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O objetivo deste estudo foi o de avaliar a eficácia da punção aspirativa por agulha fina (PAAF) da tireóide comparando-a com o diagnóstico histopatológico. Os autores avaliaram os resultados citológicos de 50 pacientes atendidos no período de dezembro de 1995 a julho de 1997, nos Departamentos de Citopatologia, Anatomia Patológica e Cirurgia da Santa Casa de Belo Horizonte, Minas Gerais. No mesmo período foram realizados 256 PAAF de tireóide, sendo que somente 50 pacientes foram à cirurgia e puderam ter os diagnósticos citológicos comparados aos histológicos. O grupo estudado consistiu em 40 mulheres e 10 homens, com idades variando entre 10 e 79 anos, sendo a maior incidência observada nas 4ª e 5ª décadas. Baseando-se na comparação dos diagnósticos, os autores obtiveram as taxas de sensibilidade (80%), especificidade (100%), valor preditivo positivo (100%), valor preditivo negativo (89,5%) e acurácia (92,6%). De acordo com estes resultados, pôde-se concluir que a PAAF é um método seguro, eficiente e confiável no diagnóstico dos nódulos tireoidianos.

Neuroendocrine neoplasms (NENs), arising from various sites, present therapeutic challenges. Radioligand therapy (RLT) is effective for unresectable/metastatic NENs with increased somatostatin receptor uptake. While evidence supports RLT's efficacy in midgut NETs, its role in lung NETs remains underexplored. Clinical guidelines place RLT as a third or fourth-line option in this setting. However, in the last years several studies investigated mainly retrospectively effectiveness and safety of RLT in lung NET. The aim of this review is to assess the efficacy and safety of RLT in patients with lung NETs. Following PRISMA guidelines, a systematic review of MEDLINE and EMBASE databases retrieved English articles until March 31, 2023. Inclusion criteria encompassed studies involving RLT in lung NETs with efficacy and safety assessments. Twenty-seven studies met the criteria, totaling 786 patients. The pooled analysis revealed a 25.6% objective response rate and 75.6% disease control rate. Median progression-free survival averaged 20 months, while overall survival averaged 45 months. Factors affecting response included tumor burden, prior treatments, 18F-FDG PET scan uptake, and histological variants. RLT exhibited manageable grade 1/2 adverse effects, predominantly hematological, with Lu177 demonstrating a more favorable profile than Y90. The findings support RLT's effectiveness in lung NETs, offering hope for advanced SSTR-positive patients. Although identifying predictive factors for response remains challenging, RLT retained efficacy even after prior therapies and typical carcinoids displayed a slightly better response than atypical ones. Prospective trials are imperative to establish RLT's definitive efficacy and its place in the therapeutic landscape for lung NETs. [ABSTRACT FROM AUTHOR]

Abstract BACKGROUND: Gastrointestinal (GI) symptoms are frequent complaints from individuals with nonalcoholic fatty liver disease (NAFLD). Dyspepsia is a universal clinical symptom and is among the most common GI complaints observed in the general population, but its prevalence in the population with NAFLD has not been previously investigated. OBJECTIVE: To compare the prevalence of functional dyspepsia (FD) between patients with NAFLD and controls without liver disease. DESIGN AND SETTING: Cross-sectional study at the Outpatient Liver Clinic, University Hospital, Belo Horizonte, Brazil. METHODS: We included 96 NAFLD patients and 105 controls without liver disease. All participants were assessed for GI symptoms in accordance with the Rome III criteria. Evaluation methods included a questionnaire for FD (validated in Brazil), laboratory tests and upper GI endoscopy. RESULTS: Mean age and sex were similar between the groups. The NAFLD group presented higher frequency of proton-pump inhibitor usage (31.3% vs 4.8%; P < 0.001) and prevalence of FD (25.0% versus 12.4%; P = 0.021). The symptom frequencies were as follows: postprandial distress, 22.9% versus 11.4% (P = 0.030); postprandial fullness, 18.8% versus 10.5% (P = 0.095); early satiation, 8.3% versus 5.7% (P = 0.466); and epigastric pain or burning, 18.8% versus 5.7% (P = 0.004), in NAFLD patients and controls, respectively. Multivariate analysis demonstrated that female sex (odds ratio, OR 6.97; 95% confidence interval, CI: 1.51-32.12; P = 0.013) and NAFLD diagnosis (OR 2.45; 95% CI: 1.14-5.27; P = 0.021) were independently associated with FD occurrence. CONCLUSION: FD occurs more frequently in individuals with NAFLD than in controls without hepatic disease.

