Asbtract Introduction This study aimed to determine whether cytokine receptor-like factor 2 (CRLF2) antigen expression evaluated using multiparametric flow cytometry (MFC) could predict the genotype of CRLF2 and Janus kinase 2 (JAK2) status for application in the diagnosis of pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Methods A total of 321 BCP-ALL bone marrow samples were collected, 291 at diagnosis and 13 at first relapse, while 17 samples were excluded due to low cellular viability. The CRLF2 antigen expression was evaluated using flow cytometry (percentage of positivity and median fluorescence intensity [MFI]). The CRLF2 transcript levels were assessed via quantitative reverse transcription polymerase chain reaction using SYBR Green. The CRLF2 rearrangements (CRLF2-r) were identified using the CRLF2 break-apart probe via fluorescence in situ hybridization. Sanger sequencing was performed to identify the JAK2 exon 16 mutations. Results We observed that 60 of the 291 cases (20.6%) presented CRLF2 antigen positivity, whereas the CRLF2 transcript overexpression was found in 19 of 113 cases (16.8%). The JAK2 mutation was found in four out of 116 cases (3.4%), all of which had CRLF2 ≥10% of positive cells and intermediate or high MFI (p < 0.0001). In addition, in the 13 cases with the CRLF2-r, a positive correlation was found with the CRLF2 antigen intermediate (61.5%) MFI (p= 0.017). Finally, the CRLF2-positive antigen was identified in the BCP-ALL subclones. Conclusion The identification of the CRLF2 antigen using the MFC, based on the percentage of positivity and MFI values, is a useful tool for predicting JAK2 mutations and CRLF2-r. receptorlike receptor like CRLF (CRLF2 MFC (MFC JAK (JAK2 Bcell B cell BCPALL. BCPALL BCP ALL . (BCP-ALL) 32 collected 29 1 relapse viability MFI. [MFI]) Green CRLF2r CRLFr r (CRLF2-r breakapart break apart hybridization 6 20.6% 206 20 (20.6% 11 16.8%. 168 16.8% 8 (16.8%) 3.4%, 34 3.4% , 3 4 (3.4%) 10 ≥10 p 0.0001. 00001 0.0001 0 0001 0.0001) addition CRLF2r, r, CRLF2-r 61.5% 615 61 5 (61.5% p= 0.017. 0017 0.017 017 0.017) Finally CRLF2positive CRLFpositive subclones values CRLF2r. r. (CRLF (JAK (BCP-ALL [MFI] 20.6 (20.6 16.8 (16.8% 3.4 (3.4% ≥1 0000 0.000 000 61.5 (61.5 001 0.01 01 [MFI 20. (20. 16. (16.8 3. (3.4 ≥ 0.00 00 61. (61. 0.0 (20 (16. (3. (61 0. (2 (16 (3 (6 ( (1

Resumen Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R., y Aquino, R. (2022). Análisis de redes sociales en el deporte desde el punto de vista del enfoque ecológico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-21. El análisis del rendimiento está relacionado con la pedagogía del deporte. Las bases teóricas que sustentan las selecciones metodológicas deben estar bien establecidas para que haya una convergencia entre los instrumentos de evaluación y el proceso de enseñanza y entrenamiento. Este ensayo pretende presentar y discutir la importancia y representatividad del análisis de redes sociales para evaluar el rendimiento en los deportes de equipo. El objetivo principal del análisis de redes sociales es estudiar la relación entre los jugadores para identificar las posibles causas y consecuencias de los eventos durante el partido. Así, el análisis de redes sociales es diferente de los análisis tradicionales, en los que el foco principal está en el sujeto, o de los análisis notacionales, que son más utilizados y acumulan la frecuencia de los eventos ocurridos (por ejemplo, los goles marcados, la posesión del balón, las zonas de remate). Esta herramienta de evaluación, posicionada teóricamente en un enfoque ecológico, se muestra eficaz para la identificación de los patrones de interacción en un grupo y la comprensión de los artificios sociales que ayudan a entender el rendimiento de un equipo. Así, los equipos pasan a ser analizados como grupos sociales y no como sujetos aislados. En este ensayo también se exponen las principales aplicaciones prácticas de esta herramienta de evaluación en diferentes deportes de equipo como el fútbol, el fútbol sala, el balonmano, el baloncesto y el voleibol.

