ABSTRACT Both systemic lupus erythematosus and antiphospholipid syndrome are autoimmune diseases with thromboembolic potential, especially due to the presence of thrombogenic antibodies. The lung is a common place where a thrombus usually settles and generates a thromboembolism, sometimes with subsequent infarction and cavitation. There are few studies reporting cavitary pulmonary infarction in a patient with lupus associated with antiphospholipid syndrome. We present the case of a 24-year-old woman with general symptoms and cavitated right lung lesion. She was initially treated as tuberculous or fungal infection. Laboratory tests and images guided and diagnosed lupus associated with antiphospholipid syndrome, complicated by pulmonary thromboembolism that later became cavitated. The patient improved considerably with anticoagulants, corticosteroids, and cyclophosphamide.

RESUMEN Tanto lupus eritematoso sistémico como el síndrome antifosfolípido son enfermedades autoinmunes con potencial tromboembólico, sobre todo por la presencia de anticuerpos trombogénicos. El pulmón es un lugar común donde suele asentarse un trombo y generar una tromboembolia, a veces con posterior infarto y cavitación. Existen pocos estudios que informen un infarto pulmonar cavitado en un paciente con lupus asociado a síndrome antifosfolípido. Presentamos el caso de una mujer de 24 años con síntomas generales y lesión pulmonar derecha cavitada. Fue tratada inicialmente como infección tuberculosa o fúngica. La analítica y las imágenes orientaron y diagnosticaron lupus asociado a síndrome antifosfolípido, complicado con tromboembolismo pulmonar que luego pasó a cavitarse. La paciente mejoró considerablemente con anticoagulantes, corticoides y ciclofosfamida.

Resumen Objetivo: Evaluar los resultados funcionales de tres protocolos distintos de tratamiento conservador en pacientes con capsulitis adhesiva del hombro. Materiales y Métodos: Se revisaron las historias clínicas de los pacientes tratados por capsulitis adhesiva en nuestra institución, entre enero de 2016 y enero de 2019. Se compararon tres protocolos diferentes de tratamiento: grupo 1, bloqueo del nervio supraescapular con un anestésico local y corticoide, analgésicos y fisioterapia después del alivio del dolor; grupo 2, bloqueo del nervio supraescapular con anestésico local sin corticoide, analgésicos y fisioterapia; grupo 3, analgésicos y fisioterapia, sin bloqueo del nervio supraescapular. Se determinaron los resultados funcionales con la escala ASES y el resultado subjetivo con el SSV. Resultados: Se dividió en tres grupos a 46 pacientes tratados por capsulitis adhesiva. Los pacientes del grupo 3 tuvieron, en promedio, más sesiones de fisioterapia (30,31 ± 21,07). Los del grupo 2 recibieron la mayor cantidad promedio de bloqueos del nervio supraescapular (3,27 ± 1,22). Los resultados de los puntajes funcionales fueron: grupo 1 (15 pacientes): media 84 ASES y 84 SSV; grupo 2 (15 pacientes): media 93,40 ASES y 91,67 SSV; grupo 3 (16 pacientes): media 79,4 ASES y 80,63 SSV. Conclusiones: Las distintas formas de tratamiento conservador para la capsulitis adhesiva logran excelentes resultados. La analgesia mediante bloqueos seriados del nervio supraescapular con un anestésico y corticoide logró mejores resultados funcionales y subjetivos, y disminuyó la necesidad de administrar analgésicos y de sesiones de fisioterapia (grupo 1).

Abstract Objective: To evaluate the functional outcomes of three different conservative treatment protocols in patients with adhesive capsulitis of the shoulder. Materials and Methods: Reviews of medical records were carried out on patients treated at the institution for adhesive capsulitis in the period between January 2016 and January 2019. 3 different treatment protocols were compared. Group 1; Suprascapular nerve block (SSNB) with local anesthetic and corticosteroid, analgesics, and physiotherapy after pain reduction. Group 2: SSNB with local anesthetic without corticosteroids, analgesics, and physiotherapy, and group 3: analgesics and physiotherapy, without SSNB. The functional outcomes were determined with the ASES scale and the subjective results were assessed with the SSV. Results: A total of 46 patients treated for adhesive capsulitis were divided into 3 groups. Group 3 presented a higher mean number of physiotherapy sessions (30.31±21.07). Group 2 had the highest mean number of SSN blocks (3.27±1.22). The results of the functional scores were: group 1 (15 patients): mean ASES 84 and mean SSV 84; group 2 (15 patients): mean ASES 93.40 and mean SSV 91.67; group 3 (16 patients): mean ASES 79.4 and mean SSV 80.63. Conclusion: The various forms of conservative treatment for adhesive capsulitis achieve excellent outcomes. Analgesia through serial blocks of the suprascapular nerve with an anesthetic and corticosteroid achieved better functional and subjective outcomes and decreased the need to administer analgesics and physiotherapy sessions (group 1).

