This thesis proposes an implementation of battery-powered, time-synchronized wireless nodes that can be deployed in a wireless network topology. Wireless sensor networks are used in a wide variety of scenarios where emphasis is placed on the wireless nodes’ battery life. The main area of focus in this thesis is to examine how wireless nodes can save battery power by utilizing a deep sleep mode and wake up simultaneously using time synchronization to carry out their data communication. This was achieved by deploying five time-synchronized, battery-powered nodes in a wireless network topology. The difference in battery current draw between continuously running nodes and sleep-enabled nodes were measured, as well as the time duration needed by the nodes to successfully send their payloads and route other nodes’ data. The nodes needed between 1502 ms and 3273 ms on average to carry out their data communication, depending on where they were located in the network topology. Measurements show that sleep-enabled nodes on average draw substantially less current than continuously running nodes during a complete data communication cycle. When sleep-enabled nodes were powered by two AA batteries, an increase in battery life of up to 1800% was observed.

New technologies arise everyday, but which ones are the best for your project? How do you store data in a safe manner that complies with the new European GDPR law? How do you plan, develop and complete a project? These are but a few formulations of questions that the study in this report will cover.  The report is based around a business idea and vision for a company that offers advanced products built with modern technologies. The first step for the development of this company is to create a prototyp of its first product, a web platform. The prototyp will be formed after a projectplan with meetings with a supervisor and with the use of professional tools like Gantt, WBS and Trello. First and foremost a study will be done behind the theory of different frameworks and technologies but also a reasearch about GDPR and data security. The design phase will be the first part in shaping the projekt where wireframes, sitemap and ERdiagram have been created and documented. The choice of frameworks, mainly Vue, Express and MongoDB and the data security standards JWT and Oauth will be explained and used in the prototype as a base for the technical aspects of the project. Lastly the results och the finished prototype will be presented together with a discussion regarding problems that arose during the project, improvments that needs to be done and what the future holds for the complete web platform. / Nya tekniker växer i rasande fart, men vilka är bäst för ens projekt? Hur lagrar man data på ett säkert sätt som följer den nya europeiska GDPR lagen? Hur planerar, utvecklar och genomför man ett projekt? Dessa är några få frågeställningar som undersökningen i denna rapport tar tittar närmare på.  Rapporten grundar sig på en affärsidé och vision för ett företag som erbjuder avancerade produkter skapade med moderna webbteknologier. Det första steget för företagets utveckling är att skapa en prototyp av den första produkten, en webbplattform. Prototypen kommer att utvecklas efter en projektplan med handledningsmöten och användning av professionella verktyg som Gantt, WBS och Trello. Först och främst studeras teorin bakom om olika ramverk och tekniker men även en undersökning om GDPR och datasäkerhet. Designfasen kommer sedan vara det första momentet för projektets utformning där bland annat wireframes, sitemap och ERdiagram har skapats och dokumenterats. Valet av ramverk, främst Vue, Express och MongoDB samt datasäkerhetsstandarna JWT och Oauth kommer att förklaras och användas i prototypen som grund för projektets tekniska skapande.  Slutligen presenteras resultatet av den färdiga prototypen tillsammans med en diskussion över problem som uppstod under projektets gång, förbättringar som behöver göras och vilka framtidsplaner som finns för den fullständiga webbplattformen.

