Genomic signatures in breast cancer in a real-world setting: Experience in a Brazilian Northeastern Center.

OBJECTIVE: We aim to evaluate the indication and use of genomic signatures in breast cancer patients and outcomes who in patients undergoing adjuvant chemotherapy or not. METHODS: This is a retrospective study of breast cancer patients managed in a private oncology clinic in Teresina, from November 2014 to February 2021. All patients with an indication of genomic signature were included. Clinical and pathological variables, use of genomic signatures, treatment and follow-up were obtained. The nomogram to predict Oncotype DX results (University of Tennessee Medical Center) was also calculated. Clinical risk calculation was based on MINDACT, using the modified version of Adjuvant Online. The genetic signatures performed were: the Oncotype, MammaPrint and EndoPredict. RESULTS: Fifty (50) female patients were included in the study. The mean age of the participants was 57.1 years. Among the patients receiving a genomic signature (26-52.0%), there was a change in treatment in 8 (30.7%) cases. Chemotherapy was indicated in four patients, It was contraindicated in another four patients. Treatment changed in 30.7% of the tested patients. Chemotherapy was indicated for those who would not receive it before. It was contraindicated in patients who would previously undergo chemotherapy.

Granulosa cell tumor of the ovary: a series of 6 cases.

Granulosa cell tumor (GCT) is a rare ovarian malignancy that represents only 2-3% of all cases. There are two subtypes of GCT: juvenile/JGCT (5% of cases) and adult/AGCT (95% of cases). This study aimed to describe a series of 6 GCT cases. The 6 study patients were managed from June 2011 to November 2022 in a private oncology clinic located in Teresina (PI), Brazil. At diagnosis, the mean patient age was 47 years, and symptoms in 5 patients (83%) were pelvic pain and/or increased abdominal volume. The majority of the patients (N=4/67%) had no comorbidities or findings related to GCT on physical examination. The mean tumor size was 11 cm. Five (83%) tumors were stage Ia and one tumor (17%) was stage III. Regarding tumor subtype, 5 (83%) were AGCT and 1 (17%) was JGCT. Surgical treatment consisted of unilateral salpingo-ophorectomy in 2 patients (33%), total hysterectomy and bilateral salpingo-ophorectomy in 3 patients (50%), and cytoreduction (suboptimal) in 1 patient (17%). After a mean follow-up period of 62.7 months, 5 patients (83%) are still alive and free of disease. One (17%) died from disease progression after 126 months. In the current study, disease-free overall survival was 83%, in a mean follow-up period of 62.7 months.

Disease Progression and Death From Cervical Melanoma in a Patient Undergoing Nivolumab Therapy: A Case Report.

Melanoma of the uterine cervix is an exceedingly rare malignancy that has high recurrence rates and distant metastases. In general, surgery is the preferred treatment for this tumor, and depending on stage additional consideration to radiotherapy and chemotherapy. Immunotherapy has emerged as a new treatment option in this context. The aim of this study was to report a case of melanoma of the uterine cervix that progressed rapidly to death while the patient was undergoing immunotherapy with nivolumab. A 39-year-old woman presented with an amelanotic ulcerated lesion of the uterine cervix in February of 2023. Histopathology study demonstrated melanoma of the uterine cervix. Treatment was initiated with surgery. Two months after cancer diagnosis, the tumor board decided to initiate adjuvant treatment with nivolumab. After four cycles of immunotherapy, progression of the disease occurred with death of the patient within six months of follow-up. The rare case presented illustrates the aggressive natural history of the tumor and possible use of immunotherapy in this context, despite current evidence that response to nivolumab is less effective in cervical melanoma than in skin melanoma.

Optimizing the Vanillin-Acid Sulfuric Method to Total Saponin Content in Leaves of Yerba Mate Clones.

