O termo \"Distúrbio do Espectro do Autismo\" reflete uma tendência a valorizar a grande variedade clínica observada na prática diária e a possibilidade de existirem outros subtipos da patologia. A natureza clínica dos critérios de diagnóstico e a falta de instrumentos definidos e acessíveis para esse processo, em conjunto com a preocupação em não \"rotular\" a criança, contribuem para o atraso no diagnóstico. Para presente pesquisa, dividida em três estudos, foi utilizado o instrumento Differential Assessment of Autism and Other Developmental Disorders (DAADD) e traz como objetivos identificar as variações do Espectro do Autismo das crianças e adolescentes em atendimento no Laboratório de Investigação Fonoaudiológica nos Distúrbios do Espectro do Autismo da Faculdade de Medicina da Universidade de São Paulo, identificar os comportamentos das variações do Espectro do Autismo o instrumento com o Autism Behavior Checklist e por fim a partir dele, propor um instrumento reduzido. As análises permitem dizer que, quanto mais nova a criança, mais fácil se dá a diferenciação entre estar incluída no Espectro do Autismo e não estar, e quanto maior a idade da criança mais o DAADD identifica o diagnóstico diferencial dentro dos Distúrbios do Espectro do Autismo. O instrumento mostrou-se eficiente para o diagnóstico no espectro do autismo na comparação dos resultados apresentados no Autism Behavior Checklist pelo mesmo grupo de sujeitos, uma vez que o diagnóstico de Autismo foi o mais prevalente na classificação \"alta probabilidade\" do ABC para as idades de 4 a 8 anos. Outros estudos, com outros distúrbios do desenvolvimento (como Retardo Mental e Paralisia Cerebral) podem confirmar a utilidade e a especificidade do DAADD e de sua versão reduzida / The term \"autism spectrum disorder\" reflects a larger clinical variability observed in daily practice and the possibility of other subtypes of the disease. The clinical diagnostic criteria and the lack of accessible and defined instruments with the concern to not \"label\" the child, contribute to the delay in diagnosis. To this study, divided into three studies, we used the instrument Differential Assessment of Autism and Other Developmental Disorders (DAADD) and has as objective to identify variations Autism Spectrum children and adolescents in care at the Laboratory of Speech Spectrum Disorders Autism, Faculty of Medicine, University of São Paulo, identify behaviors variations Autism Spectrum instrument with the Autism Behavior Checklist (ABC) and finally, propose an instrument reduced. Analyses showed that for the younger children was easier to differentiate between being included in the Autism Spectrum and not being, and as the age increases the DAADD is more effective to give the differential diagnosis in the Autism Spectrum Disorders . The instrument proved to be efficient for the diagnosis on the autism spectrum in comparing the results presented in the ABC by the same group of subjects, once the diagnosis of autism was more prevalent in ranking \'high probability\' ABC for ages 4-8 years. Other studies with other developmental disorders (such as mental retardation and cerebral paralysis) may confirm the use and specificity of DAADD and its reduced version

Yes / Radiography has frequently been used during palaeopathological research, and plays an important role in the differential diagnosis of many diseases, including Paget¿s disease and carcinomas. Traditionally, radiographs were taken in hospitals with clinical equipment. However industrial radiography techniques have gradually become more commonly used, as their superior image quality and improved potential for diagnoses become recognised. The introduction of radiographic scanners has facilitated the digitisation of these images for dissemination and publication. However this is not all that radiographic digitisation can offer the researcher. Digital image processing (DIP) allows the researcher to focus on an area of interest and to adjust the brightness and contrast of the captured image. This allows the investigation of areas of high radio-opacity and radio-lucency, providing detailed images of the internal structures of bone and pathological lesions undetectable by the naked eye. In addition 3D effects, edge enhancement and sharpening algorithms, available through commonly used image processing software, can be very effective in enhancing the visibility of specific features. This paper will reveal how radiographic digitisation and manipulation can enhance radiographic images of palaeopathological lesions and potentially further our understanding of the bony manifestations of disease.

