RESUMO A doença renal crônica (DRC) representa um dos principais problemas de saúde pública da atualidade. A dosagem da creatinina sérica e a estimativa da taxa de filtração glomerular (TFG) são as principais ferramentas para avaliação da função renal. Para a estimativa da TFG, existem diversas equações, sendo a mais recomendada a CKD-EPI (Chronic Kidney Disease – Epidemiology). Existem ainda algumas controvérsias com relação à dosagem da creatinina sérica e da estimativa da TFG, uma vez que vários fatores podem interferir nesse processo. Uma importante mudança recente foi a retirada da correção por raça das equações para estimativa da TFG, que superestimavam a função renal, e consequentemente retardavam a implementação de tratamentos como diálise e transplante renal. Neste documento de consenso da Sociedade Brasileira de Nefrologia e Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial são revisados os principais conceitos relacionados à avaliação da função renal, possíveis controvérsias existentes e recomendações para a estimativa da TFG na prática clínica. DRC (DRC atualidade (TFG CKDEPI CKD EPI Chronic Epidemiology. Epidemiology . Epidemiology) processo clínica

ABSTRACT Chronic kidney disease (CKD) represents one of today’s main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease – Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice. CKD (CKD todays today s problems (GFR CKDEPI EPI Epidemiology process transplantation Medicine reviewed practice

Resumo Mesmo com a criação de políticas públicas voltadas para melhoria do acesso da população LGBT aos serviços de saúde, persiste muita fragilidade nas estratégias inclusivas para esta população. O estudo analisa o acesso da população LGBT às Unidades Básicas de Saúde do município de Senhor do Bonfim, Bahia, a partir de dimensões de acesso teorizadas por Giovanella e Fleury e aprofundados por Assis e Almeida. Trata-se de um estudo de abordagem qualitativa exploratória que utilizou como técnica de seleção da amostra a snowball sampling, na qual os participantes indicam outros participantes. Foram realizadas entrevistas semiestruturadas e uma análise de conteúdo temática organizada em quatro dimensões analíticas: à luz da dimensão simbólica, à luz da dimensão técnica, à luz da dimensão política e à luz da dimensão econômica. Os resultados apontaram fragilidades no acolhimento da população LGBT nos serviços de atenção básica à saúde. As pessoas LGBT participantes apontam experiências com profissionais desqualificados para atender suas necessidades e seus anseios, além do convívio cotidiano com preconceito, discriminação, estigma e desrespeito. Os padrões sociais instituídos socialmente influenciam negativamente na inclusão das pessoas LGBT nos serviços.

Abstract Even with the creation of public policies aimed at improving the LGBT population's access to health services, inclusive strategies for this population remain very weak. This study analyzes the LGBT population's access to Basic Health Units in the city of Senhor do Bonfim, Bahia, Brazil, based on the dimensions of access theorized by Giovanella and Fleury and further developed by Assis and Almeida. This exploratory qualitative study used snowball sampling as its sample selection technique, in which participants indicate other participants. Semi-structured interviews were carried out and a thematic content analysis was organized into four analytical dimensions: in light of the symbolic dimension, in light of the technical dimension, in light of the political dimension, and in light of the economic dimension. The results showed weaknesses in the reception of the LGBT population in primary health care services. The LGBT people who took part pointed to experiences with professionals who are unqualified to meet their needs and desires, as well as the daily experience of prejudice, discrimination, stigma, and disrespect. Socially instituted social standards have a negative influence on the inclusion of LGBT people in health services.

Organotin compounds (OTCs) are pollutants that affect the reproduction of some marine organisms and can cause autoimmune diseases in humans. Most of the techniques used for detection and monitoring of OTCs in the environment have limitations due to several stages of sample pre-processing. Here, we demonstrated the use of the α-hemolysin (αHL) nanopore as an alternative platform for the detection of the cyhexatin and diphenyltin dichloride (DPhT) in aqueous systems. The detection process is based on the analysis of the residence times of each OTCs within the unitary nanopore, as well as, on the amplitudes of the blockages in the ionic current flowing through it. Cyhexatin and DPhT induced two and three patterns in the amplitude of the blockages in the ionic current, respectively. Residence time value of the cyhexatin inside the nanopore was higher than the value presented by the DPhT. Molecular docking was used to evaluate the interactions between OTCs and nanopore constriction, mainly identifying cation-π and hydrogen interactions. Classical atomistic molecular dynamic simulations confirm moderate aggregative behavior of these OTCs in solution in cationic form, especially for cyhexatin species. The nanopore detects OTCs at nanomolar level and it is possible to use this nanopore to monitor OTCs in aqueous systems. (OTCs humans preprocessing. preprocessing pre processing. processing pre-processing Here αhemolysin α hemolysin αHL (αHL (DPhT systems respectively constriction cationπ cation π form species

