Abstract The purpose of this article is to theoretically discuss the relationship between knowledge management and dynamic capabilities, a reason for the little exploration it has had in the literature on strategic management. This discussion is carried out around the theoretical approaches of the theory of the firm, the Resources-based Vision of the firm (RBV) and Knowledge-based Vision of the firm (KBV), from which it is argued that the Knowledge management allows the strategic renewal of organizations. Therefore, in this article the influence of knowledge management on the dynamic capacities of sensing, learning, seizing and coordination is exposed. Finally, some theoretical, empirical and practical implications are offered.

Resumen Este artículo tiene como propósito discutir teóricamente la relación entre la gestión del conocimiento y las capacidades dinámicas, a razón de la poca exploración que ha tenido en la literatura sobre dirección estratégica. Esta discusión se realiza alrededor de los planteamientos teóricos de la teoría de la firma, la Visión de la Firma Basada en Recursos (RBV) y la Visión de la Firma Basada en el Conocimiento (KBV), a partir de los cuales se argumenta que la gestión del conocimiento permite la renovación estratégica de las organizaciones. Por tanto, en este artículo se expone la influencia de la gestión del conocimiento en las capacidades dinámicas de detección, aprendizaje, integración y coordinación. Finalmente, se ofrecen algunas implicaciones teóricas empíricas y prácticas.

Abstract Objective: To determine anxiety and depression frequency in residents from hospital centers during COVID-19 pandemic. Methods: A descriptive, observational, cross-sectional study was carried out from June to December 2020. Residents from hospitals of Secretary of Health, Puebla, were identified. The sample included 247 residents, who had an individual interview and answered a questionnaire through CEMEVI (Virtual Medical Center of High Specialty). Results: 17 % of anxiety and 45 % of depression were reported. The most frequent age group was 26 to 31 years; 124 women and 123 men; anesthesiology, internal medicine and pediatrics were the medical specialties with greater depression; internal medicine and pediatrics were the medical specialties with greater anxiety. The risk factors for depression were anxiety (OR = 36.9), record of contact with COVID-19 patients (OR = 2.49 p = 0.035), and parental anxiety record (OR = 2.6, p = 0.009). The medical history of parents with anxiety was risk factor for anxiety (OR = 2.3, p = 0.031). Conclusions: Prevalence of depression and anxiety should alert to seek answers to the problem.

Resumen Objetivo: Determinar la frecuencia de ansiedad y depresión en médicos residentes en centros hospitalarios en México durante la pandemia de COVID-19. Métodos: Se realizó estudio transversal observacional de junio a diciembre de 2020. Se identificaron médicos residentes de diferentes hospitales de la Secretaría de Salud en Puebla. La muestra incluyó a 247 médicos residentes, quienes fueron entrevistados individualmente y a través de un cuestionario de CEMEVI (Centro Médico Virtual de Alta Especialidad). Resultados: La frecuencia de ansiedad fue de 17 % y de depresión, de 45 %. El grupo etario más frecuente fue el de 26 a 31 años: 124 médicos fueron mujeres y 123 hombres; los médicos de las especialidades que mostraron mayor frecuencia de depresión fueron anestesiología, medicina interna y pediatría; y de ansiedad, medicina interna y pediatría. Los factores de riesgo para depresión fueron ansiedad (RM = 36.9), historia de contacto con paciente con COVID-19 (RM = 2.49, p = 0.035) e historia de ansiedad en los padres (RM = 2.6, p = 0.009). La ansiedad se asoció con historia de padres con este trastorno (RM = 2.3, p = 0.031). Conclusiones: La frecuencia de depresión y ansiedad en la población de médicos residentes debe alertar a buscar. respuestas al problema.

Resumen Este articulo reflexiona sobre los avances en la conceptualizacion del papel del conocimiento, la innovacion tecnologica y los modelos de negocios en las organizaciones. Estos avances modificaron el marco estrecho de la microeconomia del equilibrio optimo mediante enfoques alternos mas realistas sobre el desarrollo competitivo de las empresas. Especificamente, la aparicion de modelos de negocios innovadores a gran escala, a traves de redes soportadas por tecnologías poderosas, ha permitido evaluar conceptualizaciones nuevas por fuera del marco optimizador neoclasico. Asi, este articulo responde al interrogante de si el modelo de negocios impacta las capacidades dinamicas. Pese a que teoricamente se plantea que esta es una relacion de reciprocidad, en la literatura poco se aborda la relacion en la direccion planteada. En este articulo, por tanto, se especifica como la percepcion del modelo innovador de negocios impulsa la reconfiguracion de las capacidades dinamicas para crear valor nuevo, ampliar el mercado, absorber conocimiento e integrarlo a dichas capacidades. La discusion que se desarrolla en este articulo plantea que el modelo de negocios influye en las capacidades dinamicas, pues permite identificar los tipos de clientes, conectar el usuario con la empresa y configurar la cadena de suministro que crea valor anadido y monetizarlo.

