Resumo Antecedentes Dados acerca da prevalência da estenose arterial intracraniana (EAIC) entre os pacientes com acidente vascular isquêmico (AVCi) agudo no Brasil e América Latina são limitados. Objetivo O presente estudo pretendeu investigar a frequência e os preditores da EAIC nos pacientes AVCi ou ataque isquêmico transitório (AIT) em um centro brasileiro utilizando o Doppler transcraniano colorido (duplex transcraniano). Métodos Pacientes consecutivos com AVCi ou AIT, admitidos entre fevereiro e dezembro de 2014 em um centro acadêmico brasileiro especializado em doenças cerebrovasculares, foram avaliados prospectivamente com duplex transcraniano. Os estreitamentos vasculares > 50% foram considerados como EAIC, baseado em critérios ultrassonográficos definidos previamente na literatura. Resultados Foram avaliados 170 pacientes com AVCi ou AIT, dos quais 27 (15,9%) foram excluídos em decorrência da janela óssea transtemporal acústica inadequada. Confirmamos EAIC em 55 pacientes (38,5%). A localização mais comum foi o segmento proximal da artéria cerebral média (28,2%), seguida pelas artérias vertebral (15,4%), cerebral posterior (13,6%), carótida interna terminal (9,1%) e basilar (8,2%). No modelo multivariado, ajustado para os potenciais confundidores, a pressão arterial sistólica aumentada (OR: 1,03; IC 95%: 1,01–1,04; p = 0,008) foi independentemente associada a EAIC. Conclusão Foi identificada EAIC significativa em quase ⅓ dos pacientes admitidos com sintomas de AVCi ou AIT em um serviço acadêmico público de atendimento especializado em doenças cerebrovasculares. O Doppler transcraniano colorido é uma ferramenta acessível e não invasiva que pode ser utilizada com segurança para a investigação da presença de EAIC moderada ou grave, especialmente nos pacientes que não podem ser expostos a exames complementares mais invasivos com uso de contraste intravenoso. (EAIC (AVCi limitados (AIT . transcraniano) 201 cerebrovasculares 50 literatura 17 2 15,9% 159 15 9 (15,9% inadequada 5 38,5%. 385 38,5% 38 (38,5%) 28,2%, 282 28,2% , 28 (28,2%) 15,4%, 154 15,4% 4 (15,4%) 13,6%, 136 13,6% 13 6 (13,6%) 9,1% 91 1 (9,1% 8,2%. 82 8,2% 8 (8,2%) multivariado confundidores OR (OR 1,03 103 03 95% 95 1,01–1,04 101104 01 04 0,008 0008 0 008 grave intravenoso 20 15,9 (15,9 38,5 3 (38,5% 28,2 (28,2% 15,4 (15,4% 13,6 (13,6% 9,1 (9,1 8,2 (8,2% 1,0 10 1,01–1,0 10110 0,00 000 00 15, (15, 38, (38,5 28, (28,2 (15,4 13, (13,6 9, (9, 8, (8,2 1, 1,01–1, 1011 0,0 (15 (38, (28, (13, (9 (8, 1,01–1 101 0, (1 (38 (28 (13 ( (8 1,01– (3 (2 1,01

Abstract Background There is limited data available regarding the prevalence of intracranial arterial stenosis (ICAS) among acute ischemic stroke (AIS) patients in Brazil and Latin America. Objective The present study sought to investigate the frequency and predictors of ICAS among patients with AIS or transient ischemic attack (TIA) in a Brazilian center, with transcranial color-coded duplex sonography (TCCS) technique. Methods Consecutive AIS and TIA patients, admitted to an academic public comprehensive stroke center in Brazil from February to December 2014, evaluated by TCCS were prospectively selected. Vascular narrowings > 50% were considered as ICAS, based on ultrasound criteria previously defined in the literature. Results We assessed 170 consecutive patients with AIS or TIA, of whom 27 (15.9%) were excluded due to an inadequate transtemporal acoustic bone window. We confirmed ICAS in 55 patients (38.5%). The most common location was the proximal segment of the middle cerebral artery (28.2%), followed by the vertebral (15.4%), posterior cerebral (13.6%), terminal internal carotid (9.1%) and basilar (8.2%) arteries. On multivariate models adjusting for potential confounders, systolic blood pressure (OR: 1.03, 95%CI: 1.01–1.04; p = 0.008) was independently associated with ICAS. Conclusion We found significant ICAS in approximately ⅓ of patients admitted with symptoms of AIS or TIA in a public tertiary academic stroke center in Brazil. The TCCS is an accessible and noninvasive technique that can be used to investigate the presence of moderate and severe ICAS, especially in patients who cannot be exposed to more invasive exams, such as the use of intravenous contrast agents. (ICAS (AIS America (TIA colorcoded color coded (TCCS 2014 selected 50 literature 17 2 15.9% 159 15 9 (15.9% window 5 38.5%. 385 38.5% . 38 (38.5%) 28.2%, 282 28.2% , 28 (28.2%) 15.4%, 154 15.4% 4 (15.4%) 13.6%, 136 13.6% 13 6 (13.6%) 9.1% 91 1 (9.1% 8.2% 82 8 (8.2% arteries confounders OR (OR 103 03 1.03 95%CI 95CI CI 95 1.01–1.04 101104 01 04 0.008 0008 0 008 exams agents 201 15.9 (15.9 38.5 3 (38.5% 28.2 (28.2% 15.4 (15.4% 13.6 (13.6% 9.1 (9.1 8.2 (8.2 10 1.0 1.01–1.0 10110 0.00 000 00 20 15. (15. 38. (38.5 28. (28.2 (15.4 13. (13.6 9. (9. 8. (8. 1. 1.01–1. 1011 0.0 (15 (38. (28. (13. (9 (8 1.01–1 101 0. (1 (38 (28 (13 ( 1.01– (3 (2 1.01

