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To evaluate the validity of partial protocols (PP) to assess the prevalence of developmental defects of enamel (DDE) in permanent teeth and identify the strength of the association between DDE and some risk factors, using PP compared to the full-mouth (FM) exam.This study was conducted in a population-based birth cohort of children born in 2004 in Pelotas, Southern Brazil. Socioeconomic, demographic, pre-, per-, and post-birth variables were collected. A subsample of 994 children was clinically examined for DDE in 2017, using the modified DDE index, using the "full- mouth" (FM) protocol. After FM had been performed, a dataset was created. Two different partial protocols (PP) were simulated from FM data: "only buccal surfaces (BS)" and "incisive and molars only (IM)." Sensitivity, absolute and relative bias, and inflation factors were calculated.For any DDE, FM had prevalence of 40.8%. The prevalence of DDE was 38.8% and 36.0%, for BS and IM protocols, respectively. When tested for any DDE, PP "BS" and "IM" showed high sensitivity. The underestimation of the true prevalence did not exceed 6.9% for PP "BS" and 16.1% for PP "IM." All protocols showed similar magnitude of association with the selected risk factors.Both PP "BS" and "IM" can be used to estimate the prevalence of DDE in epidemiological studies.Oral health surveys now have the option of using PP to collect DDE prevalence and investigate their association with risk factors, being less time-consuming, expensive, and labor intensive.

Introduction Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease. Objective To evaluate the prevalence and cardiovascular (CV) risk factors associated with metabolically healthy obesity (MHO) in a young population assisted by a Family Health Care unit in a large urban center. Design and method A cross-sectional population study for CV risk assessment in adults aged 20–50 years old from a Family Health Care unit. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (BP) measurements, laboratory evaluation (lipid and glycidic profile). Obesity was defined as a body mass index (BMI) >30 kg/m2 and MHO are those who have less than 3 of the following criteria for metabolic syndrome: office BP higher or equal to 130 x 85 mmHg, hypertension, fasting blood sugar higher or equal to 100 mg/dL, HDL 150 mg/dL and waist circumference >102 cm (men) and >88 cm (women). Results A total of 632 individuals were evaluated (60% female; mean age 37±9 years). The prevalence of obesity was 26%, of which 73% were classified as MHO. Obeses are older, with a higher prevalence of physical inactivity (51% vs 41%, p=0.03), hypertension (44% vs 19%, p Conclusion MHO was more prevalent in this young population and seems to have a lower CV risk, however it is not clear whether these younger and less obese individuals are only at an earlier stage of the disease. Perhaps the CV diseases onset is postponed for a few years. Even so, these individuals should not be excluded from public health policies as a form of primary prevention. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): CNPQFAPERJ

This study aims to evaluate the effect of etiolation and the usage of indolbutyric acid (IBA) in the propagation of Olea europaea cv. Maria da Fe minicuttings. The experimental outline is a completely randomized design, with a 2 x 3 bifactorial scheme [minicuttings from plants with and without etiolation and three concentrations of indolbutyric acid (0, 1,000, and 2,000 mg L-1)]. After 110 days, the following has been evaluated: percentage of survival, foliar retention and rooting, number of roots, length of the largest root, root dry matter mass and percentage of unrooted minicuttings with calluses. For the percentage of survival, foliar retention and rooting, number of roots and root dry matter mass, there has only been significance for IBA concentrations, and in general, the IBA 1,000 mg L-1 concentration provided the highest scores. For the length of the largest root and minicuttings with non-rooted callus, there has been interaction between treatments, with the lowest scores for callus formation in the minicuttings with etiolation and without IBA. It can be concluded that the minicutting of Olea europaea cv. Maria da Fe can be carried out without etiolation in the mother plants, using 1,000 mg L-1 of IBA.

Objectives. To evaluate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over 6 months in the Brazilian State of Rio Grande do Sul (population 11.3 million), based on 8 serological surveys. Methods. In each survey, 4151 participants in round 1 and 4460 participants in round 2 were randomly sampled from all state regions. We assessed presence of antibodies against SARS-CoV-2 using a validated lateral flow point-of-care test; we adjusted figures for the time-dependent decay of antibodies. Results. The SARS-CoV-2 antibody prevalence increased from 0.03% (95% confidence interval [CI] = 0.00%, 0.34%; 1 in every 3333 individuals) in mid-April to 1.89% (95% CI = 1.36%, 2.54%; 1 in every 53 individuals) in early September. Prevalence was similar across gender and skin color categories. Older adults were less likely to be infected than younger participants. The proportion of the population who reported leaving home daily increased from 21.4% (95% CI = 20.2%, 22.7%) to 33.2% (95% CI = 31.8%, 34.5%). Conclusions. SARS-CoV-2 infection increased slowly during the first 6 months in the state, differently from what was observed in other Brazilian regions. Future survey rounds will continue to document the spread of the pandemic.

