Propuesta de indicadores para la selección de atletas en poomsae para el alto rendimiento. Validación práctica

La investigación propuesta, en el área de selección de talentos en el alto rendimiento, específicamente en la modalidad de poomsae, en su evento free style, representa un estudio estratégico, pues se encontraron limitaciones en el proceso de selección en dicha modalidad deportiva. Por lo que este trabajo presentó como objetivo evaluar los indicadores técnicos para la selección de atletas con respecto a la modalidad de poomsae en su evento free style. Esta selección se realiza acorde con las exigencias reglamentarias competitivas actuales, aplicadas por la Federación Mundial de este deporte. Se utilizaron métodos de nivel teórico inductivo-deductivo, analítico-sintético, así como histórico y del nivel empírico, la revisión documental y la medición. Se midieron los ángulos de los indicadores propuestos, a través del software biomecánico Kinovea. La técnica estadística utilizada fue el procesador estadístico SPSS 20. Se definieron y evaluaron de forma práctica los indicadores flexibilidad (splits central, lateral izquierdo, lateral derecho) con una media de 10.25 puntos; técnicas de pateo (pateos básicos, mantención, pateos con giro en el aire) con resultados de media de 2.5; 1,9 y 1.87 puntos; saltos acrobáticos (saltos en horcajadas, saltos en splits izquierdo, saltos en splits derecho) y los elementos acrobáticos con resultados de media de 8.69 y 2.21 puntos, para el proceso de selección de las escuelas de iniciación deportiva escolar en la modalidad de poomsae en su evento free style.

A pesquisa proposta, na área de seleção de talentos no alto rendimento, especificamente na modalidade poomsae, em sua prova de estilo livre, representa um estudo estratégico, uma vez que foram encontradas limitações no processo de seleção na referida modalidade esportiva. Portanto, este trabalho apresentou o objetivo de avaliar os indicadores técnicos para seleção de atletas no que diz respeito à modalidade poomsae em sua prova de estilo livre. Esta seleção é feita de acordo com os requisitos regulamentares competitivos em vigor, aplicados pela Federação Mundial desta modalidade. Foram utilizados métodos de nível teórico indutivo-dedutivo, analítico-sintético, bem como de nível histórico e empírico, revisão documental e mensuração. Os ângulos dos indicadores propostos foram medidos através do software biomecânico Kinovea. A técnica estatística utilizada foi o processador estatístico SPSS 20. Os indicadores de flexibilidade (abertura central, lateral esquerda, lateral direita) foram definidos e avaliados de forma prática com média de 10,25 pontos; técnicas de chutes (chutes básicos, segurar, chutes com giro no ar) com resultados médios de 2,5; 1,9 e 1,87 pontos; saltos acrobáticos (saltos de passada, saltos divididos à esquerda, saltos divididos à direita) e elementos acrobáticos com resultados médios de 8,69 e 2,21 pontos, para o processo seletivo das escolas de iniciação esportiva escolar na modalidade poomsae em sua prova de estilo livre.

The proposed research, in the area of talent selection in high performance, specifically in the poomsae modality in its free style event, represents a strategic study, since limitations were found in the selection process in said sporting modality. Therefore, this work presented the objective of evaluating the technical indicators for the selection of athletes with respect to the poomsae modality in its free style event. This selection is made in accordance with the current competitive regulatory requirements, applied by the World Federation of this sport. Theoretical level methods like inductive-deductive, analytical-synthetic and historical were used and from the empirical level, documentary review and measurement, and the angles of the proposed indicators were measured through the Kinovea biomechanical software. The statistical technique used was the SPSS 20 statistical processor. There were defined and evaluated in a practical way the indicators of flexibility (central, left lateral, right lateral splits ) with an average of 10.25 points; kicking techniques (basic kicks, holding, kicks with spin in the air) with average results of 2.5; 1.9 and 1.87 points; acrobatic jumps (stride jumps, left split jumps , right split jumps ) and acrobatic elements with average results of 8.69 and 2.21 points, for the selection process of school sports initiation schools in the poomsae modality in their free style event .

