ABSTRACT Purpose: This study aimed to describe the demographic and clinical characteristics of victims of fireworkrelated ocular trauma treated at the ophthalmologic emergency de partments of two reference centers in Pernambuco, Brazil, and to identify risk factors related to poor visual prognosis. Methods: We retrospectively evaluated the medical records of patients admitted in emergency departments with a report of firework-related trauma between January 2012 and December 2018. Data collected included patient’s age, sex, place of origin, month and year of the accident, ocular structures affected, characteristics of the injuries, and type of treatment that patients received. For patients who were followed for >30 days, the final visual acuity and patient’s origin were analyzed. Results: Three hundred and seventy eyes from 314 patients were included, of which 248 (79.0%) were male and 160 (51.0%) were from the metropolitan region of Recife. The mean patient age was 25.6 ± 18.8 years. In 56 (17.8%) patients, the ocular trauma was bilateral. A total of 152 (48.4%) cases occurred in June. The most affected sites were the eyelids in 91 (24.6%) eyes and ocular surface in 252 (68.1%). Surgical treatment was required in 87 (23.5%) eyes. After clinical and surgical management, 37 (10.0%) eyes presented final visual acuity of <20/400. Of these, 34 (91.9%) eyes were from patients from the countryside or from another state. Patients from the countryside presented higher risk of developing blindness after a firework trauma than those from the metropolitan area (odds ratio of 5.46). Conclusions: Victims of firework-related ocular trauma were mostly male, from the metropolitan region of Pernambuco state and mainly pediatric patients or economically active. Those coming from the countryside and other states had higher risk of developing blindness

RESUMO Objetivos: Descrever as características demográficas e clínicas das vítimas de trauma ocular por fogos de artifício atendidas nas emergências oftalmológicas de dois centros de referência em Pernambuco e identificar fatores relacionados a mau prognóstico visual. Métodos: Avaliação retrospectiva dos prontuários de pacientes admitidos na emergência oftalmológica com história de trauma por fogos de artifício entre janeiro de 2012 e dezembro de 2018. A coleta de dados incluiu idade, gênero, procedência, mês e ano do acidente, estruturas oculares acometidas e características das lesões, além do tipo de tratamento a que os pacientes foram submetidos. Naqueles pacientes acompanhados por mais de 30 dias, analisou-se a acuidade visual final e a associação com sua procedência. Resultados: Foram incluídos 370 olhos de 314 pacientes. Destes, 248 (79,0%) vítimas eram do sexo masculino e 160 (51,0%) da região metropolitana do Recife, com uma média de idade de 25.6 ± 18.8 anos. Em 56 (17,8%) dos casos o trauma foi bilateral. No mês de junho ocorreu um total de 152 (48,4%) casos. Os sítios mais acometidos foram pálpebras em 91 (24,6%) olhos e superfície ocular em 252 (68,1%). O tratamento cirúrgico foi necessário em 87 (23,5%) olhos. Após manejo clínico-cirúrgico, 37 (10.0%) olhos desenvolveram visão pior do que 20/400. Destes, 34 (91,9%) olhos eram de pacientes do interior do estado de Pernambuco ou de outro estado. Os pacientes provenientes do interior do estado apresentaram maior chance de desenvolver cegueira quando comparados aos que eram provenientes da região metropolitana (Odds Ratio de 5,46). Conclusões: As vítimas de trauma ocular por fogos de artificio foram em sua maioria do sexo masculino, procedentes da região metropolitana do estado e das faixas etárias pediátrica e economicamente ativa. Aqueles provenientes do interior ou de outros estados apresentaram maior chance de desenvolver cegueira.

