ABSTRACT BACKGROUND: Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke. OBJECTIVE: To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis. DESIGN AND SETTING: Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil. METHODS: A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke. CONCLUSIONS: Patients on hemodialysis, especially women and older people, have little knowledge about stroke. BACKGROUND worldwide based rare OBJECTIVE (CKD SETTING Crosssectional Cross sectional northeastern north eastern Brazil METHODS selfadministered self 2022 chisquare chi square regression RESULTS 19 535 53 5 53.5 participants 100 10 0 10.0 decisionmaking decision making 299 29 9 29.9 symptom however number education odds OR, OR , [OR] 0.40% 040 40 95 CI [CI] 0.200.82, 020082 0.20 0.82 20 82 0.20-0.82) (OR 0.24% 024 24 0.090.63 009063 0.09 0.63 09 63 0.09-0.63 0.48% 048 48 0.230.98 023098 0.23 0.98 23 98 0.23-0.98 CONCLUSIONS people 202 1 53. 10. 2 29. [OR 0.40 04 4 [CI 200 0.200.82 02008 020 0.2 082 0.8 8 0.20-0.82 0.24 02 090 0.090.6 00906 009 0.0 063 0.6 6 0.09-0.6 0.48 230 0.230.9 02309 023 098 0.9 0.23-0.9 0.4 0.200.8 0200 0. 08 0.20-0.8 0.090. 0090 00 06 0.09-0. 0.230. 0230 0.23-0. 0.200. 0.20-0. 0.090 0.09-0 0.230 0.23-0 0.200 0.20-0 0.09- 0.23- 0.20-

Abstract Diabetes mellitus (DM) is a major cause of chronic kidney disease (CKD) and changes in lipoprotein. Literature data suggest that cholesterol associated with high-density lipoprotein (HDLc) plays a protective role against albuminuria and diabetic nephropathy. These factors are related with changes in serum apolipoproteins such Apo A-I. This work aims to evaluate the correlation of apolipoprotein A-I with renal function in diabetic outpatients. Samples were collected from 281 outpatients for analyses of glycated hemoglobin (HbA1c), serum creatinine (SCr), urea (BUN), cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDLc) and estimation of glomerular filtration rate (eGFR). Urinary samples were obtained to assess urine albumin creatinine ratio (UACR). Triglyceride-glucose index (TyG) was calculated to estimate insulin resistance. The mean age was 61,5 ± 16,4 years. Most patients were female, Afro-Mestizo and over 50 years of age. Pearson's revealed negative correlation of creatinine with HDLc and Apo A-I. There was a correlation of eGFR with HbA1c, TG and HDLc. TyG presented a negative correlation with Apo A-I and HDLc. The highest quartiles of UACR presented the highest TyG and the lowest Apo A-I. In conclusion, Apo A-I indicated an association with insulin resistance and changes in renal function parameters, especially as a factor associated with the onset of albuminuria, with a better predictive potential than the HDLc. DM (DM CKD (CKD highdensity high density (HDLc nephropathy AI. AI A I. I 28 HbA1c HbAc , HbA c (HbA1c) SCr, SCr (SCr) BUN, BUN (BUN) TC, TC (TC) TG, (TG) HDLcholesterol HDL eGFR. . (eGFR) UACR. (UACR) Triglycerideglucose Triglyceride glucose (TyG 615 61 5 61, 164 16 4 16, female AfroMestizo Afro Mestizo Pearsons Pearson s conclusion parameters 2 (HbA1c (SCr (BUN (TC (TG (eGFR (UACR 6 1