Yes / Objective This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases. Methods Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging. Results Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses. Conclusion Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD. Practical implications Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care.

Yes / Objectives: In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on ‘timely diagnosis’ aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints. Method: This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group. Results: Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences. Conclusion: The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

INTRODUÇÃO: O impacto na saúde pública dos transtornos neuropsiquiátricos como a demência e o comprometimento cognitivo tem aumentado com o aumento da população idosa de países em desenvolvimento como o Brasil. O diagnóstico destas entidades requer confirmação objetiva da presença de prejuízo cognitivo, para a qual recomenda-se o uso de testes neuropsicológicos. OBJETIVO: Comparar o perfil neuropsicológico de sujeitos com comprometimento cognitivo leve (CCL), com um grupo de sujeitos considerados normais, provenientes de uma amostra comunitária identificada em um estudo de prevalência de demência e comprometimento cognitivo na cidade de São Paulo. MÉTODO: A amostra total (1.563 sujeitos de 60 ou mais anos de idade) foi selecionada aleatóriamente em três áreas com diferentes perfis sócio-econômicos em São Paulo. Os sujeitos foram classificados como CCL amnéstico, utilizando critérios adaptados de Petersen et al. (1999) usando os seguintes instrumentos: um questionário de queixas de memória de 10-pontos, Mini Exame do Estado Mental (MEEM), FOME e a escala internacional de atividades da vida diária (ADL-IS). Em uma segunda fase, os sujeitos foram submetidos novamente ao MEEM, ADL- IS, questionário (SRQ 20) para identificar sintomas psiquiátricos, e uma bateria de testes neuropsicológicos para avaliar: atenção (Dígitos de WMS-R, Trail Making Test), memória (Memória Lógica e Reprodução Visual de WMS-R, Selective Reminding Test - Buschke), praxia (desenho do relógio, Cubos do WAIS-R), linguagem (Teste de Nomeação de Boston, fluência verbal - animais) e QI estimado (Vocabulário e Cubos do WAIS-R). RESULTADOS: trinta e sete indivíduos classificados como CCL amnéstico e trinta e um classificados como normais completaram a avaliação. Não foram encontradas diferenças significativas entre os grupos quanto a: idade, gênero, anos de escolaridade, estado civil, classe social ou pontuações no MEEM ou no SRQ-20. Houve diferenças significativas entre os dois grupos nos seguintes testes: Trail Making A, Memória Lógica (evocação imediata e tardia), Selective Reminding Test (aprendizagem total), Reprodução Visual (evocação Imediata e tardia), Nomeação de Boston (nomeação e paragnosias), Cubos e QI Estimado, sendo que os indivíduos com CCL tiveram pior desempenho que os controles. CONCLUSÕES: Os achados sugerem que submetidos a uma bateria neuropsicológica abrangente, os dois grupos estudados apresentam diferenças significativas no desempenho não somente da memória mas também em outros domínios como atenção, linguagem e praxia. Estes achados sugerem que o conceito de CCL múltiplos domínios pode ser mais útil que o conceito de CCL amnéstico, quando são avaliados idosos que pertencem a uma amostra comunitária / BACKGROUND: The impact on public health of neuropsychiatry disorders as dementia and mild cognitive impairment is growing as the population grows older in developing countries as Brazil. The diagnosis of these entities requires confirmation of cognitive impairment assessed by neuropsychological tests. OBJECTIVE: Compare the neuropsychological profile of Mild Cognitive Impairment (MCI) individuals and Normal subjects from a community sample identified in a Prevalence Study of Dementia and MCI in São Paulo. METHOD: The total sample (1.563 subjects over 60 years old) was randomly selected from three different social class areas of São Paulo. The subjects were classified as amnestic MCI following criteria adapted from Petersen et