A novel peptide 'T14' reflects age and photo-aging in human skin.

T14 is a 14mer peptide derived from the C-terminus of acetylcholinesterase (AChE). Once cleaved, it is independently bioactive of the parent molecule and enhances calcium influx in different cell types, in a range of scenarios: it binds to an allosteric site selectively on the alpha-7 receptor, where it modulates calcium influx and is thus a potential trophic agent, as already reported in a range of normal developmental scenarios. However, if inappropriately activated, this erstwhile beneficial effect converts to a toxic one, resulting in pathologies as disparate as Alzheimer's and various metastatic cancers. Given that epidermal keratinocyte cells have the same ectodermal origin as brain cells, as well as expressing AChE and the alpha-7 receptor, we have explored whether T14 plays a comparable role. Here we report that the T14 immunoreactivity is detectable in human keratinocytes with levels inversely related to age: this decrease is even more apparent with chronic photo-exposure and thus accelerated skin aging. We conclude that T14, an agent promoting cell growth and renewal in other parts of the body, also operates in skin, Moreover, monitoring of keratinocyte T14 levels might offer further insights into the now well reported link between degenerative diseases and epidermal cell profile.

Nicotinamide effects on the metabolism of human fibroblasts and keratinocytes assessed by quantitative, label-free fluorescence imaging.

Alterations in metabolism are central to the aging process. Therefore, understanding the subcellular functional and structural changes associated with metabolic aging is critical. Current established methods for exploring cell metabolism either require the use of exogenous agents or are destructive to the tissue or cells. Two-photon excited fluorescence (TPEF) imaging has emerged as a method for monitoring subtle metabolic changes non-invasively. In this study, we use TPEF imaging to acquire high-resolution fluorescence images from two coenzymes, NAD(P)H (reduced form of nicotinamide adenine dinucleotide) and FAD (flavin adenine dinucleotide), within human fibroblasts and keratinocytes in response to B3 (a nicotinamide precursor) supplementation and/or UV irradiation, without addition of exogenous labels. In addition, multi-parametric analysis methods are used to extract functional information of cellular metabolism, including cellular redox state, NAD(P)H fluorescence lifetime, and mitochondrial organization. Our results demonstrate that such optical metabolic assessments can serve as sensitive, label-free, non-destructive reporters of known effects of B3 to maintain and in some cases even enhance the respiratory function of mitochondria, while lowering oxidative damage. Thus, TPEF imaging, supported by highly-quantitative analysis, can serve as a tool to understand aging-dependent metabolic changes as well as the effect of actives on human epidermal and dermal cells.

Principles of Moisturizer Product Design

Moisturizers provide significant benefit in dermatology ­ as adjuvant therapy for many clinical conditions, as a key player in anti-aging regimens, and as a core component in maintaining healthy skin barrier function. Although they have been a mainstay for decades, lotions and creams are no longer formulated with a one-size-fits-all approach, where thickness was the primary cue for efficacy. In fact, moisturizer design today has become an art as well as a science. Product efficacy, aesthetics, and packaging are all engineered in a variety of ways, to create an expansive market of products that meet many consumer needs. The addition of specific types of functional ingredients can make a noteworthy difference as well. This article will explore the myriad approaches for moisturizer development and debunk some of the long-standing myths that have pervaded the marketplace. J Drugs Dermatol. 2019;18(1 Suppl):s89-95

Diagnósticos, resultados e intervenções de enfermagem no parto cesáreo / Diagnoses, results, and nursing interventions in c-sections

Objetivo: descrever a Sistematização da Assistência de Enfermagem das parturientes admitidas no centro obstétrico para o parto cesáreo e o puerpério. Método: trata-se de um estudo quantitativo, descritivo, exploratório, realizado com 152 clientes em um hospital. Realizaram-se, para a coleta de dados, a anamnese e o exame clínico, e os resultados apresentam-se em forma de tabelas. Resultados: observa-se que os diagnósticos mais predominantes pertencem aos domínios Segurança e Proteção, Enfrentamento e Tolerância ao Estresse e Conforto. Conclusão: destacam-se as necessidades das mulheres admitidas, proporcionando o subsídio teórico e científico por meio da associação das classificações de Enfermagem. Evidencia-se, neste estudo, a relevância da sistematização da Enfermagem como um método científico seguro para uma assistência holística e mais eficaz.(AU)

Acolhimento com classificação de risco obstétrico: proposta de readequação do instrumento de registro

