ABSTRACT A flexible parametric mixture cure model, called bi-lognormal cure rate model or simply BLN model, is defined and studied. The BLN model can be effectively used to analyze survival dataset in the presence of long-term survivors, especially when the dataset presents the underlying phenomenon of latent competing risks or when there is evidence that a bimodal hazard function is appropriated to described it, which are advantages over other cure rate models found in the literature. We discuss the maximum likelihood estimation for the model parameters considering interval-censored data through the differential evolution algorithm that is a nature-inspired computing metaheuristic used for global optimization of functions defined in multidimensional spaces. This approach is also used because the likelihood function of the model is multimodal and the direct application of gradient methods in this case is not ideal, since such methods are local search methods with a high chance of getting stuck at a local maximum when the starting point is chosen outside the basin of attraction of a global maximum. In addition, a simulation study was implemented to compare the performance of differential evolution algorithm with the performance of the Newton-Raphson algorithm in terms of bias, root mean square error, and the coverage probability of the asymptotic confidence intervals for the parameters. Finally, an application of the BLN model to real data is presented to illustrate that it can provide a better fit than other mixture cure rate models. bilognormal bi lognormal studied longterm long term survivors literature intervalcensored interval censored natureinspired nature inspired spaces ideal addition NewtonRaphson Newton Raphson bias error Finally

Abstract The litter deposited on the soil surface at various stages of decomposition is important for primary productivity that impacts the microbial communities and soil carbon storage. The objective of this study was to evaluate the accumulation and decomposition of cultural residues of Theobroma grandiflorum (Willd. ex. Spreng) Schum, Paullinia cupana (Mart.) Ducke, Bixa orellana L., and forest in the Amazon region. The study was carried out in the São Francisco settlement, Canutama in the south of Amazonas, in a randomized block experimental design, and the treatments consisted of four areas with different crops: 1 - P. cupana; 2 - T. grandiflorum; 3 - B. orellana; 4 - Native woodland area (forest), in time subdivided plots: 7, 15, 30, 60, 90, 120, 150, 180, 210, 240, 270, 300, and 330 days after the distribution of the bags in the field, all with four repetitions. To evaluate the contribution and fractions of litter, conical collectors were used in each area, and collections were performed monthly in the period from March 2020 to February 2021. The estimate of the decomposition rate of the litter was done by quantifying the loss of mass, using litter bags, which allow for a direct analysis of the rate of decay over time. The forest and P. cupana environments presented the highest litter production, and greater deposition when compared to environments cultivated with T. grandiflorum and B. orellana. The forest and B. orellana areas showed the highest speed of decomposition, while the opposite situation occurred under T. grandiflorum and P. cupana cultivation. storage Willd. Willd (Willd ex Spreng Schum Mart. Mart (Mart. Ducke L L. region settlement Amazonas design crops P T B forest, , (forest) plots 7 15 30 60 90 120 150 180 210 240 270 300 33 field repetitions 202 2021 mass production cultivation (Mart (forest 6 9 12 18 21 24 27 20

Resumo A serrapilheira depositada na superfície do solo, em vários estágios de decomposição tem importância na produtividade primária que impacta nas comunidades microbianas e estocagem de carbono no solo. Objetivou-se neste trabalho avaliar o acúmulo e decomposição dos resíduos culturais de cupuaçu, guaraná, urucum e floresta na região do Amazonas. O estudo foi realizado no assentamento São Francisco, Canutama no Sul do Amazonas, em delineamento experimental de blocos casualisados, sendo que os tratamentos constaram de quatro áreas com diferentes culturas: 1- Guaraná; 2 – Cupuaçu; 3 – Urucum; 4 – Área de mata nativa (floresta), em parcelas subdivididas no tempo: 07, 15, 30, 60, 90, 120, 150, 180, 210, 240, 270 e 300, 330 dias após a distribuição das sacolas no campo, todas com 04 repetições. Para avaliar o aporte e frações dá serapilheira, foram utilizados coletores cônicos em cada área, sendo as coletas realizadas mensalmente no período de março de 2020 a fevereiro de 2021. A estimativa da taxa de decomposição da serrapilheira foi realizada pela quantificação da perda de massa, utilizando-se litter bags, os quais permitem analisar de forma direta a taxa de decaimento ao longo do tempo. Os ambientes de floresta e guaraná apresentaram as maiores produções de serapilheira, e maior deposição quando comparados aos ambientes cultivados com cupuaçu e urucum. As áreas de floresta e urucum apresentaram a maior velocidade de decomposição, já a situação inversa ocorreu sob o cultivo do cupuaçu e guaraná. solo Objetivouse Objetivou se Amazonas Francisco casualisados culturas 1 Guaraná Cupuaçu Urucum floresta, , (floresta) tempo 07 15 30 60 90 120 150 180 210 240 27 300 33 campo 0 repetições serapilheira área 202 2021 massa utilizandose utilizando bags (floresta 6 9 12 18 21 24 20

