Resumo Este trabalho objetivou avaliar o efeito de ondas de calor na dormência de gemas de videiras com necessidades contrastantes de frio hibernal. Estacas lenhosas de videiras ‘Chardonnay’, ‘Merlot’ e ‘Cabernet Sauvignon’ foram coletadas em vinhedos de Veranópolis-RS, e expostas a temperatura constante (7,2°C) ou alternada (7,2 e 18°C, por 12/12 horas), combinadas com zero, um ou dois dias por semana a 25°C. Periodicamente, parte das estacas era transferida para 25°C, para avaliação da brotação das gemas. A endodormência (dormência controlada pelo frio) foi superada com 150 horas de frio (HF) a 7,2ºC em ‘Chardonnay’, 300 HF em ‘Merlot’ e 400 HF em ‘Cabernet Sauvignon’. Ciclos diários de temperaturas, variando de 7,2ºC, a 18°C não afetaram o processo de endodormência. Ondas de calor de 25°C resultaram em aumento de HF para a superação da endodormência. O efeito negativo das ondas de calor dependeu de sua duração, sendo que o calor anulou parcialmente o acúmulo de frio após 36 horas contínuas na dormência. Tais evidências mostram que a evolução da dormência é afetada pelo impacto do calor intercalado ao frio hibernal, devendo ser considerada no ajuste e/ou no desenvolvimento de modelos mais adaptados para a predição do potencial de brotação de videiras no Sul do Brasil.

Abstract The objective of this work was to evaluate the effect of heat waves on the bud dormancy of grapevines with contrasting chilling requirements. ‘Chardonnay’, ‘Merlot’ and ‘Cabernet Sauvignon’ hardwood cuttings were collected in vineyards of Veranópolis, State of Rio Grande do Sul, Brazil, and were exposed to constant (7.2°C) or alternate (7.2 and 18°C for 12/12 hours) temperatures, combined with zero, one or two days a week at 25°C. Periodically, part of cuttings was transferred to 25°C for daily budburst evaluation. Endodormancy (dormancy controlled by cold) was overcome with 150 chilling hours (CH) at 7.2ºC in ‘Chardonnay’, 300 CH in ‘Merlot’ and 400 CH in ‘Cabernet Sauvignon’. Daily temperature cycles ranging from7.2ºC to 18°C did not affect the endodormancy process. Heat waves of 25°C resulted in increase in CH to overcome endodormancy. The negative effect of heat waves depended on their duration, with heat partially canceling out the chilling accumulation after 36 continuous hours on the dormancy. Such evidence shows that the dormancy evolution is affected by the impact of the heat interspersed with cold, and should be considered in the adjustment and/or development of better-adapted models for the prediction of the budburst potential of the grapevine culture in Southern Brazil.

RESUMO: O aumento no uso do 2,4-D é esperado, uma vez que as culturas tolerantes foram aprovadas para uso no Brasil, o que pode afetar negativamente culturas importantes, como o tabaco. Nosso objetivo foi determinar a distância segura entre aplicações de 2,4-D e lavouras de tabaco, considerando a contaminação do herbicida no produto colhido. Um experimento de campo foi realizado, utilizando aplicação de 2,4-D perpendicularmente à direção do vento, com pulverizador tratorizado. A deriva do herbicida foi coletada plantas de tabaco colocadas em vários pontos (-50 até 400 metros da zona de aplicação), seguindo três esquemas: a) 0 a 0,5 horas após a aplicação (HAT); b) 0 a 24 HAT; e c) 0,5 a 24 HAT. As condições ambientais foram registradas. Foi quantificado o herbicida em folhas de tabaco. A deriva foi detectada até 200 m em 2015 e até 150 m em 2016. A volatilização ocorreu em ambos os anos, pois o 2,4-D foi detectado em plantas transportadas para o campo após a aplicação. As condições ambientais em 2015 favoreceram o movimento fora do alvo (maior velocidade do vento e temperatura do ar e menor umidade). Esses resultados indicam que uma zona de exclusão de 100 metros é suficiente para diminuir significativamente as chances de contaminação do tabaco acima do limite tolerado e, destaca a importância das condições ambientais nos processos de transporte do 2,4-D em condições de campo.