Resumo Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R., e Aquino, R. (2022). Análise de redes sociais no esporte pela ótica da abordagem ecológica: um ensaio teórico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-21. A análise de desempenho é uma disciplina intimamente relacionada à pedagogia do esporte. As bases teóricas que sustentam as escolhas metodológicas devem ser bem estabelecidas para existir uma convergência entre os instrumentos de avaliação e o processo de ensino e treinamento. Este ensaio teórico teve por objetivo apresentar e discutir a importância e representatividade da análise de redes sociais para avaliar o desempenho em esportes coletivos. O principal objetivo da análise de redes sociais é estudar a relação entre os jogadores para identificar possíveis causas e consequências dos eventos ocorridos durante a partida. Sendo assim, a análise de redes sociais trabalha de forma diferente das análises tradicionais, nas quais o principal foco está no sujeito, ou em análises notacionais que são as mais comumente utilizadas e que buscam a acumulação da frequência dos eventos ocorridos (e.g. gols marcados, posse de bola, áreas de finalização das jogadas). Tal instrumento de avaliação, teoricamente posicionado numa abordagem ecológica, mostra-se eficaz para a identificação de padrões de interação num grupo e o entendimento dos artifícios sociais que ajudam a compreender o desempenho em uma equipe. Assim, as equipes passam a ser analisadas como grupos sociais e não como sujeitos isolados. Neste ensaio, também se apresentam as principais aplicações práticas desse instrumento de avaliação em diferentes esportes coletivos, tais como o futebol, o futsal, o handebol, o basquetebol e o voleibol.

Abstract Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R., & Aquino, R. (2022). Social networks analysis in sports through an ecological approach—a theoretical framework. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-21. Performance analysis is a discipline that is closely related to the pedagogy of sports. The theoretical foundations that undergird methodological choices must be well established in order for a convergence to exist between evaluation instruments and the process of teaching and training. The objective of the present theoretical study was to present and discuss the importance and representativeness of social networks analysis in order to evaluate the performance in group sports. The main purpose of social networks analysis is to study the relationships among players, in order to identify possible causes and consequences of the events that took place during a match. Thus, the analysis of social networks works differently from traditional analyses, whose major focus is on the subject, or in notational analyses that are most commonly used and that look for the accumulation of frequency of the events that have occurred (e.g., goals scored, ball possession, finishing zones). Such an instrument of evaluation, theoretically positioned on an ecological approach, proves effective for the identification of interaction patterns in a group and for understanding the social artifices that help to understand performance in a team. Thus, teams come to be analyzed as social groups instead of isolated individuals. This study also presents the main practical applications of this evaluation instrument in different group sports such as soccer football, indoor soccer, handball, basketball and volleyball.

Resumen Petroni de Senzi Barreira, C., da Silva Musa, V., Pereira Morato, M. y Pombo Menezes, R. (2022). Eficacia de los sistemas defensivos en superioridad e igualdad numérica en balonmano: panorama de una competición europea. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-13. Las acciones realizadas durante la fase defensiva en balonmano pueden ser determinantes para los resultados de los partidos, y los análisis en esta fase permiten identificar aspectos clave que pueden ayudar en la planificación y entrenamiento de los equipos. El objetivo de este trabajo fue analizar la influencia de las relaciones numéricas en sistemas defensivos cerrados y abiertos en partidos de balonmano de alto nivel. Se analizaron doce partidos del Campeonato de Europa de clubes de Balonmano, cuyo instrumento de análisis permitió identificar la relación numérica del juego (superioridad defensiva o igualdad) y cuantificar los resultados (GO: gol; NG: sin gol; PP: perdida del balón) y regiones de la cancha en las que terminaron las acciones ofensivas. Se utilizó el chi-cuadrado para el análisis de datos. Los resultados mostraron similitudes para la realización del ataque a través de situaciones de igualdad con el uso de sistemas cerrados (GO = 47.3%; NG = 33.6%; PP = 19.1%) y sistemas abiertos (GO = 46.0%; NG = 34.3%; PP = 19.7%). Para esta situación, se demostró que el uso de sistemas cerrados provoca la pérdida del balón más lejos de la portería (9m- = 56.9%; 9m + = 43.1%), cuando se compara con el uso de sistemas abiertos (9m- = 64.5%; 9m + = 35.5%). En superioridad numérica defensiva, el uso de sistemas abiertos (GO = 28.6%; NG = 53.6%; PP = 17.9%), en comparación con sistemas cerrados (GO = 49.3%; NG = 29.6%; PP = 21.1 %), mostró mayor efectividad en los resultados de las acciones. Además, las secuencias terminaron más lejos del objetivo cuando se utilizaron sistemas abiertos (9m- = 42.9%; 9m+ = 57.1%), en comparación con sistemas cerrados (9m- = 68.3%; 9m+ = 31.7%). Se concluyó que la elección del sistema defensivo debe basarse en el modelo de juego del equipo y en las relaciones recurrentes del juego, especialmente en situaciones de igualdad numérica (más frecuentes). Sin embargo, cuando se tiene una ventaja numérica defensiva, limitar el espacio y el tiempo para que los atacantes tomen decisiones parece ser una estrategia eficaz.

