Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients.

Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07–0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96–4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52–0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes.

ABSTRACT No-till farming is the practice closest to the concept of sustainable agriculture. The minimum soil movement and continuous contribution of crop residues to the farming system reduce erosion, mitigate the greenhouse effect, increase the organic matter content, and improve the physical and chemical quality of the soil. This study aimed to assess the effect of five-year succession cropping on the physical and chemical attributes of oxisol. The crops were sown for five consecutive years in the same plots, using a randomized block design in split plots with four replicates. The plots were crops grown in succession to soybean, namely Congo grass (Urochloa ruziziensis syn. Brachiaria ruziziensis), Congo grass intercropped with maize (Zea mays L.), pearl millet (Pennisetum glaucum), sorghum (Sorghum bicolor L.), maize, and slender leaf rattlebox (Crotalaria ochroleuca). The subplots were the following sampled soil layers: 0-5, 5-10, and 10-20 cm. The physicochemical attributes of these three soil layers were evaluated. Pearl millet cycled K efficiently, providing the soil with K concentrations equivalent to those of the K fertilization treatments. No single crop or intercrop increased the soil P concentration. Congo grass stood out for its ability to increase the Mg concentration. The 0-5 cm soil layer had the best physicochemical attributes based on the accumulated organic matter.

RESUMO O sistema plantio direto é o sistema que mais se aproxima do conceito de agricultura sustentável. A movimentação mínima do solo e o aporte contínuo de palhada ao sistema, reduz a erosão, contribui para a atenuação do efeito estufa, aumenta o teor de matéria orgânica e melhora a qualidade física e química do solo. Objetivou-se com este estudo avaliar o efeito de cinco anos de sucessão de culturas sobre os atributos físicos e químicos de latossolo vermelho distroférrico. As culturas foram semeadas por cinco anos consecutivos nas mesmas parcelas, utilizando o delineamento em blocos casualizados, em parcelas subdivididas, com quatro repetições. As parcelas foram cultivadas em sucessão à soja, sendo elas: braquiária solteira (Urocloa ruziziensis syn Brachiaria ruziziensis), braquiária consorciada com milho (Zea mays L.), milheto (Pennisetum glaucum), sorgo (Sorghum bicolor L.), milho e crotálaria (Crotalaria ochroleuca). Já as subparcelas, foram representadas pelas camadas de solo amostradas: 0-5, 5-10 e 10-20 cm. Foram avaliados os atributos químicos e físicos do solo, nas três camadas mencionadas. O milheto é eficiente na ciclagem de K, proporcionando níveis deste elemento no solo equivalentes aos tratamentos que receberam adubação potássica. Nenhuma cultura isolada ou em consórcio elevou a concentração de P no solo. A braquiária destaca-se pela sua capacidade de elevar as concentrações de Mg. A camada do solo de 0-5 cm possui as melhores condições físico-químicas em função da matéria orgânica acumulada.

The route of professional education in Brazil is characterized by educational duality, which relegates workers to precarious work-oriented training, while ensuring elites a complete education. In a context where there are attacks on the project of a democratic, inclusive and universal school, it is necessary to understand the identities and the role of institutions and people in strengthening education. The objective of this article is to analyze the school cultures of integrated secondary education graduates, based on their narratives and memories, and their contribution to the construction of identities at the IFTM Campus Patrocínio. This is a qualitative approach. Data has been obtained through a questionnaire applied to graduates of technical courses integrated secondary education, entering between 2014 and 2021, were submitted to content analysis methodology. The perceptions captured in the narratives of subjects were articulated to the concepts of school culture, memory and identity, considering the principles and concepts of integrated secondary education. In the conjuncture of educational policies that serve the market, to the detriment of the concretization of the universal school and omnilateral training project, it can be deduces that consolidating the teaching of an integrated method of professional education also depends on the valorization of life trajectories, incentive to participate and understanding the identities of all the actors and actresses of the academic community, especially students and graduates.

