A validated ultra-performance liquid chromatography with tandem mass spectrometry method for the quantification of Brazilian green propolis main compounds.

Brazilian green propolis is used in folk medicine because of its various biological properties. The hydroalcoholic extract of Brazilian green propolis is characteristic for possessing several pharmacological properties. Phytochemical investigations have attributed some of these properties to the presence of compounds, which were chosen as analytical markers. This paper reports the development and analytical validation using UPLC-MS/MS in MRM mode. Veratraldehyde was used as an internal standard in qualitative and quantitative analyses of the extracts. Relative standard deviation values obtained for intra-day and inter-day precision were lower than 4%. Of the five parameters for robustness, wavelength detection and flow rate were the critical ones. Limits of detection and quantification ranged from 0.300 to 39.500 ng.mL-1 and from 1.400 to 85.00 ng.mL-1, respectively. The recoveries were between 94.00 and 119.00%, with relative standard deviation values around 5.0%. The developed method is precise, sensitive, and reliable for analysing Brazilian green propolis.

Comics as a Physical Education Tool for Health Promotion in Brazilian Primary Education, Based on Paulo Freire's Principles of Empowerment.

Incorrect postural habits developed already at an early age are predictors of low back pain and functional limitations in adult life. Postural education programs (PEPs) are activities developed in Physical Education classes with the aim of promoting healthy habits. One tool used by PEPs is comics. The objective of this study was to develop comics and apply them as a teaching tool in PEPs for students aged seven to ten years. The procedures were based on individual empowerment principles, including creation activities, reading, painting, crosswords, and discussion of comics. The activities strengthened the students' interactions, gaining new knowledge that required cognitive and expressive resources to interpret, associate, and conceptualize themes of correct body posture. During six weeks of intervention, knowledge about body posture, anatomy, and health promotion exercises increased significantly in relation to the beginning of activities. The comic book proved to be an effective, attractive, and low-cost didactic resource.

Fear of cancer recurrence among Brazilian patients with cancer: Translation and cultural adaptation of FCR4/7 and FCRI-SF measures.

OBJECTIVE: Fear of cancer recurrence or progression (FCR) is considered one of the most common unmet needs among patients with cancer. This study sought to translate and evaluate the psychometric properties of the Fear of Cancer Recurrence scale (FCR4/7) and Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). METHODS: This study involved three phases: (1) translation and cultural adaptation of the FCR4/7 and FCRI-SF measures, (2) validity and reliability testing of the Portuguese version of these measures, and (3) examining patient's perceptions of these measures. Eligible patients were diagnosed with localized breast cancer, and patients with metastatic cancer. Descriptive analyses were collated, and psychometric analysis were conducted (confirmatory factor analysis). RESULTS: A total of 200 patients were recruited (100 patients with localized and 100 patients with metastatic cancer). A significant proportion of patients reported moderate to severe FCR (FCR7: 32.0% and FCRI-SF: 43.0%). Female gender, younger age and metastatic cancer were associated with higher levels of FCR. Psychometric analyses suggested that the Portuguese versions of the FCR4/7 and FCRI-SF were valid, unidimensional in nature, with acceptable reliability coefficients across all scales. In a sub-sample qualitative analysis (n = 75), most patients were satisfied with the relevance of both measures. CONCLUSION: Our findings suggest the Portuguese versions of the FCR4/7 and FCRI-SF are valid tools to assess FCR among patients with localized and metastatic cancer. Future research can now extend our understanding of FCR and assess this construct among Portuguese speaking patients, to guide the development of effective and targeted interventions for patients globally.

Genotoxicity and toxicological evaluations of Brazilian red propolis oral ingestion in a preclinical rodent model.

