Rastreamento da síndrome da apneia-hipopneia obstrutiva do sono em hipertensos na atenção primária à saúde / Screening of obstructive sleep apnea-hypopnea syndrome in hipertensive individuals in primary health care

Introdução: a síndrome da apneia-hipopneia obstrutiva do sono (SAHOS) é o distúrbio respiratório do sono mais comum, associado a condições facilmente identificáveis, como a hipertensão arterial sistêmica. Objetivo: determinar prevalência de rastreamento positivo para SAHOS e identificar fatores associados em hipertensos em serviço de Atenção Primária à Saúde (APS). Métodos: estudo transversal com 326 hipertensos adscritos a uma unidade de APS. Foram obtidas variáveis antropométricas, clínicas e sociodemográficas e utilizados os questionários Short Assessment of Health Literacy for Portuguese-Speaking Adults, para identificar o letramento em saúde; a Morisky Medication Adherence Scale, para a adesão medicamentosa e o Snoring, Tiredness, Observed Apnea, High Blood Pressure, Bodymass index, Age, Neck Circumference, and Gender -STOP-Bang, para rastreamentoda SAHOS. Resultados: o sexo feminino foi majoritário (66,3%). A média temporal de tratamento para hipertensão arterial sistêmica alcançou 12,51 ± 9,83 anos. Constatou-se prevalência de 86,5% de rastreio positivo para SAHOS e o sexo masculino e a obesidade como fatores associados a essa condição (p<0,01). Conclusão: o rastreamento sistemático da SAHOS na APS deve ser incorporado à prática dos profissionais de saúde, assim como é feito para outras doenças crônicas não transmissíveis 1.

Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is the most common sleep breathing disorder, associated with easily identifiable conditions such as systemic arterial hypertension. Objective: To determine the prevalence of positive screening for Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and to identify associated factors in the hypertensive population in the Primary Health Care (PHC) service. Method: This was a cross-sectional study with 326 hypertensive individuals assigned to a PHC unit in a medium-sized city in the state of Minas Gerais. Anthropometric, clinical, and sociodemographic variables were obtained. The Short Assessment of Health Literacy for Portuguese-Speaking Adults questionnaire was used to identify literacy in health; the Morisky Medication Adherence Scale was used for medication adherence; and the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender -STOP-Bang questionnaire was used for the screening of OSAHS. Results: The majority was female (66.3%) and the treatment time average for high blood pressure was 12.51 ± 9.83 years. The study identified the prevalence of 86.5% of positive screening for OSAHS, and male sex and obesity as factors associated with this condition (p <0.01). Conclusion: The systematic screening of OSAHS in PHC services should be incorporated into the practice of health professionals, as itis done for other chronic non-communicable diseases.

Multispectral and multiangle measurements of acoustic seabed backscatter acquired with a tilted calibrated echosounder.

A multispectral and multiangle analysis of seabed backscatter intensity has been conducted using data from a calibrated single-beam echosounder (SBES) with five frequency channels deployed over four homogeneous areas with different sediment types in the Bay of Brest (France). The SBES transducers were tilted at incidence angles from 0° to 70° to record the seafloor backscatter angular response at discrete frequencies ranging from 35 to 450 kHz. The recorded backscatter levels were analyzed for their angular dependence (average backscatter strength versus frequency and angle) as well as for their sample statistical distribution. The angle and frequency dependence of the seafloor backscatter obtained using a calibrated SBES can potentially be used to calibrate multibeam systems, and it can also help in elucidating the physical processes of backscatter controlled by the interaction between the acoustic wave characteristics and the sediment properties. Backscatter measurements for each area showed a consistent frequency dependence with little variation between the four sediment types.

A statistical approach for analyzing and modeling multibeam echosounder backscatter, including the influence of high-amplitude scatterers.

The statistical analysis of acoustic backscatter samples recorded by multibeam echosounders can be a valuable tool for remote seafloor characterization and interpretation. The present paper aims at analyzing the statistics of backscatter data values, both in "raw" status and after various averaging operations, using field data. It is shown that the statistics of the data can be adequately described by a Weibull distribution parametrized by the incidence angle and the level of applied processing: the distribution of the averaged backscatter amplitude, processed according to various schemes, varies from a Rayleigh law for raw data to lognormal and finally to Gaussian distribution after successive averaging operations. Based on these results, some recommendations for the calculation of the mean backscatter strength are presented. Finally, the influence of high-amplitude scatterers in the backscatter probability density function is addressed; a scheme is suggested to separate the contributions of the substrate from the contributions of the scatterers on the statistical distribution of sonar data samples.

