Resumo As metástases para as glândulas salivares são raras, ocorrendo sobretudo de neoplasias da cabeça e do pescoço para a glândula parótida. Até ao momento apenas uma metástase na glândula sublingual foi reportada na literatura. Neste trabalho apresentamos o segundo caso, que ocorreu numa mulher na casa dos 50 anos, anteriormente diagnosticada com carcinoma metaplásico da mama (MpBC) com diferenciação condroide, e com metástases ganglionares e orgânicas difusas. A lesão sublingual surgiu como uma tumefação no pavimento da boca que causava desconforto na mastigação. Histologicamente era formada por células epiteliais com características citomorfológicas de alto grau, com uma área central condroide. O caso foi desafiante dada a raridade do tumor primário e o local improvável de metastização. Considerámos tumores primários da glândula salivar com diferenciação condroide como diagnósticos alternativos, mas a integração clínica foi crucial para estabelecer o diagnóstico de metástase de MpBC para a glândula sublingual.

Abstract Metastatic spread to the salivary glands is rare, occurring primarily from head and neck tumors to the parotid gland. So far, only one sublingual gland metastasis has been reported in the literature. We herein report the second case of metastasis to this gland occurring in a woman in her 50s, previously diagnosed with HER2-positive metaplastic breast carcinoma (MpBC) with chondroid differentiation, with lymph node and diffuse organ metastases. The sublingual lesion presented as a tumefaction on the floor of the mouth, causing masticatory discomfort. Histologically it was formed by epithelial cells with high-grade cytomorphological features with a large central area of chondroid differentiation. The case was clinically and pathologically challenging, given the rarity of the primary MpBC and the improbable secondary location. Alternative primary salivar gland tumors with chondroid differentiation were considered, but ultimately the clinical integration was crucial in establishing the diagnosis of MpBC metastasis to the sublingual gland.

ABSTRACT Objective: To analyze the relationship between one-minute sit-to-stand test (1MSTST) parameters and a diagnosis of post COVID-19 condition in a cohort of patients who previously had COVID-19. Methods: This was a prospective cohort study of patients with post COVID-19 condition referred for body plethysmography at a tertiary university hospital. Post COVID-19 condition was defined in accordance with the current WHO criteria. Results: Fifty-three patients were analyzed. Of those, 25 (47.2%) met the clinical criteria for post COVID-19 condition. HR was lower in the patients with post COVID-19 condition than in those without it at 30 s after initiation of the 1MSTST (86.2 ± 14.3 bpm vs. 101.2 ± 14.7 bpm; p < 0.001) and at the end of the test (94.4 ± 18.2 bpm vs. 117.3 ± 15.3 bpm; p < 0.001). The ratio between HR at the end of the 1MSTST and age-predicted maximal HR (HRend/HRmax) was lower in the group of patients with post COVID-19 condition (p < 0.001). An HRend/HRmax of < 62.65% showed a sensitivity of 78.6% and a specificity of 82.0% for post COVID-19 condition. Mean SpO2 at the end of the 1MSTST was lower in the patients with post COVID-19 condition than in those without it (94.9 ± 3.6% vs. 96.8 ± 2.4%; p = 0.030). The former group of patients did fewer repetitions on the 1MSTST than did the latter (p = 0.020). Conclusions: Lower SpO2 and HR at the end of the 1MSTST, as well as lower HR at 30 s after initiation of the test, were associated with post COVID-19 condition. In the appropriate clinical setting, an HRend/HRmax of < 62.65% should raise awareness for the possibility of post COVID-19 condition.

RESUMO Objetivo: Analisar a relação entre parâmetros do teste de se sentar e levantar durante um minuto (TSL1) e o diagnóstico de síndrome pós-COVID-19 em uma coorte de pacientes que anteriormente apresentaram COVID-19. Métodos: Estudo prospectivo de coorte de pacientes com síndrome pós-COVID-19 encaminhados para realizar pletismografia corporal em um hospital universitário terciário. A síndrome pós-COVID-19 foi definida conforme os critérios atuais da OMS. Resultados: Foram analisados 53 pacientes. Destes, 25 (47,2%) preencheram os critérios clínicos de síndrome pós-COVID-19. A FC foi menor nos pacientes com síndrome pós-COVID-19 do que naqueles sem a síndrome 30 s após o início do TSL1 (86,2 ± 14,3 bpm vs. 101,2 ± 14,7 bpm; p < 0,001) e no fim do teste (94,4 ± 18,2 bpm vs. 117,3 ± 15,3 bpm; p < 0,001). A relação entre a FC no fim do TSL1 e a FC máxima prevista para a idade (FCfim/FCmáx) foi menor nos pacientes com síndrome pós-COVID-19 (p < 0,001). A relação FCfim/FCmáx < 62,65% apresentou sensibilidade de 78,6% e especificidade de 82,0% para síndrome pós-COVID-19. A média da SpO2 no fim do TSL1 foi menor nos pacientes com síndrome pós-COVID-19 do que naqueles sem a síndrome (94,9 ± 3,6% vs. 96,8 ± 2,4%; p = 0,030). Os pacientes com síndrome pós-COVID-19 realizaram menos repetições durante o TSL1 do que os sem a síndrome (p = 0,020). Conclusões: SpO2 e FC mais baixas no fim do TSL1 e FC mais baixa 30 s após o início do teste apresentaram relação com síndrome pós-COVID-19. No contexto clínico apropriado, a relação FCfim/FCmáx < 62,65% deve alertar para a possibilidade de síndrome pós-COVID-19.

