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A síndrome braquicefálica é um conjunto de alterações anatômicas e fisiológicas, que dificultam a passagem de ar nas vias aéreas. Essa síndrome combina a estenose de narinas e alongamento do palato mole como alterações primárias, que levam a alterações secundárias. Em função desses fatores, o animal faz maior esforço respiratório, apresentando sinais clínicos como ronco durante o sono e acordado, intolerância ao exercício físico, disfagia, espirro reverso e cianose. O relato objetiva apresentar as técnicas cirúrgicas estafilectomia e rinoplastia utilizadas para correção da angústia respiratória em canino da raça Bulldog Francês.

HPV-positive (HPV+) cervical cancer (CC) cells have been reported to express the IL-2 receptor (IL-2R) in contrast to virus-negative CC cells. This work was carried out to evaluate whether HPV infection induces IL-2R expression in CC cells. The analysis of the IL-2R expression data collected from The Cancer Genome Atlas (TCGA) and Genotype Tissue Expression project (GTEx) using the Xena platform demonstrate a higher expression of IL-2R subunits in CC tumors in comparison with normal tissues. Moreover IL-2Rβ expression is consistently higher in HPV+ tumors versus HPV- tumors. Furthermore, it was demonstrated that transfection of the HPV E6/E7 genes into the C33A (HPV-) cell line promotes IL-2R expression and regulates proliferation in response to exogenous IL-2. Additionally, we found that HPV+ cell lines enhances their proliferation in co-culture with peripheral blood lymphocytes (PBLs). To corroborate that the viral proteins E6 and E7 were related to the effects mediated by IL-2, we used cells derived from the HeLa cell line in which the expression of E6/E7 has decreased, we found that it loses the ability to respond to the exogenous IL-2 stimuli. Finally, the importance of IL-2R in CC, as an immune escape mechanism, is discussed.

Este artigo apresenta uma análise exploratória de como as informações de saúde foram compartilhadas e discutidas no Twitter em termos de tópicos de conscientização e posicionamentos durante surto da Febre Amarela de 2017 no Brasil. Para isso, foi utilizada a abordagem de mineração de dados com análise exploratória de grafos. Como principais resultados, foram identificados os picos de mensagens comparados aos picos de casos notificados em algumas regiões do país, uma análise das hashtags vinculadas ao principal assunto e diferentes tópicos oriundos da análise exploratória de grafos como campanha de vacinação, sentimentos, prevenção, rumores, outras doenças vinculadas ao mesmo transmissor entre outros. Este estudo demonstrou que as redes sociais, como o Twitter, oferecem oportunidades únicas para a vigilância participativa, podendo auxiliar no monitoramento de alguns aspectos da saúde pública e oferecer dados adicionais aos gestores de saúde de como as pessoas interagem durante um surto.

To present a cognitive map to support the radiological diagnosis of solitary bone tumors, as well as to facilitate the determination of the nature of the tumor (benign or malignant), in pediatric patients.We selected 28 primary lesions in pediatric patients, and we identified the findings typically associated with each of the diagnoses. The method used for the construction of the final cognitive map was the Bayesian belief network model with backward chaining.We developed a logical, sequential structure, in the form of a cognitive map, based on the Bayesian belief network model, with the intention of simulating the sequence of human thinking, in order to minimize the number of unnecessary interventions and iatrogenic complications arising from the incorrect evaluation of bone lesions.With this map, it will be possible to develop an application that will provide support to physicians and residents, as well as contributing to training in this area and consequently to a reduction in diagnostic errors in patients with bone lesions.Apresentar um mapa cognitivo para suporte na determinação da natureza benigna ou maligna, bem como no diagnóstico radiológico, de tumores ósseos solitários na faixa etária pediátrica.Foi realizada uma seleção de 28 lesões principais na faixa etária pediátrica e dos achados característicos e associados a cada um desses diagnósticos. O método utilizado para a construção da estrutura cognitiva final foi o modelo de rede de crenças bayesianas com a técnica de encadeamento regressivo.Foi desenvolvida uma estrutura lógica e sequencial no formato de um mapa cognitivo, segundo o modelo de rede de crenças bayesianas, na tentativa de simular o raciocínio humano sequencial e minimizar esforços e iatrogenias oriundas da avaliação equivocada de lesões ósseas.Com base nesse mapa, será possível oferecer um aplicativo para apoio a profissionais e residentes médicos e colaborar com o treinamento nessa área e, consequentemente, diminuir erros no diagnóstico de uma lesão óssea.

