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NAD+ is a central metabolite participating in core metabolic redox reactions. The prokaryotic NAD synthetase enzyme NadE catalyzes the last step of NAD+ biosynthesis, converting nicotinic acid adenine dinucleotide (NaAD) to NAD+ Some members of the NadE family use l-glutamine as a nitrogen donor and are named NadEGln Previous gene neighborhood analysis has indicated that the bacterial nadE gene is frequently clustered with the gene encoding the regulatory signal transduction protein PII, suggesting a functional relationship between these proteins in response to the nutritional status and the carbon/nitrogen ratio of the bacterial cell. Here, using affinity chromatography, bioinformatics analyses, NAD synthetase activity, and biolayer interferometry assays, we show that PII and NadEGln physically interact in vitro, that this complex relieves NadEGln negative feedback inhibition by NAD+ This mechanism is conserved in distantly related bacteria. Of note, the PII protein allosteric effector and cellular nitrogen level indicator 2-oxoglutarate (2-OG) inhibited the formation of the PII-NadEGln complex within a physiological range. These results indicate an interplay between the levels of ATP, ADP, 2-OG, PII-sensed glutamine, and NAD+, representing a metabolic hub that may balance the levels of core nitrogen and carbon metabolites. Our findings support the notion that PII proteins act as a dissociable regulatory subunit of NadEGln, thereby enabling the control of NAD+ biosynthesis according to the nutritional status of the bacterial cell.

A puncao aspirativa por agulha fina (PAAF) tem sido mundialmente aceita na abordagem das lesoes mamarias. Porem, alguns pontos ainda sao controversos. Entre eles, esta o metodo de puncao a ser utilizado. OBJETIVO: Comparar os aspirados gerados pelo dispositivo de autovacuo com os da pistola de apreensao de seringa, atraves de citometria de fluxo e de citologia oncologica. SUJEITOS E METODOS: O estudo foi dividido em duas partes distintas, sendo a primeira um ensaio em que a puncao era realizada por ambos os metodos, na peca cirurgica fresca, contendo tumor de mama ex vivo. Para a segunda parte foi conduzido um estudo randomizado, onde pacientes com nodulos mamarios eram submetidas a PAAF, utilizando-se a pistola de apreensao ou o dispositivo de autovacuo in vivo. No estudo ex vivo, foram utilizadas 44 pecas frescas, contendo tumores mamarios. Em cada, peca procedeu-se a PAAF por ambas as tecnicas. Posteriormente as mesmas foram fixadas e incluidas em parafina. Tanto os aspirados quanto o material histologico desparafinizado foram preparados para citometria de fluxo. Utilizou-se um aparelho BD FACScan, com leitura de 10.000 celulas por exame. Para o estudo in vivo, 380 pacientes com nodulos solidos na mama foram submetidas a PAAF utilizando-se um dos dispositivos de puncao, de forma aleatoria. A leitura citologica foi feita por um unico observador, sendo que 29 casos nao foram vistos por ele e excluidos da analise. Posteriormente, 295 pacientes tiveram seus tumores ressecados. Para os 273 casos remanescentes analisou-se a acuracia para cada metodo, alem da taxa de material insuficiente, celularidade, distorcao celular e hemorragia de fundo. RESULTADOS: No estudo ex vivo, a citometria de fluxo mostrou que as medias do coeficiente de variacao, do indice de DNA, da fase-S e da aneuploidia, foram semelhantes entre os aspirados da pistola e do autovacuo. A media de celulas aneuploides foi significativamente maior nos aspirados do autovacuo do que na peca cirurgica (43,4 DP±23 vs 27,9 DP±17; p=0,04). No estudo in vivo, a taxa de material insuficiente foi de 16% e 22% (NS) para os aspirados do autovacuo e da pistola, respectivamente. A sensibilidade absoluta foi de 63% e 58%; a especificidade de 77% e 78% e a acuracia total de 76% e 75%, para o autovacuo e para a pistola, respectivamente. A celularidade, a distorcao celular e o fundo hemorragico tambem foram semelhantes entre os dois metodos. CONCLUSAO: Os dois metodos de puncao foram equivalentes para estudo de citometria de fluxo e citologia oncologica. Abstract

The PII proteins sense and integrate important metabolic signals which reflect the cellular nutrition and energy status. Such extraordinary ability was capitalized by nature in such a way that the various PII proteins regulate different facets of metabolism by controlling the activity of a range of target proteins by protein-protein interactions. Here, we determined the PII protein interaction network in the plant growth-promoting nitrogen-fixing bacterium Azospirillum brasilense. The interactome data along with metabolome analysis suggest that PII functions as a master metabolic regulator hub. We provide evidence that PII proteins act to regulate c-di-GMP levels in vivo and cell motility and adherence behaviors., The PII family comprises a group of widely distributed signal transduction proteins ubiquitous in prokaryotes and in the chloroplasts of plants. PII proteins sense the levels of key metabolites ATP, ADP, and 2-oxoglutarate, which affect the PII protein structure and thereby the ability of PII to interact with a range of target proteins. Here, we performed multiple ligand fishing assays with the PII protein orthologue GlnZ from the plant growth-promoting nitrogen-fixing bacterium Azospirillum brasilense to identify 37 proteins that are likely to be part of the PII protein-protein interaction network. Among the PII targets identified were enzymes related to nitrogen and fatty acid metabolism, signaling, coenzyme synthesis, RNA catabolism, and transcription. Direct binary PII-target complex was confirmed for 15 protein complexes using pulldown assays with recombinant proteins. Untargeted metabolome analysis showed that PII is required for proper homeostasis of important metabolites. Two enzymes involved in c-di-GMP metabolism were among the identified PII targets. A PII-deficient strain showed reduced c-di-GMP levels and altered aerotaxis and flocculation behavior. These data support that PII acts as a major metabolic hub controlling important enzymes and the homeostasis of key metabolites such as c-di-GMP in response to the prevailing nutritional status. IMPORTANCE The PII proteins sense and integrate important metabolic signals which reflect the cellular nutrition and energy status. Such extraordinary ability was capitalized by nature in such a way that the various PII proteins regulate different facets of metabolism by controlling the activity of a range of target proteins by protein-protein interactions. Here, we determined the PII protein interaction network in the plant growth-promoting nitrogen-fixing bacterium Azospirillum brasilense. The interactome data along with metabolome analysis suggest that PII functions as a master metabolic regulator hub. We provide evidence that PII proteins act to regulate c-di-GMP levels in vivo and cell motility and adherence behaviors.

Western blotting (WB) is widely used to test antibody specificity, but the assay has low throughput and precision. Here we used preparative gel electrophoresis to develop a capture format for WB. Fractions with soluble, size-separated proteins facilitated parallel readout with antibody arrays, shotgun mass spectrometry (MS) and immunoprecipitation followed by MS (IP-MS). This pipeline provided the means for large-scale implementation of antibody validation concepts proposed by an international working group on antibody validation (IWGAV).Western blotting (WB) is widely used to test antibody specificity, but the assay has low throughput and precision. Here we used preparative gel electrophoresis to develop a capture format for WB. Fractions with soluble, size-separated proteins facilitated parallel readout with antibody arrays, shotgun mass spectrometry (MS) and immunoprecipitation followed by MS (IP-MS). This pipeline provided the means for large-scale implementation of antibody validation concepts proposed by an international working group on antibody validation (IWGAV).

