RESUMO O amendoim (Arachis hypogaea) é uma importante cultura agrícola no Brasil, considerada uma das mais importantes oleaginosas cultivadas. O uso de bactérias solubilizadoras de fertilizantes pode mitigar o estresse salino. O objetivo deste estudo foi avaliar as trocas gasosas, o crescimento e a eficiência do uso da água da cultura do amendoim irrigado com água salobra sob adubação fosfatada e inoculada com bactérias do gênero Bacillus sp. O delineamento experimental utilizado neste estudo foi inteiramente casualizado, em esquema fatorial 4 × 2 × 2, com 5 repetições, referente às formas de adubação (F1 - 0% fósforo, F2 - 50% fósforo, F3 - 100% fósforo e F4 - bovino biofertilizante), presença e ausência do inoculante e dois níveis de condutividade elétrica da água de irrigação (CEa - 0.3 e 4.0 dS m-1). As adubações com fertilizante orgânico (100% de biofertilizante) e mineral (50 e 100% de fósforo) associada a Bacillus sp. mitigou os danos causados pelo estresse salino e proporcionou maior eficiência no uso da água, índice de clorofila, concentração interna de CO2 e diâmetro do caule. O tratamento controle (sem adubação fosfatada e sem estresse salino) e a aplicação de Bacillus sp., promoveu maior desempenho na fotossíntese líquida, taxa de transpiração, condutância estomática e altura das plantas em plantas de amendoim. Arachis hypogaea Brasil cultivadas gasosas sp casualizado repetições F1 F (F 0 50 100 biofertilizante, biofertilizante , CEa 03 3 0. 40 4. m1. m1 m 1 . m-1) (100 (5 clorofila CO caule líquida transpiração 10 m-1 (10 ( m- (1

ABSTRACT Peanut (Arachis hypogaea) is an important agricultural crop in Brazil, considered one of the most important oilseed crops cultivated. The use of fertilizer-solubilizing bacteria can mitigate salt stress. The objective of this study was to evaluate the gas exchange, growth, and water use efficiency of the peanut crop irrigated with brackish water under phosphate fertilization and inoculated with bacteria of the genus Bacillus sp. The experimental design used in this study was completely randomized, in a 4 × 2 × 2 factorial scheme, with 5 replicates, referring to the forms of fertilization (F1 - 0% phosphorus, F2 - 50% phosphorus, F3 - 100% phosphorus, and F4 - bovine biofertilizer), presence and absence of the inoculant and two levels of electrical conductivity of the irrigation water (ECw - 0.3 and 4.0 dS m-1). Fertilization with organic fertilizer (100% biofertilizer) and mineral fertilizer (50 and 100% phosphorus) associated with Bacillus sp. mitigated the damage caused by salt stress and promoted greater water use efficiency, chlorophyll index, internal CO2 concentration and stem diameter. The control treatment (without phosphate fertilization and without salt stress) and the application of Bacillus sp. promoted greater performance in net photosynthesis, transpiration rate, stomatal conductance, and plant height in peanut plants. Arachis hypogaea Brazil cultivated fertilizersolubilizing solubilizing exchange growth sp randomized scheme replicates F1 F (F 0 phosphorus 50 100 biofertilizer, biofertilizer , ECw 03 3 0. 40 4. m1. m1 m 1 . m-1) (100 (5 index CO diameter photosynthesis rate conductance plants 10 m-1 (10 ( m- (1

