Effects of Noise Exposure and Ageing on Anxiety and Social Behaviour in Zebrafish.

Noise pollution is creating a wide range of health problems related to physiological stress and anxiety that impact the social life of vertebrates, including humans. Ageing is known to be associated with changes in susceptibility to acoustic stimuli; however, the interaction between noise effects and senescence is not well understood. We tested the effects of 24 h continuous white noise (150 dB re 1 Pa) on both young adults and old zebrafish in terms of anxiety (novel tank diving test), social interactions (with mirror/conspecific attraction), and shoaling behaviour. Both noise and ageing induced higher anxiety responses in a novel environment. Since the old zebrafish showed longer bottom dwelling, acoustic treatment induced the opposite pattern with an initial increase in vertical exploration in the aged individuals. Both noise- and age-related anxiety responses were lowered when individuals were tested within a group. Regarding social interactions, both noise and ageing seemed to cause an increase in their proximity to a mirror. Although the results were not statistically significant, noise exposure seemed to further enhance conspecific attraction. Moreover, the interindividual distance within a shoal decreased with noise treatment in the aged individuals. This study is a first attempt to investigate the effects of both noise and ageing on zebrafish behaviour, suggesting the age-dependent physiological coping mechanisms associated with environmental stress.

Behavioral and endocrine responses to noninteractive live and video conspecifics in males of the Siamese fighting fish.

The physiological mechanisms underlying variation in aggression in fish remain poorly understood. One possibly confounding variable is the lack of standardization in the type of stimuli used to elicit aggression. The presentation of controlled stimuli in videos, a.k.a. video playback, can provide better control of the fight components. However, this technique has produced conflicting results in animal behavior studies and needs to be carefully validated. For this, a similar response to the video and an equivalent live stimulus needs to be demonstrated. Further, different physiological responses may be triggered by live and video stimuli, and it is important to demonstrate that video images elicit appropriate physiological reactions. Here, the behavioral and endocrine responses of male Siamese fighting fish Betta splendens to a matched-for-size conspecific fighting behind a one-way mirror, presented live or through video playback, were compared. The video playback and live stimulus elicited a strong and similar aggressive response by the focal fish, with a fight structure that started with stereotypical threat displays and progressed to overt attacks. Postfight plasma levels of the androgen 11-ketotestosterone were elevated as compared to controls, regardless of the type of stimuli. Cortisol also increased in response to the video images, as previously described for live fights in this species. These results show that the interactive component of a fight and its resolution are not needed to trigger an endocrine response to aggression in this species. The study also demonstrates for the first time in a fish a robust endocrine response to video stimuli and supports the use of this technique for researching aggressive behavior in B. splendens.

Mineralocorticoid receptor knockout in Schwann cells alters myelin sheath thickness.

Myelination allows fast and synchronized nerve influxes and is provided by Schwann cells (SCs) in the peripheral nervous system. Glucocorticoid hormones are major regulators of stress, metabolism and immunity affecting all tissues. They act by binding to two receptors, the low-affinity glucocorticoid receptor (GR) and the high-affinity mineralocorticoid receptor (MR). Little is known about the effect of glucocorticoid hormones on the PNS, and this study focuses on deciphering the role of MR in peripheral myelination. In this work, the presence of a functional MR in SCs is demonstrated and the expression of MR protein in mouse sciatic nerve SC is evidenced. Besides, knockout of MR in SC (SCMRKO using Cre-lox system with DesertHedgeHog (Dhh) Cre promoter) was undertaken in mice. SCMRKO was not associated with alterations of performance in motor behavioral tests on 2- to 6-month-old male mice compared to their controls. No obvious modifications of myelin gene expression or MR signaling gene expression were observed in the SCMRKO sciatic nerves. Nevertheless, Gr transcript and GR protein amounts were significantly increased in SCMRKO nerves compared to controls, suggesting a possible compensatory effect. Besides, an increase in myelin sheath thickness was noted for axons with perimeters larger than 15 µm in SCMRKO illustrated by a significant 4.5% reduction in g-ratio (axon perimeter/myelin sheath perimeter). Thus, we defined MR as a new player in peripheral system myelination and in SC homeostasis.