Yerba mate (Ilex paraguariensis) is a forest species consumed in the form of non-alcoholic beverages in South America, with applications in foods, cosmetics, and pharmaceutical industries. The species leaves are globally recognized for their important bioactive compounds, including, saponins. We adjusted the vanillin-acid sulfuric method for determining spectrophotometrically the total saponin in yerba mate leaves. Seeking to maximize the extraction of saponins from leaves, a Doehlert design combined with Response Surface Methodology (RSM) was used, considering ethanol:water ratios and ultrasound times. In addition, the same methodology was used for the analysis of times and temperatures in the vanillin-sulfuric acid reaction heating. The contents of total saponin in mature leaves were compared in four yerba mate clones. The extraction was maximized using 40 % ethanol:60 % water and 60 minutes of ultrasound assisted extraction (UAE) without heating. For the reaction conditions, 70 °C for 10 minutes heating is recommended, and UV/Vis reading from 460 to 680 nm. Using the optimized methodology, total saponin contents ranged from 28.43 to 53.09 mg g-1 in the four yerba mate clones. The significant difference in saponin contents between clones indicate great genetic diversity and potential for clones' selection and extraction of these compounds from yerba mate leaves.

Pulmonary Benign Metastasizing Leiomyoma: Case Report of Late Occurrence in Postmenopausal Patient / Leiomiomatose Benigna Metastatizante Pulmonar: Relato de um Caso com Ocorrência Tardia em Paciente Pós-menopausa / Leiomiomatosis Benigna Metastatizante Pulmonar: Reporte de un Caso con Ocurrencia Tardía en Paciente Posmenopáusica

Introduction: Pulmonary benign metastasizing leiomyoma (PBML) is a rare condition that occurs most commonly in young women of reproductive age some years after hysterectomy. The aim of this study was to report a PBML case which occurred 33 years after hysterectomy in a postmenopausal patient. Case report: A 59-year-old female diabetic patient, G2P2A0, with dyslipidemia, a non-smoker and ex-alcoholic (quit in the 90s), with pulmonary symptoms was referred to the health service. A chest computed tomography (CT) revealed multiple pulmonary nodules. A previous history of hysterectomy at 26 years of age led to a diagnostic hypothesis of PBML. The patient underwent segmentectomy of the largest nodule (measuring 1.2 x 0.9 cm) located in the left lung. Histopathology and immunohistochemistry studies confirmed the diagnosis of PBML. Conclusion: The patient is currently in good physical condition (regression of previous pulmonary symptoms) and scheduled for clinical follow-up. A new chest CT will be performed in 6 months

Introdução: A leiomiomatose benigna metastatizante pulmonar (LBMP) é uma doença rara, ocorrendo mais comumente em mulheres jovens em idade reprodutiva alguns anos após a realização de histerectomia. O objetivo deste estudo foi relatar um caso de LBMP de ocorrência tardia, 33 anos após a realização de histerectomia, em uma paciente pós-menopausa. Relato do caso: Paciente do gênero feminino, 59 anos, G2P2A0, diabética, dislipidêmica, não tabagista e ex-etilista (parou na década de 1990), foi encaminhada ao serviço médico com sintomas pulmonares, sendo realizada tomografia computadorizada (TC) de tórax que revelou múltiplos nódulos pulmonares. Havia história prévia de histerectomia aos 26 anos de idade, sendo levantada a hipótese diagnóstica de LBMP. Paciente realizou segmentectomia do maior nódulo (medindo 1,2 x 0,9 cm) localizado no pulmão esquerdo. Exame anatomopatológico e imuno-histoquímica confirmaram o diagnóstico de LBMP. Conclusão: Atualmente, a paciente se encontra em seguimento clínico e em bom estado geral (sem os sintomas pulmonares apresentados inicialmente). Será realizada uma nova TC de tórax em seis meses

