesas. Métodos: A amostra final foi composta por 19 escolares com idade entre oito e 10 anos (10 no grupo pedômetro e nove no grupo controle). A atividade física foi mensurada e orientada por meio do pedômetro Yamax(r) sw 700 (Tóquio, Honchu, Japão). Para comparações intra e entre grupos foi aplicado a ANOVA two way para medidas repetidas com significância estipulada em p < 0,05. Resultados: O número de passos aumentou significativamente somente no grupo pedômetro após as 12 semanas de intervenção (pré 9729,7 ± 2539,8 vs. pós 13151,6 ± 3581,7). Foi observado aumento significativo do peso corporal, da estatura e do IMC no grupo controle. No grupo pedômetro, observou-se aumento significativo apenas na estatura. Com relação aos fatores de risco metabólicos, não foi encontrada mudança significativa no grupo controle, enquanto no grupo pedômetro foi observada diminuição significante nos valores de insulina (pré 12,21 ± 8,53 vs. pós 7,26 ± 4,70 µUI/ml) e HOMA IR (pré 2,76 ± 1,93 vs. pós 1,49 ± 0,93). Conclusão: A presente intervenção com atividade física a partir do estabelecimento de metas utilizando pedômetros reduziu significativamente as concentrações de insulina e o índice de homeostase (HOMA IR) em crianças obesas, independentemente da perda de peso.

ABSTRACT Introduction: In recent decades, the incidence of obesity in children is increasing along with physical inactivity. Obesity and physical inactivity are predisposing components to the worsening of metabolic risk factors and treatment is fundamental aiming at improving the health of young people. Objective: To verify the effect of 12 weeks of an intervention focused on physical activity on metabolic risk factors in obese children. Methods: The final sample consisted of 19 students aged between 8 and 10 years (10 in the pedometer group and nine in the control group). Physical activity was measured and guided by the Yamax(r) sw 700 pedometer (Tokyo, Honshu, Japan). For within and between groups comparisons the two way ANOVA was applied for repeated measures with significance set at p<0.05. Results: The number of steps increased significantly only in the pedometer group after the 12-week intervention (9729.7±2539.8 before vs. 13151.6±3581.7 after). Significant increase was observed in body weight, height, and BMI in the control group. In the pedometer group, it was observed significant increase only in stature. Regarding the metabolic risk factors, there was no significant change found in the control group, while in the pedometer group a significant decrease in insulin levels was observed (12.21±8.53 before vs. 7.26±4.70 µUI/ml after) and HOMA IR (2.76±1.93 before vs. 1.49±0.93 after). Conclusion: This intervention with physical activity from setting goals using pedometers significantly reduced the concentrations of insulin and the homeostasis index (HOMA IR) in obese children regardless of weight loss.

RESUMEN Introducción: En las últimas décadas, la incidencia de la obesidad en los niños es cada vez mayor, junto con la inactividad física. La obesidad y la inactividad física son componentes que predisponen al empeoramiento de los factores de riesgo metabólico, siendo de fundamental importancia el tratamiento destinado a mejorar la salud de los jóvenes. Objetivo: Comprobar el efecto de 12 semanas de una intervención centrada en la actividad física sobre los factores de riesgo metabólico en los niños obesos. Métodos: La muestra final fue de 19 estudiantes de edades comprendidas entre ocho y 10 años (10 en el grupo podómetro y nueve en el grupo de control). La actividad física se midió y fue guiada por el podómetro Yamax(r) sw 700 (Tokio, Honchu, Japón). Para las comparaciones dentro y entre grupos se aplicó la ANOVA de dos vías para medidas repetidas, con una significación establecida en p < 0,05. Resultados: El número de pasos aumentó significativamente sólo en el grupo podómetro después de 12 semanas de intervención (pre 9729,7 ± 2539,8 vs. post 13151,6 ± 3581,7). Se observó un aumento significativo en el peso corporal, la estatura y el IMC en el grupo control. En el grupo podómetro, hubo un aumento significativo sólo en estatura. En cuanto a los factores de riesgo metabólico, no hubo ningún cambio significativo en el grupo control, mientras que en el grupo podómetro se observó disminución significativa de los valores de insulina (pre 12,21 ± 8,53 vs. post 7,26 ± 4,70 µUI/ml) y HOMA IR (pre 2,76 ± 1,93 vs. post 1,49 ± 0,93). Conclusión: Esta intervención con actividad física a partir del establecimiento de metas utilizando podómetros redujo significativamente las concentraciones de insulina y el índice de la homeostasis (HOMA-IR) en niños obesos, independientemente de la pérdida de peso.

