Methods used to determine pesticide residues in teas typically require several laborious steps for sample preparation before analysis. In this study, a simple method based on solid-liquid extraction with low-temperature partitioning (SLE/LTP) and analysis by gas chromatography coupled to mass spectrometry (GC-MS) was optimized and validated for the determination of pesticide residues (pirimiphos-methyl, flutriafol, cyproconazole, and bifenthrin) in dehydrated green tea leaves. After low-temperature partitioning (LTP), the extract in acetonitrile was subjected to a clean-up step using primary secondary amine (PSA) and octadecylsilane (C18) as sorbents for chlorophyll removal. The optimized SLE/LTP-GC-MS method was validated, and it proved to be effective and selective for extracting pesticides from green tea samples, presenting limit of detection (LOD) and limit of quantification (LOQ) of 0.015 and 0.050 mg kg-1, respectively. Recovery ranged between 81-111%, coefficients of variation were less than 16% and coefficients of determination (R2) were greater than 0.990. The optimized and validated method was applied to green tea and 13 other tea varieties sampled in South and Southeast regions of Brazil. The pesticides under study were detected in some of those samples at values higher than the maximum residue limits (MRLs) allowed by the European Union. solidliquid solid liquid lowtemperature low temperature SLE/LTP SLELTP SLE LTP (SLE/LTP GCMS GC MS (GC-MS pirimiphosmethyl, pirimiphosmethyl pirimiphos methyl, methyl (pirimiphos-methyl flutriafol cyproconazole bifenthrin leaves LTP, , (LTP) cleanup clean up PSA (PSA C18 C (C18 removal SLE/LTPGCMS SLELTPGCMS LOD (LOD LOQ (LOQ 0015 0 015 0.01 0050 050 0.05 kg1, kg1 kg 1, 1 kg-1 respectively 81111%, 81111 81 111%, 111 81-111% 16 R2 R (R2 0990 990 0.990 Brazil MRLs (MRLs Union (LTP C1 (C1 LTPGCMS 001 01 0.0 005 05 kg- 81111% 8111 8 111% 11 81-111 (R 099 99 0.99 (C 00 0. 811 81-11 09 9 0.9 81-1 81-

Abstract Objective It was to verify the association between the definition of sex of rearing and, clinical and cytogenetic features among patients with genital ambiguity referred without a sex assignment. Methods The sample consisted of 133 patients with genital ambiguity seen at a single reference service. These patients did not have a defined social sex at the first consultation and their etiological diagnosis was obtained during follow-up. Results A total of 133 cases were included, 74 of which were reared as males and 59 as females. No correlation was found between the year of birth and the year of the first consultation with the definition of sex of rearing. However, the definition of sex of rearing was associated with age at the first consultation, severity of genital ambiguity, presence of palpable gonad(s), presence of uterus on ultrasound, karyotype, and diagnosis. Palpable gonad(s), more virilized genitalia, absence of a uterus on ultrasound, 46, XY karyotype, or a karyotype with sex chromosome abnormalities emerged as strong predictors for defining male sex. All 77 (58 %) patients over 18 years old had a gender identity in accordance with the sex of rearing; though 9 of 77 (12 %) had homo or bisexual orientation, especially girls with Congenital Adrenal Hyperplasia. Conclusions Clinical and cytogenetic data were strongly associated with the definition of the sex of rearing of children with genital ambiguity referred to a DSD center without sex assignment. Management in a specialized center allows the establishment of a gender identity in accordance with the sex of rearing. assignment 13 service followup. followup follow up. up follow-up included 7 5 females However gonads, gonads gonad s , gonad(s) ultrasound genitalia 46 58 (5 % 1 12 (1 orientation Hyperplasia gonad(s 4 (