ETHNOPHARMACOLOGICAL RELEVANCE: Brazilian red propolis is a natural product known due to its medicinal properties. The efficacy of this natural resin has been proved; however, few studies report the safety of its oral use. Some toxic effects of natural products may not be expressed in traditional use, and preclinical studies are necessary to guarantee their safety. Health regulatory agency currently requires these non-clinical studies to develop drugs and herbal medicines, including genotoxic and oral toxicity tests. AIM OF THE STUDY: Accomplish the preclinical toxicity studies of Brazilian red propolis extract (BRP) in rodents, including genotoxicity, acute and sub-chronic toxicities. MATERIAL AND METHODS: Genotoxicity assays followed the erythrocyte micronucleus test protocol in a range of 500-2000 mg/kg BRP oral treatment on male Swiss mice. After an up-and-down procedure, acute oral toxicity (single dose) was performed on female Wistar Hannover rats, reaching a 2000 mg/kg BRP oral gavage concentration. Animals were monitored periodically until 14 days and euthanized for a macroscopic necropsy analysis. The sub-chronic oral toxicity test (90 days) was achieved with 1000 mg/kg of BRP on Wistar Hannover rats (males/females). Animals were monitored to evaluated behavioral and biometrical changes, then were euthanized to perfomed hematological, biochemical, and histopathological analyses. RESULTS: No genotoxic effect of the BRP was detected. The acute toxicity indicated no toxicity of a single oral dose of 2000 mg/kg of BRP. The long-term oral toxicity performed with 1000 mg/kg of BRP altered water and food intake and the biometrics, hematological and biochemical parameters. Biochemical alterations in hepatic and renal parameters were detected only in the males. Despite the detection of biochemical alterations, no histopathological changes were detected in the organs of any group. CONCLUSIONS: BRP, at a higher dose, showed no signs of immediate toxicity. However, the obtained results suggest that the chemical composition and the intake of higher doses deserve special attention regarding possible toxicity.

Placental Alterations in a Chikungunya-Virus-Infected Pregnant Woman: A Case Report.

Chikungunya virus (CHIKV) is an arthropod-borne virus first isolated in Tanzania, Africa. The virus has spread to Asia as well as South and Central America through infected Aedes mosquitoes. Vertical transmission may also occur, and was first documented during a chikungunya outbreak in La Réunion Island in 2005. Since then, some authors have been discussing the role of the placenta in maternal-fetal CHIKV transmission. CHIKV infection is characterized by fever, headache, rash, and arthralgia. However, atypical manifestations and clinical complications, including neurological, cardiac, renal, ocular, and dermal, may occur in some cases. In this report, we describe the case of a pregnant woman infected by CHIKV during the third trimester of gestation, who presented with severe dermatological manifestations during the epidemic in Rio de Janeiro, Brazil in 2019. CHIKV RNA and antigens were detected in the placental tissue, which presented with histopathological (deciduitis, fibrin deposition, edema, fetal vessel thickening, and chorioamnionitis) and ultrastructural alterations (cytotrophoblast with mitochondrial swelling and dilated cisterns in endoplasmic reticulum, vesicles in syncytiotrophoblasts, and thickening of the basement membrane of the endothelium).

Andrographis paniculata Formulations: Impact on Diterpene Lactone Oral Bioavailability.

Diterpene lactones have been identified as active compounds in several medicinal plants, including Andrographis paniculata (Burm. f.) Nees, which is a medicinal plant that has been used for centuries across the world. Andrographolide is the major diterpene from A. paniculata and the main bioactive constituent of this species. The effectiveness of diterpenes can be affected by factors that limit their oral bioavailability, such as their poor water solubility, slow dissolution rates, low gastrointestinal absorption, high chemical and metabolic instability, and rapid excretion. In this context, the purpose of the present review is to compile and compare literature data on the bioavailability of diterpene lactones from A. paniculata after oral administration in medicinal plant extracts or in their free forms and to highlight strategies that have been used to improve their oral bioavailability. Considering that medicinal plant extracts are commonly used as dried powder that is reconstituted in water before oral administration, novel pharmaceutical formulation strategies that are used to overcome difficulties with diterpene solubility are also compiled in this review. The use of self-microemulsifying drug delivery systems is a good strategy to enhance the dissolution and consequently the bioavailability of andrographolide after oral administration of A. paniculata extract formulations. On the other hand, herbosome technology, pH-sensitive nanoparticles, nanosuspensions, nanoemulsions, nanocrystal suspensions, nanocrystal-based solid dispersions, and solid dispersion systems are useful to formulate andrographolide in its free form and increase its oral bioavailability. The use of a suitable andrographolide delivery system is essential to achieve its therapeutic potential.

