RESUMO: Botulismo é causado pela ingestão de toxinas pré-fromadas produzidas por Clostridium botulinum. Este estudo descrevre um surto de botulismo tipo D em um rebanho bovino, com alta taxa de mortalidade (67%), devido ao consumo de silagem mal acondicionada. Os bovinos afetados apresentaram curso clínico hiperagudo e agudo de paralisia flácida progressiva. Cinco animais foram necropsiados e não foram visualizadas alterações macroscópicas e microscópicas. Embora a toxina não tenha sido detectada no alimento, a fonte mais provável de contaminação foi considerada a silagem armazenada inadequadamente. O diagnóstico de botulismo foi baseado nos achados clínicos, epidemiológicos e pela detecção da toxina botulínica no conteúdo intestinal de dois bovinos. O presente estudo enfatiza a morte de muitos bovinos por uma fonte incomum de toxina botulínica e a importância do manejo adequado no fornecimento de ração aos animais. RESUMO préfromadas pré fromadas botulinum bovino 67%, 67 67% , (67%) acondicionada progressiva microscópicas alimento inadequadamente clínicos 6 (67% (67 (6 (

ABSTRACT: Botulism is a condition caused by the ingestion of pre-formed toxins produced by the bacterium Clostridium botulinum. This study described an outbreak of type D botulism with a high mortality rate (67%) in a cattle herd, caused by the consumption of fermented silage. The affected cattle presented with a hyperacute to acute clinical course with progressive flaccid paralysis. Five animals underwent necropsy with no significant macroscopic and microscopic alterations. A most probable source of contamination was deemed to be an inadequately stored silage; although, the toxin was not detected in the feed. The diagnosis of botulism was based on both clinical and epidemiological findings and the detection of botulinum toxin in the intestinal contents of two of the affected cattle. The present study emphasized the high number of fatally affected cattle, an unusual source of botulinum toxin and the importance of proper management of animal feed supply. ABSTRACT preformed pre formed 67% 67 (67% herd silage paralysis alterations although supply 6 (67 (6 (

ABSTRACT Cobalt (Co) and molybdenum (Mo) are essential elements with a fundamental role in biological nitrogen fixation in legumes. Vitamins such as thiamine, despite being required in small quantities, influence plant growth. This study aimed to assess the efficiency of different doses of thiamine applied as seed treatment, combined or not with Co and Mo, in enhancing the development of soybean crops. The experiment was conducted in a greenhouse according to a randomized block design with a 6 × 2 factorial arrangement, comprising six thiamine doses (0, 10, 25, 50, 100, and 200 mg kg-1) in the presence or absence of Co and Mo at the recommended rate of 100 mL ha-1. At 40 days after sowing, plants were analyzed for root length, root dry weight, shoot length, shoot dry weight, nodule number, and nodule dry weight. Principal component analysis showed that combined application of Co and Mo with thiamine was negatively associated with all variables and that the thiamine doses most positively associated with the analyzed variables were 50 and 200 mg kg-1. In treatments containing thiamine alone, there was a linear direct relationship between thiamine dose and nodule dry weight. Root and shoot lengths and dry weights were highest in plants treated with thiamine only at a dose of 122 mg kg-1. Application of Co and Mo combined with thiamine via seed treatment does not promote the development of soybean crops. Thiamine application is a promising treatment to increase shoot length, root dry weight, and nodule dry weight in soybean. (Co (Mo legumes quantities growth crops arrangement 0, 0 (0 10 25 20 kg1 kg 1 kg-1 ha1. ha1 ha 1. ha-1 4 sowing length number 5 kg1. alone 12 ( kg- ha-

ABSTRACT Chia (Salvia hispanica L.) seeds have attracted great economic interest for their high levels of linoleic and α-linolenic acids. In Brazil, there is a lack of studies on the agronomic characteristics and physiological quality of chia, necessitating research on germination processes and strategies to enhance yield under field conditions. There are no studies assessing the development of seeds with different coat colors in the presence of fungicides. This study aimed to assess the physiological quality of chia seeds as a function of coat color and fungicide treatment. The experiment followed a completely randomized design with a 2 × 2 factorial arrangement and six replications. For this, seeds were divided into two groups according to coat color (black and white) and subjected or not to treatment with carboxin + thiram. Germination speed index, germination rate, and shoot length were evaluated in plants sown at 0, 90, and 180 days after seed treatment. Germination rate and speed index differed significantly between coat colors, with white seeds having higher vigor than black seeds. Shoot length, however, differed only for seeds sown on the day of treatment, indicating that treated seeds were more vigorous. Salvia L. L αlinolenic α linolenic acids Brazil conditions fungicides replications this thiram 0 90 18 however vigorous 9 1