Abstract Objective Evaluate the level of information of pediatricians about the diagnosis and management of cryptorchidism. Method A cross-sectional observational study was conducted using a form via the "Google Forms" platform. The study population included pediatricians and pediatric residents associated with the Brazilian Society of Pediatrics. Seven hundred twenty-eight responses were recorded and analyzed using IBM SPSS v21. Results 728 valid responses were obtained. Of these answers, only 20.5 % answered that the physical examination was sufficient for the diagnosis, and 79.4 % responded that they requested ultrasound as the best test to aid in diagnosing cryptorchidism. When questioned about the ideal age for referring a patient with cryptorchidism, the survey recorded 56.3 % of the responses defending the correct age as six months old, 30.2 % shortly after birth, and 13.2 % at two years old. Other topics were addressed in the form, such as the frequency of evaluation of testicular position and investigation for DDS, among others. Still, the answers to these questions were compatible with current manuals and guidelines on cryptorchidism. Conclusion It is evident that the understanding of the professionals consulted about the diagnosis and management of cryptorchidism needs to be updated with the current practices adopted and that pediatricians, in general, must maintain periodic programs on this subject. Therefore, this topic should be part of a continuing education program with pediatric surgery. crosssectional cross sectional Google Forms platform Pediatrics twentyeight twenty eight v21 v 72 obtained 205 20 5 20. 794 79 4 79. 563 56 3 56. old 302 30 2 30. birth 132 13 13. DDS others Still general subject Therefore surgery v2 7 1

Abstract Objective: To investigate the effectiveness of linezolid and vancomycin for the treatment of nosocomial infections in children under 12 years old. Data sources: This is a systematic review in which five randomized clinical trials about the effectiveness of linezolid and vancomycin, involving a total of 429 children with nosocomial infections, were evaluated. They were searched in scientific databases: PubMed, Bvs, and SciELO. Summary of findings: The main nosocomial infections that affected children were bacteremia, skin, and soft tissue infections followed by nosocomial pneumonia. Most infections were caused by Gram-positive bacteria, which all studies showed infections caused by Staphylococcus aureus, with methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci strains being isolated. Both linezolid and vancomycin showed high therapeutic efficacy against different types of nosocomial infections, ranging from 84.4% to 94% for linezolid and 76.9% to 90% for vancomycin. Patients receiving linezolid had lower rates of rash and red man syndrome compared to those receiving vancomycin. However, despite the adverse reactions, antimicrobials can be safely administered to children to treat nosocomial infections caused by resistant Gram-positive bacteria. Conclusion: Both linezolid and vancomycin showed good efficacy in the treatment of bacterial infections caused by resistant Gram-positive bacteria in hospitalized children. However, linezolid stands out regarding its pharmacological safety. Importantly, to strengthen this conclusion, further clinical trials are needed to provide additional evidence. Objective 1 old sources 42 evaluated databases PubMed Bvs SciELO findings bacteremia skin pneumonia Grampositive Gram positive methicillinresistant methicillin S MRSA (MRSA coagulasenegative coagulase negative isolated 844 84 4 84.4 94 769 76 9 76.9 90 However reactions Conclusion safety Importantly conclusion evidence 8 84. 7 76.

SUMMARY: Knowledge of the suboccipital space (OA) is essential for clinicians because its decrease is associated with headache. The aim of this study was to determine the differences in the length of the suboccipital space in lateral cephalograms of men and women of different age ranges. In this cross-sectional study, a total of 371 lateral cephalograms were analyzed. Descriptive statistics and the application of Student's t-test and ANOVA were performed to evaluate the association between the suboccipital space with sex and age. The mean distance of the suboccipital space was of 5.62 ± 2.7 mm, being higher in men than women (6.49 ± 2.8 mm and 5.09 ± 2.5 mm respectively, p < 0.001). Regarding age, the distance of the suboccipital space did not show significant variations. The length of the OA between men and women of different age groups also showed no significant differences. There is a great variability in the distance of the suboccipital space, which is observed to be more decreased in women; therefore, an individual analysis by lateral cephalograms is suggested in patients with chronic headaches.