Natural infection and molecular detection of Cytauxzoon felis in a free-ranging Puma concolor in the state of Goiás, Brazil / Infecção natural e detecção molecular de Cytauxzoon felis em Puma concolor de vida livre no estado de Goiás, Brasil

The puma (Puma concolor Linnaeus, 1771), the most widely distributed felid species in the Americas, can be found in all Brazilian biomes. Nevertheless, few studies have focused on hemoparasites in this species. Cytauxzoon felis, a hemoparasite that can infect domestic cats, has also been described in wild felids in Brazil. To the best of our knowledge, this study is the first to diagnose the natural infection and molecular detection of C. felis in a P. concolor in the state of Goiás. This animal presented non-regenerative anemia and inclusion suggestive of piroplasmids within red blood cells. The amplified 551 bp fragment of partial Piroplasmida 18S rRNA gene sequence was 100% identical to corresponding sequences of C. felis available in GenBank. No specific treatment for cytauxzoonosis was administered, and after rehabilitation, the animal was reintroduced into the wild. This finding provides some evidence that P. concolor may act as a natural host of the parasite. The epidemiology, vector and pathogenicity of this hemoparasite in wild and domestic cats in Brazil deserves further investigation.

O puma (Puma concolor Linnaeus, 1771) tem a maior distribuição entre os felídeos das Américas e é encontrado em todos os biomas do Brasil. No entanto, poucos estudos têm se concentrado nos hemoparasitos nesta espécie. Cytauxzoon felis, um hemoparasito que pode infectar gatos domésticos, também foi descrito em felídeos selvagens no Brasil. A saber, este estudo é o primeiro diagnóstico de infecção natural e detecção molecular de C. felis em um P. concolor do estado de Goiás. Este animal apresentou anemia arregenerativa e inclusão de piroplasmídeos nos glóbulos vermelhos. A amplificação do fragmento de 551 pb da sequência parcial do gene Piroplasmorida 18S rRNA foi 100% idêntica a sequências correspondentes de C. felis disponíveis no GenBank. Nenhum tratamento específico para citauxzoonose foi administrado e, após a reabilitação, o animal foi reintroduzido na natureza. Essa descoberta fornece algumas evidências de que P. concolor pode atuar como um hospedeiro natural do parasito. A epidemiologia, vetor e patogenicidade deste hemoparasito em gatos selvagens e domésticos no Brasil merecem uma investigação mais aprofundada.

Análise do estágio de desenvolvimento motor de escolares da zona leste da cidade de São Paulo / Analysis of the developmental stage of motor development of the east zone of the city of São Paulo

O objetivo do estudo foi analisar o estágio de desenvolvimento motor de escolares do ensino Fundamental II em Instituições públicas e privadas, por meio da habilidade motora salto vertical. Participaram do estudo 79 escolares da zona leste da cidade de São Paulo / SP, matriculados no Ensino Fundamental II. Os instrumentos utilizados de medidas antropométricas foram uma balança de bioimpedância, estadiômetro, filmadora digital e a Sistemática de Avaliação do Padrão Motor de crianças no Salto Vertical proposta por Araujo. De acordo com os resultados foi observado (26-32,9%) dos participantes no estágio Inicial, (47-59,5%) no estágio Emergentes Elementar e (6-7,6%) no estágio Proficiente. Constatou-se uma incidência elevada no estágio Emergentes Elementar (47-59,5%), o que sugere que o desenvolvimento motor para o salto vertical não está adequado para a faixa etária. Os resultados se diferem do que sugere a Teoria de Gallahue, pois, para a faixa etária dos participantes desse estudo, os mesmos deveriam apresentar padrões de movimentos fundamentais consistentes e proficientes. Essa discordância com a Teoria de Gallahue pode estar associada a quantidade e a qualidade dos estímulos presentes nessa fase que compreende os participantes do estudo, influenciando diretamente o desenvolvimento, esses fatores não foram controlados por esse estudo. (AU)

