Molecular classification of endometrial cancer: preliminary experience from a single Portuguese academic center.

Background: Since the seminal publication of the TCGA consortium in 2013, the molecular classification of endometrial cancer has been widely accepted as a new and powerful tool to better understand the natural history of this malignancy. Adoption of routine molecular classification around the world has been limited. We sought to demonstrate our initial experience in incorporating the four molecular subtypes for endometrioid carcinomas. Methods: This was a retrospective analysis at a single center in Portugal. Molecular classification was determined using immunohistochemical staining for MMR and p53 and Sanger Sequencing to determine POLE mutation status as per published PROMISE method. Descriptive statistics were reported. Results: 20 patients with endometrioid histology were included. Median age of the cohort was 64 years (range 45-76). Median Body Mass Index (kg/m2) was 29.81 (range 21.3-43.1). In terms of tumor grading, 16 (80%) of the endometrial carcinomas of the cohort were low-grade (either grade 1 or grade 2). 16 (80%) of the cases were FIGO stage I. Regarding the molecular classification the tumors were classified as: MMRd [n = 6 (30%)]; p53 abn [n = 2 (10%)]; NSMP (n = 10 (50%)), POLE ultramut [n = 2 (10%)]. Conclusion: Despite the small sample size, we were able to show that molecular classification is feasible. To our knowledge this is the first cohort of endometroid endometrial carcinomas fully characterized according to the TCGA classification in Portugal, from one single center.

Corrigendum: Evaluation of PIK3CA mutations in advanced ER+/HER2-breast cancer in Portugal - U-PIK Project.

[This corrects the article DOI: 10.3389/fmolb.2023.1082915.].

Evaluation of PIK3CA mutations in advanced ER+/HER2-breast cancer in Portugal - U-PIK Project.

Background: Around 40% of ER+/HER2-breast carcinomas (BC) present mutations in the PIK3CA gene. Assessment of PIK3CA mutational status is required to identify patients eligible for treatment with PI3Kα inhibitors, with alpelisib currently the only approved tyrosine kinase inhibitor in this setting. U-PIK project aimed to conduct a ring trial to validate and implement the PIK3CA mutation testing in several Portuguese centers, decentralizing it and optimizing its quality at national level. Methods: Eight Tester centers selected two samples of patients with advanced ER+/HER2- BC and generated eight replicates of each (n = 16). PIK3CA mutational status was assessed in two rounds. Six centers used the cobas® PIK3CA mutation test, and two used PCR and Sanger sequencing. In parallel, two reference centers (IPATIMUP and the Portuguese Institute of Oncology [IPO]-Porto) performed PIK3CA mutation testing by NGS in the two rounds. The quality of molecular reports describing the results was also assessed. Testing results and molecular reports were received and analyzed by U-PIK coordinators: IPATIMUP, IPO-Porto, and IPO-Lisboa. Results: Overall, five centers achieved a concordance rate with NGS results (allele frequency [AF] ≥5%) of 100%, one of 94%, one of 93%, and one of 87.5%, considering the overall performance in the two testing rounds. NGS reassessment of discrepancies in the results of the methods used by the Tester centers and the reference centers identified one probable false positive and two mutations with low AF (1-3%, at the analytical sensitivity threshold), interpreted as subclonal variants with heterogeneous representation in the tissue sections processed by the respective centers. The analysis of molecular reports revealed the need to implement the use of appropriate sequence variant nomenclature with the identification of reference sequences (HGVS-nomenclature) and to state the tumor cell content in each sample. Conclusion: The concordance rates between the method used by each tester center and NGS validate the use of the PIK3CA mutational status test performed at these centers in clinical practice in patients with advanced ER+/HER2- BC.

Comprehensive Genomic Profiling of Cell-Free Circulating Tumor DNA Detects Response to Ribociclib Plus Letrozole in a Patient with Metastatic Breast Cancer.

