Objective: The stigma toward individuals with mental disorders is highly prevalent, not only in the general population but among health care providers as well. The aim of this study was to identify subgroups based on stigmatizing beliefs related to psychiatric disorders among Brazilian psychiatrists, as well as to investigate their association with clinical and personality characteristics. Methods: Latent cluster analysis was used to find subgroups of cases in multivariate data according to a psychotic (schizophrenia) and a nonpsychotic disorder (attention-deficit hyperactivity disorder). The clusters for each psychiatric disorder were compared according to sociodemographic, emotional traits, and personality characteristics. Results: A total of 779 psychiatrists answered the questionnaire. Three different subgroups of stigma levels were identified regarding schizophrenia: the highest (n=202 [51.7%]), intermediate (108 [27.6%]), and the lowest (81 [20.7%]). Participants from the highest stigma group had a significantly longer time since graduation, higher anxiety-state scores, and lower positive affect. Two subgroups were identified with respect to attention-deficit hyperactivity disorder, although there were no differences between them in sociodemographic or clinical variables. Conclusion: There were more subgroups of stigmatizing beliefs regarding psychotic disorders. Individual characteristics, such as those related to trait anxiety and affect, can be associated with high stigma toward schizophrenia.

Introdução: O stent farmacológico liberador de sirolimus Firebird® já demonstrou eficácia na inibição de hiperplasia neointimal em pacientes selecionados submetidos à intervenção coronária percutânea. Nosso objetivo foi avaliar o desempenho e o resultado clínico tardio do dispositivo Firebird® em pacientes submetidos à intervenção coronária percutânea na prática diária nacional. Métodos: O Registro CLARIFIRE foi um estudo prospectivo, não randomizado, multicêntrico, que incluiu 455 pacientes (536 lesões) em 14 centros no Brasil entre dezembro de 2008 e maio de 2011. O seguimento clínico foi realizado aos 1, 6, 12 e 24 meses, e os eventos adversos foram adjudicados por um Comitê de Eventos Clínicos independente. Resultados: A média das idades foi de 61,1 ± 10,4 anos, 30,8% eram do sexo feminino, 41,9% tinham diabetes e 58,2% apresentaram-se com angina estável. O vaso-alvo mais prevalente foi a artéria descendente anterior (46,5%), 29,9% eram lesões reestenóticas e 8% lesões em bifurcação. Foram implantados 613 stents e as médias de extensão e diâmetro nominal dos stents foram 22,0 ± 6,4 mm e 2,90 ± 0,40 mm, respectivamente. O sucesso do procedimento foi de 97,6%. A taxa cumulativa de eventos cardíacos adversos maiores aos 12 meses (desfecho primário) foi 8,1%. Considerando-se os eventos pós-hospitalização até 24 meses (409/455), observaram-se eventos cardíacos adversos maiores em 9,8%, morte cardíaca em 3,9% e revascularização do vaso-alvo em 7,6%. Já a trombose de stent (definitiva/provável) ocorreu em nove casos (2%) até 30 dias, sem ocorrências subsequentes. Conclusões: O stent farmacológico liberador de sirolimus Firebird ® demonstrou desempenho favorável, Além de segurança e eficácia sustentadas no tratamento de pacientes da prática diária, conforme evidenciado pela elevada taxa de sucesso do procedimento e pela ocorrência relativamente baixa de eventos adversos ao final de 2 anos.

Background: The Firebird™ sirolimus-eluting stent has proven to be effective in inhibiting neointimal hyperplasia in selected patients undergoing percutaneous coronary intervention. Our objective was to evaluate the performance and long-term outcomes of Firebird ™ in patients undergoing percutaneous coronary intervention in daily practice in Brazil. Methods: The CLARIFIRE Registry was a prospective, non-randomized, multicenter study enrolling 455 patients (536 lesions) in 14 Brazilian sites between December 2008 and May 2011. Clinical follow-up was performed at 1, 6, 12, and 24 months, and adverse events were adjudicated by the independent Clinical Events Committee. Results: Mean age was 61.1 ± 10.4 years, 30.8% were women, 41.9% had diabetes, and 58.2% had stable angina. The left anterior descending artery was the most prevalent target vessel (46.5%), 29.9% were restenotic lesions, and 8% were bifurcations. Six hundred and thirteen stents were implanted, and the mean nominal stent length and diameter were 22.0 ± 6.4 mm and 2.90 ± 0.40 mm, respectively. Procedural success was 97.6%. The cumulative major adverse cardiac events rate at 12 months (primary endpoint) was 8.1%. Considering post-discharge events up to 24 months (409/455), major adverse cardiac events were observed in 9.8%, cardiac death in 3.9%, and target vessel revascularization in 7.6% of the patients. Definite/probable stent thrombosis was observed in nine cases (2%) up to 30 days, and no further occurrences were found. Conclusions: The Firebird ™ sirolimus-eluting stent has demonstrated good performance and sustained safety and efficacy for patients treated in daily practice, as evidenced by the high procedural success rates and relatively low adverse event rates after 2 years.