ABSTRACT Mapping resistant populations makes it possible to identify the evolution and dispersal of resistance cases, providing important information for control-related decision making. This study aimed to identify and map herbicide-resistant sourgrass (Digitaria insularis) populations in Brazilian regions. The results showed no glufosinate resistance, with 485 samples (96.6%) classified as putative resistant to glyphosate, while nine (1.8%) and five (1%) were considered putative resistant to haloxyfop and clethodim, respectively. Two samples were deemed putative resistant to three herbicides (glyphosate, haloxyfop, and clethodim). One of the samples characterized as a control failure for all three herbicides was used on the dose-response curve. This biotype was identified as glyphosate-resistant, with low-level resistance to clethodim and haloxyfop. Based on C50, resistance factors of 10.96, 3.26, and 3.15 were identified for glyphosate, clethodim, and haloxyfop, respectively. Mapping sourgrass resistance is vital to understand and ensure the early identification and quantification of the frequency of these plants. cases controlrelated related making herbicideresistant herbicide Digitaria insularis regions 48 96.6% 966 96 6 (96.6% glyphosate 1.8% 18 1 8 (1.8% 1% (1% respectively (glyphosate clethodim. . clethodim) doseresponse dose response curve glyphosateresistant, glyphosateresistant resistant, glyphosate-resistant lowlevel low level C50 C 1096 10 10.96 326 3 26 3.26 315 15 3.1 plants 4 96.6 9 (96.6 1.8 (1.8 (1 C5 109 10.9 32 2 3.2 31 3. 96. (96. 1. (1. ( 10. (96 (9

RESUMO: Oitocentas e sessenta frangas Embrapa 051 foram alocadas em três grupos de peso corporal às 19 semanas (pesadas: 1,48 kg ± 0,01 DP, N= 172 aves, médias: 1,32 kg ± 0,039 DP, N= 516 aves, leves: 1,19 kg ± 0,019 DP, N=172 aves) e alojadas em piso com ninhos por 65 semanas. As aves pesadas apresentaram maior produção de ovos nas semanas 24-28, enquanto as médias superaram as pesadas nas semanas 41-46, e as leves superaram as pesadas nas semanas 61-65. Nas semanas 57 a 65, não houve diferenças significativas na produção de ovos entre as aves pesadas e médias. O peso às 19 semanas afetou ovos no chão, ovos trincados e ovos duplos (P < 0,05) nas semanas 22-34. As aves pesadas botaram menos ovos no chão, as médias tiveram menos ovos trincados (0,3%), e as leves produziram menos ovos com duas gemas (1,1%). Não houve impacto significativo do peso inicial no peso dos ovos. Em conclusão, o peso às 19 semanas influencia o ciclo de postura, com aves pesadas, médias e leves exibindo padrões distintos de produção de ovos, uso do ninho e características de qualidade em diferentes fases do ciclo. RESUMO 05 1 (pesadas 148 48 1,4 001 0 01 0,0 DP N 17 132 32 1,3 0039 039 0,03 51 119 1,1 0019 019 N172 N=17 6 2428, 2428 24 28, 28 24-28 4146, 4146 41 46, 46 41-46 6165. 6165 61 65. 61-65 5 chão P 0,05 005 2234. 2234 22 34. 34 22-34 0,3%, 03 0,3% , 3 (0,3%) 1,1%. 11 1,1% . (1,1%) conclusão postura 14 4 1, 00 0, 13 003 N17 N=1 242 2 24-2 414 41-4 616 61-6 223 22-3 0,3 (0,3% (1,1% N1 24- 41- 61- 22- (0,3 (1,1 (0, (1, (0 (1 (

ABSTRACT: A total of 860 Embrapa 051 pullets were allocated into three groups based on their 19-week body weights (heavy: 1.48 kg ± 0.01 SD, N= 172 birds, medium: 1.32 kg ± 0.039 SD, N= 516 birds, light: 1.19 kg ± 0.019 SD, N=172 birds) and housed in floor pens with nests for a 65-week production period. Heavy-weight birds exhibited higher egg production during weeks 24-28, while medium-weight hens surpassed heavy-weight counterparts between weeks 41-46, and light-weight hens outperformed heavy-weight birds in weeks 61-65. From weeks 57-65, no significant egg production differences were noted between heavy and medium-weight hens. Body weight at 19 weeks affected floor eggs, cracked eggs, and double-yolk eggs (P < 0.05) during weeks 22-34. Heavy-weight hens laid fewer floor eggs, medium-weight hens had fewer cracked eggs (0.3%), and light-weight hens produced fewer double-yolk eggs (1.1%). No significant impact of weight grouping on egg weight was observed. Results indicated that body weight at 19 weeks influences the laying cycle, with heavy, medium, and light-weight hens exhibiting distinct egg production patterns, nest use and egg quality traits at different phases of the cycle. ABSTRACT 86 05 19week week (heavy 148 1 48 1.4 001 0 01 0.0 SD N 17 medium 132 32 1.3 0039 039 0.03 51 light 119 1.1 0019 019 N172 N=17 65week 65 period Heavyweight Heavy 2428, 2428 24 28, 28 24-28 mediumweight heavyweight 4146, 4146 41 46, 46 41-46 lightweight 6165. 6165 61 65. 61-65 5765, 5765 57 65, 57-65 doubleyolk double yolk P 0.05 005 2234. 2234 22 34. 34 22-34 0.3%, 03 0.3% , 3 (0.3%) 1.1%. 11 1.1% . (1.1%) observed cycle patterns 8 14 4 1. 00 0. 13 003 5 N17 N=1 6 242 2 24-2 414 41-4 616 61-6 576 57-6 223 22-3 0.3 (0.3% (1.1% N1 24- 41- 61- 57- 22- (0.3 (1.1 (0. (1. (0 (1 (