OBJECTIVEWhat determines the extent of tissue destruction during brain abscess formation is not known. Pyogenic brain infections cause destruction of brain tissue that greatly exceeds the area occupied by microbes, as seen in experimental studies, pointing to cytotoxic factors other than microbes in pus. This study examined whether brain abscess pus contains cytotoxic proteins that might explain the extent of tissue destruction.METHODSPus proteins from 20 human brain abscesses and, for comparison, 7 subdural empyemas were analyzed by proteomics mass spectrometry. Tissue destruction was determined from brain abscess volumes as measured by MRI.RESULTSBrain abscess volume correlated with extracellular pus levels of antibacterial proteins from neutrophils and macrophages: myeloperoxidase (r = 0.64), azurocidin (r = 0.61), lactotransferrin (r = 0.57), and cathelicidin (r = 0.52) (p values 0.002–0.018), suggesting an association between leukocytic activity and tissue damage. In contrast, perfringolysin O, a cytotoxic protein from Streptococcus intermedius that was detected in 16 patients, did not correlate with abscess volume (r = 0.12, p = 0.66). The median number of proteins identified in each pus sample was 870 (range 643–1094). Antibiotic or steroid treatment prior to pus evacuation did not reduce the number or levels of pus proteins. Some of the identified proteins have well-known neurotoxic effects, e.g., eosinophil cationic protein and nonsecretory ribonuclease (also known as eosinophil-derived neurotoxin). The cellular response to brain infection was highly complex, as reflected by the presence of proteins that were specific for neutrophils, eosinophils, macrophages, platelets, fibroblasts, or mast cells in addition to plasma and erythrocytic proteins. Other proteins (neurofilaments, myelin basic protein, and glial fibrillary acidic protein) were specific for brain cells and reflected damage to neurons, oligodendrocytes, and astrocytes, respectively. Pus from subdural empyemas had significantly higher levels of plasma proteins and lower levels of leukocytic proteins than pus from intracerebral abscesses, suggesting greater turnover of the extracellular fluid of empyemas and washout of pus constituents.CONCLUSIONSBrain abscess pus contains leukocytic proteins that are neurotoxic and likely participate actively in the excessive tissue destruction inherent in brain abscess formation. These findings underscore the importance of rapid evacuation of brain abscess pus.

This work was carried out to investigate the mechanisms regulating fruit calcium (Ca) content and susceptibility to bitter pit (BP) in 'Fuji' and 'Catarina' apples (cultivars with low and high susceptibility to BP, respectively). Fruit of both cultivars were harvested at commercial maturity in an orchard located in southern Brazil, and assessed for xylem functionality and lenticels pore area (mm2 mm-2 of skin) at the distal end. Fruits were also cold stored for four months (0.0±0.5°C/95% RH) and then separated in lots without and with BP. Fruits of both cultivars without and with BP were assessed at the distal (blossom end), middle (equatorial region) and proximal (peduncle end) portions for pectin methylesterase (PME) activity in the skin and flesh tissues, and at distal portion for peroxidase (POD) and ascorbate peroxidase (APX) activities and Ca content in the flesh tissue. At harvest, 'Catarina' apples had lower xylem functionality and lower lenticels pore area at the distal end than 'Fuji' apples. 'Catarina' had higher incidence of BP after cold storage (12.7%) than 'Fuji' (2.3%). In both cultivars, fruit with BP had lower Ca content in the flesh at the distal end. Fruits with BP showed at the distal region higher POD activity in the flesh in 'Fuji' and higher PME activity in the skin in 'Catarina' than fruit without BP. Only in 'Fuji', fruits with BP had higher PME activity in the flesh tissue at the middle and distal portion than fruits without BP. The results show that impairment of xylem functionality, and reduced lenticels pore area and high PME activity in the skin tissue at the distal portion of the fruit might reduce fruit Ca content and increase the incidence of BP, especially in 'Catarina', a cultivar highly susceptible to the disorder.

The nitrogen-related PTSNtr system, present in many Proteobacteria including Escherichia coli, acts as a phosphorelay cascade composed of the EINtr, NPr and EIIANtr proteins. Phosphotransfer initiates with phosphoenolpyruvate-dependent EINtr autophosphorylation, the phosphoryl group is then transferred to NPr and finally to a conserved histidine residue on EIIANtr. The reporter metabolites L-glutamine and 2-oxoglutarate reciprocally regulate EINtr autophosphorylation (Lee et al. 2013) and consequently the phosphorylation status of the PTSNtr components is controlled by the availability of nitrogen and carbon. The final phosphate acceptor, EIIANtr, regulates a range of cellular process by acting as the central hub of a complex protein-protein interaction network. Contact between EIIANtr and its target proteins is usually regulated by the EIIANtr phosphorylation status. In this study we performed ligand fishing assays coupled to label-free quantitative proteomics to examine the protein-protein interaction network of E. coli EIIANtr and a phosphomimic variant of the protein. The ligand fishing data, along with phenotypic analysis, indicated that EIIANtr interacts with proteins related to chemotaxis and thereby regulates cell motility. Important metabolic enzymes were also identified as potential EIIANtr binding partners.

The accentuation of the climate change effects generates a positive prospect for the use of bioenergy at the expense of fossil fuels. There is an expansion of sugarcane in the state of Paraná. This growth combined with installation of new plants or expanding production capacity will benefit directly and indirectly the locational economic dynamics of cities. The aim of this paper is to understand the relevance of related economic activities to the production of ethanol compared to petroleum-based fuels amid new prospects. This article discusses the concept of productive agglomerations in the sectors in question from the perspective of social externalities. The indicator location quotient (LQ) is used as a proxy for the presence of agglomeration and thus production of presence of social externalities. Formal Jobs data were used from the Annual List of Social Information (RAIS) for sugarcane, ethanol, oil extraction and oil products sectors. In this case, it was found that the sugarcane and ethanol production sectors are relevant in the state, which leads to the inference of the presence of agglomeration and externalities economies. In the oil extraction industry and derivatives, however, its performance is incipient and timely. The results showed that the high capillarity from the sugarcane and ethanol sector can generate both a positive externality as a vulnerability.

Global characterization of tissue proteomes from small amounts of biopsy material has become feasible due to advances in mass spectrometry and bioinformatics tools. In celiac disease (CD), dietary gluten induces an immune response which is accompanied by pronounced remodeling of the small intestine. Removal of gluten from the diet abrogates the immune response and the tissue architecture normalizes. In this study differences in global protein expression of small intestinal biopsies from CD patients were quantified by analyzing formalin-fixed, paraffin-embedded material using liquid-chromatography mass spectrometry and label-free protein quantitation. Protein expression was compared in biopsies collected from the same patients before and after one year treatment with gluten-free diet (n=10) or before and after three-day gluten provocation (n=4). Differential expression of proteins in particular from mature enterocytes, neutrophils, and plasma cells could distinguish untreated from treated CD mucosa, and immunoglobulin variable region IGHV5-51 expression was found to serve as a CD-specific marker of ongoing immune activation. In patients that had undergone gluten challenge coordinated up-regulation of wound response proteins including the CD autoantigen transglutaminase 2 was observed. Our study provides a global and unbiased assessment of antigen-driven changes in protein expression in the celiac intestinal mucosa.

In this manuscript we describe Proteogenomics Viewer, a web-based tool that collects MS peptide identification, indexes to genomic sequence and structure, assigns exon usage, reports the identified protein isoforms with genomic alignments and, most importantly, allows the inspection of MS2 information for proper peptide identification. It also provides all performed indexing to facilitate global analysis of the data. The relevance of such tool is that there has been an increase in the number of proteogenomic efforts to improve the annotation of both genomics and proteomics data, culminating with the release of the two human proteome drafts. It is now clear that mass spectrometry-based peptide identification of uncharacterized sequences, such as those resulting from unpredicted exon joints or non-coding regions, is still prone to a higher than expected false discovery rate. Therefore, proper visualization of the raw data and the corresponding genome alignments are fundamental for further data validation and interpretation. Also see the video abstract here: http://youtu.be/5NzyRvuk4Ac.

