Resumen: El estrés oxidativo y las reacciones de óxido-reducción se encuentran presentes en todos los procesos biológicos. En pacientes con síndrome metabólico, contribuyen al desarrollo de esteatohepatitis no alcohólica, cirrosis y carcinoma hepatocelular, mediante procesos de lipotoxicidad, reclutamiento de citocinas, activación de células estelares, síntesis progresiva de colágena, DAMPs (patrón molecular asociado a lesiones), PAMPs (patrón molecular asociado a patógenos) y daño irreversible al ADN mitocondrial. Nrf2 es el factor de transcripción más importante en la regulación de la expresión de los genes de la respuesta antioxidante enzimática y juega un papel primordial en la respuesta citoprotectora ante la inflamación aguda y en la regeneración hepática. Sin embargo, se ha asociado también al desarrollo de quimiorresistencia y recurrencia tumoral. En este artículo, hacemos una revisión sobre la evidencia existente al respecto.

Abstract: Oxidative stress and oxide-reduction reactions are present in all biological processes. In patients with metabolic syndrome, they contribute to the development of non-alcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma, through processes of lipotoxicity, cytokine recruitment, activation of stellar cells, progressive synthesis of collagen, DAMPs (Damage-associated molecular pattern), PAMPs (Pathogen-associated molecular pattern molecules) and irreversible damage to mitochondrial DNA. Nrf2 is the most important transcription factor in regulating the expression of enzymatic antioaxidant response genes and plays a major role in the cytoprotective response to acute inflammation and liver regeneration. However, it has also been associated with the development of chemoresistance and tumor recurrence. This article reviews the most recent evidence in this regard.

Abstract: Introduction: In December 2019, an outbreak of pneumonia of unknown cause was first reported in Wuhan, Province of Hubei, China. Its contagiousness quickly crossed borders, becoming a pandemic now present in 188 countries, with a total of 16’950,407 cases and 664,961 deaths. This event has generated substantive changes in all areas of human activity. Medical and surgical practice is no exception. Objective: To collect and analyze data related to some conditions of the general surgeon’s practice and the effect caused by the COVID-19 pandemic. To highlight useful information that could allow building a support reference for personal actions and decision-makers. Material and methods: A descriptive observational study. The authors developed an anonymous survey using the Survey Monkey® tool sent to surgeons by email using the Asociación Mexicana de Cirugía General, Mexican Association of General Surgery’s member database, reinforced by social networks. The following sections were included to provide an overview: demographics, professional activity, hospital characteristics, surgical practice, personal protection equipment, and COVID-19. Results: There were 723 responses from surgeons. The following highlights were collected: 90.32% were general surgeons, 79.61% males, and 20.39% females. The main age group between 30 and 60 years (75.5%). The main comorbidity is hypertension (23.24%), with a median risk of complications from COVID-19 at 59.86%. 52.52% of the surgeons work in COVID Hospitals. Elective surgery is performed at 44.2% of these. In 63.99% no device is used to filter CO2 during minimally invasive surgery, and only 20.76% of operating rooms have negative pressure. 48.5% of the staff buy their Personal Protection Equipment (PPE). Physicians are among the staff with the highest infection rate (42.46%), those in the Emergency Service with a 43.26% rate. As a response to this situation, adaptation to the professional and family environment has been difficult for 49.57% of them. Conclusions: The impact of the COVID-19 pandemic has generated substantial changes in the practice of general surgery in Mexico, from an immediate response requiring training and prevention measures to the development of medium and long-term strategies for improved performance and safety for patients and health professionals.

