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au:Ribeiro, Gustavo Cardoso

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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

Gestational and congenital syphilis: gaps to be elucidated
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Carvalho, Déborah Esteves

; Pimentel, João Victor Andrade

; Silva, Luise Oliveira Ribeiro da

; Rodrigues, Letícia Maria Cardoso Lima

; Andrade, Leonardo Santana

; Santana, Carlos Ramon Costa

; Menezes, Marcelo Antônio Silva

; Silva, Eloyse Emanuelle Nunes

; Santos, Gabryelle Eduarda Gama dos

; Santos, Sayron Natanael Lopes Pereira

; Gomes, Breno Gustavo do Nascimento

; Meira, Letícia Almeida

; Santos, Helga Machado de Farias

; Lopes, Izailza Matos Dantas

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0038-2023

Abstract: En | Text: En | PDF: En

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.

https://doi.org/10.1590/0037-8682-0038-2023

Energy values and metabolizability of lipid sources of plant and animal origin in the diet of Japanese quail
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Valentim, Jean Kaique

; Garcia, Rodrigo Garófallo

; Burbarelli, Maria Fernanda de Castro

; Caldara, Fabiana Ribeiro

; Komiyama, Claudia Marie

; Serpa, Felipe Cardoso

; Zanella, Joyce

; Heiss, Vivian Aparecida Rios de Castilho

; Polycarpo, Gustavo do Valle

; Albino, Luiz Fernando Teixeira

Revista Brasileira de Zootecnia

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2023, Volume 52 elocation e20220105

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to determine the energy values and metabolizability of different lipid sources in the diet of Japanese quail at the laying phase. The quail were distributed in a completely randomized design with ten replications of seven poultry per treatment, totaling six treatments: basal feed (control) and basal feed containing 10% soybean oil, corn oil, canola oil, sunflower oil, and poultry fat. The values of nitrogen-corrected apparent metabolizable energy (AMEn) and the metabolizability coefficient (MC%) were evaluated. No significant difference was found between the different lipid sources for AMEn (kcal/kg) and MC (%). The value of metabolizable energy corrected for nitrogen for soybean oil was 8,790 kcal/kg; 8,773 kcal/kg for corn oil; 8,784 kcal/kg for canola oil; 8,788 kcal/kg for sunflower oil; and 8,681 kcal/kg for poultry fat in laying Japanese quail. The digestibility coefficients were 93.88% for soybean oil, 93.53% for corn oil, 93.32% for canola oil, 93.74% for sunflower oil, and 93.06% for poultry fat.

https://doi.org/10.37496/rbz5220220105

Triatomine fauna in the state of Bahia, Brazil: What changed after 40 years of the vector-control program?
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Ribeiro-Jr, Gilmar

; Araújo, Renato Freitas de

; Carvalho, Cristiane Medeiros Moraes de

; Cunha, Gabriel Muricy

; Lanza, Fernanda Cardoso

; Miranda, Diego Lopes Paim

; Sousa, Orlando Marcos Farias de

; Santos, Carlos Gustavo Silva dos

; Fonseca, Eduardo Oyama Lins

; Santos, Roberto Fonseca dos

; Reis, Renato Barbosa

; Gurgel-Gonçalves, Rodrigo

; Reis, Mitermayer Galvão

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0732-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Neglected tropical diseases are a growing threat to global health, and endemic Chagas disease has emerged as one of the most important health problems in America. The main strategy to prevent Trypanosoma cruzi transmission is chemical control of vectors. This study presents a descriptive analysis of synanthropic triatomines before and after the implementation of a vector-control program in Bahia, Brazil. Methods: Descriptive analysis and geospatial statistics were performed on triatomine data, (1) the relative abundance and (2) proportional spatial distribution, from Bahia during two periods: (A) 1957 to 1971 and (B) 2006 to 2019. Results: We observed a decrease in the relative abundance of Panstrongylus megistus (A: n=22.032, 61.9%; B: n=1.842, 1.0%) and Triatoma infestans (A: n=1.310, 3.7%; B: n=763, 0.43%), as well as an increase in the relative abundance of T. sordida (A: n=8.314, 23.4%, B: n=146.901, 81.6%) and T. pseudomaculata (A: n=894, 2.5%, B: n=16.717, 9.3%). Conclusions: Our results indicate a clear reduction in the occurrence of P. megistus and T. infestans (last record in 2015) and an increase in the relative abundance and geographical distribution of T. sordida and T. pseudomaculata after 40 years of the vector-control program. The high frequency of other triatomine species in the municipalities of the state of Bahia and their abundance in recent years highlight the need to reinforce permanent entomological surveillance actions to prevent Chagas disease.