The incidence of cancer in pre-pubertal boys has significantly increased and, it has been recognized that the gonado-toxic effect of the cancer treatments may lead to infertility. Here, we have evaluated the effects on porcine neonatal Sertoli cells (SCs) of three commonly used chemotherapy drugs; cisplatin, 4-Hydroperoxycyclophosphamide and doxorubicin. All three drugs induced a statistical reduction of 5-hydroxymethylcytosine in comparison with the control group, performed by Immunofluorescence Analysis. The gene and protein expression levels of GDNF, were significantly down-regulated after treatment to all three chemotherapy drugs comparison with the control group. Specifically, differences in the mRNA levels of GDNF were: 0,8200 ± 0,0440, 0,6400 ± 0,0140, 0,4400 ± 0,0130 fold change at 0.33, 1.66, and 3.33μM cisplatin concentrations, respectively (**p < 0.01 at 0.33 and 1.66 μM vs SCs and ***p < 0.001 at 3.33μM vs SCs); 0,6000 ± 0,0340, 0,4200 ± 0,0130 fold change at 50 and 100 μM of 4-Hydroperoxycyclophosphamide concentrations, respectively (**p < 0.01 at both these concentrations vs SCs); 0,7000 ± 0,0340, 0,6200 ± 0,0240, 0,4000 ± 0,0230 fold change at 0.1, 0.2 and 1 µM doxorubicin concentrations, respectively (**p < 0.01 at 0.1 and 0.2 μM vs SCs and ***p < 0.001 at 1 μM vs SCs). Differences in the protein expression levels of GDNF were: 0,7400 ± 0,0340, 0,2000 ± 0,0240, 0,0400 ± 0,0230 A.U. at 0.33, 1.66, and 3.33μM cisplatin concentrations, respectively (**p < 0.01 at both these concentrations vs SCs); 0,7300 ± 0,0340, 0,4000 ± 0,0130 A.U. at 50 and 100 μM of 4- Hydroperoxycyclophosphamide concentrations, respectively (**p < 0.01 at both these concentrations vs SCs); 0,6200 ± 0,0340, 0,4000 ± 0,0240, 0,3800 ± 0,0230 A.U. at 0.l, 0.2 and 1 µM doxorubicin concentrations, respectively (**p < 0.01 at 0.1 and 0.2 μM vs SCs and ***p < 0.001 at 1 μM vs SCs). Furthermore, we have demonstrated the protective effect of eicosapentaenoic acid on SCs only at the highest concentration of cisplatin, resulting in an increase in both gene and protein expression levels of GDNF (1,3400 ± 0,0280 fold change; **p < 0.01 vs SCs); and of AMH and inhibin B that were significantly recovered with values comparable to the control group. Results from this study, offers the opportunity to develop future therapeutic strategies for male fertility management, especially in pre-pubertal boys.

Objective: This study aimed to investigate bone composition in male rats treated with diet supplemented with taro (Colocasia esculenta) flour until their 90 days. Methods: Weanling male rats were divided into control (C, n=11) and experimental group (T, n=12); the latter comprised animals treated with taro flour until their 90 days. Food intake, body mass and length were evaluated on a weekly basis throughout the experimental period. Spine bone dimension, as well as bone mineral density (BMD), mineral content (BMC), total area and biomechanical properties were determined after 90 days. Results: T group recorded higher values for (P

A orelha é estrutura com peculiaridades anatômicas, localizada em área exposta a traumas e suscetível a uma série de dermatoses que merecem atenção, muitas vezes subdiagnosticadas pelos dermatologistas. Realizou-se revisão de literatura incluindo a embriologia e a anatomia do pavilhão auricular, bem como diagnóstico e tratamento das lesões traumáticas de natureza física e por alterações de temperatura, entre outras.