Avaliação da lactoferrina e da calprotectina como marcadores de inflamação intestinal na pancreatite crônica / Evaluating lactoferrin and calprotectin as markers of intestinal inflammation inchronic pancreatitis

ABSTRACT Background: The treatment of chronic pancreatitis does not consistently solve intestinal abnormalities, and despite the implementation of various therapeutic measures, patients often continue to experience persistent diarrhea. Therefore, it is imperative to recognize that diarrhea may stem from factors beyond pancreatic insufficiency, and intestinal inflammation emerges as a potential contributing factor. Objective: The aim of this study was to assess fecal lactoferrin and calprotectin levels as indicators of intestinal inflammation in patients with chronic pancreatitis experiencing persistent diarrhea. Methods: In this study, 23 male patients with chronic pancreatitis primarily attributed to alcohol consumption and presenting with diarrhea (classified as Bristol stool scale type 6 or 7), underwent a comprehensive evaluation of their clinical and nutritional status. Fecal lactoferrin and calprotectin levels were mea­sured utilizing immunoassay techniques. Results: The average age of the participants was 54.8 years, 43.5% had diabetes, and 73.9% were smokers. Despite receiving enzyme replacement therapy and refraining from alcohol for over 4 years, all participants exhibited persistent diarrhea, accompanied by elevated calprotectin and lactoferrin levels indicative of ongoing intestinal inflammation. Conclusion: The findings of this study underscore that intestinal inflammation, as evidenced by elevated fecal biomarkers calprotectin and lactoferrin, may contribute to explaining the persistence of diarrhea in patients with chronic pancreatitis.

RESUMO Contexto: O tratamento da pancreatite crônica não resolve de forma consistente as anomalias intestinais e, apesar da implementação de várias medidas terapêuticas, os pacientes muitas vezes continuam a apresentar diarreia persistente. Portanto, é imperativo reconhecer que a diarreia pode resultar de fatores além da insuficiência pancreática, e a inflamação intestinal surge como um potencial fator contribuinte. Objetivo: O objetivo deste estudo foi avaliar os níveis fecais de lactoferrina e calprotectina como indicadores de inflamação intestinal em pacientes com pancreatite crônica com diarreia persistente. Métodos: Neste estudo, 23 pacientes do sexo masculino com pancreatite crônica atribuída principalmente ao consumo de álcool e apresentando diarreia (classificada na escala de fezes de Bristol tipo 6 ou 7), foram submetidos a uma avaliação abrangente de seu estado clínico e nutricional. Os níveis fecais de lactoferrina e calprotectina foram medidos utilizando técnicas de imunoensaio. Resultados: A idade média dos participantes foi de 54,8 anos, 43,5% tinham diabetes e 73,9% eram fumantes. Apesar de receber terapia de reposição enzimática e abster-se de álcool por mais de 4 anos, todos os participantes apresentaram diarreia persistente, acompanhada por níveis elevados de calprotectina e lactoferrina, indicativos de inflamação intestinal contínua. Conclusão: Os achados deste estudo ressaltam que a inflamação intestinal, evidenciada pelos biomarcadores fecais elevados calprotectina e lactoferrina, pode contribuir para explicar a persistência da diarreia em pacientes com pancreatite crônica.

Urethrocutaneous fistulas after voluntary medical male circumcision for HIV prevention-15 African Countries, 2015-2019.

BACKGROUND: Voluntary medical male circumcision (VMMC) is an HIV prevention strategy recommended to partially protect men from heterosexually acquired HIV. From 2015 to 2019, the President's Emergency Plan for AIDS Relief (PEPFAR) has supported approximately 14.9 million VMMCs in 15 African countries. Urethrocutaneous fistulas, abnormal openings between the urethra and penile skin through which urine can escape, are rare, severe adverse events (AEs) that can occur with VMMC. This analysis describes fistula cases, identifies possible risks and mechanisms of injury, and offers mitigation actions. METHODS: Demographic and clinical program data were reviewed from all reported fistula cases during 2015 to 2019, descriptive analyses were performed, and an odds ratio was calculated by patient age group. RESULTS: In total, 41 fistula cases were reported. Median patient age for fistula cases was 11 years and 40/41 (98%) occurred in patients aged < 15 years. Fistulas were more often reported among patients < 15 compared to ≥ 15 years old (0.61 vs. 0.01 fistulas per 100,000 VMMCs, odds ratio 50.9 (95% confidence interval [CI] = 8.6-2060.0)). Median time from VMMC surgery to appearance of fistula was 20 days (interquartile range (IQR) 14-27). CONCLUSIONS: Urethral fistulas were significantly more common in patients under age 15 years. Thinner tissue overlying the urethra in immature genitalia may predispose boys to injury. The delay between procedure and symptom onset of 2-3 weeks indicates partial thickness injury or suture violation of the urethral wall as more likely mechanisms of injury than intra-operative urethral transection. This analysis helped to inform PEPFAR's recent decision to change VMMC eligibility policy in 2020, raising the minimum age to 15 years.