ABSTRACT Focal segmental glomerulosclerosis (FSGS) is a kidney histologic lesion that may be caused by multiple aetiologies and pathophysiological mechanisms, with podocyte injury and depletion as the common denominator. FSGS may be subdivided into different subclasses: primary, secondary, genetic and unknown forms. Notwithstanding the overlapping clinical and histological characteristics across the different forms of FSGS, their management and response to treatment are strikingly different. Genetic FSGS may be suggested by the appearance of nephrotic syndrome during childhood, but it may also present in adulthood, where the diagnosis is rather challenging due to widely variable clinical and histological phenotypes. Herein we present the case of a 34-year-old female with a family history of chronic kidney disease of undetermined aetiology, referred for a Nephrology consultation due to haematoproteinuria and de novo arterial hypertension. Complementary evaluation revealed a urinary protein/creatinine ratio of 4.3 g/g and albumin/creatinine ratio of 3.9 g/g with hypoalbuminaemia. Kidney biopsy revealed lesions of FSGS, associated with extensive foot process effacement. The constellation of findings and family history of kidney disease raised the suspicion of a genetic cause, therefore genetic testing was performed. Two variants in the NPHS2 gene [c.686G>A, p.(Arg229Gln) and c.855_856del, p(Arg286Thrfs*17)] were found in compound heterozygosity, compatible with the diagnosis of genetic FSGS. This case highlights the importance of a detailed evaluation of patients with FSGS lesions in order to identify the FSGS form, given its therapeutic and prognostic impact, including after kidney transplantation.

RESUMO Objetivos: Descrever as características demográficas e clínicas das vítimas de trauma ocular por fogos de artifício atendidas nas emergências oftalmológicas de dois centros de referência em Pernambuco e identificar fatores relacionados a mau prognóstico visual. Métodos: Avaliação retrospectiva dos prontuários de pacientes admitidos na emergência oftalmológica com história de trauma por fogos de artifício entre janeiro de 2012 e dezembro de 2018. A coleta de dados incluiu idade, gênero, procedência, mês e ano do acidente, estruturas oculares acometidas e características das lesões, além do tipo de tratamento a que os pacientes foram submetidos. Naqueles pacientes acompanhados por mais de 30 dias, analisou-se a acuidade visual final e a associação com sua procedência. Resultados: Foram incluídos 370 olhos de 314 pacientes. Destes, 248 (79,0%) vítimas eram do sexo masculino e 160 (51,0%) da região metropolitana do Recife, com uma média de idade de 25.6 ± 18.8 anos. Em 56 (17,8%) dos casos o trauma foi bilateral. No mês de junho ocorreu um total de 152 (48,4%) casos. Os sítios mais acometidos foram pálpebras em 91 (24,6%) olhos e superfície ocular em 252 (68,1%). O tratamento cirúrgico foi necessário em 87 (23,5%) olhos. Após manejo clínico-cirúrgico, 37 (10.0%) olhos desenvolveram visão pior do que 20/400. Destes, 34 (91,9%) olhos eram de pacientes do interior do estado de Pernambuco ou de outro estado. Os pacientes provenientes do interior do estado apresentaram maior chance de desenvolver cegueira quando comparados aos que eram provenientes da região metropolitana (Odds Ratio de 5,46). Conclusões: As vítimas de trauma ocular por fogos de artificio foram em sua maioria do sexo masculino, procedentes da região metropolitana do estado e das faixas etárias pediátrica e economicamente ativa. Aqueles provenientes do interior ou de outros estados apresentaram maior chance de desenvolver cegueira.

ABSTRACT Purpose: This study aimed to describe the demographic and clinical characteristics of victims of fireworkrelated ocular trauma treated at the ophthalmologic emergency de partments of two reference centers in Pernambuco, Brazil, and to identify risk factors related to poor visual prognosis. Methods: We retrospectively evaluated the medical records of patients admitted in emergency departments with a report of firework-related trauma between January 2012 and December 2018. Data collected included patient’s age, sex, place of origin, month and year of the accident, ocular structures affected, characteristics of the injuries, and type of treatment that patients received. For patients who were followed for >30 days, the final visual acuity and patient’s origin were analyzed. Results: Three hundred and seventy eyes from 314 patients were included, of which 248 (79.0%) were male and 160 (51.0%) were from the metropolitan region of Recife. The mean patient age was 25.6 ± 18.8 years. In 56 (17.8%) patients, the ocular trauma was bilateral. A total of 152 (48.4%) cases occurred in June. The most affected sites were the eyelids in 91 (24.6%) eyes and ocular surface in 252 (68.1%). Surgical treatment was required in 87 (23.5%) eyes. After clinical and surgical management, 37 (10.0%) eyes presented final visual acuity of <20/400. Of these, 34 (91.9%) eyes were from patients from the countryside or from another state. Patients from the countryside presented higher risk of developing blindness after a firework trauma than those from the metropolitan area (odds ratio of 5.46). Conclusions: Victims of firework-related ocular trauma were mostly male, from the metropolitan region of Pernambuco state and mainly pediatric patients or economically active. Those coming from the countryside and other states had higher risk of developing blindness

