Resumo Introdução: O hiperparatireoidismo secundário (HPTS) é uma das causas de inflamação na DRC. Avaliamos o impacto da paratireoidectomia (PTX) nas relações neutrófilo/linfócito (N/L) e plaqueta/linfócito (P/L) em pacientes com HPTS. Métodos: Foram analisados 118 pacientes [hemodiálise (HD, n = 81) e transplantados (TX, n = 37)] submetidos à PTX entre 2015 e 2021. Resultados: Houve redução significativa de cálcio e PTH nos dois grupos, além de elevação de vitamina D. No grupo HD, a PTX não mudou as relações N/L e P/L. Já no grupo TX, houve redução nas relações N/L e P/L acompanhadas de elevação significativa do número de linfócitos totais. Conclusão: As relações N/L e P/L não são marcadores fidedignos de inflamação em pacientes com HPTS submetidos à PTX. A uremia, que induz um estado de inflamação crônica em pacientes dialíticos, e o uso de imunossupressão em pacientes transplantados renais são alguns dos fatores de confusão que impedem o uso dessa ferramenta na prática clínica. Introdução (HPTS DRC (PTX neutrófilolinfócito neutrófilo linfócito NL N L (N/L plaquetalinfócito plaqueta PL P (P/L Métodos 11 hemodiálise HD (HD 81 TX (TX 37 37) 201 2021 Resultados grupos D totais Conclusão uremia dialíticos clínica 1 8 3 20 202 2

Abstract Introduction: Secondary hyperparathyroidism (SHPT) is one of the causes for inflammation in CKD. We assessed the impact of parathyroidectomy (PTX) on neutrophil-to-lymphocyte (N/L) and platelet-to-lymphocyte (P/L) ratios in SHPT patients. Methods: A total of 118 patients [hemodialysis (HD, n = 81), and transplant recipients (TX, n = 37)] undergoing PTX between 2015 and 2021 were analyzed. Results: There was a significant reduction in calcium and PTH levels in both groups, in addition to an increase in vitamin D. In the HD group, PTX did not alter N/L and P/L ratios. In the TX group, there was a reduction in N/L and P/L ratios followed by a significant increase in total lymphocyte count. Conclusion: N/L and P/L ratios are not reliable biomarkers of inflammation in SHPT patients undergoing PTX. Uremia, which induces a state of chronic inflammation in dialysis patients, and the use of immunosuppression in kidney transplant recipients are some of the confounding factors that prevent the use of this tool in clinical practice. Introduction (SHPT CKD (PTX neutrophiltolymphocyte neutrophil NL N L (N/L platelettolymphocyte platelet PL P (P/L Methods 11 hemodialysis HD, (HD 81, 81 , 81) TX, (TX 37 37) 201 202 analyzed Results groups D group count Conclusion Uremia practice 1 8 3 20 2

Resumo O presente artigo apresenta uma reflexão teórica sobre as interpretações da pobreza, sobretudo a pobreza urbana no período atual, com inspiração nas obras de Milton Santos. Fundamenta-se na teoria crítica da Geografia e outros diálogos possíveis para se contextualizar e se analisar a pobreza, entendida aqui como resultado da violência estrutural na formação territorial e das metrópoles brasileiras. Conclui-se que a pobreza é estrutural-urbana e pode estar direcionada para um debate qualitativo (e não somente no âmbito quantitativo) sobre a falta de dignidade humana, para buscar reconhecer a legitimidade da existência nos lugares. atual Santos Fundamentase Fundamenta brasileiras Concluise Conclui estruturalurbana quantitativo humana lugares

Abstract This article presents a theoretical reflection on interpretations of poverty, principally contemporary urban poverty, inspired by the works of Milton Santos. It is based on Geographical critical theory and other potential dialogues that contextualize and analyze poverty, understood here as the result of structural violence in territorial formation and Brazilian metropolises. It is concluded that poverty is structural-urban and can inform a qualitative debate (not only quantitative) on the lack of human dignity seeking to recognize the legitimacy of existence in places. Santos metropolises structuralurban not quantitative places