Resumo Petroni de Senzi Barreira, C., da Silva Musa, V., Pereira Morato, M. y Pombo Menezes, R. (2022). Eficácia dos sistemas defensivos em superioridade e igualdade numérica no handebol: panorama de uma competição europeia. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-13. As ações e escolhas realizadas durante a fase defensiva no handebol podem ser determinantes para os resultados das partidas. Análises abordando essa fase do jogo vêm sendo realizadas para identificar aspectos determinantes e que possam auxiliar no planejamento e treinamentos das equipes. Este estudo teve como objetivo analisar a influência das relações numéricas nos sistemas defensivos fechados e abertos no handebol de alto nível. Para isso foram analisados 12 jogos do campeonato europeu de handebol de clubes, cujo instrumento de análise permitiu identificar a relação numérica do jogo (superioridade ou igualdade numérica defensiva) e quantificar os resultados (GO: gol; NG: não-gol; PP: perda de posse da bola) e os locais em que se encerraram as ações ofensivas. Foi utilizado o teste qui-quadrado para análise dos dados. Os resultados apontaram semelhanças para a conclusão do ataque mediante situações de igualdade com a utilização dos sistemas fechados (GO = 47.3%; NG = 33.6%; PP = 19.1%) e dos sistemas abertos (GO = 46.0%; NG = 34.3%; PP = 19.7%). Para essa situação, demonstrou-se que a utilização dos sistemas fechados provoca o encerramento da posse mais distante do gol (9m- = 56.9%; 9m+ = 43.1%), quando comparado à utilização dos sistemas abertos (9m- = 64.5%; 9m+ = 35.5%). Em situações de superioridade numérica defensiva a utilização dos sistemas abertos (GO = 28.6%; NG = 53.6%; PP = 17.9%), quando comparados aos sistemas fechados (GO = 49.3%; NG = 29.6%; PP = 21.1%), apresentou maior eficácia nos resultados das ações. Além disso, as sequências se encerraram mais distantes do gol quando foram utilizados sistemas abertos (9m- = 42.9%; 9m+ = 57.1%) em comparação aos sistemas fechados (9m- = 68.3%; 9m+ = 31.7%). Conclui-se que a escolha do sistema defensivo deve ser pautada no modelo de jogo da equipe e nas relações recorrentes do jogo, nos momentos de igualdade numérica (mais frequentes). Porém, em momentos de vantagem numérica defensiva limitar o espaço e o tempo para que os atacantes tomem decisões mostra-se como uma estratégia eficaz.

Abstract Petroni de Senzi Barreira, C., da Silva Musa, V., Pereira Morato, M. y Pombo Menezes, R. (2022). Efficiency of handball defensive systems in numerical equality and superiority: panorama of a european competition. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-13. Actions taken during the defensive phase in handball can determine match results; therefore, analyzing this phase helps identify key aspects that can assist in team training and planning. The aim of this paper was to analyze the influence of numerical relations on closed and open defense systems in top level handball matches. Twelve matches of the European handball club championship were analyzed, which allowed us to identify the numerical relationship of the game (defensive superiority or equality) and quantify results (GO: goal; NG: non-goal; PP: loss of ball possession) and the sections of the court where offensive actions ended up. A chi-squared test was used for data analysis. Results showed similarities in terms of the attack’s conclusion in numerical equality situations, when defense used closed systems (GO = 47.3%; NG = 33.6%; PP = 19.1%) and open systems (GO = 46.0%; NG = 34.3%; PP = 19.7%). For this situation, using closed systems results in losing ball possession further from the goal (9m- = 56.9%; 9m+ = 43.1%), when compared to open systems (9m- = 64.5%; 9m+ = 35.5%). In defensive numerical superiority, using open systems (GO = 28.6%; NG = 53.6%; PP = 17.9%), compared to closed systems (GO = 49.3%; NG = 29.6%; PP = 21.1%) gives more efficient results. In addition, sequences end further from the goal when open systems were used (9m- = 42.9%; 9m+ = 57.1%), compared to closed systems (9m- = 68.3%; 9m+ = 31.7%). It was concluded that the selection of the defensive system should be based on the team’s game model and game relationships, especially in situations of numerical equality (more frequent). However, when in defensive numerical advantage, limiting the space and time for attackers to make decisions seems to be an effective strategy.