Resumen: Introducción: En diciembre de 2019 se reportó por primera vez un brote de neumonías de causa desconocida en la ciudad de Wuhan, provincia de Hubei, China; su contagiosidad rápidamente traspasó fronteras, y se convirtió en una pandemia que a la fecha está presente en 188 países, con un total de 16,950,407 de casos y 664,961 muertes. Este evento ha generado cambios sustantivos en todos los ámbitos de la actividad humana, la práctica médica y quirúrgica no son la excepción. Objetivo: Recolectar y analizar datos relacionados con algunas condiciones de la práctica del cirujano general y el efecto causado por la pandemia COVID-19, además de resaltar información útil con la posibilidad de construir una referencia de apoyo para acciones personales y para los tomadores de decisiones. Material y métodos: Estudio observacional descriptivo, los autores desarrollaron una encuesta anónima utilizando la herramienta Survey Monkey®, enviada a cirujanos por correo electrónico y tomando la base de datos de asociados de la Asociación Mexicana de Cirugía General, reforzado por redes sociales. Para tener un panorama general, se incluyeron los siguientes apartados: datos demográficos, actividad profesional, características del hospital, práctica quirúrgica, equipo de protección personal y COVID-19. Resultados: Se obtuvieron 723 respuestas de cirujanos, de los que se recolectaron los siguientes puntos sobresalientes: 90.32% fueron cirujanos generales, del género masculino 79.61% y femenino 20.39%; el grupo de edad está centrado entre 30 y 60 años (75.5%); la principal comorbilidad es la hipertensión (23.24%), con un nivel medio de riesgo de complicaciones por COVID-19 en 59.86%. El 52.52% de los cirujanos laboran en Hospitales COVID; la cirugía electiva se realiza en 44.2%, en cirugía de mínima invasión no se utiliza algún dispositivo para filtrar CO2 en el 63.99% y sólo 20.76% de las salas de operaciones cuenta con presión negativa. El personal adquiere su equipo de protección personal en el 48.5%; el personal con mayor contagio es el médico (42.46%), y del servicio de urgencias con 43.26%; y como respuesta a esta situación le ha sido complicado adaptarse en el terreno profesional y familiar al 49.57%. Conclusiones: El impacto de la pandemia COVID-19 ha generado cambios sustantivos en la práctica de cirugía general en México, desde una respuesta inmediata que requiere capacitación y medidas de prevención hasta desarrollar estrategias a mediano y largo plazo para el mejor desempeño y seguridad para los pacientes y los profesionales de la salud.

Abstract This paper analyzes how globalization has modified peasant food production practices. Research combines qualitative and quantitative methods for the collection of ethnographic, statistical and documentary information. The results show that the presence of transnational companies in the lands adjacent to the ejidos has caused a decrease in food production, because the opening of the Mexican economy has made possible an unequal relationship between the global and local dimensions of the economy. The importance of this work lies in the fact that it shows the interconnections that transnational capital maintains with the rural localities of the arid zones of San Luis Potosí.

Resumen Este artículo analiza la manera en que la globalización ha modificado las prácticas campesinas de producción de alimentos. La investigación combina métodos cualitativos y cuantitativos para la recopilación de información etnográfica, estadística y documental. Los resultados dan cuenta de que la instalación de empresas transnacionales en los terrenos adyacentes a los ejidos ha provocado la disminución de la producción de alimentos, porque la apertura de la economía mexicana ha posibilitado una relación desigual entre las dimensiones global y local de la economía. El valor de este trabajo radica en que muestra las interconexiones que el capital transnacional mantiene con las localidades rurales de las zonas áridas de San Luis Potosí.

ABSTRACT Hsp70 proteins are widely found through several species, and they are considered among the most conservative proteins in nature, in both their sequence and function. They play an important role in the response mechanism to several different kinds of stress such as temperature and pathogens among others. In some species, the variations in the sequence of the Hsp70 gene result in intra-specific differential expression, and therefore in differences in thermo-tolerance of individuals as well as other productive characteristics. The study of the potential impact of the Hsp70 gene polymorphisms represents a field of study that could greatly help the mollusk farming industry.

Abstract The MIKE SHE hydrological model was applied by the present work in order to simulate water runoff from the Teapa River basin in southeastern Mexico. The basin has a humid tropical climate, high slopes, and is relatively little altered by human activities. There is relatively detailed information on climatic conditions, topography, vegetation, and soils in the basin, as well as data on the hydrologic regime of Teapa River. The MIKE SHE model is preferible because of its high capacity to process detailed characteristics of the river basin. The process to simulate the Teapa River’s hydrological regime involved two calculation stages. First, calibration of the model by means of some of its parameters, initially determined and related with hydrophysical properties of soils and hydraulic roughness of the surface, for a better fit between calculated and observed river discharges. Then, validation of the model by comparing calculated and observed river discharges. The results of the simulation showed that the MIKE SHE model validation process resulted in a rather good fit between the calculated and observed mean and maximum monthly discharges from the Teapa River, with a determination coefficient of R 2 = 0.81. However, the calculated and observed daily discharges did not result in a good fit, with R 2 = 0.62. A large number of model parameters, each of which presumably had an error, can possibly explain such a relatively low fit for the daily discharges.