RESUMO O estresse salino limita o crescimento e a fisiologia da capuchinha (Tropaeolum majus), devido a distúrbios bioquímicos, fisiológicos e anatômicos. A aplicação de ácido salicílico é uma alternativa para mitigar os efeitos prejudiciais do estresse salino, no entanto, em capuchinha os estudos são escassos. Assim, objetivou-se avaliar os efeitos da aplicação de ácido salicílico via foliar em capuchinha cultivada sob estresse salino. O experimento foi realizado em delineamento inteiramente casualizado, em esquema fatorial 3 x 3, referente a 0 (sem estresse) 50 (estresse salino moderado) e 100 (estresse salino severo) mM de NaCl e aplicação de 0, 0,5 e 1 mM de ácido salicílico, com seis repetições. O crescimento (altura de planta, diâmetro do caule e número de folhas), trocas gasosas (condutância estomática, fotossíntese, transpiração, concentração interna de CO2, eficiência intrínseca do uso da água, eficiência instantânea do uso da água e eficiência intrínseca de carboxilação) e os índices de clorofila e fluorescência da clorofila a foram avaliados. O estresse salino afetou as variáveis analisadas neste estudo. A aplicação de ácido salicílico teve um efeito positivo na mitigação dos efeitos do estresse salino severo, resultando em um aumento significativo no número de folhas, sendo a dose mais eficaz a concentração de 1 mM, levando ainda, a melhorias notáveis na eficiência no uso da água e na eficiência fotoquímica. No entanto, as demais combinações de salinidade e ácido salicílico reduziram o crescimento e as trocas gasosas nas plantas de capuchinha. Tropaeolum majus, majus , majus) bioquímicos anatômicos entanto escassos Assim objetivouse objetivou se casualizado sem 5 moderado 10 severo 05 repetições altura planta folhas folhas) condutância estomática fotossíntese transpiração CO2 CO carboxilação avaliados estudo ainda fotoquímica

ABSTRACT Salt stress hampers the growth and physiology of nasturtium (Tropaeolum majus), due to biochemical, physiological, and anatomical disruptions. The application of salicylic acid stands as an alternative to alleviate the detrimental effects of salt stress, but studies on nasturtium are scarce. Thus, the aim of present study was to assess the effects of foliar application of salicylic acid on nasturtium cultivated under salt stress. The experiment followed a completely randomized design in a 3 x 3 factorial scheme, with 0 (no stress), 50 (moderate salt stress), and 100 (severe salt stress) mM of NaCl, and application of 0, 0.5, and 1 mM of salicylic acid, each with six replications. Growth (plant height, stem diameter, and number of leaves), gas exchange (stomatal conductance, photosynthesis, transpiration, internal CO2 concentration, intrinsic water use efficiency, instantaneous water use efficiency, and intrinsic carboxylation efficiency), as well as chlorophyll indices and chlorophyll a fluorescence were evaluated. Salt stress affected the variables analyzed in this study. The application of salicylic acid had a positive effect on mitigating the effects of severe salt stress, resulting in a significant increase in the number of leaves. The most effective dose was 1 mM, also leading to notable improvements in water use efficiency and photochemical efficiency. However, other combinations of salinity and salicylic acid reduced growth and gas exchange in nasturtium plants. Tropaeolum majus, majus , majus) biochemical physiological disruptions scarce Thus scheme no 5 moderate 10 NaCl 05 0.5 replications plant height diameter leaves, leaves leaves) stomatal conductance photosynthesis transpiration CO concentration efficiency) evaluated However plants 0.

Abstract By an analytical-interpretative effort of re-reading the historical facts regarding the idea, proposal, movement, and process of the Brazilian Health Care Reform (HCR) in light of decolonial and Black Feminist theories and critics, this study aims to propose an epistemological and political turn toward a decolonial health praxis. In a first moment, it reflects about some points of incoherence of certain dimensions in the HCR proposal. The second part of this studyd (re)positions this analysis concerning the coloniality situation in Brazil regarding what lies at stake in the attempt of “life redemocratization” in this country. Finally, it highlights that despite much progress to be made, the Brazilian Health Reform is assuredly not a “denatured movement.”

Resumo Por meio de um esforço analítico-interpretativo de releitura dos fatos históricos apresentados acerca da ideia, da proposta, do movimento e do processo da Reforma Sanitária Brasileira (RSB), e à luz das teorias e críticas decolonial e feminista negra, este artigo de cunho ensaístico tem como objetivo propor um giro epistemológico e político para uma práxis sanitária decolonial. Em um primeiro momento, reflete acerca de alguns pontos de incoerência de certas dimensões da RSB que possivelmente contribuíram para que houvesse promessas não cumpridas em sua proposta. Na segunda parte do trabalho, (re)posiciona a analítica concernente à situação de colonialidade no Brasil com relação ao que está em jogo, na tentativa de “redemocratizar a vida” neste país. Finalmente, evidencia-se que, apesar de haver muito a avançar, asseguradamente a RSB não é um “movimento desnaturado”.

