La cognición 4E para el aprendizaje matemático en pospandemia: una revisión sistemática / 4E cognition for post-pandemic math learning: A systematic review / 4E cognição para aprendizagem de matemática pós-pandemia: uma revisão sistemática

Resumen (analítico) Este estudio tiene como objetivo describir la adaptación de las ideas de la cognición 4E en el estudio del aprendizaje de las matemáticas en la investigación contemporánea, de manera que pueda proporcionar estrategias para cualificar los procesos pedagógicos y didácticos en las aulas en tiempos de pospandemia. Se realizó la búsqueda de artículos a texto completo en las bases de datos Science Direct y Ebsco Academic Search Ultimate, de los últimos cuatro años. Se seleccionaron 56 artículos, que se analizaron mediante análisis de conglomerados, nubes de palabras y mapas jerárquicos en Nvivo 11. Se obtuvieron cuatro núcleos temáticos (andamiaje, trayectoria socio-cultural, numerosidad y adquisición de conceptos básicos en matemáticas y exploración de nichos matemáticos) que permiten avanzar en la implementación de mejoras en la enseñanza y el aprendizaje en pospandemia.

Abstract (analytical) This study aims to describe the adaptation of the ideas of 4E cognition in research on Mathematics learning in contemporary research. These ideas can provide strategies to improve pedagogical and didactic processes in classrooms during the post-pandemic period. Fulltext articles published in the last 4 years were searched for in the Science Direct and Ebsco Academic Search Ultimate databases. A total of 56 articles were selected and were analyzed through the generation of cluster analysis, word clouds and hierarchical maps in the NVivo 11 software. Four thematic cores were identified (scaffolding; sociocultural trajectory; numeracy and acquisition of basic concepts in mathematics; and exploration of mathematical niches) that contribute to improvements in teaching and learning in the post-pandemic period.

Resumo (analítico) Este estudo tem como objetivo descrever a adaptação das ideias da cognição 4E no estudo da aprendizagem da Matemática na pesquisa contemporânea, de modo que possa fornecer estratégias para qualificar processos pedagógicos e didáticos em sala de aula em tempos pós-pandêmicos. Artigos de texto completo foram pesquisados nas bases de dados Science Direct e Ebsco Academic Search Ultimate nos últimos 4 anos. Foram selecionados 56 artigos, os quais foram analisados por meio de análise de cluster, nuvem de palavras e mapas hierárquicos no Nvivo 11. Foram obtidos quatro núcleos temáticos (andaimes, trajetória sociocultural, multiplicidade e aquisição de conceitos básicos em matemática e exploração de nichos matemáticos) que permitem avançar na implementação de melhorias no ensino e aprendizagem no pós-pandemia.

Carbon and nitrogen isotopes to distinguish sources of sedimentary organic matter in a Caribbean estuary.

Carbon and nitrogen stable isotope compositions (δ13C and δ15N) of organic matter (OM) and total organic carbon to total nitrogen ratio (Corg/TN) in a sediment core collected in Sagua estuary (Cuba), were investigated to elucidate the origin of the Sedimentary OM (SOM) and changes in its main sources, over the last 100 years. Results showed almost constant values in the elemental and isotope composition of SOM from 1908 to 1970 with an abrupt change after 1970. From 1970 to 2005, δ13C increased from -21.2 up to -19.3 ‰, while δ15N declined from 1.5 to values close to 0 ‰. The output of the mass-balance model for the identification of OM sources indicated that δ13C and Corg/TN values are generally influenced by marine Particulate OM (POM) sources. Between 1900 and 1970, the main OM source in sediments was marine POM (>85 %), with freshwater POM contributing ca. 15%. Since 1970, the establishment of the Alacranes Dam determined drastic environmental changes influencing the OM sources in the area. Mixing models pointed to seagrasses (79 %) as the main contributors to SOM in the first period, while since 1973 onward, the contribution of human-derived sources such as fertilizers and urban discharges became greater. This information can provide baseline data for the environmental management of the Sagua watershed.

Levels, spatial distribution, risk assessment, and sources of environmental contamination vectored by road dust in Cienfuegos (Cuba) revealed by chemical and C and N stable isotope compositions.