RESUMEN: El conocimiento del espacio suboccipital (OA) es esencial para el clínico debido a que su disminución se asocia a posible causa de cefaleas. El objetivo de este estudio fue determinar las diferencias entre la longitud del espacio suboccipital en telerradiografías laterales entre hombres y mujeres de distintos rangos etarios. En este estudio transversal se analizaron un total de 371 telerradiografías laterales de cráneo. Se realizó estadística descriptiva y la aplicación de prueba T-Student y ANOVA para evaluar la asociación entre el espacio suboccipital con el género y la edad. La distancia media del espacio suboccipital fue de 5.62 ± 2.7 mm, siendo mayor en hombres que en mujeres (6.49 ± 2.8 mm y 5.09 ± 2.5 mm respectivamente, p<0.001). Con respecto a la edad, la distancia del espacio suboccipital no presentó variaciones significativas. La longitud del OA entre los hombres y mujeres de distintos grupos tampoco mostró diferencias significativas. Existe una gran variabilidad en la distancia del espacio suboccipital, el cual se observa más disminuido en mujeres, por lo que se sugiere un análisis individual mediante telerradiografía lateral frente a pacientes con cefaleas.

Abstract Objective: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). Methods: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. Results: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach’s alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett’s test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. Conclusion: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese. Objective 2 3 cases (SSIPPE translate adapt SSIPPEBr. SSIPPEBr Br . (SSIPPE-Br) Methods crosscultural cross cultural adaptation translations backtranslation, backtranslation back back-translation prefinal pre final crossculturally Brazil 13itens itens 13 Br. SSIPPEBr, Br, crosssectional sectional out (CABI used Results 12 97 9 7 9. 28 8 2. years 4 male Cronbachs Cronbach s alpha 086 0 86 0.8 089 89 0.89 consistency KMO 0755 755 0.755 Bartletts Bartlett 0.001 0001 001 705 70 5 70. variability 094 94 0.9 1 perfect pvalue p value Conclusion Portuguese (SSIPPE-Br 08 0. 075 75 0.75 0.00 000 00 09 07 0.7 0.0

RESUMEN Introducción: La relación entre las toxicomanías y el suicidio se asocian en su función como agente causal y precipitante de la conducta suicida. Objetivo: Determinar los factores pronósticos de la conducta suicida en pacientes adictos a sustancias psicoactivas. Métodos: Se desarrolló un estudio observacional transversal. Se trabajó con el universo, constituido por los pacientes adictos atendidos en el Hospital Militar Central “Dr. Carlos J. Finlay”, desde 2016 a 2019. Las variables estudiadas fueron: conducta suicida, función ejecutiva, edad, sexo, características clínicas del consumo, sustancia consumida, deterioro cognitivo, ansiedad y depresión. Se utilizaron técnicas de la estadística descriptiva e inferencial. Resultados: Se estudiaron 257 pacientes con consumo, fundamentalmente de alcohol y marihuana, con edad promedio de 34 años; predominó el sexo masculino (89 %). La conducta suicida estuvo presente en el 53,7 % (n= 138). Los principales factores pronósticos en los pacientes fueron: necesidad subjetiva de consumo (odd ratio-OR= 3,4), depresión (OR= 3,3), deterioro cognitivo (OR= 3,0), tener 30 años de edad o menos al iniciar el consumo (OR= 2,6), antecedentes familiares de adicción (OR=2,3), nivel escolar de 9no grado (OR= 2,0), recaer antes de los 6 meses de tratamiento (OR= 1,1), tiempo consumiendo de 20 años o menos (OR= 3,0) y consumir otras drogas diferentes al alcohol (OR= 2,1). Conclusiones: Los principales factores pronósticos de la conducta suicida en los pacientes adictos estudiados son la necesidad subjetiva de consumo, la depresión y el deterioro cognitivo.

