Impacto de la maestría en la formación investigativa de sus egresados a través de sus publicaciones / The Master's Degree in Research Training's Impact on its Graduates, Analyzed through their Publications

Introducción: La Maestría en Investigación en Aterosclerosis constituye una propuesta académica para elevar la calidad de la formación en salud sobre la base de métodos de investigación y aterosclerosis. Evaluar el impacto de su formación científica, evidenciará la relación causa-efecto entre la acción de superación y el comportamiento en el desempeño. Existen criterios de medida que sirven para hacerlo. Este trabajo empleó la publicación de artículos científicos. Objetivo: Evaluar el impacto de la maestría mediante el efecto producido sobre el desempeño investigativo de los graduados, a través de sus publicaciones en revistas científicas. Métodos: Estudio bibliométrico, descriptivo y retrospectivo. Se buscaron publicaciones de alumnos de tres ediciones en Google Académico. El criterio de desempeño investigativo evaluado fue el de artículos publicados. Se midieron las publicaciones de artículos científicos en cuanto a cantidad, calidad y extensión, en dos etapas; se compararon para medir impacto. Resultados: Se incrementaron significativamente los artículos originales y las revisiones bibliográficas en la segunda etapa. Se identificaron graduados más productivos, más citados, líderes; se publicó más en revistas grupo I. Las palabras clave estaban relacionadas con la aterosclerosis; se hallaron diferentes tipos de colaboración. Conclusiones: El incremento de publicaciones, especialmente artículos científicos con mayor liderazgo y colaboración en los últimos años, de citas y predominio en bases de datos internacionales, fueron muestra de productividad, visibilidad e impacto de la actividad científica(AU)

Introduction: The master's degree in Atherosclerosis Research is an academic proposal to raise the quality of health training based on research methods and atherosclerosis. To assess the impact of scientific training will show the cause-effect relationship between improvement action and performance behavior. There are measurement criteria that serve to this purpose. This work used the publication of scientific articles. Objective: To assess the impact of the master's degree through the effect produced on the research performance of graduates, through their publications in scientific journals. Methods: A descriptive and retrospective bibliometric study was carried out, searching, in Google Scholar, for publications by students from three editions. The assessed research performance criterion was the number of published articles. Publications of scientific articles were measured in terms of quantity, quality and length, in two stages; they were compared to measure impact. Results: Original articles and bibliographic reviews increased significantly in the second stage. More productive and more cited leading graduates were identified; more articles were published in group I journals. The keywords were related to atherosclerosis; different types of collaboration were found. Conclusions: The increase in publications, especially scientific articles with higher leadership and collaboration in recent years, as well as in citations and the predominance of representativeness in international databases, evidenced productivity, visibility and impact of the scientific activity(AU)

Relationship between the Synthesis Method and the Magnetoelectric Properties of Bismuth Sodium-Potassium Titanate/Nickel Cobalt Ferrite Lead-Free Composites.

In this work, the influence of the synthesis methods of piezoelectric and magnetostrictive phases on the final properties of the Bi0.5(Na0.8K0.2)0.5TiO3-Ni0.5Co0.5Fe2O4 composites was studied. Different routes were used to individually synthesize each phase, and the composites were prepared using different fractions for each phase. Composites were sintered, and the structural, microstructural, dielectric, and magnetoelectric properties were evaluated. According to the selected synthesis method employed for each phase, different particle sizes and reactivities of the individual phases were obtained. These differences determined the suitable sintering temperature for each set of composites and were responsible for the final properties. In fact, magnetoelectric properties were modulated by the combination of composition and synthesis routes.

Transport and Recovery of Gilthead Seabream (Sparus aurata L.) Sedated With Clove Oil and MS-222: Effects on Stress Axis Regulation and Intermediary Metabolism.