Resumen Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R. y Aquino, R. (2021). Análisis de redes sociales en el deporte desde el punto de vista del enfoque ecológico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-19. El análisis del rendimiento está relacionado con la pedagogía del deporte. Las bases teóricas que sustentan las selecciones metodológicas deben estar bien establecidas para que haya una convergencia entre los instrumentos de evaluación y el proceso de enseñanza y entrenamiento. Este ensayo pretende presentar y discutir la importancia y representatividad del análisis de redes sociales para evaluar el rendimiento en los deportes de equipo. El objetivo principal del análisis de redes sociales es estudiar la relación entre los jugadores para identificar las posibles causas y consecuencias de los eventos durante el partido. Así, el análisis de redes sociales es diferente de los análisis tradicionales, en los que el foco principal está en el sujeto, o de los análisis notacionales, que son más utilizados y acumulan la frecuencia de los eventos ocurridos (por ejemplo, los goles marcados, la posesión del balón, las zonas de remate). Esta herramienta de evaluación, posicionada teóricamente en un enfoque ecológico, se muestra eficaz para la identificación de los patrones de interacción en un grupo y la comprensión de los artificios sociales que ayudan a entender el rendimiento de un equipo. Así, los equipos pasan a ser analizados como grupos sociales y no como sujetos aislados. En este ensayo, también se exponen las principales aplicaciones prácticas de esta herramienta de evaluación en diferentes deportes de equipo, como el fútbol, el fútbol sala, el balonmano, el baloncesto y el voleibol.

Resumo Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R. e Aquino, R. (2021). Análise de redes sociais no esporte pela ótica da abordagem ecológica: um ensaio teórico. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-19. A análise de desempenho é uma disciplina intimamente relacionada à pedagogia do esporte. As bases teóricas que sustentam as escolhas metodológicas devem ser bem estabelecidas para existir uma convergência entre os instrumentos de avaliação e o processo de ensino e treinamento. Este ensaio teórico teve por objetivo apresentar e discutir a importância e representatividade da análise de redes sociais para avaliar o desempenho em esportes coletivos. O principal objetivo da análise de redes sociais é estudar a relação entre os jogadores para identificar possíveis causas e consequências dos eventos ocorridos durante a partida. Sendo assim, a análise de redes sociais trabalha de forma diferente das análises tradicionais, nas quais o principal foco está no sujeito, ou em análises notacionais que são as mais comumente utilizadas e que buscam a acumulação da frequência dos eventos ocorridos (e.g. gols marcados, posse de bola, áreas de finalização das jogadas). Tal instrumento de avaliação, teoricamente posicionado numa abordagem ecológica, mostra-se eficaz para a identificação de padrões de interação num grupo e o entendimento dos artifícios sociais que ajudam a compreender o desempenho em uma equipe. Assim, as equipes passam a ser analisadas como grupos sociais e não como sujeitos isolados. Neste ensaio, também se apresentam as principais aplicações práticas desse instrumento de avaliação em diferentes esportes coletivos, tais como o futebol, o futsal, o handebol, o basquetebol e o voleibol.

Abstract Meli Neto, B., Fuini Puggina, E., Pombo Menezes, R., Cláudio Machado, J., Vanella, R. & Aquino, R. (2021). Social networks analysis in sports through an ecological approach—a theoretical framework. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-19. Performance analysis is a discipline that is closely related to the pedagogy of sports. The theoretical foundations that undergird methodological choices must be well established in order for a convergence to exist between evaluation instruments and the process of teaching and training. The objective of the present theoretical study was to present and discuss the importance and representativeness of social networks analysis in order to evaluate the performance in group sports. The main purpose of social networks analysis is to study the relationships among players, in order to identify possible causes and consequences of the events that took place during a match. Thus, the analysis of social networks works differently from traditional analyses, whose major focus is on the subject, or in notational analyses that are most commonly used and that look for the accumulation of frequency of the events that have occurred (e.g., goals scored, ball possession, finishing zones). Such an instrument of evaluation, theoretically positioned on an ecological approach, proves effective for the identification of interaction patterns in a group and for understanding the social artifices that help to understand performance in a team. Thus, teams come to be analyzed as social groups instead of isolated individuals. This study also presents the main practical applications of this evaluation instrument in different group sports such as soccer football, indoor soccer, handball, basketball and volleyball.