ABSTRACT The development and the use of new technologies in agriculture contribute to significant advances in research with practical applications in several fields, such as image analytical techniques, which are simple, fast, and objective analyses. This work aimed to evaluate rice seeds’ quality using X-ray, multispectral, and chlorophyll fluorescence image analytical techniques and relate this information with the photosynthetic efficiency of seedlings. Initially, the seeds were identified and enumerated, then X-ray images were obtained, and the void space (area between the endosperm + embryo and the glumes) was calculated. Next, the same seeds were used in the X-rays, multispectral, and chlorophyll fluorescence images. Afterward, the seeds were placed to germinate in polyethylene cups with a capacity of 250 mL, and evaluations of the photochemical yield of photosynthesis photosystem II (FSII) and of the seedling fluorescence chlorophyll were carried out seven, nine, and 11 days after the emergence of the seedlings. The reflectance of seeds in the spectral bands between 365 nm and 780 nm showed a positive correlation with the chlorophyll fluorescence. Furthermore, the higher photosynthetic efficiency of rice seedlings at 11 days after emergence is directly related to the reflectance of the seeds at spectral bands between 365 nm and 780 nm. fields simple fast analyses Xray, Xray X ray, ray multispectral Initially enumerated obtained area glumes calculated Next Xrays, Xrays rays, rays X-rays Afterward 25 mL FSII (FSII seven nine 1 36 78 Furthermore 2 3 7

ABSTRACT The term toposequence, proposed to designate a lateral succession of soils on a slope due to the influence of topography, began to be used differently over time, distancing itself from its original concept. Here, we discuss how this concept has been used since its inception. We carried out bibliometric analyses of publications in the database available on the Web of Science since 1900. Three main approaches and related concepts, explicit or not, one at a regional scale and two others at a local scale were identified. From this analysis, we suggest: a) when the approach is regional, the term geomorphic surface or position in the landscape should be used to address the spatial distribution and genetic implications of soils at this scale; b) when dealing with series/sequences of soils on slopes for mapping purposes or discontinuous profiles that emphasize taxonomic classification, the term catena should be used; c) when the determining factor of the soil sequence is climatic, biotic, lithological, chronological, the corresponding term climo-, bio-, litho- or chronosequence should be used; d) when dealing with a lateral succession of horizons in the continuum on slopes, resulting from the influence of topography on soil formation, which may reflect the soil contribution to the model evolution, only in this case should the term toposequence be used, returning to its original concept. time Here inception 1900 concepts not identified analysis suggest b seriessequences series sequences classification c climatic biotic lithological chronological climo, climo , climo- bio, bio bio- litho d formation evolution 190 19 1

Abstract In reproductive technologies, uncovering the molecular aspects of oocyte and embryo competence under different conditions is crucial for refining protocols and enhancing efficiency. RNA-seq generates high-throughput data and provides transcriptomes that can undergo additional computational analyses. This study presented the transcriptomic profiles of in vitro matured oocytes and blastocysts produced in vitro from buffalo crossbred (Bubalus bubalis), coupled with gene co-expression and module preservation analysis. Cumulus Oophorus Complexes, obtained from slaughterhouse-derived ovaries, were subjected to in vitro maturation to yield metaphase II oocytes (616) or followed in vitro fertilization and culture to yield blastocysts for sequencing (526). Oocyte maturation (72%, ±3.34 sd) and embryo development (21.3%, ±4.18 sd) rates were obtained from three in vitro embryo production routines following standard protocols. Sequencing of 410 metaphase II oocytes and 70 hatched blastocysts (grade 1 and 2) identified a total of 13,976 genes, with 62% being ubiquitously expressed (8,649). Among them, the differentially expressed genes (4,153) and the strongly variable genes with the higher expression (fold-change above 11) were highlighted in oocytes (BMP15, UCHL1, WEE1, NLRPs, KPNA7, ZP2, and ZP4) and blastocysts (APOA1, KRT18, ANXA2, S100A14, SLC34A2, PRSS8 and ANXA2) as representative indicators of molecular quality. Additionally, genes exclusively found in oocytes (224) and blastocysts (2,200) with specific biological functions were identified. Gene co-expression network and module preservation analysis revealed strong preservation of functional modules related to exosome components, steroid metabolism, cell proliferation, and morphogenesis. However, cell cycle and amino acid transport modules exhibited weak preservation, which may reflect differences in embryo development kinetics and the activation of cell signaling pathways between buffalo and bovine. This comprehensive transcriptomic profile serves as a valuable resource for assessing the molecular quality of buffalo oocytes and embryos in future in vitro embryo production assays. technologies efficiency RNAseq RNA seq highthroughput high throughput analyses Bubalus bubalis, bubalis , bubalis) coexpression co Complexes slaughterhousederived slaughterhouse derived ovaries 616 (616 526. 526 . (526) 72%, 72 (72% 334 3 34 ±3.3 sd 21.3%, 213 21 (21.3% 418 4 18 ±4.1 41 7 grade 2 13976 13 976 13,97 62 8,649. 8649 8,649 8 649 (8,649) them 4,153 4153 153 (4,153 foldchange fold change 11 BMP15, BMP15 BMP (BMP15 UCHL1 UCHL WEE1 WEE NLRPs KPNA7 KPNA ZP2 ZP ZP4 APOA1, APOA1 APOA (APOA1 KRT18 KRT ANXA2 ANXA S100A14 SA S A SLC34A2 SLCA SLC PRSS Additionally 224 (224 2,200 2200 200 (2,200 components metabolism proliferation morphogenesis However bovine assays 61 (61 52 (526 72% (72 33 ±3. 21.3% (21.3 ±4. 1397 97 13,9 6 864 8,64 64 (8,649 4,15 415 15 (4,15 BMP1 (BMP1 (APOA KRT1 S100A1 SLC34A 22 (22 2,20 220 20 (2,20 (6 5 (52 (7 ±3 21.3 (21. ±4 139 9 13, 86 8,6 (8,64 4,1 (4,1 (BMP S100A (2 2,2 (2,2 ( (5 ± 21. (21 8, (8,6 4, (4, 2, (2, (8, (4 (8