RESUMO Introdução: Doenças pulmonares são comuns em pacientes com doença renal em estágio terminal (DRET), dificultando o diagnóstico diferencial com COVID-19. Este estudo descreve achados de tomografia computadorizada de tórax (TC) em pacientes com DRET em terapia renal substitutiva (TRS) hospitalizados com suspeita de COVID-19. Métodos: Indivíduos maiores de 18 anos com DRET, encaminhados ao pronto-socorro com suspeita de COVID-19 foram incluídos. Dados clínicos e epidemiológicos foram extraídos de registros eletrônicos de saúde. A TC foi classificada como típica, indeterminada, atípica, negativa. Comparamos achados tomográficos de pacientes com COVID-19 positivos e negativos. Resultados: Recrutamos 109 pacientes (62,3% COVID-19-positivos) entre março e dezembro de 2020, idade média de 60 ± 12,5 anos, 43% mulheres. A etiologia mais comum da DRET foi diabetes. Tempo médio em diálise foi 36 meses, intervalo interquartil = 12–84. A lesão pulmonar mais comum foi opacidades em vidro fosco. O padrão típico de TC foi mais comum em pacientes com COVID-19 (40 (61%) vs. 0 (0%) em pacientes sem COVID-19, p < 0,001). Sensibilidade 60,61% (40/66), especificidade 100% (40/40). Valores preditivos positivos e negativos foram 100% e 62,3%, respectivamente. Padrão atípico de TC foi mais frequente em pacientes COVID-19-negativos (9 (14%) vs. 24 (56%) em COVID-19-positivos, p < 0,001), enquanto padrão indeterminado foi semelhante em ambos os grupos (13 (20%) vs. 6 (14%), p = 0,606), e padrão negativo foi mais comum em pacientes COVID-19-negativos (4 (6%) vs. 12 (28%), p = 0,002). Conclusões: Em pacientes com DRET em TRS hospitalizados, um padrão atípico de TC de tórax não pode excluir adequadamente o diagnóstico de COVID-19. Introdução , (DRET) COVID19. COVID19 COVID 19. 19 (TC (TRS Métodos 1 prontosocorro pronto socorro COVID-1 incluídos saúde típica indeterminada atípica negativa Resultados 10 62,3% 623 62 3 (62,3 COVID19positivos COVIDpositivos COVID-19-positivos 2020 125 5 12, 43 mulheres diabetes meses 1284 84 12–84 fosco 40 61% 61 (61% vs 0% (0% COVID19, 19, 0,001. 0001 0,001 . 001 0,001) 6061 60,61 40/66, 4066 40/66 66 (40/66) 100 40/40. 4040 40/40 (40/40) respectivamente COVID19negativos COVIDnegativos 9 ( 14% 14 (14% 2 56% 56 (56% COVID19positivos, positivos, 0,001, 13 (1 20% 20 (20% 14%, 0,606, 0606 0,606 606 0,606) 4 6% (6% 28%, 28 28% (28%) 0,002. 0002 0,002 002 0,002) Conclusões (DRET COVID1 COVID- 62,3 (62, 202 128 8 12–8 (61 (0 000 0,00 00 60,6 406 40/6 (40/66 404 40/4 (40/40 (14 (56 (20 060 0,60 (6 (28% 62, (62 12– 0,0 60, 40/ (40/6 (40/4 (5 (2 06 0,6 (28 0, (40/