https://doi.org/10.1590/0037-8682-0732-2021

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; DIAS, André Roncon

; FORONES, Nora Manoukian

; CARVALHO, Marineide Prudêncio de

; CASTRO, Osvaldo Antonio Prado

; KASSAB, Paulo

; COSTA-JÚNIOR, Wilson Luiz da

; WESTON, Antônio Carlos

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira

; ZeideCharruf, Amir

; Brandalise, André

; Silva, André Maciel da

; Alves, Barlon

; Marins, Carlos Augusto Martinez

; Malheiros, Carlos Alberto

; Leite, Celso Vieira

; Bresciani, Claudio José Caldas

; Szor, Daniel

; Mucerino, Donato Roberto

; Wohnrath, Durval R.

; JirjossIlias, Elias

; Martins Filho, Euclides Dias

; PinatelLopasso, Fabio

; Coimbra, Felipe José Fernandez

; Felippe, Fernando E. Cruz

; Tomasisch, Flávio Daniel Saavedra

; Takeda, Flavio Roberto

; Ishak, Geraldo

; Laporte, Gustavo Andreazza

; Silva, Herbeth José Toledo

; Cecconello, Ivan

; Rodrigues, Joaquim José Gama

; Grande, José Carlos Del

; Lourenço, Laércio Gomes

; Motta, Leonardo Milhomem da

; Ferraz, Leonardo Rocha

; Moreira, Luis Fernando

; Lopes, Luis Roberto

; Toneto, Marcelo Garcia

; Mester, Marcelo

; Rodrigues, Marco Antônio Gonçalves

; Franciss, Maurice Youssef

; AdamiAndreollo, Nelson

; Corletta, Oly Campos

; Yagi, Osmar Kenji

; Malafaia, Osvaldo

; Assumpção, Paulo Pimentel

; Savassi-Rocha, Paulo Roberto

; Colleoni Neto, Ramiro

; Oliveira, Rodrigo Jose de

; AissarSallun, Rubens Antonio

; Weschenfelder, Rui

; Oliveira, Saint Clair Vieira de

; Abreu, Thiago Boechat de

; Castria, Tiago Biachi de

; Ribeiro Junior, Ulysses

; Barra, Williams

; Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 1 elocation e1563

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.

ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

https://doi.org/10.1590/0102-672020210001e1563 768 downloads

Isolation, fractionation and anticoagulant activity of a sulfated galactan extracted from the green algae Penicillus capitatus
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Moreira, Thamyris Almeida

; Costa, Bianca Barros da

; Celestino, Regina Célia Alves

; Faria, Caroline Nogueira

; Gianelli, Jéssica Lopes D’Dego

; Santos, Gustavo Ramalho Cardoso dos

; Glauser, Bianca Fernandes

; Soares, Angélica Ribeiro

; Mourão, Paulo Antônio de Souza

; Rodrigues, Carlos Rangel

; Cinelli, Leonardo Paes

Ciência Rural

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2021, Volume 51 N. 8 elocation e20200138

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: As algas marinhas são fontes naturais de macromoléculas conhecidas como polissacarídeos sulfatados. Esta classe de compostos atraiu o interesse das Ciências Farmacêuticas devido às suas propriedades farmacológicas como anticoagulante, antiplaquetária e antitrombótica. Portanto, este estudo tem como objetivo avaliar o potencial anticoagulante de polissacarídeos sulfatados extraídos de algas de Penicillus capitatus. Os polissacarídeos sulfatados extraídos foram purificados, parcialmente caracterizados e sua atividade anticoagulante foi avaliada. O processo de extração seguido pela precipitação com etanol resultou em cinco frações. Entre as frações analisadas, F44 foi a maior concentração de polissacarídeos sulfatados. Após a purificação, as frações F23 e F44 mostraram atividade anticoagulante in vitro em um teste de tempo de tromboplastina parcialmente ativada e tempo de protrombina. Seu mecanismo preferencial é baseado nas interações entre trombina e fator Xa. Estudos adicionais sobre a estrutura farmacológica são necessários para testar a viabilidade do uso como agente terapêutico.

