bluuebunny/crossref_metadata_2025 huggingface dataset:
Progressive muscular dystrophy: Duchenne type. Controversies of the kinesitherapy treatment
Authors: Leitão Ana Valéria de Araujo , Duro Luiz Alves , Penque Glória Maria Cardoso de Andrade
Published: February 2017

The authors carried out a study of children with progressive muscular dystrophy of Duchenne type (DMD), giving special attention to physiatrical follow-up, having in mind that the practice of exercises has been debated very much in the specialized literature. The goal of this study is to try to settle the limits for the utilization of kinesitherapy which should be applied only in specific situations, such as: after skeletal muscular trauma or when the respiratory system is at risk. In this situation the physiatrical procedure would be to restrict physical activity, with early use of wheelchairs and the exclusion of the use of orthoses for orthostatism. DMD, at present, has been considered a result of duplication (60%), deletion (5 to 6%) or point mutations at gen Xp21 (Zatz, 1994), that codifies a protein called Dystrophin ( Hoffman et al., 1987). Dystrophin is a cytoskeletal sarcolemmic protein that constitutes about .002% of the total protein of the muscle, present in skeletal fibers concentrated in muscle tendinous joints, which supplies mechanical reinforcement to the surface of the membrane during stretching and shortening physical activity. This protein is absent in DMD cases, wherefore, the sarcolemma undergoes a segmentary necrosis losing its contractile property during eccentric and concentric physical activity. The importance of physiatrical follow-up for DMD patients is to avoid deformities and tendon shortening, to ameliorate the patient's quality of life, to provide respiratory assistance and general couseling to members of the patient's family. The objective of this study is to try to clarify the risks and possibilities of kinesitherapy applied to DMD cases.
Inguinal hernia incarceration as a form of intestinal tuberculosis
Authors: Faccin Mellyssande , Youssef Soraia Rachid , Mozetic Valeria , Catapani Wilson Roberto
Published: February 2017

We report the case of a 41 year-old male who came to the emergency room with a complaint of abdominal pain, and was diagnosed to have an acute obstructive abdomen due to a right inguinal hernia incarceration. During surgery, an intestinal granulomatous inflammation was observed adhered to the hernial sac.The histopathologic study confirmed the diagnosis of tuberculosis. We present a review of the different clinical forms of intestinal tuberculosis and the difficulties encounted in the differential diagnosis of such, emphasizing the uncommon presentation described in our patient.
Ultrastructural aspects of the remodeling process of the Corpus albicans in the recent postmenopausal period
Authors: Focchi Gustavo Rubino de Azevedo , Simões Manuel de Jesus , Baracat Edmund Chada , Lima Geraldo Rodrigues de , Evêncio Neto Joaquim
Published: February 2017

To study the cytophysiology of the Corpus albicans in the recent postmenopausal period, the authors analyzed the ovarian ultrastructure of ten patients submitted to oophorectomy due to non-malignant gynecological diseases. Evidence of a remodeling process with connective tissue substitution of the corpora albicantia was observed. The remodeling process appears to depend on the activity of three essential cell types: the fibroblasts, which provide collagen synthesis; the macrophages, which phagocytize the flaky material; and the myofibroblasts, mainly located in the peripheral region of the corpora albicantia, which may have a retracting action on the remodeling site of the Corpus albicans.
HTLV-I infection and adult T-cell leukemia in Brazil: an overview
Authors: Oliveira Maria do Socorro Pombo de , Hamerschlak Nelson , Chiattone Carlos , Loureiro Paula
Published: February 2017

Human T-cell lymphotropic Virus Type I (HTLV-I) is the etiologic factor for adult T-cell leukemia/lymphoma (ATL). HTLV-I infection can also lead to other diseases, such as HTLV -I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), uveitis, arthropathy and infectious dermatitis. Studies of the infectious mode of transmission of HTLV-I and risk factors for HTLV-I-related diseases have been conducted in several countries, and differences in the prevalence, age patterns, ethnic groups and clinical presentation of the related diseases have been described worldwide. Based on the geographical characteristics of Brazil and data from the literature, we have summarized the distribution of seroprevalence in blood donors in different states around the country, as well as the incidence of ATL in regards to the endemic foci. ATL in Brazil has the same characteristics as those described elsewhere, but is reported more frequently at a younger age. In order to better evaluate ATL in Brazil, a registry has been established at the several hematologic centers under the sponsorship of the Instituto Nacional de Cancer and the Brazilian Society of Hematology and Hemotherapy, for the purpose of recording all cases originally diagnosed in Brazil.
Neurological examination in obsessive-compulsive disorder
Authors: Caramelli Paulo , Lima Mauro Aranha de , Stip Emmanuel , Bacheschi Luiz Alberto
Published: February 2017

