RESUMO

Several hantaviruses result in zoonotic infections of significant public health concern, causing hemorrhagic fever with renal syndrome (HFRS) or hantavirus cardiopulmonary syndrome (HCPS) in the Old and New World, respectively. Given a 35% case fatality rate, disease-causing New World hantaviruses require a greater understanding of their biology, genetic diversity, and geographical distribution. Juquitiba hantaviruses have been identified in Oligoryzomys nigripes in Brazil, Paraguay, and Uruguay. Brazil has reported the most HCPS cases associated with this virus. We used a multiplexed, amplicon-based PCR strategy to screen and deep-sequence the virus harbored within lung tissues collected from Oligoryzomys species during rodent field collections in southern (Itapúa) and western (Boquerón) Paraguay. No Juquitiba-like hantaviruses were identified in Boquerón. Herein, we report the full-length S and M segments of the Juquitiba hantaviruses identified in Paraguay from O. nigripes. We also report the phylogenetic relationships of the Juquitiba hantaviruses in rodents collected from Itapúa with those previously collected in Canindeyú. We showed, using the TN93 nucleotide substitution model, the coalescent (constant-size) population tree model, and Bayesian inference implemented in the Bayesian evolutionary analysis by sampling trees (BEAST) framework, that the Juquitiba virus lineage in Itapúa is distinct from that in Canindeyú. Our spatiotemporal analysis showed significantly different time to the most recent ancestor (TMRA) estimates between the M and S segments, but a common geographic origin. Our estimates suggest the additional geographic diversity of the Juquitiba virus within the Interior Atlantic Forest and highlight the need for more extensive sampling across this biome.

Assuntos

RESUMO

Advances in genome sequencing techniques produced a significant growth of phylogenomic datasets. This massive amount of data represents a computational challenge for molecular dating with Bayesian approaches. Rapid molecular dating methods have been proposed over the last few decades to overcome these issues. However, a comparative evaluation of their relative performance on empirical data sets is lacking. We analyzed 23 empirical phylogenomic datasets to investigate the performance of two commonly employed fast dating methodologies: penalized likelihood (PL), implemented in treePL, and the relative rate framework (RRF), implemented in RelTime. They were compared to Bayesian analyses using the closest possible substitution models and calibration settings. We found that RRF was computationally faster and generally provided node age estimates statistically equivalent to Bayesian divergence times. PL time estimates consistently exhibited low levels of uncertainty. Overall, to approximate Bayesian approaches, RelTime is an efficient method with significantly lower computational demand, being more than 100 times faster than treePL. Thus, to alleviate the computational burden of Bayesian divergence time inference in the era of massive genomic data, molecular dating can be facilitated using the RRF, allowing evolutionary hypotheses to be tested more quickly and efficiently.

Assuntos

RESUMO

The genus Sprattus comprises five species of marine pelagic fishes distributed worldwide in antitropical, temperate waters. Their distribution suggests an ancient origin during a cold period of the earth's history. In this study, we evaluated this hypothesis and corroborated the non-monophyly of the genus Sprattus, using a phylogenetic approach based on DNA sequences of five mitochondrial genome regions. Sprattus sprattus is more closely related to members of the genus Clupea than to other Sprattus species. We also investigated the historical biogeography of the genus, with the phylogenetic tree showing two well-supported clades corresponding to the species distribution in each hemisphere. Time-calibrated phylogenetic analyses showed that an ancient divergence between Northern and Southern Hemispheres occurred at 55.8 MYBP, followed by a diversification in the Oligocene epoch in the Northern Hemisphere clade (33.8 MYBP) and a more recent diversification in the Southern Hemisphere clade (34.2 MYBP). Historical biogeography analyses indicated that the most recent common ancestor (MRCA) likely inhabited the Atlantic Ocean in the Southern Hemisphere. These results suggest that the ancestral population of the MRCA diverged in two populations, one was dispersed to the Northern Hemisphere and the other across the Southern Hemisphere. Given that the Eocene was the warmest epoch since the Paleogene, the ancestral populations would have crossed the tropics through deeper cooler waters, as proposed by the isothermal submergence hypothesis. The non-monophyly confirmed for the genus Sprattus indicates that its systematics should be re-evaluated.