Transport processes between aquaculture facilities activate the stress response in fish. To deal with these situations, the hypothalamic-pituitary-interrenal (HPI) axis releases cortisol, leading to an increase in circulating energy resources to restore homeostasis. However, if the allostatic load generated exceeds fish tolerance limits, stress-related responses will compromise health and welfare of the animals. In this context, anesthetics have arisen as potential agents aiming to reduce negative effects of stress response. Here we assessed the effects of a sedative dose of clove oil (CO) and MS-222 on hallmarks involved in HPI axis regulation and energy management after simulated transport, and further recovery, in gilthead seabream (Sparus aurata L.) juveniles. Fish were placed in a mobile setup of water tanks where transport conditions were simulated for 6 h. Sedation doses of either CO (2.5 mg L-1) or MS-222 (5 mg L-1) were added in the water tanks. A control group without anesthetics was also included in the setup. Half of the animals (n = 12 per group) were sampled immediately after transport, while remaining animals were allowed to recover for 18 h in clean water tanks and then sampled. Our results showed that the HPI axis response was modified at peripheral level, with differences depending on the anesthetic employed. Head kidney gene-expressions related to cortisol production (star and cyp11b1) matched concomitantly with increased plasma cortisol levels immediately after transport in CO-sedated fish, but these levels remained constant in MS-222-sedated fish. Differential changes in the energy management of carbohydrates, lipids and amino acids, depending on the anesthetic employed, were also observed. The use of CO stimulated amino acids catabolism, while MS-222-sedated fish tended to consume liver glycogen and mobilize triglycerides. Further studies, including alternative doses of both anestethics, as well as the assessment of time-course HPI activation and longer recovery periods, are necessary to better understand if the use of clove oil and MS-222 is beneficial for S. aurata under these circumstances.

3,4-Dihydroisocoumarins, Interesting Natural Products: Isolation, Organic Syntheses and Biological Activities.

BACKGROUND: 3,4-dihydroisocoumarins are an important small group belonging to the class of naturally occurring lactones isolated from different bacterial strains, molds, lichens, and plants. The structures of these natural compounds show various types of substitution in their basic skeleton and this variability influences deeply their biological activities. These lactones are structural subunits of several natural products and serve as useful intermediates in the synthesis of different heterocyclic molecules, which exhibit a wide range of biological activities, such as anti-inflammatory, antiplasmodial, antifungal, antimicrobial, antiangiogenic and antitumoral activities, among others. Their syntheses have attracted attention of many researchers reporting many synthetic strategies to achieve 3,4-dihydroisocoumarins and other related structures. OBJECTIVE: In this context, the isolation of these natural compounds from different sources, their syntheses and biological activities are reviewed, adding the most recent advances and related developments. CONCLUSION: This review aims to encourage further work on the isolation and synthesis of this class of natural products. It would be beneficial for synthetic as well as the medicinal chemists to design selective, optimized dihydroisocoumarin derivatives as potential drug candidates, since dihydroisocoumarin scaffolds have significant utility in the development of therapeutically relevant and biologically active compounds.

Ressignificando-se como mulher na experiência do parto: experiência de participantes de movimentos sociais pela humanização do parto / Reframing herself as a woman in childbirth experience: experience of participants in social movements for the humanization of birth