Augmenter la durée de vie d'une pile, voire s'en passer est aujourd'hui devenu une obligation pour les microsystèmes. En effet, à cette échelle, le remplacement des piles et leur rejet dans l'environnement sont problématiques. La voie préconisée pour répondre à cet enjeu est d'utiliser des sources d'énergie renouvelables (solaire, thermique et mécanique). Pour cela, nous proposons de développer une plateforme de récupération d'énergie multi-sources/multi-charges (MANAGY) capable de s'adapter à son environnement pour en extraire le maximum d'énergie et répondre à des applications diverses. L'architecture est constituée de chemins directs et de chemins indirects où l'énergie provenant des sources est d'abord transférée dans une unité de stockage avant d'être réutilisée par les charges du microsystème. L'utilisation de cette nouvelle architecture permet d'optimiser le transfert d'énergie entre sources et charges et améliore le rendement du système de 33%. Avant de développer une architecture multi-sources, nous avons cherché à améliorer le rendement de la source photovoltaïque (PV) qui, au vu de l'état de l'art, a la densité de puissance la plus élevée. La recherche du rendement maximum de la source PV revient à la recherche du point de puissance maximum (MPPT). Il existe pour chaque condition d'irradiance, de température, et d'énergie extraites un couple tension-courant permettant à la source de fournir un maximum de puissance (MPP). Grâce à l'utilisation de deux chemins de puissance, nous arrivons simultanément à créer une boucle de régulation faible puissance agissant sur le rapport cyclique du système de gestion d'énergie (MPPT) et une boucle de régulation de la tension de sortie agissant sur le transfert de l'énergie. La modélisation du système nous a permis de spécifier ses performances. Pour atteindre les performances requises, des architectures innovantes ont été réalisées qui ont fait l'objet de trois brevets. De plus, des blocs ne sont activés qu'aux instants de changement d'état du système et sont conçus, quand cela a été possible, avec des transistors fonctionnant en mode faible inversion. Toutes ces optimisations permettent au système de fonctionner sur une large plage de variation de l'éclairement (de conditions intérieures supérieures à 500 lux à extérieures) avec un rendement proche de 90%. / Enhancing the life time of battery or being able to work without it is today mandatory for microsystems. Most of systems are nowadays limited by the capacity of the embedded battery. Moreover the replacement and waste of baterries is no more possible at this scale. One way to achieve longer life time is the use of renewable energy sources (solar, thermal, or kinetic). This work proposes to develop a new energy harvesting platform with numerous sources and loads (MANAGY) able to adapt itself to the surrounding environment in order to extract the maximum of energy while answering to various of applications. The architecture is composed of directs and indirects power paths where the extracted energy coming from renewable sources is firstly transferred to a storage unit before being used by loads. This novel architecture makes it possible to optimize the energy transfer between sources and loads and to achieve a 33% gain. Before developing this architecture with numerous sources, we have searched to enhance the efficiency of the photovoltaic source which has the best power density at the state of the art. Looking for improving the efficiency of the PV source is the same as tracking the maximum power point (MPPT). There is for each irradiance, temperature and quantity of energy extracted a couple of voltage and current enabling the PV source to deliver the maximum of power (MPP). Thanks to the two power paths used we are able to create a low power feedback loop adjusting the duty cycle from the power management unit (MPPT) while having a second feedback loop optimizing the power transfer and regulating the output voltage. Thanks to a high level model we have specified the system performances. To achieve the performances required we have realized novel architectures protected through three patents. Moreover, blocs are only activated when the system changes its state and furthermore there are designs, when achievable, with transistors working in weak inversion. All these optimizations make the system working for a large range of irradiance (from inside conditions higher than 500 lux to outdoor conditions) with an efficiency close to 90%.