Brief Report: Modeling the Impact of Voluntary Medical Male Circumcision on Cervical Cancer in Uganda.

BACKGROUND: In addition to providing millions of men with lifelong lower risk for HIV infection, voluntary medical male circumcision (VMMC) also provides female partners with health benefits including decreased risk for human papillomavirus (HPV) and resultant cervical cancer (CC). SETTING: We modeled potential impacts of VMMC on CC incidence and mortality in Uganda as an additional benefit beyond HIV prevention. METHODS: HPV and CC outcomes were modeled using the CC model from the Spectrum policy tool suite, calibrated for Uganda, to estimate HPV infection incidence and progression to CC, using a 50-year (2018-2067) time horizon. 2016 Demographic Health Survey data provided baseline VMMC coverage. The baseline (no VMMC scale-up beyond current coverage, minimal HPV vaccination coverage) was compared with multiple scenarios to assess the varying impact of VMMC according to different implementations of HPV vaccination and HPV screening programs. RESULTS: Without further intervention, annual CC incidence was projected to rise from 16.9 to 31.2 per 100,000 women in 2067. VMMC scale-up alone decreased 2067 annual CC incidence to 25.3, averting 13,000 deaths between 2018 and 2067. With rapidly-achieved 90% HPV9 vaccination coverage for adolescent girls and young women, 2067 incidence dropped below 10 per 100,000 with or without a VMMC program. With 45% vaccine coverage, the addition of VMMC scaleup decreased incidence by 2.9 per 100,000 and averted 8000 additional deaths. Similarly, with HPV screen-and-treat without vaccination, the addition of VMMC scaleup decreased incidence by 5.1 per 100,000 and averted 10,000 additional deaths. CONCLUSIONS: Planned VMMC scale-up to 90% coverage from current levels could prevent a substantial number of CC cases and deaths in the absence of rapid scale-up of HPV vaccination to 90% coverage.

The Role of Nurses and Midwives in Expanding and Sustaining Voluntary Medical Male Circumcision Services for HIV Prevention: A Systematic and Policy Review.

ABSTRACT: Male circumcision reduces men's risk of acquiring HIV through heterosexual sex, and voluntary medical male circumcision (VMMC) is central to HIV prevention strategies in 15 sub-Saharan African countries. Nurses have emerged as primary VMMC providers; however, barriers remain to institutionalizing nurse-led VMMC. Patient safety concerns have hindered task sharing, and regulations governing nurse-performed VMMC are not always supportive or clear. We performed a systematic review on VMMC safety by provider cadre and a desk review of national policies governing the VMMC roles of nurses and midwives. Also, VMMC by nurses is safe and has become standard practice. Countries had multiple policy combinations among different documents, with only one disallowing VMMC by these cadres. Countries with alignment between policies often ensured that nursing workforces were equipped with clinical competencies through national certification. Regulatory clarity and formalized certification for nurse-performed VMMC can increase program sustainability and build nursing capacity to meet other critical basic surgical needs.

At 100 years of Gaceta Médica de México resumption

Gaceta Médica de México, official journal of the National Academy of Medicine of Mexico, began its circulation on September 15, 1864, and continues to be positioned as the oldest medical periodical publication. However, its publication was temporarily interrupted. The present study analyzes the interruption suffered by Gaceta in 1916, its resumption in 1919, and the causes that originated that discontinuity. The consequences of the so-called Mexican revolution and the enthusiasm and commitment of the academy and its editors to continue working for the progress of national medicine are discussed.

Rollout of ShangRing circumcision with active surveillance for adverse events and monitoring for uptake in Kenya.