RESUMO O estudo analisou postagens no Twitter sobre Atenção Primária à Saúde (APS) a fim de identificar os problemas e as potencialidades referidos pelos usuários. Trata-se de uma pesquisa exploratória, qualitativa e observacional não participante, em que foram coletados 135.855 tweets publicados entre janeiro de 2020 e dezembro de 2021, analisados por meio da Mineração de Textos. Como resultado, do corpus analisado, foram identificadas quatro categorias temáticas não exclusivas, nomeadamente: Acessibilidade e Cobertura; Prestação de Serviços; Gestão e Recursos e Organização do SUS. Cinco modos de participação foram também identificados no debate sobre a APS: a denúncia, o compartilhamento de experiências positivas, a call for action, a accountability e a conscientização (awareness). Na especificidade da pandemia, críticas sistemáticas foram apresentadas relacionadas com as quatro dimensões analisadas. Apesar da existência dos problemas, a maior parte das denúncias não foram feitas de forma a explicitar um SUS-problema, mas um SUS-real. Reitera-se que o ciberespaço precisa ser devidamente apreendido enquanto lócus de investigação, pois ele é apropriado pelas pessoas para expressar suas opiniões e participar da vida cívica avaliando as políticas e os diversos componentes do sistema de serviços de saúde. APS (APS usuários Tratase Trata se exploratória participante 135855 135 855 135.85 202 2021 Textos resultado analisado exclusivas nomeadamente Cobertura Serviços SUS denúncia positivas action awareness. awareness . (awareness) pandemia analisadas SUSproblema, SUSproblema problema, problema SUS-problema SUSreal. SUSreal real. real SUS-real Reiterase Reitera investigação saúde 13585 13 85 135.8 20 (awareness 1358 1 8 135. 2

ABSTRACT The study analyzed Twitter posts about Primary Health Care (PHC) to identify the problems and strengths mentioned by users. It is a qualitative, non-participant observational, and exploratory research, in which 135.855 tweets published between January 2020 and December 2021 were collected and analyzed using Text Mining, a methodological procedure similar to Content Analysis. As a result, four non-exclusive thematic categories were identified from the analyzed corpus: Accessibility and Coverage, Service Delivery, Management and Resources, and SUS Organization (referring to the Brazilian Unified Health System). Five modes of participation in the debate on PHC were also identified: denunciation, sharing of positive experiences, call for action, accountability, and awareness. In the specificity of the pandemic, systematic criticisms were presented related to the four analyzed dimensions. Despite the problems, most of the complaints were not made in a way that explicitly highlighted a problematic SUS, but a real SUS. It is emphasized that cyberspace needs to be properly understood as a locus of investigation, as it is used by people to express their opinions and participate in civic life by evaluating policies and the various components of the health services system. (PHC users qualitative nonparticipant non participant observational research 135855 135 855 135.85 202 Mining Analysis result nonexclusive exclusive corpus Coverage Delivery Resources referring System. System . System) denunciation experiences action accountability awareness pandemic dimensions investigation system 13585 13 85 135.8 20 1358 1 8 135. 2

ABSTRACT Epidemics and outbreaks caused by the dengue virus pose risks to populations and have high mortality rates, causing burdens and economic costs worldwide. Brazil recently experienced an explosive increase in the number of dengue cases and fatalities. Dengue is an acute febrile illness that can progress to severe forms. It affects more than 100 countries, presenting ongoing challenges in Brazil and globally since its identification. Other conditions may be overlooked or mistaken for dengue. The most important differential diagnoses are other infectious diseases and rheumatological, hematological, gastroenterological, and neurological disorders. In this article, we discuss the primary differential diagnoses of dengue and offer a literature review highlighting the key clinical differences among clinicians. This review emphasizes the critical importance of differentiating dengue fever from infectious diseases such as meningococcemia and malaria and autoimmune and rheumatological conditions such as systemic lupus erythematosus to ensure timely and appropriate management. rates worldwide fatalities forms 10 countries identification hematological gastroenterological disorders article clinicians management 1