Road dust is an indicator widely used when monitoring contamination and evaluating environmental and health risks in urban ecosystems. We conducted an exhaustive characterization of road dust samples coupling their chemical characteristics and stable isotope compositions (C and N) with the aim of evaluating the levels and spatial distribution of local contamination as well as to identify its main source(s) in the coastal city of Cienfuegos (Cuba). Results indicate that the concentrations of several elements (total nitrogen, S, Ca, V, Cu, Zn, Mo, Sn, Hg, and Pb) exceed the background values reported for both Cuban soils and the upper continental crust (UCC) and showed a high variability among the sampling sites. We show that road dust contamination in Cienfuegos induces high associated ecological risks. Among the studied elements, Cd and Hg are the major contributors to the environmental contamination in the city, mainly along busy roads and downtown. δ13C and δ15N, coupled to a multivariate statistical analysis, help associate the studied elements to several local sources of contamination: mineral matter derived from local soils, cement plant and related activities, road pavement alteration, power plant, road traffic, and resuspension of particulate organic matter (POM). Our results suggest that incorporating the chemical and isotope monitoring of road dust may help implement more effective environmental management measures in order to reduce their adverse impact on ecosystems and human health.

Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors.

BACKGROUND:: The best way to approach surgically removed basal cell carcinoma with positive histopathological margins is a controversial issue. Some authors believe that the more appropriate treatment is an immediate reoperation while others prefer a periodic follow up. The rates of recurrence are variable in literature, between 10% and 67%. OBJECTIVE:: To define the recurrence rate of basal cell carcinoma with positive margins after surgery. Secondarily, identify morphological aspects that can suggest a more frequent tumoral recurrence. METHODS:: This was a retrospective and observational study made by analysis of medical records of 487 patients between January 2003 and December 2009 in Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). From 402 basal cell carcinomas surgically treated, 41 fulfilled inclusion criteria and were evaluated for five years or more. Recurrence rate of these tumors was analyzed in all patients and clinical characteristics such as sex, age, tumor size, tumor site, ulceration, and histological type were evaluated in order to find if they were related to more common tumoral recurrence. RESULTS:: The rate of positive margins after surgery was 12.18%. There were five cases of tumoral recurrence in the observation group and three cases in the re-excision group. Tumor size, site, histological type, ulceration and type of positive margin did not differ statistically between groups. It was not possible to consider if these factors were important in recurrence rates. STUDY LIMITATIONS:: Ideally, a prospective study with a larger sample would be more accurate. CONCLUSION:: The treatment of choice in basal cell carcinoma with positive margins must be individualized to reduce recurrence rates.

Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors

Abstract: BACKGROUND: The best way to approach surgically removed basal cell carcinoma with positive histopathological margins is a controversial issue. Some authors believe that the more appropriate treatment is an immediate reoperation while others prefer a periodic follow up. The rates of recurrence are variable in literature, between 10% and 67%. OBJECTIVE: To define the recurrence rate of basal cell carcinoma with positive margins after surgery. Secondarily, identify morphological aspects that can suggest a more frequent tumoral recurrence. METHODS: This was a retrospective and observational study made by analysis of medical records of 487 patients between January 2003 and December 2009 in Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). From 402 basal cell carcinomas surgically treated, 41 fulfilled inclusion criteria and were evaluated for five years or more. Recurrence rate of these tumors was analyzed in all patients and clinical characteristics such as sex, age, tumor size, tumor site, ulceration, and histological type were evaluated in order to find if they were related to more common tumoral recurrence. RESULTS: The rate of positive margins after surgery was 12.18%. There were five cases of tumoral recurrence in the observation group and three cases in the re-excision group. Tumor size, site, histological type, ulceration and type of positive margin did not differ statistically between groups. It was not possible to consider if these factors were important in recurrence rates. STUDY LIMITATIONS: Ideally, a prospective study with a larger sample would be more accurate. CONCLUSION: The treatment of choice in basal cell carcinoma with positive margins must be individualized to reduce recurrence rates.

Sweet's syndrome: a study of 23 cases.

