A multicentric outbreak of Candida auris in Mexico: 2020 to 2023.

BACKGROUND: Candida auris, an emerging multidrug-resistant yeast, has become a global concern due to its association with nosocomial outbreaks and resistance to antifungal medications. The COVID-19 pandemic has exacerbated the situation, with several outbreaks reported worldwide, including in Mexico. We describe the clinical and microbiological characteristics of a multicentric outbreak in private institutions in Mexico. METHODS: A retrospective observational study was conducted across 4 Christus Muguerza Hospital Health Care System facilities in Monterrey, Mexico, where simultaneous outbreaks of C auris occurred. Patients with colonization or infection with C auris between September 2020 and December 2023 were included. RESULTS: Analysis revealed 37 cases, predominantly male (median age, 55.8years). While most cases were initially colonization, a significant proportion progressed to infection (32.4%). Patients with documented infection had longer intensive care unit and hospital stays, often requiring mechanical ventilation. Antifungal treatment varied, with empirical fluconazole being the first drug in most cases, followed by anidulafungin and caspofungin. Resistance to fluconazole was widespread, but susceptibility to other antifungals varied. The overall mortality rates were high (40.5%), with no significant difference in median survival between colonized and infected patients. CONCLUSIONS: We reported a high rate of infection in previously colonized cases associated with longer hospital lenght stay, and a high susceptibility to echinocandins.

Health care of sexual partners of adolescents with gestational syphilis and their children: an integrative review. / Atenção à saúde dos parceiros sexuais de adolescentes com sífilis gestacional e seus filhos: uma revisão integrativa.

Gestational syphilis (GS) in adolescents is a challenge for Brazilian public health, with high incidence rates. Testing, diagnosis and treatment of sexual partners is essential to interrupt the chain of transmission, but since 2017 it is no longer a criterion for the proper treatment of pregnant women. We sought to analyze and synthesize the knowledge produced about the health care of sexual partners of adolescents with GS in Brazil. We carried out a systematic review in the BVS, SciELO and PubMed databases, selecting articles that addressed GS and/or congenital syphilis (CS) in adolescents aged 15 to 19 years and that included information about sexual partners. Forty-one articles were comprehensively analyzed using the WebQDA software and classified into two categories: a) Approach to sexual partners during prenatal care, and b) The role of sexual partners in the transmission cycle of GS and CS. The studies show that the partner's approach is deficient, with a lack of data on the sociodemographic profile and information on testing and treatment. In the context of Primary Health Care, there are no studies that address factors inherent to the context of vulnerability of sexual partners in relation to coping with syphilis.

A sífilis gestacional (SG) em adolescentes é um desafio para a saúde pública brasileira, com elevadas taxas de incidência. A testagem, diagnóstico e tratamento dos parceiros sexuais é indispensável para interromper a cadeia de transmissão, mas desde 2017 deixou de ser critério para o tratamento adequado da gestante. Buscamos analisar e sintetizar o conhecimento produzido sobre a atenção à saúde de parceiros sexuais de adolescentes com SG no Brasil. Realizamos uma revisão integrativa nas bases de dados BVS, SciELO e PubMed, selecionando artigos que abordavam SG e/ou sífilis congênita (SC) em adolescentes de 15 a 19 anos e que incluíam informações sobre os parceiros sexuais. Quarenta e um artigos foram analisados compreensivamente com auxílio do software WebQDA e classificados em duas categorias: (a) Abordagem dos parceiros sexuais no pré-natal, e (b) Papel dos parceiros sexuais no ciclo de transmissão da SG e da SC. Os estudos evidenciam que a abordagem do parceiro é deficitária, com ausência de dados sobre o perfil sociodemográfico e informações sobre testagem e tratamento. No âmbito da atenção primária à saúde não se encontram estudos que abordem fatores inerentes ao contexto de vulnerabilidade dos parceiros sexuais em relação ao enfrentamento da sífilis.

Brown spiders (Loxosceles) are taking hold in Pernambuco, Brazil: a case series, 2018-2022.

