Abstract Introduction: Postoperative nausea and vomiting is still a common complication. Serotonin receptor antagonists are commonly used in clinical practice for antiemetic prophylaxis. Interin-dividual variations in drug response, including single nucleotide polymorphisms, are related to pharmacokinetic and pharmacodynamic changes in these drugs and may lead to a poor therapeutic response. This study aimed to evaluate the influence of CYP2D6 isoenzyme and ABCB1 gene polymorphisms on the frequency of postoperative nausea and vomiting with the use of ondansetron or palonosetron. Methods: A randomized, double-blind clinical trial including 82 women aged 60 years or over undergoing laparoscopic cholecystectomy was conducted. Patients were randomized to receive either ondansetron or palonosetron for postoperative nausea and vomiting prophylaxis. DNA was extracted from saliva. Genetic polymorphisms were analyzed by real-time polymerase chain reaction. The following polymorphisms were analyzed: rs3892097 C/T, rs1128503 A/G, rs16947A/G, rs1065852 A/G, rs1045642 A/G, rs2032582 C/A, and rs20325821 C/A. Results: Overall, vomiting, and severe nausea occurred in 22.5% and 57.5% of patients, respectively. In the palonosetron group, patients with the GG genotype (rs16947 A/G) experienced more severe nausea (p = 0.043). In the ondansetron group, patients with the M genotype (rs16947 A/G) presented mild nausea (p = 0.034), and those with the AA genotype (rs1065852 A/G) experienced more vomiting (p = 0.034). Conclusion: A low antiemetic response was observed with ondansetron in the presence of the AA genotype (rs16947 A/G) and the AA genotype (rs1065852 A/G), and a low therapeutic response was found with palonosetron in the presence of the GG genotype (rs16947 A/G) in laparoscopic cholecystectomy. Register: ClinicalTrials.gov. Introduction complication prophylaxis Interindividual Interin dividual CYPD CYP D CYP2D ABCB Methods doubleblind double blind 8 6 conducted saliva realtime real time reaction rs rs389209 CT C T C/T rs112850 AG G A/G rs16947AG rsAG rs16947A rs16947A/G rs106585 rs104564 rs203258 CA C/A Results Overall 225 22 5 22.5 575 57 57.5 respectively group rs16947 (rs1694 p 0.043. 0043 0.043 . 0 043 0.043) 0.034, 0034 0.034 , 034 0.034) (rs106585 0.034. Conclusion Register ClinicalTrialsgov ClinicalTrials gov ClinicalTrials.gov rs38920 rs11285 rsA rs10658 rs10456 rs20325 2 22. 57. rs1694 (rs169 004 0.04 04 003 0.03 03 (rs10658 rs3892 rs1128 rs1065 rs1045 rs2032 rs169 (rs16 00 0.0 (rs1065 rs389 rs112 rs106 rs104 rs203 rs16 (rs1 0. (rs106 rs38 rs11 rs10 rs20 rs1 (rs (rs10 rs3 rs2

Abstract Objective: To describe the effect of prednisolone on language in children with autism spectrum disorder. This study is based upon two hypotheses: autism etiology may be closely related to neuroinflammation; and, an effective treatment should restore the individual's language skills. Method: This is a prospective, double-blinded, randomized, placebo-controlled clinical trial, carried out in a federal university hospital. The initial patient sample consisted of 40 subjects, which were randomized into two parallel groups. Inclusion criteria were: male gender, 3-7 years of age, and meeting the Diagnostic and Statistical Manual of Mental Disorders - 4th edition (DSM-IV) diagnostic criteria. The final sample consisted of 38 patients, of whom 20 were randomized to the placebo group and 18 to the active group. The latter received prednisolone for 24 weeks, at an initial dose of 1 mg/kg/day and a tapering dose from the ninth week onward. Language was measured on four occasions over a 12-month period by applying two Brazilian tools: the Language Development Assessment (ADL) and the Child Language Test in Phonology, Vocabulary, Fluency, and Pragmatics (ABFW). Results: The side effects were mild: two patients had hypertension, five had hyperglycemia, and two had varicella. Prednisolone increased the global ADL score in children younger than 5 years of age who had developmental regression (p = 0.0057). The ABFW's total of communicative acts also responded favorably in those participants with regression (p = 0.054). The ABFW's total of vocal acts showed the most significant results, especially in children younger than 5 years (p = 0.004, power = 0.913). Conclusions: The benefit of prednisolone for language scores was more evident in participants who were younger than five years, with a history of developmental regression, but the trial's low dose may have limited this benefit. The observed side effects do not contraindicate corticosteroid use in autism.

