ABSTRACT BACKGROUND AND OBJECTIVES: The temporomandibular disorder (TMD) is an anatomical-functional disorder that affects the muscles of chewing, the temporomandibular joint (TMJ) or both structures. It is one of the most common orofacial pain of non-dental origin with a prevalence of 5% to 7% of the population, being considered a public's health problem. The main symptom of TMD is pain and, when chronic, it affects the quality of life. The drug classes that are commonly used in this condition are antidepressants, anticonvulsants and muscle relaxants that modulate symptomatology in these subjects. The aim of this study was to review the literature about main drugs used to control TMD, its mechanisms of action and effectiveness as well as the possible causes of TMD. CONTENTS: Literature was searched in the following databases: Pubmed, Scielo and Lilacs with a time sample from 2010 to 2021. As inclusion parameter, were selected literatures review and systematic articles, randomized clinical cases, placebo-controlled and double-blind studies with the TMD theme, considering pharmacological treatments aspects. As exclusion parameter, articles in which the outcome was not the TMD, congress abstracts and personal opinions were rejected. After the articles' selection, reading of titles and abstracts, 09 articles were selected, consisting of reviews and clinical studies relevant to the subject. CONCLUSION: The pharmacological approach has demonstrated its positive effects in the management of TMD-related chronic pain, with more effective results when associated with other therapies, due to its multifactorial characteristic.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) é uma desordem anátomo-funcional que afeta os músculos da mastigação, da articulação temporomandibular (ATM) ou ambas as estruturas. E uma das dores orofaciais mais comuns de origem não dentária, com prevalência de 5% a 7% da população, sendo considerada um problema de saúde pública. O principal sintoma da DTM é a dor que, quando crônica, afeta a qualidade de vida. As classes de fármacos mais comumente empregadas nessa condição são os antidepressivos, anticonvulsivantes e relaxantes musculares, que modulam os sintomas nesses pacientes. O objetivo deste estudo foi revisar a literatura acerca dos principais fármacos utilizados no controle da DTM, seus mecanismos de ação e eficácia, bem como as suas possíveis causas. CONTEÚDO: Buscou-se na literatura artigos científicos nas bases de dados: Pubmed, Scielo e Lilacs, com a amostra temporal de 2010 a 2021. Como parâmetro de inclusão, foram selecionados artigos de revisão de literatura e sistemática, casos clínicos randomizados, estudos placebo-controlados e estudos duplo-cegos com a temática DTM, considerando aspectos do tratamento farmacológico. Como parâmetro de exclusão, artigos em que o desfecho não era a DTM, resumos em congressos e opiniões pessoais foram rejeitados. Após a seleção dos artigos, leitura de títulos e resumos, 9 artigos foram selecionados, consistindo em revisões e estudos clínicos pertinentes ao assunto. CONCLUSÃO: A abordagem farmacológica demonstrou efeitos positivos no manejo da dor crônica em DTM, tendo resultados mais eficazes quando associada a outras terapias, em virtude de sua característica multifatorial.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) é uma desordem anátomo-funcional que afeta os músculos da mastigação, da articulação temporomandibular (ATM) ou ambas as estruturas. E uma das dores orofaciais mais comuns de origem não dentária, com prevalência de 5% a 7% da população, sendo considerada um problema de saúde pública. O principal sintoma da DTM é a dor que, quando crônica, afeta a qualidade de vida. As classes de fármacos mais comumente empregadas nessa condição são os antidepressivos, anticonvulsivantes e relaxantes musculares, que modulam os sintomas nesses pacientes. O objetivo deste estudo foi revisar a literatura acerca dos principais fármacos utilizados no controle da DTM, seus mecanismos de ação e eficácia, bem como as suas possíveis causas. CONTEÚDO: Buscou-se na literatura artigos científicos nas bases de dados: Pubmed, Scielo e Lilacs, com a amostra temporal de 2010 a 2021. Como parâmetro de inclusão, foram selecionados artigos de revisão de literatura e sistemática, casos clínicos randomizados, estudos placebo-controlados e estudos duplo-cegos com a temática DTM, considerando aspectos do tratamento farmacológico. Como parâmetro de exclusão, artigos em que o desfecho não era a DTM, resumos em congressos e opiniões pessoais foram rejeitados. Após a seleção dos artigos, leitura de títulos e resumos, 9 artigos foram selecionados, consistindo em revisões e estudos clínicos pertinentes ao assunto. CONCLUSÃO: A abordagem farmacológica demonstrou efeitos positivos no manejo da dor crônica em DTM, tendo resultados mais eficazes quando associada a outras terapias, em virtude de sua característica multifatorial.