Perfil de morbidade no primeiro ano de vida entre recém-nascidos de alto risco / Morbidity profile in the first year of life among high-risk newborns

Os cuidados destinados aos recém-nascidos prematuros extremos têm propiciado importantes resultados na sobrevida dessas crianças. Objetivo: Caracterizar o perfil de morbidade no primeiro ano de vida entre recémnascidos de alto risco. Materiais e Métodos: Trata-se de uma pesquisa exploratória realizada no ambulatório de seguimento de recém-nascidos de alto risco do norte de Minas Gerais. A coleta de dados foi referente às admissões no período de março de 2014 a abril de 2015. O instrumento contemplava características: demográficas, sociais, condições de gestação e parto, intercorrências no pós-parto e condições de saúde das crianças acompanhadas ao longo do primeiro ano de vida. Realizou-se a análise estatística descritiva e o teste Qui-Quadrado, assumindo-se um nível de significância de 5% para comparação da distribuição das morbidades por faixas de peso. Resultados: Participaram deste estudo 282 recém-nascidos, sendo 53,9% do sexo masculino. Entre as mães, 58,2% era multípara e 35,8% hipertensas. Em relação ao peso de nascimento, 59,6% dos recém-nascidos acompanhados pesaram menos de 1500 gramas. As principais morbidades identificadas no primeiro ano de vida foram atraso do desenvolvimento neuro-psicomotor, infecções de vias aéreas superiores, as alterações neurológicas e as afecções respiratórias crônicas. Foram registradas diferenças estatisticamente significantes para o atraso do desenvolvimento neuro-psico-motor (p<0,001), intercorrências neurológicas (p=0,008) e episódios de diarreia (p=0,047), entre as faixas de peso de nascimento. Conclusão: A assistência ambulatorial para o recém-nascido prematuro de alto risco contribui para a identificação e a prevenção de doenças recorrentes nessa população(AU)

Introduction: Care for extremely premature newborns has provided important results in the survival of these children. Objective: To characterize the morbidity profile in the first year of life among high-risk newborns. Materials and Method: This is an exploratory research carried out at the follow-up clinic for high-risk newborns in the north of Minas Gerais. Data collection referred to admissions in the period from March 2014 to April 2015. The instrument included characteristics: demographic, social, pregnancy and delivery conditions, postpartum complications and health conditions of children monitored during the first year of life. Descriptive statistical analysis and the chisquare test were performed, assuming a significance level of 5% to compare the distribution of morbidities by weight range. Results: A total of 282 newborns participated in this study, 53.9% of whom were male. Among the mothers, 58.2% were multiparous and 35.8% were hypertensive. Regarding birth weight, 59.6% of newborns monitored weighed less than 1500 grams. The main morbidities identified in the first year of life were delayed neuro-psycho-motor development, upper airway infections, neurological disorders and chronic respiratory conditions. Statistically significant differences were recorded for delayed neuro-psycho-motor development (p<0.001), neurological complications (p=0.008) and episodes of diarrhea (p=0.047), between birth weight ranges. Conclusion: Outpatient care for high-risk premature newborns contributes to the identification and prevention of recurrent diseases in this population(AU)

Factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units / Fatores associados à sibilância recorrente no primeiro ano de vida entre recémnascidos prematuros provenientes de Unidades de Terapia Intensiva Neonatais

Abstract Objectives: to determine the prevalence and factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units, in the city of Montes Claros, northern Minas Gerais. Methods: cross-sectional study, with data collection from medical records of a follow-up clinic, interviews with mothers and, eventually, search in hospital records. Bivariate analyzes were carried out between sociodemographic and clinical characteristics and recurrent wheezing. Variables associated up to the level of 20% were analyzed by binary logistic regression, and associations defined by the Odds Ratio and respective 95% confidence intervals. Only variables associated with a 5% significance level were maintained in the final model of logistic regression. Results: among 277 infants studied, about one fifth (21.3%) were extremely low birth weight preterm and more than half (60.7%) had birth weight below 1500 grams. The prevalence of recurrent wheezing was 14.4% (CI95% = 10.3-18.4). Mechanical ventilation (OR = 2.12; CI95% = 1.09-4.76; p = 0.030) and oxygen therapy time ≥ 15 days (OR = 2.49; CI95%= 1.12-5.00; p = 0.010) were the risk factors for the event. Conclusions: there is a high prevalence of recurrent wheezing in the evaluated group and the associated variables reiterate the risk of prolonged oxygen therapy and mechanical ventilation for premature newborns.