Abstract The study aimed to evaluate the effectiveness of combining two injectable progesterone (iP4) formulas for estrous synchronization in ewes and to compare it with traditional intravaginal progesterone devices. Additionally, the study assessed whether the inclusion of GnRH enhances the reproductive outcomes of the iP4 treatment. Two experiments were conducted. In the first experiment, 20 Santa Inês ewes were divided into two groups: one group received intravaginal progesterone devices, and the other received combined long-acting and short-acting iP4. In the second experiment, 30 Corriedale ewes were divided into two groups: one received the combined iP4 with GnRH, and the other without GnRH. Estrous, ovulation, follicular populations, and progesterone concentrations were monitored. The combined iP4 treatment induced an artificial luteal phase and produced reproductive responses similar to those obtained with intravaginal devices. In the first experiment, the iP4 treatment tended to result in more synchronized ovulation compared to the control (P=0.095). In the second experiment, adding GnRH enhanced the quality of the corpus luteum, as indicated by increased diameter and vascularization on Day 23 (P=0.047 and P=0.02, respectively). The combined administration of long-acting and short-acting iP4 effectively synchronized estrous in ewes and showed similar efficacy to traditional intravaginal devices. The inclusion of GnRH improved luteal quality, suggesting potential benefits for reproductive management in ewes. Further studies are needed to evaluate the fertility outcomes of these protocols under field conditions. iP (iP4 devices Additionally conducted experiment 2 groups longacting long acting shortacting short 3 Estrous populations monitored P=0.095. P0095 P P=0.095 . 0 095 (P=0.095) luteum P=0.047 P0047 047 (P=0.04 P002 02 P=0.02 respectively. respectively respectively) conditions (iP P009 P=0.09 09 (P=0.095 P=0.04 P004 04 (P=0.0 P00 P=0.0 (P=0.09 (P=0. P0 P=0. (P=0 P=0 (P= P= (P

Abstract Surgical practice is essential in the training of new specialists in Otorhinolaryngology (ORL). With this study, we characterized the surgical experience of ORL residents who completed their first year of residency in 2021. The 18 responses were obtained through the completion of a questionnaire and represent 82% of the ORL residents. The average annual number of surgical procedures performed was 58, with a minimum value of 4 and a maximum of 135. These procedures included an average of 16 tonsillectomies, 22 adenoidectomies, 18 transtympanic ventilation tube placements and 5 tracheotomies. The number of surgical procedures performed showed great variability among the different ORL residents. The future development of national surgical objectives, adapted to each year of internship, may be useful for standardizing the surgical training of ORL residents in Portugal.

Resumo A prática cirúrgica é essencial na formação de novos especialistas em Otorrinolaringologia (ORL). Com este trabalho caracterizamos a experiência cirúrgica dos internos de ORL que realizaram o seu primeiro ano de internato em 2021. As 18 respostas foram obtidas através do preenchimento de um questionário e representam 82% destes internos. A média anual de procedimentos cirúrgicos realizados foi 58, com um valor mínimo de 4 e máximo de 135. Estes procedimentos incluíram, em média, 16 amigdalectomias, 22 adenoidectomias, 18 colocações de tubos de ventilação transtimpânicos e 5 traqueotomias. O número de procedimentos cirúrgicos realizados apresentou grande variabilidade entre os diferentes internos de ORL. O desenvolvimento futuro de objetivos cirúrgicos nacionais, adaptados a cada ano do internato, poderá ser útil para a uniformização da formação cirúrgica dos internos de ORL em Portugal.