Soil is an essential natural resource for humans and an important part of the environment. However, soil is often used and managed inappropriately, causing its erosion and degradation, with concomitantly negative social, political and economic impacts. This study aimed to discuss sustainable development; and losses and problems caused by soil erosion, and to suggest a model for assessing erosion costs. The relevance of economic models for costing soil erosion is stressed. Based on an economic theory, it presents a procedure for assessing economic costs of soil erosion, centered on the on-site and off-site costs that are generated. The physical processes of soil erosion are described and their economic effects reviewed, drawing on theoretical and empirical sources. Limited data and information is available on the economic losses resulting from erosion, which hampers assessment and valuation.

The sodium (Na

OBJECTIVE: To compare the rates of overall survival (OS), disease-free survival (DFS) and toxicity in different techniques of postoperative radiotherapy for stage IA endometrioid adenocarcionoma of endometrium, histological grades 1and 2. METHODS: A historical comparison between treatment regimens was performed, and 133 women with a minimum follow-up of 5 years were included. Teletherapy (TELE group), with 22 patients treated from 1988 to 1996, with a 10 MV linear accelerator, average dose 46.2 Gy. Low dose rate brachytherapy (LDRB group) was performed between 1992 and 1995, in 19 women, with an insertion of Cesium 137, at a 60 Gy dose. Fourteen women operated between 1990 and 1996 did not receive radiotherapy (NO RT group). High dose rate brachytherapy was performed in 78 patients (HDRB group), from 1996 to 2004, in five weekly 7 Gy insertions, prescribed at 0.5 cm from the vaginal cylinder. RESULTS: The 5-year disease-free survival was 94.6% for the HDRB group, 94.1% for the LDRB group, 100% for the TELE group and NO RT groups (p = 0.681). The 5-year overall survival was 86.6% for the HDRB group, 89.5% for the LDRB group and 90% for the TELE group and NO RT groups (p = 0.962). Grades 3-5 late toxicity was 5.3% in LDRB group and 27.3% for the TELE group (p < 0.001). CONCLUSION: Patients submitted to adjuvant teletherapy showed very high toxicity, which contraindicates that treatment for those patients. There may be a role for adjuvant HDRB, but randomized controlled trials are still needed to evaluate its benefit.OBJETIVO: Comparar as taxas de sobrevida global (SG), sobrevida livre de doença (DFS) e de toxicidade em diferentes técnicas de radioterapia pós-operatória para adenocarcionoma endometrioide do endométrio estádio IA, graus histológicos 1 e 2. MéTODOS: Realizou-se uma comparação histórica entre regimes de tratamento, incluindo 133 mulheres com seguimento mínimo de cinco anos. Teleterapia (grupo TELE), com 22 pacientes, de 1988 a 1996, tratadas com acelerador linear 10 MV, dose média de 46,2 Gy. Braquiterapia de baixa taxa de dose (grupo LDRB), realizada entre 1992 e 1995, em 19 mulheres, com uma inserção de Césio 137, dose de 60 Gy. Quatorze mulheres operadas entre 1990 e 1996 não receberam radioterapia (grupo NO RT). Braquiterapia de alta taxa de dose foi realizada em 78 pacientes (grupo BATD), 1996-2004, cinco inserções semanais de 7 Gy, a 0,5 cm do cilindro vaginal. RESULTADOS: A DFS em cinco anos foi de 94,6% para o grupo BATD, 94,1% para o grupo LDRB, 100% para os grupos TELE e RT (p = 0,681). A sobrevida global em cinco anos foi de 86,6% para o grupo BATD, 89,5% para o grupo LDRB e 90% para os grupos TELE e NO RT (p = 0,962). A toxicidade tardia graus 3-5 foi de 5,3% no grupo LDRB e 27,3% para o grupo TELE (p < 0,001). CONCLUSãO: Pacientes submetidos à teleterapia adjuvante apresentaram toxicidade muito elevada, o que contraindica o tratamento para essas pacientes. Pode haver um papel para a BATD adjuvante, mas estudos controlados randomizados são necessários para avaliar seu benefício.

OBJETIVO: avaliar a influência da fisioterapia realizada durante a radioterapia (RT) sobre a qualidade de vida (QV) de mulheres em tratamento para câncer de mama. MÉTODOS: ensaio clínico randomizado com 55 mulheres em tratamento radioterápico, sendo 28 alocadas no grupo submetido à fisioterapia (GF) e 27 no grupo controle sem fisioterapia (GC). A técnica fisioterápica utilizada para o GF foi a cinesioterapia para membros superiores, com emprego de 19 exercícios realizados ativamente, com uma série de dez repetições rítmicas ou alongamentos, englobando movimentos de flexão, extensão, abdução, adução, rotação interna e rotação externa dos ombros, isolados ou combinados. A QV foi avaliada por meio do Functional Assessment of Cancer Therapy-Breast (FACT-B) no início, no final da RT e seis meses após seu término. As sessões de fisioterapia começavam concomitantemente à RT, em média 90 dias após a cirurgia. RESULTADOS: não houve diferença entre os grupos para as subescalas: bem-estar físico (p=0,8), bem-estar social/familiar (p=0,3), bem-estar funcional (p=0,2) e subescala de mama (p=0,2) nos três momentos avaliados. A comparação da subescala emocional obtida nas três avaliações demonstrou melhor comportamento do GF em relação ao GC (p=0,01). Ambos apresentaram melhora na subescala de mama entre o início e final da RT (GF p=0,0004 e GC p=0,003). Houve melhora dos escores do FACT-B ao final da RT em ambos os grupos (GF p=0,0006 e GC p=0,003). No entanto, seis meses após a RT, esta melhora manteve-se somente no GF (p=0,005). A qualidade de vida avaliada ao longo do tempo pelo FACT B (p=0,004) e Trial Outcome Index (TOI) (soma das subescalas bem-estar físico, funcional e subescala de mama) foi melhor no GF (p=0,006). Não houve evidência de efeitos negativos associados aos exercícios. CONCLUSÕES: a realização de exercícios para membros superiores beneficiou a qualidade de vida durante e seis meses após a RT. PURPOSE: to assess the influence of physiotherapy performed during radiotherapy (RT) on the quality of life (QL) of women under treatment for breast cancer. METHODS: this was a randomized clinical trial conducted on 55 women under RT treatment, 28 of whom were assigned to a group submitted to physiotherapy (PG) and 27 to the control group receiving no PG (CG). The physiotherapy technique used for PG was kinesiotherapy for the upper limbs using 19 exercises actively performed, with a series of ten rhythmic repetitions or stretching movements involving flexion, extension, abduction, adduction, internal and external shoulder rotation, separate or combined. QL was evaluated using the Functional Assessment of Cancer Therapy-Breast (FACT-B), at the beginning and at the end of RT and six months after the end of RT. The physiotherapy sessions were started concomitantly with RT, 90 days after surgery, on average. RESULTS: there was no difference between subgroups regarding the following subscales: physical well-being (p=0.8), social/family well-being (p=0.3), functional well-being (p=0.2) and breast subscale (p=0.2) at the three time points assessed. A comparison of the emotional subscale applied at the three evaluations demonstrated a better behavior of PG as compared to CG (p=0.01), with both groups presenting improvement on the breast subscale between the beginning and the end of RT (PG p=0.0004 and CG p=0.003). There was improvement in FACT-B scores at the end of RT in both groups (PG p=0.0006 and CG p=0.003). However, at the sixth month after RT, this improvement was maintained only in PG (p=0,005). QL assessed along time by the FACT B (p=0.004) and the Trial Outcome Index (TOI) (sums of the physical and functional well-being subscales and of the breast subscale) was better for PG (p=0.006). There was no evidence of negative effects associated with the exercises. CONCLUSIONS: the execution of exercises for the upper limbs was beneficial for QL during and six months after RT.