Resumo Objetivos: determinar a prevalência e fatores associados à sibilância recorrente no primeiro ano de vida entre recém-nascidos prematuros egressos de Unidades de Terapia Intensiva Neonatais, na cidade de Montes Claros, norte de Minas Gerais. Métodos: estudo transversal, com coleta de dados em prontuários de ambulatório de seguimento, entrevistas com mães e, eventualmente, consultas aos prontuários hospitalares. Foram realizadas análises bivariadas entre as características sociodemográficas e clínicas e a sibilância recorrente. As variáveis associadas ao desfecho até um nível de significância de p ≤20% foram analisadas por regressão logística binária e as associações definidas pelas Odds Ratios e respectivos intervalos de confiança de 95%. Somente variáveis associadas a um nível de significância de 5% foram mantidas no modelo final de regressão logística. Resultados: entre 277 crianças estudadas, cerca de um quinto (21,3%) eram prematuros de extremo baixo peso e mais da metade (60,7%) tinha peso de nascimento abaixo de 1500 gramas. A prevalência de sibilância recorrente foi de 14,4% (IC95%=10,3-18,4). Ventilação mecânica (OR=2,12; IC95%= 1,09-4,76; p=0,030) e tempo de oxigenioterapia ≥15 dias (OR=2,49; IC95%=1,12-5,00; p=0,010) foram os fatores de risco para o evento. Conclusão: existe uma elevada prevalência de sibilância recorrente no grupo avaliado e as variáveis associadas reiteram o risco do uso prolongado de oxigenioterapia e da ventilação mecânica para recém-nascidos prematuros.

Prevalence of premalignant and malignant skin lesions in oculocutaneous albinism patients.

OBJECTIVE: Oculocutaneous albinism describes a group of pigmentary disorders that lead to skin sensitivity and predisposition to skin malignances. AIMS: To analyze clinical and epidemiological data in oculocutaneous albinism patients and to determine the prevalence of malignant skin lesions, assessing possible risk factors for skin cancer. METHODS: Cross-sectional study evaluating epidemiological data, habits of sun exposure and sun protection, and clinical examination of albino patients followed in a reference dermatology outpatient clinic in Brasil. Our primary outcome was the occurrence of malignant skin lesions in biopsied tissues. RESULTS: Of 74 patients analyzed, 11 (15%) had one or more suspicious lesions and were biopsied, of which 8 (72.7%) patients presented with basal cell carcinomas, 7 (63.3%) presented with squamous cell carcinoma, and 1 (9%) presented with melanoma. Moreover, 32(43%) patients presented with actinic keratosis. Age, female gender, previous history of sunburn, history of malignant lesions and history of sun exposure without photoprotection were associated with the presence of malignant lesions. LIMITATIONS: Unicentric, non-aleatory sample. CONCLUSIONS: There was a high prevalence of malignant and pre-malignant lesions in this population. Some potentially modifiable risk factors were associated with the occurrence of malignant skin lesions.

Androgens and corticosteroids increase in response to mirror images and interacting conspecifics in males of the Siamese fighting fish Betta splendens.

