Abstract Objectives Evidence suggests that ketamine’s influence on brain-derived neurotrophic factor (BDNF) might be involved in its mechanism of rapid antidepressant action. We aimed to evaluate the differential impact of ketamine and esketamine on serum BDNF levels and its association with response patterns in treatment-resistant depression (TRD). Methods Participants (n = 53) are from a randomized, double-blind clinical trial comparing the efficacy of single-dose ketamine (0.5mg/kg, n = 27) and esketamine (0.25mg/kg, n = 26) in TRD. Depression severity was assessed before and 24 hours, 72 hours, and 7 days after the intervention, using the Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected before infusion, 24 hours, and 7 days afterwards. Results There were no significant changes in BDNF levels at post-infusion evaluation points, and no difference in BDNF levels comparing ketamine and esketamine. Both drugs exhibited similar therapeutic effect. There was no association between BDNF levels and response to treatment or severity of depressive symptoms. Conclusion There was no significant treatment impact on BDNF serum levels – neither with ketamine nor esketamine – despite therapeutic response. These results suggest that ketamine or esketamine intervention for TRD has no impact on BDNF levels measured at 24 hours and 7 days after the infusion. This clinical trial is registered on the Japan Primary Registries Network: UMIN000032355.

Abstract Objective To analyze the quality of life of family caregivers of patients under hemodialysis and the existence of an association with their sociodemographic and clinics characteristics. Methods This is a cross-sectional study conducted with 75 family caregivers in two hemodialysis centers. Caregivers’ quality of life was measured using the World Health Organization Quality of Life – BREF instrument, and its association with sociodemographic characteristics was assessed using the Kruskal-Wallis test (significance level equal to 5%). Results Most family caregivers were women (84%), spouses (41.3%), children (38.7%), housewives (38.7%) and had a family income of one to three minimum wages (85.4 %). The variable working outside the home had a positive influence on overall quality of life (p=0.014), psychological domains (p=0.009) and social relationships (p≤0.001). Being male (p=0.016), not having diseases (p=0.002) and not using medications (p=0.007) positively interfered with the physical domain. The absence of financial help from other people and/or family members had a negative influence on the social relationships (p=0.050) and environment (p=0.001) domains. Conclusion Male family caregivers, or those who work outside the home or receive financial help from other people and/or family members had better quality of life levels. On the other hand, clinical conditions such as using a drug or having diseases have negatively influenced quality of life levels.

Resumen Objetivo Analizar la calidad de vida de los cuidadores familiares de pacientes en hemodiálisis y la existencia de asociación con las características demográficas y clínicas. Métodos Estudio transversal, realizado con 75 cuidadores familiares en dos centros de diálisis. La calidad de vida de los cuidadores fue medida a través del instrumento World Health Organization Quality of Life – BREF, y su relación con las características sociodemográficas fue evaluada mediante la prueba de Kruskal-Wallis (nivel de significación igual a 5 %). Resultados La mayoría de los cuidadores familiares era mujer (84 %), cónyuge (41,3 %), hijo (38,7 %), del hogar (38,7 %) y poseía ingresos familiares de uno a tres salarios mínimos (85,4 %). La variable trabajar fuera de casa tuvo influencia positiva en la calidad de vida general (p=0,014), en los dominios psicológicos (p=0,009) y en las relaciones sociales (p≤0,001). Ser de sexo masculino (p=0,016), no tener enfermedades (p=0,002) y no usar medicamentos (p=0,007) interfirieron positivamente en el dominio físico. La ausencia de ayuda financiera de otras personas o familiares influyó de manera negativa en los dominios de las relaciones sociales (p=0,050) y del medio ambiente (p=0,001). Conclusión Los cuidadores familiares de sexo masculino, o que trabajan fuera de casa o reciben ayuda financiera de otras personas o familiares presentaron mejores niveles de calidad de vida. En contraste, las condiciones clínicas, tales como hacer uso de algún medicamento o padecer enfermedades, influyeron de forma negativa en los niveles de calidad de vida.