OBJECTIVE: To describe accidents involving brown spider (genus Loxosceles) bites notified by the Pernambuco Poison Information and Care Center (CIATox-PE), Brazil, from January 2018 to December 2022. METHODS: This was a case series study of brown spider bites notified by the CIATox-PE. RESULTS: The study included 22 cases with median age of 35 years, the majority being female (13); the cases occurred in rural and urban areas (12 versus 10), at night (10); Petrolina was the municipality with the highest number of notifications (6); spider bites occurred mainly in the lower (11) and upper (9) limbs, almost exclusively inside households (21); specific serum therapy was not indicated for 8 cases because the time for its effectiveness had already elapsed. CONCLUSION: Loxoscelism cases occurred more frequently in females, in both rural and urban areas and mainly at home, with delays in seeking medical care. MAIN RESULTS: The 22 cases described represent an alert for the presence of a venomous species not reported in previous studies in Pernambuco. The severity of cases may be associated with delays in seeking medical care, especially due to the population's lack of information. IMPLICATIONS FOR SERVICES: Identify the presence of brown spiders in households in the region and the potential severity of poisonings. Alert health professionals to recognize the clinical picture with a view to appropriate early treatment. PERSPECTIVES: Develop research on poisoning by venomous animals and educational actions alerting the population to prevent these accidents and updating health professionals on care.

Brown spiders (Loxosceles) are taking hold in Pernambuco, Brazil: a case series, 2018-2022 / Las arañas marrones (Loxosceles) están instalándose en Pernambuco, Brasil: serie de casos, 2018-2022 / As aranhas-marrons (Loxosceles) estão se estabelecendo em Pernambuco: série de casos, 2018-2022

ABSTRACT Objective To describe accidents involving brown spider (genus Loxosceles) bites notified by the Pernambuco Poison Information and Care Center (CIATox-PE), Brazil, from January 2018 to December 2022. Methods This was a case series study of brown spider bites notified by the CIATox-PE. Results The study included 22 cases with median age of 35 years, the majority being female (13); the cases occurred in rural and urban areas (12 versus 10), at night (10); Petrolina was the municipality with the highest number of notifications (6); spider bites occurred mainly in the lower (11) and upper (9) limbs, almost exclusively inside households (21); specific serum therapy was not indicated for 8 cases because the time for its effectiveness had already elapsed. Conclusion Loxoscelism cases occurred more frequently in females, in both rural and urban areas and mainly at home, with delays in seeking medical care.

RESUMEN Objetivo Describir accidentes causados ​​por arañas pardas (género Loxosceles) notificados por el Centro de Información de Asistencia Toxicológica de Pernambuco (CIATox-PE), Brasil, de enero de 2018 a diciembre de 2022. Métodos Reporte de 22 casos notificados de CIATox-PE. Resultados Casos con media de idade de 35 años, predominio femenino (13); los casos ocurrieron en área rural/urbana (12 versus 10), por la noche (10); Petrolina fue el municipio con más notificaciones (6); las picaduras fueron principalmente en los miembros inferiores (11) y superiores (9), casi exclusivamente en el interior de las viviendas (21); en 8 de los casos no se indicó sueroterapia específica por haber superado el tiempo de efecto. Conclusión Los casos de loxoscelismo ocurrieron con mayor frecuencia en el sexo femenino, en áreas rurales y urbanas, y principalmente en el hogar, con demoras en la búsqueda de atención médica.

RESUMO Objetivo Descrever os acidentes por picada de aranhas-marrons (gênero Loxosceles), notificados no Centro de Informação de Assistência Toxicológica de Pernambuco (CIATox-PE), Brasil, no período de 2018 a 2022. Métodos Estudo de série, sobre casos notificados no CIATox-PE. Resultados Foram incluídos 22 casos com mediana de idade de 35 anos e houve predomínio do sexo feminino (13); os casos ocorreram nas zonas rural e urbana (12 versus 10), durante a noite (10), e Petrolina foi o município com mais notificações (6); as picadas ocorreram, principalmente, nos membros inferiores (11) e superiores (9), quase exclusivamente dentro das residências (21); para 8 acidentados, não se prescreveu soroterapia específica por terem ultrapassado o tempo de efetividade. Conclusão Os casos de loxoscelismo ocorreram com maior frequência no sexo feminino, nas zonas rural e urbana indiferentemente, quase todos foram intradomiciliares e houve demora na procura por atendimento médico.