INTRODUCTION: Since 2011, Kenya has been evaluating ShangRing device for use in its voluntary medical male circumcision (VMMC) program according to World Health Organization (WHO) guidelines. Compared to conventional surgical circumcision, the ShangRing procedure is shorter, does not require suturing and gives better cosmetic outcomes. After a pilot evaluation of ShangRing in 2011, Kenya conducted an active surveillance for adverse events associated with its use from 2016-2018 to further assess its safety, uptake and to identify any operational bottlenecks to its widespread use based on data from a larger pool of procedures in routine health care settings. METHODS: From December 2017 to August 2018, HIV-negative VMMC clients aged 13 years or older seeking VMMC at six sites across five counties in Kenya were offered ShangRing under injectable local anesthetic as an alternative to conventional surgical circumcision. Providers described both procedures to clients before letting them make a choice. Outcome measures recorded for clients who chose ShangRing included the proportions who were clinically eligible, had successful device placement, experienced adverse events (AEs), or failed to return for device removal. Clients failing to return for follow up were sought through phone calls, text messages or home visits to ensure removal and complete information on adverse events. RESULTS: Out of 3,692 eligible clients 1,079 (29.2%) chose ShangRing; of these, 11 (1.0%) were excluded due to ongoing clinical conditions, 17 (1.6%) underwent conventional surgery due to lack of appropriate device size at the time of the procedure, 97.3% (1051/1079) had ShangRing placement. Uptake of ShangRing varied from 11% to 97% across different sites. There was one severe AE, a failed ShangRing placement (0.1%) managed by conventional wound suturing, plus two moderate AEs (0.2%), post removal wound dehiscence and bleeding, that resolved without sequelae. The overall AE rate was 0.3%. All clients returned for device removal from fifth to eleventh day after placement. CONCLUSION: ShangRing circumcision is effective and safe in the Kenyan context but its uptake varies widely in different settings. It should be rolled out under programmatic implementation for eligible males to take advantage of its unique benefits and the freedom of choice beyond conventional surgical MMC. Public education on its availability and unique advantages is necessary to optimize its uptake and to actualize the benefit of its inclusion in VMMC programs.

Socioeconomic profile and degree of satisfaction of patients attending Gastroenterology Outpatient Clinics of a University Institution.

OBJECTIVE: To evaluate the degree of satisfaction and the socioeconomic profile of patients attending Gastroenterology Outpatient Clinics at a University institution linked to the Brazilian Unified Health System. METHOD: A researcher-administered questionnaire was applied during a structured interview in outpatient clinics. RESULTS: Two hundred and forty (240) patients were included in the study (mean age of 53 years, 55% women). About 30% of the patients had incomplete elementary education, 25% had complete secondary education, and 53% were active workers. Approximately 87% attending the outpatient clinics were from the B2, C1 and C2 socioeconomic classes with an estimated family income of USD$275.00 to USD$825.00/month. Ninety-two percent (92%) of patients were satisfied with the care received; the items associated with a lower degree of satisfaction were facilities/comfort, cleanliness, and waiting time for consultation. No relationship was observed between socioeconomic profile and degree of satisfaction. CONCLUSION: Satisfaction surveys are important to identify opportunities for improving healthcare services, and it is incumbent upon managers, health professionals and even users to promote compliance with laws and decrees that seek to improve healthcare.

Socioeconomic profile and degree of satisfaction of patients attending Gastroenterology Outpatient Clinics of a University Institution / Perfil socioeconômico e grau de satisfação de pacientes que são atendidos em clínicas externas de gastrenterologia de uma instituição universitária / Perfil socioeconómico y grado de satisfacción de pacientes atendidos en clínicas externas de gastroenterología de un centro universitario

ABSTRACT Objective: To evaluate the degree of satisfaction and the socioeconomic profile of patients attending Gastroenterology Outpatient Clinics at a University institution linked to the Brazilian Unified Health System. Method: A researcher-administered questionnaire was applied during a structured interview in outpatient clinics. Results: Two hundred and forty (240) patients were included in the study (mean age of 53 years, 55% women). About 30% of the patients had incomplete elementary education, 25% had complete secondary education, and 53% were active workers. Approximately 87% attending the outpatient clinics were from the B2, C1 and C2 socioeconomic classes with an estimated family income of USD$275.00 to USD$825.00/month. Ninety-two percent (92%) of patients were satisfied with the care received; the items associated with a lower degree of satisfaction were facilities/comfort, cleanliness, and waiting time for consultation. No relationship was observed between socioeconomic profile and degree of satisfaction. Conclusion: Satisfaction surveys are important to identify opportunities for improving healthcare services, and it is incumbent upon managers, health professionals and even users to promote compliance with laws and decrees that seek to improve healthcare.