Background: Alzheimer's disease (AD) is the most common neurodegenerative disorder. Depositions of amyloid β peptide (Aβ) and tau protein are among the major pathological hallmarks of AD. Aβ and tau burden follows predictable spatial patterns during the progression of AD. Nevertheless, it remains obscure why certain brain regions are more vulnerable than others; to investigate this and dysregulated pathways during AD progression, a mass spectrometry-based proteomics study was performed. Methods: In total 103 tissue samples from regions early (entorhinal and parahippocampal cortices - medial temporal lobe (MTL)) and late affected (temporal and frontal cortices - neocortex) by tau pathology were subjected to label-free quantitative proteomics analysis. Results: Considering dysregulated proteins during AD progression, the majority (625 out of 737 proteins) was region specific, while some proteins were shared between regions (101 proteins altered in two areas and 11 proteins altered in three areas). Analogously, many dysregulated pathways during disease progression were exclusive to certain regions, but a few pathways altered in two or more areas. Changes in protein expression indicate that synapse loss occurred in all analyzed regions, while translation dysregulation was preponderant in entorhinal, parahippocampal and frontal cortices. Oxidative phosphorylation impairment was prominent in MTL. Differential proteomic analysis of brain areas in health state (controls) showed higher metabolism and increased expression of AD-related proteins in the MTL compared to the neocortex. In addition, several proteins that differentiate brain regions in control tissue were dysregulated in AD. Conclusions: This work provides the comparison of proteomic changes in brain regions affected by tau pathology at different stages of AD. Although we identified commonly regulated proteins and pathways during disease advancement, we found that the dysregulated processes are predominantly region specific. In addition, a distinct proteomic signature was found between MTL and neocortex in healthy subjects that might be related to AD vulnerability. These findings highlight the need for investigating AD's cascade of events throughout the whole brain and studies spanning more brain areas are required to better understand AD etiology and region vulnerability to disease.

AbstractObjective:This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil.Methods:This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality.Results:Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay.Conclusion:Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding.

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Introduction: There are few studies on body composition and the effects of diet on weight postpartum women. The aim was to evaluate the body composition and bone parameters in lactating rats treated with diet containing flaxseed flour during postweaning period. Methods: After weaning, the lactating rat were divided in control (n = 6) and experimental (F, n = 6) group, treated with 25% flaxseed flour diet. After 30 days, body composition by dual-energy X-ray absorptiometry, serum analysis, organs and intra-abdominal fat mass, femur and lumbar vertebra parameters were determined. Results: The groups showed similar food intake, body mass and bone parameters. While F group showed the following: lower body (-5%), gonadal (-17%), mesenteric (-23%) and intra-abdominal (-6%) fat mass. Increase of HDL-cholesterol (+10%) and lower glucose (-15%), triglycerides (P < 0.05, -37%) and cholesterol (P < 0.05, -21%). Conclusions: The findings highlight the effects of flaxseed for control of adiposity and to maintain a healthy biochemical profile during the postnatal period.

OBJECTIVE: Recent evidence suggests that non-alcoholic fatty liver disease is associated with diet. Our aim was to investigate the dietary patterns of a Brazilian population with this condition and compare them with the recommended diet. METHODS: A cross-sectional study was conducted on 96 non-alcoholic fatty liver disease patients before any dietetic counseling. All patients underwent abdominal ultrasound, biochemical tests, dietary evaluations, and anthropometric evaluations. Their food intake was assessed by a semi-quantitative food-frequency questionnaire and 24-hour food recall. RESULTS: The median patient age was 53 years, and 77% of the individuals were women. Most (67.7%) participants were obese, and a large waist circumference was observed in 80.2% subjects. Almost 70% of the participants had metabolic syndrome, and 62.3% presented evidence of either insulin resistance or overt diabetes. Most patients (51.5, 58.5, and 61.7%, respectively) exceeded the recommendations for energy intake, as well as total and saturated fat. All patients consumed less than the amount of recommended monounsaturated fatty acids, and 52.1 and 76.6% of them consumed less polyunsaturated fatty acids and fiber, respectively, than recommended. In most patients, the calcium, sodium, potassium, pyridoxine, and vitamin C intake did not meet the recommendations, and in 10.5-15.5% of individuals, the tolerable upper limit intake for sodium was exceeded. The patients presented a significantly high intake of meats, fats, sugars, legumes (beans), and vegetables and a low consumption of cereals, fruits, and dairy products compared with the recommendations. CONCLUSIONS: Although patients with non-alcoholic fatty liver disease exhibited high energy and lipid consumption, most of them had inadequate intake of some micronutrients. The possible role of nutrient-deficient intake in the development of non-alcoholic fatty liver disease warrants investigation.