Resumen Pombo Menezes, R. (2021). Perspectiva de enseñanza-aprendizaje de principios y reglas de acción en deportes colectivos de invasión. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 17-13. Este ensayo tuvo como objetivos presentar las principales características del Teaching Games for Understanding (TGfU), contextualizar los principios y reglas de acción inherentes a las fases del juego y presentar un escenario hipotético de aplicación de estos conceptos. Los deportes colectivos de invasión tienen principios y reglas de acción que guían el comportamiento táctico-técnico de los jugadores y la organización de la clase o sesión de entrenamiento por el profesor/entrenador. El cambio de paradigma en la enseñanza de los deportes de equipo (del tecnicismo a la enseñanza a través del juego) propuesto por modelos que se apoyan en el juego, como el TGfU, fue importante porque colocó al alumno en el centro del proceso de enseñanza-aprendizaje y promovió la construcción del conocimiento en contextos complejos. En particular, TGfU se guía por los principios y reglas de acción para organizar la clase, además de proponer preguntas orientadoras para desarrollar la toma de decisiones de los jugadores. Por tanto, el escenario hipotético propuesto en este ensayo, luego de reflexiones sobre los principios y reglas de acción, permite al profesor/entrenador planificar la aplicación de estos conceptos de acuerdo con los principios TGfU.

Resumo Pombo Menezes, R. (2021). Perspectiva de ensino-aprendizagem dos princípios de ação e das regras de ação nos esportes coletivos de invasão. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 17-13. Este estudo teve como objetivo apresentar as principais características do Teaching Games for Understanding (TGfU), contextualizar os princípios e as regras de ação inerentes às fases do jogo e apresentar um cenário hipotético de aplicação desses conceitos. Os esportes coletivos de invasão são constituídos por princípios e regras de ação que balizam os comportamentos tático-técnicos dos jogadores e a organização da aula ou sessão de treinamento pelo professor/treinador. A mudança de paradigma no ensino dos esportes coletivos (do tecnicismo ao ensino por meio de jogos) proposta por modelos que se apoiam no jogo, como o TGfU, foi importante por considerar o aluno no centro do processo de ensino-aprendizagem e promover a construção do conhecimento em contextos complexos. O TGfU, em específico, pauta-se nos princípios e regras de ação para a organização da aula, assim como propõe perguntas norteadoras para desenvolver a capacidade de tomada de decisão dos alunos. Assim sendo, o cenário hipotético proposto neste ensaio após as reflexões sobre os princípios e regras de ação permite que o professor/treinador vislumbre a aplicação desses de maneira congruente aos princípios do TGfU.

RESUMO Os óleos essenciais (EO), como o carvacrol, são descritos por representarem ampla gama de compostos principalmente voláteis de plantas aromáticas, com potencial antioxidante, antibacteriano, antifúngico, entre outras propriedades de interesse para a saúde animal, como a modulação do microbioma. Atualmente, os cavalos são submetidos a manejo intensivo, com uso excessivo de ração concentrada, o que pode causar graves distúrbios digestivos e metabólicos. Em cavalos, estudos com EO são limitados, mas o uso de óleo essencial de carvacrol (CEO) poderia promover benefícios na fermentação microbiana. O objetivo da presente pesquisa foi investigar o efeito de diferentes quantidades de óleo essencial de carvacrol, adicionadas à dieta de equinos, sobre a digestibilidade aparente total de nutrientes, o perfil microbiano por meio das fezes e a resposta sanguínea pós-prandial de glicose e insulina. Foram utilizados oito cavalos castrados, da raça Mini-Horse (42±6 meses), 135±15kg PV, alimentados na proporção de 60% concentrado e 40% feno de capim. Os tratamentos foram: 0, 100, 200 e 300ppm de CEO. A adição de CEO até 300ppm não influencia a digestibilidade aparente dos nutrientes e a resposta de glicose e insulina plasmática pós-prandial. O uso de EO demonstra manter a saúde digestiva fermentativa quando os cavalos são alimentados com dieta rica em concentrado.

ABSTRACT Essential oils (EO) such as carvacrol represent a wide range of mainly volatile aromatic plant compounds which hold antioxidant, antibacterial and antifungal potential, in addition to other properties of interest to animal health, such as the ability to modulate the microbiome. Current horse care commonly involves an intensive management system with an excessive use of concentrated feed, which can lead to severe digestive and metabolic disorders. Studies with EO in horses are limited, but the use of carvacrol essential oil (CEO) can promote benefits in microbial fermentation. The objective was to investigate the effect of different quantities of CEO on the apparent total digestibility of nutrients, microbial profile in the feces and postprandial blood glucose and insulin response when added to the equine diet. Eight Mini-Horse geldings were used (42±6 months; 135±15 kg BW) and fed with a proportion of 60% concentrate and 40% grass hay. The treatments were: 0, 100, 200 and 300 ppm of CEO. The addition of CEO up to 300 ppm did not influence the apparent digestibility of nutrients or the postprandial plasma glucose and insulin response. The use of CEO maintained the fermentative digestive health of horses fed with concentrate diets.