RESUMO O objetivo deste trabalho foi identificar o momento ótimo para substituição de um Harvester utilizado na colheita florestal, comparando diferentes métodos econômicos. A máquina florestal utilizada foi o Harvester John Deere modelo 1270D, com cabeçote modelo 270. O custo da máquina por hora trabalhada foi calculado pela soma dos custos fixos com os custos variáveis. Os métodos utilizados para determinação da substituição ótima da máquina foram o Custo Médio Total (CMT) e o Custo Anual Equivalente (CAE), que consideram funções discretas e o Ciclo Terminal e Cadeia de Substituição Constante, que consideram funções contínuas. Os quatro métodos utilizados diferiram entre si na indicação do momento ótimo de substituição do Harvester. O CMT, apesar de ser um método simples e conhecido, não conduziu a um resultado adequado (2 anos), pois, a substituição de uma máquina florestal é usualmente feita com um período maior de uso, com as atuais rotinas de manutenção preventivas e preditivas. Tal divergência é justificada devido aos elevados valores de aquisição e de custo operacional, além do método não considerar a variação do capital no tempo (a taxa de juros) e as receitas ou a produção do Harvester, o que impacta drasticamente a análise. O CAE, por utilizar a taxa de desconto, foi mais eficiente que o CMT e forneceu um resultado mais coerente com a realidade do setor florestal, sendo 6 anos. Além disso, é o método mais difundido nos estudos de substituição de máquinas e equipamentos, por ser simples, de fácil aplicação e eficiente. Já o método da Cadeia de Substituição forneceu um momento ótimo de substituição entre 7 e 8 anos, também coerente com a realidade das empresas do setor florestal que praticam a atividade de colheita florestal por um longo período. Portanto, este método pode ser considerado na tomada de decisão, por considerar as variáveis de custo e receita da máquina. A determinação da vida útil de uma máquina utilizada na colheita florestal, do ponto de vista econômico, ou o período em que ela executa suas atividades com menor custo operacional está diretamente relacionada com seu menor custo de produção, e no presente estudo, os métodos mais adequados para determinar o momento ótimo de substituição do Harvester foram o CAE e o método da Cadeia de Substituição. econômicos 1270D D 270 (CMT , (CAE) Constante contínuas conhecido 2 ( anos anos) pois uso preditivas juros análise desconto disso equipamentos Portanto decisão econômico estudo 27 (CAE

ABSTRACT This research sought to identify the ideal timeframe for replacing a Harvester, used in forest harvesting, employing a comparative evaluation of different economic methods. A John Deere 1270D harvester, equipped with a 270-model head was utilized in this study. The machine’s cost per hour worked was calculated by adding fixed costs with variable costs. The methods used to determine the machine’s optimal replacement time were: the Total Average Cost (TAC) and the Equivalent Annual Cost (EAC), which consider discrete functions, and the Terminal Cycle and Constant Chain Replacement, which consider continuous functions. The four methods differed in their indication of the optimal replacement time for the harvester. Although the TAC is a simple and well-known method, it did not yield an adequate result (2 years). This is because replacing a forest machine usually occurs over a longer period of use, with current preventive and predictive maintenance routines. This discrepancy arises from the high acquisition and operational costs, as well as the method’s failure to account for the variation of capital over time (interest rate) and the revenues or production of the harvester, which significantly affects the analysis. Utilizing the discount rate, the EAC proved to be more efficient than the TAC, yielding a result that is more aligned with the reality of the forest sector (6 years). Furthermore, it is the most widespread method in machine and equipment replacement studies due to its simplicity, ease of application, and efficiency. The Chain Replacement method provided an optimal replacement time between 7 and 8 years, also consistent with the reality of companies in the forest sector engaged in forest harvesting for an extended period. Therefore, this method can be considered in decision-making as it takes into account the cost and revenue variables of the machine. Determining the useful life of a machine used in forest harvesting from an economic perspective, or the period in which it performs its activities with the lowest operational cost, is directly related to its lowest production cost. In the present study, the most suitable methods to determine the optimal replacement time for the harvester were the EAC and the Chain Replacement method. Harvester D 270model model 270 study machines s (TAC EAC, , (EAC) functions wellknown known 2 ( years. years . years) use routines interest rate analysis 6 Furthermore simplicity application efficiency Therefore decisionmaking decision making perspective 27 (EAC