Introdução: A medicalização do parto é uma transformação cultural que influenciou a capacidade de enfrentamento autônomo da experiência de parir. As redes e movimentos sociais pela humanização do parto são apontados como promotores da autonomia no exercício do direito à saúde, na medida em que possibilitam apoio mútuo, compartilhamento de experiências e mobilização coletiva das mulheres para reivindicarem seus direitos no parto. Objetivos: 1) Compreender o significado para a mulher de sua participação nos movimentos sociais pela humanização do parto, a trajetória de gestação e parto dessa mulher e como essa participação influencia sua experiência de gestação e parto; 2) Elaborar um modelo teórico explicativo da experiência de gestação e parto da mulher que participa de movimentos sociais pela humanização do parto. Método: Pesquisa qualitativa, conduzida pelo referencial teórico do Interacionismo Simbólico e referencial metodológico da Teoria Fundamentada nos Dados. O cenário do estudo foi constituído por grupos de usuárias do movimento pela humanização do parto, em Belo Horizonte (MG). Os sujeitos foram 15 mulheres e os dados foram obtidos por meio de observação participante, entrevistas intensivas e análise textual de relatos de parto. Resultados: Foram construídas as categorias Rompendo barreiras em busca de uma experiência de parto normal, Conquistando o protagonismo no processo do parto e Ressignificando a experiência vivida, que permitiram compreender a trajetória de gestação e parto da mulher que integra os movimentos sociais pela humanização do parto.A análise e o modo como estas categorias interagem possibilitaram identificar a categoria central Ressignificando-se como mulher na experiência do parto. O modelo teórico explicita o movimento da mulher de ressignificar-se na experiência do parto, participando de uma engrenagem capaz de ressignificar culturalmente o parto, na medida em que cada mulher compartilha sua experiência e convida outras mulheres para participarem dos movimentos sociais pela humanização do parto. Deste modo, contribui para uma ressignificação cultural do parto como experiência fortalecedora para a mulher e com significado de superação e prazer. Ao ressignificar-se como mulher, ela se considera uma pessoa mais forte, capaz de cuidar de si e dos filhos, capaz de tudo o que desejar e transformada por sua experiência de parto. Mesmo quando não consegue parir, considera que a mulher tem direito de viver o parto como um evento que fortalece sua feminilidade e deseja lutar por esse direito, para que outras mulheres se superem e experimentem o prazer de parir. Conclusão: De modo consensual, as mulheres que participam de movimentos sociais pela humanização do parto compartilham entre si o significado do parto como experiência de superação e prazer. Esse processo contínuo, ao longo do tempo, é capaz de modificar a estrutura social que sustenta o significado do parto como sofrimento e risco e de ressignificar culturalmente o parto, sendo de grande relevância para países como o Brasil, com elevadas taxas de intervenções no parto, em especial, de cesarianas desnecessárias e indesejadas.

Introduction: The medicalization of childbirth is a cultural change that has affected womens empowerment to face their childbirth experience. Social networks and consumer movements for childbirth humanization are seen as promoters of womens autonomy on health right performance as they provide mutual support, the sharing of experiences and social mobilization of women to claim their rights in childbirth. Aims: 1) To understand the meaning according to womans perspectives on her involvement in social movements for the humanization of childbirth, her pathway during pregnancy and childbirth and how her own participation in the social movement have influenced pregnancy and birth experiences; 2) To develop a theoretical model in order to explain the experience of pregnancy and childbirth of woman participating in social movements for the humanization of childbirth. Method: Qualitative research carried out using the theoretical framework of Symbolic Interactionism and the methodological framework of Grounded Theory. The study setting consisted of consumer health groups connected to the childbirth humanization movement in Belo Horizonte (MG), Brazil. Data were collected through participant observation of the social movements groups as well as intensive face to face interviews and textual birth reports with fifteen women. Results: Analysis of the data elicited a number of themes. These included "Breaking barriers searching for an experience of normal childbirth", "Conquering to place herself at the centre of her process of childbirth" and "Reframing the experience" which allowed us to understand the pregnancy and childbirth stories of the woman who engaged in the movement for the humanization of childbirth. Further analysis of the interaction of these categories identified a core category: "Reframing herself as a woman in the experience of childbirth".The theoretical model explains how woman reframed herself in the experience of childbirth as each woman shares her experience and invites other women to join the movement to humanize childbirth. The movement therefore contributed to a cultural redefinition of childbirth as an empowering experience for woman and a source of resilience and pleasure. By reframing herself as a woman she considered herself a stronger person, able to care for herself and her children, able to make whatever she wants, and transformed by her experience of childbirth. Even when she can't give birth, believes that women have a right to live childbirth as an event that strengthens their femininity and want to fight for this right, in order that other women might also experience the pleasure of giving birth. Conclusion: Women who participate in social movements for the humanization of childbirth share among themselves the meaning of the childbirth as an experience of overcoming and pleasure. Over time, this process is able to change the dominant notion of childbirth as suffering and risky and to culturally reframe childbirth. This process is of great relevance in countries like Brazil, with high rates of intervention in childbirth, specially, unnecessary and unwanted caesarean section.

