Caracterização de pacientes atendidos em um ambulatório-escola de Fonoaudiologia / Characterization of patients seen at a speech therapy school clinic / Caracterización de los pacientes atendidos en una consulta externa de logopedia

Introdução: Pesquisas sobre caracterização de pacientes, condições de saúde, demandas para atendimento e serviços fonoaudiológicos permitem o direcionamento de ações, a elaboração de políticas e o desenvolvimento de recursos para a ampliação da qualidade da assistência. Objetivo: Caracterizar os pacientes de um ambulatório de Fonoaudiologia, área de linguagem oral, de um hospital universitário, e verificar a associação do diagnóstico fonoaudiológico com os dados sociodemográficos. Métodos: Realizada coleta de dados sociodemográficos e clínicos em prontuários de pacientes do ambulatório de Fonoaudiologia, área da linguagem oral infantil, do Hospital das Clínicas da Universidade Federal de Minas Gerais. A análise descritiva foi realizada por meio da distribuição de frequência das variáveis categóricas e análise das medidas de tendência central e de dispersão das variáveis contínuas; a análise de associação foi por meio dos testes Qui-quadrado de Pearson e Kruskal-Wallis. Resultados: Houve prevalência do sexo masculino, média de idade de 6,70 anos, estudante da rede pública, proveniente da região metropolitana e regionais com baixos indicadores socioeconômicos, que realizam acompanhamento médico concomitante ao fonoaudiológico, diagnóstico realizado em idade pré-escolar e maior ocorrência de transtornos de linguagem associados a outras condições de saúde. Houve associação entre o diagnóstico fonoaudiológico e idade na época do diagnóstico. Conclusão: O estudo contribui para o conhecimento do perfil sociodemográfico da população assistida, favorecendo a organização e a otimização da assistência conforme as demandas dos usuários, dinamizando o atendimento e proporcionando maior rotatividade e abrangência ao público.

Introduction: Research on the characterization of patients, health conditions, demands and speech therapy services allow the targeting of actions, preparation of policies and development of resources to increase the quality of care. Purpose: Characterize the patients in a Speech-Language Pathology clinic, oral language area, at a university hospital, and verify the association between speech and language diagnosis and sociodemographic data. Methods: Data were collected from medical records of patients at the Speech-Language Pathology and Audiology clinic, children's oral language area, from Clinic Hospital of Federal University of Minas Gerais State. The descriptive analysis of the data was done through the frequency distribution of the categorical variables and analysis of the measures of central tendency and dispersion of the continuous variables, and analysis of association through the tests Pearson's chi-square and Kruskal-Wallis. Results: The patients' profile was characterized by the prevalence of males, average of 6,70 years, public schools' students, coming from the metropolitan region and regionals with low socioeconomic indicators, that participate in medical monitoring and speech therapy simultaneously, diagnosis made at preschool age and a higher occurrence of language disorders associated with other conditions. There was an association between speech therapy diagnosis and age at the time of diagnosis. Conclusion: The study contributes to the knowledge of the sociodemographic profile of the population assisted, favoring the organization and optimization of the assistance according to the users' demands, streamlining the service and providing more turnover and coverage to the public.

Introducción: La investigación sobre la caracterización de los pacientes, condiciones de salud, demandas y servicios de logopedia permiten la dirección de acciones, desarrollo de políticas y recursos para incrementar la calidad de la atención. Objetivo: Caracterizar los pacientes de una clínica logopédica, área de lenguaje oral, de un hospital universitario, y verificar la asociación del diagnóstico logopédico con datos sociodemográficos. Métodos: Se recolectaron datos de las historias clínicas de los pacientes de la clínica de Patología del Habla y el Lenguaje, área de lenguaje oral infantil, en el Hospital das Clínicas da Universidade Federal de Minas Gerais. El análisis descriptivo de los datos se realizó mediante distribución de frecuencia de variables categóricas, análisis de medidas de tendencia central y dispersión de variables continuas, y análisis de asociación mediante las pruebas Chi-cuadrado de Pearson y Kruskal-Wallis. Resultados: El perfil se caracterizó por la prevalencia del sexo masculino, edad media 6,70 años, estudiantes de escuelas públicas, de la región metropolitana y regiones con bajos indicadores socioeconómicos, que se someten a seguimiento médico de manera concurrente con logopedia, diagnóstico realizado en edad preescolar y mayor ocurrencia de trastornos del lenguaje asociados a otros condiciones. Hubo una asociación entre el diagnóstico logopédico y edad al momento del diagnóstico. Conclusión: El estudio contribuye al conocimiento del perfil sociodemográfico de la población atendida, favoreciendo la organización y optimización de la atención de acuerdo a las demandas de los usuarios, agilizando la atención y brindando mayor rotación y alcance al público.