Abstract Introduction Treatment-free remission (TFR) is successful in half of the patients with chronic myeloid leukemia who discontinue Imatinib (IM) after sustained molecular response. Methods In a prospective trial, we used pioglitazone for 3 months before stopping IM in 30 patients. Percentages of peripheral blood lymphocyte subsets were assessed before and after treatment. The relation of these data with duration of IM treatment and TRF were examined. Results The median time of IM treatment was 117.6 months. After discontinuation, 11 patients had molecular recurrence after 5.2 months (2.4 - 30). The observation time for those remaining in TFR was 46 (26 - 56) months. The independent factors for the maintenance of TFR were the duration of IM treatment and the percentage of double-positive T cells at IM stop. Conclusion A longer treatment with imatinib was associated with a longer TFR after discontinuation. Pioglitazone could act as an immunomodulator, increasing DP T cells which may contribute to prevent relapse. Treatmentfree Treatment free (TFR (IM response trial examined 1176 117 6 117. discontinuation 1 52 5 2 5. 2.4 24 4 (2. 30. . 30) 26 (2 56 doublepositive double positive stop immunomodulator relapse 2. (

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (

Abstract Objective To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis. Methods We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil. Results Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 – 3.72, p = 0.0366) than those who underwent breast-conserving surgery. Conclusion Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973. outcomes demographic (BC 2years followup follow up GBECAM0115 GBECAM (GBECAM0115 study 201 Brazil 297 59 3 5.8% 58 5 8 (5.8% followup. up. 8.25% 825 25 (8.25 vs 279 79 2.79% 309 09 3.09 139 39 1.3 703 7 03 7.03 0.007. 0007 0.007 . 0 007 0.007) skinsparing skin sparing 8.1% 81 (8.1 449 4 49 4.49% 197 97 1.97 9 104 04 1.0 372 72 3.72 0.0366 00366 0366 breastconserving conserving surgery longterm long term stressors treatment Registration NCT02663973 NCT GBECAM011 (GBECAM011 20 29 5.8 (5.8 8.25 82 (8.2 27 2.79 30 3.0 13 1. 70 7.0 000 0.00 00 8.1 (8. 44 4.49 19 1.9 10 37 3.7 0.036 0036 036 NCT0266397 GBECAM01 (GBECAM01 5. (5. 8.2 2.7 3. 7. 0.0 8. (8 4.4 0.03 003 NCT026639 GBECAM0 (GBECAM0 (5 2. 0. ( 4. NCT02663 (GBECAM NCT0266 NCT026 NCT02 NCT0

RESUMO Objetivo: avaliar a necessidade de desenvolver um aplicativo com informações sobre a vacina antissarampo para indígenas Warao. Métodos: Estudo quantitativo, realizado no abrigo de refugiados chamado Espaço de Acolhimento Tapanã, na cidade de Belém, Pará, Brasil. Amostra do estudo foi por conveniência. Os dados foram analisados de forma descritiva, por meio do software Bioestat 5.0. Resultados: foram entrevistados 21 indígenas Warao. Identificou-se que 91% (n=20) perderam o cartão de vacina; 91% (n=20) afirmaram que perderam o cartão de vacina mais de 3 vezes e 91% afirmaram que gostariam de um aplicativo para guardar suas informações de vacina. Conclusões: A pesquisa ofereceu informações importantes para a construção de um aplicativo em saúde chamado WaraoMedI (Warao Mesles Diversity Indigenous), assim como disponibilizou aos profissionais de enfermagem evidências sobre as dificuldades de os indígenas Warao refugiados autogerenciarem informações sobre vacina. Objetivo Métodos quantitativo Tapanã Belém Pará Brasil conveniência descritiva 50 5 0 5.0 Resultados 2 Identificouse Identificou se 91 n=20 n20 n 20 (n=20 Conclusões Indigenous, Indigenous , Indigenous) 5. 9 n=2 n2 (n=2 n= (n= (n