Abstract Changes in lipoprotein metabolism are among the main causes of hemodynamic impairment in renal function. COVID-19 is an multisystemic inflammatory disease, aggravating this situation. This cross-sectional study investigated the relationship of serum lipoprotein profile with inflammatory parameters and renal function in 95 COVID-19 outpatients in comparison with 173 with flu-like symptoms. Serum samples were collected for the determination of total cholesterol and fractions, apolipoproteins (Apo A-I and Apo B), urea (sUr) and creatinine (sCr). The glomerular filtration rate (eGFR) was calculated. Neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratios were calculated as inflammatory parameters derived from the blood tests. COVID-19 patients presented lower high-density lipoprotein cholesterol (HDL-c) (47.90 ± 1.543 vs. 51.40 ± 0.992) and higher PLR (190.9 ± 9.410 vs. 137.6 ± 5.534) and NLR (3.40 ± 0.22 vs. 2.80 ± 0.15). Both NLR and PLR correlated with each other (r = 0.639). Furthermore, the Apo B/Apo A-I ratio was correlated with PLR (r = 0.5818) and eGFR (r = -0.2630). COVID-19 patients classified as at high risk of developing acute myocardial infarction based on the Apo B/ Apo A-I ratio had higher values for sUr/sCr. Thus, serum apolipoproteins, PLR, and NLR could be related to renal dysfunction in COVID-19. COVID19 COVID 19 COVID-1 disease situation crosssectional cross sectional 9 17 flulike flu like symptoms fractions AI A I B, B , B) sUr (sUr sCr. sCr . (sCr) (eGFR Neutrophillymphocyte Neutrophil lymphocyte (NLR plateletlymphocyte platelet (PLR tests highdensity density HDLc HDL c (HDL-c 47.90 4790 47 90 (47.9 1543 1 543 1.54 vs 5140 51 40 51.4 0.992 0992 0 992 190.9 1909 190 (190. 9410 410 9.41 1376 137 6 137. 5.534 5534 5 534 3.40 340 3 (3.4 022 22 0.2 280 2 80 2.8 0.15. 015 0.15 15 0.15) r 0.639. 0639 0.639 639 0.639) Furthermore BApo 0.5818 05818 5818 0.2630. 02630 0.2630 2630 -0.2630) sUrsCr sUr/sCr Thus COVID19. 19. COVID1 COVID- (sCr 47.9 479 4 (47. 154 54 1.5 514 51. 0.99 099 99 190. (190 941 41 9.4 13 5.53 553 53 3.4 34 (3. 02 0. 28 8 2. 01 0.1 063 0.63 63 0.581 0581 581 0263 0.263 263 -0.2630 47. (47 1. 0.9 09 (19 94 9. 5.5 55 3. (3 06 0.6 0.58 058 58 026 0.26 26 -0.263 (4 (1 5. ( 0.5 05 -0.26 -0.2 -0. -0 -

ABSTRACT BACKGROUND: Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES: To assess high school students’ knowledge of stroke. DESIGN AND SETTING: Cross-sectional study conducted in high schools in northeastern Brazil. METHODS: A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS: There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.

RESUMO Objetivo: analisar as potenciais influências do polimorfismo genético R/X do gene ACTN3 e das características antropométricas e metabólicas no desempenho funcional de mulheres idosas atendidas na atenção primária em saúde. Método: Cento e quarenta e uma idosas foram avaliadas em relação as características antropométricas, metabólicas, funcionais, aspectos clínicos, cognitivos e demográficos. Foram determinadas as frequências de alelos e genótipos do polimorfismo do gene ACTN3. Resultados: 141 idosas (68,30 ± 6,18 anos) foram avaliadas. Não foram observadas diferenças significativas (p > 0,05) entre os genótipos RR e RX/XX no desempenho funcional, características antropométricas ou metabólicas das idosas. O tempo de realização do TUG apresentou correlações positivas com idade, índice de massa corporal, circunferência da cintura e percentual de gordura (s = 0,315; p < 0,001; s = 0,238; p = 0,005; s = 0,174; p = 0,039; s = 0,207; p = 0,014) respectivamente. Correlações negativas foram observadas entre o TUG com força de preensão manual absoluta (s = - 0,314; p < 0,001) e relativa (s = - 0,380; p < 0,001). Conclusão: Em nosso estudo, não foram observadas influências dos polimorfismos do gene ACTN3 no desempenho funcional das idosas, sendo este, influenciado por outros fatores.