RESUMEN La seguridad de imágenes médicas está incrementando su importancia para preservar la integridad y la confidencialidad de la información (datos médicos), frente a usuarios malintencionados dada su importancia en el diagnóstico oportuno y acertado. En este contexto, se han desarrollado varias técnicas para proteger las imágenes médicas, como el cifrado, la ocultación de datos, el etiquetado de imágenes, la aplicación de algoritmos Hash, etc. Este trabajo propone una técnica para cifrar imágenes médicas añadiendo los metadatos dentro de una imagen de cubierta, basada en la criptografía visual extendida, así como la inclusión de una función tipo Hash para comprobar la integridad de la imagen y los metadatos una vez estos sean recuperados. El método propuesto en este trabajo se implementa utilizando imágenes médicas con una resolución en escala de grises de [0,4095] es decir una profundidad de 12 bits/ píxel e imágenes en color con 24 bits/píxel de profundidad. Los resultados experimentales demuestran la eficacia del método propuesto en la tarea de transmisión segura de imágenes médicas permitiendo una mayor capacidad de ocultamiento, una menor distorsión en la calidad visual de la imagen con los datos médicos ocultos, así como un medio para comprobar la integridad de los datos enviados, en comparación con los artículos publicados.

ABSTRACT Medical image security is acquiring its importance to preserve the integrity and confidentiality of information (medical data) from malicious users given its importance in timely and successful diagnosis. In this context, several techniques have been developed to protect medical images, such as encryption, data hiding, image tagging, application of Hash algorithms, etc. This paper proposes a technique to cipher medical images by adding the metadata inside a cover image, based on extended visual cryptography as well as the inclusion of a Hash-like function to verify the integrity of the image and the metadata once they are recovered. The method proposed in this work is implemented using medical images with a grayscale resolution of [0,4095] that is a depth of 12 bits/pixel and color images with 24 bits/pixel depth. Experimental results prove the effectiveness of the proposed method in the task of secure exchange of medical images by allowing higher hiding capability, lower distortion in the visual quality of the image with the hidden medical data, as well as a means to verify the integrity of the sent data, compared to state-of-the-art.

Resumen Objetivo: Evaluar los datos demográficos, como edad, sexo, profesión, lado afectado, lesión única o múltiple, tipo de material utilizado, tiempo de cicatrización ósea y posibles complicaciones de los pacientes con fracturas diafisarias de húmero tratados mediante la técnica MIPO en tres centros hospitalarios de Ecuador, Paraguay y Brasil. Materiales y Métodos: Estudio retrospectivo, longitudinal, observacional de los datos de 133 pacientes recolectados en tres Servicios: de Quito (Ecuador), Asunción (Paraguay) y Passo Fundo (Brasil). Se compararon las distribuciones entre diferentes Servicios mediante la prueba x2 de Pearson. Resultados: La edad de los pacientes varió entre 17 y 76 años, con una media de 36 años. El tiempo promedio hasta la consolidación fue de 11 semanas (126 de 132 pacientes). Predominó el sexo masculino (70,45%), el lado derecho era el más afectado (55,3%), la mayoría de las fracturas eran únicas (85,61%), se logró la consolidación en el 95,45%. Solo el 9,09% tuvo complicaciones y el 6,82% fueron severas. El 87,12% no tuvo complicaciones; el 0,76% sufrió neuropraxia posquirúrgica; el 3,03%, infección y el 4,55%, seudoartrosis. Conclusión: Con la técnica MIPO para el tratamiento de las fracturas diafisarias de húmero, las tasas de complicaciones y de morbilidad son bajas, y la tasa de consolidación es buena.

Abstract Objective: To determine the demographic data of the patients in relation to age, sex, profession, affected side, single or multiple lesions, type of material used, bone healing time and possible complications of the treatment of diaphyseal fractures of the humerus treated using the MIPO technique in a series of patients from three hospital units in Ecuador, Paraguay, and Brazil. Materials and Methods: A retrospective, longitudinal, observational study of data from 133 patients collected in 3 services in Quito, Ecuador; Asunción, Paraguay; and Passo Fundo, Brazil. The distributions between different services were compared using Pearson’s chisquare test. Results: The age of the patients ranged from 17 to 76 years, with a mean of 36 years. The median time to union which occurred in 126 of the 132 patients, was 11 weeks. Most of the patients were male (70.45%), the right side was the most affected (55.3%), most of the fractures were single (85.61%), consolidation occurred in 95.45% of cases, complications occurred only in 9.09% of patients, 6.82% of them were severe. In relation to complications, they were divided according to the absence (87.12%) or presence of the following: post-surgical neuropraxia (0.76%), infection (3.03%), and pseudarthrosis (4.55%). Conclusion: The MIPO technique for the treatment of diaphyseal fractures of the humerus presents low rates of complications and morbidity, demonstrating good rates of consolidation.