Abstract Leiomyossarcomas of the vagina are extremely rare and may arise years after pelvic radiation therapy. Information about clinical and imaging findings, as well as ideal treatment strategies for these potentially aggressive malignancies are lacking. We report a case of a leiomyosarcoma of the vagina in a 65-year-old postmenopausal woman who presented with vaginal bleeding and a palpable hard mass, 11 years after postoperative pelvic radiation therapy for an endometrial cancer. Despite surgical resection and adjuvant chemotherapy, she passed away soon after, endorsing the reserved prognosis of these malignancies.

O objetivo deste estudo crossover foi avaliar o efeito de um concentrado de uva (bebida teste - BT) sobre biomarcadores do estresse oxidativo (substâncias reativas ao ácido tiobarbitúrico - TBARS, catalase - CAT, superóxido dismutase - SOD e glutationa - GSH). Seis triatletas do sexo masculino foram avaliados quanto à aptidão física, percentual de gordura (%G) e ingestão alimentar. Posteriormente, em duas ocasiões, os atletas receberam duas doses de 300 ml de BT (45,8g de polifenóis/kg) ou bebida placebo (PL) no desjejum e após uma sessão de treinamento (100 km de ciclismo, 6 km de corrida e 1,5 km de natação). Amostras de sangue (5 ml) foram coletadas em jejum, imediatamente após o exercício e 1h após o mesmo. Caracterização da amostra: idade: 43,8±10,2 anos, VO2máx: 45±5,15 ml/kg/min, %G: 13,6±4,2%, volume de treino: 270,8±87,1 km/semana e 3,1±1,88 horas/treino/dia. Houve aumento significativo da atividade de SOD da 1ª para as 2ª (p=0,027) e 3ª coletas (p=0,02) em resposta ao exercício, independente da bebida consumida. Os valores de GSH foram superiores 1 hora após o exercício quando houve consumo do PL (27,5%) em relação ao consumo da BT (1,8%). Ainda, o exercício elevou as concentrações de TBARS, mas no grupo PL os valores médios foram superiores (PL=2,5±1,2 nmol/ml vs. BT=1,77±1,3 nmol/ml). Em relação à atividade da CAT, os valores médios (BT=34,2±6,9 U/mgHb vs. PL=24,6±12,5 U/mgHb) foram menores quando comparadas 1ª e 2ª coletas (28,6%) para os atletas que consumiram PL. Os resultados referentes à concentração de TBARS, atividade de CAT e níveis de GSH sugerem que a BT modulou o estresse oxidativo induzido pelo exercício.

The aim of this crossover study was to evaluate the effect of a grape concentrate (test drink [TD]) on oxidative stress markers (thiobarbituric acid reactive substances [TBARS], catalase [CAT], superoxide dismutase [SOD], and glutathione [GSH]). Six triathletes had their physical fitness, body fat composition (%BF) and food intake evaluated. Afterwards, the athletes received two doses of 300 mL of the TD (45.8g of polyphenols/kg) or a placebo drink (PL), at breakfast and after a training session (100 km of cycling, 6 km of running and 1.5 km of swimming). Blood samples (5 ml) were collected after an overnight fasting, immediately after exercise, and one hour after exercise. The triathletes presented the following characteristics (mean and standard-deviation): 43.8±10.2 years old, VO2máx 45±5.15 mL/kg/min, %BF 13.6±4.2 %, training 270.8±87.1 km/week, 3.1±1.88 hours/training/day. There was a significant increase in SOD from the 1st to the 2nd (p=0.027) and 3rd (p=0.02) blood tests, in response to exercise, regardless of the drink consumed. One hour after exercise, the increase in glutathione values was greater when the PL was consumed (27.5%) in relation to the TD intake (1.8%). In both tests, exercise increased TBARS values; however, when PL was consumed, subjects' values were higher (PL=2.5±1.1 nmol/ml vs. BT=1.77±1.3 nmol/ml). When PL was consumed, mean CAT values (BT=34.2±6.9 U/mgHb vs. PL=24.6±12.5 U/mgHb) reduced from the 1st to the 2nd blood test (28.6%). TBARS, CAT and GSH values suggest that the TD presents potential to modulate exercise-induced oxidative stress.