ABSTRACT Objective: To analyze potential influences of the R/X genetic polymorphism of the ACTN3 gene, as well as of anthropometric and metabolic characteristics on the functional performance of elderly women assisted in primary health care. Method: One hundred and forty-one elderly women were assessed in terms of anthropometric, metabolic and functional aspects, in addition to clinical, cognitive and demographic characteristics. Allele and genotype frequencies of ACTN3 gene polymorphism were determined. Results: 141 elderly women (68.30 ± 6.18 years) were evaluated. No significant differences (p > 0.05) were observed between the RR and RX/XX genotypes in the elderly women’s functional performance, anthropometric or metabolic characteristics. The TUG test completion time showed positive correlations with age, body mass index, waist circumference, and fat percentage (s = 0.315; p < 0.001; s = 0.238; p = 0.005; s = 0.174; p = 0.039; s = 0.207; p = 0.014), respectively. Negative correlations were found between the TUG test with absolute handgrip strength (s = - 0.314; p < 0.001) and relative handgrip strength (s = - 0.380; p < 0.001). Conclusion: In our study, there were no influences from ACTN3 gene polymorphisms on the functional performance of the elderly women, which is influenced by other factors.

Resumo Objetivo: Avaliar taxas de sucesso e de complicações de biópsias renais guiadas por ultrassonografia em um hospital terciário. Materiais e Métodos: Análise retrospectiva de 97 biópsias renais realizadas entre 1º de março de 2017 e 31 de outubro de 2019, guiadas por ultrassonografia e executadas por um único médico radiologista. Resultados: Oitenta e sete biópsias apresentaram diagnóstico anatomopatológico definitivo. Cinco biópsias foram inconclusivas (5,4%) e precisaram de um segundo procedimento. Houve complicações em sete procedimentos (7,6%), todas devidamente solucionadas. Conclusão: A biópsia renal guiada por ultrassonografia demonstrou ser um método efetivo e seguro para o diagnóstico de nefropatias, com elevada taxa de sucesso em sua execução.

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.

RESUMO Objetivo: avaliar as características demográficas e clínicas associadas ao desenvolvimento de pneumonia em pacientes após acidente vascular encefálico internados em um hospital terciário do Vale do São Francisco que atende os estados de Pernambuco e Bahia, Brasil. Métodos: trata-se de estudo unicêntrico, observacional, analítico e transversal realizado a partir dos prontuários de pacientes com diagnóstico de acidente vascular encefálico incluídos no Registro de Acidente Vascular Encefálico (Estudo RAVESS). A análise estatística foi composta pelos testes qui-quadrado, exato de Fisher e a análise de variância com pós-teste de Bonferroni com nível de P≤0,05. Resultados: foram coletados dados de 69 pacientes com AVE agudo com média±desvio padrão de idade de 63,2±16,8 anos, sendo 37 (53,6%) do sexo feminino, com prevalência de pneumonia durante o internamento estimada em 31,9% (Intervalo de Confiança de 95%: 21,2-44,2%). Na análise univariada para preditores de pneumonia após acidente vascular encefálico foram identificados: idade mais avançada (72,6±17,9 vs. 58,8±14,5; P=0,001), menor sinal de resposta a escala de coma de Glasgow durante a admissão (11,3±1,8 vs. 13,3±2,1; P=0,001) e maior frequência de disartria na admissão (61,9% vs. 27,9%; P=0,009). Conclusão: a pneumonia foi uma complicação prevalente em pacientes após acidente vascular encefálico de um hospital terciário brasileiro, tendo sido relacionada com idade avançada do paciente e a severidade do evento encefálico.