RESUMO

COVID-19 is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared by the World Health Organization a global public health emergency. Among the severe outbreaks across South America, Uruguay has become known for curtailing SARS-CoV-2 exceptionally well. To understand the SARS-CoV-2 introductions, local transmissions, and associations with genomic and clinical parameters in Uruguay, we sequenced the viral genomes of 44 outpatients and inpatients in a private healthcare system in its capital, Montevideo, from March to May 2020. We performed a phylogeographic analysis using sequences from our cohort and other studies that indicate a minimum of 23 independent introductions into Uruguay, resulting in five major transmission clusters. Our data suggest that most introductions resulting in chains of transmission originate from other South American countries, with the earliest seeding of the virus in late February 2020, weeks before the borders were closed to all non-citizens and a partial lockdown implemented. Genetic analyses suggest a dominance of S and G clades (G, GH, GR) that make up >90% of the viral strains in our study. In our cohort, lethal outcome of SARS-CoV-2 infection significantly correlated with arterial hypertension, kidney failure, and ICU admission (FDR < 0.01), but not with any mutation in a structural or non-structural protein, such as the spike D614G mutation. Our study contributes genetic, phylodynamic, and clinical correlation data about the exceptionally well-curbed SARS-CoV-2 outbreak in Uruguay, which furthers the understanding of disease patterns and regional aspects of the pandemic in Latin America.

Assuntos

RESUMO

Resumo Objetivo: Verificar a associação entre a idade materna e os motivos alegados pelas mães para o início precoce da alimentação complementar aos 30, 90 e 180 dias de vida da criança. Métodos: Trata-se de um estudo de coorte prospectivo, desenvolvido em uma maternidade do Sistema Único de Saúde de um município de médio porte do interior do Estado de São Paulo, Brasil. A amostra foi de 545 participantes, sendo 103 adolescentes e 442 adultas no período pós-parto. Os dados foram coletados de outubro de 2016 a outubro de 2017, face-a-face na maternidade e via telefone em 30, 90 e 180 dias após o pato, e analisados por meio dos testes Qui-Quadrado e Exato de Fisher. Resultados: Aos 30 dias pós-parto as adolescentes referiram motivos para introdução de chá relacionados às orientações de outras pessoas; já as adultas, referiram motivos relacionados à criança (p = 0,001). Aos 90 dias, para a introdução de água e chá, as adolescentes alegaram orientações de outras pessoas e as adultas alegaram motivos da criança (p = 0,004 para água e p < 0,001 para chá). Aos 180 dias, para a introdução de outro leite, adolescentes e adultas referiram motivos relacionados ao seu próprio desejo (p = 0,03). Conclusão: As adolescentes e adultas apresentaram motivos diferentes para a introdução de chá aos 30 dias pós-parto, para a introdução de água e chá aos 90 dias e apresentaram o mesmo motivo para a introdução de outro leite aos 180 dias pós-parto.

Resumen Objetivo: Verificar la relación entre la edad materna y los motivos indicados por las madres para el inicio precoz de la alimentación complementaria a los 30, 90 y 180 días de vida del bebé. Métodos: Se trata de un estudio de cohorte prospectivo, llevado a cabo en una maternidad del Sistema Único de Salud de un municipio de tamaño medio en el interior del estado de São Paulo, Brasil. La muestra fue de 545 participantes, de las cuales 103 eran adolescentes y 442 adultas en el período de posparto. Los datos fueron recopilados de octubre de 2016 a octubre de 2017, cara a cara en la maternidad y por teléfono a los 30, 90 y 180 días después del parto, y fueron analizados mediante la prueba χ2 de Pearson y la prueba exacta de Fisher. Resultados: A los 30 días de posparto, las adolescentes mencionaron motivos para la introducción de té relacionados con in strucciones de otras personas. Las adultas mencionaron motivos relacionados con el bebé (p = 0,001). A los 90 días, para la introducción de agua y té, las adolescentes declararon que siguieron instrucciones de otras personas y las adultas que fue por motivos del bebé (p = 0,004 para agua y p < 0,001 para té). A los 180 días, para la introducción de otra leche, las adolescentes y las adultas mencionaron motivos relacionados con su propio deseo (p = 0,03). Conclusión: Las adolescentes y adultas presentaron motivos diferentes para la introducción de té a los 30 días posparto y para la introducción de agua y té a los 90 días, y presentaron el mismo motivo para la introducción de otra leche a los 180 días posparto.