Gestantes que participam da organização não governamental bem nascer: estudo descritivo / Mujeres embarazadas que participan de la organización no gubernamental bem nacer: estudio descriptivo / Pregnant women who participate of the non-government organization bem nascer: a descriptive study

Conhecer o perfil sócio-demográfico, a história obstétrica e a participação de gestantes nas atividades da Organização NãoGovernamental (ONG) Bem Nascer. Estudo descritivo com mulheres que participaram das atividades de janeiro a maio de2011. Dados coletados por meio de questionário aplicado nas rodas de conversa ou por e-mail. O perfilpredominante foi:média de idade de 32 anos; união estável ou casada;parda; ensino superior; renda familiar igual ou superior a quatrosalários mínimos; trabalho fora de casa; nulíparas;acesso ao setor suplementar de saúde; desejo de ter parto vaginal como mínimo de intervenções. A maioria conheceu a ONGatravés de amigos e da Internet. As razões para participar foram abusca de informações sobre parto normal e a troca de experiências. Este estudo corrobora achados de pesquisa quetambém estudou mulheres que procuram experiência departo natural, sem intervenção, fora do hospital.Apesar deretratar a realidade de um número pequeno de gestantes, sabe-se que o movimento social pelo parto humanizado vemcrescendo no país. Isto aponta para a possibilidadede mais mulheres procurarem seus direitos, a fim de viverem umaexperiência de parto normal com assistência humanizada.

Relative adrenal insufficiency in decompensated cirrhosis: Relationship to short-term risk of severe sepsis, hepatorenal syndrome, and death.

UNLABELLED: The prevalence of relative adrenal insufficiency (RAI) in critically ill cirrhosis patients with severe sepsis is over 60% and associated features include poor liver function, renal failure, refractory shock, and high mortality. RAI may also develop in noncritically ill cirrhosis patients but its relationship to the clinical course has not yet been assessed. The current study was performed in 143 noncritically ill cirrhosis patients admitted for acute decompensation. Within 24 hours after hospitalization adrenal function, plasma renin activity, plasma noradrenaline and vasopressin concentration, and serum levels of nitric oxide, interleukin-6 and tumor necrosis factor alpha were determined. RAI was defined as a serum total cortisol increase <9 µg/dL after 250 µg of intravenous corticotropin from basal values <35 µg/dL. Patients were followed for 3 months. RAI was detected in 26% of patients (n = 37). At baseline, patients with RAI presented with lower mean arterial pressure (76 ± 12 versus 83 ± 14 mmHg, P = 0.009) and serum sodium (131 ± 7 versus 135 ± 5 mEq/L, P = 0.007) and higher blood urea nitrogen (32 ± 24 versus 24 ± 15 mg/dl, P = 0.06), plasma renin activity (7.1 ± 9.9 versus 3.4 ± 5.6 ng/mL*h, P = 0.03), and noradrenaline concentration (544 ± 334 versus 402 ± 316 pg/mL, P = 0.02). During follow-up, patients with RAI exhibited a higher probability of infection (41% versus 21%, P = 0.008), severe sepsis (27% versus 9%, P = 0.003), type-1 hepatorenal syndrome (HRS) (16% versus 3%, P = 0.002), and death (22% versus 7%, P = 0.01). CONCLUSION: RAI is frequent in noncritically ill patients with acute decompensation of cirrhosis. As compared with those with normal adrenal function, patients with RAI have greater impairment of circulatory and renal function, higher probability of severe sepsis and type-1 HRS, and higher short-term mortality.