Resumen En el presente trabajo se ha aplicado el modelo hidrológico MIKE-SHE, para simular procesos de escorrentía de agua de la cuenca hidrológica del río Teapa, en el sureste de México. La cuenca tiene un clima tropical húmedo, altas pendientes y una escasa presencia de núcleos urbanos. Existe información detallada sobre las condiciones climáticas, topografía, de vegetación y suelos de la cuenca, así como datos del régimen hidrológico del río Teapa. Se ha implementado el modelo MIKE-SHE, principalmente por la gran capacidad de procesamiento de la información detallada de las cuencas. El proceso de simulación del régimen hidrológico del río Teapa comprende dos etapas de cálculo: la calibración del modelo, que tiene como finalidad obtener un buen ajuste entre los datos observados y los calculados, lo cual se logra mediante modificación de algunos de los parámetros iniciales relacionados con las propiedades físicas de los suelos y con la rugosidad hidráulica de la superficie y cauces; la validación del modelo consiste en la aplicación del mismo en un periodo sin calibración y la comparación de los gastos calculados y observados. Los resultados de la simulación señalan que en el proceso de validación del modelo MIKE-SHE se logró un ajuste entre los gastos del río Teapa medios y máximos mensuales, obteniendo un coeficiente de determinación R 2 = 0.81. Sin embargo, no se ha logrado buen ajuste de los gastos diarios con R 2 = 0.62.

Resumo Fundamento: Mutações em genes do sarcômero são encontradas em 60-70% dos indivíduos com formas familiares de cardiomiopatia hipertrófica. (CMH). Entretanto, essa estimativa refere-se a populações de países do hemisfério norte. O perfil genético-molecular da CMH foi tema de poucos estudos no Brasil, particularmente na região sul do país. Objetivo: Realizar a pesquisa de mutações dos genes sarcoméricos MYH7, MYBPC3 e TNNT2 numa coorte de CMH estabelecida no extremo sul do Brasil, assim como avaliar as associações genótipo-fenótipo. Métodos: Sequenciamento direto do DNA de todas as regiões codificantes dos três genes sarcoméricos foi realizada em 43 indivíduos consecutivos de dez famílias não-relacionadas. Resultados: Mutações para CMH foram encontradas em 25 (58%) indivíduos de sete (70%) das dez famílias estudadas, sendo 14 (56%) deles fenótipo-positivos. Todas as mutações eram missense, quatro (66%) no gene MYH7 e duas (33%) no gene MYBPC3. Não foram encontradas mutações no gene TNNT2. Mutações em MYH7 foram identificadas em 20 (47%) indivíduos de seis (60%) famílias. Duas delas não haviam sido previamente relatadas. Mutações de MYBPC3 foram detectadas em sete (16%) membros de duas (20%) famílias. Dois (5%) indivíduos apresentaram dupla heterozigose com mutações em ambos os genes. As mutações acometeram distintos domínios das proteínas codificadas e produziram expressão fenotípica variável. História familiar de CMH foi identificada em todos os indivíduos genótipo-positivos. Conclusões: Nessa primeira análise genético-molecular da CMH realizada no sul do Brasil, foram encontradas mutações nos genes sarcoméricos MYH7 e MYBPC3 em 58% dos indivíduos. Doença relacionada ao gene MYH7 foi identificada na maioria dos casos com mutação.

Abstract Background: Mutations in sarcomeric genes are found in 60-70% of individuals with familial forms of hypertrophic cardiomyopathy (HCM). However, this estimate refers to northern hemisphere populations. The molecular-genetic profile of HCM has been subject of few investigations in Brazil, particularly in the south of the country. Objective: To investigate mutations in the sarcomeric genes MYH7, MYBPC3 and TNNT2 in a cohort of HCM patients living in the extreme south of Brazil, and to evaluate genotype-phenotype associations. Methods: Direct DNA sequencing of all encoding regions of three sarcomeric genes was conducted in 43 consecutive individuals of ten unrelated families. Results: Mutations for CMH have been found in 25 (58%) patients of seven (70%) of the ten study families. Fourteen (56%) individuals were phenotype-positive. All mutations were missense, four (66%) in MYH7 and two (33%) in MYBPC3. We have not found mutations in the TNNT2 gene. Mutations in MYH7 were identified in 20 (47%) patients of six (60%) families. Two of them had not been previously described. Mutations in MYBPC3 were found in seven (16%) members of two (20%) families. Two (5%) patients showed double heterozygosis for both genes. The mutations affected different domains of encoded proteins and led to variable phenotypic expression. A family history of HCM was identified in all genotype-positive individuals. Conclusions: In this first genetic-molecular analysis carried out in the south of Brazil, we found mutations in the sarcomeric genes MYH7 and MYBPC3 in 58% of individuals. MYH7-related disease was identified in the majority of cases with mutation.