Abstract This article reflects on the advances in the conceptualization of the role of knowledge, technological innovation, and business models in organizations. These advances modified the narrow framework of the optimal equilibrium microeconomy through more realistic alternative approaches to competitive business development. Specifically, the emergence of large-scale innovative business models, through networks supported by powerful technologies, has allowed new conceptualizations to be tested outside the optimizing neoclassical framework. Thus, this article answers the question of whether the business model impacts dynamic capabilities. Although theoretically it is posited that this is a relationship of reciprocity, in the literature the relationship in the proposed direction is little-explored. This article, therefore, details how the perception of the innovative business model drives the reconfiguration of dynamic capabilities to create new value, expand the market, and absorb knowledge and integrate it into said capabilities. The discussion carried out in this article concludes that the business model influences dynamic capacities, since it allows identifying the types of customers, connecting the user with the company, configuring the supply chain that creates added value and monetizing it.

El presente artículo presenta una síntesis de trabajo de investigación sobre la problemática relacionada con el actual modelo de ocupación del suelo suburbano² del municipio de Pereira (Risaralda), dicha investigación parte de la premisa de que dicho modelo genera impactos ambientales negativos y un deterioro progresivo de los Servicios Ecosistémicos (SE), lo que conlleva a una pérdida de las capacidades territoriales para el mantenimiento del bienestar de la población. El estudio de caso metodológicamente se desarrolla bajo un enfoque mixto, vinculando herramientas de análisis cualitativas y cuantitativas, lo que permitió identificar los impactos más representativos sobre los SE y los aspectos comunes a dichos impactos; posteriormente se realizó la identificación de las causas estructurales que originan el actual modelo de suburbanización. Los análisis realizados permitieron conducir a la definición de una propuesta de planificación ambiental territorial, con el objeto de procurar una ocupación sustentable del suelo suburbano, por medio de la identificación de unos principios de sustentabilidad y unas determinantes ambientales para este tipo de suelos, entendidas como el conjunto de directrices, lineamientos y propuestas normativas que direccionan la forma de usar y ocupar el suelo suburbano en busca de una sustentabilidad del mismo, y donde los instrumentos de planificación, gestión y financiación identificados permiten hacerlos operativos.

This article presents a research project synthesis about the problems associated with the current suburban land use model of the municipality of Pereira (Risaralda). The research was conducted under the hypothesis that this model generates a negative environmental impact and progressive deterioration of the Ecosystem Services (ES) which implies the loss of territorial capabilities for the maintenance of the population welfare. Methodologically the study is developed under a mixed approach, linking qualitative and quantitative analysis tools which allowed identifying the most representative impacts about ES and the common aspects to these impacts. Subsequently the identification of structural causes behind the current model of suburbanization was carried out. The analyses performed allowed reaching the definition of a territorial environmental planning proposal in order to ensure sustainable suburban ground occupation by means of the identification of some sustainability principles and environmental determinants for this type of ground, understood as a set of directives, guidelines and policy proposals to address the way to use and occupy the suburban land searching for its sustainability and where the identified planning, management and financing instruments allow them to be operational.

En este escrito se estudia la implicación de condiciones suficientes y/o necesarias en un cambio estructural, comparando el proceso de industrialización de Corea del Sur con el de Colombia. Se analizan dos períodos: 1960-1990 y 1991-2007, antes y después de la apertura en ambos países. Se afirma que las economías de Corea del Sur y de Colombia continuaron siendo variedades de crony capitalism incluso después de que ambos países abrazaron reformas liberacionistas. La calidad de las instituciones de embedded autonomy del Estado y de las instituciones del sistema de gobierno corporativo (corporate governance) son las que explican el cambio estructural.

