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Foram apresentadas as alterações hematológicas do sangue periférico e da medula óssea em pacientes expostos cronicamente ao benzeno. Foram descritos a biotransformação metabólica e os possíveis mecanismos envolvidos neste tipo de toxicidade. Os dados hematológicos do sangue periférico são mostrados e avaliados em sua importância, sendo a macrocitose e a linfocitopenia sinais precoces de toxicidade ao benzeno. As alterações da medula óssea observadas são demonstradas pelos métodos complementares citológico e histológico. A anormalidade histológica de maior importância foi a hipocelularidade global devida principalmente ao setor granulocítico. Foi observado também aumento do percentual de eosinófilos, de mastócitos e de atipias no setor megacariocítico. Foram observadas alterações de caráter inflamatório e ressaltada a presença de sinais de dismielopoiese. Foram enfatizadas a necessidade da valorização das alterações hematológicas do sangue periférico e a visão critica e global desse importante problema de saúde pública.A study was carried out into the hematological abnormabilities of peripheral blood bone marrow in patients chronically exposed to benzene. The metabolic biotransformation and the mechanisms involved in toxicity are described. Hematological data are described and discussed. Macrocytosis and lymphopenia are the earlieste hematological signs of benzene toxicity. Bone marrow abnormabilities are demostrated by the complementary methods of cytology and histology. Global hypocellularity was mainly due to the granulocytic series. Mastocytosis, eosinophilia and magakariocytic abnormalities are also presented. Inflamatory abnormalities and signs of dismyelopoiese could also be observed. The importance of peripheral blood abnormalities and the need for a critical approach to this important public health problem are emphasized.

Foram apresentadas as alterações hematológicas do sangue periférico e da medula óssea em pacientes expostos cronicamente ao benzeno. Foram descritos a biotransformação metabólica e os possíveis mecanismos envolvidos neste tipo de toxicidade. Os dados hematológicos do sangue periférico são mostrados e avaliados em sua importância, sendo a macrocitose e a linfocitopenia sinais precoces de toxicidade ao benzeno. As alterações da medula óssea observadas são demonstradas pelos métodos complementares citológico e histológico. A anormalidade histológica de maior importância foi a hipocelularidade global devida principalmente ao setor granulocítico. Foi observado também aumento do percentual de eosinófilos, de mastócitos e de atipias no setor megacariocítico. Foram observadas alterações de caráter inflamatório e ressaltada a presença de sinais de dismielopoiese. Foram enfatizadas a necessidade da valorização das alterações hematológicas do sangue periférico e a visão critica e global desse importante problema de saúde pública.

The Guidelines Project of the Associacao Medica Brasileira (AMB) and of the Conselho Federal de Medicina (CFM) began in 2000 with specialist societies participating in the preparation of the texts. The guidelines are based on research and contain solid advice on the diagnosis, therapy, and prevention of diseases. Grounded in evidence-based medicine, they seek to answer specific or crucial questions regarding the disease. A review of the literature is performed and, using pre-established criteria, studies on the disease are selected and graded according to their characteristics and type. Randomized clinical trials and meta-analyses have the highest value (A). Second in importance are observational and clinical studies (B), then case reports and case series (C), and finally, publications of consensuses and opinions (D). Due to the methodology employed, current systematic reviews are clearly more relevant when compared to those written in the past. Historically, reviews were much more based on personal opinions and subject to the author's interest, that is, more concerned with the individual point of view and based on personal experience.1 The Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) began to participate effectively in the development of the guidelines of the AMB in 2009, with contributions by several experts as shown in Table 1; previously, the collection was limited, with fewer themes. After 2012, guidelines on several diseases were completed and published in the Revista Brasileira de Hematologia e Hemoterapia (RBHH); chronic myelogenous leukemia,2 multiple myeloma,3 and diagnosis4 and treatment of immune thrombocytopenic purpura.5 It is also important to quote other systematic reviews published in the RBHH, such as preventive practices in longterm hematopoietic stem cell transplantation survivors, with the participation of experts from several different countries.6 The consensus of the Sociedade Brasileira de Transplante de Medula Ossea (SBTMO) produced the famous 'Pink Book'; this was rounded out with two publications on transplantation in acute myeloid leukemia7 and autoimmune diseases.8 Table 1 Guidelines published on hematological diseases. Acute promyelocytic leukemia (APL) has well-defined clinical, cytogenetic, and morphological characteristics; it encompasses 10% to 15% of all myeloid-type leukemias. Its molecular bases are well defined, with different variations influencing the treatment of patients.9 The results, as reported by the International Consortium on APL, established the treatment strategies and the conduct for the disease in developing countries.10,11 The guidelines for the diagnosis and treatment of APL12 are published in this issue of the RBHH, the first in 2014, thereby adding to those already published. Hopefully, this will stimulate other experts to continue this hard work, aiming to contribute to medical practice and to solidify the knowledge on the diagnoses and treatment of hematologic diseases.

Portadores de leucemia linfoide cronica (LLC) apresentam curso clinico indolente e prolongado que devem ser diferenciados daqueles que tem doenca de evolucao agressiva e fatal. Pacientes mais jovens e com criterios de alto risco podem se beneficiar com tratamento mais agressivo como o transplante de celulas-tronco hemopoeticas (TCTH). O transplante autologo apresenta casos com remissao citogenetica e molecular, baixa taxa de mortalidade, mas nao demonstram plato nas curvas de sobrevivencia e alta taxa de recaidas. Os transplantes alogenicos com regime mieloablativos tem altos indices de toxicidade e mortalidade, mas evidenciam o efeito enxerto versus leucemia, que aumenta a possibilidade de cura destes individuos. Assim, a opcao dos transplantes alogenicos esta dirigida para os transplantes com regime de condicionamento nao mieloablativo, que pode ser aplicado inclusive a pacientes mais idosos ou portadores de comorbidades, e manter o potencial efeito GVL. A identificacao dos pacientes que podem ser beneficiados por esses procedimentos, caracterizar e apontar os novos marcadores prognosticos permanece objeto de muitos estudos clinicos e foi o objetivo do grupo responsavel em discutir as diretrizes do TCTH no consenso da Sociedade Brasileira de Transplante de Medula Ossea - SBTMO. Assim, consideramos que o TCTH para a leucemia linfoide cronica (LLC) deve seguir, para sua indicacao, os criterios do European Group for Blood and Marrow Transplantation (EBMT) e, quando houver disponibilidade de um doador aparentado, a opcao deve ser do TCTH alogenico com regime nao mieloablativo. O TCTH alogenico nao aparentado e o autologo devem ser considerados como opcao secundaria de indisponibilidade de doador, situacoes especiais e ensaios clinicos.

Neste relato os autores apresentam informações sobre os instrumentos bibliométricos e a sua importância na aferição da qualidade dos periódicos científicos, pesquisadores e docentes. Apresentam em particular a história e a implantação do fator de impacto do Institute for Scientific Information, existente desde 1955. São apresentados e discutidos as críticas referentes à inadequação do fator de impacto para avaliação da produção científica, uso indevido e estratégias editoriais de manipulação deste índice bibliométrico.É apresentada a nova classificação Capes para os periódicos, baseada em vários critérios e no Fator de Impacto, em especial, e a sua influência na vida acadêmica e científica nacional. Conclui que, apesar de todos os óbices e discussões, o Fator de Impacto do Institute for Scientific Information ainda é uma ferramenta útil e, isoladamente, a única existente para avaliar os periódicos científicos e a produtividade intelectual. In this report, the authors present information on bibliometric instruments and their importance in measuring the quality of scientific journals and researchers. They present the history and deployment of the impact factor by the Institute for Scientific Information that exists since 1955. Criticism regarding the inadequacy of the impact factor in the evaluation of scientific publications, its misuse and editorial handling strategies of this bibliometric index are presented and discussed. The new Capes classification for journals, based on various criteria and in particular the impact factor, is presented as is its influence on national scientific and academic life. The authors conclude that, despite all obstacles and discussions, the impact factor of the Institute for Scientific Information is still a useful tool and is the only one available to assess, in isolation, scientific and intellectual productivity.