Resumo Galhas são estruturas vegetais neo-formadas que ocorrem em diferentes órgãos. Elas são geradas por uma interação espécie-específica com um organismo indutor. Os indutores manipulam o metabolismo do hospedeiro. Microgramma vacciniifolia (Langsd. & Fisch.) Copel. é uma samambaia epífita neotropical que hospeda duas galhas caulinares, uma induzida por uma espécie de mosquito (Diptera) e outra por uma micromariposa (Lepidoptera). O objetivo deste estudo foi avaliar o impacto desses dois insetos indutores de galhas na bioquímica dos ácidos fenólicos e da cianogênese em galhas, caules e folhas de M. vacciniifolia. Em análise de cromatografia líquida de alta eficiência (CLAE) foi possível indicar a presença de um total de 14 derivados fenólicos, incluindo ácido cafeico e ácido cumárico. Análise das Coordenadas Principais (ACoP) indicou três grupos (1) caules não galhados e galhas induzidas pela micromariposa; (2) galhas induzidas pelo mosquito; (3) galhas induzidas pelo mosquito com parasitoides. Em relação a frequência da cianogênese analisada com o teste do papel picrato, o teste do qui-quadrado apresentou diferença significativa entre as folhas férteis (8,3%), folhas estéreis (27,7%), caules não galhados (0%) e galhas. Entre as galhas, somente aquelas induzidas pelo mosquito foram cianogênicas (15%). Os resultados encontrados indicam, ao menos para as substâncias fenólicas, que os insetos indutores de galha (mosquito e micromariposa) promovem alterações espécie-específica na composição química da samambaia hospedeira.

Abstract Galls, neo-formed plant structures that can occur in different organs, are generated by species-specific interaction with an inducing organism. Inducers manipulate the metabolism of its host. Microgramma vacciniifolia (Langsd. & Fisch.) Copel. is a Neotropical epiphytic fern that hosted two stem galls, one induced by a midge species (Diptera) and other by a micromoth species (Lepidoptera). The aim of this study was to evaluate the impact of these two gall-inducing insects on the biochemistry of phenolic acids and the cyanogenesis in galls, stems and leaves of M. vacciniifolia. High performance liquid chromatography (HPLC) indicated a total of 14 phenol derivatives, including caffeic and coumaric acid. Principal Coordinates Analysis (PCoA) of the phenolic substances indicated three groups consisting (1) non-galled stems and micromoth-induced galls; (2) midge-induced galls; (3) midge-induced galls with parasitoids. Regarding the frequency of cyanogenesis assessed by the picrate paper test, the chi-squared test showed significant difference between fertile leaves (8.3%), sterile leaves (27.7%), non-galled stems (0%) and galls. Among galls, only the midge-induced galls analyzed were cyanogenic (15%). Our results indicated that the different gall-inducers (midge and micromoth) promote species-specific alterations to the phenolic substance composition of the host fern.

Introduction. To determine the effectiveness of the electronic case-based portfolio combined with the flipped classroom and team-based learning on academic performance. Subjects and methods. Quasi-experimental pretest-post study of a single group carried out during the year 2020, in 15 medical students (6 men, 9 women) of an online module of surgical oncology at the Antenor Orrego Private University, Trujillo, Peru. Results. The average score of the theoretical exam at the end (13.8 ± 13.12) was significantly higher than that obtained at the beginning of the module (8.64 ± 2.29) (average increase of 5.17 ± 0.83; 95% confidence interval, 3.92 - 6.43; p <0.001). The average score in the virtual OSCE at the end of the module was 12.34 ± 2.21. Conclusions. The case-based electronic portfolio model combined with the flipped classroom and team-based learning is effective in academic performance in the teaching of surgical oncology.

