Association between Leukemic Evolution and Uncommon Chromosomal Alterations in Pediatric Myelodysplastic Syndrome.

Background: Pediatric myelodysplastic syndrome (pMDS) is a group of rare clonal neoplasms with a difficult diagnosis and risk of progression to acute myeloid leukemia (AML). The early stratification in risk groups is essential to choose the treatment and indication for allogeneic hematopoietic stem cell transplantation (HSCT). According to the Revised International Prognostic Scoring System, cytogenetic analysis has demonstrated an essential role in diagnosis and prognosis. In pMDS, abnormal karyotypes are present in 30-50% of the cases. Monosomy 7 is the most common chromosomal alteration associated with poor prognosis. However, the rarity of specific cytogenetic alterations makes its prognosis uncertain. Thus, this study aimed to describe uncommon cytogenetic alterations in a cohort of 200 pMDS patients and their association with evolution to AML. Methods: The cytogenetic analysis was performed in 200 pMDS patients by G-banding and fluorescence in situ hybridization between 2000 to 2022. Results: Rare chromosome alterations were observed in 7.5% (15/200) of the cases. These chromosome alterations were divided into four cytogenetic groups: hyperdiploidy, biclonal chromosomal alterations, translocations, and uncommon deletions representing 33.3%, 33.3%, 20%, and 13.3%, respectively. Most of these patients (10/15) were classified with advanced MDS (MDS-EB and MDS/AML) and the initial subtype was present in five patients (RCC). The leukemic evolution was observed in 66.66% (10/15) of the patients. Most patients had poor clinical outcomes and they were indicated for HSCT. Conclusion: The study of uncommon cytogenetic alterations in pMDS is important to improve the prognosis and guide early indication of HSCT.

An application of a non-homogeneous Poisson model to study PM2.5 exceedances in Mexico City and Bogota.

It is very important to study the occurrence of high levels of particulate matter due to the potential harm to people's health and to the environment. In the present work we use a non-homogeneous Poisson model to analyse the rate of exceedances of particulate matter with diameter smaller that 2.5 microns (PM 2.5 ). Models with and without change-points are considered and they are applied to data from Bogota, Colombia, and Mexico City, Mexico. Results show that whereas in Bogota larger particles pose a more serious problem, in Mexico City, even though nowadays levels are more controlled, in the recent past PM 2.5 were the ones causing serious problems.

Avaliação da qualidade microbiológica do queijo de coalho comercializado na praia de Copacabana ­ RJ / Evaluation of the microbiological quality of coalho cheese commercialized on Copacabana beach ­ RJ

A pesquisa teve o objetivo de avaliar as condições higiênicas e sanitárias de comercialização do queijo de coalho por vendedores ambulantes na praia de Copacabana, por meio de inspeção visual e análises microbiológicas. Para o estudo foram coletadas quinze amostras de cinco diferentes ambulantes e estas foram encaminhadas para o Centro Estadual de Pesquisa em Qualidade de Alimentos da Empresa de Pesquisa Agropecuária do Estado do Rio de Janeiro (PESAGRO-RIO/CEPQA) onde foram submetidas às análises microbiológicas. O resultado da avaliação visual das condições higiênico-sanitárias demonstrou 100% de não conformidades em relação à adoção das Boas Práticas de Fabricação por parte dos manipuladores. Os resultados das contagens de Estafilococos coagulase positiva e de Coliformes termotolerantes se apresentaram acima do limite preconizado pela legislação vigente em 75% e 6,7% das amostras respectivamente. Em 25% das amostras foi verificada a presença de Salmonella spp. O estudo demonstrou que o queijo de coalho vendido por ambulantes da praia de Copacabana estava impróprio para o consumo podendo representar risco à saúde dos consumidores

The research aimed to evaluate the hygienic and sanitary commercialized conditions of coalho cheese by street vendors on Copacabana beach, through visual inspection and microbiological analysis. For conducting the study, fifteen samples were collected from five different street vendors and these were analyzed at the State Center for Research in Food Quality of the Agriculture Research Company of the State of Rio de Janeiro (PESAGRO-RIO/CEPQA). The result of the visual assessment of hygienic-sanitary conditions demonstrated 100% of non-conformities in relation to the adoption of Good Manufacturing Practices by the manipulators. In counts of coagulase positive Staphylococcus and Thermotolerant Coliforms were above the limit recommended by the current legislation in 75% and 6.7% of the samples, respectively. Salmonella spp. was present in 25% of the analyses.The study showed that the coalho cheese sold by street vendors on Copacabana beach was unfit for consumption and could pose a risk to consumer health

Expression Profiles of DNA Methylation and Demethylation Machinery Components in Pediatric Myelodysplastic Syndrome: Clinical Implications.