The objective of the study was to analyze the stage of motor development of elementary schoolchildren in public and private institutions, through motor skill vertical jump. The study was attended by 79 schoolchildren from the eastern zone of the city of São Paulo / SP, enrolled in Elementary School II. The instruments used for anthropometric measurements were: a bioimpedance scale, stadiometer, digital camcorder and the Child Motor Pattern Assessment Systematic in the Vertical Jump proposed by Araujo. According to the results (26-32.9%) of the participants in the Initial stage, (47-59.5%) in the Emergents Elementary stage and (6-7.6%) in the Proficient stage. There was a high incidence in the Emergentes Elemental stage (47-59.5%), which suggests that motor development for vertical jump is not adequate for the age group. The results differ from those suggested by the Gallahue Theory, since, for the age group of the participants of this study, they should present consistent and proficient fundamental movement patterns. This disagreement with the Gallahue Theory may be associated with the quantity and quality of the stimuli present in this phase that comprises study participants, directly influencing the development, these factors were not controlled by this study. (AU)

Herpetic whitlow in a child with AIDS: the importance of Tzanck test in the diagnosis

Abstract Herpetic whitlow is a viral infection of the fingers caused by the herpes simplex virus. The disease has a bimodal age distribution, affecting children under 10 years of age and young adults between 20 and 30 years old. It can be easily mistaken for panaritium or bacterial cellulitis. In patients with AIDS, atypical, chronic and recurrent ulcerated lesions occur. The Tzanck test allows a quick and low-cost diagnosis of herpes simplex virus infection. The authors report the case of a child with AIDS with painful finger ulcers in which the diagnosis was confirmed by the Tzanck test.

Herpetic whitlow in a child with AIDS: the importance of Tzanck test in the diagnosis.

Herpetic whitlow is a viral infection of the fingers caused by the herpes simplex virus. The disease has a bimodal age distribution, affecting children under 10 years of age and young adults between 20 and 30 years old. It can be easily mistaken for panaritium or bacterial cellulitis. In patients with AIDS, atypical, chronic and recurrent ulcerated lesions occur. The Tzanck test allows a quick and low-cost diagnosis of herpes simplex virus infection. The authors report the case of a child with AIDS with painful finger ulcers in which the diagnosis was confirmed by the Tzanck test.

Avaliação dos níveis de ansiedade e seus fatores associados em estudantes internos de Medicina / Evaluation of anxiety levels and their associated factors in medical interns