ABSTRACT Introduction: The relationship between drug addiction and suicide is associated in its function as a causal and precipitating agent of suicidal behavior. Objective: To determine the prognostic factors of suicidal behavior in patients addicted to psychoactive substances. Methods: An observational and cross-sectional study was developed. It worked with the universe, made up of addicted patients treated at the Central Military Hospital "Dr. Carlos J. Finlay" from 2016 to 2019. The variables studied were: suicidal behavior, executive function, age, sex, clinical characteristics of consumption, substance consumed, cognitive impairment, anxiety and depression. Descriptive and inferential statistical techniques were used. Results: 257 patients with consumption, mainly of alcohol and marijuana, with an average age of 34 years were studied; the male sex predominated (89%). Suicidal behavior was present in 53.7% (n= 138). The main prognostic factors in the patients were: subjective need for consumption (odd ratio-OR= 3.4), depression (OR= 3.3), cognitive impairment (OR= 3.0), being 30 years of age or less at the start of the consumption (OR= 2.6), family history of addiction (OR= 2.3), 9th grade school level (OR= 2.0), relapse before 6 months of treatment (OR= 1.1), time consuming 20 years or less (OR= 3.0) and consuming drugs other than alcohol (OR= 2.1). Conclusions: The main prognostic factors of suicidal behavior in the addicted patients studied are: the subjective need for consumption or craving, depression and cognitive impairment.

RESUMO Introdução: Problemas renais podem ser devido apenas ao baixo peso ao nascer ou podem ocorrer em associação com outras condições. O objetivo deste estudo foi avaliar a associação entre características maternas e de nascimento, medidas antropométricas e déficit da função renal em bebês de baixo peso ao nascer. Métodos: Estudo transversal com crianças que nasceram com peso < 2500 gramas e estavam sob acompanhamento ambulatorial. Os fatores maternos investigados foram cuidados pré-natal e presença de hipertensão, diabetes e infecção durante a gravidez. As variáveis das crianças foram sexo, idade gestacional, peso ao nascer, índice Apgar, uso de medicamentos nefrotóxicos, idade, peso corporal no momento da avaliação, altura e dosagens séricas de creatinina e cistatina C. A taxa de filtração glomerular (TFG) foi estimada com a equação combinada de Zapittelli. Utilizou-se um modelo de regressão logística multivariada para identificação de fatores associados, com déficit da função renal (TFG < 60 mL/min/1,73 m2) como variável dependente. Resultados: Das 154 crianças avaliadas, 34,42% apresentaram déficit da função renal. A maioria tinha idade gestacional > 32 semanas (56,6%), peso médio ao nascer de 1439,7 gramas, e TFG média estimada de 46,9 ± 9,3 mL/min/1,73 m2. Houve uma associação significativa da TFG < 60 mL/min/1,73 m2 com o peso atual das crianças e o uso de medicamentos nefrotóxicos. Discussão: Crianças nascidas com baixo peso apresentaram alta prevalência de déficit da função renal e o peso atual normal foi um fator de proteção, enquanto o uso de medicamentos nefrotóxicos durante o período perinatal aumentou a chance de déficit renal. Estes achados reforçam a necessidade de avaliar a função renal destas crianças, especialmente aquelas que usam medicamentos nefrotóxicos. Introdução condições nascimento Métodos 250 ambulatorial prénatal pré natal hipertensão gravidez sexo Apgar avaliação C Zapittelli Utilizouse Utilizou se associados 6 mLmin173 mLmin mL min 1 73 mL/min/1,7 m dependente Resultados 15 avaliadas 3442 34 42 34,42 3 56,6%, 566 56,6% , 56 (56,6%) 14397 1439 7 1439, 469 46 9 46, 93 9, Discussão proteção 25 mLmin17 mL/min/1, 344 4 34,4 56,6 5 (56,6% 143 2 mLmin1 mL/min/1 34, 56, (56,6 14 mL/min/ (56, mL/min (56 (5 (