La trayectoria de la educación profesional en Brasil está marcada por la dualidad educativa, que relega a los trabajadores a una formación precaria, ligera y enfocada al mercado de trabajo, al tiempo que garantiza a las elites una formación más integral. En un contexto en el que se observan ataques al proyecto de escuela democrática, inclusiva y universal, es necesario comprender las identidades y el papel de las instituciones y las personas para fortalecer la educación. El objetivo de este artículo es analizar las culturas escolares de bachilleres integrados, a partir de sus narrativas y memorias, y su contribución a la construcción de identidades en el IFTM Campus Patrocínio. Se trata de una investigación cualitativa: los datos, obtenidos a través de un cuestionario aplicado a egresados ​​y egresadas de cursos técnicos integrados a la enseñanza media, que ingresaron entre 2014 y 2021, fueron sometidos a análisis de contenido. Las percepciones captadas en las narrativas de los sujetos participantes se vincularon a los conceptos de cultura, memoria e identidad escolar, considerando los principios y conceptos de la educación secundaria integrada. Se infiere que, en un escenario de políticas educativas al servicio del mercado, en detrimento de la implementación del proyecto de escuela universal y de la formación omnilateral, la consolidación de la educación secundaria integrada con la formación profesional depende también de la valorización de las trayectorias de vida, la participación incentivadora y reconocimiento de las identidades de todos los actores y actrices de la comunidad académica, en particular estudiantes y egresados.

A trajetória da educação profissional no Brasil é marcada pela dualidade educacional, que relega aos trabalhadores uma formação precária, aligeirada, voltada ao mercado de trabalho, enquanto garante às elites uma formação mais abrangente. Em um contexto em que se observa ataques ao projeto da escola democrática, inclusiva e universal, é necessário compreender as identidades e o papel de instituições e pessoas para o fortalecimento da educação. O objetivo deste artigo é analisar as culturas escolares dos egressos do ensino médio integrado, a partir de suas narrativas e memórias, e sua contribuição para a construção de identidades no IFTM Campus Patrocínio. Trata-se de uma pesquisa qualitativa: os dados, obtidos por meio de questionário aplicado a egressos e egressas dos cursos técnicos integrados ao ensino médio, ingressantes entre 2014 e 2021, foram submetidos à análise de conteúdo. As percepções captadas nas narrativas dos sujeitos participantes foram articuladas aos conceitos de cultura escolar, memória e identidade, considerando os princípios e concepções do ensino médio integrado. Infere-se que, em um cenário de políticas educacionais que servem ao mercado, em detrimento da concretização do projeto da escola universal e da formação omnilateral, consolidar o ensino médio integrado à educação profissional depende, também, da valorização das trajetórias de vida, do incentivo à participação e do reconhecimento das identidades de todos os atores e atrizes da comunidade acadêmica, notadamente de estudantes e ex-estudantes.

ABSTRACT Growing lettuce under high temperatures and light incidence, as in the Alagoas State hinterland, Brazil, induces early tasseling and decreases the quality of the product. Thus, the objective of this work was to evaluate the production and post-harvest quality of lettuce cultivars in different crop seasons in western Alagoas, Brazil. A randomized block experimental design was used, with four replications. The treatments consisted of lettuce cultivars: Baba-de-Verão, Cinderela, Elba, Mônica, Solaris, and Veneranda. The winter crop was more favorable for plant diameter, except for Baba-de-Verão, whose performance was similar in both seasons and stood out in the summer. The winter crop resulted in better performance in plant height, stem diameter, and fresh matter yield, whereas summer plants reached larger number of leaves. The cultivar Mônica presented longer stem length, denoting lower tolerance to early tasseling and, therefore, it is not indicated to be grown in the region. The cultivar Baba-de-Verão (Lisa group) reached higher fresh matter yield, number of leaves per plant, and stem diameter, and it was the most adequate cultivar to be grown in western Alagoas. Elba, Solaris, and Veneranda were the lettuce cultivars from the Crespa group that stood out. Baba-de-Verão was the cultivar that presented the best performance for chlorophyll a, b, and total. The cultivar Solaris presented the highest carotenoid contents. Plants grown in the winter reached higher chlorophyll a and total, carotenoid contents, pH, and soluble solid (SS) to titratable acidity (TA) ratio, whereas the lettuce grown in the summer had higher SS and TA.