Objetivo: determinar a viabilidade da identificação do linfonodo-sentinela em pacientes com câncer invasor de colo uterino estádio Ib1. Material e Métodos: 16 pacientes consecutivas com câncer de colo uterino agendadas para histerectomia radical com linfadenectomia pélvica bilateral realizaram estudo para detecção de linfonodo-sentinela. Onze pacientes injetaram 1 mCi de tecnécio 99 (99Tc) em quatro pontos do estroma superficial do colo uterino ao redor do tumor, às 12, 3, 6 e 9 h ( 16 horas antes da cirurgia ). No dia da cirurgia, as pacientes foram submetidas ao mapeamento linfático com gamma-probe e azul patente injetado nos mesmos pontos que o 99Tc.Cinco pacientes realizaram a detecção apenas com azul patente. Resultados: foi detectado pelo menos um (1 a 3 por paciente) linfonodo-sentinela em cada uma das 15 pacientes (93,7 %) que realizaram a técnica combinada.Foi detectado pelo menos 1 linfonodo-sentinela em 4 pacientes ( 80% )com azul patente apenas. A maioria dos linfonodos-sentinela foi localizada nas regiões: obturadora (37 %), ilíaca externa (22,2 %) e inter-ilíacas (18,5 %). Seis pacientes (40 %) tiveram linfonodos-sentinela bilaterais. Dos 27 linfonodos-sentinela detectados, 11 (40,7 %) foram detectados pelo corante, 9 (33,3%) pela radioatividade e 7 (26 %) pela radioatividade e corante. O índice de detecção intra-operatória com o gamma-probe foi de 90,9 % ( 11 pacientes ). Destes, 7 linfonodos foram azul e quente (31,8 %), 6 linfonodos foram apenas azuis (27,2 %) e 9 linfonodos foram apenas quentes (40,9 %). A sensibilidade, especificidade e valor preditivo negativo para a detecção do linfonodo-sentinela foram 100%, 85,7 % e 100 % respectivamente. Conclusão: A combinação do radiofármaco 99Tc e azul patente é efetiva na detecção do linfonodosentinela em câncer de colo uterino inicial. / Objective: to establish the feasibility of sentinel lymph node identification in patients with stages Ib1 invasive cervical cancer. Material and Methods: 16 consecutive patients with cervical cancer, were scheduled for radical hysterectomy with bilateral pelvic lymphadenectomy, were submitted to sentinel lymph node detection. Eleven patients was injected 1 mCi of technetium-99 (99Tc) into four points of the superficial cervical stroma around the tumor, at the 12, 3, 6 and 9 o’clock positions (sixteen hours before surgery ). On the day of the surgery, the patients were submitted to gamma-probe-guided lymphatic mapping and patent blue dye was injected into the same points as the 99Tc. Five patients were submitted to detection with patent blue only. Results: at least one sentinel lymph node (one to three per patient) was detected in each of the 15 patients (93.7%) in whom a combination of both methods was used. At least one sentinel lymph node was detected in four patients ( 80 % ) with patent blue only. Most sentinel lymph nodes were identified in the obturator (37%), external iliac (22.2%) and interiliac (18.5%) regions. Six patients (40%) had bilateral sentinel lymph nodes. Of the 27 sentinel lymph nodes detected, 11 (40.7%) were identified by the blue-dye technique, 9 (33.3%) by radiation, and 7 (26%) by radiation and by the blue-dye technique. The intraoperative detection rate was 90.9% with gamma-probe only ( 11 patients ). Of these, 7 lymph nodes were blue-stained and hot (31.8), 6 were just blue-stained (27.2%) and 9 were just hot (40.9%). Sensitivity, specificity and the negative predictive value for sentinel lymph node detection were 100%, 85,7% and 100 % respectively. Conclusion: the combination of 99Tc and patent blue dye is effective in the detection of sentinel lymph nodes in early-stage cervical cancer.