ABSTRACT: An increase in 2,4-D use is expected as tolerant crops have been approved to use in Brazil, which may negatively affect important crops such as tobacco. Our objective was to determine safe distances between 2,4-D applications and tobacco fields considering herbicide contamination to the harvested product. A field experiment was conducted, consisting of a 2,4-D application done perpendicularly to the wind direction, using a tractor sprayer. Drifted herbicide was collected using tobacco plants placed at various points (-50 up to 400 meters from application zone), following three schemes: a) 0 to 0.5 hours after application (HAT); b) 0 to 24 HAT; and c) 0.5 to 24 HAT. Environmental conditions were recorded. Herbicide in tobacco leaves was quantified. Drift was detected up to 200 m in both years. Vapor movement of 2,4-D was detected up to 400 m from the application strip in 2016, on plants taken to the field after herbicide application. Environmental conditions in 2015 favored off-target movement (higher wind speed and air temperature and lower humidity); although, in 2016 the herbicide traveled further due to wet deposition. These results indicated that a 100-meter buffer zone is enough to significantly decrease chances of tobacco contamination above the tolerated threshold, and highlighted the importance of environmental conditions in the transport processes for 2,4-D under field conditions.

RESUMO Introdução: Mudanças recentes dos critérios diagnósticos e nos tratamentos para Esclerose Múltipla (EM) promoveram um grande impacto na maneira com que os especialistas manejam a doença. Objetivos: Investigar fatores considerados no manejo de pacientes com EM, por neurologistas brasileiros, bem como identificar como estes contribuem para o diagnóstico e o tratamento da doença. Métodos: Participantes foram selecionados pelo Comitê Organizador (especialistas em EM responsáveis por desenvolver a pesquisa). Apenas especialistas em EM foram incluídos (neurologistas com fellowship em neuroimunologia ou que atendem, atualmente, mais de 30 pacientes com EM). Os links de acesso a um questionário foram distribuídos entre março de 2019 e janeiro de 2020, o qual consistia em cenários hipotéticos referentes à EM. Resultados: Neurologistas de 13 estados brasileiros responderam à pesquisa (n=94). No cenário de Síndrome Clínica Isolada, os participantes concordaram em tratar pacientes com alto risco de diagnóstico de EM no futuro, resultado não encontrado nos casos de Síndrome Radiológica Isolada, no qual metade dos participantes optaram por não tratar, mesmo em casos de alto risco. Nos casos de EM Remitente-Recorrente de baixa atividade, a escolha para tratamento foi interferon beta, acetato de glatirâmer ou teriflunomida, sendo trocado para fingolimode e natalizumabe quando de aumento da gravidade. Discordâncias foram encontradas referentes ao uso de medicações durante a gestação e seus períodos de washout. Conclusões: Este estudo identificou concordâncias e discordâncias entre neurologistas brasileiros sobre EM, as quais podem ser auxiliares nas futuras atualizações de protocolos, visando melhorar o manejo dos pacientes.

ABSTRACT Background: Recent changes to the diagnostic criteria for multiple sclerosis (MS) and new medications have had a major impact on the way in which specialists manage the disease. Objective: To investigate factors considered by Brazilian neurologists in managing MS, and to identify how these contribute to diagnosis and treatment. Methods: Potential participants were selected by a steering committee (MS experts who developed this survey). Only MS specialists were included in the study (neurologists who had completed a neuroimmunology fellowship or who were treating more than 30 MS patients). Links to the online questionnaire were distributed between March 2019 and January 2020. This questionnaire was composed of sections with hypothetical MS scenarios. Results: Neurologists from 13 Brazilian states responded to the survey (n = 94). In the clinically isolated syndrome (CIS) scenario, the respondents agreed to treat patients with a high risk of MS diagnosis, whereas in the radiologically isolated syndrome (RIS) half of the respondents opted not to treat, even among high-risk patients. In cases of low-activity relapsing-remitting MS (RRMS), the choice of treatment was distributed among interferon beta, glatiramer acetate and teriflunomide, which were changed to fingolimod and natalizumab, as RRMS severity increased. The topics in which disagreement was found included practices regarding use of disease-modifying therapy (DMT) for pregnant patients and the washout period required for some DMTs. Conclusions: This study enabled identification of areas of agreement and disagreement about MS treatment among Brazilian neurologists, which can be used to update future protocols and improve patient management.