Classificação Internacional de Funcionalidade e transtornos da linguagem: revisão integrativa da literatura / International Classification of Functionality and language disorders: integrative literature review / Clasificación Internacional de Funcionalidad y trastornos del lenguaje: revisión integradora de la literatura

Objetivo: Identificar as evidências científicas do uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) na caracterização da funcionalidade de pacientes com transtornos da linguagem, considerando o modo como tem sido aplicada e visando explorar estratégias de aplicação. Estratégia de pesquisa: Levantamento de literatura nacional e internacional com buscas realizadas nas bases BVS, PubMed e Portal de Periódicos da CAPES. A pergunta norteadora da revisão questiona a utilização da CIF na caracterização da funcionalidade de pacientes com transtornos da linguagem. Critério de seleção: Artigos publicados até setembro de 2019 em português, inglês ou espanhol que abordassem a relação entre CIF e Fonoaudiologia. Resultados: 257 artigos encontrados que se restringiram a 35 após os filtros. Os temas mais recorrentes foram o uso da CIF na avaliação do impacto dos transtornos da linguagem, na análise e criação de instrumentos avaliativos, e no acompanhamento do processo terapêutico, principalmente na infância. Conclusão: A CIF tem sido empregada para distintos fins no âmbito da linguagem e pode revelar aspectos da funcionalidade em relação ao meio e às condições em que o sujeito está inserido. Seu uso é recomendado por pesquisadores e profissionais de saúde para estabelecer o modelo biopsicossocial.

Purpose: Identify scientific evidence for the use of International Classification of Functioning, Disability and Health in the characterization of functioning of patients with language disorders, considering the way it has been applied and aiming to explore application strategies. Research strategies: Search in national and international literature in the bases BVS, PubMed and CAPES. This review guiding question is the use of the ICF to characterize the functioning of patients with language disorders. Selection criteria: Articles published until September 2019 in Portuguese, English or Spanish that addressed the relation between the ICF and Speech, Language and Hearing Sciences. Results: 257 articles found that were narrowed down to 35 after the filters. The most recurrent topics were the use of the ICF in the evaluation of the impact of communication disorders, in the analyses and creation of assessment instruments and in the follow-up of the intervention process, especially in childhood. Conclusion: The ICF has been used for different purposes in language scope and it can reveal functionality aspects relating to the environment and conditions in which the person is in. Its use is recommended by researchers and health professionals in order to establish the biopsychosocial model.

Objetivo: Identificar la evidencia científica del uso de la Clasificación Internacional de Funcionalidad, Discapacidad y Salud en la caracterización de la funcionalidad de pacientes con trastornos del lenguaje, considerando la forma en que se ha aplicado y buscando explorar estrategias de aplicación. Estrategia de investigación: Relevamiento de la literatura nacional e internacional con búsquedas realizadas en el Portal de Revistas BVS, PubMed y CAPES. La pregunta orientadora de la revisión cuestiona el uso de la CIF para caracterizar la funcionalidad de los pacientes con trastornos del lenguaje. Criterios de selección: Artículos publicados hasta septiembre de 2019 en portugués, inglés o español que abordaran la relación entre CIF y Logopedia. Resultados: Se encontraron 257 artículos que se restringieron a 35 después de los filtros. Los temas más recurrentes fueron el uso de la CIF en la evaluación del impacto de los trastornos del lenguaje, en el análisis y creación de herramientas de evaluación y en el seguimiento del proceso terapéutico, especialmente en la infancia. Conclusión: La CIF se ha utilizado para diferentes propósitos en el ámbito del lenguaje y puede revelar aspectos de funcionalidad en relación con el entorno y las condiciones en las que se inserta el sujeto. Su uso es recomendado por investigadores y profesionales de la salud para establecer el modelo biopsicosocial.

Late middle Miocene caviomorph rodents from Tarapoto, Peruvian Amazonia.

Miocene deposits of South America have yielded several species-rich assemblages of caviomorph rodents. They are mostly situated at high and mid- latitudes of the continent, except for the exceptional Honda Group of La Venta, Colombia, the faunal composition of which allowed to describe the late middle Miocene Laventan South American Land Mammal Age (SALMA). In this paper, we describe a new caviomorph assemblage from TAR-31 locality, recently discovered near Tarapoto in Peruvian Amazonia (San Martín Department). Based on mammalian biostratigraphy, this single-phased locality is unambiguously considered to fall within the Laventan SALMA. TAR-31 yielded rodent species found in La Venta, such as the octodontoid Ricardomys longidens Walton, 1990 (nom. nud.), the chinchilloids Microscleromys paradoxalis Walton, 1990 (nom. nud.) and M. cribriphilus Walton, 1990 (nom. nud.), or closely-related taxa. Given these strong taxonomic affinities, we further seize the opportunity to review the rodent dental material from La Venta described in the Ph.D. volume of Walton in 1990 but referred to as nomina nuda. Here we validate the recognition of these former taxa and provide their formal description. TAR-31 documents nine distinct rodent species documenting the four extant superfamilies of Caviomorpha, including a new erethizontoid: Nuyuyomys chinqaska gen. et sp. nov. These fossils document the most diverse caviomorph fauna for the middle Miocene interval of Peruvian Amazonia to date. This rodent discovery from Peru extends the geographical ranges of Ricardomys longidens, Microscleromys paradoxalis, and M. cribriphilus, 1,100 km to the south. Only one postcranial element of rodent was unearthed in TAR-31 (astragalus). This tiny tarsal bone most likely documents one of the two species of Microscleromys and its morphology indicates terrestrial generalist adaptations for this minute chinchilloid.

