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Introduction: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular diseases, have fallen. Objectives: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave. Methods: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods – P1 (March 1 to April 30) and P2 (May 1 to June 30). Patient's clinical data and hospital outcomes were compared between the years 2017 to 2019 and 2020 for both periods. Results: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005). Conclusions: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality. Resumo: Introdução: Recentemente durante a pandemia por Covid-19 houve uma perceção global de uma diminuição de admissões hospitalares por causas não infeciosas, em particular por doenças cardiovasculares. Objetivos: Avaliar o impacto da pandemia nas admissões por enfarte agudo do miocárdio com supradesnivelamento de ST (STEMI), na primeira onda da pandemia. Métodos: Análise multicêntrica e retrospetiva de doentes consecutivos admitidos em dois hospitais portugueses por STEMI em dois períodos sequenciais - P1 (1 de março a 30 de abril) e P2 (1 de maio a 30 de junho). Foi realizada uma comparação dos dados clínicos e de evolução hospitalar entre 2017 a 2019 e 2020 para os dois períodos. Resultados: No P1 de 2020 observou-se, relativamente a anos prévios, uma redução do número de doentes com STEMI (26,0±4,2 versus 16,5±4,9 casos por mês; p=0,033) e um aumento do número de complicações mecânicas (0,0% versus 3,0%; p=0,029). Os casos de angioplastia após trombólise falhada foram mais frequentes (1,9% versus 9,1%; p=0,033). Observou-se uma tendência global para um maior atraso nos tempos-chave de abordagem de doentes com STEMI. A taxa de mortalidade destes doentes no P1 foi superior comparativamente a anos prévios (1,9% versus 12,1%; p=0,005). Conclusões: Durante a primeira onda da pandemia Covid-19 houve uma redução do número de doentes submetidos a angioplastia coronária por STEMI. Esses apresentaram mais complicações mecânicas e uma maior mortalidade.

Resumo: A angina refratária define‐se como a persistência de sintomas superior a três meses apesar da terapêutica médica otimizada e revascularização. É uma entidade em crescimento, resultado da melhoria do prognóstico da doença coronária com a terapêutica farmacológica e com as técnicas de revascularização contemporâneas. A mortalidade a longo prazo enquadra‐se no espetro prognóstico da doença estável assintomática, contudo interfere com a qualidade de vida do doente e tem um impacto significativo nos sistemas de saúde.Múltiplos alvos terapêuticos têm sido investigados, contudo, a maioria com resultados dececionantes. Muitas das técnicas foram abandonadas por ausência de eficácia, problemas de segurança e limitações tanto logísticas como económicas à sua implantação.Esta revisão incide essencialmente sobre o dispositivo de redução do seio coronário, cuja evidência, embora ainda escassa, é promissora relativamente à segurança e eficácia na redução dos sintomas anginosos e na melhoria da qualidade de vida. Para além do seu efeito terapêutico, é uma opção virtualmente acessível a todos os serviços de cardiologia de intervenção. Abstract: Refractory angina is defined as persistent angina (≥3 months) despite optimal medical and interventional therapies. It is increasing in frequency, due to the success of current medical and interventional therapies in improving the prognosis of coronary artery disease. Long‐term mortality is similar to that of patients with asymptomatic stable disease, but it affects patients’ quality of life, and has a significant impact on health care resources.Several therapeutic targets have been investigated, most with disappointing results. Many of the techniques have been abandoned because of lack of efficacy, safety issues, or economic and logistic limitations to wider applicability.The primary focus of this review is the coronary sinus Reducer, supporting evidence for which, although scarce, is promising regarding safety and efficacy in improving anginal symptoms and quality of life. It is also accessible to virtually all interventional cardiology departments.

