Synthesis of copaiba (Copaifera officinalis) oil nanoemulsion and the potential against Zika virus: An in vitro study.

Zika virus (ZIKV) has spread all over the world since its major outbreak in 2015. This infection has been recognized as a major global health issue due to the neurological complications related to ZIKV infection, such as Guillain-Barré Syndrome and Zika virus Congenital Syndrome. Currently, there are no vaccines or specific treatments for ZIKV infection, which makes the development of specific therapies for its treatment very important. Several studies have been developed to analyze the potential of compounds against ZIKV, with the aim of finding new promising treatments. Herein, we evaluate the ability of a copaiba (Copaifera officinalis) oil nanoemulsion (CNE) to inhibit ZIKV. First, the highest non-cytotoxic concentration of 180 µg/mL was chosen since this concentration maintains 80% cell viability up to 96h after treatment with CNE in VERO cells resulted from MTT assay. The intracellular uptake assay was performed, and confirmed the internalization of the nanoemulsion in cells at all times analyzed. VERO cells were infected with ZIKV and simultaneously treated with CNE and the nanoformulation without oil (ENE) at the highest non-toxic concentration. The results evaluated by plaque assay revealed a viral inhibition of 80% for CNE and 70% for ENE. A dose-dependence assay revealed that the CNE treatment demonstrated a dose-dependent response in the viral RNA levels, whereas all ENE tested concentrations exhibited a similar degree of reduction. Taken together, our results suggest CNE as a promising nano-sized platform to be further studied for antiviral treatments.

Desafios à segurança do paciente na terapia intensiva: uma teoria fundamentada / Desafíos para la seguridad del paciente en cuidados intensivos: una teoría fundamentada / Challenges to patient safety in intensive care: a grounded theory

Resumo Objetivo Compreender, na perspectiva de enfermeiros de unidades de terapia intensiva, os desafios à segurança do paciente confrontados neste contexto. Métodos Pesquisa qualitativa realizada com 20 enfermeiros em dois grupos amostrais de duas unidades de terapia intensiva (UTI) do Norte do Brasil. Os dados foram coletados mediante entrevista semiestruturada. O método adotado foi a Teoria fundamentada nos dados, enfatizando-se neste artigo uma categoria e suas subcategorias no que concerne às condições. O estudo foi aprovado pelos comitês de ética de duas instituições sob os pareceres de número: 2.755.619 e número 2.829.210, no ano de 2018. Resultados Três subcategorias explicitaram desafios à segurança do paciente, a saber: estando imerso em processos de trabalho não sistematizados; falhando a comunicação entre os profissionais; e constatando lacunas na educação permanente. Conclusão A desorganização dos processos de trabalho, a comunicação falha e ações de educação permanente insuficientes correspondem aos principais desafios apontados pelos enfermeiros na rotina da UTI, gerando encadeamentos que incidem diretamente na gestão da segurança do paciente.

Resumen Objetivo Comprender, bajo la perspectiva de enfermeros de unidades de cuidados intensivos, los desafíos para la seguridad del paciente que enfrentan este contexto. Métodos Estudio cualitativo realizado con 20 enfermeros en dos grupos de muestras de dos unidades de cuidados intensivos (UCI) del norte de Brasil. Los datos fueron recopilados mediante entrevista semiestructurada. El método adoptado fue la teoría fundamentada en los datos, con énfasis en una categoría y sus subcategorías en lo que respecta a las condiciones. El estudio fue aprobado por los comités de ética de las dos instituciones, con los números de informe 2.755.619 y 2.829.210, en el año 2018. Resultados Tres subcategorías explicitaron los desafíos para la seguridad del paciente, a saber: estar inmerso en procesos de trabajo no sistematizados, fallar en la comunicación entre los profesionales, y constatar vacíos en la educación permanente. Conclusión La desorganización de los procesos de trabajo, la comunicación defectuosa y las acciones de educación permanente insuficientes son los principales desafíos indicados por los enfermeros en la rutina de la UCI, lo que genera una serie de eventos que inciden directamente en la gestión de la seguridad del paciente.