Abstract Objective: Check for associations between maternal age and the reasons provided by mothers for the early introduction of complementary feeding in infants at 30, 90 and 180 days after birth. Methods: This is a prospective cohort study, conducted in a maternity hospital of the Brazilian Unified Health System (SUS) located in a medium-sized city of the State of São Paulo, Brazil. The sample was made up of 545 participants - 103 adolescents and 442 adults in the postpartum period. Data were collected from October 2016 to October 2017, face to face, at the maternity hospital and via telephone 30, 90 and 180 days after birth, and analyzed using the Chi-square and Fisher's exact tests. Results: Thirty days after birth, the adolescent mothers mentioned recommendations of other people for introducing tea into the baby's diet; on the other hand, the adult mothers mentioned reasons related to the child (p=0.001). Ninety days after birth, the adolescent mothers reported recommendations for the introduction of water and tea from other people and the adult mothers reported reasons related to the child (p=0.004 for water and p<0.001 for tea). And 180 days after birth, the adolescent and adult mothers reported reasons related to their own choice for the introduction of another type of milk (p = 0.03). Conclusion: Adolescent and adult mothers presented different reasons for introducing tea 30 days after birth, for introducing water and tea 90 after birth, and presented the same reason for introducing another type of milk 180 days after birth.

Assuntos

RESUMO

Highly pathogenic H7N3 influenza A viruses have persisted in poultry in Mexico since 2012, diversifying into multiple lineages that have spread to three Mexican states, as of 2016. The H7N3 viruses segregate into three distinct clades that are geographically structured. All 2016 viruses are resistant to adamantane antiviral drugs and have an extended 24-nucleotide insertion at the HA cleavage site that was acquired from host 28S ribosomal RNA.

Assuntos

RESUMO

The integration of approaches that allow the incorporation of stochasticity of gene histories with phylogenetic methods resulted in new approaches for the old issue of species delimitation. Nevertheless, coalescent methods seem problematic for taxa with large effective population size and shallow temporal diversification (like marine fishes). Here, we investigate the performance of single-locus (cytochrome oxidase 1, commonly used in DNA barcoding initiatives) methods for molecular species delimitation in snappers of Lutjaninae from the Western Atlantic and Pacific Eastern. Our results show incongruences among methods. ABGD, PTP and mPTP trend towards a lower number of estimated species. Phylogenetic-coalescent methods with single threshold were majority congruent for a same number of lineages. On the other hand, algorithms with multiple thresholds tend to estimate a higher number of potential species. We do not endorse the use of single-locus for species delimitation, but we do reinforce that single-locus data is sufficient to flag many problems.

Assuntos

RESUMO

PREMISE OF THE STUDY: The subtribe Menthinae (Lamiaceae), with 35 genera and 750 species, is among the largest and most economically important subtribes within the mint family. Most genera of Menthinae are found exclusively in the New World, where the group has a virtually continuous distribution ranging from temperate North America to southern South America. In this study, we explored the presence, timing, and origin of amphitropical disjuncts within Menthinae. METHODS: Our analyses were based on a data set consisting of 89 taxa and the nuclear ribosomal DNA markers ITS and ETS. Phylogenetic relationships were determined under maximum likelihood and Bayesian criteria, divergence times were estimated with the program BEAST, and ancestral range estimated with BioGeoBEARS. KEY RESULTS: A North Atlantic Land Bridge migration event at about 10.6 Ma is inferred from western Eurasia to North America. New World Menthinae spread rapidly across North America, and then into Central and South America. Several of the large speciose genera are not monophyletic with nuclear rDNA, a finding mirrored with previous chloroplast DNA results. Three amphitropical disjunctions involving North and southern South America clades, one including a southeastern South American clade with several genera, were inferred to have occurred within the past 5 Myr. CONCLUSIONS: Although three New World Menthinae genera occur in both North and South America, none exhibit an amphitropical disjunction. However, three clades exhibit amphitropical disjunctions, all dating to the early Pliocene, and all involve jump dispersals to either southeastern or southwestern South America from southeastern North America.