ABSTRACT Myrciaria dubia (camu-camu) is an Amazonian fruit of economic importance. The most common problems are the damage caused by Conotrachelus dubiae and the drop of developing fruits. The objective was to clarify the factors influencing post-defoliation fruit retention influenced by C. dubiae in flooded areas. Four treatments were applied: control (T1), bottle trap (T2), adhesive tape trap (T3), and foliar fertilization (T4). The research was conducted at a camu-camu plot on the Amazon River banks. As an additional control, plants at a highland plot were evaluated. Data on the retention of flowers and fruits, yield, and quality were obtained. The presence of pests was monitored, and fruits attacked by C. dubiae were harvested. T2 showed the highest levels of damaged fruit (11.9% ± 9) and fruit retention (24.5% ± 21). This supports the hypothesis that the primary cause of fruit drop is not pest damage. In fact, T4 was the most effective pest control (damaged fruits: 4.1% ± 4). The critical period for fruit retention was right after the fruit set. Defoliation did not have any effects on fruit quality. Flowering induction, unusually occurring during the flooding period, explains the high stress that caused low fruit retention.

RESUMEN Myrciaria dubia (camu-camu) es un frutal amazónico de importancia económica. Los problemas más comunes son el daño ocasionado por Conotrachelus dubiae y la caída de los frutos en desarrollo. El objetivo fue encontrar los factores que influyen sobre la retención de frutos post-defoliación en áreas inundables. Se aplicaron cuatro tratamientos: testigo (T1), trampa botella (T2), trampa cinta adhesiva (T3) y fertilización foliar (T4). La investigación se realizó en una parcela de camu-camu en la orilla del río Amazonas. Como testigo adicional se evaluaron plantas en tierra firme. Se obtuvieron datos sobre la retención de flores y frutos, su rendimiento y calidad. Se monitoreó la presencia de plagas; además, se cosecharon frutos atacados por C. dubiae. T2 mostró los niveles más altos de frutos dañadas (11,9% ± 9) y de retención de frutos (24,5% ± 21). Esto respalda la hipótesis de que la primera causa de la caída de frutos no se debe al daño por plagas. De hecho, T4 resultó ser el control de plagas más efectivo (frutos dañados: 4,1% ± 4). El período crítico para la retención del fruto fue inmediatamente después de su cuajado. La defoliación no afectó la calidad de los frutos. La inducción floral, ocurrida inusualmente durante la inundación, explica el alto estrés que causó una baja retención de frutos.

RESUMO. A versão de 12 itens do Teste de Nomeação de Boston (TNB) foi adaptada para a Argentina para a detecção de demência por doença de Alzheimer (DA), com escores semelhantes à versão original de 60 itens (sensibilidade e especificidade de 85 e 94%, respectivamente) sem influência demográfica (idade e escolaridade). Até o momento, não foram relatadas publicações sobre o uso do TNB abreviado em outras patologias degenerativas com comprometimento da linguagem. Objetivo: avaliar a utilidade do TNB de 12 itens na afasia progressiva primária (APP), na variante comportamental da demência frontotemporal (DFT) e na doença de Alzheimer (DA). Métodos: 47 prováveis DA (NIA-AA 2011) — CDR 0,5–1, 55 DFT, 17 APP e 46 controles foram avaliados e pareados por idade e escolaridade. Critérios de exclusão: alcoolismo, outras doenças neurológicas ou psiquiátricas prévias e escolaridade <4 anos. Todos foram avaliados com uma bateria neuropsicológica completa e versão de 12 itens do TNB. Resultados: medianas das pontuações de 12 itens TNB: APP: 3,87 (DP=2,99), DA: 6,13 (DP=3,03); DFT: 8,41 (DP=2,53) e Controles: 10,22 (DP=1,82). As curvas ROC foram traçadas. Conclusões: O TNB de 12 itens pode ser útil, simples e rápido para identificar e diferenciar APP, DFT e DA nos controles, mantendo a capacidade discriminativa da versão original.

ABSTRACT. The 12-item version of the Boston Naming Test (BNT) was adapted to Argentina for the detection of dementia due to Alzheimer's disease (AD), with scores similar to the original 60-item version (sensitivity and specificity of 85 and 94%, respectively) without demographic influence (age and educational level). To date, no publications on the use of abbreviated BNT in other degenerative pathologies with language impairment have been reported. Objective: The objective of this study was to evaluate the usefulness of 12-item BNT in primary progressive aphasia (PPA), the behavioral variant of frontotemporal dementia (FTDbv), and AD. Methods: Notably, 47 patients with probable AD (NIA-AA 2011) — clinical dementia rating (CDR) 0.5–1, 55 with FTDbv, 17 with PPA, and 46 controls were evaluated and matched for age and education. Exclusion criteria were as follows: alcoholism, other previous neurological or psychiatric illnesses, and education <4 years. All were assessed with a full neuropsychological battery and a 12-item version of BNT. Results: Median scores of 12-item BNT were as follows: PPA: 3.87 (SD=2.99), AD: 6.13 (SD=3.03); FTDbv: 8.41 (SD=2.53); and controls: 10.22 (SD=1.82). Receiver Operating Characteristic (ROC) curves were plotted. Conclusions: The 12-item version of BNT can be useful, simple, and fast to identify and differentiate PPA, FTDbv, and AD from controls while retaining the discriminative ability of the original version.