Abstract Objective To understand, from Intensive Care Unit nurses' perspective, the challenges to patient safety. Methods This is qualitative research conducted with 20 nurses in two sample groups of two Intensive Care Units (ICU) in northern Brazil. Data were collected through semi-structured interviews. The method adopted was the Grounded Theory, emphasizing in this article a category and its subcategories with regard to conditions. The study was approved by the Research Ethics Committees of two institutions, under Opinions 2,755,619 and 2,829,210, in 2018. Results Three subcategories explained challenges to patient safety, namely: Being immersed in non-systematized work processes; Communication failure among professionals; and Finding gaps in continuing education. Conclusion The disorganization of work processes, faulty communication and insufficient continuing education actions correspond to the main challenges pointed out by nurses in the ICU routine, generating chains that directly affect patient safety management.

Poor Health Conditions among Brazilian Healthcare Workers: The Study Design and Baseline Characteristics of the HEROES Cohort.

This study was conducted to describe the health conditions (the psychosocial aspects, sleep quality, and musculoskeletal symptoms) among Brazilian healthcare workers in the context of the pandemic. Workers answered an online questionnaire, including the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II), the Pittsburgh Sleep Quality Index (PSQI), the Nordic Musculoskeletal Questionnaire (NMQ), and the Beck Depression Inventory (BDI). The most unfavourable psychosocial factors were work pace (61%; 95% CI: 52-69%), emotional work demands (75%; 95% CI: 67-82%), predictability (47%; 95% CI: 39-56%), work-family conflict (55%; 95% CI: 46-64%), burnout (86%; 95% CI: 78-91%), and stress (81%; 95% CI: 73-87%). Most workers (74%; 95% CI: 66-81%) were classified as poor sleepers. Musculoskeletal symptoms were frequent in the neck (64%; 95% CI: 55-72%), shoulders (62%; 95% CI: 54-70%), upper back (58%; 95% CI: 50-67%), and lower back (61%; 95% CI: 52-69%). Depressive symptoms were also highly prevalent (mild: 22%; 95% CI: 15-30%, moderate: 16%; 95% CI: 11-23%, severe: 8%; 95% CI: 4-14%). Most healthcare workers experience unfavourable psychosocial factors, poor sleep quality, as well as musculoskeletal and depressive symptoms. These findings underscore the urgent need to acknowledge and address psychological and physical distress to improve the personal and professional well-being of this population.

Low-Grade Squamous Intraepithelial Lesion in the Setting of Human Papillomavirus and Chlamydia Coinfection.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. It most commonly affects the genital areas, as well as the mouth and throat. Research has shown that HPV is a cause of cervical cancer and Chlamydia trachomatis is a potential cofactor in the development of cervical intraepithelial neoplasia (CIN). However, there have been limited cases reported on understanding this coinfection and its mechanism through the lens of molecular biology. We present a case of a 22-year-old female with complaints of persistent lesions on the labia for more than 6 months that have increased in number. Histopathology was suggestive of HPV. This case report emphasizes the importance of HPV and chlamydia coinfection as leading causes for persistence of condyloma acuminatum and low-grade squamous intraepithelial lesion (LSIL), and the importance of screening and clinically managing vaginal HPV.

Atypical Legionnaires' Disease in the Setting of Suspected Recurrent Lung Cancer.

Legionnaires' disease is a type of pneumonia caused by Legionella bacteria. This type of bacteria can be found anywhere across the world, mostly in moist environments (e.g., ground soil, rivers, lakes). More importantly, Legionella can multiply in water systems such as air conditioners, which is a common source of outbreaks nationwide, particularly during the summer months. We present a unique clinical course of Legionnaires' disease with suspected underlying recurrent lung cancer in a 77-year-old man during an outbreak that originated in a small city near our hospital. The patient presented to Urgent Care and after initial assessment, was admitted to the Internal Medicine Unit. He underwent supportive treatment with antibiotic therapy and oxygen, and was discharged one week after admission with improvement. The patient returned to Urgent Care a few weeks later with worsening dyspnea, where he was then transferred to another hospital for admission to the Intensive Care Unit (ICU), and later died. We report this special case to bring awareness to physicians of the possibility and importance of early detection and prompt management of Legionnaires' disease in lung cancer and critically ill patients with possible environmental risk factors. Prompt detection and management of Legionella pneumophila allows for a greater chance of a favorable prognosis, particularly in the immunocompromised.