OBJECTIVES: Strategic planning for coronavirus disease (COVID-19) care has dominated the agenda of medical services, which have been further restricted by the need for minimizing viral transmission. Risk is particularly relevant in relation to endoscopy procedures. This study aimed to describe a contingency plan for a tertiary academic cancer center, define a strategy to prioritize and postpone examinations, and evaluate the infection rate among healthcare workers (HCWs) in the endoscopy unit of the Cancer Institute of the State of São Paulo (ICESP). METHODS: We created a strategy to balance the risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to mitigate the effects of postponing endoscopic procedures in oncological patients. A retrospective analysis of prospectively collected data on all endoscopies between March and June 2020 compared with those during the same period in 2019 was carried out. All HCWs were interviewed to obtain clinical data and SARS-CoV-2 test results. RESULTS: During the COVID-19 outbreak, there was a reduction of 55% in endoscopy cases in total. Colonoscopy was the most affected modality. The total infection rate among all HCWs was 38%. None of the senior digestive endoscopists had COVID-19. However, all bronchoscopists had been infected. One of three fellows had a serological diagnosis of COVID-19. Two-thirds of all nurses were infected, whereas half of all technicians were infected. CONCLUSIONS: In this pandemic scenario, all endoscopy services must prioritize the procedures that will be performed. It was possible to maintain some endoscopic procedures, including those meant to provide nutritional access, tissue diagnosis, and endoscopic resection. Personal protective equipment (PPE) seems effective in preventing transmission of COVID-19 from patients to digestive endoscopists. These measures can be useful in planning, even for pandemics in the future.

ABSTRACT Background: Acute myeloid leukemia presenting the MYST3-CREBBP fusion gene is a rare subgroup associated with hemophagocytosis in early infancy and monocytic differentiation. The aim of this study was to define the relevant molecular cytogenetic characteristics of a unique series of early infancy acute myeloid leukemia cases (≤24 months old), based on the presence of hemophagocytosis by blast cells at diagnosis. Methods: A series of 266 infant cases of acute myeloid leukemia was the reference cohort for the present analysis. Acute myeloid leukemia cases with hemophagocytosis by blast cells were reviewed to investigate the presence of the MYST3-CREBBP fusion gene by fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction. Results: Eleven cases with hemophagocytosis were identified with hemophagocytic lymphohistiocytosis being ruled out. Six cases were classified as myelomonocytic leukemia, three as AML-M7 and two as AML-M2. In five cases, the presence of the MYST3-CREBBP fusion gene identified by molecular cytogenetics was confirmed by fluorescence in situ hybridization. All patients received treatment according to the Berlin-Frankfürt-Münster acute myeloid leukemia protocols and only one out of the five patients with the MYST3-CREBBP fusion gene is still alive. Conclusions: Our findings demonstrate that the presence of hemophagocytosis in acute myeloid leukemia was not exclusively associated to the MYST3-CREBBP fusion gene. Improvements in molecular cytogenetics may help to elucidate more complex chromosomal rearrangements in infants with acute myeloid leukemia and hemophagocytosis.

Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement or hormonal levels at 18 years of age.

Heparin induced thrombocytopenia (HIT) is an immune-mediated disorder due to antibodies anti platelet factor 4-heparin (HPIA). Thrombocytopenia is often moderate but certain patients can develop morbid thrombotic complications. HPIA detection by ELISA has high sensitivity but low specificity, and low titers (without clinical significance) are frequent. A pretest clinical score (4T´s) was developed in order to recognize patients that are at high risk of HIT. The aim of this study was to correlate HPIA levels and the 4T´s score of consecutive patients derived to our center. We evaluated 84 patients (35 of them developed thrombosis); the clinical questionnaire was sent along with the sample and was analyzed by an investigator who did not know the patients´ characteristics, and 4T´s scores were calculated before performing the laboratory tests. HPIA were measured by ELISA (Asserachrom HPIA) that detects IgG, IgM and IgA isotypes, (the only reagent available in our country). 4T´s score correlated with HPIA levels (rho spearman 0.472, p < 0.001). Patients with 4T´s ≥ 6 had higher absorbance percentages than those with ≤ 5 (67 vs. 39%, p < 0.001), and patients with thrombosis also presented higher titers (59 vs. 39%, p = 0.017) than those who did not develop this complication. In conclusion, high titers of HPIA measured by EIA which detects the 3 isotypes, clearly correlate with 4T´s score ≥ 6 and are more frequent in patients who develop thrombosis, just as reported when an IgG specific ELISA is used.