Os profissionais de atividades físicas de aventura na natureza no cenário Capixaba / Professionals of physical adventure activities in nature at the Capixaba scenery

A realização das Atividades Físicas de Aventura na Natureza (AFAN) conta com a atuação de profissionais que possam garantir sua prática de forma segura e prazerosa. Este artigo objetivou delinear o perfil dos profissionais de AFAN que atuam na Região Metropolitana de Vitória, Espírito Santo, incluindo dados socioeconômicos, condições de trabalho, formação e os riscos a que estão sujeitos. Trata-se de uma pesquisa qualiquantitativa, com a coleta de dados realizada por meio de questionário semiestruturado. Participaram 25 profissionais e os resultados apontaram que a maioria eram homens, jovens, autônomos, que obtém a maior parte de sua renda com o trabalho com AFAN. Grande parte apresentava formação no ensino superior e corria risco no exercício da profissão. Como conclusão, verificamos a necessidade de formação interdisciplinar, a regulação do mercado das AFAN e o investimento em políticas públicas para esse setor. A realização das Atividades Físicas de Aventura na Natureza (AFAN) conta com a atuação de profissionais que possam garantir sua prática de forma segura e prazerosa. Este artigo objetivou delinear o perfil dos profissionais de AFAN que atuam na Região Metropolitana de Vitória, Espírito Santo, incluindo dados socioeconômicos, condições de trabalho, formação e os riscos a que estão sujeitos. Trata-se de uma pesquisa qualiquantitativa, com a coleta de dados realizada por meio de questionário semiestruturado. Participaram 25 profissionais e os resultados apontaram que a maioria eram homens, jovens, autônomos, que obtém a maior parte de sua renda com o trabalho com AFAN. Grande parte apresentava formação no ensino superior e corria risco no exercício da profissão. Como conclusão, verificamos a necessidade de formação interdisciplinar, a regulação do mercado das AFAN e o investimento em políticas públicas para esse setor.

The accomplishment of Physical Adventure Activities in Nature (AFAN) has the performance of professionals who can ensure your practice in a safe and pleasant way. This article aimed to outline the profile of the AFAN professionals working in the Metropolitan Region of Vitória, Espírito Santo, Brazil, including socioeconomic data, working conditions, training and the risks to which they are subject. It is a qualitative and quantitative research, with data collection carried out through a semi-structured questionnaire. Twenty five professionals participated and the results showed that the majority were men, young, self-employed, who obtain most of their income from working with AFAN. Most of them were trained in higher education and were at risk in the exercise of their profession. As a conclusion, we see the need for interdisciplinary training, regulation of the AFAN market and investment in public policies for this sector.

Scale of Perception and Analysis of Reading Fluency - SOLAR: usability and consistency / Escala de Percepção e Análise da Fluência Leitora - SOLAR: usabilidade e consistência

ABSTRACT Objective: to analyze the consistency of responses of evaluators and to verify the usability of the perception and analysis of SOLAR (Science of Language and Reading) Methods: a non-experimental descriptive cross-sectional study. Elementary school teachers and undergraduate students of speech therapy and pedagogy participated as the judges. The judges used the SOLAR Scale as an instrument to analyze the reading fluency of twenty audios recorded by elementary school students. Usability comparisons were performed using the Kruskal Wallis test and two-by-two comparisons using the Mann Whitney test. To analyze the consistency of the responses between the judges, the calculation of the interclass correlation coefficient was used. Results: the analysis of the reliability of the answers showed an excellent intraclass correlation coefficient for all the skills of the Scale. As for the usability of the Scale, more than 80% of the participants positively evaluated the assessment. This was verified through the usability questionnaires which confirmed that it was easy to use, with clear guidelines and that users felt comfortable and confident using it. Conclusion: SOLAR obtained good results in reliability and consistency with excellent agreement between the evaluators. These results indicated satisfactory reliability of the SOLAR items and favorable qualitative ratings from users.