Association between BRAF (V600E) mutation and clinicopathological features of papillary thyroid carcinoma: a Brazilian single-centre case series.

OBJECTIVES: We aimed to investigate the prevalence of the BRAF (V600E) mutation in consecutive cases of papillary thyroid carcinoma (PTC) in patients diagnosed and treated at the Hospital Sao Rafael (Salvador, BA, Brazil) and evaluate its association with clinical and pathological characteristics of PTC. SUBJECTS AND METHODS: We retrospectively enrolled in the study a total of 43 consecutive PTC patients who underwent total thyroidectomy. We performed DNA extraction from formalin-fixed paraffin-embedded (FFPE) tumour tissue samples. Polymerase chain reaction (PCR) and direct sequencing were used to determine BRAF (V600E) mutation status. Univariate and multivariate logistic regression analyses were employed to identify independent associations. RESULTS: The prevalence of BRAF (V600E) mutation was 65.1% (28/43). A high frequency of older patients (p value: 0.004) was observed among the BRAF-mutated PTC group and, in contrast, a low frequency of concurrent Hashimoto's thyroiditis (HT) (p value: 0.011) was noted. Multivariate analysis confirmed that older age (OR: 1.15; 95% CI: 1.00 - 1.33; p value: 0.047) and HT (OR: 0.05; 95% CI: 0.006-0.40; p value: 0.005) were independent factors associated with BRAF (V600E) mutation. CONCLUSION: We found a high prevalence of BRAF (V600E) mutation in PTC cases. Older age and no concurrent HT were independently associated with BRAF (V600E) mutation.

Granular Cell Tumor Located in the Bulbar Subconjunctival Space.

AIM: To report an unusual case of granular cell tumor. METHODS: Case report. RESULTS: A 14-year-old male presented with a bulbar conjunctival yellowish nonmovable mass, in the left eye. The tumor was removed and histopathologic evaluation revealed a granular cell tumor. CONCLUSION: Granular cell tumor can occur at the bulbar subconjunctival space.

Weeds control with herbicides applied in pre-emergence in potato cultivation / Controle de plantas daninhas com herbicidas aplicados em pré-emergência na cultura da batata

There are few pre-emergent herbicides that are selective and registered for potato crop. Thus, this study aimed to evaluate the control of weeds with pre-emergent herbicides, as well as their effects on potato crop. The treatments consisted of a control, a hoed control (manual weed removal), metribuzin (240 g ha-1), linuron (450 g ha-1), diclosulan (25,2 g ha-1), imazetapir (700 g ha-1), prometryn (1000 g ha-1), clomazone + carfentrazone (300 + 7.5 g ha-1), clomazone + carfentrazone (600 + 15 g ha-1) and sulfentrazone (125 g ha-1). A randomized complete block design (RCB) was used with four replications. Largest stem, phytotoxicity, and weed control were measured at 10 and 30 days after stem emergence (DAE), which coincided with the periods before and after hilling, respectively. Soluble solids content, yield and tuber classification were determined after harvesting. The results were compared by a Tukey test (5% significance). The evaluated herbicides did not affect the number of stems per meter and length of the largest stem. Regarding weed control, clomazone + carfentrazone (600 + 15 g ha-1) controlled C. benghalensis (Behghal dayflower), E. heterophyla (milkweed) and R. raphanistrum (wild radish), better than the other herbicides, which provided little control over E. heterophyla and R. raphanistrum. The strongest symptoms of phytotoxicity were observed with metribuzin, diclosulan and imazethapyr, which were also associated with lower levels of soluble solids, total yield, and yield of "special" tubers. Therefore, these herbicides were considered less selective. Linuron and clomazone did not produce phytotoxicity, did not affect levels of soluble solids, and did not reduce total or "special" tuber yield, and were thus considered more selective for this potato cultivar.

