Prevalence of modifiable risk factors among patients hospitalized for acute coronary syndrome in Brazil: a call to action for Brazilian healthcare

BACKGROUND: Acute Coronary Syndrome (ACS) represents a substantial public health challenge in Brazil. Modifiable risk factors are pivotal in its incidence, yet large-scale data is sparse for crafting effective interventions to mitigate the leading cause of mortality. purpose: To elucidate the prevalence of classic modifiable risk factors in ACS hospitalizations at a premier Brazilian public cardiology.institution. METHODS: This investigation harnessed the ACS registry data from a prominent high-complexity cardiology reference center in Brazil. The study spanned from July 2018 to October 2022, encompassing patient demographics, clinical characteristics, and outcomes. The focus was on the prevalence of modifiable risk factors (hypertension, diabetes, dyslipidemia, overweight/obesity) in patients with verified ACS diagnoses, ascertained via self-reporting or at admission. RESULTS: Of 143,352 patients evaluated in the emergency department, 19,752 required admission, with 5,580 confirmed ACS cases (28.2%). ACS presentations were unstable angina (56.0%), NSTEMI (34.8%), and STEMI (9.2%). The mean age was 63 years, with females constituting 35.9%. A staggering 99.3% displayed sedentary lifestyles, 80.4% had hypertension, 72.5% were overweight/obese, 56.6% had diabetes, 53.5% had dyslipidemia, and 20.6% were smokers. CONCLUSION: The study underscores a critical prevalence of modifiable risk factors in ACS admissions. These findings underscore the critical need for aggressive public health strategies and lifestyle interventions to tackle the modifiable risks associated with ACS in Brazil.

Application of artificial intelligence to optimize the diagnosis and treatment of acute coronary syndrome: a real experience

BACKGROUND/INTRODUCTION: cardiovascular disease (CVD) is the leading cause of death in the world, with acute myocardial infarction (AMI) being the main responsible for this leadership. One of the determining factors in the outcome of Acute Coronary Syndrome (ACS) is the time to start treatment. An extremely promising path for obtaining earlier diagnosis and treatment has been the use of technological innovations in emergency care units. PRUPOSE: this study was carried out to assess the impact of applying a technology hub in the chest pain scenario in the emergency room, regarding the feasibility and potential reduction of time for diagnosis and treatment of ACS. METHODS: data obtained from 10 hospitals in the public health system in Brazil, which implemented the technology hub in the last 7 months (May to October 2021), were analyzed. This technology hub uses Artificial Intelligence (AI) to identify electrocardiograms (ECGs) with a high probability of alterations, which must be reported within 5 minutes by the cardiologist on shift (24/7) on the platform. RESULTS: 5,506 ECGs were entered into the platform, of which 53.77% (2,961) were considered abnormal; of these, 9.92% (294) had alterations compatible with ischemic events (currents of injury or myocardial ischemia). The median time for the ECG report made by the specialist was 2 minutes and 51 seconds. CONCLUSION: the implementation of a technology hub in the chest pain scenario in the emergency room proved to be feasible and has great potential for reducing the distance between symptoms and the treatment of patients with ACS.

Recombinase polymerase amplification in the molecular diagnosis of microbiological targets and its applications.

Since the introduction of the polymerase chain reaction (PCR) technique in 1983, nucleic acid amplification has permeated all fields of biological science, particularly clinical research. Despite its importance, PCR has been restricted to specialized centers and its use in laboratories with few resources is limited. In recent decades, there has been a notable increase in the development of new isothermal technologies for molecular diagnosis with the hope of overcoming the traditional limitations of the laboratory. Among these technologies, recombinase polymerase amplification (RPA) has a wide application potential because it does not require thermocyclers and has high sensitivity, specificity, simplicity, and detection speed. This technique has been used for DNA and RNA amplification in various pathogenic organisms such as viruses, bacteria, and parasites. In addition, RPA has been successfully implemented in different detection strategies, making it a promising alternative for performing diagnoses in environments with scarce resources and a high burden of infectious diseases. In this study, we present a review of the use of RPA in clinical settings and its implementation in various research areas.