RESUMO A alface, quando produzida em altas temperaturas e elevada luminosidade, como as encontradas no Sertão Alagoano, é induzida ao pendoamento precoce e à baixa qualidade. Em função disso, o objetivo foi avaliar a produção e a qualidade pós-colheita de cultivares de alface em função de épocas de cultivo distintas no oeste do Estado de Alagoas. O delineamento experimental foi em blocos ao acaso, com quatro repetições, sendo os tratamentos referentes às cultivares Babá-de-Verão, Cinderela, Elba, Mônica, Solaris e Veneranda. Para diâmetro de planta, o cultivo de inverno foi mais favorável, com exceção da Babá-de-Verão que manteve o desempenho semelhante nas duas épocas e destaque da cultivar no verão. O cultivo de inverno proporcionou melhor desempenho de altura de planta, diâmetro de caule e produtividade de massa verde, enquanto no verão as plantas atingiram maior número de folhas. A cultivar Mônica obteve maior comprimento do caule, indicando menor tolerância ao pendoamento precoce, não sendo indicada para o cultivo na região. A Babá-de-Verão (lisa) atingiu maior produtividade de massa verde, número de folhas por planta e diâmetro de caule, sendo a cultivar mais adequada para o cultivo no oeste de Alagoas. Dentre as crespas, destacaram-se as cultivares Elba, Solaris e Veneranda. A cultivar que apresentou melhor desempenho para clorofilas a, b e totais foi a Babá-de-Verão. A Solaris obteve maior teor de carotenoides. As plantas de inverno alcançaram maiores clorofilas a e totais, carotenoides, pH e relação sólidos solúveis totais (SS) e acidez total titulável (TA), enquanto a alface de verão obteve maior SS e TA.

Abstract Pancreatic ductal adenocarcinoma is one of the most aggressive malignant neoplasms, with a one-year survival rate below 20%. Axial methods (computed tomography and magnetic resonance imaging) play a fundamental role in the diagnosis and staging of the disease, because they provide adequate anatomical resolution in the assessment of key structures, mainly vascular structures. Pancreatic ductal adenocarcinoma is most often discovered in advanced stages, when surgical resection is no longer feasible. In that scenario, minimally invasive treatment alternatives have been developed in attempts to change the natural history of the disease. Irreversible electroporation, an interventional procedure that minimizes deleterious effects on adjacent tissues, has proven useful for the treatment of tumors traditionally considered unresectable. Despite the growing acknowledgment of this technique as a tool for the management of pancreatic ductal adenocarcinoma, it is still relatively unknown among radiologists. In this study, we sought to provide an overview of the main characteristics and eligibility criteria that must be considered for the indication of irreversible electroporation in cases of pancreatic ductal adenocarcinoma.

Resumo O adenocarcinoma ductal de pâncreas é uma das neoplasias malignas mais agressivas, com taxas de sobrevivência anuais inferiores a 20%. Os métodos axiais (tomografia computadorizada e ressonância magnética) têm papel fundamental no diagnóstico e estadiamento da doença, por fornecerem adequada resolução anatômica na avaliação de estruturas-chave, principalmente vasculares. O adenocarcinoma ductal de pâncreas é frequentemente descoberto em estágios avançados e sem viabilidade de ressecção cirúrgica, e nesse cenário o desenvolvimento de alternativas terapêuticas minimamente invasivas tem sido ainda mais importante para a mudança de sua história natural. A eletroporação irreversível, procedimento intervencionista que minimiza efeitos deletérios nos tecidos adjacentes, vem se destacando no tratamento de lesões tradicionalmente consideradas irressecáveis. Essa técnica, apesar de ganhar cada vez mais espaço no manejo terapêutico do adenocarcinoma ductal de pâncreas, ainda é pouco familiar aos radiologistas. Neste estudo, buscamos expor, de forma sucinta e didática, os fundamentos da técnica, as principais características de imagem e os critérios de elegibilidade que devem ser considerados para indicação da eletroporação irreversível nessa doença.

Abstract: Eucalyptus planted forests contribute to maximizing lumber production but problems such as longitudinal growth strain can negatively influence the quality of the products. Knowing dendrometric variables and wood properties can help in the prediction of longitudinal growth strain, mainly with the help of artificial intelligence. Thus, the aim of this research was to evaluate the use of artificial neural networks to predict longitudinal growth strain in Eucalyptus trees based on dendrometric variables, spacing between trees and wood density. The longitudinal growth strain was measured in trees of four Eucalyptus clones planted in three spacings. The diameter and height of each tree were measured. The basic wood density was determined. Artificial neural networks were used to estimate longitudinal growth strain as a function of dendrometric variables, tree spacing and wood density. The results showed that the artificial neural networks presented good results for training and validation, with most of them resulting in high correlation coefficient values. The trained artificial neural networks showed a correlation coefficient above 0,56. Artificial neural networks showed that the variables clone and basic wood density were the ones that most contributed to the prediction of longitudinal growth strain. On the other hand, the spacing between trees, the height of the tree and the diameter at breast height were not relevant to predict growth stresses.