RESUMO Objetivo: Avaliar o grau de satisfação e o perfil socioeconômico de pacientes que são atendidos em Clínicas Externas de Gastrenterologia de uma instituição universitária vinculada ao Sistema Único de Saúde brasileiro. Método: Um questionário administrado por pesquisador foi aplicado durante uma entrevista estruturada em clínicas externas. Resultados: Duzentos e quarenta (240) pacientes foram incluídos no estudo (idade média de 53 anos, 55% mulheres). Aproximadamente 30% dos pacientes tinham ensino fundamental incompleto, 25% tinham ensino médio incompleto e 53% eram trabalhadores na ativa. Cerca de 87% dos que eram atendidos nas clínicas externas se encontravam nas classes econômicas B2, C1 e C2 com renda familiar estimada entre 275,00 e 825,00 dólares americanos por mês. Noventa e dois por cento (92%) dos pacientes estavam satisfeitos com o atendimento recebido; os itens associados a baixo grau de satisfação foram as instalações/conforto, limpeza e tempo de espera para consulta. Nenhuma relação foi observada entre perfil socioeconômico e grau de satisfação. Conclusão: Pesquisas de satisfação são importantes para identificar oportunidades para melhorar os serviços de saúde e para que seus gerentes responsáveis, profissionais da saúde e até mesmo usuários possam promover o cumprimento às leis e decretos que visam melhorar o atendimento em saúde.

RESUMEN Objetivo: Evaluar el grado de satisfacción y el perfil socioeconómico de pacientes atendidos en Clínicas Externas de Gastroenterología de un centro universitario vinculado al Sistema Único de Salud brasileño. Método: Un cuestionario administrado por investigador fue aplicado durante entrevista estructura en clínicas externas. Resultados: Doscientos cuarenta (240) pacientes fueron incluidos en el estudio (edad media de 53 años, el 55% mujeres). Un 30% de los pacientes tenían educación básica incompleta, el 25% tenían el bachillerato/secundaria incompleto/a y el 53% eran trabajadores activos. Cerca del 87% de los que eran atendidos en la clínicas externas se hallaban en las clases económicas B2, C1 y C2 con ingresos familiares estimados entre 275,00 y 825,00 dólares estadounidenses por mes. El noventa y dos por ciento (92%) de los pacientes estaban satisfechos con la atención recibida; los puntos asociados con bajo grado de satisfacción fueron las instalaciones/comodidad, limpieza y tiempo de espera para consulta. Ninguna relación fue observada entre perfil socioeconómico y grado de satisfacción. Conclusión: Encuestas de satisfacción son importantes para identificar oportunidades de mejorar los servicios sanitarios y para que sus gerentes responsables, profesionales sanitarios e incluso los mismos usuarios puedan promocionar el cumplimiento a la leyes y decretos a fin de mejorar la atención sanitaria.

Circumcision status at HIV infection is not associated with plasma viral load in men: analysis of specimens from a randomized controlled trial.

BACKGROUND: Male circumcision provides men with approximately 60% protection from acquiring HIV infection via heterosexual sex, and has become a key component of HIV prevention efforts in sub-Saharan Africa. Possible mechanisms for this protection include removal of the inflammatory anaerobic sub-preputial environment and the high concentration of Langerhans cells on the inside of the foreskin, both believed to promote local vulnerability to HIV infection. In people who do acquire HIV, viral load is partially determined by infecting partner viral load, potentially mediated by size of infecting inoculum. By removing a portal for virion entry, prior male circumcision could decrease infecting inoculum and thus viral load in men who become HIV-infected, conferring the known associated benefits of slower progression to disease and decreased infectiousness. METHODS: We performed an as-treated analysis of plasma samples collected under a randomized controlled trial of male circumcision for HIV prevention, comparing men based on their circumcision status at the time of HIV acquisition, to determine whether circumcision is associated with lower viral load. Eligible men were seroconverters who had at least one plasma sample available drawn at least 6 months after infection, reported no potential exposures other than vaginal sex and, for those who were circumcised, were infected more than 6 weeks after circumcision, to eliminate the open wound as a confounder. Initial viral load testing indicated that quality of pre-2007 samples might have been compromised during storage and they were excluded, as were those with undetectable or unquantifiable results. Log viral loads were compared between groups using univariable and multivariable linear regression, adjusting for sample age and sexually transmitted infection diagnosis with 3.5 months of seroconversion, with a random effect for intra-individual clustering for samples from the same man. A per-protocol analysis was also performed. RESULTS: There were no viral load differences between men who were circumcised and uncircumcised at the time of HIV infection (means 4.00 and 4.03 log10 copies/mL respectively, p = .88) in any analysis. CONCLUSION: Circumcision status at the time of HIV infection does not affect viral load in men. TRIAL REGISTRATION: The original RCT which provided the samples was ClinicalTrials.gov trial NCT00059371 .