RESUMO A presente investigação pesquisou a concepção de programas de orientação vocacional para a educação formal no nível secundario, visando resolver a carência de um programa de orientação vocacional efetivo e adequado às condições sociodemográficas da população estudantil. O objetivo foi desenvolver uma síntese crítica da literatura científica relacionada à orientação vocacional e profissional, mediante investigação aplicada a partir da metodologia de revisão sistemática. A partir da análise, concluiu-se que são ações essenciais nos programas de orientação profissional para determinar altos níveis de qualidade: oferecer informação sobre oferta acadêmica e demanda laboral, deenvolver perfis ocupacionais das diferentes carreiras, oferecer informação sobre interesses, aptidões e preferências, realizar treinamento em tomada de decisões, vincular-se ao grupo de apoio principal, prover estratégias para o desenvolvimento da autoeficácia e maturidade vocacional, apoiar-se no uso de TICs, prover estratégias para a transição, priorizar o papel do orientador e dos pares, estabelecer um projeto ou plano de vida, contar com um fundamento teórico e promover avaliação constante dos programas. Com a intenção de reduzir a taxa de evasão universitária e promover o desenvolvimento humano, sugere-se a aplicação desses critérios em programas vocacionais realizados a longo prazo, durante as distintas etapas do ciclo de vida.

ABSTRACT The present investigation explores the design of vocational guidance programs for formal education at the secondary level, to address the lack of an effective vocational guidance program suited to the sociodemographic conditions of the student population. The objective was to develop a critical synthesis of the scientific literature related to vocational and professional orientation, through applied research based on the systematic review methodology. From the analysis, it was concluded that there are essential actions in professional orientation programs to determine high levels of quality: to offer information about academic supply and labor demand, to develop occupational profiles of different careers, to offer information on interests, aptitudes and preferences, carry out training in decision making, link to the primary support group, provide strategies for the development of self-efficacy and vocational maturity, support the use of ICTs, provide strategies for the transition, prioritize the role of mentor and peers, establish a project or life plan, counting on a theoretical foundation and developing a constant evaluation of the vocational programs, during the different stages of the life cycle.

RESUMEN La presente investigación exploró el diseño de programas de orientación vocacional para educación formal en el nivel secundario, para resolver la carencia de un programa de orientación vocacional efectivo y adecuado a las condiciones sociodemográficas de la población estudiantil. El objetivo fue desarrollar una síntesis crítica de la literatura científica relacionada a la orientación vocacional y profesional, mediante investigación aplicada a partir de la metodología de revisión sistemática. A partir del análisis, se concluyó que son acciones esenciales en los programas de orientación profesional para determinar altos niveles de calidad: ofrecer información sobre oferta académica y demanda laboral, desarrollar perfiles ocupacionales de las diferentes carreras, ofrecer información sobre intereses, aptitudes y preferencias, realizar entrenamiento en toma de decisiones, vincular al grupo de apoyo primario, proveer estrategias para el desarrollo de la autoeficacia y madurez vocacional, apoyarse en el uso de las TICs, proveer estrategias para la transición, priorizar el rol del orientador y los pares, establecer un proyecto o plan de vida, contar con un fundamento teórico y desarrollar evaluación constante de los programas. Con la intención de reducir la tasa de deserción universitaria y promover el desarrollo humano, se sugiere la aplicación de esos criterios en programas vocacionales desarrollados a largo plazo, durante las distintas etapas del ciclo de vida.