ResumoFundamento:Insuficiência cardíaca com fração de ejeção preservada é uma síndrome caracterizada por alterações da função diastólica mais prevalente em idosos, mulheres e portadores de hipertensão arterial sistêmica (HAS) e diabete melito. No início, entretanto, não revela sinais de congestão, identificando-se por remodelamento adverso, diminuição da capacidade de exercício e disfunção diastólica nos exames.Objetivo:Comparar variáveis ecocardiográficas e de doppler (Eco) e do teste cardiopulmonar de exercício (TCPE) - ergoespirométricas - entre duas amostras populacionais: indivíduos portadores dessa síndrome em estágio inicial e outra de saudáveis.Métodos:Vinte e oito pacientes ambulatoriais com diagnóstico de insuficiência cardíaca por critérios de Framingham, fração de ejeção > 50% e disfunção diastólica segundo a european society of cardiology (ESC), e 24 indivíduos saudáveis realizaram estudos de Eco e TCPE.Resultados:O grupo de pacientes apresentou volume atrial e massa ventricular esquerda indexadas, bem como as razões E/E’ e VAEi/A´ significativamente maiores, além de significativa redução do consumo máximo de oxigênio e incremento da inclinação da variável VE/VCO2, mesmo com semelhantes dimensões do ventrículo esquerdo, quando comparados à amostra dos saudáveis.Conclusão:Há diferenças significativas entre variáveis estruturais e funcionais analisadas nos estudos ao Eco e ao TCPE, comparando-se duas amostras populacionais: pacientes com estágio inicial de insuficiência cardíaca com fração de ejeção maior ou igual a 50% e outra de indivíduos saudáveis.

AbstractBackground:Heart failure with preserved ejection fraction is a syndrome characterized by changes in diastolic function; it is more prevalent among the elderly, women, and individuals with systemic hypertension (SH) and diabetes mellitus. However, in its early stages, there are no signs of congestion and it is identified in tests by adverse remodeling, decreased exercise capacity and diastolic dysfunction.Objective:To compare doppler, echocardiographic (Echo), and cardiopulmonary exercise test (CPET) variables - ergospirometry variables - between two population samples: one of individuals in the early stage of this syndrome, and the other of healthy individuals.Methods:Twenty eight outpatients diagnosed with heart failure according to Framingham’s criteria, ejection fraction > 50% and diastolic dysfunction according to the european society of cardiology (ESC), and 24 healthy individuals underwent Echo and CPET.Results:The group of patients showed indexed atrial volume and left ventricular mass as well as E/E’ and ILAV/A´ ratios significantly higher, in addition to a significant reduction in peak oxygen consumption and increased VE/VCO2 slope, even having similar left ventricular sizes in comparison to those of the sample of healthy individuals.Conclusion:There are significant differences between the structural and functional variables analyzed by Echo and CPET when comparing two population samples: one of patients in the early stage of heart failure with ejection fraction greater than or equal to 50% and another of healthy individuals.

Abstract Introduction: The indications for laparoscopic hepatectomy are limited, usually tumors measuring less than 5 cm. Among these, small tumors less than 4 cm of nodular type and under 6 cm pedunculated type are those within the most appropriate indications. Case report: Here, a case of a patient with a secondary liver mass to focal nodular hyperplasia measuring 8 cm in liver left side segment, in which treatment is performed by means of Segmentectomy left side (resection segment II is reported and III), being the first liver resection reported in the Central Military Hospital. Conclusion: According to the characteristics and size of the tumor, the goal in the treatment of focal nodular hyperplasia is durability and minimally invasive procedure. Laparoscopic hepatectomy in this case was beneficial to the quality of life and patient recovery.

Resumen Introducción: Las indicaciones para hepatectomía laparoscópica son limitadas, generalmente tumores que miden menos de 5 cm. Entre estos, los tumores pequeños de menos de 4 cm del tipo nodular y los menores de 6 cm del tipo pedunculado son los que están dentro de las indicaciones más apropiadas. Reporte de caso: Aquí se reporta un caso de un paciente con una masa hepática secundaria a hiperplasia nodular focal que mide 8 cm en el segmento lateral izquierdo del hígado, en el cual se realizó tratamiento por medio de segmentectomía lateral izquierda (resección de los segmentos II y III), siendo la primera resección hepática reportada en el Hospital Central Militar. Conclusión: De acuerdo con las características del tumor y el tamaño, el objetivo en el tratamiento de la hiperplasia nodular focal es la durabilidad y la mínima invasión en el procedimiento. La hepatectomía laparoscópica en este caso fue benéfica para la calidad de vida y la recuperación del paciente.