Introdução: A Organização Mundial da Saúde (OMS) define a adolescência como o período entre os 10 e 19 anos, 11 meses e 29 dias, a etiologia da obesidade é de causa multifatorial, envolvendo aspectos ambientais e genéticos sendo fator de risco para o aparecimento de diversas comorbidades na vida adulta. Alguns estudos associaram a microbiota oral com a obesidade em adolescentes. Objetivo: Realizar um levantamento bibliográfico a respeito da microbiota oral e a correlação com a obesidade em adolescentes. Metodologia: Trata-se de uma revisão bibliográfica que utilizou as plataformas NCBI (PubMed), Scielo e Google Acadêmico, os artigos coletados foram nos idiomas português e inglês no formato de teses e artigos científicos. Os dados da pesquisa foram levantados através da busca eletrônica com as seguintes palavras: microbiota oral, adolescente, excesso de peso. Resultados: Os resultados apontam uma alteração no perfil da microbiota oral em relação à obesidade em adolescentes. Conclusão: Conclui-se que a microbiota exerce um certo papel na obesidade em adolescente, apesar disso há uma necessidade da realização de novos estudos sobre essa temática.

The cultivar Malbec has been present’s good performance and quality in the South Half of Rio Grande do Sul (RS). In this context, we aimed to evaluate the quality of “Malbec” grapes in relation to the phytotechnical, physicochemical parameters and bioactive compounds under different intensities of cluster thinning in Encruzilhada do Sul-RS. The experiment was carried out in a commercial vineyard in the 2015/16 with the cultivar Malbec (Vitis vinifera L.) under rootstock “1103 Paulsen”, with spacing of 2.2 m between rows and 1.1 m between plants. The experimental design was of randomized complete blocks with five replications. The treatment factor tested was the cluster thinning, with four levels (0%, 10%, 30% and 50%), performed in veraison. The evaluated phytotechnical variables were cluster length, cluster fresh weight, berries fresh weight, number of berries, rachis fresh weight. Also what were determined are the number of clusters, production and Ravaz index. The physicochemical variables verified were pH, soluble solids (SS), titratable acidity (TA) and SS/TA ratio. The bioactive compounds were total polyphenols index and total anthocyanins. The appropriate balance between source and sink, by the Ravaz index, occurs to zero and 10% of cluster thinning. The “Malbec” grapes present an increase of the maturation index (SS/TA) at 50% of cluster thinning, due to the low titratable acidity at this level. The total polyphenols index has a larger increment when the plants are submitted to the cluster thinning of 10%, providing a larger quality to the fruits. At all the levels of cluster thinning tested, when compared to the control, there was a greater contribution of total anthocyanins in the berries.

Blueberry (Vaccinium spp.), much appreciated for its exotic flavor and nutraceutical properties, can be consumed in natura and in beverages such as nectar and juice. The aim of this study was to evaluate the chemical characteristics and the acceptance of commercial nectar and blueberry juice elaborated by the steam dragging method. The work was carried out in August of 2016, at the Universidade Federal de Pelotas, Pelotas (RS). The experimental design was in a uniform scheme, with two levels: commercial nectar and juice elaborated with the combination of fruits of cultivars Bluegem and Powderblue. Soluble solids content, titratable acidity and the pH of the samples were evaluated. For the sensorial analysis, a panel of fifty-five judges evaluated attributes such as color, aroma, flavor, body and global acceptance, using a nine-point hedonic scale. Regarding the chemical analyzes, there was a statistical difference for total soluble solids content and the nectar showed the highest content. In the sensory analysis, the juice elaborated with ‘Bluegem’ and ‘Powderblue’ obtained the highest mean for color, while for the flavor and body attributes, the preference of the judges for the nectar was verified. However, both had good overall acceptance, with scores between 7.52 and 7.62. Thus, acceptance of both nectar and juice was considered satisfactory by the evaluators.

