40 anos de política externa brasileira, 1958-1998: três inflexões

A política externa brasileira, de 1958 a 1998, atravessa três grandes períodos ou mudanças em suas orientações e formas de atuação. Numa primeira fase, herdada ainda do período anterior do imediato pós-guerra e mesmo anterior a ela, ela vive ainda o "paradigma Rio Branco", isto é, orienta-se basicamente e busca manter relações especiais com a principal potência hemisférica. No período do regime militar, assiste-se a uma ampliação do quadro de relacionamento externo, contemporaneamente a grandes mudanças na estrutura econômica do País. Na fase recente, finalmente, emerge a importância do multilateralismo econômico, no contexto da globalização. Essas inflexões são analisadas colocando-se lado a lado mudanças na conjuntura internacional e nas condições políticas e econômicas do País.

Comparación de ranking del Ministerio de Salud (Minsal) e impacto financiero de las 40 primeras patologías Auge-GES vigentes en Chile

El presente artículo compara el ranking Minsal de 40 patologías Auge-GES con el determinado por impacto financiero. Se elaboró una base de datos homogénea, se estandarizaron datos y se aplicaron correlaciones Pearson y Spearman. Se concluye que el criterio de impacto financiero cambia efectivamente las prioridades y modifica la congruencia social de la política de Estado.

Mammography in asymptomatic women aged 40-49 years

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality.

Multiple skin neoplasms in subjects under 40 years of age in Goiania, Brazil

OBJECTIVE To describe the trend for malignant skin neoplasms in subjects under 40 years of age in a region with high ultraviolet radiation indices.METHODS A descriptive epidemiological study on melanoma and nonmelanoma skin cancers that was conducted in Goiania, Midwest Brazil, with 1,688 people under 40 years of age, between 1988 and 2009. Cases were obtained fromRegistro de Câncer de Base Populacional de Goiânia(Goiania’s Population-Based Cancer File). Frequency, trends, and incidence of cases with single and multiple lesions were analyzed; transplants and genetic skin diseases were found in cases with multiple lesions.RESULTS Over the period, 1,995 skin cancer cases were observed to found, of which 1,524 (90.3%) cases had single lesions and 164 (9.7%) had multiple lesions. Regarding single lesions, incidence on men was observed to have risen from 2.4 to 3.1/100,000 inhabitants; it differed significantly for women, shifting from 2.3 to 5.3/100,000 (Annual percentage change – [APC] 3.0%, p = 0.006). Regarding multiple lesions, incidence on men was observed to have risen from 0.30 to 0.98/100,000 inhabitants; for women, it rose from 0.43 to 1.16/100,000 (APC 8.6%, p = 0.003). Genetic skin diseases or transplants were found to have been correlated with 10.0% of cases with multiple lesions – an average of 5.1 lesions per patient. The average was 2.5 in cases without that correlation.CONCLUSIONS Skin cancer on women under 40 years of age has been observed to be increasing for both cases with single and multiple lesions. It is not unusual to find multiple tumors in young people – in most cases, they are not associated with genetic skin diseases or transplants. It is necessary to avoid excessive exposure to ultraviolet radiation from childhood.

A retrospective study of 40 victims of Crotalus snake bites: analysis of the hepatic necrosis observed in one patient

Forty patients with a diagnosis of snake bite were studied at the Infectious and Parasitic Disease Service of the Faculty of Medicine of Botucatu. Thirty were males and 10 females, ranging in age from 16 to 70 years. All were farm laborers and 35 of them were bitten in the lower limbs. Two of the 9 patients seen more than 6 hours after the bite died. The low mortality rate (5%) observed could be explained by the early care provided, by the use of appropriate doses of anti-crotalus serum, parenteral hydration, urine alkalinization with sodium bicarbonate and induction of osmotic diuresis with a mannitol solution. Anatomopathological examination of one of the patients who died revealed extensive hepatic necrosis. The authors discuss the possibility of the effect of a factor of snake venom in the genesis of hepatic necrosis and in the increased transaminase levels.