Resumo Mesmo com a criação de políticas públicas voltadas para melhoria do acesso da população LGBT aos serviços de saúde, persiste muita fragilidade nas estratégias inclusivas para esta população. O estudo analisa o acesso da população LGBT às Unidades Básicas de Saúde do município de Senhor do Bonfim, Bahia, a partir de dimensões de acesso teorizadas por Giovanella e Fleury e aprofundados por Assis e Almeida. Trata-se de um estudo de abordagem qualitativa exploratória que utilizou como técnica de seleção da amostra a snowball sampling, na qual os participantes indicam outros participantes. Foram realizadas entrevistas semiestruturadas e uma análise de conteúdo temática organizada em quatro dimensões analíticas: à luz da dimensão simbólica, à luz da dimensão técnica, à luz da dimensão política e à luz da dimensão econômica. Os resultados apontaram fragilidades no acolhimento da população LGBT nos serviços de atenção básica à saúde. As pessoas LGBT participantes apontam experiências com profissionais desqualificados para atender suas necessidades e seus anseios, além do convívio cotidiano com preconceito, discriminação, estigma e desrespeito. Os padrões sociais instituídos socialmente influenciam negativamente na inclusão das pessoas LGBT nos serviços. saúde Bonfim Bahia Almeida Tratase Trata se sampling analíticas simbólica econômica anseios preconceito discriminação desrespeito

Abstract Even with the creation of public policies aimed at improving the LGBT population's access to health services, inclusive strategies for this population remain very weak. This study analyzes the LGBT population's access to Basic Health Units in the city of Senhor do Bonfim, Bahia, Brazil, based on the dimensions of access theorized by Giovanella and Fleury and further developed by Assis and Almeida. This exploratory qualitative study used snowball sampling as its sample selection technique, in which participants indicate other participants. Semi-structured interviews were carried out and a thematic content analysis was organized into four analytical dimensions: in light of the symbolic dimension, in light of the technical dimension, in light of the political dimension, and in light of the economic dimension. The results showed weaknesses in the reception of the LGBT population in primary health care services. The LGBT people who took part pointed to experiences with professionals who are unqualified to meet their needs and desires, as well as the daily experience of prejudice, discrimination, stigma, and disrespect. Socially instituted social standards have a negative influence on the inclusion of LGBT people in health services. populations s services weak Bonfim Bahia Brazil Almeida technique Semistructured Semi structured dimension desires prejudice discrimination stigma disrespect