Introduction: Cervical cancer is currently the third malignancy on number of female deaths in the world. Persistent HPV infection is the main agent involved in cervical cancer development, particularly of high risk (HR) HPV types 16 and 18, accountable for approximately 75% of cervical cancer cases. These aspect has increased demand for HPV detection molecular tests. Objectives: To summarise and update the current knowledge on HPV and cervical cancer screening techniques and, also, discuss HPV-related data and screening techniques in Brazil. Methods: We include articles published in the past 10 years, both in English and Portuguese. Scientific search engines as Scopus, Cochrane Library and Pubmed were used for the terms “cervical cancer”, “HPV”, “cervical carcinoma”, “HPV vaccine”. Only research articles and reviews were considered. Results: The most used techniques for HPV detection are PCR and Hybrid Capture 2 (HC2). However, techniques for detection of HPV E6/E7 mRNA and p16INK4a have been developed, which are still being validated. These tests may help distinguish transient from persistent HPV infections. Conclusion: To reduce the number of cervical cancer cases, screening strategies could be adjusted to contain the best combination of cytological and molecular tests. The ideal screening strategy require high sensitivity to minimize false negative results, and high specificity, to avoid false positives and over referral. Optimization may be achieved by using by co-testing, combining HPV genotyping and cytology triage with low-grade intraepithelial lesions (LSILs) or with atypical squamous cells of undetermined significance (ASC-US). Besides, strategies to prevent cervical cancer cases include HPV vaccination.

Introduction: High-risk Human Papillomavirus (HR HPV) infection is known to be linked to cervical cancer, with molecular biology tests being an important tool in diagnosis. objective: This study is aimed to quantify the prevalence of HPV infection in women from the Southern part of the State of Rio Grande do Sul, Brazil, correlating factors associated with the development of precursor lesions and of cervical cancer. Methods: 643 women were enrolled in the study, by filling out a standardized questionnaire and undergoing cytology, colposcopy, and HR HPV Hybrid Capture 2 (HC2) tests. results: Most patients were aged between 20 to 39 years (70.6%), this decreased the percentage of smokers from 23% to 11%. The average age of sexual debut through the period studied was of 18 years old. HR HPV prevalence was correlated with younger ages, with fewer patients infected by HR HPV when they were older at first sexual activity. Almost 70% prevalence of infection was observed in women who had 4 or more sexual partners. Altered cytology and colposcopy results had significantly higher rates of HR HPV infection. 334 women were referred for biopsy. Of those, 321 had altered colposcopy results and cytopathology of ASC-US/AGC-US, LSILs and HSILs, with 231 biopsies performed by the study. None of the results indicated cervical cancer. HC2 showed higher specificity than cytology, with high positive and negative prediction values (49.8% and 78.6%, respectively).conclusion: The inclusion of HR HPV testing in screening programs in Brazil, according to international policies, will lead to fewer biopsies in women without infection and increased interval between screenings.

CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico O carcinoma de células escamosas oral (CCEO) é uma doençaa mutifatorial que envolve fatores genéticos, epigenéticos e ambientais. Caracteriza-se por um padrão de crescimento agressivo, altamente metastático e elevadas taxas de mortalidade. Apesar dos avanços da tecnologia nos tratamentos cirúrgicos, rádio e quimioterápicos, a taxa de sobrevivência de cinco anos não houve melhora significativa nos últimos anos. Através da regulação da expressão de genes alvos, os microRNAs desempenham papel importante na iniciação e progressão em cânceres humano, consequentemente, são uma ferramenta promissora para investigação de biomarcadores de identificação de risco, prognóstico e alvos terapêuticos. Com objetivo de investigar o perfil de expressão dos miRNAs no cancêr gástrico, dez tecidos de CCEO foram caracterizados a partir de dados gerados de sequenciamento de alto desempenho. Além disso, por qRT-PCR avaliamos o tecido adjacente ao CCEO para quatro miRNAs. Os resultados mostraram 17 miRNAs diferecialmente expressos, os quais foram capazes de discriminar o tecido CCEO do sem câncer. Dentre esses, encontramos sete novos miRNAs (hsa-let-7c, hsa-miR-10a, hsa-miR- 199a, hsa-miR-381, hsa-miR-501, hsa-miR-654 e hsa-miR-941), os quais ainda não estão descritos na literatura suas participações no CCEO. Adicionalmente, verificamos que os quatro miRNAs hsa-miR-221, hsa-miR-21, hsa-miR-135b e hsa-miR-29c foram hiperexpressos no tecido adjacente, confirmando o efeito de campo de câncerização. Os resultados revelaram que esses miRNAs são potenciais biomarcadores de ocorrencia no CCEO com a capacidade de identificar indivíduos com maior risco de desenvolver este câncer, e indicam sua utilidade como possíveis alvos