Analysis of cell-free circulating tumor DNA obtained by liquid biopsy is a non-invasive approach that may provide clinically actionable information when conventional tissue biopsy is inaccessible or infeasible. Here, we followed a patient with hormone receptor-positive and human epidermal growth factor receptor (HER) 2-negative breast cancer who developed bone metastases seven years after mastectomy. We analyzed circulating cell-free DNA (cfDNA) extracted from plasma using high-depth massively parallel sequencing targeting 468 cancer-associated genes, and we identified a clonal hotspot missense mutation in the PIK3CA gene (3:178952085, A > G, H1047R) and amplification of the CCND1 gene. Whole-exome sequencing revealed that both alterations were present in the primary tumor. After treatment with ribociclib plus letrozole, the genetic abnormalities were no longer detected in cfDNA. These results underscore the clinical utility of combining liquid biopsy and comprehensive genomic profiling to monitor treatment response in patients with metastasized breast cancer.

Phenotype-Genotype Correlation in Colorectal Cancer: A Real-Life Study.

BACKGROUND AND AIMS: Colorectal cancer (CRC) is a heterogeneous disease with distinctive genetic pathways, such as chromosomal instability, microsatellite instability and methylator pathway. Our aim was to correlate clinical and genetic characteristics of CRC patients in order to understand clinical implications of tumour genotype. METHODS: Single-institution retrospective cohort of patients who underwent curative surgery for CRC, from 2012 to 2014. RAS and BRAF mutations were evaluated with the real-time PCR technique Idylla®. Mismatch repair deficiency (dMMR) was characterized by absence of MLH1, MSH6, MSH2 and/or PMS2 expression, evaluated by tissue microarrays. Overall survival (OS) and disease-free survival (DFS) were assessed using survival analysis. RESULTS: Overall, 242 patients were included (males 57.4%, age 69.3 ± 12.9 years; median follow-up 49 months). RAS-mutated tumours were associated with reduced DFS (p = 0.02) and OS (p = 0.045) in stage I-III CRC. BRAF-mutated tumours were more predominant in females and in the right colon, similarly to dMMR tumours. BRAF status did not influence OS (4 years)/DFS (3.5 years) in stage I-III disease. However, after relapse, length of survival was 3.5 months in BRAF-mutated tumours in contrast to 18.6 months in BRAF wild-type tumours (p = NS). No germline mutations in mismatch repair genes were so far identified in the patients with dMMR tumours. Molecular phenotype (RAS, BRAF and MMR) did not influence OS in metastatic patients. Our small sample size may be a limitation of the study. CONCLUSION: In our cohort, RAS-mutated tumours were associated with worse DFS and OS in early-stage CRC, whereas the remaining molecular variables had no prognostic influence.

INTRODUÇÃO: O cancro colo-rectal (CCR) é uma doença heterogénea, com vias genéticas distintas, nomeadamente instabilidade cromossómica, instabilidade de microssatélites e via metiladora. O nosso objetivo foi correlacionar as características clínicas e genéticas dos doentes com CCR e, deste modo, conhecer as implicações na prática clínica do genótipo tumoral. MÉTODOS: Estudo de coorte retrospectivo unicêntrico de doentes diagnosticados com CCR e submetidos a cirurgia com intuito curativo, entre 2012 e 2014. As mutações RAS e BRAF foram avaliadas pela técnica de real time PCR Idylla®. A deficiência de mismatch repair (MMR) foi avaliada pela técnica de tissue microarrays e definida pela ausência de expressão de MLH1, MSH6, MSH2 e/ou PMS2. A sobrevivência global (SG) e a sobrevivência livre de doença (SLD) foram avaliadas por análise de sobrevivência. RESULTADOS: No total, foram incluídos 242 doentes (homens 57.4%, idade 69.3 ± 12.9 anos, mediana de seguimento de 49 meses). Os tumores RAS-mutados associaram-se a menor SLD (p = 0.02) e SG (p = 0.045) em doentes com CCR estadio I­III. Os tumores BRAF-mutados foram mais frequentes em mulheres e nos tumores do cólon direito, assim como os tumores com deficiência para MMR. O status BRAF não influenciou a SG (4 anos)/SLD (3.5 anos) nos estadio I­III. Contudo, após a recidiva, o tempo de sobrevivência foi de 3.5 meses nos tumores BRAF-mutados, em comparação com 18.6 meses nos tumores sem esta mutação (p = NS). Não se identificaram mutações germinativas nos genes de mismatch repair nos doentes com tumores deficientes para estas proteinas (dMMR). O perfil molecular (RAS, BRAF e MMR) não influenciou a sobrevivência global dos doentes com metástases ao diagnóstico. O tamanho da amostra pode ser uma limitação do estudo. CONCLUSÃO: Na nossa coorte, os tumores RASmutados associaram-se a pior SLD e SG nos estádios precoces de CCR. Os restantes marcadores moleculares não influenciaram o prognóstico dos doentes.