Estudo qualitativo, do tipo descritivo exploratório, de natureza aplicada, desenvolvido com 16 enfermeiros do setor de urgência e emergência obstétrica de um hospital de referência do Estado do Pará, realizado de maio a junho de 2017, por meio de entrevista semiestruturada. Objetivou descrever a visão dos enfermeiros da triagem obstétrica que atuam no acolhimento da usuária, quanto à aplicabilidade do instrumento de coleta de dados da classificação de risco, em uso na Instituição e identificar as sugestões e propostas dos mesmos para readequação do referido instrumento, com apresentação de proposta. O projeto de pesquisa foi aprovado por Comitê de Ética em pesquisa. Os dados foram submetidos a análise de conteúdo de Bardin. Os resultados foram organizados em três categorias: conhecimentos sobre o Acolhimento com Classificação de Risco; dificuldades e limites frente ao instrumento de registro do Acolhimento com Classificação de Risco e contribuições e propostas para readequação do instrumento de registro do Acolhimento com Classificação de Risco. Os achados apontam que os saberes dos enfermeiros sobre a temática estão atrelados as vivências, práticas e qualificação profissional. Revelaram-se aspectos dificultadores quanto a aplicabilidade do instrumento, como incerteza para o que registrar; repetição de dados e incompletude nos fluxogramas e discriminadores ante a realidade assistencial; não compatibilidade dos discriminadores e os níveis de prioridade diante do perfil de atendimento e a superlotação do setor; refletindo na demora da realização do processo de classificar e evidenciou-se comprometimento no atendimento. Potencializando uma ação resolutiva elaborou-se, em conformidade com as contribuições dos enfermeiros, proposta de readequação do instrumento de registro do Acolhimento e Classificação de Risco para favorecer à praticidade e otimização na execução dos registros e do serviço de classificação de risco, a fim de qualificação da assistência aos usuários

A qualitative exploratory and descriptive study of an applied nature developed with 16 nurses from the urgency and emergency sector of a referral hospital in the State of Pará, conducted in May, June 2017, through a semistructured interview. The purpose of this study was to describe the nurses' vision of obstetric screening that act on the user’s, as to the applicability of the data collection instrument of the risk classification, in the general version and to identify suggestions and proposals for the re-adaptation of said instrument, with presentation of proposal. The search project was approved by the Research Ethics Committee. The data were submitted to Bardin content analysis. The results were organized in 3 categories: knowledge about the reception with risk classification; difficulties and limits for the registration instrument of the reception with the risk classification and contributions and proposals for the readjustment of the registration instrument of reception with the risk classification. The findings indicate that the nurses' knowledge about the theme is linked to experiences, practices and professional qualification. Difficulties have been revealed regarding the applicability of the instrument, as uncertainty for which register; repetition of data and incompleteness in flowcharts and discriminators before the reality of care; isn’t compatible with the discriminators and the levels of priority in front of the service profile and an overcrowding of the sector; reflecting in the delay of the accomplishment of the classification process and evidenced the commitment in the service. In accordance with the contributions of the nurses, proposal was made for the readjustment of the registration instrument of the reception and classification of risk to favor the practicality and optimization in the execution of the records and to perform the risk classification service, in order to a qualification of assistance to users

Readequação do instrumento de registro do acolhimento com classificação de risco obstétrico

Este estudo é o produto da dissertação intitulada:” Acolhimento com Classificação de Risco Obstétrico: proposta de readequação do instrumento de registro”. Pesquisa qualitativa, do tipo descritiva exploratória, de natureza aplicada, desenvolvida com 16 enfermeiros do setor de urgência e emergência obstétrica de um hospital de referência do Estado do Pará, realizada de maio a junho de 2017, por meio de entrevista semiestruturada. Objetivou descrever a visão dos enfermeiros da triagem obstétrica que atuam no acolhimento da usuária, quanto à aplicabilidade do instrumento de coleta de dados da classificação de risco em uso na instituição, e identificar as sugestões e propostas dos mesmos para readequação do referido instrumento. Aprovada por Comitê de Ética em pesquisa. Os dados foram submetidos a análise de conteúdo de Bardin. Potencializando uma ação resolutiva, a partir da análise dos dados e das contribuições e propostas obtidas das respostas dos enfermeiros, e da revisão literária sobre a temática, houve elaboração deste produto de dissertação, que foi a readequação do instrumento de registro do ACCR da FSCMP. Com intuito de favorecer à praticidade e otimização na execução dos registros e a qualificação da assistência aos usuários, contribuindo para elevar a credibilidade da Instituição, com a utilização de uma ferramenta mais adequada para o serviço