Abstract We articulate a distinction between ontology, understood as involving existence questions, and metaphysics, understood as either providing for metaphysical profiles of entities or else as dealing with fundamentality and/or grounding and dependence questions. The distinction, we argue, allows a better understanding of the roles of metaontology and metametaphysics when it comes to discussing the relations between ontology and science on the one hand, and metaphysics and science on the other. We argue that while ontology, as understood in this paper, may have reasonable perspectives for naturalization, given its relation to science, the same cannot be said for metaphysics, given that it is typically understood as an additional theoretical layer over science, not participating in the scientific investigation. That may result either in skepticism over metaphysics, or else on accepting that metaphysics is an autonomous branch of investigation, depending on one’s concern for metaphysics.

ABSTRACT The objective of this study was to determine the effect of the longitudinal distance between a cutting disc and a fertilizer furrow opener on the operational performance of the furrow opener working at different forward speeds during soil mobilization. The soil in the experimental area was classified as Typic Hapludalf with a loam soil texture. The experiment involved 24 treatment combinations in a 2 × 3 × 4 factorial scheme. These combinations were formed by the interaction of the following factors: furrow opening mechanisms, longitudinal distance from the center of the cutting mechanism to center of the furrow opener, and forward speeds. The effects of the tools on the soil mobilization variables were characterized in three phases: analysis of the natural profile and elevation and mobilization of the soil using a microprofilometer. A statistical analysis of variance was performed on the acquired data and the significance of the factors was verified using an F test. The furrow opener factor significantly substantially influenced all variables, whereas the distance significantly modified only the soil swelling and elevated soil area, with a reduction of approximately 30% in this variable when separating the mechanisms by an additional meter. Likewise, for a hoe furrow opener, the speed significantly influenced only the maximum depth of the furrow. Hence, we recommend the installation of fertilizer furrow openers close to the cutting mechanisms to increase the quality of the furrows produced in seeding operations using the direct planting system.

RESUMO: Este estudo visou quantificar as necessidades de frio para a indução e superação da endodormência (dormência fisiológica controlada por frio) de gemas de videiras. Estacas de das cultivares Chardonnay, Merlot e Cabernet Sauvignon foram coletadas em vinhedos em Veranópolis-RS, no período hibernal de 2019 e 2020. As estacas foram submetidas a temperatura de 7,2 ºC constante ou a ciclos diários de 7,2/18 °C por 6/18 h, 12/12 h ou 18/6 h, até 600 horas de frio (HF). A cada 50 HF, parte das estacas de cada tratamento foi transferida para a temperatura de 25°C, para avaliação diária da brotação das gemas, em estádio de ponta verde. As cultivares tiveram necessidades distintas de frio para indução e superação da endodormência, atingindo um total de 150 HF para ‘Chardonnay’, 300 HF para ‘Merlot’ e 400 HF para ‘Cabernet Sauvignon’. Destes totais, 50 HF foram necessárias para indução da endodormência nas cultivares Chardonnay e Merlot e 100 HF na cultivar Cabernet Sauvignon. A evolução da dormência não diferiu entre cultivares em resposta aos regimes térmicos, sendo a temperatura de 18 °C inerte ao acúmulo de HF. A precocidade e uniformidade de brotação das gemas foram maiores após suprido o frio na dormência para cada genótipo.

ABSTRACT: This study quantified the chilling requirements for the induction and overcoming of endodormancy (chilling-controlled physiological dormancy) of grapevines buds. Cuttings of the cultivars Chardonnay, Merlot and Cabernet Sauvignon were collected in vineyards in Veranópolis-RS in the winter period of 2019 and 2020. The cuttings were kept at a constant temperature of 7.2 °C or daily cycles of 7.2/18 °C for 6/18 h, 12/12 h or 18/6 h, up to 600 chilling hours (CH). Every 50 CH, part of the cuttings from each treatment was transferred to a temperature of 25 °C for daily assessment of the budburst in the green tip stage. The cultivars had different chilling requirements for inducing and overcoming endodormancy, reaching a total of 150 CH for ‘Chardonnay’, 300 CH for ‘Merlot’ and 400 CH for ‘Cabernet Sauvignon’. Of these, 50 CH were required to induce endodormancy in cultivars Chardonnay and Merlot and 100 CH for cultivar Cabernet Sauvignon. Dormancy evolution did not differ between cultivars in response to thermal regimes, with a temperature of 18 °C inert to the accumulation of CH. Precocity and uniformity of budburst were higher after chilling requirements were met during endodormancy for each genotype.