Association between psychosocial factors in workers and multisite pain: cross-sectional study / Associação entre fatores psicossociais em trabalhadores e dor multirregional: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Psychosocial factors may be associated with multisite pain, which is characterized by pain symptoms in more than one part of the body. The aim of the present study was to determine associations between psychosocial factors and multisite pain in a population of workers. METHODS: A cross-sectional study was conducted involving 195 workers (educators, administrative technicians, healthcare workers, cleaners, and zookeepers). Psychosocial factors were evaluated using the short form of the second version of the Copenhagen Psychosocial Questionnaire. Multisite pain was identified using the Nordic Musculoskeletal Questionnaire. RESULTS: Multisite pain was associated with quantitative demands (OR=1.31; 95% CI: 1.06-1.63), work pace (OR=1.20; 95% CI: 1.01-1.43), emotional demands (OR=1.39; 95% CI: 1.18-1.63), commitment to the workplace (OR=0.75; 95% CI: 0.62-0.91), predictability (OR=0.86; 95% CI: 0.76-0.99), job satisfaction (OR=0.53; 95% CI: 0.32-0.88), work-family conflict (OR=1.37; 95% CI: 1.16-1.62), justice (OR=0.81; 95% CI: 0.69-0.94), general health perception (OR=0.54; 95% CI: 0.38-0.76), burnout (OR=1.41; 95% CI: 1.17-1.69), and stress (OR=1.41; 95% CI: 1.18-1.68). CONCLUSION: Several psychosocial factors were associated with multisite pain, indicating that these factors could be considered in the multisite pain management.

RESUMO JUSTIFICATIVA E OBJETIVOS: Fatores psicossociais podem estar associados à dor multirregional, caracterizada por sintomas de dor em mais de uma parte do corpo. O objetivo do presente estudo foi determinar associações entre fatores psicossociais e dor multirregional em uma população de trabalhadores. MÉTODOS: Foi realizado um estudo transversal com 195 trabalhadores (professores, técnicos administrativos, profissionais de saúde, faxineiros e funcionários de zoológicos). Os fatores psicossociais foram avaliados por meio da versão abreviada da segunda versão do Copenhagen Psychosocial Questionnaire. A dor multirregional foi identificada por meio do Nordic Musculoskeletal Questionnaire. RESULTADOS: A dor multirregional foi associada com demandas quantitativas (OR=1,31; IC 95%: 1,06-1,63), ritmo de trabalho (OR=1,20; IC 95%: 1,01-1,43), demandas emocionais (OR=1,39; IC 95%: 1,18- 1,63), compromisso com o local de trabalho (OR=0,75; IC 95%: 0,62-0,91), previsibilidade (OR=0,86; IC 95%: 0,76-0,99), satisfação no trabalho (OR=0,53; IC 95%: 0,32-0,88), conflito trabalho-família (OR=1,37; IC 95%: 1,16-1,62), justiça (OR=0,81; IC 95%: 0,69-0,94), percepção geral de saúde (OR=0,54; IC 95%: 0,38-0,76), burnout (OR=1,41; IC 95%: 1,17-1,69) e estresse (OR=1,41; IC 95%: 1,18-1,68). CONCLUSÃO: Vários fatores psicossociais foram associados à dor multirregional, indicando que estes devem ser abordados no manejo da dor.