RESUMO Objetivo: analisar a consistência de respostas entre avaliadores e verificar a usabilidade da Escala de Percepção e Análise da Fluência Leitora - SOLAR. Métodos: estudo descritivo não experimental de corte transversal. Participaram como juízes professores do Ensino Fundamental e acadêmicos de Fonoaudiologia e Pedagogia. Os juízes utilizaram como instrumento a Escala SOLAR para a análise de fluência leitora de áudios de 20 estudantes do Ensino Fundamental. A comparação da usabilidade foi realizada por meio do teste Kruskal Wallis e comparação dois a dois pelo teste Mann Whitney. Para análise da consistência de respostas entre juízes foi utilizado o cálculo do coeficiente de correlação interclasse. O nível de significância utilizado foi de 5%. Resultados: a análise da fidedignidade das respostas demonstrou coeficiente de correlação intraclasse excelente para todas as habilidades da escala. Quanto à usabilidade do instrumento, mais de 80% dos participantes o avaliaram positivamente. Verificou-se, por meio dos questionários de usabilidade, que é uma escala de fácil uso, com orientações claras, os seus usuários se sentem confortáveis e confiantes em utilizá-la. Conclusão: a SOLAR obteve bons indicadores de fidedignidade e consistência, com excelente concordância entre os avaliadores. Tais resultados indicam confiabilidade satisfatória dos itens e avaliações qualitativas favoráveis dos usuários.

Modification of PapA5 acyltransferase substrate selectivity for optimization of short-chain alcohol-derived multimethyl-branched ester production in Escherichia coli.

Plant waxes are interesting substitutes of fossil-derived compounds; however, their limited sources and narrow structural diversity prompted the development of microbial platforms to produce esters with novel chemical structures and properties. One successful strategy was the heterologous expression of the mycocerosic polyketide synthase-based biosynthetic pathway (MAS-PKS, PapA5 and FadD28 enzymes) from Mycobacterium tuberculosis in Escherichia coli. This recombinant strain has the ability to produce a broad spectrum of multimethyl-branched long-chain esters (MBE) with novel chemical structures and high oxidation stability. However, one limitation of this microbial platform was the low yields obtained for MBE derived of short-chain alcohols. In an attempt to improve the titers of the short-chain alcohol-derived MBE, we focused on the PapA5 acyltransferase-enzyme that catalyzes the ester formation reaction. Specific amino acid residues located in the two-substrate recognition channels of this enzyme were identified, rationally mutated, and the corresponding mutants characterized both in vivo and in vitro. The phenylalanine located at 331 position in PapA5 (F331) was found to be a key residue that when substituted by other bulky and aromatic or bulky and polar amino acid residues (F331W, F331Y or F331H), gave rise to PapA5 mutants with improved bioconversion efficiency; showing in average, 2.5 higher yields of short-chain alcohol-derived MBE compared with the wild-type enzyme. Furthermore, two alternative pathways for synthetizing ethanol were engineered into the MBE producer microorganism, allowing de novo production of ethanol-derived MBE at levels comparable with those obtained by the external supply of this alcohol. KEY POINTS: • Mutation in channel 2 changes PapA5 acyltransferase bioconversion efficiency. • Improved production of short-chain alcohol derived multimethyl-branched esters. • Establishing ethanologenic pathways for de novo production of ethanol derived MBE. • Characterization of a novel phenylethanol-derived MBE.

Mycobacterium tuberculosis FasR senses long fatty acyl-CoA through a tunnel and a hydrophobic transmission spine.

Mycobacterium tuberculosis is a pathogen with a unique cell envelope including very long fatty acids, implicated in bacterial resistance and host immune modulation. FasR is a TetR-like transcriptional activator that plays a central role in sensing mycobacterial long-chain fatty acids and regulating lipid biosynthesis. Here we disclose crystal structures of M. tuberculosis FasR in complex with acyl effector ligands and with DNA, uncovering its molecular sensory and switching mechanisms. A long tunnel traverses the entire effector-binding domain, enabling long fatty acyl effectors to bind. Only when the tunnel is entirely occupied, the protein dimer adopts a rigid configuration with its DNA-binding domains in an open state, leading to DNA dissociation. The protein-folding hydrophobic core connects the two domains, and is completed into a continuous spine when the effector binds. Such a transmission spine is conserved in a large number of TetR-like regulators, offering insight into effector-triggered allosteric functional control.

New record of Neosaimiri (Cebidae, Platyrrhini) from the late Middle Miocene of Peruvian Amazonia.

The Honda Group of La Venta, Colombia, has yielded a wide array of crown platyrrhine primates, documenting the late Middle Miocene epoch (ca. 13.1-12.6 Ma, Laventan South American Land Mammal Age). Although exceptional, this record represents only a snapshot of the evolutionary history of New World monkeys because virtually none of the primate taxa recorded at La Venta had so far been found elsewhere. We describe here few dental remains of a cebine platyrrhine discovered from Laventan deposits in the San Martín Department of Peru (Peruvian Amazonia). The primate dental specimens from that new fossil-bearing locality (TAR-31) are strongly reminiscent morphologically of the teeth of Neosaimiri fieldsi from La Venta. However, given that several aspects of the dental variability from TAR-31 are unknown, we prefer to provide an assignment with open nomenclature (i.e., N. cf. fieldsi), instead of formally referring these remains to N. fieldsi, pending the discovery of additional specimens. The occurrence of Neosaimiri in Peru, in coeval deposits of La Venta, thus represents a second and southernmost record of that low-latitude genus in the Neotropics, thereby demonstrating its wide distribution along the northwestern edge of the Pebas Mega-Wetland System, in tropical western South America.