ABSTRACT BACKGROUND AND OBJECTIVES: The temporomandibular disorder (TMD) is an anatomical-functional disorder that affects the muscles of chewing, the temporomandibular joint (TMJ) or both structures. It is one of the most common orofacial pain of non-dental origin with a prevalence of 5% to 7% of the population, being considered a public's health problem. The main symptom of TMD is pain and, when chronic, it affects the quality of life. The drug classes that are commonly used in this condition are antidepressants, anticonvulsants and muscle relaxants that modulate symptomatology in these subjects. The aim of this study was to review the literature about main drugs used to control TMD, its mechanisms of action and effectiveness as well as the possible causes of TMD. CONTENTS: Literature was searched in the following databases: Pubmed, Scielo and Lilacs with a time sample from 2010 to 2021. As inclusion parameter, were selected literatures review and systematic articles, randomized clinical cases, placebo-controlled and double-blind studies with the TMD theme, considering pharmacological treatments aspects. As exclusion parameter, articles in which the outcome was not the TMD, congress abstracts and personal opinions were rejected. After the articles' selection, reading of titles and abstracts, 09 articles were selected, consisting of reviews and clinical studies relevant to the subject. CONCLUSION: The pharmacological approach has demonstrated its positive effects in the management of TMD-related chronic pain, with more effective results when associated with other therapies, due to its multifactorial characteristic.

ABSTRACT Climate-smart agriculture (CSA) practices, mainly no-tillage (NT), cover cropping (CC), soil fertilization with organic amendments (OA), and crop-livestock (CL) and crop-livestock-forestry (CLF) systems, has been widely adopted in areas from Brazilian Cerrado. The CSA may partly offset former soil C losses and contribute to climate change mitigation. However, contradictory findings brought uncertainties about the effect of CSA on soil C. Here, by a systematic review of 87 papers and using 621 data pairs, we provided a pervasive biome-scale analysis of soil C stock changes associated with the adoption of CSA across Brazilian Cerrado. All CSA practices evaluated showed average positive rates of C stock change, indicating a general tendency of soil C accretion after its adoption. In areas under NT, CC and CLF, greater rates were estimated for the deeper soil profile evaluated (0.00-1.00 m) (1.24 ± 0.85, 0.54 ± 0.54 and 1.00 ± 1.47 Mg ha–1 yr–1, respectively), while OA and CL showed more soil C accretion when the assessment was limited down to 0.10 m depth (0.82 ± 0.60 and 0.59 ± 0.66 Mg ha–1 yr–1, respectively). Unfortunately, the lack of basic information precluded any attempt to statically compare our estimations. In this sense, we must be cautious in stating that soil C sequestration occurs at those rates after the adoption of CSA practices. Despite these limitations, the results clearly show that the diversification and intensification of agricultural areas in the Cerrado by the adoption of CSA is a promising pathway to increase soil C stocks, and consequently, contribute to climate change mitigation and adaptation. Finally, our findings emphasize the importance of efforts that stimulate farmers to adopt these practices on large scale, such as Brazil’s Low-Carbon Agriculture Plan, besides providing sound empirical evidence about the role of soil C sequestration in Brazil achieving its Nationally Determined Contributions commitments.

ABSTRACT No-tillage (NT) has been largely adopted in Brazil as a strategy for soil conservation, but for the last decade, there have been governmental incentives for its adoption arising from its potential for soil C accumulation. Notwithstanding, the soil mulch formed from crop residues favors the maintenance of soil moisture and nutrients in the upper soil layers, which stimulates soil microbial activity and may increase the potential for nitrous oxide (N2O) emissions. In addition, double-cropping systems in the same year are typical in Brazil and the impact on the fraction of fertilizer N lost as N2O needs to be evaluated. This study aimed to assess the influence of soil tillage and N fertilization on N2O emissions in a wheat-soybean succession system as commonly practiced in southern Brazil. The experiment was carried out at Embrapa Soybean research station located in Southern Brazil. Treatments were conventional tillage (CT) and no-tillage (NT), with and without nitrogen fertilization for the wheat and no N fertilizer for the soybean. Closed-static chambers were used to monitor N2O fluxes for two consecutive years. Together with gas monitoring, soil samples were also taken and analyzed for mineral N, soil moisture and labile carbon. Soybean yields were higher under NT, which seemed to be the result of a higher soil water availability that helped to overcome extended periods without rainfall. Soil N2O emissions were similar between CT and NT, with just a tendency for higher emissions under NT. The highest emissions occurred from the soybean crop. In the second year under NT, the emissions from the soybean crop were higher when preceded by N-fertilized wheat, but the converse was true under CT. None of the soil variables consistently correlated with N2O emissions, with mineral-N as the best predictor in the second wheat cycle and soil moisture in the first soybean cycle. Calculated emission factors were not statistically different between CT and NT and consistently lower than the IPCC default of 1 %. The calculated N2O emission intensity by relating N2O emission to grain yield showed an environmental advantage of NT compared to CT by presenting a 44 % reduction in soybean and similar values for fertilized wheat.

