Virulence-related metabolism is activated in Botrytis cinerea mostly in the interaction with tolerant green grapes that remain largely unaffected in contrast with susceptible green grapes.

Botrytis cinerea is responsible for the gray mold disease, severely affecting Vitis vinifera grapevine and hundreds of other economically important crops. However, many mechanisms of this fruit-pathogen interaction remain unknown. The combined analysis of the transcriptome and metabolome of green fruits infected with B. cinerea from susceptible and tolerant genotypes was never performed in any fleshy fruit, mostly because green fruits are widely accepted to be resistant to this fungus. In this work, peppercorn-sized fruits were infected in the field or mock-treated, and berries were collected at green (EL32) stage from a susceptible (Trincadeira) and a tolerant (Syrah) variety. RNAseq and GC-MS data suggested that Syrah exhibited a pre-activated/basal defense relying on specific signaling pathways, hormonal regulation, namely jasmonate and ethylene metabolisms, and linked to phenylpropanoid metabolism. In addition, putative defensive metabolites such as shikimic, ursolic/ oleanolic, and trans-4-hydroxy cinnamic acids, and epigallocatechin were more abundant in Syrah than Trincadeira before infection. On the other hand, Trincadeira underwent relevant metabolic reprogramming upon infection but was unable to contain disease progression. RNA-seq analysis of the fungus in planta revealed an opposite scenario with higher gene expression activity within B. cinerea during infection of the tolerant cultivar and less activity in infected Trincadeira berries. The results suggested an activated virulence state during interaction with the tolerant cultivar without visible disease symptoms. Together, this study brings novel insights related to early infection strategies of B. cinerea and the green berry defense against necrotrophic fungi.

Propriedades Psicométricas da Frost Multidimensional Perfectionism Scale para adultos brasileiros / Propiedades psicométricas da Frost Multidimensional Perfectionism Scale para adultos brasileños / Psychometric properties of the Frost Multidimensional Perfectionism Scale for Brazilian adults

O objetivo do presente estudo foi investigar a estrutura interna da Frost Multidimensional Perfectionism Scale (FMPS) para adultos brasileiros, além de averiguar também a sua confiabilidade e estabilidade temporal. Participaram 1.222 indivíduos, com média de idade 26,57 anos (dp = 9,03), sendo que 618 participaram presencialmente e 604 por meio de coleta online. A escala foi reaplicada em 10% da amostra do grupo presencial para avaliar estabilidade temporal. Os resultados da análise fatorial confirmatória apontam que o modelo de seis dimensões, conforme proposta original dos autores da escala, apresentou os melhores índices de ajuste. A estrutura interna avaliada para os dois formatos de aplicação apresentou invariância estrutural, métrica e de configuração limítrofe, apontando para necessidade de ser mais bem investigada em estudos futuros. Tanto os índices de consistência interna quanto a estabilidade temporal são satisfatórios e corroboram os demais achados da literatura com a escala para outros idiomas. Conclui-se que a FMPS possui adequada validade de estrutura interna e confiabilidade para uso no Brasil.(AU)

The aim of this study was to examine the internal structure, reliability, and temporal stability of the Frost Multidimensional Perfectionism Scale (FMPS) for Brazilian adults. The sample included 1222 participants, with a mean age of 26.57 years (SD=9.03). Half of the sample completed the online version of the instrument, while the other half answered the paper-and-pencil version. To check temporal stability, the instrument was reapplied with 10% of the presential sample. The results from the confirmatory factorial analysis indicated that the original six-dimension model was the best fit for the scale. The internal structure evaluated for the two application formats showed only borderline structural, metric and configuration invariance, highlighting the need for future studies. Both the internal consistency and the temporal stability indices were satisfactory and corroborate the literature findings for the scale in other languages. In conclusion, the FMPS has adequate structural validity and reliability for use in the Brazilian context.(AU)