Resumo A diversidade de espécies de Rhamphichthys é revisada e sete espécies são consideradas válidas: Rhamphichthys apurensis das bacias dos rios Orinoco e Cuyuni; R. drepanium das bacias dos rios Orinoco e Amazonas; R. hahni do sistema do rio Paraná-Paraguai; R. heleios e R. lineatus da bacia do rio Amazonas; R. pantherinus do alto rio Orinoco, Amazonas, Essequibo e rios costeiros do norte do Brasil;e R. rostratus do alto rio Orinoco, Amazonas e rios costeiros das Guianas. Baseado na revisão de material das espécies nominais cobrindo toda a distribuição geográfica, incluindo os espécimes tipos, confirma a sinonímia prévia de quatro espécies nominais (R. blochii, R. reinhardti, R. schomburgki, and R. schneideri)com R. rostratus e de R. marmoratus com R. pantherinus. Duas outras espécies nominais, R. atlanticus e R. longior,são propostas como sinônimo júnior de R. pantherinus. As espécies são redescritas e diagnosticadas baseando-se no padrão de colorido, morfometria, contagens e caracteres de anatomia interna. Mapas de distribuição e uma chave de identificação baseados em uma extensa revisão de material são fornecidos. válidas Cuyuni R ParanáParaguai Paraná Paraguai Paraná-Paraguai Brasile Brasil Guianas geográfica tipos (R blochii reinhardti schomburgki schneidericom schneideri longiorsão longior baseandose baseando se colorido morfometria interna fornecidos

Abstract The species diversity and taxonomy of Rhamphichthys is reviewed and seven species are considered valid: Rhamphichthys apurensis from the Orinoco and Cuyuni river basins; R. drepanium from the Amazon and Orinoco river basins; R. hahni from the Paraná-Paraguay River system; R. heleios and R. lineatus from the Amazon River basin; R. pantherinus from theupper Orinoco, Essequibo, Amazon and coastal rivers of North Brazil,and R. rostratus from the upper Orinoco, Amazon and coastal rivers of Guianas. Based on the examination of specimens from nominal species, from across their geographic ranges, including specimen types, the previous synonymization of four species (R. blochii, R. reinhardti, R. schomburgki, and R. schneideri)with R. rostratus,and R. marmoratus with R. pantherinus is confirmed. Two other nominal species, R. atlanticus and R. longior, are proposed as junior synonyms of R. pantherinus.Species are redescribed and diagnosed based on color pattern, morphometric, meristic, and internal anatomy characters.Distribution maps and an identification key based on the examination of a comprehensive list of materials are also provided. valid basins R ParanáParaguay Paraná Paraguay system basin Essequibo Braziland Brazil Guianas ranges types (R blochii reinhardti schomburgki schneideriwith schneideri rostratusand confirmed longior pantherinusSpecies Species pattern morphometric meristic charactersDistribution characters Distribution provided