The meat complex is one of the main components of the Brazilian export agenda. Poultry meat plays an important role in Brazilian exportations, being the State of Paraná the leader in this sector. The purpose of this work is to analyze the behavior and competitiveness of exportations in the agro-industrial poultry meat complex in Brazil and in the State of Paraná, in the period between 1990 and 2005, as well as the factors that determine the performance of Brazilian exportations and its interaction with the international trade. The Constant-Market-Share analysis was used, identifying the sources of agribusiness exportations growth complex, as follows: “worldwide market growth”, “export agenda elaboration”, “exportations destination” and “competitiveness”, which are able to express the behavior and pattern of exportations in the analyzed period. The geometrical growth rate method, by means of the Ordinary Least Square Method, was used to analyze the development of the complex in the period. In order to achieve the goals and verify the pattern of Brazilian exportations and the competitiveness of Brazilian poultry meat, data on worldwide exportations and importations of poultry meat in the period of 1990 to 2005 were gathered, so that it would be possible to identify the profile of the biggest consumer markets and the meat complex exporters. The analyzed data enabled us to conclude that the geometric growth rates of poultry meat increased in Brazil and in the State of Paraná, as well. The analysis of the CMS results shows that Brazil and the State of Paraná have high competitiveness and market-share in the analyzed segment. The increasing demand for this type of meat will enable Brazil to be consolidated internationally in this market, besides suggesting sanitary policies that might reduce barriers to the entrance of this product to the main import countries. O complexo de carnes é um dos principais componentes da pauta de exportação brasileira. As carnes de frangos apresentam grande participação nas exportações brasileiras, sendo que o Estado do Paraná é o maior estado produtor exportador do Brasil. O objetivo do trabalho é analisar o comportamento e a competitividade das exportações do complexo agroindustrial de carnes de frangos brasileiro e paranaense no período de 1990 a 2005, bem como os fatores que determinam o desempenho das exportações brasileiras e sua interação com o comércio internacional. O modelo principal de análise utilizado é o “Constant-Market-Share” que realiza a decomposição as fontes de crescimento das exportações dos complexos agroindustriais em componentes denominados: “crescimento do mercado mundial”, “composição da pauta de exportação”, “destino das exportações” e “competitividade” e são capazes de expressar o comportamento e padrão das exportações no período de estudo. O método da taxa geométrica de crescimento, por meio do Método dos Mínimos Quadrados Ordinários, foi utilizado para analisar a evolução do complexo no período. A fim de alcançar os objetivos e verificar o padrão das exportações brasileiras e a competitividade do frango brasileiro, foram colhidos dados sobre exportações e importações mundiais de carne dos anos de 1990 a 2005, de forma que se identificasse o perfil dos grandes mercados consumidores e exportadores do complexo carnes. Os dados analisados permitiram concluir que os indicadores do Brasil e do Estado do Paraná evoluíram a altas taxas de crescimento geométricas de carne de frango. A partir da análise dos resultados do modelo CMS, percebe-se que o Brasil e o Paraná possuem elevada competitividade e alto market-share no segmento analisado. A crescente demanda por este tipo de carne permitirá que o Brasil se consolide internacionalmente nesse mercado, além de serem sugeridas políticas sanitárias e outras que possam reduzir as barreiras à entrada deste produto nos principais países importadores.

OBJETIVOS: Analisar a ocorrência de efeitos adversos no período de 24 horas da evolução pós-anestésica e pós-cirúrgica em mulheres submetidas a intervenções cirúrgicas ginecológicas e mamárias de pequeno porte e identificar os principais fatores associados. MÉTODOS: Trata-se de estudo tipo corte transversal que incluiu 159 mulheres submetidas a intervenções cirúrgicas ginecológicas e mamárias consideradas de pequeno porte. As mulheres foram internadas no dia anterior à intervenção cirúrgica e permaneceram no hospital por pelo menos 24 horas após o término do procedimento. As técnicas anestésicas realizadas foram bloqueio intercostal, bloqueio espinhal e anestesia geral. RESULTADOS: Os eventos adversos mais freqüentes foram vômitos, náuseas e dor, e ocorreram em 40,3% das mulheres. Destes, 60% foram observados nas primeiras quatro horas e 80% em até seis horas, após a intervenção cirúrgica. As mulheres submetidas ao bloqueio intercostal apresentaram alta mais precoce da recuperação anestésica; o bloqueio espinhal esteve associado mais freqüentemente à dor no período pós-operatório, porém houve menor incidência de náuseas e vômitos em relação à anestesia geral e bloqueio intercostal. Antecedente de tabagismo contribuiu para ocorrência de dor. CONCLUSÃO: O período de seis horas de observação mostrou-se adequado para a avaliação da maioria das complicações e efeitos adversos que ocorrem após intervenções cirúrgicas, ginecológicas e mamárias, de pequeno porte.OBJECTIVES: To analyze the occurrence of adverse effects in the first 24-hour postoperative/postanesthetic period in women undergoing minor gynecologic or minor breast surgeries and to identify main associated factors. METHODS: A cross-sectional study was conducted with 159 women who underwent minor gynecologic or breast surgeries. The women were admitted to the hospital one day before surgery and remained hospitalized for at least 24 hours after surgery. The anesthetic techniques performed were intercostal nerve blockade, spinal anesthesia, and general anesthesia. RESULTS: Tthe most frequent adverse effects were vomiting, nausea and pain that occurred in 40.3% of women. Of these effects, 60% were observed in the first four hours and 80% were observed in up to six hours after surgical intervention. Women submitted to intercostal blockade received earlier postanesthetic release. Spinal anesthesia was most frequently associated with postoperative pain, although with a lower incidence of nausea and vomiting when compared to general anesthesia and intercostal blockade. The incidence of pain was higher in women who smoked. CONCLUSIONS: A six-hour period of postoperative observation appeared to be adequate for assessment of most complications and adverse effects occurring in women who undergo minor gynecologic or minor breast surgeries.