al. (1999) using the following instruments: 10-point questionnaire on memory complaints, Mini Mental State Examination (MMSE), Fuld Object Memory Evaluation, and Activities of Daily Living - International Scale (ADL-IS). In a second phase, patients were submitted to the MMSE, ADL- IS, Self Reporting Questionnaire (SRQ 20) to identify psychiatric symptom, and Neuropsychological test battery to evaluate: Attention (Digit Symbol from WMS-R, Trail Making Test), Memory (Logic Memory and Visual Reproduction from WMS-R, Selective Reminding Test - Buschke 1973), Praxis (Clock drawing, Block Design - WAIS-R), Language (Boston Naming Test and Verbal Fluency - animal) and Intelligence (Estimated Intellectual Quotient - Vocabulary and Block Design from WAISR). RESULTS: 37 subjects classified as amnestic MCI and 31 Normal controls completed the evaluation. We did not found significant differences between the two groups in age, gender, years of education, civil status, social class, MMSE and SRQ-20 scores. There were significant differences between MCI and controls in the following tests: Trail Making A, Logical Memory (Immediate and Delayed recall), Selective Reminding Test (total learning), Visual Reproduction (Immediate and delayed Recall), Boston Naming Test (Naming and Paragnosias), Block Design, and Estimated IQ in which MCI subjects had a worse performance than the elderly Controls. CONCLUSIONS: Our findings suggest that the two groups evaluated through an extensive neuropsychological battery present differences in memory performance but also in other cognitive functions as attention, language and praxis. Perhaps the MCI multiple-domain concept would be more useful than the amnestic MCI considering individuals coming from community samples

A esquizofrenia causa severos prejuízos à pessoa, principalmente na esfera social, e nem sempre o aparecimento dos primeiros sintomas leva a um diagnóstico imediato. Diante deste contexto, a iridologia, ciência que estuda a íris com base na densidade e na configuração do seu tecido, também denominado estroma iridal, permite conhecer a constituição do organismo, bem como suas debilidades inatas. O objetivo deste estudo foi investigar sinais iridológicos presentes na representação das áreas cerebrais de pessoas com diagnóstico de esquizofrenia. Para tanto, as íris de 56 participantes com este diagnóstico, usuários de um Centro de Atenção Psicossocial III, foram fotografadas com o Iridophoto (conjunto óptico para iridologia) e analisadas com base nos fundamentos da iridologia. Os dados iridológicos foram registrados em um formulário construído para este fim e analisados descritivamente. Os resultados mostraram que as regiões com maior presença de sinais foram a área dos cinco sentidos, com prevalência de 82,1% nas íris esquerdas e 73,2% nas direitas, e da mente inata - prevalência de 89,3% e 87,5% nas íris direitas e esquerdas, respectivamente. No que se refere aos sinais de fundo genético e fenotípico, foram encontrados radii solares, aberturas/lacunas e hiperpigmentações. Na mente inata, os sinais genotípicos apareceram em 51,8% das íris direitas e em 62,5% das esquerdas. Por sua vez, os sinais fenotípicos estiveram presentes em 51,8% das íris direitas e em 46,4% das esquerdas. Na área dos cinco sentidos, os achados genotípicos foram encontrados em 48,2% das íris direitas e em 58,9% das esquerdas, e os sinais fenotípicos em 42,9% e 42,1% das íris direitas e esquerdas, respectivamente. Os anéis estruturais mais frequentes nas íris dos participantes foram o arco senil (91,07%) e os anéis de tensão (89,3%). Por meio do cálculo tStudent bicaudal para uma média, os dados referentes à presença do arco senil foram analisados estatisticamente com auxílio do Programa R versão 3.5.1 e mostraram diferença estatisticamente significativa entre a média de idade dos participantes que apresentavam o arco senil em relação à idade de 60 anos citada na literatura (p= 0,005473). Em conclusão, percebese correlação significativa entre os sinais e anéis estruturais citados, com destaque para a área da mente inata e à dos cinco sentidos, e ao arco senil e anéis de tensão. Com base nos resultados obtidos, é possível afirmar que