Linfadenopatia pode estar presente em qualquer fase da infecção pelo HIV a apresenta uma variedade de diagnósticos diferenciais possíveis, desde manifestações secundárias ao próprio HIV até doenças oportunistas ou neoplasias. Foi realizado um estudo de corte transversal de pacientes que realizaram biópsias de linfonodo periférico no Hospital de Clínicas de Porto Alegre entre Janeiro de 2004 a Dezembro de 2008. Foram realizadas 210 biópsias, 131 (61,9%) pacientes eram do sexo masculino, a mediana da idade foi 36 (18-74) anos e da contagem de CD4 149 (1-756) cels/mm3. Cento e seis (50,5%) biópsias foram realizadas na região cervical. Os diagnósticos mais prevalentes incluíram micobacteriose 105 casos (50,2%) sendo que mais de 90% dos casos foram tuberculose; hiperplasia reacional (HR) 48 casos (22,7%), linfoma 19 casos (9,0%) e micoses sistêmicas 12 casos (5,7%) que incluíram a histoplasmose, paracoccidioidomicose e criptococose. Esse estudo demonstra que a biópsia de linfonodos periféricos em pacientes com infecção pelo HIV é uma importante ferramenta no diagnóstico de doenças oportunistas no nosso meio. / Peripheral lymphadenopathy is commonly present in HIV- infected patients and has a wide spectrum of differential diagnoses. We performed a cross-sectional study of peripheral lymph node biopsies performed from 2004 to 2008 in HIV patients assisted in a public hospital in Southern Brazil. Two hundred and ten biopsies were performed, 131(61.9%) patients were male, median of age was 36 years old with a mean of lymphocyte CD4 count of 149 (1-756) cells/mm3. Most of biopsies were performed in the cervical site 106 (50.5%). The most prevalent diagnosis were mycobacteriosis 105 (50.2%), more than 90% was tuberculosis; reactive follicular hyperplasia 48 (22.7%); lymphoma 19 (9.0%); systemic mycosis 12 (5.7%), including histoplasmosis, paracoccidioidomycosis and cryptococcosis. Peripheral lymph node biopsy is a useful tool to diagnose opportunistic diseases such as mycobacteriosis, HIV related malignancies and invasive fungal infections in HIV-infected patients.

Introdução: O diagnóstico precoce do câncer de mama tem tornado a biópsia do linfonodo sentinela (BLS) um método cada vez mais preconizado. Radiofármacos são usados para pesquisa e posterior BLS, porém ainda não existe um método padronizado. Uma das divergências refere-se ao tempo ideal da realização da injeção do material radioativo, que pode ser realizado no intra ou no pré-operatório. Objetivos: Comparar os resultados da BLS dos pacientes com câncer de mama submetidos à injeção intraoperatória de 99mTc-Dextran-500 em relação aos pacientes que realizaram injeção pré-operatória deste mesmo radiofármaco. Métodos: Estudo retrospectivo por meio da revisão dos prontuários de pacientes com câncer de mama invasivo que realizaram BLS com uso de 99mTc-Dextran-500, de janeiro de 2008 a agosto de 2012, em uma única instituição. Os pacientes foram divididos segundo o momento de injeção do radiofármaco na mama acometida em grupo pré-operatório (PO) e grupo intraoperatório (IO). Os pacientes que recebiam injeção pré-operatória realizavam o mapeamento linfático por linfocintilografia. Nos dois grupos, era realizada análise da axila com auxílio do gamma probe durante o ato cirúrgico. Os grupos foram analisados quanto ao estadiamento tumoral clínico, número de focos do tumor primário, invasão vascular peritumoral, presença de receptores hormonais, resultado histológico e anatomopatológico e quantidade de linfonodos (LFs) retirados. Resultados: Foram incluídos 221 pacientes (PO=81 e IO=140). O estadiamento e a histologia tumorais, o número de focos, a invasão vascular peritumoral, bem como a idade dos pacientes eram semelhantes nos dois grupos. A média de LFs retirados foi 2,07 (+-1,33) no PO e 2,20 (+-1,13) no IO. O sucesso de identificação do LS no ato cirúrgico ocorreu em 92,59% dos casos PO e 96,42% dos casos IO. A taxa de falso negativo foi 11,1% no PO e foi 7,2% no grupo IO. A comparação destes dados não mostrou diferença significativa (considerando um nível de significância de 5%). Conclusão: Não há diferença nos resultados da BLS com uso de 99mTc-Dextran-500 no tempo pré-operatório em relação ao intraoperatório. Os dois métodos apresentaram-se eficazes e seguros. A utilização das imagens