Body image and well-being in dance practitioners: An exploratory study / Imagen corporal y bienestar en los practicantes de danza: Un estudio exploratorio / magem corporal e bem-estar em praticantes de dança: Um estudo exploratório

Literature has been concerned with the effect of dance practice on several variables, namely well-being and body image (BI). This study aimed to analyse the perception of dance practitioners on BI and subjective well-being (positive and negative affect and satisfaction with life), comparing adolescents and adults. A sample of 91 dancers (18.08±5.12 years) was recruited and divided into two groups (adolescents 11-17 years; adults 18-34 years). The group of adolescents presented a higher perception of satisfaction with life compared to adults (p=0.041; d=-0.44). Regarding the relationships between variables, when analysing separately each group, in the group of adolescents the positive affect is related to satisfaction with life (r=0.64; p≤0.001) and negative affect (r=-0.32; p=0.026), while the negative affect is related to the hours of weekly practice (r=0.46; p=0.001). In the group of adults, positive affect is related to satisfaction with life (r=0.36; p=0.017) and weekly hours of practice (r=0.39;p=0.010), while negative affect is related satisfaction with life (r=-0.45; p=0.003). With regard to (dis)satisfaction with BI, we found that, in the group of adolescents, it is related to the years of practice (r=0.33; p=0.023) and the weekly hours of practice (r=0.32; p=0.023), while in the adults' group, satisfaction with life (r=-0.42; p=0.005) and negative affect (r=0.59; p≤0.001) are related. Our results leave some indicators that should be explored in future studies, namely seeking to understand the factors that may be mediating the relationship between BI and well-being, as well as the effect of age on this relationship. (AU)

La literatura ha investigado el efecto de la práctica de la danza en variables como el bienestar y la imagen corporal (IC). El objetivo de este trabajo fue analizar la percepción de la IC y el bienestar subjetivo, comparando adolescentes y adultos. Se utilizó una muestra de 91 bailarines (18,08±5,12 años), divididos en dos grupos (adolescentes de 11 a 17 años; adultos de 18 a 34 años). Los resultados indican que el grupo de adolescentes tiene una mayor percepción de la satisfacciónde la vida (p=0,041; d=0,44). En el grupo de adolescentes, el afecto positivo está relacionado con la satisfacción con la vida (r=0,64; p≤0,001) y el afecto negativo (r=0,32; p=0,026), mientras que el afecto negativo está relacionado con las horas de práctica semanales (r=0,46; p≤0,001). En los adultos, el afecto positivo está relacionado con la satisfacción de la vida (r=0,36; p=0,017) y las horas de práctica semanales (r=0,39; p=0,010), mientras que el afecto negativo está relacionado con la satisfacción de la vida (r=0,45;p=0,003). En cuanto a la (in)satisfacción con la IC, en el grupo de adolescentes, esto está relacionado con los años de práctica (r=0,33; p=0,023) y las horas de práctica semanal (r=0,32; p=0,023). En el grupo de adultos, la satisfacción de la vida (r=0,42;p=0,05) y el afecto negativo (r=0,59; p≤0,001) están relacionados. Nuestros datos parecen dejar indicadores para explorar en el futuro, buscando una comprensión de los factores que pueden estar mediando la relación entre la IC y el bienestar. (AU)

A literatura tem-se preocupado com o efeito da prática de dança em variáveis como o bem-estar e a imagem corporal (IC). O objetivo deste trabalho foi analisar a perceção de IC e de bem-estar subjetivo, comparando adolescentes e adultos. Recorreu-se a uma amostra de 91 dançarinos (18.08±5.12 anos), divididos em dois grupos (adolescentes 11-17 anos; adultos 18-34 anos). Os resultados indicam-nos que o grupo dos adolescentes apresenta umaperceção superior de satisfação com a vida comparativamente com os adultos (p=0.041; d=-0.44). Verificamos que no grupo dos adolescentes, o afeto positivo se relaciona com a satisfação com a vida (r=0.64; p≤0.001) e com o afeto negativo (r=-0.32; p=0.026), enquanto o afeto negativo se relaciona com as horas de prática semanal (r=0.46; p=0.001). Já nos adultos, o afeto positivo relaciona-se com a satisfação com a vida (r=0.36; p=0.017) e com as horas de prática semanal (r=0.39; p=0.010), enquanto o afeto negativo se relaciona com a satisfação com a vida (r=-0.45; p=0.003). No que se refere à (in)satisfação com a IC, no grupo dos adolescentes esta relaciona-se com os anos de prática (r=0.33; p=0.023) e as horas de prática semanal (r=0.32; p=0.023). No grupo dos adultos relaciona-se a satisfação com a vida (r=-0.42; p=0.005) e com o afeto negativo (r=0.59; p≤0.001). Os nossos dados parecem deixar indicadores a explorar no futuro, procurando a compreensão dos fatores que podem estar a mediar arelação entre a IC e o bem-estar, bem como, o efeito da idade nesta relação. (AU)