Introducción. Determinar la efectividad del portafolio electrónico basado en casos combinado con el aula invertida y el aprendizaje basado en equipos en el rendimiento académico. Sujetos y métodos. Estudio cuasi experimental pretest-postest de un solo grupo realizado durante 2020 en 15 estudiantes de medicina (seis varones y nueve mujeres) de un módulo en línea de oncología quirúrgica en la Universidad Privada Antenor Orrego, Trujillo, Perú. Resultados. La puntuación promedio del examen teórico al final (13,8 ± 13,12) fue significativamente más alta que la obtenida al inicio del módulo (8,64 ± 2,29) (aumento promedio de 5,17 ± 0,83; intervalo de confianza al 95%, 3,92-6,43; p < 0,001). La puntuación promedio en el examen clínico objetivo estructurado virtual al final del módulo fue 12,34 ± 2,21. Conclusiones. El modelo de portafolio electrónico basado en casos combinado con el aula invertida y el aprendizaje basado en equipos es efectivo en el rendimiento académico en la enseñanza de oncología quirúrgica.

Resumen Objetivo. Analizar las formas de configuración del trabajo social, a través de la historia de la profesión en la Región de Atacama, desde el discurso de las y los profesionales que ejercen o han ejercido en la región, recogidos durante el año 2016. Metodología. Investigación desde el paradigma interpretativo, enfoque cualitativo, de carácter narrativo; entrevistos en profundidad y focus group con profesionales en ejercicio y en retiro, seleccionadas por muestreo estructural y por conveniencia. Resultados. Se identifican hitos de la profesión y presencias y ausencias que han definido nuestra participación en procesos sociales del contexto local y que permiten que esta disciplina emerja y se mantenga. Conclusiones. De esta forma es posible plantear que el trabajo social en la Región de Atacama ha estado determinado por el contexto nacional de la época, y a la vez, determinado por dinámicas de funcionamiento social y economía regional, marcando la impronta mediadora.

Abstract Objective: To analyze the forms of configuration of Social Work through the history of the profession in the Atacama Region, from the discourse of the professionals who practice or have worked in the region, collected during 2016. Methodology: Research from the interpretative paradigm, qualitative approach, narrative in nature. In-depth interviews and focus groups with seventeen practicing and retired professionals selected by heterogeneous sampling and convenience were applied. Results: Milestones of the profession and presences and absences are identified that have defined our participation in social processes in the local context and that allow this discipline to emerge and be maintained. Conclusions: In this way, it is possible to suggest that Social Work in the Atacama Region has been determined by the national context of the time and, at the same time, determined by dynamics of social functioning and regional economy, marking the mediator mark.

Abstract: This work presents the results of structural evaluations carried out from numerical models based on the finite element method (FEM) for a steel stair with 22.70 meters long, 8.37 high and 1.68 wide, belonging to Olympic Tennis Center, Rio de Janeiro/Brazil. A numerical model was elaborated and fitted to natural frequencies of real structure, which in turn were obtained from an operational modal test. The test was conduced by recording vibrations due to wind and traffic of people at six points over the structure, and from stochastic signals processing of these data considering frequency domain decomposition (FDD) procedure, the experimental natural frequencies were extracted. The calibrated numerical model was then used in the structural evaluation for static and dynamic loads, and it was observed that while the structural behavior obtained through the initial numerical model (used in the development of the project) indicated compliance with design codes criteria, calibrated model pointed out the need for structural reinforcement to meet vibrations service limit.

Resumen: Este trabajo presenta los resultados de las evaluaciones estructurales realizadas a partir de modelos numéricos basados en el método de elementos finitos (FEM) para una escalera de acero con 22,70 metros de largo, 8,37 de alto y 1,68 de ancho, perteneciente al Centro Olímpico de Tenis, Río de Janeiro / Brasil. Se elaboró un modelo numérico y se ajustó a frecuencias naturales de estructura real, que a su vez se obtuvieron de una prueba modal operativa. La prueba se realizó registrando las vibraciones debidas al viento y al tráfico de personas en seis puntos sobre la estructura, y del procesamiento de señales estocásticas de estos datos considerando el procedimiento de descomposición del dominio de frecuencia (FDD), se extrajeron las frecuencias naturales experimentales. El modelo numérico calibrado se utilizó luego en la evaluación estructural para cargas estáticas y dinámicas, y se observó que si bien el comportamiento estructural obtenido a través del modelo numérico inicial (utilizado en el desarrollo del proyecto) indicaba el cumplimiento de los criterios de los códigos de diseño, modelo calibrado señaló la necesidad de refuerzo estructural para cumplir con el límite de servicio de vibraciones.