FUNDAMENTO: Na Cardiomiopatia Hipertrófica (CMH), o grau de Hipertrofia Ventricular Esquerda (HVE) poderia influenciar o desenvolvimento de arritmias ventriculares. OBJETIVO: Analisar, na CMH, a associação entre a ocorrência de arritmias ventriculares no eletrocardiograma-Holter (ECG-Holter) e o grau de HVE determinado ao ecocardiograma pela espessura parietal máxima (EPM) e Índice de Massa (IM). MÉTODOS: Cinquenta e quatro pacientes consecutivos com CMH realizaram ECG-Holter de 24 horas e ecocardiograma para avaliação do grau de HVE através da EPM e IM. Foram estabelecidos dois níveis para a ocorrência de arritmias ventriculares: I - extrassístoles isoladas ou pareadas e II - Taquicardia Ventricular Não Sustentada (TVNS). RESULTADOS: Nos 13 pacientes (24%) com TVNS (nível II), houve maior frequência de EPM do ventrículo esquerdo (VE) > 21 mm (n = 10, 77%; 25 ± 4 mm) e IMVE > 144 g/m² (n = 10, 77%; 200 ± 30 g/m²), em relação àqueles que apresentavam apenas arritmia extrassistólica (nível I) (n = 41, 76%), em que essas medidas foram identificadas em, respectivamente, 37% (n = 15, 23 ± 1 mm), p = 0,023, e 39% (n = 16, 192 ± 53 g/m²) dos casos, p = 0,026. Os citados valores de corte foram determinados por curva ROC com intervalo de confiança de 95%. O registro de TVNS foi mais comum em pacientes com EPMVE > 21 mm e IMVE > 144 g/m² (8 de 13; 62%), do que naqueles com uma (4 de 13; 31%) ou nenhuma (1 de 13; 8%) variável ecocardiográfica acima dos valores de corte, p = 0,04. CONCLUSÃO: A ocorrência de arritmias ventriculares no Holter associou-se, na CMH, ao grau de HVE, avaliado pelo ecocardiograma através da respectiva EPM e IM.

BACKGROUND: In hypertrophic cardiomyopathy (HCM), the degree of left ventricular hypertrophy (LVH) could influence the development of ventricular arrhythmias. OBJECTIVE: In HCM, analyze the association between the occurrence of ventricular arrhythmias determined by Holter electrocardiogram (ECG-Holter) and the degree of LVH determined by maximum wall thickness (MWT) in echocardiography and body mass index (BMI). METHODS: Fifty-four consecutive patients with HCM underwent 24-hour ECG-Holter and echocardiography for assessment of level of LVH through MWT and BMI. Two levels were established for the occurrence of Ventricular Arrhythmias: I - alone or paired extrasystoles and II - Non- Sustained Ventricular Tachycardia (NSVT). RESULTS: In 13 patients (24%) with NSVT (level II), there was a higher frequency of MWT of the left ventricle (LV) > 21 mm (n = 10, 77%, 25 ± 4 mm) and LLLV = 144 g/m² (n = 10, 77%, 200 ± 30 g/m²), in comparison with those presenting with extrasystole arrhythmias (level I) (n = 41, 76%), in which these measures were identified in, respectively, 37 % (n= 15, 23 ± 1 mm), p = 0.023, and 39% (n = 16, 192 ± 53 g / m²) of the cases (p = 0.026). The cut-off values mentioned were determined by the ROC curve with a confidence interval of 95%. NSVT was more common in patients with MWTLV > 21 mm and LLLV > 144 g/m² (8 of 13, 62%) than in those with (4 of 13, 31%) or without (1 of 13; 8%) echocardiographic variables above cut-off values (p = 0.04). CONCLUSION: In HCM, occurrence of ventricular arrhythmias by Holter was associated with the degree of LVH assessed by echocardiography through MWT and BMI.