A previous study associated CD34(+) levels with NYHA functional class in heart failure patients. The aim of this study was to correlate CD34(+) levels to exercise capacity, functional class, quality of life and norepinephrine in heart failure patients.Twenty three sedentary patients (52 +/- 7 years, 78% male) answered the Minnesota Living with Heart Failure Questionnaire and rested for 20 minutes before an investigator collect a blood sample. After this, patients performed a cardiopulmonary exercise test to determine the heart rate at anaerobic and ventilatory threshold and oxygen consumption at peak effort, at anaerobic and ventilatory threshold. One other blood sample was collected during the peak effort to investigate the norepinephrine and CD34(+) levels.Rest percentage of CD34(+) did not show correlation with: left ventricle ejection fraction (r = 0.03, p = 0.888), peak VO(2) (r = 0.32, p = 0.13), VO(2) at anaerobic threshold (VO(2)AT) (r = 0.03, p = 0.86), VO(2) at ventilatory threshold (VO(2)VT) (r = 0.36, p = 0.08), NYHA functional class (r = -0.2, p = 0.35), quality of life (Minnesota) (r = -0.17, p = 0.42). CD34(+) did not show correlation, either, with: peak VO(2) (r = 0.38, p = 0.06), VO(2)AT (r = 0.09, p = 0.65), VO(2)VT (r = 0.43, p = 0.4), NYHA functional class (r = -0.13, p=0.54), quality of life (r = 0.00, p = 0.99).CD34(+) levels did not correlate with exercise capacity, functional class, quality of life and norepinephrine. Percentage of CD34(+) levels did not increase during the cardiopulmonary exercise test in heart failure patients.

In this report the authors present information on the bibliometric instruments and their importance in measuring the quality of scientific journals and researchers. They in particular the history and deployment of the impact factor of the existing Institute for Scientific Information since 1955. Are presented and discussed the criticism regarding the inadequacy of the impact factor for evaluation of scientific production, misuse and strategies editorial handling of the bibliometric index. It is presented to the new classification CAPES for the journals, based on various criteria and the impact factor and its influence on national scientific and academic life. The authors conclude that, despite all obstacles and discussions, the impact factor of the Institute for Scientific Information is still an useful tool and the only isolation available to assess the scientific and intellectual productivity.

Nos últimos anos, a terapia de ressincronização cardíaca tem sido uma conduta bem definida para pacientes com insuficiência cardíaca (IC), classe funcional III ou IV, que não tiveram resposta à otimização terapêutica. Estudos já mostraram esta eficácia, mas um grupo bem definido de miocardiopatias dilatadas com áreas de fibrose não tem tido o mesmo sucesso (30%-40%). Por isto decidimos associar a estes pacientes o implante de células-tronco. A partir de 04/2005 iniciamos estes implantes em pacientes (pcs.) com IC, classe funcional III/IV, otmizados e fração de ejeção

Os autores discutem aspectos clínicos e de tratamento convencional da isquemia critica dos membros inferiores e consideram a possibilidade de tratamento com células- -tronco autógenas de medula óssea para os pacientes que já esgotaram, sem sucesso, todos os meios de tratamento conhecidos. Comentam sobre o histórico, as fontes, as experiências animais e clínicas e, finalmente, apresentam sua experiência inicial com seis pacientes, todos com indicação de amputação maior ou menor. Em apenas um paciente não foi possível evitar a amputação. Além de ótimos resultados, quanto à supressão da dor e cicatrização de lesões isquêmicas, pode-se notar a ausência de quaisquer efeitos colaterais deletérios, sugerindo que a terapia celular é eficiente e segura, demandando, porém, mais pesquisas e estudos randomizados para se tornar uma terapia de uso corrente. The authors discuss clinical aspects and conventional treatment of lower limb critical ischemia and the alternative of therapy with autogenous bone marrow stem cells in patients who have exhausted, without success, all the current means of treatment. They comment on the historical aspects, the sources, animal experiments, clinical research and, finally, their initial experience with six patients, all of whom had previous indication of major or minor amputation. For only one patient amputation could not be avoided. In addition to excellent results in pain relief and healing of ischemic ulcers, no deleterious side effects were noted suggesting that this type of cell therapy is safe and efficient although further research and randomized studies are needed to make this a standard therapy.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:40:40Z No. of bitstreams: 1 S1516-84842009000700011.pdf: 336691 bytes, checksum: 8bdcb78210a2d6e34368ea243abbd11d (MD5) Made available in DSpace on 2013-08-22T18:40:40Z (GMT). No. of bitstreams: 1 S1516-84842009000700011.pdf: 336691 bytes, checksum: 8bdcb78210a2d6e34368ea243abbd11d (MD5) Previous issue date: 2009-05-01 Made available in DSpace on 2013-09-30T19:26:34Z (GMT). No. of bitstreams: 2 S1516-84842009000700011.pdf: 336691 bytes, checksum: 8bdcb78210a2d6e34368ea243abbd11d (MD5) S1516-84842009000700011.pdf.txt: 31547 bytes, checksum: d48e673e33a4bb99ba0d88e78ae51af6 (MD5) Previous issue date: 2009-05-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:07:26Z No. of bitstreams: 2 S1516-84842009000700011.pdf: 336691 bytes, checksum: 8bdcb78210a2d6e34368ea243abbd11d (MD5) S1516-84842009000700011.pdf.txt: 31547 bytes, checksum: d48e673e33a4bb99ba0d88e78ae51af6 (MD5) Made available in DSpace on 2014-05-20T15:07:26Z (GMT). No. of bitstreams: 2 S1516-84842009000700011.pdf: 336691 bytes, checksum: 8bdcb78210a2d6e34368ea243abbd11d (MD5) S1516-84842009000700011.pdf.txt: 31547 bytes, checksum: d48e673e33a4bb99ba0d88e78ae51af6 (MD5) Previous issue date: 2009-05-01 Nesta revisão são abordadas as doenças em que existem dados e perspectivas do uso de transplante de células-tronco hematopoéticas em suas diversas modalidades. São apresentados também os aspectos referentes aos regimes de condicionamento empregados, e sua relação com toxicidade e taxa de mortalidade ligadas ao transplante. São apresentadas as doenças autoimunes e particularizados dados específicos do lúpus eritematoso sistêmico, esclerose sistêmica e esclerose múltipla e diabetes mellitus tipo 1. A base do procedimento nas doenças autoimunes é a reprogramação imunológica. Aparentemente o procedimento tem sua indicação nas doenças em que os tratamentos convencionais de imunossupressão tenham falhado, e o dano orgânico não tenha sido definitivo, mas tenha chance de ocorrer caso não seja realizado o transplante. A modalidade aparentemente indicada no momento deve ser o transplante de células-tronco autogênico com regimes de condicionamento não mieloablativo para se obter sobrevivência estimada em mais de 50% em todas as doenças, com baixa toxicidade e com mortalidade nula ligada ao transplante. São apresentados também os resultados nos tumores sólidos, que são discutíveis, e particularidades no câncer de mama. A aparente indicação para os tumores sólidos é transplante de células-tronco alogênico e se baseia no tratamento intensivo com doses mieloablativas com a finalidade de se induzir o efeito enxerto contra o tumor. Os regimes não mieloablativos são preconizados com a finalidade de redução da toxicidade e indução de imunossupressão, sendo os dados insuficientes e discutíveis, o que obriga a introdução de novas estratégias terapêuticas baseadas na terapia imune e celular. In this report we discuss data and perspectives of hematopoietic stem cell transplantation in non-hematologic diseases. Aspects related to the conditioning regimen and its relationship with toxicity and mortality are also presented. Specific autoimmune diseases are discussed, in particular systemic lupus erythematosus, systemic sclerosis, multiple sclerosis and type 1 diabetes mellitus. The aim of the procedure in autoimmune diseases is immune reprogramming. Apparently this procedure has indications for diseases in which conventional treatments have failed when organ damage is not definitive, but likely to occur if transplantation is not performed. The most promising method appears to be autologous stem cell transplantation with non-myeloablative conditioning regimens to obtain survival that is estimated at more than 50% for all autoimmune diseases, with low toxicity and no mortality related to transplantation. The controversial results of solid tumor treatment and particularities of breast cancer are also presented. Hematopoietic stem cell transplantation is the apparent indication for solid tumors based on intensive treatment with myeloablative doses in order to induce the graft versus tumor effect. The myeloablative conditioning regimens are introduced with the purpose of reducing the toxicity and inducing immunosuppression but the data are insufficient and questionable requiring the introduction of new therapeutic strategies based on cellular and immune therapy. FMUSP Disciplina de Hematologia e Hemoterapia HMC IMC Grupo de Terapia Celular APB-Hospital Infante D. Henrique IMC Hospital Infante D. Henrique APB Unesp Ibilce IMC Departamento Científico Unesp Ibilce