ABSTRACT Plant-growth-promoting bacteria of the genus Azospirillum and Herbaspirillum can improve crop yields of maize in tropical environments. The main mechanism proposed for its promotion is related to the auxins produced by these species. The aim of this study was to compare the maize growth response of inoculation using two species, Azospirillum baldaniorum Sp245 (Ab-Sp245) and Herbaspirillum seropedicae ZAE94 (Hs-ZAE94) during the initial growth under controlled conditions. A pot experiment was conducted with five harvests measuring bacterial counts, root morphology, biomass, and nitrogen content, and soluble metabolites for 38 days. Depending on the harvest period, a differential growth response between the two strains test was compared to the control. Plants use the bacterium applied to improve nitrogen acquisition and transform it into higher biomass and nitrogen accumulation, especially for Ab-Sp245. On the other side, Hs-ZAE94 altered the soluble metabolites resulting in higher NO3-, NH4+, and N-amino and lower soluble fractions compared to Ab-Sp245 and the control. The observed plant-bacteria interaction is closely fine-tuned and regulated by the strain used and differences in growth promotion effects cannot solely attributed to the root morphology.

This work aimed to manufacture scaffolds from a hydrogel composed of a sodium alginate matrix with hydroxyapatite reinforcements using a 3D bioprinter, aiming at application in bone tissue regeneration. The alginate solution was prepared by dissolving sodium alginate at a concentration of 10% (w/v). Hydroxyapatite (HAp) was added to the solution at 2.5% and 5.0% (w/v) concentrations, followed by placing the samples in a container with a 1.0% (w/v) calcium chloride solution. The scaffolds were analyzed for HAp concentration and morphological characteristics, physicochemical properties, and biological response. The scaffolds show reproducibility and spectroscopic analyses confirm hydrogel formation and hydroxyapatite incorporation in the alginate matrix. The hydrophilic properties are compatible with scaffolds obtained through 3D printing made from polysaccharides, and the thermal analysis showed the expected behavior of these same materials. Preliminary findings indicated that scaffolds containing 2.5% (w/v) hydroxyapatite are inside cytotoxicity limit (66.4 ± 7.0%) towards canine E20 lineage cells. In contrast, scaffolds with 0% and 5.0% (w/v) hydroxyapatite were non-cytotoxic. Notably, the latter scaffold demonstrated enhanced cell proliferation, as anticipated, owing to the hydrophilic properties of alginate that enable easy and swift cell seeding, facilitating nutrient transport and cellular growth within the scaffold.

Abstract The objective of this work was to compare nitrous oxide (N2O) emissions from urine and manure of Nellore and crossbred (Nellore x Angus) cattle finished in feedlot. Twenty Nellore and 20 crossbred bulls were fed a diet consisting of 75% concentrate and 25% roughage. Excreta were applied to the pens after 43 days of confinement, when N2O monitoring started through static chambers. The data were subjected to the analysis of variance, and averages were compared by Tukey’s test. The N2O fluxes from urine and manure were similar among the breeds, with important peaks after rain events. The cumulative emissions of N2O from urine per kilogram of body weight gain (BWG) and the total emissions from manure per kilogram of BWG were 22.7% and 24.4% higher in Nellore cattle. There is no breed effect on N2O flux and cumulative emissions by excreta from confined beef cattle; however, the crossbreed emits less per kilogram of BWG. There is a high correlation between rainfall volume and the N2O emissions of the next day, which indicates a period between rain occurrence and the increase in N2O emission.

Resumo O objetivo deste trabalho foi comparar as emissões de óxido nitroso (N2O) pela urina e pelas fezes de bovinos Nelore e mestiços (Nelore x Angus) terminados em confinamento. Vinte bois Nelore e 20 mestiços foram alimentados com dieta composta de 75% de concentrado e 25% de volumoso. As excretas foram aplicadas nos currais após 43 dias de confinamento, quando se iniciou o monitoramento de N2O por meio de câmaras estáticas. Os dados foram submetidos à análise de variância, e as médias foram comparadas pelo teste de Tukey. Os fluxos de N2O da urina e das fezes foram semelhantes entre as raças, com picos importantes após a ocorrência de chuvas. As emissões cumulativas de N2O da urina por quilograma de ganho de peso corporal (GPC) e as emissões totais das fezes por quilograma de GPC foram 22,7% e 24,4% maiores na raça Nelore. Não há efeito da raça sobre o fluxo de N2O e as emissões cumulativas de excretas de bovinos de corte confinados; entretanto, o gado mestiço emite menos por quilograma de GPC. Há alta correlação entre o volume de chuva e as emissões de N2O do dia seguinte, o que indica um período entre a ocorrência de chuva e o aumento da emissão de N2O.

