Repositório RCAAP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Introduction: Tacrolimus (TCR) is an immunosuppressant drug widely used in post-transplant organ recipients. Its absorption occurs principally in the duodenum and jejunum, its peak serum concentration is reached between 0.5 and 4 hours after ingestion (average 2 hours), and its absorption may be facilitated by an alkaline medium. Omeprazole (OMP) is a proton pump inhibitor in the parietal cells of the stomach that reaches maximum concentration between 0.5 and 3.5 hours after ingestion (average 2 hours), and because it reduces gastric acidity, it is capable of releasing more alkaline content into the duodenum. Pharmacological interactions between TCR and OMP are always described primarily with respect, to the common metabolic pathway (CYP3A4 and P-gp) used by both medications which may result in elevations of the TCR plasma concentration. The objectives of this study are to identify if there is an increase or decrease in the concentration of tacrolimus when administered after omeprazole and determine the frequency of subjects who increased in two hours, the bioavailability of tacrolimus after using omeprazole. Subjects and Methods: To that end, a double blind, placebo-controlled pilot study was performed in 28 post-renal transplant subjects regularly using TCR (mean: 0.08 ± 0.05 mg/kg/day BID) and OMP (20 mg/day MID). OMP or a placebo was ingested every morning at 6 am after fasting, and TCR was ingested 2 hours later at the doses reported above. Blood samples were taken 2 hours after the ingestion of TCR over 4 consecutive days under both the OMP and placebo regimes, being the subject the control same its. Serum concentrations of TCR were obtained using the chemiluminescent microparticle in human whole blood immunoassay method (CMIA, Abbott Lab., Brazil) after the subjects fasted for 3.5 hours. Results: Of the subjects evaluated, 18 (64.3%) were male, and 10 (35.7%) were female. In total, 8 (28.6%) of subjects received living donor kidneys, and 20 (71.4%) of subjects received cadaveric donor kidneys. The mean age of the subjects was 43 ± 13 years, and the average time since transplant was 41 ± 32 months. The mean serum creatinine and urea levels were 1.6 ± 0.5 mg/dL and 59 ± 27 mg/dL, respectively, and the mean hemoglobin level was 13.7 ± 1.9 g/dL. Conclusion: We found no significant difference in the mean serum TCR concentrations measured under the placebo or OMP regime (15.8 ± 8.7 ng/mL versus 15.7 ± 6.8 ng/mL, respectively, P=0.92). Compared with the placebo period, there was an increase in the serum TCR concentration greater than 10% in 13 subjects and greater than 20% in 10 subjects, which corresponded respectively, to 46.4% and 35.7% of the studied subjects. These data infer that OMP may increase the serum TCR concentration if ingested 2 hours before TCR ingestion, likely through alkalization of the intestinal contents. These frequency rates should be used to calculate the sample sizes needed for future studies with larger numbers of subjects.

Juvenile idiopathic arthritis (JIA) is the most common chronic disease of the connective tissue in children and adolescents, being related to impaired health-related quality of life. Among the various complications related to JIA are oral diseases such as caries and periodontal disease, whose risk of development is higher due to factors such as the involvement of the temporomandibular joint, difficulty in performing oral hygiene when the joints of the upper limbs are involved, and use of oral medication containing sugar. However, the extent to which oral diseases interfere with the daily life and well-being of children and adolescents affected is unknown. The aim of this study was to assess the correlation between oral health indicators and oral health-related quality of life (OHRQoL) of children and adolescents with juvenile idiopathic arthritis (JIA) according to their caregivers perceptions. Two groups of adults filled the short form of the Brazilian Parental-Caregiver Perceptions Questionnaire (SF: 13 B-PCPQ), which assesses OHRQoL. These groups were as follows: parents or guardians [mean age, 40.6 years; standard deviation (SD) = 10.97 years] of healthy children and adolescents (n = 15; mean age, 10.7 years; SD = 2.16) and parents or guardians of children and adolescents with JIA (n = 17; mean age, 9.8 years; SD = 2.86), early-onset oligoarticular (n = 8), systemic (n = 5), or polyarticular (n = 4). Dental evaluations were performed on all children and adolescents in the study. There was no significant difference in SF: 13 B-PCPQ scores of the two groups. Children and adolescents with JIA had fewer caries in their primary dentition and more gingival bleeding after probing than those without JIA. The frequency of temporomandibular disorders was 50.0% for JIA patients and 46.7% for their healthy counterparts. There was no correlation between oral health indicators and SF: 13 B-PCPQ scores. As perceived by caregivers, JIA did not negatively impact the well-being of their children and adolescents as related to oral health, and their OHRQoL did not correlate with their oral health status.