ABSTRACT: Marine algae are natural sources of macromolecules known as sulfated polysaccharides. This class of compounds has attracted the interest of Pharmaceutical Sciences due to its pharmacological anticoagulant, antiplatelet and antithrombotic properties. Therefore, this study evaluated the anticoagulant potential of sulfated polysaccharides extracted from the algae Penicillus capitatus. The extracted sulfated polysaccharides were purified, partially characterized and their anticoagulant activity was evaluated. The extraction process followed by ethanol precipitation resulted in five fractions. Among the analyzed fractions, F44 contained highest concentration of sulfated polysaccharides. After the purified fraction F23, F44 displayed in vitro anticoagulant activity in a time testing for activated partial thromboplastin time and prothrombin time. The preferential mechanism effect was based on interactions between thrombin and factor Xa. Additional studies on structure pharmacological are required to test the viability of the use of sulfated polysaccharides as therapeutic agents.

https://doi.org/10.1590/0103-8478cr20200138 173 downloads

Cryptorchidism in free-living jaguar (Panthera onca): first case report
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Jorge-Neto, Pedro Nacib

; Silva, Maitê Cardoso Coelho da

; Csermak-Júnior, Antonio Carlos

; Salmão-Júnior, Jorge Aparecido

; Araújo, Gediendson Ribeiro de

; Oliveira, Gustavo de

; Leuzinger, Lucas

; Pizzutto, Cristiane Schilbach

; Deco-Souza, Thyara de

Animal Reproduction

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2020, Volume 17 N. 4 elocation e20200555

Abstract: En | Text: En | PDF: En

Abstract Cryptorchidism is a genital alteration wherein one or both testicles fail to descend into the scrotum and has multifactorial causes. A free-range adult male was captured twice in the Pantanal of Nhecolândia to put a GPS collar and semen collection. Pharmacological semen collection, andrological examination and semen analysis were performed. At the first capture and during the andrological examination only the left testis was found, and the male qualified as cryptorchid. The penis had no penile spines at either procedure. The semen volume obtained at first and second capture was 435 and 160 μL, respectively, with a concentration of 618 and 100 x 106 sperm/mL, progressive motility of ~ 5% and ~ 1% and total morphological sperm abnormalities of 74% and 86%. The male was monitored by a GPS collar, but the signal was lost, making it difficult to re-captures and perform new seminal and ultrasound evaluations to discard monorchidism – exceedingly rare in felids. Genetic studies to assess the individual's homozygosity are necessary to verify whether cryptorchidism in this individual has a genetic factor.

https://doi.org/10.1590/1984-3143-ar2020-0555 671 downloads

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; YAGI, Osmar Kenji

; MUCERINO, Donato Roberto

; BRESCIANI, Claudio José Caldas

; RIBEIRO JÚNIOR, Ulysses

; ANDREOLLO, Nelson Adami

; ASSUMPÇÃO, Paulo Pimentel

; WESTON, Antônio Carlos

; COLLEONI NETO, Ramiro

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira

; Charruf, Amir Zeide

; Dias, André Roncon

; Brandalise, André

; Silva, André Maciel da

; Alves, Barlon

; Malheiros, Carlos Alberto

; Marins, Carlos Augusto Martinez

; Leite, Celso Vieira

; Szor, Daniel

; Wohnrath, Durval R.

; Ilias, Elias Jirjoss

; Martins Filho, Euclides Dias

; Lopasso, Fabio Pinatel

; Coimbra, Felipe José Fernandez

; Felippe, Fernando E. Cruz

; Tomasisch, Flávio Daniel Saavedra

; Takeda, Flavio Roberto

; Ishak, Geraldo

; Laporte, Gustavo Andreazza

; Silva, Herbeth José Toledo

; Cecconello, Ivan

; Rodrigues, Joaquim José Gama

; Grande, José Carlos Del

; Lourenço, Laércio Gomes

; Motta, Leonardo Milhomem da

; Ferraz, Leonardo Rocha

; Moreira, Luis Fernando

; Lopes, Luis Roberto

; Toneto, Marcelo Garcia

; Mester, Marcelo

; Rodrigues, Marco Antônio Gonçalves

; Carvalho, Marineide Prudêncio de

; Franciss, Maurice Youssef

; Forones, Nora Manoukian

; Corletta, Oly Campos

; Castro, Osvaldo Antonio Prado

; Malafaia, Osvaldo

; Kassab, Paulo

; Savassi-Rocha, Paulo Roberto

; Oliveira, Rodrigo Jose de

; Sallun, Rubens Antonio Aissar

; Weschenfelder, Rui

; Oliveira, Saint Clair Vieira de

; Abreu, Thiago Boechat de

; Castria, Tiago Biachi de

; Barra, Williams

; Costa Júnior, Wilson Luiz da

; Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2020, Volume 33 N. 3 elocation e1535

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico (ABCG) foi recentemente publicado. Nesta ocasião, inúmeros especialistas que atuam no tratamento desta doença expressaram sua opinião diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 1) quanto ao diagnóstico, estadiamento, tratamento endoscópico e seguimento dos pacientes com câncer gástrico. Métodos: Para formulação destas Diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO com os seguintes descritores: câncer gástrico, estadiamento, tratamento endoscópico e seguimento. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 24 declarações, duas (8,3%) foram classificadas com nível de evidência A, 11 (45,8%) B e 11 (45,8%) C. Quanto ao grau de recomendação, seis (25%) declarações obtiveram grau de recomendação 1, nove (37,5%) grau 2a, seis (25%) 2b e três (12,5%) 3. Conclusão: As diretrizes aqui presentes têm a finalidade de auxiliar os profissionais que atuam no combate ao câncer gástrico com informações relevantes e atuais, permitindo que sejam aplicadas na prática médica diária.