A vapor-fed high temperature proton exchange ethanol electroreformer has been developed based on the use of a H3PO4-doped polybenzimidazole membrane to produce green hydrogen. As a key parameter, this article describes the influence of platinum weight percent (wt.%) in the catalyst formulation from different commercial catalysts (20, 40, 60, 80 wt.% Pt/C and Pt black) on the activity (related to the H2 production), energy consumption, and CO2 yields. The structural and morphological analysis reveal that an increase in Pt wt.% leads to the formation of bigger nanometric Pt particles, resulting in a decrease in the electrochemically active surface area. In terms of the ethanol electro-oxidation activity, the Pt wt.% impacts on the performance of the electroreformer, with the H2 flux that increase from 0.22 STP (standard pressure and temperature, 273.15 K and 105 Pa) m3 m-2 h-1 for Pt black to 1.47 STP m3 m-2 h-1 for 60 wt.% Pt/C. The Pt wt.% also impacts on the CO2 percentages, increasing from values in the range of 20-40% for the 20 wt.% Pt/C to 45-55% for the optimum 60 wt.% Pt/C and, finally, decreasing to values between 30-45% for Pt black. These values are, in overall, higher than those of low temperature (< 90 °C) ethanol electro-oxidation systems.

Resumo O estudo visou comparar escores de ansiedade e depressão em profissionais da saúde em atendimento remoto ou presencial em um hospital universitário brasileiro durante a pandemia de Covid-19 e identificar fatores associados à ansiedade e à depressão. Para tanto, realizou-se um estudo observacional e transversal. Os participantes responderam aos protocolos Patient Health Questionnaire-9 e General Anxiety Disorder-7, além de um questionário sociodemográfico, e foram divididos em três grupos: profissionais da telessaúde (G1), profissionais que exercem de maneira presencial (G2) e profissionais que exercem de ambas as formas (G3). Participaram 159 profissionais da saúde, sendo 36 homens e 123 mulheres, a maioria de enfermeiros, com a média de idade de 42 anos. Os participantes do G2 apresentaram maiores escores de ansiedade e depressão quando comparados aos demais. No entanto, não houve diferenças e associações estatísticas significantes entre esses grupos (p>0,05). ‘Idade’, ‘tipo de profissão’ e ‘receber diagnóstico de Covid-19’ tiveram associações estatísticas com ansiedade e depressão. Concluiu-se que não houve diferença significante entre ansiedade e depressão em profissionais da saúde que trabalham de forma remota ou presencial, assim como não houve associações entre os protocolos e os grupos. ‘Idade’ ‘profissão’ e ‘receber diagnóstico de Covid-19’ podem interferir nesses escores.

Abstract This study aimed to compare anxiety and depression scores in health professionals in telehealth and/or face-to-face care at a Brazilian university hospital during the COVID-19 pandemic and to identify factors associated with anxiety and depression. For this, an observational and cross-sectional study was carried out. Participants responded to the “Patient Health Questionnaire-9” and “General Anxiety Disorder-7” and a sociodemographic questionnaire and divided into three groups: telehealth professionals (G1), face-to-face care (G2) and professionals who work in both ways (G3). 159 health professionals participated, 36 men, 123 women, the majority of whom were nurses and the average age was 42 years. G2 participants had higher anxiety and depression scores when compared to the others. However, there were no statistically significant differences and associations between these groups (p> 0.05). “Age”, “profession” and “being diagnosed with COVID-19” had statistical associations with anxiety and depression. It was concluded that there was no significant difference between anxiety and depression between health professionals who work by telehealth and/or face-to-face, as well as there were no associations between protocols and groups. Age, profession and being diagnosed with COVID-19 can interfere with these scores.

Resumen Este estudio tuvo como objetivo comparar las puntuaciones de ansiedad y depresión en profesionales de la salud en telesalud y/o atención presencial en un hospital universitario brasileño durante la pandemia de COVID-19 y identificar los factores asociados con la ansiedad y la depresión. Para ello se realizó un estudio observacional y transversal. Los participantes respondieron el Patient Health Questionnaire-9 y General Anxiety Disorder-7 y un cuestionario sociodemográfico y se dividieron en tres grupos: profesionales de telesalud (G1), atención presencial (G2) y profesionales que trabajan en ambos sentidos (G3). Participaron 159 profesionales de la salud, 36 hombres, 123 mujeres, la mayoría enfermeras y la edad promedio fue de 42 años. Los participantes del G2 tenían puntuaciones más altas de ansiedad y depresión en comparación con los demás. Sin embargo, no hubo diferencias ni asociaciones estadísticamente significativas entre estos grupos (p> 0,05). “Edad”, “profesión” y “ser diagnosticado con COVID-19” tenían asociaciones estadísticas con ansiedad y depresión. Se concluyó que no hubo diferencia significativa entre ansiedad y depresión entre los profesionales de la salud que trabajan por telesalud y / o cara a cara, así como tampoco hubo asociaciones entre protocolos y grupos. La edad, la profesión y el diagnóstico de COVID-19 pueden interferir con estos puntajes.