alguns sinais se replicam nas íris das pessoas com diagnóstico de esquizofrenia participantes do estudo. No entanto, outras pesquisas são necessárias para verificar esta relação / Schizophrenia provokes important damages to a person, mainly in the social realm, however not always the first symptoms lead to an immediate diagnostic. In this context, the iridology, science responsible to study the iris based in the density and the settings of their tissue, also known as iris stroma, enable to verify the organism constitution, such as their innate debilities. The main objective of this research was to study the presence of iridologic signs that indicate schizophrenia in representations of brainy areas of the iris of people with diagnostic of schizophrenia. In order to do this, the iris of 56 participants with schizophrenia diagnostic, users of a Psychosocial Attention Center III, were photographed with the Iridophoto (optic set for iridology) and were analyzed based the principles of iridology. The iridologic data were registered in a form elaborated for this purpose and descriptively analyzed. The results demonstrate that the regions with more presence of signs are the area of the five senses, with prevalence of 82,1% in the left iris and 73,2% right ones, and of the innate mind - prevalence of 89,3% and 87,5% in the right and in the left iris, respectively. With respect to the signs of genetic and phenotypic background, were found sunny radii, openings/gaps and hyperpigmentation. In the innate mind, the genotypic signs have appeared in 51,8% of the right iris and in 62,5% of the left ones. On the other hand, the phenotypic signs were present in 51,8% of the right iris and in 46,4% of the left ones. In the area of the five senses, the genotypic findings were noticed in 48,2% of the right iris and in 58,9% of the left ones, and the phenotypic signs in 42,9% and 42,1% of the right and left iris, respectively. The more frequent structural rings in the participants iris were the senile arc (91,07%) and the tension rings (89,3%). By the t-Student two-sided calculus for an average for the data related to the presence of the senile arc, were statistically analyzed with the R Program version 3.5.1, demonstrating significant statistic differences among the age average of the participants that had the senile arc compared to the 60 years old age found in the specialized literature (p= 0,005473). In conclusion, it is noticed a significant correlation between the signs and the structural rings mentioned, emphasizing the innate mind area and the five senses area, the senile arc and the tension rings area. Based in these results, it is possible to affirm that some signs replicate in the iris of person with diagnostic of schizophrenia that participated in this study. However, other researches are necessary to verify this relation

A brucelose é uma doença altamente contagiosa, responsável por grandes prejuízos econômicos e de saúde pública. É causada por bactérias do gênero Brucella, cujas espécies e seus biovares costumam ser caracterizados pelo isolamento e identificação de características fenotípicas da colônia. Dificuldades como, o perigo na manipulação dos microrganismos, processos laboriosos de tipificação, demora na obtenção de resultados e a instabilidade de características fenotípicas ou isolamento de linhagens atípicas dificultam a tipificação e encorajaram a busca de técnicas mais sensíveis e específicas, como a PCR, que resolveria as dificuldades e facilitaria a investigação epidemiológica dos casos humanos e animais. Diversas análises e o sequenciamento de determinados genes e do genoma completo de algumas espécies, demonstraram a existência de polimorfismos únicos no DNA das brucelas, que podem ser utilizados na sua identificação. Baseado nas dificuldades de identificação e na descoberta de polimorfismos únicos no DNA bacteriano das espécies, nosso objetivo foi desenvolver primers específicos para identificação de seis espécies do gênero B. abortus, B. melitensis, B. suis, B. canis, B. ovis e B. neotomae, e padronizar PCRs que permitissem identificá-las com maior sensibilidade e rapidez. Tentamos caracterizar marcadores moleculares