Atenção à saúde dos parceiros sexuais de adolescentes com sífilis gestacional e seus filhos: uma revisão integrativa / Health care of sexual partners of adolescents with gestational syphilis and their children: an integrative review

Resumo A sífilis gestacional (SG) em adolescentes é um desafio para a saúde pública brasileira, com elevadas taxas de incidência. A testagem, diagnóstico e tratamento dos parceiros sexuais é indispensável para interromper a cadeia de transmissão, mas desde 2017 deixou de ser critério para o tratamento adequado da gestante. Buscamos analisar e sintetizar o conhecimento produzido sobre a atenção à saúde de parceiros sexuais de adolescentes com SG no Brasil. Realizamos uma revisão integrativa nas bases de dados BVS, SciELO e PubMed, selecionando artigos que abordavam SG e/ou sífilis congênita (SC) em adolescentes de 15 a 19 anos e que incluíam informações sobre os parceiros sexuais. Quarenta e um artigos foram analisados compreensivamente com auxílio do software WebQDA e classificados em duas categorias: (a) Abordagem dos parceiros sexuais no pré-natal, e (b) Papel dos parceiros sexuais no ciclo de transmissão da SG e da SC. Os estudos evidenciam que a abordagem do parceiro é deficitária, com ausência de dados sobre o perfil sociodemográfico e informações sobre testagem e tratamento. No âmbito da atenção primária à saúde não se encontram estudos que abordem fatores inerentes ao contexto de vulnerabilidade dos parceiros sexuais em relação ao enfrentamento da sífilis.

Abstract Gestational syphilis (GS) in adolescents is a challenge for Brazilian public health, with high incidence rates. Testing, diagnosis and treatment of sexual partners is essential to interrupt the chain of transmission, but since 2017 it is no longer a criterion for the proper treatment of pregnant women. We sought to analyze and synthesize the knowledge produced about the health care of sexual partners of adolescents with GS in Brazil. We carried out a systematic review in the BVS, SciELO and PubMed databases, selecting articles that addressed GS and/or congenital syphilis (CS) in adolescents aged 15 to 19 years and that included information about sexual partners. Forty-one articles were comprehensively analyzed using the WebQDA software and classified into two categories: a) Approach to sexual partners during prenatal care, and b) The role of sexual partners in the transmission cycle of GS and CS. The studies show that the partner's approach is deficient, with a lack of data on the sociodemographic profile and information on testing and treatment. In the context of Primary Health Care, there are no studies that address factors inherent to the context of vulnerability of sexual partners in relation to coping with syphilis.

Experiences of miscarriage: the voice of parents and health professionals.

The death of a child in the intrauterine stage has legal, psychological, spiritual, and health-related connotations that condition the woman's experience. To understand better the processes set in motion around early pregnancy loss, this ethnographic study explores the experiences of miscarriage in a group of 15 women. The following themes are analyzed: Experience of losing the child, spirituality, health care, and the need to physically recognize the child. The study shows that the need women have to honor the child who did not live may be conditioned by the perception of an uncertain loss and by the absence of a place to honor him/her. Attitudes among professionals are revealed that could be perceived as gender-related abuse. The care of women places emphasis on physical aspects, underlining the lack of comprehensive care during the grieving process.

Lo psicosomático en lo infantil / Psychosomatic disorders of childhood

El concepto de lo psicosomático no es psicoanalítico, sin embargo, es claro que desde sus inicios la relación entre el cuerpo y el psiquismo es fundamental en la construcción de la teoría psicoanalítica y a travesará todos sus desarrollos. El psicoanálisis es el primero en proponer un modelo etiológico para explicar los síntomas corporales en donde lo psíquico tiene un lugar preponderante. El presente texto constituye un recorrido por este concepto, como Lacan, quien, a pesar de haberse referido en muy pocas ocasiones al respecto, nos permite, a través de otras conceptualizaciones, diferenciar el proceso de conversión histérica y el fenómeno psicosomático, en el que de lo que se trata es de una respuesta corporal que queda por fuera de cualquier orden, inclusive el simbólico. De esta manera podemos encontrar como somera conclusión que cuando el dolor no encuentra salida en las lágrimas son otros órganos los que lo expresan

Even though the concept of psychosomatic phenomenon is not a psychoanalytical one, the study of the relationship between body and psychism has been of paramount importance in the development of each aspect of psychoanalytical theory, Psychoanalysis is the first discipline to propose an etiological model to explain bodily symptoms while attibuting psychic dimension a preponderant role. The pesent paper focuses on thet concept, taking into consideration perspectives such a Lacan's, whose work allow us to distinguish between hysterical conversion and psychosomatic phenomenon, a body's response which doesn't conform to any order, not even the symbolical one. Given this, we can conclude that when pain is not expressed through tears, it is expressed through other organs