La trombocitopenia inducida por heparina (HIT) es un efecto adverso del tratamiento con heparina, mediada por anticuerpos anti complejo factor plaquetario 4 (PF4)-heparina (HPIA). La HIT es frecuentemente moderada pero pueden desarrollarse complicaciones trombóticas. El diagnóstico precoz es importante. La detección de HPIA por ELISA tiene alta sensibilidad pero baja especificidad (títulos bajos sin significación clínica). El índice de las 4T (índice 4T) puede detectar pacientes con alto riesgo de HIT. El propósito del estudio fue correlacionar los niveles de HPIA y el índice 4T de un grupo de pacientes derivados a nuestro centro. Evaluamos 84 pacientes, 34 de ellos desarrollaron trombosis. Cada médico completó un cuestionario clínico que fue remitido con la muestra a nuestro centro. Los cuestionarios fueron analizados por un investigador externo y el índice 4T se calculó previamente al ensayo. Los HPIA se determinaron por un ELISA (Asserachrom HPIA) que detecta los 3 isotipos, IgG, IgM e IgA, único reactivo disponible en Argentina. Los resultados se expresaron como porcentaje de absorbancia (%ABS). La correlación del índice 4T con los HPIA fue 0.472 (rho spearman, p < 0.001). Los pacientes con índice 4T ≥ 6 presentaban %ABS mayores que los ≤ 5 (67 vs. 39, p < 0.001). Aquéllos con trombosis presentaron títulos mayores que los que no la desarrollaron (%ABS 59 vs. 39, p = 0.017). En conclusión: Los títulos altos de HPIA medidos por ELISA, que detecta los 3 isotipos, correlacionaron claramente con el índice 4T ≥ 6 y fueron más frecuentes en los pacientes con trombosis, coincidiendo con lo ya descripto para ensayos de ELISA específicos para isotipo IgG.

OBJECTIVE: To clarify the role of peritoneography in assessing the patency of processus vaginalis (PV) in pediatric patients diagnosed with cryptorchidism. MATERIALS AND METHODS: We designed a prospective clinical trial to evaluate the patency of PV in boys presenting cryptorchidism. Herniography was performed in 310 prepubertal boys. Data about the morphology of PV was compared with operative findings in those surgically treated patients. Retractile and ectopic testes were excluded from the study. RESULTS: Of the 376 undescended testes (310 patients), 281 cases were associated with an obliterated PV. Herniography revealed 95 cases of open PV in cryptorchid boys. The 244 normally descended testes had associated patent processus vaginalis in only 31 cases. CONCLUSIONS: Herniography is the most relevant procedure for accurate diagnosis of persistent PV. The persistence of PV was significantly more frequent when the position of the testes is more cranial. The incidence of an open PV decreases with age.

Objective: The purpose of this study was to determine the epidemiological characteristics of tuberculosis (TB) in the Public Health System District of Santiago de Compostela (population : 386,125) from 1999 to 2002. Methods: Inclusion criteria were: 1) microbiological and/or pathological diagnosis of TB in any specimen, and 2) patient younger 35 years old with recent medical history of TB. Mantoux test positive, and pleural effusion with linfocitosis and adenosine deaminase >47 IU/ml. Results: 946 patients were included (568 men and 378 women), with ages ranging from 2 months to 96 years. The incidence of TB was 60.9/100,000 in 1999, 67.6/100,000 in 2000, 61.9/100,000 in 2001 and 54.6/100,000 in 2002. The incidence rate of tuberculous meningitis was 1.03/100,000 in 1999 and 2000, 0.77/100,000 in 2001 and 0.51/100,000 in 2002. The percentage of cases associated with HIV was 3.4% in 1999, 1.9% in 2000, 2.4% in 2001 and 2002. We found an increase in the rate of males over 55 years of age; with incidence per 100,000 inhabitants of 122.4 in 1999, 142.8in 2000, 115 in 2001 and 119 in 2002, whereas in females the incidence was 40.6 in 1999, 60.9 in 2000, 54.1 in 2001 and 39.1 in 2002. Conclusions: In last four years the incidence of tuberculosis has decreased but remains high in males over 55 years old.