This study is the product of the dissertation titled: "Reception with Obstetric Risk Classification: proposal to readjust the recording instrument". Qualitative research, of an exploratory descriptive nature, of an applied nature, developed with 16 nurses of the emergency and obstetric emergency department of a reference hospital in the State of Pará, carried out from May to June of 2017, through a semistructured interview. The purpose of this study was to describe nurses' vision of obstetric screening in the user's reception regarding the applicability of the data collection instrument of the risk classification in use in the institution and to identify the suggestions and proposals of the same for re-adaptation of said instrument. Approved by Research Ethics Committee. The data were submitted to Bardin content analysis. The analysis of the data and the contributions and proposals obtained from the nurses' responses, as well as the literature review on the subject, resulted in the elaboration of this dissertation product, which was the readjustment of the FSCMP registration instrument. With the purpose of favoring the practicality and optimization in the execution of the records and the qualification of the assistance to the users, contributing to increase the credibility of the Institution, with the use of a more adequate tool for the service

Elastosis perforans serpiginosa, a transepithelial elimination skin disease diagnosed by histopathology: case report / Elastoseperfurante serpiginosa, uma doença de transeliminação epidérmica e diagnóstico essencialmente histopatológico: relato de caso

ABSTRACT Elastosis perforans serpiginosa is a disease that belongs to the group of perforating dermatoses, in which dermal elastic tissue extrusion occurs through epidermis. It generally affects young male individuals, and is clinically characterized by keratotic papules of verrucous aspect with centrifugal and serpiginous growth. We report the case of a male patient presenting with papular keratotic lesions since the age of 5. Some of the lesions display a central keratotic plug and converge into circular, arciform and serpiginous lesions.

RESUMO A elastose perfurante serpiginosa é uma dermatose pouco comum pertencente ao grupo das dermatoses perfurantes, nas quais ocorre a extrusão do tecido elástico dérmico por meio da epiderme. Na maioria das vezes afeta indivíduos jovens, com predominância no sexo masculino; clinicamente caracteriza-se por pápulas ceratósicas de aspecto verrucoso, com crescimento centrífugo e serpiginoso. Relatamos o caso de um paciente do sexo masculino, com aparecimento de lesões papulares ceratósicas desde os 5 anos de idade. Algumas dessas lesões apresentavam rolha córnea central, e confluíam para lesões circulares, arciformes e serpiginosas.

Granulomatosis with polyangiitis, a new nomenclature for Wegener's Granulomatosis--Case report.

The granulomatosis with polyangiitis, initially known as Wegener's granulomatosis, is a small and medium vessels vasculitis. It's classic form presents a triad: necrotizing granuloma of respiratory tract, necrotizing cutaneous vasculitis and glomerulonephritis. This vasculitis has cytoplasmic antineutrophil antibodies as signal. This work illustrates a case, of multisystemic rare disease, in which the segment and treatment were considered satisfactory for symptoms remission.

Granulomatosis with polyangiitis, a new nomenclature for Wegener's Granulomatosis - Case report

The granulomatosis with polyangiitis, initially known as Wegener's granulomatosis, is a small and medium vessels vasculitis. It's classic form presents a triad: necrotizing granuloma of respiratory tract, necrotizing cutaneous vasculitis and glomerulonephritis. This vasculitis has cytoplasmic antineutrophil antibodies as signal. This work illustrates a case, of multisystemic rare disease, in which the segment and treatment were considered satisfactory for symptoms remission.

Instrumento de apoio para a primeira entrevista em psicoterapia cognitivo-comportamental / Instrument of support to the first interview in cognitive-behavioral psychotherapy / Instrumento de apoyo a la primera entrevista en psicoterapia cognitivo-conductual

A primeira entrevista em psicoterapia é, usualmente, vivenciada com grande ansiedade por estagiários de Psicologia. Visando facilitar essa transição profissional e colaborar para a formação de terapeutas iniciantes, este artigo tem por objetivo apresentar um instrumento para uso por estagiários de Psicoterapia Cognitivo-Comportamental na primeira sessão individual. O instrumento é apresentado na forma de uma lista de checagem, contendo aspectos a serem abordados no decorrer da sessão, além de questões abertas sobre a vivência emocional e autoavaliação do desempenho na sessão. São discutidos achados de pesquisa em psicoterapia que fundamentam o instrumento. Adicionalmente, são sugeridos estudos para avaliação de seu potencial didático na formação de psicoterapeutas.