Structural and elemental analysis of biochars in the search of a synthetic path to mimetize anthropic Amazon soils.

In this work, chemical and structural properties of various biochars were analyzed and compared with those from a highly stable anthropic soil, Terra Preta de Índio (TPI). TPI is believed to be responsible for the fertility of Amazonian soils and their stability; therefore, the production of a synthetic TPI would be of great interest for agricultural applications. Biochar produced from different raw biomasses were comprehensively characterized and, based on the obtained results, a preliminary study was performed testing three different routes of chemical activation using nitric acid, phosphoric acid, and potassium hydroxide as activating agents. After chemical activations, metal contents in the biochars decreased, as expected, and high degrees of carbonization were observed. In the case of the activation performed with HNO3, intense signals related to carboxylic groups in TG-MS analysis and in potentiometric titrations point out to a highly oxygenated biochar. Structural analysis showed that activations generated point defects in sp2-carbon structures of biochar, with the material obtained after KOH activation showing a high surface area (569 m2 g-1), an important feature for the use as soil amendment.

Saberes e experiências de idosos sobre a cirurgia de catarata: um diálogo com uma profissional de enfermagem / Saberes y experiencias de personas mayores sobre la cirugía de cataratas: un diálogo con el profesional de enfermería / Knowledge and experiences of the elderly about cataract extraction: a dialogue with a professional nurse

RESUMO Objetivo: Descrever o conhecimento e experiências de idosos sobre a cirurgia de catarata e os cuidados pré e pós-operatórios. Método: Estudo qualitativo-descritivo feito com 24 idosos em hospital privado no Rio de Janeiro e em domicílio. Realizaram-se entrevistas individuais, seguidas de discussão com cada participante, entre setembro e dezembro de 2017. Aplicou-se análise de conteúdo temática na organização dos dados. Resultados: Categorias de análise: concepções sobre a doença e a cirurgia, fontes de acesso à informação, a cultura do silêncio no contexto do cuidado em saúde, e expectativas dos idosos sobre a cirurgia e seus resultados. Os idosos apresentaram lacunas sobre o que sabem sobre a cirurgia e os cuidados pré e pós-operatórios; trouxeram situações que reiteram, por vezes, a cultura do silêncio na relação com os profissionais de saúde e fizeram proposições sobre o que consideravam importante na educação em saúde sobre o tema. Conclusões: A partir da reunião com os idosos, foi possível evidenciar não apenas seus conhecimentos sobre a patologia enfrentada e o procedimento cirúrgico de catarata, como também avaliar, de forma integral, o processo e as mudanças necessárias no âmbito da promoção da saúde.

RESUMEN Objetivo: describir el conocimiento y las experiencias de personas mayores sobre la cirugía de cataratas y los cuidados prey postoperatorios. Método: estudio cualitativo-descriptivo llevado a cabo con 24 ancianos en hospital privado en Rio de Janeiro-Brasil y en domicilio. Se realizaron entrevistas individuales, seguidas de discusión con cada participante, entre septiembre y diciembre de 2017. Se aplicó el análisis de contenido temático en la organización de los datos. Resultados: categorías de análisis: concepciones sobre la enfermedad y la cirugía, fuentes de acceso a la información, la cultura del silencio en el contexto del cuidado en salud, y expectativas de las personas mayores sobre la cirugía y sus resultados. Los ancianos presentaron lagunas sobre lo que saben respecto a la cirugía y los cuidados pre y post operatorios; trajeron situaciones que reiteran, aveces, la cultura del silencio en la relación con los profesionales de salude hicieron proposiciones sobre qué consideraban importante en la educación en salud sobre el tema. Conclusiones: a partir de la reunión con los ancianos, fue posible evidenciar no solo sus conocimientos sobre la patología enfrentada yel procedimiento quirúrgico de cataratas, sino también evaluar, de forma integral, el proceso y los cambios necesarios en el ámbito de la promoción de la salud.