Introduction: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008. Methods: The heart team prospectively assessed 473 patients using a standardized approach. A total of 214 patients were selected for TAVI and 80 for SAVR. Demographic, clinical and procedural characteristics and long-term success rates were compared between the groups. Results: TAVI patients were older than the SAVR group (median 83 vs. 81 years), and had higher surgical risk scores (median EuroSCORE II 5.3 vs. 3.6% and Society of Thoracic Surgeons score 5.1 vs. 3.1%), as did the patients under medical treatment only. These scores were unable to assess multiple comorbidities. Patients’ outcomes were different between the three groups (mortality with SAVR 25% vs. TAVI 37.6% vs. conservative therapy 57.6%, p=0.001). Conclusions: The heart team program was able to select candidates appropriately for TAVI, SAVR and conservative treatment, taking into account the risk of both invasive treatments. The use of a prospective standardized heart team approach is recommended, but requires continuous monitoring to ensure effectiveness in a timely manner. Resumo: Introdução: A estenose aórtica é atualmente a doença valvular mais prevalente na Europa. A substituição valvular aórtica cirúrgica (SVAC) é atualmente considerada a terapêutica de primeira linha, a implantação de válvula aórtica percutânea (VAP) é considerada uma opção em doentes com elevado risco cirúrgico. A avaliação dos doentes pelo Heart Team encontra-se preconizada pelas recentes guidelines publicadas de doenças valvulares, contudo existem poucas publicações acerca dessa temática. O objetivo deste manuscrito é descrever a experiência de um programa multidisciplinar VAP, iniciado em 2008. Métodos: O Heart Team avaliou de forma prospetiva e padronizada 473 doentes. Desses, 214 foram selecionados para VAP e 80 para SVAC. Os grupos foram comparados no que respeita às suas características demográficas, clínicas, de procedimento e quanto à sua evolução (mortalidade). Resultados: O grupo VAP apresentou maior idade do que o grupo SVAC (mediana 83 versus 81 anos) e apresentou scores de risco cirúrgico mais elevados (mediana Euroscore II 5,3 versus 3,6% e STS 5,1 versus 3,1%), tal como o grupo de doentes apenas sob terapêutica médica. Esses scores não foram capazes de avaliar múltiplas comorbilidades. A mortalidade entre os três grupos apresentou diferenças com significado estatístico (SVAC 25% versus VAP 37,6% versus terapêutica conservadora 57,6%, p=0,001). Conclusões: O programa Heart Team foi capaz de selecionar de forma adequada os doentes para as diversas estratégias terapêuticas tendo em conta o risco de ambos os procedimentos invasivos. Uma abordagem eficiente e standardizada pela Heart Team deve ser estimulada, necessitando de reavaliação continua. Keywords: Severe aortic stenosis, Transcatheter aortic valve implantation, Surgical aortic valve replacement, Heart team, Standardization, Palavras-chave: Estenose aórtica grave, Válvula aórtica percutânea, Substituição valvular aórtica cirúrgica, Heart Team, Standardização

Resumo: O 5‐flurouracilo é um agente de primeira linha no tratamento de várias neoplasias. Associa‐se frequentemente a toxicidade cardíaca, particularmente em doentes com doença coronária. O caso apresentado ilustra uma síndrome coronária aguda presumivelmente precipitada por 5‐FU, num doente com doença coronária previamente assintomática e desconhecida e com risco estimado de eventos cardiovasculares de nível intermédio. A avaliação de risco pré‐quimioterapia e a melhor abordagem para a prevenção e manejo desse cenário clínico permanecem por definir. Abstract: 5-Fluorouracil is a first‐line agent in several cancer‐therapy regimens. Cardiotoxicity is common, with coronary artery disease being an important risk factor. We report the case of an acute coronary syndrome presumably induced by 5‐FU, in a patient with previously unknown and asymptomatic coronary artery disease, with an estimated intermediate risk for cardiovascular events. Pre‐chemotherapy risk evaluation and optimal patient care are still not standardized in this clinical scenario. Palavras‐chave: 5‐FU, Angina Pectoris, Cardiotoxicidade, Keywords: 5‐FU, Angina pectoris, Cardiotoxicity

Abstract Background Bacterial auxin production is a mechanism that promotes plant growth. However, it can also be linked to deleterious rhizobacteria and plant-pathogenic bacteria. High levels of auxins have the potential to impede plant growth. Additionally, certain environmental factors can enhance auxin activity and impact the activity of plant growth-promoting rhizobacteria (PGPR). Results In this work, we boarded how the auxin-like effect in the soil–plant system modulates the plant growth-promoting activity of Lysinibacillus pinottii sp. nov. PB211. The effect of humified organic matter (HOM) soil was simulated with humic acids (HA) coming from vermicompost; the spectral configuration (13C-CP-TOSS-NMR and FTIR) and coleoptile elongation test indicated its bioactivity. Cucumber exhibits a PGP effect of PB211 and HA at a lower concentration compared to corn. This disparity agrees with the differential sensitivity to auxins of both plant models. Monocot plants, such as corn, generally exhibit greater resistance to exogenous auxin activity compared to eudicot plants, such as cucumber. The presence of HA in the growth substrate (sand) is found to modulate the PGPR activity of PB211, resulting in a loss of PGPR activity. Conclusions The findings highlight the importance of considering the cumulative auxin-like effects in the soil–plant system when utilizing bacterial inoculants for plant growth promotion in agriculture. Graphical Abstract

Background: Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences. Methods: Anthropometric measurements were conducted on 1564 children aged 6–10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods. Results: The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively. Conclusions: This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem.