The authors conducted a review of the most prevalent skin manifestations associated with the thyroid and its functions. Cutaneous diseases more often related to hyperthyroidism and hypothyroidism, and the structural changes of the thyroid gland are discussed separately. The pathogenesis, clinical presentation, investigative examinations, and treatment of thyroid-related cutaneous disease are described.

This chapter analyzes the various characteristics of ultraviolet radiation basically with regard to the spectrum reaching the Earth’s surface. Many biological effects determined by wavelengths are reviewed, including photodermatoses for which the pathogenesis is possibly immunologic. Useful aspects in the diagnosis and treatment of polymorphic light eruptions, actinic prurigo, hydroa vacciniforme, chronic actinic dermatitis, and solar urticaria are examined.

OBJECTIVE: To propose a semi-automated method for pattern classification to predict individuals' stage of growth based on morphologic characteristics that are described in the modified cervical vertebral maturation (CVM) method of Baccetti et al. MATERIALS AND METHODS: A total of 188 lateral cephalograms were collected, digitized, evaluated manually, and grouped into cervical stages by two expert examiners. Landmarks were located on each image and measured. Three pattern classifiers based on the Naïve Bayes algorithm were built and assessed using a software program. The classifier with the greatest accuracy according to the weighted kappa test was considered best. RESULTS: The classifier showed a weighted kappa coefficient of 0.861 ± 0.020. If an adjacent estimated pre-stage or poststage value was taken to be acceptable, the classifier would show a weighted kappa coefficient of 0.992 ± 0.019. CONCLUSION: Results from this study show that the proposed semi-automated pattern classification method can help orthodontists identify the stage of CVM. However, additional studies are needed before this semi-automated classification method for CVM assessment can be implemented in clinical practice.

To assess whether a warning system based on mobile SMS messages increases the adherence of HIV-infected Brazilian women to antiretroviral drug-based treatment regimens and their impressions and satisfaction with respect to incoming messages.A randomized controlled trial was conducted from May 2009 to April 2010 with HIV-infected Brazilian women. All participants (n=21) had a monthly multidisciplinary attendance; each participant was followed over a 4-month period, when adherence measures were obtained. Participants in the intervention group (n=8) received SMS messages 30 min before their last scheduled time for a dose of medicine during the day. The messages were sent every Saturday and Sunday and on alternate days during the working week. Participants in the control group (n=13) did not receive messages.Self-reported adherence, pill counting, microelectronic monitors (MEMS) and an interview about the impressions and satisfaction with respect to incoming messages.The HIV Alert System (HIVAS) was developed over 7 months during 2008 and 2009. After the study period, self-reported adherence indicated that 11 participants (84.62%) remained compliant in the control group (adherence exceeding 95%), whereas all 8 participants in the intervention group (100.00%) remained compliant. In contrast, the counting pills method indicated that the number of compliant participants was 5 (38.46%) for the control group and 4 (50.00%) for the intervention group. Microelectronic monitoring indicated that 6 participants in the control group (46.15%) were adherent during the entire 4-month period compared to 6 participants in the intervention group (75.00%). According to the feedback of the 8 participants who completed the research in the intervention group, along with the feedback of 3 patients who received SMS for less than 4 months, that is, did not complete the study, 9 (81.81%) believed that the SMS messages aided them in treatment adherence, and 10 (90.90%) responded that they would like to continue receiving SMS messages.SMS messaging can help Brazilian women living with HIV/AIDS to adhere to antiretroviral therapy for a period of at least 4 months. In general, the results are encouraging because the SMS messages stimulated more participants in the intervention group to be adherent to their treatment, and the patients were satisfied with the messages received, which were seen as reminders, incentives and signs of affection by the health clinic for a marginalized population.