A cardiomiopatia hipertrófica é uma doença genética prevalente caracterizada por hipertrofia ventricular esquerda, em que obstrução dinâmica da via de saída com geração de gradiente subaórtico incide em repouso em 30% dos casos. A obstrução é atribuida complexa interação entre o folheto anterior mitral, o septo interventricular e vetores anômalos de fluxo gerados no ventrículo esquerdo aliada a modificações na geometria da via de saída. Regurgitação mitral em grau variável é detectada associada ou não a deformidades estruturais do aparelho valvar. O ecocardiograma de esforço demonstra obstrução latente facilmente induzida por exercício em 60 a 75% das formas não obstrutivas. A determinação do gradiente nessas condições impõe-se na investigação de rotina dos pacientes com obstrução leve ou ausente em repouso. A avaliação da cardiomiopatia hipertrófica incorpora métodos de imagem baseados no ultrassom, os quais, adicionados ressonância magnética, possibilitam o reconhecimento de mecanismos geradores de obstrução ventricular, de modo a favorecer o diagnóstico e o manejo das formas obstrutivas e obstrutivas latentes.

Hypertrophic cardiomyopathy is a prevalent genetic disease characterized by left ventricular hypertrophy, presenting dynamic obstruction of outflow tract with subaortic gradient happening at rest in 30% of the cases. It is attributed to the intricate interaction between the anterior mitral leaflet, the interventricular septum and altered flow vectors generated in left ventricle along with changes in outflow tract geometry. Mitral regurgitation in varying degrees is found with or without association with structural deformities of the valve apparatus. The exercise echocardiogram evidences latent obstruction easily induced by exercise in 60 to 75% of non-obstructive forms. The determination of the gradient under this condition must be considered in routine investigation of patients with mild or no obstruction at rest. The evaluation of hypertrophic cardiomyopathy incorporates methods based on the ultrasound image, which, along with MRI, allow recognizing ventricular obstruction generating mechanisms, thus facilitating the diagnosis and management of obstructive and latent obstructive forms.

Este estudo objetiva desenvolver e aplicar uma metodologia de pesquisa que oportunize a análise das ações de extensão realizadas pelos docentes da Famed/UFRGS no período de 2000 a 2004. A pesquisa, qualitativa, utiliza estudo de caso, análise do conteúdo de entrevistas e documentos, e faz um mapeamento das ações quanto a plano acadêmico, relação universidade/sociedade e produção acadêmica. Os resultados obtidos explicitam a prática da extensão desenvolvida pelos docentes que participaram do estudo neste período como um espaço de interação entre professor/aluno/comunidade em cenários de produção/construção do conhecimento, contribuindo para formar um profissional comprometido com a realidade social, como preconizam as diretrizes curriculares da saúde e da medicina em particular. A metodologia proposta propiciou conhecer os cenários onde se desenvolvem as atividades e a interação presente nas ações de extensão com a graduação, a pós-graduação e a pesquisa.

This study aimed to develop and apply are search methodology allowing the analysis of extension activities by faculty members from the School of Medicine of the Federal University in Rio Grande do Sul, Brazil, from 2000 to 2004. This qualitative research used a case study approach and content analysis of interviews and documents, besides mapping the activities in relation to the course plan, the relationship between the university and society, and the school's academic output. The results reveal the extension activities practiced by faculty members participating in the study during this period as a space for interaction between faculty, students, and the community in scenarios involving the production and construction of knowledge, contributing to the training of physicians committed to the social reality, as recommended by health curriculum guidelines and specifically those for medicine. The proposed methodology helped shed light on scenarios in which the extension activities take place, as well as on the interaction between extension, undergraduate and graduate studies, and research.

Introduction. Retinopathy of prematurity (ROP) is an alteration in the development of the vessels of the retina with an incidence ranging from 12 to 78%. We undertook this study to determine risk factors associated with ROP in a group of premature infants. Methods. This is a retrospective and comparative study in search of risk factors of ROP, reviewing the records of infants weighing < 1500 g or gestational age ≤ 30 weeks admitted to the Neonatology Department. We carried out an ophthalmoscopy study at 4 weeks of age and then weekly until hospital discharge. We compared the group with and without retinopathy. Variables registered were birth weight, gestational age, oxygen exposure, total parenteral nutrition, antibiotics, lung disease, severe perinatal asphyxia, peri-intraventricular hemorrhage, septicemia, hyperbilirubinemia, bronchopulmonary dysplasia and red blood cell transfusion. Comparative analysis was carried out by ANOVA and logistic regression by calculating odds ratios (OR) and 95% confidence interval (95% CI). Results. We reviewed 112 infants with ROP and 95 infants without ROP. According to gender ratio, birth weight, gestational age, mechanical ventilation and days with ventilation, there was no significant difference. Risk factors were antibiotics (OR 2.36, 95% CI 1.22-4.59)), erythrocyte transfusion (OR 2.99, 95% CI 1.50-5.99), total parenteral nutrition (OR 3.20, 95% CI 1.63-6.25), and sepsis (OR 1.83, 95% CI 1.01-3.34). Conclusions. ROP was present mainly in infants with very serious disease and risk factors were antibiotics, erythrocyte transfusion, total parenteral nutrition and sepsis.