Introdução: Atualmente a terapia fotodinâmica é considerada uma modalidade terapêutica com resultados promissores no tratamento do fotoenvelhecimento moderado. Objetivo: Avaliação dos resultados clínicos e das mudanças histológicas no colágeno e nas fibras elásticas após a realização da terapia fotodinâmica com ácido 5-aminolevulínico. Métodos: Pacientes do sexo feminino foram submetidas a três sessões a cada duas semanas, de terapia fotodinâmica com acido 5-aminolevulínico irradiado por luz vermelha de Diodos Emissores de Luz de 630 nm. Foi avaliada a melhora clínica do fotoenvelhecimento através de método semi-quantitativo usando os escores: 0 = ausência de reação; 0.5 = reação muito fraca; 1.0 = reação discreta; 2.0 = reação moderada; 3.0 = reação intensa.As mudanças do colágeno e do tecido elástico dérmico corados respectivamente pelos métodos de Picrossirius e de Weigert-oxone, foram avaliadas por histomorfometria no período prévio ao procedimento, 24 horas após a primeira sessão e 21 dias após a terceira sessão. Resultados:Treze pacientes foram incluídas nesse estudo analítico e prospectivo. Na avaliação clínica, 21 dias após o último tratamento, 12 pacientes apresentaram melhora do fotoenvelhecimento, especialmente no que diz respeito à cor e textura da pele, clareamento de melanoses solares, regressão de queratoses actínicas, e melhora da flacidez. Na avaliação histomorfométrica, ocorreu aumento de colágeno e fibras elásticas. Estes dados foram estatisticamente comprovados. Conclusão: A terapia fotodinâmica com acido 5-aminolevulínico associado à luz vermelha foi considerada eficaz no tratamento do fotoenvelhecimento após avaliações clínicas e histológicas.

Avaliou-se o desempenho ponderal de novilhas em regime de pastejo rotacionado consumindo dois tipos de suplemento mineral. Utilizaram-se 25 novilhas Holandês × Zebu, 9 como animais reguladores e 16 como animais-prova, divididas em quatro tratamentos: capim-mombaça e sal seletivo (MSS); capim-mombaça e sal comercial (MSC); capim-elefante e sal seletivo (ESS); e capim-elefante e sal comercial (ESC). O ganho médio diário (GMD) foi calculado pesando-se os animais-prova a cada 28 dias após jejum alimentar de 16 horas. Foram avaliados os consumos de matéria seca de lâmina foliar verde (CMSLFV) e a digestibilidade aparente da matéria seca de lâmina foliar verde (DMSLFV) utilizando-se óxido crômico como marcador externo e fibra em detergente neutro indigerível como marcador interno. Foram mensurados os consumos dos suplementos minerais e avaliados os teores de matéria seca, proteína bruta, fibra em detergente neutro e de Ca, P, K, Mg, Na, Cu, Zn, Fe e Mn somente em amostras de lâmina foliar. O delineamento estatístico utilizado foi o inteiramente casualizado em esquema fatorial 2 × 2 (gramínea e mistura mineral). Cada tratamento foi composto por quatro animais, de modo que cada animal constituiu uma unidade experimental. Apenas os minerais Cu, Na e Zn foram encontrados em quantidades insuficientes nas forrageiras. Os CMSLFV não foram influenciados por nenhuma das variáveis estudadas nem por suas interações. Houve interação sal mineral × gramínea para a DMSLFV. O GMD foi influenciado apenas pelas gramíneas; o desempenho dos animais que consumiram o capim-elefante foi superior. A composição nutricional do capim-elefante foi ligeiramente superior à do capim-mombaça, o que provavelmente proporcionou melhor desempenho aos animais deste tratamento.The ponderal performance of heifers under rotational grazing fed two types mineral supplement was evaluated. A total of 25 heifers Holstein × Zebu, including nine regulator animals and 16 test animals, was divided into four treatments: mombaçagrass (Panicum maximum, CV. Mombaça) with selective salt (MSS), mombaçagrass with commercial salt (MSC), elephantgrass (Pennisetum purpureum, CV. Napier) with selective salt (ESS) and elephantgrass with commercial salt (ESC). Average daily live weight gain (DWG) was calculated by weighing the test animal every 28 days after fasting of 16 hours. Dry matter intake (CMSLFV) and apparent digestibility (DMSLFV) of green leaf blade were evaluated with chromium oxide and indigestible neutral detergent fiber, as external and internal markers, respectively. Mineral supplement intake was measured and the levels of dry matter, crude protein, and of Ca. P, K, Mg, Na, Cu, Zn, Fe and Mn only in grass leaves samples. A completely randomized design in 2 × 2 factorial arrangement (grass and mineral mix), was used. Each treatment was composed by four animals, and each animal as considered a experimental unit. Only Cu, Na and Zn were deficient in the forages. The CMSLFV were not affected by the studied variables and no significant interactions were observed. There was interaction between salt mix and grass for DMSLF. The DWG was affected only by grasses, the performance that ingested elephantgrass was higher. The nutritional composition of the elephantgrass was slightly better than that of mombaçagrass what probably provided better weight gains for the animals in this treatment.