para o desenho de primers espécie-específicos, através da amplificação randômica e clonagem dos fragmentos específicos, sem resultados satisfatórios. Apenas um primer para B. abortus foi conseguido quando foram analisados os polimorfismos já descritos na literatura. Assim, realizou-se o alinhamento múltiplo das sequências dos cromossomos I e II das espécies de Brucella, que permitiu a identificação de vários eventos polimórficos específicos para cada espécie, dos quais foram escolhidas regiões potenciais para o desenho de sete primers (dois para B. canis, B. melitensis e B. ovis, e outro para B. canis/B. suis) que tiveram sua especificidade analítica verificada com o programa Primer BLAST e testada nas 18 cepas de referência de Brucella, compreendendo a B. abortus, B. melitensis, B. suis e seus biovares, além da <iB. canis, B. ovis e B. neotomae, e em 231 isolados de campo, incluindo B. abortus, B. canis e B. suis. Os testes de especificidade dos primers resultaram na amplificação do fragmento esperado de quase todas as cepas de referência e de campo, exceto para o primer de B. canis e o de B. canis/B. suis. Estes resultados sugerem que os marcadores desenhados são promissores na diferenciação das espécies. / Brucellosis is responsible for great economic losses and serious impact on public health. This infectious disease is caused by bacteria of the genus Brucella, whose species and their respective biovars are often characterized by isolation and identification of differences in phenotypic tests. The complex and laborious process of Brucella typing, comprising the danger in handling of microorganisms, delay in obtaining results and instability of phenotypic characteristics or isolation of atypical strains, stimulated the search for more sensitive and specific techniques such as PCR. This technique would facilitate the epidemiological investigation of human and animal cases. Several analyses even as sequencing of certain genes and the complete genome of some species, demonstrated the existence of polymorphisms in the DNA of Brucella, which can be used to identify them. Due to typing difficulties and discovery of single polymorphisms in DNA bacterial species, our goals were to develop specific primers for identification of six species of the genus B. abortus, B. melitensis, B. suis, B. canis, B. ovis and B. neotomae and standardize PCRs to identify them with greater sensitivity and speed. We tried to characterize species-specific molecular markers using random amplification and cloning of specific fragments to design primers, without satisfactory results. Only one primer based on polymorphisms already described in the literature was successful for B. abortus specie differentiation. Thus, we performed the multiple alignment of the complete sequences of chromosomes I and II of Brucella species. This approach allowed the identification of several specie-specific polymorphic events, from which potential regions were chosen for the design of seven primers (two for B. canis, B. melitensis and B. ovis, and one for B. canis / B. suis). The analytical specificity of all primers was verified with the Primer BLAST software. Tests with specific primers were performed on 18 reference strains of Brucella, including all the six species of the genus Brucella and 231 field strains of B. abortus, B. canis and B. suis. The PCRs showed the expected fragment amplification in almost all reference and field strains, except for the B. canis and the B. canis / B. suis primers. Ours results suggest that these PCRs are able for Brucella species differentiation.