Detection and quantification of EGFR T790M mutation in liquid biopsies by droplet digital PCR.

BACKGROUND: Liquid biopsy allows the identification of targetable cancer mutations in a minimally invasive manner. In patients with advanced non-small cell lung cancer (NSCLC), droplet digital PCR (ddPCR) is increasingly used to genotype the epidermal growth factor receptor (EGFR) gene in circulating cell-free DNA (cfDNA). However, the sensitivity of this method is still under debate. The aim of this study was to implement and assess the performance of a ddPCR assay for detecting the EGFR T790M mutation in liquid biopsies. METHODS: A ddPCR assay was optimized to detect the EGFR T790M mutation in plasma samples from 77 patients with NSCLC in progression. RESULTS: Our ddPCR assay enabled the detection and quantification of the EGFR T790M mutation at cfDNA allele frequency as low as 0.5%. The mutation was detected in 40 plasma samples, corresponding to a positivity rate of 52%. The number of mutant molecules per mL of plasma ranged from 1 to 6,000. A re-biopsy was analyzed for 12 patients that had a negative plasma test and the mutation was detected in 2 cases. A second liquid biopsy was performed for 6 patients and the mutation was detected in 3 cases. CONCLUSIONS: This study highlights the value of ddPCR to detect and quantify the EGFR T790M mutation in liquid biopsies in a real-world clinical setting. Our results suggest that repeated ddPCR tests in cfDNA may obviate tissue re-biopsy in patients unable to provide a tumor tissue sample suitable for molecular analysis.

Children with special health needs and family: implications for Nursing.

OBJECTIVE: to understand the family experience of children and adolescents with myelomeningocele by the discovery of chronic illness and their daily life in the realization of needed care to these people. METHOD: qualitative study, developed from October 2013 to February 2014, with family, in a pediatric hospital in Fortaleza. Data were collected through interviews and checked by analysis thematic category. RESULTS: it was found that the diagnosis after the birth of the child caused fear and anguish to the families in front of the unknown and the unexpected and that over the years they started to deal with many challenges conducting the daily care due to the disease sequelae. CONCLUSION: nursing plays an important role in the lives of families, children and adolescents, through emotional support, guidelines and care inserted in the health care network.

Menores com necessidades especiais de saúde e familiares: implicações para a Enfermagem / Menores con necesidades especiales de salud y familiares: implicancias para la Enfermería / Children with special health needs and family: implications for Nursing

RESUMO Objetivo: compreender a experiência da família de crianças e adolescentes com mielomeningocele diante da descoberta do adoecimento crônico, bem como sua vivência cotidiana na realização dos cuidados necessários a essas pessoas. Método: estudo qualitativo, desenvolvido de outubro de 2013 a fevereiro de 2014, com familiares, em um hospital pediátrico de Fortaleza. Os dados foram coletados por meio de entrevistas em profundidade e verificados por análise categorial temática. Resultados: constatou-se que o diagnóstico, após o nascimento do filho, gerou medo e angústia aos familiares perante o desconhecido e o inesperado, e que, ao longo dos anos, eles passaram a lidar com muitos desafios para proceder aos cuidados diários decorrentes de sequelas da doença. Conclusão: a Enfermagem assume importante papel na vida dessas famílias, das crianças e dos adolescentes, por meio do suporte emocional, das orientações e dos cuidados inseridos na rede de atenção em saúde.