Objetivo: conocer los parámetros epidemiológicos entre los años 1999 y 2002 de la enfermedad tuberculosa (TB) en nuestra área, que consta de 386.125 habitantes. Métodos: se consideró caso TB el que cumplía los siguientes criterios: 1) hallazgos microbiológicos y/o patológicos diagnósticos de TB, en cualquier espécimen, 2) pacientes menores de 35 años con historia clínica reciente compatible con TB, con test de Mantoux significativo, linfocitosis y adenosina deaminasa (ADA) en líquido pleural >47UI/mL. Resultados: Hemos estudiado 946 pacientes (568 hombres y 378 mujeres), con extremos de 2 meses y 96 años. El número de casos fue de 235 en 1999, 261 en 2000, 239 en 2001 y 211 en 2002. La incidencia de TB fue de 60,9 en 1999, de 67,6 en 2000, de 61,9 en 2001 y de 54,6 en 2002, con una incidencia de formas contagiosas de 37,6 en 1999, de 42,5 en 2000, de 37,3 en 2001 y de 31,1 en 2002. La incidencia de meningitis tuberculosa fue de 1,03 en 1999 y 2000, 0,77 en 2001 y 0,51 en 2002. Las formas de asociación con VIH fue de 3,4% en 1999, de 1,9% en 2000, 2,4% en 2001 y 2002. La relación hombre/mujer fue de 1,37 en 1999, 1,46 en 2000, 1,52 en 2001 y 1,74 en 2002. En tasas absolutas, el 38,1% de ambos sexos se encontraban entre 15 y 34 años y el 49,8% entre 15 y 44 años, aquí con predominio femenino. Se evidenció un importante aumento en mayores de 55 años, con predominio masculino, tanto en valores absolutos como relativos, con incidencias de 122,4 en 1999, 142,8 en 2000, 115 en 2001 y 119 en 2002, mientras que en mujeres fue de 40,6 en 1999, 60,9 en 2000, 54,1 en 2001 y 39,1 en 2002. Conclusiones: La incidencia de la tuberculosis en nuestro medio ha disminuido en los últimos años, especialmente en el último, pero se mantiene elevada en los varones mayores de 55 años.

A infecção pelos vírus HTLV-I/II encontra-se presente em todas as regiões brasileiras, mas as prevalências variam de um estado para outro, sendo mais elevadas na Bahia, Pernambuco e Pará. As estimativas indicam que o Brasil possui o maior número absoluto de indivíduos infectados no mundo. Testes de triagem de doadores e estudos conduzidos em grupos especiais (populações indígenas, usuários de drogas intravenosas e gestantes) constituem as principais fontes de informação sobre essas viroses em nosso país. O HTLV-I causa a leucemia/linfoma de células T do adulto (LLTA), a paraparesia espástica tropical/mielopatia associada ao HTLV (TSP/HAM), uveíte associada ao HTLV (HAU) e anormalidades dermatológicas e imunológicas. O HTLV-II não se mostrou associado a nenhuma doença até o momento. O diagnóstico é feito com testes de triagem (ELISA, aglutinação) e confirmatórios (Western Blot, PCR). Estes vírus são transmitidos pelo sangue e agulhas contaminadas, através de relações sexuais e de mãe para filho, especialmente através do aleitamento materno. Medidas de prevenção devem focalizar a orientação de doadores soropositivos, mães infectadas e usuários de drogas intravenosas.

HTLV-I/II infection is present in all regions of Brazil, but its prevalence varies according to the geographical area, being higher in Bahia, Pernambuco and Pará. It has been estimated that Brazil has the highest absolute number of infected individuals in the world. Blood donors screening and research conducted with special groups (indigenous population of Brazil, IV drug users and pregnant women) are the major sources of information about these viruses in our Country. HTLV-I causes adult T cell leukemia/lymphoma (ATLL), HTLV associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV associated uveitis (HAU), dermatological and immunological abnormalities. HTLV-II is not consistently associated with any disease. Diagnosis is established using screening (enzymatic assays, agglutination) and confirmatory (Western blot, PCR) tests. The viruses are transmitted by blood and contaminated needles, by sexual relations and from mother to child, especially by breast feeding. Prevention efforts should focus on education of positive blood donors, infected mothers and IV drug users.

Os autores relatam o segundo caso publicado no Brasil de glioblastoma cerebelar na infância. A despeito da escassa citação na literatura mundial, questionam a raridade real desta patologia, achando que deverá ser mais frequente do que é acreditado, tendo em vista as indefinições e controvérsias anátomo-patológicas desta neoplasia.

The authors relate a case of glioblastoma multiforme of the cerebellum in a nine-years old girl. They correlate this case with reports published and they think that this pathology is not so rare as believed. This is the second case report, in Brazil, in children.