Recent studies suggest the occurrence of a neurological dysfunction in Obsessive-Compulsive Disorder (OCD). The purpose of the present study was to verify the clinical value of a neurological evaluation in patients with the disease. We submitted 15 patients with OCD (five of whom were under clomipramine) and 15 controls in a detailed neurological examination, including assessment of the neurological soft-signs. Eleven patients (73.3 percent) and four controls (26.7 percent) presented abnormalities on examination. The main findings among the patients were: palmomental reflex (six cases); mirror movements (five cases); agraphestesia and dysdiadochokinesia (three cases). Three out of the four patients who had a normal examination were on clomipramine. Palmomental reflex was the main finding among the controls. These results, although preliminary, stress the interest and usefulness of performing a detailed neurological examination in OCD.
Placenta percreta with silent rupture of the uterus
Authors: Passini Junior Renato , Knobel Roxana , Barini Ricardo , Marussi Emílio
Published: February 2017

We report a case of placenta percreta diagnosed by ultrasound and color doppler image at the fourteenth week of gestation. Initial approach was a trial of IM methotrexate followed by total hysterectomy, during which was observed a rupture of the uterus with the adherence of the placenta to the posterior region of the bladder. We also present a literature review on the incidence of placenta percreta, etiology, diagnosis, treatment, and complications.
Postnephrectomy arteriovenous fistula
Authors: Baptista-Silva José Carlos Costa , Figueiredo Luiz Francisco Poli de , Castro Marcos Joaquim , Veríssimo Marcos José Martins , Camara André Luiz Guimarães
Published: February 2017

The development of the postnephrectomy arteriovenous fistula (PNAVF) between the renal vessels stumps is rare. Here we present a case report of PNAVF, and review the diagnosis, treatment and prevention.The most common clinical features include a loud murmur over the previous nephrectomy scar, and heart failure resistant to common medical treatment. A 58-year-old white woman was admitted to the hospital for a complete evaluation of an unexplained congestive heart failure with no response to common medical treatment. She had had a right nephrectomy for pyonephrosis 13 years before. The diagnosis of PNAVF was suspected because over the right lumbar region a definite trill was palpated, and on auscultation a harsh, machinery-like murmur was heard.The diagnosis was confirmed by aortogram and selective renal arteriography. In May 1989, the right arteriovenous was excised through a right subcostal transperitoneal approach. The renal vessel stumps were individually ligated and sutured separately close to aorta and vena cava. The patient's postoperative course was entirely uneventful in the following seven years. We conclude that during nephrectomy, the renal vessels should be ligated separately, and the transfixation in mass of the stumps avoided to prevent arteriovenous fistula.
Factors affecting compliance with the measles vaccination schedule in a Brazilian city
Authors: Logullo Patricia , Carvalho Heráclito Barbosa de , Saconi Renata , Massad Eduardo
Published: February 2017

CONTEXT AND OBJECTIVE: The success of vaccination campaigns depends on the degree of adherence to immunization initiatives and schedules. Risk factors associated with children's failure to receive the measles vaccine at the correct age were studied in the city of São Paulo, Brazil. DESIGN AND SETTING: Case-control and exploratory study, in the metropolitan area of São Paulo. METHODS: The caregivers of 122 children were interviewed regarding their perceptions and understanding about the measles vaccination and the disease. RESULTS: The results showed that age, region of residence, marital status and education level were unrelated to taking measles vaccines adequately. Most individuals remembered being informed about the last annual vaccination campaign by television, but no communication channel was significantly associated with vaccination status. The answers to questions about knowledge of the disease or the vaccine, when analyzed alone, were not associated with taking measles vaccinations at the time indicated by health agencies. The results showed that, when parents felt sorry for their children who were going to receive shots, they delayed the vaccination. Most of the children did not take the measles vaccination on the exactly recommended date, but delayed or anticipated the shots. CONCLUSION: It is clear that there is no compliance with the government's recommended measles vaccination schedule (i.e. first dose at nine and second at 15 months of age, as recommended in 1999 and 2000). Feeling sorry for the children receiving shots can delay vaccination taking.
Prevalence of c-myc expression in breast lesions associated with microcalcifications detected by routine mammography
Authors: Mazzini Renato Coimbra , Elias Simone , Nazário Afonso Celso Pinto , Kemp Cláudio , Logullo Ângela Flávia
Published: February 2017

CONTEXT AND OBJECTIVE: Genetic abnormalities in cell proliferation-regulating genes have been described in premalignant lesions. The aims here were to evaluate c-myc protein expression in non-palpable breast lesions associated with microcalcifications, detected by screening mammography, and to compare these results with histopathological, clinical and epidemiological variables. DESIGN AND SETTING: Analytical cross-sectional study, with retrospective data collection, in a university hospital in São Paulo. METHODS: Seventy-nine female patients who underwent routine mammography between 1998 and 2004 were studied. Lesions classified by the Breast Imaging Reporting and Data System (BI-RADS) as 4 or 5 underwent percutaneous biopsy using a large-core needle. Ninety-eight lesions were studied anatomopathologically. Paraffin blocks properly representing the lesions were selected for immunohistochemical analyses using the streptavidin-biotin-peroxidase technique with monoclonal mouse c-myc antibodies. RESULTS: Among the 98 lesions, 29 (29.6%) contained malignant neoplasia; 40 (40.8%) had a positive immunohistochemical reaction for c-myc. When the groups were divided between lesions without atypias versus atypical lesions plus malignant lesions, 31.03% of the 58 lesions without atypias were positive for c-myc and 55% of the 40 malignant and atypical lesions (P = 0.018). Comparing the atypical lesions with ductal carcinoma in situ versus the benign lesions without atypias, c-myc was present in 51.61% of the 31 atypical lesions and 31.03% of the benign lesions without atypias (P = 0.057). CONCLUSION: C-myc protein was more frequently expressed in atypical and malignant lesions than in benign lesions without atypias. C-myc expression correlated with the presence of atypias (P = 0.018).
Müllerian duct anomalies: review of current management
Authors: Ribeiro Sérgio Conti , Tormena Renata Assef , Peterson Thais Villela , Gonzáles Marina de Oliveira , Serrano Priscila Gonçalves , Almeida José Alcione Macedo de , Baracat Edmund Chada
Published: February 2017