The aim of this paper is to contribute with an initial approach to the study of turning points in medical students training. Until now, there has been few research regarding turning points in the field of medical education. This concept highlights a variety of events and experiences that have a significant impact in life paths. Turning points in education are not easily visible, they often go unnoticed and they are only recognized years after graduation. It is relevant to study turning points in student's life paths in the field of medical education, both in terms of capturing and understanding a phenomenon that is difficult to identify, as well as from the demands that imply its recognition and promotion within the medical school.

El objetivo del presente trabajo es contribuir con un acercamiento inicial al estudio de los turning points en cuanto temática relevante en la formación de los estudiantes de medicina. Hasta ahora los turning points se han estudiado poco dentro del campo de la educación médica. Se trata de un concepto que pone el acento en una variedad de situaciones y experiencias que tienen impacto significativo en las trayectorias vitales de los estudiantes, pero que no son fácilmente visibles. Los turning points son eventos que cambian la vida de los estudiantes. Sin embargo, muchas veces pasan desapercibidos y sólo se reconocen sus efectos años después del paso por la facultad. En esta colaboración se intenta una aproximación a su delimitación conceptual y a los mecanismos o metodología para identificarlos. De esta forma, surgen nuevos desafíos para el campo de la educación médica tanto desde la captación y la comprensión de un fenómeno difícil de identificar como desde las exigencias que implican su reconocimiento y promoción en el interior de las facultades de Ciencias de la Salud.

Introduction: Sjögren’s syndrome (SS) is a chronic autoimmune disease that primarily affects the lacrimal and salivary exocrine glands. In children, it is a rare condition. Objective: To present the case of an adolescent with non-specific symptoms, but with a clinical suspicion of SS. Case report: A male 12-year old patient, with history of arthralgias for 3 years and suspicion of xerophthalmia. Physical examination showed mild conjunctival congestion, dry mouth and hypermobility of the knees. Laboratory work: blood count and ESR were normal, antinuclear antibodies (+) > 60, Ro (+) > 60 U, and rheumatoid factor concentration (+) 160 IU/ml. SS was suspected, and a study was carried out: Schirmer test determined mild dry eye, salivary gland scintigraphy showed parotid and submandibular gland dysfunction, and salivary gland biopsy reported focal lymphocytic acinar and periductal infiltration. SS was confirmed and treated with prednisone 7.5 mg/day and hydroxychloroquine 200 mg/day, and local treatment, with good response. Conclusions: The diagnostic criteria for SS in adults identified only 39% of pediatric patients, due to the low frequency of sicca symptoms. Still there are no validated diagnostic criteria for children. A good diagnosis will alleviate symptoms, prevent complications and detect associated diseases.

Introducción: El síndrome de Sjögren (SS) es una enfermedad crónica, autoinmune, que afecta principalmente a las glándulas exocrinas lagrimales y salivales. En niños es una enfermedad rara. Objetivo: Presentar el caso de un adolescente con síntomas inespecíficos, en que la sospecha clínica hizo llegar al diagnóstico de SS. Caso Clínico: Paciente de 12 años, de sexo masculino, con historia de artralgias de 3 años de evolución y xeroftalmia dudosa. El examen físico mostró leve congestión conjuntival, boca seca e hiperlaxitud de rodillas. Pruebas de laboratorio: hemograma y VHS normales, anticuerpos antinucleares (+) > 60, Ro (+) > 60 U, factor reumatoideo (+) 160 UI/ml. Se sospechó SS y se completó el estudio: test de Shirmer, que determinó ojo seco leve; gammagrafía de las glándulas salivales, que mostró disfunción de las glándulas submaxilares y parotídeas; biopsia de glándulas salivales, que mostró focos de infiltrado linfoide acinar y periductal. Se confirmó SS y se inició tratamiento con prednisona 7,5 mg/día e hidroxicloroquina 200 mg/día y tratamientos locales, con buena respuesta. Conclusiones: Los criterios diagnósticos del SS en adultos identifican solo al 39% de los pacientes pediátricos por la baja frecuencia de síntomas de sicca. Aún no existen criterios diagnósticos validados para niños. Un buen diagnóstico permitirá aliviar los síntomas, evitar complicaciones y detectar enfermedades asociadas.