The role of hormones as modulators of aggressive behavior in fish remains poorly understood. Androgens and corticosteroids, in particular, have been associated with aggressive behavior in fish but it is still not clear if animals adjust the secretion of these hormones to regulate behavior during ongoing fights, in response to fight outcomes in order to adjust aggressive behavior in subsequent fights, or both. With its stereotyped displays and high aggression levels, the Siamese fighting fish Betta splendens is an excellent model to investigate this question. Here, we compared the behavioral and endocrine response of male B. splendens to fights where there is no winner or loser by presenting them with a size-matched live interacting conspecific behind a transparent partition or with a mirror image. The aggressive response started with threat displays that were overall similar in frequency and duration towards both types of stimuli. Fights transitioned to overt attacks and interacting with a live conspecific elicited a higher frequency of attempted bites and head hits, as compared with the mirror image. There was a pronounced increase in plasma androgens (11-ketotestosterone and testosterone) and corticosteroids (cortisol) levels in response to the aggression challenge, independent of stimulus type. Post-fight intra-group levels of these hormones did not correlate with measures of physical activity or aggressive behavior. A linear discriminant analysis including all behavioral and endocrine data was a poor classifier of fish from the conspecific and mirror trials, showing that overall the behavioral and endocrine response to mirror images and conspecifics was similar. The results show that fight resolution is not necessary to induce an evident increase in peripheral levels of androgens and corticosteroids in B. splendens. However, the function of these hormones during present and future aggressive contests remains to be clarified.

Retrospective study of the concordance between clinical and histopathological diagnosis in oral pathology / Estudio retrospectivo de la concordancia entre diagnóstico clínico e histopatológico en patología oral

Objectives: Evaluate the agreement between the clinical and histopathological diagnosis of oral lesions in patients submitted to biopsies. Identify the most frequent oral lesions and their correlation with age, gender, and anatomical location. Methods: A retrospective study of 368 pathological examinations collected between 2008 and 2018, corresponding to biopsies performed at the Clínica Universitária Egas Moniz. A detailed analysis of the histopathological reports attached to the patients' files was made and the variables gender, age, anatomical site, clinical diagnosis, and histopathological diagnosis was evaluated. Results: The most affected gender was female (55%); the most common age group was 61-70 years old; The most biopsied anatomical location was the gum (23.9%); the five most common pathological entities were fibroma(26.4%),root cyst(8.7%),oral lichen planus(7.6%), hemangioma (6.3%) and oral leukoplakia (6.0%). On agreement, 74.5% of the cases were concordant and 25.5% discordant. The most concordant lesions were Radicular Cyst (90.6%), Traumatic Injury (87.5%), Hemangioma (82.6%), Fibroma (82.5%) and Mucocele (82.5%). Conclusion: this study proves a significant level of agreement between clinical and histopathological diagnosis in this particular area, consistently obtained in a ten years period of time.

Objetivos: Evaluar el nivel de acuerdo entre el diagnóstico clínico e histopatológico de lesiones orales en pacientes sometidos a biopsias. Identificar las lesiones orales más frecuentes y su correlación con la edad, el sexo y la ubicación anatómica. Métodos: Estudio retrospectivo de 368 exámenes patológicos recogidos entre 2008 y 2018, correspondientes a biopsias realizadas en la Clínica Universitária Egas Moniz. Se realizó un análisis detallado de los informes histopatológicos adjuntos a los archivos de los pacientes y se evaluaron las variables de género, edad, sitio anatómico, diagnóstico clínico y diagnóstico histopatológico. Resultados: El género más afectado fue femenino (55%); el grupo de edad más común fue de 61-70 años; La ubicación anatómica más biopsiada fue la encía (23,9%); las cinco entidades patológicas más comunes fueron fibroma (26,4%), quiste radicular (8,7%), liquen plano oral (7,6%), hemangioma (6,3%) y leucoplasia oral (6,0%). Según el grado de acuerdo, el 74,5% de los casos fueron concordantes y el 25,5% discordantes. Las lesiones más concordantes fueron Quiste Radicular (90,6%), Lesión Traumática (87,5%), Hemangioma (82,6%), Fibroma (82,5%) y Mucocele (82,5%). Conclusión: este estudio demuestra un nivel significativo de acuerdo entre el diagnóstico clínico e histopatológico en esta área en particular, obtenido consistentemente en un período de diez años de tiempo

Prevalence of premalignant and malignant skin lesions in oculocutaneous albinism patients