ABSTRACT Introduction: Chronic kidney disease has significant morbidity and mortality worldwide. Various studies have demonstrated that incidente patients experience a higher mortality rate within the first 3 months of dialysis. Methods: A single-center retrospective case-control study (1:3) was performed to determine early (<90 days) mortality rate and associated risk factors in incident hemodialysis patients from January 2013 to December 2018. We compared variables between survivors and non-survivors at 90 days after initiation of hemodialysis. Multivariate logistic regression was used to calculate the adjusted odds ratio with 95% confidence intervals for the variables associated with early mortality and a predictive model was developed. Results: From a total of 626 incident hemodialysis patients, 48 (7.7%) died before 90 days of treatment. Non-survivors were older [OR 1.07 (1.03-1.11)], had higher rates of non-recovering acute kidney injury [OR 7.91 (3.63-17.24)], emergency start of hemodialysis [OR 4.31 (2.15-8.62)], congestive heart failure [OR 5.68 (2.81-11.48)], ischemic cardiomyopathy [OR 4.50 (2.25-8.99)], chronic obstructive pulmonary disease [OR 3.60 (1.44-8.95)], Charlson comorbidity index [OR 1.47 (1.27-1.70)] and dependence of assistance in daily living activities [OR 3.46 (1.76-6.82)]. Patients were less likely to have 90-day mortality if they had nephrologist appointments at least 90 days prior to end-stage renal disease [OR 0.25, 95% CI (0.13-0.50); p<0.001] or a higher serum albumin [OR 0.34, 95% CI (0.19-0.62); p<0.001]. Multivariate analysis risk factors independently associated with early mortality were older age [aOR 1.06 (1-01-1.10), p=0.022], acute kidney injury as cause of end-stage renal disease [aOR 12.62 (4.50-35.40), p<0.001], congestive heart failure [aOR 3.79 (1.58-9.11), p=0.003], and Charlson comorbidity index [aOR 1.30 (1.09-1.56), p=0.005]. The model showed very good discriminative ability [AUROC (95% CI) 0.88 (0.83-0.94)]. Conclusion: Early mortality occurred in 7.7% of our population. Our model could be used to identify patients at higher risk of death during the first 90 days of hemodialysis and aid informed decision-making regarding end-stage renal disease treatment options.

Resumo Neste trabalho descrevemos duas espécies novas de Diapoma, uma do rio Negro, afluente do rio Uruguai, Brasil e Uruguai, e a segunda do rio Iguaçu, Brasil e Argentina. A espécie nova do rio Negro é diagnosticada de suas congêneres pela combinação das seguintes características: uma linha preta, estreita e conspícua restrita ao septo horizontal do corpo, linha lateral incompleta, dentes da série interna da pré-maxila tricuspidados, e baixa altura do corpo na vertical que passa pela origem da nadadeira dorsal (29,3–32,8% SL em machos e 27,7–33,3% SL em fêmeas). A espécie nova do rio Iguaçu é diagnosticada de suas congêneres pela combinação das seguintes características: linha lateral descontínua, nadadeira adiposa não pigmentada de preto, base da nadadeira anal longa (26,5–32,4% SL) e raios médios da nadadeira caudal com uma linha preta longitudinal. Adicionalmente, atualizamos a filogenia molecular do gênero, incluindo novas sequências destas duas espécies novas e de Diapoma thauma. Uma chave de identificação para as espécies de Diapoma é apresentada, modificada de estudo anterior.

Abstract Herein we describe two new species of Diapoma, one from the Negro River, a tributary of the Uruguay River in Brazil and Uruguay, and one from the Iguaçu River, in Brazil and Argentina. The new species from the Negro River basin is distinguished from its congeners by the following combination of characters: a black narrow and conspicuous line restricted to the body horizontal septum, incomplete lateral line, tricuspid teeth in the inner series of the premaxilla, and a lower body depth at vertical through the dorsal-fin origin (29.3–32.8% SL in males and 27.7–33.3% SL in females). The new species from the Iguaçu River basin is distinguished from its congeners by the following combination of characters: a discontinuous lateral line, adipose fin hyaline, longer anal-fin base (26.5–32.4% SL), and a longitudinal black stripe along the median region of caudal-fin rays. Additionally, we updated the molecular phylogeny of the genus, including new sequences from these two new species and Diapoma thauma. An identification key for species of Diapoma is presented, modified from previous study.

