RESUMO Este relato de caso apresenta um paciente feminino de 33 anos encaminhado para um serviço especializado de retina devido à leve perda de visão em olho direito. A acuidade visual foi de 20/25 no olho direito e 20/50 no olho esquerdo, o equivalente esférico foi de -12,75 dioptrias e -14,75 dioptrias, respectivamente. Avaliações multimodais revelaram isquese peripapilar nas camadas internas e externas da retina, descolamento vítreo posterior grau II e fundo tesselado. Avaliação funcional com perimetria Humphrey e microperimetria MP-3 revelaram sensibilidade macular normais e diminuição da sensibilidade na região peripapilar, especialmente no olho direito. Potencial visual evocado de padrão reverso apresentou no olho direito latência e amplitude N75 e P100 dentro dos valores normais para verificação de 1º. Entretanto, a amplitude foi baixa para a de 15′. Pacientes alto míopes com esfiloma posterior envolvendo o nervo óptico são suscetíveis à tração da hialoide posterior. Portanto a tração vitreopapilar resultante pode causar comprometimento da visão. 3 2025 20 25 20/2 2050 50 20/5 esquerdo 12,75 1275 12 75 -12,7 14,75 1475 14 -14,7 respectivamente tesselado MP3 MP MP- N N7 P P10 1º º Entretanto 15 15′ 202 2 20/ 205 5 12,7 127 1 7 -12, 14,7 147 -14, P1 12, -12 14, -14 -1 -

ABSTRACT This case report presents the details of a 33-year-old female patient who was referred to a specialized retina service because of mild vision loss in her right eye). The patient’s visual acuity was 20/25 in right eye and 20/50 in the left eye (; amblyopic); the spherical equivalent was -12.75 diopters (right eye) and -14.75 diopters (left eye). Multimodal retinal imaging showed peripapillary schisis in both the inner and outer retinal layers, grade II posterior vitreous detachment, and a tessellated fundus. Using Humphrey perimetry and MP-3 microperimetry, the functional evaluation indicated macular sensitivity within normal limits and decreased sensitivity in the peripapillary region, especially in right eye. The pattern-re versal visual evoked potential was measured. The N75 and P100 latency and amplitude in right eye were within normal values for checks of 1º. However, the amplitude was low for checks of 15′. Highly myopic patients who have posterior staphyloma that involves the optic nerve are susceptible to posterior hyaloid traction, and the resulting peripapillary vitreous traction may compromise vision. 33yearold yearold 33 year old . s 2025 20 25 20/2 2050 50 20/5 ( amblyopic amblyopic) 12.75 1275 12 75 -12.7 14.75 1475 14 -14.7 layers detachment fundus MP3 MP 3 MP- microperimetry region patternre pattern re measured N N7 P P10 1º º However 15 15′ 202 2 20/ 205 5 12.7 127 1 7 -12. 14.7 147 -14. P1 12. -12 14. -14 -1 -

ABSTRACT Objective: To evaluate cognitive learning, ability to perform and interpret lung ultrasound exams, and self-perception of learning among medical students after a short pedagogical intervention at a medical school in Brazil. Methods: An experimental pilot study was conducted with medical students at different stages of their education (basic cycle, clinical cycle, and medical internship). The participants underwent a cognitive test before and after the intervention, a practical test, a test to recognize lung ultrasound pathologies, and a qualitative evaluation test at the end of the intervention. Statistical analysis was performed using a significance level of p < 0.05. Results: A total of 42 students were included in the study, with a median age of 23 years and a predominance of males. The mean score of the pre-intervention cognitive test was 2.97 ± 0.87, and that of the post-intervention test was 6.57 ± 1.41, showing significant improvement (p < 0.001). The score of the practical test and that of the recognition of pathologies test also showed significant improvement after the intervention. There was no significant difference in execution time between the groups. Students in the clinical cycle had a better self-perception of learning. Conclusions: Theoretical teaching and practical training of lung ultrasound in a short pedagogical intervention can improve cognitive performance, practical skills, and interpretation of the exam. The level of learning achievement was higher among more advanced students in medical education. Additionally, the students in the clinical cycle had a better perception of their learning. Objective exams selfperception self Brazil Methods basic internship. internship . internship) 005 0 05 0.05 Results 4 2 males preintervention pre 297 97 2.9 087 87 0.87 postintervention post 657 6 57 6.5 141 1 41 1.41 0.001. 0001 0.001 001 0.001) groups Conclusions performance skills exam Additionally 00 0.0 29 9 2. 08 8 0.8 65 5 6. 14 1.4 000 0.00 0. 1.

