Resumo Introdução: A doença renal crônica (DRC) e a síndrome metabólica (SM) são reconhecidas como problemas de saúde pública relacionados ao excesso de peso e a fatores cardiometabólicos. O objetivo deste estudo foi desenvolver um modelo para prever a SM em pessoas com DRC. Métodos: Este foi um estudo transversal prospectivo de pacientes de um centro de referência em São Luís, MA, Brasil. A amostra incluiu voluntários adultos classificados de acordo com a presença de DRC leve ou grave. Para o rastreamento da SM, o algoritmo de classificação k-nearest neighbors (KNN) foi utilizado com os seguintes dados: sexo, tabagismo, circunferência do pescoço e relação cintura-quadril. Os resultados foram considerados significativos com p < 0,05. Resultados: Foram avaliados 196 pacientes adultos com média de idade de 44,73 anos, 71,9% do sexo feminino, 69,4% com sobrepeso e 12,24% com DRC. Desses últimos, 45,8% apresentaram SM, a maioria tinha até 3 componentes metabólicos alterados, e o grupo com DRC apresentou significância estatística em: circunferência da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia de jejum. O algoritmo KNN comprovou ser um bom preditor para a triagem de SM com acurácia e sensibilidade de 79% e especificidade de 80% (área sob a curva ROC – AUC = 0,79). Conclusão: O algoritmo KNN pode ser usado como um método de triagem de baixo custo para avaliar a presença de SM em pessoas com DRC. Introdução (DRC (SM cardiometabólicos Métodos Luís MA Brasil grave knearest k nearest (KNN dados tabagismo cinturaquadril. cinturaquadril cintura quadril. quadril cintura-quadril 005 0 05 0,05 Resultados 19 4473 44 73 44,7 anos 719 71 9 71,9 feminino 694 69 4 69,4 1224 12 24 12,24 últimos 458 45 8 45,8 alterados sistólica jejum 79 80 área 0,79. 079 0,79 . 0,79) Conclusão 00 0,0 1 447 7 44, 71, 6 69, 122 2 12,2 45, 07 0,7 0, 12,

Abstract Introduction: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD. Methods: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05. Results: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve – AUC = 0.79). Conclusion: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD. Introduction (CKD (MS factors Methods crosssectional cross sectional Luís MA Brazil tracking knearest k nearest (KNN inputs gender smoking circumference waisttohip hip ratio 005 0 05 0.05 19 4473 44 73 44.7 years 719 71 9 71.9 female 694 69 4 69.4 1224 12 24 12.24 latter 458 45 8 45.8 components pressure glucose 79 80 area 0.79. 079 0.79 . 0.79) Conclusion lowcost low cost 00 0.0 1 447 7 44. 71. 6 69. 122 2 12.2 45. 07 0.7 0. 12.

ABSTRACT OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.

ABSTRACT OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.

Abstract Introduction Functional magnetic resonance imaging (fMRI) is a non-invasive technique that allows the detection of specific cerebral functions in humans based on hemodynamic changes. The contrast changes are about 5%, making visual inspection impossible. Thus, statistic strategies are applied to infer which brain region is engaged in a task. However, the traditional methods like general linear model and cross-correlation utilize voxel-wise calculation, introducing a lot of false-positive data. So, in this work we tested post-processing cluster algorithms to diminish the false-positives. Methods In this study, three clustering algorithms (the hierarchical cluster, k-means and self-organizing maps) were tested and compared for false-positive removal in the post-processing of cross-correlation analyses. Results Our results showed that the hierarchical cluster presented the best performance to remove the false positives in fMRI, being 2.3 times more accurate than k-means, and 1.9 times more accurate than self-organizing maps. Conclusion The hierarchical cluster presented the best performance in false-positive removal because it uses the inconsistency coefficient threshold, while k-means and self-organizing maps utilize a priori cluster number (centroids and neurons number); thus, the hierarchical cluster avoids clustering scattered voxels, as the inconsistency coefficient threshold allows only the voxels to be clustered that are at a minimum distance to some cluster.