RESUMEN Objetivo: comprender la experiencia de la familia de ninos y adolescentes con mielomeningocele ante el descubrimiento de la enfermedad crónica, así como su vivencia cotidiana en la realización de los cuidados necesarios a esas personas. Método: estudio cualitativo, desarrollado de octubre de 2013 a febrero de 2014, con familiares, en un hospital pediátrico de Fortaleza. Los datos fueron recogidos por medio de entrevistas en profundidad y verificados por análisis de categoria temática. Resultados: se constató que el diagnóstico, después del nacimiento del hijo, generó miedo y angustia a los familiares ante lo desconocido y lo inesperado, y que, a lo largo de los anos, ellos pasaron a lidiar con muchos desafios para proceder a los cuidados diarios decurrentes de secuelas de la enfermedad. Conclusión: la Enfermería asume un importante papel en la vida de esas familias, de los ninos y de los adolescentes, por medio del soporte emocional, de las orientaciones y de los cuidados inseridos en la red de atención en salud.

ABSTRACT Objective: to understand the family experience of children and adolescents with myelomeningocele by the discovery of chronic illness and their daily life in the realization of needed care to these people. Method: qualitative study, developed from October 2013 to February 2014, with family, in a pediatric hospital in Fortaleza. Data were collected through interviews and checked by analysis thematic category. Results: it was found that the diagnosis after the birth of the child caused fear and anguish to the families in front of the unknown and the unexpected and that over the years they started to deal with many challenges conducting the daily care due to the disease sequelae. Conclusion: nursing plays an important role in the lives of families, children and adolescents, through emotional support, guidelines and care inserted in the health care network.

Conhecimento das famílias de crianças e adolescentes com malformação neural acerca dos seus direitos em saúde / Families' knowledge about children and adolescents with neural malformation about their rights in health / Conocimiento de las familias de niños y adolescentes con malformación neuronal sobre sus derechosen materia de salud

Objetivo: Compreender o conhecimento das famílias de crianças e adolescentes com mielomeningocele sobre os seus direitos em saúde e identificar como tem ocorrido o processo de orientação acerca das políticas públicas de saúde. Métodos: Estudo qualitativo, realizado em hospital de referência pediátrica no Ceará, onde desenvolveram-se entrevistas semiestruturadas com 15 famílias, de setembro de 2013 a fevereiro de 2014. Os dados foram submetidos à análise categorial temática. Resultados: As famílias possuíam pouca informação acerca dos direitos de seus filhos, aspecto que esteve relacionado às lacunas existentes na orientação dos familiares por parte dos profissionais de saúde. Esse desconhecimento repercutiu em dificuldades econômicas, devido aos altos custos com os insumos necessários no cotidiano. Conclusão: Conclui-se ser necessário investir na formação dos profissionais, favorecendo a sua aquisição de competências para atuar junto às famílias, de modo a contribuir para a sua apreensão de conhecimentos e autonomia.

Objective: This study aimed to understand the information quality offered to the families of children and adolescents withmyelomeningocele about their rights in health and identify how has been occurred the process of guidance on public healthpolicies. Methods: Qualitative research conducted in a pediatric referral hospital in Ceará. Fifteen families participated in asemi-structured interview, developed from September 2013 to February 2014. The data were submitted to thematic categoricalanalysis. Results: Families had insufficient information about the rights of their children, aspect that is related to the gaps inthe orientation transmitted by health professionals and results in economic difficulties due to the high costs with the necessarysupplies in day to day. Conclusion: The study disclosed the need to expand the training of professionals, improving their skillsfor providing assistance to these families, contributing with information on its rights and autonomy.

Objetivo: Comprender el grado de conocimiento de las familias de niños y adolescentes con mielomeningocele con respecto asus derechos en materia de salud, e identificar como ha sido el proceso de orientación acerca de las políticas públicas de salud.Métodos: Estudio cualitativo realizado en hospital pediátrico de referencia en Ceará, donde se han desarrollado entrevistassemiestructuradas con 15 familias, de septiembre 2013 a febrero de 2014. Los datos fueron sometidos al análisis categorialtemático. Resultados: Las familias tenían información insuficiente sobre los derechos de sus hijos, aspecto que se relaciona conlas lagunas en la orientación transmitida por profesionales de salud y resulta en dificultades económicas debido a los altos costoscon los insumos necesarios en el día a día. Conclusión: Se necesita ampliar la capacitación de profesionales, confiriéndoleshabilidades para prestación de asistencia a las familias, contribuyendo con la información de sus derechos y autonomía.