This paper aims to find out sufficient conditions for implying structural change. It examines experiences of South Korea and Colombia around late industrialization to comparative purposes before and after economic openness, through two periods: 1960-1990 and 1991-2007. It shows that quality of state's institutions and corporate governance systems, allows carry out successful structural change.

Approximately 85% of the water consumed in Chile is destined to agricultural irrigation and is managed by the users themselves. This study analyzed the price that irrigation water users pay to their Water User Associations (WUAs) to which they belong and the relationship of this price to the professional level and performance of the WUAs. The study included 24 WUAs: 10 River Administration Boards (JV) and 14 Irrigation Canal Associations (AC). The annual operational budget of each WUA, the price paid by users and the management capacities of the board of directors of each WUA were compared. The study also determined the relative value of user payments to WUAs as a proportion of total production costs of the main crops in each zone. The variability of user fees per irrigated hectare decreases when the irrigation area of the WUA is more than 10 000 ha, though this was not observed in JVs. The presence of technical-professional staff directly affects the development and growth of the WUAs. As well, the WUAs with a greater level of capacity development (NDC) have more board members with a higher education level and have lower rates of unpaid user fees. The price that users pay to the WUA by irrigated hectare represents less than 4.0% of the average total production cost of the main crops in the study area. Finally, no correlation was found between the prices that users pay and the average profitability of the main crops, or between price and the geographical location of the WUAs.

Aproximadamente, el 85% del agua consumida en Chile es destinada al riego agrícola, siendo administrada por los propios usuarios. En este estudio, se analizó el costo que cancelan los usuarios del agua de riego a sus Organizaciones de Usuarios de Agua (WUAs) y el nivel de profesionalización y desempeño de éstas. Se estudiaron 24 WUAs: 10 Juntas de Vigilancia (JV) y 14 Asociaciones de Canalistas (AC). Se comparó el presupuesto anual de operaciones de cada WUA, el valor que cancelan los usuarios y las capacidades de gestión de la directiva con el desempeño de la respectiva WUA. Además, se analizó la significancia del pago de los usuarios en los costos de producción de los principales cultivos en cada zona. En las AC, la variabilidad de precios por hectárea regada que cancelan los usuarios, disminuye cuando el territorio de la WUA es mayor a 10 000 ha, situación no detectada en las JV. El personal técnico-profesional de apoyo incide directamente sobre el desarrollo y crecimiento de las WUAs. Asimismo, las WUAs con nivel de desarrollo de capacidades (NDC) más elevado poseen directivas con mayor escolaridad promedio y los usuarios presentan menor morosidad en el pago. El precio que cancelan los usuarios a las WUAs por hectárea regada representa menos del 4,0% de los costos promedio totales de producción de los principales cultivos de cada zona. Finalmente, no se evidenció correlación entre el precio que cancelan los usuarios y la rentabilidad promedio de los cultivos, ni por ubicación geográfica de las WUAs.

OBJETIVO: O cateterismo dos seios petrosos inferiores (SPI) ajuda a diferenciar as formas hipofisária e ectópica na síndrome de Cushing (SC). O objetivo desse trabalho é descrever a técnica empregada em nosso serviço, discutir a solução de dificuldades e verificar o índice de sucesso atingido. CASUÍSTICA E MÉTODO: Foram submetidos a cateterismo bilateral dos SPI 42 pacientes com SC, entre setembro de 2000 e setembro de 2005. As dificuldades para o posicionamento do cateter foram correlacionadas com as soluções empregadas. RESULTADOS: As variações anatômicas, a semelhança entre o SPI e a veia emissária do plexo basilar e a dificuldade de contrastar as estruturas a contrafluxo para localizá-las foram os principais problemas. Foram utilizados cateter pré-moldado, fio-guia semicurvo e dirigível, road-maping e venografia por injeção contralateral, além de critérios para diferenciar o SPI da veia emissária. Dos 84 SPI abordados, um apresentava trombose, e dos 83 possíveis, 80 (96,4%) foram cateterizados. Não se observaram complicações. CONCLUSÃO: A cateterização dos SPI pode ser feita na maioria dos pacientes. A identificação da veia emissária do plexo basilar e o uso de flebografia por injeção contralateral melhoraram o desempenho do método.