El objetivo del presente estudio fue investigar la estructura interna de la Frost Multidimenrsional Perfectionism Scale (FMPS) para adultos brasileños, además de averiguar también su confiabilidad y estabilidad temporal. Participaron 1.222 individuos, con media de edad 26,57 años (DS=9,03), siendo que 618 participaron presencialmente y 604 por medio de colecta online. La escala fue reaplicada en 10% de la muestra del grupo presencial para evaluar la estabilidad temporal. Los resultados del análisis factorial confirmatorio indicaron que el modelo de seis dimensiones, conforme la propuesta original de los autores de la escala, presentaron los mejores índices de ajuste. La estructura interna evaluada para los dos formatos de aplicación presentó invarianza estructural, métrica y de configuración limítrofe, apuntando para la necesidad de ser mejor investigada en estudios posteriores. Los índices de consistencia interna y estabilidad temporal son satisfactorios y corroboran los demás encontrados en la literatura con la escala para otros idiomas. Se concluye que la FMPS dispone de adecuada validez de estructura interna y confiabilidad para la utilización en Brasil.(AU)

Transcriptional, hormonal, and metabolic changes in susceptible grape berries under powdery mildew infection.

Grapevine (Vitis vinifera) berries are extremely sensitive to infection by the biotrophic pathogen Erysiphe necator, causing powdery mildew disease with deleterious effects on grape and wine quality. The combined analysis of the transcriptome and metabolome associated with this common fungal infection has not been previously carried out in any fruit. In order to identify the molecular, hormonal, and metabolic mechanisms associated with infection, healthy and naturally infected V. vinifera cv. Carignan berries were collected at two developmental stages: late green (EL33) and early véraison (EL35). RNA sequencing combined with GC-electron impact ionization time-of-flight MS, GC-electron impact ionization/quadrupole MS, and LC-tandem MS analyses revealed that powdery mildew-susceptible grape berries were able to activate defensive mechanisms with the involvement of salicylic acid and jasmonates and to accumulate defense-associated metabolites (e.g. phenylpropanoids, fatty acids). The defensive strategies also indicated organ-specific responses, namely the activation of fatty acid biosynthesis. However, defense responses were not enough to restrict fungal growth. The fungal metabolic program during infection involves secretion of effectors related to effector-triggered susceptibility, carbohydrate-active enzymes and activation of sugar, fatty acid, and nitrogen uptake, and could be under epigenetic regulation. This study also identified potential metabolic biomarkers such as gallic, eicosanoic, and docosanoic acids and resveratrol, which can be used to monitor early stages of infection.

Analysis of Radiometry on Patients Undergoing Radioactive Iodine Therapy.

The treatment for differentiated thyroid cancer consists of thyroidectomy followed by radioactive iodine therapy (RIT), in which the patient remains in isolation until the dose rate of the radioactive iodine reduces to a certain limit. The present research intends to estimate the length of stay of patients who undergo RIT, with radiometry analysis performed throughout the patient's admission. Methods: Information such as age, sex, weight, height, prescribed activity, volume of liquids ingested, and the use of recombinant human thyrotropin was gathered from 204 patients with differentiated thyroid cancer who underwent RIT. During the admission, the dose rate was periodically measured. The data served as variables for a multiple regression, in which the coefficients (the term coefficient in this paper is related to the multiplicative factor of each considered variable used in Eqs. 1-4) and significance of each were verified as a function of the dose rate. Results: The results showed that length of stay, administered activity, volume of liquids ingested, use of recombinant human thyrotropin, and patient weight impacted significantly on the dose rate. The average effective half-life of the 131I, considering all patients, was 12.61 ± 3.28 h, and the average time for their radiologic release was 15.23 ± 5.50 h. On the basis of the results, it was possible to develop a tool to estimate a patient's length of stay and effective half-life. Conclusion: The results can contribute to optimization of the radiologic protection of patients who undergo RIT, as well as allow better logistics regarding their admission, which can lead to more appropriate accommodation for the patient and a better use of resources.