The aim of this paper was to discuss the embryological aspects of Müllerian duct anomalies and to analyze the current diagnostic methods and therapy. Müllerian anomalies are congenital defects of the female reproductive tract resulting from failure in the development of the Müllerian ducts and their associated structures. Their cause has yet to be fully clarified, and it is currently believed to be multifactorial. Symptoms appear principally during adolescence or early adulthood, and affect the reproductive capacity of these women. When clinically suspected, investigations leading to diagnosis include imaging methods such as hysterosalpingography, ultrasonography and magnetic resonance. The classification of these malformations relates to their embryogenesis, and defines the therapy and prognosis. Müllerian anomalies consist of a wide range of defects that may vary from patient to patient. Therefore, their management must also be individual, taking anatomical and clinical characteristics into consideration, as well as the patient's wishes.
Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy
Authors: Tavares Marília Buenos Aires Cabral , Sousa Rodrigo Beserra , Silva Thiago Oliveira e , Moreira Larissa Almeida , Silva Loyana Teresa Teófilo Lima , Tavares Carolina Buenos Aires Cabral , Vieira Sabas Carlos
Published: February 2017

CONTEXT AND OBJECTIVE: Cancer of the uterine cervix is still very common in Brazil. It is important to evaluate factors that influence its prognosis. The aim here was to analyze the prevalence of prognostic anatomoclinical factors among patients with carcinoma of the uterine cervix undergoing radical hysterectomy. DESIGN AND SETTING: Cross-sectional study on 301 patients with invasive carcinoma of the uterine cervix who underwent Level III Piver-Rutledge hysterectomy surgery at São Marcos Hospital. METHODS: The following variables were analyzed: age, histological type, degree of differentiation, invasion of lymphatic, vascular and perineural space, lymph node metastasis, distance to nearest margin, tumor invasion depth, vaginal cuff size, largest diameter of the tumor, presence of necrosis and surgical margin involvement. Descriptive statistics, multiple regression analysis, Kaplan-Meier survival curves and the log-rank test were performed. A significance level of 5% was used. RESULTS: The mean age was 48.27 years. The following were not important for the prognosis, in relation to survival analysis: degree of differentiation and tumor invasion depth; presence of lymphatic, blood and perineural invasions; distance to nearest margin; and vaginal cuff size. Tumor size (P < 0.036), presence of lymph node metastasis (P < 0.0004), necrosis (P < 0.05) and surgical margin involvement (P < 0.0015) presented impacts on survival. The overall survival with 98 months of follow-up was 88.35%. CONCLUSION: The most prevalent prognostic factors were the presence of lymph node metastasis, tumor size and surgical margin involvement.
Prevalence of high-grade squamous intraepithelial lesions and cervical cancer among patients with unsatisfactory colposcopic examination, without visible lesion
Authors: Veiga Fernanda Rangel da , Russomano Fábio Bastos , Camargo Maria José de , Monteiro Aparecida Cristina Sampaio , Tristão Aparecida , Silva Gabriela Villar e
Published: February 2017

CONTEXT AND OBJECTIVE: Cervical cancer is a serious public health problem in Brazil. For patients with unsatisfactory colposcopic examinations without visible lesions, but with cervical cytological tests suggesting high-grade squamous intraepithelial lesion (HSIL), the national recommendation is to repeat cervical cytological tests after three months. Our aim was to assess the prevalence of HSIL and cancer among patients with initial cervical cytological tests suggestive of HSIL but with unsatisfactory colposcopic examinations without visible lesions, in order to contribute towards the discussion regarding a more effective clinical approach that might diminish the likelihood of patient abandonment of follow-up before appropriate diagnosis and treatment. DESIGN AND SETTING: Cross-sectional study in Colposcopy Clinic of IFF/Fiocruz. METHOD: Patients admitted between December 1989 and April 2007 with cytological diagnoses of HSIL but with unsatisfactory colposcopic examinations without visible lesions underwent cervical cone biopsy. RESULTS: Sixty-five such patients were included, comprising 33.8% with HSIL and 4.6% with cancer, confirmed histologically. The other patients presented low-grade squamous intraepithelial lesion (26.1%), glandular dysplasia (1.5%) and absence of disease (33.8%). CONCLUSION: The observed prevalence of cancer and HSIL does not seem to be enough to justify immediate referral for cone biopsies to investigate the cervical canal in these cases. The findings suggest that the recommendation of repeated cytological tests following an initial one with HSIL, among patients with unsatisfactory colposcopic examinations without visible lesions, is appropriate in our setting. Efforts are needed to ensure adherence to follow-up protocols in order to reduce the chances of losses.
Diagnostic accuracy of sonography for pleural effusion: systematic review
Authors: Grimberg Alexandre , Shigueoka David Carlos , Atallah Álvaro Nagib , Ajzen Sergio , Iared Wagner
Published: February 2017