Resumo: Introdução: O período do internato para um estudante de Medicina é complexo e demanda atenção das escolas médicas em relação à saúde mental desses médicos em formação. Objetivo: Este estudo teve como objetivo avaliar os fatores associados aos níveis de ansiedade em estudantes internos de Medicina. Método: Trata-se de um estudo transversal analítico com abordagem quantitativa. Aplicaram-se dois questionários: um com dados sociodemográficos, pessoais e clínicos, e o Inventário de Ansiedade de Beck (BAI). Resultados: Foram incluídos na pesquisa 140 estudantes internos de um curso de Medicina. A maioria tinha até 24 anos (67,9%) e 70,7% eram do sexo feminino. Dos participantes, 54,2% eram solteiros, 31% eram adeptos de uma religião e 68,3% moravam com familiares. Na comparação dos aspectos sociodemográficos com os níveis de ansiedade, identificou-se, no sexo feminino, uma frequência bem maior de ansiedade leve e moderada do que no sexo masculino (p = 0,0133). Aspectos pessoais e clínicos comparados com os níveis de ansiedade mostraram uma frequência maior de ansiedade em estudantes que afirmaram realizar terapia psiquiátrica ou psicológica (p = 0,0110). Ter insônia esteve relacionado com ansiedade de moderada a severa (p < 0,0001). A utilização de substâncias que alteram o sono foi associada com maior frequência a todos os níveis de ansiedade (p = 0,0099). A satisfação com o rendimento acadêmico teve menor relação com os níveis de ansiedade (p = 0,0017). Entretanto, maiores frequências de ansiedade de moderada a severa e ansiedade severa foram encontradas nos alunos que afirmaram ter pensado em abandonar o curso de Medicina (p = 0,0239). Conclusão: O presente estudo revelou os aspectos sociodemográficos, pessoais e clínicos, e, consequentemente, os fatores de risco que estão mais associados ao nível de ansiedade em estudantes internos de Medicina. Ademais, expõem-se as consequências que os níveis de ansiedade podem provocar em um indivíduo, sendo imprescindível a adoção de medidas para combater e prevenir o desenvolvimento de sintomas ansiosos.

Abstract: Introduction: The internship period for a medical student is complex and demands attention from medical schools regarding the mental health of these trainee doctors. Objective: Accordingly, the aim of this study was to assess factors associated with anxiety levels among medical interns. Method: A cross-sectional analytical study with a quantitative approach. Two questionnaires were applied, one with sociodemographic, personal and clinical data and the other consisting of the Beck Anxiety Inventory (BAI) Results: 140 medical students were included in the research. Most of the students were 24 years old or under (67.9%); 70.7% were female. The majority were single (54.2%), and lived with family members (68.3%), while 31% reported having a religion. When correlating sociodemographic aspects to levels of anxiety, a much higher frequency of females with mild and moderate anxiety was identified than that of males (p = 0.0133). Personal and clinical aspects compared to the levels of anxiety showed a higher frequency of anxiety in all levels of students who claimed to undergo psychiatric or psychological therapy (p = 0.0110). Suffering from insomnia is related to moderate to severe anxiety (p <0.0001). Using substances that alter sleep is related to a higher frequency of students at all levels of anxiety (p = 0.0099). Satisfaction with academic performance is less related to anxiety levels (p = 0.0017). However, higher frequency in students with moderate to severe and severe anxiety were found in those who reported having already contemplated leaving medical school (p = 0.0239). Conclusion: This study revealed the sociodemographic, personal and clinical aspects and, consequently, the risk factors that are most frequently associated to anxiety in medical interns. Furthermore, it exposes the consequences that the variable levels of anxiety can have on an individual, and it is essential to adopt measures to combat and prevent the development of anxiety symptoms.

Disputed Territories in Southeastern Brazil: Effects of the Serra da Bocaina National Park on Nearby Coastal Communities.

The establishment of national parks in Brazil has been made based on a history of conflicts with local populations living within the limits or buffer zones of protected areas. These conflicts begin with disputes over territorial ownership. They affect local livelihoods, access to and use of space and natural resources, and create power asymmetries. In response to these conflicts, the Federal Conservation Agency has put forward norms that guarantee inclusive arenas for local people to take part in negotiations with park managers. In this study, environmental conflicts caused by the implementation of parks overlapping local population territories are analyzed aiming to understand their role as mechanisms promoting institutional changes. We collected data from two communities that overlap the Serra da Bocaina National Park through interviews, workshops, and direct observations. For each community, we characterized conflicts involving the community and Park officers. We identified consequences to the community's livelihoods and analyzed their influence on institutional change. The results suggest that one community responded to conservation conflicts through actions towards negotiation and collaboration with the national park. The other community promoted changes in agricultural production methods and sought new markets as a strategy for staying in the territory. Conflicts are effective as a mechanism for institutional changes, as local actors articulate with autonomous organizations at different levels. We highlight the importance of a continuous documentation on conflicts and their consequences to rural livelihoods in both communities and conflict management actions taken by the Park in the long term.