Resumo Objetivo Analisar a qualidade de vida do cuidador familiar do paciente em hemodiálise e a existência de associação com suas características clínicas e sociodemográficas. Métodos Estudo transversal, realizado com 75 cuidadores familiares em dois centros de diálise. A qualidade de vida do cuidador foi medida por meio do instrumento World Health Organization Quality of Life – BREF, e sua associação com as características sociodemográficas foi avaliada pelo teste de Kruskal-Wallis (nível de significância igual a 5%). Resultados A maioria dos cuidadores familiares era mulher (84%), cônjuge (41,3%), filho (38,7%), do lar (38,7%) e possuía renda familiar de um a três salários mínimos (85,4%). A variável trabalhar fora de casa teve influência positiva na qualidade de vida geral (p=0,014), nos domínios psicológicos (p=0,009) e nas relações sociais (p≤0,001). Ser do sexo masculino (p=0,016), não ter doenças (p=0,002) e não usar medicamentos (p=0,007) interferiram positivamente no domínio físico. A ausência de ajuda financeira de outras pessoas e/ou familiares influenciou de forma negativa nos domínios das relações sociais (p=0,050) e meio ambiente (p=0,001). Conclusão O cuidador familiar do sexo masculino, ou que trabalha fora de casa ou recebe ajuda financeira de outras pessoas e/ou familiares apresentaram melhores níveis de qualidade de vida. Em contrapartida, as condições clínicas tais como fazer uso de algum medicamento ou ter doenças influenciaram de forma negativa nos níveis de qualidade de vida.

Abstract INTRODUCTION: Neck circumference (NC) and anthropometric data of people living with HIV (PLWH) are correlated. METHODS: Socioeconomic, NC, body mass index (BMI), tricipital skinfold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), waist circumference (WC), and hip circumference (HC) data of 72 PLWH were correlated. RESULTS Higher adiposity was observed in NC (40.3% [n=29]) and WC (31.9% [n=23]). Correlations between NC/BMI, NC/WC, NC/HC, NC/MAC, NC/MAMC, and NC/WHtR were significant. Increased NC (40.3%[n=29]) and WC (31.9 [n=23]) were associated with higher cardiometabolic risk. CONCLUSIONS: NC correlations are adequate for estimating cardiometabolic risk.

RESUMO Objetivo: Analisar o coeficiente, os fatores associados e as causas de mortalidade em idosos comunitários. Método: Estudo longitudinal e analítico. A coleta de dados, na linha de base, foi realizada no domicílio do idoso. A primeira onda ocorreu após 42 meses. Realizou-se coleta complementar para identificação da causa da morte. Variáveis analisadas: demográficas, sociais, econômicas e clínicas. Para análise dos dados, foi utilizada regressão logística. Resultados: O coeficiente de mortalidade foi 7,9%. As variáveis associadas à mortalidade foram: longevidade, não saber ler, ausência de prática religiosa, acidente vascular encefálico, realização de consulta e internação nos últimos 12 meses. Os principais grupos de causas básicas de morte foram causas mal definidas e as não especificadas de mortalidade; doenças do aparelho respiratório; e neoplasias. Conclusão: O coeficiente de mortalidade em idosos comunitários mostrou-se menor em comparação aos estudos nacionais e internacionais investigados.

ABSTRACT Objective: Analyze the coefficient, associated factors, and causes of mortality in community-dwelling elderly. Method: Longitudinal and analytical study. Data collection, at baseline, was performed in the elderly’s home. The first wave occurred after 42 months. Complementary data collection identified the cause of death. Variables analyzed: demographic, social, economic, and clinical. Logistic regression was used for data analysis. Results: The coefficient of mortality was 7.9%. The variables associated with mortality were longevity, inability to read, absence of religious practice, stroke, consultation, and hospitalization in the last 12 months. The main groups of primary causes of death were ill-defined and unspecified causes of mortality, respiratory system diseases, and neoplasms. Conclusion: The coefficient of mortality in community-dwelling elderly was lower than national and international studies investigated.