Resumo A Lei nº 13.769/2018, que altera o Código de Processo Penal, regula a prisão domiciliar da mulher gestante ou que for mãe ou responsável por crianças ou pessoas com deficiência. Esta pesquisa foi dedicada a observar a construção do sentido jurídico de situação excepcionalíssima por meio de Habeas Corpus (HC) que requereram a prisão domiciliar de gestantes e mães presas com filhos menores de 12 anos. Essa delimitação levou a termos por corpora 122 decisões do Superior Tribunal de Justiça (STJ) e 3 do Supremo Tribunal Federal (STF), todas prolatadas entre 20 de dezembro de 2018 a 19 de dezembro de 2019, primeiro ano de vigência da Lei nº 13.769/2018. As decisões foram coletadas dos sítios eletrônicos do STJ e do STF, usando por verbetes de busca: “13.769”, “situação e excepcionalíssima”, “preventiva pela domiciliar” e “prisão domiciliar”. Os dados foram lançados em planilha de Excel e analisados sob a perspectiva teórico-metodológica da comunicativação. A análise tratou dos elementos metodológicos aplicados em pesquisa empírica com decisão jurídica, da construção de sentido jurídico e da autoria, quando o relator, o voto, a unanimidade foram tomados, não como transmissores de informações e decisões, mas como referentes de enunciados. A pesquisa viabilizou reflexões que indicam a necessidade de se promover um afastamento da lógica causal e a aplicação da lógica circular reflexiva, como propõe a perspectiva comunicativacionista, além da impossibilidade de pesquisa empírica com decisão jurídica se não transdisciplinar. Quanto ao sentido jurídico, observamos que não cabe falar em sentido fixado, mas sim em processo constante de construção, reconstrução, desconstrução de sentido, é o que observamos ao constatar que os três argumentos (tráfico de drogas exercido na residência, descumprimento de prisão domiciliar anterior e participação em organização criminosa) que impulsionam a construção de sentido de situação excepcionalíssima não estão contidos no texto legal, nem em qualquer precedente judicial, bem como que eles foram aplicados, não aplicados e reaplicados. Por fim, ao observar que um mesmo ministro, numa mesma sessão, quando é relator vota pela concessão da prisão domiciliar e quanto não é relator vota contrário a ela, consideramos que não cabe manter a autoria como se responsabilidade por estabelecer sentido, antes, o sentido jurídico de algo se faz e se desfaz devido à comunicação jurídica mesma, não devido ao/à autor/a. A pesquisa, com essas contribuições, revela quão importante e necessário se faz desenvolver reflexões metodológicas e epistemológicas sobre pesquisa com decisão jurídica. 137692018 13 769 13.769/2018 Penal deficiência HC (HC 1 anos (STJ STF , (STF) 2 201 2019 busca 13.769, 13769 13.769 “13.769” excepcionalíssima, excepcionalíssima” preventiva domiciliar. . teóricometodológica teórico metodológica comunicativação voto tomados enunciados reflexiva comunicativacionista transdisciplinar fixado reconstrução tráfico residência criminosa legal judicial reaplicados fim ministro sessão ela antes aoà autora autor autor/a contribuições 13769201 76 13.769/201 (STF 1376 13.76 “13.769 1376920 7 13.769/20 137 13.7 “13.76 137692 13.769/2 13. “13.7 13.769/ “13. “13 “1 “

Abstract Law nº 13.769/2018, upon altering the Code of Criminal Procedure, regulates house arrest for pregnant women or for mothers responsible for children or the disabled. This research was dedicated to observing the construction of juridical meaning in the context of a very exceptional situation by way of Habeas Corpus (HC) in the appeal for house arrest in cases of pregnancy and imprisoned mothers with children less than 12 years of age. This demarcation has led us to a set of 122 decisions by the Supreme Justice Tribunal (STJ) and 3 by the Supreme Federal Court (STF), all sentencing having occurred between December 20, 2018 and December 19, 2019, representing the first year of validity for Law nº 13.769/2018. The decisions were collected from the electronic sites of the STJ and STF, using the following entries for searching: “13.769”, “situation” and “very exceptional”, “remand” and “house arrest”. The data was distributed onto an Excel spreadsheet and analyzed under the theoretical-methodological perspective of communicativation. The analysis treated methodological elements applied in empirical research on sentencing and the construction of juridical meaning and authorship, where rapporteur, vote and unanimity were not taken as transmitters of information and decisions, but as pertaining to wordings. The study made viable reflections that indicate the necessity for distancing from causal logic, at the same time promoting the application of reflexive circular logic, as proposed by the communicativationist perspective. What one stresses here is the impossibility of empirical research on juridical decision without transdisciplinary reflection. As for juridical meaning, we observe that it is not suited to a fixed meaning, but rather a constant process of construction, reconstruction and deconstruction of meaning. Observation reveals that three deliberations (drug trafficking at the residence, noncompliance with previous house arrest and participation in organized crime), having induced the construction of meaning in the direction of a very exceptional situation, are not contained in the legal text, nor in any judicial precedent, independent of their first-time application, non-application or reapplication. Finally, as a result of observing that within the same proceedings the same minister, whilst rapporteur votes for house arrest and whilst not rapporteur votes against it, we consider that it is not fitting to maintain authorship as though it would be responsible for the establishment of meaning. Preceding this, the juridical meaning of something is made and unmade due to juridical communication itself, not due to the author. The study, with these contributions, reveals how important and necessary it is to develop methodological and epistemological reflections about studies on juridical decision. 137692018 13 769 13.769/2018 Procedure disabled HC (HC 1 age (STJ STF , (STF) 20 201 19 2019 searching 13.769, 13769 13.769 “13.769” “situation exceptional, exceptional” remand “remand arrest. . arrest” theoreticalmethodological theoretical communicativation wordings logic reflection drug residence crime, crime crime) text precedent firsttime nonapplication non reapplication Finally minister this itself author contributions 13769201 76 13.769/201 (STF 2 1376 13.76 “13.769 1376920 7 13.769/20 137 13.7 “13.76 137692 13.769/2 13. “13.7 13.769/ “13. “13 “1 “