Abstract In this study, we report the occurrence of multisystemic inflammatory syndrome among 64 children (2 deaths) with recent severe acute respiratory syndrome-related coronavirus 2 (SARS-COV-2) infections in the northeast region of Brazil. The major clinical symptoms and signs reported were exanthema (60.9%), abdominal pain (56.3%), nausea and vomiting (46.9%), diarrhea (37.5%), and dyspnea (37.5%). Laboratory findings revealed that the levels of C-reactive protein (75.0%), hemoglobin (51.6%), D-dimer (48.4%), lymphocytes (43.8%), LDH (45.3%), AST (42.2%), ALT (51.6%), and ferritin (48.4%) were above the reference values for a given age and gender. The clinical findings were similar to those observed in Kawasaki disease, although it represents a separate entity, emphasizing the need for proactive surveillance and early treatment.

RESUMO Introdução: A atividade muscular no gesto motor da pedalada no cicloergômetro pode ser mensurada por meio da eletromiografia de superfície. A eletromiografia de superfície tem sido um método efetivo e aprimorado para estudar a ação muscular, determinando com objetividade os diferentes potenciais de ação dos músculos empenhados em movimentos específicos. O comportamento da frequência cardíaca tem relação importante durante o exercício com carga. Objetivo: Identificar o comportamento da frequência cardíaca e o padrão da atividade muscular do reto femoral e vasto medial em indivíduos saudáveis na dinâmica da pedalada em diferentes cargas, teste submáximo, no cicloergômetro instrumentado. Métodos: Foram avaliados 20 adultos saudáveis, realizando-se a mensuração da frequência cardíaca e a análise eletromiográfica no domínio do tempo dos músculos reto femoral e vasto medial durante o exercício incremental dos membros inferiores em cicloergômetro. Resultados: O comportamento da frequência cardíaca apresentou diferença significante para p ≥ 0,05 com relação ao incremento das cargas. A intensidade do sinal EMG do músculo vasto medial (valor RMS normalizado) em cada quadrante do ciclo da pedalada mostrou diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes III e IV. No músculo reto femoral (RF) verificou-se diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e III. Conclusão: Constatou-se aumento da frequência cardíaca proporcional ao incremento das diferentes cargas e também se evidenciou um aumento na amplitude do sinal eletromiográfico proporcional ao incremento da carga. Foi possível identificar o padrão da ativação dos músculos com relação ao ciclo da pedalada nos quadrantes estudados, independentemente do nível da carga. Nível de evidência III; Estudo de pacientes não consecutivos; sem padrão de referência “ouro” aplicado uniformemente.

ABSTRACT Introduction: Muscle activity in the pedal stroke movement on a cycle ergometer can be measured by surface electromyography, as an effective and improved method for studying muscle action and objectively determining the different action potentials of the muscles involved in specific movements. Heart rate behavior is an important factor during exercise with load. Objective: To identify heart rate behavior and pattern of muscle activity of the rectus femoris and vastus medialis in healthy subjects in the pedaling dynamic at different loads, submaximal test, on an instrumented cycle ergometer. Methods: 20 healthy adults were evaluated. Heart rate measurement was performed, together with electromyographic analysis, in the time domain, of the rectus femoris and vastus medialis muscles during incremental exercise of the lower limbs on the cycle ergometer. Results: Heart rate behavior presented significant difference for p≥0.05 in relation to increased loads. The EMG signal intensity from the vastus medialis muscle (normalized RMS value) in each quadrant of the pedaling cycle showed significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants III and IV. In the rectus femoris (RF) muscle, there was significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants I, II and III. Conclusion: An increase in heart rate proportional to the increase in load was observed, as well as an increase in the amplitude of the electromyographic signal proportional to the increase in load. It was possible to identify the pattern of muscle activation in the studied quadrants during pedal stroke movements, independent of load. Level of evidence III; Study of non-consecutive patients; without uniform application of the “gold” standard reference.

RESUMEN Introducción: La actividad muscular en el gesto motor de la pedaleada en el cicloergómetro se puede medir por medio de la electromiografía de superficie. La electromiografía de superficie ha sido un método efectivo y mejorado para estudiar la acción muscular, determinando con objetividad los diferentes potenciales de acción de los músculos empeñados en movimientos específicos. El comportamiento de la frecuencia cardíaca tiene relación importante durante el ejercicio con carga. Objetivo: Identificar el comportamiento de la frecuencia cardíaca y el patrón de la actividad muscular del recto femoral y vasto medial en individuos en la dinámica de la pedaleada en el cicloergómetro instrumentado. Métodos: Se evaluaron 20 adultos saludables, realizándose la medición de la frecuencia cardíaca y el análisis electromiográfico en el dominio del tiempo de los músculos recto femoral y vasto medial durante el ejercicio incremental de los miembros inferiores en cicloergómetro. Resultados: El comportamiento de la frecuencia cardíaca presentó una diferencia significativa para p ≥ 0,05 con relación al incremento de las cargas. La intensidad de la señal EMG del músculo vasto medial (valor RMS normalizado) en cada cuadrante del ciclo de la pedaleada mostró diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes III y IV. En el músculo recto femoral (RF) se verificó diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV, y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y III. Conclusión: Se constató aumento de la frecuencia cardíaca proporcional al incremento de las diferentes cargas y también se evidenció un aumento en la amplitud de la señal electromiográfica proporcional al incremento de la carga. Fue posible identificar el patrón de la activación de los músculos con relación al ciclo de la pedaleada en los cuadrantes estudiados, independientemente del nivel de la carga. Nivel de evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia “oro” aplicado uniformemente.