Introducción. La retinopatía del prematuro es una alteración en el desarrollo de los vasos de la retina que se observa con una incidencia que va de 12 a 78%. La complicación más temida es el desprendimiento de retina con ceguera permanente. Objetivo: determinar algunos factores de riesgo que se encuentran asociados a la retinopatía del prematuro en un grupo de neonatos pretérmino. Métodos. Estudio retrospectivo y comparativo que determinó factores de riesgo para retinopatía del prematuro, con base en la revisión de los expedientes de neonatos con peso igual o menor de 1 500 g, o edad gestacional igual o menor a 30 semanas, ingresados al Departamento de Neonatología, a los que se les realizó estudio de oftalmoscopia en la cuarta semana de vida y posteriormente cada semana hasta su egreso. Se compararon los grupos con retinopatía y sin retinopatía. Las variables analizadas fueron: peso al nacer, edad gestacional, exposición a oxígeno, nutrición parenteral, antibióticos, transfusión de eritrocitos y morbilidad que presentaron. El análisis comparfativo se realizó mediante ANOVA y regresión logística, calculando razón de momios (RM) e intervalo de confianza al 95% (IC95%). Resultados. Se revisaron 112 casos con retinopatía y 95 sin ella. En género, peso, edad gestacional, ventilación mecánica y días-ventilación no hubo diferencia significativa. Las variables con diferencia significativa fueron: antibióticos (RM 2.36, IC95% 1.22-4.59), transfusión de eritrocitos (RM 2.99, IC95% 1.50-5.99), nutrición parenteral (RM 3.20, IC95% 1.63-6.25), sepsis (RM 1.83, IC95% 1.01-3.34) y hemorragia intracraneal (47 vs 52; 41.9 vs 54.7%); esta última predominó en el segundo grupo. Conclusiones. La retinopatía del prematuro se presentó principalmente en neonatos muy graves, y los factores de riesgo asociados fueron: antibióticos, transfusión de paquete globular, nutrición parenteral y sepsis.

A cardiomiopatia hipertrófica é uma doença de origem genética e caráter familiar, causada por mutações em genes codificantes de proteínas do sarcômero. Determina hipertrofia ventricular esquerda de grau variável, geralmente difusa, com predominante acometimento do septo interventricular. A ocorrência de formas assintomáticas com hipertrofia segmentar, de grau leve ou ausente, dificulta o diagnóstico e o rastreamento de formas familiares. A penetrância elevada costuma ser incompleta, o que faz com que 20% a 30% dos adultos carreadores de mutações gênicas não expressem o fenótipo. A suscetibilidade à morte súbita e a possibilidade de expressão tardia tornam relevante o diagnóstico em fase pré-clínica. A investigação por meio do ecocardiograma Doppler e da ressonância magnética adicionada à análise detalhada do eletrocardiograma pode contribuir nesse processo. O diagnóstico genético-molecular identifica mutações em 60% a 80% dos casos. A complexidade, a demora e o elevado custo, aliados à insuficiente avaliação das relações genótipo/fenótipo restringem sua aplicação de rotina. O aprimoramento dos métodos de imagem e a introdução de técnicas moleculares mais simplificadas devem favorecer o diagnóstico clínico e pré-clínico da cardiomiopatia hipertrófica e possibilitar a futura introdução de medidas terapêuticas que possam impedir ou retardar o desenvolvimento da doença.

Hypertrophic cardiomyopathy is a familial, genetic disease caused by mutations in genes encoding sarcomeric proteins. It is characterized by various deGrees of left ventricular hypertrophy, usually diffuse, predominantly involving the interventricular septum. The asymptomatic forms with mild or no segmental hypertrophy makes it difficult to establish the diagnosis and screening for familial forms. Its high penetrance is often incomplete and, as a result, 20% to 30% of adults who carry disease-causing gene mutations do not express the phenotype. The susceptibility to sudden death and likelihood of late expression makes establishing a preclinical diagnosis all the more important. The use of Doppler echocardiography and magnetic resonance imaging, in conjunction with a detailed ECG analysis, may be useful in this process. Molecular genetic studies can identify mutations in 60% to 80% of the cases. However, its complex, time-consuming and costly nature, coupled with an inadequate assessment of genotype-phenotype relationships, limits its routine application. Major advances in imaging methods and the introduction of more simplified molecular techniques may contribute to clinical and preclinical diagnosis of hypertrophic cardiomyopathy, in addition to allowing implementation of therapeutic strategies to prevent or delay the development of the disease.