Taxonomy and chemically semi-defined media for the analysis of the tacrolimus producer 'Streptomyces tsukubaensis'.

'Streptomyces tsukubaensis' was the first tacrolimus producer strain identified. Although it has been included in the Streptomyces genus, its taxonomic position has not been rigorously determined. By using a polyphasic approach, we have established that the tacrolimus producer strain 'S. tsukubaensis' NRRL 18488 represents a unique species in the Streptomyces genus, which is phylogenetically distant from other subsequently described producers. This fact means a horizontal transference of the tacrolimus-producing gene cluster. Physiology, nutrient requirement, and molecular genetics analyses of tacrolimus biosynthesis in 'S. tsukubaensis' necessitate chemically defined or semi-defined media, which work as a jigsaw puzzle and allow for pieces (nutrients) exchange. To date, studies related to 'S. tsukubaensis' have been mainly focused in the improvement of tacrolimus production using complex industrial fermentation media, which difficulty allows testing of tacrolimus overproduction enhancers or inhibitors because of the presence of non-defined substances. In the present work, two semi-defined media were developed in order to study the main factors involved in tacrolimus production in 'S. tsukubaensis'.

[Effects of raloxifene on endothelial function and hemostasis in women with ischemic heart disease]. / Efecto del raloxifeno en la función endotelial y la hemostasia en mujeres con enfermedad coronaria.

INTRODUCTION AND OBJECTIVES: Modulation of vascular tone is one of the most relevant estrogen effects. A beneficial effect on endothelial function in postmenopausal women has also been proposed for the selective estrogen receptor modulator raloxifene. However, its effects in women with established cardiovascular disease have not been fully elucidated. In addition, recent trials have generated controversy regarding thromboembolic risk with raloxifene use. The aim of the study was to assess the effect of raloxifene on: a) endothelial function and b) coagulation and fibrinolysis pathways. METHODS: The MERCED trial was a prospective, randomized clinical trial. Thirty-three postmenopausal women with ischemic heart disease were enrolled in the study. Raloxifene treatment was administered for a 3-month period, according to a double-blind crossover design. Assessment of vascular function and biologic parameters related to coagulation pathways were conducted at various pre-established time-points. RESULTS: Flow-mediated dilatation was severely impaired in the study population, and raloxifene had no effect on endothelial function. Treatment with raloxifene was associated to decreased levels of fibrinogen (3.41 [3.11-3.74] vs. 3.69 [3.40-4.00], P<.05); prothrombin fragments F(1+2) (0.93 [0.77-1.12] vs. 0.94 [0.78-1.15], P<.05); and plasmin/antiplasmin complexes (211 [166-267] vs. 242 [199-295], P<.01). CONCLUSIONS: The present study provides evidence that in postmenopausal women with demonstrated endothelial dysfunction and ischemic heart disease, mid-term treatment with raloxifene does not affect endothelial function. In the MERCED trial, no increased thrombotic risk was observed, but a decreased thrombotic and fibrinolytic activity was observed with raloxifene. Further studies are required to determine whether thrombotic risk is associated with specific clinical characteristics or subgroups of postmenopausal women with cardiovascular disease. Full English text available from: www.revespcardiol.org.

Tabaquismo como factor de riesgo de enfermedades crónicas / Smoking as risk factor of chronic diseases

Se realizó una revisión bibliográfica sobre el efecto del tabaquismo como factor de riesgo para muchas enfermedades crónicas, entre ellas, las cardiovasculares, con el objetivo de profundizar sobre los efectos perjudiciales de esta drogadicción y para que los médicos, enfermeras y otros profesionales de la salud se actualicen sobre el tema. Actualmente el hábito de fumar constituye el principal factor de riesgo para estas enfermedades y los profesionales deben estar preparados para brindar acciones de prevención y promoción de salud en los diferentes grupos etarios y con ello disminuir la morbilidad y mortalidad por enfermedades cardiovasculares. Se trata la magnitud del problema, enfermedades que provocan, factores de riesgo, prevención y recomendaciones para disminuir este hábito tóxico.