Resumo: As técnicas de análise de imagens apresentam-se em expansão na agricultura e por consistirem em avaliações rápidas, simples e não destrutivas, são alternativas interessantes para a detecção de sementes de arroz imaturas. Assim, o objetivo deste trabalho foi avaliar a qualidade de sementes de arroz utilizando as técnicas de análise de imagens de raios X, multiespectrais e de fluorescência de clorofila. Inicialmente, com as sementes identificadas e enumeradas, foram obtidas imagens radiográficas para a obtenção do espaço vazio (área entre o endosperma + embrião e as glumelas). Posteriormente, com as mesmas sementes utilizadas na análise de raios X, procedeu-se a aquisição das imagens multiespectrais e de fluorescência de clorofila. Na sequência, realizou-se a análise computadorizada de plântulas com o software SVIS ®. Concluiu-se que as sementes de arroz que não germinam ou originam plântulas anormais apresentam espaço vazio interno igual ou superior a 18,68%, maior reflectância nas bandas espectrais de comprimento de onda de 590 nm a 780 nm (41,46% a 64,21%, respectivamente) e na banda de 970 nm (75,65%), além de apresentarem valores de fluorescência de clorofila iguais ou superiores a 40,58 e a 112,92, respectivamente nas energias de excitação/emissão de 630/700 nm e de 645/700 nm. Resumo apresentamse se rápidas destrutivas imaturas Assim X Inicialmente enumeradas área glumelas. glumelas . glumelas) Posteriormente procedeuse procedeu sequência realizouse realizou ® Concluiuse Concluiu 1868 18 68 18,68% 59 78 41,46% 4146 41 46 (41,46 6421 64 21 64,21% 97 75,65%, 7565 75,65% , 75 65 (75,65%) 4058 40 58 40,5 11292 112 92 112,92 excitaçãoemissão excitação emissão 630700 630 700 630/70 645700 645 645/70 186 1 6 18,68 5 7 41,46 414 4 (41,4 642 2 64,21 9 756 75,65 (75,65% 405 40, 1129 11 112,9 63070 63 70 630/7 64570 645/7 18,6 41,4 (41, 64,2 75,6 (75,65 112, 6307 630/ 6457 645/ 18, 41, (41 64, 75, (75,6 (4 (75, ( (75 (7

Abstract: Image analysis techniques are expanding in agriculture and, for being fast, simple, and not destroying samples, they are interesting alternatives in the detection of immature rice seeds. Therefore, the aim of this study was to evaluate the quality of rice seeds using X-ray, multispectral and chlorophyll fluorescence image analysis techniques. Initially, with the seeds identified and numbered, radiographic images were obtained to determine the free space (area between the endosperm + embryo and the glumes). Subsequently, with the same seeds used in the X-ray, multispectral and chlorophyll fluorescence images were acquired, and then the computerized seedling analysis was performed with the SVIS® software. It was concluded that rice seeds that do not germinate or originate abnormal seedlings have free space equal to or greater than 18.68%, higher reflectance in the spectral bands with wavelength from 590 nm to 780 nm (41.46% to 64.21%, respectively) and in the band of 970 nm (75.65%), in addition to having chlorophyll fluorescence values equal to or greater than 40.58 and 112.92 at excitation/emission energies of 630/700 nm and 645/700 nm, respectively. Abstract fast simple samples Therefore Xray, Xray X ray, ray X-ray Initially numbered area glumes. glumes . glumes) Subsequently acquired SVIS software 1868 18 68 18.68% 59 78 41.46% 4146 41 46 (41.46 6421 64 21 64.21% respectively 97 75.65%, 7565 75.65% , 75 65 (75.65%) 4058 40 58 40.5 11292 112 92 112.9 excitationemission excitation emission 630700 630 700 630/70 645700 645 645/70 186 1 6 18.68 5 7 41.46 414 4 (41.4 642 2 64.21 9 756 75.65 (75.65% 405 40. 1129 11 112. 63070 63 70 630/7 64570 645/7 18.6 41.4 (41. 64.2 75.6 (75.65 6307 630/ 6457 645/ 18. 41. (41 64. 75. (75.6 (4 (75. ( (75 (7

