Abstract The objective of this work was to describe and compare the patterns of genetic variation in 19 populations of Anacardium humile from the Cerrado biome of the Brazilian Midwestern region. The ex situ germplasm collection of Universidade Federal de Jataí, in the state of Goiás, Brazil, was used for the study. To quantify the genetic variability of A. humile, 529 plants from 17 populations in Goiás from 2 in the state of Mato Grosso were studied, from which nine microsatellite loci were genotyped by capillary electrophoresis. The populations showed high levels of genetic diversity, with an average value of 0.830, and high inbreeding values, which suggests a deficit of heterozygotes. The genetic differentiation value between populations was 0.065. The greatest variability, which is moderately structured, was observed within populations. There is a significant inbreeding within the A. humile population in the Cerrado biome of the Brazilian Midwestern region. The A. humile populations are divided into two groups.

Resumo O objetivo deste trabalho foi descrever e comparar os padrões de variação genética em 19 populações de Anacardium humile do bioma Cerrado da região Centro-Oeste brasileira. A coleção ex situ de germoplasma da Universidade Federal de Jataí, no estado de Goiás, Brasil, foi utilizada para o estudo. Para quantificar a variabilidade genética de A. humile, 529 plantas oriundas de 17 populações de Goiás e de 2 do estado de Mato Grosso foram estudadas, das quais nove loci microssatélites foram genotipados por eletroforese capilar. As populações apresentaram altos níveis de diversidade genética, com valor médio de 0,830, e altos valores de endogamia, o que sugere um déficit de heterozigotos. O valor de diferenciação genética entre as populações foi de 0,065. Já a maior variabilidade, estruturada de forma moderada, foi observada dentro das populações. Há endogamia significativa na população de A. humile no bioma Cerrado da região Centro-Oeste brasileira. As populações de A. humile estão divididas em dois grupos.

Objetivo.Evaluar la necesidad de la incorporación de los cuidados paliativos en la Atención Primária en Salud (APS), a partir de la caracterización de los usuarios elegibles para esta modalidad de cuidados, registrados em um programa de dispensación de insumos. Métodos. Investigación descriptiva del tipo series de casos realizada en 14 unidades de salud del municipio de São Paulo (Brasil) en 2012. Fueron incluídas las historias clínicas de los usuarios registrados en um programa de dispensación de insumos para las incontinencias urinaria y fecal, siendo aplicado el índice de Karnofsky (KPS) para identificar la indicación de cuidados paliativos. Resultados. 141 de las 160 historias clínicas seleccionadas tenían información de KPS. La mayoría de los casos (98.3%, 138/141) tenían desempeño por debajo del 70%, por lo cual eran pacientes elegibles para cuidados paliativos. Las patologías con mayor frecuencia se relacionaban con cuadros crónicos y degenerativos (46.3%), seguidos por las patologías relacionadas com la calidad de la atención de la gestación y el parto (24.38%). Conclusión. Existe necesidad de incluir los cuidados paliativos en la APS, con el fin de brindar un cuidado integral, compartido y humanizado a los pacientes que lo requieren.

Objective.Assess the need for incorporation of palliative care in primary health care (PHC) through the characterization of users eligible for this type of care, enrolled in a program for devices dispensing. Methods. Descriptive study of case series conducted in 14 health units in São Paulo (Brazil) in 2012. It was included medical records of those enrolled in a program for users with urinary and fecal incontinence, and it was applied Karnofsky Performance Scale Index (KPS) to identify the indication of palliative care. Results. 141 of the 160 selected medical records had KPS information. Most cases (98.3%, 138/141) had performance below 70% and, therefore, patients were eligible for palliative care. The most frequent pathologies was related to chronic degenerative diseases (46.3%), followed by disorders related to quality of care during pregnancy and childbirth (24.38%). Conclusion. It is necessary to include palliative care in PHC in order to provide comprehensive, shared and humanized care to patients who need this.

Objetivo.Avaliar a necessidade de incorporação dos cuidados paliativos na atenção primária à saúde (APS) a partir da caracterização dos usuários elegíveis para este tipo de cuidados, registrados em um programa de dispensação de insumos. Métodos. Estudo descritivo do tipo série de casos, realizado em 14 unidades de saúde do município de São Paulo (Brasil), em 2012. Foram incluídos prontuários de inscritos em um programa de distribuição de insumos para usuários com incontinência urinária e fecal, sendo aplicada Escala de Performance de Karnofsky (KPS) para identificar a indicação de cuidados paliativos. Resultados. 141 dos 160 prontuários selecionados tinham informações de KPS. A maioria dos casos (98,3%, 138/141) teve desempenho abaixo de 70% e, portanto, eram pacientes elegíveis para cuidados paliativos. As patologias mais frequentes relacionavam-se a quadros crônico-degenerativos (46,3%), seguidas pelas patologias relacionadas com a qualidade da atenção à gestação e ao parto (24,38%). Conclusão. Há necessidade de se incluir cuidados paliativos na APS, a fim de prestar um cuidado integral, compartilhado e humanizado aos pacientes que necessitam deste.