FUNDAMENTOS: a ceratose actínica é lesão pré-maligna frequente, que ocorre em áreas expostas à luz solar, em pessoas idosas ou adultas de meia-idade e pele clara. A criocirurgia com nitrogênio líquido é a modalidade mais comum para o tratamento de ceratoses actínicas. OBJETIVOS: o objetivo primário deste estudo foi medir a intensidade da dor durante a criocirurgia, por meio da Escala Visual Análoga. Também buscou-se identificar o nível de dor considerado adequado pelo paciente, avaliar a proporção de pacientes que consideram necessária a diminuição da dor sentida e verificar a necessidade ou não de analgesia suplementar. MÉTODOS: Estudo transversal com pacientes encaminhados para terapêutica criocirúrgica de ceratoses actínicas no Ambulatório de Dermatologia Sanitária. Foram avaliados 112 pacientes, após tratamento de ceratoses actínicas, aplicando-se um questionário com perguntas sobre a intensidade da dor sentida durante o procedimento cirúrgico, assim como a dor considerada confortável ou adequada ao procedimento. RESULTADOS: participaram 48 homens (42,8%) e 64 mulheres (57,2%). A média da dor referida durante o procedimento cirúrgico, medida em milímetros na Escala Visual Análoga, foi de 32,85 mm; a média da dor considerada adequada pelos pacientes foi de 23,01 mm. A diferença entre as duas médias foi estatisticamente significativa (p

Os autores apresentam caso clínico-patológico de Granuloma Anular Perfurante Generalizado, com extensa distribuição de lesões, as quais se mostram em diversas fases de evolução. Pústulas, lesões papulosas, em distribuição anular e arciforme, erosões recobertas por crostas hemáticas, áreas máculo atróficas e cicatrizes foram as faces de apresentação da doença. Os aspectos histopatopatológicos são detalhadamente discutidos, dentro das dermatites granulomatosas não infecciosas. O texto baseia-se nas opiniões de alguns autores da literatura. Além disso, o resultado terapêutico obtido foi demonstrado por fotografias, resultado de 3 meses de Dapsona na dose de 100 mg por dia.

Objetivo: Avaliar os serviços descentralizados de reabilitação física direcionados aos portadores de deficiência à luz da portaria GM/MS nº818/2001, considerando-se também a percepção dos profissionais e usuários sobre os referidos serviços. Participaram 5 serviços de reabilitação, 10 profissionais e 42 usuários. Método: Utilizou-se um formulário estruturado, contendo 67 itens da portaria, 21 itens foram apontados pelos profissionais e uma pergunta foi realizada aos usuários sobre a qualidade do serviço. Elaborou-se um ranking de classificação entre os serviços de reabilitação. Resultados: Verificou-se que 100% dos serviços possuem uma classificação regular considerando a portaria e 80% dos profissionais consideraram o serviço que atuam como regular. A qualidade dos serviços foi “muito boa” na opinião dos usuários. Existe uma relação entre os itens apontados na portaria ministerial e a opinião dos profissionais dos serviços Conclusão: A implantação dos serviços de reabilitação física no estado de Alagoas parece ser favorável, em especial na opinião dos usuários.

Introdução: Há séculos, a Humanidade preocupa-se em substituir órgãos defeituosos por outros sadios, mas somente há poucas décadas os avanços da Medicina tornaram esse sonho realidade, por meio dos transplantes de órgãos. Com o intuito de melhorar o entendimento dos processos envolvidos e até mesmo detectar qual perfil de paciente receptor terá maior chance de sobrevida, diversas técnicas de análise de base de dados de transplantes de órgãos têm sido empregadas, contribuindo de forma direta ou indireta na descoberta de conhecimento ainda não mapeado. Objetivo: Apresentar, a partir da literatura científica especializada, quais técnicas computacionais estão sendo utilizadas para analisar bases de dados de transplante de órgãos. Métodos: Para revisão bibliográfica foi realizada pesquisa em resumos de artigos publicados no biênio 2007-2008, utilizando bases de dados científicas PubMed e ISI. Resultados: Foram selecionados 89 resumos de artigos e, após análise dos resumos considerando os critérios de inclusão e exclusão, foram selecionados cinco artigos. Esses mostravam que redes neurais artificiais e regressão logística obtêm bons resultados quando aplicados em bases de dados de transplante de órgãos para descoberta de conhecimento e, de forma geral, apresentavam resultados animadores em suas respectivas bases de dados de estudo. Poucos estudos realmente foram aplicados na prática clínica. Conclusão: Tendo em vista os resultados encontrados na literatura, a aplicação de técnicas de inteligência artificial tem obtido resultados superiores às normalmente utilizadas para previsão em dados de transplante e existe potencial para desenvolvimento de sistemas de apoio à decisão clínica para transplante de órgãos.