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:40:40Z No. of bitstreams: 1 S1516-84842009000700021.pdf: 533243 bytes, checksum: 220169311ee56609387f466ba4aa6c97 (MD5) Made available in DSpace on 2013-08-22T18:40:40Z (GMT). No. of bitstreams: 1 S1516-84842009000700021.pdf: 533243 bytes, checksum: 220169311ee56609387f466ba4aa6c97 (MD5) Previous issue date: 2009-05-01 Made available in DSpace on 2013-09-30T19:26:34Z (GMT). No. of bitstreams: 2 S1516-84842009000700021.pdf: 533243 bytes, checksum: 220169311ee56609387f466ba4aa6c97 (MD5) S1516-84842009000700021.pdf.txt: 46179 bytes, checksum: 5aed5ff85ba7feb6e714e64eca7cfe99 (MD5) Previous issue date: 2009-05-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:07:26Z No. of bitstreams: 2 S1516-84842009000700021.pdf: 533243 bytes, checksum: 220169311ee56609387f466ba4aa6c97 (MD5) S1516-84842009000700021.pdf.txt: 46179 bytes, checksum: 5aed5ff85ba7feb6e714e64eca7cfe99 (MD5) Made available in DSpace on 2014-05-20T15:07:26Z (GMT). No. of bitstreams: 2 S1516-84842009000700021.pdf: 533243 bytes, checksum: 220169311ee56609387f466ba4aa6c97 (MD5) S1516-84842009000700021.pdf.txt: 46179 bytes, checksum: 5aed5ff85ba7feb6e714e64eca7cfe99 (MD5) Previous issue date: 2009-05-01 A terapia celular poderia ser conceituada de forma ampla e genérica como o emprego de células para tratamento de doenças. Apesar de um número não tão expressivo de relatos tendo o pulmão como objeto de estudo na terapia celular em pacientes humanos, há dados consistentes da literatura, tanto em humanos, quanto em modelos animais,que evidenciam a migração de células-tronco da medula óssea para o pulmão,em diferentes situações experimentais. Esses resultados forneceram o embasamento experimental para o emprego de células-tronco na regeneração do tecido pulmonar em modelos animais. em nosso laboratório, vários projetos de pesquisa têm sido conduzidos com a finalidade de avaliar a resposta pulmonar (morfológica e funcional) ao tratamento com células-tronco adultas em camundongos com doença pulmonar obstrutiva crônica (DPOC) induzida experimentalmente. Os resultados obtidos, aliados àqueles de outros grupos de pesquisa, permitem aventar a possibilidade de aplicação, a curto prazo, da terapia celular em pacientes com DPOC. em outra patologia pulmonar, fibrose cística (FC), cuja abordagem terapêutica com células-tronco apresenta aspectos particulares em relação às patologias pulmonares crônico-degenerativas, há avanços promissores e potencialmente interessantes; no entanto, os resultados podem ser considerados incipientes e deve-se assinalar, portanto, que a associação da terapia gênica e celular apresenta-se como uma alternativa possível, mas ainda muito distante quanto à sua consolidação e incorporação como opção terapêutica segura e eficaz em FC. Por outro lado, tendo por embasamento os resultados obtidos em modelos experimentais, é possível postular que a terapia celular com células-tronco hematopoéticas (ou de outras fontes) encerra perspectivas consistentes de aplicação em diversas outras patologias pulmonares humanas, especialmente em DPOC. Cell therapy can be briefly described as the use of cells in the treatment of diseases. Although the number of scientific reports involving lung and cell therapy in humans is not expressive, there are consistent data, both in humans and animal models. Experiments show the migration of bone marrow stem cells to the lung, in different situations. These results provide the experimental basis for the use of stem cells in the regeneration of the lung tissue in animal models. In our laboratory, several projects have been conducted aiming to evaluate the pulmonary response (morphological and functional) to treatment with adult stem cells in mice with experimentally induced chronic obstructive pulmonary disease. The results obtained, together with those from other research groups, allow us to consider the possibility of application, in the near future, of cell therapy in chronic obstructive pulmonary disease patients. For another disease, cystic fibrosis, cell therapy shows particular aspects in relation to other chronic degenerative pulmonary diseases. In this pathology, there are interesting and promising advances, however, the results are incipient and, thus, it must be said that the association between genetic and cell therapy appears to be a possibility, but still far from being consolidated and incorporated as a safe and effective therapeutic alternative in cystic fibrosis. on the other hand, based on the results obtained in experimental models, it is possible to postulate that cell therapy with hematopoietic stem cells (or from other sources) brings consistent application perspectives in several other human pulmonary diseases, especially in chronic obstructive pulmonary disease. Unesp Departamento de Ciências Biológicas Instituto de Moléstias Cardiovasculares FMUSP HMC IMC USP Programa de Pós-graduação em Biotecnologia Unesp Curso de Engenharia Biotecnológica Unesp Departamento de Ciências Biológicas Unesp Curso de Engenharia Biotecnológica

Faleceu recentemente Augusto Luiz Gonzaga. Foi vice-presidente da Sociedade Brasileira de Hematologia e Hemo-terapia (SBHH) de 1983 a 1985 e presidente do bienio de 1985-1987. Polemico, contestador, visionario, centralizador, esteseram alguns dos adjetivos a ele atribuidos em sua epoca deatividades na Hematologia e Hemoterapia brasileira. Funda-dor do Centro de Hematologia Santa Catarina, no Rio de Ja-neiro militou intensamente na area de coagulacao e hemostasiae foi o grande incentivador da organizacao das Casas dosHemofilicos. A sua participacao no CLAHT (Grupo LatinoAmericano de Hemostasia e Trombose) e WFH (Confedera-cao Mundial de Hemofilia) foram relevantes, organizandoeventos e aproximando a SBHH destes organismos interna-cionais. Em 1985 organizou o Congresso Mundial deHemofilia no Rio de Janeiro em conjunto com o CongressoBrasileiro de Hematologia, pratica que se disseminou poste-riormente no seio da Sociedade Brasileira de Hematologia eHemoterapia.Afastado das lides hematologicas, ha mais de 10 anos,desde o inicio contribuiu com o Boletim, sendo o responsa-vel pela coluna "Clube do Anticorpo" e da edicao de diver-sas contribuicoes. Foi o mentor principal da transformacaodaquele veiculo de comunicacao em revista, inclusive pres-tando decisivo apoio financeiro para a sua edicao, que eramensal. Fazia juz a todos os adjetivos e dele, dentre outrascoisas, me recordo quando, como presidente, disse: “

CONTEXT AND OBJECTIVE: Gene expression and immunohistochemical profiling of diffuse large B-cell lymphoma (DLBCL) have revealed important prognostic subgroups: germinal center B-cell-like (GCB-like) DLBCL and activated B cell-like (ABC-like) DLBCL. Although few reports on high-risk DLBCL are available, the prognosis for the GCB-like subgroup has been shown to be better than that of the ABC-like subgroup. The role of Bcl-2 as a predictor of survival in DLBCL cases is unclear and its expression varies between the two subgroups of DLBCL. In this study, we analyzed the frequency and prognostic impact of Bcl-2 protein expression in high-risk DLBCL cases. DESIGN AND SETTING: Retrospective cohort study among DLBCL patients treated at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). METHODS: The prognostic impact of the expression of the proteins CD10, Bcl-6, MUM1 (multiple myeloma oncogene-1) and Bcl-2 on high-risk DLBCL cases was evaluated by means of immunohistochemistry. Seventy-three patients aged 18-60 years were evaluated for all these markers. RESULTS: Twenty-four cases (32.9%) were GCB-like and 49 (67.1%) were ABC-like, with no difference regarding complete remission, disease-free survival or overall survival rates. Twenty-seven patients (37%) showed Bcl-2 expression, which was the only independent factor predicting a worse prognosis for overall survival according to multivariate analysis. CONCLUSION: Bcl-2 protein was expressed in 37% of the high-risk DLBCL patients, without any difference between the ABC-like DLBCL and GCB-like DLBCL cases.

CLL is a heterogeneous disease that affects elderlypatients with three to five cases for every 100 million peopleper year however this number rises to 20 cases per 100million in over 70-year-old individuals; thus it is the mostcommon leukemia in Western countries. The number of casesof the disease is increasing partly because of changes inthe habits of the population, but mainly due to the reductionin the minimum number of peripheral lymphocytes used inits diagnosis.