BACKGROUND Although blood transfusion is an essential therapeutic procedure, it can present risks, including transmitting infectious diseases, such as malaria. In Acre, the thick blood smear microscopic examination (TBS) is used to screen infected malaria blood donors. However, TBS has low sensitivity for detecting Plasmodium in situations of low parasitaemia, such as those presented by asymptomatic clinically healthy individuals. OBJECTIVES To investigate the pertinence of using polymerase chain reaction (PCR) to detect malarial infection for screening blood donors in Cruzeiro do Sul, Acre, an endemic high-risk malaria area in the Legal Amazon. METHODS A cross-sectional study was conducted among individuals eligible and ineligible to be blood donors, according to clinical and epidemiological criteria. Besides the mandatory screening of HCV, HBV, and HIV tests, malaria PCR and TBS were also carried out on all blood donor candidates who attended the Cruzeiro do Sul Blood Centre from July to September 2022. FINDINGS Of the 230 participants, 209 (91%) were eligible for blood donation by clinical-epidemiological screening. Surprisingly, no blood donor candidate reported a history of malaria. All TBS microscopic tests were negative at the time of recruitment. However, samples from four blood donor candidates (two eligible by clinical and epidemiological malaria criteria and two ineligible by hypertension and recent tattoo) were positive by Plasmodium and P. vivax molecular tests. MAIN CONCLUSIONS Malaria molecular techniques for screening blood donors should be introduced in the Brazilian Blood Centres to maximise recipient safety. Furthermore, selecting zero-risk donors could pave the way to build a transmissible malaria-free environment in the blood bank context in the near future. procedure risks diseases Acre (TBS However parasitaemia (PCR highrisk high risk Amazon crosssectional cross sectional HCV HBV 2022 23 participants 20 91% 91 (91% clinicalepidemiological Surprisingly recruitment tattoo P safety Furthermore zerorisk zero malariafree free future 202 2 9 (91 (9 (

ABSTRACT Macaw palm (Acrocomia aculeata) is a widespread tree in Brazil, and the oil industry has been increasing interest in this tree due to its high oil concentrations, rusticity, and adaptability to different environments. Currently, macaw palms are being domesticated and are in an early rational cultivation process. Foliar diagnosis can contribute to managing fertilization, but there is no protocol for leaf sampling. This study aimed to evaluate the seasonal variation of leaf nutrient contents and indicate an adequate period for leaf sampling. Leaf contents of macro (N, P, K, Ca, Mg and S) and micronutrients (Cu, Mn, Fe and Zn) from composed samples of leaflets collected from the middle part of the tenth leaf were evaluated in 12 uninterrupted sampling times (January to December 2016). The data were submitted to analysis of variance. The distance from Mahalanobis and Tocher optimization methods was used to group sampling times of similar seasonal variations. Contents of N, P, K, Ca, S, Mn and Fe varied throughout the months. May and June are adequate to sample diagnostic leaves of macaw palm to analyze the nutritional status. Seasonal variation of N, S and Ca mostly contributed to the indication of leaf sampling time of macaw palm. Acrocomia aculeata Brazil concentrations rusticity environments Currently process fertilization N (N P K Cu, Cu (Cu Zn 1 January 2016. 2016 . 2016) variance variations months status 201 20 2