Secondary syphilis presenting as Syphilide psoriasiforme: lessons from the older syphilology literature.

It is essential for health care providers to be familiared with the full spectrum of clinical presentations of syphilis. We present herein a case of syphilide psoriasiforme, an uncommon but well recognized clinical presentation of secondary syphilis. A 46-year-old HIV-infected female patient was referred to our attention with a presumptive diagnosis of palmoplantar psoriasis. On examination, there were exuberant pinkish-red papules and plaques covered with a thick silvery scale in the palms, flexor surfaces of the wrists, and the medial longitudinal arches of the feet. Serological and histopathological analyses uncovered the diagnosis of syphilis. Clinical remission was obtained after treatment. A detailed review of the literature on syphilide psoriasiforme, including descriptions from older syphilology textsis provided. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.

Polineuropatia desmielinizante como manifestação inicial isolada de hanseníase: relato de caso / Demyelinating polyneuropathy as an isolated initial manifestation of leprosy: case report

RESUMO: Modelo do Estudo: Relato de caso. Importância do problema: No mundo, mais de três milhões de pessoas estão vivendo com deficiência física devido à hanseníase. O Brasil é o segundo país com o maior número de casos novos registrados.A magnitude e o alto risco de incapacidade mantêm a doença como problema de saúde pública. O diagnóstico de hanseníase em geral é simples. Porém, quadros com ausência de lesões cutâneas características, somente com alterações neurais, representam um desafio para o diagnóstico diferencial com outras doenças neurológicas. Comentários: Relatamos o caso de um paciente encaminhado ao serviço de neurologia com história clínica e eletroneuromiografia compatíveis com polineuropatia desmielinizante, sem qualquer lesão cutânea ao exame de admissão. O raciocínio clínico inicial foi direcionado para o diagnóstico das polineuropatias desmielinizantes inflamatórias adquiridas como Polineuropatia Desmielinizante Inflamatória Crônica (CIDP) e suas variantes. No entanto, após anamnese e exame físico detalhados, chamou a atenção a ausência do componente atáxico e a presença predominante de alterações sensitivas de fibra fina, espessamento de nervo e importante fator epidemiológico para hanseníase, motivando a suspeita e a in-vestigação desta enfermidade por meio da biópsia de nervo que foi sugestiva de hanseníase. Após três meses, em novo exame do paciente para biopsiar áreas de anestesia para reforçar o diagnóstico, observou-se o surgimento de extensas lesões levemente hipocrômicas no tronco e membros inferiores, cuja biópsia definiu o diagnóstico de hanseníase. (AU)

ABSTRACT: Study: Case report. Importance: Worldwide over three million people are living with disabilities due to leprosy. Brazil is the second country with the highest number of new cases registered. The magnitude and high risk of disability make the disease a public health problem. The diagnosis of leprosy can be simple. However, in the absence of skin lesions and with many possibilities of neurological impairment, diagnosis can become a challenge. Comments: We report the case of a patient referred to the neurology service with a clinical history and electrophysiological tests compatible with demyelinating polyneuropathy, without any skin lesion at admission examination. The initial clinical research was directed to the diagnosis of acquired inflammatory demyelinating polyneuropathies such as Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)and its variants. However, after anamnesis and detailed physical examination, the absence of the ataxic component and the predominant presence of sensory alterations of fine fiber, nerve thickening and important epidemiological factor for leprosy,led to the suspicion and investigation of this disease by nerve biopsy that was suggestive of leprosy. After three months, in a new patient examination "to perform a biopsy in areas of anesthesia" to reinforce the diagnosis, there was the appearance of extensive slightly hypochromic lesions in the trunk and lower limbs, whose biopsy defined the diagnosis of leprosy.(AU)