This transversal study intends to verify the frequency of histopathological findings diagnosed in specimens of reductional mammoplasthy performed in ten years; assessing whether there is a statistical difference in this frequency among women younger or older than 35 years; and then contribute to the debate about histopathological examination of all surgical specimens as a routine. The records of patients undergoing reductional mammoplasty between 2002 and 2011 were reviewed to analyze the histopathological reports and distributed into two groups: women younger or older than 35 years. Findings were classified according to the Cancer Committee of the College of American Pathologists, estimating the relative risk of the lesion associate to breast cancer. There were 389 surgeries performed. Histopathological alterations were found in 228 (58,61 %) specimens. Nonproliferative lesions were identified in 208 (53,47 %) patients and proliferative lesions in 12 (3,08%), being the most common papilloma (1,5%). Of the atypical epithelial hyperplasia, found in 7 (1,79%) cases, there were 4 (1,02%) atypical ductal hyperplasia and 4 (1,02%) atypical lobular hyperplasia. Invasive carcinoma (PT1a) was diagnosed in 1 (0,25%) case. Frequency of the findings was higher (p < 0,05) in the older group. The histopathological examination of all specimens is questionable only in patients under 35 years old. The group above 35 years seems to be benefited by this practice due care imposed in monitoring and/or treatment of patients, as a result of the diagnostics performed by this routine. The low incidence of lesions imposes further studies, for definition with more propriety of a protocol.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Objectives: The considerable increase in the use of epidural analgesia with catheters leads to the need to establish the security of the method. Although infections have been constant targets of discussions in epidural analgesia, studies have been limited to case reports and retrospective reviews. The aim of this study was prospective and epidemiological analysis of patients admitted to medical wards undergoing epidural analgesia postoperatively, as well as the incidence of catheter colonization and bacteria responsible for these settlements. Methods: From November 2011 to April 2012 were assessed patients electively operated and maintained under analgesia by epidural catheter hospitalized in surgical wards in Hospital of the Federal University of Uberlândia. The tip of the catheter was collected for microbiological qualitative and semi-quantitative analysis. Results: Six (8.8%) of 68 catheter tips cultured had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45 hours (18-118 hours), 51.1 hours in colonized catheters and 42.7 hours among those who showed no colonization (P=0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients and duration of surgery showed no relationship with the colonization of catheters. The isolated microorganisms in catheter tips were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. Conclusion: It is concluded that the epidural catheter for analgesia postoperative, in conditions of this study, revealed procedure with low risk of bacterial colonization in patients from surgical wards.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Objective: This study sought to compare acute systemic hemodynamic changes after the infusion of peritoneal dialysis (PD) solution to diabetic and non-diabetic patients. Design: Diabetic and non-diabetic CKD patients receiving PD between July 2011 and August 2012 were selected. Patients: A total of 42 patients undergoing PD were analyzed and divided into 2 groups: diabetics (D) and non-diabetics (ND). Interventions: After echocardiography and clinical evaluation, patients were submitted to thoracic electrical bioimpedance (TEB) cardiography. Two liters of 1.5% glucose PD solution (Dianeal PD-2, Baxter®) at room temperature (25 to 28°C) was then infused into the abdominal cavity. TEB was performed 20 min before and after the initiation of infusion. Outcome measures: The following parameters were measured before and after the infusion of PD solution: systolic (SAP), diastolic (DAP) and mean arterial pressure (MAP) (mmHg); heart rate (HR) (bpm); cardiac index (CI) (L/min/m²); stroke index (SI) (mL/beat/m²); systemic vascular resistance index (SVRI) (dyne·sec·cm&#713;5/m²) and total arterial compliance index (TACI) (mL/mmHg/m²). Results: Significant increases in SAP, DAP, MAP and SVRI were found, as well as a significant decrease in the CI, after the infusion of PD solution to both groups (p < 0.05). The HR values changed from 67 ± 7 to 62 ± 9 bpm (p < 0.05) in the ND group and maintained the baseline values in the D group after the infusion of PD solution. In addition, TACI was reduced from 6.2 ± 2.5 to 5.4 ± 2.4 mL/mmHg/m² (p < 0.05) in the D group but exhibited no alterations in the ND group after the infusion of PD solution. Conclusion: The infusion of PD solution acutely alters left ventricular systolic function in diabetic and non-diabetic patients. Moreover, hemodynamic reflex adaptive processes, such as changes in HR, seem to be attenuated in diabetic patients.