Chitosan microspheres can be used in several applications, as biomaterials, in biotechnology processes and as adsorbents. The control of particle size in microsphere production is important to make these applications viable. This study focuses on the production and morphological characterization of chitosan microspheres. Microspheres were prepared by a spraying and coagulation process. Particles underwent chemical modifications with glutaraldehyde, epichlorohydrin or acetic anhydride treatments. The microspheres presented a fairly good sphericity (0.74) but an irregular micro-surface morphology. The mean particle size (MPS) ranged from 140 to 281 mum and the mean standard deviation (MSD) from 119 to 238 mm. The conditions were modelled to provide desired MPS and MSD by using the response surface methodology (RSM).

OBJETIVO:Verificar o comportamento dos valores da hemoglobina e a prevalência de anemia entre lactentes de termo de 3 a 6 meses de idade em aleitamento materno exclusivo. MÉTODOS: Estudo transversal em 242 lactentes de 3 a 6 meses de idade com peso de nascimento superior a 2.500 g, em aleitamento materno exclusivo e em acompanhamento no Programa de Promoção do Crescimento e Desenvolvimento do Lactente do Programa Einstein na Comunidade de Paraisópolis. A dosagem de hemoglobina foi realizada por meio de punção digital entre o terceiro e o sexto meses de vida. Adotaram-se os valores de Hb < 10,3 g/dL (Saarinen) e Hb < 10 g/dL (Brault-Dubuc) como critério de anemia nas idades de 3 a 5 meses e Hb < 11,0 g/dL (OMS) para os lactentes de 6 meses. RESULTADOS: A media da hemoglobina foi de 11,3 e 11,4 g/dL aos 3 e 4 meses, 11,2 e 11,1 g/dL aos 5 e 6 meses, respectivamente. A porcentagem de anêmicos variou conforme a idade e o padrão adotado, sendo de 11,8, 10,2 e 8,3% aos 3, 4 e 5 meses, segundo o critério adotado por Brault-Dubuc, e de 20,6, 14,8 e 10,4%, respectivamente, para o critério de Saarinen. Aos 6 meses, a prevalência de anemia foi de 37,5%. CONCLUSÕES: Observaram-se prevalências de anemia variando entre 8,3 e 37,5% nos lactentes do terceiro ao sexto mês de vida, que justificam maior atenção do pediatra em relação aos níveis de hemoglobina em lactentes em aleitamento materno exclusivo, que pertençam a famílias de baixa renda e que apresentem fatores de risco para deficiência de ferro.

OBJECTIVE: To verify the behavior of hemoglobin levels and anemia prevalence in full term infants, aged 3 to 6 months and on exclusive breastfeeding. METHODS: A cross-sectional study of 242 infants aged 3 to 6 months with birth weights of more than 2,500 g, on exclusive breastfeeding and monitored by the Program for the Promotion of Infant Growth and Development, part of the Paraisópolis Einstein Community Program. Hemoglobin was assayed by finger prick between the third and sixth months of life. Anemia was defined as Hb < 10.3 g/dL (Saarinen) or Hb < 10 g/dL (Brault-Dubuc) for infants aged 3 to 5 months and as Hb < 11.0 g/dL (WHO) for infants aged 6 months. RESULTS: Mean hemoglobin concentration was 11.3 and 11.4 g/dL at 3 and 4 months and 11.2 and 11.1 g/dL at 5 and 6 months, respectively. The percentage of anemic infants varied depending on age and the cutoff adopted, being 11.8, 10.2 and 8.3% at 3, 4 and 5 months, respectively, according to the Brault-Dubuc criteria, and 20.6, 14.8 and 10.4% by the Saarinen criteria. Anemia prevalence at 6 months was 37.5%. CONCLUSIONS: Anemia prevalence rates observed among infants aged between 3 and 6 months varied from 8.3 to 37.5%, justifying increased attention on the part of pediatricians to the hemoglobin levels of infants who are on exclusive breastfeeding, come from low-income families and present risk factors for iron deficiency.