RESUMEN Objetivo: Analizar el coeficiente, los factores relacionados y las causas de mortalidad en ancianos comunitarios. Método: Estudio longitudinal y analítico. La recogida de datos, en la línea de base, ha sido realizada en el domicilio del anciano. La primera onda ocurrió tras 42 meses. Realizó recogida complementar para identificación de la causa de la muerte. Variables analizadas: demográficas, sociales, económicas y clínicas. Para análisis de los datos, se utilizó regresión logística. Resultados: El coeficiente de mortalidad fue 7,9%. Las variables relacionadas a la mortalidad fueron: longevidad, no saber leer, ausencia de práctica religiosa, accidente vascular encefálico, realización de consulta e internación en los últimos 12 meses. Los principales equipos de causas básicas de muerte fueron causas mal definidas y las no especificadas de mortalidad; enfermedades del aparato respiratorio; y neoplasias. Conclusión: El coeficiente de mortalidad en ancianos comunitarios se mostró menor en comparación a los estudios nacionales e internacionales investigados.

Resumo Aprendizagem socioemocional nem sempre é contemplada, com devido planejamento e embasamento científico, na educação infantil. Avaliou-se impacto de intervenção de Regulação Emocional (RE) no desempenho escolar e Habilidades Sociais (HS) de 55 crianças de escolas públicas, utilizando-se Matrizes Progressivas Coloridas de Raven (CPM), Teste de Desempenho Escolar e Sistema de Avaliação de Habilidades Sociais (SSRS-BR).Após nove encontros de 50 minutos abordando estratégias de RE, avaliação de HS pelo professor indicou melhora em todos os aspectos de HS noGrupo Intervenção (GI) e piora no autocontrole no GrupoComparação (GC). Autoavaliação de HS mostrou que GI superou diferença inicial na assertividadee evitação de problemas. Os resultados sugerem que programas de RE podem trazer benefícios para o desenvolvimento das HS.

Abstract In early childhood education, socio-emotional learning is not always considered with appropriate planning nor based on scientific evidence. Aiming to analyze impact of an Emotional Regulation (ER) Intervention in school achievement and social skills (SS), fifty-five children from public schools were evaluated by Raven's Coloured Progressive Matrices (CPM), School Achievement Test (TDE) and Social Skills Rating System (SSRS-BR). After nine 50-minute meetings addressing ER strategies, evaluation of SS by the teacher indicated improvement in all aspects of SS in Intervention Group (IG) and worsening of the self-control in Comparison Group (CG). Self-evaluation of SS showed that IG overcame the initial difference in assertiveness and problem avoidance. Results suggest that ER programs can bring benefits to the development of SS.

Resumo O presente artigo visa discutir a formação do psicólogo, tendo como eixo de reflexão a prática com grupos no âmbito do estágio profissionalizante em Psicologia. A Psicologia Social do Trabalho é referência nos saberes e fazeres das atividades descritas ao longo do artigo, e auxilia na compreensão crítica sobre como se dão as relações sociais no mundo, estruturadas a partir do trabalho. Assume-se o trabalho como elemento fundamental para a compreensão do ser humano e da sociedade e direciona-se o foco de análise e compreensão das vivências humanas para como estas são emolduradas pela atividade laboral. Nesse sentido, reconhece-se que a forma de inserção dos trabalhadores e trabalhadoras no modo de produção será determinante das demais experiências e modos de existência acessíveis para esses e essas. A prática de grupos aqui retratada toma os participantes enquanto sujeitos ativos, e parte da noção de grupo como dispositivo, cujo desafio é criar junto aos membros novas configurações para suas experiências, descortinando outras possibilidades para pensar sua relação com o trabalho e consigo próprio, promovendo reorganizações subjetivas e objetivas. Desse modo, o grupo opera como promotor de novas formas de (se) ver e estar no mundo também para as estagiárias, gerando questionamentos sobre as práticas psi e sobre o papel e o compromisso social do psicólogo.