Effect of exercise order on the number of repeats and training volume in the tri-set training method / Efeito da ordem dos exercícios sobre o número de repetições e volume de treino no método de treinamento tri-set

Abstract Although the tri-set system is widely adopted by athletes and experienced weight training practitioners aimed at optimizing the metabolic overload, there are still few works in literature on the effect of exercise order manipulation on this training system. Therefore, this work was aimed at investigating the effect of exercise order manipulation on the number of repeats and training volume using the tri-set system for lower limbs. This is a randomized cross-over design study. The experimental group consisted of 14 healthy men (23.53 ± 5.40 years; 24.51 ± 2.96 kg/m2). Subjects were submitted to two experimental sessions at different exercise order for lower limbs: Sequence A: squat on guided bar, leg press 45° and bilateral leg extension; sequence B: bilateral leg extension, leg press 45° and squat on guided bar. Three sets to volitional fatigue in all exercises were performed, with intensity of 75% 1RM. Superiority for sequence B in the total number of repeats (70.14 ± 13 vs 60.93 ± 7.94 repeats, p = 0.004) and total training volume (9129.64 ± 2830.05 vs 8238.29 ± 2354.20 kg, p = 0.014) was observed. Based on the above, the performance of single-joint exercises before multi-joint exercises in the tri-set system adopted for lower limbs induced higher number of repeats and total training volume.

Resumo Embora o sistema tri-set seja amplamente adotado por atletas e praticantes experientes de treinamento com pesos que buscam otimizar a sobrecarga metabólica, a literatura carece de investigações acerca do efeito da manipulação da ordem dos exercícios nesse sistema de treinamento. Sendo assim, objetivou-se investigar o efeito da manipulação da ordem dos exercícios sobre o número de repetições e volume de treino, utilizando o sistema tri-set para membros inferiores. Trata-se de uma pesquisa com delineamento cross-over aleatorizado. O grupo experimental foi composto por 14 homens saudáveis (23,53 ± 5,40 anos; 24,51 ± 2,96 kg/m2). Os avaliados foram submetidos a duas sessões experimentais em diferentes ordens de exercícios para membros inferiores: sequência A: agachamento na barra guiada, leg press 45° e cadeira extensora bilateral; sequência B: cadeira extensora bilateral, leg press 45° e agachamento na barra guiada. Foram executadas três séries até a fadiga voluntária em todos os exercícios, com intensidade de 75% de 1RM. Observou-se superioridade para a sequência B no número total de repetições (70,14 ± 13,00 vs 60,93 ± 7,94 repetições; p = 0,004) e volume total (9129,64 ± 2830,05 vs 8239,29 ± 2354,20 kg; p = 0,014). Diante do exposto, a execução de um exercício monoarticular antes de multiarticulares, no sistema tri-set adotado para membros inferiores, induziu a um maior número de repetições e volume total de treinamento.

[Satisfação com o Internato Médico em Portugal]. / Satisfação com o Internato Médico em Portugal.

INTRODUCTION: In the last years, the global context of medical education and Medical Residency programs in Portugal suffered substantial changes. The primary objective of this study was to evaluate and characterize medical residents ́ satisfaction with medical residency programs in Portugal and to identify features that could be improved. MATERIAL AND METHODS: We utilized as model the survey Postgraduate Hospital Educational Environment Measure that has been developed in the United Kingdom and is speci cally targeted to medical residents. The survey was translated and adapted to the Portuguese reality. The survey was available online during April and May of 2016. RESULTS: A total of 3456 responses were obtained, corresponding to a response rate of 35%. Endocrinology/Nutrition, Cardiology, Anesthesiology, Family Physician and Gastroenterology were the specialties in which the degree of satisfaction was higher, while Forensic Medicine, Medical Oncology, Internal Medicine, General Surgery and Pneumology showed the lowest level of satisfaction. DISCUSSION: This study presented a high response rate when compared to previous studies. Portuguese medical residents presented high levels of satisfaction. Depending on year of medical residency, region, type of specialty and type of hospital marked asymmetries were noticed. CONCLUSION: The survey ́s results should constitute in the future a support tool for the implementation of local and national measures relating to the medical residency. It is advisable to regularly conduct satisfaction surveys to medical residents.