Resumo Objetivo Descrever uma coorte de casos do espectro do acretismo placentário (PAS) de uma instituição terciária e comparar os resultados maternos antes e depois da criação de uma equipa multidisciplinar (MDT). Métodos Estudo retrospectivo utilizando bancos de dados hospitalares. Identificação de casos de PAS com confirmação patológica entre 2010 e 2021. Divisão em dois grupos: grupo Standard Care (SC) – 2010–2014; e grupo MDT – 2015–2021. Análise descritiva de suas características e desfechos maternos. Resultados Durante o período do estudo, houve 53 casos de PAS (24 - grupo SC; 29 - grupo MDT). Grupo Standard Care: 1 placenta increta e 3 percretas; 12,5% (3/24) tiveram suspeita anteparto; 4 casos tiveram histerectomia periparto – uma eletiva devido à suspeita anteparto de PAS; 3 devido a hemorragia pós-parto. A média de perda hemática estimada (EBL) foi de 2.469 mL; transfusão de concentrado eritrocitário (PRBC) em 25% (6/24) - mediana 7,5 unidades. Equipa multidisciplinar: 4 casos de placenta increta e 3 percretas. A taxa de suspeita anteparto foi de 24,1% (7/29); foram realizadas 9 histerectomias, 7 eletivas por suspeita anteparto de PAS, 1 após diagnóstico intraparto de PAS e 1 após rotura uterina após interrupção da gravidez no segundo trimestre. A EBL média foi de 1.250 mL, com transfusão de PRBC em 37,9% (11/29) - mediana de 2 unidades. Conclusão Após a criação da MDT, houve redução na média de EBL e na mediana do número de unidades de PRBC transfundidas, apesar do maior número de PAS invasivos. (PAS MDT. . (MDT) hospitalares 201 2021 grupos SC (SC 2010–2014 20102014 2014 20152021 2015 2015–2021 estudo 5 24 (2 MDT) percretas 125 12 12,5 3/24 324 (3/24 pósparto. pósparto pós parto. parto pós-parto (EBL 2469 469 2.46 mL (PRBC 25 6/24 624 6 (6/24 75 7, 241 24,1 7/29 729 (7/29) histerectomias trimestre 1250 250 1.25 379 37 37,9 11/29 1129 11 (11/29 transfundidas invasivos (MDT 20 202 2010–201 2010201 2015202 2015–202 ( 12, 3/2 32 (3/2 246 46 2.4 6/2 62 (6/2 24, 7/2 72 (7/29 1.2 37, 11/2 112 (11/2 2010–20 201020 201520 2015–20 3/ (3/ 2. 6/ (6/ 7/ (7/2 1. 11/ (11/ 2010–2 20102 20152 2015–2 (3 (6 (7/ (11 2010– 2015– (7 (1

Abstract Objective To describe a cohort of placenta accreta spectrum (PAS) cases from a tertiary care institution and compare the maternal outcomes before and after the creation of a multidisciplinary team (MDT). Methods Retrospective study using hospital databases. Identification of PAS cases with pathological confirmation between 2010 and 2021. Division in two groups: standard care (SC) group – 2010–2014; and MDT group – 2015–2021. Descriptive analysis of their characteristics and maternal outcomes. Results During the study period, there were 53 cases of PAS (24 - SC group; 29 - MDT group). Standard care group: 1 placenta increta and 3 percreta; 12.5% (3/24) had antenatal suspicion; 4 cases had a peripartum hysterectomy – one planned due to antenatal suspicion of PAS; 3 due to postpartum hemorrhage. Mean estimated blood loss (EBL) was 2,469 mL; transfusion of packed red blood cells (PRBC) in 25% (6/24) - median 7.5 units. Multidisciplinary team group: 4 cases of placenta increta and 3 percreta. The rate of antenatal suspicion was 24.1% (7/29); 9 hysterectomies were performed, 7 planned due to antenatal suspicion of PAS, 1 after intrapartum diagnosis of PAS and 1 after uterine rupture following a second trimester termination of pregnancy. The mean EBL was 1,250 mL, with transfusion of PRBC in 37.9% (11/29) - median 2 units. Conclusion After the creation of the MDT, there was a reduction in the mean EBL and in the median number of PRBC units transfused, despite the higher number of invasive PAS disorders. (PAS MDT. . (MDT) databases 201 2021 groups (SC 2010–2014 20102014 2014 20152021 2015 2015–2021 period 5 24 (2 group. group) percreta 125 12 12.5 3/24 324 (3/24 hemorrhage (EBL 2469 469 2,46 mL (PRBC 25 6/24 624 6 (6/24 75 7. 241 24.1 7/29 729 (7/29) performed pregnancy 1250 250 1,25 379 37 37.9 11/29 1129 11 (11/29 transfused disorders (MDT 20 202 2010–201 2010201 2015202 2015–202 ( 12. 3/2 32 (3/2 246 46 2,4 6/2 62 (6/2 24. 7/2 72 (7/29 1,2 37. 11/2 112 (11/2 2010–20 201020 201520 2015–20 3/ (3/ 2, 6/ (6/ 7/ (7/2 1, 11/ (11/ 2010–2 20102 20152 2015–2 (3 (6 (7/ (11 2010– 2015– (7 (1