Factores que influyen en la participación en cursos de educación continua del personal de enfermería / Elements that influence the particpation of nursing staff in continuous education courses

Introducción: la educación continua se concibe como una modalidad educativa que permite, a una persona ­profesional o no­, actualizarse en un área específica para desarrollarse profesionalmente. Objetivo: determinar los factores que influyen en la participación, en cursos de educación continua, del personal de enfermería. Material y métodos: estudio observacional, trasversal, prolectivo y descriptivo, a una muestra por conveniencia de 136 sujetos, conformada por personal de base del área de enfermería del Hospital General Fernando Quiroz Gutiérrez del ISSSTE. Los datos fueron recolectados con un instrumento diseñado ex-profeso, auto-administrado, con una confiabilidad Alpha de Cronbach de 0.93 (0.82-0.93). Resultados: de la participación en cursos de educa-ción continua en los que participa el personal de enfermería, llama la atención el reporte de no asistencia a los mismos del 34% (46) de los enfermeros(as). La antigüedad que tiene el personal de enfermería dentro del instituto, se correlaciona de manera negativa con el número de cursos tomados (rs = -0.316, p < 0.0001) esto es, a mayor antigüedad, menor número de cursos tomados; mientras que a mayor nivel académico, se observa una correlacion positiva, es decir que, asisten a un mayor número de cursos (rs = 0.265, p < 0.002). Conclusión: Los cursos de educación continua deben tener características de visibilidad que los hagan atractivos y, en su programación, deben considerarse las habilidades que se desea sean adquiridas.

Antimicrobial, Optical and Mechanical Properties of Chitosan-Starch Films with Natural Extracts.

Natural extracts possess several kinds of antioxidants (anthocyanins, betalains, thymol, carvacrol, and resveratrol) that have also demonstrated antimicrobial properties. In order to study these properties, extracts from cranberry, blueberry, beetroot, pomegranate, oregano, pitaya, and resveratrol (from grapes) were obtained. Growth inhibition tests of mesophilic aerobes, coliforms, and fungi were conducted in films prepared from the extracts in accordance with Mexican Official Norms (NOM). Optical properties such as transparency and opacity, mechanical properties, and pH were also analyzed in these materials. The films with beetroot, cranberry, and blueberry extracts demonstrated the best antimicrobial activity against various bacteria and fungi in comparison with unmodified chitosan-starch film. This study shows that the addition of antioxidants improved the antimicrobial performance of these films. It was also found that antimicrobial properties are inherent to the films. These polymers combined with the extracts effectively inhibit or reduce microorganism growth from human and environmental contact; therefore, previous sterilization could be unnecessary in comparison with traditional plastics. The presence of extracts decreased transmittance percentages at 280 and 400 nm, as well as the transparency values, while increasing their opacity values, providing better UV-VIS light barrier properties. Despite diminished glass transition temperatures (Tg), the values obtained are still adequate for food packaging applications.

Cover crops growth under water deficit / Crescimento de plantas de cobertura sob déficit hídrico

One of the challenges to be overcome in no till deploying in tropical regions is the production of straw in the offseason, a period commonly with low water availability. To help in the choice of species to be used as cover crop in dry winter regions, the aim of this work was to evaluate the effect of soil water potential on growth of black oat (Avena strigosa Sckreb), pearl millet (Pennisetum glaucum (L.) R. Brown), grain sorghum (Sorghum bicolor L. Moench.) e guinea sorghum (Sorghum bicolor subespécie bicolor raça guinea). Pearl millet is a good option to be cropped during offseason by show high yield potencial, even been more sensitive to water deficit. Grain sorghum and guinea sorghum are also good options, particularly by showed abundant root system, which possibly gives them a certain tolerance to low water availability conditions. The black oat, even with high tolerance to water stress (tolerance conferred by highest percentage of fine roots), seems to be much affected by higher temperatures, common to these regions.