ABSTRACT Purpose: To evaluate the effects on peripheral neural regeneration of the end-to-side embracing repair technique compared to the autograft repair technique in Wistar rats. Methods: Fifteen male Wistar rats were divided into three groups with five animals each: denervated group (GD), autograft group (GA), and embracing group (EG). For the evaluation, the grasping test, electroneuromyography (ENMG), and muscle weight assessment were used. Results: Muscle weight assessment and ENMG did not show significant neural regeneration at the end of 12 weeks in the DG and GE groups, but only in GA. The grasping test showed an increase in strength between the surgery and the fourth week in all groups, and only the GA maintained this trend until the 12th week. Conclusions: The present study indicates that the neural regeneration observed in the end-to-side embracing neurorrhaphy technique, in the repair of segmental neural loss, is inferior to autograft repair in Wistar rats. Purpose endtoside side Methods each GD, GD , (GD) GA, (GA) EG. EG . (EG) evaluation ENMG, (ENMG) used Results 1 th Conclusions loss (GD (GA (EG (ENMG

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil. Brazil tests Venereal Laboratory 22yearold yearold 22 year old treatment test 2

The automotive industry is one of the largest industrial segments in the world market. The exhaust system of motor vehicles is responsible for the emission and treatment of toxic gasses released by the engine. In this sense, the application of titanium on an AISI 1020 steel substrate was carried out by plasma deposition using a cathode cage. The aim of this research was to evaluate the application of this material in the exhaust system of motor vehicles. The samples were characterized by scanning electron microscopy (SEM), confocal microscopy (CM), microhardness tests and corrosion resistance tests. The samples exhibited a thin film with higher titanium content and hardness than the uncoated sample. The corrosion potential also increased and the current density was lower than the uncoated sample. The conclusion is that the deposition of thin titanium films on AISI 1020 steel with CCPD has the potential to produce thin films. market engine sense 102 cage SEM, SEM , (SEM) CM, CM (CM) sample 10 (SEM (CM 1

RESUMO Objetivo: os erros diagnósticos durante a interpretação de um exame de imagem pelo médico podem acarretar aumento da mortalidade e do tempo de internação dos pacientes. A taxa de divergência entre o laudo dado por um médico radiologista e a avaliação preliminar de um Médico Emergencista (ME) pode chegar a mais de 20%. O objetivo deste trabalho foi comparar as avaliações dos exames de imagem realizadas pelo ME com os laudos oficiais emitidos pelos radiologistas. Métodos: estudo seccional e transversal, no qual foram avaliadas interpretações dos exames (documentadas no prontuário pelos ME) de todos os pacientes submetidos à tomografia computadorizada (TC) de tórax, abdome ou pelve realizada na emergência, em um intervalo de 8 meses. Esses dados foram comparados com os laudos oficiais do médico radiologista (padrão ouro). Resultados: foram incluídos 508 pacientes no estudo. A divergência entre ME e radiologista ocorreu em 27% dos casos. O tipo de divergência mais incidente foi a não descrita pelo ME, mas descrita pelo radiologista. A chance de haver divergência em um caso de politrauma é 4,93 vezes maior em relação ao caso de somente trauma contuso em um segmento. Foi encontrada também uma diferença estatisticamente relevante no tempo de internamento dos pacientes que tiveram interpretações divergentes das tomografias. Conclusão: o estudo encontrou uma taxa de divergência relativamente alta entre o laudo do ME e o laudo oficial do radiologista. Contudo, menos de 4% dessas foram consideradas como clinicamente relevantes, indicando a capacidade dos ME em interpretar os exames de imagem de forma satisfatória. Objetivo (ME 20 20% radiologistas Métodos transversal documentadas TC (TC tórax emergência meses padrão ouro. ouro . ouro) Resultados 50 27 casos 493 4 93 4,9 segmento tomografias Conclusão Contudo relevantes satisfatória 2 5 49 9 4,