ABSTRACT Purpose: to assess the demographic and clinical characteristics associated with the development of pneumonia in post-stroke patients hospitalized in a tertiary hospital, located in the Vale do São Francisco, that covers the states of Pernambuco and Bahia, Brazil. Methods: a unicentric, observational, analytical, cross-sectional study, based on the medical records of patients diagnosed with stroke and included in the Stroke Registry (RAVESS study). The statistical analysis was made with the chi-square test, Fisher’s exact test, and the analysis of variance, with the Bonferroni’s post-test, and P≤0.05. Results: data from 69 patients presented with acute stroke were collected, aged 63.2±16.8 years; 37 (53.6%) were females; the prevalence of pneumonia during hospital stay was estimated at 31.9% (95% confidence interval: 21.2-44.2%). In the univariate analysis of predictors for post-stroke pneumonia, the following were identified: older age (72.6±17.9 vs. 58.8±14.5; P = 0.001), lower response signal to the Glasgow Coma Scale at admission (11.3±1.8 vs. 13.3±2.1; P = 0.001), and higher frequency of dysarthria at admission (61.9% vs. 27.9%; P = 0.009). Conclusion: pneumonia was a prevalent complication in post-stroke patients at a Brazilian tertiary hospital. It was related to the patient’s older age and the severity of the cerebral event.

Abstract In the present study, the complete characterization of cDNA and genomic sequences of IL-1β and IL-8, as well as the expression profile of these genes in the South American fish pacu (Piaractus mesopotamicus) is provided. The full-length pmIL-1β cDNA was composed of 1208 nucleotides that would produce a precursor peptide with 273 amino acid residues. A putative caspase-1 cleavage site, similar to what is found in mammalian IL-1β, was identified producing a mature peptide with a theoretical molecular weight of 17.21 kDa. The pmIL-8 cDNA sequence consisted of 1019 nucleotides which encoded a 95-amino acid protein with a theoretical molecular weight of 10.43 kDa that showed all typical CXC chemokine features, including a 20-residue signal peptide and four conserved cysteine residues. Constitutive mRNA expression was detected for both genes in the liver, head kidney, gill, intestine, skin and spleen. After a bacterial challenge, up-regulation was detected for both pmIL-1β and pmIL-8 in the spleen and head kidney at 12 h post-infection. At 24 h post-infection there was a decrease in the expression of both genes, with pmIL-8 showing a significant down-regulation in the liver and head kidney when compared to the control groups.

RESUMO Febre de origem indeterminada (FOI) é uma entidade desafiadora com presença marcante nos hospitais de todo o mundo. É definida como temperatura ≥37,8 ° C em várias ocasiões, com duração ≥3 semanas, na ausência de diagnóstico após três dias de investigação hospitalar ou três consultas ambulatoriais. As principais etiologias são de ordem infecciosa, neoplásica e doenças inflamatórias não infecciosas. O diagnóstico é baseado na história clínica e no exame físico minuciosos desses pacientes, com a finalidade de direcionar os exames complementares específicos a serem realizados em cada caso. A abordagem diagnóstica inicial do paciente com FOI deve incluir exames complementares inespecíficos. A terapia empírica não é recomendada (com poucas exceções) em pacientes com febre prolongada, uma vez que ela pode camuflar e retardar o diagnóstico e a conduta para tratar a etiologia específica. O prognóstico engloba uma mortalidade de 12-35%, variando de acordo com a etiologia de base.

SUMMARY Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world. It is defined as temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or 3 outpatient visits. The main etiologies are infectious, neoplastic, and non-infectious inflammatory diseases. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. The initial diagnostic approach of the FUO patient should include non-specific complementary exams. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12-35%, varying according to the baseline etiology.