Introdução: Nos últimos anos, o contexto global da formação médica, e em particular do Internato Médico em Portugal, sofreu profundas alterações. O presente estudo teve como objetivo avaliar e caracterizar a satisfação dos médicos internos com a realização do Internato Médico em Portugal e identificar aspetos passíveis de melhoria.Material e Métodos: Foi utilizado como modelo de inquérito o questionário Postgraduate Hospital Educational Environment Measuredesenvolvido no Reino Unido e dirigido a médicos internos, o qual foi traduzido e adaptado à realidade portuguesa. O questionário esteve disponível online durante os meses de abril e maio de 2016.Resultados: Foram obtidas 3456 respostas, correspondendo a uma taxa de resposta de 35%. Endocrinologia/Nutrição, Cardiologia, Anestesiologia, Medicina Geral e Familiar e Gastrenterologia foram as especialidades nas quais o grau de satisfação foi mais elevado,enquanto que Medicina Legal, Oncologia Médica, Medicina Interna, Cirurgia Geral e Pneumologia apresentaram o grau de satisfaçãomais baixo.Discussão: O presente estudo apresenta uma elevada taxa de resposta comparativamente com estudos prévios. A nível nacional, no global, os médicos internos apresentaram níveis elevados de satisfação, destacando-se marcadas assimetrias de acordo com o ano de especialidade, região, tipologia de instituição e de especialidade.Conclusão: Os resultados deste inquérito poderão constituir uma ferramenta de apoio à implementação de medidas de âmbito local enacional relacionadas com o Internato Médico, sendo desejável a realização regular de inquéritos de satisfação aos médico internos.

EFEITO DO EXERCÍCIO FÍSICO SOBRE OS MARCADORES INFLAMATÓRIOS DE ADOLESCENTES COM EXCESSO DE PESO: UMA REVISÃO SISTEMÁTICA / EFFECT OF PHYSICAL EXERCISE ON INFLAMMATORY MARKERS OF ADOLESCENTS WITH OVERWEIGHT: A SYSTEMATIC REVIEW

Recentemente os marcadores inflamatórios tem sido alvo de inúmeras de pesquisas. Porém as formas de tratamento não medicamentoso para o controle desses marcadores não estão claros na literatura. Objetivou-se realizar uma revisão sistemática acerca do efeito crônico dos exercícios físicos sobre os marcadores inflamatórios em adolescentes com excesso de peso. Realizou-se uma busca sistemática nas bases de dados: Medline (Pubmed), Science Direct, Scopus, Sport Discus, Web of Science, Cinahl, Scielo, Lilacs e Cochrane até maio de 2014. Foi verificado que o treinamento aeróbio e o treinamento combinado como corrida, caminhada, circuito, brincadeiras e jogos são os mais utilizados nos protocolos para o controle da obesidade e inflamação. Os resultados demonstraram uma relação de dependência entre a gordura corporal e as concentrações de adiponectina, PCR e leptina em adolescentes, indicando que o treinamento físico foi eficaz na modulação dos marcadores inflamatórios apenas quando houve diminuição significativa da gordura corporal.

Recently inflammatory markers has been the subject of numerous research. However forms of non-drug treatment for the control of these markers are not clear in the literature. The objective was to conduct a systematic review of the chronic effect of exercise on inflammatory markers in overweight adolescents. Was performed a sistematic search in databases: Medline (Pubmed), Science Direct, Scopus, Sport Discus, Web of Science, Cinahl, Scielo, Lilacs e Cochrane until may 2014. It was found that aerobic training and combined training as running, circuit , play and games are the most used in the protocols for the control of obesity and inflammation. The result demonstrated a dependency relationship between body fat and the concentrations of adiponectin, CRP and leptin in adolescents. indicating that physical training was effective in the modulation of inflammatory markers only when there was a significant decrease in body fat.