RESUMO CONTEXTO: A hipertensão portal é uma das complicações da cirrose e está associada a inúmeras manifestações sistêmicas, incluindo alterações renais, cerebrais, pulmonares, cardíacas e vasculares. Nos exames oftalmológicos de rotina realizados em nosso serviço, observamos que algumas crianças diagnosticadas com hipertensão portal apresentaram aumento da tortuosidade vascular da retina. OBJETIVO: 1. Avaliar a presença de anormalidades vasculares da retina (tortuosidade vascular) em crianças diagnosticadas com hipertensão portal; 2. Investigar a associação entre tortuosidade vascular da retina e presença de varizes gastroesofágicas nessas crianças; 3. Avaliar o uso de parâmetros clínicos e laboratoriais para prever a presença de varizes gastroesofágicas em crianças com hipertensão portal. MÉTODOS: Estudo transversal e observacional, que incluiu pacientes com idade <18 anos com diagnóstico de hipertensão portal. Os participantes incluídos foram submetidos ao exame de fundo de olho dilatado e fotografia de fundo com dispositivo Visucam (Carl Zeiss Meditec AG). Além disso, foram coletados dados clínicos e laboratoriais dos prontuários dos pacientes. RESULTADOS: Um total de 72 pacientes foi incluído neste estudo e 36% deles apresentaram aumento da tortuosidade vascular da retina. Contagem de plaquetas (P=0,001), dosagem de bilirrubina (P=0,013) e dosagem de aspartato transaminase (AST) (P=0,042) foram associados à presença de varizes gastroesofágicas na endoscopia digestiva. Não houve associação entre tortuosidade vascular da retina e presença de varizes gastroesofágicas (P=0,498). CONCLUSÃO: Os resultados deste estudo sugerem que a contagem de plaquetas, a dosagem de bilirrubina e a aspartato transaminase foram associadas à presença de varizes gastroesofágicas na endoscopia digestiva. Em relação aos achados da retina, descobrimos que houve um aumento na tortuosidade vascular da retina em 36% dos pacientes pediátricos, mas nenhuma associação foi encontrada com a presença de varizes gastroesofágicas.

ABSTRACT BACKGROUND: Portal hypertension is one of the complications of cirrhosis and is associated with numerous systemic manifestations, including renal, brain, pulmonary, cardiac and vascular changes. In routine ophthalmological examinations performed at our service, we observed that some children diagnosed with portal hypertension had increased retinal vascular tortuosity. OBJECTIVE: 1. To evaluate the presence of retinal vascular abnormalities (vascular tortuosity) in children diagnosed with portal hypertension; 2. To investigate the association between retinal vascular tortuosity and the presence of gastroesophageal varices in these children; 3. To evaluate the use of clinical and laboratory parameters to predict the presence of gastroesophageal varices in children with portal hypertension. METHODS: This was a cross-sectional and observational study that included patients aged <18 years with a diagnosis of portal hypertension. The participants included were submitted to dilated fundus examination and fundus photography with Visucam (Carl Zeiss Meditec AG) device. Besides, clinical and laboratorial data were collected from the patients’ medical records. RESULTS: A total of 72 patients were included in this study, and 36% of them had an increase in retinal vascular tortuosity. Platelet count (P=0.001), bilirubin dosage (P=0.013) and aspartate transaminase dosage (AST) (P=0.042) were associated with the presence of gastroesophageal varices in digestive endoscopy. There was no association between retinal vascular tortuosity and the presence of gastroesophageal varices (P=0.498). CONCLUSION: The results of this study suggest that platelet count, bilirubin dosage, and aspartate transaminase dosage were associated with the presence of gastroesophageal varices in digestive endoscopy. Regarding the retinal findings, we found that there was an increase in retinal vascular tortuosity in 36% of pediatric patients, but no association was found with the presence of gastroesophageal varices.