Abstract Biofertilizers are an alternative to face the sustainability problem that chemical fertilizers represent in agriculture. Among them, plant growth-promoting rhizobacteria (PGPR) is a microbial group with high potential, but lack of reproducible results from their application is a bottleneck for its use in agricultural production. Here we highlight a factor that could partially explain this inconsistency: the total auxin level in the soil–plant system. Auxin production is recognized as a main mechanism for plant growth promotion by PGPR; however, the final effect of auxins depends on a fine balance of its content, and this will be a result of all the sources of auxin compounds in the system. In addition to the auxins produced by inoculated bacteria, the plant itself produces its own hormones as part of complex physiological processes, varying in amount and sensitivity. Also, soil organic matter displays like auxin activity, causing plant responses just like those produced by added auxins. Therefore, the inoculation of an auxin-producing PGPR on plants might cause a wide variety of responses, ranging from effective growth promotion to growth restriction, depending on the total auxin content in root tissue. We think this must be considered for the practical use of bacterial biofertilizers, in order to have better and more consistent results of inoculation. Graphical Abstract

Introduction: Compared to bare-metal stents (BMS), drug-eluting stents reduce stent restenosis and improve subsequent revascularization rates. The impact on patients’ survival has been the subject of debate. Objective: To assess the long-term (10-year) survival of patients undergoing percutaneous coronary intervention (PCI) with first-generation sirolimus-eluting stents (SES) in comparison with BMS. Methods: In a single-center registry, 600 consecutive patients who underwent successful PCI with SES between April 2002 and February 2003 were compared to 594 patients who underwent PCI with BMS between January 2002 and April 2002, just before the introduction of SES. Clinical and procedural data were collected at the time of intervention and 10-year survival status was assessed via the national life status database. Results: All baseline characteristics were similar between groups except for smaller stent diameter (2.84±0.38 vs. 3.19±0.49 mm; p

Abstract Background A new prototype of bio-conditioner useful in rehabilitation of degraded soils was performed. In order to obtain this aim two stages were established: production of biomass of Microbacterium sp. CSB3 and formulation of this inoculum in a sediment supplemented with low-rank coal (LRC). Materials and methods The effect of agitation and pH on microbial growth was determined. As response variables, the final production of biomass (Xf) and yield (Yx/s) were determined. Growth dynamics of CSB3 in a 2-L reactor was also evaluated through Xf, Yx/s and the determination of kinetic parameters (specific growth rate [μ] and duplication time [Dt]). The formulation of CSB3 was evaluated; mixtures of several LRC proportions with a sediment from a municipal aqueduct were made. During 90 days, the viability of CSB3 was monitored by counting CFU. Results The optimal pH and agitation for Xf and Yx/x were 7.5 and 232 rpm, respectively; the values of Xf, Yx/s, μ and Dt in 2-L reactor were: 1.5 gL−1, 0.28 g/g, 0.0208 h−1, 33.3 h, respectively. Regarding the formulation, the most suitable combination to conserve the viability of CSB3 was LRC 25%–sediment 75%; the heavy metals content of LRC allow to infer that the prototype of bio-conditioner does not represent a pollution risk for environment soil. Conclusions It was possible to optimize the growth of CSB3 under laboratory conditions. The viability of CSB3 could be maintained by a formulation in a sediment supplemented with lignite; this formulation constitutes a new prototype of soil bio-conditioner.