Resumen Este artículo presenta una reflexión teórica sobre las interpretaciones de la pobreza, especialmente la urbana en el período actual, inspirada en las obras de Milton Santos. Se fundamenta en la teoría crítica de la Geografía y otros diálogos posibles para contextualizar y analizar la pobreza, entendida aquí como resultado de la violencia estructural en la formación territorial y las metrópolis brasileñas. Se concluye que la pobreza es estructural-urbana y puede encaminarse hacia un debate cualitativo (y no sólo en el ámbito cuantitativo) sobre la falta de dignidad humana, para buscar reconocer la legitimidad de la existencia en los lugares. actual Santos brasileñas estructuralurbana cuantitativo humana lugares

Resumo Uma das principais dificuldades na implantação dos sistemas agroflorestais está na escolha das espécies componentes. Esta pesquisa objetivou verificar a viabilidade de utilização de duas espécies amazônicas em sistema agroflorestal, quantificando a possível interferência da espécie dominante (mogno-brasileiro) sobre a espécie do dossel inferior (cupuaçuzeiro). O experimento foi conduzido por 14 anos, em uma propriedade comercial em Tomé-Açu, PA. Foram estabelecidos quatro níveis de espaçamento entre as árvores de cupuaçuzeiro e mogno: Nível 1 = 2,3 m; Nível 2 = 5,5 m; Nível 3 = 7,3 m; Nível 4 = 8,8 m. Avaliaram-se o desenvolvimento vegetativo inicial do cupuaçuzeiro, a produção durante 12 safras e a taxa de mortalidade. Para o mogno, mensurou-se o vigor das plantas e realizaram-se estimativas de produção de madeira. Ademais, estimaram-se alguns parâmetros morfométricos para verificar a adaptação do mogno ao ambiente de SAF e sua influência sobre o cupuaçuzeiro. Os resultados demonstraram que o cupuaçuzeiro teve um bom desenvolvimento vegetativo, mostrando não ter sido prejudicado pela competição com as árvores de mogno. A produção de frutos também não foi afetada pelo consórcio, assim como não houve diferenças nas taxas de mortalidade nos diferentes níveis de proximidade das espécies. O mogno teve crescimento vigoroso, beneficiado pelos tratos culturais dispensados, normalmente, em pomares de cupuaçuzeiro, como adubação anual e aporte hídrico. Pelas evidências obtidas, conclui-se que o SAF constituído por mogno-brasileiro e cupuaçuzeiro, nos espaçamentos aqui utilizados, oferece condições apropriadas ao desenvolvimento de ambas as espécies, e poderá ser uma alternativa aos sistemas de produção convencionais na Amazônia, bem como para incrementar a restauração de áreas antropizadas com espécies nativas.

Abstract One of the main difficulties in implementing agroforestry systems is the choice of component species. This research aimed to verify the feasibility of using two Amazonian species in an agroforestry system, quantifying the possible interference of the dominant species (Brazilian mahogany) on the lower canopy species (cupuassu tree). The experiment was conducted for 14 years, on a commercial property in Tomé-Açu, PA. Four levels of spacing between cupuassu tree and mahogany trees were established: Level 1 = 2.3 m; Level 2 = 5.5 m; Level 3 = 7.3 m; Level 4 = 8.8 m. The initial vegetative development of the cupuassu tree, the production during 12 harvests, and the mortality rate were evaluated. For mahogany, the vigor of the plants was measured and wood production estimates were made. In addition, some morphometric parameters were estimated to verify the adaptation of mahogany to the SAF environment and its influence on cupuaçuzeiro. The results showed that the cupuassu tree had a good vegetative development, showing that it was not harmed by the competition with the mahogany trees. Fruit production was also not affected by the consortium, just as there were no differences in mortality rates at different levels of species proximity. Mahogany grew vigorously, benefiting from the cultural treatments normally provided in cupuassu tree orchards, such as annual fertilization and water supply. Based on the evidence obtained, it can be concluded that the SAF made up of Brazilian mahogany and cupuassu tree, in the spaces used here, offers appropriate conditions for the development of both species, and could be an alternative to conventional production systems in the Amazon, as well as, to increase the restoration of anthropized areas with native species.