À partir de l'affirmation sur l'universalité du délire à laquelle Lacan se réfère à la fin de son enseignement, une enquête rétrospective a été réalisée depuis Lacan en s'étendant jusqu'à Freud. Pour cela, il fallait vérifier ce que Lacan voulait dire par être fou. Une réflexion sur la clinique structurelle et continuiste chez les deux auteurs a été élaborée ainsi que la notion de diagnostic en psycanalyse en ayant pour fil conducteur les questions qui se réfèrent aux frontières cliniques et théoriques entre la névrose et la psychose. L'approche de Lacan aux catégories du délire et de la folie ouvre un chemin d'investigation vers le rapport de la folie et ce qui seraient ces phénomènes. La discussion entre la limite d'être ou ne pas être fou, entre névrose et psychose apparaît constamment dans la psycanalyse, et la théorie borroméene peut aider à comprendre cette question puisqu'elle permet une clinique à plusieurs tonalités dans laquelle de différents dégrés de folie sont possibles, ce qui semble être présent depuis Freud. Parmi ces autres travaux, il a mis l'accent sur l'article Die Verneinung (1925) qui permettrait de traiter certains phénomènes cliniques et impasses diagnostics selon une approche différente d'après les termes employés par Freud. La décision méthodologique adoptée dans cette thèse portait sur la recherche bibliographique, en faveur de Freud et Lacan, ainsi que sur certains de ses commentateurs qui avaient comme thèmes de référence les limites de la folie et le diagnostic différentiel en psychanalyse. Au cours de notre formation doctorale à Nice, en France, nous avons approfondi l’article de 1925 de Freud Die Verneinung par le biais de sa version bilingue allemand/français. De là, nous soulignons le terme utilisé par Freud, l’élevant à la dignité de concept, ce qui nous a conduit à établir une nouvelle hypothèse théorique et clinique, traitée avec méticulosité dans la thèse. Ainsi et à partir de l'affirmation lacanniene, il était possible de corroborer l'hypothèse selon laquelle tout le monde est fou, c'est-à-dire délirant, comme une conception qui apparaît depuis Freud. / Taking into consideration the statement on the universality of delirium, to which Jacques Lacan refers at the end of his teaching, a retrospective investigation on the subject was held since Lacan, extending to Sigmund Freud’s work. For this, it was important to examine what would be this "being mad" which Lacan refers to. Having the questions concerning the clinical and theoretical boundaries between neurosis and psychosis as the research’s guideline, a reflection on the structural clinic and the clinic of continuity was elaborated in both authors, as well as the notion of diagnosis in psychoanalysis. Lacan's approximation of the categories of delirious and madness opens a way of an investigation into the relation of madness and what would be its phenomena. The discussion between the limit of being mad or not, between neurosis and psychosis appears constantly in psychoanalysis, and the borromean theory can help in the understanding of this question since it makes possible a multi-tone clinic, in which different degrees of madness are possible. A notion that already seems to be present in the Freudian works. Among his other works, the article Die Verneinung (1925) was emphasized which, from the terms and conceptions employed by Freud, allowed to treat some clinical phenomena and diagnostic impasses by a different approach. The methodological decision adopted in this thesis focused on bibliographical research, in favor of Freud and Lacan, as well as on some of its commentators whose themes were the limits of madness and the differential diagnosis in psychoanalysis. During our research in Nice, France, we have deepened the 1925 article by Freud Die Verneinung through its bilingual German / French version. From here we emphasize the term used by Freud, elevating it to the dignity of concept, which led us to establish a new theoretical and clinical hypothesis, treated with meticulousness in the thesis. Thus taking into consideration the Lacanian affirmation, it was possible to corroborate the hypothesis that everyone is mad, that is to say, delirious, as a conception that appears since Freud.