Abstract Introduction: Chimney EVAR (ChEVAR) for the treatment of complex abdominal aortic aneurysm (AAA) has been largely relegated for when fenestrated endografts are unavailable, especially due to durability concerns. However, the off-the-shelf nature of ChEVAR makes it a good option for emergent AAA repair. We report our institutional experience in ChEVAR in an urgent setting. Methods: ChEVAR procedures were collected f rom 2019 to 2023 in a tertiary hospital, and a retrospective analysis was performed. This includes gathered information f rom electronic medical records, surgical reports and the picture archiving system. Descriptive statistics were applied. The main endpoints were technical success,30-day and 1-year survival. Results: Five patients were submitted to urgent aneurysm repair using the chEVAR technique. Average age was 73,4 years and all patients were male. Arterial hypertension was present in 100% patients and all patients were ASA 4. Indications for surgery were post EVAR type 1a endoleak with associated rupture or abdominal pain in two patients; symptomatic/contained rupture of pararenal AAA in two patients; and contained rupture of a thoracoabdominal aneurysm in one patient. A total of eight target vessels were catheterized: two patients required single-vessel chimney and the remainder two-vessel chimney. Target vessels were two superior mesenteric arteries and six renal arteries. Technical success rate was 100% and 30-day mortality was 0%. There were no major complications. Follow-up time is 20.2 months (4.7-38). Target vessel patency during the follow-up period was 87.5%. Three patients (60%) died due to non-aortic related pathologies, on average 18 months after surgery (4.7-38), with a 1-year survival of 80%. Conclusion: Our experience with ChEVAR for emergent AAA repair is satisfactory, with high technical success rates and low short-term mortality. Sac regression, low rates of target vessel occlusion and type 1a endoleaks reveal a favourable profile for aneurysm exclusion. ChEVAR is a viable option in emergent setting for patients unfit for open repair.

Abstract Introduction: Depression in early childhood was first described by Spitz in 1940. The literature reports an association between depressive symptoms in infants and early affective deprivation, pinpointing maternal depression as a major risk factor. However, there is little evidence on the impact of maternal comorbid depression and gender dysphoria on the risk of depression in early childhood. Case report: A 25-month-old toddler was referred to the Child and Adolescent Psychiatry Outpatient Department for persistent irritability and sleep disturbances. His mother had persistent depressive disorder and had never felt comfortable in her role as a mother, struggling with caregiving and responding to the child’s emotional needs. During follow-up, maternal symptoms of gender dysphoria were identified. Discussion: Mother-infant bonding and responsive caregiving are essential for adequate socioemotional development.

Resumo Introdução: A depressão na primeira infância foi descrita pela primeira vez por Spitz em 1940. A literatura relata a associação entre sintomas depressivos na criança e privação afetiva precoce, sendo a depressão materna um fator de risco amplamente reconhecido. No entanto, há pouca evidência sobre o impacto da disforia de género materna no desenvolvimento de depressão na primeira infância. Caso clínico: Uma criança de 25 meses foi referenciada para a consulta de Psiquiatria da Infância e da Adolescência por irritabilidade persistente e perturbações do sono. A mãe apresentava perturbação depressiva persistente e manifestava grande dificuldade na resposta às necessidades emocionais da criança. Durante o seguimento, foi identificada sintomatologia materna de disforia de género. Discussão: A qualidade da relação mãe-bebé e dos primeiros cuidados são requisitos fundamentais para o normal desenvolvimento psicoafetivo infantil.

Abstract This article focuses on the emergence and development of rehabilitation operations with façade retention and interior demolition in the city of Lisbon. This type of intervention, commonly referred to as façade work, became widespread in the city from the end of the nineteen hundreds, being supported by a cultural and socio-economic context, which would even be shaped by legislation. Interventions of façade reconstruction have antecedents in the history of Architecture and Urbanism, however, the proliferation of reverse operations is controversial in the disciplinary debate. This article summarizes, delimits and interprets the roots of this type of intervention in Lisbon. It intends to clarify the motives and context of its vulgarization, including the socio-economic, cultural and normative situation, pondering also on its effects and limitations for the built space. For this purpose, it observes a series of interventions in Avenida da Liberdade, considered the archetypical urban axis of bourgeois Lisbon. From the reading of case studies and their context two chronological moments emerge: the pre-normative façadeism between 1980 and 1995, followed by a post-normative one, which consolidates itself in the first decade of the new century and is reflected in the present moment.

