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Introdução: o hiperparatireoidismo primário (HPTP) é um distúrbio endócrino comum, tipicamente caracterizado por hipercalcemia e níveis elevados ou inapropriadamente normais do hormônio da paratireoide (HPT). O HPTP resulta da secreção autônoma e excessiva do HPT de uma ou mais glândulas paratireoides. O HPTP é benigno e causado por adenoma, na maioria dos casos. Os elementos essenciais para definir a natureza benigna ou maligna da paratireoide requerem informações clínicas juntamente com as peças cirúrgicas para avaliação patológica, além de elementos não essenciais como avaliação bioquímica pré-operatória e achados operatórios, auxiliando na definição dessa doença. Objetivo: descrever o perfil clínico-epidemiológico dos pacientes com HPTP operados no Instituto Nacional de Câncer (INCA). Método: estudo epidemiológico observacional descritivo com desenho transversal retrospectivo de pacientes maiores de 18 anos de idade, de ambos os sexos, submetidos à paratireoidectomia no INCA, cujas peças cirúrgicas e laudos histopatológicos estavam registradas pela Divisão de Patologia (DIPAT), além do registro bioquímico da elevação do HPT no pré-operatório, no período de janeiro de 1998 até maio 2022. Resultados: dos 28 prontuários avaliados, verificou se que 78,6% dos pacientes eram do sexo feminino; relação mulher/homem de 3 a 4:1; a idade média foi de 55 anos; 75,0% tinham adenoma como principal causa de HPTP, seguido do carcinoma da paratireoide (CP) (14,3%); como fator etiológico da tumorigênese, 14,3% fazem parte da síndrome endócrina hereditária, incluindo neoplasia endócrina múltipla (NEM). 71,2% dos pacientes com HPTP são sintomáticos; 57,3% manifestação esquelética pré-operatória, sendo a dor óssea (28,8%), o sintoma mais frequente, 17,8% radiograficamente representado pelo tumor marrom; 53,5% manifestação renal pré-operatória, 42,8% radiograficamente representado por litíase renal. O principal fator de risco para carcinoma da paratireoide (CP) pré-operatório foi a avaliação bioquímica com dosagem sérica pré-operatório do cálcio, PTH e fósforo (p<0,05). Finalizando, a média de seguimento foi de 31,1 meses, com a cura cirúrgica (92,8%) como principal desfecho clínico seguido de doença estrutural (7,2%). Durante todo o seguimento 17,8% evoluíram com óbito. Conclusão: evidenciou-se uma população de HPTP de maioria benigna, tipicamente por adenoma com manifestação sintomática, com hipercalcemia acentuada, onde CP foi a segunda causa mais prevalente do HPTP operado no INCA

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder, typically characterized by hypercalcemia and elevated or inappropriately normal levels of parathyroid hormone (PTH). HPTP results from autonomous and excessive secretion of HPT from one or more parathyroid glands. HPTP is benign and caused by adenoma in most cases. The essential elements to define the benign or malignant nature of the parathyroid require clinical information together with the surgical specimens for pathological evaluation, in addition to non-essential elements such as preoperative biochemical evaluation and operative findings, helping to define this disease. Objective: to describe the clinical-epidemiological profile of patients with PHPT operated on at Brazilian National Cancer Institute (INCA). Method: descriptive observational epidemiological study with retrospective cross-sectional design of patients over 18 years of age, of both sexes, submitted to parathyroidectomy at INCA, whose surgical specimens and histopathological reports were registered by the Division of Pathology (DIPAT), in addition to the biochemical registry preoperative HPT elevation, from January 1998 to May 2022. Results: of the 28 medical records evaluated, it was found that 78.6% of the patients were female; female/male ratio from 3 to 4:1; the average age was 55 years; 75.0% had adenoma as the main cause of PHPT, followed by parathyroid carcinoma (PC) (14.3%); as an etiological factor of tumorigenesis, 14.3% are part of the hereditary endocrine syndrome, including multiple endocrine neoplasia (MEN). 71.2% of patients with PHPT are symptomatic; 57.3% preoperative skeletal manifestation, with bone pain (28.8%) being the most frequent symptom, 17.8% radiographically represented by the brown tumor; 53.5% preoperative renal manifestation, 42.8% radiographically represented by renal lithiasis. The main risk factor for preoperative parathyroid carcinoma (PC) was the biochemical evaluation with preoperative serum levels of calcium, PTH and phosphorus (p<0.05). Finally, the mean follow-up was 31.1 months, with surgical cure (92.8%) as the main clinical outcome, followed by structural disease (7.2%). During the entire follow-up, 17.8% died. Conclusion: a benign majority of PHPT population was evidenced, typically due to adenoma with symptomatic manifestation, with severe hypercalcemia, where CP was the second most prevalent cause of PHPT operated at INCA