Objetivo. Determinar la competencia sobre la Práctica Basada en Evidencias (PBE) que tienen las enfermeras españolas e iberoamericanas con participación activa en grupos de Internet y establecer si existen factores sociodemográficos y profesionales influyentes en dicha competencia, definida como el conocimiento, actitud e implementación de la PBE. Metodología. Se administró una encuesta online a una muestra no probabilística de profesionales de enfermería activos en grupos de Internet. Incluía variables sociodemográficas, profesionales y los instrumentos Evidence-Based Practice Questionnaire (EBPQ) y Practice Environment Scale of the Nursing Work Index (PES-NWI) en versión española. Resultados. 314 encuestas fueron respondidas del total (76.96%). La puntuación media para el total del cuestionario EBPQ fue de 5.02 (IC 95%=4.89-5.14), sobre un máximo posible de 7. Las variables que se asociaron significativamente con una mayor competencia en la PBE fueron el nivel académico (p<0.001), la categoría profesional (p=0.001), el país de trabajo (p<0.001), la percepción del entorno de práctica (p=0.018) y las actividades relacionadas con la investigación (p<0.036). El grado de competencia sobre la PBE en esta muestra de profesionales de enfermería fue moderado, mostrando una actitud positiva hacia la PBE y puntuaciones intermedias tanto en habilidades y conocimientos, como en su implementación. Conclusión. A mayor nivel académico y categoría profesional se asocian con mayores competencias sobre la PBE. La percepción desfavorable del entorno de práctica influye de forma negativa en la disposición al uso.

Objective. to determine the evidence-based practice (EBP) competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. Methodology: An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ) and Practice Environment Scale of the Nursing Work Index (PES-NWI) and socio-demographics and professional variables. Results: 314 questionnaires were obtained (76.96%). The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14). The variables associated with a higher competence in EBP were academic level, (p<03001), professional category (p=0.001), country of work (p<0.001), perception of practice environment (p=0,018) and research activities (p<0,036). Conclusions: These nurses showed a moderate level of EBP competence. They revealed a positive attitude towards EBP and achieved intermediate scores in both EBP-related skills and knowledge and their implementation. Higher academic levels and professional categories were associated with greater EBP competence. A practice environment perceived to be unfavorable has a negative influence on EBP implementation.

Objetivo. Determinar a competência sobre a Prática Baseada em Evidências (PBE) que têm as enfermeiras espanholas e ibero-americanas com participação ativa em grupos de Internet e estabelecer se existem fatores sócio-demográficos e profissionais influentes em dita concorrência, definida como o conhecimento, atitude e implementação da PBE. Metodologia. Administrou-se uma enquete online a uma mostra não probabilística de profissionais de enfermagem ativos em grupos de Internet. Incluía variáveis sócio-demográficas, profissionais e os instrumentos Evidence-Based Practice Questionnaire (EBPQ) e Practice Environment Scale of the Nursing Work Index (PES-NWI) em versão espanhola. Resultados. 314 enquetes foram válidas (76.96%). A pontuação média para o total do questionário EBPQ foi de 5.02 (IC 95%=4.89-5.14), sobre um máximo possível de 7. As variáveis que se associaram significativamente com uma maior concorrência na PBE foram o nível acadêmico (p<0.001), a categoria profissional (p=0.001), o país de trabalho (p<0.001), a percepção do meio de prática (p=0.018) e as atividades relacionadas com a investigação (p<0.036). O grau de competência sobre a PBE nesta mostra de profissionais de enfermagem foi moderado, mostrando uma atitude positiva para a PBE e pontuações intermédias tanto em habilidades e conhecimentos, como em sua implementação. Conclusão. O maior nível acadêmico e categoria profissional se associam com maiores competências sobre a PBE. A percepção desfavorável do meio de prática influi de forma negativa na disposição ao uso.