RESUMO Objetivo: Avaliar os resultados da vertebroplastia percutânea (VP) em fraturas por fragilidade da coluna (osteoporose/tumoral), analisando possíveis complicações. Método: Foram avaliados 33 pacientes com fratura da coluna vertebral (FXV) por osteoporose ou tumor, entre janeiro e novembro de 2021, submetidos à VP. Foi realizado exame físico junto à obtenção da história e fatores de risco para fragilidade óssea / tumor, além de avaliação radiológica da coluna para constatação de FXV. O método semiquantitativo de Genant foi empregado para a classificação no pós-operatório, além do score EVA e do questionário de incapacidade (ODI). O controle tomográfico foi avaliado por médico radiologista para quantificação do preenchimento vertebral e extravasamento, determinando para onde ocorreram. Resultados: Foram operadas 46 vértebras de 33 pacientes, como média de idade de 71 anos, sendo 11 pacientes com mais de um nível operado. Do total, 13 pacientes apresentavam fraturas tumorais e 20 possuíam fraturas por insuficiência. Observou-se extravasamento do PMMA em 31 vértebras, mais frequentemente para Plexo Venoso Vertebral Externo (23), Corpo Discal (9), Recesso Epidural Anterior (4) Vasos Pulmonares (4), Plexo Venoso Vertebral Interno (3), Cava Inferior (2), Plano Adiposo (2) e Veia Ázigos (1). Nenhum paciente apresentou complicações clínicas. Ainda, o EVA pré-operatório médio foi 8 e o pós-operatório de 3, enquanto o ODI pré-operatório médio foi de 56 e o pós-operatório de 30. Conclusão: O extravasamento de PMMA foi frequente em diversos locais e níveis, sem nenhuma complicação clínica. A VP mostrou-se eficaz na melhora de dor e função. Nível III; Estudo Longitudinal Coorte Retrospectivo.

ABSTRACT Objective: To evaluate the results of percutaneous vertebroplasty (PV) in spinal fragility fractures (osteoporosis/tumor), analyzing possible complications. Method: We evaluated 33 patients with spinal fractures (FXV) due to osteoporosis or tumor who underwent PV between January and November 2021. A physical examination was performed, obtaining the history and risk factors for bone fragility/tumor and a radiological evaluation of the spine to verify FXV. Genant’s semiquantitative method was used for postoperative classification, the VAS score, and a disability questionnaire (ODI). A radiologist evaluated tomographic control to quantify vertebral filling and extravasation, determining where they occurred. Results: 46 vertebrae of 33 patients were operated on, with a mean age of 71 years, and 11 patients with more than one level of surgery. Of the total, 13 patients had tumor fractures, and 20 had fractures due to insufficiency. PMMA extravasation was observed in 31 vertebrae, most frequently in the External Vertebral Venous Plexus (23), Discal Body (9), Anterior Epidural Recess (4), Pulmonary Vessels (4), Internal Vertebral Venous Plexus (3), Inferior Cava (2), Adipose Plane (2) and Azygos Vein (1). No patient had clinical complications. Furthermore, the mean preoperative VAS was eight, the postoperative one was 3, the mean preoperative ODI was 56, and the postoperative one was 30. Conclusion: PMMA extravasation was frequent in several locations and levels without any clinical complications. VP proved to be effective in improving pain and function. Level III; Longitudinal Retrospective Cohort Study.

RESUMEN Objetivo: Evaluar los resultados de la vertebroplastia percutánea (PV) en fracturas por fragilidad de columna (osteoporosis/tumor), analizando posibles complicaciones. Método: Se evaluaron 33 pacientes con fractura de columna (FXV) por osteoporosis o tumor, entre enero y noviembre de 2021, que fueron sometidos a PV. Se realizó examen físico junto con obtención de antecedentes y factores de riesgo de fragilidad ósea/tumor, además de evaluación radiológica de columna para verificar FXV. Para la clasificación postoperatoria se utilizó el método semicuantitativo de Genant, además de utilizar la escala EVA y un cuestionario de discapacidad (ODI). El control tomográfico fue evaluado por un radiólogo para cuantificar el llenado vertebral y la extravasación, determinando dónde se producían. Resultados: Se operaron 46 vértebras de 33 pacientes, con una edad promedio de 71 años, 11 pacientes con más de un nivel de cirugía. Del total, 13 pacientes presentaron fracturas tumorales y 20 fracturas por insuficiencia. Se observó extravasación de PMMA en 31 vértebras, con mayor frecuencia en el Plexo Venoso Vertebral Externo (23), Cuerpo Discal (9), Receso Epidural Anterior (4), Vasos Pulmonares (4), Plexo Venoso Vertebral Interno (3), Cava Inferior (2), Plano Adiposo (2) y Vena Azygos (1). Ningún paciente presentó complicaciones clínicas. Además, la EVA preoperatoria media fue de 8 y la postoperatoria de 3, mientras que la ODI preoperatoria media fue de 56 y la postoperatoria de 30. Conclusión: La extravasación de PMMA fue frecuente en varias localizaciones y niveles, sin complicaciones clínicas. VP demostró ser eficaz para mejorar el dolor y la función. Nivel III; Estudio de cohorte retrospectivo longitudinal.