Introducción: La leiomiomatosis benigna metastatizante pulmonar (LBMP) es una enfermedad rara, que ocurre con mayor frecuencia en mujeres jóvenes en edad reproductiva pocos años después de la histerectomía. El objetivo de este estudio fue reportar un caso de LBMP de inicio tardío, 33 años después de la histerectomía, en una paciente posmenopáusica. Reporte del caso: Paciente de género femenino, 59 años, G2P2A0, diabética, dislipidémica, no fumadora y exalcohólica (parado en los 90), fue remitida al servicio por cuadro pulmonar, siendo sometida a tomografía computarizada (TC) de tórax, que reveló múltiples nódulos pulmonares. Existía antecedente de histerectomía a los 26 años, planteando la hipótesis diagnóstica de LBMP. Paciente fue sometida a segmentectomía del nódulo de mayor tamaño (de 1,2 x 0,9 cm) localizado en el pulmón izquierdo. El examen patológico y la inmunohistoquímica confirmaron el diagnóstico de LBMP. Conclusión: Actualmente la paciente se encuentra en seguimiento clínico y en buen estado general (sin los síntomas pulmonares presentados inicialmente). Se realizará una nueva TC de tórax en seis meses

Cutaneous metastasis of occult breast cancer: a case report.

Occult breast cancer (OBC) is characterized by metastatic presentation of undetectable breast tumor on imaging exams. OBC is a rare disease (accounting for 0.3% to 1.0% of all breast cancers) that represents a major diagnostic challenge. The aim of this study was to report a case of OBC with primary presentation of multiple cutaneous metastases with subsequent emergence of bone metastasis. A 70-year female patient had multiple cutaneous metastatic lesions in the left cervical region, left breast, left axillary region, left subscapular region, in three chirodactylus of the right hand and three chirodactylus of the left hand. Imaging tests (mammogram, ultrasonography and magnetic resonance imaging of the breast) did not show alterations. Biopsy, histology sections and immunohistochemistry of the left cervical cutaneous lesion were compatible with OBC. After two years of anastrozole treatment (1mg/day), there was regression of all cutaneous lesions and stabilization of bone metastasis. OBC has a better prognosis. It may exhibit spontaneous regression or respond to less aggressive treatment strategies, as described in this case.

Locally advanced lymphoepithelial carcinoma of the larynx/hypopharynx: A case report.

Lymphoepithelial carcinoma (LEC) is an uncommon, aggressive cancer that affects mainly the nasopharynx (a form that is closely related to the Epstein-Barr virus). LEC of the larynx/hypopharynx is extremely rare, accounting for only 0.2% of malignant tumors of the larynx. This study describes a case of locally advanced LEC of the larynx/hypopharynx with effective response to chemoradiation (an option that spares the patient from the risks of surgical resection). A 60-year-old sedentary, hypertensive male patient with a previous history of smoking and alcohol abuse received a histopathological diagnosis of locally advanced LEC of the larynx/hypopharynx in May 2018. He underwent treatment with chemoradiation and exhibited a complete clinical response. At about 3 years of follow-up, the patient is currently alive, free from disease and has not presented any tumor recurrences.

Pharmacological Effects and Toxicogenetic Impacts of Omeprazole: Genomic Instability and Cancer.

Omeprazole (OME) is commonly used to treat gastrointestinal disorders. However, long-term use of OME can increase the risk of gastric cancer. We aimed to characterize the pharmacological effects of OME and to correlate its adverse effects and toxicogenetic risks to the genomic instability mechanisms and cancer-based on database reports. Thus, a search (till Aug 2019) was made in the PubMed, Scopus, and ScienceDirect with relevant keywords. Based on the study objective, we included 80 clinical reports, forty-six in vitro, and 76 in vivo studies. While controversial, the findings suggest that long-term use of OME (5 to 40 mg/kg) can induce genomic instability. On the other hand, OME-mediated protective effects are well reported and related to proton pump blockade and anti-inflammatory activity through an increase in gastric flow, anti-inflammatory markers (COX-2 and interleukins) and antiapoptotic markers (caspases and BCL-2), glycoprotein expression, and neutrophil infiltration reduction. The reported adverse and toxic effects, especially in clinical studies, were atrophic gastritis, cobalamin deficiencies, homeostasis disorders, polyp development, hepatotoxicity, cytotoxicity, and genotoxicity. This study highlights that OME may induce genomic instability and increase the risk of certain types of cancer. Therefore, adequate precautions should be taken, especially in its long-term therapeutic strategies and self-medication practices.