Alguns apontamentos sobre o idadismo: a posição de pessoas idosas diante desse agravo à sua subjetividade / Some notes on ageism: the elderly position of an appeal over subjectivity

O novo perfil da pessoa idosa acarretou uma maior visibilidade da velhice, evidenciando um de seus problemas — a discriminação social etária, manifesta por meio de afirmações, condutas e atitudes preconceituosas —, ainda presentes nas interações diárias, contra a pessoa idosa. O objetivo desta pesquisa é investigar, à luz da perspectiva da Gerontologia Social, a posição de pessoas idosas em episódios de discriminação social etária e a avaliação do consequente impacto negativo. O presente artigo se baseia na revisão da literatura, apresentando algumas posições teóricas sobre o preconceito e a discriminação, subsumidos ao Idadismo, e da interpretação de dados empíricos advindos de entrevista com idosos. Este é um estudo de corte transversal, com amostra de 145 sujeitos, de 60 a 86 anos, de ambos os sexos. A coleta de dados valeu-se da versão portuguesa do instrumento Ageism Survey, com vistas às funções avaliadas: frequência de discriminação; reconhecimento da discriminação ligada à idade, ao sexo, à escolaridade e ao estado civil. Os resultados mostram, de forma significativa, a presença de discriminação em todas as variáveis. Assim, este estudo chama a atenção para as necessárias ações voltadas à educação sobre o envelhecimento, a fim de que pessoas idosas, especialmente as menos favorecidas, deixem de receber os efeitos da discriminação etária e possam, ao ter preservada sua subjetividade, viver com mais dignidade a velhice, contribuindo, desta forma, a uma sociedade adequada a todas as idades. (AU)

The elderly new profile has resulted in greater visibility towards old age, highlighting one of the problems it faces — social discrimination, expressed by means of prejudicial statements, behaviors and attitudes — still present within everyday interactions against old people. The objective of this research is to investigate, in the light of Social Gerontology, old people perception before social discrimination episodes and evaluate the consequent negative impacts they cause. The present article is based on the revision of literature, providing some theoretical positions as to prejudice and discrimination, subsumed under Ageism as well as empirical data from interviews with old people. A cross-sectional study was conducted counting on a sample of subjects of both sexes and ranging in age from 60 to 86 years old. The data collection used the Portuguese version of the instrument Ageism Survey, with a view towards the functions evaluated: frequency of discrimination; perception of discrimination related to sex, schooling and marital status. The results showed significant perception of discrimination on all variables. Thus, this study draws attention to the need of actions focused on education about aging and old age so as the elderly quit receiving the effects of age discrimination, being able to live old age with more dignity, provided subjectivity is preserved, building a society suitable for all ages. (AU)

Alguns apontamentos sobre o idadismo: a posição de pessoas idosas diante desse agravo à sua subjetividade / Some notes on ageism: the elderly position of an appeal over subjectivity

O novo perfil da pessoa idosa acarretou uma maior visibilidade da velhice, evidenciando um de seus problemas — a discriminação social etária, manifesta por meio de afirmações, condutas e atitudes preconceituosas —, ainda presentes nas interações diárias, contra a pessoa idosa. O objetivo desta pesquisa é investigar, à luz da perspectiva da Gerontologia Social, a posição de pessoas idosas em episódios de discriminação social etária e a avaliação do consequente impacto negativo. O presente artigo se baseia na revisão da literatura, apresentando algumas posições teóricas sobre o preconceito e a discriminação, subsumidos ao Idadismo, e da interpretação de dados empíricos advindos de entrevista com idosos. Este é um estudo de corte transversal, com amostra de 145 sujeitos, de 60 a 86 anos, de ambos os sexos. A coleta de dados valeu-se da versão portuguesa do instrumento Ageism Survey, com vistas às funções avaliadas: frequência de discriminação; reconhecimento da discriminação ligada à idade, ao sexo, à escolaridade e ao estado civil. Os resultados mostram, de forma significativa, a presença de discriminação em todas as variáveis. Assim, este estudo chama a atenção para as necessárias ações voltadas à educação sobre o envelhecimento, a fim de que pessoas idosas, especialmente as menos favorecidas, deixem de receber os efeitos da discriminação etária e possam, ao ter preservada sua subjetividade, viver com mais dignidade a velhice, contribuindo, desta forma, a uma sociedade adequada a todas as idades.