Comparison of physical activity, sedentary behavior and physical fitness between full-time and part-time students / Atividade física, comportamento sedentário e aptidão física de escolares: comparação entre período integral e parcial

Abstract The aim of this study was to compare physical activity, sedentary behavior and physical fitness between full-time and part-time students. The sample consisted of 72 students (9 to 12 years), 34 of them studying full time. The subjects answered a questionnaire about physical activity, sedentary behavior, and sociodemographic characteristics. Data regarding sexual maturation, body composition and physical fitness were also collected. The results showed that girls studying full time spent less time per day in sedentary behavior compared to part-time girls (p<0.05). Analysis of anthropometric variables showed a significantly lower body fat percentage in boys studying full time. With respect to the physical fitness tests, significant differences were identified in the sit and reach test, horizontal jump, medicine ball throw and agility, with the observation of higher performance in full-time students. Similarly, girls studying full time exhibited significantly higher performance in the horizontal jump and agility tests compared to their peers. It can be concluded that full-time students spend less time in sedentary behavior and exhibit better physical fitness indices in most of the tests used, irrespective of gender.

Resumo Objetivou-se comparar a prática de atividade física, o comportamento sedentário e a aptidão física entre escolares de período integral e parcial. A amostra foi composta por 72 escolares (9 a 12 anos), sendo 34 de período integral, os quais responderam um questionário sobre atividade física, comportamento sedentário e características sóciodemográficas. Também foram coletadas informações sobre a maturação sexual, composição corporal e aptidão física dos escolares. Os dados revelaram que as meninas de período integral apresentaram menor tempo diário dispendido com comportamento sedentário em comparação às meninas de período parcial (p < 0,05). Nas variáveis antropométricas, foram encontrados valores significativamente inferiores de % Gordura para os meninos de período integral. Em relação aos testes motores, foram identificadas diferenças significativas nos testes sentar e alcançar, salto horizontal, medicine ball e quadrado, com desempenho superior para os alunos de período integral. Da mesma forma, as meninas de período integral demonstraram um desempenho significativamente superior nos testes salto horizontal e quadrado quando comparadas a seus pares. Conclui-se que os escolares de período integral apresentam menor tempo gasto em comportamento sedentário e melhores índices de aptidão física, na maioria dos testes utilizados, independentemente do gênero sexual.

Correlação da força muscular com indicadores antropométricos, estágio maturacional e testes neuromotores em adolescentes / Correlation of muscle strength with anthropometric indicators, maturational stage and neuromotor tests in adolescents

A força muscular é um importante componente da aptidão física relacionada à saúde e ao desempenho, porém, na adolescência esta variável pode sofrer influencia de diversos fatores, dificultando assim, a análise dos resultados. Assim, objetivou-se correlacionar força muscular com indicadores ntropométricos, estágio maturacional, testes neuromotores em adolescentes de ambos os sexos. A amostra foi composta por 12 meninos (14,08±1,40 anos) e nove meninas (14,12±0,58 anos). Para avaliação da força muscular de flexão e extensão do joelho (FJ e EJ respectivamente) foi utilizado dinamômetro isocinético da marca Biodex®, seguindo um protocolo com as velocidades de 60° e 300°/s, sendo estes movimentos realizados pelo membro dominante. A composição corporal foi estimada seguindo as equações de Slaughter. Os testes motores utilizados foram: teste de impulsão horizontal, corrida de 50 metros e teste de Legér. A maturação biológica foi avaliada através da maturação sexual por meio do método auto-relatado. Os resultados mostram que a massa magra correlacionou significativamente com extensão e flexão de joelhos a 300º/s para ambos os gêneros (0,751 e 0,628 para meninos e 0,925 e 0,848 para meninas. Além disso, foram observadas correlações significativas nos meninos na extensão e flexão do joelho a 60º/s com impulsão horizontal (0,899 e 0,804, respectivamente) e teste de 50 metros (0,813 e 0,747, respectivamente). Os resultados apresentados indicam que existe uma influência multifatorial na força muscular de adolescentes, mostrando a necessidade de se considerar os aspectos morfológicos e maturacionais na análise dos resultados.(AU)