Um dos desafios a serem vencidos na implantação do sistema de semeadura direta em regiões tropicais é a produção de palhada na entressafra, período comumente com baixa disponibilidade hídrica. Visando auxiliar a escolha das espécies a serem empregadas como planta de cobertura em regiões de inverno seco, objetivou-se com este trabalho avaliar o efeito de potenciais de água no solo no crescimento de aveia preta (Avena strigosa Sckreb), milheto (Pennisetum glaucum (L.) R. Brown), sorgo granífero (Sorghum bicolor L. Moench.) e sorgo-de-guiné (Sorghum bicolor subespécie bicolor raça guinea), bem como detectar possíveis estratégias destas espécies para contornarem condições de baixa disponibilidade hídrica. O milheto, mesmo sendo mais sensível ao déficit hídrico, é uma boa opção a ser cultivado na entressafra pelo seu elevado potencial produtivo. O sorgo granífero e o sorgo-de-guiné também são boas opções, em especial por apresentarem abundante sistema radicular, o que confere aos mesmos certa tolerância à condições de baixa disponibilidade hídrica. A aveia preta, mesmo apresentando aparentemente elevada tolerância à deficiência hídrica (tolerância esta conferida pela maior porcentagem de raízes finas), parece ser muito prejudicada por temperaturas mais elevadas, comuns a estas regiões.

Cover crops growth under water deficit / Crescimento de plantas de cobertura sob déficit hídrico

One of the challenges to be overcome in no till deploying in tropical regions is the production of straw in the offseason, a period commonly with low water availability. To help in the choice of species to be used as cover crop in dry winter regions, the aim of this work was to evaluate the effect of soil water potential on growth of black oat (Avena strigosa Sckreb), pearl millet (Pennisetum glaucum (L.) R. Brown), grain sorghum (Sorghum bicolor L. Moench.) e guinea sorghum (Sorghum bicolor subespécie bicolor raça guinea). Pearl millet is a good option to be cropped during offseason by show high yield potencial, even been more sensitive to water deficit. Grain sorghum and guinea sorghum are also good options, particularly by showed abundant root system, which possibly gives them a certain tolerance to low water availability conditions. The black oat, even with high tolerance to water stress (tolerance conferred by highest percentage of fine roots), seems to be much affected by higher temperatures, common to these regions.

Um dos desafios a serem vencidos na implantação do sistema de semeadura direta em regiões tropicais é a produção de palhada na entressafra, período comumente com baixa disponibilidade hídrica. Visando auxiliar a escolha das espécies a serem empregadas como planta de cobertura em regiões de inverno seco, objetivou-se com este trabalho avaliar o efeito de potenciais de água no solo no crescimento de aveia preta (Avena strigosa Sckreb), milheto (Pennisetum glaucum (L.) R. Brown), sorgo granífero (Sorghum bicolor L. Moench.) e sorgo-de-guiné (Sorghum bicolor subespécie bicolor raça guinea), bem como detectar possíveis estratégias destas espécies para contornarem condições de baixa disponibilidade hídrica. O milheto, mesmo sendo mais sensível ao déficit hídrico, é uma boa opção a ser cultivado na entressafra pelo seu elevado potencial produtivo. O sorgo granífero e o sorgo-de-guiné também são boas opções, em especial por apresentarem abundante sistema radicular, o que confere aos mesmos certa tolerância à condições de baixa disponibilidade hídrica. A aveia preta, mesmo apresentando aparentemente elevada tolerância à deficiência hídrica (tolerância esta conferida pela maior porcentagem de raízes finas), parece ser muito prejudicada por temperaturas mais elevadas, comuns a estas regiões.

Quantitative histological analysis of the mandibular branch of the facial nerve in rats.

PURPOSE: To establish a model to quantitative histological analysis of the mandibular branch of the facial nerve in rats. METHODS: Eleven Wistar rats had their right and left mandibular branches of the facial nerve surgically removed and were sacrificed afterwards. Quantitative histological analysis was performed with: a) partial number of axons; b) partial area of the transversal cut of the nerve (9000 µm(2)); c) partial density. The averages of partial density were obtained. The statistical study was established by Wilcoxon test (p=0.05). RESULTS: In relation to density of axons, comparison between sides shows no statistically significant difference (p=0.248; p=0.533). Mean partial density of distal and proximal samples was, respectively, 0.18 ± 0.02 and 0.19 ± 0.02 axons/µm(2). Comparison between proximal and distal samples shows no statistically significant difference (p=0.859; p=0.182). CONCLUSION: This study has successfully established a model to histological quantitative analysis of the mandibular branch of the facial nerve in rats.