terapêuticos. Oral squamous cell carcinoma (OSCC) is a multifactorial disease involving genetic, epigenetic and environmental factors. It is characterized by a pattern of aggressive growth, high metastatic potential and high mortality rates. Despite advances in technology in the surgical treatment, radiotherapy and chemotherapy, the five-year survival rate has no significant improvement in recent years. By regulating the expression of target genes, microRNAs play an important role in the initiation and progression of human cancers. Therefore, they are a promising tool for the identification of biomarkers of risk, as well as prognostic and therapeutic targets. In order to investigate the miRNAs expression profile in ten tissues of OSCC were characterized based on data generated from high-performance sequencing. Furthermore, by qPCR we assessed the adjacent tissue to the OSCC for four miRNAs. The results showed 17 differentially expressed miRNAs were able to discriminate the tissue without cancer. Among these, we found seven new miRNAs (hsalet- 7c, hsa-miR-10a, hsa-miR-199a, hsa-miR-381, hsa-miR-501, hsa-miR-654 and hsamiR- 941) which are not described in the literature their participation in OSCC. Additionally, we found that the four miRNAs hsa-miR-221, hsa-miR-21, hsa-miR-135b and hsa-miR-29c presented overexpression in the adjacent tissue, confirming the field cancerization effect. The results revealed that these miRNAs are potential biomarkers occurring in OSCC with the ability to identify individuals at high risk of developing this type of cancer, and indicate their utility as potential therapeutic targets.

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Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T21:55:51Z No. of bitstreams: 1 Dissertacao - Alessandra Lopes.pdf: 1903411 bytes, checksum: cd67f80d34aa3ce3121be3225ef37d13 (MD5) Made available in DSpace on 2021-01-05T21:55:51Z (GMT). No. of bitstreams: 1 Dissertacao - Alessandra Lopes.pdf: 1903411 bytes, checksum: cd67f80d34aa3ce3121be3225ef37d13 (MD5) Previous issue date: 2015-02-26 Is school the place for children? Maybe it is. Maybe it is not. Perhaps the problem lies in wanting to establish a place for kids that are constantly in motion, moving in a diversity and a variety of spaces and times. The road that runs through this text begins to move in this initial question, but does not aim to find a proper answer to it. It intends to think a school of early childhood education that is inhabited, and inhabitable, by children, where their voices are heard in contrast to the adults in a experience of a childhood that is more than a mere step in a chronological development. A childhood that makes us beings lurking, waiting, sensitive to the new born to the world, to becomings that leads us to renew the world. This school is being circumvented by the idea of skholé, a space of free time, a time that equates every one in it, where something is suspended, profaned, made common, something that draws us to the present. And what present would that be? A present that is seen as a point between the past and the future or a present that happens in a moment of intensity in which changing comes? Between children and adults, in their incessant movements, one finds a school made of experiences, of an idea of learning that leads us to decipher the world in individuations in which we are one and multiple. A school that makes teachers and students at the same time that it is made by them. Could play in such a school of early childhood education differentiate ourselves at the same time it equates us, leading us to inhabit the present, to make a world? Lugar de criança é na escola? Talvez sim. Talvez não. Talvez exista um problema em querer determinar um lugar para crianças que estão em movimento, que se movimentam por diversos e variados espaços e tempos. O caminho que percorre este texto se põe a caminhar nessa questão inicial, mas não se preocupa em respondê-la. Busca, antes, pensar uma escola de educação infantil habitada e habitável por crianças, onde suas vozes se fazem ouvir em contraponto às dos adultos na experiência de uma infância que é mais do que mera etapa em um desenvolvimento cronológico. Uma infância que nos faz seres à espreita, sensíveis ao novo que nasce para o mundo, e a devires que nos levam a renovar o mundo. Essa escola vai sendo contornada na ideia de skholé, um espaço de tempo livre. Um tempo que iguala todos que nela estão em torno de algo comum, algo que é suspenso, profanado, feito comum, algo que nos atrai para o presente. E que presente seria esse? Um presente que se vê em um ponto entre um passado e um futuro ou um presente que acontece em um instante de intensidade que tudo muda? Entre crianças e adultos, em suas incessantes movimentações, encontra-se uma escola feita de experiências, de um aprender que nos leva a decifrar o mundo em individuações em que somos unos e múltiplos. Uma escola que faz professores-pedagogos e crianças-alunos, e que é feita por eles. Poderia o brincar, em uma tal escola de educação infantil nos igualar ao mesmo tempo que nos diferencia, fazendo-nos dissolver; levar-nos a habitar o presente, a fazer um mundo?