Resumo Pacientes em hemodiálise são expostos ao cálcio, por meio do dialisato, pelo menos três vezes por semana. As alterações no cálcio sérico variam de acordo com a transferência de massa de cálcio durante a diálise, que é dependente do gradiente entre a concentração de cálcio no plasma e no dialisato (d [Ca]) e o estado de renovação do esqueleto que altera a capacidade do osso de incorporar cálcio. Embora subestimado, o d [Ca] pode potencialmente causar balanço positivo de cálcio que leva a danos em órgãos sistêmicos, incluindo associações com mortalidade, disfunção miocárdica, tolerabilidade hemodinâmica, calcificação vascular e arritmias. A fisiopatologia desses efeitos adversos inclui alterações do cálcio sérico, supressão do hormônio da paratireóide e calcificação vascular por meio de efeitos diretos e indiretos. Alguns órgãos são mais suscetíveis a alterações na homeostase do cálcio. Nesta revisão, discutimos os dados existentes e os mecanismos potenciais que ligam o d [Ca] ao equilíbrio do cálcio com a consequente disfunção no esqueleto, miocárdio e artérias.

Abstract Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.

Resumo Introdução: A composição corporal é fundamental para a avaliação de pacientes com Doença Renal Crônica (DRC), e pode ser obtida por análise de impedância bioelétrica por multifrequência (BIA) ou absorciometria de dupla energia (DXA). Embora a discrepância entre os resultados obtidos pelos dois métodos já tenha sido descrita, os motivos são desconhecidos e podem estar relacionados ao hiperparatireoidismo secundário, devido à perda óssea. Métodos: Avaliamos 49 pacientes (25 homens e 24 mulheres): 20 com DRC não em diálise e 29 em hemodiálise de manutenção [18 com hiperparatireoidismo grave (HD-SHPT) e 11 submetidos à paratireoidectomia (HD-PTX)]. Todos os pacientes foram submetidos à DXA e BIA. Resultados: A mediana da idade e do índice de massa corporal (IMC) foram de 49 anos e 25,6 kg/m2, respectivamente. Os pacientes exibiram baixo conteúdo mineral ósseo (CMO) medido pelo DXA, particularmente aqueles do grupo HD-SHPT. A maior discordância da medida do CMO entre DXA e BIA foi encontrada no grupo HD-SHPT (p = 0,004). Os fatores independentemente associados a essa discrepância na medida do CMO foram fosfato sérico (p = 0,003) e grupo de pacientes (p = 0,027), mesmo após ajustes para idade, IMC e sexo (r2 ajustado = 0,186). PTX atenuou essa diferença. Discussão: A BIA deve ser interpretada com cautela em pacientes com HPTS devido a uma perda de precisão, o que pode comprometer a interpretação da composição corporal.

Abstract Introduction: Body composition is critical for the evaluation of patients with Chronic Kidney Disease (CKD) and can be obtained from either multifrequency bioelectrical impedance analysis (BIA) or dual-energy absorptiometry (DXA). Although the discrepancy between the results obtained from both methods has already been described, reasons are unknown, and might be related to secondary hyperparathyroidism, which is associated with bone loss. Methods: We have evaluated 49 patients (25 males and 24 females): 20 with CKD not on dialysis and 29 on maintenance hemodialysis [18 with severe hyperparathyroidism (HD-SHPT) and 11 submitted to parathyroidectomy (HD-PTX)]. All patients underwent DXA and BIA. Results: The median age and body mass index (BMI) were 49 years and 25.6 kg/m2, respectively. Patients exhibited low bone mineral content (BMC) measured by DXA, particularly those from the HD-SHPT group. The largest BMC measurement disagreement between DXA and BIA was found in the HD-SHPT group (p=0.004). Factors independently associated with this discrepancy in BMC measurement were serum phosphate (p=0.003) and patient group (p=0.027), even after adjustments for age, BMI, and gender (adjusted r2=0.186). PTX attenuated this difference. Discussion: BIA should be interpreted with caution in patients with SHPT due to a loss of accuracy, which can compromise the interpretation of body composition.