Resumo Cambeva contém espécies com taxonomia complexa ou mal delimitadas em termos morfológicos e de distribuição geográfica. Realizamos uma extensa revisão de populações de Cambeva das drenagens costeiras do Sul ao Sudeste do Brasil para avaliar os limites das espécies com uma análise integrativa incluindo dados morfológicos e moleculares (COI). Testamos se dois métodos de locus único, Implementação Bayesiana dos Processos da Árvore de Poisson (bPTP) e Coalescente de Yule Misto Generalizado (GMYC), são eficientes para delimitar os limites das espécies em Cambeva pela comparação com as unidades morfológicas diagnosticáveis. Usando o GMYC, também avaliamos a combinação de árvores e relógios moleculares para reconstruir a filogenia e avaliamos o quão bem o modelo implementado se ajustava aos nossos dados empíricos. Foram identificadas 11 espécies usando o critério morfológico: Cambeva balios, C. barbosae, C. botuvera, C. cubataonis, C. davisi, C. guaraquessaba, C. iheringi, C. tupinamba e C. zonata e duas tratadas como espécies não-descritas. Em contraste com o conhecimento prévio, muitas delas têm distribuição mais ampla e alta variação intraespecífica. A delimitação das espécies baseada em locus único demonstrou incongruências entre os métodos e diferiu fortemente da delimitação morfológica. Essas discordâncias e a violação do modelo GMYC sugerem que os dados de locus único são insuficientes para delimitar as espécies de Cambeva e a falha pode ser atribuída a eventos de introgressão mitocondrial e sorteio incompleto da linhagem.

Abstract Cambeva contains species with complex taxonomy or poorly delimitated in terms of morphology and geopraphic distribution. We conducted an extensive review of Cambeva populations from coastal drainages of Southern to Southeastern Brazil to evaluate species geographic limits with an integrative analysis including morphological and molecular data (COI). We test if two single-locus methods, Bayesian Poisson Tree Processes (bPTP) and Generalized Mixed Yule Coalescent (GMYC), are efficient to delimit species boundaries in Cambeva by the comparison with the diagnosable morphological units. Using GMYC, we also evaluated the combination of tree and molecular clock priors to reconstruct the input phylogeny and assessed how well the implemented model fitted our empirical data. Eleven species were identified using a morphological diagnosability criterion: Cambeva balios, C. barbosae, C. botuvera, C. cubataonis, C. davisi, C. guaraquessaba, C. iheringi, C. tupinamba, and C. zonata and two treated as undescribed species. In contrast with previous knowledge, many of them have wider distribution and high intraspecific variation. Species delimitation based on single-locus demonstrated incongruences between the methods and strongly differed from the morphological delimitation. These disagreements and the violation of the GMYC model suggest that a single-locus data is insufficient to delimit Cambeva species and the failure may be attributable to events of mitochondrial introgression and incomplete lineage sorting.

Resumo As bacias costeiras do sul do Brasil são influenciadas pelas mudanças climáticas que causaram oscilações no nível do mar durante o Pleistoceno. Essas transgressões e regressões marinhas geraram isolamento e conexão entre os rios. Nessa região, as espécies de peixe são excelentes modelos para estudos filogeográficos, pois suas distribuições podem ter sido afetadas por mudanças históricas e ecológicas decorrentes desses processos. Portanto, o objetivo principal deste estudo foi testar os efeitos das alterações do nível do mar durante o Pleistoceno na estrutura genética das populações do loricarídeo Hisonotus leucofrenatus ao longo de sua área de ocorrência. Dois genes foram sequenciados: Citocromo Oxidase subunidade 1 (gene mitocondrial) e o intron 1 da proteína ribossomal rpS7 (gene nuclear) de espécimes representando 14 bacias de drenagens. A estrutura genética observada corrobora uma divisão para peixes de água doce separada pela Serra do Tabuleiro, em Santa Catarina. Essa divisória determina dois grupos principais genéticos em H. leucofrenatus: um grupo ao sul e outro ao norte desse divisor. A estrutura genética também coincide com os limites dos sistemas de paleodrenagens estimados para a região, sustentando que as transgressões e regressões marinhas durante o Pleistoceno influenciaram a história biogeográfica de H. leucofrenatus.