ABSTRACT Objective: diagnostic errors during the interpretation of an imaging test by the physician can lead to increased mortality and length of hospital stay for patients. The rate of divergence in the report given by a radiologist and an Emergency Physicians (EP) can reach over 20%. The objective of this study was to compare the unofficial tomographic reports issued by EP with the official reports issued by radiologists. Methods: a cross-sectional study, in which interpretations of the exams (documented in the medical records by the EP) of all patients undergoing computed tomography (CT) of the chest, abdomen or pelvis performed in the emergency room, at an interval of 8 months, were evaluated. These data were compared with the official reports of the radiologist (gold standard). Results: 508 patients were included. The divergence between EP and the radiologist occurred in 27% of the cases. The most common type of divergence was the one not described by the EP, but described by the radiologist. The chance of having divergence in a case of multiple trauma is 4.93 times greater in relation to the case of only blunt trauma in one segment. A statistically relevant difference was also found in the length of stay of patients who had different interpretations of the CT scans. Conclusion: the study found a relatively high divergence rate between the EP report and the official radiologist report. However, less than 4% of these were considered to be clinically relevant, indicating the ability of the EP to interpret it satisfactorily. Objective (EP 20 20% radiologists Methods crosssectional cross sectional documented (CT chest room months evaluated gold standard. standard . standard) Results 50 included 27 cases 493 4 93 4.9 segment scans Conclusion However satisfactorily 2 5 49 9 4.

RESUMEN Objetivo: Comparar la carga de trabajo de enfermería en una unidad de cuidados intensivos oncológicos según el estado de infección por COVID-19. Método: Estudio de cohorte retrospectivo. El Nursing Activities Score se utilizó para medir la carga de trabajo y el análisis de documentos para la extracción de datos. Las historias clínicas se dividieron en pacientes con COVID-19 y pacientes sin la infección. Resultados: Los valores del Nursing Activities Score no fueron diferentes en función de las variables sociodemográficas, pero el promedio de este puntaje fue estadísticamente diferente en función de si el paciente tenía COVID-19 o no, siendo mayor en aquellos que lo tenían. Conclusión: Se comprobó que la carga de trabajo de enfermería es elevada en la unidad de terapia intensiva oncológica. Sin embargo, el COVID-19 aumentó aún más este puntaje, siendo el Nursing Activities Score una herramienta importante para dimensionar el equipo en este contexto. Objetivo COVID19. COVID19 COVID 19. 19 Método retrospectivo datos COVID-1 Resultados sociodemográficas tenían Conclusión oncológica embargo contexto COVID1 1 COVID-

ABSTRACT Objective: To compare the nursing workload in an oncology intensive care unit according to the condition of COVID-19 infection. Method: A retrospective cohort study. The Nursing Activities Score was used to measure the workload and document analysis for data extraction. The medical records were divided into a group of patients with COVID-19 and another group of patients without the infection. Results: The values of the Nursing Activities Score were not different depending on the sociodemographic variables, but the average of this score was statistically different depending on whether the patient had the diagnosis of COVID-19 or not, being higher in those who had the disease. Conclusion: It was proved that the nursing workload is high in the context of the oncology intensive care unit. However, COVID-19 increased this score even more, with the Nursing Activities Score being an important tool to size the team in this context. Objective COVID19 COVID 19 COVID-1 infection Method study extraction Results variables disease Conclusion However more COVID1 1 COVID-

RESUMO Objetivo: Comparar a carga de trabalho da enfermagem em unidade de terapia intensiva oncológica, de acordo com a condição de infecção por COVID-19. Método: Estudo do tipo coorte retrospectiva. Utilizaram-se do Nursing Activies Score para mensuração da carga de trabalho e da análise documental para extração dos dados. Os prontuários foram divididos em um grupo de pacientes com COVID-19 e outro grupo de pacientes sem a infecção. Resultados: Os valores do Nursing Activies Score não foram diferentes, conforme as variáveis sociodemográficas, porém a média deste escore foi estatisticamente diferente a depender de o paciente apresentar ou não o diagnóstico de COVID-19, sendo superior naqueles que possuíam a doença. Conclusão: Comprovou-se que a carga de trabalho da enfermagem foi alta no contexto da unidade de terapia intensiva oncológica. No entanto, a COVID-19 aumentou ainda mais este escore, sendo o Nursing Activies Score importante ferramenta para dimensionar a equipe nesse contexto. Objetivo oncológica COVID19. COVID19 COVID 19. 19 Método retrospectiva Utilizaramse Utilizaram se dados COVID-1 Resultados diferentes sociodemográficas COVID19, 19, doença Conclusão Comprovouse Comprovou entanto COVID1 1 COVID-