A literature review was carried out on the effect of smoking as risk factor for many chronic diseases, including cardiovascular disease, with the objective of deepening on the harmful effects of this drug abuse, so doctors, nurses and other health professionals be updated on the subject. Currently, smoking is the major risk factor for these diseases and professionals must be prepared to provide preventive measures and health promotion in the different age groups and thus reduce morbidity and mortality from cardiovascular disease. The magnitude of the problem, diseases caused by it, risk factors, prevention and recommendations for reducing this toxic habit are treated.

Cheilitis granulomatosa associated with Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome (MRS) consists of persistent or recurrent orofacial edema, relapsing facial palsy and fissured tongue. The complete triad of symptoms is uncommon, varying from 8 to 25%. The presentation of only one symptom is more common. The most frequent complaint is facial edema and enlargement of the lips. We describe a case of a 17-year-old Brazilian girl with limited edema of the lower lip and fissured tongue due to MRS. Her complaints had started two years before. She referred previous clinical treatments without success. We proposed intralesional injection of triamcinolone at 20 mg every 15 days associated with oral clofazimine at 50 mg/day for three months. The lip became normal after four triamcinolone injections. Recent studies have considered MRS a granulomatous disease, and possibly the initial presentation of Crohn's disease in orofacial area of some patients. MRS patients, therefore, should be screened and monitored for gastrointestinal symptoms. Corticosteroid treatment seems to be effective in reducing lip enlargement. We discuss the clinical features of this disease, the treatment, and the importance of corticosteroid therapy in cases of MRS-related facial palsy.

Queilite granulomatosa associada à síndrome de Melkersson-Rosenthal / Cheilitis granulomatosa associated with melkersson-rosenthal syndrome

A síndrome de Melkerson-Rosenthal (SMR) caracteriza-se por edema orofacial, paralisia facial recorrente e língua plicada. A tríade completa é incomum, com freqüência variando de 8 a 25 por cento, sendo que a apresentação mais comum é a presença de somente um sintoma. A queixa mais freqüente é o edema facial e/ou no lábio. No presente relato, descreve-se o caso de uma jovem, 17 anos, com edema no lábio persistente e língua plicada devido à SMR. A paciente informou que o edema e as alterações na língua haviam se iniciado há 2 anos. Tratamentos prévios haviam sido realizados, porém sem sucesso. Propôs-se a injeção intralesional de 20mg de triancinolona a cada 15 dias, associada a 5mg ao dia de clofazimine por três meses. O lábio voltou ao seu aspecto normal após quatro infiltrações da medicação. Estudos recentes têm considerado a SMR como uma doença granulomatosa, sendo a fase inicial da apresentação orofacial da Doença de Crohn em alguns pacientes. Assim, pacientes com SMR deveriam ser avaliados e seguidos quanto à presença de sintomas gastroenterológicos. O tratamento com corticosteróides tem se mostrado efetivo em reduzir a tumefação do lábio associada a essa doença. Discute-se características clínicas, tratamento e importância da terapia com corticosteróides na paralisia facial associada à SMR.