Fratura fisária do rádio e luxação perilunar do carpo: um relato de caso / Physeal fracture of radius and perilunate dislocation of carpo: a case report

A relevância do relato de caso em questão está em sua raridade de acometimento durante a infância (período em que se observa um sinal clássico em uma das radiografias solicitadas). Trata-se de uma luxação perilunar em punho direito, associada à fratura fisária do rádio em criança de onze anos, após acidente com laço. Foi feita a redução fechada e colocação de tala gessada no membro, o qual também apresentava áreas de sofrimento da pele causadas pela corda. O quadro clínico do paciente evoluiu com dor, edema e diminuição da perfusão. Nesse momento, foi encaminhado para o centro cirúrgico onde foi realizada redução aberta com incisão dorsal em S, fixação da luxa-ção e fasciotomia. Após o ato cirúrgico, paciente evoluiu bem. Atualmente, após algumas sessões de fisioterapia, tem movimento quase total de flexão e extensão do punho, restando apenas limitação no desvio ulnar e radial. As crianças do século XXI se mostram muito ativas em vista disso têm aumentado os casos de fratura e luxação na pediatria, tanto pelo aumento do impacto quanto pela exposição a possíveis mecanismos de lesão. (AU)

The relevance of this case report is its rarity of involvement during childhood (the period in which there is a classic sign in one of the required x-rays). This is a case of perilunate dislocation in right wrist associated with physeal fracture of radius in an eleven-year-old child, after a rope accident. The closed reduction and placement of a plas-ter splint were performed, which also presented areas of skin suffering caused by the rope. The patient's medical condition evolved for pain, edema, and decreased perfusion. At that time, he was transferred to a surgical center where it was performed an open reduction with a dorsal incision in S, dislocation fixation and fasciotomy. After the surgical procedure, the patient's medical condition developed well. Currently, after some physical therapy sessions, he has almost total movement of flexion and extension of his wrist, there is the only limitation in ulnar and radial deviation. Children of the 21st century are very active, and there has been an increase in the cases of fracture and dislocation, in pediatrics, both by increasing impact and exposure to possible mechanisms of injury (AU)

A conditional mutant of the fatty acid synthase unveils unexpected cross talks in mycobacterial lipid metabolism.

Unlike most bacteria, mycobacteria rely on the multi-domain enzyme eukaryote-like fatty acid synthase I (FAS I) to make fatty acids de novo. These metabolites are precursors of the biosynthesis of most of the lipids present both in the complex mycobacteria cell wall and in the storage lipids inside the cell. In order to study the role of the type I FAS system in Mycobacterium lipid metabolism in vivo, we constructed a conditional mutant in the fas-acpS operon of Mycobacterium smegmatis and analysed in detail the impact of reduced de novo fatty acid biosynthesis on the global architecture of the cell envelope. As expected, the mutant exhibited growth defect in the non-permissive condition that correlated well with the lower expression of fas-acpS and the concomitant reduction of FAS I, confirming that FAS I is essential for survival. The reduction observed in FAS I provoked an accumulation of its substrates, acetyl-CoA and malonyl-CoA, and a strong reduction of C12 to C18 acyl-CoAs, but not of long-chain acyl-CoAs (C19 to C24). The most intriguing result was the ability of the mutant to keep synthesizing mycolic acids when fatty acid biosynthesis was impaired. A detailed comparative lipidomic analysis showed that although reduced FAS I levels had a strong impact on fatty acid and phospholipid biosynthesis, mycolic acids were still being synthesized in the mutant, although with a different relative species distribution. However, when triacylglycerol degradation was inhibited, mycolic acid biosynthesis was significantly reduced, suggesting that storage lipids could be an intracellular reservoir of fatty acids for the biosynthesis of complex lipids in mycobacteria. Understanding the interaction between FAS I and the metabolic pathways that rely on FAS I products is a key step to better understand how lipid homeostasis is regulated in this microorganism and how this regulation could play a role during infection in pathogenic mycobacteria.

The pleiotropic transcriptional regulator NlpR contributes to the modulation of nitrogen metabolism, lipogenesis and triacylglycerol accumulation in oleaginous rhodococci.

