Primary malignant tumors of the adrenal glands

Malignancy must be considered in the management of adrenal lesions, including those incidentally identified on imaging studies. Adrenocortical carcinomas (ACCs) are rare tumors with an estimated annual incidence of 0.7–2 cases per year and a worldwide prevalence of 4–12 cases per million/year. However, a much higher incidence of these tumors (415 times) has been demonstrated in south and southeastern Brazil. Most ACCs cause hypersecretion of steroids including glucocorticoids and androgens. ACC patients have a very poor prognosis with a 5-year overall survival (OS) below 30% in most series. Pheochromocytoma or paraganglioma (PPGL) is a metabolically active tumor originating from the chromaffin cells of the adrenal medulla. The incidence of PPGL is 0.2 to 0.9 cases per 100,000 individuals per year. Pheochromocytomas are present in approximately 4-7% of patients with adrenal incidentalomas. Classically, PPGL manifests as paroxysmal attacks of the following 4 symptoms: headaches, diaphoresis, palpitations, and severe hypertensive episodes. The diagnosis of malignant PPGL relies on the presence of local invasion or metastasis. In this review, we present the clinical and biochemical characteristics and pathogenesis of malignant primary lesions that affect the cortex and medulla of human adrenal glands

Does Triatoma brasiliensis occupy the same environmental niche space as Triatoma melanica?

Submitted by Nuzia Santos ([email protected]) on 2016-02-19T16:12:55Z No. of bitstreams: 1 Does Triatoma brasiliensis occupy the same.pdf: 568419 bytes, checksum: 8ebd865012b7ba92c6be897286f9868e (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2016-02-19T16:19:20Z (GMT) No. of bitstreams: 1 Does Triatoma brasiliensis occupy the same.pdf: 568419 bytes, checksum: 8ebd865012b7ba92c6be897286f9868e (MD5)Made available in DSpace on 2016-02-19T16:19:20Z (GMT). No. of bitstreams: 1 Does Triatoma brasiliensis occupy the same.pdf: 568419 bytes, checksum: 8ebd865012b7ba92c6be897286f9868e (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, Minas Gerais, Brazil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, Minas Gerais, Brazil.Secretaria de Saúde do Estado do Ceará. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, Minas Gerais, Brazil.IMBIV-CONICET. Córdoba, Argentina.Background: Triatomines (Hemiptera, Reduviidae) are vectors of Trypanosoma cruzi, the causative agent of Chagas disease, one of the most important vector-borne diseases in Latin America. This study compares the environmental niche spaces of Triatoma brasiliensis and Triatoma melanica using ecological niche modelling and reports findings on DNA barcoding and wing geometric morphometrics as tools for the identification of these species. Methods: We compared the geographic distribution of the species using generalized linear models fitted to elevation and current data on land surface temperature, vegetation cover and rainfall recorded by earth observation satellites for northeastern Brazil. Additionally, we evaluated nucleotide sequence data from the barcode region of the mitochondrial cytochrome c oxidase subunit I (CO1) and wing geometric morphometrics as taxonomic identification tools for T. brasiliensis and T. melanica. Results: The ecological niche models show that the environmental spaces currently occupied by T. brasiliensis and T. melanica are similar although not equivalent, and associated with the caatinga ecosystem. The CO1 sequence analyses based on pair wise genetic distance matrix calculated using Kimura 2-Parameter (K2P) evolutionary model, clearly separate the two species, supporting the barcoding gap. Wing size and shape analyses based on seven landmarks of 72 field specimens confirmed consistent differences between T. brasiliensis and T. melanica. Conclusion: Our results suggest that the separation of the two species should be attributed to a factor that does not include the current environmental conditions. However, as the caatinga is a biome that has existed in the area for at least the last 18,000 years, past conditions might have had an influence in the speciation process. The DNA Barcoding approach may be extended to these members of the subfamily Triatominae

Prognostic factors of a good response to initial therapy in children and adolescents with differentiated thyroid cancer