ABSTRACT Knowing the relationship between the total suspended solids concentration (TSS), turbidity in the waters, and that turbidity analysis can be done faster and in less expensive way, this study aimed to obtain mathematical model to estimate the total suspended solids (TSS) concentration from the turbidity values for waters of Doce river basin. For this purpose, it was used the water quality database of the Minas Gerais Institute of Water Management (IGAM). The data were pre-treated using the adjusted boxplot technique followed by adjustment of curves for the different management units and rainfall regime period. It was verified the possibility of a single curve through the dummy variable technique, subsequently. With the results it was observed that the adjusted boxplot technique proved to be useful for environmental data. Linear relationships with R2 values, as a rule, were higher than 0.6, however, it was not possible to develop a single model. It is concluded that the generated models presented good adjustments being able to be used for predicting the concentration of TSS as a function of turbidity. However, each management unit in each period of rainfall regime presents particularities that were reflected in the prediction models.

ABSTRACT The achievement of all the water quality parameters that constitute the water quality indices can be a hamper to their use. The objective of this study was to analyze the viability of using minimum indices to monitor water quality, comparing different methods. For this purpose, the Environmental Company of the State of São Paulo database for the year 2016 of the Tietê/Jacaré and the Tietê/Batalha units was used. Four indices present in the literature were compared with the indices currently practiced in the states of São Paulo and Minas Gerais (“standard indices”). For feasibility analysis, the indices were classified by the “standard indices” methods and compared to them. The minimum indices were significantly correlated with the “standard indices”, from moderate to strong degree. The minimum indices, as a rule, overestimated water quality when compared to the index of the state of Minas Gerais; and underestimated when compared to the index of the state of São Paulo. It is concluded that the minimum indices are useful and practicable tools, with respect to the use of the WQI for management purposes. However, such indices should be evaluated periodically to avoid making mistaken decisions.

OBJECTIVES: Recent studies have shown a high prevalence of hypovitaminosis D, defined as a serum 25-hydroxyvitamin D level less than 30 ng/ml, in both healthy populations and patients with chronic kidney disease. Patients undergoing kidney transplant are at an increased risk of skin cancer and are advised to avoid sunlight exposure. Therefore, these patients might share two major risk factors for hypovitaminosis D: chronic kidney disease and low sunlight exposure. This paper describes the prevalence and clinical characteristics of hypovitaminosis D among patients undergoing kidney transplant. METHODS: We evaluated 25-hydroxyvitamin D serum levels in a representative sample of patients undergoing kidney transplant. We sought to determine the prevalence of hypovitaminosis D, compare these patients with a control group, and identify factors associated with hypovitaminosis D (e.g., sunlight exposure and dietary habits). RESULTS: Hypovitaminosis D was found in 79% of patients undergoing kidney transplant, and the major associated factor was low sunlight exposure. These patients had higher creatinine and intact parathyroid hormone serum levels, with 25-hydroxyvitamin D being inversely correlated with intact parathyroid hormone serum levels. Compared with the control group, patients undergoing kidney transplant presented a higher prevalence of 25-hydroxyvitamin D deficiency and lower serum calcium, phosphate and albumin but higher creatinine and intact parathyroid hormone levels. CONCLUSIONS: Our results confirmed the high prevalence of hypovitaminosis D in patients undergoing kidney transplant. Therapeutic strategies such as moderate sunlight exposure and vitamin D supplementation should be seriously considered for this population.