The regulatory mechanisms involved in lipogenesis and triacylglycerol (TAG) accumulation are largely unknown in oleaginous rhodococci. In this study a regulatory protein (here called NlpR: Nitrogen lipid Regulator), which contributes to the modulation of nitrogen metabolism, lipogenesis and triacylglycerol accumulation in oleaginous rhodococci was identified. Under nitrogen deprivation conditions, in which TAG accumulation is stimulated, the nlpR gene was significantly upregulated, whereas a significant decrease of its expression and TAG accumulation occurred when cerulenin was added. The nlpR disruption negatively affected the nitrate/nitrite reduction as well as lipid biosynthesis under nitrogen-limiting conditions. In contrast, its overexpression increased TAG production during cultivation of cells in nitrogen-rich media. A putative 'NlpR-binding motif' upstream of several genes related to nitrogen and lipid metabolisms was found. The nlpR disruption in RHA1 strain led to a reduced transcription of genes involved in nitrate/nitrite assimilation, as well as in fatty acid and TAG biosynthesis. Purified NlpR was able to bind to narK, nirD, fasI, plsC and atf3 promoter regions. It was suggested that NlpR acts as a pleiotropic transcriptional regulator by activating of nitrate/nitrite assimilation genes and others genes involved in fatty acid and TAG biosynthesis, in response to nitrogen deprivation.

Neotropics provide insights into the emergence of New World monkeys: New dental evidence from the late Oligocene of Peruvian Amazonia.

Recent field efforts in Peruvian Amazonia (Contamana area, Loreto Department) have resulted in the discovery of a late Oligocene (ca. 26.5 Ma; Chambira Formation) fossil primate-bearing locality (CTA-61). In this paper, we analyze the primate material consisting of two isolated upper molars, the peculiar morphology of which allows us to describe a new medium-sized platyrrhine monkey: Canaanimico amazonensis gen. et sp. nov. In addition to the recent discovery of Perupithecus ucayaliensis, a primitive anthropoid taxon of African affinities from the alleged latest Eocene Santa Rosa locality (Peruvian Amazonia), the discovery of Canaanimico adds to the evidence that primates were well-established in the Amazonian Basin during the Paleogene. Our phylogenetic results based on dental evidence show that none of the early Miocene Patagonian taxa (Homunculus, Carlocebus, Soriacebus, Mazzonicebus, Dolichocebus, Tremacebus, and Chilecebus), the late Oligocene Bolivian Branisella, or the Peruvian Canaanimico, is nested within a crown platyrrhine clade. All these early taxa are closely related and considered here as stem Platyrrhini. Canaanimico is nested within the Patagonian Soriacebinae, and closely related to Soriacebus, thereby extending back the soriacebine lineage to 26.5 Ma. Given the limited dental evidence, it is difficult to assess if Canaanimico was engaged in a form of pitheciine-like seed predation as is observed in Soriacebus and Mazzonicebus, but dental microwear patterns recorded on one upper molar indicate that Canaanimico was possibly a fruit and hard-object eater. If Panamacebus, a recently discovered stem cebine from the early Miocene of Panama, indicates that the crown platyrrhine radiation was already well underway by the earliest Miocene, Canaanimico indicates in turn that the "homunculid" radiation (as a part of the stem radiation) was well underway by the late Oligocene. These new data suggest that the stem radiation likely occurred in the Neotropics during the Oligocene, and that several stem lineages independently reached Patagonia during the early Miocene. Finally, we are still faced with a "layered" pattern of platyrrhine evolution, but modified in terms of timing of cladogeneses. If the crown platyrrhine radiation occurred in the Neotropics around the Oligocene-Miocene transition (or at least during the earliest Miocene), it was apparently concomitant with the diversification of the latest stem forms in Patagonia.

Dental remains of cebid platyrrhines from the earliest late Miocene of Western Amazonia, Peru: Macroevolutionary implications on the extant capuchin and marmoset lineages.

OBJECTIVES: Undoubted fossil Cebidae have so far been primarily documented from the late middle Miocene of Colombia, the late Miocene of Brazilian Amazonia, the early Miocene of Peruvian Amazonia, and very recently from the earliest Miocene of Panama. The evolutionary history of cebids is far from being well-documented, with notably a complete blank in the record of callitrichine stem lineages until and after the late middle Miocene (Laventan SALMA). Further documenting their evolutionary history is therefore of primary importance. MATERIAL: Recent field efforts in Peruvian Amazonia (Contamana area, Loreto Department) have allowed for the discovery of an early late Miocene (ca. 11 Ma; Mayoan SALMA) fossil primate-bearing locality (CTA-43; Pebas Formation). In this study, we analyze the primate material, which consists of five isolated teeth documenting two distinct Cebidae: Cebus sp., a medium-sized capuchin (Cebinae), and Cebuella sp., a tiny marmoset (Callitrichinae). RESULTS: Although limited, this new fossil material of platyrrhines contributes to documenting the post-Laventan evolutionary history of cebids, and besides testifies to the earliest occurrences of the modern Cebuella and Cebus/Sapajus lineages in the Neotropics. Regarding the evolutionary history of callitrichine marmosets, the discovery of an 11 Ma-old fossil representative of the modern Cebuella pushes back by at least 6 Ma the age of the Mico/Cebuella divergence currently proposed by molecular biologists (i.e., ca. 4.5 Ma). This also extends back to > 11 Ma BP the divergence between Callithrix and the common ancestor (CA) of Mico/Cebuella, as well as the divergence between the CA of marmosets and Callimico (Goeldi's callitrichine). DISCUSSION: This discovery from Peruvian Amazonia implies a deep evolutionary root of the Cebuella lineage in the northwestern part of South America (the modern western Amazon basin), slightly before the recession of the Pebas mega-wetland system (PMWS), ca. 10.5 Ma, and well-before the subsequent establishment of the Amazon drainage system (ca. 9-7 Ma). During the late middle/early late Miocene interval, the PMWS was seemingly not a limiting factor for dispersals and widespread distribution of terrestrial mammals, but it was also likely a source of diversification via a complex patchwork of submerged/emerged lands varying through time.