Abstract This article aims to discuss the training of psychologists through the reflection on the practice with groups within the scope of the professional training in Psychology. Social Psychology of Work is a reference in the knowledge and practices of the activities described through the article, helping in the critical understanding of how social relations come about in the scope of work. This perspective perceives work as a fundamental element to understand human beings and societies, with focus on human experiences and how they are framed by work-related activities. In this sense, we recognize that the workers’ place in the production system will be determinant of their other experiences and modes of existence accessible to them. The group practice depicted here considers the participants as active subjects. It also makes use of the notion of group as a device. The challenge is to jointly create new experience configurations with the members of the groups, revealing other possibilities to think about their relationship with their work and with themselves, and promoting subjective and objective reorganizations. Thus, the group also acts as a promoter of new ways of seeing and being in the world for the trainees, raising questions about the practice, the role, and the social commitment of psychologists.

Resumen El presente artículo trata de discutir la formación del psicólogo, teniendo como eje de reflexión la práctica con grupos en el ámbito de la etapa profesional en Psicología. La Psicología Social del Trabajo es referencia en los saberes y hacer de las actividades descritas a lo largo del artículo, y auxilia en la comprensión crítica sobre cómo se dan las relaciones sociales en el mundo, estructuradas a partir del trabajo. Se asume el trabajo como elemento fundamental para la comprensión del ser humano y de la sociedad y se dirige el foco de análisis y comprensión de las vivencias humanas para mostrar cómo éstas son enmarcadas por la actividad laboral. En ese sentido, se reconoce que la forma de inserción de los trabajadores y trabajadoras en el modo de producción será determinante de las demás experiencias y modos de existencia accesibles para ésas y ésos. La práctica de grupos aquí retratados toma a los participantes como sujetos activos, y parte de la noción de grupo como dispositivo, cuyo desafío es crear junto a los miembros nuevas configuraciones para sus experiencias, descortinando otras posibilidades para pensar su relación con el trabajo y consigo mismo, promoviendo reorganizaciones subjetivas y objetivas. De este modo, el grupo opera como promotor de nuevas formas de (ver) y estar en el mundo también para las pasantes, generando cuestionamientos sobre las prácticas psi y sobre el papel y el compromiso social del psicólogo.

Abstract Background: Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. Methods: The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. Results: Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. Conclusion: As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.

ABSTRACT Objective The goal of this study was evaluate the conicity index (C index) in women and its association with hypertension (SAH) and diabetes mellitus (DM). Subjects and methods This was a cross-sectional study, with 573 women between 20 and 59 years of age. After analysis of clinical and demographic characteristics, anthropometric variables were measured and used to calculate the C index. Plasma glucose and lipid profile were evaluated by standard methods. The analysis of the results was based on logistic regression and the odds ratio (OR) was calculated, which was used to assess the association of the variable outcome with the variable exposure using two logistic regression models that tested the possible influence of the C index in the chance of developing SAH or DM. A confidence interval of 95% was used. Results In the crude and adjusted models, the OR confirmed the association of the C index with DM and SAH. Compared with women that showed C index p < 75, the risk of women with C index (p ≥ 75) developing DM and SAH was 1.72 and 1.75, respectively. Results demonstrated that the negative impact of age on these associations significantly raised the odds of women having DM and SAH. The high C index was also linked to low HDL-C. Conclusion The C index is an important tool in estimating the risk of diabetes and hypertension in women. Besides, high C indexes are negatively associated with HDL-C, an important lipid marker related to cardiovascular risk.

O objetivo deste trabalho foi determinar o potencial de cinco espécies de vespas Scelionidae - Telenomus podisi, Trissolcus basalis, Trissolcus urichi, Trissolcus teretis e Trissolcus brochymenae -, como inimigos naturais do percevejo neotropical Dichelops melacanthus, e determinar se a presença de ovos de outras espécies de percevejo tem influência sobre o parasitismo e o desenvolvimento dos parasitoides. Foram realizados dois tipos de experimentos em laboratório: sem escolha de hospedeiros (ovos de D. melacanthus) e com escolha (ovos de D. melacanthus e de Euschistus heros). Foram registrados parâmetros biológicos que incluíram: proporção de parasitismo, sobrevivência de imaturos, razão sexual da progênie, tempo de desenvolvimento dos estágios imaturos e preferência de hospedeiro. Todas as espécies de parasitóides avaliadas podem parasitar e desenvolver-se em ovos de D. melacanthus. A escolha inicial de ovos não influenciou a proporção de ovos de D. melacanthus parasitados por Tr. basalis, Tr. teretis ou Tr. brochymenae. Entretanto, para Te. podisi e Tr. urichi, a escolha inicial por ovos de D. melacanthus aumentou em 9 e 14 vezes, respectivamente, a chance de parasitismo nesta espécie. Aspectos comportamentais e ecológicos dos inimigos naturais devem ser considerados antes de sua utilização em programas de controle biológico.