ABSTRACT BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19–5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19–5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76–4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

RESUMO RACIONAL: O tecido adiposo, músculos e ossos representam órgãos endócrinos, capazes de interferir no perfil metabólico e risco cardiovascular. Relacionar esses componentes será importante para estratégias de intervenção precoce, em obesos. OBJETIVOS: Avaliar a influência dos compartimentos da massa corporal, sobre o perfil metabólico e risco cardiovascular, no pré-operatório de cirurgia bariátrica. MÉTODOS: Estudo transversal, com pacientes admitidos para cirurgia bariátrica, em hospital universitário. A composição corporal foi avaliada pela absortometria radiológica de dupla energia e o risco cardiovascular pelo escore de risco de Framingham. Foram analisadas variáveis antropométricas, clínicas e de estilo de vida. Foi avaliado perfil lipídico (colesterol total, HDL-c, LDL-c, triglicerídeos), glicemia e vitamina D, utilizando a metodologia padrão. RESULTADOS: Foram analisados 60 pacientes, 86,7% apresentavam comorbidades, 33,3% risco cardiovascular moderado/elevado e 71,4% insuficiência/deficiência de vitamina D. Menor massa corporal magra associou-se à gravidade da obesidade. O índice de massa corpórea e a circunferência da cintura correlacionaram-se negativamente com a massa corporal magra (r=-0,52; p<0,01)/r=-0,36; p<0,01). A massa corporal magra correlacionou-se negativamente com a massa gorda (r=-0,26; p<0,05), gordura troncular (r=-0,29; p<0,05), glicemia de jejum (r=-0,26; p<0,05) e densidade mineral óssea (r=-0,26; p<0,05). Ao todo, 84,2% dos indivíduos com menos gordura troncular apresentaram tendência a baixo risco cardiovascular (p=0,05). Contudo, inatividade física (razão de prevalência ajustada 2,14; IC95% 1,19–5,54) e risco de dependência alcoólica foram as únicas variáveis independentemente associadas ao risco cardiovascular. CONCLUSÕES: Os pacientes obesos em pré-operatório de cirurgia bariátrica com menos gordura troncular, apresentaram tendência a baixo risco cadiovascular. Contudo, o risco cardiovascular também não foi associado aos demais componentes da massa corporal.

Abstract Introduction The pathogenesis of cutaneous and mucosal leishmaniasis is associated with different immune responses. Vitamin D may modulate the immune system. Here we evaluate the association of vitamin D levels with the severity of the clinical forms of cutaneous and mucosal leishmaniasis. Methods We conducted an observational study evaluating the association between vitamin D levels, disease severity and therapeutic response in patients with cutaneous and mucosal leishmaniasis. Additionally, we conducted a cross-sectional study to compare vitamin D levels in patients with leishmaniasis and healthy subjects. Hypovitaminosis D was defined as a serum level of 25 (OH) D < 30 ng/mL. Results In patients with leishmaniasis, vitamin D serum levels were 38.5 ± 11.54 ng/mL, and 37.5 ± 10.43 ng/mL in healthy subjects The prevalence of hypovitaminosis D was 23.3% and 20.0%, respectively (p = 0.72). There was no correlation between vitamin D serum levels, disease severity, and healing time in the mucosal leishmaniasis group. Conclusion Vitamin D levels are not associated with neither susceptibility nor severity of tegumentary leishmaniasis.

ABSTRACT Objective: to identify mobile applications on intravenous therapy and prevention of catheter-associated bloodstream infection. Method: technological prospection, with data search in Patent Bases and Virtual Stores, data collection occurred from May to August 2021. Inclusion criteria: mobile applications focused on Intravenous Therapy; mobile applications focused on the prevention of bloodstream infection. The analysis was carried out in a qualitative comparative way, recognizing the functions developed by the applications and their potential for use in clinical practice. Results: 19 applications were selected and organized into themes: applications to assist in catheterization; applications for catheter maintenance; applications on bloodstream infection prevention; and applications on diagnosis of catheter-associated bloodstream infection. Conclusion: The identification of few apps on the theme serves to promote the construction of new apps.