CONTEXT AND OBJECTIVE: The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. DESIGN AND SETTING: This was a systematic review with meta-analysis on accuracy studies. This study was conducted in the Department of Diagnostic Imaging and in the Brazilian Cochrane Center, Discipline of Emergency Medicine and Evidence-Based Medicine, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil. METHOD: The following databases were searched: Cochrane Library, Medline, Web of Science, Embase and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). The references of relevant studies were also screened for additional citations of interest. Studies in which the accuracy of sonography for detecting pleural effusion was tested, with an acceptable reference standard (computed tomography or thoracic drainage), were included. RESULTS: Four studies were included. All of them showed that sonography had high sensitivity, specificity and accuracy for detecting pleural effusions. The mean sensitivity was 93% (95% confidence interval, CI: 89% to 96%), and specificity was 96% (95% CI: 95% to 98%). CONCLUSIONS: In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.
Marfan's syndrome: an overview
Authors: Yuan Shi-Min , Jing Hua
Published: February 2017

Marfan's syndrome is an autosomal dominant condition with an estimated prevalence of one in 10,000 to 20,000 individuals. This rare hereditary connective tissue disorder affects many parts of the body. The diagnosis of Marfan's syndrome is established in accordance with a review of the diagnostic criteria, known as the Ghent nosology, through a comprehensive assessment largely based on a combination of major and minor clinical manifestations in various organ systems and the family history. Aortic root dilation and mitral valve prolapse are the main presentations among the cardiovascular malformations of Marfan's syndrome. The pathogenesis of Marfan's syndrome has not been fully elucidated. However, fibrillin-1 gene mutations are believed to exert a dominant negative effect. Therefore, Marfan's syndrome is termed a fibrillinopathy, along with other connective tissue disorders with subtle differences in clinical manifestations. The treatment may include prophylactic β-blockers and angiotensin II-receptor blockers in order to slow down the dilation of the ascending aorta, and prophylactic aortic surgery. Importantly, β-blocker therapy may reduce TGF-β activation, which has been recognized as a contributory factor in Marfan's syndrome. The present article aims to provide an overview of this rare hereditary disorder.
Health technology assessment in Brazil: what do healthcare system players think about it?
Authors: Ferraz Marcos Bosi , Soárez Patricia Coelho de , Zucchi Paola
Published: February 2017

CONTEXT AND OBJECTIVES: The health technology assessment (HTA) process has been developed locally. The aim of this study was to describe, analyze and compare the opinions of participants in international health economics symposia about the HTA process used in Brazil. DESIGN AND SETTING: Observational cross-sectional study at the 2006 and 2008 International Health Economics Symposia, in São Paulo. METHODS: A structured questionnaire was applied. For the statistical analysis, the percentage distribution for each category was calculated, and variables were compared using tests for two-sample proportion hypotheses. RESULTS: Totals of 153 and 74 participants answered the 2006 and 2008 surveys, respectively. The response rate was better for the 2006 survey (67.1%) than for the 2008 survey (31.8%). Most interviewees were between the ages of 30 and 49 years and were managers in the healthcare system. Most of them considered that the current HTA process was incomplete and unable to meet the needs of the healthcare system. They mentioned the government, academia and experts as the three main groups of people who should be involved in the process, and selected efficiency/effectiveness, safety and disease relevance as the three main criteria to be considered in the HTA process. There is a trend towards developing decentralized regionalized HTA processes, with separate assessment and decision-making for the public and private systems. CONCLUSIONS: The HTA concept is well known. Healthcare system players feel that the process has methodological limitations. Additional surveys are needed to track the HTA process and its application in Brazil.
Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial
Authors: Facci Ligia Maria , Nowotny Jean Paulus , Tormem Fabio , Trevisani Virgínia Fernandes Moça
Published: February 2017

CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. RESULTS: There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84% of the patients stopped using medications after the treatment; in group 2, 75%; and in group 3, 34%. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). CONCLUSION: There was no difference between TENS and interferential current for chronic low back pain treatment. CLINICAL TRIAL REGISTRATION: NCT01017913.
Cyclooxygenase-2 and human epidermal growth factor receptor type 2 (HER-2) expression simultaneously in invasive and in situ breast ductal carcinoma
Authors: Lucarelli Adrienne Pratti , Martins Maria Marta , Montor Wagner , Oliveira Vilmar , Galvão Maria Antonieta Longo , Piato Sebastião
Published: February 2017