PURPOSE: The aim of this study was to analyse the expression profiles of DNMT1, DNMT3A, DNMT3B (components of DNA methylation machinery), TET2 and APOBEC3B (components of DNA demethylation machinery) in pediatric MDS patients and investigate their associations with MDS subtypes, cytogenetics, evolution to acute myeloid leukemia (AML) and p15INK4B methylation level. PATIENTS AND METHODS: The expressions of DNMT1, DNMT3A, DNMT3B, TET2, and APOBEC3B were evaluated in 39 pediatric MDS patients by real-time quantitative PCR (qPCR). The quantification of p15INK4B methylation levels (MtL) was performed in 20 pediatric MDS patients by pyrosequencing. Mann-Whitney test was used to evaluate possible differences between the expression levels of selected in patients and donors, according to MDS subtypes, karyotypes, evolution to AML and p15INK4B MtL. The correlations between the expression levels of the different genes were assessed by Spearman rank correlation coefficient. RESULTS: We found that DNMTs expression levels were higher in pediatric MDS compared to donors [DNMT1 (p<0.03), DNMT3A (p<0.03), DNMT3B (p<0.02)]. TET2 and APOBEC3B expression levels did not show a statistically significant difference between pediatric patients and donors. Considering MDS subtypes, patients at initial stage presented DNMT1 overexpression (p<0.01), while DNMT3A (p<0.02) and DNMT3B (p<0.007) were overexpressed in advanced subtypes. TET2 and APOBEC3B expression did not differ in MDS subtypes. DNMT1 (p<0.03), DNMT3B (p<0.03), and APOBEC3B (p<0.04) expression was higher in patients with normal karyotypes, while patients with abnormal karyotypes showed higher DNMT3A expression (p<0.03). Karyotypes had no association with TET2 expression. DNMTs overexpression was observed in patients who showed disease evolution. A positive correlation was found between DNMTs expression and between APOBEC3B and DNMT3A/DNMT3B. However, TET2 expression was not correlated with DNMTs or APOBEC3B. p15INK4B MtL was higher in pediatric MDS patients compared with donors (p<0.03) and its hypermethylation was associated with increased DNMT1 expression (p<0.009). CONCLUSION: Our results suggest that the overexpression of DNMTs and an imbalance between the expressions of the DNA methylation/demethylation machinery components play an important role in MDS development and evolution to AML. These results have clinical implications indicating the importance of DNMTs inhibitors for preventing or delaying the progression to leukemia in pediatric MDS patients.

A computer simulation study on the influences of loss and damage of primary muscle spindle afferents on soleus muscle stretch reflex.

Sensory loss is detrimental to sensorimotor control. Several studies have reported that loss and/or damage of primary (Ia) muscle spindle afferents significantly influence the stretch reflex responses of leg and foot muscles. However, a systematic experimental evaluation on how the impairment of Ia muscle spindle afferents affects the stretch reflex is difficult due to technical and ethical issues. In the present study, the aim was to use computer simulations of a multiscale neuromusculoskeletal model to investigate how changes in: i) the number of Ia afferents, ii) the synaptic conductance between Ia sensory fibers and spinal motor neurons (MNs), and iii) the conduction velocities (CVs) of Ia afferents, would influence the stretch reflex of a leg muscle (soleus). Simulation results showed that both anatomical and functional loss of Ia afferents exerted an influence on the amplitude of short-latency stretch reflex response (M1) and the late phase of medium-latency response (M2). Additionally, changes in CVs of Ia afferents mainly influenced the latency of M1 and the amplitude of M2. Our findings provide conceptual evidence that a combination of anatomical and functional loss, as well as changes in CVs of Ia afferents due to demyelination, can explain the stretch reflex responses observed in peripheral neuropathies.