Abstract Microbial biomass is considered a renewable and environmentally friendly resource. Thus, the research conducted a kinetic study and thermodynamic equilibrium modeling of the cobalt (Co) and manganese (Mn) bioadsorption process using the Rhodococcus opacus (RO) strain as a biosorbent. The inactive biomass subjected to 0.1 M NaOH pretreatment was brought into contact with synthetic solutions of Co and Mn. The experimental data for the Co(II) and Mn(II) bioadsorption process were fit to the Langmuir model with kads of 0.65 and 0.11 L.mg-1, respectively. A better statistical fit was also obtained for the pseudo-second order kinetic model (R2Co(II) = 0.994 and R2Mn(II) = 0.995), with 72.3% Co(II) and 80% Mn(II) removals during the first 10 min. In addition, a higher affinity of RO for the Co(II) ion was observed, with maximum uptake values of 13.42 mg.g-1; however, a higher adsorption rate was observed for Mn(II) ion (k = 0.21 g.mg-1.min-1 at 318 K). The bioadsorption process was spontaneous and dependent on temperature, being endothermic and irreversible for the Co(II) ion (∆H = 2951.91 J.mol-1) and exothermic and reversible for the Mn(II) ion (∆H = -2974.8 J.mol-1). The kinetic and thermodynamic equilibrium modeling allowed to identify the main mechanisms involved in the biosorption process of both metals.

Resumen: La tuberculosis es una enfermedad infecciosa endémica en México, la cual es causada por Mycobacterium tuberculosis, un bacilo ácido-alcohol resistente. La principal afección orgánica es a nivel pulmonar; sin embargo, se ha reportado que hasta 25% de los casos pueden tener una afección extrapulmonar, ya sea por diseminación linfática o hematógena, y en casos aislados como primoinfección extrapulmonar. Presentamos el caso de un masculino de 62 años de edad con un cuadro de dolor abdominal de siete días de evolución asociado con melena, en la que se documentaron múltiples perforaciones ileales en el borde antimesentérico con diagnóstico histológico de tuberculosis intestinal. Esta entidad debe sospecharse en pacientes con tratamiento inmunosupresor crónico y deben realizarse medidas de escrutinio de manera preventiva.

Abstract: Tuberculosis is an endemic infectious disease in Mexico, caused by Mycobacterium tuberculosis, an acid-fast stain-positive bacillus. The most common clinical scenarios are pulmonary affections. However, it has been reported that up to 25% of the cases may present as an extrapulmonary disease, either due to lymphatic or hematogenous dissemination, and isolated cases have been reported as an extrapulmonary primary infection. We present the case of a 62-year-old male with a 7-day history of abdominal pain associated with melena, in which multiple ileal perforations were documented in the anti-mesenteric border with a histological diagnosis of intestinal tuberculosis. This entity should be suspected in patients with chronic immunosuppressive treatment and special screening should be performed to prevent these clinical scenarios.