ABSTRACT Introduction: Lung diseases are common in patients with end stage kidney disease (ESKD), making differential diagnosis with COVID-19 a challenge. This study describes pulmonary chest tomography (CT) findings in hospitalized ESKD patients on renal replacement therapy (RRT) with clinical suspicion of COVID-19. Methods: ESKD individuals referred to emergency department older than 18 years with clinical suspicion of COVID-19 were recruited. Epidemiological baseline clinical information was extracted from electronic health records. Pulmonary CT was classified as typical, indeterminate, atypical or negative. We then compared the CT findings of positive and negative COVID-19 patients. Results: We recruited 109 patients (62.3% COVID-19-positive) between March and December 2020, mean age 60 ± 12.5 years, 43% female. The most common etiology of ESKD was diabetes. Median time on dialysis was 36 months, interquartile range = 12–84. The most common pulmonary lesion on CT was ground glass opacities. Typical CT pattern was more common in COVID-19 patients (40 (61%) vs 0 (0%) in non-COVID-19 patients, p < 0.001). Sensitivity was 60.61% (40/66) and specificity was 100% (40/40). Positive predictive value and negative predictive value were 100% and 62.3%, respectively. Atypical CT pattern was more frequent in COVID-19-negative patients (9 (14%) vs 24 (56%) in COVID-19-positive, p < 0.001), while the indeterminate pattern was similar in both groups (13 (20%) vs 6 (14%), p = 0.606), and negative pattern was more common in COVID-19-negative patients (4 (6%) vs 12 (28%), p = 0.002). Conclusions: In hospitalized ESKD patients on RRT, atypical chest CT pattern cannot adequately rule out the diagnosis of COVID-19. Introduction ESKD, , (ESKD) COVID19 COVID 19 COVID-1 challenge (CT RRT (RRT COVID19. 19. Methods 1 records typical Results 10 62.3% 623 62 3 (62.3 COVID19positive COVIDpositive COVID-19-positive 2020 125 5 12. 43 female diabetes months 1284 84 12–84 opacities 40 61% 61 (61% 0% (0% nonCOVID19 nonCOVID non non-COVID-1 0.001. 0001 0.001 . 001 0.001) 6061 60.61 40/66 4066 66 (40/66 100 40/40. 4040 40/40 (40/40) respectively COVID19negative COVIDnegative 9 ( 14% 14 (14% 2 56% 56 (56% COVID19positive, positive, 0.001, 13 (1 20% 20 (20% 14%, 0.606, 0606 0.606 606 0.606) 4 6% (6% 28%, 28 28% (28%) 0.002. 0002 0.002 002 0.002) Conclusions (ESKD COVID1 COVID- 62.3 (62. 202 128 8 12–8 (61 (0 nonCOVID1 non-COVID- 000 0.00 00 60.6 40/6 406 (40/6 404 40/4 (40/40 (14 (56 (20 060 0.60 (6 (28% 62. (62 12– non-COVID 0.0 60. 40/ (40/ (40/4 (5 (2 06 0.6 (28 0.

Resumo Fundamento A Doença de Chagas (DC) representa um grave problema de saúde pública na América Latina. O Benznidazol (BNZ) é utilizado para o tratamento DC e, apesar do seu amplo uso, poucas informações estão disponíveis sobre sua toxicidade e mecanismos das Reações Adversas ao Medicamento (RAM). Objetivos Identificar e classificar as reações adversas clínicas e laboratoriais ocasionadas pelo uso do BNZ quanto à sua causalidade e gravidade. Métodos Estudo de coorte prospectivo realizado no período de janeiro de 2018 a dezembro de 2021. O acompanhamento do tratamento incluiu consultas e análises laboratoriais antes, 30 e 60 dias após o início do tratamento. As RAM foram classificadas quanto à causalidade e gravidade. Na análise estatística o nível de significância adotado foi p<0,05. Resultados Participaram do estudo 40 pacientes com DC crônica, observou-se alta prevalência de RAM com um total de 161 em 30 (90%) pacientes. Destas, 104 (64,6%) foram classificadas como possíveis e 57 (35,4%) como prováveis. As reações foram classificadas em moderadas e leves. Dos 40 pacientes, nove (22,5%) suspenderam o tratamento. As RAM associadas à interrupção e intervenções foram as que afetaram o sistema dermatológico, sistema nervoso central e periférico ou que culminaram em ageusia. Após 30 dias de tratamento, alterações hematológicas e bioquímicas leves foram observadas como linfopenia. Conclusão Apesar do elevado percentual de RAM, muitos pacientes foram capazes de completar o tratamento, o que se atribui ao êxito da estratégia de acompanhamento com intervenções de tratamento sintomático juntamente ao aconselhamento, levando à compreensão da sintomatologia e manutenção do tratamento. (DC Latina (BNZ RAM. . (RAM) gravidade 201 2021 antes 3 6 p005 p 0 05 p<0,05 4 crônica observouse observou 16 90% 90 (90% Destas 10 64,6% 646 64 (64,6% 5 35,4% 354 35 (35,4% prováveis 22,5% 225 22 (22,5% dermatológico ageusia linfopenia aconselhamento (RAM 20 202 p00 p<0,0 1 9 (90 64,6 (64,6 35,4 (35,4 22,5 2 (22,5 p0 p<0, (9 64, (64, 35, (35, 22, (22, p<0 ( (64 (35 (22 p< (6 (3 (2

Abstract Background Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR). Objectives To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity. Methods Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p<0.05. Results Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment. Conclusion Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient’s awareness of symptoms and treatment adherence. (CD America (BNZ use ADR. . (ADR) severity 201 2021 followup follow up count before analysis p005 p 0 05 p<0.05 16 3 90% 90 [90%] these 10 64.6% 646 64 6 (64.6% 5 35.4% 354 35 4 (35.4% probable mild 22.5% 225 22 (22.5% ageusia counseling patient s adherence (ADR 20 202 p00 p<0.0 1 9 [90% 64.6 (64.6 35.4 (35.4 22.5 2 (22.5 p0 p<0. [90 64. (64. 35. (35. 22. (22. p<0 [9 (64 (35 (22 p< [ (6 (3 (2 (