Correction: Expected population weight and diabetes impact of the 1-peso-per-litre tax to sugar sweetened beverages in Mexico.

[This corrects the article DOI: 10.1371/journal.pone.0176336.].

Expected population weight and diabetes impact of the 1-peso-per-litre tax to sugar sweetened beverages in Mexico.

STUDY QUESTION: What effect on body mass index, obesity and diabetes can we expect from the 1-peso-per-litre tax to sugar sweetened beverages in Mexico? METHODS: Using recently published estimates of the reductions in beverage purchases due to the tax, we modelled its expected long-term impacts on body mass index (BMI), obesity and diabetes. Microsimulations based on a nationally representative dataset were used to estimate the impact of the tax on BMI and obesity. A Markov population model, built upon an age-period-cohort model of diabetes incidence, was used to estimate the impact on diagnosed diabetes in Mexico. To analyse the potential of tax increases we also modelled a 2-peso-per-litre tax scenario. STUDY ANSWER AND LIMITATIONS: Ten years after the implementation of the tax, we expect an average reduction of 0.15 kg/m2 per person, which translates into a 2.54% reduction in obesity prevalence. People in the lowest level of socioeconomic status and those between 20 and 35 years of age showed the largest reductions in BMI and overweight and obesity prevalence. Simulations show that by 2030, under the current implementation of 1-peso-per-litre, the tax would prevent 86 to 134 thousand cases of diabetes. Overall, the 2-peso-per-litre scenario is expected to produce twice as much of a reduction. These estimates assume the tax effect on consumption remains stable over time. Sensitivity analyses were conducted to assess the robustness of findings; similar results were obtained with various parameter assumptions and alternative modelling approaches. WHAT THIS STUDY ADDS: The sugar-sweetened beverages tax in Mexico is expected to produce sizable and sustained reductions in obesity and diabetes. Increasing the tax could produce larger benefits. While encouraging, estimates will need to be updated once data on direct changes in consumption becomes available.

Transcranial direct current stimulation combined with upper limb functional training in children with spastic, hemiparetic cerebral palsy: study protocol for a randomized controlled trial.

BACKGROUND: The aim of the proposed study is to perform a comparative analysis of functional training effects for the paretic upper limb with and without transcranial direct current stimulation over the primary motor cortex in children with spastic hemiparetic cerebral palsy. METHODS: The sample will comprise 34 individuals with spastic hemiparetic cerebral palsy, 6 to 16 years old, classified at level I, II, or III of the Manual Ability Classification System. Participants will be randomly allocated to two groups: (1) functional training of the paretic upper limb combined with anodic transcranial stimulation; (2) functional training of the paretic upper limb combined with sham transcranial stimulation. Evaluation will involve three-dimensional movement analysis and electromyography using the SMART-D 140® system (BTS Engineering) and the FREEEMG® system (BTS Engineering), the Quality of Upper Extremity Skills Test, to assess functional mobility, the Portable Device and Ashworth Scale, to measure movement resistance and spasticity, and the Pediatric Evaluation of Disability Inventory, to evaluate performance. Functional reach training of the paretic upper limb will include a range of manual activities using educational toys associated with an induced constraint of the non-paretic limb during the training. Training will be performed in five weekly 20-minute sessions for two weeks. Transcranial stimulation over the primary motor cortex will be performed during the training sessions at an intensity of 1 mA. Findings will be analyzed statistically considering a 5 % significance level (P ≤ 0.05). DISCUSSION: This paper presents a detailed description of a prospective, randomized, controlled, double-blind, clinical trial designed to demonstrate the effects of combining transcranial direct current stimulation over the primary motor cortex and functional training of the paretic limb in children with cerebral palsy classified at level I, II, or III of the Manual Ability Classification System. The results will be published and evidence found may contribute to the use of transcranial stimulation for this population. TRIAL REGISTRATION: ReBEC RBR-6V4Y3K . Registered on 11 February 2015.