BACKGROUND: Sweet's syndrome or acute febrile neutrophilic dermatosis is a rare disease characterized by painful violaceous erythematous skin lesions, fever, neutrophilic leukocytosis and dense dermal neutrophilic inflammatory infiltrate. It shows excellent response to corticosteroids. OBJECTIVES: To assess cases of Sweet's syndrome in a university hospital, identifying its clinical, laboratory and epidemiological characteristics and compare them with the data found on the literature. METHODS: We conducted a retrospective epidemiological study by examining the medical records of 23 patients who met the diagnostic criteria for the disease from March 1995 to July 2009. We collected clinical and epidemiological data on the patients, such as lesion location, presence of cutaneous and extracutaneous manifestations, conditions associated with SS and some laboratory data, such as leukocyte count and ESR. RESULTS: The age of the patients in the study ranged from 2 to 75 years. There were more females. The lesions mostly affected the trunk and upper limbs. Fever was the most common systemic manifestation, followed by arthralgia and myalgia, conjunctivitis and arthritis. The triggering factors most commonly identified were infections of the respiratory tract. Associated neoplasia occurred in 30% of the patients, especially hematologic neoplasia. CONCLUSION: The clinical and epidemiological data found in our study are mostly similar to those found in the literature. Given the high prevalence of malignant diseases in patients with Sweet's syndrome, it is necessary to know how to perform the diagnosis, carry out a full investigation as well as do the patient's follow up.

Síndrome de Sweet: estudo de 23 casos / Sweet's syndrome: a study of 23 cases

FUNDAMENTOS: A síndrome de Sweet (SS) é uma doença rara, caracterizada por lesões cutâneas eritematovioláceas dolorosas, febre, leucocitose com neutrofilia e derme com infiltrado inflamatório neutrofílico denso à histologia. Apresenta excelente resposta à corticoterapia. OBJETIVOS: Avaliar os casos de SS em hospital universitário, identificando as características clínicas, laboratoriais e epidemiológicas e compará-las com os dados da literatura. MÉTODOS: Realizou-se estudo epidemiológico, retrospectivo, mediante revisão de prontuários. Identificaram-se 23 pacientes que preencheram os critérios diagnósticos para a doença no período de março de 1995 a julho de 2009. Coletaram-se dados clínicos e epidemiológicos dos pacientes, tais como: localização das lesões, presença de manifestações cutâneas e extracutâneas, condições associadas à SS e alguns dados laboratoriais, como con tagem de leucócitos e velocidade de hemossedimentação (VHS). RESULTADOS: As idades variaram entre 2 e 75 anos. Houve predomínio do sexo feminino. As lesões acometeram, preferencialmente, tronco e membros superiores. Febre foi a manifestação sistêmica mais comum, seguida por artralgias e mialgia, conjuntivite e artrite. Os fatores desencadeantes mais comumente detectados foram infecções de vias aéreas. Neoplasias associadas ocorreram em 30 por cento dos pacientes, principalmente hematológicas. CONCLUSÕES: Os dados clínicos e epidemiológicos encontrados no presente estudo são, em sua maior parte, similares aos já disponíveis na literatura. Devido à alta prevalência de doenças malignas na SS é importante diagnosticá-la, realizar investigação sistêmica adequada e manter seguimento dos pacientes.

BACKGROUND: Sweet's syndrome or acute febrile neutrophilic dermatosis is a rare disease characterized by painful violaceous erythematous skin lesions, fever, neutrophilic leukocytosis and dense dermal neutrophilic inflammatory infiltrate. It shows excellent response to corticosteroids. OBJECTIVES: To assess cases of Sweet's syndrome in a university hospital, identifying its clinical, laboratory and epidemiological characteristics and compare them with the data found on the literature. METHODS: We conducted a retrospective epidemiological study by examining the medical records of 23 patients who met the diagnostic criteria for the disease from March 1995 to July 2009. We collected clinical and epidemiological data on the patients, such as lesion location, presence of cutaneous and extracutaneous manifestations, conditions associated with SS and some laboratory data, such as leukocyte count and ESR. RESULTS: The age of the patients in the study ranged from 2 to 75 years. There were more females. The lesions mostly affected the trunk and upper limbs. Fever was the most common systemic manifestation, followed by arthralgia and myalgia, conjunctivitis and arthritis. The triggering factors most commonly identified were infections of the respiratory tract. Associated neoplasia occurred in 30 percent of the patients, especially hematologic neoplasia. CONCLUSION: The clinical and epidemiological data found in our study are mostly similar to those found in the literature. Given the high prevalence of malignant diseases in patients with Sweet's syndrome, it is necessary to know how to perform the diagnosis, carry out a full investigation as well as do the patient's follow up.