Introduction: Surgical risk scores are widely used to identify patients at high surgical risk who may benefit from transcatheter aortic valve implantation (TAVI). A multiparametric TAVI mortality risk score based on a French registry (FRANCE-2) has recently been developed. The aim of our study was to compare the 30-day mortality prediction performance of the FRANCE-2, EuroSCORE II and STS scores. Methods: We retrospectively studied 240 patients from a single-center prospective registry who underwent TAVI between January 2008 and December 2015. All scores were assessed for calibration and discrimination using calibration-in-the-large and ROC curve analysis, respectively. Results: The observed mortality was 5.8% (n=14). The median EuroSCORE II, STS and FRANCE-2 scores were 5.0 (IQR 3.2-8.3), 5.1 (IQR 3.6-7.1) and 2.0 (IQR 1.0-3.0), respectively. Discriminative power was greater for EuroSCORE II (C-statistic 0.67) and STS (C-statistic 0.67) than for FRANCE-2 (C-statistic 0.53), but this was not statistically significant (p=0.26). All scores showed adequate calibration. Conclusions: All scores showed modest performance in early mortality prediction after TAVI. Despite being derived from a TAVI population, FRANCE-2 was no better than surgical risk scores in our population. Resumo: Introdução: Os scores de risco cirúrgico têm sido amplamente usados para identificar doentes com alto risco cirúrgico que podem beneficiar da implantação de válvula aórtica por via percutânea (TAVI). Foi recentemente apresentado um «score de risco» multiparamétrico de mortalidade por TAVI com base num registo francês – FRANCE 2. O objetivo do nosso estudo foi comparar o desempenho do FRANCE 2, EuroSCORE II (ES II) e STS-Prom (STS) em prever a mortalidade a 30 dias nos doentes submetidos a TAVI. Métodos: Foram estudados retrospetivamente 240 doentes de um registo prospetivo de centro único que foram submetidos a TAVI entre janeiro de 2008 e dezembro de 2015. Todos os scores foram avaliados para discriminação e calibração, com o uso da análise de curvas ROC e da análise de calibration-in-the-large, respetivamente. Resultados: A mortalidade observada foi de 5,8% (n = 14). A mediana do ES II, STS II e FRANCE II foi de 5,0 (IQR 3,2-8,3), 5,1 (IQR 3,6-7,1) e 2,0 (IQR 1,0-3,0), respetivamente. O poder discriminatório foi maior para ES II (C-statistic 0,67) e STS (C-statistic 0,67) quando comparado com o FRANCE 2 (C-statistic 0,53), embora não fosse estatisticamente significativo (p = 0,26). Todos os scores apresentaram calibração adequada. Conclusões: Todos os scores apresentaram um desempenho modesto em prever a mortalidade precoce após TAVI. Apesar de ser derivado de uma população de doentes submetidos a TAVI, o FRANCE-2 não mostrou ser melhor do que os scores de risco cirúrgicos na nossa população. Keywords: Aortic stenosis, Transcatheter aortic valve implantation, Risk scores, Early mortality, Palavras-chave: Estenose aórtica, TAVI, Scores de risco, Mortalidade precoce

El efecto auxin-like consiste en la promoción del crecimiento vegetal por ácidos húmicos (AH). En este trabajo, se evaluó el efecto auxin-like de ácidos húmicos, mediante la determinación del área foliar y la superficie radicular de plántulas de maíz. Los AH fueron obtenidos por solubilización alcalina de carbón, denominados AH-NaOH y mediante solubilización bacteriana de carbón, designados AH-BSC3 y AH-BSC25. Se probó la aplicación de AH, mediante inmersión de semillas en soluciones de 20, 80 y 150mgAH/L y por aspersión foliar sobre plántulas de dos semanas. El ensayo, se desarrolló bajo condiciones de casa de malla y constó de cinco repeticiones por tratamiento; 30 días después de la siembra en suelo, se determinó el área foliar, utilizando el software ImageJ y la superficie total de raíces, mediante un algoritmo desarrollado en Matlab. Se registraron incrementos significativos en el área foliar de plantas tratadas mediante la inmersión de semillas, en soluciones de AH-BSC-3-80mg/L y 150mg/L, AH-BSC-25-20mg/L y 150mg/L, y AH-NaOH-80mg/L y plantas tratadas mediante aspersión foliar de AH-BSC-3-150mg/L, AH-BSC-25-150mg/L y AH-NaOH-150mg/L. También, se evidenciaron incrementos significativos en la superficie total de raíces de plántulas tratadas con AH-BSC25-150mg/L, AH-NaOH-80mg/L y AH-BSC3-80mg/L y todos los tratamientos de AH por aspersión. Se presentó el efecto auxin-like de AH sobre el desarrollo radicular y foliar de plántulas de maíz, a través del análisis digital de imágenes; esta herramienta puede producir información precisa para medir algunos parámetros del proceso vegetal.