The elderly new profile has resulted in greater visibility towards old age, highlighting one of the problems it faces — social discrimination, expressed by means of prejudicial statements, behaviors and attitudes — still present within everyday interactions against old people. The objective of this research is to investigate, in the light of Social Gerontology, old people perception before social discrimination episodes and evaluate the consequent negative impacts they cause. The present article is based on the revision of literature, providing some theoretical positions as to prejudice and discrimination, subsumed under Ageism as well as empirical data from interviews with old people. A cross-sectional study was conducted counting on a sample of subjects of both sexes and ranging in age from 60 to 86 years old. The data collection used the Portuguese version of the instrument Ageism Survey, with a view towards the functions evaluated: frequency of discrimination; perception of discrimination related to sex, schooling and marital status. The results showed significant perception of discrimination on all variables. Thus, this study draws attention to the need of actions focused on education about aging and old age so as the elderly quit receiving the effects of age discrimination, being able to live old age with more dignity, provided subjectivity is preserved, building a society suitable for all ages.

Trypanocide, cytotoxic, and antifungal activities of Momordica charantia.

CONTEXT: Chagas disease, caused by Trypanosoma cruzi, is a public health problem. Currently, chemotherapy is the only available treatment for this disease, and the drugs used, nifurtimox and benzonidazol, present high toxicity levels. An alternative for replacing these drugs are natural extracts from Momordica charantia L. (Cucurbitaceae) used in traditional medicine because of their antimicrobial and biological activities. OBJECTIVE: In this study, we evaluated the extract of M. charantia for its antiepimastigote, antifungal, and cytotoxic activities. MATERIALS AND METHODS: An ethanol extract of leaves from M. charantia was prepared. To research in vitro antiepimastigote activity, T. cruzi CL-B5 clone was used. Epimastigotes were inoculated at a concentration of 1 × 10(5) cells/mL in 200 µl tryptose-liver infusion. For the cytotoxicity assay, J774 macrophages were used. The antifungal activity was evaluated by microdilution using strains of Candida albicans, Candida tropicalis, and Candida krusei. RESULTS: The effective concentration capable of killing 50% of parasites (IC(50)) was 46.06 µg/mL. The minimum inhibitory concentration (MIC) was ≤ 1024 µg/mL. Metronidazole showed a potentiation of its antifungal effect when combined with an extract of M. charantia. CONCLUSIONS: Our results indicate that M. charantia could be a source of plant-derived natural products with antiepimastigote and antifungal-modifying activity with moderate toxicity.

Evaluation of the Antimicrobial Activity of the Decoction of Tropidurus hispidus (Spix, 1825) and Tropidurus semitaeniatus (Spix, 1825) Used by the Traditional Medicine.

Tropidurus hispidus and Tropidurus semitaeniatus are two lizard species utilized in traditional medicine in Northeast Brazil. Their medicinal use includes diseases related with bacterial infections such as tonsillitis and pharyngitis. They are used in the form of teas (decoctions) for the treatment of illnesses. In this work, we evaluated the antimicrobial activity of the decoctions of T. hispidus (DTH) and T. semitaeniatus (DTS) against bacterial strains, namely, standard and multiresistant Escherichia coli, Staphylococus aureus, and Pseudomonas aureuginosa, alone and in combination with aminoglycoside antibiotics. The decoctions were prepared using the whole body of the dried lizards, and the filtrate was frozen and lyophilized. When tested alone, the samples did not demonstrate any substantial inhibition of bacterial growth. However, in combination with antibiotics as aminoglycosides, decoctions reduced the minimal inhibitory concentration (MIC) of the assayed antibiotics against multiresistant strains of S. aureus and P. aureuginosa. Chemical prospecting tests revealed the presence of alkaloids in DTS. This is the first study evaluating the medicinal efficacy of T. hispidus and T. semitaeniatus and contributes to the list of new sources of medicines from natural products of animal origin.