The first interview in psychotherapy is usually experienced with great anxiety by psychology undergraduate trainees. In search of making easier that professional transition and collaborate for the professional training of beginners therapists, this paper has the aim to present an instrument for use by trainees in the first session of Cognitive Behavioral Psychotherapy. The instrument is presented in the format of a checklist, consisting of features to be addressed during the session, besides open questions about the emotional experience and evaluation of the own performance. Research findings in the psychotherapy field which provide the basis for the instrument are discussed. Additionally, further studies are recommended in order to evaluate its didactic potential in the psychotherapy training.

La primera entrevista en psicoterapia es, generalmente, vivida con gran ansiedad por los alumnos de Psicología en prácticas. Con la finalidad de facilitar esta transición profesional y colaborar con la formación de nuevos terapeutas, este artículo tiene como objetivo presentar una herramienta para la primera sesión individual de los alumnos de Psicoterapia Cognitivo-Conductual. El instrumento se presenta en forma de una lista de verificación que contiene los aspectos a tratar durante la sesión, además de preguntas abiertas acerca de la experiencia emocional y una auto-evaluación de su desempeño en la sesión. Se discuten los hallazgos de investigaciones en psicoterapia que fundamentan el instrumento. Adicionalmente, se sugieren estudios para evaluar su potencial educativo en la formación de psicoterapeutas.

Instrumento de apoio para a primeira entrevista em psicoterapia cognitivo-comportamental / Instrument of support to the first interview in cognitive-behavioral psychotherapy / Instrumento de apoyo a la primera entrevista en psicoterapia cognitivo-conductual

A primeira entrevista em psicoterapia é, usualmente, vivenciada com grande ansiedade por estagiários de Psicologia. Visando facilitar essa transição profissional e colaborar para a formação de terapeutas iniciantes, este artigo tem por objetivo apresentar um instrumento para uso por estagiários de Psicoterapia Cognitivo-Comportamental na primeira sessão individual. O instrumento é apresentado na forma de uma lista de checagem, contendo aspectos a serem abordados no decorrer da sessão, além de questões abertas sobre a vivência emocional e autoavaliação do desempenho na sessão. São discutidos achados de pesquisa em psicoterapia que fundamentam o instrumento. Adicionalmente, são sugeridos estudos para avaliação de seu potencial didático na formação de psicoterapeutas.(AU)

The first interview in psychotherapy is usually experienced with great anxiety by psychology undergraduate trainees. In search of making easier that professional transition and collaborate for the professional training of beginners therapists, this paper has the aim to present an instrument for use by trainees in the first session of Cognitive Behavioral Psychotherapy. The instrument is presented in the format of a checklist, consisting of features to be addressed during the session, besides open questions about the emotional experience and evaluation of the own performance. Research findings in the psychotherapy field which provide the basis for the instrument are discussed. Additionally, further studies are recommended in order to evaluate its didactic potential in the psychotherapy training.(AU)

La primera entrevista en psicoterapia es, generalmente, vivida con gran ansiedad por los alumnos de Psicología en prácticas. Con la finalidad de facilitar esta transición profesional y colaborar con la formación de nuevos terapeutas, este artículo tiene como objetivo presentar una herramienta para la primera sesión individual de los alumnos de Psicoterapia Cognitivo-Conductual. El instrumento se presenta en forma de una lista de verificación que contiene los aspectos a tratar durante la sesión, además de preguntas abiertas acerca de la experiencia emocional y una auto-evaluación de su desempeño en la sesión. Se discuten los hallazgos de investigaciones en psicoterapia que fundamentan el instrumento. Adicionalmente, se sugieren estudios para evaluar su potencial educativo en la formación de psicoterapeutas.(AU)

Retinopatia em pacientes hipertensos e/ou diabéticos em uma unidade de saúde da família / Retinopathy in patients with hypertension and/or diabetes in a family health unit

