Bisphenol A (BPA), an endocrine disruptor used in different commercial polymers, is a persistent pollutant commonly found in effluents. Conventional wastewater treatment processes have low chemical removal efficiency and are expensive. This work evaluated BPA removal using laccase enzyme produced from white rot fungus Pleurotus ostreatus. For the enzymatic production, residues of acai berry and pineapple were used as laccase inducers. The use of natural inducers led to a high enzyme production (1139 and 1031 U mL−1 to acai and pineapple, respectively). Bisphenol A was removed to a concentration lower than LOD (limit of detection) after 4 h. The degradation mechanism of BPA occurred by oxidation of methyl to hydroxymethyl group in a propane portion, with breakdown of the aromatic ring. The developed technology brought to the scene a new green, viable methodology, using vegetable waste, adding value to these residues and bringing an alternative to the BPA treatment. BPA, , (BPA) polymers effluents expensive ostreatus 1139 (113 103 mL1 mL 1 mL− respectively. respectively . respectively) limit detection h portion ring green methodology waste (BPA 113 (11 10 11 (1 (

Fruits of Schinus terebinthifolia Raddi were investigated. A fast and efficient method for the simultaneous determination of 11 polyphenolic substances by high performance liquid chromatography-diode array detector (HPLC-DAD) was applied. Limits of quantification ranged between 0.78 and 3.14 mg L-1. High concentrations of kaempferol were found. An exploratory evaluation was performed using principal component analysis (PCA) for fruit origin differentiation. Total phenolic content (TPC) ranged from 274 to 517 mg GAE 100 g-1; total flavonoid content (TFC) ranged from 101 to 283 mg QE 100 g-1. In vitro analyses showed that antioxidant capacity with 2,2-diphenyl-1-picrylhydrazyl (DPPH) ranged from 1.7 to 7 µM DPPH 100 g-1. The bacteriostatic and bactericidal effect were also evaluated against: Bacillus subtilis, B. cereus, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella choleraesuis, Candida albicans and C. glabrata, using broth microdilution assay. It can be inferred that S. terebinthifolia Raddi fruit has the potential to act as an ally in the search for new alternatives in the action against pathogens, and it can be used as a potential natural antioxidant and antimicrobial agent. Metals (Cu, Fe, Mg, Mn and Zn) were also determined by flame atomic absorption spectrometry (FAAS), with emphasis on high concentrations of Mg, Zn and Fe. investigated 1 chromatographydiode chromatography diode HPLCDAD HPLC DAD (HPLC-DAD applied 078 0 78 0.7 314 3 14 3.1 L1. L1 L 1. L-1 found PCA (PCA differentiation TPC (TPC 27 51 10 g1 g g-1 TFC (TFC 28 g1. 2,2diphenyl1picrylhydrazyl 22diphenyl1picrylhydrazyl diphenylpicrylhydrazyl 2,2 diphenyl picrylhydrazyl 2 (DPPH 17 subtilis B cereus aureus coli aeruginosa choleraesuis C glabrata assay S pathogens agent Cu, Cu (Cu Fe Mg FAAS, FAAS , (FAAS) 07 0. 31 3. L- 5 g- 2diphenyl1picrylhydrazyl 22 2, (FAAS

Layered double hydroxides (LDHs) and related materials have been studied for a long time and their application in catalytic processes remain attractive due to the tuned properties, morphologies and metal-support interactions obtained from a variety of composition and synthesis route. In this mini-review, some important reactions, such as photocatalysis, electrocatalysis, reduction, carbon-carbon cross-couplings and water-gas shift will be emphasized along with the role of LDHs as catalysts, co-catalysts or catalytic precursors when it was clearly indicated. (LDHs properties metalsupport metal support route minireview, minireview mini review, review mini-review reactions photocatalysis electrocatalysis reduction carboncarbon carbon crosscouplings cross couplings watergas water gas catalysts cocatalysts co indicated