O Carcinoma Epidermóide do Esôfago (CEE) é uma das neoplasias malignas mais agressivas e letais do trato digestivo. Seu diagnóstico frequentemente ocorre em indivíduos com doença avançada, sendo baixas as possibilidades de cura. O Rio Grande do Sul é o estado brasileiro com maior número de diagnósticos, com estimativa de contribuir com 10% dos casos do país em 2008, atingindo uma incidência de 19,73 casos novos/100.000 habitantes do sexo masculino e 7,58 novos casos/100.000 habitantes do sexo feminino. O CEE permanece o tipo mais comum com mais de 80% dos casos. Tentativas de diagnóstico precoce do CEE em indivíduos sob risco têm sido feitas utilizando-se citologia coletada com balões abrasivos. Porém, tal técnica tem demonstrado que, apesar de obter boas amostras de células da mucosa esofágica, apresenta sensibilidade abaixo do esperado para sua aplicação na rotina. No presente estudo os autores se propõem estudar a prevalência da expressão da proteína p53 em material citológico coletado pelo Balão RS em indivíduos sob risco para CEE, além de verificar sua acurácia diagnóstica para rastreamento de CEE. Foram incluídos indivíduos assintomáticos que apresentassem ao menos um dos fatores de risco: a) consumo de mais de 40 gramas de etanol/dia por mais de 10 anos; b) consumo de mais de 10 cigarros/dia por mais de 10 anos; c) uso diário de chimarrão por mais de 10 anos; d) diagnóstico prévio de carcinoma epidermóide do trato aéro-digestivo superior (TADS). Foram excluídos indivíduos com: a) recusa em participar do estudo; b) agitação psicomotora que impossibilitasse a passagem do balão; c) varizes esofágicas; d) disfagia progressiva; e) hepatopatia crônica descompensada; f) hemorragia digestiva alta nos últimos 30 dias; g) sinais de encefalopatia metabólica; h) diagnóstico de divertículo de Zenker. Entre março de 2006 e dezembro de 2007, 171 indivíduos foram avaliados com citologia esfoliativa pelo Balão RS e as biópsias esofágicas guiadas pela cromoendoscopia com solução de Lugol. O material citológico foi analisado após coloração de Papanicolaou e imunocitoquímica p53. O material de biópsia foi corado pela Hematoxilina/Eosina e imunoistoquímica p53. Oito sujeitos foram excluídos (4,7%) por apresentarem material citológico inadequado coletado pelo Balão RS. A amostra de 163 pacientes consistiu de 150 homens (92%), com idade entre 28 e 84 anos (média= 52,6 ± 12 anos). Tabagismo ativo foi observado em 141 pacientes (86,5%), com mediana de carga tabágica de 39,5 maços/ano. Alcoolismo ativo foi observado em 114 indivíduos, com consumo de destilados em 78,1% dos casos e quantidade mediana de 320 gramas de álcool/dia. Alcoolismo e tabagismo ativos concomitantes foram observados em 63,8% da amostra estudada (104 sujeitos). Consumo de chimarrão diário foi observado em 69,9% no grupo estudado. Tabagismo, consumo de álcool e consumo de chimarrão em bases regulares foram identificados de maneira concomitante em 77 indivíduos (47,2%). Carcinoma do TADS foi o fator de inclusão em 42 pacientes (25,8%). A utilização do Balão RS foi fácil e rápida, sendo bem tolerado sem complicações. Os resultados dos exames citológicos foram os seguintes: 147 normais (90,2%), 10 alterações celulares reativas (6,1%), 3 alterações escamosas de significado indeterminado (ASCUS) (1,8%), 1 lesão intra-epitelial de baixo grau (LISL) (0,6%), 1 lesão intra-epitelial de alto grau (HSIL) (0,6%) e 1 carcinoma escamoso (0,6%). A cromoendoscopia com Lugol apresentava áreas descoradas em 65 indivíduos (40,1%). As áreas coradas apresentaram diagnóstico histopatológico normal em 110 (67,5%) e esofagite em 53 indivíduos (32,5%). Dos 65 pacientes com áreas descoradas foi atribuído diagnóstico anatomopatológico normal em 23 (35,4%), esofagite em 39 (60%), displasia de alto grau em 1 (1,5%), carcinoma in situ em 1 (1,5%) e carcinoma invasivo em 1 (1,5%). A citologia positiva (ASCUS, LSIL, HSIL, Carcinoma) coletada pelo Balão RS obteve sensibilidade de 66,7% (IC95% 22,0 – 93,6), especificidade de 97,5% (IC95% 96,7 – 98,0), acurácia de 96,9% (IC95% 95,3 – 97,9), valor preditivo positivo de 33,3% (IC95% 11,0 – 46,8) e negativo de 99,4% (IC95% 98,5 – 99,9) para identificação de lesões neoplásicas histológicas. A imunoistoquímica com p53 foi executada em 161 indivíduos, sendo que a expressão desta proteína foi positiva em 38 indivíduos (23,6%), com acometimento da camada basal em 29 (76,3%), camada média em 8 (21,1%) e camada superficial em 1 (2,6%). Não houve expressão imunocitoquímica da proteína p53 no material citológico obtido com Balão RS nesta amostra de indivíduos sob risco de CEE. Podemos concluir que, apesar do Balão RS ter apresentado um bom desempenho na coleta de amostras citológicas do esôfago, a negatividade da expressão da imunocitoquímica da proteína p53 em todas as amostras sugere que seu uso não contribui para a melhora da efetividade diagnóstica da citologia. Squamous Cell Carcinoma of the Esophagus (SCCE) is one of the most aggressive and lethal digestive cancers. Unfavorable prognosis is common due to late diagnosis, resulting in low chances of curative treatment. Rio Grande do Sul is the leading Brazilian state in new cases, with an estimated 2008 prevalence of 19.73 new cases/100,000 male inhabitants and 7.58 new cases/100,000 female inhabitants. SCCE remains the most frequent histological type, contributing with 80% of the cases. Exfoliative cytology obtained with abrasive balloons has been used to attempt early diagnosis of SCCE. Although this technique collects good cytological samples from the esophageal mucosa, the low sensitivity of cytology precludes its use in clinical practice. In the current work the author studied the prevalence of p53 expression in cytologic smear collected by the RS Balloon in high risk individuals, and tested its yield in the cytological screening of SCCE and its precursor lesions. Asymptomatic individuals with at least one of the following risk factors for SCCE were included: a) current alcohol drinking (more than 40 g of alcohol/day); b) tobacco smoking (>10 cigarettes/day); c) maté drinking for more than 10 years; d) previous head and neck cancer. Exclusion criteria were: a) refusal to participate in the study; b) agitation that precludes the collection of cytologic material with the RS Ballon; c) esophageal varices; d) progressive dysphagia; e) unstable cirrhosis; f) upper digestive tract hemorrhage in the previous 30 days; g) metabolic encephalopathy; h) previous diagnosis of Zenker’s diverticulum. Between march/2006 and december/2007, 171 individuals were recruited and submitted to exfoliative cytology with RS Balloon, and esophageal biopsies guided by Lugol chromoendoscopy. Cytology samples were analyzed after Papanicolaou staining and p53 immunostaining. Biopsy samples were analyzed after Hematoxilin/Eosin staining and p53 immunostaining. RS Balloon cytological samples were inadequate in eight (4.7%) individuals who were excluded from the analysis. The final sample consisted of 163 individuals where 150 were male (92%), with ages ranging between 28 and 84 years old (mean 52.6 ± 12.0). Current tobacco smoke was observed in 141 patients (86.5%), with a median of 39.5 pack/year. Current alcoholism was found in 114 individuals, who consumed mainly distilled beverages, (median = 320 g of alcohol/day). Concomitant alcoholism and tobacco smoking were observed in 104 (63.8%) subjects. Daily Maté consumption was observed in 69.9%. Current smoking, daily Maté and alcohol drinking were observed in 77 individuals (47.2%). Previous head and neck cancer was the inclusion criterion in 42 patients (25.8%). Using the RS Balloon was quick, easy and well tolerated by patients (no complications observed). The cytological results were: 147 normal (90.2%), 10 benign reactive cellular changes (6.1%), 3 atypical squamous cells of undetermined significance (ASCUS) (1.8%), 1 low grade squamous intraepithelial lesion (LISL) (0.6%), 1 high grade squamous intraepithelial lesion (HSIL) (0.6%) and 1 squamous carcinoma (0.6%). Lugol chromoendoscopy showed unstained areas in 65 patients (40.1%). Biopsies from normally stained areas were diagnosed as normal in 110 (67.5%) and esophagitis in 53 (32.5%) individuals. Biopsies from unstained areas were diagnosed as normal in 23 (35.4%), esophagitis in 39 (60%), high grade dysplasia in 1 (1.5%), carcinoma in situ in 1 (1.5%), and invasive carcinoma in 1 (1.5%). Positive cytology (ASCUS, LSIL, HSIL, Carcinoma) collected by the RS balloon had a sensitivity of 66.7% (IC95% 22.0 – 93.6), a specificity of 97.5% (IC95% 96.7 – 98.0), a positive predictive value of 33.3% (IC95% 11 – 46.8), a negative predictive value of 99.4% (IC95% 98.5 – 99.9) and accuracy