OBJETIVO: Avaliar em mulheres com carcinoma escamoso da vulva menor que 5 cm e clinicamente sem comprometimento inguinal a invasão por neoplasia nos linfonodos inguinais superficiais e profundos. MÉTODOS: Foram avaliados os dados de 59 mulheres atendidas entre outubro de 1982 e janeiro de 2004 na Universidade Estadual de Campinas, em decorrência de carcinoma escamoso invasivo da vulva T1 ou T2 e com linfonodos inguinais clinicamente livres de invasão neoplásica (N0). Foram levantadas características clínicas do tumor e das pacientes e os dados do seguimento. Foram calculados os odds ratio e teste exato de Fisher para as associações entre a invasão dos linfonodos inguinais com o tamanho do tumor, grau histológico, recidivas e complicações. A confiança estatística foi de 95%. RESULTADOS: A idade das mulheres variou de 34 a 91 anos (média de 67 anos), com tempo de seguimento entre três dias (óbito perioperatório) e 252 meses (média de 27 meses). Clinicamente, 22 (37%) mulheres apresentavam tumores T1 e 37 (63%) T2. Após análise histológica, seis (10%) mulheres apresentavam invasão unilateral e três (5%) bilateral, não havendo associação entre o tamanho do tumor e a invasão dos linfáticos inguinais. Também o tamanho do tumor à avaliação patológica e seu grau histológico não se mostraram associados à invasão nos linfonodos inguinais. Recidivas e complicações tardias não se correlacionaram com a invasão neoplásica inguinal. CONCLUSÕES: A dissecção inguinal superficial e profunda revelou invasão neoplásica clinicamente não detectável em 15% das mulheres estudadas, apesar de que tamanho e grau histológico do tumor, recidivas e complicações tardias não estiveram associadas com a invasão nos linfonodos. OBJECTIVE: To assess the neoplastic invasion of superficial and deep inguinal lymph nodes of women with invasive vulvar squamous carcinoma smaller than 5 centimeters with a clinically normal inguinal region. METHODS: the medical records of 59 women cared at the State University of Campinas with invasive vulvar squamous carcinoma T1 and T2 and who presented clinically normal inguinal regions (N0) were reviewed. Clinical characteristics of both tumor and patients were evaluated as well as the follow-up data. Odds ratios and Fisher's Exact Test were used to assess the correlations between the invasion of inguinal lymph nodes and tumor size, grade, relapses and clinical complications. Confidence limits of 95% were used. RESULTS: Age of the patients ranged from 34 to 91 years (mean 67 years), and follow-up time ranged from 3 days (peri-operatory death) to 252 months (mean 27 months). Clinically, 22 (37%) women had lesions T1 lesions and 37 (63%) T2. Histological analysis showed unilateral lymphatic invasion in six (10%) women and bilateral in three (5%). There was no significant association between tumor size and lymph node invasion. Also, pathologic tumor size and grade were not associated with lymph node neoplastic involvement. Relapses and late complications were not correlated with lymph node neoplastic invasion. CONCLUSIONS: Superficial and deep inguinal dissection disclosed clinically undetectable lymph node neoplastic invasion, although tumor size and histological grade, relapses and late complications were not associated with node involvement.

Objetivo: comparar os tamanhos dos tumores mamários localmente avançados por meio de exame clínico, mamografia, ultra-sonografia e dopplervelocimetria associada à ultra-sonografia, avaliados antes e depois da quimioterapia primária. Métodos: estudo clínico prospectivo e descritivo. Foram incluídas dezoito mulheres com tumor primário clínico maior ou igual a 50 mm que foram submetidas à palpação, mamografia, ultra-sonografia e dopplervelocimetria, no momento do diagnóstico e após 3 ciclos de quimioterapia. A resposta foi considerada presente quando ocorreu diminuição clínica maior que 50% e ultra-sonográfica maior que 25%, e ausente quando a redução medida pela clínica fosse inferior 50% e a ultra-sonográfica menor que 25%. A análise estatística utilizada foi descritiva com teste de Wilcoxon na comparação dos métodos. Resultados: em relação ao tamanho dos tumores, o método cuja medida mais se aproximou do exame anatomopatológico foi o exame clínico na pós-quimioterapia, quando comparado com a ultra-sonografia e a mamografia. A mamografia permitiu avaliação em 44% dos casos, antes da quimioterapia (8/18). Nos casos em que não houve resposta à quimioterapia, a dopplervelocimetria demonstrou aumento significativo do fluxo, com a diminuição dos índices de pulsatilidade e resistência. Nos casos em que houve resposta (9 casos), com redução do tamanho tumoral, a dopplervelocimetria não mostrou alterações significativas em relação aos parâmetros estudados. Conclusão: o exame clínico mostrou-se como melhor método de avaliação da redução do volume dos tumores tratados com quimioterapia neoadjuvante quando comparado com o exame de ultra-sonografia e a mamografia. A dopplervelocimetria demonstrou que houve aumento do fluxo nos casos com resposta ausente. Purpose: to compare the size of locally advanced breast tumors through clinical examination, mammography, and ultrasound, and describe the parameters of color Doppler ultrasound evaluated before and after primary chemotherapy. Methods: it was a prospective and descriptive clinical study. Eighteen women with the diagnosis of breast carcinoma, with clinical primary tumors of 50 mm or larger, were submitted to palpation, mammography, ultrasound and color Doppler ultrasound at the moment of diagnosis and after 3 cycles of chemotherapy. The response was considered present when there was a clinical decrease of 50% or more and an ultrasonographic decrease of 25% or more, and absent when there was a clinical decrease less than 50% and ultrasonographic decrease less than 25%. A descriptive statistical analysis and Wilcoxon test were used. Results: regarding the size of the tumors, the method whose results were closer to pathological examination was the clinical examination after chemotherapy, when compared with sizes on ultrasound and mammography. The mammography helped to evaluate 44% of the cases before chemotherapy (8/18). In the cases where the response was absent, the Doppler showed a significant increase of the flow and a decrease of resistance and pulsatility index. In the cases where the response was present (9 cases), the Doppler did not show any significant change regarding the studied parameters. Conclusion: clinical examination was the most efficient method to evaluate the decrease of the volume of tumors submitted to neoadjuvant chemotherapy when compared with ultrasound and mammographic examinations. Doppler showed increase of the flow in the cases of absent response.

Purpose The benefits of chemoradiotherapy (CRT) for cervical cancer compared with radiation (RT) alone seem to diminish in later-stage disease. However, these modalities have not been directly compared for disease-free interval (DFI) and overall survival (OS) of women with stage IIIB cervical cancer. Patients and Methods We conducted a randomized controlled clinical trial comparing DFI and OS of 147 women with stage IIIB squamous cervical cancer who received either cisplatin plus RT (CRT) or RT alone (72 patients in the CRT group and 75 patients in the RT-only group). Results The CRT group had significantly better DFI (hazard ratio [HR], 0.52; 95% CI, 0.29 to 0.93; P = .02). However, patients in the CRT group did not have significantly better OS than those in the RT-only group (HR, 0.67; 95% CI, 0.38 to 1.17; P = .16). Toxicity was graded according to criteria of the Radiation Therapy Oncology Group. The organs affected (excluding hematologic effects) did not differ significantly between groups. Also, late toxicity events and organs affected were not significantly disproportionate between the study groups. Conclusion For stage IIIB cervical cancer, the addition of cisplatin offers a small but significant benefit in DFI, with acceptable toxicity.