ABSTRACT Cereus hildmannianus K. Schum is a columnar cactus native to South and Southeast Brazil. The cultivation of this species seems justifiable for several reasons: its fruits are spineless and edible; it is not threatened with extinction; it naturally occurs in Pampa and Atlantic Forest under non-xeric conditions that may be unsuitable for the cultivation of other tropical cacti; and the plants are pollinator-dependent and so should benefit from native pollinators. This study aimed to test seed germination of C. hildmannianus with samples collected at three different localities in southern Brazil, as a necessary step preceding any attempts of management and domestication. Seeds were exposed to temperatures of 20° C, 25° C, 30° C and room temperature. The germinability, average germination time and synchronization index were calculated. All samples showed higher germinability at 20° C and 25° C. Seeds from Caçapava do Sul and Santiago showed significant variation in the synchronization index at 25° C and 30° C, respectively. Seeds from Porto Alegre had maximum germinability, indicating greater vigor. Our results show that the seeds of C. hildmannianus germinate well and thrive within a wide range of temperatures and that cultivation of the species from seed-raised plants should not be problematic.

Resumo Introdução Infecções micobacterianas constituem um grave problema de saúde pública a nível mundial. As manifestações anoperineais são raras, mas constituem um importante diagnóstico diferencial com outras patologias igualmente graves que podem acometer a região, como as neoplasias malignas e a doença de Crohn. Objetivos Realizar um levantamento da literatura sobre infecções micobacterianas da região anoperineal, considerando as informações mais atuais para orientação diagnóstica e terapêutica dessa enfermidade. Métodos Foi realizada pesquisa nos bancos de dados PUBMED e LILACS com as expressões Mycobacterium, Anal, Infection e Tuberculosis. Foram revisados artigos referentes a séries de casos tratados, relatos clínicos e revisão da literatura publicada a partir de 2005. Resultados Foram compiladas informações sobre a epidemiologia das infecções micobacterianas; o comportamento clínico dos indivíduos afetados; opções diagnósticas e sua validade na prática clínica; e, por fim, opções terapêuticas. Conclusões Infecções micobacterianas da região anoperineal são raras. As apresentações clínicas mais comuns são a formação de ulceras e a fistulização. O diagnóstico envolve mais de um procedimento para identificação dos bacilos, e deve considerar a presença de manifestações em mais de um órgão. O tratamento é principalmente medicamentoso, sendo a cirurgia recomendada nas complicações agudas ou sequelas crônicas da doença.

Abstract Background Mycobacterial infections are a serious public health problem worldwide. Involvement of the anal canal and perineum is very rare, but constitute an important differential diagnosis with other equally serious pathologies that may affect the region, such as malignant neoplasms and Crohn’s disease. Objectives To conduct a literature review on mycobacterial infections of the perianal region considering the most recent information for diagnostic and therapeutic guidance of this disease. Methods Research was performed on the PUBMED and LILACS databases with the expressions Mycobacterium, Anal, Infection and Tuberculosis. We reviewed articles referring to series of treated cases, clinical reports and literature review published since 2005. Results Information was compiled on the epidemiology of mycobacterial infections; the clinical behavior of affected individuals; diagnostic options and their validity in clinical practice; and, finally, therapeutic options. Conclusions Mycobacterial infections of the anus and perineum are rare. The most common clinical presentations are the presence of ulceration and fistulization. The diagnosis involves more than one procedure for identifying the bacilli and should consider the presence of manifestations in more than one organ. The treatment is based on pharmacological intervention. Surgery is recommended for acute complications or chronic sequelae of the disease.