PURPOSE: Inferior petrosal sinus catheterization and sampling for corticotropin dosage helps to differentiate hypophisary and ectopic forms of Cushing syndrome. The aim of this paper is to describe the technique used in inferior petrosal sinus catheterization in our service, emphasizing the solution found for frequent difficulties, and verify the success rate achieved. PATIENTS AND METHODS: Between September/2000 and September/2005, forty-two (eighty-four sinuses) patients were submitted to inferior petrosal sinus sampling. The difficulties for correct catheter positioning were identified and correlated with their solutions. RESULTS: Anatomical variations, similarity between IPS and emissary vein of the basilar plexus and unfavorable flow to the contrastation of the structures (retrograde catheterization) were the main problems. Using pre-shaped catheters, curved, steerable guide-wires, road-maping and venography by contalateral injection, besides criteria to differentiate IPS from the emissary vein. Of the 84 sinuses approached, one was thrombosed, and 80 (96.4%) of 83 possible were selectively catheterized. No clinical complication occurred. CONCLUSION: IPSC can be safe and successfully performed in most cases. The identification of the emissary vein of the basilar plexus and use of venography by contralateral injection, improved the method performance.

OBJECTIVES: To assess the risk associated with nitrate contamination of wells that supply drinking water in the rural, Parral region of central Chile. METHODS: The nitrate concentration levels were determined using water samples from 94 wells. An analysis of the distribution of nitrate concentration levels was performed in order to assess possible geographic correlations. For the risk analysis, two exposure situations were identified among the population (for adults and for infants), and the health risks were mapped. RESULTS: Fourteen percent of the wells studied had nitrate concentration levels greater than what the Chilean health standards allow for drinking water. There was no geographic correlation for the nitrate concentration levels. The mean hazard quotient (HQ) for adults in the study area was 0.12, indicating an absence of risk for this population group. For infants, the HQ values had a maximum value of 3.1 in some locations, but the average was 0.69 (still below 1.0), indicating that the well water in the study area was generally not hazardous for infants. CONCLUSIONS: In the Parral region of Chile, nitrate contamination of wells is primarily linked to certain factors such as construction practices and the proximity of livestock. These factors affect the quality of drinking water in isolated cases. There was no risk found for the adult population, but there was for infants fed on formula mixed with water coming from the contaminated wells.

OBJETIVOS: Evaluar el riesgo asociado a la contaminación con nitrato de pozos noria de suministro de agua potable rural en la zona de Parral, Chile. MÉTODOS: Se recogieron datos de concentración de nitrato obtenidos de un muestreo de agua de 94 pozos noria. Se analizó la distribución de la concentración de nitrato en los pozos para determinar la existencia de algún tipo de correlación espacial. En el análisis de riesgo, se identificaron dos situaciones de exposición de la población (adultos y lactantes) y se elaboraron mapas de riesgo para la salud. RESULTADOS: El 14% de los pozos estudiados presentó valores de concentración de nitrato mayores que los permitidos por la normativa nacional relativa al agua potable. No se detectó correlación espacial de las concentraciones de nitrato. El valor medio del cociente de peligro (CP) para los adultos en la zona de estudio fue 0,12, lo que indica la ausencia de riesgo para la salud de esa población. Para los lactantes, el cociente de peligro medio fue 0,69, pero se identificaron algunos pozos donde el cociente de peligro indica un riesgo para esta población. CONCLUSIONES: En la zona de Parral, la contaminación de pozos noria por nitrato está asociada principalmente a la existencia de ciertos factores, como los métodos constructivos o la cercanía de animales, que afectan de manera aislada la calidad del agua. No se detectó la existencia de riesgo para la población adulta, pero sí para los lactantes alimentados con fórmulas preparadas con agua proveniente de los pozos contaminados.

A doença de Cushing é rara em crianças e sua ocorrência em gêmeos é ainda mais rara. O presente estudo relata a ocorrência de gêmeas idênticas discordantes quanto à doença de Cushing. Uma das gêmeas, desenvolveu síndrome de Cushing aos 10 anos de idade. Sua investigação demonstrou cortisol urinário elevado, ACTH sérico elevado e testes de supressão com dexametasona compatíveis com doença de Cushing. A RMN mostrou macroadenoma hipofisário que foi operado por via transesfenoidal. O estudo imuno-histoquímico confirmou a presença de células produtoras de ACTH. A paciente entrou em remissão clínica e laboratorial desde a cirurgia. Após o desaparecimento dos estigmas do Cushing, a paciente reiniciou ganho estatural, mas permanece menor que sua irmã gêmea. Esta última permanece saudável 4 anos após o início da doença de sua irmã. Este é o terceiro caso do gênero relatado na literatura. Estes achados sugerem que fatores não genéticos estão envolvidos na gênese da doença de Cushing.