CONTEXT AND OBJECTIVE: Cyclooxygenase-2 (COX-2) and human epidermal growth factor receptor type 2 (HER-2) are associated with tumorigenesis. Studies have shown that HER-2 can regulate COX-2 expression. The aim of this study was to evaluate the correlation between COX-2 and HER-2 expression in normal breast epithelium and in ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) present in the same breast. DESIGN AND SETTING: Cross-sectional study at the Mastology Unit of the Department of Gynecology and Obstetrics, Santa Casa de Misericórdia de São Paulo Hospital. METHODS: COX-2 and HER-2 were detected using immunohistochemistry on 100 tissue fragments. HER-2 > +2 was subjected to fluorescence in situ hybridization (FISH). RESULTS: COX-2 expression was detected in 87%, 85% and 75% of IDC, DCIS and normal epithelium, respectively. HER-2 expression was detected in 34% of IDC and 34% of DCIS. COX-2 in DCIS correlated with HER-2 in IDC (P = 0.049) and DCIS (P = 0.049). COX-2 in normal epithelium correlated with HER-2 in IDC (P = 0.046) and DCIS (P = 0.046). COX-2 in IDC was not associated with HER-2 (P = 0.235). Comparison between COX-2 and HER-2 in DCIS showed that there was a statistically significant difference with regard to nuclear grades II and III and presence of comedonecrosis (P < 0.001). In IDC, there was significant expression with nuclear grades II and III and histological grade II (P < 0.001). CONCLUSIONS: Our findings provide evidence that HER-2 and COX-2 regulate each other
Factors relating to failure to quit smoking: a prospective cohort study
Authors: Azevedo Renata Cruz Soares de , Fernandes Rejane Firmino
Published: February 2017

CONTEXT AND OBJECTIVE: Considering the difficulties in stopping smoking, this article aimed to identify factors relating to failure of attempts to quit smoking among smokers who sought care at an outpatient clinic in a general university hospital. DESIGN AND SETTING: Prospective cohort study evaluating 100 smokers who sought treatment at the Psychoactive Substances Outpatient Clinic. METHODS: The variables gathered were sociodemographic factors; degree of dependence (Fagerström questionnaire); stage of motivation for change (University of Rhode Island Change Assessment Scale); and presence of depression and anxiety (Hospital Anxiety and Depression Scale). The patients were followed up after 4, 8, 12 and 24 weeks to identify factors relating to failure to quit smoking. RESULTS: The patients were mostly women (75%), between 40 and 59 years of age (67%); with incomplete elementary education (60%); with leisure activities (57%); suffering from tobacco-related disease (53%); with previous attempts to quit smoking (70%); with a medical recommendation to stop (51%); with encouragement to stop (66%); and with a high degree of dependence (78%). The main motivational stage was contemplation/action (43%); the anxiety rate was 64% and the depression rate was 39%. The quitting rate was 66% among adherents and 17% among non-adherents (P < 0.001). Lack of success was correlated with absence of leisure, higher education and absence of tobacco-related disease. CONCLUSION: The variables of lack of leisure activities, higher education and/or lack of tobacco-related disease correlated with failure to quit smoking among smokers who sought treatment at an outpatient clinic in a tertiary general hospital.
Insulin stimulation of Akt/PKB phosphorylation in the placenta of preeclampsia patients
Authors: Ferreira Gustavo Dias , Orcy Rafael Bueno , Martins-Costa Sérgio Hofmeister , Ramos José Geraldo Lopes , Brum Ilma Simoni , Corleta Helena von Eye , Capp Edison
Published: February 2017

CONTEXT AND OBJECTIVE: Preeclampsia is a multi-systemic disease and one of the most frequent severe health problems during pregnancy. Binding of insulin triggers phosphorylation and activates cytoplasmic substrates such as phosphatidylinositol 3 kinase (PI3K). Phosphorylation of membrane phosphoinositide 2 (PIP2) to phosphoinositide 3 (PIP3) by PI3K starts Akt/PKB activation. Defects in phosphorylation of the insulin receptor and its substrates have an important role in insulin resistance. Studies have shown that insulin resistance is associated with preeclampsia and its pathophysiology. The aim here was to investigate insulin stimulation of the Akt/PKB pathway in the placenta, in normal and preeclampsia parturients. DESIGN AND SETTING: Cross-sectional study in a tertiary public university hospital. METHODS: Placentas were collected from 12 normal and 12 preeclampsia patients. These were stimulated and analyzed using Western blot to quantify the Akt/PKB phosphorylation. RESULTS: The insulin stimulation was confirmed through comparing the stimulated group (1.14 ± 0.10) with the non-stimulated group (0.91 ± 0.08; P < 0.001). The phosphorylation of Akt/PKB did not differ between the placenta of the normal patients (1.26 ± 0.16) and those of the preeclampsia patients (1.01 ± 0.11; P = 0.237). CONCLUSIONS: In vitro insulin stimulation of the human placenta has been well established. There was no difference in Akt/PKB phosphorylation, after stimulation with insulin, between placentas of normal and preeclampsia patients. Nevertheless, it cannot be ruled out that the Akt/PKB signaling pathway may have a role in the pathophysiology of preeclampsia, since the substrates of Akt/PKB still need to be investigated.
Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil
Authors: Noronha Elda Pereira , Marinho Heliana Trindade , Thomaz Erika Bárbara Abreu Fonseca , Silva Cintia Assunção , Veras Geni Lourdes Ramos , Oliveira Raimundo Antônio Gomes
Published: February 2017