ABSTRACT Introduction: Kidney problems may be due to low birth weight alone or may occur in association with other conditions. The objective this study was to evaluate the association between maternal and birth characteristics, anthropometric measurements, and kidney function deficit in low birth weight infants. Methods: Cross-sectional study with children who were born weighing < 2500 grams and were under outpatient follow-up. Maternal factors investigated were prenatal care and presence of hypertension, diabetes, and infection during pregnancy. The children’s variables were sex, gestational age, birth weight, Apgar score, use of nephrotoxic medications, age, body weight at the time of evaluation, height, and serum creatinine and cystatin C dosages. The glomerular filtration rate (GFR) was estimated with the combined Zapittelli equation. Multivariate logistic regression model was used for identification of associated factors, with renal function deficit (GFR < 60 mL/min/1.73 m2) as the dependent variable. Results: Of the 154 children evaluated, 34.42% had kidney function deficit. Most of them had a gestational age > 32 weeks (56.6%), a mean birth weight of 1439.7 grams, and mean estimated GFR of 46.9 ± 9.3 mL/min/1.73 m2. There was a significant association of GFR < 60 mL/min/1.73 m2 with children’s current weight and use of nephrotoxic drugs. Discussion: Children born with low birth weight had a high prevalence of kidney function deficit and current normal weight was a protective factor while the use of nephrotoxic drugs during perinatal period increased the chance of kidney deficit. These findings reinforce the need to evaluate the kidney function in these children, especially those who use nephrotoxic drugs. Introduction conditions characteristics measurements infants Methods Crosssectional Cross sectional 250 followup. followup follow up. up follow-up hypertension diabetes pregnancy childrens s sex score medications evaluation height dosages equation 6 mLmin173 mLmin mL min 1 73 mL/min/1.7 m variable Results 15 evaluated 3442 34 42 34.42 3 56.6%, 566 56.6% , 56 (56.6%) 14397 1439 7 1439. 469 46 9 46. 93 9. Discussion 25 mLmin17 mL/min/1. 344 4 34.4 56.6 5 (56.6% 143 2 mLmin1 mL/min/1 34. 56. (56.6 14 mL/min/ (56. mL/min (56 (5 (

Abstract Background: Short bowel syndrome (SBS) is one of the most frequent causes of intestinal failure, needing parenteral nutrition to maintain an energy-protein and water-electrolyte balance. At the Hospital Infantil de México Federico Gómez (HIMFG), the formation of two stomas is a technique used for intestinal rehabilitation, where the use of residue through the bypass technique (BT) helps to maintain gastrointestinal functionality, water-electrolyte, and nutritional stability. This study aimed to describe the technique of using intestinal residue through BT as a treatment strategy in intestinal rehabilitation and its effect on the biochemical and nutritional status of pediatric patients with SBS. Methods: An analytical and retrospective cross-sectional study was performed in patients hospitalized at HIMFG with SBS who underwent BT during their hospital stay between 2019 and 2020 and then followed up for 8 weeks. Results: A total of 10 patients were included in this study, with a mean age of 24 months; 50% were female. BT was able to reduce the inflammatory process in the liver caused by the continuous use of parenteral nutrition; enteral caloric intake increased from 25.32 kcal/kg/day to 72.94 kcal/kg/day, but it was insufficient to improve their nutritional status. Conclusions: BT is a safe and effective alternative in intestinal rehabilitation in patients with SBS to stimulate trophism and intestinal functionality, allowing a progression of enteral feeding and a decrease in the hepatic inflammatory process that occurs in these patients with prolonged parenteral nutrition.