Quantitative histological analysis of the mandibular branch of the facial nerve in rats / Análise histológica quantitativa do ramo mandibular do nervo facial em ratos

PURPOSE: To establish a model to quantitative histological analysis of the mandibular branch of the facial nerve in rats. METHODS: Eleven Wistar rats had their right and left mandibular branches of the facial nerve surgically removed and were sacrificed afterwards. Quantitative histological analysis was performed with: a) partial number of axons; b) partial area of the transversal cut of the nerve (9000μm²); c) partial density. The averages of partial density were obtained. The statistical study was established by Wilcoxon test (p=0.05). RESULTS: In relation to density of axons, comparison between sides shows no statistically significant difference (p=0.248; p=0.533). Mean partial density of distal and proximal samples was, respectively, 0.18 ± 0.02 and 0.19 ± 0.02 axons/μm². Comparison between proximal and distal samples shows no statistically significant difference (p=0.859; p=0.182). CONCLUSION: This study has successfully established a model to histological quantitative analysis of the mandibular branch of the facial nerve in rats.(AU)

OBJETIVO: Estabelecer um modelo para análise histológica quantitativa do ramo mandibular do nervo facial de ratos. MÉTODOS: Onze ratos Wistar tiveram os ramos mandibulares de seus nervos faciais direito e esquerdo removidos cirurgicamente, e submetidos à análise histológica quantitativa de suas regiões proximal e distal com: a) contagem total do número de axônios, b) medida da área parcial (9000μm²) de corte transversal do nervo, c) cálculo de densidade parcial (DP). RESULTADOS: Em relação à densidade dos axônios, a comparação entre os lados não mostrou diferença estatisticamente significativa (p=0,248; p=0,533). A densidade parcial média das amostras distais e proximais foi, respectivamente, 0,18 ± 0,02 e 0,19 ± 0,02 axônios/μm². A comparação entre as amostras proximais e distais não mostrou diferença estatisticamente significativa (p=0,859; p=0,182). CONCLUSÃO: Este estudo estabeleceu com sucesso um modelo de análise histológica quantitativa do ramo mandibular do nervo facial em ratos.(AU)

Quantitative histological analysis of the mandibular branch of the facial nerve in rats / Análise histológica quantitativa do ramo mandibular do nervo facial em ratos

PURPOSE: To establish a model to quantitative histological analysis of the mandibular branch of the facial nerve in rats. METHODS: Eleven Wistar rats had their right and left mandibular branches of the facial nerve surgically removed and were sacrificed afterwards. Quantitative histological analysis was performed with: a) partial number of axons; b) partial area of the transversal cut of the nerve (9000μm²); c) partial density. The averages of partial density were obtained. The statistical study was established by Wilcoxon test (p=0.05). RESULTS: In relation to density of axons, comparison between sides shows no statistically significant difference (p=0.248; p=0.533). Mean partial density of distal and proximal samples was, respectively, 0.18 ± 0.02 and 0.19 ± 0.02 axons/μm². Comparison between proximal and distal samples shows no statistically significant difference (p=0.859; p=0.182). CONCLUSION: This study has successfully established a model to histological quantitative analysis of the mandibular branch of the facial nerve in rats.

OBJETIVO: Estabelecer um modelo para análise histológica quantitativa do ramo mandibular do nervo facial de ratos. MÉTODOS: Onze ratos Wistar tiveram os ramos mandibulares de seus nervos faciais direito e esquerdo removidos cirurgicamente, e submetidos à análise histológica quantitativa de suas regiões proximal e distal com: a) contagem total do número de axônios, b) medida da área parcial (9000μm²) de corte transversal do nervo, c) cálculo de densidade parcial (DP). RESULTADOS: Em relação à densidade dos axônios, a comparação entre os lados não mostrou diferença estatisticamente significativa (p=0,248; p=0,533). A densidade parcial média das amostras distais e proximais foi, respectivamente, 0,18 ± 0,02 e 0,19 ± 0,02 axônios/μm². A comparação entre as amostras proximais e distais não mostrou diferença estatisticamente significativa (p=0,859; p=0,182). CONCLUSÃO: Este estudo estabeleceu com sucesso um modelo de análise histológica quantitativa do ramo mandibular do nervo facial em ratos.