The objective of this work was to determine the potential of five species of Scelionidae wasps - Telenomus podisi, Trissolcus basalis, Trissolcus urichi, Trissolcus teretis and Trissolcus brochymenae - as natural enemies of the neotropical stink bug Dichelops melacanthus, and to determine if the presence of eggs of other stink bug species influences the parasitism and development of the parasitoids. Two kinds of experiments were done in laboratory: without choice of hosts (eggs of D. melacanthus) and with choice (eggs of D. melacanthus and of Euschistus heros). Biological parameters, including proportion of parasitism, immature survivorship, progeny sex ratio, immature stage development period, and host preference were recorded. All the evaluated parasitoids can parasitize and develop on D. melacanthus eggs. The first choice of eggs did not influence the proportion of D. melacanthus eggs parasitized by Tr. basalis, Tr. teretis or Tr. brochymenae. However, D. melacanthus eggs as the first choice of Te. podisi and Tr. urichi increased, respectively, 9 and 14 times the chance for parasitism on eggs of this species. Behavioral and ecological aspects of parasitoids should be considered prior to their use in biological control programs.

O enfisema lobar congênito (ELC) é uma malformação pouco frequente do desenvolvimento pulmonar, que pode ser a causa de insuficiência respiratória em lactentes. Esta doença caracteriza -se pela hiperinsuflação de um ou mais lobos pulmonares com compressão de parênquima normal e deslocamento contralateral do mediastino, causando insuficiência respiratória. O diagnóstico clínico é confirmado por exames radiológicos simples. O tratamento de escolha nos casos graves é a lobectomia, que apresenta resultados superiores ao tratamento clínico. Nosso propósito é relatar um caso desta rara patologia em lactente atendida em nosso serviço com quadro de insuficiência respiratória grave, sendo submetida a exames complementares tendo diagnóstico presuntivo de ELC. A doente foi submetida à lobectomia superior esquerda, com excelente evolução pós-operatória.

Congenital Lobar Emphysema (CLE) is a rare malformation of lung development, which may be the cause of respiratory insufficiency in the suckling child. It is produced by the hyperinsufflation of one or more lung lobs with compression of the normal lung parenchyma and contralateral displacement of the mediastinum. Clinical diagnosis is confirmed by simple radiology exams. Lobectomy has better results than clinical treatment and should be chosen. Our purpose is to present one case of this rare illness in a newborn seen in our service with serious respiratory insufficiency and after complementary exams, CLE was confirmed. The patient was submitted to a surgical procedure (lobectomy) with an excellent post surgery evolution. Child is asymptomatic in long term follow up.

Pneumomediastino é definido como a presença de ar livre no mediastino, sendo que o espontâneo ocorre na ausência de enfermidades ou factores precipitantes. É raro em adultos, sendo mais frequente em recém-nascidos. Contudo, ocorre mais em adultos jovens, sendo 8:1 a relação entre homens e mulheres. Constitui achado raro na asma, representando 1% dos casos. Os sintomas mais frequentes são dor torácica e dispneia. O diagnóstico é feito com exames de imagem, como radiografia e tomografia computadorizada de tórax. O tratamento de escolha é conservador, não operatório, com prognóstico favorável na maioria dos casos. O nosso propósito é relatar um caso desta patologia em jovem atendido em nosso serviço com quadro de dor torácica e dispneia, sendo submetido a exames complementares e feito o diagnóstico de pneumomediastino espontâneo. O doente foi submetido a tratamento conservador com excelente evolução clínica. No momento encontra-se assintomático, em acompanhamento ambulatorial.