Association between male circumcision and women's biomedical health outcomes: a systematic review.

BACKGROUND: Male circumcision reduces men's risk of acquiring HIV and some sexually transmitted infections from heterosexual exposure, and is essential for HIV prevention in sub-Saharan Africa. Studies have also investigated associations between male circumcision and risk of acquisition of HIV and sexually transmitted infections in women. We aimed to review all evidence on associations between male circumcision and women's health outcomes to benefit women's health programmes. METHODS: In this systematic review we searched for peer-reviewed and grey literature publications reporting associations between male circumcision and women's health outcomes up to April 11, 2016. All biomedical (not psychological or social) outcomes in all study types were included. Searches were not restricted by year of publication, or to sub-Saharan Africa. Publications without primary data and not in English were excluded. We extracted data and assessed evidence on each outcome as high, medium, or low consistency on the basis of agreement between publications; outcomes found in fewer than three publications were indeterminate consistency. FINDINGS: 60 publications were included in our assessment. High-consistency evidence was found for five outcomes, with male circumcision protecting against cervical cancer, cervical dysplasia, herpes simplex virus type 2, chlamydia, and syphilis. Medium-consistency evidence was found for male circumcision protecting against human papillomavirus and low-risk human papillomavirus. Although the evidence shows a protective association with HIV, it was categorised as low consistency, because one trial showed an increased risk to female partners of HIV-infected men resuming sex early after male circumcision. Seven outcomes including HIV had low-consistency evidence and six were indeterminate. INTERPRETATION: Scale-up of male circumcision in sub-Saharan Africa has public health implications for several outcomes in women. Evidence that female partners are at decreased risk of several diseases is highly consistent. Synergies between male circumcision and women's health programmes should be explored. FUNDING: US Centers for Disease Control and Prevention and Jhpiego.

Complicação tardia em biópsia hepática percutânea: é possível? / Late complication after percutaneous liver biopsy: is it possible?

A biópsia hepática percutânea, guiada ou não por ultrassonografia, consiste na retirada de fragmento de tecido hepático. É um procedimento invasivo para estudo histopatológico do órgão, propor terapêutica, avaliar resultados de tratamento e fazer acompanhamento após transplante em várias doenças hepáticas. A taxa de complicações deste procedimento está em torno de 1%, podendo citar dor, hipotensão, hemorragia, pneumotórax, peritonite biliar, bacteremia transitória e morte, e, na sua grande maioria, ocorre dentro das primeiras 48 horas. Relatamos o caso de um paciente do sexo masculino, 62 anos, com história de infecção crônica pelo vírus da hepatite C, submetido à biópsia hepática para estadiamento METAVIR. Após duas semanas, retornou ao serviço de urgência com quadro de abdome agudo hemorrágico, evoluindo a óbito. Com base no relato, os autores discutem as complicações da biópsia hepática, as causas de sangramento abdominal considerando a apresentação tardia do sangramento e a provável causa do óbito do paciente.

Liver biopsy, guided by ultrasonography or not, is an invasive procedure in which a hepatic tissue is removed for histopathological study of the organ, treatment planning, evaluate treatments results and follow-up after liver transplant in several hepatic diseases. Complication rate of the procedure is around 1%, including pain, hypotension, bleeding or hemorrhage, pneumothorax, biliary peritonitis transitory bacteremia and death, and most of them occur within 48 hours after the biopsy. We report a case about a male patient, 62 years old, with previous chronic hepatitis C virus infection, which underwent a liver biopsy for METAVIR staging. After two weeks, patient returns to the hospitals emergency service with hemorrhagic acute abdomen, leading to death. Based on the case report, authors discuss the complications of the liver biopsy, causes of abdominal bleeding considering its late manifestation and the patients probable cause of death.

Mammary analog secretory carcinoma of the parotid gland: A case report and literature review.

BACKGROUND: Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic mass in the parotid gland and predominantly affects men. This tumor is considered a low-grade carcinoma but has the potential for high-grade transformation. We report one MASC case and a review of world literature. CASE REPORT: A 66-year-old male patient presented because he noticed a mass of approximately 3×3cm on the right pre-auricular region. Physical examination demonstrated a 3×3.5cm, firm, fixed, non-tender mass in the right pre-auricular region. An MRI of the head and neck showed an ovoid heterogeneous lesion, dependent of the right parotid gland of 27×28mm. We performed a superficial parotidectomy with identification and preservation of the facial nerve. The immunophenotype was positive for epithelial membrane antigen (EMA), CK8/18, vimentin, S-100 protein, and mammoglobin. No further surgical interventions or adjuvant therapies were needed. The patient will have a close follow up. CONCLUSION: The presence of t(12;15) (p13;q25) translocation which results in the ETV6-NTRK3 gene fusion or positive immunochemical studies for STAT5, mammoglobin and S100 protein, are necessary to confirm the diagnosis of MASC. MASC treatment should mimic the management of other low-grade malignant salivary gland neoplasms. The inhibition of ETV6-NTRK3 gene fusion could be used as treatment in the future.