SUMMARY OBJECTIVE: Oculocutaneous albinism describes a group of pigmentary disorders that lead to skin sensitivity and predisposition to skin malignances. Aims: To analyze clinical and epidemiological data in oculocutaneous albinism patients and to determine the prevalence of malignant skin lesions, assessing possible risk factors for skin cancer. METHODS: Cross-sectional study evaluating epidemiological data, habits of sun exposure and sun protection, and clinical examination of albino patients followed in a reference dermatology outpatient clinic in Brasil. Our primary outcome was the occurrence of malignant skin lesions in biopsied tissues. RESULTS: Of 74 patients analyzed, 11 (15%) had one or more suspicious lesions and were biopsied, of which 8 (72.7%) patients presented with basal cell carcinomas, 7 (63.3%) presented with squamous cell carcinoma, and 1 (9%) presented with melanoma. Moreover, 32(43%) patients presented with actinic keratosis. Age, female gender, previous history of sunburn, history of malignant lesions and history of sun exposure without photoprotection were associated with the presence of malignant lesions. Limitations: Unicentric, non-aleatory sample. CONCLUSIONS: There was a high prevalence of malignant and pre-malignant lesions in this population. Some potentially modifiable risk factors were associated with the occurrence of malignant skin lesions.

Chromosome-level reference genome of the Siamese fighting fish Betta splendens, a model species for the study of aggression.

Background: Siamese fighting fish Betta splendens are notorious for their aggressiveness and accordingly have been widely used to study aggression. However, the lack of a reference genome has, to date, limited the understanding of the genetic basis of aggression in this species. Here, we present the first reference genome assembly of the Siamese fighting fish. Findings: Frist, we sequenced and de novo assembled a 465.24-Mb genome for the B. splendens variety Giant, with a weighted average (N50) scaffold size of 949.03 Kb and an N50 contig size of 19.01 Kb, covering 99.93% of the estimated genome size. To obtain a chromosome-level genome assembly, we constructed one Hi-C library and sequenced 75.24 Gb reads using the BGISEQ-500 platform. We anchored approximately 93% of the scaffold sequences into 21 chromosomes and evaluated the quality of our assembly using the high-contact frequency heat map and Benchmarking Universal Single-Copy Orthologs. We also performed comparative chromosome analyses between Oryzias latipes and B. splendens, revealing a chromosome conservation evolution in B. splendens. We predicted 23,981 genes assisted by RNA-sequencing data generated from brain, liver, muscle, and heart tissues of Giant and annotated 15% repetitive sequences in the genome. Additionally, we resequenced five other B. splendens varieties and detected ∼3.4 M single-nucleotide variations and 27,305 insertions and deletions. Conclusions: We provide the first chromosome-level genome for the Siamese fighting fish. The genome will lay a valuable foundation for future research on aggression in B. splendens.

Atuação dos enfermeiros ante aos direitos dos pacientes: tomada de decisão, identidade e autonomia pessoal / Nurses' actuation over the patients' rights: decision making, identity and personal autonomy

Estudo que objetivou verificar a percepção dos enfermeiros acerca de sua atuação ante os direitos dos pacientes, considerando os fundamentos: tomada de decisão, identificação do paciente e autonomia pessoal. Estudo quantitativo, descritivo-observacional e transversal, realizado num Hospital Universitário de Brasília-DF. Dados foram coletados a partir da aplicação de instrumento específico para o objetivo proposto já validado, a 128 enfermeiros. Realizada análise estatística descritiva e teste estatístico não-paramétrico de Wilcoxon. Verificou-se que os enfermeiros perceberam-se atuando em defesa dos direitos dos pacientes em todos os fundamentos analisados sendo a autonomia pessoal o mais exercido e o favorecimento de informações para a tomada de decisão como o menos exercido. O estudo viabilizou a verificação de quais fundamentos do respeito aos direitos dos pacientes são percebidos como mais respeitados, além de produzir questionamento acerca do conhecimento teórico que os enfermeiros possuem sobre os conceitos e a aplicação destes fundamentos.

Study that aimed to verify the nurses ́ perception about their actuation over the patients ́ rights, considering thefoundations: decision making, patient ́s identification and personal autonomy. Quantitative, descriptive-observational and cross-sectional study, carried out at the University Hospital of Brasília-DF. Data were collected from the application of a specific tool for the proposed objective already validated, to 128 nurses. Descriptive statistical analysis and Wilcoxon ́s non-parametric test were carried out. It was noticed that the nurses perceived themselves acting in defense of the patients ́rights in all foundations analyzed being the personal autonomy the most exercised and the favoring information for decision making as the least exercised. The study enabled verifying which foundations of the patients ́ rights areperceived as the most respected, in addition to producing questionings about the theoretical knowledge that the nurses possess on the concepts and the application of these foundations.

