ABSTRACT Introduction: Pediatric heart transplantation is the definitive therapy for children with end-stage heart failure. This paper describes our initial experience in pediatric heart transplantation in a tertiary center in Brazil Methods: This is a historical prospective descriptive cohort study based on a review of the medical records of children undergoing heart transplantation at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto. Variables were displayed as frequency, mean, or median. Statistical analysis and Kaplan-Meier actuarial curve were obtained with the aid of Microsoft® Excel® 2019 and STATSDirect version 3.3.5. Results: Between January 2010 and December 2020, ten children underwent bicaval orthotopic heart transplantation, 30% of which were under one year of age. Nine patients had end-stage heart failure (International Society for Heart and Lung Transplantation-Heart Failure D) and 50% of the recipients were transplanted under conditions of progressive clinical deterioration (Interagency Registry for Mechanically Assisted Circulatory Support ≤ 2). Forty percent of the recipients had a panel-reactive antibody > 20% on virtual crossmatch. In the postoperative period, 80% of patients required high dose of inotropic support (vasoactive-inotropic score > 10) for > 48 hours. The death-free survival rate at 131 months was 77.1±14.4%. Most patients (88.9%) in late follow-up had an episode of active cytomegalovirus infection. Cellular rejection, with or without clinical repercussion, was present in 44.4% of the patients. Conclusion: Pediatric heart transplantation produces acceptable and feasible outcomes as definitive therapy for children with end-stage heart failure.

ABSTRACT Objective: Adipose tissue-derived stromal/stem cells (ASCs) and vitamin D have immunomodulatory actions that could be useful for type 1 diabetes (T1D). We aimed in this study to investigate the safety and efficacy of ASCs + daily cholecalciferol (VIT D) for 6 months in patients with recent-onset T1D. Materials and methods: In this prospective, dual-center, open trial, patients with recent onset T1D received one dose of allogenic ASC (1 x 106 cells/kg) and cholecalciferol 2,000 UI/day for 6 months (group 1). They were compared to patients who received chol-ecalciferol (group 2) and standard treatment (group 3). Adverse events were recorded; C-peptide (CP), insulin dose and HbA1c were measured at baseline (T0), after 3 (T3) and 6 months (T6). Results: In group 1 (n = 7), adverse events included transient headache (all), mild local reactions (all), tachycardia (n = 4), abdominal cramps (n = 1), thrombophlebitis (n = 4), scotomas (n = 2), and central retinal vein occlusion at T3 (n = 1, resolution at T6). Group 1 had an increase in basal CP (p = 0.018; mean: 40.41+/-40.79 %), without changes in stimulated CP after mixed meal (p = 0.62), from T0 to T6. Basal CP remained stable in groups 2 and 3 (p = 0.58 and p = 0.116, respectively). Group 1 had small insulin requirements (0.31+/- 0.26 UI/kg) without changes at T6 (p = 0.44) and HbA1c decline (p = 0.01). At T6, all patients (100%; n = 7) in group 1 were in honeymoon vs 75% (n = 3/4) and 50% (n = 3/6) in groups 2 and 3, p = 0.01. Conclusions: Allogenic ASC + VIT D without immunosuppression was safe and might have a role in the preservation of β-cells in patients with recent-onset T1D. ClinicalTrials.gov: NCT03920397.

Os autores apresentam e discutem uma atividade do projeto de extensão Prescrevendo Histórias: desenvolvimento de competência narrativa em estudantes de Medicina, da Universidade do Estado do Rio de Janeiro, Brasil. O foco do artigo é a descrição da metodologia desenvolvida: distribuição de pílulas literárias na sala de espera de um ambulatório e produção de narrativas por meio da experiência, bem como sua análise. O artigo está dividido em seções. Inicialmente são apresentados a dinâmica de desenvolvimento da atividade e o procedimento metodológico engendrado para a análise do material produzido por encontros virtuais do grupo. A seguir, é abordada a análise das 25 narrativas, com destaque para as temáticas, os recursos linguísticos e as vozes presentes. Os autores concluem que o recurso didático-pedagógico apresentado possibilitou a incorporação de valores humanísticos à formação dos estudantes de Medicina.

The authors present and discuss an activity of the extension project “Prescribing stories: development of narrative competence in medical students, from the State University of Rio de Janeiro, Brazil”. The focus of the article is the description of the developed methodology: distribution of literary pills in the waiting room of an outpatient clinic and production of narratives from this experience, as well as the analysis of the created narratives. The article is divided into sections. Initially, the dynamics of the activity’s development and the methodological procedure conceived for the analysis of the analysis of the material produced are presented, based on virtual group meetings. Then, the analysis of the 25 narratives is addressed, emphasizing their voices, themes and linguistic resources The authors conclude that the in question didactic-pedagogical resource enabled the incorporation of humanistic values in the education of medical students.