Cushing's disease is rare in children and its ocurrence in identical twins is extremely rare. This paper reports on identical twins discordant for Cushing's disease. One of them first presented with a cushingoid phenotype by the age of 10. Her evaluation showed an increased urinary free-cortisol and serum ACTH. Her pattern in the dexametazone supression tests was compatible with Cushing's disease. MRI disclosed a pituitary macroadenoma which was removed by the transesphenoidal approach. Immunohistochemical studies of the tumor showed the presence of ACTH-producing cells. The patient went into clinical and laboratorial remission after surgery. She re-started to grow after the disappearance of the Cushing's phenotype but she is still shorter than her healthy sister. The latter remains disease-free 4 years after her sister's diagnosis. This represents the third such case reported in the literature. Our findings suggest that acquired factors may be responsible for the genesis of Cushing's disease.

Apoplexia pituitária aguda é fenômeno relativamente raro, mesmo em macroadenomas. No entanto, a presença de áreas necro-hemorrágicas intratumorais nestes tumores que não se relacionam a qualquer sintomatologia aguda parece ser bem mais frequente do que se imaginava na era da tomografia. Com o advento da ressonância magnética estas áreas podem ser facilmente diagnosticadas pré-operatoriamente. Dentre os 40 últimos macroadenomas operados e examinados com RMN, 10 possuíam áreas apopléticas subclínicas em seu interior. Sete destes tumores eram não secretores, 2 secretores de GH e um de prolactina. O quadro clínico incluiu, além daqueles correspondentes à eventual secreção endócrina, perda visual progressiva (sem história de piora abrupta ou rápida) (n=8) e cefaléia (n=3). Após a remoção cirúrgica destes tumores e descompressão do aparato óptico, obtivemos melhora visual em 6 pacientes e em 2 a visão permaneceu inalterada. A cefaléia desapareceu em 2 casos. A presença de áreas apopléticas nestes macrotumores bem como sua ausência em séries de microtumores relatadas na literatura sugere que se relacionam mais ao tamanho do tumor do que ao seu caráter secretor ou não, o que é compatível com a provável natureza (insuficiência vascular) da apoplexia subclínica nesses casos.

Acute pituitary apoplexy is a rare event, even in patients with pituitary macroadenomas. On the other hand, the presence of necrotic/hemorrhagic areas, especially in macroadenomas, seems to be more common than earlier reported in the CT period. After the introduction of MR in the presurgical workup of these patients, these apopleptic areas have been more easily diagnosed preoperatively. Forty consecutive patients with pituitary macroadenomas were studied with high-resolution 1.5 T T1 coronal, sagittal and axial slices over the sellar region. Special attention was paid in the detection of necrotic, cystic and hemorrhagic areas within these tumors. Ten patients had hemorrhagic/necrotic areas within their tumors, without any sign or symptom of acute apoplexy. These areas varied from small (2 mm) to very large (30 mm) ones. Seven patients had non-secreting tumors, 2 GH and 1 prolactin secreting tumors, which is the same profile of secretory pattern for the whole series (40 patients). The clinical picture included (other than that caused by endocrine secretion) slowly progressive (but not acute) visual loss (n=8) and headache (n=3). After surgical decompression of the surrounding structures and visual apparatus, which was facilitated by the presence of the necrotic areas, there was visual improvement in 6 patients and headache resolution in 2. The presence of asymptomatic apopleptic areas in these macroadenomas and their absence in microadenomas as can be seen in the literature suggest that they are related more to the size of the tumor than to its endocrine secretion pattern. This is in agreement with a vascular insufficiency hypothesis in the pathogenesis of these lesions.