Introduction: The management of patients in intensive care service requires monitoring of hemodynamic parameters, ensuring optimization and control of blood volume. Studies indicate that the correct horizontal positioning is unnecessary to invasive measurement of pressures. However there are few comparisons between the effect of the inclinations of 0°, 30° and 60° on the different types of hemodynamic measurements. Objectives: To investigate the effects of different backrest inclinations on measures of variation in pulse pressure (ΔPP), central venous pressure (CVP), distensibility index of the vena cava (IDVI), cardiac output (CO) and mean arterial pressure (MAP). Compare the predictive value for indicating volume using CVP and ΔPP as a predictor of IDVI. Methods: A prospective study of 31 patients admitted to the intensive care unit of the HCU-UFU. Patients were positioned with backrest inclination of 0°, 30° and 60°. For each inclination, measures ΔPP, CVP, IDVI, CO and MAP were obtained. For comparison of the results between groups was used analysis of variance. Results: There were no significant differences between the measurements obtained on the inclination 0° and 30°. In the inclination of 60°, significant variations in measures of ΔPP and CO were found. Referring to IDVI variable as a predictor of blood volume, when correlated with the CVP and ΔPP variables, the latter showed a strong correlation with the IDVI. Conclusion: The results suggest that the patient can be maintained with the backrest inclination of 30° to measurement of hemodynamic variables. The authors suggest the inclusion of assessments of ΔPP in daily use as a predictor of blood volume, in intensive care units.

Food allergy is the term used to designate the group of adverse reactions to foods, which involves immunological mechanisms and is reproducibly when exposed to a given food. Although several studies suggest the significant increase of food allergy cases in the world in recent decades, the actual prevalence remains unknown and is estimated to affect 6-8% of children. The most prevalent food associated with food allergy is cow\'s milk, affecting 2-3% of children. Food allergy reported by parents is present in about 1.4 to 35% of the population. Objectives: To determine the prevalence of food allergy reported by parents and diagnosed by health professionals, as well as major food and clinical manifestations in infants enrolled at the School District Early Childhood Education from Uberlândia, MG. Methods: This was a cross-sectional study in children 4-23 months who were enrolled at the School District Early Childhood Education Uberlândia by using a self-administered questionnaire to assess the prevalence of food allergy reported by parents and subsequent clinical and laboratory evaluation of infants identified by parents as allergic food in order to meet the prevalence of food allergy diagnosed. Results: Out of 1244 children enrolled, 596 parents responded to the questionnaire. The prevalence of food allergy reported by parents was 23.5% and the incidence of asthma, rhinitis and dermatitis was significantly higher in the group of children with food allergies reported (p = 0.0317, p < 0.0001 and p < 0.0001, respectively). The main foods mentioned were: cow\'s milk, egg, chocolate, pork and fruits. And the main associated symptoms: red spots (55.7 %), diarrhea (43.6 %), vomiting (30.7%), abdominal pain (21.4%) and mouth and eyes swelling. Infants with suspected food alergy reported by parents underwent clinical and laboratory evaluation. The food allergy prevalence was 3.5%, 1.9% of these were confirmed during the study and 1.6% previously. IgE-mediated events occurred in 1.2% of infants while non-IgE mediated events were detected in 0.7% of them. The milk was the major food allergen reaching 1.04% of infants, followed by egg (0.87%), wheat (0.34%), soy, coconut, peanut and tomato (0.17%). The main symptoms were: red spots (90.9%), pruritus (54.5%) and eyes edema (45.5%). Conclusion: The food allergy prevalence reported by parents is high in this age group, and is associated with increased frequency of allergic diseases such as asthma, atopic dermatitis and allergic rhinitis. The main foods reported by parents are part of the usual diet as milk, chocolate, egg, fruit and pork. The diagnosed food allergy prevalence was close to the reported in the literature. It was found lower frequence for milk and peanuts, while eggs and soybeans showed similar average values as found in other studies, and wheat was the only one showing higher prevalence than what reported in the literature. Although numerous studies regarding reported food allergy suggest that food allergens are affected by regional and cultural influences, the foods actually associated to food allergy, the end of the survey, were the same as described in the literature.