Adaptação e validação da escala de perfeccionismo Almost Perfect Scale-Revised para o português brasileiro / Adaptation and validation for Brazilian Portuguese of the Revised Almost Perfect Scale / Adaptación y validación de la escala de perfeccionismo Almost Perfect Scale-Revised para el portugués brasileño

O perfeccionismo é um construto multidimensional cujo estudo vem aumentando desde os anos de 1990. Uma das escalas mais utilizadas para sua mensuração é a Almost Perfect Scale - Revised (APS-R), composta por três dimensões: Padrões, Discrepância e Ordem. Devido à ausência de medidas como essa no Brasil, este estudo objetivou adaptar e analisar as propriedades psicométricas da APS-R em uma amostra brasileira, por meio da análise de sua estrutura interna e levantamento de sua confiabilidade. Participaram 787 universitários (79,3% do sexo feminino), idade média de 25,98 anos (DP = 7,29) que responderam à APS-R e a um questionário sociodemográfico. Os itens adaptados mostraram IVC adequados: equivalência semântica (0,99), cultural (0,94) e conceitual (0,94). Dentre os modelos estruturais testados, o bifatorial mostrou-se superior aos demais (χ2 = 452,371; TLI = 0,94; CFI = 0,96; RMSEA = 0,047). Assim, a escala apresentou propriedades psicométricas satisfatórias para uso no Brasil, tanto no que se refere à sua validade quanto confiabilidade. São discutidas limitações e implicações do estudo. (AU)

The study of perfectionism as a multidimensional construct has increased since the 1990's. The Almost Perfect Scale (APS-R) is widely used across studies to measure perfectionism; it is composed by three dimensions: High Standards, Discrepancy, and Order. However, despite increasing interest in the measurement of perfectionism, there were no scales available for Brazilian-Portuguese. Accordingly, we aimed to adapt the APS-R and to analyze the psychometric properties and test confirmatory models for the Brazilian version of the Almost Perfect Scale (APS-R Brasil). A sample of university students (n=787) with a mean age 25.98 years (SD=7.29), 79.3% women, completed the APS-RB. The adapted items demonstrated semantic, cultural and conceptual adequacy (all CVI <90). The ESEM two factor model, showed the better fit index (χ²= 452.371; TLI=0.94; CFI=0.96; RMSEA=0.047). The Brazilian version of APS-R was shown to be valid and reliable. Limitations and implications of the study are discussed. (AU)

El estudio del perfeccionismo como un constructo multidimensional ha aumentado desde los años 90. La escala Almost Perfect Scale-Revised (APS-R), que se usa ampliamente en los estudios del perfeccionismo, está compuesta por tres factores: altos estándares, la percepción de la discrepancia y el orden. Sin embargo, a pesar del creciente interés en la medición del perfeccionismo, todavía no hay escalas disponibles para el portugués brasileño. Por lo tanto, el objetivo de esta investigación fue adaptar y analizar las propiedades psicométricas, y probar modelos confirmatorios para la APS-R en una muestra brasileña. Dicha muestra se compuso por estudiantes universitarios (n = 787) con una edad media de 25,98 años (DE = 7,29) y 79,3% mujeres. Los ítems adaptados demostraron adecuación semántica, cultural y conceptual (todos los IVC <90). El modelo ESEM Bifactor mostró el mejor índice de ajuste (χ2 = 452,371; TLI = 0,94; CFI = 0,96; RMSEA = 0,047). La versión brasileña de APS-R demostró ser válida y fiable. Aparte, se discute las limitaciones e implicaciones del estudio. (AU)

The study of hormonal metabolism of Trincadeira and Syrah cultivars indicates new roles of salicylic acid, jasmonates, ABA and IAA during grape ripening and upon infection with Botrytis cinerea.