Abstract The aim was to prepare mayonnaises with natural preservatives and improved protein content to verify their structural and nutritional properties. Three formulations were developed (70% fat + variation in protein), F1 (powdered whey) did not reach the structural standards of commercial mayonnaise; F2 (skimmed milk) reached standards equivalent to commercialized products; F3 (powdered whey + skimmed milk) presented light mayonnaise pattern; F0 (Control). Protein content was higher than market products (more than 1.0 %). The evaluation of 30 days showed variations: AW (0.934-0.941); extrusion values F1 (1.035 N ±0.026 - 0.566 N ±0.024), F2(4.255 N ±0.160 - 3.218 N ±0.060), F3 (3.198 N ±0.086 - 1.700 N ±0.044). The preservatives favored the color ∆E: F1 (11.31 ±0.04), F2 (2.65 ±0.14), F3 (1.65 ± 0.22). DPPH analysis showed the difference of products with added natural preservatives and whey in relation to the F0; F3 formulation was favored. Thixotropy appeared in all samples. The exothermic peak occurred F1 (6˚C - 7˚C), F2 (5˚C - 7˚C) and F3 (3˚C - 4˚C), indicating faster crystallization of the F3 (lipid-protein bond). The use of whey and powdered milk as emulsifying agent for mayonnaise emulsions, garlic and mustard, increased shelf life and protein content were demonstrated.

Resumen El objetivo fue preparar mayonesas con conservantes naturales y contenido proteico mejorado, y verificar sus propiedades estructurales y nutricionales. Se desarrollaron tres formulaciones (70% grasa + variación en proteína), la F1 (suero en polvo) no alcanzó los padrones estructurales de la mayonesa comercial; F2 (leche desnatada) alcanzó padrones equivalentes a los productos comercializados; F3 (suero en polvo + leche desnatada) presentó patrón de mayonesa; F0 (Control). El contenido de proteínas fue superior al de los productos del mercado (más del 1,0 %). La evaluación de 30 días mostró variaciones: AW (0,934-0,941); valores de extrusión F1 (1.035 N ±0.026 - 0.566 N ±0.024), F2(4.255 N ±0.160 - 3.218 N ±0.060), F3 (3.198 N ±0.086 - 1.700 N ±0.044). Los conservantes favorecieron el color ∆E: F1 (11,31 ±0,04), F2 (2,65 ±0,14), F3 (1,65 ± 0,22). DPPH mostró la diferencia de los productos con conservantes naturales añadidos y suero con relación a la F0. Se favoreció la formulación F3. La tixotropía apareció en todas las muestras. El pico exotérmico se produjo en F1 (6˚C - 7˚C), F2 (5˚C - 7˚C) y F3 (3˚C - 4˚C), lo que indica una cristalización más rápida del F3 (enlace lípido-proteína). Se demostró el uso de suero y leche en polvo como agente emulsionante para emulsiones de mayonesa, ajo y mostaza, mayor vida útil y contenido de proteínas.

Resumo Introdução: Os doentes com síndroma de apneia obstrutiva do sono (SAOS) sob ventiloterapia, após alta da consulta hospitalar, devem manter o seguimento nos cuidados de saúde primários, para monitorização terapêutica. Objetivos: Melhorar o seguimento de doentes com SAOS sob ventiloterapia e sem acompanhamento hospitalar, numa Unidade de Saúde Familiar (USF). Outcome secundário: avaliação do número de referenciações hospitalares por terapêutica ineficaz/baixa adesão. Métodos: Estudo quasi-experimental, pré-pós intervenção, numa USF. Foram identificados doentes com diagnóstico de Perturbação do Sono (P06 - ICPC2), com SAOS, sob ventiloterapia, sem seguimento em consulta hospitalar. Analisados os dados do processo clínico relativos a interpretação de relatório de ventiloterapia, realização de consulta de seguimento e referenciação hospitalar. A primeira avaliação incidiu sobre o período entre janeiro e dezembro/2019. Posteriormente foram realizadas sessões formativas, com envolvimento da equipa multiprofissional. Desenvolvido procedimento de atuação para otimizar o pedido de relatórios por parte da equipa administrativa. Fornecido material auxiliar de memória e criada pasta informática com guião de seguimento de utentes, documento modelo para solicitação de relatório e panfleto sobre SAOS. A segunda avaliação incidiu sobre janeiro e dezembro/2021. Foram estabelecidas as seguintes metas, após discussão em reunião médica: taxa de consultas de seguimento ≥20%; taxa de interpretação de relatórios de ventiloterapia ≥20%. Resultados: Na primeira avaliação não se verificou a realização de consultas de seguimento de SAOS na USF. Em 2021 atingiu-se uma taxa de interpretação de relatórios de ventiloterapia de 25,47%, uma taxa de consultas de seguimento de 15,09% e foram realizadas cinco referenciações hospitalares por terapêutica inadequada. Conclusões: Apesar da meta definida para consultas de seguimento não ter sido atingida, este estudo promoveu o envolvimento de toda a equipa multiprofissional e a implementação de uma estratégia simples de acompanhamento e otimização terapêutica de doentes com SAOS na USF.