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River.

In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River / Abundância de Gavião-real e Gavião-real falso numa área sob impacto de reservatório no Baixo e Médio rio Xingu

Abstract In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

Resumo Na Amazônia brasileira dois gêneros mono-específicos, Harpia e Morphnus, caracterizam-se por baixa densidade e estão classificados pelo IUCN como Quase Ameaçados, porém ocorrem sobre grande parte do território nacional, suas principais ameaças são a fragmentação florestal, a degradação de hábitat e a caça. Neste estudo avaliamos a abundância destas duas grandes aves de rapina utilizando a base de dados dos programas ambientais da UHE Belo Monte, integrando-se dois métodos para construir um mapa de distribuição ao longo de 245 km do rio Xingu. Os levantamentos terrestres pelo método RAPELD mostraram-se mais eficientes para os registros de grandes águias quando comparado aos esforços padronizados aquáticos, entretanto estes foram complementares na ausência de módulos. Cinquenta e tres por cento foram registros ocasionais durante a supressão da vegetação, afugentamento ou deslocamento. Entre 2012-2014 quatro harpias foram removidas da natureza, dois indivíduos alvo de disparos, uma por colisão com rede elétrica, e outra por atropelamento. Sete ninhos mapeados, a distância média entre os registros de harpia na calha e margens do rio foi de 15 km, 20 km distância média entre ninhos, o que permitiu estimar um total de 20 casais utilizando as florestas aluviais em uma distancia de 270 km, incluindo matas ciliares e os fragmentos fora da margem do rio. Estimamos que territórios de outros 10 casais usando a Volta Grande longe do rio principal também serão afetados pela inundação. A distância média entre os registros de Morphnus foi 16 km ao longo do rio, o único ninho mapeado estava distante 1.3 km do ninho de Harpia. Estes fragmentos florestais estão sendo substituídos por pastagens, ressaltando-se a importância da manutenção das áreas de preservação permanentes (APP) e a proteção destes fragmentos em diversos formatos de áreas de proteção, para diminuir a degradação dos mesmos e garantir a manutenção das populações destes grandes predadores na região do rio Xingu.

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River / Abundância de Gavião-real e Gavião-real falso numa área sob impacto de reservatório no Baixo e Médio rio Xingu

In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.(AU)

Na Amazônia brasileira dois gêneros mono-específicos, Harpia e Morphnus, caracterizam-se por baixa densidade e estão classificados pelo IUCN como Quase Ameaçados, porém ocorrem sobre grande parte do território nacional, suas principais ameaças são a fragmentação florestal, a degradação de hábitat e a caça. Neste estudo avaliamos a abundância destas duas grandes aves de rapina utilizando a base de dados dos programas ambientais da UHE Belo Monte, integrando-se dois métodos para construir um mapa de distribuição ao longo de 245 km do rio Xingu. Os levantamentos terrestres pelo método RAPELD mostraram-se mais eficientes para os registros de grandes águias quando comparado aos esforços padronizados aquáticos, entretanto estes foram complementares na ausência de módulos. Cinquenta e tres por cento foram registros ocasionais durante a supressão da vegetação, afugentamento ou deslocamento. Entre 2012-2014 quatro harpias foram removidas da natureza, dois indivíduos alvo de disparos, uma por colisão com rede elétrica, e outra por atropelamento. Sete ninhos mapeados, a distância média entre os registros de harpia na calha e margens do rio foi de 15 km, 20 km distância média entre ninhos, o que permitiu estimar um total de 20 casais utilizando as florestas aluviais em uma distancia de 270 km, incluindo matas ciliares e os fragmentos fora da margem do rio. Estimamos que territórios de outros 10 casais usando a Volta Grande longe do rio principal também serão afetados pela inundação. A distância média entre os registros de Morphnus foi 16 km ao longo do rio, o único ninho mapeado estava distante 1.3 km do ninho de Harpia. Estes fragmentos florestais estão sendo substituídos por pastagens, ressaltando-se a importância da manutenção das áreas de preservação permanentes (APP) e a proteção destes fragmentos em diversos formatos de áreas de proteção, para diminuir a degradação dos mesmos e garantir a manutenção das populações destes grandes predadores na região do rio Xingu.(AU)