CONTEXT AND OBJECTIVES: The incidence of acute leukemia (AL) subtypes varies according to geographical distribution. The aim here was to determine the incidence of morphological and immunophenotypic AL subtypes in the state of Maranhão, Brazil, and to correlate the expression of aberrant phenotypes in children with acute lymphoblastic leukemia (ALL) with prognostic factors. DESIGN AND SETTING: Single prospective cohort study at a public oncology reference center in Maranhão. METHODS: Seventy AL cases were diagnosed between September 2008 and January 2010. For the diagnosis, complete blood cell counts, myelograms (at diagnosis and at the end of the induction phase), cytochemical analysis and immunophenotyping were performed. RESULTS: Among adult patients (n = 22), the incidence of AL types was: ALL (22.7%) and acute myeloid leukemia (AML) (77.3%). The subtype AML M0 occurred most frequently (29.4%). In children (n = 48), the types were: AML (18.7%), most frequently subtype AML M4 (33.4%); biphenotypic acute leukemia (BAL) (4.2%); and ALL (77.1%), including the subtypes B-ALL (72.9%) and T-ALL (27.1%). Among the children with ALL, there were no statistically significant differences between patients with and without aberrant phenotypes, in relation to hematological parameters and treatment response. CONCLUSION: This work demonstrates that the frequencies of AML M0 cases among adults and T-ALL cases among children in Maranhão were high. This suggests that there may be differences in AML subtype incidence, as seen with ALL subtypes, in different regions of Brazil. No association was found between the expression of aberrant phenotypes and prognostic factors, in children with ALL.
Analysis of CD83 antigen expression in human breast fibroadenoma and adjacent tissue
Authors: Borges Marcus Nascimento , Facina Gil , Silva Ismael Dale Cotrin Guerreiro , Waitzberg Angela Flávia Logullo , Nazario Afonso Celso Pinto
Published: February 2017

CONTEXT AND OBJECTIVE: Dendritic cell maturation is considered essential for starting an immune response. The CD83 antigen is an important marker of dendritic cell maturation. The objectives here were to analyze CD83 antigen expression in human breast fibroadenoma and breast tissue adjacent to the lesion and to identify clinical factors that might influence this expression. DESIGN AND SETTING: This was a retrospective study at a public university hospital, in which 29 histopathological samples of breast fibroadenoma and adjacent breast tissue, from 28 women of reproductive age, were analyzed. METHODS: The immunohistochemistry method was used to analyze the cell expression of the antigen. The antigen expression in the cells was evaluated by means of random manual counting using an optical microscope. RESULTS: Positive expression of the CD83 antigen in the epithelial cells of the fibroadenoma (365.52; standard deviation ± 133.13) in relation to the adjacent breast tissue cells (189.59; standard deviation ± 140.75) was statistically larger (P < 0.001). Several clinical features were analyzed, but only parity was shown to influence CD83 antigen expression in the adjacent breast tissue, such that positive expression was more evident in nulliparous women (P = 0.042). CONCLUSIONS: The expression of the CD83 antigen in the fibroadenoma was positive and greater than in the adjacent breast tissue. Positive expression of the antigen in the adjacent breast tissue was influenced by parity, and was significantly more evident in nulliparous women.
Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo
Authors: Del Ciampo Luiz Antonio , Ferraz Ivan Savioli , Tazima Maria , Bachette Letícia Graziela , Ishikawa Karla , Paixão Rodrigo
Published: February 2017

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.
Poder y violencia sobre el cuerpo de las mujeres
Authors: Femenías María Luisa , Rossi Paula Soza
Published: February 2017

Numerosos informes dan cuenta del aumento de la violencia contra las mujeres. ¿Cuál es su causa? En este artículo nos proponemos examinar algunas variables que la potencian y contribuir a su mejor comprensión en una línea ya iniciada por otras estudiosas como Amorós y Segato. Examinamos cómo reaccionan ciertos varones ante la desilusión que ocasiona la pérdida de sus privilegios entendidos como naturales y la ficción de que sus goces y prebendas se ven menguados ante las mujeres que poco a poco abandonan el polo tradicional de la pasividad. La idea de "cuerpos ejemplificadores", es decir de cuerpos disciplinados violentamente, guía nuestro análisis en el sentido de que se trata del guión de un mensaje claro, público y a la vez cifrado, inscripto en el cuerpo de las mujeres y potenciado por la crisis actual de la globalización.
A dinâmica de classe do desenvolvimento agrário na era da globalização
Authors: Bernstein Henry
Published: February 2017

Este artigo examina, primeiro, a transformação da lavoura para a agricultura, como resultado do advento do capitalismo industrial, e de sua posição dominante na escala mundial desde o século XIX; e uma segunda mudança, a partir da década de 1970, ocasionada pelo advento e pelos rumos da globalização contemporânea. O artigo, então, passa a defender que o debate sobre a (derradeira?) 'morte do campesinato', na era da globalização, é equivocado e anacrônico, e que a teoria de que 'os pequenos agricultores' são pequenos produtores de mercadorias - inseridos no capitalismo e, portanto, sujeitos a suas tendências de diferenciação de classe - oferece uma abordagem mais aceitável para as questões agrárias de hoje.
Olhares sociológicos sobre a ciência no século vinte: mudanças e continuidades
Authors: Fetz Marcelo , Defacci Fabrício Antônio , Nascimento Lerisson
Published: February 2017