Abstract Background: Patients with obstructive sleep apnea syndrome (OSAS), undergoing treatment with continuous positive airway pressure (CPAP), after discharge from the hospital consultation, should maintain follow-up in primary health care, for therapeutic monitoring. Objectives: To improve the follow-up of patients with OSAS with CPAP and without sleep medicine consultation follow-up, in a Family Health Unit (FHU). Secondary outcome: number of hospital referrals due to ineffective therapy. Methods: Quasi-experimental, pre- and post-intervention study; in a FHU. Patients diagnosed with “Perturbação do Sono” (P06 - ICPC2), with OSAS, undergoing treatment with CPAP, and without Sleep Medicine Consultation follow-up were included. Data from the clinical process related to the follow-up consultations, CPAP device data report (DDR), and hospital referrals were analyzed. A first evaluation was carried out in 2019 (January-December). Subsequently, clinical sessions at the FHU for the multidisciplinary team and an action procedure to request DDR by the administrative team were made. Pocket-sized memory aids were provided. A computer folder was shared with the user follow-up guide, a model document for DDR requests, and a pam-phlet on OSAS. The second evaluation focused on January-December 2021. After discussion at a medical meeting, the defined outcomes were a rate of follow-up appointments ≥20% and a DDR interpretation rate ≥20%. Results: It was found that no patient had an adequate follow-up in the first evaluation. In 2021, a DDR interpretation rate of 25.47% and a follow-up appointment rate of 15.09% were reached. Five hospital referrals were made for ineffective therapy. Conclusion: Although the goal set for follow-up consultations was not reached, this study promoted the involvement of the entire team and the implementation of a simple strategy for OSAS follow-up in the primary healthcare setting.

RESUMO A correlação canônica é usada para correlacionar grupos de variáveis distintas. O objetivo deste estudo foi utilizar análise de correlação canônica para avaliar a interação entre atributos de qualidade da água causadores de entupimento e o desempenho hidráulico de gotejadores não autocompensantes operando com diluições de efluente de aquicultura em água de poço. O experimento foi conduzido em delineamento inteiramente casualizado, em esquema de parcelas subsubdivididas, com três repetições, com cinco diluições nas parcelas (Diluição 1: 100% de efluente de aquicultura; Diluição 2: 75% de efluente de aquicultura + 25% de água de poço; Diluição 3 : 50% efluente de aquicultura + 50% água de poço; Diluição 4: 25% efluente de aquicultura + 75% água de poço; e Diluição 5: 100% água de poço), três emissores nas subparcelas (ST (1,6 L h-1) , SL (1,6 L h-1) e NJ (1,7 L h-1)), e três tempos de operação nas subsubparcelas (início do experimento, 80 e 160 horas, em que 0 horas de operação significa o início das avaliações). As análises estatísticas realizadas foram matriz de correlação e análise canônica. A análise de correlação canônica indicou que quando as concentrações dos atributos aumentam, o desempenho hidráulico dos gotejadores diminui. A interação desse grupo de atributos indica que o entupimento dos gotejadores que operam com as cinco diluições de efluente de aquicultura em água de poço ocorre pela ação combinada de agentes físicos, químicos e biológicos. O gotejador ST foi o menos sensível ao grupo de atributos de qualidade das diluições, enquanto o mais sensível foi o gotejador SL. distintas casualizado subsubdivididas repetições 1 100 2 75 25 50 4 5 poço, poço) 1,6 16 6 (1, h1 h h-1 1,7 17 7 h1, h-1)) 8 avaliações. avaliações . avaliações) aumentam diminui físicos biológicos 10 1, (1 h- (

ABSTRACT The canonical correlation is used to correlate groups of distinct variables. The objective of this study was to use canonical correlation analysis to evaluate the interaction between water quality attributes clogging-causing and the hydraulic performance of non-pressure compensating drippers operating with dilutions of aquaculture effluent in well water. The experiment was in a completely randomized design in a split-split-plot scheme with three replicates, with five dilutions in the plots (Dilution 1: 100% aquaculture effluent; Dilution 2: 75% aquaculture effluent + 25% well water; Dilution 3: 50% aquaculture effluent + 50% well water; Dilution 4: 25% aquaculture effluent + 75% well water; and Dilution 5: 100% well water), three emitters in the sub-plots (ST (1.6 L h-1), SL (1.6 L h-1) and NJ (1.7 L h-1)), and three operating times in the sub-subplots (0, 80 and 160 hours, in which 0 hours operating time means the start of evaluations). The statistical analyses performed were correlation matrix and canonical analysis. The canonical correlation analysis indicated that when the concentrations of attributes increase, the hydraulic performance of the drippers decreases. The interaction of this group of attributes indicates that the clogging of drippers operating with the five dilutions of aquaculture effluent in well water occurs by the combined action of physical, chemical, and biological agents. The ST dripper was the least sensitive to the group of quality attributes of the dilutions, whereas the most sensitive was the SL dripper. variables cloggingcausing causing nonpressure non pressure splitsplitplot split plot replicates 1 100 2 75 25 3 50 4 5 water, , water) subplots sub 1.6 16 6 (1. h1, h1 h h-1 1.7 17 7 h-1)) subsubplots 0, (0 8 evaluations. evaluations . evaluations) increase decreases physical chemical agents 10 1. (1 h- (