Pneumonia por toxoplasmose em paciente imunocompetente / Toxoplasma pneumonia in an immunocompetent patient: case repor

Com grande distribuição mundial e incidência significativa, a toxoplamose é uma doença comum em mamíferos e pássaros, causada pelo protozoário Toxoplasma gondii. No homem, o parasitismo na fase proliferativa intracelular pode se apresentar sem sintomas, ou causar clínica transitória caracterizada por febre, fadiga e linfadenopatia. Por se tratar de patologia com sintomas inespecíficos e comuns a muitas outras, é fundamental a correta pesquisa de diagnósticos diferenciais, como citomegalovírus e Epstein-Barr. Relatamos o caso de um jovem e hígido, que desenvolveu pneumonia e, após confirmação sorológica para toxoplasmose e o tratamento adequado, apresentou melhora clínica.

With great worldwide distribution and significant incidence, toxoplamosis is a common disease in mammals and birds, caused by the protozoan Toxoplasma gondii. In humans, the parasitism in its intracellular proliferative phase may present no symptoms, or cause a transient condition characterized by fever, fatigue, and lymphadenopathy. Because it is a pathology with nonspecific symptoms that are common to many other conditions, it is fundamental to find the correct research of differential diagnoses, such as for Cytomegalovirus and Epstein Barr. We report a case of a young and healthy man who developed pneumonia and, after serological confirmation for toxoplasmosis and the appropriate treatment, presented clinical improvement

Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension

Abstract Background: Resistant hypertension (RH) consists of increased blood pressure (BP) despite the use of 3 or more antihypertensives or BP control only when is use of 4 or more antihypertensives. It is fundamental to exclude pseudoresistance, which can be attributed to poor therapeutic adherence. Adherence evaluation, generally by the Morisky-Grenn test, is important because, when appropriate, it is associated with fewer cardiovascular complications and better BP control. Objectives: To evaluate the adherence of patients with RH and to investigate its relation with epidemiological, anthropometric and clinical characteristics, as well as to estimate the prevalence of pseudoresistance and to outline strategies to improve adherence. Methods: Retrospective observational cohort from an interview with patients followed at an outpatient clinic for RH. Therapeutic adherence, demographic, anthropometric data, cardiovascular risk factors, comorbidities, complementary exams and BP level were collected. One-way ANOVA and Student's t-tests were used for normal variables, and the Kruskal-Wallis and Mann-Whitney tests were used for non-normal tests. Categorical variables were compared using the Chi-Square test. We considered a 5% significance level in all tests. Results: 217 individuals were included. Of these, 17% had poor adherence. Epidemiological and clinical characteristics, complications, comorbidities, BP level or drugs used were statistically insignificant between groups. The poor adherence group used significantly more drugs (p = 0.0313) and 28% of pseudoresistance was estimated. Conclusions: Most of the individuals presented good therapeutic adherence by the Morisky test. Only the number of antihypertensive drugs had a statistically significant influence on adherence, while the epidemiological, anthropometric and clinical characteristics were statistically insignificant.

Papillary intralymphatic angioendothelioma: Dabska tumor.

Papillary intralymphatic angioendothelioma (Dabska tumor) is a rarely metastasizing lymphatic vascular neoplasm that usually affects children and young adults. The majority of these cases occur in soft tissues of extremities, and to date less than 40 cases have been described. Despite the generally indolent evolution, can be locally invasive with the potential to metastasize. We describe a case of a young woman presenting with a plantar lesion, for 9 months and histological diagnosis of Dabska tumor. This neoplasm should be considered in the differential diagnosis of vascular dermatoses, allowing early diagnosis and treatment. Long-term follow-up should be performed.