RESUMO OBJETIVO: Avaliar a relação do índice de massa corporal (IMC) do paciente com o grau de gravidade radiográfica da osteoartrose do joelho. MÉTODO: Foram avaliados, de forma prospectiva, 117 pacientes portadores de gonartrose. Os pacientes tiveram seus índices de massa corporal calculados e a artrose do joelho foi classificada segundo os critérios de Ahlbäck modificados. Usou-se a Anova de Kruskal-Wallis para avaliar a relação entre essas duas variáveis. RESULTADOS: O grupo classificado como grau V de Ahlbäck apresentou um IMC significativamente maior do que os demais. CONCLUSÃO: Existe relação direta entre o IMC e o grau de gravidade radiográfico da gonartrose. A obesidade parece estar diretamente relacionada à progressão da osteoartrose do joelho.

ABSTRACT OBJECTIVE: To evaluate the relationship between patients' body mass index (BMI) and the degree of radiographic severity of knee osteoarthrosis. METHOD: 117 patients with gonarthrosis were evaluated prospectively. The patients' BMI was calculated and their knee arthrosis was classified in accordance with the modified Ahlbäck criteria. Kruskal-Wallis analysis of variance (ANOVA) was used to evaluate the relationship between these two variables. RESULTS: The group classified as Ahlbäck grade V had significantly higher BMI than the others. CONCLUSION: There is a direct relationship between BMI and the degree of radiographic severity of gonarthrosis. Obesity appears to be directly related to the progression of knee osteoarthrosis.

RESUMO OBJETIVO: Definir o perfil antropométrico do joelho em população brasileira portadora de gonartrose, com o uso da mensuração intraoperatória, e avaliar a compatibilidade de três implantes disponíveis para artroplastia total do joelho. MÉTODOS: Foram coletados, de forma prospectiva, os dados morfométricos de 117 pacientes portadores de gonartrose. Documentaram-se seis dimensões no fêmur distal e duas na tíbia proximal em 118 joelhos, durante a artroplastia total. Esses dados foram comparados com as dimensões dos três implantes disponíveis para artroplastia total do joelho. RESULTADOS: A análise estatística revelou que mais de um quarto dos pacientes apresentou relação inadequada entre os joelhos e as próteses. CONCLUSÃO: Os implantes avaliados necessitam de ajustes para melhor atender aos pacientes brasileiros.

ABSTRACT OBJECTIVE: To define the anthropometric profile of the knee in a Brazilian population with gonarthrosis using intraoperative measurements; and to evaluate the compatibility of three implants available for total knee arthroplasty. METHODS: Morphometric data were collected prospectively from 117 subjects with gonarthrosis. Six dimensions in the distal femur and two in the proximal tibia were documented in 118 knees while performing total arthroplasty. These data were compared with the dimensions of three implants available for total knee arthroplasty. RESULTS: The statistical analysis showed that more than a quarter of the patients presented an unsatisfactory relationship between the knee and prosthesis. CONCLUSION: The implants evaluated need to be adjusted to better fit Brazilian patients.

Resumo O termo de consentimento livre e esclarecido (TCLE) é documento onde se explicita o consentimento do participante, contendo todas as informações necessárias para que seja elucidada a pesquisa da qual se propõe participar. O objetivo deste trabalho foi avaliar o nível de compreensão do TCLE assinado por 146 voluntários, utilizando instrumento de coleta de dados autoaplicável. A média de idade foi 47,3 anos, com prevalência de participantes do gênero feminino (67,2%), ensino fundamental incompleto (53,4%) e sem assistência privada de saúde (93,2%). A média de acertos foi 53,1%. Não houve associação entre o percentual de acerto e as variáveis gênero, idade, escolaridade e tempo de resposta. Houve associação significativa entre levar a via do TCLE para casa e o percentual de acerto. O valor médio de acertos evidenciou a necessidade de novas medidas educativas, buscando aumentar a compreensão e a segurança dos participantes.