Vivenciar a realidade de uma Estratégia de Saúde da Família: contribuição para a formação / Experience the reality of a Family Health Strategy: contribution for training / Vivir la realidad de una Estrategia de Salud de la Familia: contribución para la formación

Objetivo: descrever a experiência vivenciada por estudantes do curso de enfermagem a partir da inserção destes em atividades práticas do componente curricular "Enfermagem em Saúde Coletiva". Método: estudo descritivo, tipo relato de experiência, elaborado a partir de vivências de acadêmicos de Enfermagem, durante as atividades práticas e inserção em Estratégia Saúde da Família. Resultados: os estudantes foram desafiados a conviver com a comunidade e os profissionais de saúde da Estratégia Saúde da Família, oportunidade muito rica, para relacionar a teoria com a prática, o que culminou na interação com a realidade social da comunidade e o desenvolvimento de habilidades e raciocínio clínico voltados ao bem-estar e ao cuidado integral. Conclusão: denota-se a importância da vivência em campo de prática durante a formação acadêmica, o que contribui para o crescimento pessoal e profissional, por meio da interação entre pessoas, tomada de decisões e conhecimento da realidade da comunidade.(AU)

Objective: to describe the experience of nursing students of their insertion in practical activities of the curricular component "Collective Health Nursing". Method: descriptive study of the type case report, drawn from the experiences of nursing students during practices and integration into activities of the Family Health Strategy. Results: students were challenged to interact with the community and health professionals of the Family Health Strategy. This was a very rich opportunity to link theory with practice. This experience led to interaction with the social reality of the community and the development of skills and clinical reasoning aimed at well-being and integral care. Conclusion: the importance of practical experience during academic training was evident, because this contributes to personal and professional growth, through the interaction between people, decision-making process, and knowledge about the reality of the community.(AU)

Objetivo: describir la experiencia vivida por estudiantes del curso de enfermera a partir de la inserción de estos en actividades prácticas del componente curricular "Enfermería en Salud Colectiva". Método: estudio descriptivo, tipo relato de experiencia, elaborado a partir de vivencias de académicos de Enfermería, durante las actividades prácticas e inserción en Estrategia Salud de la Familia. Resultados: los estudiantes fueron desafiados a convivir con la comunidad y los profesionales de salud de la Estrategia Salud de la Familia, oportunidad muy rica, para relacionar la teoría con la práctica, lo que culminó en la interacción con la realidad social de la comunidad y el desarrollo de habilidades y raciocinio clínico dirigido al bienestar y al cuidado integral. Conclusión: se ve la importancia de la vivencia en campo de práctica durante la formación académica, lo que contribuye para el crecimiento personal y profesional, por medio de la interacción entre personas, tomada de decisiones y conocimiento de la realidad de la comunidad.(AU)

Modeling environmental noise exceedances using non-homogeneous Poisson processes.

In this work a non-homogeneous Poisson model is considered to study noise exposure. The Poisson process, counting the number of times that a sound level surpasses a threshold, is used to estimate the probability that a population is exposed to high levels of noise a certain number of times in a given time interval. The rate function of the Poisson process is assumed to be of a Weibull type. The presented model is applied to community noise data from Messina, Sicily (Italy). Four sets of data are used to estimate the parameters involved in the model. After the estimation and tuning are made, a way of estimating the probability that an environmental noise threshold is exceeded a certain number of times in a given time interval is presented. This estimation can be very useful in the study of noise exposure of a population and also to predict, given the current behavior of the data, the probability of occurrence of high levels of noise in the near future. One of the most important features of the model is that it implicitly takes into account different noise sources, which need to be treated separately when using usual models.

Influence of the number of feeding environments on the performance of bullfrog tadpoles / Influência do número de ambientes de alimentação no desempenho de girinos de rã-touro

Feeding is one of the major factors that influences the growth and development of animals, justifying thus the present experiment that analyzed the effect of the number of feeding environments on the performance of bullfrog tadpoles through the growth (weight and length) and performance (food remains, average feed intake, average weight gain, and feed conversion). The treatments consisted of subunits of two, four, and eight feeding environments in the experimental units at disposal for the tadpole population, and one without subdivisions, comprising a single environment, during 60 experimental days. The design was completely randomized, with four treatments and three replications. The values were tested using an analysis of variance and Duncan test (α = 0.05). The growth in weight and length and the indices of animal performance were influenced by the number of feeding environments, with the best results found for the treatments with four and eight environments, and the worst, for the treatment with a single environment. The increased number of feeding environments may be an alternative to improve the performance of bullfrog tadpoles.