Resumo Este artigo incide sobre o surgimento e desenvolvimento de operações de reabilitação com retenção da fachada e demolição do interior na cidade de Lisboa. Este tipo de intervenção, comumente designado de fachadismo, generalizou-se na cidade desde o final de novecentos, sendo suportado por um contexto cultural e socioeconómico, que seria inclusivamente plasmado pela normativa. As intervenções de reconstrução de fachadas têm antecedentes na história da Arquitetura e do Urbanismo; todavia, a proliferação de operações inversas é controversa no debate disciplinar. Este artigo resume, delimita e interpreta as raízes deste tipo de intervenção em Lisboa. Pretende clarificar os motivos e contexto da sua vulgarização, incluindo a situação socioeconómica, cultural e normativa, ponderando igualmente sobre os seus efeitos e limitações para o espaço edificado. Para este efeito, observa uma série de intervenções na Avenida da Liberdade, considerada o eixo urbano arquétipo da Lisboa burguesa. Da leitura de casos de estudo e do seu contexto emergem dois momentos cronológicos: o fachadismo pré-normativo entre 1980 e 1995, seguindo de um pós-normativo, que se consolida na primeira década do novo século e se reflete no momento presente.

RESUMO O uso de bioestimulantes em mudas de café pode promover ganhos em seu crescimento e na sua qualidade. Assim, o objetivo desse trabalho foi avaliar as características de crescimento e qualidade de mudas de café arábica sob o efeito da aplicação dos bioestimulantes nicotinamida e Azospirillum brasilense. O delineamento experimental utilizado foi o de blocos casualizados, em esquema fatorial 5 × 2, com quatro repetições. Os tratamentos resultaram da utilização de cinco doses de nicotinamida (0, 30, 60, 90 e 120 mg L-1 de água) combinadas com a ausência e presença de Azospirillum brasilense aplicadas em mudas de Coffea arabica da cultivar Catuaí Vermelho 144. Foram avaliadas a altura de planta, diâmetro do caule, número de folhas, área foliar, massa seca da parte aérea, massa seca da raiz, razão entre altura e diâmetro do caule, razão entre massa seca da parte aérea e massa seca da raiz, razão entre altura e massa seca da parte aérea e índice de qualidade Dickson. A utilização conjunta ou isolado do A. brasilense e da nicotinamida, até a dose de 33.5 mg L-1, aumentou características biométricas e acúmulo de massa seca. No entanto, a utilização de doses de nicotinamida entre 30 e 61,8 mg L-1 aumentou da qualidade de mudas de Coffea arabica. Foi verificado efeito sinérgico do uso de A. brasilense e nicotinamida para crescimento e qualidade de mudas.

ABSTRACT The use of biostimulants in coffee seedlings can promote gains in their growth and quality. Thus, this study aimed to evaluate the growth and quality characteristics of Coffea arabica seedlings under the effect of the nicotinamide and Azospirillum brasilense application. The experimental design was randomized blocks with treatments arranged in a 5 × 2 factorial scheme, with four replicates. The treatments resulted from the use of five doses of nicotinamide (0, 30, 60, 90, and 120 mg L-1 of water) combined with the absence and presence of Azospirillum brasilense applied to Coffea arabica seedlings from Catuaí Vermelho 144 cultivar. Plant height, stem diameter, number of leaves, leaf area, shoot dry mass, root dry mass, plant height:stem diameter ratio, shoot:root dry mass ratio, plant height:shoot dry mass ratio, and Dickson quality index were evaluated. The combined or isolated use of A. brasilense and nicotinamide, up to a dose of 33.5 mg L-1, increased the biometric characteristics and dry mass accumulation. However, using nicotinamide doses between 30 and 61.8 g L-1 increased the quality of Coffea arabica seedlings. The synergistic effect of the use of A. brasilense and nicotinamide was verified for the growth and quality of Coffea arabica seedlings.