Resumo Objetivos Avaliar o perfil epidemiológico de crianças e adolescentes portadores de estomas intestinais atendidos no Hospital Universitário Presidente Dutra (HUPD) em São Luís (MA). Métodos Estudo observacional, descritivo, retrospectivo e individuado em que foram coletados dados de 110 crianças e adolescentes com estomas intestinais de eliminação de janeiro de 2006 a fevereiro de 2013. Analisaram-se as variáveis: idade, sexo, procedência dos pacientes, indicação, tipo e caráter temporal dos estomas. Após coleta dos dados, foi feita análise descritiva pelo programa Bioestat 5.0. Resultados Dos 110 pacientes, 78,2% eram do sexo masculino e 21,8% do sexo feminino. A idade média foi de 9,4 anos. 55,5% era procedente do interior do Estado do Maranhão e 44,5% da capital, São Luís. Com relação ao tipo: 88,2% eram colostomias e 11,8% ileostomias, todos os estomas temporários. A causa principal foi o trauma (42,7%), sendo a perfuração abdominal por arma de fogo a mais frequente (71,5% da categoria); seguido pelas anomalias congênitas (38,2%), causas obstrutivas (5,4%) e inflamatórias (4,5%). Conclusão As crianças e adolescentes estudados eram, em sua maioria, do sexo masculino, proveniente do interior do Estado do Maranhão, tendo como principal causa a traumática e a colostomia como o tipo de estoma mais comum.

Abstract Objectives To assess the epidemiological profile of children and adolescents with intestinal stoma, assisted at the Presidente Dutra University Hospital (HUPD), São Luís (MA). Methods Observational, descriptive, retrospective, and individuated study. Data were collected from 110 children and adolescents with elimination intestinal stoma, from January 2006 to February 2013. The following variables were analyzed: age, gender, patient origin, and stomata indication, type, and temporal character. After data collection, descriptive analysis was made by Bioestat 5.0 program. Results Of 110 patients, 78.2% were male and 21.8% female. The average age was 9.4 years old. 55.5% came from the Maranhão state countryside, and 44.5% from the capital, São Luís. Regarding stoma type, colostomies made up 88.2%, and were 11.8% ileostomies, all temporary stoma. The main cause was trauma (42.7%), with firearm abdominal puncture being the most frequent cause (71.5% of the category); followed by congenital anomalies (38.2%), and obstructive (5.4%) and inflammatory (4.5%) causes. Conclusion Studied children and adolescents were mostly male, from Maranhão state countryside. The main cause was trauma, and colostomy was the most common stoma type.

PURPOSE: To evaluate the effects of crude extract of Euphorbia tirucalli in cutaneous wound healing. METHODS: A total of 20 Swiss mice were randomly divided into two groups, aveloz (GA) and control (CG), and each group was further divided into two subgroups based on the deaths scheduled for the 7th and 14th days after surgery. The animals underwent a resection of cutaneous fragment with 1cm in diameter on the dorsum; the GA was applied in each animal on the subsequent days, 0.1 mL (30 mg/mL) hydroalcoholic extract of Euphorbia tirucalli was applied on the wound, while the same volume of 0.9% saline solution was applied to the GC. It was evaluated the lesion diameter and after programmed death, a surgical specimen was resected for histopathology. RESULTS: In the macroscopic analysis, no statistically significant difference was observed (p = 0.120 and p = 0.186, for the 7th and 14th days of death, respectively). The histological evaluation revealed no statistically significant difference in the variables acute inflammation (p = 0.014) and fibrosis (p = 0.018), when compared the group aveloz with the control group on day 14. CONCLUSION: The crude hydroalcoholic extract of Euphorbia tirucalli L. demonstrated better outcomes in the healing process, acute inflammation and fibrosis on the 14 day postoperatively.

Introduction The incidence of American cutaneous leishmaniasis (ACL) is increasing in Latin America, especially in Brazil, where 256,587 cases were confirmed in the last decade. Methods This study used a Bayesian model to examine the spatial and temporal distribution of ACL cases between 2000 and 2009 in 61 counties of State of Maranhão located along the three main road and railway corridors. Results During the study period, 13,818 cases of ACL were recorded. There was a significant decrease in the incidence of ACL in the ten study years. The recorded incidence rate ranged from 7.36 to 241.45 per 100,000 inhabitants. The relative risk increased in 77% of the counties, decreased in 18% and was maintained in only five counties. Conclusions Although there was a decreased incidence of the disease, ACL was present in all of the examined municipalities, thus maintaining the risk of contracting this illness.