O artigo examina, em dois momentos distintos, as principais abordagens sociológicas sobre a ciência no século vinte: a Sociologia do Conhecimento, a Sociologia da Ciência e a Sociologia do Conhecimento Científico. No primeiro tópico são recapitulados os argumentos sociológicos de Karl Mannheim e de Robert King Merton. Defende-se a interpretação de que a obra de Mannheim seja reconhecida enquanto pressuposto epistemológico para o desenvolvimento da Sociologia da Ciência de Merton. Adaptada por Merton, a metateoria sociológica de Mannheim surge através de uma abordagem estrutural funcionalista associada a uma teoria de médio alcance. No segundo momento, são retomados os argumentos de Thomas Kuhn para, logo após, ser analisada a Sociologia do Conhecimento Científico enquanto apreciação construtiva da tradição de pensamento mertoniana. O estudo dos princípios lógicos da Sociologia do Conhecimento Científico de David Bloor e a investigação acerca da tradição de pensamento iniciada na Universidade de Edimburgo, na Escócia, foram o foco elementar dessa etapa do artigo. Finalmente, as principais características de cada uma das tradições são ressaltadas, buscando-se por mudanças e continuidades que viabilizaram o desenvolvimento da abordagem sociológica sobre a atividade científica desde sua gênese clássica até os estudos contemporâneos.
Sartre e o humanismo racista europeu: uma leitura sartriana de Frantz Fanon
Authors: Arantes Marco Antonio
Published: February 2017

Centrado no livro de Sartre, "Colonialismo e Neocolonialismo - Situações V", e no seu prefácio escrito para o livro Les Dammés de La Terre, de Frantz Fanon, o presente artigo propõe percorrer algumas considerações sartrianas a respeito de Fanon e o colonialismo francês na Argélia, tendo como pano de fundo a complexidade das relações sociais em países colonizados. Como representantes do pensamento anticolonial e críticos das alienações geradas pelo colonialismo, Sartre e Fanon elaboraram críticas radicais sobre as estratégias de violência, subordinação e desumanização que atingiram o colonizado africano, instigados pela reconstrução social com o uso da violência, buscando-se assim um novo homem em sua verdadeira humanidade.
Movimentos sociais e eleições: por uma compreensão mais ampla do contexto político da contestação
Authors: Mcadam Doug , Tarrow Sidney
Published: February 2017

Por que duas literaturas cognatas - estudos eleitorais e de movimentos sociais - seguem trajetórias paralelas e pouco dialogam? E o que se pode fazer para conectá-las no futuro? Partindo de seu trabalho com Charles Tilly sobre as dinâmicas do confronto (Dynamics of Contention, 2001), Dough McAdam e Sydney Tarrow analisam as conexões entre movimentos sociais e eleições, propõem um conjunto articulado de vínculos entre eleições e movimentos sociais e aplicam sua abordagem a um exame preliminar das relações entre eleições, movimentos e políticas de confronto racial nos Estados Unidos.
Movimentos sociais na teoria e na prática: como estudar o ativismo através da fronteira entre estado e sociedade?
Authors: Abers Rebecca , Bülow Marisa Uon
Published: February 2017

Nas últimas duas décadas, os estudiosos dos movimentos sociais passaram a questionar as fronteiras do seu campo de pesquisa. Alguns defenderam a substituição do conceito de "movimentos sociais" por "sociedade civil", enquanto outros propuseram falar de "política do conflito". Em ambos os casos, argumentou-se que o campo de estudos havia se tornado excessivamente limitado, tanto empírica como teoricamente. O artigo discute essas iniciativas e identifica um problema comum: a falta de atenção dada às numerosas formas de interação entre ativistas de movimentos sociais situados dentro e fora do Estado. Argumentamos que a pesquisa empírica que vem sendo realizada no Brasil ajuda a compreender melhor a relação entre Estado e movimentos sociais. Do ponto de vista teórico, é a literatura recente sobre redes sociais que oferece pistas analíticas sobre como pensar no ativismo a partir de dentro das estruturas do Estado.
Associativismo avant la lettre: as sociedades pela abolição da escravidão no Brasil oitocentista
Authors: Alonso Angela
Published: February 2017

O artigo contesta a tese da tibieza da vida associativa no Brasil oitocentista, tomando como caso as associações formadas em protesto contra a escravidão no Brasil na segunda metade do século XIX. Contra a tese do insolidarismo, o levantamento do número de associações antiescravistas criadas e da heterogeneidade social de seus participantes denota a exuberância do associativismo no Brasil imperial. Adicionalmente, o artigo argumenta que as inflexões de crescimento e declínio do associativismo abolicionista se explicam por variações nas "oportunidades políticas" (Tarrow, 1998).
Inventário da sociologia do engajamento militante: Nota crítica sobre algumas tendências recentes dos trabalhos franceses
Authors: Sawicki Frédéric , Siméant Johanna
Published: February 2017