Vocal differentiation parallels development of auditory saccular sensitivity in a highly soniferous fish.

Vocal differentiation is widely documented in birds and mammals but has been poorly investigated in other vertebrates, including fish, which represent the oldest extant vertebrate group. Neural circuitry controlling vocal behaviour is thought to have evolved from conserved brain areas that originated in fish, making this taxon key to understanding the evolution and development of the vertebrate vocal-auditory systems. This study examines ontogenetic changes in the vocal repertoire and whether vocal differentiation parallels auditory development in the Lusitanian toadfish Halobatrachus didactylus (Batrachoididae). This species exhibits a complex acoustic repertoire and is vocally active during early development. Vocalisations were recorded during social interactions for four size groups (fry: <2 cm; small juveniles: 2-4 cm; large juveniles: 5-7 cm; adults >25 cm, standard length). Auditory sensitivity of juveniles and adults was determined based on evoked potentials recorded from the inner ear saccule in response to pure tones of 75-945 Hz. We show an ontogenetic increment in the vocal repertoire from simple broadband-pulsed 'grunts' that later differentiate into four distinct vocalisations, including low-frequency amplitude-modulated 'boatwhistles'. Whereas fry emitted mostly single grunts, large juveniles exhibited vocalisations similar to the adult vocal repertoire. Saccular sensitivity revealed a three-fold enhancement at most frequencies tested from small to large juveniles; however, large juveniles were similar in sensitivity to adults. We provide the first clear evidence of ontogenetic vocal differentiation in fish, as previously described for higher vertebrates. Our results suggest a parallel development between the vocal motor pathway and the peripheral auditory system for acoustic social communication in fish.

Consumo de refrigerantes e fatores relacionados aos hábitos alimentares de crianças e adolescentes de escolas municipais da região nordeste de Juiz de Fora / Consumption of soft drinks and factors related to eating habits of children and adolescents in the northeast region of Juiz de Fora

O objetivo deste artigo foi verificar o perfil do consumo de refrigerantes e hábitos inadequados de crianças e adolescentes do primeiro ao nono ano escolar de cinco escolas municipais da região nordeste de Juiz de Fora. Participaram deste estudo 567 estudantes com média de idade 11,43 (+2,23) anos, de ambos os sexos, matriculados regularmente no ensino fundamental. Para avaliação dietética dos alunos foi utilizado questionário contendo questões relativas aos hábitos alimentares. Além disso, foi realizada a avaliação antropométrica dos alunos que estavam com o termo de consentimento assinado pelos pais. Os dados foram processados e analisados no programa STATA, versão 9.0, onde foram calculadas as frequências das variáveis e o teste do Qui-quadrado. Observou-se com os resultados encontrados que a maioria das crianças e adolescentes relatou consumir refrigerante (97%), comer doces (94%), assistir televisão durante as principais refeições (90,4%) e comer frutas (96,4%). Para o IMC, verificou-se que a maioria estava eutróficos (72,3%). Para o consumo de refrigerantes foi verificado maior percentual do seu consumo entre as crianças e adolescentes que também consomem doces (94,5%) e assistem televisão durante as principais refeições (91,2%). Observou-se que, neste estudo os estudantes apresentaram resultados preocupantes, principalmente no que diz respeito ao elevado consumo de doces e refrigerantes, sem distinção do estado nutricional e atrelado ao hábito de assistir televisão durante as refeições. Diante desse quadro, são necessárias ações voltadas para a promoção de hábitos alimentares saudáveis tanto na escola quanto orientação familiar.