Hormones play an important role in fruit ripening and in response to biotic stress. Nevertheless, analyses of hormonal profiling during plant development and defense are scarce. In this work, changes in hormonal metabolism in grapevine (Vitis vinifera) were compared between a susceptible (Trincadeira) and a tolerant (Syrah) variety during grape ripening and upon infection with Botrytis cinerea. Infection of grapes with the necrotrophic pathogen Botrytis cinerea leads to significant economic losses worldwide. Peppercorn-sized fruits were infected in the field and mock-treated and infected berries were collected at green, veraison and harvest stages for hormone analysis and targeted qPCR analysis of genes involved in hormonal metabolism and signaling. Results indicate a substantial reprogramming of hormonal metabolism during grape ripening and in response to fungal attack. Syrah and Trincadeira presented differences in the metabolism of abscisic acid (ABA), indole-3-acetic acid (IAA) and jasmonates during grape ripening that may be connected to fruit quality. On the other hand, high basal levels of salicylic acid (SA), jasmonates and IAA at an early stage of ripening, together with activated SA, jasmonates and IAA signaling, likely enable a fast defense response leading to grape resistance/ tolerance towards B. cinerea. The balance among the different phytohormones seems to depend on the ripening stage and on the intra-specific genetic background and may be fundamental in providing resistance or susceptibility. In addition, this study indicated the involvement of SA and IAA in defense against necrotrophic pathogens and gains insights into possible strategies for conventional breeding and/or gene editing aiming at improving grape quality and grape resistance against Botrytis cinerea.

Postharvest dehydration induces variable changes in the primary metabolism of grape berries.

Postharvest dehydration causes changes in texture, color, taste and nutritional value of food due to the high temperatures and long drying times required. In grape berries, a gradual dehydration process is normally utilized for raisin production and for making special wines. Here we applied a raisin industry-mimicking dehydration process for eleven days at 50°C to intact berry clusters from cv. Sémillon plants, and a set of molecular, cellular and biochemical analyses were performed to study the impact of postharvest dehydration in the primary metabolism. Transcriptional analyses by real time qPCR showed that several aquaporins (VvTIP1;2 and VvSIP1) and sugar transporters (VvHT1, VvSWEET11, VvSWEET15, VvTMT1, VvSUC12) genes were strongly upregulated. Moreover, the study of key enzymes of osmolytes metabolism, including mannitol dehydrogenase (VvMTD) and sorbitol dehydrogenase (VvSDH), at gene expression and protein activity level, together with the transcriptional analysis of the polyol transporter gene VvPLT1, showed an enhanced polyol biosynthesis capacity, which was supported by the detection of sorbitol in dehydrated grapes only. The metabolism of organic acids was also modulated, by the induction of transcriptional and biochemical activity modifications in malate dehydrogenases and malic enzymes that led to organic acid degradation, as demonstrated by HPLC analysis. Taken together, this study showed that primary metabolism of harvested berries was severely influenced in response to dehydration treatments towards lower organic acid and higher sorbitol concentrations, while sugar transporter and aquaporin genes were significantly upregulated.

Utilização de vestimentas de proteção radiológica para redução de dose absorvida: uma revisão integrativa da literatura / Utilization of radiation protection gear for absorbed dose reduction: an integrative literature review

OBJETIVO: Avaliar a relação entre o uso de vestimenta de proteção radiológica e a diminuição da dose absorvida de radiação ionizante, reforçando a eficácia do seu uso tanto para pacientes quanto para indivíduos ocupacionalmente expostos. MATERIAIS E MÉTODOS: O estudo foi desenvolvido utilizando-se o método de revisão integrativa de literatura, e teve como materiais: 21 artigos, 2 livros, 1 tese, 1 trabalho de conclusão de curso, 1 programa de computador, 4 pesquisas em base de dados (Instituto Brasileiro de Geografia e Estatística e Departamento de Informática do Sistema Único de Saúde) e 2 diretrizes de proteção radiológica. RESULTADOS: A utilização da vestimenta de proteção radiológica, teoricamente, reduz 86 por cento a 99 por cento a dose absorvida. Na prática, a redução nos pacientes pode ser de 88 por cento na radiologia convencional e chegar a 95 por cento no exame tomográfico. Nos indivíduos ocupacionalmente expostos, a redução durante um cateterismo cardíaco é em torno de 90 por cento e durante uma cirurgia ortopédica é de 75 por cento. CONCLUSÃO: Conforme demonstrado em várias pesquisas, o uso de vestimenta de proteção radiológica é eficaz e de baixo custo e reduz a dose desnecessária nos pacientes e nos indivíduos ocupacionalmente expostos. Logo, sua utilização é necessária para a implementação de um efetivo programa de proteção radiológica em um serviço de radiodiagnóstico.