A new genus of dipnoiformes from the Cretaceous of Brazil

The Alcântara Formation, an important stratigraphic unit from the early Cenomanian of Brazil, was deposited under transitional (estuarine) conditions, and its fossil record includes fragmentary remains of plants, fishes, crocodylomorphs, pterosaurs and dinosaurs, with a noteworthy diversity of dipnoiformes tooth plates. The dipnoiformes material reported here comprises a new taxon, Equinoxiodus alcantarensis, gen. et sp. nov. Most of the identified morphotypes of continental vertebrates collected in the Alcântara Formation are similar to chronocorrelative faunas from Northern Africa, but this new genus of Dipnoiformes indicates some degree of paleogeographic isolation and endemism. This was probably caused by the widening of the equatorial Atlantic Ocean during the early Cenomanian, which may have selectively affected some species.

A Formação Alcântara, uma importante unidade estratigráfica do início do Cenomaniano no Brasil, foi depositada sob condições transicionais (estuarinas), e o seu registro fóssil inclui restos fragmentários de vegetais, peixes, crocodilomorfos, pterossauros e dinossauros, com uma notável diversidade de placas dentárias de dipnoiformes. O material de dipnoiformes aqui reportado compreende um novo taxon, Equinoxiodus alcantarensis gen. et sp. nov. A maioria dos morfótipos de vertebrados continentais coletados na Formação Alcântara são similares a faunas cronocorrelatas do norte da África, mas este novo gênero de Dipnoiformes indica algum grau de isolamento paleogeográfico e endemismo, provavelmente causado pelo alargamento do Oceano Atlântico equatorial no início do Cenomaniano, que pode ter afetado, de forma seletiva, algumas espécies.

Avaliação de erro sistemático e discrepância das medições de modelos odontológicos utilizando-se paquímetro digital / Analysis of systematic error and discrepancy in measurements of dental models using digital caliper

Objetivo: Determinar os índices de erro e de discrepância de medições realizadas em modelos ortodônticos em acrílico com dentes de estoque em oclusão dentária e maloclusão, utilizando paquímetro digital e avaliar a influência do tempo de experiência profissional na exatidão das medições. Método: Duas medições, com um intervalo mínimo de 30 dias, foram realizadas por 30 alunos de graduação em Odontologia da FO da UFJF, 12 alunos do curso de especialização em Ortodontia da FO da UFJF e 6 professores do curso de especialização em Ortodontia da UFJF. Após a realização das medidas, as médias das dimensões utilizadas no estudo foram obtidas por grupo. A análise estatística utilizada lançou mão do teste t de Student, do ANOVA e do teste de Tukey. Resultados: Erros sistemáticos foram observados na oclusão dentária entre os alunos da especialização e na maloclusão entre os professores da especialização e os alunos da graduação. Discrepâncias de medidas foram observadas na oclusão dentária e na maloclusão entre os alunos da especialização e os da graduação. Erros de medidas foram encontrados na oclusão dentária entre os alunos da graduação e os da especialização. Erros de medidas foram encontrados na maloclusão entre os professores da especialização e os alunos da graduação. Conclusão: O tempo de experiência profissional teve influência significativa nas medições, pois se verificou que o número de erros sistemáticos e discrepâncias de medidas foi maior no grupo de menor experiência, isto é, alunos de graduação, e menor no grupo de maior experiência, grupo de professores da especialização.

Anti-ganglioside antibody-induced tumor cell death by loss of membrane integrity.