Alimentação íntegra a um conjunto de fatores que influenciam o crescimento e o desenvolvimento dos animais. Com isso, foi realizado o experimento com o objetivo de verificar pelo crescimento (peso e comprimento) e o desempenho (sobras diárias de ração, consumo médio de ração, ganho de peso médio e conversão alimentar) dos girinos de rã-touro a influência do número de ambientes de alimentação no desempenho de girinos de rã-touro. Os tratamentos foram subdivisões em dois, quatro e oito ambientes de alimentação das unidades experimentais em relação à população de girinos e um sem subdivisões com único ambiente, durante 60 dias experimentais. O delineamento foi inteiramente casualizado, com quatro tratamentos e três repetições. Os valores encontrados foram submetidos à análise de variância e ao teste de Duncan (α = 0,05). O crescimento em peso e comprimento e os índices de desempenho zootécnicos foram influenciados pelo número de ambientes de alimentação, sendo que os melhores resultados foram para os tratamentos com quatro e oito ambientes e o piores para com único ambiente. O aumento do número de ambientes de alimentação pode ser uma alternativa para melhorar o desempenho dos girinos de rã-touro.

Análise do uso da irradiação e do metabissulfito de sódio em camarão Pleoticus muelleri refrigerado, através do pH / Analysis of the use of irradiation and sodium metabisulfite in chilled Pleoticus muelleri shrimp through pH

O objetivo do presente trabalho foi avaliar o uso da irradiação de alimentos em associação ou substituição ao uso do metabissulfito de sódio no processamento do camarão vermelho, levando em consideração o parâmetro físico-químico do pH. As amostras foram separadas em quatro grupos (controle, irradiado a 1,5 kGy, metabissulfito de sódio a 2%, metabissulfito de sódio 1,25% associado a 1,5 kGy), provenientes de pesca de arrasto e comercializadas em Niterói, Rio de Janeiro. As irradiadas foram processadas no LIN-COPPE / UFRJ. As análises de pH foram realizadas por potenciômetro em intervalos de 2 dias durante 7 dias de estocagem em refrigeração. Todas as amostras obtiveram resultados superiores ao preconizado pela legislação durante o período de análise, porém, a que foi processada com metabissulfito de sódio e depois irradiada foi a que atingiu melhores resultados.

The objective of this study was to evaluate food irradiation combining or replacing the use of sodium metabisulphite in the processing of red shrimp, concerning the physicochemical parameters of pH. The samples were separated into four groups (control, irradiated at 1.5 kGy, sodium metabisulphite 2%, sodium metabisulphite 1.25% associated with 1.5 kGy). They came from trawling and were commercialized in Rio de Janeiro state. The irradiated samples were processed in the laboratory of LIN-COPPE/UFRJ. pH analyses were done by potentiometers every 2 days during 7 days of storage under refrigeration. All samples had higher results than recommended by law during the period of analysis, but that one processed with sodium metabisulphite and then submitted to irradiation showed the best results.

Liver histopathological changes in breeding bullfrogs / Alterações histopatológicas do fígado de reprodutores de rã-touro

In order to complement the histopathological study of juveniles and tadpoles of the bullfrog, Lithobathes catesbeianus, fed commercial diet used by frog farms in Rio de Janeiro, containing 40% crude protein, we performed necropsy and histopathology of the liver to establish a relationship between the quality of crude protein in the diet and animal health. For this, it was used twenty breeding male bullfrogs, with average weight 591.30 g (± 91.90 g) and length 165.02 mm (± 14.22 mm), and ten females with average weight and length of 629.80 g (± 134.47 g) and 169.32 mm (± 21.82 mm). The liver histopathology showed hyperemia, high number of elanomacrophages and cytoplasmic rarefaction, probably due to protein deficiency and fatty liver degeneration and presence of inflammatory processes. These lesions indicate a degenerative nutritional process. These findings suggest that the animals were fed with proteins of low biological value, indicating poor quality of feed, undermining the sanity. The impairment of liver function by these injuries will lead to reduced availability of precursors of sex hormones, since the liver is important in the metabolism of the same, and reproductive performance of these animals may be impaired.