Avaliaram-se a composição bromatológica e as frações de carboidratos e proteínas de aveia-preta (Avena strigosa Schreb) cv. EMBRAPA 29 e triticale (X triticosecale Wittmack) cv. IAC 3 semeados em abril, maio e junho e colhidos nos sistemas corte e pastejo a intervalos de 30 dias nas condições do norte do estado do Rio de Janeiro. O experimento constou de um fatorial 2 × 2 × 3, arranjado em blocos ao acaso, com três repetições, composto dos fatores: gramínea, sistema e época de plantio. Os teores de matéria seca (MS) diferiram entre espécies e sistemas e foi superior no triticale e no sistema pastejo, porém, não diferiram dentro de cada espécie nas diferentes épocas de plantio. Houve efeito significativo dos fatores e/ou de suas interações sobre os teores de fibra em detergente neutro (FDN), FDN livre de cinzas e proteína (FDNcp) e lignina; o teor de FDN foi maior no triticale semeado em abril. Os teores médios de carboidratos totais (%CT na MS) não diferiram entre as espécies e os sistemas, porém, foram maiores em abril, exceto para o triticale no sistema de pastejo; o teor médio geral foi de 77,83% da MS. Do total de carboidratos na MS, 25,5% no triticale e 19,20% na aveia-preta foram compostos de carboidratos não-fibrosos (CNF). A fração B2 variou apenas entre as épocas, de 45,32 a 49,13%, respectivamente, para as épocas de plantio em abril e junho no triticale sob o sistema de corte. A fração das proteínas solúveis em detergente neutro (fração A+B1+B2) diferiu apenas entre os teores médios de carboidratos totais (%CT na MS). Considerando o valor médio de PB obtido e sua disponibilidade no triticale e na aveia-preta, pode-se indicar essas forrageiras como excelentes fontes de proteína.Black-oat (Avena strigosa Schreb.) cv. EMBRAPA 29 and Triticale (X triticosecale Wittmack) cv. IAC 3 were studied under harvest or grazing every 30 d, in three planting seasons (April, May and June), in order to evaluate the bromatological composition under Northern Rio de Janeiro State conditions. The experiment was done in a factorial arrangement 2 × 2 × 3, in randomized block design with three replicates, being the factors: grass, systems and planting season. The dry matter (DM) concentration differed between species and cutting systems, with Triticale showing higher DM under grazing; however there were no differences within species in relation to planting seasons. Significant effects were found between factors and/or its interactions on the levels of neutral detergent fiber (NDF), NDF free of ash and crude protein (NDFacp) and lignin, with higher NDF for Triticale planted in April. Total carbohydrate concentration (%TCHO in DM) did not vary among species and cutting systems, however slightly higher concentrations were found on April, except for Triticale under grazing system; average %TCHO was 77.83% in DM. From this total (%TCHO in DM), 25.5 and 19.20% in the Triticale and in Black-oat, respectively, were composed by non fiber carbohydrate (%NFC in TC). The B2 fraction (%B2 in TC) varied only among planting periods in Triticale under harvest system, ranging from 45.32 to 49.13%, respectively, for April and June. The protein fractionation showed high protein solubility in forage DM, but statistical differences were found only among planting periods for the soluble protein fractions in neutral detergent (fractions A+B1+B2). Considering the average CP value obtained and its availability it is possible to point out these forages as excellent protein sources.