Relação entre o estadiamento do cancer colorretal e o estado nutricional na internação hospitalar em pacientes submetidos a procedimentos cirúrgicos / Relationship between stage of colorectal cancer and nutritional status during hospitalization in patients undergoing surgical procedures

Introdução: O cãncer colorretal (CCR) apresenta crescente incidência no mundo e a cirurgia é seu principal tratamento. Diante da forte associação entre estado nutricional (EN) e complicações no pós-operatório, evidencia-se a importância da avaliação adequada do EN. Objetivo: Verificar se o estadiamento do CCR de pacientes submetidos á cirurgia se correlaciona com um pior EN no momento da internação hospitalar. Método: Realizou-se um estudo retrospectivo com 100 pacientes portadores de CCR internandos e submetidos à cirurgia em um Hospital Universitário no Rio de Janeiro, entre 2003 e 2007. os indicadores do EN foram o ìndice de Massa Corporal (IMC) e o porcentual de perda de peso. O estadiamento seguiu os critérios do American Joint on Cancer (1997) fundamentado na classificação Tumor, Nodes and Metastasis. Para análise estatística, utilizaram-se os testes exato de Fisher e Kruskal-Wallis. Resultados: Na internação, 43% dos pacientes encontravam-se com sobrepeso ou obesidade, 53% eutróficos e 4% desnutridos. Do total, 36% relataram perda ponderal leve ou ausente, 17% significativa e 47% grave. O estadiamento mais avançado não se correlacionou com menor IMC (p=0,5624), nem com incidência (p=0,4037) e gravidade da perda ponderal 9p=0,6017). Porém, a gravidade da perda ponderal se correlacionou com uma alteração na ingestão alimentar (p<0,001, para ambos). Conclusão: Não houve correlação entre o estadiamento mais avançado do CCR e um pior estado nutricional no momento da internação hospitalar. Assim, novos estudos devem abordar outros métodos de avaliação nutricional e possíveis diferenças no metabolismo do cãncer de cólon e reto.

Introduction: Colorectal cancer (CRC) incidence is rising worldwide and its main treatment is surgery. Given the strong association between nutritional status (NS) and postoperative complications, highlights the importance of proper assessment of the EN. Objective: To determine whether the staging of CRC patients undergoing surgery correlates with a worse EN at the time of hospitalization. Method: We conducted a retrospective study of 100 patients with RCC internandos and underwent surgery at a university hospital in Rio de Janeiro, between 2003 and 2007. indicators of EN were the Body Mass Index (BMI) and percentage of weight loss. Staging followed the criteria of the American Joint on Cancer (1997) classification based on the Tumor, Nodes and Metastasis. Statistical analysis used the Fisher exact test and Kruskal-Wallis. Results: At baseline, 43% of patients were overweight or obese, 53% normal and 4% undernourished. Of the total, 36% reported weight loss is minimal or absent, a significant 17% and 47% severe. A more advanced stage was not correlated with lower BMI (p = 0.5624), nor with incidence (p = 0.4037) and severity of weight loss 9p = 0.6017). However, the severity of weight loss correlated with a change in food intake (p <0.001 for both). Conclusion: There was no correlation between more advanced stage of RCC and a poor nutritional status at the time of hospitalization. Thus, further studies should address other methods of nutritional assessment and possible differences in metabolism of the colon and rectum.

Introducción: El cáncer colorrectal (CCR) incidencia está aumentando en todo el mundo y su principal tratamiento es la cirugía. Dada la fuerte asociación entre el estado nutricional (NS) y las complicaciones postoperatorias, pone de relieve la importancia de la evaluación adecuada de la ES. Objetivo: determinar si la puesta en escena de los pacientes sometidos a cirugía de CRC se correlaciona con un peor ES en el momento de la hospitalización. Método: Se realizó un estudio retrospectivo de 100 pacientes con CCR internandos y se sometió a cirugía en un hospital universitario de Río de Janeiro, entre 2003 y 2007. indicadores de la norma fueron el Índice de Masa Corporal (IMC) y porcentaje de pérdida de peso. La estadificación seguido los criterios de la empresa común de América sobre el Cáncer (1997) clasificación basada en el tumor, nódulos y las metástasis. El análisis estadístico utilizó el test exacto de Fisher y Kruskal-Wallis. Resultados: Al inicio del estudio, el 43% de los pacientes con sobrepeso u obesidad, 53% normal y el 4% de desnutrición. Del total, 36% informó de la pérdida de peso es mínimo o ausente, un significativo del 17% y 47% graves. Una etapa más avanzada no se correlacionó con menor IMC (p = 0,5624), ni con la incidencia (p = 0,4037) y la severidad de la pérdida de peso 9p = 0,6017). Sin embargo, la severidad de la pérdida de peso relacionada con un cambio en la ingesta de alimentos (p <0,001 para ambos). Conclusión: No se encontró correlación entre más avanzado estado de CCR y un estado nutricional deficiente en el momento de la hospitalización. Así, los estudios, debería abordar otros métodos de valoración nutricional y las posibles diferencias en el metabolismo del colon y el recto.