First report of the production of a potent biosurfactant with α,ß-trehalose by Fusarium fujikuroi under optimized conditions of submerged fermentation.

Biosurfactants have many advantages over synthetic surfactants but have higher production costs. Identifying microorganisms with high production capacities for these molecules and optimizing their growth conditions can reduce cost. The present work aimed to isolate and identify a fungus with high biosurfactant production capacity, optimize its growth conditions in a low cost culture medium, and characterize the chemical structure of the biosurfactant molecule. The fungal strain UFSM-BAS-01 was isolated from soil contaminated with hydrocarbons and identified as Fusarium fujikuroi. To optimize biosurfactant production, a Plackett-Burman design and a central composite rotational design were used. The variables evaluated were pH, incubation period, temperature, agitation and amount of inoculum in a liquid medium containing glucose. The partial structure of the biosurfactant molecule was identified by nuclear magnetic resonance spectrometry. F. fujikuroi reduced surface tension from 72 to 20mNm-1 under the optimized conditions of pH 5.0, 37°C and 7 days of incubation with 190rpm agitation. The partial identification of the structure of the biosurfactant demonstrated the presence of an α,ß-trehalose. The present study is the first report of the biosynthesis of this compound by F. fujikuroi, suggesting that the biosurfactant produced belongs to the class of trehalolipids.

Interações Medicamentosas na Farmacoterapia de Idosos com Câncer atendidos em um Ambulatório de Onco-Hematologia / Drug Interactions in Elderly Cancer Patients Treated at a Hematology-Oncology Outpatient Clinic / Interacciones Farmacológicas en la Farmacoterapia de Adultos Mayores con Cáncer Atendidos en un Ambulatorio de Onco-Hematología

Introdução: Mais de 50% dos diagnósticos de câncer ocorrem na população idosa. Esse grupo etário possui outros problemas de saúde concomitantes à neoplasia que aumentam o risco de polifarmácia e interações medicamentosas. Objetivo: Identificar a frequência das interações medicamentosas potenciais e analisar os fatores associados na farmacoterapia de idosos com câncer. Método: Estudo transversal realizado em um ambulatório de onco-hematologia de um hospital de ensino. Foram entrevistados 160 idosos submetidos à terapia antineoplásica parenteral. Registraram-se informações sobre farmacoterapia, diagnóstico da neoplasia, outros problemas de saúde e funcionalidade. A funcionalidade foi determinada usando o Vulnerable Elders Survey. As informações clínicas foram coletadas em prontuário. Identificaram-se interações medicamentosas potenciais empregando o software Drug Interaction Checking. A regressão logística foi utilizada para determinar os fatores associados às interações medicamentosas potenciais. Resultados: Noventa e sete (60,6%) idosos apresentaram pelo menos uma interação medicamentosa e 42 (26,3%), interação envolvendo um medicamento antineoplásico. Ciclofosfamida e fluouracila foram os mais envolvidos em interações. O mecanismo farmacodinâmico foi responsável por 52,5% das interações. Identificou-se que 51% das interações foram classificadas como graves. A regressão logística mostrou que interações medicamentosas estiveram associadas de forma independente com número de medicamentos [OR=1,51; IC95% (1,277-1,78), p