1. Wendel S, Levi JE. Dengue em doadores de sangue. Necessitamos detriagem laboratorial no Brasil?Rev. Bras. Hematol. Hemoter.2008;30(5):417-418.2. Colombia First National Communication to UNFCCC - UnitedNations Framework Convention on Climate Change, 2001.3. Chen LH, ME Wilson ME. Non-Vector transmission of dengue andother flaviviruses. Dengue Bulletin, vol. 9, 2005 - Harvard MedicalSchool, Division of Infectious Diseases.4. Mohammed H, Linnen JM

Foi realizado no âmbito da 5a Reuniao de CoordenacaoRegional da Biblioteca Virtual em Saude (BVS5) e do 8o Con-gresso Regional de Informacao em Ciencias da Saude(CRICS8), no Rio de Janeiro, a III Reuniao dos Editores deRevistas Cientificas da Lilacs e SciELO.Os objetivos do encontro foi o de estabelecer um forumcritico de discussao sobre os pontos que se seguem:a) Determinacao e identificacao dos temas mais rele-vantes para os editores dos paises da America Latina, Espa-nha e Portugal.b) Disseminacao das experiencias nacionais na area decomunicacao cientifica no âmbito da BVS (http://www.bireme.br/php/index.ph)c) Divulgacao dos novos produtos e servicos da BVSna area de comunicacao cientifica.A coordenacao do evento apresentou para discussaocomo tema principal a relevância da necessidade da insercaodas revistas cientificas nos indices internacionais.Em relacao a este tema, no painel de gestao da comuni-cacao cientifica foram apresentadas as experiencias de diver-sos editores que obtiveram insercao no ISI (Institute ofScience for Information) e no Medline (National Library ofMedicine, USA). O editor dos

Neste primeiro suplemento do ano de 2008 da Revista Brasileira de Hematologia e Hemoterapia (RBHH), o tema em foco e a Leucemia Mieloide Cronica (LMC). Sao editores convidados o Professor Ricardo Pasquini, da Universidade Federal do Parana (UFP, PR), e o Professor Carmino Antonio de Souza, da Universidade Estadual de Campinas (Unicamp, SP), e que foram os responsaveis pela pauta e o convite aos autores dos manuscritos que compoem este suplemento. A leucemia mieloide cronica ha mais de 125 anos evolui desde a terapia primaria com o arsenio, benzol, uretano, irradiacao esplenica e ate mais recentemente com a administracao do busulfano, hidroxiurea e o alfa interferon. O transplante de celulas-tronco hematopoeticas trouxe a possibilidade de cura e os pacientes com LMC passaram a ser mais transplantados no pais. Como exemplo, no periodo de 1994 a 2002, 30% dos transplantes do Servico de TMO do HCFMUSP foram em pacientes com LMC. Com a introducao dos inibidores, mais efetivamente a partir de 2003, da tirosina quinase BCR-ABL, houve radical mudanca na abordagem primaria e secundaria dos pacientes.1 Ocorreram avancos nos conhecimentos da doenca, o controle e monitorizacao dos pacientes se sofisticou e rapidamente novos conceitos estao sendo incorporados com perspectivas de disponibilizacao de novas drogas, transformando a LMC como um novo paradigma no tratamento do câncer. Neste suplemento educativo, a RBHH tem a honra e o prazer de mais uma vez ofertar a comunidade hematologica todos os aspectos citados e debatidos no Consenso Brasileiro em Leucemia Mieloide Cronica e LLA-Ph1+.

O editorial deste fasciculo, que inicia o volume 30, seriasobre os avancos da Revista Brasileira de Hematologia eHemoterapia (RBHH) na qual seriam enfatizados aspectosdo aumento da periodicidade, agora bimestral, e a perspecti-va de edicao de novos suplementos tematicos. Da adocao dasubmissao exclusivamente

Neste fasciculo organizado e conduzido pelo co-editorRodolfo Delfini Cancado, produto de um evento de granderepercussao nacional sobre anemia falciforme, discutem-seas varias nuances clinicas e hematologicas sobre o tema.A anemia falciforme, do ponto de vista historico, e doconhecimento da humanidade desde os tempos imemoriais econstatadas como secular na Africa pelo habito existente emdiversas tribos do continente de tatuar os portadores e ospacientes para identificar a doenca. O primeiro relato em rela-cao a doenca ocorreu nos Estados Unidos da America emnecropsias de pacientes nos quais se identificou agenesiaesplenica em afro-americano com antecedentes clinicos cro-nicos similares ao da anemia falciforme.

O transplante de células-tronco é uma nova terapia com objetivo de produzir regeneração cardíaca pela diferenciação ou aumento dos miócitos cardíacos ou proliferação neovascular em pacientes no estágio final de insuficiência cardíaca congestiva secundária a cardiomiopatia dilatada¹, mas os resultados são desconhecidos2,3. Stem cell transplantation is a new therapy applied to produce cardiac regeneration through differentiation or increase of heart myocytes or neovascular proliferation in patients in the end stage of congestive heart failure secondary to dilated cardiomyopathy¹, but the results are still unknown2,3.

Recentemente os editores das revistas indexadas nabase de dados Lilacs e Scielo, caso da Revista Brasileira deHematologia e Hemoterapia (RBHH), receberam comunicadoque a seguir transcrevemos: "Informamos que a Bireme pas-sara a exigir dos periodicos que publicam ensaios controla-dos aleatorios (

The incidence of Gram-negative bacteremia has increased in hematopoietic stem cell transplant (HSCT) recipients. We prospectively collected data from 13 Brazilian HSCT centers to characterize the epidemiology of bacteremia occurring early post transplant, and to identify factors associated with infection due to multi-drug-resistant (MDR) Gram-negative isolates. MDR was defined as an isolate with resistance to at least two of the following: third- or fourth-generation cephalosporins, carbapenems or piperacillin-tazobactam. Among 411 HSCT, fever occurred in 333, and 91 developed bacteremia (118 isolates): 47% owing to Gram-positive, 37% owing to Gram-negative, and 16% caused by Gram-positive and Gram-negative bacteria. Pseudomonas aeruginosa (22%), Klebsiella pneumoniae (19%) and Escherichia coli (17%) accounted for the majority of Gram-negative isolates, and 37% were MDR. These isolates were recovered from 20 patients, representing 5% of all 411 HSCT and 22% of the episodes with bacteremia. By multivariate analysis, treatment with third-generation cephalosporins (odds ratio (OR) 10.65, 95% confidence interval (CI) 3.75-30.27) and being at one of the hospitals (OR 9.47, 95% CI 2.60-34.40) were associated with infection due to MDR Gram-negative isolates. These findings may have important clinical implications in the decision of giving prophylaxis and selecting the empiric antibiotic regimen.

da Revista Brasileira de Hematologia eHemoterapia (RBHH) revisou os manuscritos e produziu estefasciculo tematico, que deve servir de fonte de referencia ede debate para os hematologistas brasileiros.A organizacao de fasciculos tematicos e um recursoque a RBHH tem utilizado com o objetivo de discutir e sinali-zar os avancos que ocorrem em temas especificos para osleitores e sua comunidade.

Stem cell transplantation is a new therapy applied to produce cardiac regeneration through differentiation or increase of heart myocytes or neovascular proliferation in patients in the end stage of congestive heart failure secondary to dilated cardiomyopathy, but the results are still unknown.

editorialda RBHH, revisou os manuscritos para produzir um fasciculotematico atualizado com o objetivo de servir de fonte e dereferencia para os hematologistas brasileiros.A organizacao de fasciculos tematicos nao e um recur-so novo da RBHH e tem sido utilizado ao longo dos anos porvarios titulos nacionais e internacionais para discutir e sina-lizar os avancos que ocorrem em temas especificos para osleitores e sua comunidade.A primeira investida da revista na elaboracao de umfasciculo tematico ocorreu em 1987, quando a revista era en-tao denominada “Boletim da Sociedade Brasileira de Hema-tologia”, e foi editado um numero especial sobre Leucopenia.

The Brazilian Journal of Hematology and Hemotherapy isbeginning its eighth year of uninterrupted circulation. Successorof the Bulletin of the Brazilian Society of Hemotherapy the journalis the official organ of the Brazilian Society of Bone MarrowTransplantation and the Italian-Brazilian Association ofHematology. The objective of this report is to evaluate the resultsobtained by the scientific periodic since its title was changed,results that culminated in its inclusion in the Scielo ElectronicLibrary and its classification as a national class A andinternational class B journal according to Coordination for theimprovement of Higher Education Personnel (Capes).With theanalysis of the issues edited from 1999 to 2001 (three-monthly)and those that followed from 2002 to 2005 (quarterly editions),the progressive increase in the number of submissions and pagespublished becomes evident. The data observed will be of much useto direct future decisions in order to improve the scientific periodic.Rev. bras. hematol. hemoter. 2006