[Reproducibility of Her-2/neu overexpression with HERCEP test in invasive ductal breast cancer]. / Reproducibilidad de la sobreexpresión de HER-2/neu con el sistema HERCEP en carcinoma mamario infiltrante.

OBJECTIVE: The aim of this study was to determine the reproducibility of the HERCEP-test (Dako Co. Carpintería Ca) for the assessment of HER-2/neu protein overexpression in archival tissues samples of women with ductal invasive breast carcinoma. MATERIALS AND METHODS: The study population was 40 retrospective and consecutive cases of women with ductal invasive breast carcinoma. The tumors were graded by the Elston and Ellis modified Scarf, Bloom and Richardson score. For immunohistochemical studies, 4 microns thick sections were cut and were immunostained with the HERCEP-test kit. We evaluated the overexpression using the numeric score approved for the FDA of USA, ranging from 0 to 3+ reflecting the intensity and pattern of the immunohistochemical signal present in 10% or more of tumor cells. The slides were reviewed twice independently and blinded by two pathologists. The second assessment was made two months after the first one. The level of inter and intraobserver was quantitated using kappa statistics. RESULTS: The interobserver agreement was 0.98 and the intraobserver agreement was 1.00 and 0.87 respectively. There was no significant differences in the assessment of the different scores of the numeric scale. CONCLUSION: The reproducibility of the numeric score evaluated was excellent.

Helicobacter pylori: sus relaciones y controversias morfológicas / Helicobacter pylori; its relationships and morphologic controversies

Desde 1984 año en que se describió Helicobacter pylori en la mucosa gastrointestinal, se le ha relacionado con múltiples alteraciones morfológicas benignas y malignas. Actualmente se conoce con mayor detalle la distribución de las enfermedades gastroduodenales, sus expresiones morfológicas y las controversias de su relación con HP. El objetivo de este trabajo es revisar algunos de estos aspectos.

Riesgo de carcinoma mamario poco diferenciado en tumores con receptores de estrógeno negativos / Risk for poorly differentiated invasive ductal carcinoma in tumors with receptors of negative estrogen

Se evaluó el riesgo de carcinoma ductal infiltrante poco diferenciado (grado III) en tumores con receptores hormonales negativos con inmuhohistoquímica contra receptores de estrógeno (RE), y posteriormente se correlacionó con el grado histológico del tumor. Los tumores poco diferenciados tuvieron un mayor riesgo (OR=17.8) de ser negativos. Se encontró un alto grado de correlación entre la positividad de receptores de estrógeno y los tumores bien diferenciados (grado I) p=0.0001. Nuestros resultados son semejantes a los de algunos autores; se discute la utilidad de estos hallazgos y se plantea la posibilidad de utilizarlos ocasionalmente, cuando la falta de recursos económicos o tecnológicos no permita la determinación de receptores

Aspectos prácticos sobre el tamaño de la muestra en la investigación clínica / Practical aspects about the size of the sample in clinical research

Antecedentes: El conocimiento el tamaño apropiado de una muestra nos permite estar seguros de si los resultados publicados en diversos informes de la literatura médica tuvieron como base, además de un diseño cuidadoso, una conclusión apropiada, en función de la significancia de la diferencia observada. Para caulcular el tamaño de la muestra debemos tener en cuenta los errores tipo I y II, la varianza, la magnitud del efecto, el nivel de significancia y el poder de la prueba. Para decidir qué tipo de fórmula matemática se utlizará, lo primero que debemos observar es si nuestro estudio es de prevalencia de valores promedio o comparativo. En este artículo se explican algunos conceptos básicos de estadística y se dan cuatro ejemplos sencillos de cálculo de tamaño de muestra.