Introduction: More than 50% of all cancer diagnoses occur in the elderly population. This age group has other health problems concomitant with neoplasia, a scenario that increases the likelihood of polypharmacy and the risk of drug interactions. Purpose: To identify the frequency of and factors associated with drug interactions in the pharmacological treatment of elderly cancer patients. Method: This was a cross-sectional study conducted at the hematology-oncology outpatient clinic of a university hospital. We interviewed 160 elderly patients receiving intravenous antineoplastic therapy, collecting information about antineoplastic and other pharmacotherapy, the diagnosis of neoplasia, other health problems, and functionality. Functionality was assessed with the Vulnerable Elders Survey. Clinical data were collected from the patient charts. To identify potential drug interactions, we used drug interaction checking software. Logistic regression was used in order to identify factors associated with drug interactions. Results: Of the 160 elderly patients interviewed, 97 (60.6%) presented at least one drug interaction and 42 (26.3%) presented at least one interaction with an antineoplastic drug. Cyclophosphamide and fluorouracil were the drugs most often involved in interactions. Of the interactions, 52.5% were attributable to a pharmacodynamic mechanism of action and 51.0% were classified as severe. Logistic regression showed that drug interactions were independently associated with the number of drugs taken (OR=1.51, 95% CI: 1.277-1.78, p<0.0001) and with the number of health problems (OR=1.39, 95% CI: 1.030-1.880, p=0.031). Conclusion: The frequency of drug interactions in elderly cancer patients receiving intravenous antineoplastic therapy is high, and severe interactions account for approximately half of all such interactions. The number of health problems and the number of drugs taken appear to be positively associated with drug interactions

Introducción: Más del 50% de los diagnósticos de cáncer ocurren en la población anciana. Este grupo de edad posee otros problemas de salud concomitantes a la neoplasia que aumenta el riesgo de polifarmacia e interacciones medicamentosas. Objetivo: Identificar la frecuencia y los factores asociados con interacciones farmacológicas potenciales en la farmacoterapia de adultos mayores con cáncer. Método: Estudio transversal realizado en un ambulatorio de onco-hematología de un hospital universitario. Se entrevistó a 160 adultos mayores sometidos a la terapia antineoplásica parenteral. Se registró informaciones acerca de la farmacoterapia antineoplásica y no antineoplásica, diagnóstico de la neoplasia, otros problemas de salud y funcionalidad. La información clínica fue recolectada en los registros de los pacientes. La funcionalidad se determinó utilizando el Vulnerable Elders Survey. Se identificaron las interacciones medicamentosas potenciales empleando el programa Drug Interaction Checking y se utilizó la regresión logística para determinar los factores asociados a las interacciones farmacológicas. Resultados: Un total de 97 (60,6%) de los ancianos presentó al menos una interacción farmacológica y 42 (26,3%) presentaron interacción envolviendo un medicamento antineoplásico. Los antineoplásicos ciclofosfamida y fluouracilo fueron los más implicados en las interacciones. El mecanismo farmacodinámico fue responsable por 52,5% de las interacciones. Se identificó que 51% de las interacciones fueron clasificadas como graves. La regresión logística mostró que las interacciones medicamentosas se asociaron de forma independiente con el número de medicamentos [OR=1,51; IC95% (1,277- 1,78), p<0,0001) y el número de problemas de salud [OR=1,39; IC95% (1,030- 1,880), p=0,031]. Conclusiones: La frecuencia de interacciones farmacológicas potenciales en ancianos con cáncer sometidos a terapia antineoplásica parenteral fue elevada aunque la proporción de interacciones graves corresponde a aproximadamente la mitad del total de interacciones. El número de problemas de salud y el número de medicamentos presentaron una asociación positiva con las interacciones farmacológicas.

First report of the production of a potent biosurfactant with ,-trehalose by Fusarium fujikuroi under optimized conditions of submerged fermentation

Abstract Biosurfactants have many advantages over synthetic surfactants but have higher production costs. Identifying microorganisms with high production capacities for these molecules and optimizing their growth conditions can reduce cost. The present work aimed to isolate and identify a fungus with high biosurfactant production capacity, optimize its growth conditions in a low cost culture medium, and characterize the chemical structure of the biosurfactant molecule. The fungal strain UFSM-BAS-01 was isolated from soil contaminated with hydrocarbons and identified as Fusarium fujikuroi. To optimize biosurfactant production, a PlackettBurman design and a central composite rotational design were used. The variables evaluated were pH, incubation period, temperature, agitation and amount of inoculum in a liquid medium containing glucose. The partial structure of the biosurfactant molecule was identified by nuclear magnetic resonance spectrometry. F. fujikuroi reduced surface tension from 72 to 20 mN m1 under the optimized conditions of pH 5.0, 37 °C and 7 days of incubation with 190 rpm agitation. The partial identification of the structure of the biosurfactant demonstrated the presence of an ,-trehalose. The present study is the first report of the biosynthesis of this compound by F. fujikuroi, suggesting that the biosurfactant produced belongs to the class of trehalolipids.