Objetivou-se avaliar comparativamente a composição química, a digestibilidade in vitro e a degradabilidade dos carboidratos de amostras de capim-elefante (Pennisetum purpureum Schum, cv. Napier) e capim-mombaça (Panicum maximum, Jacq. cv. Mombaça) obtidas por extrusa esofágica e por simulação manual de pastejo. O capim-elefante apresentou os maiores teores de MS, PB e nitrogênio não-protéico. A composição do capim-mombaça sofreu variações conforme aumentaram os dias de pastejo, principalmente quanto aos teores de MS e nitrogênio. A fração potencialmente degradável dos carboidratos diferiu entre as metodologias de avaliação. Não foram observadas diferenças entre as forrageiras quanto à cinética de degradação dos carboidratos.Chemical composition and IVDMD of elephantgrass (Pennisetum purpureum, Schum. cv. Napier) and mombaçagrass (Panicum maximum, cv. Mombaça) were evaluated using samples of esophageal extrusa and hand-plucked samples. Greater DM, CP, and non-protein N concentrations were observed in the elephantgrass. Chemical composition of mombaçagrass, mainly DM and N concentration, varied with grazing day. Potentially degradable carbohydrate fraction differed between sampling techniques. No differences were observed regarding the kinetics of carbohydrates degradation for both grasses.

Com o objetivo de avaliar a viabilidade técnica de produção forrageira de culturas de inverno sob os sistemas de corte e pastejo nas condições do norte do estado do Rio de Janeiro, foram semeadas em abril (21/4/2004), maio (20/5/2004) e junho de 2004 (21/06/2004) as forrageiras aveia-preta (Avena strigosa Schreb) cv. EMBRAPA 29 e triticale (X triticosecale Wittmack) cv. IAC 3. A produção de MS foi maior no sistema corte e na época maio. No sistema de corte, a aveia-preta produziu em média 2.317,48 kg MS/ha e o triticale, 2.128,30 kg MS/ha, ao passo que, no sistema pastejo, produziram 1.169,42 e 678,31 kg MS/ha, respectivamente. As condições climáticas no momento do 1º corte/pastejo anteciparam o ciclo fenológico, o que comprometeu a expressão do potencial produtivo destes cultivares reduzindo o período da germinação ao florescimento e aumentando o percentual de caule + bainha e inflorescência na massa de forragem. A massa de forragem foi composta em média por 34% de lâmina foliar, 31,08% de caule + bainha, 24,56% de inflorescência e 10,35% de material morto. A proporção de caule + bainha foi maior na aveia-preta. A relação lâmina foliar/caule + bainha diferiu significativamente entre espécies e épocas de plantio e não foi influenciada pelo sistema. Na época junho, a aveia-preta apresentou maior relação lâmina foliar/caule + bainha, portanto, a menor produção de MS, em virtude do estádio em que as plantas se encontravam no momento das primeiras avaliações. O triticale, apesar da maior participação de inflorescência, apresentou maior relação lâmina foliar/caule + bainha e não diferiu significativamente entre os tratamentos. A melhor época para plantio do triticale na região norte do Rio de Janeiro é abril e para plantio de aveia-preta é maio/junho, ambos no sistema de corte.The winter forage species Black-oat (Avena strigosa Schreb.) cv. EMBRAPA 29 and triticale (X triticosecale Wittmack.) cv. IAC 3, were studied on three planting dates, April (4/21/2004), May (5/20/2004), and June (6/21/2004) in order to evaluate the technical viability of forage produced under harvest and grazing, in the Northern Region of Rio de Janeiro State. DM production was greater for the harvest system when planted in May, where Black-oat produced 2,317.48 kg DM/ha and triticale 2,128.30 kg DM/ha, compared to 1,169.42 e 678.31 kg MS/ha for black oat and triticale under grazing, respectively. Climatic conditions by the onset of the first cut/grazing anticipated the physiological cycle of these crops, reducing the production potential by decreasing the germination-blooming period and increasing the percentage of stem and inflorescences in the forage mass. The forage mass was composed by 34% of leaf blade, 31.08% stem, 24.56% of inflorescences, and 10.35% of dead material. Black oat showed greater stem + sheath proportion. Black oat species planted in June showed higher leaf blade/stem + sheath ratio, due to the initial stage when plants were submitted to the first evaluation. Despite the higher contribution of inflorescences, triticale species presented a higher leaf blade/stem + sheath ratio, however with no significant difference among treatments. The best planting time for triticale is April, while that for the Black-oat, May/June, both under the cutting system.