Muscle strength is an important component of physical fitness for health and performance, however, this variable during adolescence may suffer influences of various factors, thus complicating the analysis of the results. Was aimed to correlate muscle strength with anthropometric indicators, maturational stage, neuromotor tests in adolescents of both sexes. The sample consisted of 12 boys (14.08 ± 1.40 years) and nine girls (14.12 ± 0.58 years). To evaluate the muscular strength of knee flexion and extension (FJ and EJ respectively) was used isokinetic dynamometer Biodex® brand, following a protocol with speeds of 60° and 300°/sec, and these movements performed by the dominant limb. Body composition was estimated following the equations of Slaughter. The motor tests used were: standing long jump test, 50-meter sprint and Legér test. Biological maturation was evaluated by the sexual maturation by means of self-reported method. Lean mass correlated significantly with extension and knee flexion at 300°/s for both genders (0.751 and 0.628 for boys and 0.925 and 0.848 for girls. Furthermore, significant correlations were observed among boys in extension and flexion of the knee 60°/s with horizontal impulse (0.899 and 0.804, respectively) and 50 yards (0.813 and 0.747, respectively) test. The results indicate that there is a multifactorial influence muscle strength in adolescents, indicating the need to consider the morphological and maturational aspects when analyzing the results.(AU)

Factors related to overweight among university students / Fatores associados ao excesso de peso de universitários

OBJECTIVE: To identify the prevalence of overweight and its associated factors among university students of the area of health. METHODS: The sample comprised 344 students. Body Mass Index (BMI) and associated factors were assessed from a self-report questionnaire. Students who presented BMI ≥25 kg/m² were rated overweight. Statistical analysis was performed using the chi-square test and associations were estimated by odds ratio with 95% (95% CI). The prevalence of overweight students was 23.8% overall. RESULTS: Factors associated with overweight were as follows: male (OR=3.773: CI=2.152-6.614); not living in the city where one studies (OR=1.830: CI=1.104-3.034); attending the final years of an undergraduate course (OR =1.758: CI=1.066-2.897); attending night classes (OR=1.654: CI=1.004-2.726); alcohol consumption (OR=1.676: CI=1.014-2.769); smoking (OR=3.914: CI=1.458-10.506); and working (OR=2.029: CI=1.222-3.366). CONCLUSION: The groups with the highest risk of overweight were male students who live in other cities, attend the final years, study at night, consume alcohol and tobacco, and work

OBJETIVO: Identificar a prevalência de excesso de peso e os fatores associados em universitários da área da Saúde. MÉTODOS: A amostra foi constituída por 344 acadêmicos. Índice de Massa Corpórea (IMC) e fatores associados foram avaliados a partir de um questionário de autorrelato. Foi classificado com excesso de peso aquele estudante que tivesse IMC ≥ 25 kg/m². A análise estatística foi realizada por meio do teste qu i-quadrado e as associações foram calculadas pelo odds ratio 95% (IC95%). RESULTADOS: A prevalência de excesso de peso geral foi de 23,8%. Os fatores associados ao excesso de peso foram: ser do sexo masculino (OR = 3,773: IC = 2,152-6,614); não morar na cidade em que estuda (OR = 1,830: IC = 1,104-3,034); estar cursando as séries finais do curso de graduação (OR = 1,758: IC = 1,066-2,897), estudar no período noturno (OR = 1,654: IC = 1,004-2,726), consumir bebidas alcoólicas (OR = 1,676: IC = 1,014-2,769), fumar (OR = 3,914: IC = 1,458-10,506) e trabalhar (OR = 2,029: IC = 1,222-3,366). CONCLUSÃO: Os grupos com maior risco de excesso de peso foram estudantes do sexo masculino, que vivem em outras cidades, participam de séries de estudo finais, à noite, consomem álcool, usam tabaco e trabalham

Orbital lymphangiomas: surgical treatment and clinical outcomes.