Abstract Introduction: Experience with endoscopic retrograde cholangiopancreatography (ERCP) in the pediatric population is limited. Few medical centers have experts specifically trained in pediatric therapeutic endoscopy. As a result, patients are generally referred to adult endoscopists with high experience in the procedure. The aim of this study was to characterize the experience of an adult endoscopy unit with ERCP on pediatric patients, with a special focus on very young patients. Methods: We retrospectively analyzed indications, technical success rate, final clinical diagnosis, and complica-tions of ERCPs in children <18 years at our tertiary referral hospital center between January 1994 and June 2022. Results: Sixty-five ERCPs were performed on 57 children with a median age of 13 years (range 1-17 years). Eleven ERCPs were performed on 9 patients up to 5 years old. Indications for ERCP were as follows: biliary obstruction (n = 40), mainly due to choledocholithiasis, lithiasic acute pancreatitis (n = 19), recurrent pancreatitis (n = 3), stent extraction (n = 2), and post-operative biliary fistula (n = 1). The cannulation success rate was 95.1%. Therapeutic interventions were performed in 79% of ERCP. All patients were followed up as inpatients. Complications were recorded in two procedures (3.1%), and no procedure-related mortality occurred. Conclusion: In our experience, ERCP in children can be safely performed with high success rates by advanced adult-trained expert endoscopists at a high-volume center.

Resumo Introdução: Existe pouca experiência na realização de colangiopancreatografia retrógrada endoscópica (CPRE) na população pediátrica. A maioria dos centros carece de especialistas especificamente treinados em endoscopia terapêutica pediátrica, sendo os doentes geralmente referenciados para Gastroenterologistas de adultos com elevada experiência na técnica. O objectivo deste estudo foi caracterizar a experiência de um departamento de Gastrenterologia de adultos em CPRE pediátrica, com destaque particular nos doentes muito novos. Métodos: Foram analisadas retrospectivamente as indicações, sucesso técnico, diagnósticos e complicações das colan-giopancreatografias retrógradas endoscópicas (CPREs) realizadas no nosso hospital terciário em crianças <18 anos, entre Janeiro de 1994 e Junho de 2022. Resultados: Foram realizadas 65 CPREs em 57 crianças com idade mediana 13 anos (1-17 anos). Doze procedimentos foram realizados em 9 crianças com idade até 5 anos. As indicações para CPRE foram: obstrução biliar (n = 40), sobretudo devido a coledocolitíase, pancreatite aguda litiásica (n = 19), pancreatite recorrente (n = 3), extracção de prótese (n = 2) e fístula biliar pós cirurgia (n = 1). A taxa de sucesso de canulação foi 95.4%. Foram realizados procedimentos terapêuticos em 80.0% das CPREs. Todos os doentes foram vigiados em regime de internamento, tendo-se registado complicações em dois exames (3.1%). Não existiram mortes relacionadas com a técnica. Discussão/Conclusão: A CPRE pode ser realizada na população pediátrica com segurança e elevada taxa de sucesso por Gastrenterologistas de adultos com experiência na técnica, num centro com elevado volume de exames.

Abstract A compression or interruption of the oculosympathetic pathway is generally the cause of Horner syndrome. Different etiologies are usually considered, either in the central or in the peripheral nervous system. Horner syndrome due to a herniated cervical or dorsal disc seems to be an excedingly rare event, which is the diagnosis of the presented case. The patient is a 59-year-old woman with sudden onset of dorsal pain and right unilateral ptosis and slight miosis, along with numbness in the third, fourth and fifth fingers of the right hand, due to a D1-D2 herniated disc with associated spinal nerve root compression. An extensive investigation ruled out other possible etiologies. In conclusion, the differential diagnosis of patients presenting with Horner syndrome should include upper thoracic disk herniation.

Resumo A compressão ou bloqueio da via óculossimpática é a causa principal de síndrome de Horner. Várias etiologias podem geralmente ser consideradas, quer no sistema nervoso central, quer no periférico. A síndrome de Horner devida a uma hérnia discal cervical ou dorsal constitui um evento particularmente raro, sendo o diagnóstico do caso apresentado. Este trata uma doente de 59 anos com um quadro súbito de dorsalgia e ptose unilateral direita, devidas a uma hérnia discal ao nível de D1-D2. Foi conduzida uma investigação extensiva para excluir outras possíveis etiologias. Em conclusão, o diagnóstico diferencial de doentes com síndrome de Horner deverá incluir a hérnia discal torácica superior.