Acute Generalized Exanthematous Pustulosis (AGEP) is a drug-induced dermatosis characterized by an acute episode of sterile pustules over erythematous-edematous skin. It is accompanied by an episode of fever, which regresses a few days after discontinuation of the drug that caused the condition or as a result of corticosteroid treatment. The main triggering drugs are antibiotics, mainly beta-lactam ones. Other medications, such as antifungal agents, non steroid anti-inflammatory drugs, analgesics, antiarrhythmic, anticonvulsant and antidepressant drugs, may also be responsible. Histologically, it is characterized by the existence of vasculitis, associated with non-follicular subcorneal pustules. A case of a Caucasian female outpatient unit of Dermatology with AGEP, who presented with generalized pustulosis lesions after the use of cephalosporin for urinary infection is related. The diagnosis was confirmed by the clinical and pathological correlations, the resolution of the dermatosis after discontinuation of the drug and use of systemic corticosteroid treatment, and the recurrence of the disorder after the introduction of a similar drug. The importance of the recognition of this drug-induced dermatosis is given by its main differential clinical and histological diagnoses: generalized pustular psoriasis and subcorneal pustulosis.A pustulose exantemática aguda generalizada (AGEP) é uma dermatose induzida por droga, caracterizada por episódio agudo de aparecimento de pústulas estéreis sobre base eritemato-edematosa, acompanhado de febre. Este quadro regride espontâneamente após a suspensão da droga ou em resultado do tratamento com corticóide sistêmico. As principais drogas envolvidas são agentes antifúngicos, antiinflamatórios não hormonais, analgésicos, antiarrítmicos e anticonvulsivantes. Histologicamente caracteriza-se por vasculite associada a pústulas subcórneas não foliculares. Relatamos caso de paciente branca, feminina, que se apresentou com lesões pustulosas generalizadas após o uso de cefalosporina. O diagnóstico foi confirmado pelos achados clínicos e histológicos; pela resolução do quadro após a suspensão da droga e pela introdução de corticóide sistêmico, e pela recorrência após a introdução de droga similar. A importância do reconhecimento deste tipo de dermatose induzida por droga reside na necessidade importante de seu diagnóstico diferencial, clínico e histológico, com a psoríase pustulosa generalizada e a pustulose subcórnea, particularmente no que tange às opções terapêuticas que se apresentam para o tratamento das mesmas.

Este artigo visa proporcionar um questionamento, no âmbito jurídico, a respeito da cirurgia plástica corretiva e a cirurgia plástica estética, analisando qual será a responsabilidade civil do médico se ele realizar esses procedimentos com erro. Assim, para efetivar o trabalho foi realizada uma pesquisa bibliográfica a partir de doutrinas brasileiras e uma pesquisa documental. Portanto, dentre as conclusões obtidas por meio desse trabalho, ressalta-se que, com base no atual Código Civil e no Código de Defesa do Consumidor, usualmente a prova da culpa pertencerá ao paciente, pois em regra a obrigação assumida pelos médicos é de meio como, por exemplo, na hipótese de cirurgia reparadora, constatando a responsabilidade subjetiva.

O presente trabalho refere-se à elaboração de um Manual de Orientação Sexual para pacientes portadores de lesão medular, realizado por uma Enfermeira, integrante da Equipe de Reabilitação, da Divisão de Medicina de Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (D.M.R.H.C.F.M.U.S.P.). Tem como finalidade principal levar esses pacientes ao conhecimento da sexualidade e também orientações para exercê-la. Além disso, constitui-se em recurso para utilização durante as Consultas de Enfermagem ou nos grupos de Educação à Saúde, qualificando, assim, a assistência prestada.

Flaxseed oil (FO) is an alpha linolenic acid source important for growth and body development. However, there is little literature on the role of FO in critical stages of bone development and formation. This study evaluated the influence of a diet containing FO on rat femurs. After birth, mothers and pups were divided into control and flaxseed groups (n = 6 pups each) fed diets containing 7% soybean oil (C) or 7% FO. At 21 days, pups were weaned and separated from the mothers, and control or experimental diets were continued. At 67 days, the following were analyzed: osteocalcin and osteoprotegerin (OPG) levels, bone mineral density (BMD) and content, and bone area; the dimension, BMD, head radiodensity, and biomechanical proprieties of the right femur; and histomorphometric parameters of the left femur. Compared to the C group, the FO group presented (p < 0.05) a lower body mass (−3.7%) and medullary area (−10.1%) and higher osteocalcin (+36.7%), OPG (+52.5%), femur width (+3.8%), absolute mass (+2.3%), femur BMD (+3.6%), head radiodensity (+6.1%), maximum force (+7.4%), breaking strength (+17.3), and cortical thickness (+7.0). The FO diet contributed to femur quality in healthy male Wistar rats. [ABSTRACT FROM AUTHOR]