Existem poucos herbicidas pré-emergentes registrados e seletivos à cultura da batata. Assim, este estudo teve como objetivo avaliar o controle de plantas daninhas com herbicidas pré-emergente, bem como seus efeitos na cultura da batata. Os tratamentos foram testemunha, testemunha capinada, metribuzin (240 g ha-1), metribuzin (480 g ha-1), linuron (450 g ha-1), linuron (990 g ha-1), diclosulan (25,2 g ha-1), imazetapir (700 g ha-1), prometryn (1000 g ha-1), clomazone (360 g ha-1), clomazone + carfentrazone (300 + 7,5 g ha-1), clomazone + carfentrazone (600 + 15 g ha-1) e sulfentrazone (125 g ha-1). O delineamento experimental utilizado foi o de blocos casualizados (DBC), com quatro repetições totalizando 52 parcelas. Foram realizadas avaliações número e comprimento da maior haste, fitotoxicidade e controle de plantas daninhas aos 10 e 30 dias após emergência das hastes (DAE), que correspondem ao período antes e após da operação de amontoa, respectivamente. Após a colheita foram avaliados o teor de sólidos solúveis, produtividade e classificação. Os resultados obtidos foram comparados pelo teste de Tukey a 5% de significância A ocorrência de plantas daninhas proporcionou redução de produtividade. Os herbicidas avaliados não afetaram o número de hastes por metro e comprimento da maior haste. No controle de plantas daninhas, os herbicidase clomazone + carfentrazone (600 + 15 g ha-1) controlaram C. benghalensis, E. heterophyla e R. raphanistrum, se destacando frente aos demais, que apresentaram baixo controle das espécies E. heterophyla e R. raphanistrum. Os sintomas de fitotoxicidade mais elevados foram observados com metribuzin, diclosulan e imazetapir, que também apresentaram menor teor de sólidos solúveis, produtividade total e de tubérculos classe "especial", sendo assim considerados menos seletivos. Linuron e clomazone, não proporcionaram fitotoxicidade e redução de produtividade total e de tubérculos classe "especial", não afetaram o teor de sólidos sendo considerados mais seletivos para esta cultivar.

Optic Disc Pyogenic Granuloma.

AIM: The aim of this paper was to report a rare presentation of adenoid cystic carcinoma. METHOD: This is a case report presenting clinical, radiographic, and histopathologic findings. RESULTS: A 72-year-old female with no reported ocular symptoms was found to have an incidental right orbital mass on imaging. Additional studies revealed multiple liver lesions, which were biopsied and found to be consistent with adenoid cystic carcinoma. She was then referred to the ophthalmology service, where ocular examination demonstrated 2.5 mm of right proptosis with elevation and abduction deficits. Diplopia could be elicited in extreme upgaze and right lateral gaze. An excisional biopsy of the orbital mass was performed, with histopathology confirming the diagnosis of primary adenoid cystic carcinoma of the lacrimal gland, thereby also supporting the initial suspicion that the hepatic adenoid cystic carcinoma lesions represented metastases. CONCLUSION: The authors describe a rare presentation of adenoid cystic carcinoma of the lacrimal gland, initially asymptomatic, with metastatic lesions restricted to the liver at the time of diagnosis. Three previous cases of adenoid cystic carcinoma with isolated metastatic hepatic lesions at the time of diagnosis have been reported; all of these cases localized the primary tumor to the salivary glands.

Carcinoma hepatocelular metastático em Jaguatirica (Leopardus pardalis ) / Metastatic hepatocellular carcinoma in ocelot (Leopardus pardalis

O carcinoma hepatocelular (CHC) é uma neoplasia rara nos animais domésticos e em espécies selvagens foi relatado somente em antílopes, veado, cães da pradaria e furões, mas não existem relatos em Leopardus pardalis (jaguatirica). Este trabalho descreve um caso de carcinoma hepatocelular metastático em uma fêmea felina de aproximadamente 18 anos de idade, da espécie Leopardus pardalis, proveniente do Parque Zoobotânico de Teresina-PI, com histórico de anorexia, apatia e evolução ao óbito que foi encaminhada ao Setor de Patologia Animal da Universidade Federal do Piauí para exame anatomopatológico. À necropsia foram observadas duas nodulações de aproximadamente 8,0cm de diâmetro no fígado, de coloração variando da brancacenta ao vermelhado claro, amarelada a vermelho escuro, subdivididas em lóbulos por tecido conjuntivo. No pâncreas foram observadas múltiplas nodulações de aproximadamente 1,0 cm de diâmetro, com superfície lisa, consistência firme, coloração vermelho-amarelada. A superfície de corte dos rins também apresentava várias nodulações milimétricas de distribuição multifocal, na região córtico-medular, consistência firme, coloração branco-acinzentada ou amarelada, sugerindo metástase. Os fragmentos das lesões de fígado foram coletados e no exame microscópico observaram-se proliferação de hepatócitos em cordões bem diferenciados, formando trabéculas com espessura de três ou mais células. Os hepatócitos apresentavam-se volumosos, pleomórficos, com citoplasma eosinofílico. Na coloração com PAS constataram-se, regularmente, acúmulo de glicogênio nos hepatócitos neoplásicos. A confirmação foi feita pela técnica de imunoistoquímica, utilizando-se anticorpo monoclonal (Hepatocyte Specific Antigen). Os achados anatomohistopatológicos, e o auxilio da imunoistoquímica permitiram concluir pelo diagnóstico de hepatocarcinoma trabecular metastático em Leopardus pardalis criado em cativeiro...