ABSTRACT Aim: To describe the knowledge and experiences of the elderly about cataract surgery and pre- and post-operative care. Method: This qualitative-descriptive study was conducted with 24 elderly people in a private hospital in Rio de Janeiro and at their homes. Individual interviews were held, followed by a discussion with each participant, between September and December 2017. Thematic content analysis was applied in the organization of the data. Results: Categories of Analysis: concepts of the disease and surgery, sources of access to information, the culture of silence in the context of health care, and expectations of the elderly about surgery and its results. The elderly had gaps in their knowledge about the surgery and pre- and post-operative care; spoke about situations that sometimes reiterated the culture of silence in their relationships with health professionals and made proposals about aspect of the topic that they considered important in health education. Conclusions: Based on meetings with the elderly, it was possible to show not only their knowledge about the pathology they faced and surgical procedure [for the treatment of cataracts], but also to fully assess the process and the changes required in the scope of health promotion.

Autoestima e distress em indivíduos submetidos a cirurgias oncológicas: estudo correlacional / Self-esteem and distress in patients undergoing cancer surgery: a correlational study / Autoestima y angustia en individuos sometidos a cirugías oncológicas: estudio correlacional

OBJETIVO: avaliar, em pacientes em pós-operatório de cirurgias oncológicas, a presença de distress e alterações da autoestima, e sua possível relação com o tratamento cirúrgico. MÉTODO: estudo transversal, quantitativo, correlacional, realizado em um hospital localizado no estado de Minas Gerais. Foi utilizado o termômetro de Distress, a Escala de Autoestima de Rosenberg e um questionário de caracterização dos participantes. RESULTADOS: participaram 100 pacientes com média de idade de 59,56 anos, com câncer urológico (30%), a maioria de homens (54,0%). Identificou-se a presença de distress em 65% dos pacientes, cuja média de pontuação foi de 5,05. A média do nível de autoestima foi de 7,07. As variáveis distress e autoestima apresentaram correlação significativa. CONCLUSÃO: quanto melhor é o nível da autoestima, menor é o de distress; as variáveis idade e escolaridade não tiveram relação; não houve diferença significativa entre as variáveis sexo e tipos de tumor.

AIM: to evaluate, in patients in postoperative cancer surgery, the presence of distress and changes in self-esteem, and their possible relationship to the surgical treatment. METHOD: a cross-sectional study, quantitative, correlational, performed in a hospital located in the state of Minas Gerais. Three instruments of data collection were used: Thermometer Distress, the Rosenberg Self-Esteem Scale and a questionnaire about the participants. RESULTS: 100 patients participated with an average age of 59.56 years, with urological cancer (30%), mostly men (54.0%). The presence of distress was identified in 65% of patients whose average score was 5.05. The average self-esteem level was 7.07. The distress and self-esteem variables were significantly correlated. CONCLUSION: the better the level of self-esteem, the lower the distress; variables of age and education had no relationship; there was no significant difference between gender and tumor types.

OBJETIVO: evaluar, en pacientes en post-operatorio de cirugías oncológicas, la presencia de angustia y alteraciones del autoestima, y su posible relación con el tratamiento quirúrgico. MÉTODO: estudio transversal, cuantitativo, correlacional, realizado en un hospital localizado en el estado de Minas Gerais. Fue utilizado el termómetro de angustia, la Escala de Autoestima de Rosenberg es un cuestionario de caracterización de los participantes. RESULTADOS: participaron 100 pacientes con media de edad de 59,56 años, con cáncer urológico (30%), la mayoría de hombres (54,0%). Se identifico la presencia de angustia en 65% de los pacientes, cuya media de puntuación fue de 5,05. La media del nivel de autoestima fue de 7,07. Las variables angustia y autoestima presentaron correlación significativa. CONCLUSIÓN: cuanto mejor es el nivel de la autoestima, menor es el de angustia; las variables edad y escolaridad no tuvieron relación; no hubo diferencia significativa entre las variables sexo y tipos de tumor.