Resumo: O objetivo deste trabalho foi avaliar o efeito do uso de diferentes adubos nitrogenados nas perdas de N por volatilização de NH3 e no rendimento de grãos de cultura de milho (Zea mays) na região semiárida do estado de Sergipe. O milho foi manejado sob condições de sequeiro e preparo convencional. Os tratamentos de fertilização foram: ureia revestida com enxofre (SU) e ureia organomineral (OMU). Também foram incluídos ureia comercial e sulfato de amônio (SA) como referência de fontes de N com alto e baixo potencial de volatilização de NH3, além de um controle não fertilizado com N. As fontes de N foram aplicadas na superfície do solo a uma taxa de 150 kg ha-1 de N, como cobertura, no estádio V5 de crescimento do milho. O experimento foi realizado em 2015 e repetido em 2016. As perdas de N pela volatilização de NH3 foram diferentes entre as fontes de N nos dois anos de estudo, com SA tendo apresentado a menor perda de N e ureia comercial, a maior. Na área tratada com OMU, as perdas pela volatilização de NH3 foram controladas de forma consistente, tendo mostrado redução de 74 e 67% em relação à da ureia regular em ambos os anos. SU, no entanto, apenas mitigou as perdas de NH3 em 2015, tendo as aumentado em 2016, em comparação à ureia comercial. O rendimento de grãos e o status de N da planta de milho, avaliados pela folha-índice, não refletiram claramente a perda de N pela volatilização de NH3. Para o semiárido de Sergipe, OMU é o melhor fertilizante à base de ureia para mitigar as perdas de N pela volatilização de NH3, e o uso de SA é uma alternativa para aumentar o rendimento do milho e eliminar as perdas de N como NH3.

Abstract: The objective of this work was to evaluate the effect of the use of different nitrogen fertilizers on N losses by NH3 volatilization and on the grain yield of a corn (Zea mays) crop grown in the semiarid region of the state of Sergipe, Brazil. Corn was managed under rainfed conditions and conventional tillage. The fertilization treatments were: sulfur-coated urea (SU) and organo-mineral-coated urea (OMU). Regular urea and ammonium sulfate (AS) were also included as a reference of N sources of high and low NH3-volatilization potential, as well as a control without N fertilization. The N sources were applied to the soil surface at a rate of 150 kg ha-1 N as side-dressing at the V5 growth stage of corn. The experiment was carried out in 2015 and repeated in 2016. Losses of N through NH3 volatilization differed among the N sources in the two study years, with AS presenting the lowest N losses and regular urea, the highest. In the area treated with OMU, losses by NH3 volatilization were consistently controlled, showing a reduction of 74 and 67% in relation to that of regular urea in both years. SU, however, only mitigated NH3-N losses in 2015, increasing them in 2016, compared with regular urea. Corn plant grain yield and N status, assessed by the index leaf, did not clearly reflect N losses by NH3 volatilization. For the semiarid of Sergipe, OMU is the best urea-based fertilizer to mitigate N losses by NH3 volatilization, and the use of AS is an alternative to increase corn yield and eliminate N losses as NH3.

Abstract: Introduction: The Covid-19 pandemic has had a direct impact on medical student training, through the sudden change from face-to-face to remote learning and the stress and anxiety caused. Students need coping strategies for the sake of their mental health and to deal with situations of extreme anxiety. Experience Report: during the pandemic the ELAM (Study of Literature and Art in Medicine) group has sought to help students in lockdown deal with their mental struggles by promoting discussions on literature through texts it has produced, debates on social media and, primarily, through art activities such as watercolor painting and visual arts. Twenty-four watercolor paintings, videos, collages, chronicles and poems were produced. The main themes addressed were: love (N=2), ageing (N=2), sin and religion (N=4), life cycle (N=6), cancer, chaos, wisdom, mortality (N=3), time, looking and seeing (N=2) and regionalism (N=2). Discussion: Essential measures to tackle Covid-19 include social isolation, physical distancing and restrictions on people’s movements to prevent the rapid spread of the virus. When youngsters lack the mechanisms to cope with the resulting stressful situation, a series of mental disorders can be triggered, such as depression, anxiety and mood swings. Reflecting a broader trend in medical training, medical schools are increasingly investing in curricular content involving arts, and at this particular moment in time this represents an important coping strategy for students trying to deal with the pandemic. Conclusion: Getting through this difficult period of the Covid-19 pandemic has demanded a coping strategy to help students experience and vent their fears, where art has been the best form of expression, and the ELAM group has achieved such a strategy.

Resumo: Introdução: O momento da pandemia por Covid-19 tem um impacto direto na formação dos estudantes de Medicina, tanto pela modificação repentina na metodologia presencial para remota quanto pelo estresse e pela ansiedade gerados. A saúde mental dos estudantes necessita de estratégias de coping para que eles possam lidar com situações de extrema ansiedade. Relato de experiência: O grupo Estudo de Literatura e Arte na Medicina (Elam) criou, durante o período da pandemia, momentos de discussão de literatura por meio de produção textual e discussões em mídia social, e principalmente por meio de atividades artísticas com pintura em aquarela e artes plásticas, para lidar com os conflitos apresentados pelos alunos na quarentena. Foram 24 telas de aquarela, vídeos, telas de colagem em artes plásticas e textos de crônicas e poesias. Os temas abordados nos textos foram principalmente: amor (N = 2), envelhecer (N = 2), pecado e religiosidade (N = 4), ciclo da vida (N = 6), câncer, caos, sabedoria, mortalidade (N = 3), tempo, olhar e ver (N = 2) e regionalismo (N = 2). Discussão: O enfrentamento da Covid-19 impõe o isolamento social, o distanciamento físico e a restrição à mobilidade das pessoas como medidas fundamentais para evitar a rápida disseminação do vírus. Quando o jovem não dispõe de mecanismos para lidar com a situação estressante propiciada pela situação, pode haver o desencadeamento de uma série de psicopatologias, como depressão, ansiedade e distúrbios do humor. É uma tendência mais ampla na educação médica: cada vez mais, as escolas de Medicina estão investindo em currículo e programação em torno das artes, e, no momento atual, essa estratégia de coping se torna importante no enfrentamento da pandemia pelo estudante de Medicina. Conclusão: Atravessar esse momento de pandemia pela Covid-19 exigiu uma estratégia de coping para ajudar os alunos a vivenciar e extravasar seus medos, sendo a arte a melhor forma de expressão, o que foi atingido pelo grupo Elam.