of 96.9% (IC95% 95.3 – 97.9) for the diagnosis of histopathological neoplastic lesions. Immunohistochemical expression of p53 protein was analyzed in 161 individuals, out of which 38 (23.6%) were positive, with basal layer expression in 29 (76.3%), middle layer expression in 8 (21.1%) and superficial layer in 1 (2.6%). Immunocytochemical expression of p53 protein in cytologic smear was negative in all cytology samples. In summary, even though the RS Balloon collected adequate samples, the negative results of immunocytochemical expression of p53 protein suggest that its use does not contribute to improving the performance of conventional cytology of the esophagus in the screening for SCCE and its precursor lesions. XIV

A infecção do trato urinário (ITU) é uma das doenças mais comuns na infância e em 80 a 90% dos casos é causada por bactérias da família Enterobacteriaceae, especialmente Escherichia coli e Klebsiella pneumoniae, as quais no mundo inteiro têm emergido como produtoras de ESBL, um dos principais mecanismos de resistência bacteriana a cefalosporinas de espectro-estendido e monobactans. A prevalência da ITU em crianças, bem como as variáveis, sexo, idade, febre, bactéria mais frequente, presença de refluxo vesico-ureteral (RVU), presença de cicatrizes renais foram avaliadas no período de janeiro de 2006 a março de 2009, em hospital público de belém, região norte do Brasil e no período de abril a agosto de 2009, isolados de cepas de E. coli e K. pneumoniae foram obtidos de urina de crianças menores de 16 anos e avaliados fenotipicamente através do método automatizado de caracterização de ESBL, Vitek2, juntamente com a PCR para determinar se os genes blaTEM, blaSHV e blaCTX-M1 estavam presentes em cada organismo. Foram confirmados 199 casos de ITU no período estudado, 54,2% eram do sexo feminino, 46,2% eram menores de 02 anos de idade, febre ocorreu em 37,3% dos casos, RVU foi identificado em 38,6% das crianças com ITU e cicatriz renal em 38%, a bactéria mais frequente foi a E. coli (60%). Foram isoladas 43 amostras ( E. coli e K. pneumoniae, 74,4% e 25,6%, respectivamente), 95% foi resistente a ampicilina e sulfametoxazol-trimetroprim; 23,2% apresentaram fenótipo ESBL. O gene blaCTX-M1 foi o mais prevalente, encontrado em 19 cepas, seguido do gene blaTEM (18 cepas) e blaSHV (8 cepas). Esse estudo mostrou que bactérias com perfil de resistência ESBLcirculam no ambiente hospitalar em Belém e que os genes blaCTX-M1 e blaTEM e blaSHV estão presentes em cepas de E. coli e K. pneumoniae causadoras de ITU em crianças na região norte do Brasil. Urinary Tract Infection (UTI) is one of the most common diseases of childhood and in 80 to 90% of the cases are caused by bacteria of Enterobacteriaceae family, especially Escherichia coli and Klebsiella pneumoniae, which have emerged in the worldwide as ESBL producer, one of the main mechanisms of bacterial resistance to extended-spectrum cephalosporins and monobactans. UTI prevalence in children, as well as another variable as gender, age, fever, most common bacteria, presence of vesicoureteral reflux (VUR) and of renal scars; were evaluated between January 2006 and March 2009, in a public hospital in Belém, northern Brazil. And in the period of April to August of 2009 isolates of E.coli and K.pneumoniae were obtained from the urine samples of children and evaluated phenotypically using the method automated of characterization of ESBL, Vitek2 system. PCR was used to determine whether the genes blaTEM, blaSHV and blaCTX-M1 were present ineach organism. There were 199 confirmed cases of UTI during the study period, 54.2% were female, 46.2% were under 02 years old, fever occurred in 37.3% of cases, VUR was identified in 38.6% of children with UTI and renal scarring in 38%, the most common bacteria was E.coli (60%). We isolated 43 samples (E.coli and K.pneumoniae, 74.4% and 25.6%, respectively), 95% were resistant to ampicillin and trimethoprim-sulfamethoxazole, 23.2% had ESBL phenotype. The blaCTX-M1 was the most prevalent gene, found in 19 strains, followed blaTEM (18 strains) and blaSHV (8 strains) genes. This study showed that bacteria with resistance profile of ESBL circulate in the hospital environment in Belém and the genes blaCTX-M1, blaTEM and blaSHV are present in E. coli and K. pneumoniae causing UTI in children in northern Brazil.