Em complementação ao estudo histopatológico de girinos e imagos da rã-touro, Lithobates catesbeianus, alimentados com ração comercial utilizada pelos ranários do Rio de Janeiro, contendo 40% de proteína bruta, realizou-se necropsia e histopatologia do fígado de reprodutores, procurando uma relação entre a qualidade de proteína bruta na ração e a sanidade do animal. Foram utilizados 20 reprodutores de rã-touro, dez machos com peso de 591,30 g (± 91,90 g) e comprimento médios de 165,02 mm (± 14,22 mm), e dez fêmeas com peso e comprimento médios de 629,80 g (± 134,47 g) e 169,32 mm (± 21,82 mm). Os resultados da histopatologia mostraram que o fígado dos reprodutores, tanto machos quanto fêmeas apresentavam hiperemia, grande número de melanomacrófagos e rarefação citoplasmática provavelmente por deficiência proteica e quadro de degeneração hepática gordurosa. Tais lesões indicam quadro degenerativo nutricional. Também presente processos inflamatórios focais. Estes achados sugerem uma alimentação com proteínas de baixo valor biológico, indicando má qualidade da ração, comprometendo sua sanidade. Pode-se inferir que o comprometimento das funções hepáticas, irá diminuir a disponibilidade de precursores dos hormônios sexuais, pois o fígado é importante na metabolização dos mesmos, e a performance reprodutiva destes animais poderá ser prejudicada.

Liver histopathological changes in breeding bullfrogs - doi: 10.4025/actascibiolsci.v35i4.15981

In order to complement the histopathological study of juveniles and tadpoles of the bullfrog, Lithobathes catesbeianus, fed commercial diet used by frog farms in Rio de Janeiro, containing 40% crude protein, we performed necropsy and histopathology of the liver to establish a relationship between the quality of crude protein in the diet and animal health. For this, it was used twenty breeding male bullfrogs, with average weight 591.30 g (± 91.90 g) and length 165.02 mm (± 14.22 mm), and ten females with average weight and length of 629.80 g (± 134.47 g) and 169.32 mm (± 21.82 mm). The liver histopathology showed hyperemia, high number of melanomacrophages and cytoplasmic rarefaction, probably due to protein deficiency and fatty liver degeneration and presence of inflammatory processes. These lesions indicate a degenerative nutritional process. These findings suggest that the animals were fed with proteins of low biological value, indicating poor quality of feed, undermining the sanity. The impairment of liver function by these injuries will lead to reduced availability of precursors of sex hormones, since the liver is important in the metabolism of the same, and reproductive performance of these animals may be impaired.

o envolvimento paterno na gestação sob o olhar de gênero / Parental involvement in pregnancy under the look of gender

Objetivo: identificar a participação e o envolvimento paterno na gestação, segundo o olhar da puérpera.Método: estudo exploratório, descritivo, com abordagem qualitativa realizado com 15 puérperas internadasem uma maternidade pública, na cidade de Alfenas-MG/Brasil. A coleta de dados ocorreu por intermédio deentrevistas semiestruturadas realizadas em maio de 2010 com assinatura dos termos de consentimentos livre eesclarecido, conforme aprovação do Comitê de Ética em Pesquisa sob o protocolo nº 082/2010. Osdepoimentos foram analisados de acordo com a Análise de Conteúdo. Resultados: a partir das análises dasentrevistas, emergiram três categorias: >; >; >.Conclusão: verificou-se a importância da participação paterna no período gestacional, a qual não é impedidaquando o companheiro tem real interesse em participar, e ainda que cada pai tem uma peculiaridade emenvolver-se com a gestação.