Objetivo: Identificar a prevalência de alterações à oftalmoscopia direta em pacientes com diagnóstico de hipertensão e/ou diabetes mellitus em uma Unidade de Saúde da Família (USF). Método: Estudo individual, observacional, prioritariamente descritivo, do tipo transversal, com amostra composta por coorte de 50 pacientes hipertensos e/ou diabéticos matriculados no programa HIPERDIA de uma Unidade de Saúde Familiar (USF) do município de Ananindeua - Pará, entre os meses de setembro e novembro de 2009. Resultados: Foi realizada oftalmoscopia em 46 pacientes. Observou-se alteração à oftalmoscopia em 27 (58,7%). Ao realizar a análise específica (excluindo-se os achados de estreitamento arteriolar e ingurgitamento venoso) houve alterações em 18 (39,1%), sendo 45,5% com DM e HAS, quarenta por cento com DM e 36% com HAS. Conclusão: A elevada prevalência de alterações à oftalmoscopia encontradas no presente estudo demonstra sua eficácia como método de rastreio no contexto da atenção primária a saúde, justificando seu uso. Corrobora, ainda, a importância da atenção primária à saúde na prevenção da retinopatia hipertensiva e diabética, através do controle periódico de pacientes de alto risco vascular como a população estudada. .

Purpose: To identify the prevalence of abnormal ophthalmoscopy in patients with systemic hypertension (SH) and / or diabetes mellitus (DM) in a Family Health Unit (FHU). Method: was performed a individual study, observational, primarily descriptive and crosssectional of a sample of a cohort of 50 patients with hypertension and / or diabetic enrolled in the program HIPERDIA in a FHU of the city of Ananindeua - Para, between the months of september and november 2009. Results: ophthalmoscopy was performed in 46 patients and 27 (58.7%) had some alteration. When performing a specific analysis (excluding the findings of arteriolar narrowing and venous engorgement) were changes in 18 (39.1%), 45.5% with DM and SH, 40% with DM and 36% with SH. Conclusion: The high prevalence of the changes in ophthalmoscopy found in this study demonstrates that effectiveness as a screening method in the context of primary health care, justifying that use. corroborates also the importance of primary care in the prevention of diabetic and hypertensive retinopathy, through periodic control of patients at high vascular risk as the population studied. .

Do you know this syndrome?

The hyperimmunoglobulin E syndrome, or Job's syndrome is a rare primary immunodeficiency characterized by recurrent skin abscesses, recurrent respiratory tract infections, and high levels of IgE, eosinophilia, bone and dental changes. We report the case of a fourteen-year-old male patient presenting this disease, with both typical and also some relatively sporadic manifestations. We performed a literature review on the syndrome and its associated clinical findings.

Do you know this syndrome? / Voce conhece esta sindrome?

The hyperimmunoglobulin E syndrome, or Job's syndrome is a rare primary immunodeficiency characterized by recurrent skin abscesses, recurrent respiratory tract infections, and high levels of IgE, eosinophilia, bone and dental changes. We report the case of a fourteen-year-old male patient presenting this disease, with both typical and also some relatively sporadic manifestations. We performed a literature review on the syndrome and its associated clinical findings.

A síndrome de hiperimunoglobulinemia E, ou síndrome de Job é uma imunodeficiência primária rara, caracterizada por abcessos cutâneos recorrentes, infecções de repetição do trato respiratório, títulos elevados de IgE, eosinofilia, alterações ósseas e dentárias. Relata-se o caso de um paciente do sexo masculino, 14 anos, portador da doença, com manifestações desde típicas a algumas relativamente esporádicas, fazendo-se uma revisão da síndrome e dos achados clínicos associados.

Seroprevalence of hantavirus and Yersinia pestis antibodies in professionals from the Plague control program.

INTRODUCTION: Professionals who handle rodents in the field and in the laboratory are at risk of infection by the microorganis mharbored by these animals. METHODS: Serum samples from professionals involved in rodent and Yersinia pestis handling in field or laboratory work were analyzed to determine hantavirus and plague seroprevalence and to establish a relationship between these activities and reports of illnesses. RESULTS: Two individuals had antibodies against hantavirus, and two harbored antibodie against the plague; none of the individuals had experienced an illness related to their duties. CONCLUSIONS: These results confirm the risks of hantavirus- and plague-related field and laboratory activities and the importance of protective measures for such work.

Study of dermatoses in kidney transplant patients.