ABSTRACT Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.

https://doi.org/10.1590/0102-672020200003e1535 2100 downloads

II BRAZILIAN CONSENSUS ON GASTRIC CANCER BY THE BRAZILIAN GASTRIC CANCER ASSOCIATION
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; DIAS, André Roncon

; ANDREOLLO, Nelson Adami

; WESTON, Antônio Carlos

; LOURENÇO, Laércio Gomes

; MALHEIROS, Carlos Alberto

; KASSAB, Paulo

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira

; Charruf, Amir Zeide

; Brandalise, André

; Silva, André Maciel da

; Alves, Barlon

; Marins, Carlos Augusto Martinez

; Leite, Celso Vieira

; Bresciani, Claudio José Caldas

; Szor, Daniel

; Mucerino, Donato Roberto

; Wohnrath, Durval R.

; Ilias, Elias Jirjoss

; Martins Filho, Euclides Dias

; Lopasso, Fabio Pinatel

; Coimbra, Felipe José Fernandez

; Felippe, Fernando E. Cruz

; Tomasisch, Flávio Daniel Saavedra

; Takeda, Flavio Roberto

; Ishak, Geraldo

; Laporte, Gustavo Andreazza

; Silva, Herbeth José Toledo

; Cecconello, Ivan

; Rodrigues, Joaquim José Gama

; Grande, José Carlos Del

; Motta, Leonardo Milhomem da

; Ferraz, Leonardo Rocha

; Moreira, Luis Fernando

; Lopes, Luis Roberto

; Toneto, Marcelo Garcia

; Mester, Marcelo

; Rodrigues, Marco Antônio Gonçalves

; Carvalho, Marineide Prudêncio de

; Franciss, Maurice Youssef

; Forones, Nora Manoukian

; Corletta, Oly Campos

; Yagi, Osmar Kenji

; Castro, Osvaldo Antonio Prado

; Malafaia, Osvaldo

; Assumpção, Paulo Pimentel

; Savassi-Rocha, Paulo Roberto

; Colleoni Neto, Ramiro

; Oliveira, Rodrigo Jose de

; Sallun, Rubens Antonio Aissar

; Weschenfelder, Rui

; Oliveira, Saint Clair Vieira de

; Abreu, Thiago Boechat de

; Castria, Tiago Biachi de

; Ribeiro Junior, Ulysses

; Barra, Williams

; Costa Júnior, Wilson Luiz da

; Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2020, Volume 33 N. 2 elocation e1514

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Racional: Desde a publicação do primeiro Consenso Brasileiro sobre Câncer Gástrico em 2012 realizado pela Associação Brasileira de Câncer Gástrico (ABCG), novos conceitos sobre o diagnóstico, estadiamento, tratamento e seguimento foram incorporados. Objetivo: Promover uma atualização aos profissionais que atuam no combate ao câncer gástrico (CG) e fornecer diretrizes quanto ao manejo dos pacientes portadores desta afecção. Métodos: Cinquenta e nove especialistas responderam 67 declarações sobre o diagnóstico, estadiamento, tratamento e prognóstico do CG com cinco alternativas possíveis: 1) concordo plenamente; 2) concordo parcialmente; 3) indeciso; 4) discordo e 5) discordo fortemente. Foi considerado consenso a concordância de pelo menos 80% da soma das respostas “concordo plenamente” e “concordo parcialmente”. Este artigo apresenta apenas as respostas dos especialistas participantes. Os comentários sobre cada declaração, assim como uma revisão da literatura serão apresentados em publicações futuras. Resultados: Das 67 declarações, houve consenso em 50 (74%). Em 10 declarações, houve concordância de 100%. Conclusão: O tratamento do câncer gástrico evoluiu consideravelmente nos últimos anos. Este consenso reúne princípios consolidados nas últimas décadas, novos conhecimentos adquiridos recentemente, assim como perspectivas promissoras sobre o manejo desta doença.