ABSTRACT Objective: To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people. Methods: This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software. Results: Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information. Conclusions: The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information. Objective people Methods Belém Pará Brazil convenience 50 5 0 5. software Results Twentyone Twenty one interviewed 91 n=20 n20 n 20 (n=20 times Conclusions Indigenous, Indigenous , Indigenous) selfmanaging self managing 9 n=2 n2 2 (n=2 n= (n= (n

RESUMEN Objetivo: evaluar la necesidad de desarrollar una aplicación con información sobre la vacuna contra el sarampión para los indígenas Warao. Métodos: Estudio cuantitativo, realizado en el refugio de refugiados llamado Espacio de Acolhida Tapanã, en la ciudad de Belém, Pará, Brasil. La muestra del estudio fue por conveniencia. Los datos fueron analizados de forma descriptiva, mediante el software Bioestat 5.0. Resultados: se entrevistaron a 21 indígenas Warao. Se identificó que el 91% (n=20) perdieron su tarjeta de vacunación; el 91% (n=20) afirmó que perdió la tarjeta de vacunación más de 3 veces y el 91% afirmó que les gustaría una aplicación para guardar su información de vacunación. Conclusiones: La investigación proporcionó información importante para la construcción de una aplicación de salud llamada WaraoMedI (Warao Measles Diversity Indigenous), así como proporcionó a los profesionales de enfermería evidencia sobre las dificultades de los indígenas Warao refugiados para autogestionar información sobre vacunación Objetivo Métodos cuantitativo Tapanã Belém Pará Brasil conveniencia descriptiva 50 5 0 5.0 Resultados 2 91 n=20 n20 n 20 (n=20 Conclusiones Indigenous, Indigenous , Indigenous) 5. 9 n=2 n2 (n=2 n= (n= (n

Resumo Por meio de um esforço analítico-interpretativo de releitura dos fatos históricos apresentados acerca da ideia, da proposta, do movimento e do processo da Reforma Sanitária Brasileira (RSB), e à luz das teorias e críticas decolonial e feminista negra, este artigo de cunho ensaístico tem como objetivo propor um giro epistemológico e político para uma práxis sanitária decolonial. Em um primeiro momento, reflete acerca de alguns pontos de incoerência de certas dimensões da RSB que possivelmente contribuíram para que houvesse promessas não cumpridas em sua proposta. Na segunda parte do trabalho, (re)posiciona a analítica concernente à situação de colonialidade no Brasil com relação ao que está em jogo, na tentativa de “redemocratizar a vida” neste país. Finalmente, evidencia-se que, apesar de haver muito a avançar, asseguradamente a RSB não é um “movimento desnaturado”. analíticointerpretativo analítico interpretativo ideia proposta RSB, , (RSB) negra momento trabalho reposiciona re posiciona jogo redemocratizar vida país Finalmente evidenciase evidencia se avançar desnaturado. desnaturado . desnaturado” (RSB

Abstract By an analytical-interpretative effort of re-reading the historical facts regarding the idea, proposal, movement, and process of the Brazilian Health Care Reform (HCR) in light of decolonial and Black Feminist theories and critics, this study aims to propose an epistemological and political turn toward a decolonial health praxis. In a first moment, it reflects about some points of incoherence of certain dimensions in the HCR proposal. The second part of this studyd (re)positions this analysis concerning the coloniality situation in Brazil regarding what lies at stake in the attempt of “life redemocratization” in this country. Finally, it highlights that despite much progress to be made, the Brazilian Health Reform is assuredly not a “denatured movement.” analyticalinterpretative analytical interpretative rereading re reading idea proposal movement (HCR critics praxis moment repositions positions life redemocratization country Finally made denatured movement.