Antibacterial and modulatory effect of Stryphnodendron rotundifolium.

CONTEXT: Stryphnodendron rotundifolium Mart. (Leguminosae), a tree in Northeast Brazil (Chapada do Araripe), is used in popular medicine to treat different processes such as inflammation and infectious diseases, mainly caused by bacterial pathogens. OBJECTIVE: This study determined the modulatory and antimicrobial activity of the hydroethanol extract of dried stem bark, the most used form of this natural product, as a remedy by the traditional communities, against standard and clinical isolates of Escherichia coli and Staphylococcus aureus. MATERIAL AND METHODS: The antibacterial and modulatory activities of the hydroalcoholic extract from the leaves were obtained by maceration/hydrodistillation method and assayed by microdilution. RESULTS: In the microbiological assays, growth inhibition was demonstrated by this extract against the bacterial strains tested, with minimal inhibitory concentration (MIC) values of 512 µg/mL. However, when a subinhibitory concentration (MIC/8 = 64 µg/mL) was combined with conventional antimicrobial drugs (gentamicin, kanamycin, amikacin and neomycin), the extract showed a potentiating effect, reducing the MIC for all drugs assayed in a range between 312.5 and 2.4 µg/mL. CONCLUSIONS: We indicate that the extract of S. rotundifolium showed potential synergistic antibiotic activity. With the results obtained, these extracts proved to be a promising source of antibacterial and modulatory agents.

Perfil clínico-epidemiológico de idosos com aids / Clinical-epidemiologic profile off elderly with aids

Introdução: a análise da evolução da aids entre os idosos, através da descrição das características epidemiológicas da população afetada, contribuirá para a adoção de políticas públicas de enfrentamento desse problema. Objetivo: analisar o perfil epidemiológico de idosos com aids no município de João Pessoa, Paraíba. Métodos: pesquisa epidemiológica descritiva de fonte secundária de dados. A população foi formada por pacientes com idade superior a 59 anos atendidos no Complexo Hospitalar Clementino Fraga (CHCF), em 2007. Os dados foram obtidos a partir da análise dos prontuários dos pacientes e da consulta ao banco de dados do SINANW e do SINAN NET. As variáveis investigadas foram: faixa etária, sexo, grau de escolaridade, procedência, estado civil, categoria de exposição, uso de preservativo, tipo de parceria e óbitos. Os dados foram analisados através da avaliação de diferença de percentuais. Resultados: o gênero masculino foi predominante na amostra, correspondendo a 55% dos casos; 89% das mulheres e 54,55% dos homens declararam-se heterossexuais; entre as mulheres, 66,67% mantinham relações sexuais com parceiros soropositivos para o HIV, 22,2% não usavam preservativo, a maioria possuía baixo grau de instrução e procedia de cidades do interior; entre os homens, 36,37% mantinham relações sexuais com múltiplos parceiros, a maioria era formada por solteiros com baixo grau de instrução e provenientes de cidades do interior. Conclusão: a população em geral, tanto homens quanto mulheres, caracterizou-se por heterossexualidade, baixo grau de instrução e procedência, resultados que demonstram, nessa população, a tendência atual da epidemia de heterossexualização, pauperização e interiorização.