RESUMO Regiões com climas semiáridos apresentam condições ambientais que resultam em estresses abióticos às plantas. A maior área de produção de melão (Cucumis melo L.) do Brasil, o Estado do Rio Grande do Norte, possui essas características climáticas. O uso de bioestimulantes nesses sistemas de produção pode mitigar os efeitos dos estresses abióticos e aumentar a produtividade e a qualidade dos frutos. O objetivo neste estudo foi avaliar as características fisiológicas e de produção do meloeiro, sob aplicação de bioestimulantes. Os bioestimulantes Acadian®, Folicist® e Nov@® foram aplicados e comparados ao tratamento controle (sem bioestimulantes), em melões ‘Goldex’ e ‘McLaren’. Nov@® proporcionou maior assimilação de CO2, transpiração e condutância estomática, assim como ascorbato peroxidase em ‘Goldex’ e ‘McLaren’. Maior catalase foi obtida pela aplicação de Nov@®, enquanto que o uso de Folicist® resultou em maior teor de malondialdeído. A cultivar McLaren apresentou o melhor desempenho fisiológico e bioquímico e a ‘Goldex’ o melhor rendimento. Folicist® promove adaptações fisiológicas aos estresses sem prejudicar a atividade fotossintética. Os bioestimulantes aumentaram a produtividade e o número de frutos por planta e promoveram adaptações fisiológicas às condições semiáridas. plantas Cucumis L. L Brasil Norte climáticas meloeiro Acadian Acadian® Folicist Nov Nov@ bioestimulantes, , bioestimulantes) ‘Goldex Goldex ‘McLaren. ‘McLaren . ‘McLaren’ CO2 CO estomática malondialdeído rendimento fotossintética semiáridas

ABSTRACT Regions with semi-arid climates have environmental conditions that result in abiotic stress to plants. The largest melon (Cucumis melo L.) production area in Brazil, the state of Rio Grande do Norte, has these climatic characteristics. Use of biostimulants in these production systems can mitigate effects of abiotic stress and increase yield and fruit quality. The objective in this study was to evaluate the physiological and production characteristics of melon, under the application of biostimulants. The biostimulants Acadian®, Folicist® and Nov@® were applied and compared to the control treatment (no biostimulants), in ‘Goldex’ and ‘McLaren’ melons. Nov@® led to higher CO2 assimilation, transpiration and stomatal conductance, as well as ascorbate peroxidase, in ‘Goldex’ and ‘McLaren’. Greater catalase was obtained with the application of Nov@®, while the use of Folicist® resulted in higher malondialdehyde content. The cultivar ‘McLaren’ exhibited the best physiological and biochemical performance, and ‘Goldex’ the best yield. Folicist® promotes physiological adaptations to stress without impairing photosynthetic activity. The biostimulants increased yield and number of fruits per plant and promoted physiological adaptations to semi-arid conditions. semiarid semi arid plants Cucumis L. L Brazil Norte quality Acadian Acadian® Folicist Nov Nov@ no biostimulants, , biostimulants) ‘Goldex Goldex ‘McLaren McLaren melons CO assimilation conductance peroxidase ‘McLaren. . content performance activity

ABSTRACT Optic neuritis is an important cause of unilateral and acute visual loss in young adults, but other differential diagnoses should be considered, especially when the disease has an atypical presentation. This report presents the case of a young woman with reduced visual acuity in her right eye, associated with optic disc edema and a relative afferent pupillary defect, that was initially misdiagnosed as optic neuritis and subsequently found to have paracentral acute middle maculopathy, possibly secondary to subtle impending central retinal vein occlusion. This case emphasizes the need to remember that retinal vascular diseases can occasionally mimic optic neuritis. Detailed anamnesis and ophthalmic examination can avoid unnecessary interventions. adults considered presentation eye defect maculopathy occlusion interventions

Asphaltene aggregation mechanism is still a nebulous and controversial issue. Many authors argue that the aggregation of its components is due to π-stacking interactions, nonetheless, alkyl chains, heteroatoms, and even acidic groups are also constituents of asphaltenes and can play an important role in the chemistry of asphaltene. Excimers from pyrene are easily detected by fluorescence and were used in the current study to probe the effect of the side chain on the π-stacking capacity of pyrene. Pyrene was acylated with acyl chains varying from two to twelve carbon atoms, and the effect of the variation of the acyl chain length on excimer formation was followed by fluorescence emission spectroscopy. The results revealed that as the side chain grows from two to twelve carbon atoms the excimer/monomer ratio decreases and the excimer heat of formation drops from ΔH = -6.00 to -1.29 kcal mol-1. Further, the crystal structure of octanoyl pyrene (PC8) indicates that in the crystal structure, the aromatic moiety faces the acyl chain. This result was corroborated by density functional theory (DFT) calculations. Finally, the results were compared with two different asphaltenes and indicate that π-stacking cannot be assumed as the main driving force for asphaltene aggregation. issue πstacking π stacking interactions nonetheless heteroatoms spectroscopy excimermonomer monomer 6.00 600 6 00 -6.0 1.29 129 1 29 -1.2 mol1. mol1 mol 1. mol-1 Further PC8 PC (PC8 DFT (DFT calculations Finally 6.0 60 0 -6. 1.2 12 2 -1. mol- (PC 6. -6 -1 -