ABSTRACT The aim of this study was to evaluate the possible association between the roughness of 5 brands of stainless steel endodontic files and their resistance to fracture due to cyclic fatigue. The study includedfive different brands of stainless steel endodontic files: SybroEndo Triple-Flex Files (Kerr, Glendora, USA), Ready Steel K-Flexofile (Dentsply Sirona, Ballaigues, Switzerland), Mani Flexile Files (Mani, Tochigi- Ken, Japan), FKG K-Files (FKG, La Chaux-de-Fonds, Switzerland) and Zipperer Flexicut Files (VDW, Munich, Germany). Twelve files per brand (total 60 files) were evaluated. File surface roughness over an area (Sa) was quantified using a focus variation microscope. Then the files were subject to a cyclical fatigue test to determine the number cycles to fracture due to fatigue and length of fractured fragment. Finally, fractographic analysis was performed using a scanning electron microscope. The electropolished Ready Steel K-Flexofile® files had the highest roughness according to Sa parameters, though they also had the highest resistance to fracture due to cyclic fatigue and the longest fractured fragment. Moderate positive correlation was found between fractured fragment length and roughness. The fractured surface showed characteristics of ductile fracture with cracks and plastic deformation. The electropolished stainless steel Ready Steel K-Flexofile® files werethe most resistant to fracture due to cyclic fatigue even though they had highest surface roughness.

RESUMEN El objetivo del presente estudio fue evaluar la posible asociación entre la rugosidad de 5 marcas de limas endodónticas de acero inoxidable y su resistencia a la fractura por fatiga cíclica. Se incluyeron cinco grupos diferentes de limas endo-dónticas de acero inoxidable: SybroEndo Triple-Flex Files (Kerr, Glendora, EE. UU.), Ready Steel K-Flexofile (Dentsply Sirona, Ballaigues, Suiza), Mani Flexile Files (Mani, Tochigi-Ken, Japón), FKG K-Files (FKG, La Chaux-de-Fonds, Suiza) y Zipperer Flexicut Files (VDW, Munich, Alemania); se evaluaron doce instrumentos por grupo para un total de 60 limas. Mediante un microscopio de variación focal se cuantificó la rugosidad superficial por área (Sa) de los instrumentos, posteriormente fueron sometidos a una prueba de fatiga cíclica donde se determinó el número de ciclos de fractura por fatiga y la longitud del fragmento fracturado. Finalmente, se realizó un análisis fractográfico mediante microscopía electrónica de barrido. Las limas Ready Steel K-Flexofile® con electropulido mostraron el mayor valor de rugosidad en los parámetros Sa; sin embargo, también tenían la mayor resistencia a la fractura por fatiga cíclica y la mayor longitud del fragmento fracturado del instrumento. Además, se encontró una correlación moderada positiva entre la longitud del fragmento fracturado y la rugosidad. La superficie fracturada mostró características de fractura dúctil con grietas y deformación plástica. Las limas Ready Steel K-Flexofile® fabricadas en acero inoxidable con electropulido, fueron más resistentes a la fractura por fatiga cíclica a pesar de tener la mayor rugosidad superficial.

Abstract The aim of this study was to determine the influence of air temperature and rainfall on the phenological development of Mauritia flexuosa in plantations located in Ucayali, Peru. For this, during a 24-month period, 191 19-year-old palm trees were evaluated, distributed in three plantations established on low terrace soils. The results showed that the 45% of palm trees did not manifest their sexual maturity, meanwhile, 42% and 13% of individuals with male and female sex, respectively, were verified. It was found that the phenological cycle was biannual, with overlapping phenophases and staggered events. In female individuals, maximum flowering was observed in phenophase FLA1 (4-5%) from September to November 2018 and maximum fruiting FRM1 (4-6%) from October 2018 to January 2019; In male individuals, the FLA2 flowering phenophase occurs in two periods between September 2018 and February 2020, meanwhile, the open flower phenophase of both sexes is synchronous in a higher proportion between September and November. It was determined that pluvial precipitation and air temperature (maximum and minimum) did not show correlation (p ≤ 0.05) with the productive phenophases of Mauritia flexuosa. The pluvial precipitation, the maximum temperature and the minimum air temperature showed null association with each one of the phenological phases of the Mauritia flexuosa palm trees during the evaluation period. In order to obtain information for the planning of silvicultural management activities for the conservation of the species, it is recommended to evaluate for more years the influence of climatic elements on the productive development of Mauritia flexuosa.