RESUMO Objetivo Analisar a associação entre perda auditiva e a vulnerabilidade à saúde em crianças na faixa etária de 25 a 36 meses. Método Estudo observacional analítico do tipo transversal realizado por meio da triagem auditiva infantil em nove creches. A triagem constou de anamnese, meatoscopia, timpanometria, emissões otoacústicas transientes e audiometria tonal limiar. Para cada exame realizado foi estabelecido o critério de “passa” e “falha”. Os endereços residenciais das crianças foram georreferenciados e foi construído mapa coroplético da distribuição espacial, considerando o Índice de Vulnerabilidade à Saúde (IVS). Foi realizada análise de associação entre o IVS com as variáveis sexo, exames audiológicos e regional de domicílio por meio dos testes Qui-quadrado de Pearson, e Exato de Fisher. Resultados Foram avaliadas 95 crianças de ambos os sexos, destas, 44,7% apresentaram alteração em pelo menos um dos exames realizados, sendo encaminhadas para avaliação otorrinolaringológica e auditiva. Das alterações observadas 36,9% ocorreram na timpanometria e 7,8% nas emissões otoacústicas transientes. Dentre crianças encaminhadas para avaliação, 9,7% apresentaram diagnóstico de perda auditiva do tipo condutiva, 13,6% resultados dentro da normalidade e 21,4% não compareceram para reavaliação. Das crianças que apresentaram o diagnóstico final de perda auditiva do tipo condutiva (9,7%), 1,9% foi classificado como IVS de risco baixo e 6,8% como IVS de risco médio. Houve significância estatística entre IVS e o local de residência da criança. Conclusão Não houve associação com significância estatística entre alteração auditiva e IVS, entretanto foi possível observar que 77,7% das crianças com diagnóstico de perda auditiva residiam em setores censitários de risco médio do IVS. 2 3 meses creches anamnese meatoscopia limiar passa “passa falha. falha . “falha” espacial (IVS) sexo Quiquadrado Qui quadrado Pearson Fisher 9 sexos destas 447 44 7 44,7 realizados 369 36,9 78 8 7,8 97 9,7 136 13 6 13,6 214 21 4 21,4 reavaliação 9,7%, , (9,7%) 19 1 1,9 68 6,8 criança 777 77 77,7 “falha (IVS 44, 36, 7, 9, 13, 21, (9,7% 1, 6, 77, (9,7 (9, (9 (

ABSTRACT Purpose To analyze the association between hearing loss and health vulnerability in children aged 25 to 36 months. Methods Analytical observational cross-sectional study conducted through child hearing screening in nine day-care centers. The screening consisted of anamnesis, otoscopy, tympanometry, transient otoacoustic emissions, and pure tone audiometry. For each exam performed, the 'pass' and 'fail' criteria were established. The children's residential addresses were georeferenced and a choropleth map of the spatial distribution was built, considering the Health Vulnerability Index (HVI). The analysis of the association between the HVI and the variables sex, auditory assessment, and region area of the household was performed using Pearson's Chi-square and Fisher's Exact tests. Results Ninety-five children of both sexes were evaluated, of which 44.7% presented alterations in at least one of the exams performed, being referred for otorhinolaryngological evaluation and subsequent auditory assessment. Of the observed changes, 36.9% occurred in the tympanometry and 7.8% in the transient otoacoustic emissions. Among children referred for reassessment, 9.7% were diagnosed with conductive hearing loss, 13.6% results within normal limits and 21.4% did not attend for assessment. Of the children who presented the final diagnosis of conductive hearing loss (9.7%), 1.9% were classified as low-risk HVI and 6.8% as medium-risk HVI. There was statistical significance between HVI and the child's place of residence. Conclusion The association between hearing loss and HIV was not statistically significant; however, it was possible to observe that 77.7% of the children with hearing loss resided in sectors with medium- risk HIV 2 3 months crosssectional cross sectional daycare day care centers anamnesis otoscopy emissions audiometry pass 'pass fail 'fail established childrens s built . (HVI) sex assessment Pearsons Pearson Chisquare Chi square Fishers Fisher tests Ninetyfive Ninety five evaluated 447 44 7 44.7 changes 369 9 36.9 78 8 7.8 reassessment 97 9.7 136 13 6 13.6 214 21 4 21.4 9.7%, , (9.7%) 19 1 1.9 lowrisk low 68 6.8 mediumrisk medium childs residence significant however 777 77 77.7 (HVI 44. 36. 7. 9. 13. 21. (9.7% 1. 6. 77. (9.7 (9. (9 (