Abstract The informed consent form (ICF) is a document which explicitly confirms the consent of a participant in a research project, and should contain all necessary information clarifying the study in which the subject intends to participate. This study evaluates the level of comprehension of an ICF signed by 146 volunteers using a self-administered instrument. The average age of the sample was 47.29 years, and there was a prevalence of women (67.2%), incomplete primary education (53.4%) and no private health care (93.2%). The mean score of correct answers of 146 respondents was 53.1%. There was no association between the percentage of correct answers and the variables of gender, age, education and time of response. There was a significant association between taking the ICF home and the percentage of correct answers. The average value of correct answers found was not acceptable and educational measures must be implemented, seeking an increase in comprehension and the safety of participants.

Resumen El consentimiento libre, previo e informado (CLPI) es un documento en el cual se explicita el consentimiento del participante, conteniendo toda la información necesaria para la elucidación sobre la investigación en la cual se propone participar. El objetivo de esta investigación fue evaluar el nivel de comprensión del consentimiento informado firmado por 146 voluntarios utilizando un instrumento auto-aplicable para la recolección de datos. La edad promedio fue de 47,3 años, con prevalencia de participantes de género femenino (67,2%); educación primaria incompleta (53,4%) y sin cobertura privada de salud (93,2%). El promedio de aciertos de los 146 entrevistados fue de 53,1%. No hubo asociación entre el porcentaje de respuestas correctas y las variables de género, edad, educación y tiempo de respuesta. Hubo una asociación significativa entre la posibilidad de llevarse el consentimiento informado a la casa y el porcentaje de respuestas correctas. El valor promedio de aciertos encontrado destacó la necesidad de nuevas medidas educativas, buscando aumentar la comprensión y la seguridad de los participantes.

RESUMO: Objetivo: Descrever a metodologia de um estudo sobre associações entre crescimento intrauterino restrito (CIUR) e prevalência de sobrepeso, obesidade e hipertensão arterial em escolares. Métodos: O estudo, conduzido em dois estágios, foi desenvolvido em 2 escolas municipais de Niterói (RJ) de junho a dezembro de 2010, sendo elegíveis todos os escolares de 6 a 14 anos. O primeiro estágio consistiu em um inquérito nutricional e de potenciais fatores de risco. Foram aplicados questionários aos responsáveis e adolescentes. Concomitantemente, foram selecionados os participantes de um estudo caso-controle, com casos prevalentes definidos como todos os escolares que apresentaram excesso de peso (Z-score de índice de massa corporal -IMC/idade/sexo > +1,00). O grupo controle consistiu em uma amostra aleatória da população de estudo do inquérito, o que permitiu o cálculo de razões de prevalências. Foram realizados bioimpedância elétrica, exames de sangue, ultrassonografia da carótida e entrevistas. As variáveis proxy de CIUR foram definidas a partir de informações sobre peso ao nascer (PN) e idade gestacional (IG). Adicionalmente, foram coletadas informações sobre os dois primeiros anos de vida dos escolares a partir de seus prontuários médicos. Resultado s: Entre os 1.040 escolares elegíveis, participaram do estudo 795 escolares (76,4%). A taxa de retorno do questionário enviado para os responsáveis foi de 85,1%. Para o estudo caso-controle, 62,5% (n = 363) dos selecionados participaram, resultando em uma razão caso:controle de 1:1,8. Foram localizados 55,8% (n = 444) dos prontuários, dos quais em 65,7% (n = 292) foram coletadas informações dos primeiros anos de vida. Conclusão: O presente estudo permitirá a análise de múltiplos desfechos e exposições relacionados ao CIUR e alterações metabólicas.

ABSTRACT: Objective: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. Methods: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case-cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z-score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal-medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. Results: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent's questionnaires were returned. 62.5% of the eligible children participated in the case-control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. Conclusion: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.