A apoplexia pituitária é evento raro e a ocorrência de remissão endócrina em pacientes portadores de tumores secretores é ainda mais incomum. O presente estudo relata os casos de dois pacientes portadores de macroadenomas (um com doença de Cushing e outro com acromegalia) nos quais houve remissão endócrina após apoplexia tumoral. A primeira paciente era portadora de doença de Cushing e teve episódio ictal espontâneo de cefaléia e vômitos, após o qual iniciou remissão endócrina. Como houvesse persistência de imagem de macroadenoma à ressonância magnética, a paciente foi submetida a cirurgia transesfenoidal, sendo encontrado apenas cisto hemorrágico hipertensivo, sem sinais de tumor. O segundo paciente apresentava acromegalia e enquanto realizava um teste de LHRH teve evento agudo de cefaléia e vômitos, sem perda visual e instalação de diabetes insipidus. A tomografia computadorizada de sela túrcica mostrou sinais de sangue. Como não houve quadro visual agudo, o paciente foi seguido com exames de imagens seriadas, que demonstraram o desaparecimento completo da lesão e o aparecimento de sela vazia. A avaliação endócrina mostrou remissão da acromegalia. Tendo em vista a tendência à recidiva já documentada na literatura, esses pacientes devem continuar em seguimento a longo prazo.

Pituitary apoplexy is rare and endocrine remission in patients with apopletic secreting pituitary adenomas is even rarer. This study reports on two patients with pituitary macroadenomas (one with Cushing's disease and the other with acromegaly) in whom endocrine remission occurred after apoplexy. The first patient had Cushing's disease and had an ictus of headache and vomiting after which she started a progressive remission of hypercortisolism. A post-apoplexy MRI disclosed persistence of a sellar and supra-sellar mass. She was submitted to transesphenoidal surgery. An hypertensive hemorhagic cyst was found with no tumor. The second patient had acromegaly. While performing a LHRH-stimulation test he had an ictus of headache, vomiting, no visual loss and appearance of diabetes insipidus. A CT scan disclosed an intrasellar hematoma. Despite the size of the tumor and since there was no visual impairment, this patient was followed up without surgery. Imaging follow-up showed a progressive shrinkage and disappearance of the mass, which was corroborated by endocrine remission. A high rate of recurrence is reported in such patients in the literature. Both patients are being currently followed-up on a long-term basis.

O predador Doru luteipes (Scudder) é um dos principais reguladores da população de Spodoptera frugiperda (J.E. Smith) e Helicoverpa zea (Boddie) na cultura de milho (Zea mays). O objetivo do trabalho foi estudar a seletividade de cinco inseticidas químicos (deltametrina, lambdacialotrina, permetrina, diflubenzuron e triflumuron) e dois microbianos [Baculovirus e Bacillus thuringiensis (Berliner)] sobre as diferentes fases de desenvolvimento do predador. Ovos e ninfas dos quatro ínstares receberam os inseticidas diretamente através de um pulverizador acoplado a uma esteira rolante. Adultos do predador receberam como alimento posturas de S. frugiperda, que foram pulverizadas com os diferentes inseticidas. Para os ovos, houve um efeito letal pronunciado com os inibidores de crescimento diflubenzuron (81,8% de mortalidade) e triflumuron (78,6%), sendo este também tóxico para os ínstares ninfais (69,6%). Os inseticidas biológicos Baculovirus e B. thuringiensis foram seletivos a todas as fases do predador. A sobrevivência do predador aos inseticidas foi crescente com o instar do inseto (S = 39,5 + 7,79 I, R2² = 0,87). Os adultos foram tolerantes a todos os inseticidas (95,3% de sobrevivência).

The earwig Doru luteipes (Scudder) is one the best natural enemies of Spodoptera frugiperda (J. E. Smith) and Helicoverpa zea (Boddie) both pests of maize (Zea mays). The objective of this work was to evaluate the selectivity of five chemical (deltamethrin, lambdacyhalothrin, permethrin, diflubenzuron and triflumuron) and two microbial [Baculovirus and Bacillus thuringiensis (Berliner)] insecticides to the different developmental stages of the predator. Eggs and the four nymphal stages were sprayed using a sprayer connected to a rolling mat. Adults were fed egg masses of S.frugiperda sprayed with insecticides. Eggs of the predator were highly affected by the growth inhibitors diflubenzuron (81.8% mortality) and triflumuron (78.6%), the latter also toxic to the nymphal stages (69.6%). The bioinsecticides Baculovirus and B. thuringiensis were selective to all stages of the predator. The survivorship increased with the increase of the insect's age (S = 39,5 + 7,79 I, R2² = 0,87). Adults were tolerant to all treatments (95.3% survivorship).