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River

Abstract In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

Resumo Na Amazônia brasileira dois gêneros mono-específicos, Harpia e Morphnus, caracterizam-se por baixa densidade e estão classificados pelo IUCN como Quase Ameaçados, porém ocorrem sobre grande parte do território nacional, suas principais ameaças são a fragmentação florestal, a degradação de hábitat e a caça. Neste estudo avaliamos a abundância destas duas grandes aves de rapina utilizando a base de dados dos programas ambientais da UHE Belo Monte, integrando-se dois métodos para construir um mapa de distribuição ao longo de 245 km do rio Xingu. Os levantamentos terrestres pelo método RAPELD mostraram-se mais eficientes para os registros de grandes águias quando comparado aos esforços padronizados aquáticos, entretanto estes foram complementares na ausência de módulos. Cinquenta e tres por cento foram registros ocasionais durante a supressão da vegetação, afugentamento ou deslocamento. Entre 2012-2014 quatro harpias foram removidas da natureza, dois indivíduos alvo de disparos, uma por colisão com rede elétrica, e outra por atropelamento. Sete ninhos mapeados, a distância média entre os registros de harpia na calha e margens do rio foi de 15 km, 20 km distância média entre ninhos, o que permitiu estimar um total de 20 casais utilizando as florestas aluviais em uma distancia de 270 km, incluindo matas ciliares e os fragmentos fora da margem do rio. Estimamos que territórios de outros 10 casais usando a Volta Grande longe do rio principal também serão afetados pela inundação. A distância média entre os registros de Morphnus foi 16 km ao longo do rio, o único ninho mapeado estava distante 1.3 km do ninho de Harpia. Estes fragmentos florestais estão sendo substituídos por pastagens, ressaltando-se a importância da manutenção das áreas de preservação permanentes (APP) e a proteção destes fragmentos em diversos formatos de áreas de proteção, para diminuir a degradação dos mesmos e garantir a manutenção das populações destes grandes predadores na região do rio Xingu.

Abundance of Harpy and Crested Eagles from a reservoir-impact area in the Low- and Mid-Xingu River / Abundância de Gavião-real e Gavião-real falso numa área sob impacto de reservatório no Baixo e Médio rio Xingu

In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

Na Amazônia brasileira dois gêneros mono-específicos, Harpia e Morphnus, caracterizam-se por baixa densidade e estão classificados pelo IUCN como Quase Ameaçados, porém ocorrem sobre grande parte do território nacional, suas principais ameaças são a fragmentação florestal, a degradação de hábitat e a caça. Neste estudo avaliamos a abundância destas duas grandes aves de rapina utilizando a base de dados dos programas ambientais da UHE Belo Monte, integrando-se dois métodos para construir um mapa de distribuição ao longo de 245 km do rio Xingu. Os levantamentos terrestres pelo método RAPELD mostraram-se mais eficientes para os registros de grandes águias quando comparado aos esforços padronizados aquáticos, entretanto estes foram complementares na ausência de módulos. Cinquenta e tres por cento foram registros ocasionais durante a supressão da vegetação, afugentamento ou deslocamento. Entre 2012-2014 quatro harpias foram removidas da natureza, dois indivíduos alvo de disparos, uma por colisão com rede elétrica, e outra por atropelamento. Sete ninhos mapeados, a distância média entre os registros de harpia na calha e margens do rio foi de 15 km, 20 km distância média entre ninhos, o que permitiu estimar um total de 20 casais utilizando as florestas aluviais em uma distancia de 270 km, incluindo matas ciliares e os fragmentos fora da margem do rio. Estimamos que territórios de outros 10 casais usando a Volta Grande longe do rio principal também serão afetados pela inundação. A distância média entre os registros de Morphnus foi 16 km ao longo do rio, o único ninho mapeado estava distante 1.3 km do ninho de Harpia. Estes fragmentos florestais estão sendo substituídos por pastagens, ressaltando-se a importância da manutenção das áreas de preservação permanentes (APP) e a proteção destes fragmentos em diversos formatos de áreas de proteção, para diminuir a degradação dos mesmos e garantir a manutenção das populações destes grandes predadores na região do rio Xingu.