Los autores presentan y discuten una actividad del proyecto de expansión Prescribiendo historias: desarrollo de competencia narrativa en estudiantes de medicina, de la Universidad del Estado de Río de Janeiro, Brasil. El enfoque del artículo es la descripción de la metodología desarrollada: distribución de píldoras literarias en la sala de espera de un ambulatorio y producción de narrativas a partir de la experiencia, así como de su análisis. El artículo se divide en secciones. Inicialmente se presentan la dinámica de desarrollo de la actividad y el procedimiento metodológico engendrado para el análisis del material producido, a partir de encuentros virtuales del grupo. A seguir, se aborda el análisis de las 25 narrativas, con destaque para las temáticas, los recursos lingüísticos y las voces presentes. Los autores concluyen que el recurso didáctico-pedagógico presentado posibilitó la incorporación de valores humanísticos a la formación de los estudiantes de Medicina.

Os autores apresentam e discutem uma atividade do projeto de extensão Prescrevendo Histórias: desenvolvimento de competência narrativa em estudantes de Medicina, da Universidade do Estado do Rio de Janeiro, Brasil. O foco do artigo é a descrição da metodologia desenvolvida: distribuição de pílulas literárias na sala de espera de um ambulatório e produção de narrativas por meio da experiência, bem como sua análise. O artigo está dividido em seções. Inicialmente são apresentados a dinâmica de desenvolvimento da atividade e o procedimento metodológico engendrado para a análise do material produzido por encontros virtuais do grupo. A seguir, é abordada a análise das 25 narrativas, com destaque para as temáticas, os recursos linguísticos e as vozes presentes. Os autores concluem que o recurso didático-pedagógico apresentado possibilitou a incorporação de valores humanísticos à formação dos estudantes de Medicina.

The authors present and discuss an activity of the extension project “Prescribing stories: development of narrative competence in medical students, from the State University of Rio de Janeiro, Brazil”. The focus of the article is the description of the developed methodology: distribution of literary pills in the waiting room of an outpatient clinic and production of narratives from this experience, as well as the analysis of the created narratives. The article is divided into sections. Initially, the dynamics of the activity’s development and the methodological procedure conceived for the analysis of the analysis of the material produced are presented, based on virtual group meetings. Then, the analysis of the 25 narratives is addressed, emphasizing their voices, themes and linguistic resources The authors conclude that the in question didactic-pedagogical resource enabled the incorporation of humanistic values in the education of medical students.

Los autores presentan y discuten una actividad del proyecto de expansión Prescribiendo historias: desarrollo de competencia narrativa en estudiantes de medicina, de la Universidad del Estado de Río de Janeiro, Brasil. El enfoque del artículo es la descripción de la metodología desarrollada: distribución de píldoras literarias en la sala de espera de un ambulatorio y producción de narrativas a partir de la experiencia, así como de su análisis. El artículo se divide en secciones. Inicialmente se presentan la dinámica de desarrollo de la actividad y el procedimiento metodológico engendrado para el análisis del material producido, a partir de encuentros virtuales del grupo. A seguir, se aborda el análisis de las 25 narrativas, con destaque para las temáticas, los recursos lingüísticos y las voces presentes. Los autores concluyen que el recurso didáctico-pedagógico presentado posibilitó la incorporación de valores humanísticos a la formación de los estudiantes de Medicina.

ABSTRACT Objective to characterize the socioeconomic and clinical-epidemiological profile of people attended in an outpatient clinic specialized in complex wounds. Methods cross-sectional study with 69 people with wounds, through the application of a questionnaire. Data analyzed using descriptive and analytical statistics. Results most participants were male (55.1%), above 60 years old (55.1%), married (40.6%), income from one to three minimum wages (69.6%). Regarding clinical aspects, 50 (72.4%) had the injury for more than six months, 32 (46.4%) had a relative responsible wound dressing, 44 (63.8%) did not have difficulties in wound dressing. Regarding how long they had the wound, pain and arterial disease were statistically significant (p=0.042; p=0.026). Conclusion most participants were male and above 60 years old. Pain and the presence of arterial diseases were significant with regards to people with chronic wounds.