OBJECTIVE: The present study was aimed at evaluating the relation between the use of radiation protection gear and the decrease in absorbed dose of ionizing radiation, thereby reinforcing the efficacy of its use by both the patients and occupationally exposed personnel. MATERIALS AND METHODS: The integrative literature review method was utilized to analyze 21 articles, 2 books, 1 thesis, 1 monograph, 1 computer program, 4 pieces of database research (Instituto Brasileiro de Geografia e Estatística and Departamento de Informática do Sistema Único de Saúde) and 2 sets of radiological protection guidelines. RESULTS: Theoretically, a reduction of 86 percent to 99 percent in the absorbed dose is observed with the use of radiation protection gear. In practice, however, the reduction may achieve 88 percent in patients submitted to conventional radiology, and 95 percent in patients submitted to computed tomography. In occupationally exposed individuals, the reduction is around 90 percent during cardiac catheterization, and 75 percent during orthopedic surgery. CONCLUSION: According to findings of several previous pieces of research, the use of radiation protection gear is a low-cost and effective way to reduce absorbed dose both for patients and occupationally exposed individuals. Thus, its use is necessary for the implementation of effective radioprotection programs in radiodiagnosis centers.

Eruption hematoma as a possible oral sign of infantile scurvy.

Scurvy, vitamin C deficiency, is uncommon in industrialized societies today. Although supplementation of food with vitamin C has diminished its incidence, scurvy continues to occur in specific economically and nutritionally disadvantaged populations. The purpose of this report was to describe the case of infantile scurvy in a 20-month-old male with multisystem involvement including significant oral manifestations. Following an extensive initial evaluation, the multidisciplinary approach to diagnosis and management is discussed. This case demonstrates the need for heightened awareness of severe and multiplefood allergies in children and highlights disease conditions caused by nutritional deficiencies in this population.

Gingival overgrowth in a child with arthrogryposis treated with a Er,Cr:YSGG laser: a case report.

The present manuscript reports a case of a 21/2 year old girl, diagnosed with arthrogryposis, presenting increasing gingival hyperplasia which was treated with Er,Cr:YSGG Laser. The patient was treated under general anesthesia by the Pediatric Dentistry and Periodontics departments. Er,Cr:YSGG laser G6 tip was used at 1.50 watts, 20 pps, 8% water and 11% air, which is recommended by the manufacturer. Scalpel and periodontal curettes were used to complement the laser. Tissue samples from the anterior maxilla, anterior mandible and palatal sites were formalin-fixed and submitted for evaluation. The samples biopsied revealed prominent hyperplasia of the fibrous connective tissue with areas of the epithelium exhibiting pseudoepitheliomatous hyperplasia. At 1 week and 3 months follow up, oral examination showed appropriate healing of gingival tissue. The use of Er,Cr:YSGG laser in the present case proved to be effective in the removal of large amounts of hyperplasic gingival tissue and resulted in fast heeling and mild discomfort.

Shear bond strength of one etch-and-rinse and five self-etching dental adhesives when used by six operators.

OBJECTIVE: To test the hypothesis that some single-bottle self-etching adhesives bond as well to enamel and dentin as a typical two-bottle etch-and-rinse adhesive. MATERIAL AND METHODS: Six operators used one two-bottle etch-and-rinse dentin adhesive (Scotchbond MP) and five all-in-one self-etching adhesives (iBond Gluma Inside, Clearfil S(3) Bond, iBond Experimental, Xeno IV, and G-BOND). Each operator carried out six bondings to enamel and six bondings to dentin with each adhesive. After 24 h of storage in water at 37 degrees C, bond strength was determined in shear. RESULTS: The pooled results of all the adhesives revealed no significant difference (p>0.05) in bond strength between dentin and enamel. However, there were significant differences (p<0.0001) between the different adhesives. The etch-and-rinse adhesive did better than the self-etching adhesives when substrate was not an issue (pooled enamel and dentin results). On comparing the performance of the different adhesives, it became clear that there were significant interactions (p<0.0001) between substrates and products. There were also significant differences (p<0.0001) between operators, and the interaction between operators and products was significant (p<0.0002). CONCLUSIONS: The tested etch-and-rinse adhesive did better than the tested self-etching adhesives. The shear bond strength results were also strongly affected by the operator as well as by the interaction between operator and used product. The pooled bond strength values of the different adhesives revealed no difference in bond strength to dentin versus enamel.