Abstract Bacteriocins are antimicrobial peptides expressed by bacteria through ribosomal activity. In this study, we analyzed the diversity of bacteriocin-like genes in the Tucuruí-HPP using a whole-metagenome shotgun sequencing approach. Three layers of the water column were analyzed (photic, aphotic and sediment). Detection of bacteriocin-like genes was performed with blastx using the BAGEL4 database as subject sequences. In order to calculate the abundance of bacteriocin-like genes we also determined the number of 16S rRNA genes using blastn. Taxonomic analysis was performed using RAST server and the metagenome was assembled using IDBA-UD in order to recover the full sequence of a zoocin which had its three-dimensional structure determined. The photic zone presented the highest number of reads affiliated to bacteriocins. The most abundant bacteriocins were sonorensin, Klebicin D , pyocin and colicin. The zoocin model was composed of eight anti-parallel β-sheets and two α-helices with a Zn2+ ion in the active site. This model was considerably stable during 10 ns of molecular dynamics simulation. We observed a high diversity of bacteriocins in the Tucuruí-HPP, demonstrating that the environment is an inexhaustible source for prospecting these molecules. Finally, the zoocin model can be used for further studies of substrate binding and molecular mechanisms involving peptidoglycan degradation.

Abstract Introduction The literature converges regarding the use of C-reactive protein (CRP) tests between postoperative days (PODs) 3 and 5 of elective procedures. In this period, they have great sensitivity and negative predictive value (NPV) for severe and anastomotic complications about two days before the first clinical sign. The few studies on colorectal urgency suggest that, despite the different initial values according to the surgical indication, following POD 3, the level of CRP is similar to that of elective procedures. However, given the heterogeneity of the studies, there is no consensus on the cutoff values for this use. Objective To validate the use and propose a PO CRP cut-off value in urgent colorectal procedures as an exclusion criterion for complications of anastomosis or the abdominal cavity. Method Retrospective analysis of the medical records of 308 patients who underwent urgent colorectal surgical procedures between January 2017 andDecember 2019. The following data were considered: age, gender, surgical indication, type of procedure performed, complications, CRP levels preoperatively and from POD 1 to 4, and the severity of the complications. We compared the CRP levels and the percentage variations between the preoperative period and PODs 1 to 4 as markers of severe complications using the receiver operating characteristic (ROC) curve. Results The levels of CRP on POD4, and their percentage drops between PODs 2 to 4 and PODs 3 to 4, were better to predict severe complications. A cutoff of 7.45mg/dL on POD 4 had 91.7% of sensitivity and NPV. A 50% drop between PODs 3 and 4 had 100% of sensitivity and NPV. Conclusion Determining the level of CRP is useful to exclude severe complications, and it could be a criterion for hospital discharge in POD 4 of emergency colorectal surgery.

Abstract: FITOPROT, which contains curcuminoids and Bidens pilosa L. extract, is an innovative mucoadhesive formulation indicated for the topical treatment of chemoradiotherapy-induced oral mucositis (OM) in patients with advanced and visible oral squamous cell carcinoma. The formulation is used as a mouthwash directly on tumor tissue of patients with advanced neoplasms, without triggering cancer cell proliferation or tumor invasiveness. Thus, the aim of this study was to evaluate the biological effects of FITOPROT on an oral squamous cell carcinoma cell line (SCC-4). The viability of SCC-4 cells was assessed after exposure to FITOPROT using MTT reduction assay. The effects of the mucoadhesive formulation on cell cycle progression and cell death parameters were evaluated using flow cytometry. In addition, the inflammatory profile of the tumor cells was evaluated using the cytometric bead array (CBA) assay. FITOPROT promoted a concentration-dependent decrease in cell viability and cell cycle arrest at the G2/M phase (p < 0.05). Mitochondrial membrane potential was also altered after exposure to the formulation (p < 0.05), in parallel with a reduction in VEGF and IL-8 production (p = 0.01 and p = 0.05, respectively). In summary, the results indicate that FITOPROT reduces SCC-4 cell viability, promotes cell cycle arrest, modulates mitochondrial membrane potential, and exhibits antiangiogenic and anti-inflammatory properties, thus indicating its potential for topical use in patients with OM and visible tumors in the mouth.