BACKGROUND: Orbital lymphangiomas (OL) are rare benign lesions that represent less than 4% of all space-occupying orbital lesions. Total surgical resection is usually difficult because of its infiltrative nature. Our objective was to analyze the indications for surgical treatment, the selection of surgical approach, and the clinical outcome after surgical treatment of OL. METHODS: Five patients with OL who were surgically treated between January 2003 and December 2009 were included. Clinical, surgical, and follow-up data were retrospectively analyzed. RESULTS: Mean age was 32 years, with two patients treated when they were adults. Proptosis was present in all patients, and the mean duration of symptoms was 9.4 years. Two patients had clinically relevant hemorrhagic episodes. Three patients presenting with large retrobulbar tumors were submitted to the pterional approach with superolateral orbitotomy; in one patient, a lateral approach was used and in another an anterior superomedial approach was used. In all cases a subtotal removal was achieved. There was no permanent morbidity. With a mean follow-up of 3.2 years, no patient presented new hemorrhagic episodes or tumor recurrence. CONCLUSION: Subtotal resection of OL is an effective and safe treatment option, may prevent new hemorrhagic episodes, and is not associated with a high recurrence rate after a relatively short-term follow-up. Progressive proptosis, visual or oculomotor impairment, and repeated symptomatic hemorrhagic episodes are considered indications for surgery. Transcranial access should be performed in large tumors extending posteriorly.

Sphenoid Wing en plaque meningiomas: Surgical results and recurrence rates.

BACKGROUND: Sphenoid wing en plaque meningiomas are a subgroup of meningiomas defined by its particular sheet-like dural involvement and its disproportionately large bone hyperostosis. En plaque meningiomas represent 2-9% of all meningiomas and they are mainly located in the sphenoid wing. Total surgical resection is difficult and therefore these tumors have high recurrence rates. METHODS: Eighteen patients with sphenoid wing en plaque meningiomas surgically treated between January 1998 and December 2008 were included. Clinical, surgical, and follow-up data were retrospectively analyzed. RESULTS: Mean age was 52.2 years and 83% were female. Five patients presented extension of dural component into the orbit and six patients presented cavernous sinus infiltration. Adjuvant radiation therapy was performed in three patients. After a mean follow-up of 4.6 years, five patients developed tumor recurrence - two patients were submitted to surgical treatment and the other three were submitted to radiation therapy. No patient presented recurrence after radiation therapy, whether performed immediately in the postoperative period or performed after recurrence. Patients without tumor extension to cavernous sinus or orbital cavity have the best prognosis treated with surgery alone. When tumor extension involves these locations the recurrence rate is high, especially in cases not submitted to adjuvant radiation therapy. CONCLUSION: Cavernous sinus and superior orbital fissure involvement are frequent and should be considered surgical limits. Postoperative radiation therapy is indicated in cases with residual tumor in these locations.

[Benign fibro-osseous lesions of the craniofacial complex with aneurysmal bone cyst formation]. / Lesões fibro-ósseas craniofaciais benignas com quistos ósseos aneurismáticos associados.

Aneurysmal bone cyst are controversial osteolytic benign expansive lesions which occur more frequently in the metaphysis of long bones and spine. They are classified as primary or secondary lesions depending on the presence or absence of an associated bone pathology. The engraftment of aneurysmal bone cyst onto benign fibro-osseous lesions is established. However, in the craniofacial complex this combined lesion is rare.The authors present two histologically proven uncommon cases of benign fibro-osseous lesions (fibrous dysplasia and juvenile psammomatoid ossifying fibroma) with aneurysmal bone cyst formation, emphasizing the imaging characteristics of this hybrid entities.

Prevenção da transmissão vertical do HIV: atitude dos obstetras em Salvador, Brasil / Prevention of HIV vertical transmission: obstetricians'atitude in Salvador, Brasil

OBJETIVO: avaliar as atitudes e conhecimento dos obstetras das maternidades públicas da cidade de Salvador (MPS) sobre as recomendações do Ministério da Saúde para a profilaxia da transmissão vertical do vírus humano da imunodeficiência (HIV) e terapia antiretroviral em gestantes. Avaliou-se também a influência das condições de trabalho, disponibilidade da testagem rápida e da terapia antiretroviral em relação à aplicação destas recomendações. MÉTODOS: realizou-se um estudo de corte transversal entre agosto e novembro de 2005, envolvendo 129/152 (85 por cento) dos obstetras de todas as MPS. Utilizou-se como instrumento um questionário anônimo, estruturado e auto-explicativo, com questões sobre as características da população, condições de trabalho e disponibilidade de insumos, conhecimento e atitudes relacionadas ao aconselhamento e testagem para o HIV e condutas com as pacientes (uso da zidovudina (AZT), reconhecimento de fatores de risco, escolha e manejo da via de parto e cuidados no puerpério). RESULTADOS: dos obstetras, 69 por cento referiram conhecer integralmente as recomendações do Ministério da Saúde; 90,7 por cento concordaram com a solicitação compulsória da testagem rápida para o HIV; 63,6 por cento escolheram a cesariana para via de parto; 38 por cento contra-indicaram o parto por via vaginal; 37,5 por cento recomendaram isolamento das pacientes soropositivas e 58,1 por cento indicaram laqueadura tubária. A maioria (90 por cento) dos sujeitos referiram a existência de fatores prejudiciais à aplicabilidade das recomendações, sendo que os mais apontados foram a realização inadequada e a indisponibilidade das informações do pré-natal na admissão. Embora a testagem rápida estivesse disponível, apenas um terço dos entrevistados afirmou que o resultado estava sempre disponível em tempo hábil. CONCLUSÕES: algumas atitudes relacionadas à assistência à gestante com HIV foram discordantes das recomendações do Ministério da Saúde. Na...