The objective of this study was to determine the effect of the inclusion of different mulberry (Morus alba) levels on the nutritional quality of sorghum (Sorghum almum) silages. Five sorghum:mulberry ratios (100:0, 75:25, 50:50, 25:75 and 0:100) were evaluated, with a completely randomized design and three replications per treatment. The mixtures were made on fresh basis and they were placed in 120-L plastic tanks. Compaction was performed in 20-cm layers, tamping the materials down with the feet, and molasses was added at a rate of 4 % of the weight of the green material. The silages were stored during 40 days. Dry matter (DM), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), hemicellulose and ash were determined before and after conservation. With the increase of the mulberry percentage the DM, CP and ash contents increased significantly (p < 0,05). The NDF, ADF and hemicellulose tended to increase after conservation. The pH values of the mixtures 100:0 (3,81), 75:25 (3,91) and 50:50 (3,89) had significant differences (p < 0,01) with regards to 75:25 (4,05) and 0:100 (4,08). The organoleptic evaluation showed an adequate conservation process in all the mixtures. The inclusion of 50 % mulberry is concluded to constitute a viable alternative to improve the nutritional quality of the sorghum silage.

El objetivo de esta investigación fue determinar el efecto de la inclusión de diferentes niveles de morera (Morus alba) en la calidad nutricional de ensilajes de sorgo (Sorghum almum). Se evaluaron cinco proporciones de sorgo:morera (100:0, 75:25, 50:50, 25:75 y 0:100), con un diseño completamente aleatorizado y tres réplicas por cada tratamiento. Las mezclas se hicieron en base fresca y se colocaron en tanques plásticos de 120 L. La compactación se realizó en capas de 20 cm, mediante el apisonamiento con los pies, y se adicionó melaza a razón del 4 % del peso del material verde. Los ensilajes fueron almacenados durante 40 días. Antes y después de la conservación, se determinó: la materia seca (MS), la proteína cruda (PC), la fibra neutro detergente (FND), la fibra ácido detergente (FAD), la hemicelulosa y las cenizas. Con el aumento del porcentaje de morera se incrementaron de manera significativa los contenidos de MS, PC y cenizas (p < 0,05). La FND, la FAD y la hemicelulosa tendieron a aumentar después de la conservación. Los valores de pH de las mezclas 100:0 (3,81), 75:25 (3,91) y 50:50 (3,89) tuvieron diferencias significativas (p < 0,01) respecto a 75:25 (4,05) y 0:100 (4,08). La valoración organoléptica mostró un proceso de conservación adecuado en todas las mezclas. Se concluye que la inclusión de 50 % de morera constituye una alternativa viable para mejorar la calidad nutricional del ensilaje de sorgo.

OBJETIVO: Revisar a relação da lipoproteína (a) [Lp(a)] com outros fatores de risco para doenças cardiovasculares (DCV) em crianças e adolescentes. FONTES DE DADOS: Revisão sistemática, com estudos do período de 2001 a 2011, caracterizando um recorte temporal de dez anos. Incluíram-se estudos epidemiológicos realizados com crianças e/ou adolescentes, publicados em inglês, português ou espanhol, disponíveis integralmente on-line. Realizou-se a busca nas bases de dados Science Direct, PubMed/Medline, Biblioteca Virtual em Saúde e Biblioteca Cochrane, utilizando-se a combinação dos descritores "lipoproteína a" e "doenças cardiovasculares" e "obesidade". SÍNTESE DOS DADOS: Encontraram-se 672 estudos, porém apenas sete foram incluídos na revisão. Alguns trabalhos avaliaram o histórico familiar para DCV. Em todos, os níveis de Lp(a) eram aumentados nos pacientes com esse histórico. Observou-se também correlação positiva entre Lp(a) e colesterol LDL, colesterol total e apolipoproteína B, sugerindo uma associação entre concentrações de Lp(a) e perfil lipídico. CONCLUSÕES: A evidência de que as DCV podem ter sua origem na infância e na adolescência leva à necessidade de se investigarem os fatores de risco nesse período, para planejar intervenções cada vez mais precoces e, possivelmente, mais efetivas, reduzindo a morbimortalidade.

OBJECTIVE: To review the relationship between lipoprotein (a) [Lp(a)] and other risk factors for cardiovascular disease (CVD) in children and adolescents. DATA SOURCES: This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde) and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". DATA SYNTHESIS: Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a) levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a) and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a) levels and the lipid profile. CONCLUSIONS: The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates.