Melkersson-Rosenthal syndrome (MRS) consists of persistent or recurrent orofacial edema, relapsing facial palsy and fissured tongue. The complete triad of symptoms is uncommon, varying from 8 to 25 percent. The presentation of only one symptom is more common. The most frequent complaint is facial edema and enlargement of the lips. We describe a case of a 17-year-old Brazilian girl with limited edema of the lower lip and fissured tongue due to MRS. Her complaints had started two years before. She referred previous clinical treatments without success. We proposed intralesional injection of triamcinolone at 20 mg every 15 days associated with oral clofazimine at 50 mg/day for three months. The lip became normal after four triamcinolone injections. Recent studies have considered MRS a granulomatous disease, and possibly the initial presentation of CrohnÆs disease in orofacial area of some patients. MRS patients, therefore, should be screened and monitored for gastrointestinal symptoms. Corticosteroid treatment seems to be effective in reducing lip enlargement. We discus the clinical features of this disease, the treatment, and the importance of corticosteroid therapy in cases of MRS-related facial palsy.

Nivel de conocimiento sobre el cáncer cervical y el papanicolaou en relación al temor, estrés o verguenza al tamizaje: estudio transversal en una comunidad pobre / Level of knowledge on the cervical neoplasms and the papanicolaou in relation to the dread, stress or shame to the straining: transverse study in a poor community

Objetivo: Evaluar la asociación entre el nivel de conocimientos sobre cáncer cervical y Papanicolaou (Pap) con el miedo, estrés o verguenza asociados a este tamizaje. Diseño: Estudio descriptivo transversal, prospectivo basado en comunidad. Material y Métodos: Usando muestreo aleatorio por conglomerados, se entrevistó mujeres de una comunidad pobre de Lima, evaluando su nivel de conocimientos sobre cáncer cervical y Papanicolaou y su percepción sobre este tamizaje. Se usó chi cuadrado, Odds ratios, intervalos de confianza al 95 por ciento y regresión logística para evaluar la asociación en estudio. Resultados: De 300 mujeres entre 18 y 50 años, 20 por ciento habia tenido su último Pap hacía más de dos años y 20 por ciento nunca se lo había realizado; 57 (19 por ciento) mujeres refirieron tener mucho miedo, estrés o verguenza al tamizaje, lo cual estuvo asociado a ser adolescente (OR 5,5 IC95 por ciento 1,8-16,9), tener cinco o menos años de vivir en Lima desde haber llegado del interior del país (OR 2,6,IC95 por ciento 1,3-5,2), no haber tenido pareja sexual durante el último año (OR 2,1,IC 95 por ciento 1,1-7,6), no embarazos previos (OR 3,1, IC 95 por ciento 1,2-8,0), no tener Pap previo (OR 4,7,IC 95 por ciento 1,9-8,7) y el bajo o regular conocimiento sobre el Papanicolaou o el cáncer de cérvix (OR 4,1,IC 95 por ciento 2,2-7,9). Durante el análisis multivariado, persistieron asociados el ser adolescente y el bajo o regular nivel de conocimiento sobre el Pap y el cáncer de cérvix. Conclusión: Se recomienda informar a la comunidad sobre la prueba de Pap y cáncer cervical para mejorar las actitudes negativas asociadas al tamizaje.

Tumor de glândula ceruminosa com invasão intracraniana: relato de caso / Tumor of ceruminous gland with intracranial invasion: case report

As glândulas ceruminosas são glândulas apócrinas modificadas encontradas na região profunda da derme que reveste a porção cartilaginosa do meato acústico externo. Os tumores originados dessas glândulas são raros. Existem controvérsias em relação ao termo ceruminoma, que nos parece impróprio. Na verdade, esses tumores são atualmente classificados como adenoma, adenocarcinoma, carcinoma adenóide cístico e adenoma pleomórfico. Relatamos o caso de uma mulher de 39 anos, apresentado-se com cefaléia, hipoacusia e zumbidos à direita, além de vertigem e náuseas. A TC de crânio evidenciou tumoração do ouvido médio, invadindo os limites ósseos e cartilaginosos, com extensão intracraniana. Foi submetida a cirurgia, com exérese parcial do tumor, seguida de radioterapia (6000 cG). A histologia mostrou tratar-se de carcinoma adenóide cístico de glândulas ceruminosas. A paciente apresentou no pós-operatório paralisia facial periférica à direita, mantendo os déficits anteriores. Após um ano da cirurgia encontra-se estável clinicamente.