Objective: Despite the importance of cesarean section, when appropriately indicated, organs such as the World Health Organization (WHO) are concerned about its increasing incidence worldwide. The objective of this study was to evaluate the effectiveness of an intervention in order to readjust the indications for cesarean sections in a Brazilian teaching hospital. Methods: This study was carried out in three stages: I: Random selection of 160 cesarean records of May, June and July, 2011; II: Implantation of the guideline of cesarean sections indications; III: Random selection of 160 cesarean records of May, June and July, 2012. These records were classified into high and low-risk, according to type of prenatal, and into consistent and inconsistent clinical cases based on the guideline. Statistical analysis: Binomial Test for Two Proportions. P-values under 0.05 were considered statistically significant. Results: Among the lowrisk cesareans, 27 (51.92%) were consistent with the protocol at stage I, and 49 (72.05%) at stage III (p=0.02). Conclusion: The proposed intervention, under the conditions by which it was tested, favors the suitability of indications for cesarean sections in low-risk pregnancies.

Background: The medical literature shows that alcohol consumption is common among diabetic individuals and is associated with poor adherence to treatment, resulting in increased morbidity and mortality. However, no study has assessed the association between high-risk alcohol consumption and the presence of anxiety and depression in individuals with type 1 diabetes mellitus (1DM). Objectives: To know the degree of alcohol use, the prevalence at risk alcohol use and symptoms of anxiety and depression, the level of glycemic control and the association between these variables in adolescents and adults diagnosed with type 1 diabetes treated at the Clinic of Endocrinology Outpatient, Federal University of Uberlândia (UFU) and the Municipal Diabetic Care Center of Uberlândia. Methods: The present cross-sectional study assessed 209 outpatients in regards to alcohol consumption and the presence of anxiety and depression symptoms, using the Alcohol Use Disorders Identification Test (AUDIT), the Hospital Anxiety and Depression (HAD) scale, and glycemic control, according to the levels of glycated hemoglobin (HbA1c). The chi-square test and logistic regression analysis were used to investigate the association between the investigated variables. Results: The prevalence of high-risk alcohol consumption (AUDIT ≥ 8) among individuals with 1DM was high, specifically 24.88% among the entire group of subjects, 12.9% among the adolescents, 14.7% among the females, and 34.6% among the males. Upon comparisons based on gender and age, the odds of high-risk drinking were higher among males and participants aged 30 to 40 years (33.93%). The frequency of high-risk alcohol consumption did not differ as a function of gender among adolescents (females: 9.09%, males: 16.21%; p=0.374). Neither the frequency of anxiety (total: 29.66%, females: 37.25%, males: 22.43%) nor depression (total: 11%, females: 17.65%, males: 4.7%) symptoms exhibited associations with high-risk alcohol consumption. Moreover, the odds of female subjects exhibiting anxiety or depression symptoms were higher (odds ratio OR: 4.37 and OR: 7.4, respectively). Glycemic control was inadequate in most of the sample and did not exhibit an association with high-risk alcohol consumption or the presence of anxiety and depression symptoms. Conclusions: The prevalence of high-risk alcohol consumption and the presence of anxiety and depression symptoms were high in this patient sample. The frequency of high-risk drinking increased together with age and was greater among males; however, this frequency did not exhibit differences in terms of gender among adolescents. Glycemic control was inadequate in most of the sample independent of alcohol consumption and the presence of anxiety and depression symptoms.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

In Brazil, much has been published on the nature of sickness absence of civil servants employed in federal institutions of higher education, but so far, there are few researches that used for such purposes the data base of the Integrated Administration System of Human resources-SIAPE. This study aimed to identify possible diferences between sickness absence of civil servants employed in the health sector and those working in other sectors of a federal institution of higher education located in Minas Gerais, with a corresponding population to 4011 servers.This cross-sectional study, with data collected from the webpage Siapnet health module, includes 1.860 sickness absence for treatment of the server and for sick family care; 1.318 of these sickness absence referred to servants of the health sector (group I) and 542 to servants of other sectors (group II), all of both sexes and holding positions compatible with 2nd and 3rd degree education. These sickness absence were granted between January and June 2012.We classified the diagnosis of the cause of morbidity in accordance with ICD 10. The statistical evaluation included descriptive analysis of the sample. We used the Kolmogorov-Smirnov test to ensure the normality of data. We employed the Mann-Whitney U-test to evaluate the difference between medians, and to verify the associations between variables statistical Pearson s chi-square test or the Binomial test were used. We adopted a significance level of 5% (p ≤ 0,05) for the analyses. In the two groups we investigated, the highest sickness absence rates occured in Group I, among females, and in the 40 to 50 age group. In both groups, were characterized days away with short duration (1 to 14 days). Musculoskeletal and connective tissue disorders are the most frequent causes of sickness absence in the Group I; the factors that are determinants of health, the contact with health services and the respiratory diseases were the main causes of sickness absence in Grupo II. The results presented in this study confirm the health sector, female, aged between 40 and 50 years as predictors of risk of sickness absenteeism factors, as well as increased frequency of musculoskeletal and connective tissue diseases on servers in the health area, tendency corroborated in other studies.