Implementation of the INTERGROWTH-21st Project in Brazil.

The Latin American site in the INTERGROWTH-21(st) Project was Pelotas, Brazil, with approximately 4000 births per year. The sample for the Newborn Cross-Sectional Study (NCSS) was drawn from four hospitals, covering 99% of births in the city. The Fetal Growth Longitudinal Study (FGLS) sample was recruited from one of the largest private ultrasound clinics in the city and 30 smaller, private, antenatal clinics serving middle to high socio-economic status women. Among this site's major challenges was the recruitment of women for FGLS from numerous different clinics. Several public relations activities were conducted to improve collaborative efforts between the research team and obstetricians, paediatricians and community leaders in Pelotas.

The first case of Angiostrongylus cantonesis eosinophilic meningitis diagnosed in the city of São Paulo, Brazil

Introduction: Angiostrongylus cantonensis is a natural parasite found in lung arteries of rats, which in humans may cause eosinophilic meningitis. Objective: To report the first case of eosinophilic meningitis caused by Angiostrongylus cantonensis in the city of São Paulo, Brazil. Case report: A male patient, 11 years old, living in the southern area of São Paulo, was admitted to the Pediatric Emergency Department with ongoing headaches for three days, but no fever or any other complaint. The presence of snails and rodents was reported in the peridomicile. The child was awake, lucid, oriented; muscular strength preserved, isochoric, photo reagent pupils and terminal nuchal rigidity - Glasgow Coma Scale (GCS) = 15. The laboratory tests showed a mild leukocytosis with 1736 eosinophils/mm3 and the CSF analysis disclosed 160 leukocytes/mm3 with 36% of eosinophils. The bacterial culture was negative. Computed Cerebral Tomography showed no alterations. The RT-PCR assay for detecting Angiostrongylus cantonensis larvae and DNA was negative. ELISA antibodies for IgG anti-A. cantonensis was negative in serum and undetermined in CSF and samples collected five days after the onset of symptoms. Seroconversion was observed in the sample collected 135 days later. Conclusion: the epidemiological and clinical data, the CSF alterations with eosinophilia and the seroconversion strongly suggest Angiostrongylus cantonensis eosinophilic meningitis.

Introdução: Angiostrongylus cantonensis é um parasito natural das artérias de pulmões de ratos, que pode causar, em humanos, meningite eosinofílica. Objetivo: Relatar o primeiro caso de meningite eosinofílica causado por A. cantonensis na cidade de São Paulo, Brasil. Relato de caso: Paciente do sexo masculino, 11 anos, residente na zona sul de São Paulo, foi admitido no serviço de emergência pediátrica com história de cefaléia há três dias, sem febre ou outras queixas. Relato de presença de moluscos e roedores no peridomicílio. Ao exame físico, criança desperta acianótica, anictérica, hidratada; lúcido, orientado; força muscular preservada, isocórica, pupilas fotorreagentes e rigidez de nuca terminal - Glasgow Coma Scale = 15. Exames laboratoriais indicaram leve leucocitose com 1736 eosinófilos/mm3 e a análise do líquor revelou a presença de 160 leucócitos/mm3 com 36% de eosinófilos. Cultura para bactérias negativa. Tomografia cerebral sem alterações. Pesquisa direta de larvas e de DNA por PCR-RT para Angiostrongylus cantonensis foi negativa. ELISA para anticorpos IgG anti-A. cantonensis negativo no soro e indeterminado no líquor nas amostras coletadas após cinco dias do início dos sintomas. Soroconversão observada na amostra coletada após 135 dias. Conclusão: A história epidemiológica, dados clínicos, alterações liquóricas com presença de eosinofilia e a soroconversão sugerem fortemente o diagnóstico de meningite eosinofílica por A. cantonensis.