Impact of Er,Cr:YSGG laser therapy on the cleanliness of the root canal walls of primary teeth.

Root canal therapy might be required for primary teeth displaying signs of pulpal inflammation or necrosis. Cleaning and shaping followed by obturation of the canal space with a resorbable paste have been widely performed with remarkable clinical success. However, lengthy endodontic procedures might be contraindicated when treating certain pediatric patients. The aim of this study was to compare the cleanliness of the root canal walls of primary teeth and the time required for the completion of the cleaning and shaping procedures performed by the Er,Cr:YSGG laser, manual or rotary instrumentation techniques. Thirty-five extracted, single-rooted, primary teeth were divided into 4 groups: I, canals were instrumented with Profile .04 rotary instruments to a master apical file size #35; II, the laser was used (parameters: 1.50 W, 20 pps, 30% water and 50% air) with a Z3 laser tip (0.32-mm diameter); III, canals were instrumented with stainless steel K-files; and IV, no instrumentation was performed (control). The teeth were split in 2 halves and prepared for scanning electron microscopy analysis. Images from the coronal, middle, and apical thirds of the roots were analyzed independently by 2 calibrated, blinded evaluators. Statistical analysis revealed significant differences among the groups (Kruskal-Wallis, P = .0001). The techniques were not capable of providing completely clean canals. Treatment with Er,Cr:YSGG laser provided similar cleanliness when compared with rotary instrumentation technique and was superior to manual instrumentation. The laser technique required less time for completion of the cleaning and shaping procedures when compared with both rotary or hand instrumentation.

Interdisciplinary approach to endodontic therapy for uncooperative children in a dental school environment.

The aim of this study was to describe an interdisciplinary approach for endodontic therapy of behavior-challenging children and to report the efficacy of sedation techniques for these procedures. Sedation records of thirty-two patients who received root canal treatment were reviewed. Age at treatment in months, gender, year of treatment, tooth type, status of root maturation (open or closed apex), etiological factor(s), sedation protocol, and outcome were the variables analyzed. The collected information was entered into a computerized flowchart and the data analyzed using descriptive statistics. Midazolam in combination with meperidine or hydroxyzine were the most common protocols used (46 percent and 40 percent of the cases, respectively). Only two (6 percent) treatments were aborted due to uncontrolled behavior during sedation. We conclude that cooperation between pediatric dentists and endodontists is fundamental to achieving success when providing root canal treatment for uncooperative child patients.

Prevalência de tentativas e ideação suicida em pessoas com transtornos mentais graves na cidade de São Paulo / Prevalence of attempts and suicidal ideation in people who have serious mental disorder in the city of São Paulo