RESUMO: Objetivo: Descrever a metodologia de um estudo sobre associações entre crescimento intrauterino restrito (CIUR) e prevalência de sobrepeso, obesidade e hipertensão arterial em escolares. Métodos: O estudo, conduzido em dois estágios, foi desenvolvido em 2 escolas municipais de Niterói (RJ) de junho a dezembro de 2010, sendo elegíveis todos os escolares de 6 a 14 anos. O primeiro estágio consistiu em um inquérito nutricional e de potenciais fatores de risco. Foram aplicados questionários aos responsáveis e adolescentes. Concomitantemente, foram selecionados os participantes de um estudo caso-controle, com casos prevalentes definidos como todos os escolares que apresentaram excesso de peso (Z-score de índice de massa corporal -IMC/idade/sexo > +1,00). O grupo controle consistiu em uma amostra aleatória da população de estudo do inquérito, o que permitiu o cálculo de razões de prevalências. Foram realizados bioimpedância elétrica, exames de sangue, ultrassonografia da carótida e entrevistas. As variáveis proxy de CIUR foram definidas a partir de informações sobre peso ao nascer (PN) e idade gestacional (IG). Adicionalmente, foram coletadas informações sobre os dois primeiros anos de vida dos escolares a partir de seus prontuários médicos. Resultado s: Entre os 1.040 escolares elegíveis, participaram do estudo 795 escolares (76,4%). A taxa de retorno do questionário enviado para os responsáveis foi de 85,1%. Para o estudo caso-controle, 62,5% (n = 363) dos selecionados participaram, resultando em uma razão caso:controle de 1:1,8. Foram localizados 55,8% (n = 444) dos prontuários, dos quais em 65,7% (n = 292) foram coletadas informações dos primeiros anos de vida. Conclusão: O presente estudo permitirá a análise de múltiplos desfechos e exposições relacionados ao CIUR e alterações metabólicas.

ABSTRACT: Objective: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. Methods: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case-cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z-score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal-medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. Results: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent's questionnaires were returned. 62.5% of the eligible children participated in the case-control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. Conclusion: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.

O objetivo deste estudo foi avaliar o efeito de um extrato de Nectandra (N. membranacea), de Ginkgo (EGb) e de Passiflora e. flavicarpa (PEF) na marcação de constituintes sanguíneos (BC, IF-P, IF-BC) com Tc-99m, na morfologia de hemácias (RBC), na biodistribuição do 99mTcO4Na na morfologia do duodeno. Amostras de sangue foram incubadas com os extratos. Tc-99m foi adicionado e as frações do plasma (IF-P) e da célula (IF-BC) foram isoladas. Estudos morfométricos foram realizados. Os resultados mostram que EGb promove alteração na marcação de BC, IF-P e IF-BC. N. membranacea não altera a radiomarcação e PEF altera a marcação de IF-P. O extrato de N. membranacea, EGb e PEF alteraram a morfologia de RBC (p<0.05). Os extratos de N. membranacea e EGb modificam a biodistribuição do 99mTcO4Na, e o EGb influencia a morfometria (p<0.05) do duodeno de ratos.

The aim of this study was to evaluate the effect of the extracts of Nectandra membranacea (N. membranacea), Ginkgo biloba (EGb) and Passiflora (PEF) on the morphology of red blood cells (RBC), on the biodistribution of sodium pertechnetate (99mTcO4Na), on the morphology of duodenum and on the labeling of blood constituents (BC, IF-P, IF-BC) with technetium-99m (Tc-99m). Morphometry studies also were performed. The results show that EGb promotes alteration of the labeling of BC, IF-P and IF-BC (p<0.05). The N. membranacea extract does not promote significant alteration of the radiolabeling, and PEF extract alters the IF-P labeling. N. membranacea, EGb and PEF extracts were able to alter the RBC morphology (P<0.05). N. membranacea extract and EGb modifies the biodistribution of the 99mTcO4Na, and EGb influences the morphometry of duodenum isolated from rats (P<0.05).