ABSTRACT Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fifty-nine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.

https://doi.org/10.1590/0102-672020190001e1514 3675 downloads

10.

Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol
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Ferreira, Juliana C.

; Ho, Yeh-Li

; Besen, Bruno A.M.P.

; Malbuisson, Luiz M.S.

; Taniguchi, Leandro U.

; Mendes, Pedro V.

; Costa, Eduardo L.V.

; Park, Marcelo

; Daltro-Oliveira, Renato

; Roepke, Roberta M.L.

; Silva Jr, João M.

; Carmona, Maria José C.

; Carvalho, Carlos Roberto Ribeiro

; Hirota, Adriana

; Kanasiro, Alberto Kendy

; Crescenzi, Alessandra

; Fernandes, Amanda Coelho

; Miethke-Morais, Anna

; Bellintani, Arthur Petrillo

; Canasiro, Artur Ribeiro

; Carneiro, Bárbara Vieira

; Zanbon, Beatriz Keiko

; Batista, Bernardo Pinheiro De Senna Nogueira

; Nicolao, Bianca Ruiz

; Besen, Bruno Adler Maccagnan Pinheiro

; Biselli, Bruno

; Macedo, Bruno Rocha De

; Toledo, Caio Machado Gomes De

; Pompilio, Carlos Eduardo

; Carvalho, Carlos Roberto Ribeiro De

; Mol, Caroline Gomes

; Stipanich, Cassio

; Bueno, Caue Gasparotto

; Garzillo, Cibele

; Tanaka, Clarice

; Forte, Daniel Neves

; Joelsons, Daniel

; Robira, Daniele

; Costa, Eduardo Leite Vieira

; Silva Júnior, Elson Mendes Da

; Regalio, Fabiane Aliotti

; Segura, Gabriela Cardoso

; Marcelino, Gustavo Brasil

; Louro, Giulia Sefrin

; Ho, Yeh-Li

; Ferreira, Isabela Argollo

; Gois, Jeison de Oliveira

; Silva Junior, Joao Manoel Da

; Reusing Junior, Jose Otto

; Ribeiro, Julia Fray

; Ferreira, Juliana Carvalho

; Galleti, Karine Vusberg

; Silva, Katia Regina

; Isensee, Larissa Padrao

; Oliveira, Larissa dos Santos

; Taniguchi, Leandro Utino

; Letaif, Leila Suemi

; Lima, Lígia Trombetta

; Park, Lucas Yongsoo

; Chaves Netto, Lucas

; Nobrega, Luciana Cassimiro

; Haddad, Luciana

; Hajjar, Ludhmila

; Malbouisson, Luiz Marcelo

; Pandolfi, Manuela Cristina Adsuara

; Park, Marcelo

; Carmona, Maria José Carvalho

; Andrade, Maria Castilho Prandini H De

; Santos, Mariana Moreira

; Bateloche, Matheus Pereira

; Suiama, Mayra Akimi

; Oliveira, Mayron Faria de

; Sousa, Mayson Laercio

; Louvaes, Michelle

; Huemer, Natassja

; Mendes, Pedro

; Lins, Paulo Ricardo Gessolo

; Santos, Pedro Gaspar Dos

; Moreira, Pedro Ferreira Paiva

; Guazzelli, Renata Mello

; Reis, Renato Batista Dos

; Oliveira, Renato Daltro De

; Roepke, Roberta Muriel Longo

; Pedro, Rodolpho Augusto De Moura

; Kondo, Rodrigo

; Rached, Samia Zahi

; Fonseca, Sergio Roberto Silveira Da

; Borges, Thais Sousa

; Ferreira, Thalissa

; Cobello Junior, Vilson

; Sales, Vivian Vieira Tenório

; Ferreira, Willaby Serafim Cassa

Clinics

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2020, Volume 75 elocation e2294

Abstract: En | Text: En | PDF: En

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital’s electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

https://doi.org/10.6061/clinics/2020/e2294 1957 downloads

11.

Completely endophytic renal tumor: A laparoscopic approach
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Santos, Victor Espinheira

; Meduna, Rafael Ribeiro

; Bachega Jr., Wilson

; Guimarães, Gustavo Cardoso

International braz j urol

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oct 2018, Volume 44 N. 5 Pages 1050 - 1050

Abstract: En | Text: En | PDF: En

ABSTRACT Kidney cancer is the third most common urologic malignancy and a 2% annual increase in the incidence has occurred over the past two decades, largely because of the increased utilization of imaging. The majority of these tumors are small, so the indications for nephron-sparing surgery and for minimally invasive surgery are continually expanding. Complex kidney lesions, such as those completely endophytic, are still a challenge even for experienced surgeons. Our objective is to demonstrate the operative technique for laparoscopic partial nephrectomy with the aid of intra-operative ultrasound in a man with a totally endophytic renal lesion. Case: A 52 years old man, asymptomatic, with incidental renal mass of 2.9 cm, completely endophytic (R.E.N.A.L score 9p) submitted to partial laparoscopic nephrectomy. Surgical time was 2 hours, with 20 minutes of ischemia. Pathological anatomy confirmed tumor of clear cells T1a, free margins.

https://doi.org/10.1590/s1677-5538.ibju.2017.0534 485 downloads

12.