RESUMO Hemorragia subaracnóidea (HSA) proporciona alterações nas altas funções cerebrais. Contudo, há poucos trabalhos enfatizando as alterações da linguagem na HSA aneurismática e a influência da localização do aneurisma. Objetivos Analisar e comparar os desempenhos da linguagem e fluência verbal na HSA nos períodos pré e pós-cirúrgicos nos pacientes com aneurismas da comunicante anterior (AcomA), cerebral média (ACME) e comunicante posterior esquerdas (AcomPE). Métodos A avaliação da linguagem de 79 pacientes com HSA aneurismática foi realizada em duas ocasiões: pré e pós cirurgia. Eles foram divididos em três grupos de acordo com a localização do aneurisma. Resultados Os grupos apresentaram deterioração na avaliação pós-operatória com diferentes características. O grupo da ACME demonstraram deterioração na fluência e nomeação, enquanto o da AcomPE pioraram nos testes de linguagem escrita e fluência. Conclusões Após o tratamento cirúrgico, os pacientes deterioraram em vários itens de linguagem com diferenças relacionadas à localização do aneurisma.

ABSTRACT Sub-arachnoid hemorrhage (SAH) promotes impairment of upper cortical functions. However, few information is available emphasizing changes in language after aneurismal SAH and aneurysm location influence. Objective To assess the language and verbal fluency performance in aneurismal SAH pre- and post-surgery in patients caused by an aneurysm of the anterior communicating artery (AcomA), left middle cerebral artery (L-MCA) and left posterior comunicating artery (L-PcomA). Methods Assessment in 79 patients with SAH, on two occasions: pre- and post surgical treatment. They were divided into three groups by the aneurysms’ location. Results Deterioration is detected in the performance of all patients during the post-surgical period; L-MCA aneurysm patients displayed a reduction in verbal naming and fluency; L-PcomA patients deteriorated in the written language and fluency tasks. Conclusion After the surgical procedure the patients decreased in various language tasks and these differences in performance being directly related to the location of the aneurysm.

INTRODUÇÃO: A prevenção secundária após intervenção coronária percutânea (ICP) é fundamental para melhorar a sobrevida livre de eventos e consiste principalmente no controle de fatores de risco. Analisou-se a prevenção secundária de pacientes de alto risco, incluídos prospectivamente no estudo Sequence Variation in Platelet Aggregation in Response to Clopidogrel and aspirin (SPARC). MÉTODOS: Foram arrolados 187 pacientes consecutivos entre dezembro de 2009 e fevereiro de 2011, tratados por ICP com stent e avaliados em retornos ambulatoriais de 30 dias, 3 meses, 6 meses e 12 meses quanto ao controle de hipertensão arterial, disglicemia, dislipidemia e tabagismo, e medidas terapêuticas respectivas. RESULTADOS: Houve aumento significativo de pacientes com controle pressórico (29%; P = 0,02), que cessaram tabagismo (18%; P = 0,003), e que receberam hipolipemiantes (19%; P < 0,0001) entre a internação para ICP e o primeiro retorno após o procedimento. Esse melhora do controle de fatores de risco refletiu-se em redução do escore de risco de Framingham médio observado no mesmo período (9,9%; P < 0,0001). Durante seguimento de até 12 meses o ganho atingido na internação para ICP se manteve para todos os fatores de risco. CONCLUSÕES: Observou-se efeito importante relativamente à internação índice para ICP, com aumento da prescrição de medicamentos para controle de fatores de risco e alcance de metas. Esse estudo identifica relevante janela de oportunidade para priorização do controle de fatores de risco na internação inicial, quando ganhos expressivos são observados e mantidos. Mas também explicita que esforços adicionais são necessários para expandir o benefício da prevenção secundária no seguimento a médio prazo de pacientes tratados por ICP.