ABSTRACT >Injection molds can fail after a certain period of use, which may compromise the final part’s integrity and quality, but that can be solved using welding repair processes. This work aimed to investigate the influence of AISI P20 molds repaired by Gas Tungsten Arc Welding (GTAW) and Nd-YAG laser-welding processes on the properties of injection-molded parts with semi-crystalline (polypropylene) and amorphous (polycarbonate and acrylonitrile butadiene and styrene terpolymer) thermoplastics. Welds were prepared by machining 0.8 mm-deep 40 mm x 5 mm grooves to be filled by GTAW and Nd-YAG laser-welding deposits, in order to simulate the repair of AISI P20 molds. All polymers were injected into weld-repaired and unrepaired molds, and then evaluated in terms of microstructure, crystallinity degree, mechanical properties and gloss. The results suggest that the repaired region for both studied welding processes, despite the difference in hardness of the weld region, does not significantly affect the properties of semi-crystalline and amorphous injected polymers.

A tecnologia proporciona aos professores e terapeutas uma infinidade de recursos para fornecer orientações e suporte instrucional ao desenvolvimento de novas competências e habilidadesa. Essa realidade evidencia um cenário de conceitos de mídia, interação e aprendizado complexo, que atualmente não está amparado por modelos teórico-metodológicos tradicionais da comunicação, computação e pedagogia. Avançando nesta temática, este trabalho propõe um arranjo teórico rumo a criação de um framework de interações para descrição, planejamento e produção de sistemas para o ensino de competências e habilidades aos portadores de TEA. O framework conceitual proposto surge da integração teórica do Design Audiovisual aos estudos da taxonomia de Objetivos Educacionais. Somado ao aporte teórico, uma revisão do estado da arte revela a natureza compartilhada de mídia, entre o a criança autista, familiares, profissionais clínicos e educacionais, além de quatro estágios de interação. Desta forma, a pesquisa contribui para estratégias de ensino que integram níveis de interação a partir de domínios cognitivos, afetivos e psicomotores, que impactam a geração de conteúdos e sistemas adaptativos as necessidades da pessoa com o TEA.

Technology provides teachers and therapists with a wealth of resources to provide guidance and instructional support to the development of new skills and competencies. This reality evidences a scenario of media concepts, traditional theoretical-methodological models of communication, computation and pedagogy do not support interaction and complex learning, which currently. This work proposes a theoretical approach towards the creation of an interaction framework for the description, planning and production of systems for the teaching of skills and abilities to those with ASD. The proposed conceptual framework arises from the theoretical integration of Audiovisual Design to the studies of the Taxonomy of Educational Objectives. In addition to theoretical input, a review of the state of the art reveals the shared nature of media, between the autistic child, family members, clinical and educational professionals, and four stages of interaction. In this way, the research contributes to teaching strategies that integrate levels of interaction from cognitive, affective and psychomotor domains, that impact the generation of contents and adaptive systems the needs of the person with ASD.

ABSTRACT: In this work, we compared nitrate-supplied plants (non-nodulated) with non-nitrate-supplied plants (nodulated) under oxygen privation of root system (hypoxia) and re-oxygenation (post-hypoxia; recovery) in order to verify whether N sources affect the antioxidant system during oxidative stress caused by hypoxia and post-hypoxia conditions. Antioxidant enzymatic activities, ascorbate redox state, and reactive oxygen species (ROS) levels were analyzed in roots and leaves of two soybean genotypes, Fundacep 53 RR and BRS Macota at reproductive stage R2, during hypoxia and post-hypoxia in an experiment carried out in a hydroponic system. The antioxidant system was strongly induced in roots of nitrate-supplied plants of both genotypes, with high activity of superoxide dismutase, ascorbate peroxidase, catalase, glutathione reductase and guayacol peroxidase. It also increased reduced ascorbate and ascorbate redox state and decreased ROS production under hypoxia and recovery, while in leaves of nodulated and non-nodulated plants, a slight increase on antioxidant system was observed. Nitrate may benefit soybean plants under hypoxic conditions and subsequent re-oxygenation by inducing the antioxidant system mainly in roots to cope with ROS production and reduce oxidative damage.