Título en ingles: Halotolerant alkalophilic and indolacetic acid producing acid producing bacteria associated with Arthrospira platensis (Cyanophyceae) Resumen: Este trabajo tuvo como propósito contribuir al conocimiento de la interacción entre la cianobacteria alcalófila Arthrospira platensis y las bacterias que crecen asociadas a su mucilago. Se desarrolló un medio de cultivo heterotrófico en el cual se aislaron cinco cepas bacterianas asociadas a un monocultivo de A. platensis. Se determinó la capacidad de estas cinco cepas para producir ácido 3- indol acético (AIA). La tipificación molecular de los aislamientos bacterianos permitió identificarlos como Exiguobacterium aurantiacum str. DSM 20416, Xanthomonas sp. ML-122, Halomonas sp. Ap-5, Bacillus okhensis str. Kh10-101, Indibacter alkaliphilus, type str. LW1T; todas las cepas bacterianas obtenidas son halotolerantes, alcalófilas y productoras de AIA. Los resultados aportan evidencia para sugerir una interacción benéfica entre A. platensis y sus bacterias asociadas, quizá como estrategia evolutiva de cooperación para desarrollarse en un ambiente hipersalino. Palabras claves: Bacillus okhensis, Exiguobacterium aurantiacum, Halomonas sp., Indibacter alkaliphilus. Xanthomonas sp. Abstract: The aim of this study was contribute to knowledge over alkalophilic cianobacteryum Arthrospira platensis and their interaction with some associated bacteria growing in their mucilage. Heterotrophic culture medium was designed, in this medium were isolated five bacterial strains associated to single culture of A. platensis. It was measured the 3-indol acetic acid (IAA) production by these bacterial strains. Molecular typing allowed identify these bacterial strains like Exiguobacterium aurantiacum str. DSM 20416, Xanthomonas sp. ML-122, Halomonas sp. Ap-5, Bacillus okhensis str. Kh10-101, Indibacter alkaliphilus, type str. LW1T; all these bacteria are halotolerant, alkalophilic and IAA producer. The findings allow suggest a beneficial interaction between A. platensis and their associated bacteria, maybe as evolutionary strategy of cooperation to grow and develop in hypersaline environments. Key words: Bacillus okhensis, Exiguobacterium aurantiacum, Halomonas sp., Indibacter alkaliphilus.Xanthomonas sp.

Arthrospira platensis associated bacteria (APAB) identified through molecuar biology like Bacillus okhensis, Indibacter alkaliphilus and Halomonas sp., are also producing 3-indol acetic acid (IAA), these bacteria was used in early plant growth promotion tests over Sorghum bicolor, these bioassay was considered indirect evidence to suggest that APAB also may have stimulatory effects over A. platensis growth naturally. I. alkaliphilus and B. okhensis enhanced early germination of S. bicolor seads, with better results than that achieved by Azospirillum brasilense, bacterium used like reference as a common plant growth promoting rizobacteria. The three APAB enhanced significative differences (P≤0.05) over morphoagronomic parameters, I. alkaliphilus and B. okhensis exhibith better resoults in elongation stimulation and root and foliage dry weight. Above evidence suggest this bacteria like plant growth promoting and it recomended testing with A. platensis axenic cultures and its associated bactteri for understanding true interaction between them.

Bronquiectasia consiste em dilatação anormal, permanente e irreversível de brônquios e bronquíolos, com infecções recorrentes, inflamações, hipersecreção e redução da limpeza mucociliar. Acomete predominantemente o sexo feminino, entre 28 e 48 anos de idade e afeta com maior freqüência os lobos inferiores bilateralmente. Manifestações clínicas da doença são a tosse crônica, febre e expectoração volumosa, purulenta, com odor fétido. Etiologia é inespecífica e representada pelo estádio final de diversos processos patológicos. Pode ser classificada em cilíndrica, varicosa e sacular, e ainda, em localizada e multissegmentar. Drenagem postural e percussão são técnicas desobstrutivas usuais na prática clínica diária, no entanto, há escassez de estudos comparativos enfatizando-as com amostras populacionais e recursos metodológicos. Tomando por base as considerações, teve-se como objetivo verificar a eficácia da drenagem postural e da percussão na higiene brônquica de pacientes bronquiectásicos, bem como seus efeitos e associação com outras técnicas apontadas pela literatura atual. Os principais achados comprovaram que a drenagem postural e a percussão são efetivas na mobilização da secreção pulmonar, uma vez que aumentam a velocidade do muco transportado, melhoram a função pulmonar e as trocas gasosas. A efetividade requer ajuda de um profissional, o que pode dificultar a prática clínica diária. Por esta razão, fisioterapeutas têm selecionado técnicas que propiciem independência ao paciente.Bronchiectasis consists of abnormal, permanent and irreversible dilation of bronchi and bronchia, with recurrent infections, inflammation, hypersecretion and reduction of mucus clearance. It predominantly affects women of between 28 and 48 years old and more frequently affects the inferior lobes. Clinical manifestations are chronic cough, fever and voluminous expectoration, with a fetid odor. The etiology is unspecific and is considered the final stage of diverse pathological processes. It can be classified in cylindrical, varicose and cystic, and also in respect to located and whether it affects multiple segments. Postural drainage and chest clapping are commonly used clearence however, there are few published comparative population studies or reviews of techniques. In this context, this study aimed at evaluating the efficaciouness of postural drainage and chest clapping on bronchus clearence in bronchiectasis patients and to compare the effects and associations of these techniques with others reported in the literature. Recent research reported that postural drainage and chest clapping are effective therapies to mobilize pulmonary secretions as they increase the velocity of mucus transportion, improving pulmonary function and gas exchange. This requires the assistance of a professional, which can make the necessary daily treatment difficult. For this reason physiotherapists have been choosing techniques that give more independence to patients.