Introduction: analyzing the evolution of aids among the elderly through the description of epidemiologic characteristics of infected people will contribute to the adoption of public politics to face this problem. Objective: analysing the epidemiologic profile from the elderly in the of city João Pessoa, Paraíba. Methods: descriptive epidemiologic research based on secondary source of data. Results: the population was formed by patientes aged above 59 years old, who attended the Complexo Hospitalar Clementino Fraga (CHCF) between January 1st, 2004 and February 28th, 2008. The data had been obtained from handbooks of patients and from consultation to SINANW and SINAN NET databasis. The investigated variables were: age group, gender, educational level, origin, marital states, category of exhibition, use of preservative, type of parcery and deaths. The data were analysed through the evaluation of difference in percentages. Results: male gender was majority in the sample corresponding to 55% of cases; 89% of women and 54,55% of men were declared heterosexuals; among women, 66,67% was maintaining sexual relations with partners infected by HIV, 22,2% were not using preservative, the majority had low educational levels and proceeded from cities from countryside; among the men, 36,37% were maintaining sexual relations with multiples partners, the majority was formed by singles with low degree of education and originating from cities of the countryside. Conclusion: the population in general, both men and women, was characterized by heterosexuality, low degree of education and origin, results that demonstrate the current tendency of the epidemic in heterossexual, poor and countryside inhabitants process.

Análise epidemiológica dos pacientes dos pacientes HIV-positivo atendidos em hospital de referência da rede pública de João Pessoa - PB / Epidemic analysis of patients positives HIV assisted at public hospital of reference in João Pessoa - PB

Introdução: abordar a epidemia da aids através da análise epidemiológica de suas variáveis clínicas e sociodemográfi cas é uma das estratégias de controle da epidemia. Objetivo: analisar o perfi l clínico-epidemiológico dos pacientes acometidos pela aids, no município de João Pessoa, Paraíba. Métodos: tratase de uma pesquisa epidemiológica descritiva de fonte secundária de dados. A população foi formada por pacientes com HIV/aids atendidos no Complexo Hospitalar Clementino Fraga (CHCF), durante o ano de 2007. Os dados foram obtidos a partir do Sistema Nacional de Agravos de Notifi cação (SINAN) disponibilizado pelo setor de epidemiologia do CHCF. As variáveis investigadas foram: gênero, faixa etária, grau de instrução; categoria de exposição e evolução do caso. Os dados foram analisados através da avaliação de diferença de percentuais. Resultados: do total de casos avaliados 63,12% eram homens; a maioria, em ambos os sexos, foi de heterossexuais (70,625%); A faixa etária de 30 a 35 anos (31,87%) predominou na amostra; a maioria dos pacientes (35%) estudou da 1a à 4a série incompleta do ensino fundamental (EF); 93,75% dos pacientes eram procedentes da zona urbana; 19,38% da população vieram a óbito no mesmo ano do diagnóstico da doença. Conclusão: a população investigada era, na sua maioria, formada por homens, adultos jovens; a maioria heterosssexual vem a corroborar com a heterossexualização da epidemia; a predominância de pacientes com baixo grau de instrução é umdos sinais da pauperização da aids. As ações de controle da epidemia devem ser intensifi cadaa entre os homens, jovens e heterossexuais

Introduction: to approach the aids epidemic through the epidemiologist analysis of its clinical and socio-demographic variables is one of the strategies of control epidemic. Objective: to analyze the clinical profi le epidemiologist from patients affected for aids in the city of João Pessoa, Paraíba. Methods: it?s treated of a descriptive epidemiologist research of secondary source of data. The population was formed by patients with HIV/aids attended in the Complexo Hospitalar Clementino Fraga (CHCF), during the year of 2007. The data had been gotten from the National Reporting Information System (SINAN) available by Epidemiology Sector of the CHCF. The investigated variables were: sexes, age group, educational level; category of exhibition and evolution?s case. The data were analysed through the evaluation from difference of percentages. Results: of the total from evaluated cases 63,12% was men; the majority, in both sexes, was heterosexuals (70,625%); the age group between 30 and 35 years (31,87%) predominated in the sample; most of the patients (35%) studied of the 1st one to 4th incomplete serie of the basic teaching (BT); 93,75% of the patients was derived of the urbane zone; 19,38% of the population died in the same year of the disease?s diagnosis. Conclusion: the investigated population was, in his majority formed by men, young adults;the majority heterosexual comes to corroborate with the heterosexual process of the epidemic; the predominance of patients with low educational level is one the signs of the aids?s poverty. The actions of the epidemic?s control must be that it intensifi es between men, young persons and heterosexuals.