Introdução: as doenças linfoproliferativas de células B maduras correspondem a cerca de 80% das neoplasias linfoides, são caracterizadas pela proliferação clonal de uma célula B precursora em diferentes estágios de diferenciação. A semelhança imunofenotípica a um dado estágio maturativo é relevante para o diagnóstico diferencial através da imunofenotipagem por citometria de fluxo, embora a sobreposição de expressões possa dificultar a identificação correta de cada linfoproliferação. Alguns marcadores são pouco conhecidos nas diferentes linfoproliferações B e há pouca literatura analisando os dados quantitativamente, sendo grande parte qualitativa. Objetivos: este trabalho avalia a expressão quantitativa em intensidade de fluorescência média (IFM) dos anticorpos CD200, CD43, CD52 e CD123 no diagnóstico diferencial das doenças linfoproliferativas B crônicas. Métodos: estudo transversal, com 124 amostras de pacientes em investigação diagnóstica de doenças linfoproliferativas que realizaram imunofenotipagem em um centro de referência em neoplasias hematológicas no período de outubro de 2014 a junho de 2015. Foram analisadas as IFMs de cada marcador nas onze diferentes doenças diagnosticadas. Resultados: as neoplasias dos 124 pacientes analisados foram: 81 leucemias linfocíticas crônicas (LLC), 17 linfomas de zona marginal (LZM), 9 linfomas linfoplasmocíticos (LLPL), 6 linfomas do manto (LM), 2 tricoleucemias (TRL), 2 tricoleucemias variantes (TRLv), 5 linfomas foliculares (LF), 1 linfoma de Burkitt e 1 linfoma difuso de grandes células B (LDGCB). A expressão mediana do CD200 foi de 46,8 (intervalo: 1,5-334). A expressão mediana de CD200 foi maior na TRL (incluindo a TRLv) e na LLC (85 e 61,2, respectivamente). A expressão de IFM do CD200 na TRLv diferiu quando comparado à TRL na sua forma clássica (mediana: 36,1 versus 220,3). A mesma diferença foi observada na expressão do CD123 quando comparada a TRL à TRLv. Verificamos, que casos de LZM demonstraram IFM medianas de CD43 de 7,1 (intervalo: 1,1-106), em comparação a casos de LM e LLC, nos quais as medianas de IFM do CD43 foram 90 e 176, respectivamente. A comparação da intensidade de CD52 entre amostras demostrou diferença estatisticamente significativa entre LLC e LZM com medianas de IFM de 775,5 versus 1297,0 (P=0,04). Conclusões: nossos resultados sugerem que a citometria de fluxo quantitativa desses marcadores pode ser uma ferramenta adicional útil na identificação de alguns tipos de DLPCBs. / Background: lymphoproliferative disorders of mature B cells account for about 80% of the lymphoid malignancies. They are characterized by the clonal proliferation of a B cell precursor at different stages of differentiation. The similarity of a given phenotypical maturation stage is relevant for the differential diagnosis by immunophenotyping, however overlap in cell morphology and immunologic features may difficult the correct identification of each pathology. Some markers are not well known in different B lymphoproliferative neoplasms and there is little literature analyzing the data quantitatively. Objectives: this study evaluated the expression of CD200, CD43, CD52 and CD123 by flow cytometry on B-cell chronic lymphoproliferative disorders (BCLDs) differential diagnosis. Methods: cross-sectional study, of 124 samples from patients for diagnostic investigation of lymphoproliferative disorders who underwent immunophenotyping in a referral center for hematologic malignancies from October 2014 to June 2015. MFIs were analyzed for each marker in eleven different diagnosed pathologies. Results: the diseases of the 124 patients investigated comprised: 81 chronic lymphocytic leukemia (CLL), 17 marginal zone lymphoma (MZL), 9 lymphoplasmacytic lymphoma (LPL), 6 mantle cell lymphoma (MCL), 2 hairy cell leukemia (HCL), 2 hairy cell leukemia variant (HCLv), 5 folicular lymphoma (FL), 1 Burkitt lymphoma (BL) e 1 diffuse large B cell lymphoma (DLBCL). The CD200 median MFI expression was 46,8 (range: 1,5-334). CD200 was higher in HCL (including HCLv) and CLL cells (85 and 61,2 respectively). HCLv difference in CD200 MFI, when compared to classical HCL (median 36,1 versus 220,3). The same difference in CD123 expression was observed when comparing HCL versus HCLv. We found that cases of MZL exhibited CD43 median MFI of 7,1 (range: 1,1-106), in contrast to cases of MCL and CLL, which had median MFIs for CD43 of 90 and 176, respectively. The comparison of CD52 intensity between CLL and MZL samples showed statistically significant difference with a median MFI of 777,5 versus 1297,0 (P=0,04). Conclusion: our results suggest that quantitative flow cytometry of these markers may be a useful additional tool to better identify some types of BCLDs.