No campo da pesquisa em etanol de segunda geração (lignocelulósico), o Brasil mostra-se como um ator em potencial para a transformação e difusão da ciência em tecnologia. A produção em escala comercial - em especial na fronteira da inovação em etanol lignocelulósico e dos novos produtos oriundos desta conversão - requer alta tecnologia para o desenvolvimento de produtos e processos, matéria-prima disponível e viável, além de um ambiente institucional favorável. Esses fatores colocam o setor sucroenergético brasileiro em posição de destaque e justificam a questão central desta tese que é analisar - sob a perspectiva dos avanços científicos nacionais para o etanol de segunda geração e de seu potencial inovativo - o grau de desenvolvimento do Sistema Nacional de Inovação (SNI) com base na articulação existente entre as pesquisas realizadas por brasileiros em comparação com as realizadas por outros países e em específico os Estados Unidos. A abordagem teóricoconceitual e metodológica estrutura-se nos conceitos da economia evolucionista, subjacentes à formação de Redes de Inovação. Há robustas evidências que mostram que a colaboração científica em redes correlaciona-se positivamente com a difusão do conhecimento científico. As patentes ao assimilarem o conhecimento científico disponível permitem criar novos padrões tecnológicos, novos produtos e processos. Mas também, podem direcionar o fluxo de conhecimento criando uma trajetória tecnológica, ou seja, o caminho realizado para chegar-se em determinada patente. O conhecimento acumulado em determinada patente é representado pelas patentes que a originaram e que envolve diversos setores e atividades. Assim as Redes de Inovação na ótica evolucionista podem ser consideradas indicadores de inovação de determinada atividade ou produto, proxy, para o grau de desenvolvimento de um SNI. Neste cenário, são utilizados dois procedimentos metodológicos complementares, que permitem entender a dinâmica da produção científica e da inovação: a) Redes de Inovação em publicações para a colaboração científica entre países, instituições, KeyWord Plus e citações; e b) Redes de Inovação em patentes para as áreas de aplicação através do IPC8. Portanto, na ótica do desenvolvimento de um SNI, contam principalmente: o grau de colaboração científica, relevância e inserção. Apesar do SNI em etanol de segunda geração possuir elementos necessários para a transformação da ciência em tecnologia, observou-se baixo grau de desenvolvimento em reflexo às seguintes características: a) um baixo grau de colaboração científica internacional em comparação com os Estados Unidos e o Mundo; b) os esforços gerados não estão alinhados com o gargalo tecnológico do etanol de segunda geração; c) há apenas uma instituição representativa no cenário internacional, d) existe uma relação fraca entre universidade-governo-empresa; e) o potencial de difusão do conhecimento não é explorado, seja na forma de publicações científicas quanto na forma de patentes. Conclui-se que o SNI em etanol de segunda geração no Brasil está desenvolvendose, mas com baixa articulação com pesquisadores internacionais, além de uma baixa interação universidade-governo-empresa. Os esforços indicam que o Brasil irá especializar-se na fermentação, processo em que já possui conhecimento acumulado. In the research area of second generation ethanol (lignocellulosic), Brazil has been shown as a potential actor for changing and spreading the science through technologies. The commercial scale of production - especially in the innovation frontier in lignocellulosic ethanol and new products from this conversion - requires high technology for products and processes development, available and feasible raw materials, plus a favorable institutional environment. These factors place the Brazilian sugarcane industry in a prominent position and justify the central question of this thesis which is to analyze - from the perspective of national scientific advances in second generation ethanol and its innovative potential - the development degree of a National Innovation System (NIS) based on the articulation between researches conducted by Brazilians in the comparison to researches made by other countries, specific by the United States. The theoretical-conceptual and methodological framework is based on evolutionary economics concepts, underlying the Innovation Networks formation. There is a robust evidence that shows the scientific collaboration though networks are positively correlated with the spread of scientific knowledge. Patents in the process of assimilating available scientific knowledge allow to create new technological standards, new products and processes. But also can direct the knowledge flow by creating a technological path, in other words, the path taken to arrive in certain patent. The accumulated knowledge in a particular patent is represented by patents which have originated and that involving different sectors and activities. Thus the Innovation Networks in an evolutionary perspective can be considered as measures of the innovation of a particular activity or product, indeed a proxy for the development degree of the NIS. In this scenario, it was used two complementary methodological procedures, which allow to understand the dynamics of scientific production and innovation: a) Innovation Networks in publications for the scientific collaboration between countries, institutions, KeyWord Plus and citations and b) Innovation Networks in patents for some application areas using IPC8 class. Therefore, in the sight of development of NIS rely mainly: the scientific collaboration degree, relevance and insertion. Despite the NIS in second generation ethanol has necessary elements to change the science and technology, it was observed a low development degree which reflects the following characteristics: a) low degree of international scientific collaboration in comparison with the United States and World; b) efforts generated are not aligned with the technological bottleneck in second generation ethanol; c) only one representative institution in the international scenario; d) weak relationship between university-government-enterprise, e) potential of conversion of knowledge is not exploited, either in the form of scientific publications and in the form of patents. It was concluded that the NIS on second generation ethanol in Brazil is developing, but with low articulation with international researchers, besides a low university-government-enterprise interaction. Efforts indicate that Brazil will specialize in the fermentation, process that has already accumulated knowledge.

This study examined the associations between GRP78 expression and breast cancer recurrence and survival in patients treated with anthracyclines in the adjuvant setting. GRP78 expression was assessed in 106 stage II/III breast cancer patients. Tissue microarray was used to perform immunohistochemistry and to determine the GRP78 expression in endoplasmic reticulum and cell membrane of breast tumors. Four distinct scenarios (low and high thresholds) were developed. For high thresholds, 16% and 40% of our cases were GRP78-positive for endoplasmic reticulum and cell membrane, respectively. For low thresholds, 74% and 87% of our cases were GRP78-positive for endoplasmic reticulum and cell membrane, respectively. In the endoplasmic reticulum high-threshold scenario, GRP78 positive was found to be significantly frequent in T3 tumors (p=0.02), and inversely related to ERBB2 overexpression (p=0.03). There was a lower proportion of GRP78-positive cases among women between 50 and 65 years of age (p=0.02). In the endoplasmic reticulum low-threshold scenario, the proportion of GRP78-positive cases was significantly higher in women younger than 50 years and in those who were premenopausal (p=0.04). No statistically significant difference was found in survival probabilities among the scenarios examined. In our cohort, GRP78 overexpression was not a predictor of overall or disease-free survival of patients receiving anthracycline-based adjuvant chemotherapy.

Two cases of women who underwent breast nodule exeresis and drainage are described; in both instances a Penrose drain was used and part of the drain, remaining in the surgical cavity after the surgery, acted as a foreign body. The author discusses the reasons why it can happen, as well as the need to take this possibility into account in the differential diagnosis of clinical findings (e.g., nodules) or mammographic alterations (e.g., gross calcification) in the vicinity of a previous surgery scar.

OBJETIVO: Avaliar artigos, na literatura, que verificam o valor preditivo positivo das categorias 3, 4 e 5 doBreast Imaging Reporting and Data System (BI-RADS®). MATERIAIS E METODOS: Foi realizada pesquisa nabase de dados Medline utilizando os termos “predictive value” e “BI-RADS”. Foram incluidos 11 artigos nestarevisao. RESULTADOS: O valor preditivo positivo das categorias 3, 4 e 5 variou entre 0% e 8%, 4% e 62%,54% e 100%, respectivamente. Tres artigos avaliaram, concomitantemente, os criterios morfologicos daslesoes que apresentaram maior valor preditivo positivo na mamografia, sendo nodulo espiculado o criteriocom maior valor preditivo positivo. CONCLUSAO: Houve grande variabilidade do valor preditivo positivo dascategorias 3, 4 e 5 do BI-RADS® em todos os estudos, porem foram identificadas diferencas metodologicasque limitaram a comparacao desses estudos.Unitermos: Mamografia; BI-RADS®; Câncer de mama.Breast Imaging Reporting and Data System – BI-RADS®: positive predictive value of categories 3, 4 and 5.A systematic literature review.OBJECTIVE: To review the literature about the positive predictive value of Breast Imaging Reporting andData System (BI-RADS®) categories 3, 4 and 5. MATERIALS AND METHODS: A research was performed inthe online Medline database, entering the terms “predictive value” and “BI-RADS”. Eleven studies were in-cluded in this review. RESULTS: The positive predictive values ranged respectively between 0% and 8%,4% and 62%, and 54% and 100% for BI-RADS® categories 3, 4 and 5. Three studies have also evaluatedmorphological criteria with higher positive predictive value in mammography, mass with spiculated marginsbeing the finding with highest positive predictive value for malignancy. CONCLUSION: A high variability wasfound in the reviewed literature among positive predictive values of BI-RADS® categories 3, 4 and 5, al-though methodological differences have been identified, limiting the comparative analysis.Keywords: Mammography; BI-RADS®; Breast cancer.