Gangliosides have been involved in multiple cellular processes such as growth, differentiation and adhesion, and more recently as regulators of cell death signaling pathways. Some of these molecules can be considered as tumor-associated antigens, in particular, N-glycolyl sialic acid-containing gangliosides, which are promising candidates for cancer-targeted therapy because of their low expression in normal human tissues. In this study, we provided the molecular and cellular characterization of a novel cell death mechanism induced by the anti-NGcGM3 14F7 monoclonal antibody (mAb) in L1210 murine tumor cell line but not in mouse normal cells (B and CD4(+) T lymphocytes) that expressed the antigen. Impairment of ganglioside synthesis in tumor cells abrogated the 14F7 mAb cytotoxic effect; however, exogenous reincorporation of the ganglioside did not restore tumor cell sensitivity to 14F7 mAb-induced cytotoxicity. 14F7 F(ab')(2) but not Fab fragments retained the cytotoxic capacity of the whole mAb. By contrary, other mAb, which recognizes N-glycolylated gangliosides, did not show any cytotoxic effect. These mAbs showed quite different capacities to bind NGcGM3-positive cell lines measured by binding inhibition experiments. Interestingly, this complement-independent cell death mechanism did not resemble apoptosis, because no DNA fragmentation, caspase activation, or Fas mediation were observed. However, NGcGM3 ganglioside-mediated 14F7 mAb-induced cell death was accompanied by cellular swelling, membrane lesion formation, and cytoskeleton activation, suggesting an oncosis-like phenomenon. This novel mechanism of cell death lets us to support further therapeutic approaches using NGcGM3 as a molecular target for antibody-based cancer immunotherapy.

Papel da Criptosporidiose na doença inflamatória intestinal / The role of cryptosporidiosis in inflammatory bowel disease

Relata-se o caso de um paciente com quadro diarréico sem antecedente de doença intestinal prévia que, inicialmente, foi tratado para a infecção por Cryptosporidium sp. Na evolução, mostrou ser portador de doença inflamatória intestinal

Programa educativo em esquistossomose: modelo de abordagem metodológica / Educational program in schistosomiasis: a model for a methodological approach

OBJETIVO: A falta de conhecimento é um dos fatores relacionados à persistência de doenças infecciosas no Brasil. O presente estudo tem como objetivo desenvolver, implementar e avaliar um programa educativo de baixo custo, usando como modelo portadores de esquistossomose. MÉTODOS: Estudo descritivo desenvolvido com população constituída por pessoas saudáveis (grupo 1) e esquistossomóticos (grupos 2 e 3), com 20 indivíduos em cada grupo. Foi elaborado material didático (manual ilustrado e álbum seriado) e um questionário de 17 questões para avaliar o conhecimento nos grupos. Nos grupos 1 e 2, o questionário foi aplicado antes e no grupo 3, depois do programa educativo. As variáveis estudadas foram: programa educativo, nível de escolaridade, idade, forma clínica da esquistossomose e sintomatologia e o desempenho dos indivíduos na resposta ao questionário. Para a análise estatística foram utilizados o teste exato de Fisher e análise de variância com um fator fixo. RESULTADOS: O programa educativo foi avaliado em quatro tópicos: ciclo, clínica, tratamento e prevenção da doença. Verificou-se que o grupo 3 apresentou mediana de respostas certas superior aos grupos 1 e 2 em todos os tópicos abordados. O grupo 2 apresentou mediana de respostas certas superior ao grupo 1 em todos os tópicos, exceto em relação ao tópico prevenção. CONCLUSÕES: O processo educativo aplicado foi eficiente, melhorou o conhecimento sobre a doença, podendo constituir-se num modelo de atuação efetiva e de baixo custo que também pode ser aplicado no combate a outras endemias.

Construcão e implementacão de acões de enfermagem em ambulatório de gastroenterologia / Construction and implementation of nursing actions in the gastroenterology outclinic

Em 1998, iniciou-se reestruturacão do Setor de Esquistossomose da Disciplina de Gastroenterologia da UNIFESP, com a implantacão do Servico de Enfermagem. Objetivo: desenvolver acões administrativas de enfermagem, sistematizacão da assistência e programa de orientacão ao esquistossomótico. Método: estudo descritivo, realizado no Ambulatório de Gastroenterologia que atende portadores de esquistossomose, nas suas diferentes formas clínicas. Resultados e discussão: a reestruturacão das atividades do Setor resultaram em: criacão de estrutura organizacional e implantacão da consulta de enfermagem; criacão e distribuicão dos folhetos explicativos e desenvolvimento do Programa de Educacão em Esquistossomose; início de projeto piloto de banco de dados de todos os clientes do ambulatório e do cadastro eletrônico da coleta de materiais biológicos. Conclusão: a iniciativa abriu nova oportunidade de atuacão para o enfermeiro e contribuiu para melhorar a qualidade do atendimento ambulatorial.