RESUMEN Objetivo: identificar aplicaciones móviles sobre terapia intravenosa y prevención de la infección del torrente sanguíneo asociada a catéteres. Método: prospección tecnológica, con búsqueda de datos en Bases de Patentes y Almacenes Virtuales, la recolección de datos ocurrió de mayo a agosto de 2021. Criterios de inclusión: aplicaciones móviles centradas en la Terapia Intravenosa; aplicaciones móviles centradas en la prevención de la infección del torrente sanguíneo, el análisis se realizó de forma cualitativa comparativa, reconociendo las funciones desarrolladas por las aplicaciones y su potencial de uso en la práctica clínica. Resultados: Se seleccionaron 19 aplicaciones y se organizaron en temas: aplicaciones para ayudar en el cateterismo; aplicaciones para el mantenimiento del cateterismo; aplicaciones sobre la prevención de la infección de transmisión sanguínea; y aplicación sobre el diagnóstico de la infección de transmisión sanguínea asociada al cateterismo. Conclusión: la identificación de pocas aplicaciones sobre el tema sirve de estímulo para la construcción de nuevas aplicaciones.

RESUMO Objetivo: identificar aplicativos móveis sobre terapia intravenosa e prevenção de infecção de corrente sanguínea associada ao cateter. Método: prospecção tecnológica, com busca dos dados nas Bases de Patentes e Lojas Virtuais, a coleta dos dados ocorreu de maio a agosto de 2021. Critérios de inclusão: aplicativos móveis voltados para a Terapia Intravenosa; aplicativos móveis voltados para a prevenção de infecção de corrente sanguínea, a análise foi realizada de forma qualitativa comparativa, reconhecendo as funções desenvolvidas pelos aplicativos e seus potenciais para utilização na prática clínica. Resultados: 19 aplicativos foram selecionados e organizados em temáticas: aplicativos para auxiliar no cateterismo; aplicativos para manutenção de cateter; aplicativos sobre prevenção de infecção de corrente sanguínea; e aplicativo sobre diagnóstico de infecção de corrente sanguínea associada ao cateter. Conclusão: a identificação de poucos aplicativos sobre a temática serve de fomento para construção de novos aplicativos.

Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram.

ABSTRACT This study aimed to determine the effects of relocation time (RT; Experiment 1) and storage time after relocation (ST; Experiment 2) on microbial population, fermentative characteristics, and chemical composition of corn silage. In experiment 1, corn silage was stored for 30 d, subjected to different RT (0–60 h), and stored again for 30 d. Thirty experimental silos were used in a completely randomized design, with three replicates per treatment. In experiment 2, after 150 d of ensiling, silage was removed from a bunker silo, exposed to air for 9 h, relocated to experimental silos, and stored for periods ranging from 0 to 128 d. Twenty-eight experimental silos were used in a completely randomized design, with four replicates per treatment. Relocation time had no effect on fungi counts and concentrations of lactic and propionic acids in corn silage but resulted in a significant increase in dry matter content. In experiment 2, dry matter recovery and concentration of non-fiber carbohydrates decreased in corn silage stored for more than 32 d after relocation. Exposure of corn silage to air during relocation for up to 60 h followed by 30 d of storage did not compromise the fermentation profile or nutritive value of the silage. Increased storage time of relocated corn silage (up to 128 d) consistently decreases its nutritional value. The storage period seems to have an increased impact on nutrient loss in relocated silage than the relocation period.

Abstract Objectives: To compare variables of access to healthcare between the LGBT+ population aged 50 and over and those non-LGBT+. Methods: A cross-sectional study was carried out in Brazil through a confidential online questionnaire. The use of the health system was characterized by the number of preventive tests performed and measured by the PCATool-Brasil scale (a 10-point scale in which higher scores were associated with better assistance in healthcare). The association between being LGBT+ and access to health was analyzed in Poisson regression models. Results: 6693 participants (1332 LGBT+ and 5361 non-LGBT+) with a median age of 60 years were included. In the univariate analysis, it was observed not only lower scores on the PCATool scale (5.13 against 5.82, p < 0.001), but a greater proportion of individuals among those classified with the worst quintile of access to healthcare (< 4 points), 31% against 18% (p < 0.001). Being LGBT+ was an independent factor associated with worse access to health (PR = 2.5, 95% CI 2.04‒3.06). The rate of screening cancer, for breast, colon, and cervical cancer was also found to be lower in the LGBT+ population. Conclusion: Healthcare access and health service experiences were worse in the LGBT+ group than in their non-LGBT peers. Inclusive and effective healthcare public policies are essential to promote healthy aging for all.