BACKGROUND: The increasing in the number of kidney transplant recipients has favored, more frequently than before, the emergence of dermatoses and warranted their study through subsequent publications. OBJECTIVES: to evaluate the frequency of dermatoses in kidney transplant recipients. METHODS: kidney transplant recipients with suspected dermatoses between March 1st 2009 and June 30th 2010. RESULTS: 53 patients (28 males and 25 females), aged between 22 and 69 (mean age = 45 years) were evaluated. Most of them came from the cities of Ceilândia, Samambaia and São Sebastião/DF, and had already been transplanted for 5 to 10 years before (37.7%); 62.3% were recipients of living donors and 83% were prednisone-treated. The most prevalent dermatoses were of fungal (45.3%) and viral (39.6%) etiologies. Among the non-melanoma malignant neoplasms, the basal cell carcinoma prevailed (six cases), in spite of the low incidence. Concerning fungal dermatoses, 12 cases of onychomycosis, five of pityriasis versicolor and four of pityrosporum folliculitis were reported. For diagnosis, in most cases (64.2%), laboratory examinations (mycological and histopathological) were performed. CONCLUSION: cutaneous manifestations in kidney transplant recipients are generally secondary to immunosuppression. The infectious dermatoses, especially those of fungal origin, are frequently found in kidney transplant recipients and their occurrence increases progressively according to the time elapsed from the transplantation, which makes follow-up important.

[Climacteric symptoms and nutritional status of women in post-menopause users and non-users of hormone therapy]. / Sintomas climatéricos e estado nutricional de mulheres na pós-menopausa usuárias e não usuárias de terapia hormonal.

PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.

Study of dermatoses in kidney transplant patients / Estudo das dermatoses em pacientes transplantados renais

BACKGROUND: The increasing in the number of kidney transplant recipients has favored, more frequently than before, the emergence of dermatoses and warranted their study through subsequent publications. OBJECTIVES: to evaluate the frequency of dermatoses in kidney transplant recipients. METHODS: kidney transplant recipients with suspected dermatoses between March 1st 2009 and June 30th 2010. RESULTS: 53 patients (28 males and 25 females), aged between 22 and 69 (mean age = 45 years) were evaluated. Most of them came from the cities of Ceilândia, Samambaia and São Sebastião/DF, and had already been transplanted for 5 to 10 years before (37.7%); 62.3% were recipients of living donors and 83% were prednisone-treated. The most prevalent dermatoses were of fungal (45.3%) and viral (39.6%) etiologies. Among the non-melanoma malignant neoplasms, the basal cell carcinoma prevailed (six cases), in spite of the low incidence. Concerning fungal dermatoses, 12 cases of onychomycosis, five of pityriasis versicolor and four of pityrosporum folliculitis were reported. For diagnosis, in most cases (64.2%), laboratory examinations (mycological and histopathological) were performed. CONCLUSION: cutaneous manifestations in kidney transplant recipients are generally secondary to immunosuppression. The infectious dermatoses, especially those of fungal origin, are frequently found in kidney transplant recipients and their occurrence increases progressively according to the time elapsed from the transplantation, which makes follow-up important. .

FUNDAMENTOS: o crescente aumento do número dos transplantados renais tem favorecido o aparecimento mais frequente das dermatoses e permitido o estudo em sucessivos trabalhos. OBJETIVOS: avaliar a frequência das dermatoses em pacientes transplantados renais. MÉTODOS: captação de pacientes transplantados renais durante o período de 1° de março de 2009 a 30 de junho de 2010 com suspeita de dermatoses. RESULTADOS : foram avaliados 53 pacientes (28 homens e 25 mulheres), entre 22 e 69 anos (com uma média de 45 anos), a maioria procedente de Ceilândia, Samambaia e São Sebastião/DF, entre 5 e 10 anos de transplante renal (37,7%), sendo 62,3% receptor de doador vivo e 83% em uso de prednisona. As dermatoses mais prevalentes foram as de etiologia fúngica (45,3%) e viral (39,6%). Das neoplasias malignas não-melanoma, apesar da baixa incidência, predominou o carcinoma basocelular (seis casos). Com relação s dermatoses de origem fúngica, ocorreram 12 casos de onicomicoses, cinco casos de pitiríase versicolor e quatro casos de foliculite pitirospórica. Para realização do diagnóstico, na maioria dos casos (64,2%), foi utilizado os exames laboratoriais ( micológicos e histopatológicos). CONCLUSÃO: as manifestações cutâneas em pacientes transplantados renais são geralmente secundárias imunossupressão. As dermatoses infecciosas, principalmente as de etiologia fúngica, são frequentes em pacientes transplantados renais, e sua ocorrência aumenta progressivamente, conforme o tempo transcorrido, a partir do transplante, sendo importante o acompanhamento. .