RESUMO Objetivo caracterizar perfil socioeconômico e clínico epidemiológico de pessoas com feridas, atendidas em ambulatório especializado em feridas complexas. Métodos estudo transversal, com 69 pessoas com feridas, mediante aplicação de questionário. Dados analisados por meio de estatística descritiva e analítica. Resultados predominância do sexo masculino (55,1%), idade acima de 60 anos (55,1%), casados (40,6%), com renda entre um e três salários mínimos (69,6%). Quanto aos aspectos clínicos, 50 (72,4%) tinham a lesão a mais de seis meses, 32 (46,4%) algum familiar como responsável pelos curativos e 44 (63,8%) não apresentaram dificuldade com as trocas dos curativos. Em relação ao tempo da ferida, as variáveis dor e doença arterial apresentaram significância estatística (p=0,042; p=0,026). Conclusão predominaram o sexo masculino e as pessoas acima de 60 anos. No tocante às características das lesões, a dor e presença de doença arterial apresentaram significância em relação às pessoas com feridas crônicas.

ABSTRACT To mitigate the deleterious effects of abiotic stress, the use of plant growth-promoting bacteria along with diazotrophic bacteria has been increasing. The objectives of this study were to investigate the key enzymes related to nitrogen and carbon metabolism in the biological nitrogen fixation process and to elucidate the activities of these enzymes by the synergistic interaction between Bradyrhizobium and plant growth-promoting bacteria in the absence and presence of salt stress. Cowpea plants were cultivated under axenic conditions, inoculated with Bradyrhizobium and co-inoculated with Bradyrhizobium sp. and Actinomadura sp., Bradyrhizobium sp. and Bacillus sp., Bradyrhizobium sp. and Paenibacillus graminis, and Bradyrhizobium sp. and Streptomycessp.; the plants were also maintained in the absence (control) and presence of salt stress (50 mmolL-1 NaCl). Salinity reduced the amino acids, free ammonia, ureides, proteins and total nitrogen content in nodules and increased the levels of sucrose and soluble sugars. The co-inoculations responded differently to the activity of glutamine synthetase enzymes under salt stress, as well as glutamate synthase, glutamate dehydrogenase aminating, and acid invertase in the control and salt stress. Considering the development conditions of this experiment, co-inoculation with Bradyrhizobium sp. and Bacillus sp. in cowpea provided better symbiotic performance, mitigating the deleterious effects of salt stress.

Abstract Soil salinity is an important abiotic stress worldwide, and salt-induced oxidative stress can have detrimental effects on the biological nitrogen fixation. We hypothesized that co-inoculation of cowpea plants with Bradyrhizobium and plant growth-promoting bacteria would minimize the deleterious effects of salt stress via the induction of enzymatic and non-enzymatic antioxidative protection. To test our hypothesis, cowpea seeds were inoculated with Bradyrhizobium or co-inoculated with Bradyrhizobium and plant growth-promoting bacteria and then submitted to salt stress. Afterward, the cowpea nodules were collected, and the levels of hydrogen peroxide; lipid peroxidation; total, reduced and oxidized forms of ascorbate and glutathione; and superoxide dismutase, catalase and phenol peroxidase activities were evaluated. The sodium and potassium ion concentrations were measured in shoot samples. Cowpea plants did not present significant differences in sodium and potassium levels when grown under non-saline conditions, but sodium content was strongly increased under salt stress conditions. Under non-saline and salt stress conditions, plants co-inoculated with Bradyrhizobium and Actinomadura or co-inoculated with Bradyrhizobium and Paenibacillus graminis showed lower hydrogen peroxide content in their nodules, whereas lipid peroxidation was increased by 31% in plants that were subjected to salt stress. Furthermore, cowpea nodules co-inoculated with Bradyrhizobium and plant growth-promoting bacteria and exposed to salt stress displayed significant alterations in the total, reduced and oxidized forms of ascorbate and glutathione. Inoculation with Bradyrhizobium and plant growth-promoting bacteria induced increased superoxide dismutase, catalase and phenol peroxidase activities in the nodules of cowpea plants exposed to salt stress. The catalase activity in plants co-inoculated with Bradyrhizobium and Streptomyces was 55% greater than in plants inoculated with Bradyrhizobium alone, and this value was remarkably greater than that in the other treatments. These results reinforce the beneficial effects of plant growth-promoting bacteria on the antioxidant system that detoxifies reactive oxygen species. We concluded that the combination of Bradyrhizobium and plant growth-promoting bacteria induces positive responses for coping with salt-induced oxidative stress in cowpea nodules, mainly in plants co-inoculated with Bradyrhizobium and P. graminis or co-inoculated with Bradyrhizobium and Bacillus.