Nontransferrin-bound iron (NTBI) has been reported shortly after myeloablative conditioning in patients undergoing hematopoietic stem cell transplantation (HSCT), and it is assumed that the appearance of unbound iron in this nontransfusion setting possibly reflects a major disturbance in body iron distribution, which is related mainly to its underutilization due to erythropoiesis suppression. There is a concern that labile plasma iron (LPI), the most toxic fraction of NTBI that includes the redox-active forms of iron, can be involved in the occurrence of toxicity and other complications commonly observed in the early post-HSCT period. Recently, we demonstrated that LPI levels, albeit normal at baseline measurements, increased substantially 48 hours after the start of conditioning in HSCT patients and remained increased until engraftment, when it returned to normal levels (Acta Haematol 2014;131:222-226). Here we provide a more detailed analysis of iron status in HSCT patients by adding determinations of hepcidin and standard iron parameters along with LPI in 25 adult patients undergoing first autologous HSCT following myeloablative conditioning. All iron parameters were determined before the start of conditioning (baseline), on day 0 (before stem cells infusion) and upon documented engraftment (Table). The fast and substantial increase in LPI levels on day 0, indeed reflected a disruption of iron homeostasis by conditioning, that was accompanied by a response in hepcidin and TfS levels. However, reutilization of iron by a restored erythropoiesis upon engraftment lead to a substantial drop in LPI, but not in hepcidin levels, possibly due to the fact that production of hepcidin by the liver is not only modulated by iron loading and erythropoietic activity, but also inflammation. Ferritin baseline levels were already increased and did not change throughout the study. Considering all determinations (baseline, day 0 and engraftment), hepcidin levels correlated positively with ferritin (r=0,43; p=0,01; Figure Panel A) and TfS (r=0,37; p=0,02; Figure Panel B); and LPI correlated positively with TfS (r=4,3; p=0,002; Figure Panel C), although increased LPI levels were observed with normal TfS levels in some patients. A tendency of correlation between hepcidin and LPI was found considering only baseline and day 0 levels (r=0,30; p=0,05; Figure Panel D). These results indicate that LPI reflected better the changes in iron status caused by cytotoxic chemotherapy in HSCT patients, and could serve as a target in the eventuality of chelation therapy in the early period of HSCT. The other iron parameters were probably influenced by inflammation, even upon engraftment, and would not behave as appropriate surrogate markers for increased LPI levels. *LPI levels Figure. Correlations between LPI, hepcidin and transferrin saturation levels throughout the study. Figure. Correlations between LPI, hepcidin and transferrin saturation levels throughout the study. Disclosures No relevant conflicts of interest to declare.

By contributing new knowledge to a particular area of science, the publication of scientific articles is the primary objective of research projects and of the researcher. The systematic planning of a project, obedience to every step of the research protocol makes sure that the results found, whether relevant or not, are accepted by the scientific community. The result of this work will always be the publication of a scientific paper. Afterwards the author submits his contribution to a peer-reviewed scientific journal, either within his field or to a more prestigious journal, for publication. In several editorials, the Revista Brasileira de Hematologia e Hemoterapia (RBHH) has discussed the Qualis classification system of the Coordenacao de Apoio aos Profissionais do Ensino Superior (CAPES) and its effects on the Brazilian academic community(1,2). Unhappily this system punishes almost all Brazilian authors but, in particular, those that publish in journals dedicated to their specialty such as the RBHH. As the lay press reported the classification system puts Brazilian scientific journals at "risk of extinction"(3). On the subject of Brazilian scientific journals, editors on several occasions have disagreed with the use of the impact factor of Institute for Scientific Information (ISI) Thomson Reuters JCR to evaluate Brazilian scientific production(4). Moreover, data showing the geometric growth of the number of scientific publications in Brazil and relatively low number of citations of national studies were presented in the last editorial(5). Recently, via the scientific publishers list of the World Association of Medical Editors on the web, journal editors from diverse areas have been condemning cases of plagiarism and duplicate publications(6). Furthermore they criticize the cutting up of data resulting from a single research project with the goal of increasing the number of publications of one specific author or group of authors, a technique that received the facetious name of 'salami science'. Although distinct, articles and texts have recently appeared in the lay press on both these subjects(3,7). The articles about CAPES were not complimentary to this government institution. In fact, discussions about the position of CAPES in respect to the evaluation of scientific production have been circulating in the scientific corridors for a few years now. Debates condemn its policies, but it seems that nothing really changes. One of the major concerns of bureaucrats, who have little or no knowledge of true scientific research, is the need to systematically measure the worth of scientists. How do we decide, for example, whether researchers deserve promotion, pay increases, more political clout or even that grant that they have applied for? To do this, government intuitions around the world are using the number of publications and the impact factor, an index developed to compare journals and not authors. Does this make a difference? This has created the 'Publish or Perish' culture which includes 'Salami Science'. Whether duplicate publications (which the RBHH does not accept) are ethically correct or not can be argued. Although this may waste the reader's time and, for example, distort the overall results of database searches, it seems that there may be ethical support for this practice when the author truly believes that his work will make a difference in the quality of patients' treatment. Certainly publications in different languages should not be frowned upon as most practitioners in non-English speaking countries do not speak English. This is definitely the case of Brazil where even the aforementioned government institution, CAPES, encourages all to publish in English with no importance whatsoever given to the native language. This it does by a points system where articles that are not published in ISI are assigned a very low number of points and only three articles are included in an author's scientific production evaluation. Even articles published in PubMed, for many researchers the preferred source database for research, receives half the points of an article published in the lowest ISI classification. Furthermore, splitting a long arduous paper into simpler parts can be helpful not only to the understanding of readers but also to increase the spread of knowledge. Unfortunately today we are living in a world where people are reading less and less due to culture changes related to the modern way of life. Many individuals, including physicians, are not used to reading complicated articles anymore and either get lost in the middle, lose patience or both and so, many long articles remain relatively unread. Perhaps we should change our opinions on this subject. And this leads me to the most important question - why do we publish? There are numerous reasons but the most common in medicine are to improve patient care, to exchange knowledge with other researchers and to improve academic careers. Of course our egos do not suffer from a good publication too. One imagines that the primary goal of medical publications should be to improve treatment for patients. It seems fairly clear that the best way to achieve this end is to make knowledge widely and freely available to all practitioners, independent as to whether they are university professors, researchers or the ordinary physician in a small town in the middle of nowhere. We know that today the changes in medicine are rapid and that lifelong learning is essential to keep up, but for many this is not possible as the information is not readily available. All researchers would like to publish in journals with the highest impact factors. Of course this, as renowned researchers seek to publish in The Lancet, JAMA, Nature and the New England Medical Journal, perhaps artificially and definitely wrongly, consolidates the position of the elite journals at the top. The reason I suggest this is as follows. As initially the ISI, the fore runner of Thompson Reuters, the 'owner' of the Impact Factor, only included journals published in English, this gave the North American and British journals a head start, they had impact factors before any 'foreign' journal even thought about publishing in English. As the impact factor became important to their careers, 'top' researchers obviously invested in trying to publish in these journals. Moreover, the Lancet, JAMA, Nature and the New England Medical Journal are journals that cover all fields in medicine. This gives them a much greater opportunity of finding articles that they believe will be cited. However, for most everyday practitioners, these 'elite' journals are not the first choice. Most practitioners want all the information in one place, concentrated and at a low cost (or free) and therefore subscribe to a journal of their specialty. Hence, it seems that most authors who submit to these 'top name journals' perhaps do so, not to spread knowledge to improve the health of the population, but for their own careers. With the attitude of CAPES can we blame them? Even HINARI, the Access to Research Initiative, in which the RBHH participates, started in 2002 by the WHO and major publishers, although a very good start, has its flaws as only medical and nursing schools, universities and research institutions in developing countries have access and not to all journals(8). After a physician leaves medical school, is he no longer entitled to have access to new advances in medicine? But perhaps the solution to this problem is around the corner. Until now many articles are published in more than one database (SciELO, PubMed, ISI and in smaller databases) and also in the site of the journal itself. This distorts any calculation of the impact factor and limits it only to articles published in ISI. With the creation of the digital object identifier (DOI) the next logical step is to create a new manner to really identify the importance of scientific publications that is independent of the database or databases in which an article is 'published'. Furthermore, with the simplicity of analysis using the World Wide Web, all articles can be broken down to their source articles giving all due respect to the real discoverer of new knowledge and not just to the people who report it in review articles.