Procesos de peritaje en pacientes diabéticos / Medical inspection in diabetic patients

Se revisaron 2 595 expedientes de peritajes realizados en el Hospital "Comandante Manuel Fajardo", en 2 años y se estudió el grupo de los diabéticos comparándolos con un grupo no diabético. El estudio reflejó que el 4,7 % de los procesos de peritajes pertenecían a pacientes diabéticos. En el grupo de diabéticos el 24 % tenía como causa de peritaje la diabetes mellitus o sus complicaciones. De ellos, el 81,5 % fue a peritaje antes de la edad establecida para la jubilación y el 63 % fue declarado con invalidez total. La comparación de causas de peritajes entre diabéticos y no diabéticos reflejó un marcado incremento de enfermedades cardiovasculares en los diabéticos (p < 0,0001). El dictamen médico reflejó una mayor frecuencia de invalidez total en los diabéticos (p < 0,002). La edad de peritaje y el dictamen médico de invalidez total también mostró diferencias significativas entre los 2 grupos, y aunque los procesos de peritajes fueron más frecuentes en los diabéticos (p < 0,05), este hecho no mostró dependencia estadística en su relación con dictámenes médicos

Diagnóstico precoz del cáncer mamario por examen clínico del médico de la familia / Early diagnosis of breast cancer by family doctor's clinical examination

A una muestra de 3 961 mujeres entre 30 y 70 años del municipio 10 de Octubre, le fue aplicado el examen clínico de la mama por el médico de la familia. Fueron remitidas a interconsulta de ginecología 961 casos (24 %) de los cuales 83 requirieron tratamiento quirúrgico, y fueron positivos 11 casos para un 13 %. Se comprobó la eficacia del examen clínico que es un método muy económico y permite llevar a cabo conductas terapéuticas menos mutilantes mediante la detección de estadios tempranos

Césio-137 em leite produzido em fazendas da regiäo de Angra dos Reis RJ / Cesium-137 in milk produced in farms of the region of Angra dos Reis, RJ

Nos efluentes líquidos e gasosos a serem descarregados no meio ambiente pela Central Nuclear Almirante Alvaro Alberto, em Angra dos Reis, os radionuclídeos de maior impacto potencial para a populaçäo säo trítio e radioisótopos de Cs,I, Co e Sr. Durante a fase preliminar dom programa pré-operacional de monitoraçäo radiológica ambiental, realizado por FURNASD Centrais Elétricas S.A., 137 Cs proveniente de resíduos de explosöes necleares, realizadas no passado na atmosfera, foi detectado em leite de apenas uma das fazendas incluídas nq programa. Este resultado pareceu estranho,levando a crer na existência de uma anomalia no solo fazenda, que tornasse o 137 Cs mais disponível do que o habitual para absorçäo por plantas, como já observado em alguns países. Visando esclarecer este assunto o Lab.de Radioisótopos do Instituto de Biofísica e o Lab.de Radiocologia de FURNAS decidiram uma série de análises de 137 Cs em amostras de leite,capim e solos coletados periodicamente nas quatro fazendas do programa. Os resultados obtidos demostraram a näo existência de uma naomalia de comportamento de 137 Cs no solo na regiäo. Os teores de 137 Cs em leite variaram de 0,05 a 0,93 Bq/1, mas os valores médios, nas quatro fazendas, näo eram estatisticamente diferentes. Numa das fazendas do programa obvservaram-se picos ocasionais da concentraçäo de 137Cs em leite. Estes parecem ser devidos ao manejo do gado, com permanência temporária em áreas nas quais os teores de 137Cs em solo e pasto säo mais elevados do que nas demais áreas da mesm5 azenda, e da regiäo em geral, devido à influência de micro-clima e erosäo de solo superficial