Mastocitose sistêmica na infância: relato de 3 casos / Systemic mastocytosis in childhood: report of 3 cases

Objetivo: mastocitose é o termo usado para um grupo de moléstias caracterizadas pelo acúmulo de mastócitos na pele, com ou sem comprometimento de outros órgäos. Os sintomas podem ser apenas cutâneos, associados aos decorrentes dos órgäos envolvidos ou também sistêmicos, pela liberaçäo de mediadores químicos. Säo descritos três casos de mastocitose sistêmica, cada um com diferentes manifestaçöes próprias da doença.Descriçäo: no primeiro caso é relatado um paciente com urticária pigmentosa que evoluiu com persistência das lesöes até a puberdade, quando iniciaram as manifestaçöes sistêmicas com o comprometimento linforreticular, esplenomegalia e infiltraçäo da medula óssea. No segundo caso, a paciente apresentava mastocitose bolhosa acompanhada de sintomas gastrintestinais, cuja investigaçäo mostrou infiltraçäo de mastócitos na parede intestinal. A terceira paciente ilustra a manifestaçäo cutânea precoce e extensa da mastocitose, com uma evoluçäo dramática para choque e posterior óbito. Comentários: säo discutidos aspectos clínicos, laboratoriais, tratamento e diagnóstico

[Systemic mastocytosis in childhood: report of 3 cases]. / Mastocitose sistêmica no infância: relato de 3 casos.

OBJECTIVE: Mastocytosis comprises a group of diseases characterized by accumulation of mast cells on the skin, with the possibility of affecting other systems. Symptoms can be exclusively cutaneous, associated with symptoms of the organs involved or even systemic, due to the release of chemical mediators. Three cases of systemic mastocytosis are described, each case presenting different manifestations of the disorder. DESCRIPTION: The first report is about a patient with urticaria pigmentosa that presented persistent lesions until puberty when systemic manifestations initiated with lymphoreticular involvement, splenomegaly and bone marrow infiltration. In the second case, the child had bullous mastocytosis associated with gastrointestinal symptoms, whose investigation showed mast cell infiltration in the intestinal wall. The third patient presented an early and extensive cutaneous manifestation of mastocytosis, with a dramatic evolution to shock and posterior death. DISCUSSION: Clinical aspects, treatment and prognosis of such forms of the disease are discussed.

Tratamento da artrose da articulaçäo do trapézio metacarpiano do polegar pela técnica da suspensoplastia de thompson modificada / Treatment of arthrosis of the trapeziometacarpal in the thumb joint using modified Thompson suspensoplasty technique

De janeiro de 1995 a fevereiro de 1997, dez pacientes que apresentavam artrose da articulaçäo do trapézio metacarpiano do polegar, estágios III e IV, na classificaçäo de Eaton & Littler (1973), foram operados pela técnica de suspensoplastia de Thompson modificada, com a reconstruçäo do ligamento intermetacarpiano do polegar, utilizando o tendäo do abdutor longo do polegar. Os pacientes (nove mulheres e um homem) tinham idade média de 66,2 anos. O seguimento médio foi de 18,2 meses. Todos apresentaram alívio do quadro doloroso, retorno às atividades diárias, em média, com 10,6 semanas. Houve ganho na força de preensäo de 28,6 por cento e na força de pinça de 31,2 por cento. A amplitude de movimento apresentou ganho de 7,3 por cento na oponência e 13,5 por cento na abduçäo. Todos os pacientes mostraram-se totalmente satisfeitos com os resultados estético e funcional finais.