Abstract The coastal basins of southeastern Brazil are influenced by climatic changes that caused sea-level oscillations during the Pleistocene. These marine transgressions and regressions can generate isolation and connection among coastal rivers. In this region, freshwater fishes are excellent models for phylogeographic studies because their distributions may have been affected by geographical and ecological changes resulting from these processes. Therefore, the main objective of this study was to evaluate the effects of Pleistocene sea-level changes on the genetic structure of the loricariid Hisonotus leucofrenatus throughout its area of occurrence. Two genes were sequenced: Cytochrome Oxidase subunit 1 (mitochondrial gene) and rpS7 ribosomal protein gene intron 1 (nuclear gene) from specimens representing 14 river drainages. The genetic data corroborate a divide for freshwater fish by the Serra do Tabuleiro mountain in Santa Catarina State. This divide determines two main genetic groups in H. leucofrenatus: one group to the south and one to the north of this mountain range. The genetic structure observed coincide with the limits of estimated paleodrainage systems for the region, supporting that marine transgressions and regressions during the Pleistocene influenced the biogeographical history of H. leucofrenatus.

ABSTRACT Here we explore the use of community phylogenetics as a tool to document patterns of biodiversity in the Fitzcarrald region, a remote area in Southwestern Amazonia. For these analyses, we subdivide the region into basin-wide assemblages encompassing the headwaters of four Amazonian tributaries (Urubamba, Yuruá, Purús and Las Piedras basins), and habitat types: river channels, terra firme (non-floodplain) streams, and floodplain lakes. We present a robust, well-documented collection of fishes from the region including 272 species collected from 132 field sites over 63 field days and four years, comprising the most extensive collection of fishes from this region to date. We conduct a preliminary community phylogenetic analysis based on this collection and recover results largely statistically indistinguishable from the random expectation, with only a few instances of phylogenetic structure. Based on these results, and of those published in other recent biogeographic studies, we conclude that the Fitzcarrald fish species pool accumulated over a period of several million years, plausibly as a result of dispersal from the larger species pool of Greater Amazonia.

RESUMEN Aquí exploramos el uso de la filogenética de comunidades como herramienta para documentar patrones de biodiversidad en la región de Fitzcarrald, un área remota en el suroeste de la Amazonía. Para estos análisis subdividimos la región en grupos de toda la cuenca que abarcan las cabeceras de cuatro tributarios del Amazonas (cuencas Urubamba, Yuruá, Purús y Las Piedras) y en los tipos de hábitat: canales fluviales, arroyos de tierra firme (sin planicie aluvial) y lagos de planicie aluvial. Presentamos una colección de peces robusta y bien documentada que incluye 272 especies, colectadas a lo largo de cuatro años y 63 días de campo, en 132 puntos de monitoreo. Convirtiéndose en la colección más extensa de peces de esta región hasta la fecha. Realizamos un análisis filogenético preliminar de la comunidad basado en esta recopilación y recuperamos resultados en gran medida estadísticamente indistinguibles de la expectativa aleatoria, con sólo unos pocos casos de estructura filogenética. Basándonos en estos resultados y los publicados en otros estudios biogeográficos recientes, concluimos que el grupo de especies de peces de Fitzcarrald acumulado durante un período de varios millones de años, se debe posiblemente al resultado de la dispersión del mayor grupo de especies de la Gran Amazonia.