Malaria control in an Amazon municipality / Controle da malária em um município amazônico / Control de la malaria en un municipio amazónico

This study aimed to evaluate the organization of malaria control actions in the Indigenous population of the municipality of São Gabriel da Cachoeira, Amazonas, AM, Brazil, from 2003 to 2007. This is an ecological study to evaluate the impact of control measures. Statistical analysis of the indicators revealed that the number of cases showed an increasing trend, with the highest numbers occurring in the rural areas. The same trend was observed for the Annual Parasite Index (API), however the highest APIs were found in the urban areas. The proportion of cases caused by Plasmodium falciparum showed a reduction. Hospitalization and mortality rates presented fluctuations and the fatality rate decreased. The findings indicate that control actions have proved partially effective and that they have provided a broader capacity to detect cases and to provide immediate treatment. Although the municipality still presents a high risk for transmission, the Pluriannual Plan in progress seems to have a good prognosis for the control of the disease, if maintained in a sustainable and permanent way.

Este estudo objetiva avaliar a organização das ações de controle da malária em populações indígenas do município de São Gabriel da Cachoeira, Amazonas, AM, Brasil, no período de 2003 a 2007. Trata-se de estudo ecológico, de avaliação do impacto de medidas de controle. A análise estatística dos indicadores revelou o número de casos, mostrando tendência crescente, os maiores números ocorrendo na área rural. Mesma tendência observada pela incidência parasitária anual (IPA); entretanto, as maiores IPA verificaram-se na área urbana. A proporção de casos por Plasmodium falciparum mostrou redução. Taxas de internação e mortalidade apresentaram oscilações e a taxa de letalidade, decréscimo. Os achados indicam que as ações de controle mostraram-se parcialmente efetivas, assim como proporcionaram capacidade de detecção mais ampla de casos e tratamento imediato. Apesar de o município ainda apresentar alto risco para transmissão, o plano plurianual em andamento parece ter bom prognóstico quanto ao controle da doença, se mantido de forma sustentável e permanente.

Este estudio objetiva evaluar la organización de las acciones de control de la malaria en indígenas del municipio de Sao Gabriel de la Cachoeira, en el estado Amazonas (MA), en Brasil, en el período de 2.003 a 2.007. Se trata de un estudio ecológico, de evaluación del impacto de medidas de control. El análisis estadístico de los indicadores reveló el número de casos mostrando una tendencia creciente, los mayores números ocurrieron en el área rural. La misma tendencia fue observada para la Incidencia Parasitaria Anual (IPA), entre tanto las mayores IPA se verificaron en el área urbana. La proporción de casos por Plasmodium falciparum mostró una reducción. Las tasas de internación y mortalidad presentaron oscilaciones y la tasa de letalidad una disminución. Los resultados indican que las acciones de control se mostraron parcialmente efectivas, así como proporcionaron una capacidad de detección más amplia de casos y tratamiento inmediato. A pesar de que el municipio todavía presenta alto riesgo para transmisión, el Plan Plurianual en andamiento parece tener buen pronóstico en el control de la enfermedad, manteniéndose de forma sustentable y permanente.

[Presence of cells of the cervical transitional zone in cervicovaginal smears in women older than 40 years old]. / Presença de células da junção escamo-colunar em esfregaços cérvico-vaginais de mulheres acima de 40 anos.

PURPOSE: to evaluate the frequency of cells of the cervical transitional zone (CTZ) in cervicovaginal smears of women older than 40 years. METHODS: we conducted a retrospective study with review of 24,316 Pap smear reports during the period from January 2005 to December 2008, to evaluate the cases without material of the CTZ. Exclusion criteria were: total hysterectomy, smears with severe atrophy or unsatisfactory for analysis, cases without visualization of the cervix or the external orifice of the cervix closed during examination and records without the patient's age. A total of 21,866 cervical-vaginal cytology reports were included in this study. We evaluated the relationship between the presence of material of the CTZ and use of hormone replacement therapy (HRT) in patients aged 40 years or more and the relationship between presence of material of the CTZ and a moderate to intense inflammatory process in patients aged 39 years or less. Data were analyzed statistically by the χ2 test and Odds Ratio. RESULTS: only 11.2% of patients younger than 40 years had no material from the CTZ in their smears, while 47% patients older than 40 years had no material from the CTZ (p=0.0001). Most patients aged 40 years or more (92.1%) did not use HRT and this was not a predictor of incidence of CTZ material in these patients (p> 0.05). In contrast, most patients younger than 40 years without CTZ material (74.5%) had abundant inflammation in the smears (p=0.0001). CONCLUSION: patients aged 40 years or more had a lower incidence of material from the CTZ in cervicovaginal smears, and inflammation was a factor that contributed to the absence of CTZ material in the smears from patients younger than 40 years.