OBJETIVO: Revisar la relación de la lipoproteína (a) {Lp(a)} con otros factores de riesgo para enfermedades cardiovasculares (ECV) en niños y adolescentes. FUENTES DE DATOS: Se trata de una revisión sistemática, realizada de julio a agosto de 2011, con estudios del periodo de 2001 a 2011, caracterizando un recorte temporal de diez años. Se incluyeron estudios epidemiológicos realizados en niños y/o adolescentes, publicados en inglés, portugués o español, disponibles integralmente en línea. Se realizó la búsqueda en las bases de datos Science Direct, PubMed/Medline, Biblioteca Virtual en Salud y Biblioteca Cochrane, utilizándose la combinación de los descriptores "lipoproteína a", "enfermedades cardiovasculares" y "obesidad". SÍNTESIS DE LOS DATOS: Se encontraron 672 estudios, pero solamente siete fueron incluidos en la revisión. Algunos trabajos evaluaron el histórico familiar para ECV. En todos, los niveles de Lp (a) eran aumentados en los pacientes con ese histórico. Se observó además la correlación positiva entre Lp(a) y colesterol LDL, colesterol total y apolipoproteína B, sugiriendo una asociación entre concentraciones de Lp(a) y perfil lipídico. CONCLUSIONES: La evidencia de que las ECV pueden tener su origen en la infancia y adolescencia lleva a la necesidad de investigar los factores de riesgo en ese periodo, para planear intervenciones cada vez más tempranas y, posiblemente, más efectivas, reduciendo la morbimortalidad.

A great number of the population consumes daily a variety of infusions such as Tea, Chamomile and Mate Herb. Different studies have determined their favorable effects in human beings, for this reason those infusions habitually used have been selected for this study, in order to characterize their immediate effects on the saliva properties. We studied groups of 37 healthy subjects, between 18-23 years of age, with low caries risk, and obtained 3 samples of non-stimulated saliva: Basal; Post-ingestion of Distilled Water (Placebo); Post-ingestion of Infusion (Black Tea, Green Tea, Mate Herb, Chamomile and Chamomile with Sucralose). All the tests were realized under standard conditions. We measured, salivary flow (ml/min); pH with pH-meter (PL-600, GOnDO Electronics Co, TW) and buffer capacity with Ericsson's method. All the information was processed with Anova Test in Origin 6.0. Our results showed the average of Salivary Basal Flow (0.51 ml/min) tends to increase standing out the effect of Chamomile with Sucralose (0.63 ml/min), the basal pH (7.25) was maintained relatively constant, and finally the Buffer Capacity (4.38) also tends to increase, emphasizing Chamomile (5.01). The effect of some infusions is positive on the salivary properties, emphasizing the Infusion of Chamomile, Chamomile with Sucralose and Mate Herb, which increase significantly the flow and the salivary buffer capacity. This suggests a favorable effect in the prevention of caries.

Gran cantidad de población consume cotidianamente infusiones, como el Té, Manzanilla y Yerba Mate. Diferentes estudios han determinado sus efectos benéficos en los seres humanos, razón por la cual, para este estudio se han seleccionado aquellas infusiones de uso habitual con el fin de caracterizar sus efectos inmediatos sobre las propiedades de la saliva. Con grupos de 37 sujetos sanos, entre 18-23 años, de bajo riesgo cariogénico se obtuvieron 3 muestras de saliva no estimulada: Basal; Post-ingesta de Agua Destilada (Placebo) y Post-ingesta Infusión (Té Negro, Té Verde, Mate, Manzanilla y Manzanilla con Endulzante), respectivamente. Todas las pruebas fueron realizadas bajo condiciones estándar. Se determinó el flujo salival (ml/min), pH mediante pH-metro (PL-600, GOnDO Electronics Co, TW) y capacidad buffer mediante método de Ericsson. Todos los datos se procesaron mediante la prueba ANOVA con el programa Origin 6.0. El promedio de Flujo Salival Basal (0,51 ml/min) tiende a aumentar destacando el efecto de la Manzanilla con Endulzante (0,63 ml/min); el pH basal (7,25) se mantuvo relativamente constante, y la Capacidad Buffer (4,38) también tiende a aumentar destacando la Manzanilla (5,01). El efecto de algunas infusiones es positivo sobre las propiedades salivales, destacando la Infusión de Manzanilla, Manzanilla con Endulzante y Yerba Mate las cuales aumentan significativamente el flujo y la capacidad buffer salival, lo cual sugiere un efecto benéfico en la prevención de caries.