Acompanhamento operacional e avaliação de uma estação compacta de tratamento de esgoto sanitário: reator UASB seguido de filtro aerado submerso
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Ribeiro, Jaqueline Cardoso

; Silva, Gustavo Henrique Ribeiro da

Engenharia Sanitaria e Ambiental

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feb 2018, Volume 23 N. 1 Pages 27 - 31

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Estações Compactas de Tratamento de Efluentes (ECTEs) são uma ótima alternativa para a implantação de sistemas descentralizados de esgoto doméstico que possam atender pequenas comunidades. No entanto, tais sistemas ainda são pouco utilizados e há pouca experiência em relação à sua operação. Diante de tal demanda, esta pesquisa visou avaliar a eficiência e realizar o acompanhamento operacional de uma ECTE composta por reator Upflow Anaerobic Sludge Blanket (UASB), seguido de filtro aerado submerso (FAS), que está localizada no município de Uru, em São Paulo, Brasil. Durante a pesquisa, o sistema mostrou-se uma alternativa viável de tratamento para pequenas comunidades, pois apresentou boa eficiência, com valores médios de remoção de demanda bioquímica de oxigênio (DBO5) e demanda química de oxigênio (DQO) de 91 e 85%, respectivamente. O monitoramento realizado durante a pesquisa também contribuiu para melhorias gerais no sistema.

ABSTRACT Compact Wastewater Treatment Plants (CWTPs) are a great alternative to implementing decentralized sewage systems that can serve small communities. However, such systems are still poorly used and there is little experience regarding their operation. Based on such demand, this research aimed to evaluate the efficiency and to conduct an operational monitoring of a CWTP composed by an Upflow Anaerobic Sludge Blanket (UASB) reactor, followed by Submerged Aerated Filter (SAF), in the city of Uru, São Paulo, Brazil. During the research, the system proved to be a viable alternative for small communities, because it showed good efficiency, with average removal values of biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) of 91 and 85%, respectively. The monitoring carried out during the research also contributed to general improvements in the system.

https://doi.org/10.1590/s1413-41522018164458 1901 downloads

13.

COMPORTAMENTO INGESTIVO DE VACAS F1 HOLANDÊS X ZEBU ALIMENTADAS COM DIFERENTES FONTES DE COMPOSTOS NITROGENADOS
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Almeida Filho, Silvio Humberto Cardoso de

; Rocha Júnior, Vicente Ribeiro

; Menezes, Gustavo Chamon de Castro

; Ruas, José Reinaldo Mendes

; Aguiar, Ana Cássia Rodrigues de

; Santana, Pedro Felipe

; Borges, Lucas Daniel Alcântara

; Costa, Natanael Mendes

Ciência Animal Brasileira

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sep 2016, Volume 17 N. 3 Pages 349 - 358

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: Avaliou-se o comportamento ingestivo de vacas F1 Holandês x Zebu com 80 ± 12 dias de lactação e produção média de 20 ± 0,42 kg de leite/dia, alimentadas com diferentes fontes de compostos nitrogenados: farelos de soja, de girassol, de mamona desintoxicados e ureia. Utilizaram-se dois quadrados latinos 4 x 4, compostos de quatro animais e quatro dietas, com quatro períodos experimentais. O comportamento ingestivo foi obtido por avaliação visual para definir o tempo despendido em alimentação, ruminação, ócio e para avaliar mastigações merícicas e tempo de mastigação por bolo ruminal. Não houve diferença no tempo em alimentação (P = 0,1384), ruminação (P = 0,5964), ócio (P = 0,6314), número de períodos de alimentação (P = 0,5995), de ruminação (P = 0,4575) e de ócio (P = 0,4151), duração dos períodos de alimentação (P = 0,2711), ruminação (P = 0,8699) e ócio (P = 0,4025), em função da dieta utilizada. Não houve diferença na produção de leite (P = 0.2755) das vacas entre as dietas experimentais. A adição do farelo de girassol à dieta, em relação à utilização de ureia, resulta em menor consumo de FDN em minutos/kg (P = 0,0399) e consequentemente menor eficiência de alimentação da matéria seca (P = 0,0069), comparado ao tratamento com ureia. Assim, algumas características do comportamento ingestivo de vacas F1 Holandês x Zebu em lactação podem ser alteradas pelo uso de diferentes fontes nitrogenadas; entretanto, sem prejudicar a produção média de 20 kg de leite corrigida para 3,5% de gordura/dia.