linfocintilográficas não parece ter influenciado o resultado final do exame. A injeção intraoperatória apresenta melhor logística, custo financeiro menor e extingue a dor e ansiedade do paciente. Logo, esta técnica deve ser preconizada. / Background: Early diagnosis of breast cancer has turned the sentinel node biopsy (SNB) into an increasingly advocated method. Radiopharmaceuticals are used for research and subsequent SNB, but there is still no standardized method. The time of injection, for example, can be intraoperative or preoperative. Objective: Compare the results of SNB of patients with breast cancer undergone intraoperative injection of 99mTc-Dextran-500 with patients underwent preoperative injection of the same radiopharmaceutical. Methods: Retrospective study through reviewing the medical records of patients with invasive breast cancer undergone SNB using 99mTc-Dextran-500, from January 2008 to August 2012, in a single institution. Patients were divided by the type of radiopharmaceutical injection: preoperative with lymphoscintigraphy (PO) or intraoperative (IO). All were subjected to analysis of the axilla with the aid of gamma probe during surgery. We analyzed clinical tumor staging, number of foci, peritumoral vascular invasion, pathological and histological results, number of lymph nodes removed and the presence of hormone receptors. Results: 221 patients included (IO group = 140; PO group = 81). The two groups had similar pathophysiological and etiological characteristics. The average number of lymph nodes removed was IO 2.20 (+ -1.13) and PO 2.07 (+ -1.33). The sentinel limph node (SLN) was positive for metastasis in 36% of IO and 35.8% of the PO. The successful identification of SLN during surgery was 96.42% in IO and 92.59% in PO. The false negative rate was 7.2% in the IO group and 11.1% in the PO. There was no significant difference between the two groups. Conclusion: There is no difference in results between SNB using 99mTc-Dextran-500 intraoperative and preoperative. The use of intraoperative injection is effective and safe, and extinguishes the patient's pain and anxiety, improves logistics issue and costs less. Therefore, this technique can be envisaged.

Introdução: o status dos linfonodos axilares permanece um dos mais importantes fatores prognósticos no carcinoma de mama em estágios iniciais, além de definir o uso de terapias complementares. A biópsia de linfonodo sentinela (BLNS) surgiu com a finalidade de estadiar a axila com o mínimo de morbidade, tendo como objetivo a identificação e o estudo patológico do primeiro linfonodo axilar proveniente da drenagem linfática da mama. Pacientes com axila clinicamente negativa têm indicação de biópsia de linfonodo sentinela como método de estadiamento da axila, e quando o resultado era positivo para metástase recomendava-se o esvaziamento axilar. Por recomendação do ACOSOG Z0011, o esvaziamento axilar (EA) após uma biópsia de linfonodo sentinela positivo não é necessário. Esse estudo demonstrou não haver benefício em realizar o EA na presença de LNS positivo na sobrevida global ou na sobrevida livre de doença. Objetivos: Avaliar a taxa de recidiva e morte em pacientes submetidas à cirurgia conservadora de mama e BLNS positiva com posterior esvaziamento axilar no Hospital de Clínicas de Porto Alegre; e, como objetivo secundário, avaliar as características clínicas e patológicas dessa população. Método: foi realizado um estudo de coorte retrospectiva, incluindo pacientes com diagnóstico de carcinoma de mama invasor submetidas à cirurgia conservadora da mama e BLNS, cujo resultado foi positivo para presença de metástases, e foram submetidas ao EA o período de janeiro de 2004 a dezembro de 2008. Resultados: foram incluídas 144 pacientes submetidas à biópsia de linfonodo sentinela e CCM; 33 tiveram o achado de biópsia de linfonodo sentinela positivo para metástase, e dessas 33 pacientes restaram 27 para análise dos dados. A taxa de sucesso na identificação do LNS foi de 0,96. A idade média das pacientes foi de 53,8 anos, o número de LNS ressecados foi de 1,6 por paciente; a média do tamanho tumoral foi de 2,3 cm. Seis pacientes apresentaram doença axilar residual correspondendo a 22,2% da amostra e tiveram um risco relativo de morte de 3 vezes mais para aquelas sem doença axilar