CONTEXT AND OBJECTIVE: Breast cancer is thought to derive from progressively aberrant, non-invasive breast lesions, but it is not known exactly how invasive breast cancer develops from these lesions. The aim of this study was to verify the changes in c-erbB-2 and p53 protein expression between non-neoplastic ducts, ductal carcinoma in situ and invasive ductal carcinoma found in the same breast. DESIGN AND SETTING: This was a cross-sectional study at Centro de Atenção Integral à Saúde da Mulher, Campinas, Brazil. METHODS: Fifty-six women with invasive ductal carcinoma and ductal carcinoma in situ in the same breast were included. The expression of c-erbB-2 and p53 proteins was assessed in non-neoplastic and neoplastic cells using immunohistochemical techniques. RESULTS: The c-erbB-2 protein was absent in non-neoplastic ducts but was present in 46% and 36% of in situ and invasive carcinoma components, respectively. Only 2% of non-neoplastic ducts, and 18% and 16% of ductal carcinoma in situ and invasive carcinoma components, respectively, were positive for p53 protein. No significant difference in c-erbB-2 and p53 protein expression was observed between in situ and invasive components. The nuclear grade agreement between in situ and invasive carcinoma was very good. CONCLUSIONS: The invasiveness of ductal carcinoma in situ seems to be independent of the Her-2/neu and TP53 genes. The general features of an occurrence of breast carcinoma are formulated at the outset of carcinogenesis, and the Her-2/neu and TP53 genes are involved.

To analyze the occurrence of adverse effects in the first 24-hour postoperative/postanesthetic period in women undergoing minor gynecologic or minor breast surgeries and to identify main associated factors.A cross-sectional study was conducted with 159 women who underwent minor gynecologic or breast surgeries. The women were admitted to the hospital one day before surgery and remained hospitalized for at least 24 hours after surgery. The anesthetic techniques performed were intercostal nerve blockade, spinal anesthesia, and general anesthesia.The most frequent adverse effects were vomiting, nausea and pain that occurred in 40.3% of women. Of these effects, 60% were observed in the first four hours and 80% were observed in up to six hours after surgical intervention. Women submitted to intercostal blockade received earlier postanesthetic release. Spinal anesthesia was most frequently associated with postoperative pain, although with a lower incidence of nausea and vomiting when compared to general anesthesia and intercostal blockade. The incidence of pain was higher in women who smoked.A six-hour period of postoperative observation appeared to be adequate for assessment of most complications and adverse effects occurring in women who undergo minor gynecologic or minor breast surgeries.

OBJETIVOS: avaliar a variação do grau nuclear e da expressão das proteínas p53 e c-erbB-2 e dos receptores de estrógeno (RE) no carcinoma ductal in situ (CDIS) e no carcinoma invasivo, presentes na mesma mama. MÉTODOS: estudo descritivo retrospectivo com 38 mulheres com CDIS associado a carcinoma invasivo da mama. Foi avaliado o grau nuclear e o realizado estudo imunohistoquímico para expressão das proteínas p53 e c-erbB-2 e para os RE. Os casos considerados positivos para a expressão das proteínas e dos RE foram aqueles com contagem de células positivas igual ou superior a 10%. A concordância entre estas variáveis no componente in situ e invasivo foi avaliada pelo coeficiente kappa (k), interpretado de acordo com os critérios de Landis e Koch. O teste de MacNemar foi usado para testar diferenças entre os dois grupos. RESULTADOS: a concordância entre o grau nuclear e a expressão dos RE nos componentes in situ e invasivo foi de 0,89 para ambos, quase perfeita. A concordância para a expressão da proteína c-erbB-2 também foi considerada quase perfeita, com coeficiente de 0,84. Já a concordância entre a expressão da proteína p53 no componente in situ e no invasivo foi de 1,0, considerada perfeita. Não houve diferenças significativas entre o grau nuclear e as expressões das proteínas e dos RE nos componentes in situ e invasivo na mesma mama. CONCLUSÕES: existe concordância alta do grau nuclear e da expressão das proteínas p53 e c-erbB-2 no CDIS e no carcinoma invasivo presentes na mesma mama. OBJECTIVES: The aim of the present study was to evaluate the nuclear grade, the expressions of p53 and c-erbB-2 proteins, and the estrogen receptors (ER) of 38 women with ductal carcinoma in situ (DCIS) and invasive carcinoma of the same breast. METHODS: the protein profile of 38 women was investigated in a descriptive and retrospective study, through the immune-histochemical technique. The cut-off limit for positive staining was chosen at 10% or more of positive cells for p53 and c-erbB-2 proteins and for ER. The analysis of the concordance between the expressions of proteins and the nuclear grade was done by the kappa coefficient, according to Landis and Koch's criteria. MacNemar's test was used to assess the differences between the two groups. RESULTS: there was a perfect concordance in the expression of p53 proteins (kappa coefficient = 1.00) and almost a perfect concordance for c-erbB-2 proteins, ER and nuclear grade (kappa coefficients = 0.84, 0.89 and 0.89) between in situ and invasive elements of the same tumor. CONCLUSION: there was no difference between the expressions of p53 and c-erbB-2 proteins, ER and nuclear grade in the DCIS and invasive carcinoma of the same breast.

CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evaluate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p < 0.01 in both cases. Twelve weeks after the treatment, all the women answered a questionnaire, which showed that 71% had improvement in menstrual regularity, 90% decreased menstrual volume and 81% shortened menstrual duration. The most frequent immediate post-procedure symptoms, established as complications, were pain (100%) and fatigue (34%). One woman had myoma degeneration and was submitted to myomectomy. CONCLUSION: The significant reduction in uterine and dominant myoma volume confirms the validity of the treatment of symptomatic myomas by the technique of uterine artery embolization in Brazilian women. There was significant reduction in menstrual flow and duration, as well as better cycle regularity in the women studied. The few adverse effects observed in the sample studied mainly involved pain immediately after embolization. CONTEXTO: Miomas uterinos são tumores benignos que ocorrem na idade reprodutiva das mulheres com uma freqüência que varia entre 20% a 25%. Quando presentes os sintomas, estes se caracterizam por aumento do fluxo menstrual, dor e sinais de compressão. Têm sido propostas novas formas de tratamento, destacando-se a embolização das artérias uterinas. OBJETIVO: Avaliar os efeitos do tratamento com embolização das artérias uterinas em mulheres portadoras de miomas sintomáticos e os volumes uterino e do mioma dominante, antes e após 12 semanas após o procedimento. TIPO DE ESTUDO: Ensaio clínico aberto. LOCAL: Hospital Leonor Mendes de Barros, São Paulo, Brasil. PARTICIPANTES: 32 mulheres com diagnóstico de mioma sintomático, único ou múltiplo, do corpo uterino, atendidas no Ambulatório de Ginecologia do Hospital Leonor Mendes de Barros, entre maio de 2000 e setembro de 2001. VARIÁVEIS ESTUDADAS: As mulheres foram submetidas a exame ginecológico seguido de ultra-sonografia abdominal, pélvica e endovaginal, repetidos 12 semanas após o procedimento. A embolização da artéria uterina com PVA (partículas de álcool polivinil de 355 a 700 µ) foi realizada através da cateterização da artéria femoral direita em 30 mulheres e, em duas mulheres, a cateterização foi bilateral. RESULTADOS: A média do volume uterino de 32 mulheres antes da embolização foi 455 cm³ e a média do volume do mioma dominante foi de 150 cm³ antes da embolização. Após 12 semanas de embolização, média do volume uterino e do mioma dominante foram 256 cm³ e 91 cm³ respectivamente. A redução dos volumes uterino e do mioma dominante foi estatisticamente significativa (p < 0,01) quando usado o teste de Wilcoxon. Doze semanas após o tratamento, questionário respondido por todas as mulheres mostrou melhor regularidade menstrual em 71%, redução do volume menstrual em 90% e menor duração em 81%. As complicações imediatas mais freqüentes foram dor e fadiga. Apenas em uma mulher ocorreu degeneração do mioma. CONCLUSÃO: A significativa diminuição dos volumes uterinos e dos miomas dominantes comprova a validade do tratamento dos miomas sintomáticos pela técnica de embolização das artérias uterinas. Houve uma redução significativa do fluxo e da duração menstrual, assim como uma melhor regularidade do ciclo nas mulheres estudadas. Nesta amostra, a dor imediata após a embolização foi o principal evento adverso observado.