Abstract: We evaluated the feeding behavior of F1 Holstein x Zebu lactating cows at 80 ± 12 days of lactation and average production of 20 ± 0.42 kg of milk / day, fed different sources of nitrogen compounds: soybean meal, sunflower meal, detoxified castor meal, and urea. We used two 4 x 4 Latin squares, consisting of four animals, four diets, and four experimental periods. The feeding behavior was obtained by visual evaluation to set the time spent eating, ruminating, idling and to assess ruminating chews and chewing time for ruminal boluses. There was no difference regarding the times spent in feeding (P = 0.1384), rumination (0.5964), idleness (P = 0.6314), number of periods in feeding (P = 0.5995), rumination (P = 0.4575), and idleness (P = 0.4251), duration of periods in feeding (P = 0.2711), rumination (P = 0.8699) and idling (P = 0.4025), depending on the used diet. There was no difference in milk production (P = 0.2755) of the cows among the experimental diets. The addition of sunflower meal to the diet, regarding the use of urea, results in lower consumption of NDF in minutes / kg (P = 0.0399) and, thus, a lesser feed efficiency of dry matter (P = 0.0069). Therefore, some feeding behavior characteristics of F1 Holstein x Zebu lactating cows can be changed by using different nitrogen sources; however, without harming the average production of 20 kg of milk corrected to 3.5% fat / day.

https://doi.org/10.1590/1089-6891v17i336054 1180 downloads

14.

Eficiência simbiótica de progenitores de cultivares brasileiras de feijão-caupi
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Alcantara, Rosa Maria Cardoso Mota de

; Xavier, Gustavo Ribeiro

; Rumjanek, Norma Gouvêa

; Rocha, Maurisrael de Moura

; Carvalho, Jackeline dos Santos

Revista Ciência Agronômica

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mar 2014, Volume 45 N. 1 Pages 1 - 9

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Devido à variabilidade das leguminosas quanto à eficiência da fixação biológica de nitrogênio (FBN), tem sido enfatizada a importância do melhoramento genético vegetal no favorecimento da fixação do nitrogênio. Este estudo teve como objetivo avaliar a eficiência simbiótica de progenitores de cultivares brasileiras de feijão-caupi e dar suporte científico à inclusão da FBN ao programa de melhoramento genético da cultura do feijão-caupi no Brasil. O experimento foi conduzido em Teresina, Piauí. Utilizou-se delineamento experimental em blocos casualizados em esquema fatorial 6 x 5, com três repetições, sendo seis fontes de N: quatro estirpes de bactérias diazotróficas (BR 3267, BR 3299, BR 3262 e INPA 03-11B), um tratamento com nitrogênio mineral e outro sem inoculação e sem N; e cinco genótipos de feijão-caupi: quatro progenitores (TVu 1190, Pitiúba, CNC 0434 e Alagoano) e uma cultivar (BRS Guariba). Na análise de variância utilizou-se software SAS e as médias foram comparadas pelo teste Tukey. O progenitor Alagoano destacou-se dos demais em eficiência de nodulação, foi superior ao Pitiúba em massa seca de nódulos e diferiu do TVu 1190 em nitrogênio acumulado na parte aérea. Para nitrogênio derivado da fixação biológica verificou-se uma variação média de 49,42 a 65,50%. Nos componentes de produção, o Alagoano se destacou em massa de vagem, comprimento de vagem e massa de 100 sementes. Concluiu-se que os progenitores avaliados são responsivos a FBN e que há indícios de especificidade entre os progenitores e as estirpes de rizóbio. O progenitor Alagoano apresenta resultados mais promissores nos componentes de nodulação e produção.