Excisão triangular cutânea com fechamento primário / Cutaneous triangular excision with primary closure

Introdução: Tumores cutâneos são frequentes e podem apresentar crescimento irregular, cujas ressecções resultam em figuras geométricas variadas. Objetivo: Descrição de técnica de excisão em triângulo seguida de fechamento primário para tratamento de neoplasias cutâneas.Métodos: Foram estudados 11 pacientes com tumores de pele medindo entre 1,8 e 5,7cm em regiões anatômicas que favoreceram a utilização de incisões no formato de triângulo equilátero seguidas de fechamento primário. Resultados:Todos os casos tiveram seus defeitos cirúrgicos fechados com a formação de cicatriz em formato de Y. No pós-operatório foram observados dois casos de deiscência parcial da sutura. Conclusões: A técnica cirúrgica de fechamento primário de excisão triangular de pele apresenta bom resultado estético e bom controle de margens cirúrgicas conservando tecido adjacente.

Dermatologia clínico-cirúrgica: avaliação da mudança no perfil dos procedimentos de um serviço de residência médica no Paraná-BR / Clinical-surgical dermatology: assessment of the changes in types of procedures performed in a dermatologic residency in the Brazilian State of Paraná

Introdução: Nas últimas quatro décadas a dermatologia transformou-se, de especialidade puramente clínica, em especialidade clinicocirúrgica. O dermatologista passou a realizar, além da diagnose e do tratamento clínico,o tratamento cirúrgico das afecções e neoplasias cutâneas,a correção de cicatrizes e procedimentos cutâneos necessários para melhora da aparência individual. Objetivo: Demonstrar a mudança do perfil das atividades do Serviço de Dermatologia do HC-UFPR no período estudado. Material e métodos: Foi realizada a revisão sistemática dos registros próprios do Ambulatório de Dermatologia, além dos dados fornecidos pelo Sistema de Estatística e Planejamento do HC-UFPR entre 2002 e 2007. Resultados: Houve aumento relativo de 16% no número de procedimentos cirúrgicos no período estudado, com aumento também de sua complexidade, passando o índice de exerese de lesões benignas em relação ao da exerese de tumores malignos de 2,25:1 em 2002 para 1,04:1 em 2007. Quanto aos procedimentos cosmiátricos, a realização de peelings ampliou-se 74% no período estudado. O preenchimento e a aplicação de toxina botulínica passaram de procedimentos esporádicos em 2002 para procedimentos de rotina, com 3,33 preenchimentos/mês e três aplicações toxina/mês. Conclusões: Os dados obtidos demonstram objetivamente a transformação das atividades do Serviço de Dermatologia do HC-UFPR, de principalmente clínicas, para clinicocirúrgicas, com aumento da complexidade dos procedimentos realizados no treinamento do residente de dermatologia, em concordância com a evolução da especialidade no Brasil e no mundo.

Introduction: During the last four decades, dermatology has evolved from a purely clinic into a clinical- surgical specialty. In addition to diagnosing conditions and conducting clinical therapies, dermatologists began performing surgical treatments of cutaneous affections and neoplasias, corrections of scars, and cosmetic cutaneous procedures. Objective: To describe the change in types of procedures performed at the Dermatology Service of the Clinical Hospital of the Federal University of Paraná during the period studied. Material and methods: A systematic review of the Dermatology Service's proprietary registers, and of additional data supplied by the hospital's Statistics and Planning System, was carried out for the period ranging from 2002 to 2007. Results: A relative increase of 16% in the number of surgical procedures has been verified in the study period, with an increase in the complexity of the procedures ­ with the ratio of excisions of benign lesions/ malignant tumors falling to 1.04:1 in 2007, from 2.25:1 in 2002. Among cosmetic procedures there has been a 74% increase in the application of chemical peels during this time. The use of fillers and botulinum toxin evolved from sporadic procedures in 2002 to frequent practice in 2007, with 3.33 and 3 procedures being conducted per month, respectively. Conclusions:The data, which were obtained objectively, demonstrate the transformation of the activities of the Dermatology Service of the Clinical Hospital of the Federal University of Paraná from mainly clinical to clinical- surgical procedures, with an increase in the complexity of the procedures performed to help train dermatology residents, in accordance with the development of the specialty throughout Brazil and the rest of the world.

Porocarcinoma écrino: relato de quatro casos e revisão da literatura / Eccrine porocarcinoma: report of four cases and literature review

Porocarcinoma écrino é um tumor de pele raro derivado do acrossiríngeo. Quatro casos de porocarcinoma écrino são estudados. Os pacientes tinham idade entre 49 e 64 anos, sendo dois homens e duas mulheres. O tempo de crescimento dos tumores variou de um a 20 anos. As lesões mediam de 1,2 x 2 a 4 x 5 cm e se localizavam nas extremidades ou na face. Dois pacientes apresentavam carcinoma basocelular em sítios diferentes do porocarcinoma écrino. Duas das biópsias foram previamente descritas como poroma écrino; entretanto, malignidade foi observada em todos os casos após excisão ampla. Portanto, em toda biópsia de pele compatível com poroma écrino, deve-se considerar a possibilidade de malignidade.

Eccrine porocarcinoma is an extremely rare skin tumor derived from the acrosyringium. Four cases of eccrine porocarcinoma are described, two males and two females, aged from 49 to 64 years. Tumors grew in an interval of one to 20 years. Lesions ranged from 1.2 x 2 cm to 4 x 5 cm and were on limbs or face. Two patients had basal cell carcinoma in a site different from the eccrine porocarcinoma. Two biopsies were described as eccrine poroma. Malignancy was observed in all cases after wide excision. Therefore, eccrine porocarcinoma should always be considered after a biopsy compatible with eccrine poroma.

Sarcoma de Kaposi primário do pênis / Primary Kaposi's sarcoma of the penis

Sarcoma de Kaposi é um tumor vascular que afeta a parede dos vasos linfáticos. Possui quatro formas: clássica, endêmica, iatrogênica e associada ao HIV. É uma doença sistêmica, maligna, multifatorial e de curso variável. A apresentação inicial no pênis é rara, e mais observada em pacientes HIV positivos. Em pacientes HIV negativos, os casos que ocorrem nesta região, apresentam-se com pápulas, nódulos, placas e lesões verruciformes, assintomáticas. Para o tratamento da forma clássica, dispõem-se de excisão cirúrgica, crioterapia, eletrocirurgia, laser e radioterapia. Neste trabalho, é relatado um caso raro de um paciente com a forma clássica, em região peniana tratado com sucesso com radioterapia.

Kaposi's sarcoma is a vascular tumor involving the wall of lymphatic vessels. There are four types: classic, endemic, iatrogenic and HIV-associated. It is a systemic, malignant and multifactorial disease and has a variable course. The primary presentation on the penis is uncommon and is mainly observed in HIV-positive patients. In HIV-negative individuals, asymptomatic papules, nodules, plaques and verrucous lesions are found. The treatment for the classic form involves surgery, cryotherapy, electrosurgery, laser and radiation therapy. The authors present a rare case of a patient with the classic form on the penis, who was successfully treated by radiation therapy.

[Eccrine porocarcinoma: report of four cases and literature review]. / Porocarcinoma écrino: relato de quatro casos e revisão da literatura.

Eccrine porocarcinoma is an extremely rare skin tumor derived from the acrosyringium. Four cases of eccrine porocarcinoma are described, two males and two females, aged from 49 to 64 years. Tumors grew in an interval of one to 20 years. Lesions ranged from 1.2 x 2 cm to 4 x 5 cm and were on limbs or face. Two patients had basal cell carcinoma in a site different from the eccrine porocarcinoma. Two biopsies were described as eccrine poroma. Malignancy was observed in all cases after wide excision. Therefore, eccrine porocarcinoma should always be considered after a biopsy compatible with eccrine poroma.