Abstract Objective Pain is the primary limitation to performing hysteroscopy. We aimed to evaluate the predictive factors of low tolerance to office hysteroscopic procedures. Methods Retrospective cohort study of the patients who underwent office hysteroscopy from January 2018 to December 2020 at a tertiary care center. Pain tolerance to office-based hysteroscopy was subjectively assessed by the operator as terrible, poor, moderate, good, or excellent. Categorical variables were compared with the use of the Chi-squared test; an independent-samples t-test was conducted to compare continuous variables. Logistic regression was performed to determine the main factors associated with low procedure tolerance. Results A total of 1,418 office hysteroscopies were performed. The mean age of the patients was 53 ± 13.8 years; 50.8% of women were menopausal, 17.8% were nulliparous, and 68.7% had a previous vaginal delivery. A total of 42.6% of women were submitted to an operative hysteroscopy. Tolerance was categorized as terrible or poor in 14.9% of hysteroscopies and moderate, good, or excellent in 85.1%. A terrible or poor tolerance was more frequently reported in menopausal women (18.1% vs. 11.7% in premenopausal women, p = 0.001) and women with no previous vaginal delivery (18.8% vs. 12.9% in women with at least one vaginal birth, p = 0.007). Low tolerance led more often to scheduling a second hysteroscopic procedure under anesthesia (56.4% vs. 17.5% in reasonable-to-excellent tolerance, p < 0.0005). Conclusion Office hysteroscopy was a well-tolerated procedure in our experience, but menopause and lack of previous vaginal delivery were associated with low tolerance. These patients are more likely to benefit from pain relief measures during office hysteroscopy. procedures 201 202 center officebased based moderate good Chisquared Chi squared test independentsamples independent samples ttest t 1418 1 418 1,41 5 138 13 8 13. years 508 50 50.8 178 17 17.8 nulliparous 687 68 7 68.7 426 42 6 42.6 149 14 9 14.9 851 85 85.1% 18.1% 181 18 (18.1 vs 117 11 11.7 0.001 0001 0 001 18.8% 188 (18.8 129 12 12.9 birth 0.007. 0007 0.007 . 007 0.007) 56.4% 564 56 4 (56.4 175 17.5 reasonabletoexcellent reasonable 0.0005. 00005 0.0005 0005 0.0005) welltolerated well tolerated experience 20 141 41 1,4 50. 17. 68. 42. 14. 85.1 18.1 (18. 11. 0.00 000 00 18.8 12. 56.4 (56. 0000 0.000 2 1, 85. 18. (18 0.0 56. (56 (1 0. (5 (

Abstract Objectives: Myringoplasties are frequently performed in pediatric patients, but there is still controversy regarding the best surgical technique and factors influencing its success. The aim of this study is to characterize a population of pediatric patients undergoing myringoplasty and evaluate the following outcomes: perforation closure, audiometric results and factors affecting surgical success. Study Design: Descriptive retrospective study Material and Methods: We evaluated 56 patients (57 ears) with a mean age of 10.4(3.2 years (6-17 years) over a 5-year period (2016-2020) Results: Most perforations occurred after grommet insertion. Retroauricular approach and underlay temporal fascia graft placement technique was used in most cases, with a success rate of 74% after a mean follow-up of 30 months. Pure tone average improved after the procedure. Craniofacial malformations were associated with incomplete air-bone gap closure. Conclusions: Pediatric myringoplasty has a high success rate.

Resumo Objetivos: As miringoplastias são cirurgias frequentemente realizadas em idade pediátrica, existindo controvérsia quanto à melhor técnica cirúrgica e fatores que influenciam o seu sucesso. O objetivo deste estudo é caracterizar uma população de doentes pediátricos submetidos a miringoplastia e avaliar como desfechos: o encerramento da perfuração, resultado audiométrico e existência de factores determinantes de sucesso cirúrgico. Desenho do Estudo: Estudo retrospectivo descritivo Material e Métodos: Foram avaliados 56 doentes (57 ouvidos) com média de idades de 10,4(3,2 anos (6-17 anos) num período de 5 anos (2016-2020) Resultados: A maioria das perfurações ocorreu após colocação de tubo de ventilação transtimpânico. A técnica cirúrgica mais utilizada foi a abordagem retroauricular com colocação de fascia temporalis underlay obtendo-se uma taxa de sucesso de 74% após 30 meses de seguimento médio. O limiar tonal médio da via aérea melhorou significativamente após o procedimento. A presença de malformações craniofaciais relacionou-se com um menor encerramento do Rinne audiométrico. Conclusões: As miringoplastias em idade pediátrica têm uma elevada taxa de sucesso.