A tutoria como estratégia educacional no ensino médico / Mentoring as an educational approach in medical education

A relação de tutoria é anterior à invenção da linguagem escrita. Desde seu surgimento, ocorreram mudanças em sua estrutura, mas não se perdeu a essência de promover o desenvolvimento do aprendiz. A tutoria é um processo de aprendizado individualizado, numa relação dinâmica, tendo hoje grande importância como ferramenta de ensino em cursos de graduação e treinamentos profissionais. Na educação médica, está relacionada positivamente à percepção de suporte acadêmico, à satisfação com a carreira, à produção científica, à diminuição do risco de burn-out e ao desenvolvimento de relações dentro da profissão. Entretanto, existem limitações, como o pequeno número de tutores preparados, a falta de tempo dos participantes e o restrito apoio institucional. Este trabalho revê os conceitos sobre tutoria, a função dos integrantes e a relação estabelecida entre eles, e avalia a importância, as expectativas e as limitações da tutoria na educação médica, em especial nas escolas de Medicina do Brasil. Foi realizada revisão de artigos científicos do período 2005-2011, no banco de dados PubMed, além de referências citadas nos artigos selecionados.

The mentoring relationship dates back to prior to the invention of written language. There have been changes in its structure, but it has not lost the essence of promoting the development of the apprentice. Mentoring is a personalized learning process, in a dynamic relationship, which has great importance as a learning instrument in undergraduate courses and professional training. In medical education, it is positively related to scholarly support, career satisfaction, academic production and a reduced risk of burn-out. However, it is still limited by the small number of trained mentors, participants’ lack of time and lack of institutional support. This paper reviews the concepts of mentoring, the attributes of mentors and apprentices and their relationship, and assesses the importance, the expectations and the limitations of mentoring in medical education, especially in Brazilian public medical schools. A review of scientific articles on the PubMed database and published between 2005 and 2011 was performed, as well as other publications cited in the selected articles.

The linkage between psoriasis and non-alcoholic fatty liver disease: a literature review.

Psoriasis is a chronic systemic inflammatory disease mainly affecting the skin. Population-based surveys have shown a higher prevalence of non-alcoholic fat liver disease (NAFLD) in patients with psoriasis compared with the general population, especially in those with a greater psoriasis area and severity index (PASI). It is speculated that similar pathogenic bases may play a role in this association, highlighting insulin resistance and the release of inflammatory cytokines as the most likely causes. In the present work, we review basic aspects of the relationship between psoriasis and NAFLD.

Consulta ginecológica sob a ótica de adolescentes / Gynecological consultation according to adolescents

Objetivou-se descrever as características sociodemográficas e analisar a percepção de adolescentes sobre a consulta ginecológica. Trata-se de estudo descritivo-exploratório, com abordagem quantitativa, realizado com 40 adolescentes do sexo feminino com idade entre 15 e 19 anos que estudavam numa escola estadual do município de São Paulo-SP no períodode agosto a setembro de 2012. Aplicou-se questionário abordando características sociodemográficas, comportamento sexual e avaliação da consulta ginecológica. Os dados foram coletados por questionário estruturado, sendo tabulados e analisados nos programas EpiData 3.1 e Epi Info 6.04. A média de idade foi de 17,5 anos e a média de idade da menarca foi de 12 anos, 67% relataram que já tiveram relação sexual. A maioria referiu conhecimento sobre anticoncepção,métodos contraceptivos e doenças sexualmente transmissíveis, porém pequena parte obteve essas orientações na consulta ginecológica. As adolescentes manifestaram desejo de que o profissional investisse mais tempo, paciência e disponibilidade no atendimento. Concluiu-se que o atendimento ginecológico foi insatisfatório segundo a avaliação dasadolescentes estudadas. Portanto, é necessário criar mecanismos que facilitem o acesso e a adesão desse grupo etário à rotina preventiva ginecológica...

This study aimed to describe the sociodemographic characteristics and analyze the perception of adolescents about gynecological consultations. This is a descriptive, exploratory study with a quantitative approach, performed in 40 female adolescents aged 15-19 years who attended a state school in São Paulo-SP, in the period of August to September, 2012. A questionnaire which covered sociodemographic characteristics, sexual behavior and evaluation of gynecologicalconsultations was applied. Data were collected by structured questionnaire, and were tabulated and analyzed usingEpiData and Epi Info 6.04 3.1 programs. The average age was 17.5 years, and the average age of menarche was 12 years; 67% reported that they had had sexual intercourse. The majority reported knowledge about contraception, birth controlmethods and sexually transmitted diseases, but only a small party learned such guidelines in gynecological consultations. The teens expressed a desire that the professionals invest more time, patience and availability during the appointments. It was concluded that the gynecological care was unsatisfactory according to the evaluation of adolescents. Therefore, itis necessary to create me chanisms that facilitate access and adherence in this age group to gynecological preventiveroutines...