Resumo A hipercalemia é um dos distúrbios eletrolíticos mais comuns, responsável por um grande número de desfechos adversos, incluindo arritmias potencialmente fatais. Quelantes de potássio são amplamente prescritos para o tratamento da hipercalemia, mas infelizmente são muitos os eventos adversos associados ao seu uso, em particular os gastrointestinais. A identificação de pacientes com risco mais elevado para complicações graves associadas aos quelantes de potássio atualmente em uso, como necrose e perfuração do cólon, pode evitar desfechos fatais. O presente artigo descreve o caso de um homem de 56 anos com diabetes secundário e doença renal crônica em tratamento por hipercalemia com poliestirenossulfonato de cálcio (PSC). Posteriormente o paciente apresentou abdômen agudo devido a perfuração do ceco e foi submetido a uma ressecção ileocecal, mas acabou indo a óbito por choque séptico uma semana mais tarde. Durante a cirurgia, uma massa branca sólida foi isolada no lúmen do cólon. A massa foi identificada como um bezoar de PSC, uma massa de fármaco de rara ocorrência formada no trato gastrointestinal que contribuiu para a perfuração. História pregressa de gastrectomia parcial e vagotomia foi identificada como provável fator de risco para o desenvolvimento do bezoar de PSC. Espera-se que os dois novos quelantes de potássio - patiromer e ciclossilicato de zircônio sódico - ajudem a tratar pacientes de alto risco em um futuro próximo.

Abstract Hyperkalemia is one of the most common electrolyte disorders, responsible for a high number of adverse outcomes, including life-threatening arrhythmias. Potassium binders are largely prescribed drugs used for hyperkalemia treatment but unfortunately, there are many adverse events associated with its use, mostly gastrointestinal. Identification of patients at highest risk for the serious complications associated with the current potassium binders, such as colon necrosis and perforation, could prevent fatal outcomes. The authors present a case of a 56-year-old man with secondary diabetes and chronic renal disease that was treated for hyperkalemia with Calcium Polystyrene Sulfonate (CPS). He later presented with acute abdomen due to cecum perforation and underwent ileocecal resection but ultimately died from septic shock a week later. During surgery, a solid white mass was isolated in the lumen of the colon. The mass was identified as a CPS bezoar, a rare drug-mass formed in the gastrointestinal tract that contributed to the perforation. A previous history of partial gastrectomy and vagothomy was identified as a probable risk factor for the CPS bezoar development. Hopefully, the two new potassium binders patiromer and (ZS-9) Sodium Zirconium Cyclosilicate will help treat such high-risk patients, in the near future.

O linfoma primário da supra-renal é uma entidade extremamente rara que constitui menos de 1% dos linfomas extra-nodais. A maioria dos casos apresenta-se com massas bilaterais na supra-renal, com ou sem envolvimento extra-nodal. Uma das manifestações mais graves é a insuficiência supra-renal. O mecanismo etiológico não está completamente esclarecido, mas acredita-se que a auto-imunidade tenha um papel importante. Apresentamos o caso de um homem de 44 anos, internado no Departamento de Medicina Interna por dor torácica, sintomas constitucionais e febre. Uma tomografia computorizada abdominal mostrou massas supra-renais bilaterais. Efectuou-se uma adrenalectomia esquerda e o exame histológico revelou tratar-se de um linfoma não- -Hodgkin de células-T. Da revisão da literatura, foram descritos apenas 5 casos de linfoma T primário da supra-renal. Este caso clínico enfatiza a complexidade do diagnóstico diferencial perante massas bilaterais da supra-renal, alertando para a possibilidade de linfoma cuja precocidade diagnóstica tem impacto prognóstico. Uma revisão da literatura sobre esta entidade pouco frequente foi realizada.

Primary adrenal lymphoma is an extremely rare entity which constitutes less than 1% of all extranodal lymphomas. Most cases are presented with bilateral adrenal masses with or without extra-adrenal involvement. Presentation may be with adrenal insufficiency which can be a life-threatening situation. The etiological mechanism is not completely understood but autoimmunity seems to have an important role. We report a case of a 44-year old man admitted to the Internal Medicine Department due to thoracic pain, constitutional symptoms and fever. An abdominal computed tomography scan revealed bilateral adrenal masses. A left surgical adrenalectomy was performed, and histological examination diagnosed a non-Hodgkin T-cell lymphoma. Only 5 cases of T-cell type PAL have been reported in literature. This case report emphasizes the complexity of differential diagnosis in the presence of bilateral adrenal masses, the possibility of lymphoma and the importance of early diagnosis in order to improve the clinical outcomes. A review of the literature of this unusual entity was carried out.