INTRODUÇÃO: O impacto na saúde pública dos transtornos neuropsiquiátricos como a demência e o comprometimento cognitivo tem aumentado com o aumento da população idosa de países em desenvolvimento como o Brasil. O diagnóstico destas entidades requer confirmação objetiva da presença de prejuízo cognitivo, para a qual recomenda-se o uso de testes neuropsicológicos. OBJETIVO: Comparar o perfil neuropsicológico de sujeitos com comprometimento cognitivo leve (CCL), com um grupo de sujeitos considerados normais, provenientes de uma amostra comunitária identificada em um estudo de prevalência de demência e comprometimento cognitivo na cidade de São Paulo. MÉTODO: A amostra total (1.563 sujeitos de 60 ou mais anos de idade) foi selecionada aleatóriamente em três áreas com diferentes perfis sócio-econômicos em São Paulo. Os sujeitos foram classificados como CCL amnéstico, utilizando critérios adaptados de Petersen et al. (1999) usando os seguintes instrumentos: um questionário de queixas de memória de 10-pontos, Mini Exame do Estado Mental (MEEM), FOME e a escala internacional de atividades da vida diária (ADL-IS). Em uma segunda fase, os sujeitos foram submetidos novamente ao MEEM, ADL- IS, questionário (SRQ 20) para identificar sintomas psiquiátricos, e uma bateria de testes neuropsicológicos para avaliar: atenção (Dígitos de WMS-R, Trail Making Test), memória (Memória Lógica e Reprodução Visual de WMS-R, Selective Reminding Test - Buschke), praxia (desenho do relógio, Cubos do WAIS-R), linguagem (Teste de Nomeação de Boston, fluência verbal - animais) e QI estimado (Vocabulário e Cubos do WAIS-R). RESULTADOS: trinta e sete indivíduos classificados como CCL amnéstico e trinta e um classificados como normais completaram a avaliação. Não foram encontradas diferenças significativas entre os grupos quanto a: idade, gênero, anos de escolaridade, estado civil, classe social ou pontuações no MEEM ou no SRQ-20. Houve diferenças significativas entre os dois grupos nos seguintes testes: Trail Making A, Memória Lógica (evocação imediata e tardia), Selective Reminding Test (aprendizagem total), Reprodução Visual (evocação Imediata e tardia), Nomeação de Boston (nomeação e paragnosias), Cubos e QI Estimado, sendo que os indivíduos com CCL tiveram pior desempenho que os controles. CONCLUSÕES: Os achados sugerem que submetidos a uma bateria neuropsicológica abrangente, os dois grupos estudados apresentam diferenças significativas no desempenho não somente da memória mas também em outros domínios como atenção, linguagem e praxia. Estes achados sugerem que o conceito de CCL múltiplos domínios pode ser mais útil que o conceito de CCL amnéstico, quando são avaliados idosos que pertencem a uma amostra comunitária / BACKGROUND: The impact on public health of neuropsychiatry disorders as dementia and mild cognitive impairment is growing as the population grows older in developing countries as Brazil. The diagnosis of these entities requires confirmation of cognitive impairment assessed by neuropsychological tests. OBJECTIVE: Compare the neuropsychological profile of Mild Cognitive Impairment (MCI) individuals and Normal subjects from a community sample identified in a Prevalence Study of Dementia and MCI in São Paulo. METHOD: The total sample (1.563 subjects over 60 years old) was randomly selected from three different social class areas of São Paulo. The subjects were classified as amnestic MCI following criteria adapted from Petersen et al. (1999) using the following instruments: 10-point questionnaire on memory complaints, Mini Mental State Examination (MMSE), Fuld Object Memory Evaluation, and Activities of Daily Living - International Scale (ADL-IS). In a second phase, patients were submitted to the MMSE, ADL- IS, Self Reporting Questionnaire (SRQ 20) to identify psychiatric symptom, and Neuropsychological test battery to evaluate: Attention (Digit Symbol from WMS-R, Trail Making Test), Memory (Logic Memory and Visual Reproduction from WMS-R, Selective Reminding Test - Buschke 1973), Praxis (Clock drawing, Block Design - WAIS-R), Language (Boston Naming Test and Verbal Fluency - animal) and Intelligence (Estimated Intellectual Quotient - Vocabulary and Block Design from WAISR). RESULTS: 37 subjects classified as amnestic MCI and 31 Normal controls completed the evaluation. We did not found significant differences between the two groups in age, gender, years of education, civil status, social class, MMSE and SRQ-20 scores. There were significant differences between MCI and controls in the following tests: Trail Making A, Logical Memory (Immediate and Delayed recall), Selective Reminding Test (total learning), Visual Reproduction (Immediate and delayed Recall), Boston Naming Test (Naming and Paragnosias), Block Design, and Estimated IQ in which MCI subjects had a worse performance than the elderly Controls. CONCLUSIONS: Our findings suggest that the two groups evaluated through an extensive neuropsychological battery present differences in memory performance but also in other cognitive functions as attention, language and praxis. Perhaps the MCI multiple-domain concept would be more useful than the amnestic MCI considering individuals coming from community samples