Introdução: Ideação suicida e tentativas de suicídio são geralmente complicações dos transtornos psiquiátricos. O estudo da freqüência e fatores associados podem contribuir para uma abordagem mais adequada por profissionais de saúde mental. Objetivos: Estimar a prevalência de tentativas e pensamentos suicidas, em pessoas com transtornos mentais graves (TMG) e as associações com características sócio-demograficas, diagnóstico, ajustamento social, sintomas psiquiátricos, uso de substâncias psicoativas, envolvimento familiar e tratamentos realizados. Método: Foram entrevistados e avaliados 192 pessoas que apresentavam TMG, com idade entre 18 e 65 anos e que tiveram contato com os serviços de saúde mental de três regiões definidas do município de São Paulo em período determinado. Utilizou-se anamneses estruturadas com questionários padronizados e escalas psicométricas. As entrevistas foram realizadas no domicílio do paciente. Realizou-se análise descritiva, análise univariada e análise multivariada. Resultados: Da amostra estudada predominaram as pessoas do sexo masculino (53,1 por cento), solteiras (57,3 por cento), com diagnóstico de esquizofrenia (58,3 por cento). Poucas pessoas apresentavam abuso ou dependência de álcool (7,3 por cento) e apenas três pessoas (1,6 por cento) não utilizaram medicações psiquiátricas no período de um ano anterior à entrevista. Cento e nove (57,7 por cento) entrevistados apresentaram pensamentos suicidas ao longo da vida e nos 12 meses anteriores a entrevista, trinta e oito (20,1 por cento) tiveram tais pensamentos. Cinqüenta e nove (30,9 por cento) pessoas já haviam tentado suicídio durante a vida e oito (4,2 por cento) apresentaram tentativas nos 12 meses anteriores à entrevista. Para todas as variáveis de desfecho, apresentaram associação estatística, a presença de sentimentos de culpa e sintomas depressivos. Na análise multivariada, o uso de neurolépticos apresentou associação com pensamentos e tentativas de suicídio ao longo da vida. Conclusão: Ideação e tentativas de suicídio foram bastante prevalentes na população estudada devendo sempre ser investigadas pelos profissionais de saúde mental, para que se possa tomar as devidas condutas, como o manejo dos sentimentos de culpa e depressão, além do ajuste correto da medicação para o transtorno mental.

Transtorno desintegrativo da infância: relato de dois casos clínicos com estudo de perfusäo sanguínea cerebral / Disintegrative disorders of childhood: report of 2 clinical cases with cerebral blood perfusion study

Säo apresentados dois casos de síndrome de Heller (transtorno desintegrativo da infância), caracterizados por um desenvolvimento neuromotor e psicológico inicial normal até os sete anos de idade, seguidos por perda importante das habilidades cognitivas adquiridas, principalmente de comunicaçäo e de relacionamento social. E feita uma revisäo sobre aspectos clínicos e neurobiológicos dessa síndrome. Verificou-se uma sobreposiçäo curiosa entre os sintomas de nossas pacientes com síndrome de Heller e sintomas característicos da síndrome de Kluver-Buck. No Spect, uma das pacientes apresentou hiperperfusäo frontal e a outra, hipoperfusäo temporal esquerda. Estudos com maiores casuísticas, grupos-controle e métodos de Neuroimagem estrutural e funcional deveräo ser conduzidos para esclarecer a fisiopatologia da síndrome de Heller e o possível envolvimento das estruturas mesolímbicas.

O papel do citocromo P450 nas interações farmacológicas entre antidepressivos / The role of cytochrome P450 on antidepressants drug interaction

Foi realizada uma revisão bibliográfica sobre interações farmacológicas entre antidepressivos e o papel do CYP. O sistema citocromo P450 ( cerca de 30 enzimas oxidativas agrupadas em 11 grandes famílias é o componente fundamental no metabolismo hepático dos diversos fármacos. A polifarmacoterapia, prática frequente nos ambulátórios psiquiátricos, eleva o risco de interações medicamentosas; estas podendo ser farmacocinéticos e farmacodinâmicas. Dentre as interações farmacocinéticas, as que envolvem o citocromo P450(CYP) apresentam dois princípios: a indução e a inibição enzimáticas. Tais mecanismos participam do metabolismo de diferentes substâncias, inclusive dos antidepressivos, influenciando significativamente a prática clínica, promovendo toxicidade ou falta de eficácia

Problemas oftalmológicos mais freqüentes de interesse pediátrico / More frequent ophthalmological problems in the pediatric practice

Tecem-se consideraçöes apontando problemas oftalmológicos mais freqüentes de interesse na Pediatria, abordando técnicas de avaliaçäo das funçöes visuais nas crianças, que podem ser utilizadas pelos pediatras, assim como as indicaçöes para o encaminhamento correto ao especialista. Por fim, fazem a descriçäo do diagnóstico diferencial de algumas entidades clínicas e dos sinais e sintomas das mesmas