The disruption in actin-perinuclear theca interactions are related with changes induced by cryopreservation observed on sperm chromatin nuclear decondensation of boar semen.

The perinuclear theca (PT) is a cytoskeletal structure that surrounds the mammal sperm nucleus which must be disrupted once the sperm has penetrated the oocyte to permit normal chromatin decondensation and formation of male pronucleus. F-actin is a thermo sensitive protein found in the equatorial segment which is involved in the stability of PT. It has been reported that cryopreservation induces alterations in nuclear decondensation of spermatozoa, which have been interpreted as an over condensation. The aims of the present study were identified the presence of changes in sperm sPT integrity of frozen-thawed boar spermatozoa and its effect in sperm nuclei decondensation; and whether changes in the actin cytoskeleton are involved using an in vitro model to test probably differences in a chemical decondensation (DTT/heparin) between fresh (FS) and frozen-thawed (TS) spermatozoa. Results showed an increase on sPT damage in TS (P<0.001), and significant changes in sperm chromatin nuclear decondensation (P<0.05). In same way differences on the swelling degree was found assessed by measures in equatorial region of head sperm (P<0.05). Evaluation with rodamine-labeled actin (0.2µM) showed two different patterns with differences in percentages before and after cryopreservation (P<0.001). F-actin stabilization constrained the equatorial segment of FS while this was not observed in TS. The data showed that the presence of early changes in sPT integrity and changes in the F-actin localization on TS may suggest the participation in F-actin in decondensation process and probably that the disruption of actin-PT interaction during freezing-thawing process could have far-reaching consequences for the subsequent fertility of spermatozoa.

Rabdomiosarcoma en niños / Childhood rabdomyosarcoma

Determinar presentación epidemiológica del rabdomiosarcoma, en Servicio de Oncología del Hospital de Niños "J.M. de Los Ríos" desde 01.01.1997 al 31.12.2005. Revisión retrospectiva de Historias clínicas de pacientes con rabdomiosarcoma, ambos sexos, menores de 16 años. 59 pacientes, edades entre 1 mes 16 años. 66,1 por ciento eran varones, 45,76 por ciento presentaban antecedentes oncológicos familiares. El Lag time entre inicio síntomas y diagnóstico histológico fue 127 días. Síntomas y signos más frecuentes: Aumento de volumen 83 por ciento, dolor: 50 por ciento, pérdida de peso: 28,8 por ciento localización anatómica: cabeza y cuello: 33,8 por ciento; genitourinario: 23,7 por ciento; extremidades: 22 por ciento; piso pélvico 11,8 por ciento. Tipo histológico más frecuente: embrionario 76,3 por ciento; seguido del aveolar 20,3 por ciento; no tipificable: 3,3 por ciento. La distribución encontrada por estadiaje TNM fue: ST I: 14 (23,7 porciento), ST II: 2 (3,4 por ciento); STIII: 23 (39 por ciento); ST IV: 20 (33,9 por ciento). Todos recibieron quimioterapia sistémica. El abandono fue de 8,47 por ciento. En total 31 pacientes recibieron radioterapia: 28 con fines curativos y 3 paliativos. El status actual de los pacientes: 27 pacientes vivos (45,7 por ciento) 24 sin enfermedad, 3 con enfermedad; 29 pacientes fallecidos, 3 abandonaron el seguimiento. La presentación clínica del rabdomiosarcoma en nuestra serie es similar a la reportada en la literatura; asociado en 45,7 por ciento a antecedentes oncológicos familiares; primarios de cabeza y cuello, predominantemente de tipo embrionario. Se observaron retardos diagnósticos prolongados: más del 70 por ciento de nuestros pacientes se diagnostican en estadios avanzados.