A resistência aos antibióticos é uma ameaça à saúde pública, em parte devido ao uso indiscriminado de antibióticos. As infeções do trato urinário (ITU) são as segundas mais frequentes na comunidade, sendo a Escherichia coli (E. coli) o microrganismo mais frequente. Para uma correta terapêutica empírica é fundamental realizar a monitorização do perfil de sensibilidade aos antibióticos. Esse constitui o objetivo deste trabalho. Realizou-se um estudo do tipo observacional, descritivo e retrospetivo, no qual foram avaliados os resultados laboratoriais das uroculturas efetuadas entre 01/07/2015 e 30/06/2017 em vários postos de colheita do Laboratório Unilabs, na nossa área de influência. Com os dados fornecidos foi avaliada a sensibilidade aos antibióticos dos agentes isolados na população em estudo, tendo sido feita uma comparação por sexo (p<0,05). Obtiveram-se 6.584 uroculturas, das quais 14,4% positivas; destas, 74,3% eram referentes ao sexo feminino. A estirpe predominante foi a E. coli (61,03%), seguida da Klebesiella pneumoniae (7,81%) e Proteus mirabilis (6,23%). De forma global, os agentes isolados foram sensíveis à cefixima em 92,5%, à fosfomicina em 89,9%, à nitrofurantoína em 82,9% e à amoxicilina/ácido clavulânico em 82,9%. Relativamente ao sexo feminino verifica-se uma sensibilidade das estirpes à cefixima de 95,52%, à fosfomicina de 91,49%, à moxifloxacina de 90,60% e à cefuroxima de 89,15%. A sensibilidade à nitrofurantoína foi de 84,08%. Em relação à amoxicilina/ácido clavulânico e à ciprofloxacina, a sensibilibadade das estirpes foi de 85,74% e 85,8%, respetivamente. Relativamente ao sexo masculino releva-se a taxa de sensibilidade à cefixima de 79,55%, à levofloxacina de 79,37% e à fosfomicina de 80,69%. Foram encontradas taxas de sensibilidade inferiores às do sexo feminino em todos os antibióticos avaliáveis, com exceção do cotrimoxazol, tetraciclina e ceftriaxone. Os dados obtidos são concordantes com outros estudos e com as normas de orientação clínica da Direção-Geral da Saúde confirmando a adequação destas recomendações à nossa população. Este trabalho representa uma importante contribuição para o conhecimento do nosso contexto epidemiológico, permite uma abordagem terapêutica das ITU dirigida e fundamentada e é decisiva para a redução das resistências aos antibióticos.

Antibiotic resistance is a major public health threat, mainly due to its indiscriminate use. Urinary tract infections are the second most frequent in the community. Thus, we consider it is essential to monitor the antibiotic sensitivity profile in order to prescribe proper empirical therapy. This was the main objective of this work. We carried out an observational, descriptive, retrospective study. The laboratory results from urine cultures collected at several Unilabs Laboratory collecting points situated in our area of influence, between 1st July 2015 and 30th June 2017, were assessed. With the provided data, antibiotic susceptibility of the isolated agents was evaluated in this population and a comparison between genders was performed (p<0.05). We obtained 6,584 urine cultures, 14.4% of which were positive. The female sex contributes to 74.3% of the positive results. The predominant strain was E. coli (61.03%), followed by K. pneumoniae (7.81%) and P. mirabilis (6.23%). Overall, the isolated agents were sensitive to cefixime in 92.5%, fosfomycin in 89.9%, nitrofurantoin in 82.9%, and amoxicillin/clavulanic acid in 82.9%. Regarding the female sex, we detected a sensitivity of the strains to cefixime of 95.52%, fosfomycin of 91.49%, moxifloxacin of 90.60% and cefuroxime of 89.15%. The sensitivity to nitrofurantoin was 84.08%. In relation to amoxicillin/clavulanic acid and ciprofloxacin, the susceptibility of the strains was 85.74% and 85.8% respectively. Regarding the male gender, the cefixime sensitivity rate was 79.55%, levofloxacin was 79.37%, and fosfomycin 80.69%. We found lower sensitivity rates for females in all evaluable antibiotics, with the exception of cotrimoxazole, tetracycline, and ceftriaxone. The obtained data is in agreement with other studies and with the official recommendations from the Portuguese DGS attesting their suitability to our population. This type of work is essential to an individualized approach to UTIs based in our epidemiology data and constitutes a strong contribution to antibiotic resistance reduction effort.