Hepatocellular carcinoma (HCC) is a rare neoplasm in domestic and wildlife animals and has been reported only in antelope, deer, prairie dogs and ferrets; but there are no reports in Leopardus pardalis (ocelot). This paper describes a case of metastatic hepatocellular carcinoma in a female of an about 18-year-old Leopardus pardalis from the Zoological Garden of Teresina, Piauí, after a history of anorexia, apathy and fatal outcomes, forwarded to the Department of Animal Pathology at the Federal University of Piaui for pathological examination. Necropsy revealed two nodules of about 8.0cm in diameter in the liver, of whitish to bright red or yellow to dark red color divided into lobes by connective tissue. In the pancreas were found multiple nodules of about 1.0cm diameter, with smooth surface, firm consistency, and yellowish-red color. The cut surface of the kidneys also presented multiple whitish-gray or yellowish millimeter small nodules in the corticomedullary region, of firm consistence, suggesting metastases. Fragments of the liver lesions examined microscopically revealed hepatocyte proliferation in well differentiated strands, forming trabeculars of three or more cells. The hepatocytes were large and pleomorphic, with eosinophilic cytoplasm. In PAS staining glycogen accumulation was found in neoplastic hepatocytes . The confirmation of the diagnosis was made by immunohistochemistry, using monoclonal antibody hepatocyte specific antigen. The findings allowed us to characterize the neoplasm as a trabecular metastatic hepatocarcinoma in Leopardus pardalis bred in captivity...

Spontaneous canine transmissible venereal tumor: association between different phenotypes and the insertion LINE-1/c-myc / Tumor venéreo transmisible canino espontáneo: asociación entre diferentes fenotipos y la inserción LINE -1/c-myc / Tumor venéreo transmissível canino espontâneo: associação entre diferentes fenótipos e a inserção LINE-1/c-myc

Objective: this study aimed to evaluate the LINE-1 transposon inserted in c-myc gene as a specific genetic alteration in cells of spontaneous canine Transmissible Venereal Tumor (TVT) with either lymphocytoid or plasmacytoid phenotypes. Methods: tumoral biopsies from 35 dogs were collected by puncture or exfoliation. Polymerase Chain Reaction (PCR) was carried out with primers myc.s and LINE. A, specific to the LINE-1 segment to detect the presence of LINE-1/c-myc molecular marker. Results: sequence alignment of DNA samples from lymphocytoid and plasmacytoid TVT cells did not show polymorphisms, and the comparison with sequences from the GenBank identified them as a LINE-1/c-myc rearrangement. Conclusions: considering the aggressive nature of the plasmacytoid phenotype, there is no apparent relation between LINE-1/c-myc and the malignancy of TVT. Further studies are needed to establish molecular differences associated with the aggressiveness of the various phenotypes of canine TVT.

Objetivo: evaluar la expresión del trasposón LINE-1 insertado en el oncogén c-myc como una alteración genética específica en células de Tumor Venéreo Transmisible canino espontáneo con fenotipos linfocitoideos o plasmocitoideos. Métodos: se tomaron muestras citológicas de 35 caninos naturalmente afectados por Tumor Venéreo Transmisible (TVT), separándolas en dos grupos de acuerdo al fenotipo predominante. La identificación del marcador molecular LINE-1/c-myc fue posible mediante la técnica de Reacción en Cadena de la Polimerasa (PCR) usando los primers myc.s y LINE. A, específicos para el segmento LINE-1. Resultados: el resultado del alineamiento de las secuencias obtenidas a partir del DNA de cada uno de los fenotipos de TVT no presentó variación entre ellos y al compararlas con el alineamiento de otras secuencias depositadas en el GenBank, pudo observarse que se trata de un reordenamiento LINE- 1/c-myc. Conclusiones: teniendo en cuenta la naturaleza agresiva del fenotipo plasmocitoide, se estableció que no hay polimorfismo genético entre los grupos analizados, siendo necesario realizar nuevos estudios tendientes a establecer diferencias moleculares asociadas con la agresividad de los diferentes fenotipos del TVT canino.