Resumo Introdução: A trombocitemia essencial (TE) é uma condição pouco comum e assintomática na maioria dos casos. No entanto, podem surgir sintomas como cefaleias, síncope, vertigem, dor torácica, eritromelalgia e distúrbios visuais transitórios. Os eventos hemorrágicos e tromboembólicos são os grandes riscos desta patologia. O objetivo da partilha deste caso clínico é alertar para uma patologia rara que pode passar despercebida e causar eventos potencialmente graves. Descrição do caso: Sexo feminino, 43 anos, raça caucasiana, antecedentes de hepatite B crónica, sem antecedentes cirúrgicos nem medicação habitual, incluindo método contracetivo hormonal. Recorreu a consulta com queixas de enfartamento precoce, dispepsia e epigastralgia com três dias de evolução, negando alterações do trânsito intestinal, características das fezes, náuseas ou vómitos. Exame físico e endoscopia digestiva alta recente sem alterações de relevo. Foi consultado o estudo analítico que a utente realizava regularmente no hospital, verificando-se que o valor do número de plaquetas se encontrava consistentemente a rondar os 500.000/uL desde há três anos. Pediu-se ecografia abdominal que descrevia trombose parcial da veia porta e do seu ramo esquerdo. A doente foi medicada com enoxaparina 60 mg 12h/12 h. Foi realizado angio-TC abdominal, estudo pró-trombótico e estudo genético e iniciou varfarina 5 mg 1x/dia, inicialmente sobreposta com enoxaparina 60 mg 12/12h. O angio-TC viria a confirmar a trombose da veia porta e confirmou-se positiva a mutação JAK2 V617F. Assumido o diagnóstico de TE e iniciado tratamento citorredutor com hidroxiureia 500 mg em dias alternados. Comentário: Este caso chama a atenção pelo excesso de plaquetas secundário à TE, ainda que ligeiramente acima do valor de referência, ter originado uma trombose da veia porta. Pretende-se alertar os médicos de família para a importância de realizar um estudo atento, valorizando pequenas variações sustentadas fora dos intervalos da normalidade e fazer uma referenciação correta e atempada quando necessário.

Abstract Introduction: Essential thrombocythemia (ET) is an asymptomatic rare condition in most cases. Nonetheless, symptoms like headache, syncope, vertigo, thoracic pain, erythromelalgia, and transient visual disturbances may surge. The major concerns of this pathology are hemorrhagic and thromboembolic events. The aim of sharing this case report is to alert for the existence of this rare pathology that can go unnoticed and cause potentially serious events. Case description: Female, 43-year-old, Caucasian. Background of chronic B hepatitis, without surgical background nor usual medication, including the contraceptive pill. She appealed to a medical appointment with an early feeling of fullness when eating, dyspepsia, and epigastric pain in the last three days. She denied changes in intestinal habits, feces characteristics, nausea, or vomiting. Physical examination and recent upper endoscopic study were normal. The hospital medical record was examined, verifying that platelet levels were consistently rounding 500,000/uL for the past three years. An abdominal ultrasonography was requested, and it described a partial portal vein and left branch thrombosis. The patient started enoxaparin 60 mg every 12 hours. It was conducted an abdominal angiotomography, prothrombotic, and genetic study, including the JAK2 V617F mutation. The patient started warfarin 5 mg one time daily, initially overlaid with enoxaparin 60 mg 12h/12h. The abdominal angiotomography would confirm the portal vein thrombosis and the JAK2 V617F mutation study was positive. It was assumed the diagnosis of ET and was initiated cytoreductive therapy with hydroxyurea 500 mg on alternated days. Comment: This case report shows that the excessive platelet count, secondary to ET, even if slightly above the reference value, caused a portal vein thrombosis. We aim to alert family physicians to the importance of doing a careful study, valuing little sustained variations out of the normal intervals, and referring correctly and promptly when necessary.

A new class of deep eutectic solvents (DES) was used in the extraction of levodopa (L-dopa) present in Mucuna cinerea, which has been termed “green” or “designer” solvents, with notable productive and economic/environmental benefits. The seeds of Mucuna cinerea were prepared and submitted to extraction with heating and agitation in a solvent mixture of DES with citric acid, urea, or glycerol. The extracts were analyzed by high performance liquid chromatography (HPLC) which confirmed the efficiency of DES in extracting L-dopa. These extractions were carried out to determine the L-dopa extracts in DES with regard to the induction of cellular response activity, demonstrating the synergy between L-dopa and DES. The DES-glycerol extract exhibited a higher proliferative activity than commercial L-dopa after 24 h of treatment. The human glandular kallikrein-1 gene (hGK3) demonstrated higher expression in the treatment with the DES-urea, while the G protein-coupled receptor kinase-6 gene (GRK6) showed higher expression for all extracts compared to commercial L-dopa, with a higher value obtained for DES glycerol, followed by DES urea extract. The DES extraction method is therefore promising and unprecedented, confirming its possible use in the replacement of expensive solvents, supporting the use of ecologically viable DES in the extractions of other plant species. (DES Ldopa L dopa (L-dopa green “green designer “designer economicenvironmental economic environmental benefits acid glycerol HPLC (HPLC Ldopa. dopa. DESglycerol 2 kallikrein1 kallikrein 1 kallikrein- hGK3 hGK (hGK3 DESurea, DESurea DES-urea proteincoupled protein coupled kinase6 kinase 6 kinase- GRK6 GRK (GRK6 Ldopa, dopa, unprecedented species (hGK (GRK