residual e 50% a mais de desenvolvimento de metástases. Conclusão: O comprometimento axilar é importante fator no prognóstico das pacientes com câncer de mama, quanto maior o comprometimento da axilar pior será o desfecho de sobrevida livre de doença e de morte. Acreditamos que se pode aplicar a conduta do ACOSOG Z0011 também nas pacientes do HCPA devido à alta sensibilidade do método no nosso meio. / Introduction: The status of axillary lymph nodes remains one of the most important prognostic factors in breast carcinoma in the early stages, in addition it helps to defining the use of complementary therapies. Sentinel lymph node biopsy (SLNB) was developed with the purpose of staging the axilla with minimal morbidity, aiming at the identification and pathological study of the first axillary lymph node from the lymphatic drainage of the breast. Patients with clinically negative lymph node have indication of SLNB as a method of axillary staging, and with a positive finde for metastasis the axilar clereance was performed. Nowadays, due to the ACOSOG Z0011 Study, the axillary dissection (AD) after a positive SLNB for metastasis was put in check. This estudy have as a result no difference in global survive ou disease free survive if ALND was not performed in a positive SLNB. In the present study, we intend to evaluate the clinical and histopathological characteristics of patients submitted to breast conservative surgery and sentinel lymph node biopsy with a positive result for metastasis. Main objective: Evaluate the rate of recurrence and death in patients submitted to conservative breast surgery and BLNS with posterior axillary emptying at Hospital de Clínicas, Porto Alegre. It is a secondary objective to evaluate the clinical and pathological characteristics of this population. Material and Methods: A retrospective cohort study was performed, including 144 patients diagnosed with invasive breast carcinoma submitted to conservative breast surgery and SLNB, whose results were positive for metastases, and were submitted to AD, at the Mastology Unit of the Hospital de Clinicas de Porto Alegre (HCPA), from January 2004 to December 2008. Results: Of 144 patients submitted to SLNB and BCS, 33 had SLNB positive for metastasis, of these 33 patients remained 27 for data analysis. The success rate in LNS identification was 0.96. The mean age of the patients was 53.8 years, the number of resected SLN was 1.6 per patient; The mean tumor size was 2.3 cm. Six patients had residual axillary disease corresponding to 22.2% of the sample and had a relative risk of death of 3 times more for those without residual axillary disease and 50% more for the development of metastases. Conclusion: Axillary involvement is an important factor in the prognosis of patients with breast cancer, and the greater the axillary impairment, the worse the diseasefree survival outcome and death. We believe that the ACOSOG Z0011 trial can also be applied to HCPA patients who meet the inclusion criteria for this purpose, due to the high sensitivity of the method in our environment.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Laparoscopic pelvic lymphadenectomy has been performed routinely in medicine, using injectable lymphatic markers for delineation of lymphatic tissue and promoting free surgical margins of resection in tumor tissues. This practice also has therapeutic and diagnostic purposes when the pelvic lymph nodes are tumor-chain, resulting in a better prognosis for patients with certain types of cancer. Lymphadenectomy also aids in the diagnosis of regional metastases in other organs as well as in establishing the type of therapy to be adopted in the immediate postoperative period. However, this procedure is seldom performed in veterinary medicine, and practically not applied in combination with laparoscopy. This work consists of three scientific papers, with the first two showing the authors' experience with the techniques of marking and lymphatic resection associated with breast neoplasms in clinical cases. The last document involves research with healthy animals without mammary neoplasms. The results allowed us to check the effectiveness of the technique of lymphatic markup for the chain of pelvic lymph nodes using the dyes (methylene blue and indocyanine green) in