Resumen El objetivo en este estudio fue determinar la influencia de la temperatura del aire y la precipitación pluvial en el desarrollo fenológico deMauritia flexuosaen plantaciones ubicadas en Ucayali, Perú. Para ello, durante un periodo de 24 meses, se evaluaron 191 palmeras de 19 años, distribuidas en tres plantaciones establecidas en suelos de terraza baja. Los resultados mostraron que el 45% de palmeras no manifestaron su madurez sexual, no obstante, fue verificado 42% y 13% de individuos con sexo masculino y femenino, respectivamente. Fue constatado que el ciclo fenológico fue bianual, con superposición de fenofases y eventos escalonados. En individuos femeninos se observó máxima floración en fenofase FLA1 (4-5%) de setiembre a noviembre de 2018 y máxima fructificación FRM1 (4-6%) de octubre 2018 a enero de 2019; en individuos masculinos la fenofase de floración FLA2 se presenta en dos periodos entre setiembre de 2018 y febrero de 2020, entre tanto, la fenofase de flores abiertas de ambos sexos, es sincrónica en mayor proporción entre setiembre y noviembre. Fue determinado que la precipitación pluvial y la temperatura del aire (máxima y mínima) no presentaron correlación (p ≤ 0,05) con las fenofases productivas deMauritia flexuosa. La precipitación pluvial, la temperatura máxima y temperatura mínima del aire presentaron asociación nula con cada una de las fases fenológicas de las palmeras deMauritia flexuosadurante el periodo de evaluación. Con la finalidad de obtener información para la planificación de actividades de manejo silvicultural para su conservación de la especie, se recomienda evaluar por más años la influencia de los elementos climáticos sobre el desarrollo productivo deMauritia flexuosa.

Abstract The research summarized and validated the individual selection of camu-camu (Myrciaria dubia (Kunth) McVaugh) plants. 43 progenies, previously selected in genetic tests and fields of producers of flood areas, were evaluated. Each progeny was installed in a row of 10 half-sister plants, with a space of 3x2 m. Using the SELEGEN (Reml / Blup) Model 63 program, four crops were analyzed, and individuals were selected for each of the 16 descriptors evaluated. For fruit yield, the Tipishca-Río Tigre population stood out, occupying 5 of the first 10 places. The individuals TT0725-4 (Tigre-Tipishca) turned out to be a natural recombinant for fruit yield / weight. And individual 64-8 turned out to be triple recombinant (yield / fruit weight / ascorbic acid). The descriptors with the highest genetic control with r ≥ 0.30 were: average fruit weight, brix degrees, plant height, number of basal branches and petiole length. The criteria of similarity of the morphological markers with the fruit yield are proposed as predictive indexes of productivity. The plant height at two years of age was the most important.

Resumo: Introdução: É necessário que a residência de psiquiatria conste um programa da disciplina de neurologia. No Brasil, como não existe uma padronização dos conteúdos a serem abordados, os residentes realizam estágios em diferentes serviços de neurologia. Neste relato, descreve-se a experiência da aplicação do Programa de Neurologia para Residência Médica de Psiquiatria (PNRMP). Métodos: Trata-se de um estudo observacional e descritivo da experiência do PNRMP em Curitiba, no Paraná. Para a elaboração do PNRMP, realizou-se uma pesquisa teórico-reflexiva nos sites da Associação Brasileira de Psiquiatria, Residências Médicas de Psiquiatria Brasileiras, do PubMed e da SciELO. Na pesquisa, utilizaram-se as seguintes palavras-chave: programa de residência em psiquiatria; residência em neurologia e psiquiatria; neurologia em psiquiatria. Resultados: Em 2011, iniciou-se a elaboração do PNRMP com o objetivo de oferecer aos residentes os subsídios teórico-práticos da interface psiquiatria e neurologia sob supervisão de um preceptor neurologista. O programa, com nove anos de aplicação e 54 residentes formados, ocorre em dois ambulatórios do Sistema Único de Saúde - um de neurologia geral (para residentes do primeiro ano) e outro de epilepsia ou transtornos neurocognitivos do idoso (para residentes do terceiro ano -, com duração de quatro a cinco horas, uma vez por semana. Os residentes realizam um atendimento/hora, e os casos são revisados em parceria com o preceptor que esclarece as dúvidas da entrevista/do exame físico e define o diagnóstico e a conduta colegiada. Procure-se as competências clínicas em treinamento em serviço, discussões de casos, revisões teóricas e seminários. No final do ambulatório, realiza-se uma reunião da equipe para compartilhar os conhecimentos gerados nos atendimentos e orientar atualizações clínicas/terapêuticas. As avaliações são diárias, trimestrais, anuais e quanti-qualitativa, em que se consideram a aquisição de habilidades, o raciocínio clínico, a qualidade nos atendimentos, o profissionalismo e a comunicação com a equipe, os pacientes e os familiares. Conclusão: O PNRMP supera a dicotomia “orgânico versus funcional”. Na integração das atividades teóricas e práticas, busca-se um conhecimento abrangente e resolutivo que permita ao futuro psiquiatra prestar um serviço competente e humano. Recomenda-se a participação dos residentes egressos para que eles possam avaliar o PNRMP. Os autores propõem o desenvolvimento de um PNRMP reprodutivo nacional e padronizado.