A Miocene hyperdiverse crocodylian community reveals peculiar trophic dynamics in proto-Amazonian mega-wetlands.

Amazonia contains one of the world's richest biotas, but origins of this diversity remain obscure. Onset of the Amazon River drainage at approximately 10.5 Ma represented a major shift in Neotropical ecosystems, and proto-Amazonian biotas just prior to this pivotal episode are integral to understanding origins of Amazonian biodiversity, yet vertebrate fossil evidence is extraordinarily rare. Two new species-rich bonebeds from late Middle Miocene proto-Amazonian deposits of northeastern Peru document the same hyperdiverse assemblage of seven co-occurring crocodylian species. Besides the large-bodied Purussaurus and Mourasuchus, all other crocodylians are new taxa, including a stem caiman-Gnatusuchus pebasensis-bearing a massive shovel-shaped mandible, procumbent anterior and globular posterior teeth, and a mammal-like diastema. This unusual species is an extreme exemplar of a radiation of small caimans with crushing dentitions recording peculiar feeding strategies correlated with a peak in proto-Amazonian molluscan diversity and abundance. These faunas evolved within dysoxic marshes and swamps of the long-lived Pebas Mega-Wetland System and declined with inception of the transcontinental Amazon drainage, favouring diversification of longirostrine crocodylians and more modern generalist-feeding caimans. The rise and demise of distinctive, highly productive aquatic ecosystems substantially influenced evolution of Amazonian biodiversity hotspots of crocodylians and other organisms throughout the Neogene.

The effect of insulin resistance on breast cancer risk in Latinas of Mexican origin.

BACKGROUND: Conclusive evidence has yet to emerge regarding the association between markers of hyperinsulinemia and breast cancer. We determined the effect of insulin resistance (IR) on breast cancer risk in Latinas of Mexican origin who did not have a direct family history of breast cancer and had not been previously diagnosed with prediabetes or diabetes. METHODS: This was a case-control study in which a case (n=124) was defined as a patient with a recent histopathologic diagnosis of breast cancer and a control (n=197) was defined as a participant who had recently undergone a mammography and had either a Breast Imaging, Reporting & Data System (BI-RADS)-1 or a BI-RADS-2 score. Plasma glucose, insulin, and glycated hemoglobin (HbA1c) levels were measured. IR was determined by using the homeostasis model assessment (HOMA-IR) criterion. Odds ratios (OR) and 95% confidence intervals (CI) were determined using unconditional binary logistic regression analysis. RESULTS: IR was detected in 33.9% of cases and 41.6% of controls, based on a HOMA-IR ≥3.5. Although multivariate analysis did not show any association between IR and breast cancer risk (OR 0.56, 95% CI 0.31-1.01), it showed that an HbA1c ≥5.7% increased the risk of breast cancer (OR 3.41, 95% CI 1.93-6.01), regardless of menopausal status. CONCLUSIONS: The findings suggest that IR had no effect on breast cancer risk; however HbA1c increased the risk in Latinas of Mexican origin who had not been diagnosed previously with prediabetes or diabetes and had no direct family history of breast cancer. Prospective studies are required to establish the impact of IR over time.

Prediabetes, diabetes, and risk of breast cancer: a case-control study.

BACKGROUND AND AIMS: Although underlying mechanisms have been described to account for the association between prediabetes and diabetes with breast cancer, reported results have been inconsistent. We undertook this study to determine whether prediabetes and diabetes are risk factors for breast cancer in Mexican women with no family history of breast cancer in the mother, daughters, or sisters. METHODS: A case-control study was carried out during 2011-2013. "Case" referred to patients with a histopathological diagnosis of breast cancer (incident and primary cases) (n = 240); "controls" were those with a BI-RADS 1 or 2 mammography result (n = 406). Categorization of prediabetes and diabetes was based on self-reporting or fasting glucose and glycated hemoglobin blood sampling results. Reproductive and sociodemographic data were collected by interview. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated using multivariate unconditional binary logistic regression analysis. RESULTS: Prediabetes increased the risk of breast cancer in postmenopausal women (adjusted OR 2.08, 95% CI 1.10-3.96) as did diabetes (adjusted OR 2.85, 95% CI 1.55-5.26). A history of diabetes preceding breast cancer by ≥7 years and <7 years were both associated with an increased risk for breast cancer (adjusted OR 2.80, 95% CI 1.40-5.60 and 3.00, 95% CI 1.50-5.90, respectively). CONCLUSIONS: This is the first study in Mexico evaluating prediabetes and diabetes as breast cancer risk factors in women with no first-degree relatives with breast cancer. Our findings suggest that women with prediabetes and diabetes should be considered a more vulnerable population for early breast cancer detection.