Among the progenitors, the Alagoano shows most promising results in components of nodulation and production.Due to the variability of leguminous plants as regards their efficiency in the biological fixation of nitrogen (BFN), the importance of plant breeding to improve nitrogen fixation has been emphasized. The objective of this study was to evaluate the symbiotic efficiency of parents of Brazilian cultivars of the cowpea, and give scientific support to the inclusion of BFN in the breeding program for the cowpea crop in Brazil. The experiment was conducted in Teresina, Piauí. An experimental design of randomized blocks in a 5 x 6 factorial arrangement was used, with three replications, consisting of six sources of N: four strains of diazotrophic bacteria (BR 3267, BR 3299, BR 3262 and INPA 03-11B); one treatment with mineral nitrogen and another with no inoculation and no N, and five cowpea genotypes: four parents (TVu 1190, Pitiúba, CNC 0434 and Alagoano) and one cultivar (BRS Guariba). For the variance analysis SAS software was used, and the averages compared by Tukey test. The parent, Alagoano, stood out from the others in nodulation efficiency, was higher than Pitiúba for nodule dry mass, and differed from TVu 1190 in nitrogen accumulation in the shoots. For nitrogen derived from biological fixation there was a mean variation of from 49.42 to 65.50%. As for production components, the Alagoano excelled in pod weight, pod length and 100 seed weight. It was concluded that the evaluated parents are responsive to BFN, and that there is evidence for specificity between the parents and the strains of rhizobia. Of the parents, the Alagoano presents the most promising results for the components of nodulation and production.

3384 downloads Cited 2 times in SciELO

15.

Análise do gene PTEN por hibridização in situ fluorescente no carcinoma de células renais
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Campos, Eurico Cleto Ribeiro de

; Fonseca, Francisco Paulo da

; Zequ, Stênio de Cássio

; Guimarães, Gustavo Cardoso

; Soares, Fernando Augusto

; Lopes, Ademar

Revista do Colégio Brasileiro de Cirurgiões

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dec 2013, Volume 40 N. 6 Pages 471 - 475

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: avaliar a frequência de deleção do gene PTEN no carcinoma de células renais e o impacto da deleção nas taxas de sobrevida global e livre de doença. MÉTODOS: foram analisados 110 pacientes portadores de carcinoma de células renais submetidos à nefrectomia radical ou parcial entre os anos de 1980 e 2007. Em 53 casos foi possível a análise do gene PTEN pelo método de hibridização in situ fluorescente através da técnica de "tissue microarray". Para a análise estatística, os pacientes foram classificados em dois grupos, de acordo com a presença ou ausência de deleção. RESULTADOS: o tempo médio de seguimento foi de 41,9 meses. Deleção hemizigótica foi identificada em 18 pacientes (33,9%), ao passo que deleção homozigótica esteve presente em três (5,6%). Em aproximadamente 40% dos casos analisados havia deleção. Monossomia e trissomia foram detectadas, respectivamente, em nove (17%) e dois pacientes (3,8%). Em 21 pacientes (39,6%), a análise por hibridização in situ do gene PTEN foi normal. Não houve diferenças estatisticamente significativas nas taxas de sobrevida global (p=0,468) e livre de doença (p=0,344) entre os pacientes portadores ou não de deleção. Foram fatores independentes para a sobrevida global: estádio clínico TNM, sintomatologia ao diagnóstico, alto grau de Fuhrmann performance status (Ecog) e recorrência tumoral. A livre de doença foi influenciada unicamente pelo estádio clínico TNM. CONCLUSÃO: deleção do gene PTEN no CCR foi detectada com frequência de aproximadamente 40% e sua presença não foi determinante de menores taxas de sobrevida, permanecendo os fatores prognósticos tradicionais como determinantes da evolução dos pacientes.

OBJECTIVE: To evaluate the frequency of deletion of the PTEN gene in renal cell carcinoma (RCC) and its impact on the rates of overall and disease-free survival. METHODS: We analyzed 110 patients with renal cell carcinoma who underwent radical or partial nephrectomy between 1980 and 2007. In 53 cases it was possible to analyse the PTEN gene by the method of fluorescent in situ hybridization using the technique of tissue microarray. For statistical analysis, patients were classified in two groups according to the presence or absence of the deletion. RESULTS: The mean follow-up time was 41.9 months. Hemizygous deletion was detected in 18 patients (33.9%), while the homozygous one was present in three (5.6%). Deletion was present in approximately 40% of the analyzed cases. Monosomy and trisomy were detected in nine (17%) and two patients (3.8%), respectively. In 21 patients (39.6%) the analysis of the PTEN gene by in situ hybridization was normal. There were no statistically significant differences in overall (p = 0.468) and disease-free (p = 0.344) survival rates between patients with or without deletion. Factors which were independent for overall survival: TNM clinical stage, symptoms at diagnosis, high Fuhrmann grade, performance status (ECoG) and tumor recurrence. Disease-free survival was influenced only by the clinical TNM stage. CONCLUSION: Deletion of the PTEN gene in RCC was detected with a frequency of approximately 40% and its presence was not determinant of lower survival rates, the traditional prognostic factors remaining as determinants of outcome.

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