Abstract: Introduction: There has been a greater demand for the psychiatry specialty, possibly associated with the paradigm change in asylum care for outpatients and communities; consequently, there is now a greater number of institutions for Medical Training in Psychiatric Residency. As such, we seek to elaborate upon the Neurology Program for Medical Residency in Psychiatry (NPMRP) and present the experience of its application. Methods: We present an observational and descriptive study of the NPMRP experience in Curitiba/Paraná/Brazil. To prepare the NPMRP, reflective theoretical research was carried out via data from the websites of the Brazilian Psychiatric Association, Brazilian Psychiatric Residencies, PubMed and SciELO. Thw keywords used included: program of psychiatry residency; neurology and psychiatry residency; neurology in psychiatry. Results: It is thought that the resident develops clinical skills through the neurology-psychiatry interface, via an in-service training of general neurology (1st year resident) and epilepsy and neurocognitive disorders (3rd year resident), which takes place once a week. Residents receive training in conducting interviews and brief neurological examinations, concerning the types of neurological diagnosis, request for additional tests and interpretation of the reports. The outpatient clinical sessions last 4-5 hours, resulting in one patient/hour per resident who, in turn, prepares the medical record. The cases are reviewed and discussed with the neurologist instructor, promoting patient/family participation in shared decision-making. At the end of the outpatient clinic session, an activity is carried out with the whole team to socialize the visits and review theoretical contents. Assessments are daily, quarterly and annual, covering both quantitative and qualitative aspects. Conclusion: The NPMRP has excellent results in improving resident training and patient care. There is an excellent opinion regarding learning by the residents and a good level of satisfaction of patients/family members. The neurologist instructor becomes part of the residency and the NPMRP integrates academic and assistance training. The authors propose the development of a national, standardized and reproducible NPMRP.

Resumo Adenium obesum (Forssk.) Roem. & Schult., amplamente conhecida como rosa-do-deserto, tem despertado interesse pelas suas características estéticas que são influenciadas pelo processo de produção de mudas. Com isso, por meio de dois experimentos consecutivos instalados inteiramente ao acaso, objetivou-se avaliar o uso de diferentes substratos e hidrogel na produção de mudas de rosa-do-deserto, em ambiente protegido. Primeiramente, foram testados onze substratos confeccionados a partir de: OrganoAmazon®; PuroHumus®; solo; casca-de-arroz in natura; casca-de-arroz carbonizada, serragem e esterco bovino. Em seguida, foram testados três substratos (S1 - OrganoAmazon® + PuroHumus®; S2 - OrganoAmazon® + PuroHumus® + casca-de-arroz in natura e S3 - OrganoAmazon® + PuroHumus® + casca-de-arroz carbonizada) associados a quatro níveis de hidrogel: 0 (irrigação diária), 1, 2 e 3 g L−1 (irrigados em dias alternados). Foram avaliadas variáveis de crescimento e índices de qualidade das mudas. Seis substratos (todos sem adição de serragem e quando usados em mistura) agruparam-se como os que promoveram o adequado crescimento das mudas, com: altura, número de folhas, diâmetro do colo, comprimento radicular e biomassa da parte aérea superiores a 6,5 cm; 13; 12 mm; 7,5 cm e 0,45 g, respectivamente. O substrato composto por OrganoAmazon® + PuroHumus® (1:1 v/v), quando irrigado diariamente, foi o que mais favoreceu a produção de mudas de qualidade. A utilização de hidrogel em substratos com turnos de rega realizados em dias alternados não favoreceu a produção das mudas de rosa-do-deserto.

Abstract Adenium obesum (Forssk.) Roem. & Schult., widely known as desert rose, has attracted interest for its esthetic characteristics, which are influenced by the process of seedling production. Using two consecutive experiments installed fully at random, the study aimed at assessing the use of different substrates and hydrogel to produce desert rose seedlings in a protected environment. First, eleven substrates were tested, prepared as follows: OrganoAmazon®; PuroHumus®; soil; rice husk in natura; carbonized rice husk, sawdust and cattle manure. Then, three substrates were tested (S1 - OrganoAmazon® + PuroHumus®; S2 - OrganoAmazon® + PuroHumus® + rice husk in natura and S3 - OrganoAmazon® + PuroHumus® + carbonized rice husk) associated to four hydrogel levels: 0 (daily irrigation), 1, 2 and 3 g L−1 (irrigated on alternate days). Growth variables and quality index of seedlings were assessed. Six substrates (all of them without addition of sawdust and where used in mix) were grouped as those the promoted appropriate growth of seedlings, with height, number of leaves, collar diameter, root length and aerial part biomass superior to 6.5 cm; 13; 12 mm; 7.5 cm and 0.45 g, respectively. The substrate composed of OrganoAmazon® + PuroHumus® (1:1 v/v), when irrigated daily, was the one that favored most the production of quality seedlings. The use of hydrogel in substrates with shifts of irrigation on alternate days did not favor the production of desert rose seedlings.