Experience with demucosalized ileum for bladder augmentation.

OBJECTIVE: To assess the use of demucosalized ileum for bladder augmentation, following the same principles previously used with the sigmoid colon. PATIENTS AND METHODS: Eleven patients with bladder exstrophy or a neurogenic bladder had their bladders augmented with demucosalized ileum instead of the sigmoid colon, but following the same technique. The use of a Foley catheter with an inflated balloon greatly facilitated the dissection of the mucosa from the muscle. A silicone model, inserted in the bladder, was used to avoid shrinkage of the patch. An animal model was also used for total bladder replacement following the same principle. RESULTS: The mean (range) follow-up was 15.4 (2-25) months. There was a significant increase in bladder compliance in all patients. A bladder of good shape and compliance was obtained in the animal model, with epithelial growth detected in all cases. CONCLUSIONS: Demucosalized ileum can be used safely for bladder augmentation in the same way as with the sigmoid colon. The distension of the isolated patch greatly facilitates dissection between the mucosa and muscle. The animal model supported this method of bladder replacement.

[The ACHEI Program: Chagas' disease awareness through comprehensive education in the municipality of Maringá, Northwest Paraná, Brazil]. / Programa ACHEI: Atenção ao chagásico com educaçao integral no município de Maringá e região noroeste do Paraná, Brasil.

This study analyzes 131 chagasic patients from different endemic areas that came to the Chagas' disease laboratory at the Maringa State University. The subjects discovered they were infected principally because they presented symptoms (58%) or donated blood (29.4%). During etiologic treatment for Trypanosoma cruzi, 45.2% of benznidazole users complained of side effects. Based on these data, the ACHEI program (Chagas' Disease Awareness through Comprehensive Education) was developed, which is a multiprofessional/interdisciplinary extension project. Monthly meetings are held that are divided into two parts: The first half of the meetings provide specific information, including the distribution of brochures explaining Chagas' disease transmission, symptoms and treatment. The second half of the meetings focuses on psycho-social assistance and includes topics such as self-esteem and personal responsibility. The meetings provide an environment for chagasic patients to share their concerns regarding post-diagnosis quality of life, fear, anxiety, stigma and family and social group relationships. In short, the meetings offer an opportunity for patients to reflect on their situation and to discover ways to deal with their disease.

Isolation and partial characterisation of highly toxic lectins from Abrus pulchellus seeds.

The seeds of Abrus pulchellus, sub-specie tenuiflorus, belonging to the Leguminosae, subfamily Papilionoideae contain highly toxic lectins exhibiting specificity for galactose and galactose-containing structures. The toxins which agglutinate rabbit erythrocytes, present a highly toxic activity in vivo when injected in the peritoneal cavity of mice (LD50=31 microg x kg(-1)) or when tested with the microcrustacean Arthemia salina (LD50=3.5 microg x ml(-1)). The active fraction was purified in a single step, by affinity chromatography on a Sepharose-4B column. The purified toxins migrated as two single bands of Mr 63000 and 61500 Da (SDS-PAGE) and Mr 31500 and 29000 Da (SDS-PAGE with 2-mercaptoethanol), respectively, suggesting the presence of disulphide-bridge interchains as occurs in other plant toxins. The antibodies anti-A. pulchellus toxins did not recognize ricin preparation and only partial identity was observed to A. precatorius toxic lectins prepared in a similar way to ricin and A. pulchellus toxins.

Histochemical study of muscle fiber types in Synbranchus marmoratus bloch, 1795.