ABSTRACT Safflower is a crop with seeds containing high amounts of oleic and linoleic acids, which have applications in cosmetics, food, feed, and pharmaceutical industries. Safflower seeds are generally reported to undergo after-ripening and to have physiological dormancy. This study comprehensively analyzed the physical changes and the induction of dormancy and germinability in developing seeds to determine whether the safflower population is adequately developed during seed dispersal. From the 80th day after flowering (DAF), seeds were collected separately from plants on a weekly basis until 131 DAF, resulting in seven sampling dates. The changes in length, diameter, thickness, water content, and fresh and dry weight during seed development were measured. Simultaneously, the effects of dark and light, temperature, and gibberellic acid (GA3) (0, 50, and 100 µM) on seed germination, dormancy and germination characteristics of safflower seeds were investigated. The seeds ceased to increase in length, width and thickness, reaching a mature appearance at 131 DAF, with a dry mass per seed of 0.0443 g. The water content decreased between 117 and 124 DAF, indicating an obvious process of desiccation during the final stage of seed maturation. Germination capacity is acquired at 117 DAF, as evidenced by an increase in germination and a reduction in dormant seeds, particularly at low temperatures (10°C) and with GA3 supplementation. At 131 DAF, seeds exhibited 7.9 % water content, and there was an increase in seed germination and a decrease in seed dormancy status, regardless of GA3 supplementation and temperature. acids cosmetics food feed industries afterripening ripening dispersal th DAF , (DAF) 13 dates length diameter thickness measured Simultaneously light temperature GA (GA3 0, 0 (0 50 10 µM investigated 00443 0443 0.044 g 11 12 maturation 10°C 10C C (10°C 79 7 9 7. status (DAF 1 (GA ( 5 0044 044 0.04 004 04 0.0 00 0.

SUMMARY: Exercise and anabolic steroids are expected to promote improvements in cardiovascular structure and reduction of visceral fat and, thus, help promote health in hyperglycemic patients. The aim of this study was to verify the influence of aerobic exercise associated with the use of steroids on cardiac structure and visceral fat in hyperglycemic Wistar rats. Methods: Thirty-two young male Wistar rats were divided into four groups: control group (n=8), control with treatment (n=8), diabetic (n=8) and diabetic with treatment (n=8). All animals were subjected to intense aerobic exercise and the animals undergoing treatment received intramuscular testosterone. Body weight, visceral fat and cardiac measurements (weight, length and width) were evaluated. The groups treated with testosterone showed a smaller than expected increase in body weight for food intake. Visceral, perirenal, retroperitoneal and epididymal fats were lower in the treated groups. Heart weight was relatively greater in the treated groups and greater width and length in the untreated groups. The proposed association of testosterone administration with aerobic exercise can provide significant benefits for the metabolism of hyperglycemic individuals.

RESUMEN: Se supone que el ejercicio y los esteroides anabólicos promuevan la mejora de la estructura cardiovascular y la reducción de la grasa visceral y, por tanto, ayuden a promover la salud en pacientes hiperglucémicos. El objetivo de este trabajo fue verificar la influencia del ejercicio aeróbico asociado al uso de esteroides sobre la estructura cardíaca y la grasa visceral en ratas Wistar hiperglucémicas. Treinta y dos ratas Wistar machos jóvenes se dividieron en cuatro grupos: grupo control (n=8), control con tratamiento (n=8), diabético (n=8) y diabético con tratamiento (n=8). Todos los animales se sometieron a ejercicio aeróbico intenso y los animales en tratamiento recibieron testosterona intramuscular. Se evaluaron el peso corporal, la grasa visceral y las medidas del corazón (peso, largo y ancho). Los grupos tratados con testosterona mostraron un aumento menor de lo esperado en el peso corporal según la ingesta dietética. Las grasas visceral, perirrenal, retroperitoneal y epididimaria fueron menores en los grupos tratados. El peso del corazón fue relativamente mayor en los grupos tratados y el mayor ancho y largo en los grupos no tratados. La asociación propuesta de la administración de testosterona con el ejercicio aeróbico puede proporcionar beneficios significativos para el metabolismo de los individuos hiperglucémicos.

Abstract Background Tuberous sclerosis complex (TSC) is a multisystem neurocutaneous syndrome with variable phenotypes. Recent updates of TSC diagnostic criteria reaffirmed the defined genetic diagnostic criterion as the finding of a pathogenic DNA alteration in either TSC1 or TSC2 genes. It also slightly modified definite clinical diagnostic criteria. TSC-associated skin lesions in infancy are important clinical signs to select individuals with possible TSC for a closer clinical follow-up and genetic testing. Objective To raise awareness of the updated TSC diagnosis criteria; to assess the frequency of skin lesions in TSC patients as well as the first dermatological presentation; and to associate the findings with either TSC1 or TSC2 mutations. Methods Observational cross-sectional study. