Low Diversity and High Genetic Structure for Platonia insignis Mart., an Endangered Fruit Tree Species.

Platonia insignis is a fruit tree native to Brazil of increasing economic importance, with its pulp trading among the highest market values. This study aimed to evaluate the structure and genomic diversity of P. insignis (bacurizeiro) accessions from six locations in the Brazilian States of Roraima, Amazonas, Pará (Amazon biome), and Maranhão (Cerrado biome). A total of 2031 SNP markers were obtained using genotyping-by-sequencing (GBS), from which 625 outlier SNPs were identified. High genetic structure was observed, with most of the genetic variability (59%) concentrated among locations, mainly between biomes (Amazon and Cerrado). A positive and significant correlation (r = 0.85; p < 0.005) was detected between genetic and geographic distances, indicating isolation by distance. The highest genetic diversity was observed for the location in the Cerrado biome (HE = 0.1746; HO = 0.2078). The locations in the Amazon biome showed low genetic diversity indexes with significant levels of inbreeding. The advance of urban areas, events of burning, and expansion of agricultural activities are most probably the main factors for the genetic diversity reduction of P. insignis. Approaches to functional analysis showed that most of the outlier loci found may be related to genes involved in cellular and metabolic processes.

T cell-specific P2RX7 favors lung parenchymal CD4+ T cell accumulation in response to severe lung infections.

CD4+ T cells are key components of the immune response during lung infections and can mediate protection against tuberculosis (TB) or influenza. However, CD4+ T cells can also promote lung pathology during these infections, making it unclear how these cells control such discrepant effects. Using mouse models of hypervirulent TB and influenza, we observe that exaggerated accumulation of parenchymal CD4+ T cells promotes lung damage. Low numbers of lung CD4+ T cells, in contrast, are sufficient to protect against hypervirulent TB. In both situations, lung CD4+ T cell accumulation is mediated by CD4+ T cell-specific expression of the extracellular ATP (eATP) receptor P2RX7. P2RX7 upregulation in lung CD4+ T cells promotes expression of the chemokine receptor CXCR3, favoring parenchymal CD4+ T cell accumulation. Our findings suggest that direct sensing of lung eATP by CD4+ T cells is critical to induce tissue CD4+ T cell accumulation and pathology during lung infections.

Tissue- and temporal-specific roles of extracellular ATP on T cell metabolism and function.

The activation and function of T cells is fundamental for the control of infectious diseases and cancer, and conversely can mediate several autoimmune diseases. Among the signaling pathways leading to T cell activation and function, the sensing of extracellular adenosine triphosphate (eATP) has been recently appreciated as an important component. Through a plethora of purinergic receptors, most prominently P2RX7, eATP sensing can induce a wide variety of processes in T cells, such as proliferation, subset differentiation, survival, or cell death. The downstream roles of eATP sensing can vary according to (a) the T cell subset, (b) the tissue where T cells are, and (c) the time after antigen exposure. In this mini-review, we revisit the recent findings on how eATP signaling pathways regulate T-cell immune responses and posit important unanswered questions on this field.

Pannexin-1 channels promote CD8+ T cell effector and memory responses through distinct intracellular pathways.

Sensing of extracellular metabolites controls CD8+ T cell function. Their accumulation can occur through export by specialized molecules, such as the release channel Pannexin-1 (Panx1). Whether Panx1 controls CD8+ T cell immune responses to antigen, however, has not been previously addressed. Here, we report that T cell-specific Panx1 is needed for CD8+ T cell responses to viral infections and cancer. We found that CD8-specific Panx1 favors memory CD8+ T cell survival primarily through ATP export and induction of mitochondrial metabolism. CD8-specific Panx1 is also crucial for the effector expansion of CD8+ T cells, however this regulation occurs independently of eATP. Instead, our results suggest a connection between Panx1-induced extracellular lactate accumulation and the complete activation of effector CD8+ T cells. In summary, Panx1 regulates effector and memory CD8+ T cells through export of distinct metabolites and by engaging different metabolic and signaling pathways.

Association of handgrip strength with anthropometry of a Brazilian healthy adolescent sample.

The importance of dynamometric and anthropometric information for industry is known; however, few studies have investigated the relationship between anthropometry and handgrip strength (HGS) in adolescents. The aim of the present study was to investigate the association of anthropometric variables with the level of HGS production in adolescents. Participants were 541 adolescents aged 12-16 years from a public school in the city of Rio de Janeiro. The behavior of the following variables was examined: the ability to generate HGS, age, total body mass, height and hand dimensions (hand width, hand span, hand length). The results showed an increase in the ability to generate HGS in adolescence and a significant difference between the genders from 13 years old, where boys generated higher HGS values. Correlations between HGS and total body mass and the hand width stood out in both genders, indicating a greater association.

P2x7 Receptor Signaling Blockade Reduces Lung Inflammation and Necrosis During Severe Experimental Tuberculosis.

The risk of developing severe forms of tuberculosis has increased by the acquired immunodeficiency syndrome (AIDS) epidemic, lack of effective drugs to eliminate latent infection and the emergence of drug-resistant mycobacterial strains. Excessive inflammatory response and tissue damage associated with severe tuberculosis contribute to poor outcome of the disease. Our previous studies using mice deficient in the ATP-gated ionotropic P2X7 receptor suggested this molecule as a promising target for host-directed therapy in severe pulmonary tuberculosis. In this study, we assessed the effects of P2X7 pharmacological blockade on disease severity. First, we observed an increase in P2RX7 gene expression in the peripheral blood of tuberculosis patients compared to healthy donors. Lung leukocytes of mice infected with hypervirulent mycobacteria also showed increased expression of the P2X7 receptor. P2X7 blockade in mice with advanced tuberculosis recapitulated in many aspects the disease in P2X7-deficient mice. P2X7-directed therapy reduced body weight loss and the development of inflammatory and necrotic lung lesions, as well as delayed mycobacterial growth. Lower TNF-α production by lung cells and a substantial reduction in the lung GR-1+ myeloid cell population were observed after P2X7 inhibition. The effector CD4+ T cell population also decreased, but IFN-γ production by lung cells increased. The presence of a large population with characteristics of myeloid dendritic cells, as well as the increase in IL-6 production by lung cells, also indicate a qualitative improvement in the pulmonary immune response due to P2X7 inhibition. These findings support the use of drugs that target the P2X7 receptor as a therapeutic strategy to improve the outcome of pulmonary tuberculosis.

Análise cinemática da marcha com medidas normalizadas e não-normalizadas em indivíduos hígidos: um estudo experimental / Kinematic gait analysis with normalized and non-normalized measurements in healthy individuals: an experimental study

O objetivo deste estudo foi analisar as possíveis relações entre a variável antropométrica comprimento dos membros inferiores e de passada na marcha, com valores naturais e normalizados, em velocidade auto-selecionada e acrescida de 50%, em indivíduos adultos jovens. Foram avaliados 32 sujeitos hígidos adultos entre 18-25 anos. Os deslocamentos corporais nas duas velocidades foram registrados através da técnica de cineantropometria, utilizando o software Skillspector® para quantificar o comprimento da passada entre as médias dos dados normalizadas e não-normalizadas, do segmento direito e do segmento esquerdo. A comparação entre os valores médios das passadas normalizadas e não-normalizadas, nas diferentes velocidades, foi realizada por meio do teste t student (p < 0,05), assim como o grau de associação entre o comprimento da passada e o comprimento do membro inferior, realizada pelo teste de correlação de Pearson (p < 0,05). Sendo assim, nosso estudo constatou uma correlação positiva entre as variáveis estudadas, nas duas velocidades e, uma diferença entre a passada com dados normalizados e não normalizados, em ambas as velocidades. (AU)

The aim of this study was to analyze the possible relationships between the anthropometric variable length of the lower limbs and gait stride, with natural and normalized values, at self-selected speed and increased by 50%, in young adult individuals. 32 healthy adult subjects aged 18-25 years were evaluated. Body movements at both speeds were recorded using the kinanthropometry technique, using the Skillspector® software to quantify the stride length between the normalized and nonnormalized data averages for the right and left segments. The comparison between the mean values of normalized and non-normalized strides, at different speeds, was performed using the Student t test (p < 0.05), as well as the degree of association between stride length and lower limb length, performed by the Pearson correlation test (p < 0.05). Thus, our study found a positive correlation between the variables studied, at both speeds, and a difference between the stride with normalized and non-normalized data, at both speeds. (AU)

Exequibilidade da Técnica de Moiré de sombra na identificação de desvios posturais em escolares / Feasibility of shadow Moiré Technique to identify postural disorders in schoolchildren

O objetivo deste estudo foi examinar a exequibilidade do uso da Técnica de Moiré de Sombra (TMS) em triagens periódicas no ambiente escolar e estabelecer o estado da prevalência de desvios posturais em uma escola pública do município do Rio de Janeiro. A amostra se compôs por 304 alunos. O exame da TMS baseou-se na diferença do número de franjas nas regiões dorsal e cintura escapular. A exequibilidade foi identificada considerando-se parâmetros preestabelecidos. Identificaram-se 225 sujeitos com diferença de franjas na região dorsal, e 224 com diferença de franjas na cintura escapular. Quanto à exequibilidade, a amostra foi examinada em sete dias e não houve dificuldades na execução da técnica, no processamento das imagens e nos materiais requeridos. Considerou-se a TMS exequível para triagens populacionais, permitindo exames periódicos em larga escala. A TMS pode ser uma estratégia na implementação de programas de saúde pública na escola, objetivando a melhora da qualidade de vida.

This study aimed to examine the feasibility of the Shadow Moiré Technique (SMT) in carrying out periodic school screenings and to identify the prevalence of postural disorders in students from a public school in Rio de Janeiro. The sample was comprised of 304 students. The SMT exam was based on the difference in the number of fringes in the dorsal and scapulothoracic regions. The feasibility of the SMT was identified based on predetermined parameters. Two hundred and twenty-five subjects were identified with fringe difference in the dorsal region and 224 were identified with fringe difference in the scapulothoracic region. Regarding feasibility, the sample was examined over the period of 7 days. There were no difficulties in obtaining the materials, in the use of the technique or in the processing of the images. SMT was considered feasible to screen the population and it allows for large-scale periodic examination. The SMT can be a strategy for implementing public health programs at school aiming at improving the quality of life.

Fuentes de luz de uso clínico en el pre grado: 7 años de seguimento / Light curing units in the undergraduate dental clinics: 7 years of follow-up

RESUMEN Objetivo: Realizar, durante siete años ininterrumpidos, un control y seguimiento de las fuentes de luz disponibles en las clínicas odontológicas de pre graado de una Institución de Enseñanza Superior Pública Brasileña. Material y métodos: Durante el período comprendido entre 2011-2017 se evaluó el control de calidad de las fuentes de luz de la Facultad de Odontología de la Universidad Federal de Goiás a través del análisis de su estado de conservación y de su densidad de potencia (mW/cm2). Los datos obtenidos se sometieron a un análisis estadístico descritpivo y a las pruebas de Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn y Chi-cuadrado (P<0,05). Resultados: No se observaron diferencias estadísticas significativas del estado de conservación de las fuentes de luz entre los años 2012, 2016 y 2017 (p>0,05). Sí se observaron diferencias estadísticas significativas entre los valores de densidad de potência entre dichos años (p<0,0001). En las comparaciones por pares, los valores de densidad de potencia para los años 2011 (p<0,01) y 2012 (p<0,05) fueron estadísticamente diferentes de los años 2015, 2016 y 2017. Conclusiones: Comparativamente se observó una mejora sustancial del estado de conservación de las fuentes de luz en los cuatro años iniciales de evaluaciones, con una disminución en el quinto año y una estabilización en los dos últimos años. Durante los siete años de estudio de la densidad de potencia de las fuentes de luz se observó en un aumento gradual de la misma con una estabilización de los resultados a partir del quinto año de control de calidad.

SUMMARY Objetive: To monitor the light curing units available at undergraduate dental clinics of a Brazilian Public Higher Education Institution for seven uninterrupted years. Materials and methods: In the period between 2011-2017, the quality control of light curing units at the Faculty of Dentistry, Federal University of Goiás, was evaluated by analyzing their state of conservation and power density (mW/cm2). Data obtained were subjected to descriptive statistical analysis and Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn and Chi-square tests (P <0.05). Results: Regarding the conservation status of the light curing units, comparatively, there was no statistically significant difference between the years 2012, 2016 and 2017 (p> 0.05). Statistically significant differences were found for power density values between years (p <0.0001). In pairwise comparisons, the power density values for the years 2011 (p <0.01) and 2012 (p <0.05) were statistically different from the years 2015, 2016 and 2017. Conclusions: A significant improvement in the state of conservation of light curing units was observed in the initial four years of evaluations, with a decline in the fifth year and stabilization in the last two years. Regarding the power density of the light curing units, a gradual increase was observed in the seven years of study, with stabilization of the results after the fifth year of quality control.

Harmful Effects of Granulocytic Myeloid-Derived Suppressor Cells on Tuberculosis Caused by Hypervirulent Mycobacteria.

BACKGROUND: The role of myeloid-derived suppressor cells (MDSCs) in patients with severe tuberculosis who suffer from uncontrolled pulmonary inflammation caused by hypervirulent mycobacterial infection remains unclear. METHODS: This issue was addressed using C57BL/6 mice infected with highly virulent Mycobacterium bovis strain MP287/03. RESULTS: CD11b+GR1int population increased in the bone marrow, blood and lungs during advanced disease. Pulmonary CD11b+GR1int (Ly6GintLy6Cint) cells showed granularity similar to neutrophils and expressed immature myeloid cell markers. These immature neutrophils harbored intracellular bacilli and were preferentially located in the alveoli. T-cell suppression occurred concomitantly with CD11b+GR1int cell accumulation in the lungs. Furthermore, lung and bone marrow GR1+ cells suppressed both T-cell proliferation and interferon γ production in vitro. Anti-GR1 therapy given when MDSCs infiltrated the lungs prevented expansion and fusion of primary pulmonary lesions and the development of intragranulomatous caseous necrosis, along with increased mouse survival and partial recovery of T-cell function. Lung bacterial load was reduced by anti-GR1 treatment, but mycobacteria released from the depleted cells proliferated extracellularly in the alveoli, forming cords and clumps. CONCLUSIONS: Granulocytic MDSCs massively infiltrate the lungs during infection with hypervirulent mycobacteria, promoting bacterial growth and the development of inflammatory and necrotic lesions, and are promising targets for host-directed therapies.

Hybrid integral transform analysis of supercooled droplets solidification.

The freezing phenomena in supercooled liquid droplets are important for many engineering applications. For instance, a theoretical model of this phenomenon can offer insights for tailoring surface coatings and for achieving icephobicity to reduce ice adhesion and accretion. In this work, a mathematical model and hybrid numerical-analytical solutions are developed for the freezing of a supercooled droplet immersed in a cold air stream, subjected to the three main transport phenomena at the interface between the droplet and the surroundings: convective heat transfer, convective mass transfer and thermal radiation. Error-controlled hybrid solutions are obtained through the extension of the generalized integral transform technique to the transient partial differential formulation of this moving boundary heat transfer problem. The nonlinear boundary condition for the interface temperature is directly accounted for by the choice of a nonlinear eigenfunction expansion base. Also, the nonlinear equation of motion for the freezing front is solved together with the ordinary differential system for the integral transformed temperatures. After comparisons of the solution with previously reported numerical and experimental results, the influence of the related physical parameters on the droplet temperatures and freezing time is critically analysed.

Assessment of Gene Flow to Wild Relatives and Nutritional Composition of Sugarcane in Brazil.

The commercial release of genetically modified organisms (GMO) requires a prior environmental and human/animal health risk assessment. In Brazil, the National Biotechnology Technical Commission (CTNBio) requires a survey of the area of natural occurrence of wild relatives of the GMO in the Brazilian ecosystems to evaluate the possibility of introgressive hybridization between sexually compatible species. Modern sugarcane cultivars, the focus of this study, derive from a series of hybridization and backcrossing events among Saccharum species. The so-called "Saccharum broad sense" group includes around 40 species from a few genera, including Erianthus, found in various tropical regions, particularly South-Eastern Asia. In Brazil, three native species, originally considered to belong to Erianthus, were reclassified as S. angustifolium (Nees) Trin., S. asperum (Nees) Steud., and S. villosum Steud., based on inflorescence morphology. Thus, we have investigated the potential occurrence of gene flow among the Brazilian Saccharum native species and commercial hybrids as a requisite for GMO commercial release. A comprehensive survey was carried out to map the occurrence of the three native Saccharum species in Brazil, concluding that they are sympatric with sugarcane cultivation only from around 14°S southwards, which precludes most Northeastern sugarcane-producing states from undergoing introgression. Based on phenology, we concluded that the Brazilian Saccharum species are unable to outcross naturally with commercial sugarcane since the overlap between the flowering periods of sugarcane and the native species is limited. A phylogenomic reconstruction based on the full plastid genome sequence showed that the three native Saccharum species are the taxa closest to sugarcane in Brazil, being closer than introduced Erianthus or Miscanthus. A 2-year study on eight nutritional composition traits of the 20 main sugarcane cultivars cultivated in Brazil was carried out in six environments. The minimum and maximum values obtained were, in percent: moisture (62.6-82.5); sucrose (9.65-21.76); crude fiber (8.06-21.03); FDN (7.20-20.68); FDA (4.55-16.90); lipids (0.06-1.59); ash (0.08-2.67); and crude protein (0.18-1.18). Besides a considerable amount of genetic variation and plastic responses, many instances of genotype-by-environment interaction were detected.

Repetições máximas e tempo sob tensão entre as ordens multiarticular para monoarticular e monoarticular para multiarticular em exercícios resistidos / Repeticiones máximas y tiempo de tensión entre los ordenes multiarticular para monoarticular y monoarticular para multiarticular en ejercicios resistidos / Maximum repetitions and time under tension between multiarticular orders to monoarticular and monoarticular to multiarticular in resisted exercises

Objetivo: analizar las repeticiones máximas (RM) y el tiempo de tensión (TST) entre los órdenes multiarticular para monoarticular y monoarticular para multiarticular en ejercicios resistidos. Métodos: 15 hombres entrenados (23,53±2,07 años; 74,8±5,1 kg; 173,8±4,6 cm) realizaron la prueba de 10RM en los ejercicios supino horizontal (SH) y rosca tríceps en el pulley (RT). Después de 48 horas realizaron repeticiones máximas para los mismos ejercicios en diferentes órdenes multiarticular-monoarticular y monoarticular-multiarticular. En los dos protocolos propuestos, el número máximo de repeticiones y el tiempo de tensión (TST) se contabilizaron sólo en el último ejercicio realizado. Resultado: La prueba T de Student pareado apuntó reducciones significativas en el número de RM en los dos protocolos analizados cuando comparados a la prueba de 10RM (p <0,005 y p <0,001). Los resultados mostraron no haber diferencias significativas en el TST en ninguna de las condiciones evaluadas. Conclusión: el orden de los ejercicios influenció el número de repeticiones realizadas, aunque no afectó el TST.

Objetivo: analisar as repetições máximas (RM) e o tempo sob tensão (TST) entre as ordens multiarticular para monoarticular e monoarticular para multiarticular em exercícios resistidos. Métodos: quinze homens treinados (23,53±2,07anos; 74,8±5,1kg; 173,8±4,6cm) realizaram teste 10RM nos exercícios supino horizontal (SH) e rosca tríceps no pulley (RT). Após quarenta e oito horas realizaram repetições máximas para os mesmos exercícios nas diferentes ordens multiarticular-monoarticular e monoarticular-multiarticular. Nos dois protocolos propostos, o númeexercício realizado. Resultado: O Teste T de Student pareado apontou reduções significativas no número de RM nos dois protocolos analisados quando comparados ao teste de 10RM (p<0,005 e p<0,001). Os resultados mostraram ainda não haver diferenças significativas para o TST em nenhuma das condições avaliadas. Conclusão: A ordem dos exercícios influenciou o número de repetições realizadas, embora não tenha afetado o tempo sob tensão.

Objective: was to analyze maximal repetitions (MR) and time under tension (TUT) between multi-joint to single-joint order and single-joint to multi-joint order in resistance exercises. Methods: Fifteen trained men (23.53 ± 2.07 years, 74.8 ± 5.1 kg, 173.8 ± 4.6cm) performed a 10RM test in the Bench Press (BP) and Arm Extension (AE). After 48h performed maximal repetitions for the same exercises in different orders, single-joint and multi-joint. In both protocols were measured the maximal repetitions (MR) and time under tension (TUT) only for the last exercise realized. Results: The paired Student's T test showed significant reductions for MR in both analyzed protocols when compared to the 10RM test (p <0.005 and p <0.001). The results showed that there were no significant differences for TUT in any of the conditions evaluated. Conclusion: The order of the exercises influenced the number of repetitions performed, although it did not affect the time under tension.

Robotic Gait Training for Individuals With Cerebral Palsy: A Systematic Review and Meta-Analysis.

OBJECTIVE: To identify the effects of robotic gait training practices in individuals with cerebral palsy. DATA SOURCES: The search was performed in the following electronic databases: PubMed, Embase, Medline (OvidSP), Cochrane Database of Systematic Reviews, Web of Science, Scopus, Compendex, IEEE Xplore, ScienceDirect, Academic Search Premier, and Physiotherapy Evidence Database. STUDY SELECTION: Studies were included if they fulfilled the following criteria: (1) they investigated the effects of robotic gait training, (2) they involved patients with cerebral palsy, and (3) they enrolled patients classified between levels I and IV using the Gross Motor Function Classification System. DATA EXTRACTION: The information was extracted from the selected articles using the descriptive-analytical method. The Critical Review Form for Quantitative Studies was used to quantitate the presence of critical components in the articles. To perform the meta-analysis, the effects of the intervention were quantified by effect size (Cohen d). DATA SYNTHESIS: Of the 133 identified studies, 10 met the inclusion criteria. The meta-analysis showed positive effects on gait speed (.21 [-.09, .51]), endurance (.21 [-.06, .49]), and gross motor function in dimension D (.18 [-.10, .45]) and dimension E (0.12 [-.15, .40]). CONCLUSIONS: The results obtained suggest that this training benefits people with cerebral palsy, specifically by increasing walking speed and endurance and improving gross motor function. For future studies, we suggest investigating device configuration parameters and conducting a large number of randomized controlled trials with larger sample sizes and individuals with homogeneous impairment.

Correction: Hypervirulent Mycobacterium tuberculosis strain triggers necrotic lung pathology associated with enhanced recruitment of neutrophils in resistant C57BL/6 mice.

[This corrects the article DOI: 10.1371/journal.pone.0173715.].

Hypervirulent Mycobacterium tuberculosis strain triggers necrotic lung pathology associated with enhanced recruitment of neutrophils in resistant C57BL/6 mice.

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb) that in most cases induces irreversible necrosis of lung tissue as a result of excessive inflammatory reactions. The murine model of TB in resistant C57BL/6 mice infected with reference Mtb strains is widely used in TB studies; however, these mice do not show a necrotic pathology, which restricts their use in studies of irreversible tissue damage. Recently, we demonstrated that necrotic lung lesions could be induced in the C57BL/6 mice by highly virulent Mtb strains belonging to the modern Beijing sublineage. However, the pathogenic mechanisms leading to necrosis in this model were not elucidated. In this study, we investigated the dynamics of lung lesions in mice infected with highly virulent Beijing Mtb strain M299, compared with those infected with laboratory Mtb strain H37Rv. The data demonstrate that necrotic lung lesions in mice infected by the strain M299 were associated with enhanced recruitment of myeloid cells, especially neutrophils, and increased levels of proinflammatory cytokines, consistent with exacerbated inflammation. High levels of IFN-γ production contributed to the control of bacterial growth. Further progression to chronic disease was associated with a reduction in the levels of inflammatory mediators in the lungs, the accumulation of foamy macrophages and partial healing of the necrotic tissue by fibrosis. At a late stage of disease, degradation of foamy cells resulted in the liberation of accumulated lipids and persisting bacilli and further activation of inflammation, which promoted lung consolidation. Overall, our studies show that C57BL/6 mice infected with highly virulent Mtb strain may serve as a TB model reproducing an exacerbated inflammatory response in a resistant host to hypervirulent mycobacteria, leading to irreversible necrotic lung lesions.

Pneumatosis intestinalis after etoposide-based chemotherapy in a patient with metastatic small cell lung cancer: successful conservative management of a rare condition / Pneumatose intestinal após quimioterapia com etoposídeo em paciente com câncer de pulmão de pequenas células: sucesso com conduta conservadora em uma condição rara

ABSTRACT A 69-year-old male patient, smoker, was diagnosed with small cell lung cancer metastatic to lung, liver and central nervous system. He received chemotherapy with carboplatin AUC 5 on day 1 and etoposide 100mg/m2 on days 1, 2 and 3. During the first cycle, the patient presented with febrile neutropenia and abdominal distension. Chest, abdomen and pelvis computed tomography scan was performed and detected gas dissecting the wall of sigmoid colon extending to the mesosigmoid. Patient had no abdominal pain, nausea, vomiting, and on physical examination he had no peritoneal irritation, tachycardia or hemodynamic instability compatible with perforation or acute abdomen. Therefore, the radiological finding was interpreted as pneumatosis intestinalis caused by chemotherapy with etoposide. Pneumatosis resolved after continuous oxygen therapy. The second cycle was administered after a complete resolution of the clinical condition and etoposide dose was reduced by 30%. The patient experienced a remarkable evolution.

RESUMO Paciente do gênero masculino, 69 anos, fumante, diagnosticado com câncer de pulmão de pequenas células, metastático para pulmão, fígado e sistema nervoso central. Foi administrada quimioterapia com carboplatina AUC 5 no dia 1 e etoposídeo 100mg/m2 nos dias 1, 2 e 3. Durante o primeiro ciclo, o paciente apresentou neutropenia febril e distensão abdominal. Tomografias de tórax, abdome e pelve detectaram gás dissecando a parede do cólon sigmoide, com extensão para o mesossigmoide. O paciente não apresentava dor abdominal, náusea, vômito e não tinha sinais de irritação peritoneal, taquicardia ou instabilidade hemodinâmica compatíveis com perfuração ou abdome agudo. O achado radiológico foi interpretado como pneumatose intestinal causada por etoposídeo. A resolução do quadro ocorreu após suplementação de oxigênio. O segundo ciclo foi administrado após resolução completa do quadro, com redução da dose do quimioterápico em 30%. O paciente evoluiu de forma bastante satisfatória.

Pneumatosis intestinalis after etoposide-based chemotherapy in a patient with metastatic small cell lung cancer: successful conservative management of a rare condition.

A 69-year-old male patient, smoker, was diagnosed with small cell lung cancer metastatic to lung, liver and central nervous system. He received chemotherapy with carboplatin AUC 5 on day 1 and etoposide 100mg/m2 on days 1, 2 and 3. During the first cycle, the patient presented with febrile neutropenia and abdominal distension. Chest, abdomen and pelvis computed tomography scan was performed and detected gas dissecting the wall of sigmoid colon extending to the mesosigmoid. Patient had no abdominal pain, nausea, vomiting, and on physical examination he had no peritoneal irritation, tachycardia or hemodynamic instability compatible with perforation or acute abdomen. Therefore, the radiological finding was interpreted as pneumatosis intestinalis caused by chemotherapy with etoposide. Pneumatosis resolved after continuous oxygen therapy. The second cycle was administered after a complete resolution of the clinical condition and etoposide dose was reduced by 30%. The patient experienced a remarkable evolution. RESUMO Paciente do gênero masculino, 69 anos, fumante, diagnosticado com câncer de pulmão de pequenas células, metastático para pulmão, fígado e sistema nervoso central. Foi administrada quimioterapia com carboplatina AUC 5 no dia 1 e etoposídeo 100mg/m2 nos dias 1, 2 e 3. Durante o primeiro ciclo, o paciente apresentou neutropenia febril e distensão abdominal. Tomografias de tórax, abdome e pelve detectaram gás dissecando a parede do cólon sigmoide, com extensão para o mesossigmoide. O paciente não apresentava dor abdominal, náusea, vômito e não tinha sinais de irritação peritoneal, taquicardia ou instabilidade hemodinâmica compatíveis com perfuração ou abdome agudo. O achado radiológico foi interpretado como pneumatose intestinal causada por etoposídeo. A resolução do quadro ocorreu após suplementação de oxigênio. O segundo ciclo foi administrado após resolução completa do quadro, com redução da dose do quimioterápico em 30%. O paciente evoluiu de forma bastante satisfatória.

Flavonoids and Wnt/ß-catenin signaling: potential role in colorectal cancer therapies.

It is now well documented that natural products have played an important role in anticancer therapy. Many studies focus on the ability of these natural compounds to modulate tumor-related signaling pathways and the relationship of these properties to an anticancer effect. According to the World Health Organization (WHO), colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer death among men and women. Therefore, finding strategies to fight against CRC is an emergent health problem. CRC has a strong association with deregulation of Wnt/ß-catenin signaling pathway. As some types of natural compounds are capable of modulating the Wnt/ß-catenin signaling, one important question is whether they could counteract CRC. In this review, we discuss the role of flavonoids, a class of natural compounds, on Wnt/ß-catenin regulation and its possible potential for therapeutic usage on colorectal cancer.

Avaliação de alunos de graduação em Medicina após treinamento / Evaluation of the effect of IMCI training on medical students

A Estratégia de Atenção Integrada às Doenças Prevalentes na Infância (AIDPI) foi adotada pelo Ministério da Saúde do Brasil em 1996, sendo adaptada de acordo com as características epidemiológicas às normas nacionais de atenção à criança. Desde 1997, a AIDPI vem progressivamente sendo implantada em diversos estados brasileiros. Algumas Universidades já incluem a AIDPI no curso médico. Em dezembro de 2002, foi iniciado treinamento na estratégia AIDPI para alunos de graduação em Medicina da UFBA. O presente estudo teve como objetivo avaliar o grau de mudança no conhecimento e nas atitudes de estudantes de Medicina após treinamento na estratégia AIDPI. Foi realizado um estudo longitudinal prospectivo no período de dezembro de 2002 a junho de 2003. Catorze alunos constituíram 2 coortes que receberam treinamento na estratégia AIDPI entre dezembro de 2002 e junho de 2003. No ponto zero do acompanhamento de cada coorte, foi realizado um teste com questões referentes a temas de conhecimentos básicos em pediatria, que também fazem parte do programa do curso de treinamento m AIDPI. O teste foi repetido nos desfechos das coortes. Foram utilizados a Prova dos Sinais e o teste de Mcnemar para análise estatística das variáveis estudadas, utilizando-se o software SPSS. Após o treinamento, houve mudanças estatisticamente significativas no conhecimento dosestudantes sobre os principais sinais de doença grave, de pneumonia, de pneumonia grave, de desnutrição grave, dedesidratação e do uso apropriado de vacinas. O conhecimento dos estudantes sobre a taxa de mortalidade infantil e causas de óbitos em crianças também se modificou de forma estatisticamente significativa. Houve significativa melhoria nas habilidades de orientação das técnicas adequadas para amamentação exclusiva e para introdução de outros alimentos no desmame. Os resultados demonstraram que o treinamento na estratégia AIDPI gerou modificações estatisticamente significativas nos conhecimentos e atitudes dos alunos...