Objetivo: apresentar uma nova abordagem laparoscópica para tratamento do câncer de endométrio. Métodos: de fevereiro de 1996 à fevereiro de 1998, doze pacientes com câncer de endométrio, diagnosticadas por histeroscopia e biópsia, foram submetidas a linfadenectomia pélvica associada à histerectomia e salpingooforectomia por laparoscopia. A média de idade das pacientes foi de 58,1 anos; o número médio de gestações foi 2,3 e o índice de massa corpórea médio foi de 28,6. Resultados: o tempo anestésico médio foi de 4,8 horas. O tempo médio de internação foi de 3,3 dias. O número total de linfonodos retirados foi de 176, sendo 104 (59,1%) do lado direito e 72 (40,9%) do lado esquerdo. Não foram encontrados linfonodos comprometidos. O número médio de linfonodos retirados por paciente foi de 18,5. Foram observadas duas complicações: em um caso houve necessidade de abandonar o procedimento por aumento da pressão endotraqueal e uma das pacientes evoluiu com formação de granuloma em cúpula vaginal. Conclusões: nesta avaliação preliminar dos resultados de histerectomia total com anexectomia bilateral e lifadenectomia laparoscópica para o tratamento do câncer de endométrio, obtivemos resultados satisfatórios quanto ao estadiamento da neoplasia ao número de linfonodos retirados e quanto às complicações cirúrgicas observadas.Purpose: to demonstrate a new approach to treatment of endometrial cancer. Methods: Between February, 1996 and February, 1998, twelve patients with endometrial cancer, diagnosed by hysteroscopy and biopsy, were submitted to pelvic lymphadenectomy and hysterectomy with salpingo-oophorectomy by laparoscopy. The mean age was 58.1 years, the mean number of gestations was 2.3 and the mean body mass index was 28.6. Results: the mean length of anesthesia was 4.8 hours. The mean time of hospital stay was 3.3 days. The total of lymph nodes obtained was 176, 104 (59.1%) being from the right side and 72 (40.9%) from the left side. The mean of lymph nodes per patient was 18.5. We observed two complications: in one case the laparoscopic procedure had to be abandoned because the patient presented a dangerous increase in intratracheal pressure and in the other case a granuloma in the vagina was observed. Conclusions: the initial evaluation of the laparoscopic hysterectomy and laparoscopy shows that we achieved good results regarding the accuracy of staging, the number of nodes and a small number (3) of complications.

INTRODUCTION: Male genital infection by human papillomavirus is of particular importance since it is often asymptomatic. The patient generally presents no clinical lesion. Therefore, men represent an important reservoir of virus, playing a special role in the transmission and perpetuation of the disease. PATIENTS AND METHODS: In the present prospective clinical trial study, 190 sex partners of women with genital infection by human papillomavirus, associated or not with cervical intraepithelial neoplasia, were investigated. All patients were unaware of or denied the presence of a genital lesion. RESULTS: Cytologic examination revealed koilocytosis in 9 cases (4.7%) in the urethra and in 3 cases (1.6%) in the corona of the glans and the distal prepuce. Peniscopy with the previous use of 5% acetic acid revealed white lesions in 97.9% of the patients. Toluidine blue stained most of the lesions. At least one fragment revealed koilocytosis in the histopathologic study of 97 cases (51.05%). CONCLUSION: The three methods complement one another, allowing a more precise diagnosis of this infection in men.