Objetivo: O presente trabalho tem como objetivo avaliar as diferenças entre a acalasia chagásica e a idiopática em pacientes do Hospital de Clínicas de Porto Alegre, através da análise de achados epidemiológicos, clínicos, radiológicos e manométricos. Métodos: Foram estudados pacientes encaminhados ao Hospital de Clínicas de Porto Alegre, entre novembro de 1996 e dezembro de 2001, com suspeita de acalasia, posteriormente, confirmada por manometria esofágica. Além das características manométricas e radiológicas, os pacientes foram avaliados quanto a idade, sexo, sintomas e tempo de evolução. Resultados: Entre 51 pacientes, nove (18%) tiveram sorologia positiva para doença de Chagas e 42 (82%) sorologia negativa. Indivíduos com sorologia negativa foram considerados portadores de acalasia idiopática. Pacientes com acalasia chagásica tinham média de idade de 62 ± 15 anos e os com idiopática 43 ± 18 anos (P < 0,02). O período de evolução dos sintomas em pacientes com acalasia chagásica foi de 74 ± 47 meses e nos idiopáticos 49 ± 35 meses (P < 0,05). Disfagia, regurgitação, dor torácica e emagrecimento, valores do esfíncter esofágico inferior (pressão basal, pressão e duração de relaxamento pós-deglutição e comprimento total) e do corpo esofágico (amplitude e duração das ondas pós-deglutição) foram similares em ambos os grupos Conclusões: As únicas diferenças estatisticamente significativas encontradas entre os dois grupos foram a média de idade e o período de evolução dos sintomas, maiores nos pacientes chagásicos. Esses dados permitem especular sobre uma maior tolerância aos sintomas nos pacientes com idade mais avançada. Unitermos: Acalasia chagásica; acalasia idiopática; doença de Chagas. Objetive: The objective of this study is to evaluate the differences between achalasia in Chagas’ disease and idiopathic achalasia in patients admitted to the Hospital de Clínicas de Porto Alegre, by analyzing epidemiologic, clinic, radiologic and manometric findings. Methods: Patients referred to the Hospital de Clinicas de Porto Alegre between November 1996 and December 2001 with suspicion of achalasia, later confirmed by esophageal manometry, were included in the study. In addition to manometric and radiologic findings, patients were assessed for age, sex, symptoms and symptomatic period Results: Among 51 patients, nine (18%) presented positive serology for Chagas’ disease and 42 (82%) presented negative serology. The latter were considered carriers of idiopathic achalasia. The mean age of patients with achalasia in Chagas’ disease was 62 ± 15 years, while the mean age in the idiopathic group was 43 ± 18 years (P < 0.02). The symptomatic period for patients with achalasia in Chagas’ disease was 74 ± 47 months, and in the idiopathic group, 49 ± 35 months (P < 0.05). Dysphagia, regurgitation, thoracic pain and weight loss, values at the lower esophageal sphincter (basal pressure, post-deglutitive relaxation pressure/duration and total length) and at the esophageal body (amplitude and duration of the post-deglutitive waves) were similar in both groups. Conclusions: The only statistically significant differences found between the two groups were age and length of the symptomatic period, significantly greater in patients with achalasia in Chagas’ disease. These data suggest a greater resistance to the symptoms in older patients.