Assuntos

RESUMO

BACKGROUND: Pleistocene climatic fluctuations are known to be an engine of biotic diversification at higher latitudes, but their impact on highly diverse tropical areas such as the Andes remains less well-documented. Specifically, while periods of global cooling may have led to fragmentation and differentiation at colder latitudes, they may - at the same time - have led to connectivity among insular patches of montane tropical habitat with unknown consequences on diversification. In the present study we utilized ~5.5 kb of DNA sequence data from eight nuclear loci and one mitochondrial gene alongside diagnostic morphological and bioacoustic markers to test the effects of Pleistocene climatic fluctuations on diversification in a complex of Andean tyrant-flycatchers of the genus Elaenia. RESULTS: Population genetic and phylogenetic approaches coupled with coalescent simulations demonstrated disparate levels of gene flow between the taxon chilensis and two parapatric Elaenia taxa predominantly during the last glacial period but not thereafter, possibly on account of downward shifts of montane forest habitat linking the populations of adjacent ridges. Additionally, morphological and bioacoustic analyses revealed a distinct pattern of character displacement in coloration and vocal traits between the two sympatric taxa albiceps and pallatangae, which were characterized by a lack of gene flow. CONCLUSION: Our study demonstrates that global periods of cooling are likely to have facilitated gene flow among Andean montane Elaenia flycatchers that are more isolated from one another during warm interglacial periods such as the present era. We also identify a hitherto overlooked case of plumage and vocal character displacement, underpinning the complexities of gene flow patterns caused by Pleistocene climate change across the Andes.

Assuntos

RESUMO

We examine the eudicot order Myrtales, a clade with strong Gondwanan representation for most of its families. Although previous phylogenetic studies greatly improved our understanding of intergeneric and interspecific relationships within the order, our understanding of inter-familial relationships still remains unresolved; hence, we also lack a robust time-calibrated chronogram to address hypotheses (e.g., biogeography and diversification rates) that have implicit time assumptions. Six loci (rbcL, ndhF, matK, matR, 18S, and 26S) were amplified and sequenced for 102 taxa across Myrtales for phylogenetic reconstruction and ten fossil priors were utilized to produce a chronogram in BEAST. Combretaceae is identified as the sister clade to all remaining families with moderate support, and within the latter clade, two strongly supported groups are seen: (1) Onagraceae+Lythraceae, and (2) Melastomataceae+the Crypteroniaceae, Alzateaceae, Penaeaceae clade along with Myrtaceae+Vochysiaceae. Divergence time estimates suggest Myrtales diverged from Geraniales ∼124Mya during the Aptian of the Early Cretaceous. The crown date for Myrtales is estimated at ∼116Mya (Albian-Aptian). BioGeoBEARS showed significant improvement in the likelihood score when the "jump dispersal" parameter was added. South America and/or Africa are implicated as important ancestral areas in all deeper nodes. BAMM analyses indicate that the best configuration included three significant shifts in diversification rates within Myrtales: near the crown of Melastomataceae (∼67-64Mya), along the stem of subfamily Myrtoideae (Myrtaceae; ∼75Mya), and along the stem of tribe Combreteae (Combretaceae; ∼50-45Mya). Issues with conducting diversification analyses more generally are examined in the context of scale, taxon sampling, and larger sets of phylogenetic trees.

Assuntos

RESUMO

Phylogenetic studies in Melastomataceae have demonstrated the need for taxonomic rearrangements in the current classification. Nonetheless, melastomes are among the most diverse groups of plants and several cases of known artificial taxa have been observed and awaiting further resolution. The Leandra s.str. clade, with ca. 200 species, includes the majority of the taxa traditionally treated in the genus Leandra and is almost restricted to eastern Brazil. In earlier studies, some attempts have been made to infer the relationships within Leandra s.str., but the sampling was sparse and the resolution low inside the clade. Here, we attempt to provide an improved phylogenetic hypothesis for this group on which to base further studies. Specifically, we provide a comprehensive taxon sampling and attempt to infer a species tree for this group, dissecting potential noise in the phylogenetic reconstruction, such as paralogy, rogue taxa, hybridization and incomplete lineage sorting. Our data set includes 126 ingroup species (192 terminals) and four partitions (six markers). We implement the (∗)BEAST model for species tree inference and perform several simulation methods to assess model fit and to discuss potential causes for the observed patterns. Major lineages of Leandra s.str. were delineated, a strictly bifurcating species tree model seems to not account for the observed data, and hybridization is very likely an important evolutionary force in this group.