Este artigo apresenta um levantamento crítico de um campo de pesquisa particularmente ativo na França, nos últimos vinte anos, a sociologia do engajamento militante. Ele retraça a renovação dessa corrente sociológica expressa pela instauração do paradigma interacionista, que se interessa pela dimensão processual do engajamento e das carreiras militantes, e também o modo como a noção de retribuições da militância foi aprimorada e repensada. Após um panorama dos debates teóricos relativos ao surgimento, ou não, de "novas formas" de militância, até mesmo de "novos militantes", o artigo destaca dois desafios atuais da pesquisa, ambos relativos à questão da divisão social do trabalho: examinar mais atentamente o vínculo entre transformações macrossociais e engajamento, e a composição organizacional da militância.
Barroco em contexto
Authors: Cusick Suzanne , Carpena Lucia Becker
Published: February 2017

Quem produziu música durante o longo período histórico que hoje chamamos "Barroco"? Quem a escutou? Como a prática musical teria articulado relações de poder, tanto dentro das culturas européias nas quais as estéticas barrocas nasceram quanto nas terras americanas que estas mesmas culturas colonizaram? Por que, no século XXI, poderíamos continuar a achar esta música interessante e bonita? Por que uma compreensão maior do Barroco pode ser útil nos dias de hoje? Este ensaio abordará estas questões preliminarmente situando a música barroca em relação aos sistemas emergentes de representação, trocas econômicas, poder político e produção artística que caracterizaram a longa transição das crises epistemológicas do final do século XVI da cultura européia, que se interligava com a resolução destas crises nos paradigmas da modernidade iluminista do século XVIII.
A ordem Carmelita
Authors: Campos Adalgisa Arantes
Published: February 2017

O presente estudo enfoca a origem lendária da Ordem Mendicante Carmelita, que remonta ao Antigo Testamento; sua fundação histórica no século XIII, que está profundamente relacionada às experiências maravilhosas (meraviglia), bem como ao seu percurso e expansão devocional, percebida a partir da ampliação no número de espaços conventuais e de associações de leigos pertencentes à mesma. Daremos especial atenção ao culto carmelita nas Minas Gerais, onde conventos não puderam ser estabelecidos, mas que conta com a presença de monumentos arquitetônicos de grande relevância histórica, religiosa e artística.
Hipertexto e complexidade
Authors: Paiva Vera Lúcia Menezes de Oliveira e , Nascimento Milton do
Published: February 2017

O texto propõe que o hipertexto deve ser visto conceitualmente como um mecanismo cognitivo e também enunciativo. Ted Nelson desenvolveu o mecanismo digital, inspirado em sua própria experiência de escritor, possibilitando que os escritores nesse meio se livrassem da linearidade imposta pela tecnologia do papel. O hipertexto, neste artigo, é discutido à luz da teoria da complexidade, em um diálogo com a teoria da enunciação de Benveniste e a teoria da integração conceitual como foi proposta por Fauconnier e Turner (2002). Defende-se a idéia de que, considerando-se a linguagem como um sistema adaptativo complexo (SAC), a hipertextualidade seja compreendida como uma instanciação do princípio da recursão, visto como uma propriedade básica dos SACs. Exemplos de diferentes tipos de textos (incluindo imagens e sons) são fornecidos para mostrar como a hipertextualidade funciona no processamento textual.
Textos e hipertextos: procurando o equilíbrio
Authors: Coscarelli Carla Viana
Published: February 2017

Neste texto discuto a questão "até que ponto precisamos tratar o hipertexto de forma diferente do texto no que diz respeito aos fatores de textualidade". Defendo que todo texto é um hipertexto e que toda leitura é um processo hipertextual. Acredito que se o texto estiver bem escrito, ou seja, estiver adequado ao leitor, e o leitor for bom, a leitura irá gerar resultados satisfatórios. Textos mal escritos e leitores pouco hábeis vão gerar um resultado muito ruim independente do formato de apresentação do texto (impresso ou hipertextual). Precisamos, portanto, ensinar nossos alunos a lidar com textos variados, de gêneros diversificados, em todos os ambientes, inclusive o digital. Apresento um levantamento dos elementos dos ambientes digitais que aparecem em livros didáticos de Língua Portuguesa, a fim de verificar como esses materiais contribuem para o letramento digital dos alunos.
O desenvolvimento de uma metaconsciência, no professor, acerca da importância de vivenciar a linguagem como prática social na sala de aula de língua inglesa por meio da pesquisa colaborativa
Authors: Ticks Luciane Kirchhof
Published: February 2017

Neste artigo, discutimos o processo reflexivo vivenciado por duas professoras de inglês ao problematizarem suas ações em sala de aula. Destacamos particularmente o processo de reconfiguração de suas atividades pedagógicas que inicialmente focalizam estruturas lexicogramaticais isoladas e, no decorrer do processo reflexivo, são reconfiguradas em direção ao uso de gêneros textuais e à (des)construção dos contextos de situação e cultura nos quais esses textos são socialmente produzidos e vivenciados (MOTTA-ROTH, 2006). Essas reflexões foram desenvolvidas por meio de um processo de pesquisa colaborativo (MAGALHÃES, 2004). A análise do discurso dessas professoras indica que o processo reflexivo lhes permitiu desenvolver uma metaconsciência acerca de como a linguagem se organiza e se constitui ao mediar a atividade social.