Pneumomediastinum is defined as the presence of free air in the mediastinum, and the spontaneous occurs in the absence of diseases or precipitating factors. It is rare in adults, and it is more frequent in newborns. However, it occurs more in young adults, with an 8:1 relationship between men and women. It constitutes a rare finding in asthma, representing 1% of the cases. More frequent symptoms are chest pain and dyspnea. Diagnosis is made with image examinations, such as radiography and chest computed tomography. Treatment of choice is conservative, nonoperative, with a favourable prognosis in the majority of the cases. Our aim is to report a case of this pathology in a young adult seen in our service with chest pain and dyspnea. He underwent complementary examinations and the diagnosis was spontaneous pneumo-mediastinum. This patient was submitted to a conservative treatment with excellent clinical evolution. At the moment, he is asymptomatic and under routine clinical care.

BACKGROUND: The aim of this study was to determine the occurrence rate, demographics, clinical characteristics, and outcomes of patients with severe sepsis admitted to the emergency department. METHODS: A prospective study evaluating all patients admitted to the emergency department unit in a public hospital of tertiary complexity in a six-month period was conducted. During this period, the emergency team was trained to diagnose sepsis. Patients who met the diagnostic criteria for severe sepsis were followed until their discharge from the hospital. RESULTS: A total of 5,332 patients were admitted to the emergency department, and 342 met the criteria for severe sepsis/septic shock. The median (interquartile range) age of patients was 74 (65-84) years, and 52.1% were male. The median APACHE II and SOFA scores at diagnosis were 19 (15-25) and 5 (3-7), respectively. The median number of dysfunctional organ systems per patient was 2 (1-3). The median hospital length of stay was 10 (4.7-17) days, and the hospital mortality rate was 64%. Only 31% of the patients were diagnosed by the emergency department team as septic. About 33.5% of the 342 severe sepsis patients admitted to the emergency department were referred to an ICU, with a median time delay of 24 (12-48) hours. Training improved diagnosis and decreased the time delay for septic patients in arriving at the ICU. CONCLUSIONS: The occurrence rate of severe sepsis in the emergency department was 6.4%, and the rate of sepsis diagnosed by the emergency department team as well as the number of patients transferred to the ICU was very low. Educational campaigns are important to improve diagnosis and, hence, treatment of severe sepsis.

INTRODUÇÃO: A leucemia linfocítica crônica (LLC) é doença neoplásica caracterizada pelo acúmulo de linfócitos B maduros CD 5, CD 19 e CD 23 positivos. Alterações cromossômicas têm sido descritas pela citogenética clássica em 30% a 50% dos casos de LLC. OBJETIVO: O objetivo do presente trabalho é demonstrar as alterações de cariótipo observadas em pacientes com LLC em nosso meio. PROCEDIMENTOS: Foram selecionados 18 casos de nosso arquivo, avaliados no período de quatro anos, com LLC diagnosticada com base nos achados morfológicos e imunofenotípicos. Havia 13 homens e cinco mulheres, uma relação de 2,6:1, com mediana de 63 anos. RESULTADOS: Foram detectadas alterações de cariótipo em 39% dos casos (7/18). CONCLUSÕES: O cariótipo permitiu a identificação de diferentes clones em um grupo homogêneo de LLC sob os pontos de vista morfológico e imunofenotípico, demonstrando que as alterações genéticas são indicativas de comportamento biológico diferente.

BACKGROUND: Chronic lymphocytic leukemia (CLL) is a neoplasic disorder characterized by the accumulation of mature B lymphocytes CD 5, CD 19 and CD 23 positive. Chromosomal abnormalities have been described in 30% to 50% of the cases by conventional cytogenetics. OBJECTIVE: The objective of the present work was to describe chromosomal abnormalities detected in Brazilian CLL patients. METHODS: Eighteen cases with CLL selected from our files, in a 4 year period, were studied. The diagnosis was based on morphology and immunophenotype. There were 13 men and 5 women, a 2.6:1 ratio, with 63 median age. RESULTS: Chromosomal abnormalities were detected in 39% of the cases (7/18). CONCLUSION: The karyotype allowed the identification of different clones in a heterogenous CLL group under morphology and immunophenotype point of view demonstrating that genetic alterations are indicative of a different biological behavior.