O objetivo do presente estudo foi avaliar a influência (in vivo e in vitro) de um extrato de Uncaria tomentosa (unha de gato) na marcação de hemácias e proteínas plasmáticas e celulares com tecnécio-99m (Tc-99m). Para o estudo in vivo, animais foram tratados com um extrato de unha de gato. Para o estudo in vitro, sangue heparinizado foi incubado com o extrato de unha de gato antes da adição de cloreto estanoso (SnCl2) e Tc-99m. Amostras de plasma e células foram separadas e também precipitadas com ácido tricloracético. As frações solúveis e insolúveis foram isoladas. A análise dos resultados do estudo in vivo, indica que não houve alteração significante na captação de Tc-99m pelos constituintes sanguíneos, entretanto, no tratamento in vitro, ocorreu redução significante da marcação de constituintes sanguíneos. Esses efeitos poderiam ser justificados por quelação dos íons estanoso e pertecnetato e bloqueio dos sítios de ligação do Tc-99m.

The influence (in vivo and in vitro) of an Uncaria tomentosa extract (Cats claw) on the labeling of red blood cells (RBCs) and plasma and cellular proteins with technetium-99m (Tc-99m) was evaluated. For the in vivo treatment, animals were treated with Cats claw. For the in vitro treatment, heparinized blood was incubated with Cats claw before the addition of stannous chloride (SnCl2) and Tc-99m. Samples of plasma (P) and RBCs were separated and also precipitated with trichloroacetic acid. The soluble and insoluble fractions of P and RBCs were isolated. The analysis of the results of the in vivo study, indicates that there is no significant alteration on the uptake of Tc-99m by the blood constituents, but it significantly decrease (p<0.05) the labeling of blood constituents by in vitro methods. These effects could be due to chelation of stannous and /or pertechnetate ions and blockage of the Tc-99m bindings sites.

O extrato de Ginkgo Biloba extract (EGb) tem sido usado para tratar dificuldades de concentração, memória, age como antagonista do fator de ativação de plaquetas e previne contra danos causados por radicais livres. EGb é um extrato padronizado com 24% de flavonóides e 6% de lactonas terpênicas. O objetivo deste estudo foi avaliar o efeito de um EGb na ultraestrutura de alguns órgãos isolados de ratos e na biodistribuição do radiofármaco pertecnetato de sódio (99mTcO4Na). Os animais foram tratados com EGb e após 6 dias receberam 99mTcO4Na. Os órgãos foram isolados e a radioatividade determinada. Os tecidos foram fixados para microscopia eletrônica. Os resultados mostraram que EGb alterou a ultraestrutura do rim, figado e duodeno e modificou a biodistribuição do 99mTcO4Na. Sugerimos que substâncias presentes no EGb poderiam agir diretamente ou gerar metabólitos capazes de promover alterações na biodistribuição e na morfologia de órgãos em nível ultraestrutural.

Ginkgo biloba extract (EGb) has been used to treat memory and concentration deficits, acts as platelet activating factor antagonism and prevents against damages caused by free radicals. EGb is a standardized extract that contains 24% flavonoids and 6% terpenoids. The aim of this work was to evaluate the possible influence of an EGb on the ultrastructure of some organs isolated from rats and on the biodistribution of sodium pertechnetate (99mTcO4Na). The animals were treated with EGb and after six days, received 99mTcO4Na. The organs were isolated and fixed for ultrastructural analysis. The results showed that EGb has modified the ultrastructure of kidney, liver and duodenum and altered the biodistribution of 99mTcO4Na (P<0.05). It is speculated that the substances present in the EGb could act directly or generate metabolites capable to promote changes on the biodistribution of 99mTcO4Na and on the morphology of organs at ultrastructural level.

The radiobiocomplexes labeled with technetium-99m (Tc-99m) have been widely used in nuclear medicine in single photon emission computed tomography and in basic research. The aim of this study was to assess the influence of a Nectandra membranácea extract on the bioavailability of the sodium pertechnetate (Na99mTc0(4)) radiobiocomplex in rat organs. The animals were treated with a N. membranácea extract (30 mg/ ml), for 6 days. Na99mTc0(4) was injected, the organs were isolated and weighed, and the radioactivity was determined in each organ (%ATI/organ). The %ATI/organ was divided by the mass of each organ to calculate the %ATI/g. A significant increase of the %ATI/organ of Na99mTc0(4) was observed in muscle and thyroid as well as in the %ATI/g in the heart, kidney and thyroid. These findings could result from the interaction between components of the plant extract and the radiobiocomplex which may influence the uptake Na99mTc0(4) in rat organs. Therefore, precaution is suggested in the interpretation of nuclear medicine results in patients using this herb