Peer-reviewed scientific journals, such as the Revista Brasileira de Hematologia e Hemoterapia (RBHH), aim to divulge the production of the academic community and leading edge research through publications. The editors of the journals that receive these articles are the guardians of the entire evaluation process; it is their obligation to guarantee that the process is carried out within the ethical principles laid down according to previously determined standards. However, nuances of editorial policy peculiar to each scientific journal are common. The editor is responsible for balancing the scientific contents by choosing titles to make each edition attractive and to stimulate without interfering in the scientific merit so that authors improve their submitted manuscripts. Subsequently the works are sent to peer-reviewers who are savvy in the subject matter in order to evaluate, in the most judicious way possible, the scientific merit. On acceptance, articles are sent for publication within one of the different sections of the journal. Hence, the progress of this laborious process of evaluation differs between journals. In the RBHH, the system is double blind. All journals go along a lengthy course to obtain credibility and respect. Over the years they advance and become reference journals in their specific field and within the scientific community. One of the most common wishes of journals, in addition to reaching the largest readership possible, is to be referenced, that is, there is a need to be in as many physical libraries, which nowadays are accessible via internet, be published in newsletters, and be indexed in the greatest number of electronic databases as possible. In conclusion, be accessible, available and indexed. This is the dream of every editor, and the RBHH has managed this and is today universally indexed. For this to be achieved, an editorial policy of representing the Brazilian hematology community was followed. The RBHH represents four medical societies and within the framework of the works that are published in its pages today, it is the second most cited journal thereby demonstrating its acceptance within the Brazilian hematology community. Since the 1950s, journals have been assessed according to several criteria with the measurement of the citation of articles within scientific publications being a way to evaluate the journal's importance(1). Thus appeared the famous impact factor created by Eugene Garfield; this index now ranks scientific journals with the objective of defining the degree of importance of each, in the scientific environment and in its specific field(1). From the very beginning the author repeatedly wrote that this index had not been intended to evaluate researchers and that there was a distortion in its use in doing this(2). Even so, in the last thirty years, this index has gained momentum and publishers began to use it as a prestigious index for the best ranked journals and consequently for the authors who publish in them. Consequently, soon publishers began to be under pressure to seek out the most renowned authors to publish in their journals and often to 'force' authors to cite articles previously published in their journal (coercive citation). This type of conduct still occurs but is condemned as unacceptable as it manipulates indexes, in particular the impact factor that today, despite serious misgivings, is the Holy Grail of editors and authors alike. One of the ways of creating scientific collusion is the famous technique of stacking in which journal publishers agree to cite articles of each other as a way of increasing the impact factors of all the participants of the scheme. At this point I would like to introduce to the readers the declarations of the Brazilian Association of scientific editors (ABEC) and the Scientific Electronic Library Online (SciELO), as signed by Sigmar de Mello Rode, President of the ABEC and Abel L. Packer Program Coordinator of SciELO about the exclusion of Brazilian journals in the 2012 Edition of the Journal Citation Reports (JCR) submitted on July 3, 2013 to editors of Brazilian journals: "Faced with the exclusion of the annual calculation of the impact factor in the 2012 Edition of the Journal Citation Reports of six important Brazilian journals due to anomalies identified in referencing, either by excessive self-citations or possible agreement between journals to publish articles with a high concentration of citations between them, the ABEC and SciELO reaffirm their uncompromising opposition to this and any other unethical practice in scientific communication and recommend to the institutions responsible for these journals that their editors should properly analyze and elucidate these anomalies and, if appropriate, remove them. The misuse of the impact factor in the evaluation of Brazilian research has, for years now, detracted the real meaning of this indicator and been harmful to the development of the journals. Thus, as much as the assessment policies of Brazilian research hinder the progress of national journals, nothing justifies artificial measures to increase the impact factor and we remind you that journal editors are responsible for ensuring compliance to the principles of ethics in the communication of scientific research. The ABEC and SciELO undertake to strengthen measures to qualify and control ethical procedures as an integral part of its development programs for national journals that fulfill an important role in the advancement of Brazilian research". In the last editorial of the RBHH, we highlighted the problems that occurred in relation to the use of the Impact Factor and Qualis classification of scientific journals and our anxiety to improve journals in the JCR ranking(3). The desire of editors, driven by academic authors, has resulted in misconduct as described in the declaration of the ABEC and SciELO. The conduct described, as a policy to misuse the Impact Factor, is not new and occurs in many countries; it has already happened in several fields of knowledge including in hematology and cellular therapy. This, however, is easier to monitor in the electronic age and more often than not guilty journals are quickly punished as happened to the six Brazilian journals mentioned above. One famous case is that of the editors of the journal Folia Phoniatrica et Logopaedica in 2007 who, as a protest against the "absurd scientific situation in some countries" related to use of the Impact Factor published an editorial that cited all the journals articles from 2005 to 2006(4). There have been numerous other examples similar to this. But what is the result of this? To punish and execrate editors in their eagerness to find prestige for and improve their journals? Is this right? Will these measures diminish the loss of importance of these journals? How can we recover the shattered credibility of Brazilian journals as this information has been widely publicized to journal publishers participating in the World Association of Medical Editors (WAME). Returning to my initial point, the devaluation of Brazilian journals; this began with the Qualis classification that is, in truth, one of the factors responsible for this distortion and for the stacking performed by Brazilian publishers(5). The way forward is to stimulate national researchers primarily at the start of their career, encouraging them to publish in Brazilian journals, rather than choosing a journal by the impact factor, which is normally forced on them by their tutor who is sometimes only interested in the curriculum. The path to be followed is to enrich national production, reduce the low national esteem syndrome of not citing Brazilian authors or articles published in national journals and to enhance the bibliometric indices with the Impact Factor and others in their correct place in importance. After all a publication in the RBHH or in the vast majority of Brazilian journals edited in English which is the technical lingua franca, is available in most of the world's databases and can be consulted and assessed by all. Ah! And without forgetting to change the Qualis classification and its criteria.

O ano de 2003 foi extremamente proficuo para a Re-vista Brasileira de Hematologia e Hemoterapia. Foram pu-blicados sete fasciculos no total, sendo quatro regularese tres suplementos especiais. Pelo segundo ano, a RBHHcirculou trimestralmente, respeitando um padrao de distri-buicao de contribuicoes em suas secoes, e esteve a dis-posicao de seus leitores dentro da periodicidade prevista.O numero medio de contribuicoes nos fasciculos regula-res variou muito pouco, tendo cada um deles mantido emmedia 14 comunicacoes cientificas. O numero medio de

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:40:36Z No. of bitstreams: 1 S1516-84842004000200008.pdf: 727515 bytes, checksum: aeb3786b7680f680349c081dadf424b3 (MD5) Made available in DSpace on 2013-08-22T18:40:36Z (GMT). No. of bitstreams: 1 S1516-84842004000200008.pdf: 727515 bytes, checksum: aeb3786b7680f680349c081dadf424b3 (MD5) Previous issue date: 2004-01-01 Made available in DSpace on 2013-09-30T18:06:55Z (GMT). No. of bitstreams: 2 S1516-84842004000200008.pdf: 727515 bytes, checksum: aeb3786b7680f680349c081dadf424b3 (MD5) S1516-84842004000200008.pdf.txt: 21213 bytes, checksum: b0327e8e494daf0ce67be05b715b3e95 (MD5) Previous issue date: 2004-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:25:03Z No. of bitstreams: 2 S1516-84842004000200008.pdf: 727515 bytes, checksum: aeb3786b7680f680349c081dadf424b3 (MD5) S1516-84842004000200008.pdf.txt: 21213 bytes, checksum: b0327e8e494daf0ce67be05b715b3e95 (MD5) Made available in DSpace on 2014-05-20T13:25:03Z (GMT). No. of bitstreams: 2 S1516-84842004000200008.pdf: 727515 bytes, checksum: aeb3786b7680f680349c081dadf424b3 (MD5) S1516-84842004000200008.pdf.txt: 21213 bytes, checksum: b0327e8e494daf0ce67be05b715b3e95 (MD5) Previous issue date: 2004-01-01 Os objetivos deste estudo foram estabelecer um protocolo para a análise de minissatélites ou VNTRs e microssatélites ou STRs em pacientes que se submeteram ao TMO alogênico; verificar a validade da metodologia e dos loci estudados e avaliar o tipo de recuperação do paciente. Foram analisados o DNA do paciente anterior e posterior ao transplante de 14 indivíduos e dos respectivos doadores. Amplificações por PCR de seis loci: D1S80, SE33, HumTH01, 33.6, HumARA e HumTPO foram realizadas. Os produtos amplificados foram separados por eletro­forese vertical em gel de poliacrilamida, e os fragmentos visualizados por coloração pela prata. Esse procedimento mostrou ser válido na verificação da recuperação alogênica, autóloga e provavelmente na quimérica. da somatória dos loci estudados, 63,1% apresentaram resultados possíveis de serem avaliados e, desses, 19,0% mostraram resultado informativo, 13,1% parcialmente informativo e 31,0% não informativo. Os 36,9% restantes não foram possíveis de avaliação. Dos loci avaliados, o que demostrou maior índice de resultado informativo foi o SE33, parcialmente informativo o HumTPO e não informativo o HumTH01, sendo o locus 33.6 o que mais apresentou resultados não possíveis de serem avaliados. Por outro lado, determinou-se a recuperação do paciente posterior ao transplante em 71,4% dos indivíduos, sendo que, desses, 90% apresentaram recuperação alogênica e 10% recuperação autóloga. The purposes of this study were to establish a protocol for the analysis of minisatellites or VNTRs and microsatellites or STRs in patients who undergo allogeneic bone marrow transplantation; to verify the validity of the methodology and of the studied loci and to verify the type of recovery of the patient. The pre-transplant and post-transplant DNA of 14 recipients and their respective donors were analyzed. Six loci were amplified by PCR (D1S80, SE33, HumTH01, 33.6, HumARA and HumTPO). The amplified products were separated using a vertical polyacrylamide gel electrophoretic system and the resulting fragments were analyzed using silver staining. This procedure proved to be efficient in verifying autologous and allogeneic regeneration and probably chimerism regeneration too. of the loci studied, 63.1% presented results which could be analyzed, 19% were informative results, 13.1% partially informative and 31.0% non-informative. The locus that most demonstrated the informative results was the SE33 locus, the one that showed the partially informative results was the HumTPO and the non-informative results was the HumTH01. The 33.6 locus was the one that presented the majority of the results that could not be tested. Furthermore, it was possible to determine the patient regeneration after transplantation in 71.4% of the cases, 90% showed allogeneic regeneration and 10% autologous regeneration. Unesp Faculdade de Ciências Farmacêuticas de Araraquara Departamento de Análises Clínicas Faculdade de Medicina de São José do Rio Preto (FAMERP) Departamento de Biologia Molecular Faculdade de Medicina de São José do Rio Preto (FAMERP) Hospital de Base Unidade de Transplante de Medula Óssea Unesp Faculdade de Ciências Farmacêuticas de Araraquara Departamento de Análises Clínicas