Se objetivó describir las características sociodemográficas y analizar la percepción de adolescentes sobre la consulta ginecológica. Se trata de un estudio descriptivo-exploratorio, con abordaje cuantitativo, realizado con 40 adolescentes del sexo femenino con edad entre 15 y 19 anos que estudiaban en una escuela estadual del municipio de São Paulo-SP en el período de agosto a septiembre de 2012. Se aplicó un cuestionario abordando características sociodemográficas, comportamiento sexual y evaluación de la consulta ginecológica. Los datos se han recolectado por cuestionarioestructurado, fueron tabulados y analizados en los programas EpiData 3.1 y Epi Info 6.04. El promedio de edad fue de 17,5 años y el promedio de edad de la menarca fue de 12 años, 67% relataron que ya tuvieron relaciones sexuales. La mayoría dijo tener conocimiento sobre contracepción, métodos contraceptivos y enfermedades sexualmente trasmisibles, sinembargo pequeña parte obtuvo dichas orientaciones en la consulta ginecológica. Las adolescentes manifestaron el deseo de que el profesional invirtiera más tiempo, paciencia y disponibilidad en la atención. Se concluyó que la atenciónginecológica fue insatisfactoria según la evaluación de las adolescentes estudiadas. Por lo tanto, es necesario crear mecanismos que faciliten el acceso y la adhesión de ese grupo etario a la rutina preventiva ginecológica...

Do you know this syndrome?

Congenital Hypertrichosis Lanugionsa is a rare autosomal dominant genetic disorder, with fewer than 50 cases reported in the literature. It is characterized by excessive lanugo hair, sparing only the mucous membranes, palms and soles. It may be associated with other organic abnormalities and should form part of the dermatologist's current knowledge. We discuss some aspects of the syndrome in question arising from the case report of a 2-year-old female patient, black, with classic clinical presentation, with no other associated congenital abnormalities.

Do you know this syndrome? / Você conhece esta síndrome?

Congenital Hypertrichosis Lanugionsa is a rare autosomal dominant genetic disorder, with fewer than 50 cases reported in the literature. It is characterized by excessive lanugo hair, sparing only the mucous membranes, palms and soles. It may be associated with other organic abnormalities and should form part of the dermatologist's current knowledge. We discuss some aspects of the syndrome in question arising from the case report of a 2-year-old female patient, black, with classic clinical presentation, with no other associated congenital abnormalities.

A hipertricose Lanugionsa Congênita é uma desordem genética rara, autossômica dominante, com menos de 50 casos descritos na literatura. É caracterizada por pêlo lanugo excessivo, poupando apenas membranas mucosas, palmas e plantas. Pode estar associada a outras anormalidades orgânicas, devendo ser de conhecimento do dermatologista. Discutiremos aspectos da síndrome em questão a partir do relato de caso de uma paciente do sexo feminino, negra, 02 anos, com apresentação clínica clássica, sem outras anormalidades congênitas associadas.

Refractory erythrodermic psoriasis in a child with an excellent outcome by using etanercept.

Psoriasis affects 0.12% to 0.71% of all children. Erythrodermic psoriasis is an uncommon but serious disorder, occurring in less than 1.5% of cases. Tumor necrosis factor-alpha blockers (TNF-α) are a new class of drugs used to treat moderate to severe psoriasis refractory to conventional therapies. Etanercept is a TNFα receptor fusion protein, approved by the FDA for treating juvenile rheumatoid arthritis. We present the case of a 7-year-old suffering from plaque psoriasis since 8 months old which evolved into erythroderma refractory to cyclosporine and methotrexate. Patient responded excellently to etanercept, with no adverse side effects.