O presente trabalho teve como objetivo avaliar a patogenicidade de Colletotrichum gloeosporioides em frutos de manga, mamão, goiaba e maracujá. A inoculação do C. gloeosporioides foi feita de forma direta, fazendo um furo no fruto e colocando, em seguida, um disco de meio de cultura contendo o micélio do fungo das diferentes espécies. O delineamento experimental utilizado foi inteiramente casualizado, com 25 tratamentos, 3 repetições, sendo as avaliações realizadas por esquema fatorial de 5 x 5. Os resultados obtidos demonstram que todos os isolados apresentam patogenicidade em todas as espécies frutíferas consideradas. A goiaba é o hospedeiro que apresenta menor suscetibilidade aos diversos isolados de C. gloeosporioides. As mangas Tommy Atkins e Rosa e o mamão apresentam o maior crescimento das lesões, portanto maior suscetibilidade.

The present work had as objective to evaluate the pathogenicity of C. gloeosporioides isolated from mango, papaya, guava and passion fruit. The inoculation with C. gloeosporioides was through a direct way, opening a hole on the fruit and inoculating PDA disks with a mycelium of the fungus. The control was inoculated with PDA disks without the fungus. A completely randomized blocks design was used, with 25 treatments and 3 repetitions. A factorial scheme (5 x 5) was used for evaluations. The results obtained demonstrate that all the isolated show pathogenicity in all fruit species studied. Guava is the host, which showed smaller susceptibility to the several isolated of C. gloeosporioides. Tommy Atkins and Rosa Mangoes and also papaya present larger lesions growth, therefore a larger susceptibility.

OBJETIVO: Os autores apresentam e descrevem uma adaptação original para o uso do nó de barqueiro na ligadura da veia renal durante a nefrectomia laparoscópica. O procedimento pode substituir a necessidade da sutura mecânica endovascular, considerada o tratamento padrão, mas não disponível em muitas instituições no Brasil. Este nó é tembém conhecidocomo "nó de porco" em várias fazendas no Brasil. MÉTODOS: Quatorze nefrectomias laparoscópicas foram realizadas pou um único cirurgião utilizando a técnica padrão em sete porcas. A veia e a artéria renal foram ligadas utilizando o "nó de barqueiro" como o único método de hemostasia. Dois nós foram colocados tanto na artéria quanto na veia renal, um deles proximal e o outro distal, e os vasos seccionados entre os nós. Esta técnica é baseada a confecção intra-corpórea de duas alças pela mão direito com um par de pinças, com o auxílio da mão esquerda. Após a secção dos vasos, as condições da hemostasia foram observadas. RESULTADOS: Todas as nefrectomias laparoscópicas foram realizadas com sucesso. O "nó de barqueiro" foi realizado pelo mesmo cirurgião sem complicações nem dificuldades, obtendohemostasia completa em todos os casos como técnica única. CONCLUSÃO: O nó de barqueiro é uma técnica factível e segura para o controle do hilo renal durante a nefrectomia laparoscópica em porcos. Entretanto, a eficácia e segurança desta técnica deve ser avaliada por outros cirurgiões antes da recomendadção do emprego na prática clínica.

PURPOSE: The authors present and describe an original adaptation for the use of "boatman's knot" in renal vein ligation during laparoscopic nephrectomy. This procedure may replace the need for the endovascular stapler, which is considered the standard of care, but not available in several institutions in Brazil. The knot presented is also known as the " pig's knot" in several farms in Brazil. METHODS: Fourteen laparoscopic nephrectomies were performed by the same surgeon in a standard fashion in seven female pigs. Both the renal artery and vein were ligated using the "boatman's knot" as the only method for hemostasis with conventional intracorporeal technique. Two knots were applied in each artery and vein; one knot was tied proximally and the other distally. The vessels were then sectioned in between both knots. This technique is based on the intracorporeal confection of two loops by the right hand pair of dissectors with the help of the left hand. The arteries and the veins were then sectioned and the capability to accomplish full hemostasis was observed. RESULTS: All the laparoscopic nephrectomies were performed successfully. The "boatman's knot" was performed by the same surgeon with neither complications nor difficulties during the confection of the knot. In all cases hemostasis was fully achieved using only the "boatman's knot" as the hemostatic method. CONCLUSION: The "boatman's knot" is feasible and safe for hilum control during laparoscopic nephrectomy in pigs and total hemostasis can be achieved using it as the only method of hemostasis. However, the safety and the capacity of others to learn how to apply it should be tested before it may be advised to use it routinely.