dogs, allowing the observation of lymph node regions on both sides to deep iliac vessels excised via laparoscopic lymphadenectomy and the effectiveness and safety of the surgical technique. We conclude that it is still necessary to conduct further studies aiming to delineate string pelvic lymph nodes of healthy animals and presenting breast neoplasms, to achieve the best results in relation to the technique of lymphatic marking the mammary glands of female dogs / A linfadenectomia pélvica videolaparoscópica vem sendo realizada de forma rotineira na medicina, utilizando-se marcadores linfáticos injetáveis para delimitação do tecido linfático e promoção de margens cirúrgicas livres de tecidos tumorais em ressecções. Tal prática possui ainda finalidade terapêutica e diagnóstica quando os linfonodos da cadeia pélvica encontram-se tumorais, propiciando melhor prognóstico aos pacientes com determinados tipos de câncer. A linfadenectomia auxilia também no diagnóstico de metástases regionais em órgãos alvo bem como no estabelecimento do tipo de terapia a ser adotada no pós-operatório imediato. Contudo, na medicina veterinária esse procedimento é pouco realizado, e praticamente não aplicado em associação com a videocirurgia. Este trabalho consiste em três documentos científicos, sendo os dois primeiros demonstrando a experiência dos autores com as técnicas de marcação e ressecção linfática associada à neoplasmas mamários em casos clínicos. O último documento envolve pesquisa com animais hígidos sem neoplasmas mamários. Os resultados permitiram a verificação da eficácia da técnica de marcação linfática para a cadeia de linfonodos pélvicos utilizando os corantes (azul de metileno e verde de indocianina) em cães, permitindo a observação de linfonodos nas duas regiões laterais aos vasos ilíacos profundos extirpados via linfadenectomia videolaparoscópica e a efetividade e segurança da técnica cirúrgica empregada. Conclui-se que ainda se faz necessário a realização de novos estudos visando delimitar a cadeia de linfonodos pélvicos de animais sadios e apresentando neoplasmas mamários, para que consiga-se resultados melhores em relação à técnica de marcação linfática das glândulas mamárias de cadelas.

Linfadenopatia pode estar presente em qualquer fase da infecção pelo HIV a apresenta uma variedade de diagnósticos diferenciais possíveis, desde manifestações secundárias ao próprio HIV até doenças oportunistas ou neoplasias. Foi realizado um estudo de corte transversal de pacientes que realizaram biópsias de linfonodo periférico no Hospital de Clínicas de Porto Alegre entre Janeiro de 2004 a Dezembro de 2008. Foram realizadas 210 biópsias, 131 (61,9%) pacientes eram do sexo masculino, a mediana da idade foi 36 (18-74) anos e da contagem de CD4 149 (1-756) cels/mm3. Cento e seis (50,5%) biópsias foram realizadas na região cervical. Os diagnósticos mais prevalentes incluíram micobacteriose 105 casos (50,2%) sendo que mais de 90% dos casos foram tuberculose; hiperplasia reacional (HR) 48 casos (22,7%), linfoma 19 casos (9,0%) e micoses sistêmicas 12 casos (5,7%) que incluíram a histoplasmose, paracoccidioidomicose e criptococose. Esse estudo demonstra que a biópsia de linfonodos periféricos em pacientes com infecção pelo HIV é uma importante ferramenta no diagnóstico de doenças oportunistas no nosso meio. / Peripheral lymphadenopathy is commonly present in HIV- infected patients and has a wide spectrum of differential diagnoses. We performed a cross-sectional study of peripheral lymph node biopsies performed from 2004 to 2008 in HIV patients assisted in a public hospital in Southern Brazil. Two hundred and ten biopsies were performed, 131(61.9%) patients were male, median of age was 36 years old with a mean of lymphocyte CD4 count of 149 (1-756) cells/mm3. Most of biopsies were performed in the cervical site 106 (50.5%). The most prevalent diagnosis were mycobacteriosis 105 (50.2%), more than 90% was tuberculosis; reactive follicular hyperplasia 48 (22.7%); lymphoma 19 (9.0%); systemic mycosis 12 (5.7%), including histoplasmosis, paracoccidioidomycosis and cryptococcosis. Peripheral lymph node biopsy is a useful tool to diagnose opportunistic diseases such as mycobacteriosis, HIV related malignancies and invasive fungal infections in HIV-infected patients.