Presença de células da junção escamo-colunar em esfregaços cérvico-vaginais de mulheres acima de 40 anos / Presence of cells of the cervical transicional zone in cervicovaginal smears in women older than 40 years old

OBJETIVO: avaliar a frequência de células da junção escamo-colunar (JEC) em esfregaços cérvico-vaginais de mulheres com 40 anos ou mais. MÉTODOS: foi realizado um estudo retrospectivo, com revisão de 24.316 laudos colpocitológicos realizados no período de janeiro de 2005 a dezembro de 2008, para avaliação dos casos sem material da JEC. Os critérios de exclusão foram: hiterectomia total, esfregaços com atrofia intensa ou insatisfatórios para análise, casos sem visualização do colo uterino ou com o orifício externo do colo uterino fechado ao exame e aqueles sem a idade da paciente. Foram incluídas neste estudo 21.866 citologias cérvico-vaginais. Avaliou-se a relação entre a presença de material da JEC e uso de terapia de reposição hormonal (TRH) nas pacientes com 40 anos ou mais e a relação entre presença de material da JEC e processo inflamatório moderado a intenso nas pacientes com idade inferior ou igual a 39 anos. Para análise estatística utilizou-se o teste do χ2 e o teste de razão de chances. RESULTADOS: apenas 11,2 por cento das pacientes com idade inferior a 40 anos não apresentavam material da JEC em seus esfregaços, enquanto nas pacientes com 40 anos ou mais, 47 por cento não apresentavam (p=0,0001). A maioria das pacientes com 40 anos ou mais (92,1 por cento) não fazia uso de TRH e este não foi um fator preditor da incidência de material da JEC nestas pacientes (p>0,05). Em contrapartida, a maioria das pacientes com idade inferior a 40 anos sem material da JEC (74,5 por cento) apresenta inflamação exuberante no esfregaço (p=0,0001). CONCLUSÃO: pacientes com 40 anos ou mais apresentam uma menor incidência de material da JEC em esfregaços cérvico-vaginais, e inflamação é um fator que contribui para ausência de material da JEC nos esfregaços das pacientes com idade inferior a 40 anos.

PURPOSE: to evaluate the frequency of cells of the cervical transitional zone (CTZ) in cervicovaginal smears of women older than 40 years. METHODS: we conducted a retrospective study with review of 24,316 Pap smear reports during the period from January 2005 to December 2008, to evaluate the cases without material of the CTZ. Exclusion criteria were: total hysterectomy, smears with severe atrophy or unsatisfactory for analysis, cases without visualization of the cervix or the external orifice of the cervix closed during examination and records without the patient's age. A total of 21,866 cervical-vaginal cytology reports were included in this study. We evaluated the relationship between the presence of material of the CTZ and use of hormone replacement therapy (HRT) in patients aged 40 years or more and the relationship between presence of material of the CTZ and a moderate to intense inflammatory process in patients aged 39 years or less. Data were analyzed statistically by the χ2 test and Odds Ratio. RESULTS: only 11.2 percent of patients younger than 40 years had no material from the CTZ in their smears, while 47 percent patients older than 40 years had no material from the CTZ (p=0.0001). Most patients aged 40 years or more (92.1 percent) did not use HRT and this was not a predictor of incidence of CTZ material in these patients (p> 0.05). In contrast, most patients younger than 40 years without CTZ material (74.5 percent) had abundant inflammation in the smears (p=0.0001). CONCLUSION: patients aged 40 years or more had a lower incidence of material from the CTZ in cervicovaginal smears, and inflammation was a factor that contributed to the absence of CTZ material in the smears from patients younger than 40 years.