Background: the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored. Objective: To identify the prevalence of MS and associated factors in children and adolescents. Methods: A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. The socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of The National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS. Results: The MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58 (1.32-5.04)] were observed. Conclusions: The MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels.

Introducción: Los factores asociados al Síndrome metabòlico (SM) han sido ampliamente estudiados en adultos, pero aún son poco explorado en niños y adolescentes Objetivo: Identificar la superioridad de SM y los factores asociados en niños y adolescentes. Métodos: Se trata de estudio transversal, con 540 niños de 7 a 14 años de edad. Los datos socioeconómicos, demográficos, estilo de vida e historia familiar de enfermedades crònicas fueron informados por la persona y/o responsable y registrados en cuestionario estructurado. Fueron realizadas dosificaciones bioquímicas (glicemia en ayuno, triglicérides, lipoproteína de alta densidad reducida, lipoproteína de muy baja densidad, ho-mocisteina y cisteina), evaluación antropométrica y verificación de la presión arterial. La SM fue definida de acuerdo con los criterios del The National Cholesterol Education Program Adult Treatment Panel III adaptado por Ferranti. Se utilizó regresión de Poisson como técnica estadística para identificar los factores asociados a la SM. Resultados: La superioridad de la SM fue del 12,8%, siendo a lipoproteína de alta densidad reducida (58,2%) el componente más frecuente, seguido por la hipertrigliceridemia (41,8%), presión arterial aumentada (29,1%), circunferencia de la cintura aumentada (26,7%) e hiperglicemia (7,2%). Fue observada asociación entre SM y exceso de peso (RP: 2,2 [1,22-3,95]), escolaridad paterna (RP: 2,19 [1,10-4,37]), concentración sérica de la lipoproteína de muy baja densidad (RP: 1,08 [1,04-1,11]) y concentraciones séricas simultáneamente aumentadas de homo-cisteina y cisteina (RP: 2,58 [1,32-5,04]). Conclusiones: La superioridad de SM es elevada en niños y adolescentes y se encuentra aumentada en paciente con exceso de peso, mayor escolaridad paterna, concentraciones séricas aumentadas de la lipoproteína de muy baja densidad, y elevación simultánea de los niveles séricos de homocisteína y cisteína.

A técnica da carta perdida foi adaptada para o contexto cultural brasileiro. Trezentas cartas endereçadas e seladas, foram colocadas "por engano", simulando perda, nos pára-brisas de veículos em dois estacionamentos. Um bilhete anexo explicava que o autor se desencontrara do amigo, "dono do carro". O bilhete variou, dando a entender que seu autor era masculino ou feminino (fator 1); tinha características pessoais distintas: homossexual, negro ou grupo controle (fator 2); permitindo a possibilidade de contatos telefônicos, ou não (fator 3), num delineamento 2 x 3 x 2. Quem encontrava a carta, podia enviá-la (comportamento pró-social) ou descartá-la. Sessenta e um por cento das cartas foram enviadas. Nenhuma diferença significativa foi encontrada em função das características dos três grupos (controle, negro ou homossexual), de gênero, da interação destes fatores. A possibilidade de telefonar para o remetente, aumentou significativamente o envio de cartas. A técnica mostrou-se promissora por possibilitar, enquanto instrumento não-reativo, o estudo de preconceito e ajuda.

The lost-letter technique was adapted to the cultural context of Brazil. Three hundred stamped and addressed letters were placed "by accident", i.e., simulating loss, on the wind shields of private cars in two large parking areas. A attached note explained that the author had missed the owner of the car. The note varied such that the author appeared to be either male or female (Factor 1), have certain personal characteristics, such as being black, homosexual, or control group (Factor 2), and allowed for telephone contact or not with the author (Factor 3) in a 2 x 3 x 2 experimental design. The finder of the letter could either (a) post the letter (pro-social behavior) or (b) ignore it. 60.7% of the letters were posted. No significant difference was found in terms of sex or personal characteristics, nor interaction between these two factors. Being able to telephone the author made a significant difference, more letter in this condition were posted. Methodologically, the lost letter technique showed promise, especially as a non-reactive research instrument in the study of prejudice and helping behavior.