RESUMO Objetivo: determinar a expressão de neurotrofinas e seus receptores tirosina quinases em pacientes com osteossarcoma (OS) e sua correlação com desfechos clínicos. Métodos: biópsias de tumores primários de pacientes com OS tratados em uma única instituição, consecutivamente, entre 2002 e 2015, foram analisados através de imuno-histoquímica para expressão de receptores de tirosina quinase A e B (TrKA e TrKB), fator de crescimento neural (NGF) e fator neurotrófico derivado do cérebro (BDNF). De forma independente, dois patologistas classificaram os marcadores de imuno-histoquímica como negativos (negativos e focais fracos) ou positivos (moderado focal/difuso ou forte focal/difuso). Resultados: foram analisados dados de 19 pacientes (10 do sexo feminino e 9 do masculino) com mediana de idade de 12 anos (5 a 17,3 anos). Dos tumores, 83,3% estavam localizados em membros inferiores e 63,2% dos pacientes eram metastáticos ao diagnóstico. A sobrevida global em cinco anos foi de 55,3%. BDNF foi positivo em 16 pacientes (84%) e NGF em 14 pacientes (73%). TrKA e TrKB apresentaram coloração positiva em quatro (21,1%) e oito (42,1%) pacientes, respectivamente. A análise de sobrevida não demonstrou diferença significativa entre receptores TrK e neurotrofinas. Conclusão: amostras de OS primário expressam neurotrofinas e receptores TrK através de imuno-histoquímica. Estudos futuros podem auxiliar na identificação do papel das mesmas na patogênese do OS e determinar se há possível correlação prognóstica.

ABSTRACT Objective: to determine the expression of neurotrophins and their tyrosine-kinase receptors in patients with osteosarcoma (OS) and their correlation with clinical outcomes. Methods: we applied immunohistochemistry to biopsy specimens of patients consecutively treated for primary OS at a single institution between 2002 and 2015, analyzing them for expression receptors of tyrosine kinase A and B (TrKA and TrKB), neural growth factor (NGF) and brain derived neurotrophic factor (BDNF). Independently, two pathologists classified the immunohistochemical markers as negative (negative or weak focal) or positive (moderate focal/diffuse or strong focal/diffuse). Results: we analyzed data from 19 patients (10 females and 9 males), with median age of 12 years (5 to 17.3). Tumors’ location were 83.3% in the lower limbs, and 63.2% of patients had metastases at diagnosis. Five-year overall survival was 55.3%. BDNF was positive in 16 patients (84%) and NGF in 14 (73%). TrKA and TrKB presented positive staining in four (21,1%) and eight (42,1%) patients, respectively. Survival analysis showed no significant difference between TrK receptors and neurotrophins. Conclusion: primary OS samples express neurotrophins and TrK receptors by immunohistochemistry. Future studies should explore their role in OS pathogenesis and determine their prognostic significance in larger cohorts.

ABSTRACT Aim To analyze the influence of the -31 C/T polymorphism of the interleukin-1β gene on Helicobacter pylori eradication therapy success in patients with functional dyspepsia. Methods Functional dyspepsia was diagnosed according to the Rome III criteria. All patients underwent upper gastrointestinal endoscopy, and gastric biopsies were obtained at screening and 12 months after randomization (last follow-up visit). Urease test and histological examination were performed to define the H. pylori status. Patients received twice-daily amoxicillin, clarithromycin and omeprazole for 10 days. Genotyping of the interleukin-1beta -31 C/T polymorphism (rs1143627) was performed using polymerase chain reaction-restriction fragment length polymorphism. Results One hundred forty-nine patients received treatment with triple therapy for H. pylori eradication. Only one patient was lost to follow-up, and adherence to study medication was 94.6%. A total of 148 patients (mean age 46.08 ± 12.24 years; 81.8% women) were evaluated for the influence of the interleukin-1beta -31 C/T polymorphism on the outcome of H. pylori eradication therapy. After treatment, bacteria were eradicated in 87% of patients (129/148). Genotype frequencies of the polymorphism were as follows: CC, 38/148 (25.7%); CT, 71/148 (47.9%); and TT, 39/148 (26.4%). Successful eradication rate was 78.9%, 94.4% and 82.1% for the CC, CT and TT genotypes, respectively. The CT genotype was significantly associated with successful H. pylori eradication (p= 0.039). Conclusion This study suggests that the CT genotype of the interleukin-1beta -31 C/T polymorphism plays a role in the successful eradication of H. pylori among patients with functional dyspepsia.