PURPOSE: to evaluate the attitudes and knowledge of obstetricians from public maternities in Salvador city (PMS) about the recommendations from the Health Ministry (HM) for the prophylaxis of vertical transmission of HIV (VTH) and antiretroviral therapy in pregnant women. The influence of working conditions, availability for quick testing and antiretroviral therapy has also been evaluated concerning the application of these recommendations. METHODOLOGY: a transversal study from August to November 2005, involving 129/152 (85 percent) of the obstetricians from all the PMS. The instrument used was a structured and self-explanatory anonymous questionnaire, with questions on the population characteristics, working conditions and availability of material, knowledge and attitudes related to HIV counseling and testing, and proceedings with the patients (use of AZT, recognition of risk factors, choice and management of type of delivery and puerperal care). RESULTS: 69 percent of the obstetricians stated they knew integrally the HM recommendations, 90.7 percent agreed with the compulsory request of quick testing for HIV; 63.6 percent chose the caesarean section as the type of delivery; 38 percent were against normal delivery; 37.5 percent recommended isolation of positive serum patients and 58.1 percent indicated tubal ligation. Most of them (90 percent) mentioned the existence of factors unfavorable to the recommendations applicability, and among those factors, the most pointed were the inadequate way the pre-natal admission was done and the lack of information at that occasion. Even though the quick testing was available, only one third of the interviewees stated that the result was always available in due time. CONCLUSIONS: some attitudes related to the assistance to the pregnant women with HIV were incompatible with the HM recommendations. According to the interviewees, the inadequacy of the pre-natal plus the non-availability of quick...

[Prevention of HIV vertical transmission: obstetricians' attitude in Salvador, Brazil]. / Prevenção da transmissão vertical do HIV: atitude dos obstetras em Salvador, Brasil.

PURPOSE: to evaluate the attitudes and knowledge of obstetricians from public maternities in Salvador city (PMS) about the recommendations from the Health Ministry (HM) for the prophylaxis of vertical transmission of HIV (VTH) and antiretroviral therapy in pregnant women. The influence of working conditions, availability for quick testing and antiretroviral therapy has also been evaluated concerning the application of these recommendations. METHODOLOGY: a transversal study from August to November 2005, involving 129/152 (85%) of the obstetricians from all the PMS. The instrument used was a structured and self-explanatory anonymous questionnaire, with questions on the population characteristics, working conditions and availability of material, knowledge and attitudes related to HIV counseling and testing, and proceedings with the patients (use of AZT, recognition of risk factors, choice and management of type of delivery and puerperal care). RESULTS: 69% of the obstetricians stated they knew integrally the HM recommendations, 90.7% agreed with the compulsory request of quick testing for HIV; 63.6% chose the caesarean section as the type of delivery; 38% were against normal delivery; 37.5% recommended isolation of positive serum patients and 58.1% indicated tubal ligation. Most of them (90%) mentioned the existence of factors unfavorable to the recommendations applicability, and among those factors, the most pointed were the inadequate way the pre-natal admission was done and the lack of information at that occasion. Even though the quick testing was available, only one third of the interviewees stated that the result was always available in due time. CONCLUSIONS: some attitudes related to the assistance to the pregnant women with HIV were incompatible with the HM recommendations. According to the interviewees, the inadequacy of the pre-natal plus the non-availability of quick testing, influence negatively the applicability of VTH prophylaxis recommendations.