Assuntos

RESUMO

A presente pesquisa tem como foco a condenação à morte e a execução, porenforcamento, em 1855, do fazendeiro Manuel da Motta Coqueiro, como mandante da chacina de uma família, em Macabu, localidade do município de Macaé, no estado do Rio de Janeiro.Durante o processo judiciário, surgiram sérias dúvidas quanto à culpa do condenado. A repercussão jornalística e literária da época e uma contínua produção editorial e artística fizeramcom que o episódio não tenha caído no esquecimento ao longo de mais de 150 anos. Com base numa perspectiva psicossocial da memória, a pesquisa buscou verificar a extensão e as condições com que a memória do episódio se encontra presente na população atual de Macaé. Foramrealizadas 400 entrevistas semiestruturadas com uma amostra estratificada representativa dapopulação. Os resultados mostram que apenas 20,5% dos entrevistados têm lembrança ou conhecimento do episódio e que, destes, 80% acreditam que a justiça falhou e 60% que tal falhafoi intencional. A construção da memória privilegiou dois conteúdos para os quais não há qualquer comprovação objetiva: uma maldição supostamente lançada pelo condenado sobre acidade de Macaé e a crença de que se tratou da última execução legal realizada no país.

The focus of the present research is the capital sentence and the hanging execution, in 1855, of Manuel da Motta Coqueiro, a farmer accused of ordering the massacre of a whole family in Macabu, a locality in the city of Macaé, State of Rio de Janeiro. During the judicial process, serious doubts about the defendant guilty emerged. The occurrence of a great journalistic and literary repercussion at that time, as well as a continuous editorial and artistic production, prevented the episode from being forgotten over more than 150 years. Based on a psychosocial perspective of the memory, this research aimed to find the extension and the context in which that episode memory exists in the contemporary population of Macaé. Four hundred semi-structured interviews have been accomplished with a stratified samplerepresentative of such population. The results showed that 20,5% of the respondents have some memory or knowledge about such episode; the results also showed that 80% of this group of respondents believe in a justice failure and that 60% consider that such failure was intentional. The building of that memory favored two propositions for which there is no objective evidence: an imprecation presumably launched by the defendant upon the city of Macaé, and the belief that such execution has been the last legal one carried out in Brazil.

Assuntos

RESUMO

A presente pesquisa tem como foco a condenação à morte e a execução, porenforcamento, em 1855, do fazendeiro Manuel da Motta Coqueiro, como mandante da chacina de uma família, em Macabu, localidade do município de Macaé, no estado do Rio de Janeiro.Durante o processo judiciário, surgiram sérias dúvidas quanto à culpa do condenado. A repercussão jornalística e literária da época e uma contínua produção editorial e artística fizeramcom que o episódio não tenha caído no esquecimento ao longo de mais de 150 anos. Com base numa perspectiva psicossocial da memória, a pesquisa buscou verificar a extensão e as condições com que a memória do episódio se encontra presente na população atual de Macaé. Foramrealizadas 400 entrevistas semiestruturadas com uma amostra estratificada representativa dapopulação. Os resultados mostram que apenas 20,5% dos entrevistados têm lembrança ou conhecimento do episódio e que, destes, 80% acreditam que a justiça falhou e 60% que tal falhafoi intencional. A construção da memória privilegiou dois conteúdos para os quais não há qualquer comprovação objetiva: uma maldição supostamente lançada pelo condenado sobre acidade de Macaé e a crença de que se tratou da última execução legal realizada no país. (AU)