ResumoEste trabalho consiste no levantamento florístico de Asteraceae nos Campos Rupestres das Serras da Bocaina e de Carrancas que estão localizadas no Planalto Alto Rio Grande, no sul de Minas Gerais, bem como uma análise de similaridade florística com outras áreas serranas do Planalto Brasileiro. O levantamento florístico foi realizado em 11 áreas localizadas nas Serras da Bocaina e de Carrancas. A similaridade florística foi realizada entre outras 17 áreas de Campos de Minas Gerais, São Paulo, Rio de Janeiro e Bahia. Neste levantamento florístico, a família apresentou 117 espécies, distribuídas em 43 gêneros pertencentes a 14 tribos. Os gêneros que têm maior riqueza de espécies sãoBaccharis(14), Lessingianthus(10),Mikania(8) e Chromolaena(8). As Serras da Bocaina e de Carrancas apresentaram maior similaridade florística com a Serra da Canastra, Serra de São José e Toca dos Urubus, enquanto a menor similaridade apresentada foi com a Serra dos Órgãos. Não houve correlação significativa em relação à similaridade florística e a distância geográfica entre as áreas analisadas. As relações na composição florística entre os grupos formados provavelmente estão relacionadas com aspectos geomorfológicos, edáficos, climáticos, além da influência vegetacional dos domínios fitogeográficos onde estes campos estão inseridos.

AbstractThis work reports on a floristic survey of Asteraceae in rocky outcrop grasslands on the Bocaina and Carrancas mountain range, located in the Upper Rio Grande highlands, southern Minas Gerais State, as well as on an analysis of floristic similarity between mountainous areas of Brazilian Plateau. The floristic survey was carried out in 11 areas on the Bocaina and Carrancas mountain range. The floristic similarity was carried out between 17 other grasslands of Minas Gerais, São Paulo, Rio de Janeiro and Bahia. In this floristic survey, the family showed 117 species, 43 genera and 14 tribes. The richest genera were Baccharis (14), Lessingianthus(10),Mikania(8) and Chromolaena(8). The mountain range of Bocaina and Carrancas showed highest floristic similarity with the mountain range of Canastra, mountain range of São José and Toca dos Urubus, while the lowest similarity were with the mountain range ofÓrgãos. There was no significant correlation in relation to floristic similarity and geographical distance between the areas analyzed. The relationships in floristic composition between the groups formed are probably related to geomorphological, edaphic, climatic, vegetation beyond the influence of phytogeographic domains where these grasslands are located.

Os cuidados paliativos (CP) apresentam-se como problema de saúde pública, devido ao substancial aumento do número de idosos e da prevalência de doenças crônico-degenerativas não transmissíveis. Evidencia-se a importância da reorganização dos serviços da atenção primária à saúde (APS) para assegurar a oferta desses cuidados. O objetivo foi identificar casos de usuários, a fim de inventariar os problemas éticos que a equipe vivencia. Estudo de caso de abordagem qualitativa, através da análise temática. Identificaram-se dois casos que revelaram, como problemas éticos, a “responsabilidade da APS para com os cuidadores e famílias” e a “dificuldade de comunicação franca e honesta entre a equipe e a família”. Os resultados indicam que a formação de recursos humanos com competência técnica e que a continuidade da assistência na transição do tratamento curativo para o paliativo são fatores propícios à integralidade e à obtenção de respostas mais adequadas aos desafios éticos que as equipes vivenciam.

Palliative Care (PC) is presented as a public health problem, due to the substantial increase in the number of elderly and the prevalence of non-communicable chronic degenerative diseases. The importance of the reorganization of Primary Health Care Services (PHCS) to ensure the provision of this care has become evident. The objective was to identify cases of users, in order to inventory the ethical problems that the team experienced. This is a case study based on a Qualitative approach, using thematic analysis. Two cases were identified, that revealed, as ethical problems, the “responsibility of the PHCS towards the caregivers and families” and the “difficulty of frank and honest communication between the team and the family”. The results indicate that the training of human resources with technical competence and the continuity of assistance in the transition from curative to palliative treatment are factors favorable to the integrality and the obtention of more adequate responses to the ethical challenges that the teams experienced.

Los cuidados paliativos (CP) se presentan como un problema de salud pública, debido al sustancial aumento del número de ancianos y de la prevalencia de enfermedades crónico-degenerativas no transmisibles. Se evidencia la importancia de la reorganización de los servicios de la atención primaria de la salud (APS) para asegurar la oferta de estos cuidados. El objetivo fue identificar casos de usuarios, a fin de enumerar los problemas éticos que el equipo vivencia. Estudio de caso con abordaje cualitativo, a través del análisis temático. Se identificaron dos casos que revelaron, como problemas éticos, la “responsabilidad de la APS para con los cuidadores y familias” y la “dificultad de comunicación franca y honesta entre el equipo y la familia”. Los resultados indican que la formación de recursos humanos con competencia técnica y que la continuidad de la asistencia en la transición del tratamiento curativo hacia el paliativo son factores propicios para la integralidad y la obtención de respuestas más adecuadas a los desafíos éticos que los equipos vivencian.