Resumo A histiocitose de células de Langerhans é uma doença rara caracterizada pela proliferação de células de Langerhans no corpo. A doença afeta principalmente os homens, predominantemente na infância. Placas ulceradas são uma das formas cutâneas de apresentação. A confirmação diagnóstica é feita através de análise imuno-histoquímica. Como opções terapêuticas, corticosteroides tópicos e quimioterapia são boas escolhas. O caso aqui relatado é de um paciente do sexo masculino, com idade de 14 anos, com ulceração perianal. Ele consultou um coloproctologista, que realizou uma biópsia da região e iniciou o tratamento com aplicações locais de triancinolona. A análise imunohistoquímica diagnosticou histiocitose de células de Langerhans. Outros exames revelaram diabetes insipidus, lesões osteolíticas no crânio e nos membros inferiores, aumento do fígado e alterações encefálicas. A quimioterapia foi iniciada com vimblastina, com melhora significativa das lesões.

Abstract Langerhans’ cell histiocytosis is a rare disease characterized by proliferation of Langerhans cells in the body. It affects mainly males, predominantly in childhood. Ulcerated plaques are one of the cutaneous forms of presentation. Diagnostic confirmation is done through immunohistochemistry. As therapeutic options, topical corticosteroids and chemotherapy are good choices. The case is reported of a male patient, aged 14, with perianal ulceration. He consulted a coloproctologist, who performed a biopsy of the region and started local triamcinolone applications. Immunohistochemistry diagnosed Langerhans’ cells histiocytosis. Further investigation revealed diabetes insipidus, osteolytic lesions in the skull and lower limbs, enlarged liver, and encephalic alterations. Chemotherapy was started with Vinblastine, with significant improvement of the lesions.

Resumo Objetivo: Avaliar a segurança, a tolerabilidade e os possíveis efeitos terapêuticos do peptídeo liberador de gastrina em três crianças com transtorno do espectro autista. Métodos: Estudo de casuística com administração intravenosa de peptídeo liberador de gastrina na dose de 160 pmol/kg por quatro dias consecutivos. Para avaliar os resultados, foram usadas a impressão dos pais, a Escala de Classificação de Autismo na Infância (CARS) e a Escala de Impressão Clínica Global (CGI). Cada criança foi submetida a novo ciclo de peptídeo após duas semanas. As crianças foram acompanhadas por quatro semanas após o término das infusões. Resultados: O peptídeo liberador de gastrina foi bem tolerado e nenhuma criança apresentou efeitos adversos. Duas crianças apresentaram melhoria na interação social, com melhoria na atenção compartilhada e nas iniciativas de interação. Duas mostraram redução dos estereótipos e melhoria na linguagem verbal. Uma criança perdeu sua compulsão por banhos, efeito que durou duas semanas após cada ciclo de infusão. A redução média no escore da CARS foi de 2,8 pontos. Quanto à CGI, os resultados foram "minimamente melhor em duas crianças" e "muito melhor" em uma. Conclusões: Este estudo sugere que o peptídeo liberador de gastrina é seguro e pode ser efetivo na melhoria dos principais sintomas do transtorno do espectro autista, porém seus resultados devem ser interpretados com cautela. Ensaios clínicos controlados, randomizados, duplo-cegos e com maior número de crianças são necessários para melhor avaliar os possíveis efeitos terapêuticos do peptídeo liberador de gastrina sobre o autismo.

Abstract Objective: To evaluate the safety, tolerability and potential therapeutic effects of gastrin-releasing peptide in three children with autistic spectrum disorder. Methods: Case series study with the intravenous administration of gastrin-releasing peptide in the dose of 160 pmol/kg for four consecutive days. To evaluate the results, parental impressions the Childhood Autism Rating Scale (CARS) and the Clinical Global Impression (CGI) Scale. Each child underwent a new peptide cycle after two weeks. The children were followed for four weeks after the end of the infusions. Results: The gastrin-releasing peptide was well tolerated and no child had adverse effects. Two children had improved social interaction, with a slight improvement in joint attention and the interaction initiatives. Two showed reduction of stereotypes and improvement in verbal language. One child lost his compulsion to bathe, an effect that lasted two weeks after each infusion cycle. Average reduction in CARS score was 2.8 points. CGI was "minimally better" in two children and "much better" in one. Conclusions: This study suggests that the gastrin-releasing peptide is safe and may be effective in improving key symptoms of autism spectrum disorder, but its results should be interpreted with caution. Controlled clinical trials-randomized, double-blinded, and with more children-are needed to better evaluate the possible therapeutic effects of gastrin-releasing peptide in autism.