Resumen Introducción: El síndrome de intestino corto (SIC) es una de las causas más frecuentes de insuficiencia intestinal que requiere del uso de nutrición parenteral para mantener un balance energético-proteico e hidroelectrolítico. En el Hospital Infantil de México Federico Gómez (HIMFG) la formación de dos estomas es una técnica empleada para la rehabilitación intestinal, donde con el aprovechamiento de residuo mediante la técnica de puenteo (TP) se ayuda a mantener la funcionalidad gastrointestinal, equilibrio hidro-electrolítico y estabilidad nutricional. El objetivo de este estudio fue describir la técnica del aprovechamiento de residuo intestinal mediante TP como estrategia de tratamiento en la rehabilitación intestinal y su efecto en el estado bioquímico y nutricional de pacientes pediátricos con SIC. Métodos: Se llevó a cabo un estudio transversal analítico y retrospectivo en pacientes hospitalizados en el HIMFG con SIC en quienes se realizó la TP durante su estancia intrahospitalaria entre 2019 y 2020. Resultados: Se incluyeron 10 pacientes en este estudio, con una edad promedio de 24 meses, y el 50% de sexo femenino. La TP logró disminuir el proceso inflamatorio hepático ocasionado por el uso continuo de nutrición parenteral; la ingesta calórica por vía enteral incrementó de 25.32 kcal/kg/día a 72.94 kcal/kg/día, pero fue insuficiente para mejorar el estado nutricional. Conclusiones: La TP es una alternativa segura y efectiva en la rehabilitación intestinal en pacientes con SIC para estimular el trofismo y funcionalidad intestinal, permitiendo una progresión de la alimentación enteral y disminución del proceso inflamatorio hepático que se presentan en estos pacientes con nutrición parenteral prolongada.

Abstract Objective: To determine the effectiveness of tele rehabilitation versus supervised treatment in the functional recovery of patients with distal radius fracture. Method: A randomized clinical trial was conducted that included 91 patients with distal radius fractures grades AO23 A and AO23B, which were randomly assigned to a treatment group, the supervised rehabilitation group received for two weeks a program of 10 treatment sessions and the tele rehabilitation group received through the Moodle platform instructions to carry out the rehabilitation program. Outcome measures (functionality, active range of motion, hand grip strength, quality of life and pain) were measured at the time of admission to rehabilitation and at 1, 3 and 6 months. Results: In both treatment groups at 6 months, statistically significant intragroup differences in functionality were demonstrated, with no intergroup differences. Conclusions: At 6 months, both rehabilitation programs increase functionality, range of motion, quality of life and decrease pain, without statistically significant differences intergroup.

Resumen Objetivo: Determinar la efectividad de la telerrehabilitación en comparación con el tratamiento supervisado en la recuperación funcional de los pacientes con fractura de radio distal. Método: Se realizó un ensayo clínico aleatorizado que incluyó 91 pacientes con fracturas de radio distal de grados AO23A y AO23B, los cuales se asignaron aleatoriamente a un grupo de rehabilitación supervisado que recibió durante 2 semanas un programa de 10 sesiones de tratamiento o un grupo de telerrehabilitación que mediante la plataforma de Moodle recibió instrucciones para realizar el programa de rehabilitación. Las medidas de resultado (funcionalidad, rango de movimiento activo, fuerza de prensión de la mano, calidad de vida y dolor) se midieron en el momento del ingreso a rehabilitación y a los 1, 3 y 6 meses. Resultados: A los 6 meses, ambos grupos de tratamiento demostraron diferencias estadísticamente significativas intragrupo en la funcionalidad, sin diferencias intergrupo. Conclusiones: A los 6 meses, ambos programas de rehabilitación aumentan la funcionalidad, el rango de movimiento y la calidad de vida, y disminuyen el dolor, sin diferencias estadísticamente significativas intergrupo.