Objetive: The aim of this study was to identify the reasons for failure in adherence to imatinib mesylate treatment in chronic myeloid leukemia. Methods: A retrospective review was performed of 100 non-electronic records of patients with Ph+ chronic myeloid leukemia treated with imatinib mesylate. The study period was from January 2001 to January2011. Data were analyzed by Chi-Square and Correspondence analysis using the Statistical Analysis System software package. Results: At the beginning of treatment 41% of patients were in advanced stages of the disease. The unavailability of the drug (44.8%) and myelotoxicity (25.7%) were the most frequent reasons for interruption. The adherence rate was < 90% in 47% of the cases. The low adherence influenced the cytogenetic response (p-value = 0.020) and molecular response (p-value = 0.001). Very high adherence (> 95%) induced complete cytogenetic response, major cytogenetic response and major molecular response. Conclusion: The population of this study obtained lower-than-expected therapeutic responses compared to other studies.

Background: In the last decade, there has been a revolution in chronic myeloid leukemia treatment with the introduction of tyrosine kinase inhibitors with imatinib mesylate becoming the frontline therapy. Objective: To evaluate the therapeutic efficacy of imatinib mesylate in treating chronic myeloid leukemia patients and to identify factors related to therapeutic efficacy. Methods: This retrospective study was based on information obtained from patients'records in the Hematology Service of Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará (HUWC / UFC). All patients diagnosed with chronic myeloid leukemia that took imatinib mesylate for a minimum of 12 months in the period from January 2001 to January 2011 were included. From a population of 160 patients, 100 were eligible for analysis. Results: The study population consisted of 100 patients who were mostly male (51%) with ages rangingbetween 21 and 40 years (42%), from the countryside (59%), in the chronic phase (95%), with high-riskprognostic factors (40%); the prognosis of high risk was not associated with complete hematologic responseor complete cytogenetic response, but correlated to complete molecular response or major molecularresponse. Reticulin condensation was associated with complete hematologic response and completecytogenetic response. It was found that 53% of patients had greater than 90% adherence to treatment. Thehigh adherence was correlated to attaining complete cytogenetic response in less than 12 months. Moreover,20% of patients had good response. Conclusion: Significant changes are indispensable in the monitoring of patients with chronic myeloid leukemia. Thus, the multidisciplinary team is important as it provides access to the full treatment and not just to medications.

Breast cancer is the most prevalent cancer in women. The most frequent therapeutic approaches for the treatment of this disease are chemotherapy, radiotherapy, hormone therapy, and surgery. Conventional pharmacological treatments cause many harmful side effects in patients. To improve the quality of life of breast cancer patients, researchers have sought alternative adjuvant treatment strategies. To assess the effects of fungi and other basidiomycetes Agaricales on the co-adjuvant treatment of breast cancer, we conducted a literary review of the available scientific evidence. We selected articles published in refereed journals from 1990 to 2011 in Medline, Lilacs, CAPES, Scielo, and Pubmed. Articles written in English, Spanish, and Portuguese were reviewed. We used the following descriptors: Agaricales, medicinal mushroom/fungus, breast cancer, dietary supplementation, synonyms, and related terms. The pharmacological effects of nutritional and medicinal mushrooms have been reported in several experimental clinical studies and have shown promising results in the adjuvant treatment of breast cancer. Adjuvant treatment with mushrooms is associated with improvements in the immunological and hematologic parameters of breast cancer, as well as in the quality of life of these patients. Randomized clinical studies are needed to elucidate the possible mechanisms of action and clinical benefits of these fungi with respect to survival time, disease progression, and metastasis in breast cancer.

This study reports on 156 specimens of the amphibian Eupemphix nattereri, a widely distributed leiuperid, obtained from 11 municipalities of central Brazil. The extent of genetic variation was quantified by determining the mean number of alleles per locus and the proportion of polymorphic loci. An analysis of molecular variance (AMOVA) was performed on the random amplified polymorphic DNA (RAPD) haplotypes. The genetic distances obtained by calculating pairwise phist among local samples were used to determine population relationships using the unweighted pair-group method (UPGMA) and non-metric multidimensional scaling (NMDS). The cophenetic correlation was calculated to confirm agreement between the genetic matrix and the unweighted pair group method with averages (UPGMA) dendrogram. To determine if genetic distances were correlated to geographical distances we constructed pairwise genetic distance and geographical distance matrices and compared them using the Mantel test. The AMOVA results indicated significant genetic differences (p < 0.001) between E. nattereri populations, representing 69.5% of the within population genetic diversity. The Mantel test showed no significant correlation (r = 0.03; p = 0.45) between the genetic and geographical distance matrices. Our findings indicate that the genetic variation of E. nattereri populations was randomly distributed in geographic space and that gene flow for this species is probably structured at spatial scales smaller than those between our samples