Hedylidae (Lepidoptera: Hedyloidea) coletados à luz a 40 metros de altura no dossel da floresta da Estação Experimental de Silvicultura Tropical em Manaus, Amazonas, Brasil

Os Hedylidae constituem um grupo de lepidópteros exclusivamente neotropical com 35 espécies conhecidas em um gênero, Macrosoma Hübner, 1818. Antes classificados entre as mariposas Geometridae, agora são considerados um grupo basal e noturno de borboletas. Foram realizadas coletas mensais de janeiro a dezembro de 2004 no dossel de uma floresta em área de terra-firme, utilizando um lençol branco iluminado por luz mista de mercúrio e outra luz negra UV-BLB, instalado a 40 m de altura em uma torre. As coletas foram realizadas das 18:00 às 6:00 h do dia seguinte. Foram coletados 55 exemplares , a maioria machos, somente dois exemplares fêmeas pertencentes a nove espécies, uma delas provavelmente nova, a saber: M. hedylaria Warren (1894), M. bahiata (Felder & Rogenhofer, 1875), M. conifera (Warren, 1897), M. heliconiaria (Guenée, 1857), M. hyacinthina (Warren, 1905), M. klagesi (Prout, 1916), M. lucivittata (Walker, 1863) M. nigrimacula (Warren, 1897) e Macrosoma sp. Os Hedylidae foram mais abundantes na estação mais chuvosa, dezembro a maio, com 65,5% dos espécimes coletados. O horário de maior atividade foi entre 19:00 e 22 h com 80% dos espécimes coletados.

Do estigma da psicose maníaco-depressiva ao incentivo ao tratamento do transtorno bipolar: a evolução da abordagem em dois veículos midiáticos nos últimos 40 anos

OBJETIVO: Investigar a evolução ao longo dos últimos 40 anos da assimilação midiática do transtorno bipolar. MÉTODOS: Foram pesquisadas referências sobre os termos "transtorno bipolar" e "maníaco-depressivo" na revista Veja e no jornal The New York Times e analisada uma amostra de 40 textos de cada veículo. Os textos foram divididos em dois grupos, o primeiro reunindo aqueles datados dos anos entre 1970 e 1999 e o segundo, 2000 a 2009. RESULTADOS: Entre os anos de 1970 e 1999 é mais utilizado o termo "maníaco-depressivo", porém na década de 2000-2009 a expressão "transtorno bipolar" predomina amplamente. Além disso, artigos mais antigos, que utilizam principalmente o termo "maníaco-depressivo", tendem a ser mais estigmatizantes e com menor pretensão informativa. Já artigos mais recentes, em que a expressão "transtorno bipolar" é mais utilizada, tendem a incentivar a busca de tratamento. CONCLUSÃO: Sugere-se que a abordagem midiática do transtorno bipolar, comparada ao tratamento recebido pela psicose maníaco-depressiva, é marcada pela maior assimilação do referencial biomédico.

Mtp-40 and alpha antigen gene fragment amplification for the detection of Mycobacterium tuberculosis in Colombian clinical specimens

In this study, the use of Mtp-40 and alpha antigen polymerase chain reaction (PCR) amplification fragments for the precise tuberculosis (TB) diagnosis was evaluated. One hundred and ninety two different samples were obtained from 113 patients with suspected TB. Mtp-40 and alpha antigen protein genes were amplified by the PCR technique and compared to both the "gold standard" (culture) test, as well as the clinical parameters (including a clinical record and X-ray film exam in 113 patients). Thirty-eight of the 113 patients had a presumptive clinical diagnosis of TB; 74% being detected by PCR technique, 58% by culture and 44% by direct microscopic visualization. Weconclude that it is possible to use PCR as a suitable technique for the detection of any mycobacteria by means of the alpha antigen product, or the specific infection of Mycobacterium tuberculosis by means of the mtp-40 gene. This might be a good supporting tool in difficult clinical TB diagnosis and pauci-bacillary cases.