RESUMO Febre de origem indeterminada (FOI) é uma entidade desafiadora com presença marcante nos hospitais de todo o mundo, à qual uma miríade de diagnósticos diferenciais podem estar associados. É definida como temperatura axilar ≥37,8 0 C em várias ocasiões, com duração ≥ três semanas, na ausência de diagnóstico após três dias de investigação hospitalar ou três consultas ambulatoriais. As principais etiologias são de ordem infecciosa, neoplásica e reumatológica. O diagnóstico é baseado na história clínica e no exame físico minuciosos desses pacientes, com a finalidade de direcionar os exames complementares específicos a serem realizados em cada caso. A terapia empírica não é recomendada (com poucas exceções) em pacientes com febre prolongada, uma vez que ela pode camuflar e retardar o diagnóstico e a conduta para tratar a etiologia específica. O prognóstico engloba uma mortalidade de 12–35%, variando de acordo com a etiologia de base. O objetivo deste estudo é revisar os principais tópicos acerca da febre de origem indeterminada, trazendo aspectos históricos e científicos, nacionais e internacionais.

SUMMARY Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world and can be associated with a myriad of differential diagnoses. It is defined as axillary temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or three outpatient visits. The main etiologies are: infectious, neoplastic, and rheumatic. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12% - 35%, varying according to the underlying etiology. In this sense, the objective of this study is to review the main topics about fever of undetermined origin, bringing historical and scientific aspects, national and international.

RESUMO A macaúba (Acrocomia aculeata) é uma palmeira oleaginosa de alto valor econômico pela sua grande produtividade e pelas amplas possibilidades de aproveitamento das diferentes partes da planta. Esta palmeira é uma das espécies mais promissoras para a produção de biodiesel, e, durante o seu uso, há geração de grande quantidade de resíduos. O objetivo deste trabalho foi produzir e avaliar a qualidade de briquetes confeccionados com epicarpo da macaúba, em associação aos resíduos da madeira de Pinus sp. Para caracterização dos resíduos foram realizadas as análises: densidade a granel, composição química imediata e poder calorífico superior. Na produção de briquetes foram adotados diferentes tratamentos, sendo T1 (100% Macaúba), T2 (75% Macaúba + 25% Pinus), T3 (50% Macaúba + 50% Pinus), T4 (25% Macaúba + 75% Pinus) e T5 (100% Pinus). Os briquetes foram produzidos à pressão de 1000 PSI, temperatura de 120-130 ºC, tempos de prensagem e resfriamento de 5 minutos e umidade média de 9.88% para a macaúba e 8.00% para o Pinus. Para qualificar os briquetes avaliou-se as dimensões, densidade aparente, carga de ruptura, poder calorífico inferior, poder calorífico útil e densidade energética. De modo geral, recomenda-se a mistura de pelo menos 50% de epicarpo de macaúba para a produção de briquetes, pois este material confere maior resistência e densidade energética ao produto.

ABSTRACT The macaúba palm (Acrocomia aculeata) is a palm-seed-oil producing tree of great economic value for its high productivity, and the broad range of possible uses for the different parts of the plant. This palm is one of the most promising species for the production of biodiesel, however, its use generates large amounts of waste. The aim of this work is to produce and evaluate the quality of briquettes made from the epicarp of the macaúba palm, in association with the waste of the Pinus sp. For the characterization of the residues, the following analyses were carried out: bulk density, immediate chemical composition, and higher calorific value. Different treatments were adopted in the production of the briquettes, namely: T1 (100% macaúba palm), T2 (75% macaúba palm + 25% pine), T3 (50% macaúba palm + 50% pine), T4 (25% macaúba palm + 75% pine) and T5 (100% pine). The briquettes were produced at a pressure of 1000 PSI, and at a temperature of 120-130 ºC, press and cooling times of 5 minutes, and an average humidity of 9.88% for the macaúba palm and 8.00% for the Pinus. In order to qualify the briquettes’ dimensions, the following were evaluated: apparent density, rupture load, lower calorific value, useful calorific value and energy density. In general, mixing at least 50% macaúba epicarp is recommended to produce briquettes, as this material provides increased strength and energy density to the product.