The occurrence of a rare ovarian abscess, spontaneously drained through the vagina after an abdominal hysterectomy is described.The treatment was an oophorectomy.The various forms of primary ovarian abscess are discussed in connection with these observations. This case illustrates the need for adequate manipulation of the gonad during pelvic surgery in order to avoid parenchymal contamination and the subsequent formation of such abscesses.

Objetivo: analisar os niveis dos esteroides sexuais endogenos e gonadotrofinas em mulheres com e sem câncer de endometrio. Metodos: foi realizado estudo clinico-comparativo com 20 mulheres na pos-menopausa com câncer de endometrio e 20 mulheres na pos-menopausa, sem câncer de endometrio. A idade, o tempo de menopausa e o indice de massa corporea foram utilizados como variaveis de emparelhamento. Os niveis plasmaticos dos esteroides sexuais endogenos foram medidos por metodos de radioimunoensaio e imunoenzimatico. Para analise estatistica utilizamos o teste "t" de Student. Resultados: os niveis de androstenediona (A), testosterona total (t) e testosterona livre (TL) foram mais elevados nas mulheres com câncer de endometrio e os niveis de hormonio luteinizante (LH) foram significativamente menores nessas mulheres. Tambem observamos que a razao (E1/A) mostrou valores significativamente menores no grupo de mulheres com câncer, ao passo que a razao (E2/E1) nao apresentou diferencas nos dois grupos. Conclusoes: destacamos a potencialidade dos esteroides sexuais e gonadotrofinas na genese do adenocarcinoma de endometrio em mulheres na pos-menopausa.

O complexo de carnes e um dos principais componentes da pauta de exportacao brasileira. As carnes de frangos apresentam grande participacao nas exportacoes brasileiras, sendo que o Estado do Parana e o maior estado produtor exportador do Brasil. O objetivo do trabalho e analisar o comportamento e a competitividade das exportacoes do complexo agroindustrial de carnes de frangos brasileiro e paranaense no periodo de 1990 a 2005, bem como os fatores que determinam o desempenho das exportacoes brasileiras e sua interacao com o comercio internacional. O modelo principal de analise utilizado e o “Constant-Market-Share” , que realiza a decomposicao as fontes de crescimento das exportacoes dos complexos agroindustriais em componentes denominados: “crescimento do mercado mundial”, “composicao da pauta de exportacao”, “destino das exportacoes” e “competitividade” e sao capazes de expressar o comportamento e padrao das exportacoes no periodo de estudo. O metodo da taxa geometrica de crescimento, por meio do Metodo dos Minimos Quadrados Ordinarios, foi utilizado para analisar a evolucao do complexo no periodo. A fim de alcancar os objetivos e verificar o padrao das exportacoes brasileiras e a competitividade do frango brasileiro, foram colhidos dados sobre exportacoes e importacoes mundiais de carne dos anos de 1990 a 2005, de forma que se identificasse o perfil dos grandes mercados consumidores e exportadores do complexo carnes. Os dados analisados permitiram concluir que os indicadores do Brasil e do Estado do Parana evoluiram a altas taxas de crescimento geometricas de carne de frango. A partir da analise dos resultados do modelo CMS, percebe-se que o Brasil e o Parana possuem elevada competitividade e alto market-share no segmento analisado. A crescente demanda por este tipo de carne permitira que o Brasil se consolide internacionalmente nesse mercado, alem de serem sugeridas politicas sanitarias e outras que possam reduzir as barreiras a entrada deste produto nos principais paises importadores.

OBJECTIVE: To compare the rates of overall survival (OS), disease-free survival (DFS) and toxicity in different techniques of postoperative radiotherapy for stage IA endometrioid adenocarcionoma of endometrium, histological grades 1and 2. METHODS: A historical comparison between treatment regimens was performed, and 133 women with a minimum follow-up of 5 years were included. Teletherapy (TELE group), with 22 patients treated from 1988 to 1996, with a 10 MV linear accelerator, average dose 46.2 Gy. Low dose rate brachytherapy (LDRB group) was performed between 1992 and 1995, in 19 women, with an insertion of Cesium 137, at a 60 Gy dose. Fourteen women operated between 1990 and 1996 did not receive radiotherapy (NO RT group). High dose rate brachytherapy was performed in 78 patients (HDRB group), from 1996 to 2004, in five weekly 7 Gy insertions, prescribed at 0.5 cm from the vaginal cylinder. RESULTS: The 5-year disease-free survival was 94.6% for the HDRB group, 94.1% for the LDRB group, 100% for the TELE group and NO RT groups (p = 0.681). The 5-year overall survival was 86.6% for the HDRB group, 89.5% for the LDRB group and 90% for the TELE group and NO RT groups (p = 0.962). Grades 3-5 late toxicity was 5.3% in LDRB group and 27.3% for the TELE group (p < 0.001). CONCLUSION: Patients submitted to adjuvant teletherapy showed very high toxicity, which contraindicates that treatment for those patients. There may be a role for adjuvant HDRB, but randomized controlled trials are still needed to evaluate its benefit. OBJETIVO: Comparar as taxas de sobrevida global (SG), sobrevida livre de doença (DFS) e de toxicidade em diferentes técnicas de radioterapia pós-operatória para adenocarcionoma endometrioide do endométrio estádio IA, graus histológicos 1 e 2. MéTODOS: Realizou-se uma comparação histórica entre regimes de tratamento, incluindo 133 mulheres com seguimento mínimo de cinco anos. Teleterapia (grupo TELE), com 22 pacientes, de 1988 a 1996, tratadas com acelerador linear 10 MV, dose média de 46,2 Gy. Braquiterapia de baixa taxa de dose (grupo LDRB), realizada entre 1992 e 1995, em 19 mulheres, com uma inserção de Césio 137, dose de 60 Gy. Quatorze mulheres operadas entre 1990 e 1996 não receberam radioterapia (grupo NO RT). Braquiterapia de alta taxa de dose foi realizada em 78 pacientes (grupo BATD), 1996-2004, cinco inserções semanais de 7 Gy, a 0,5 cm do cilindro vaginal. RESULTADOS: A DFS em cinco anos foi de 94,6% para o grupo BATD, 94,1% para o grupo LDRB, 100% para os grupos TELE e RT (p = 0,681). A sobrevida global em cinco anos foi de 86,6% para o grupo BATD, 89,5% para o grupo LDRB e 90% para os grupos TELE e NO RT (p = 0,962). A toxicidade tardia graus 3-5 foi de 5,3% no grupo LDRB e 27,3% para o grupo TELE (p < 0,001). CONCLUSãO: Pacientes submetidos à teleterapia adjuvante apresentaram toxicidade muito elevada, o que contraindica o tratamento para essas pacientes. Pode haver um papel para a BATD adjuvante, mas estudos controlados randomizados são necessários para avaliar seu benefício.

Orientador : Jose Aristodemo Pinotti Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: Não informado Abstract: Not informed Doutorado Doutor em Ciências Médicas