ABSTRACT Presence of toxic compounds in marine coastal waters has increased exponentially since Industrial Revolution. In this way, we aimed to evaluate biochemical and physiological changes occurring within Hypnea musciformis after short-term exposure to gasoline. Hypnea musciformis was cultivated without gasoline and then exposed to various concentrations of it (0.001 % - 1.0 %, v/v) for periods of 30 min, 1 h, 12 h and 24 h. A Pricncipal Compound Analysis of UV-vis spectral window (200-700 nm) was able to discriminate gasoline-exposed samples according to both exposure time and gasoline concentration. Changes in carotenoid profile composition were observed. Decreased carotenoid content was associated to gasoline exposure time, being lutein and trans-β-carotene the major compounds found. Higher gasoline concentrations negatively interfered with phenolic compounds accumulation. In addition, increased gasoline concentrations corresponded to decreased intracellular starch grains content as well as increased its deposition on cell wall external surface. Data obtained allow us to conclude that gasoline can damage Hypnea musciformis physiology and cell morphology. This is important, considering Hypnea musciformis carotenoids and phenolics are potential biomarkers of environmental stress investigated, as well as its increased cell wall thickness to avoid gasoline diffusion.

Abstract Fake news has been certainly the expression of the moment: from political round table discussions to newspapers to social and mainstream media. It is everywhere. With such an intense discussion and yet few effective ways to combat it, what can be done? Providing methods to fight back even the least harming hoax is a social responsibility. To look for authenticity in a wide sea of fake news, every detail is a lead. Image appearance and semantic content of text and images are some of the main properties, which can be analyzed to reveal even the slightest lie. In this vein, this work overviews some recent methods applicable to the verification of dubious content in text and images, and discusses how we can put them together as an option to curb away the proliferation of unverified and phony “facts”. We briefly present the main idea behind each method, highlighting real situations where they can be applied and discussing expected results. Ultimately, we show how new research areas are working to seamlessly stitch together all these methods so as to provide a unified analysis and to establish the synchronization in space and time — the X-Coherence of heterogeneous sources of information documenting real-world events.

Severe hypertriglyceridemia is defined as a serum triglyceride level >885mg/dl. It is an uncommon condition associated with serious complications, mainly acute pancreatitis. Treatment includes lifestyle changes, medical therapy and, more recently, extracorporeal apheresis techniques. Herein, we report a case of severe hypertriglyceridemia managed with therapeutic plasma exchange. Our patient presented with severe upper abdominal pain. Bloodwork showed extremely severe hypertriglyceridemia (14871mg/dl) and hypercholesterolemia (1536mg/dl) with only slight elevation of amylase and lipase and no echographic signs of acute pancreatitis. Two sessions of therapeutic plasma exchange were performed, with a mean 3L of plasma treated per session. The triglyceride levels dropped to 2325mg/dl after the first session and to 1207mg/dl after the second. Medical therapy was started, and the patient was discharged a week later. After 36 months of follow-up she remains stable, with triglyceride levels 427mg/dl. In this case therapeutic plasma exchange was an effective and well tolerated treatment for severe hypertriglyceridemia

Abstract Hibiscus acetosella was shown to exert beneficial effects in humans and animal models however, the effects of this plant on DNA are unknown. The aim of this study was to determine the antigenotoxic and antimutagenic effects of H. acetosella extracts on alkylating agent methyl methanesulfonate (MMS) in vivo in mice. Initially, we performed analysis of phenolic compounds in extracts of H. acetosella by high-performance liquid chromatography (HPLC). Next, mice were divided into 8 groups and treated with distilled water or plant extract (0.1 ml/10 g) by gavage for 15 days, followed by intraperitoneal (ip) administration of saline solution or MMS (40 mg/Kg b.w) on day 16. Caffeic acid, following by gallic acid, gallocatechin, coumaric acid, and 3,4-dihydroxybenzoic acid were found to be present in extracts of H. acetosella leaves. In peripheral blood analysis of groups receiving pretreatment with H. acetosella at doses of 50 or 100 mg/kg plus MMS decreased DNA damage as evidenced by comet assay and Micronucleus assays relative to MMS alone. These results suggested that H. acetosella extracts exerted protective effects dose dependent against genotoxicity and mutagenicity induced by alkylating agents.