RESUMO A manga (Mangifera indica L.) é uma fruta tropical de grande importância no mundo. No entanto, as perdas pós-colheita dos frutos são causadas pela antracnose, doença causada principalmente por fungos fitopatogênicos do gênero Colletotrichum. Assim, este trabalho teve como objetivo estudar a morfologia, similaridade genética e patogenicidade de isolados de Colletotrichum spp. de manga no estado do Rio Grande do Norte, Brasil. A avaliação morfológica de 28 isolados, com base na cor da colônia, tamanho dos conídios e apressórios e taxa de crescimento, mostrou que os isolados pertencem à espécie C. gloeosporioides. Posteriormente, foi confirmado com oligonucleotídeos específicos para a espécie. Além disso, a avaliação combinada com RAPD (Random Amplified Polymorphic DNA) e ISSR (Inter Simple Sequence Repeats) mostrou uma similaridade genética de 0,23 entre os Isolados 12 e 21, e 0,71 entre os Isolados 2 e 4, um indicativo de alta variabilidade entre os isolados, com dissimilaridade acima de 75%. Além disso, o dendrograma gerado pelo método UPGMA indicou que os isolados foram dispostos em oito grupos, os quais não se correlacionaram com o local de coleta. Com base na patogenicidade, embora a maioria dos isolados tenha apresentado baixa virulência para a cultivar Tommy Atkins, alguns deles se mostraram altamente agressivos (Isolados 9, 15, 20, 21, 24, 26 e 27). Além disso, a patogenicidade não se correlacionou com os aglomerados. Concluindo, os resultados revelaram alta variabilidade genética e patogênica em C. gloeosporioides isolado de cultivares de manga em uma das principais regiões exportadoras do Brasil.

ABSTRACT Mango (Mangifera indica L.) is a tropical fruit of great importance in the world. However, fruit postharvest losses are caused by anthracnose, a disease caused mainly by phytopathogenic fungi from the Colletotrichum genus. Thus, this work aimed to study morphology, genetic similarity, and pathogenicity of Colletotrichum spp. isolates from mango in Rio Grande do Norte state, Brazil. Morphological evaluation of 28 isolates, based on colony color, size of conidia and appressoria, and growth rate, showed that the isolates belong to the C. gloeosporioides species. It was later confirmed with species-specific oligonucleotides. Also, combined evaluation with RAPD (Random Amplified Polymorphic DNA) and ISSR (Inter Simple Sequence Repeats) showed a genetic similarity of 0.23 between Isolates 12 and 21, and 0.71 between Isolates 2 and 4, an indication of high variability among isolates, with dissimilarity over 75%. Moreover, the dendrogram generated by the UPGMA method indicated that the isolates were arranged in eight groups, which did not correlate with the collection site. Based on pathogenicity, although most isolates showed low virulence for Tommy Atkins cultivar, some of them proved to be highly aggressive (Isolates 9, 15, 20, 21, 24, 26, and 27). Also, pathogenicity did not correlate with clusters. In conclusion, the results revealed high genetic and pathogenic variability in C. gloeosporioides isolated from mango cultivars in one of the main exporting regions in Brazil.

Abstract Introduction: Ectopic kidneys with concomitant aortoiliac aneurysmal disease have been previously reported in the literature, however its exact prevalence is unknown. The objective of this review is to summarize current knowledge on the treatment this special group of patients. Methods: A non-systematic literature research was performed on the treatment of aortoiliac aneurysmal disease in patients with ectopic kidneys. Results: Literature on the management of patients with aorto-iliac aneurysms and concomitant ectopic kidneys is limited to case reports and very small series. Treatment modalities which include open, endovascular or hybrid techniques, should preserve the variable vasculature of the ectopic kidney. Several different surgical solutions have been proposed, highlighting the uncertainty on the optimal management strategy. However, a growing number of reports suggest safety and efficacy with adapted endovascular techniques. Conclusion: In parallel to the general trend in the management of abdominal aortic aneurysm, it is expected that a growing number of patients will concomitant aorto-iliac aneurysm and ectopic kidneys will be treated with endovascular techniques.

RESUMO: Ainda não há consenso sobre qual é o protocolo mais apropriado para a produção in vivo de embriões em ovinos, apesar do crescente conhecimento. Uma abordagem para mitigar a variabilidade de resposta de ovelhas à superovulação (SOV) é iniciar a aplicação de gonadotrofinas em uma condição ovariana favorável. O presente estudo comparou três tratamentos em delineamento do tipo crossover: protocolo de SOV tradicional (TRAD) e “Dia 0” D0 SOV sem (D0-GnRH) ou com GnRH (D0+GnRH). Quinze ovelhas Santa Inês foram superovuladas com 200 mg de FSH em seis doses decrescentes e receberam PGF2α na quinta dose de FSH. As ovelhas foram submetidas a monta natural com carneiros férteis e os embriões colhidos por via cirúrgica. O número de embriões viáveis não diferiu entre os tratamentos (TRAD = 6,0 ± 4,7; D0-GnRH = 3,8 ± 6,4; D0+GnRH = 7,5 ± 6,5). Independentemente do tratamento, ovelhas com folículos ≤ 4 mm na primeira dose de FSH produziram mais embriões viáveis (9,6 ± 6,0; P < 0.05) quando comparadas aos animais que apresentavam folículos > 4 mm no início da SOV (2,9 ± 3,1 embriões viáveis). Os grupos TRAD e D0+GnRH apresentaram menor número de animais com folículos grandes (> 4 mm), no momento da primeira dose de FSH, quando comparados ao grupo D0-GnRH (P < 0,05). Em conclusão, os protocolos TRAD e D0+GnRH induziram uma condição ovariana mais favorável (folículos ≤ 4 mm) para a SOV. No entanto, os três tratamentos apresentaram eficiência semelhante em ovelhas Santa Inês.

ABSTRACT: There is still no consensus regarding the best protocol for in vivo embryo production in sheep despite increasing studies in this area. Moreover, there is variability in the response of ewes to superovulation (SOV). An approach to mitigate this inconsistency is to initiate gonadotropin administration under favorable ovarian conditions. The present study compared three treatments in a crossover design: a traditional SOV protocol (TRAD) and “Day 0” D0 SOV protocol with (D0+GnRH), or without Lecilerin (D0-GnRH). Fifteen Santa Inês ewes received 200 mg of FSH at six decreasing doses and PGF2α with the fifth dose of FSH. They were naturally mated with fertile rams and subjected to surgical embryo collection. The number of viable embryos was similar among the different treatments (TRAD = 6.0 ± 4.7; D0-GnRH = 3.8 ± 6.4; D0+GnRH = 7.5 ± 6.5). Regardless of the treatment method, ewes with follicles ≤ 4 mm, at the first FSH dose, produced more viable embryos (9.6 ± 6.0, P < 0.05) compared to ewes that had follicles > 4 mm at the beginning of the SOV (2.9 ± 3.1, viable embryos). Both the TRAD and D0+GnRH groups had fewer animals with large follicles (> 4 mm) at the first FSH dose than the D0-GnRH group (P < 0.05). In conclusion, both the TRAD and D0+GnRH treatments induced a more favorable ovarian condition (follicles ≤ 4 mm) for adequate SOV; although, all three treatments exhibited similar efficacies in Santa Inês sheep.

ABSTRACT. The aim of this study was to evaluate the influence of weaning and concentrate supplementation on the characteristics of carcass cuts and longissimus muscle of Suffolk lambs finished on a Tifton 85 (Cynodon spp.) pasture. Weaning and concentrate supplementation strategies were evaluated in four finishing systems: i) non-weaned and non-supplemented lambs; ii) non-weaned lambs supplemented with concentrate in creep feeding; iii) weaned and non-supplemented lambs; and iv) weaned lambs supplemented with concentrate. In the systems with weaning, lambs were weaned at 46 ± 6 days of age. In the systems with supplementation, the concentrate was offered daily at 2% of lambs’ body weight. Weaning led to a decrease, whereas supplementation led to an increase in carcass cut weights. Supplemented lambs had lower yields of neck and uncovered ribs, and higher yields of breast + flank and loin. The characteristics of loin eye and fat thickness over the longissimus muscle presented lower values in weaned lambs and higher values in supplemented lambs. Keeping lambs with their dams and offering concentrate supplementation until slaughter are strategies recommended to obtain heavier cuts with increased muscularity and fat content.

BACKGROUND Angiostrongylus cantonensis is the etiological agent of neuroangiostrongyliasis in humans, which is developed in gastropods and vertebrate species, mainly rodents. Human transmission occurs through consumption of molluscs and paratenic hosts infected with L3, and the migration of larvae to the central nervous system causes eosinophilic meningitis. Laboratory diagnosis is based on molecular and immunological tests, using young or adult females as a source of antigens. However, these tests give positive results only after several weeks of symptoms onset and also cross-reactions with others parasite infections may occur. OBJECTIVES The purpose of this work was to study different antigenic preparations of distinct evolutionary phases of A. cantonensis, in order to improve serological techniques for disease immunodiagnosis. METHODS For this purpose, antigenic fractions of different evolutionary forms were evaluated by Dot-enzyme-linked immunosorbent assay (Dot-ELISA) and Western blot using serum samples. FINDINGS All analysed fractions showed reactivity with serum samples from patients with neuroangiostrongyliasis, especially female membrane alkaline (FAM) and female soluble alkaline (FAS) fractions together with female soluble saline (FSS), improving the technique specificity. MAIN CONCLUSIONS The results point to the possibility of use of raw female antigens in association with alkaline membrane antigens extracted from adult worms to aid in diagnosis and helps initiate neuroangiostrongyliasis surveillance and control actions.