First report of the production of a potent biosurfactant with α, ß-trehalose by Fusarium fujikuroi under optimized conditions of submerged fermentation

Abstract Biosurfactants have many advantages over synthetic surfactants but have higher production costs. Identifying microorganisms with high production capacities for these molecules and optimizing their growth conditions can reduce cost. The present work aimed to isolate and identify a fungus with high biosurfactant production capacity, optimize its growth conditions in a low cost culture medium, and characterize the chemical structure of the biosurfactant molecule. The fungal strain UFSM-BAS-01 was isolated from soil contaminated with hydrocarbons and identified as Fusarium fujikuroi. To optimize biosurfactant production, a Plackett-Burman design and a central composite rotational design were used. The variables evaluated were pH, incubation period, temperature, agitation and amount of inoculum in a liquid medium containing glucose. The partial structure of the biosurfactant molecule was identified by nuclear magnetic resonance spectrometry. F. fujikuroi reduced surface tension from 72 to 20 mN m−1 under the optimized conditions of pH 5.0, 37 °C and 7 days of incubation with 190 rpm agitation. The partial identification of the structure of the biosurfactant demonstrated the presence of an α,β-trehalose. The present study is the first report of the biosynthesis of this compound by F. fujikuroi, suggesting that the biosurfactant produced belongs to the class of trehalolipids.

Factors associated with the use of potentially inappropriate medications by older adults with cancer.

OBJECTIVES: To determine the frequency and the factors associated with the use of potentially inappropriate medications (PIMs) by older adults with cancer at an onco-haematology ambulatory clinic of a teaching hospital in Brazil. MATERIAL AND METHODS: Patients aged 60years or older (n=160) subjected to parenteral antineoplastic chemotherapy from May to December 2015 and treated with one or more medications in the ambulatory clinic were interviewed. Data on medications, comorbidities, oncological diagnosis, and functional status were recorded. Functionality was determined using the Vulnerable Elders Survey (VES-13). PIMs were determined using the 2015 Beers Criteria. Logistic regression was used to determine the factors associated with the use of PIMs. RESULTS: A total of 78 (48.1%) older adults used at least one PIM. The PIMs to be avoided by older adults were proton pump inhibitors (33.3%), antiemetics (10.5%), long-acting benzodiazepines (10.5%), and antidepressants (7.6%). Multivariate analysis indicated that PIMs were associated with the use of five or more medications (odds ratio, 3.14; 95% confidence interval, 1.4-6.6), after adjusting for the number of medications, number of comorbidities, depression, and arthritis/arthrosis. CONCLUSION: The frequency of use of PIMs by older adults at the investigated ambulatory clinic was high. Polypharmacy was positively associated with the use of PIMs.

Simultaneous coproduction of hydrogen and ethanol in anaerobic packed-bed reactors.

This study evaluated the use of an anaerobic packed-bed reactor for hydrogen production at different hydraulic retention times (HRT) (1-8 h). Two reactors filled with expanded clay and fed with glucose (3136-3875 mg L(-1)) were operated at different total upflow velocities: 0.30 cm s(-1) (R030) and 0.60 cm s(-1) (R060). The effluent pH of the reactors was maintained between 4 and 5 by adding NaHCO3 and HCl solutions. It was observed a maximum hydrogen production rate of 0.92 L H2 h(-1) L(-1) in R030 at HRT of 1 h. Furthermore, the highest hydrogen yield of 2.39 mol H2 mol(-1) glucose was obtained in R060. No clear trend was observed by doubling the upflow velocities at this experiment. High ethanol production was also observed, indicating that the ethanol-pathway prevailed throughout the experiment.