The psoriatic arthritis (PsA) is a rheumatologic disease that affects the musculoskeletal system (arthritis) and the skin (psoriasis). It can have a severe impact on the quality of life of those who suffer from this illness; then, the early detection of the PsA is an extremely important purpose. In 70% of the cases, this disease starts with skin problems, so that the patient monitors it exclusively at a dermatologist s office. However, there are no valid and reliable tools in Portuguese to assist dermatologists in the early diagnosis of PsA. This study aimed to translate, culturally adapt and validate the PASE (Psoriatic Arthritis Screening and Evaluation) in Brazilian Portuguese. This tool is a self-administered questionnaire developed in English to screen arthritis in patients with diagnosis of psoriasis. The process of translation and adaptation followed international protocols on this matter, whose steps included translation, reconciliation, back translation, cognitive interview, independent review and a revision performed by the linguistic team of the author of this questionnaire. After these steps, the translation was pretested on 50 individuals. The final version was applied to 465 patients with psoriasis (158 with psoriatic arthritis and 307 without it) in four Brazilian university hospitals, and the data collected was submitted to quality tests (missing data, floor and ceiling effects). The psychometric properties of the tool were verified by known-groups validity, item-discriminant validity, item-internal consistency, Cronbach\'s alpha, intraclass correlation coefficient and confirmatory factor analysis. In the cognitive interview, some changes were performed in the translation due to cultural adaptation. There was no missing data. The floor effect was present in all the items of the two subscales and the ceiling effect was observed in four items of the first subscale and in two items of the second subscale. The reliability verified through the item-internal consistency (100% success), the Cronbach\'s alpha coefficients (0.92), and the intraclass correlation (0.97) were considered adequate. The known-groups and the item-discriminant validity achieved appropriate results. The confirmatory factor analysis provided a proper fit according to the variables observed (X2 = 247.1, p <0.001; df = 79; X2/df = 3.12; GFI = 0.93, AGFI = 0.90, CFI = 0.95; SRMR = 0.04; RMSEA = 0.07). The results showed that the PASE-P (translated version of the PASE) is a valid and reliable tool to be used in Brazil.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Cerebral palsy (CP) is a group of motor disorders resulting from a lesion in the developing brain that can cause functional limitations and impair quality of live (QoL). The comparison of results from different studies and the choice of appropriate quality of life questionnaires is limited by the diversity of concepts and dimensions covered by these questionnaires. The International Classification of Functionality (ICF) has been used as a comparative interface in the analysis of QoL questionnaires. This study aimed at verifying and comparing the content of QoL questionnaires used to evaluate children and adolescents with CP according to the ICF. We identified 5 generic instruments and 5 specific ones used to evaluate the QoL of children and adolescents with CP in electronic databases. Two researchers independently analysed all the items and concepts of the questionnaires. Each item was linked to ICF categories by means of internationally recognized rules. The Kappa statistic was used to describe the degree of agreement among researchers. From the 488 items analyzed, 623 concepts were identified and 563 linked with 175 different categories of the ICF: 130 with the body function component, 333 with the activity/participation component, 50 with the environmental factors component and 50 with the personal factor component. Generic instruments, as well as specific ones had a higher number of concepts associated to the component activity/participation. The CP QOL Child was the instrument with the most balanced representation of the body function (20.0% of the concepts), activity/participation (36.2% of the concepts) and environmental factors (26.1% of the concepts) components. It also covered some concepts related to the personal factor component (9.2%) and others not included in the ICF (7.7%). The Kappa coefficients range between 0,80 at the 0,97. The study showed that QoL instruments applied to children and adolescents with CP mainly cover the activity/participation component and the body functions component of the ICF. The environmental factors and personal factors are not much studied. The body structures component was represented in only one item of the questionnaires. This analysis can guide clinicians and researchers in choosing the most appropriate instruments for the content to be evaluated.