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Objective: Examine the Strengths and Difficulties Questionnaire (SDQ) responses of parents and teachers for children with ADHD comorbid with major depressive disorder (MDD), with an emphasis on determining how well the respondent groups' responses correlate, and how well the results obtained perform as predictors of clinical diagnosis. Method: The SDQ was completed by parents and teachers of (n = 215 participants, 7-12 years old) in ADHD, MDD, ADHD + MDD, and healthy control groups. Agreement between parent and teacher SDQs and their concordance with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnoses were assessed. Receiver operating characteristic (ROC) and Kappa concordance analyses were used to compare the groups with the health control group. Results: The comorbid group presented greater impairments than the ADHD, MDD, and control groups (p < .001). Conclusion: The presence of psychiatric comorbidity causes greater impairment for school children with ADHD. The SDQ has good sensitivity for detecting these children and correlates well with DSM diagnosis.

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BACKGROUND: Recent studies have suggested that children with attention-deficit hyperactivity disorder (ADHD) may benefit from computerized cognitive training. Therapy implementation is especially complicated when ADHD is associated with learning disorders (LDs). This study tested the efficacy of a computer-based cognitive training program, namely, computerized cognitive training (CCT), in children with ADHD comorbid with an LD (ADHD-LD), with or without psychostimulant medication. MATERIALS AND METHODS: After diagnostic evaluations, 27 children with ADHD-LD (8 unmedicated and 19 medicated) participated in CCT, which is intended to improve attention, memory, reasoning, visual processing, and executive functioning. The participants completed 24 1-hour sessions over 3 months. Neuropsychometric and standardized academic test results before and after training were compared to assess treatment efficacy. Shapiro-Wilk normality tests were applied, and subsequent Wilcoxon tests were used to identify significant differences in pre-versus post-training performance. RESULTS: After CAT, children diagnosed with ADHD-LD showed 1) improvements in trained skills, measured directly within the software and indirectly by external psychometric tests; 2) improvements in attention, memory, and some executive functioning; 3) improvements in academic performance, particularly in mathematics; and 4) reductions in maladaptive behavioral features. CONCLUSION: The present findings suggest that cognitive training programs should be explored further as potential adjunctive therapies to improve outcomes in children with ADHD-LD.

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Objetivo. Verificar la hipótesis de que un periodo de hospitalización prolongado y el estado nutricional al ingreso son factores significativamente asociados con la desnutrición durante la hospitalización. Material y métodos. Estudio prospectivo con dos mediciones de peso (al ingreso y al alta) y una medición de estatura (al ingreso) por niño, realizado en el Instituto de Puericultura y Pediatría Marta-gão Gesteira (IPPMG), Río de Janeiro, Brasil. El estudio incluyó 456 niños de bajo nivel socioeconómico menores de 10 años de edad, admitidos en el IPPMG durante 1997. El análisis estadístico incluyó cálculo de prevalencia de desnutrición intrahospitalaria conforme a covariables. El periodo de hospitalización varió de 1 a 69 días. El análisis estadístico consistió en el cálculo de razones de momios usando regre-sión logística multivariada, para probar la asociación entre la desnutrición intrahospitalaria y género, edad, periodo de hospitalización, presencia de emaciación y estatura baja para la edad. Resultados. La regresión logística mostró que después de ajustar por género, edad y estatura baja para la edad al ingreso, la presencia de emaciación al ingreso (OR= 0.07, CI 95 POR CIENTO 0.01 - 0.55) y el periodo de hospita-lización de 17 a 69 días (OR= 4.68, CI 95 POR CIENTO 2.00 - 10.95) resultaron estadísticamente asociados con desnutrición intrahospitalaria en el modelo final. Conclusiones. Como medidas de intervención, los autores sugieren implementar un sistema precoz de identificación al ingreso de los niños con riesgo de desarrollar desnutrición intrahospitalaria, jun-to con una revisión e implementación de protocolos de alimentación hospitalaria.

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