Resumo A bacia do rio Guandu é de extrema importância para o estado do Rio de Janeiro, pois abastece grande parte da região metropolitana. Contudo, aspectos malacológicos e ambientais desta bacia são pouco conhecidos. O presente trabalho teve por objetivo realizar um inventário das espécies de moluscos de água doce ocorrentes na região, assim como uma avaliação ambiental através de um Protocolo de Avaliação Rápida, de dez estações de coleta na bacia do rio Guandu em seis municípios (Piraí, Paracambi, Japeri, Seropédica, Queimados e Nova Iguaçu). Foram encontradas 13 espécies, sendo oito nativas (Pomacea maculata, Biomphalaria tenagophila, Gundlachia ticaga, Gundlachia radiata, Omalonyx matheroni, Diplodon ellipticus, Anodontites trapesialis e Eupera bahiensis) e cinco exóticas (Melanoides tuberculata, Ferrissia fragilis, Physa acuta, Corbicula fluminea e Corbicula largillierti). A avaliação ambiental caracterizou a maior parte das estações de coleta como “modificado”. A dispersão das espécies exóticas e os efeitos negativos a elas associados, além da nossa falta de conhecimento sobre as espécies nativas chama a atenção para a necessidade de futuros estudos biológicos e ecológicos das espécies encontradas.

Abstract The Guandu River Basin is extremely important to state of Rio de Janeiro, as a water supplier of several municipalities. However, the malacological knowledge and environmental status is not well known to this basin. The aim of this paper is to present an inventory of freshwater mollusks, as well as an environmental assessment through a Rapid Assessment Protocol, of ten sampling sites at Guandu River basin in six municipalities (Piraí, Paracambi, Japeri, Seropédica, Queimados and Nova Iguaçu). Thirteen species of molusks were found, eight native (Pomacea maculata, Biomphalaria tenagophila, Gundlachia ticaga, Gundlachia radiata, Omalonyx matheroni, Diplodon ellipticus, Anodontites trapesialis and Eupera bahiensis) and five exotics (Melanoides tuberculata, Ferrissia fragilis, Physa acuta, Corbicula fluminea and Corbicula largillierti). The environmental analysis ranked most sites as “modified”. The expansion of exotic species with their associated negative effects, as well the gap in knowledge of native species calls attention to the need of future studies of biology and ecology of the species found.

O artigo reflete sobre como as temáticas fome, consumo de refrigerantes e consumo de feijão com arroz são enfocadas na música popular brasileira. Investigamos os anos de ditadura militar (1964-1985). O foco da análise é a chamada canção de protesto, gênero musical caracterizado por críticas estético-cultural, político-ideológica e social aos governos militares. Tomando como referencial teórico os estudos de ideologia e filosofia da linguagem de Mikhail Bakhtin, evidenciamos que a canção de protesto retratou elementos dos contextos econômico, político e social, e propiciou a difusão de hábitos e ideologias alimentares saudáveis ou não saudáveis, contribuindo para a construção da identidade alimentar brasileira.

The article reflects on how the themes of hunger, consumption of soft drinks and consumption of beans and rice are addressed in Brazilian popular music. We investigate the years of military dictatorship (1964-1985). The focus of the analysis is on the so-called protest song, a musical genre characterized by aesthetic, cultural, political, ideological and social criticism to military rule. The study of the ideology and philosophy of language of Mikhail Bakhtin is the theoretical reference; especially his concepts of “ideological sign” and “word.” Analysis reveals that the protest song portrayed elements of the economic, political and social contexts and led to the diffusion of healthy or unhealthy eating habits or ideologies, contributing to the construction of the Brazilian dietary identity.

Fundamento: A cardiomiopatia de estresse/Takotsubo (CT) é uma entidade diagnóstica cada vez mais reconhecida. Objetivo: Este estudo teve como objetivo avaliar a prevalência e os preditores clínicos de complicações de curto e longo prazo de pacientes (pts) com CT. Métodos: Foram incluídos todos os pts consecutivamente admitidos no nosso centro, entre novembro de 2006 e agosto de 2011, que preenchiam os critérios diagnósticos da Clínica Mayo. Resultados: Analisaram-se 37 pts (35 mulheres), com idade média de 63 ± 13 anos. A CT foi precipitada na maioria dos casos por eventos de estresse emocional (57%) e dor torácica foi o sintoma de apresentação mais frequente (89%). O electrocardiograma na admissão mostrou supradesnivelamento do segmento ST em 12 pts (32%) e inversão da onda T em 15 casos (41%). Verificou-se disfunção sistólica ventricular esquerda (VE) grave em 16 pts (45%) e a elevação média de troponina I foi de 2,6 ± 1,8 ng/mL. A taxa de complicações intra-hospitalares foi de 30%, sendo o choque cardiogênico a situação mais comum. O estresse físico, a disfunção sistólica grave do VE e o valor de pico do peptídeo natriurético cerebral (BNP) foram preditores de complicações agudas. Não foi encontrada associação entre o pico de troponina I e a apresentação eletrocardiográfica. Trinta e cinco pacientes foram acompanhados por um tempo médio de 482 ± 512 dias, sem recorrência clínica. Conclusão: Na nossa série de pacientes, a CT foi associada a uma alta taxa de complicações intra-hospitalares. O estresse físico, a disfunção sistólica do VE e o valor de pico do BNP foram preditores de desfechos adversos agudos.