Apresentamos o caso de um paciente proceden-te de Goiânia, 27 anos, sexo masculino, portador deLeucemiaMieloideCronica,submetidoaTMO/MO,deirmao HLA identico, aos tres meses apos o diagnosticoemfasecronica,semincompatibilidadedogrupoABOeRH.Utilizoucomotratamentodesuadoencadebaseprevio ao TMO unicamente Hidroxiurea. Regime decondicionamento com busulfano 16 mg/kg eciclofosfamida 140 mg/kg, profilaxia de Doenca En-xerto Contra o Hospedeiro (DECH) com metotrexato16mg/m

The political-economic world is gradually changing as the world powers give way to emerging countries, or more exactly, to the influence of the corporations. Why are the socalled BRIC countries (Brazil, Russia, India and China) nations that have very large land masses or, rather, very large populations (over 40% of the world population)? Today it is not so much the power of the weaponry of a country that makes it a world leader but the power of the economy, the combined spending power of the inhabitants. Scientific production should mirror the size of the population as, theoretically, the larger the population, the more people capable of doing research. If 1% of any population is intelligent, there are more intelligent people in China than the entire Belgium population at a little under 11 million(1). Of course this is not completely true of emerging countries as years of undernourishment, underinvestment in education and the allied mentality means that although countries are up-and-coming they will require some years before they can take the position of world leaders. Even so, with this transformation process comes many advantages as multinationals, who want to guarantee their future markets, will invest in these markets. Universities and other research institutions should be prepared to take advantage of these opportunities by attracting financial support for research from drugs companies. For drugs companies there are also many advantages. The first is obviously the cost. As Glickman et al. stated, the cost of a first class medical center in a developing country can be less than one tenth of the cost of a second class establishment in the USA. The authors attribute much of the cost savings to lower salaries(2). Moreover, the regulations in developed countries are much tougher and so it is more difficult to carry out research. Regulations in developed countries have become more and more complex with perhaps excessive burdens on investigators as not always empirical studies are performed to determine which elements improve the conduct in research and which only increase costs. Large populations provide researchers with great opportunities in terms of the number of eligible subjects making patient enrollment faster. According to Bansal, 83% of US clinical studies fail to recruit the required number of participants within the given timeframe; enrollment in developing countries can be between five and ten times faster than in the US(3). Additionally, the number of patients with untreated or undertreated diseases can be a great advantage in researching new therapies although some would argue that the results cannot be generalized to treated populations whose diseases are refractory to treatment(4). However there are disadvantages as well. Science in developing countries tends to be of a poorer standard. Moreover, for some authors the socioeconomic differences and disparity in healthcare provided between developing countries and developed countries is a disadvantage - a disadvantage for the developed countries, of course. However, for developing countries it is important to see the true response to treatment regimens in their reality. I believe that many of the poorer results in Brazil for example, are not necessarily due to inability to provide the necessary care for patients, but due to the fact that our reality is different. Glickman et al. correctly affirm that the genetic makeup of trial populations is very important for the results. Different genetic profiles are related to the safety and effectiveness of drugs(2). Thus trials performed solely in the USA cannot be directly translated to a country with such a mixed population as Brazil. It is also worth remembering that, with the size of the population, it may be more worthwhile for drugs to be authorized in developing countries than in the developed countries - in the past, few patients could pay for drugs but recently the buying power of the populations in these countries has been increasing. Population size alone offers the promise of expanding markets(5). Ethical considerations are another major concern in developing countries for several reasons not least the lack of education of participants who may not understand the nature of research and the principle behind placebo controls for example. Additionally, the financial reward for participation may be significant compared to the salaries of research subjects and of course there is the lack of reviewing by ethics committees etc.. But how should Brazilian researchers and universities prepare for this future. The first thing we should be doing is to really invest in our participation in international trials. By participating, researchers are not only becoming better known internationally but are also gaining valuable experience. It is important that research in Brazil reaches the international standards required for drugs to be authorized by the Food and Drugs Administration (FDA) and the European Medicines Agency (EMEA). Today Brazilian research is fragmented with little cooperation even within the same institution. If we are to become a leader in research and scientific production, we must overcome our traditional rivalry and start to work together by sharing ideas, facilities and experience. Departments specifically for research need to be created with all the professionals necessary for good research including laboratory assistants, biochemists, biologists, statistician etc. with weekly meetings to discuss new ideas, problems and the such like. We need to be more creative in our research projects. The subject matter of most research in Brazil is either dictated by western countries as part of international trials or copies of studies that were performed in other countries in an attempt to validate the data in our population. But there are great gaps in research in less developed countries where the needs are different. One example of this is that among US-sponsored phase III trials xxx examined by Glickman et al., none were trials of diseases, such as tuberculosis, that are common in less developed countries but rare in the USA. The state of research in Brazil has changed and continues to do so, but we still have a long way to go before we can truly say that we are a world leader.

A Revista Brasileira de Hematologia e Hemoterapia foi inserida na base de dados da Scientific Electronic Library On-Line (SciELO) em outubro de 2001. Esta conquista propicia o relato da evolução do veículo de divulgação da Sociedade Brasileira de Hematologia e Hemoterapia que se iniciou em 1973. Até 1984 o Boletim foi um veículo de divulgação, transformando-se em seguida em revista científica. Em 1999 mudou de título, modernizou-se e passou a ser também o órgão oficial da Sociedade Brasileira de Transplante de Medula Óssea. Para o entendimento da referida conquista foi realizado um histórico sobre o Institute for Scientific Information (ISI), principal base de dados internacional, e a SciELO, base de dados nacional de recuperação de linha. Ao final o autor apresenta uma reflexão sobre o futuro da RBHH e os caminhos que o periódico deve trilhar com a finalidade de aumentar a sua importância no meio científico. The Brazilian Hematology and Hemotherapy Journal (Revista Brasileira de Hematologia e Hemoterapia) was included in the data base of Scientific Electronic library on-line (SciELO) in October of 2001. This achievement encourages a historic registration of the means by which the performance of the Brazilian Hematology and Hemotherapy Society, which began in 1973, has been divulged. Until 1984, the Boletim was the instrument of notification of the work of the society which soon became a scientific journal. In 1999, the title was changed and the journal was modernized. At this time it also became the official publication of the Brazilian Society of Bone Marrow Transplantation. To better understand the importance of this victory, a historic review of the Institute for Scientific Information (ISI), the main international data base and SciELO, the national data base was assembled. Finally the author reflects on the future of the Journal and the paths that it should follow with the objective of increasing the periodicals importance in the scientific world.