ABSTRACT Objective: to understand the meanings attributed by family members of children with cancer to Oncology emergencies. Method: a descriptive study with a qualitative approach carried out with 18 family members of children undergoing Oncology emergencies at an institution in Rio de Janeiro-RJ, Brazil. The data were collected through semi-structured interviews, between February and September 2021, analyzed using thematic-categorical analysis and interpreted in the light of Symbolic Interactionism. Results: two categories emerged from the analysis, namely: meanings attributed by family members attribute to Oncology emergencies and family dynamics; and interaction with health professionals in the Pediatric Oncology Emergency sector. Conclusion: the findings mark intense changes of a social, emotional, economic and psychological nature in family dynamics and point to the value of interactive processes with professionals, which can contribute to the advancement of family-centered care.

RESUMEN Objetivo: comprender los significados que los familiares de niños con cáncer atribuyen a las emergencias oncológicas. Método: estudio descriptivo de enfoque cualitativo realizado en una institución de Río de Janeiro-RJ, Brasil, con 18 familiares de niños en situaciones de emergencia oncológica. Los datos se recolectaron por medio de entrevistas semiestructurada entre febrero y septiembre de 2021, y fueron analizados por medio de análisis temático-categórico e interpretados sobre la base del Interaccionismo Simbólico. Resultados: surgieron dos categorías a partir del análisis, a saber: significados que atribuyen los familiares a las emergencias oncológicas y a la dinámica familiar; e interacción con los profesionales de la salud en los servicios de Emergencia Oncológica Pediátrica. Conclusión: los hallazgos demarcan profundas alteraciones de naturaleza social, emocional, económica y psicológica en la dinámica familiar y señalan el valor de los procesos interactivos con los profesionales, con la posibilidad de contribuir al avance de medidas de atención centradas en la familia.

RESUMO Objetivo: compreender os significados que os familiares de crianças com câncer atribuem às emergências oncológicas. Método: estudo descritivo com abordagem qualitativa realizado em uma instituição no Rio de Janeiro-RJ, Brasil, com 18 familiares de crianças em emergência oncológica. Os dados foram coletados por entrevista semiestruturada, entre fevereiro e setembro de 2021, analisados através da análise temático-categorial e interpretados à luz do Interacionismo Simbólico. Resultados: a partir da análise, duas categorias emergiram: significados que familiares atribuem às emergências oncológicas e a dinâmica familiar; e interação com os profissionais de saúde na emergência oncológica pediátrica. Conclusão: os achados demarcam intensas alterações na dinâmica familiar de natureza social, emocional, econômica e psicológica e apontam para o valor dos processos interativos com os profissionais, podendo contribuir para o avanço de cuidados que sejam centrados na família.

Abstract Introduction: Optimized allocation of medical resources to patients with COVID-19 has been a critical concern since the onset of the pandemic. Methods: In this retrospective cohort study, the authors used data from a Brazilian tertiary university hospital to explore predictors of Intensive Care Unit (ICU) admission and hospital mortality in patients admitted for COVID-19. Our primary aim was to create and validate prediction scores for use in hospitals and emergency departments to aid clinical decisions and resource allocation. Results: The study cohort included 3,022 participants, of whom 2,485 were admitted to the ICU; 1968 survived, and 1054 died in the hospital. From the complete cohort, 1,496 patients were randomly assigned to the derivation sample and 1,526 to the validation sample. The final scores included age, comorbidities, and baseline laboratory data. The areas under the receiver operating characteristic curves were very similar for the derivation and validation samples. Scores for ICU admission had a 75% accuracy in the validation sample, whereas scores for death had a 77% accuracy in the validation sample. The authors found that including baseline flu-like symptoms in the scores added no significant benefit to their accuracy. Furthermore, our scores were more accurate than the previously published NEWS-2 and 4C Mortality Scores. Discussion and conclusions: The authors developed and validated prognostic scores that use readily available clinical and laboratory information to predict ICU admission and mortality in COVID-19. These scores can become valuable tools to support clinical decisions and improve the allocation of limited health resources.