RESUMO Este relato de caso apresenta um paciente feminino de 33 anos encaminhado para um serviço especializado de retina devido à leve perda de visão em olho direito. A acuidade visual foi de 20/25 no olho direito e 20/50 no olho esquerdo, o equivalente esférico foi de -12,75 dioptrias e -14,75 dioptrias, respectivamente. Avaliações multimodais revelaram isquese peripapilar nas camadas internas e externas da retina, descolamento vítreo posterior grau II e fundo tesselado. Avaliação funcional com perimetria Humphrey e microperimetria MP-3 revelaram sensibilidade macular normais e diminuição da sensibilidade na região peripapilar, especialmente no olho direito. Potencial visual evocado de padrão reverso apresentou no olho direito latência e amplitude N75 e P100 dentro dos valores normais para verificação de 1º. Entretanto, a amplitude foi baixa para a de 15′. Pacientes alto míopes com esfiloma posterior envolvendo o nervo óptico são suscetíveis à tração da hialoide posterior. Portanto a tração vitreopapilar resultante pode causar comprometimento da visão.

ABSTRACT This case report presents the details of a 33-year-old female patient who was referred to a specialized retina service because of mild vision loss in her right eye). The patient’s visual acuity was 20/25 in right eye and 20/50 in the left eye (; amblyopic); the spherical equivalent was -12.75 diopters (right eye) and -14.75 diopters (left eye). Multimodal retinal imaging showed peripapillary schisis in both the inner and outer retinal layers, grade II posterior vitreous detachment, and a tessellated fundus. Using Humphrey perimetry and MP-3 microperimetry, the functional evaluation indicated macular sensitivity within normal limits and decreased sensitivity in the peripapillary region, especially in right eye. The pattern-re versal visual evoked potential was measured. The N75 and P100 latency and amplitude in right eye were within normal values for checks of 1º. However, the amplitude was low for checks of 15′. Highly myopic patients who have posterior staphyloma that involves the optic nerve are susceptible to posterior hyaloid traction, and the resulting peripapillary vitreous traction may compromise vision.

Resumo Contexto A produção científica brasileira cresce de forma quantitativa e qualitativa a cada década. Entretanto, há uma desvalorização dos periódicos brasileiros demonstrada através da baixa quantidade de citações em comparação a textos de revistas internacionais, com justificativa subentendida de que há superioridade qualitativa de artigos estrangeiros. Objetivos Verificar a diferença entre o número de citações de periódicos nacionais e internacionais em três revistas brasileiras no período de 2016 a 2020. Métodos Foram analisados todos os artigos publicados na Revista do Colégio Brasileiro de Cirurgiões, no Jornal Vascular Brasileiro e na Acta Cirúrgica Brasileira no intervalo de 2016 a 2020. Os estudos selecionados tiveram suas referências avaliadas, sendo contabilizado o número total de citações e se eram provenientes de periódicos brasileiros ou de periódicos estrangeiros. Resultados Foram analisados 902 artigos, totalizando 23.394 referências, com média de 25,81 ± 8,59 por artigo. Nesse contexto, 2.680 (11,45%) eram nacionais, correspondentes a uma média de 2,95 ± 3,79 referências brasileiras por artigo. Conclusões Faz-se necessária a maior valorização dos periódicos brasileiros, em especial por parte dos pesquisadores nacionais e das instituições responsáveis pelo fomento da ciência.

Abstract Background The quantity and quality of Brazilian scientific output increases decade by decade. However, there is a tendency to undervalue Brazilian journals, illustrated by the low number of citations compared with texts in international journals, with the tacit justification that foreign articles are of superior quality. Objectives To investigate the differences in numbers of citations of Brazilian and international periodicals in three Brazilian journals from 2016 to 2020. Methods All articles published in the Journal of the Brazilian College of Surgeons, in the Jornal Vascular Brasileiro, and in Acta Cirúrgica Brasileira from 2016 to 2020 were analyzed. The references of these studies were analyzed, summing the total number of citations and classifying them as published in Brazilian or foreign journals. Results A total of 902 articles were analyzed, totaling 23,394 references, with a mean of 25.81 ± 8.59 references per article. Of these, 2,680 (11.45%) were Brazilian, equating to a mean of 2.95 ± 3.79 Brazilian references per article. Conclusions It is necessary to improve appreciation of Brazilian periodicals, especially among Brazilian researchers and institutions responsible for science funding.