CONTEXT: Epidemiological studies have demonstrated higher frequencies of the O blood group and the non-secretor phenotype of ABH antigens among patients suffering from peptic ulcers. Since Helicobacter pylori has been established as the main etiological factor in this disease, controversies about the associations of the ABO and Lewis blood group phenotypes and secretor and non-secretor phenotypes in relation to susceptibility towards infection by this bacillus have been presented. OBJECTIVE: To verify the frequencies of ABO, Lewis blood group phenotypes, secretor and non-secretor phenotypes in patients infected or uninfected by H. pylori. DESIGN: Cross-sectional study. SETTING: Outpatient clinic. PARTICIPANTS: One hundred and twenty patients with dyspeptic symptoms who underwent endoscopy.MAIN MEASUREMENTS: ABO and Lewis blood group phenotypes were determined by a standard hemagglutination test and the secretor and non-secretor phenotypes were evaluated by saliva samples using the inhibitor hemagglutination test. RESULTS: The diagnosis of infection, made via breath and urea tests and confirmed using polymerase chain reaction (PCR) in gastric biopsy fragments, showed the presence of H. pylori in 61.7% of the patients and absence in 38.3%. The differences between the frequencies of the ABO blood group phenotypes among infected (A 27.0%; B 12.2%; AB 4.0% and O 56.8%) and uninfected patients (A 58.7%; B 13.0%; AB 4.3% and O 24.0%) were significant. The Lewis blood type, secretor and non-secretor phenotypes showed homogeneous distribution between the groups of patients analyzed. CONCLUSIONS: Our results suggest that the infection of H. pylori can be related to ABO blood groups but not to the Lewis blood group nor to secretor and non-secretor phenotypes. CONTEXTO: Estudos epidemiológicos evidenciaram alta freqüência do tipo O e do fenótipo não-secretor dos antígenos ABH em pacientes com úlceras pépticas. Desde que o Helicobacter pylori foi estabelecido como o principal agente etiológico destas doenças, controvérsias sobre as associações dos grupos sangüíneos ABO, Lewis e dos fenótipos secretor e não-secretor com a suscetibilidade à infecção por esse bacilo foram apresentadas. OBJETIVO: Verificar as freqüências dos fenótipos ABO, Lewis, secretor e não-secretor em pacientes infectados ou não infectados pelo H. pylori. TIPO DE ESTUDO: Estudo transversal. LOCAL: Ambulatório de Gastroenterologia do Hospital de Base de São José do Rio Preto e Laboratório de Imunogenética Molecular do Hemocentro de São José do Rio Preto. PARTICIPANTES: Foram avaliados 120 pacientes com sintomas de dispepsia submetidos a endoscopia digestiva alta. VARIÁVEIS ESTUDADAS: Fenótipos eritrocitários ABO e Lewis determinados pelos métodos de hemaglutinação padronizados e fenótipos secretor e não-secretor pelo método de inibição de hemaglutinação. RESULTADOS: O diagnóstico de infecção e não-infecção, realizado pelos testes respiratório e da urease, e confirmado pelo método da reação de polimerase em cadeia (PCR) em fragmentos de biópsias gástricas demonstrou a presença do H. pylori em 61,7% dos pacientes e ausência em 38,3%. As diferenças nas freqüências dos grupos sangüíneos ABO entre os pacientes infectados (A 27,0%; B 12,2%; AB 4,0%; O 56,8%) e não-infectados (A 58,7%; B 13,0%; AB 4,3%; O 24,0%) foram significantes. Os tipos sangüíneos Lewis e os fenótipos secretor e não-secretor mostraram distribuição semelhante entre os grupos de pacientes analisados. CONCLUSÕES: Os resultados sugerem que a infecção pelo H. pylori parece ser influenciada pelos fenótipos ABO, mas não pelos fenótipos Lewis, secretor e não-secretor.

Foi realizado, no Rio de Janeiro, no mes de agosto, o VI Congresso da Sociedade Brasileira de Transplante de Medula Ossea. Como de habito, o evento, nascido do Encontro Anual de Curitiba, foi um sucesso abordando inumeros aspectos do transplante e do tratamento das hemopatias malignas. Temas de enfermagem, histocompatibilidade e de imunogenetica fizeram parte da programacao oficial e foram os responsaveis pela vinda de um grande numero de participantes de todo o pais ao Rio de Janeiro. Neste ano ocorreu tambem em paralelo o 1 o Encontro Italo-Brasileiro de TMO e He

The Revista Brasileira de Hematologia e Hemoterapia (RBHH) is now the official organ of the Sociedade Brasileira de Oncologia Pediatrica (Brazilian Society of Pediatric Oncology - SOBOPE). With this, SOBOPE will assist us to achieve our objectives to develop and internationalize the journal. The question regarding the Qualis classification of CAPES remains a matter of widespread debate and controversy. A recent event of FAPESP/SciELO, highlighted the progress of Brazil in respect to global scientific production as we had already discussed in issue no 3 of the RBHH this year.(1) In an atmosphere of jingoism, several editors presented measures they adopted for their journals to be included in the Thomson Reuters/ISI/JCR database, the most prestigious among all existing databases and the one responsible for calculating the famous Impact Factor. The measures used are all basically the same and already known to most participants. They include professionalization of the journal, publishing in English to increase international visibility and massive investment to improve the quality of content, in addition to trivial details, such as care with the frequency and quality of printing. With this, in few years, Brazil now has 89 scientific journals in all fields of the Thomson Reuters/ISI/JCR database. Several aspects were mentioned and a presentation by the representative of the University of Granada, Spain responsible for SCImago, emphasized the importance of Brazil and suggested adopting different approaches within the editorial market such as partnerships especially between scientific groups in Brazil and other countries in order to produce material with greater appeal and international impact. Examples of the influence of international publishers as well as criticism of the current Qualis classification were presented by another speaker(2-4) (Table 1). Table 1 Qualis classification of scientific journals With the approach of the publication of the new Qualis classification, representatives of SciELO and FAPESP suggested that some journals will be reclassified in higher positions than the old classification; those chosen would receive good financial support over a fiveyear period but this was not explained well. They mentioned that three journals from each of the three medical categories (Medicine 1, 2 and 3) would be indicated. Others suggested that it would only be two in each area. The criteria would be the existing parameters such as the impact factor, possibly using SCImago and the inclusion in SciELO which are criteria of the old classification system. Thus, the discussion is on the agenda. For this reason the Brazilian Medical Association met with all medical journal editors to discuss the new classification and the parameters that will be employed. Without much information, one of the area coordinators reported that Capes had asked him to indicate three journals, pure and simply. He also informed us that the nominees may even be promoted to classification A1 even with an impact factor lower than that stipulated by the old classification. At this point the meeting came to an end as the discussion became general with different opinions on various aspects; one conclusion was reached that if this measure were adopted there would be major discouragement for all the excluded journals. The RBHH, since the new classification was established, has been feeling the impact and thus has been trying to adapt to the new situation with much effort to improve.(5) The journal has invested in human resources and professionalism, which can be seen from the first edition of this volume. At this moment the RBHH advocates a comprehensive policy to stimulate national journals and does not agree with the support by sector for a few journals. However, we also know of the distinctive position of the RBHH in the world in relation to the other journals of this specialty and of course with evolution, our journal will become an even stronger representative of South America and of Latin countries as an alternative for developing countries to publish their scientific production.

Foram editados ao longo do ano2000, cinco fasciculos sendo tres regulares e doissuplementos referentes ao Congresso Brasileirode Hematologia e Hemoterapia - Hemo 2000(Abstracts e Programa Cientifico).Neste volume a revista transformou-setambem no orgao oficial da Sociedade Brasileirade Transplante de Medula Ossea, fato este queaumentou o espectro e a importância do veiculode comunicacao. A amplitude de colaboracoesesteve presente com a edicao de contribuicoesde todos os cantos do pais, com temas diversos econtando com colaboradores que ate entao naohaviam publicado na

Com o objetivo de conhecer a frequência de desnutrição proteico-calórica ao diagnóstico e avaliar a sua importância na evolução clínica de crianças portadoras de Leucemia Linfocítica Aguda, com idades inferiores a quinze anos, estudamos trinta e oito crianças com Leucemia Linfocítica Aguda e sem tratamento prévio, atendidas no Hospital de Base de São José do Rio Preto-SP, no período de Setembro/89 a Dezembro/97. Entre as crianças, 63,2% eram do sexo masculino e 36,8% do sexo feminino (1,7:1,0), a faixa etária predominante foi de cinco a nove anos (44,8%), seguida daquela entre um e quatro anos (36,8%), ³ 10 anos (10,5%) e menores de um ano (7,9%). Ao diagnóstico, 52,7% eram eutróficos e 47,3% desnutridos (escore Z). Os índices nutricionais avaliados foram peso/estatura, estatura/idade e peso/idade e 21%, 34,2% e 31,5% deles, respectivamente, estavam abaixo da normalidade. Foi observada uma alta frequência de desnutrição ao diagnóstico. Porém, na avaliação do estado nutricional, entre os pacientes vivos e não-vivos, a presença de desnutrição não foi estatisticamente significativa. Este estudo reforçou a evidência da necessidade de estabelecer uma rotina de avaliação nutricional ao diagnóstico, bem como, a presença de um profissional especializado em nutrição, numa unidade de oncologia pediátrica. This study evaluated 38 children with Acute Lymphoblastic Leukemia, under 15 years old, without previous therapy, seen at the Hospital de Base, Medical School of Saõ José do Rio Preto, S.P., during the period between September, 1989 to December, 1997. Nutritional status were compared as well as malnutrition at diagnosis with patients survival were compared. The results showed the following incidences: males 63.2%, females 36.8%. The stratification by age showed greater incidence in the age group of 5-9 years (44.8%), followed by 1-4 years (36.8%), and older than 10 years (10.5%) and the last group, younger than 1 year (7.9%). The study of nutritional status showed that 52.7% of children were wellnourished and 47.3% were undernourished at diagnosis (score Z). The anthropometric measurements showed that 21% of children were malnourished according to the weight for height index, 34.2% according to the height for age index, and 31.5% according to the weight for age index at diagnosis. Malnutrition was commonly present at diagnosis. However, the survival was not influenced by malnutrition. The present study analysis has demonstrated the necessity to improve the nutritional assessment at diagnosis as well as nutritional intervention.