Background: Stress-induced/Takotsubo cardiomyopathy (TC) is an increasingly recognized diagnostic entity. Objective: This study was aimed to assess the prevalence and clinical predictors of short and long-term outcome of patients (pts) diagnosed with TC. Methods: We included all consecutive pts admitted in our department, from November 2006 to August 2011, who met the Mayo Clinic criteria for TC diagnosis. Results: We evaluated 37 pts (35 women) with a mean age of 63 ±13 years. TC was precipitated by a stressful emotional event in the majority (57%) and chest pain was the most common symptom (89%). Twelve pts (32%) had ST-segment elevation and 15 pts (41%) had T-wave inversion on the electrocardiogram at admission. Severe left ventricular (LV) dysfunction was found in 16 pts (43%) and the mean troponin I level was 2.6±1.8 ng/mL. The in-hospital complication rate was 30%, with cardiogenic shock being the most common situation. Physical stress, severe LV systolic dysfunction and peak brain natriuretic peptide (BNP) were predictors of acute complications. On the other hand, we found no association between peak troponin I and electrocardiographic presentation. Thirty-five pts were followed for a mean time of 482 ± 512 days, without clinic recurrence. Conclusion: In our cohort of pts, TC was associated with a high in-hospital complications rate. Physical stress, LV dysfunction and peak BNP could predict acute adverse outcomes.

Objective: The use of antiretroviral therapy in HlV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HlV-infected children. Methods: The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Mnas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis. Results: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). Conclusión: Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HlV-infected children. Therefore, triple therapy should be the treatment of choice.

Objetivos: Como iniciar a terapia anti-retroviral é uma questao amplamente discutida no manejo de criangas infectadas pelo HIV. O objetivo deste estudo foi comparar a efetividade da terapia dupla e tríplice em uma coorte de criangas infectadas pelo HIV. Método: Este estudo foi realizado em um servigo de referencia para assisténcia á crianga infectada da Facul-dade de Medicina da UFMG. Foram incluídas criangas que iniciaram o primeiro regime anti-retroviral entre janeiro de 1998 e dezembro de 2000, com seguimento até dezembro de 2001. O evento final para análise foi a pri-meira falha terapéutica ou óbito. Resultados: Foram analisados 101 pacientes, sendo 58 (57,4%) e 43 (42,6%) com terapia dupla e tríplice, respectivamente. Nao houve diferenga entre os grupos quanto ao sexo, idade, contagem de linfócitos CD4+ e carga viral basal. A média de duragao da terapia dupla foi de 26,3 meses (IC95% 21,3-31,3) e da terapia tríplice, de 34,3 meses (IC95% 29,2-39,5%). Falha terapéutica ocorreu em 33 (56,9%) pacientes em terapia dupla e 11 (25,6%) em terapia tríplice (log rank 5,03; p = 0,025). O risco relativo de falha para terapia dupla foi 2,2 vezes maior (IC = 1,3-3,9). O percentual de linfócitos T CD4+ inicial foi preditor de risco para falha terapéutica (p = 0,001). Pacientes em terapia tríplice apresentaram maior redugao da carga viral (p = 0,001). Conclusáo: A terapia tríplice permaneceu eficaz por mais tempo e apresentou melhor resposta virológica do que a terapia dupla nesta coorte de criangas infectadas pelo HIV, justificando a sua escolha como regime preferencial de tratamento.

Objective: The use of antiretroviral therapy in HIV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HIV-infected children. Methods: The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Minas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis. Results: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). Conclusion: Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HIV-infected children. Therefore, triple therapy should be the treatment of choice.

OBJETIVOS: Como iniciar a terapia anti-retroviral é uma questão amplamente discutida no manejo de crianças infectadas pelo HIV. O objetivo deste estudo foi comparar a efetividade da terapia dupla e tríplice em uma coorte de crianças infectadas pelo HIV. MÉTODO: Este estudo foi realizado em um serviço de referência para assistência à criança infectada da Faculdade de Medicina da UFMG. Foram incluídas crianças que iniciaram o primeiro regime anti-retroviral entre janeiro de 1998 e dezembro de 2000, com seguimento até dezembro de 2001. O evento final para análise foi a primeira falha terapêutica ou óbito. RESULTADOS: Foram analisados 101 pacientes, sendo 58 (57,4%) e 43 (42,6%) com terapia dupla e tríplice, respectivamente. Não houve diferença entre os grupos quanto ao sexo, idade, contagem de linfócitos CD4+ e carga viral basal. A média de duração da terapia dupla foi de 26,3 meses (IC95% 21,3-31,3) e da terapia tríplice, de 34,3 meses (IC95% 29,2-39,5%). Falha terapêutica ocorreu em 33 (56,9%) pacientes em terapia dupla e 11 (25,6%) em terapia tríplice (log rank 5,03; p = 0,025). O risco relativo de falha para terapia dupla foi 2,2 vezes maior (IC = 1,3-3,9). O percentual de linfócitos T CD4+ inicial foi preditor de risco para falha terapêutica (p = 0,001). Pacientes em terapia tríplice apresentaram maior redução da carga viral (p = 0,001). CONCLUSÃO: A terapia tríplice permaneceu eficaz por mais tempo e apresentou melhor resposta virológica do que a terapia dupla nesta coorte de crianças infectadas pelo HIV, justificando a sua escolha como regime preferencial de tratamento.

OBJECTIVE: The use of antiretroviral therapy in HIV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HIV-infected children. METHODS: The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Minas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed up until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis. RESULTS: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI = 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). CONCLUSION: Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HIV-infected children. Therefore, triple therapy should be the treatment of choice.