BACKGROUND: Therapeutic approaches in pediatric populations are based on adult data because there is a lack of appropriate data for children. Consequently, there are many controversies regarding the proper treatment of pediatric patients. OBJECTIVE: The present study was designed to evaluate patients with differentiated thyroid carcinoma diagnosed before 20 years of age and to determine the factors associated with the response to the initial therapy. METHODS: Sixty-five patients, treated in two tertiary-care referral centers in Rio de Janeiro between 1980 and 2005 were evaluated. Information about clinical presentation and the response to initial treatment was analyzed and patients had their risk stratified in Tumor-Node- Metastasis; Age-Metastasis-Extracapsular-Size; distant Metastasis-Age-Completeness of primary tumor resection-local Invasion-Size and American-Thyroid-Association classification RESULTS: Patients ages ranged from 4 to 20 years (median 14). The mean follow-up was 12,6 years. Lymph node metastasis was found in 61.5% and indicated a poor response to initial therapy, with a significant impact on time for achieving disease free status (p = 0.014 for response to initial therapy and p<0,0001 for disease-free status in follow-up). Distant metastasis was a predictor of a poor response to initial therapy in these patients (p = 0.014). The risk stratification systems we analyzed were useful for high-risk patients because they had a high sensitivity and negative predictive value in determining the response to initial therapy. CONCLUSIONS: Metastases, both lymph nodal and distant, are important predictors of the persistence of disease after initial therapy in children and adolescents with differentiated thyroid cancer

Alavancagem de marca: um estudo de caso

O trabalho foi realizado em uma empresa denominada Alfa, indústria farmacêutica e de produtos naturais, localizada na Região Noroeste do Estado do Rio Grande do Sul. O objetivo geral do trabalho é a captação de recursos e investimentos financeiros dos atuais e principais distribuidores da referida empresaa fim de alavancar a marca no cenário nacional, sem onerá-la diretamente e postergar o investimento a longo prazo. Nesse caso a marca foi muito divulgada em cenário nacional, com o investimento sendo absorvido pelos distribuidores e com benefício de colocar 6.400 unidades de um produto da empresa no mercado. A metodologia do presente trabalho, quanto aos fins, é descritiva, explicativa e aplicada. Quanto aos meios, o trabalho é bibliográfico, pesquisa de campo e estudo de caso. Optou-se pela aplicação de questionários entre os principais distribuidores da empresa, sendo pesquisa quantitativa. Nesse trabalho, optou-se pela amostragem não probabilística por tipicidade. Os sujeitos da pesquisa foram os sócios proprietários das distribuidoras. O resultado do trabalho foi extremamente gratificante, pois se teve propagação da marca em cenário nacional, a colocação de produtos em diversos estados brasileiros e investimentos financeiros realizados diretamente pelos distribuidores, obtendo-se um lucro significativo sobre a venda

Educomunicação e alfabetização midiática: conceitos, práticas e interlocuções

O livro organizado por Ismar de Oliveira Soares, Claudemir Edson Viana e Jurema Brasil Xavier apresenta uma série de artigos sobre o tema divididos em quatro partes: 1-Atualizando conceitos e práticas; 2-A educação midiática em diálogo com o currículo escolar; 3-A Educomunicação em interlocução com as políticas públicas; e, 4-A Educomunicação em interlocução com as políticas públicas. A obra dedica seus 24 artigos especificamente aos saberes e às práticas inerentes ao tema da alfabetização midiática. Numa perspectiva multidisciplinar, os leitores aqui encontrarão experiências alimentadas tanto pelos referenciais da mídia-educação quanto pelo paradigma da Educomunicação, que emerge dos movimentos sociais da América Latina, na confluência entre a comunicação alternativa e a educação popular freiriana, a partir dos anos de 1960 e 1970

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Anais do V Encontro Brasileiro de Educomunicação: Educação midiática e políticas públicas

A presente coletânea, que chega ao público através de um suporte digital, tem como objetivo disponibilizar os papers, bem como os relatos de experiências educomunicativas apresentados durante o V ENCONTRO BRASILEIRO DE EDUCOMUNICAÇÃO, que teve como tema central: “Educação Midiática e Políticas Públicas”. O evento foi realizado em São Paulo, entre 19 e 21 de setembro de 2013, a partir de uma parceria entre o NCE/USP - Núcleo de Comunicação e Educação da USP, a Licenciatura em Educomunicação da ECA/USP, a ABPEducom – Associação Brasileira de Pesquisadores e Profissionais da Educomunicação e a FAPCOM – Faculdade Paulus de Tecnologia e Comunicação, que ofereceu seu campus, na Vila Mariana, para os atos do evento. Os presentes anais disponibilizam o texto de abertura, de autoria do coordenador geral do evento, denominado “Educação midiática e políticas públicas: vertentes históricas da emergência da Educomunicação na América Latina”. Na sequência, apresentam 61 papers sobre aspectos específicos da temática geral, resultantes de pesquisas na área, seguidos de 27 relatos de práticas educomunicativas, em nível nacional