[Primary Kaposi's sarcoma of the penis]. / Sarcoma de Kaposi primário do pênis.

Kaposi's sarcoma is a vascular tumor involving the wall of lymphatic vessels. There are four types: classic, endemic, iatrogenic and HIV-associated. It is a systemic, malignant and multifactorial disease and has a variable course. The primary presentation on the penis is uncommon and is mainly observed in HIV-positive patients. In HIV-negative individuals, asymptomatic papules, nodules, plaques and verrucous lesions are found. The treatment for the classic form involves surgery, cryotherapy, electrosurgery, laser and radiation therapy. The authors present a rare case of a patient with the classic form on the penis, who was successfully treated by radiation therapy.

Dermatose perfurante adquirida associada à insuficiência hepática em paciente transplantado de fígado / Acquired perforating dermatosis associated with hepatic failure in a liver-transplanted patient

A dermatose perfurante adquirida é entidade clinicopatológica caracterizada por eliminação transepitelial de material dérmico degenerado, ocorrendo em muitas condições, entre elas diabetes mellitus, insuficiência renal crônica e colangite esclerosante. Relata-se o caso de paciente de 17 anos, com dermatose perfurante adquirida associada à insuficiência hepática crônica, conseqüente à complicação hepática de transplante de fígado para tratamento de sua doença de base, a glicogenose tipo I.

Acquired perforating dermatosis is characterized by transepithelial elimination of degenerated dermal substances. It occurs in many conditions, such as: diabetes mellitus, chronic renal failure and sclerosing cholangitis. This article describes a 17-year-old Caucasian female with type I glucogenosis and acquired perforating dermatosis due to chronic hepatic failure caused by hepatic complication of liver transplant.

Síndrome antifosfolípide / Antiphospholipid syndrome

Condição adquirida, sistêmica, caracterizada por tromboses recorrentes no sistema arterial, venoso ou ambos, a síndrome antifosfolípide pode ser primária ou secundária, esta última mais associada ao lúpus eritematoso sistêmico e menos freqüentemente a infecções, fármacos e outras doenças. São marcadores sorológicos da síndrome antifosfolípide os anticorpos antifosfolípides anticoagulante lúpico e anticardiolipina. O critério diagnóstico primário inclui trombose arterial ou venosa e morte fetal recorrente. Cerca de 41% dos pacientes apresentam lesões cutâneas como primeiro sinal da síndrome, que também pode provocar livedo reticular, ulcerações cutâneas, vasculite livedóide, entre outras manifestações. Seu controle consiste principalmente no tratamento e profilaxia da trombose com anticoagulantes e antiagregantes plaquetários

Estudo aberto, prospectivo de eficácia e tolerabilidade da desloratadina na urticária idiopática crônica (UIC) / Open label, prospective studyof efficacy and tolerability of desloratadine in chronic idiopathic urticaria (CIU)