The focus of the present research is the capital sentence and the hanging execution, in 1855, of Manuel da Motta Coqueiro, a farmer accused of ordering the massacre of a whole family in Macabu, a locality in the city of Macaé, State of Rio de Janeiro. During the judicial process, serious doubts about the defendant guilty emerged. The occurrence of a great journalistic and literary repercussion at that time, as well as a continuous editorial and artistic production, prevented the episode from being forgotten over more than 150 years. Based on a psychosocial perspective of the memory, this research aimed to find the extension and the context in which that episode memory exists in the contemporary population of Macaé. Four hundred semi-structured interviews have been accomplished with a stratified samplerepresentative of such population. The results showed that 20,5% of the respondents have some memory or knowledge about such episode; the results also showed that 80% of this group of respondents believe in a justice failure and that 60% consider that such failure was intentional. The building of that memory favored two propositions for which there is no objective evidence: an imprecation presumably launched by the defendant upon the city of Macaé, and the belief that such execution has been the last legal one carried out in Brazil. (AU)

Assuntos

RESUMO

A detecção precoce do câncer de mama em estágio inicial por meio da mamografia é das maneiras efetivas de se reduzirem as taxas de morbidade e mortalidade. Os objetivos deste artigo foram verificar o conhecimento que as mulheres idosas têm sobre o câncer de mama e mamografia; identificar se elas fazem esse exame e apontar os motivos que as levam ou não a realizarem esse exame. Trata-se de estudo exploratório de corte transversal, com 98 mulheres de três Centros de Convivência da Terceira Idade em São Paulo. Sobre o conhecimento da mamografia como exame usado na detecção precoce do câncer de mama, 55 por cento das mulheres responderam que conheciam. A grande maioria (77,6 por cento) costumava fazer esse exame, e 22,4 por cento nunca o fizeram. Os motivos mais apontados para se submeter à mamografia foram: preocupação com a saúde (53,8 por cento) erecomendação médica (38,5 por cento). Os motivos para não fazer o exame foram: não ter recomendação médica (50 por cento), nunca terá a doença (23,0 por cento), não teve sintomas (19,2 por cento) e medo (7,7 por cento). Este estudo mostrou que o assunto "câncer de mama" é bem conhecido pelas mulheres, porém a mamografia ainda precisa ser esclarecida quanto aos seus objetivos e recomendações. O fato de termos mulheres idosas que nunca realizaram oexame aponta a necessidade contínua de realizarmos ações educativas sobre o câncer de mama e seus exames de detecção precoce.

Early detection at the initial stage of breast cancer through mammography is the best way of reducing morbidity and mortality rates. The scope of this study was to establish awareness about breast cancer and mammography among elderly women, if they take the exam and discover the reasons that lead them to take the exam or not. A cross-sectional and exploratory study was conducted with 98 elderly women in three Senior Citizen Daycare Centers in São Paulo. With respect to awareness of mammography as the exam used for early detection of breast cancer, 55 percent of the women answered that they knew. The majority of these women (77.6 percent) had taken the exam and 22.4 percent had never done so. The reasons most frequently cited for taking a mammography were concern with health (53.8 percent) and medical recommendation (38.5 percent). The reasons for not taking the exam were not having a medical recommendation (50 percent), conviction that they will never have the illness (23.1 percent), didn't feel symptoms (19.2 percent) and fear (7.7 percent). This study showed that the subject of "breast cancer" is well known by the women, however mammography needs to be explained better. The fact that there are elderly women who have never submitted to the exam reveals the ongoing need to stage educational campaigns about breast cancer and the early detection exams.

Assuntos

RESUMO

Pensando no instigante sucesso do desenho animado "A Bela e a Fera", da Walt Disney, que teve grande repercussão mundial na época em que fora exibido, este artigo propõe-se a compreender o desenvolvimento psicológico da personagem Bela. Para tanto, algumas cenas do filme foram escolhidas para análise, com o aporte teórico de Sigmund Freud, tendo-se observado, com isso, a transformação ocorrida na vida psicossexual de Bela ao passar do Narcisismo para o Complexo de Édipo e a resolução deste. Foi entrelaçada a seguir, com a colaboração do entendimento de Marie-Louise Von Franz, a aquisição do Feminino por parte da personagem com a importância dos contos de fadas na construção da personalidade das crianças, que, a partir destes, vivenciam de forma lúdica os conflitos inerentes ao desenvolvimento psíquico, facilitando sua elaboração e aumentando sua capacidade de simbolização.