Objetivo: determinar a viabilidade da identificação do linfonodo-sentinela em pacientes com câncer invasor de colo uterino estádio Ib1. Material e Métodos: 16 pacientes consecutivas com câncer de colo uterino agendadas para histerectomia radical com linfadenectomia pélvica bilateral realizaram estudo para detecção de linfonodo-sentinela. Onze pacientes injetaram 1 mCi de tecnécio 99 (99Tc) em quatro pontos do estroma superficial do colo uterino ao redor do tumor, às 12, 3, 6 e 9 h ( 16 horas antes da cirurgia ). No dia da cirurgia, as pacientes foram submetidas ao mapeamento linfático com gamma-probe e azul patente injetado nos mesmos pontos que o 99Tc.Cinco pacientes realizaram a detecção apenas com azul patente. Resultados: foi detectado pelo menos um (1 a 3 por paciente) linfonodo-sentinela em cada uma das 15 pacientes (93,7 %) que realizaram a técnica combinada.Foi detectado pelo menos 1 linfonodo-sentinela em 4 pacientes ( 80% )com azul patente apenas. A maioria dos linfonodos-sentinela foi localizada nas regiões: obturadora (37 %), ilíaca externa (22,2 %) e inter-ilíacas (18,5 %). Seis pacientes (40 %) tiveram linfonodos-sentinela bilaterais. Dos 27 linfonodos-sentinela detectados, 11 (40,7 %) foram detectados pelo corante, 9 (33,3%) pela radioatividade e 7 (26 %) pela radioatividade e corante. O índice de detecção intra-operatória com o gamma-probe foi de 90,9 % ( 11 pacientes ). Destes, 7 linfonodos foram azul e quente (31,8 %), 6 linfonodos foram apenas azuis (27,2 %) e 9 linfonodos foram apenas quentes (40,9 %). A sensibilidade, especificidade e valor preditivo negativo para a detecção do linfonodo-sentinela foram 100%, 85,7 % e 100 % respectivamente. Conclusão: A combinação do radiofármaco 99Tc e azul patente é efetiva na detecção do linfonodosentinela em câncer de colo uterino inicial. / Objective: to establish the feasibility of sentinel lymph node identification in patients with stages Ib1 invasive cervical cancer. Material and Methods: 16 consecutive patients with cervical cancer, were scheduled for radical hysterectomy with bilateral pelvic lymphadenectomy, were submitted to sentinel lymph node detection. Eleven patients was injected 1 mCi of technetium-99 (99Tc) into four points of the superficial cervical stroma around the tumor, at the 12, 3, 6 and 9 o’clock positions (sixteen hours before surgery ). On the day of the surgery, the patients were submitted to gamma-probe-guided lymphatic mapping and patent blue dye was injected into the same points as the 99Tc. Five patients were submitted to detection with patent blue only. Results: at least one sentinel lymph node (one to three per patient) was detected in each of the 15 patients (93.7%) in whom a combination of both methods was used. At least one sentinel lymph node was detected in four patients ( 80 % ) with patent blue only. Most sentinel lymph nodes were identified in the obturator (37%), external iliac (22.2%) and interiliac (18.5%) regions. Six patients (40%) had bilateral sentinel lymph nodes. Of the 27 sentinel lymph nodes detected, 11 (40.7%) were identified by the blue-dye technique, 9 (33.3%) by radiation, and 7 (26%) by radiation and by the blue-dye technique. The intraoperative detection rate was 90.9% with gamma-probe only ( 11 patients ). Of these, 7 lymph nodes were blue-stained and hot (31.8), 6 were just blue-stained (27.2%) and 9 were just hot (40.9%). Sensitivity, specificity and the negative predictive value for sentinel lymph node detection were 100%, 85,7% and 100 % respectively. Conclusion: the combination of 99Tc and patent blue dye is effective in the detection of sentinel lymph nodes in early-stage cervical cancer.