Introdução: A desioratadína, principal metabólito da loratadina, é um novo antagonista seletivo de receptor Hi não sedante que apresenta atividade antiinfiamatória adicional Objetivos: Avaliar a eficácia e a tolerabilídade de 5 mg de desioratadina, administra- da em dose única diária em portadores de urticária idiopátíca crônica (UIC) moderada a grave. Métodos: Estudo aberto e prospectívo avaliou 56 pacientes com UIC originados de 10 serviços universitários que foram tratados por 28 dias com 5 mg de desioratadina e avaliados após 14 e 28 dias de tratamento. A avaliação de eficácia foi realizada através de um sistema de escore de intensidade do prurido, número de pápulas e condição geral da UIC. Foram avaliadas também as análises subjetivas do investigador e dos pacientes em relação à eficácia e à tolerabilidade. Os pacientes receberam um diário para registro da intensidade do prurido matinal e noturno e de quanto o prurido atrapalhava as ativida- des diárias e o sono. Foi aplicado um Questionário de índice de Qualidade de Vida para Dermatología e um Questionário de Produtividade no Trabalho e Comprometimento de Atividades. Para a avaliação de segurança foram regístrados todos os eventos adversos e monitorados os sinais vitais a cada visita. Resultados: Houve redução estatisticamente significante do escore da intensidade do prurido, número de pápulas e condição geral da UIC. Observou-se também melhora estatisticamente significante de todos os itens do Questionário de Qualidade de Vida, Questionário de Produtividade no Trabalho e Comprometimento das Atividades e da qualidade do sono e no desempenho diurno. A eficácia do tratamento foi considerada completa, acentuada ou moderada, segundo o investigador e paciente em, respectivamente, 87por cento e 89por cento dos casos. A tolerabilidade foi considerada excelente e boa na avaliação do investigador e do paciente em 98 por cento dos casos. Conclusões: A desloratadina na dose de 5 mg foi eficaz, segura e bem tolerada no tratamento da UIC, melhorando síanificantemente a Qualidade de vida dos Dacientes.

Fenômeno de Lúcio (eritema necrosante) na gestação / The Lucio's phenomenon (necrotizing erythema) in pregnancy

O fenômeno de Lúcio, variante do estado reacional hansênico tipo 2, provavelmente mediado por imunocomplexos, caracteriza-se por reação cutânea necrosante grave que ocorre principalmente em doentes portadores de hanseníase virchowiana não nodular. Os autores relatam o caso de uma paciente de 27 anos, do sexo feminino, gestante de 32 semanas, com quadro de lesões eritêmato-purpúricas nos membros, bem delimitadas, confluentes, encimadas por bolhas, algumas necróticas e ulceradas, com uma semana de evolução, acompanhadas de febre e intensa dor local. A baciloscopia da linfa evidenciou bacilos álcool-acidorresistentes formando globias, e a histopatologia da pele confirmou hanseníase virchowiana, compatível com fenômeno de Lúcio. Foi iniciada prednisona e poliquimioterapia multibacilar com rifampicina, clofazimina e sulfona, com boa evolução. A gravidez tem sido associada à elevada incidência de aparecimento dos primeiros sinais ou ao agravamento da hanseníase por alterações hormonais que levam ao desequilíbrio imunológico, sendo considerado crítico o período compreendido entre o último trimestre de gestação e os primeiros três meses da lactação, quando a imunossupressão atinge seu ápice. Apesar da recomendação de se restringir a ingestão de drogas na gestação, o tratamento da hanseníase deve ser realizado, visto que seus benefícios superam os riscos.

Extracellular matrix in fin regeneration in teleosts

Since 1982, our group has collaborated with Prof. Gregorio S. Montes in analyzing the composition and function of the extracellular matrix during fin regeneration in teleosts. The structure and ultrastructure od fully formed and regenerating fins of various teleostean species have been studied. The dermal skeleton of fins consists of rays formed by lepidotrichia and which is surrounded by loose connective tissue and a multistratified epidermis. Distally, there are hyperpolymerized macrofibrils of elastoidin, a collagen-like protein, named actinotricha. Both lepidotrichia and actinotrichia are formed during regeneration. However, whereas the lepidotrichia form distally by the addition of new material, the actinotrichia are synthesized very early at proximal sites and then maintained by a continuous turnover at the distal margin of the regenerating ray blastema, as shown by radioactive pulse-chase experiments. Using the picrosirius-polarization method, as well as immunocytochemistry for various extracellular matrix components and enzymatic digestion, we have established correlatins between the various extracellular matrix components; glycosaminoglycans and collagen in the mature adult structure. During regeneration and after wound healing a blastema is formed. Histological analysis of the extracellular matrix has indicated that the blastema consists of the blastema proper, which is rich in hyalunorate and the actinotrichial blastemic region, which is rich in glycosaminoglycan sulphates and collagen. The inibition of collagen synthesis by several specific drugs during fin regeneration attenuated blastema formation, regenerative outgrowth and extracellular matrix formation. These findings suggest an interesting morphogenetic and regenerative function for collagen which could provide an interesting field for future research.