Sintomas climatéricos e estado nutricional de mulheres na pós-menopausa usuárias e não usuárias de terapia hormonal / Climacteric symptoms and nutritional status of women in post-menopause users and non-users of hormone therapy

OBJETIVO: Analisar os sintomas climatéricos e estado nutricional em mulheres na pós-menopausa, usuárias e não usuárias de terapia hormonal (TH). MÉTODOS: Estudo analítico, exploratório, tipo inquérito populacional domiciliar, realizado na área urbana do município de Maringá, Paraná, incluindo 456 mulheres com idade entre 45 e 69 anos, no período pós-menopausa. A coleta teve como base de referência os setores censitários urbanizados (368) do município, de acordo com o Censo Demográfico Brasileiro. Foi utilizada amostra aleatória simples proporcional às mulheres residentes em cada setor censitário e, por meio de visita domiciliar, aplicou-se um questionário e verificaram-se as medidas antropométricas e pressão arterial. Para avaliação dos sintomas climatéricos, foi utilizado o Índice Menopausal de Blatt e Kupperman. A variável desfecho foi o uso de TH. RESULTADOS: A média de idade foi de 58,7 anos. O excesso de peso esteve presente em 72,6% das mulheres e a obesidade abdominal em 81,4% delas. Sintomas climatéricos de intensidade leve foram evidenciados em 69,5% das mulheres. Apenas 18,4% das mulheres faziam uso de TH e eram, na sua maioria, brancas, não fumantes, sem comorbidades e sem companheiro. Usuárias de TH apresentaram menor frequência de excesso de peso e obesidade abdominal e tiveram menor prevalência de sintomas climatéricos de intensidade severa. CONCLUSÃO: O excesso de peso e a obesidade abdominal foram prevalentes na amostra estudada. Embora em menor número, as usuárias de TH apresentaram uma frequência menor de excesso de peso e sintomas climatéricos leves e intensos na pós-menopausa.

PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.

Co-secreção do hormônio de crescimento em pacientes portadores de prolactinoma / Co-secretion of growth hormone in patients with prolactinoma

Objetivo: investigar a co-secreção de hormônio de crescimento em pacientes com o diagnóstico deprolactinoma. Método: estudo analítico e transversal realizado no Hospital Universitário João de BarrosBarreto, no período de julho de 2008 a fevereiro de 2010. A população de referência foram todos indivíduosportadores de prolactinoma atendidos no setor de neuroendocrinologia do referido hospital; casuística de 99pacientes, dos quais 21 foram excluídos, pois não estavam realizando acompanhamento regular. Resultados:entre os pacientes em tratamento, 41% eram macroprolactinomas, apresentando uma média de idade de 36anos. A co-secreção foi investigada em 61,5% dos pacientes com prolactinoma em acompanhamento. Adosagem de GH juntamente com IGF-1 foi realizada em 32 deles (32,3%). Dezenove pacientes apresentaramGH maior que 0,4ng/mL(47,5%) e 7 foram interpretados como co-secretores por apresentarem GH superior a1,0ng/mL (17,5%). Entre os que dosaram IGF-1, 7 (17,5%) estavam acima do limite superior de normalidadepara a idade e sexo. Conclusão: todos os pacientes com prolactinoma devem ser investigados quanto à cosecreção,pela possibilidade de evoluir posteriormente para acromegalia

Objective: study a possible co-secretion of growth hormone (GH) in patients with the diagnosis ofprolactinoma. Method: observational, analytical and tranversalis study was through analysis of medicalregisters and interviews of 78(seventy-eight) patients with diagnostic of prolactinoma, who were makinguniform medical tratament, between July, 2008 and Febreuary, 2010. Results: The great majority of thepatients were female (85,89%), with microprolactinomas (59,00%) and 36,39 years average age. The GHand IGF-1 were measured in 51,28% of the patients, 47,50% showed GH over 0,4ng/mL, 17,50% of themwere considered as co-secretors, because GH was over 1ng/mL. Among the patients who were tested forIGF-1, 17,5% presented incomum gender and age. These were submitted to glucose tolerance test (GTT).During this test the diagnosis of acromegaly were confirmed in 16,6% of the patients. Conclusions: Theinvestigation of co-secretion through the tests for GH and IGF-1 should be routine in all patients withprolactinomas, due to the high risk to develop acromegaly