Perfil microbiológico do sorvete consumido em Campo Grande, MS / Microbiological profile of ice cream consumed in Campo Grande, MS

Sorvete é um produto amplamente consumido, principalmente em regiões de clima quente, e, dependendo da sua composição e processo produtivo, pode veicular micro-organismos causadores de Doenças Transmitidas por Alimentos. O objetivo desta pesquisa foi avaliar as Boas Práticas de Fabricação através da análise microbiológica de sorvetes consumidos e produzidos no município de Campo Grande/MS.

Relação entre função cognitiva e capacidade funcional em idosos institucionalizados de Caxias do Sul/RS / Relationship between cognitive function and functional capacity in institutionalized elderly of Caxias do Sul/RS

O envelhecimento normal engloba um declínio gradual nas funções cognitivas, dependentes de processos neurológicos quese alteram com a idade. O declínio que acompanha o idoso tem início e progressão extremamente variáveis, e a perda de memória aparece como uma das funções mais acometidas. O objetivo deste estudo foi caracterizar uma população de idosos institucionalizados de Caxias do Sul/RS quanto ao seu estado cognitivo, às atividades comuns de vida diária, à mobilidade e à autonomia funcional a fim de identificar possível associação existente entre déficit cognitivo e prejuízo motor decorrentes da institucionalização destes sujeitos e vice-versa. Participaram deste estudo 67 sujeitos (77,59 ± 8 anos),os quais foram submetidos ao teste cognitivo Mini-Exame do Estado Mental (MEEM). Mobilidade para membros superiores e inferiores,e as atividades de vida diária foram avaliadas através do Índice de Katz. Não foi encontrada correlação estatisticamente significativa entre MEEM e idade, gênero, escolaridade e mobilidade de membros inferiores (r = 0,02, p > 0,05, Pearson). Uma associação foi detectada entre o desempenho dos idosos no teste para mobilidade dos membros superiores e o teste cognitivo MEEM (p = 0,01 e r= 0,251 Pearson). Os idosos demonstraram um déficit significativo na realização das tarefas banho, vestuário e transferência através do Índice de Katz. Portanto, podemos concluir através deste estudo que as alterações cognitivas detectadas através do MEEM não tiveram associação com o desempenho dos idosos nos testes de mobilidade para membros inferiores. Entretanto, verificou-se uma associação significativa entre o desempenho dos idosos no teste de capacidade funcional para membros superiores e o teste cognitivo avaliado através do MEEM.

Normal aging involves a gradual decline in cognitive abilitieswhich are dependent on neurological processes that change withage. The decline accompanying the elderly is extremely variable inrelation to initiation and progression, and memory loss is one of themost affected functions. The aim of this study was to characterize a population of institutionalized elderly people of the city of Caxias do Sul/RS concerning their cognitive state, common activitiesof daily living, mobility and functional autonomy, in order toidentify possible association between cognitive deficit and motor impairment as a result of institutionalization of these subjects and vice-versa. Sixty-seven subjects (77.59 ± 8 years old) participated onthis study, and underwent cognitive testing using the Mini-MentalState Examination (MMSE). Mobility of upper and lower limbsand activities of daily life were evaluated using the Katz Index. Nostatistically significant correlation was found between MMSE withage, gender, education and mobility of lower limbs (r = 0.02, p >0.05, Pearson). Association was detected between the performance of the elderly in the mobility test of the upper limbs and cognitivetest MMSE (p = 0.01 e r = 0.251 Pearson). The Katz Index showed that the elderly had a significant deficit in performing the following tasks: bathing, clothing and transfer. Therefore, we conclude thatthe cognitive impairments of these elderly people, detected via theMMSE, did not have any association with their performance in thetest of lower limbs mobility. How ever, it was found a significant association between the performance of the elderly in the upperlimbs functional capacity test and the assessment of cognitive function using the MMSE

No labirinto das fontes do Hospício Nacional de Alienados / Inside the maze of sources on the National Asylum for the Insane