Epstein-Barr virus (EBV) association and latency profile in pediatric Burkitt's lymphoma: experience of a single institution in Argentina.

The aim of this study is to characterize EBV expression and latency pattern in pediatric Burkitt's lymphoma in a single institution in Argentina. EBV-encoded RNA or protein was analyzed in 27 patients. EBERs was expressed in 37% of patients (29% of immunocompetent and 100% of immunosuppressed patients). EBV-positive cases were observed exclusively in patients younger than 5 years old. EBV association with immunocompetent patients exhibits the sporadic pattern in region under study, while its presence in patients infected with HIV was higher than described previously. EBV latency I profile was present in most of the patients, except for two immunosuppressed patients who displayed LMP1 expression.

Moderate-intensity physical activity ameliorates the breast cancer risk in diabetic women.

OBJECTIVE: To evaluate the association between self-reported diabetes and the risk of breast cancer (BC) and its interaction with moderate-intensity physical activity in pre- and postmenopausal Mexican women. RESEARCH DESIGN AND METHODS: A population-based case-control study was conducted using 1,000 incident case subjects and 1,074 control subjects. Blood samples and information on health, diet, physical activity, and anthropometric measurements were obtained. RESULTS: The association between diabetes and BC risk decreased with increasing tertiles of moderate-intensity physical activity (odds ratio [OR] = 4.9 [95% CI 2.3-10.8]; 3.0 [1.3-6.9]; and 1.0 [0.1-9.2], respectively, for each tertile) (test for interaction = 0.04). Compared with the women in the lowest tertiles, increased risk was observed in those premenopausal women with the highest serum C-peptide, IGF-1, and IGF-1 binding protein 3 levels. CONCLUSIONS: Moderate-intensity physical activity can substantially ameliorate the increased BC risk in diabetic women.

Characterization of Epstein Barr virus latency pattern in Argentine breast carcinoma.

INTRODUCTION: Epstein-Barr virus (EBV)-associated tumors show different expression patterns of latency genes. Since in breast carcinoma this pattern is not yet fully described, our aim was to characterize EBV latency pattern in our EBV positive breast carcinoma series. METHODS: The study was conducted on 71 biopsies of breast carcinoma and in 48 non-neoplastic breast controls. EBNA1, LMP2A and LMP1 expression was assessed by immunohistochemistry with monoclonal antibodies, while viral genomic DNA and EBERs RNA transcripts expression was performed by in situ hybridization. EBV presence was confirmed by PCR. RESULTS: EBV genomic DNA and EBNA1 expression were detected in 31% (22/71) of patients specifically restricted to tumor epithelial cells in breast carcinoma while all breast control samples were negative for both viral DNA and EBNA1 protein. LMP2A was detected in 73% of EBNA1 positive cases, none of which expressed either LMP1 protein or EBERs transcripts. CONCLUSIONS: These findings suggest that EBV expression pattern in the studied biopsies could be different from those previously observed in breast carcinoma cell lines and lead us to suggest a new, EBNA1, LMP2A positive and LMP1 and EBERs negative latency profile in breast carcinoma in our population.

[Neonatal morbidity associated to gestational diabetes. A descriptive study on 74 patients]. / Morbilidad neonatal asociada a diabetes gestacional. Estudio descriptivo de 74 pacientes.

INTRODUCTION: women with gestational diabetes have an increase risk for maternal and neonatal metabolic complications. OBJECTIVE: to evaluate detection, treatment and close surveillance. METHODS: we recruited all women with gestational diabetes whose pregnancies ended in this hospital between September to November of 2005. All newborns were examined by a neonatologist and initiated early feeding with infant formula or glucose solution. RESULTS: a total of 74 patients with gestational diabetes were included. The age was 31.03 +/- 4.79 years, and the body mass index before pregnancy was 32.31 +/- 6.41. Eighteen patients developed third-trimester complications, in fourteen of them it was hypertensive disease of pregnancy. All were single pregnancies that ended in 71 term and 3 preterm newborns. There were not fetal or perinatal deaths. There were four small newborns for gestational age, 18 large for gestational age and 52 normal weight newborns. Eleven neonates had metabolic complications, eight of them had idiopathic respiratory distress syndrome, four had hypoglycaemia and one large for gestational age had obstetric trauma. Also two neonates with cardiovascular malformations were diagnosed. Thirty-six mothers returned for revaluation, eight had type 2 diabetes, six glucose intolerance. CONCLUSIONS: this group of patients shows the maternal and neonatal morbidity associated to gestational diabetes in patients under close surveillance. Systematic early screening in women at risk and close surveillance are required to obtain healthy newborns.