The myotomal muscle of Synbranchus marmoratus was investigated using histochemical and immunohistochemical reactions. This musculature is composed of a superficial red compartment, uniformly distributed around the trunk circumferentially and also in the lateral line. The red compartment fibers are small in diameter and have an oxidative metabolism, a high rate of glycogen and a negative reaction to alkaline and acid myofibrillar ATPase (mATPase). The white muscle forms the bulk of the muscle mass. Its fibers are large in diameter and have a glycolytic metabolism, a negative reaction to glycogen, a strong reaction to alkaline mATPase and a negative reaction to acid mATPase. Between these two compartments there is an intermediate layer of fibers presenting a mosaic metabolism pattern with a high rate of glycogen. These fibers stained moderately for alkaline and acid m-ATPase. Several clusters of red muscles were observed inside the white muscle. Each cluster is composed of three fiber types, with a predominance of red and intermediate fibers. Reactivity to anti-MHC BA-D5 was positive only in the intermediate fibers. Reactivity to anti-MHC SC-71 was negative in all fiber types.

Histochemical fiber types of oesophageal striated muscle in synbranchus marmoratus (Bloch, 1795-pisces, synbranchidae)

Las características histoquímicas de la musculatura externa en el esófago de Synbranchus marmoratus, han sido evidenciadas notándose que no existe una división nítida entre las capas musculares circular externa e interna. Las fibras que integran estas capas se caracterizan por tener una actividad oxidativa media y alta ante la reacción enzimática de NADH-TR. La actividad m-ATPasa con preincubaciones alcalinas fue alta en la mayoría de las fibras. Además fibras de pequeño tamaño en la región interna de la musculatura presentaron baja actividad m-ATPasa y alta actividad oxidativa

An immunohistochemical study on the pancreatic endocrine cells of the three-toed sloth, Bradypus variegatus.

The cellular composition and relative frequency of the occurrence of pancreatic endocrine cells were studied immunohistochemically in a primitive eutherian and arboreal folivore, the three-toed sloth, since previous histochemical and ultrastructural studies on the endocrine pancreas of the sloth have detected only a single islet cell type, the A cell. In the sloth pancreas, four types of endocrine cells immunoreactive for glucagon, insulin, somatostatin and serotonin (5-hydroxytryptamine) were found as reported in the pancreas of human and common experimental mammals, but pancreatic polypeptide-immunoreactive cells were not detected by either avian- or bovine-pancreatic polypeptide antiserum. The endocrine cells were distributed mainly in the islets and partly also in the exocrine tissue including the pancreatic ducts. Larger or smaller clusters consisting of glucagon- and insulin-immunoreactive cells were also found frequently in the interlobular connective tissue. In the islets, glucagon- and insulin-immunoreactive cells were the most prominent cell type, while somatostatin- and serotonin-immunoreactive cells were sparse. The most striking feature in the sloth pancreas is the high frequency of glucagon-immunoreactive cells, because these cells are by far less in number than insulin-immunoreactive cells in the islets of human and common experimental mammals. This appears to be an intriguing characteristic of the sloth pancreas in a possible relation to the animal's unique metabolic system and the phylogenetical position.

Some morphological and histochemical studies on the intestinal tract of the Brazilian sloth (Bradypus tridactylus).

The intestinal of the 3-toed sloth, Bradypus tridactylus, was studied macroscopically, with light microscope and with histochemical methods for mucosubstances. Macroscopically, the inner surface of the duodenum shows longitudinal and circular folds. There is no caecum, nor appendix. The large intestine consists of a short colon and a large rectal pouch, which has a thick wall. The mucosa of the small intestine has long leaf-shaped villi covered with columnar epithelium having a well developed striated border, and the goblet cells are scattered among the columnar cells. An association between neutral and acidic mucosubstances was detected in the goblet cells. The duodenal (Brunner's) glands are confined exclusively in the lamina propria of the duodenum. No Paneth cells were observed in the crypt lining. Argyrophil and argentaffin cells were found in the entire length of the intestine. The large intestine does not possess villi, but many goblet cells were observed in its mucosa.