Os documentos clínicos, periódicos, relatórios, leis, decretos e imagens ora apresentados referem-se ao Hospício Nacional de Alienados, durante o período em que Juliano Moreira foi seu diretor, além de diretor da Assistência a Alienados do Distrito Federal (1903-1930). O material será reunido na Biblioteca Virtual em Saúde para América Latina e Caribe - História e Patrimônio Cultural da Saúde (com informações sobre diagnósticos, pacientes, terapêuticas e funcionamento do Hospício Nacional) em 2011. O conjunto de fontes oferece elementos para a reflexão sobre a atuação de eminentes psiquiatras cariocas perante a alienação e a sociedade brasileira na Primeira República, quando a psiquiatria nacional se institucionalizava e ganhava apoio estatal.

The article presents a set of clinical documents, periodicals, reports, laws, decrees, and images about the National Asylum for the Insane dating from Juliano Moreira's tenure as its director and as director of Federal District Assistance for the Insane. In 2011, the material will be available at the site of the Virtual Library on Health in Latin America and the Caribbean: Health History and Cultural Heritage. This material, which includes information on diagnoses, patients, treatments, and the operation of the National Asylum, enhances our ability to investigate the activities of eminent psychiatrists in Rio de Janeiro and their attitudes towards "insanity" and Brazilian society under the First Republic, when Brazilian psychiatry was first gaining institutional form and winning government support.

Posicionamento dos implantes na osteossíntese do maléolo medial: avaliação radiográfica / Implant position in medial malleolus osteosynthesis: radiographic evaluation

As fraturas transversas do maléolo medial são comumente tratadas com redução aberta e fixação interna com parafusos esponjosos de 4,0mm. Frequentemente, são utilizadas radiografias em ântero-posterior (AP) e perfil para avaliação da posição do implante, em relação à articulação talomaleolar medial. Através de protocolo prospectivo foi avaliado radiograficamente o posicionamento dos parafusos utilizados para a fixação de 22 fraturas do maléolo medial. Para isso, utilizaram-se radiografias em AP com 0°, 15° e 30° de rotação interna do pé, com a finalidade de medir a distância entre os implantes e o espaço articular talomaleolar medial. Apos as mensurações concluiu-se que a radiografia da pinça articular (AP verdadeiro) pode revelar uma falsa imagem de penetração intra-articular do parafuso, enquanto na radiografia em AP com 0° de rotação interna, realizada com o feixe de raios X tangencial à superfície articular do maléolo medial, obtém-se a imagem real de sua posição em relação à superfície articular.

Craniotomia estereotáxica: relato de caso / Stereotaxic craniotomy: case report

Sistemas computadorizados e mesmo robotizados têm sido empregados em ressecçöes de tumores intracranianos. Os autores relatam o caso de um paciente submetido à craniotomia estereotáxica por tumor cerebral em regiäo temporal profunda, com o objetivo de demarcar os limites de ressecçäo da lesäo e, assim, a partir dos dados pesquisados, aumentar a eficácia terapêutica e diminuir o quadro de morbidade cirúrgica.

Alfa-amylase inhibitors of legume seeds and their involvement in the resistance to bruchid beetles

The presence of inhibitors of alfa-amylases from several sources (bacterial, plant, insect and mammallian) was investigated in seeds of several food legumes. No inhibitor of any of the tested enzymes was found in Phaseolus lunatus (Lima bean) seeds while the presence of inhibitors of insect (bruchid), porcine pancreas and human saliva alfa-amylases was confirmed in the seeds of P. vulgaris (common bean). Glycine max (soybean) seeds showed alfa-als for all the tested enzymes except for the porcine pancreatic amylase. Although we have found low levels of alfa-als in both bruchid-susceptible and resistant cowpea (Vigna unguiculata) seeds their presence does not correlate with the resistance shown by the seeds of some cultivars to the cowpea weevil Callosobruchus maculatus. The results reported here suggest that alfa-Als are not involved in the resistance of seeds of some cowpea lines to C. maculatus and that variant vicilins, the 7 S storage proteins involved in this resistance, do not show any inhibitory towards bruchi alfa-amylases