Thinking about the amazing success of the cartoon with great impact worldwide "The Beauty and the Beast", Walt Disney, this article aimed to understand the psychological development of the character Belle. To this end, some parts of the movie were chosen and analysed, based in the theory of Sigmund Freud, providing an understanding about Belle's psychosexual life, when she overcame Narcissism and Oedipus Complex. Then it was contextualized, throw Marie-Louise Von Franz, the female's acquisition of the character along the importance of fairy tales in the construction of children's personality, that experience in playful way conflicts of the psychological development, leading to a elaboration and empowering its symbolization capacity.

RESUMO

A incidência de lesões não-palpáveis da mama vem aumentando através dos tempos, fato intimamente correlacionado à difusão da mamografia de alta resolução. Para tanto, tornam-se necessárias marcações pré-operatórias para localização dessas lesões, por meio de técnicas com fio metálico, material radioativo, carvão ativado ou, como no nosso serviço, a utilização de corante vital (azul patente). Apresentaremos a experiência do Hospital e Maternidade São Cristóvão na utilização do corante azul patente para a marcação de lesões não-palpáveis da mama, abordando em concomitância a localização do linfonodo sentinela em alguns casos. Selecionaram-se as pacientes que haviam sido submetidas à marcação pré-operatória com azul patente no Hospital e Maternidade São Cristóvão, no período de julho de 1999 a março de 2007, totalizando 285 pacientes com lesão (ões) não-palpável (eis) da mama. Foram 332 marcações, por orientação mamográfica, injetando–se 1 mL de azul patente intratumoral, 30 minutos a três horas antes do procedimento cirúrgico. A lesão foi excisada e confirmada por radiografia da peça operatória e/ou congelação intra-operatória. Houve 160 casos que tinham indicação para realização do linfonodo sentinela (LS), sendo realizado, nessas pacientes, um reforço da dose de azul patente na sala operatória, acrescentando-se 1 mL do corante na região subareolar e biópsia do LS com congelação intra-operatória deste. Procedeu-se a dissecção axilar completa somente nos casos em que o LS foi positivo. A idade média das pacientes foi de 60,92 anos (23 a 89 anos). As lesões foram identificadas em todos os casos (100%) e totalmente excisadas sem intercorrências cirúrgicas. Nos casos indicados de linfonodo sentinela, a taxa de localização concomitante do LS foi de 98,13%. O tamanho médio dos tumores foi de 1,3 cm. A avaliação histopatológica em parafina revelou 133 casos malignos (40,1%), 26 lesões precursoras de risco (7,8%) e 173 tumores benignos em geral (52,1%). A localização...

The incidence of non-palpable breast lesions is increasing due to the diffusion of the high resolution mammography. For surgical biopsies orientation there are several techniques, such as the insertion of a metallic hook wire and the injection of radioisotopes or corants. The aim of this paper is to present the of the Hospita and Maternity São Cristóvão experience with blue corant for marking occult breast injuries allowing concomitantly the localization of sentinel node (SN). There were 332 markings under, mammography and/or ultrasonograph orientation, with the injection of 1 ml of bluedye intra-tumoral, from 30 minutes to 3 hours before surgical procedure. The lesion was excised and confirmed by specren radiography.In 160 cases there was indication of SN biopsy. In these patients it was injected, a reinforcement of the dose of the blue patent just in the surgical room, adding more l ml of the blue dye in the subareolar region. There average age of the patients it was 60.9 years (23 – 89). The non-palpable breast lesions were identified in all of the cases (100%) without any surgical complication. In the cases of SN biopsy, the rate of localization of the SN was 98,1%. The average size of tumors was 1.3 cm ou the histopatological evaluation in paraffin sections being the results as follows: 133 malignant (40.1%), 26 pre-malignant injuries of risk (7.8%) and 173 benign lesions (52.1%). The localization of occult lesions using blue patent - COLL (Colour Occult Lesion Localization) - and concomitant sentinel node in breast tumors are practical, safe and confident allowing, treinament with minimum aggression and satisfactory aesthetic result. As the radiocolloids method, this is a methodology of high sensitivity, with the advantage of the low cost, being able to be used in hospitals without nuclear medicine services.

Assuntos