This study aims to identify whether the use of concept mapping (CM) strategy assists a student to extend and revise their expertise in oncology and analyze the abilities developed in a student in order to go through theoretical to practical knowledge. This study is descriptive and qualitative, with 20 undergraduate students of the Undergraduate Nursing Course of Paulista School of Nursing of Federal University of Sao Paulo, Brazil. The critical incident technique and content analysis were used. There were 12 categories represented by facilities, difficulties, and learning applicability in oncology provided by CM strategy during the surgical and clinical nursing discipline. The graphics resource, CMapTools®, and the clinical case data arranged in mapping for resolution generated an active search and exercise of self-learning in oncology. Despite the challenges of the use of CM as a teaching strategy—pedagogical, the results suggested an increase of autonomy and clinical reasoning in nursing practice.

The oncology care is one of the most distinguished scenarios, considering cancer diagnosis plurality, treatment types, physical symptoms (from the treatment or the disease), and comorbidities, variety of socio-demographic and cultural profiles of patients and family, and also physical, material and technological resources. In this sense, the health professional that works in oncology has a daily challenges to ensure the quality of care and should be updated in these different aspects [1].

Dowling-Degos disease is a rare genodermatosis characterized principally by progressive reticulate hyperpigmentation of the flexures. Although the condition is benign, it may be associated with skin malignancies. Furthermore, the characteristic skin changes may be psychologically and socially detrimental to the patient as a result of the unsightliness of the condition. The present report describes a case in which this disease was associated with a keratoacanthoma, and summarizes current concepts on this skin disorder.

BACKGROUND: Actinic keratosis is a frequent lesion which occurs in sunlight exposed areas. Diclofenac sodium and 5-Fluorouracil are effective, non-invasive and easy-to-apply topical treatment options. OBJECTIVES: To assess and compare the effectiveness of 3% diclofenac sodium associated with 2.5% hyaluronic acid and of 5% 5-Fluorouracil for the treatment of actinic keratosis, as well as the patient's degree of satisfaction and tolerability. METHODS: 28 patients with a clinical diagnosis of actinic keratosis were randomized to receive diclofenac sodium or 5-Fluorouracil and were clinically assessed before and after treatment as well as 8 weeks after the end of treatment. Modified versions of the Investigator and Patient Global Improvement Scores were used. RESULTS: The average number of lesions in the diclofenac sodium group before and after treatment was 13.6 and 6.6 (p

The International Classification of Sleep Disorders lists 90 disorders. Manifestations, such as snoring, are important signs in the diagnosis of the Obstructive Sleep Apnea Syndrome; they are also socially undesirable. OBJECTIVE: The aim of this paper was to present and evaluate a computerized tool that automatically identifies snoring and highlights the importance of establishing the duration of each snoring event in OSA patients. MATERIAL AND METHODS: The low-sampling (200 Hz) electrical signal that indicates snoring was measured during polysomnography. The snoring sound of 31 patients was automatically classified by the software. The Kappa approach was applied to measure agreement between the automatic detection software and a trained observer. Student's T test was applied to evaluate differences in the duration of snoring episodes among simple snorers and OSA snorers. RESULTS: Of a total 43,976 snoring episodes, the software sensitivity was 99. 26%, the specificity was 97. 35%, and Kappa was 0. 96. We found a statistically significant difference (p

The gold standard for nephrotoxicity and acute cellular rejection (ACR) is a biopsy, an invasive and expensive procedure. More efficient strategies to screen patients for biopsy are important from the clinical and financial points of view. The aim of this study was to evaluate various artificial intelligence techniques to screen for the need for a biopsy among patients suspected of nephrotoxicity or ACR during the first year after renal transplantation. We used classifiers like artificial neural networks (ANN), support vector machines (SVM), and Bayesian inference (BI) to indicate if the clinical course of the event suggestive of the need for a biopsy. Each classifier was evaluated by values of sensitivity and area under the ROC curve (AUC) for each of the classifiers. The technique that showed the best sensitivity value as an indicator for biopsy was SVM with an AUC of 0.79 and an accuracy rate of 79.86%. The results were better than those described in previous works. The accuracy for an indication of biopsy screening was efficient enough to become useful in clinical practice.