RESUMO Objetivo: Determinar, após 3 anos de seguimento, as taxas de sucesso funcional e anatômico e a segurança da cirurgia combinada sem sutura, incluindo remoção da base vítrea e da membrana limitante interna após coloração com azul brilhante (0,5 mg/ml) para o manejo de buracos maculares idiopáticos. Métodos: Quarenta e seis olhos de 46 pacientes com buraco macular idiopático foram incluídos neste estudo retrospectivo. Os critérios de inclusão foram: buraco macular com diâmetro linear mínimo menor que 1500 micrômetros, acuidade visual com melhor correção de 0,05 decimal ou melhor e tempo de sintomas menor que 2 anos. Os critérios de exclusão foram gravidez, atrofia do nervo óptico, glaucoma avançado ou outra doença ocular crônica. A técnica cirúrgica incluiu a remoção da membrana limitante interna após coloração com Azul Brilhante 0,5 mg/ml, tamponamento com C3F8 posicionamento em prona ção durante 3 dias de pós-operatório. O seguimento foi realizado por exame oftalmológico e Tomografia de Coerência Óptica no 1 e 7 dias, 1, 6, 12, 24 e 36 meses de pós-operatório. Se o fechamento anatômico do buraco macular não fosse atingido na visita de um mês, realizava-se um segundo procedimento no qual a área do peeling da membrana limitante interna era ampliada. Para análise estatística, foram utilizados testes de regressão logística múltipla e Qui-quadrado. Valores de p menores que 0.05 foram considerados estatisticamente significativos. Resultados: Dos 46 olhos com buraco macular idiopático, 42 (91,3%) obtiveram fechamento do buraco macular após um procedimento cirúrgico e 45 (97,8%) após uma cirurgia adicional. A média de melhora da acuidade visual com melhor correção no pós-operatório foi de 0.378 (0.050-0.900) decimal. Não foram observados: reabertura do buraco macular, complicações relacionadas ao procedimento cirúrgico ou complicações relacionadas ao corante. Conclusão: A cirurgia combinada sem sutura que incluiu remoção da base vítrea e remoção membrana limitante interna após coloração com Azul Brilhante (0,5 mg/ml) para o tratamento de buracos maculares idiopáticos foi realizada com adequada capacidade de coloração, melhora da acuidade visual e fechamento do buraco macular sem sinais de toxicidade ocular no seguimento de 3 anos.

ABSTRACT Purpose: The aim of this study was to determine the functional and anatomical success rates as well as the safety of sutureless combined surgery involving vitreous base removal and internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining for the management of idiopathic macular holes after three years. Methods: Forty-six eyes of 46 patients with an idiopathic macular hole were enrolled in this retrospective study. The inclusion criteria were macular holes with a minimum linear diameter below 1,500 mm, 0.05 or better decimal best-corrected visual acuity and duration of symptoms less than two years. The exclusion criteria included pregnancy, optic nerve atrophy, advanced glaucoma, and other chronic ocular diseases. The surgical procedure included internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining, along with C3F8 tamponade and face-down positioning for three days postoperatively. Ophthalmologic examinations and optical coherence tomography were performed at 1 and 7 days and 1, 6, 12, 24, and 36 months postoperatively. If no anatomic closure of the macular holes occurred within the first month, the area of the internal limiting membrane peeling was enlarged in a second procedure. Multiple logistic regression and chi-squared tests were used for data analyses, and p-values of <0.05 were considered significant. Results: Out of 46 eyes with a preoperative idiopathic macular hole, anatomic closure was achieved in 42 (91.3%) after one procedure and in 45 (97.8%) after an additional surgery. The median postoperative best-corrected visual acuity improvement was 0.378 (range: 0.050-0.900) decimal. None of the patients experienced macular hole reopening, surgery-related complications, or ocular complications related to the dye. Conclusion: Combined surgery including vitreous base removal and internal limiting membrane peeling after staining with Brilliant Blue G (0.5 mg/mL) for the management of idiopathic macular holes resulted in adequate staining, best-corrected visual acuity improvement, and macular hole closure with no signs of ocular toxicity at the three-year follow-up examination.