This work aims to optimize the process of extracting pigments from the peel of Amazonian fruits (bacupari, peach palm, and tucumã) using the enzyme pectinase. First, pigment extraction was carried out using different solvents (ethanol and acetone 80%, ethanol and acetone 50%, and water), temperatures (44, 40, 35, and 26 °C), and wavelengths (400, 450, and 490 nm). In the second stage, the best parameters found in the first stage were applied in a statistic with a response surface varying time (60, 120, and 180 min) and enzyme concentration (40, 80, and 120 U). The best results for extraction for bacupari and peach palm were acetone at 50% and 45 °C and ethanol at 50% and 35 °C for tucumã. In the second stage, the optimum point found was 1.5 h and 100 U concentration, and 2.5 h and 90 U concentration resulted in better extractions for bacupari, peach palm, and tucumã. (bacupari tucumã pectinase First 80 80% 50 water, water , water) 44, 44 (44 40 2 °C, C °C) 400, 400 (400 450 49 nm. nm . nm) 60, 60 (60 18 min (40 12 U. U) 4 3 15 1 5 1. 10 25 2. 9 8 (4 6 (6 (

Stemodin (1) is a diterpene produced by Stemodia maritima L. (Scrophulariaceae) and shows antiviral and tumor cell proliferation inhibitory activities. Chemical modifications of 1 were performed to produce the known stemodinone (2), two new stemodinone oximes, Z (3) and E (4), and seven new oxime esters derivatives (5, 6, 7, 8, 9, 10, and 11). All derivatives were evaluated for their cytotoxic activity in HL60 (promyelocytic leukemia), SNB-19 (astrocytoma), HCT-116 (colon carcinoma), and PC3 (prostate) human cancer cell lines, and L929 (healthy murine cells). Oximes 3 and 4 showed lower cytotoxic values than 1 against all cancer cell lines tested. However, esters 9 and 10 exhibited cell growth inhibition percentages higher than 1 against PC3, SNB-19, and HCT-116 cancer cell lines, ranging from 62.96 to 94.27%. Many of these values exceed that presented by doxorubicin (66.05-86.87%). All compounds showed no cytotoxic effect on healthy cells at the tested concentration of 25 µg mL-1. (1 L Scrophulariaceae (Scrophulariaceae activities 2, 2 , (2) oximes (3 4, (4) 5, 5 (5 6 7 8 11. 11 . 11) HL HL6 promyelocytic leukemia, leukemia leukemia) SNB19 SNB 19 SNB-1 astrocytoma, astrocytoma (astrocytoma) HCT116 HCT 116 HCT-11 colon carcinoma, carcinoma carcinoma) PC prostate (prostate L92 cells. cells) However SNB19, 19, 6296 62 96 62.9 9427 94 27 94.27% 66.0586.87%. 66058687 66.05 86.87% 66 05 86 87 (66.05-86.87%) mL1. mL1 mL 1. mL-1 ( (2 (4 SNB1 SNB- (astrocytoma HCT11 HCT-1 L9 629 62. 942 94.27 0586 66.0586.87% 6605868 6605 66.0 8687 86.87 0 (66.05-86.87% mL- HCT1 HCT- 94.2 058 66.0586.87 660586 660 66. 868 86.8 (66.05-86.87 94. 66.0586.8 66058 86. (66.05-86.8 66.0586. (66.05-86. 66.0586 (66.05-86 66.058 (66.05-8 (66.05- (66.05 (66.0 (66. (66 (6