O critério imagenológico clássico para diagnóstico de invasão de seio cavernoso é a presença de tumor lateralmente à carótida em cortes coronais. Estudamos 17 pacientes com macroadenomas hipofisários com ressonância compátivel a invasão de seio cavernoso e que tiveram esta invasão confirmada cirurgicamente. Somente 8 destes pacientes possuíam tumor lateralmente à carótida (critério clássico). Treze pacientes possuíam tumor localizado entre as porções intracavernosas da carótida e em todos havia ruptura da captação anelar de contraste no seio cavernoso. Dez pacientes possuíam abertura dos folhetos posteriores do seio cavernoso. Todos os pacientes foram tratados por via transesfenoidal. Somente um caso obteve cura endocrinológica. Somente 3 pacientes portadores de algum destes sinais imagenológicos foram identificados em uma série de cerca de 250 casos e não possuíam invasão de seio cavernoso. Os critérios acima parecem adequadamente permitir prever a invasão do seio. Este diagnóstico é relevante já que a maioria dos pacientes com invasão de seio cavernoso acaba realizando terapia complementar.

The classical imaging gold-standard for this diagnosis is the presence of tumor lateral to the carotid artery. Seventeen patients with pituitary macroadenomas with intraoperative confirmation of cavernous sinus invasion were studied with MRI. Only 8 patients had tumor lateral to the carotid artery; 13 had tumor within the carotid syphon and all lacked the ring enhancement of the medial wall of the cavernous sinus. In 10 patients, widening of the posterior double leaflets of the cavernous sinus could be. All patients were operated by the transesphenoidal route. Only one patient was cured by surgery alone. Only 3 patients disclosing the above mentioned MRI features were identified in a series of 250 patients and did not have cavernous sinus invasion. The present criteria proved to be useful in the pre-operative diagnosis of cavenous sinus invasion and patients' counselling. Pre-operative diagnosis of cavernous sinus invasion of pituitary tumors has a great impact in the management of such patients.

Dezesseis pacientes com tumores da região selar que foram tratados cirurgicamente e que possuíam deficits funcionais dos eixos somatotrófico ou corticotrófico foram submetidos a teste de tolerância à insulina pré- e pós-operatoriamente. Sete pacientes possuíam adenomas não-funcionantes, 5 possuíam prolactinomas, 3 craniofaringiomas e 1 possuía cordoma de clivus. Todos os pacientes possuíam macrotumores e nenhum deles foi submetido a radioterapia durante o período do estudo. Sete pacientes possuíam deficiência isolada do setor somatotrófico, 4 isolada do setor corticotrófico e 5 possuíam deficiência de ambos os setores. Cinco pacientes com deficiência isolada do setor somatotrófico, 4 com deficit isolado do setor corticotrófico e 3 com deficiência nos dois setores obtiveram melhora funcional pós-operatoriamente. Novos deficits do setor corticotrófico ocorreram em 2 pacientes, que necessitaram reposição de esteróides por longo prazo. Estes dados sugerem que deficits endócrinos pré-operatórios podem ser revertidos pela descompressão cirúrgica da região selar e que novos deficits causados pela cirurgia são raros. Estes pacientes devem ser retestados pós-operatoriamente do ponto de vista endócrino para se determinar a necessidade de terapia de reposição hormonal.

Sixteen patients with sellar tumors that were treated surgically and who had pre-operative somatotrophic and corticotrophic function deficits were submitted to pre- and early post-operative insulin tolerance tests (ITTs). Seven patients had non-functioning adenomas, 5 had prolactinomas, 3 had craniopharyngioma and 1 had cordoma of the clivus. All patients had macro-tumors and none received radiotherapy within the studied period. Seven patients had GH, 4 had Cortisol and 5 had both GH/cortisol function pre-operative deficit. Five patients with isolated GH, 4 with isolated Cortisol and 3 with both GH/cortisol deficiencies showed a postoperative functional recovery. New Cortisol secretion deficits were observed in 2 patients postoperatively and both required long-term steroid replacement. These data suggest that preoperative endocrine deficits may be reversible after surgical decompression of the sellar region and that new endocrine deficits are rarely seen after surgery. All such patients should be tested postoperatively from an endocrinological point of view to reevaluate the need for replacement therapies.