ABSTRACT The study analyzed Twitter posts about Primary Health Care (PHC) to identify the problems and strengths mentioned by users. It is a qualitative, non-participant observational, and exploratory research, in which 135.855 tweets published between January 2020 and December 2021 were collected and analyzed using Text Mining, a methodological procedure similar to Content Analysis. As a result, four non-exclusive thematic categories were identified from the analyzed corpus: Accessibility and Coverage, Service Delivery, Management and Resources, and SUS Organization (referring to the Brazilian Unified Health System). Five modes of participation in the debate on PHC were also identified: denunciation, sharing of positive experiences, call for action, accountability, and awareness. In the specificity of the pandemic, systematic criticisms were presented related to the four analyzed dimensions. Despite the problems, most of the complaints were not made in a way that explicitly highlighted a problematic SUS, but a real SUS. It is emphasized that cyberspace needs to be properly understood as a locus of investigation, as it is used by people to express their opinions and participate in civic life by evaluating policies and the various components of the health services system.

RESUMO O estudo analisou postagens no Twitter sobre Atenção Primária à Saúde (APS) a fim de identificar os problemas e as potencialidades referidos pelos usuários. Trata-se de uma pesquisa exploratória, qualitativa e observacional não participante, em que foram coletados 135.855 tweets publicados entre janeiro de 2020 e dezembro de 2021, analisados por meio da Mineração de Textos. Como resultado, do corpus analisado, foram identificadas quatro categorias temáticas não exclusivas, nomeadamente: Acessibilidade e Cobertura; Prestação de Serviços; Gestão e Recursos e Organização do SUS. Cinco modos de participação foram também identificados no debate sobre a APS: a denúncia, o compartilhamento de experiências positivas, a call for action, a accountability e a conscientização (awareness). Na especificidade da pandemia, críticas sistemáticas foram apresentadas relacionadas com as quatro dimensões analisadas. Apesar da existência dos problemas, a maior parte das denúncias não foram feitas de forma a explicitar um SUS-problema, mas um SUS-real. Reitera-se que o ciberespaço precisa ser devidamente apreendido enquanto lócus de investigação, pois ele é apropriado pelas pessoas para expressar suas opiniões e participar da vida cívica avaliando as políticas e os diversos componentes do sistema de serviços de saúde.

Resumo Introdução: O diagnóstico por imagem da neoplasia pseudopapilar sólida do pâncreas (NPS) é difícil. O diagnóstico pré-operatório obtido pela endosonografia com punção aspirativa por agulha fina (USE-PAF) é possível e tem sido relatado na literatura em tumores do pâncreas. No entanto, sua indicação é controversa e merece discussão. O objetivo do estudo foi determinar a acurácia da USE-PAF no diagnóstico de pacientes com NPS, descrever os achados da tomografia computadorizada (TC), colangiopancreatografia por ressonância magnética (RM/CPRM) e USE, comparando os métodos de imagem isolados aos achados da microhistologia (McH) obtida pela USE-PAF. Material e Métodos: Revisamos retrospectivamente os prontuários de pacientes submetidos à USE-PAF com suspeita de NPS em exames de imagem de 5 hospitais brasileiros de alto volume (dois universitários e três privados). Foram anotados prospectivamente os dados demográficos, os achados da TC, RM/CPRM e USE e o re sultado da McH obtida pela USE-PAF. O diagnóstico final foi obtido após o anatomopatológico da peça operatória em todos os pacientes (padrão-ouro). Comparamos os resultados da TC, RM/CPRM, EUS isoladas e da McH obtida pela USE-PAF com o padrão-ouro. Resultados: Cinquenta e quatro pacientes foram incluídos no estudo, 49 (90.7%) eram mulheres com média de idade de 33.4 (11-78) anos. O sintoma mais frequente foi dor abdominal, presente em 35.2%. A NPS foi detectada acidentalmente em 32 (59%) pacientes. O tamanho médio da lesão foi de 3.8 cm (SD: 2.26). O achado mais comum à USE foi lesão sólida, sólida/cística e cística em 52.9%, 41.1% e 7.8%, respectivamente. O diagnóstico final foi NPS (51) e tumor neuroendócrino pancreático não funcionante [NF-NET] (3). O diagnóstico correto feito pela TC, RM, USE e USE-PAF foi feito em 21.9%, 28.9%, 64.7% e 88.2, respectivamente. A USE-PAF associada a TC e a RM aumentou o desempenho diagnóstico de 21.9% para 94.1% e de 28.8% para 94.1%, respectivamente. Conclusões: NPS são raras, identificadas de forma acidental na maioria dos casos e afetam principalmente mulheres jovens. O diagnóstico diferencial entre NPS, NF-NET e outros tipos de lesões com exames de imagem isolados pode ser difícil. A USE-PAF aumenta a chance do diagnóstico pré-operatório em caso de dúvida diagnóstica e deve ser usado sempre que necessário para descartar NF-NET ou outro tipo de lesão nodular sólida ou sólido/cística do pâncreas.