Background: Premature birth is associated with increased morbidity and mortality in the neonatal period. Intrauterine growth restriction is an important cause of interruption of gestation resulting in the occurrence of premature birth in addition to interfere in morbidity and mortality during neonatal period. The intraventricular hemorrhage is the most commonly brain injury found in the preterm newborn. The relationship between intrauterine growth restriction and periventricular hemorrhage is controversial in the literature. The present study aims to compare the incidence of intraventricular hemorrhage among preterm newborn with and without intrauterine growth restriction in addition to identify the risk factors for periventricular hemorrhage in these infants. Methods: This is a prospective cohort study and included premature infants that were born at the Clinics Hospital of Federal University of Uberlandia in a 12 months period. Newborns with congenital malformations, genetic syndromes, chromosome disorders, twins and those who died before 48 hours of life were excluded. Newborns were divided into 2 groups, with and without intrauterine growth restriction, based on the relationship between birth weight and gestational age. The ones classified as small for gestational age were considered with intrauterine growth restriction. Cranial ultrasounds were performed of all newborns and Papile (1978) classification was used for the diagnosis and classification of intraventricular hemorrhage. Results: 242 preterm newborns participated in this study being 120 in the group without and 122 in the group with intrauterine growth restriction. When compared maternal and newborn characteristics of the two groups, there were statistically significant difference in the incidence of maternal pre-eclampsia and birth weight. The periventricular hemorrhage was found in 19 (15,8%) preterm newborn without intrauterine growth restriction and in 28 (22,9%) with intrauterine growth restriction without statistically significant difference. In 38 (80.8%) infants the diagnosis of periventricular hemorrhage was made up to 7 days of life and were more common grades I and II. After adjustment for multiple logistic regression model, were defined as risk factors for the occurrence of periventricular hemorrhage thrombocytopenia and Respiratory Distress Syndrome. Conclusion: There was no statistically significant difference in the incidence of intraventricular hemorrhage among preterm newborn with and without intrauterine growth restriction. Logistic regression analysis indicated the Respiratory Distress Syndrome and thrombocytopenia as risk factors for the occurrence of intraventricular hemorrhage.

Introduction: Vascular changes and changes in the image, magnetic resonance imaging (MRI) during neoadjuvant chemotherapy (QTN), have been reported to predict pathological response (PR) in breast cancer breast .Tumors with the same histological types , stages and degrees of differentiation may have different outcomes in relation to prognostic factors and responses to established treatments. Moreover, molecular subtypes respond differently to neoadjuvant chemotherapy. Objective: To evaluate the accuracy of power Doppler (PD) mapping method as a predictor of pathological response in breast cancer, compared to chemotherapy neoadjuvant towards triple negative tumor (TN) subtypes, positive homonal receptor (HR +) and HER2 negative (HER2-) and HER2 positive (HER2+). Methods: Included patients with LABC treated at the Hospital of the UFU. All were subjected to Power Doppler ultrasonography before, after 2-3 cycles and at the end of chemotherapy. Tumor diameters were measured and calculated the rate of vascularization of the tumor mass by the PD. Were classified as responders those who had complete reduction to or greater than 30% of the initial vasculature and diameters. Non-responder that patients with lower than 30% reductions or increases less than 20% or greater increase of 20% compared to the initial evaluation. Tumor subtypes were identified and associated with response patterns. Spearman test was used with p = 0.05. Results: 40 patients enrolled and 26 completed in cases. After 2 or 3 cycles of the VPN QTN was 75% overall, 60% in TN in HER2 + 100% and 80% in RH + HER2 -. The accuracy even this time was 73.91% overall and TN subtypes HER2 + RH + and HER2- was 57.14%, 75% and 83.33% respectively. At the end of chemotherapy general VPN was 92.85% and 83.33%, 100% and 100% for subtypes TN, HER2 + and RH + HER2-, respectively; accurately at the end of treatment 92% of the overall assessment, and 87.50%, 80% and 100% for TN subtypes HER2 + and RH+ HER2-, respectively, when evaluated separately. Conclusion: It appears that ultrasound with power Doppler can be an important tool for evaluation of response to neoadjuvant chemotherapy and its association with breast tumor subtypes can aid in predicting response to chemotherapy and surgical planning in assessing whether or not a conservative surgery.