BACKGROUND: Secondary prevention after percutaneous coronary intervention (PCI) is essential to increase event-free survival and consists mainly in risk factor control. We analyzed the secondary prevention of high-risk patients included prospectively in the Sequence Variation in Platelet Aggregation in Response to Clopidogrel and aspirin trial (SPARC). METHODS: From December 2009 to February 2011 we enrolled 187 consecutive patients who were submitted to PCI with stent implantation and were evaluated in outpatient visits at 1, 3, 6, and 12 months of follow-up for the control of hypertension, dysglycemia, hyperlipidemia and smoking and their respective therapeutic measures. RESULTS: There was a significant increase in the number of patients with controlled hypertension (29%; P = 0.02), who stopped smoking (18%; P = 0.003), and received statins (19%; P < 0.0001) between the index PCI and the first follow-up visit. The risk factor control improvement led to a decrease in the mean Framingham risk score (9.9%; P < 0.0001). During the 12 months follow-up the gains achieved at PCI admission were maintained for all risk factors. CONCLUSIONS: An important effect was observed on the index PCI admission with increased prescription of risk factor control drugs and achievement of therapeutic goals. This study identifies a relevant opportunity window for risk factor control at the index admission, when substantial gains are observed and maintained. However, it also shows further efforts are required to expand the benefit of secondary prevention in the middle-term follow-up of patients treated by PCI.

Expression profile of a Laccase2 encoding gene during the metamorphic molt in Apis mellifera (Hymenoptera, Apidae). Metamorphosis in holometabolous insects occurs through two subsequent molting cycles: pupation (metamorphic molt) and adult differentiation (imaginal molt). The imaginal molt in Apis mellifera L. was recently investigated in both histological and physiological-molecular approaches. Although the metamorphic molt in this model bee is extremely important to development, it is not well-known yet. In the current study we used this stage as an ontogenetic scenario to investigate the transcriptional profile of the gene Amlac2, which encodes a laccase with an essential role in cuticle differentiation. Amlac2 expression in epidermis was contrasted with the hemolymph titer of ecdysteroid hormones and with the most evident morphological events occurring during cuticle renewal. RT-PCR semiquantitative analyses using integument samples revealed increased levels of Amlac2 transcripts right after apolysis and during the subsequent pharate period, and declining levels near pupal ecdysis. Compared with the expression of a cuticle protein gene, AmelCPR14, these results highlighted the importance of the ecdysteroid-induced apolysis as an ontogenetic marker of gene reactivation in epidermis for cuticle renewal. The obtained results strengthen the comprehension of metamorphosis in Apis mellifera. In addition, we reviewed the literature about the development of A. mellifera, and emphasize the importance of revising the terminology used to describe honey bee molting cycles.

Duas novas espécies de Desmiphorini, Blabicentrus alberti sp. nov. da Bolívia (Santa Cruz) e Inermestola chiapasensis sp. nov. do México (Chiapas), são descritas e ilustradas.

Two new species of Desmiphorini are described and illustrated: Blabicentrus alberti sp. nov. from Bolivia (Santa Cruz), and Inermestola chiapasensis sp. nov. from Mexico (Chiapas).

In order to assess the effectiveness of Metarhizium anisopliae var. anisopliae (Metschnikoff) Sorokin isolates in controlling the sugarcane root spittlebug Mahanarva fimbriolata (Stal) (Hemiptera: Cercopidae), nine isolates obtained from a single geographical region were studied. 'Confirmed cumulative' and 'corrected cumulative' spittlebug mortality rates were measured for each of the isolates. Based on the confirmed mortality curve, the isolates URM5946, URM5951 and URM6033 were considered to be potentially the most effective in a biological control program for M. fimbriolata.

Novas espécies descritas: Mauesia simplicis sp. nov. do Brasil (Mato Grosso) e M. panamensis sp. nov. do Panamá. Apresenta-se chave para identificação das espécies de Mauesia Lane, 1956.

Mauesia simplicis sp. nov. from Brazil (Mato Grosso) and M. panamensis sp. nov. from Panama are described. A key to the species of Mauesia Lane, 1956 is added.