Este estudo objetiva desenvolver um protocolo eletrônico com informações estruturadas e específicas para o atendimento e acompanhamento do paciente com doença celíaca, disponível na web, e avaliá-lo em termos de usabilidade. A estruturação dos dados clínicos foi feita por análise de formulários para consulta, prontuários e um protocolo clínico. Um protocolo para o atendimento durante a consulta para fins de diagnóstico clínico foi esquematizado e o sistema computacional web foi modelado e construído para suportar a implementação deste protocolo. Para a avaliação da usabilidade do sistema web, foi utilizado o questionário System Usability Scale (SUS). O SUS-score resultou em um valor médio de 83,5±10,0, o que indica que o sistema web foi considerado de fácil uso e de acordo com a satisfação do usuário. O sistema web implementou adequadamente o protocolo. A utilização do protocolo eletrônico mostrou-se válida para o atendimento e monitoramento do paciente com doença celíaca, pois manteve a especificidade dos dados clínicos e a rotina dos profissionais envolvidos.

Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine.To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques.A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations.The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (p0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician's diagnostic impression and the gold standard k=0. 64 (p0.0001). There was moderate agreement between the physician's diagnostic impression and CDSS k=0.46 (p=0.0008).The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis.

O objetivo desta pesquisa foi desenvolver um instrumento digital - aqui denominado Sistema BabyCare - para coleta, armazenamento e apoio à decisão dos profissionais de saúde e demais envolvidos na assistência primária infantil em comunidades carentes. Esse sistema baseia-se em tecnologias de dispositivos móveis para utilização local em unidades básicas de saúde em comunidades carentes, assistidos ou não pelo Programa/Estratégia Saúde da Família (PSF), organizações não governamentais, ambulatórios e hospitais. Utilizou-se Java como linguagem de programação. Foram realizadas avaliações sobre o uso do sistema na cidade de São Paulo, envolvendo 62 usuários com diferentes formações, incluindo voluntários da Pastoral da Criança e do PSF. Os questionários aplicados resultam em alto índice de aceitação geral (98,3%); treinamento in loco considerado adequado (91,9%); percepção na melhoria na rotina e na redução de tempo da consulta (100,0%) e na redução no volume de documentos (96,7%). Conclusão: o protótipo apresentou-se robusto e eficiente para uso em comunidades carentes com infraestrutura precária de informática e telecomunicação. The purpose of this work was to develop a digital device - referred as BabyCare System - for the collection, storage, and decision support for healthcare professionals and other concerned people, in order to assist patients in primary child care in deprived communities. This system is based on handheld device technologies to be used locally in basic healthcare units in deprived communities, whether assisted or not by the Family Health Program/Strategy (PSF), as well as in ambulatory facilities and hospitals. Java was used as programming language. Evaluations have been conducted regarding 62 users at São Paulo city including volunteers from the Pastoral da Criança, an ecumenical institution for children. The applied questionnaires resulted in a high level of general acceptance (98.3%); the on-site training was considered as appropriate (91.9%); a perception of routine improvement and decrease in the time of consultation (100.0%), and a decrease in the volume of paperwork (96.7%). The prototype has proven to be robust and effective for the use in deprived communities with precarious computer and telecommunication infrastructure.

We examined the agreement between diagnoses of pigmented skin lesions based on an in-person (face-to-face) dermatological examination and diagnoses based on the study of medical records and images transferred through the web (teledermatoscopy). Two experienced dermatologists examined and diagnosed 64 pigmented skin lesions, which had been surgically excised and undergone histopathology examination. Two years later, the same cases were studied and diagnosed once again by the same dermatologists via the web. There was 72% agreement between the in-person diagnoses and the biopsy results (the gold standard), and 66% agreement between the telediagnoses and the biopsy results. Telemedicine had high sensitivity (87%) and specificity (73%), although there were 4 false-negative diagnoses. A web-based dermatoscopic diagnostic service appears to be feasible and would meet the needs for access to specialized services in rural areas. However, further work is required to decrease the number of false negative cases.

SummaryBackground: Mouth breathing is a chronic syndrome that may bring about postural changes. Finding characteristic patterns of changes occurring in the complex musculoskeletal system of mouth-breathing children has been a challenge. Learning vector quantization (LVQ) is an artificial neural network model that can be applied for this purpose.Objectives: The aim of the present study was to apply LVQ to determine the characteristic postural profiles shown by mouth-breathing children, in order to further understand abnormal posture among mouth breathers.Methods: Postural training data on 52 children (30 mouth breathers and 22 nose breathers) and postural validation data on 32 children (22 mouth breathers and 10 nose breathers) were used. The performance of LVQ and other classification models was compared in relation to self-organizing maps, back-propagation applied to multilayer perceptrons, Bayesian networks, naive Bayes, J48 decision trees, k*, and k-nearest-neighbor classifiers. Classifier accuracy was assessed by means of leave-one-out cross-validation, area under ROC curve (AUC), and inter-rater agreement (Kappa statistics).Results: By using the LVQ model, five postural profiles for mouth-breathing children could be determined. LVQ showed satisfactory results for mouth-breathing and nose-breathing classification: sensitivity and specificity rates of 0.90 and 0.95, respectively, when using the training dataset, and 0.95 and 0.90, respectively, when using the validation dataset.Conclusions: The five postural profiles for mouth-breathing children suggested by LVQ were incorporated into application software for classifying the severity of mouth breathers’ abnormal posture.