ABSTRACT BACKGROUND: There are several illness-specific cultural and system-based barriers to palliative care (PC) integration and end-of-life (EOL) care in the field of oncohematology. OBJECTIVES: This study aimed to investigate the variability in the perceptions of PC and EOL care. DESIGN AND SETTING: A cross-sectional study was conducted in the Hematology Division of our University Hospital in Salvador, Bahia, Brazil. METHODS: Twenty physicians responded to a sociodemographic questionnaire and an adaptation of clinical questionnaires used in previous studies from October to December 2022. RESULTS: The median age of the participants was 44 years, 80% of the participants identified as female, and 75% were hematologists. Participants faced a hypothetical scenario involving the treatment of a 65-year-old female with a poor prognosis acute myeloid leukemia refractory to first-line treatment. Sixty percent of the participants chose to follow other chemotherapy regimens, whereas 40% opted for PC. Next, participants considered case salvage for the patient who developed septic shock following chemotherapy and were prompted to choose their most probable conduct, and the conduct they thought would be better for the patient. Even though participants were from the same center, we found a divergence from the most probable conduct among 40% of the participants, which was due to personal convictions, legal aspects, and other physicians’ reactions. CONCLUSIONS: We found considerable differences in the perception of PC and EOL care among professionals, despite following the same protocols. The study also demonstrated variations between healthcare professionals’ beliefs and practices and persistent historical tendencies to prioritize aggressive interventions. BACKGROUND illnessspecific illness specific systembased system based (PC endoflife end life (EOL oncohematology OBJECTIVES SETTING crosssectional cross sectional Salvador Bahia Brazil METHODS 2022 RESULTS 4 years 80 75 hematologists 65yearold yearold 65 year old firstline first line regimens 40 Next center convictions aspects reactions CONCLUSIONS professionals protocols interventions 202 8 7 6 20 2

Abstract Objectives Olfactory loss is a recognized long-term dysfunction after Coronavirus Disease 2019 (COVID-19) infection. This investigation aimed to assess the effect of alpha-lipoic acid as an adjuvant treatment of olfactory training on the improvement of smell loss in post-COVID-19 patients. Methods This randomized controlled trial included 128 adult outpatients who had persistent smell loss for more than 3-months after COVID-19 infection. The participants were randomly allocated into two groups: the intervention treatment group, which received alpha-lipoic acid associated to olfactory training, and comparison treatment group, which received placebo pills associated to olfactory training. The participants were followed-up for 12-weeks. Olfactory dysfunction was assessed in terms of Visual Analog Scale (VAS), and the Connecticut Chemosensory Clinical Research Center (CCCRC) test for the Brazilian population. Results A total of 100 participants completed the follow-up period and were analyzed in this study. Both groups have improved CCCRC score (p= 0.000), olfactory threshold (p= 0.000), identification score (p= 0.000) and VAS score (p= 0.000) after 12-weeks follow-up. No significant differences were determined between the intervention and comparison treatment groups in CCCRC score (p= 0.63), olfactory threshold (p= 0.50), identification score (p= 0.96) and VAS score (p= 0.97). In all these criteria, comparison treatment group went slightly worse. At the endpoint of the study, the frequency of anosmia reduced to 2% in the intervention treatment group and to 7.8% in the comparison treatment group. Also, 16.8% of the intervention group’ subjects, and 15.7% of comparison treatment group’s patients reached normosmia. Conclusions Overall, there was a strongly significant difference in olfactory function between baseline and endpoint for both groups. However, based on the lack of significant difference between the intervention treatment and the comparison treatment groups in terms of olfactory changes, our study appoints that the alpha-lipoic acid is not better than olfactory training alone to treat olfactory loss after COVID-19. Level of evidence Level 2. longterm long term 201 COVID19 COVID 19 (COVID-19 infection alphalipoic alpha lipoic postCOVID19 postCOVID post post-COVID-1 12 3months months 3 COVID-1 followedup followed up 12weeks. 12weeks weeks weeks. VAS, , (VAS) (CCCRC population 10 followup follow p= p (p 0.000, 0000 0.000 0 000 followup. up. 0.63, 063 0.63 63 0.63) 0.50, 050 0.50 50 0.50) 0.96 096 96 0.97. 097 0.97 . 97 0.97) criteria worse 2 78 7 8 7.8 Also 168 16 16.8 subjects 157 15 15.7 s normosmia Overall However changes COVID19. 19. 20 COVID1 1 (COVID-1 postCOVID1 post-COVID- COVID- (VAS 0.00 00 06 0.6 6 05 0.5 5 0.9 09 9 7. 16. 15. (COVID- post-COVID 0.0 0. (COVID