Abstract Introduction: Imaging diagnosis of pancreatic solid-pseudo-papillary neoplasms (SPNs) is difficult. Preoperative diagnosis by endosonography-guided fine-needle aspiration (EUS-FNA) is possible and has been reported in the literature in pancreatic tumors. However, its usefulness is still controversial. The aim of this study was to determine the accuracy of the EUS-FNA in the diagnosis of patients with SPN and describe the findings in computerized tomography (CT), magnetic resonance cholangiopancreatography imaging (MRI/ MRCP), and EUS therefore comparing the imaging methods alone to the findings of microhistology (McH) obtained by EUS-FNA. Materials and Methods: We retrospectively reviewed the medical records of patients undergoing EUS-FNA with suspected SPN in imaging studies in 5 Brazilian high-volume hospitals (two university hospitals and three private hos-pitals). The demographic data; findings in CT, MRI/MRCP, and EUS; and McH results obtained by EUS-FNA were noted prospectively. The final diagnosis was obtained after the anatomopathological examination of the surgical specimen in all patients (gold standard), and we compared the results of CT, MRI/MRCP, EUS, and the McH with the gold standard. Results: Fifty-four patients were included in the study, of which 49 (90.7%) were women with an average age of 33.4 (range 11-78) years. The most common symptom presented was abdominal pain, present in 35.2% patients. SPN was detected incidentally in 32 (59%) patients. The average size of the tumors was 3.8 cm (SD: 2.26). The most common finding at EUS was a solid, solid/cystic, and cystic lesion in 52.9%, 41.1%, and 7.8% patients, respectively. The final diagnosis was 51 patients with SPN and 3 with nonfunctioning pancreatic neuro-endocrine tumors (NF-NET). The correct diagnosis was made by CT, MRI/MRCP, EUS isolated, and EUS-FNA in 21.9%, 28.88%, 64.71%, and 88.24%, respectively. EUS-FNA associated with CT and MRI increased diagnostic performance from 22.72% to 94.11% and from 29.16% to 94.11%, respectively. Conclusions: SPN are rare, incidentally identified in most cases, and affect young women. Differential diagnosis between SPN, NF-NET, and other types of tumors with imaging tests can be difficult. EUS-FNA increases preoperative diagnosis in case of diagnostic doubt and should be used whenever necessary to rule out NF-NET or other type of solid/cystic nodular lesion of the pancreas.

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness. Objectives evidencebased based Methods methods search citations studies inclusion Physicians Associations Association s interventions Results parts 1 radiologic AIDS therapy surgery boneanchored bone anchored implants CI. . (CI) Conclusions elucidated it pregnancy benefit stapedotomy deafness (CI