Objective Nonattendance for appointments remains a challenge to health care managers and providers. The objective of this article is to present the results of a study on the impact of appointment reminders sent as short message service text messages to patients' cell phones on nonattendance rates at outpatient clinics in Sao Paulo, Brazil. Design Data were collected on scheduled appointments in four medical clinics using Clinic Manager ® or Clinic Web ® systems that can send automated messages to patients. Data on appointment attendance were collected from these systems. Measurements More than 29,000 appointments were scheduled between July 1, 2007, and May 31, 2008, and for 7890 of them a text message reminder was sent to the patient's cell phone. The rates of nonattendance were compared between those who were sent and those who were not sent a text message as an appointment reminder. Results The nonattendance reduction rates for appointments at the four outpatient clinics studied were 0.82% ( p =.590), 3.55% ( p =.009), 5.75% ( p =.022), and 14.49% ( p = Conclusion The study results indicate that sending appointment reminders as text messages to patients' cell phones is an effective strategy to reduce nonattendance rates. When patients attend their appointments, the facility providing care and the patients receiving uninterrupted care benefit.

There is a strong relation between chronic UV-B-induced sunburns and the development of skin cancer. Therefore, it is important to obtain a method that can be reproduced easily to detect individuals with similar skin color but different sensitiveness to sun exposure. The study evaluated 193 healthy volunteers (68% women; the average age was 38 years). They were divided into six groups of at least 30 subjects, according to skin type. The minimal erythema dose (MED) was assessed in two non-sun-exposed areas (thorax-infra-axillary area and on the buttocks), using a UV-B source (0.5 mW/cm2), with openings of 1 cm2, in increasing doses. The same areas were evaluated with a Minolta CR 300 Chromameter (L*a*b* system). The MED values ranged from 13 to 156 mJ/cm2; the coordinate L* (brightness) ranged from 75.96 to 30.15. The correlation between the MED and the brightness was negative in both areas (Pearson's correlation r = -0.91, P < 0.05). Color measurements, especially brightness, can be used to quickly assess skin sensibility. Considering the MED, there is a substantial overlapping of adjacent phototypes, but they could be separated into two groups: more sensitive individuals (Types I, II, III and IV) and less sensitive ones (Types V and VI).

Complications associated with kidney transplantation and immunosuppression can be prevented or treated effectively if diagnosed in the early stages by posttransplant monitoring. One of the major problems is diseases that occur during the first year after kidney transplantation. For this purpose, we used different classifiers to predict events of nephrotoxicity versus acute cellular rejection episodes. The classifiers were evaluated according to values of sensitivity, specificity and area under ROC curves (RCA). The classifier with better accuracy rate for nephrotoxicity achieved the value of 75.68% and RCA classifier reached the accuracy of 80.89%. These results are encouraging, with rates of accuracy and error consistent with work purpose.

The replacement of defective organs with healthy ones is an old problem, but only a few years ago was this issue put into practice. Improvements in the whole transplantation process have been increasingly important in clinical practice. In this context are clinical decision support systems (CDSSs), which have reflected a significant amount of work to use mathematical and intelligent techniques. The aim of this article was to present consideration of intelligent techniques used in recent years (2009 and 2010) to analyze organ transplant databases. To this end, we performed a search of the PubMed and Institute for Scientific Information (ISI) Web of Knowledge databases to find articles published in 2009 and 2010 about intelligent techniques applied to transplantation databases. Among 69 retrieved articles, we chose according to inclusion and exclusion criteria. The main techniques were: Artificial Neural Networks (ANN), Logistic Regression (LR), Decision Trees (DT), Markov Models (MM), and Bayesian Networks (BN). Most articles used ANN. Some publications described comparisons between techniques or the use of various techniques together. The use of intelligent techniques to extract knowledge from databases of healthcare is increasingly common. Although authors preferred to use ANN, statistical techniques were equally effective for this enterprise.