Malignant pleural mesothelioma is a highly malignant tumor, originating from mesothelial cells of the serous cavities. In mesothelioma the expression of syndecan-1 correlates to epithelioid morphology and inhibition of growth and migration. Our previous data suggest a complex role of syndecan-1 in mesothelioma cell proliferation although the exact underlying molecular mechanisms are not completely elucidated. The aim of this study is therefore to disclose critical genes and pathways affected by syndecan-1 in mesothelioma; in order to better understand its importance for tumor cell growth and proliferation. We modulated the expression of syndecan-1 in a human mesothelioma cell line via both overexpression and silencing, and followed the transcriptomic responses with microarray analysis. To project the transcriptome analysis on the full-dimensional picture of cellular regulation, we applied pathway analysis using Ingenuity Pathway Analysis (IPA) and a novel method of network enrichment analysis (NEA) which elucidated signaling relations between differentially expressed genes and pathways acting via various molecular mechanisms. Syndecan-1 overexpression had profound effects on genes involved in regulation of cell growth, cell cycle progression, adhesion, migration and extracellular matrix organization. In particular, expression of several growth factors, interleukins, and enzymes of importance for heparan sulfate sulfation pattern, extracellular matrix proteins and proteoglycans were significantly altered. Syndecan-1 silencing had less powerful effect on the transcriptome compared to overexpression, which can be explained by the already low initial syndecan-1 level of these cells. Nevertheless, 14 genes showed response to both up- and downregulation of syndecan-1. The "cytokine - cytokine-receptor interaction", the TGF-β, EGF, VEGF and ERK/MAPK pathways were enriched in both experimental settings. Most strikingly, nearly all analyzed pathways related to cell cycle were enriched after syndecan-1 silencing and depleted after syndecan-1 overexpression. Syndecan-1 regulates proliferation in a highly complex way, although the exact contribution of the altered pathways necessitates further functional studies.

A Insuficiência Renal Aguda (IRA) pode estar associada a várias etiologias no organismo humano, sendo este um dos motivos da importância dispensada àa esta doença. A prevenção é a principal ferramenta do médico e quando esta não foi possível, o tratamento visa afastar as principais causas, com investigação das demais e medidas de suporte para manter a viabilidade renal, muitas das vezes com êxito. A taxa de mortalidade em pacientes com IRA não se alterou muito nos últimos 30 anos. Os óbitos podem ocorrer em consequência da doença de base e não da própria IRA, pois o rim é um dos poucos órgãos cuja função pode ser substituída em parte por longos períodos (ex. diálise).

The clinical significance of multifocal pulmonary neuroendocrine proliferation (MNEP), including tumorlets and pulmonary neuroendocrine cell hyperplasia, in association with typical carcinoid (TC), is still debated. We evaluated a retrospective series of TC with long-term follow-up data prospectively collected from 2 institutions and compared the outcome between TC alone and MNEP plus TC. Several baseline covariates were imbalanced between the MNEP plus TC and TC groups; therefore, we conducted 1:1 propensity score matching and inverse probability of treatment weighting in the full sample. In the matched group, the association of clinical, respiratory, and work-related factors with the group was determined through univariable and multivariable conditional logistic regression analysis. A total of 234 TC patients underwent surgery: 41 MNEP plus TC (17.5%) and 193 TC alone (82.5%). In the MNEP plus TC group, older age (P <.001), peripheral tumors (P =.0032), smaller tumor size (P =.011), and lymph node spread (P =.02) were observed compared with the TC group. Relapses occurred in 8 patients in the MNEP plus TC group (19.5%) and 7 in the TC group (3.6%). After matching, in 36 pairs of patients, a significantly higher 5-year progression-free rate was observed for the TC group (P <.01). Similar results were observed using inverse probability of treatment weighting in the full sample. The odds of being in the MNEP plus TC group was higher for those with work-related exposure to inhalant agents (P =.008), asthma or bronchitis (P =.002), emphysema, fibrosis, and inflammatory status (P =.032), or micronodules on the chest computed tomography scan and respiratory insufficiency (P =.036). The association with MNEP seems to represent a clinically and prognostic relevant factor in TC. Hence, careful preoperative workup, systematic pathologic evaluation, including nontumorous lung parenchyma, and long-term postoperative follow-up should be recommended in these patients. [Display omitted] [ABSTRACT FROM AUTHOR]