Objetivo: foi avaliado o elemento de transposição LINE-1 inserido no gene c-myc como alteração genética específica nas células do TVT espontâneo canino nos grupos fenotípicos previamente classificados como linfocitóide e plasmocitóide. Métodos: amostras da lesão de 35 cães foram colhidas por punção ou esfoliação. Para identificar o marcador molecular LINE-1/c-myc nas amostras foi utilizada a técnica de Reação em Cadeia da Polimerase empregando-se os primers myc.s e LINE. A, específicos para o segmento LINE-1. Resultados: o resultado do alinhamento das sequências obtidas das amostras de DNA das células de TVT linfocitóide e plasmocitóide não apresentou polimorfismos e, por meio do alinhamento com outras sequências depositadas no GeneBank, identificou-se que trata-se do rearranjo LINE-1/c-myc. Conclusões: parece não haver relação entre este aspecto molecular analisado com a agressividade do tumor.

Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy.

CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%), abdominal pain (78%), diarrhea (78%) and weight loss (78%) were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

Occurrence of urinary tract infection in patients with renal allograft biopsies showing neutrophilic tubulitis.

Lymphocytic tubulitis is a well-accepted criterion for acute cellular rejection in renal allograft biopsies. Neutrophilic tubulitis has been used as a surrogate marker for urinary tract infection, but it is not clear how reliably this lesion can be used to make this diagnosis. Biopsy findings were correlated with clinical features in 26 renal allograft biopsies with interstitial polymorphonuclear infiltrates associated with neutrophilic tubulitis. The grade of neutrophilic tubulitis exceeded the grade of lymphocytic tubulitis in 7 (44%) of 16 patients with, but in only 0 patients without, a positive urine culture. Culture confirmed urinary tract infection in 16 (62%) of 26 patients. It is possible that prior antibiotic therapy led to a false-negative culture and masked the diagnosis in two additional patients. Lymphocytic tubulitis made it difficult to exclude concurrent acute cellular rejection in all biopsies studied. In 6 (23%) of 26 patients, negative cultures and response to steroid treatment confirmed that neutrophilic tubulitis can occur in biopsies without urinary tract infection. The relative contributions of infection and rejection could not be determined in patients treated with both steroids and antibiotics. Neutrophilic tubulitis in a renal allograft biopsy should alert the clinician to the possibility of urinary tract infection, even if concurrent lymphocytic tubulitis is present. Confirmation by urine culture is needed because biopsies with ischemic injury and acute cellular or antibody-mediated rejection can show overlapping histology.

The high-frequency backscattering angular response of gassy sediments: model/data comparison from the Eel River Margin, California.

A model for the high-frequency backscatter angular response of gassy sediments is proposed. For the interface backscatter contribution we adopted the model developed by Jackson et al. [J. Acoust. Soc. Am. 79, 1410-1422 (1986)], but added modifications to accommodate gas bubbles. The model parameters that are affected by gas content are the density ratio, the sound speed ratio, and the loss parameter. For the volume backscatter contribution we developed a model based on the presence and distribution of gas in the sediment. We treat the bubbles as individual discrete scatterers that sum to the total bubble contribution. This total bubble contribution is then added to the volume contribution of other scatters. The presence of gas affects both the interface and the volume contribution of the backscatter angular response in a complex way that is dependent on both grain size and water depth. The backscatter response of fine-grained gassy sediments is dominated by the volume contribution while that of coarser-grained gassy sediments is affected by both volume and interface contributions. In deep water the interface backscatter is only slightly affected by the presence of gas while the volume scattering is strongly affected. In shallow water the interface backscatter is severely reduced in the presence of gas while the volume backscatter is only slightly increased. Multibeam data acquired offshore northern California at 95 kHz provides raw measurements for the backscatter as a function of grazing angle. These raw backscatter measurements are then reduced to scattering strength for comparison with the results of the proposed model. The analysis of core samples at various locations provides local measurements of physical properties and gas content in the sediments that, when compared to the model, show general agreement.

Ensinando a pescar / Teatching how to fish

No município de Rio do Sul (SC), a população aprende noções de autocuidado. Em Chapecó (SC), escolares são habituados à escovação e recebem acompanhamento periódico de profissionais. Pequenos oásis que dão grandes exemplos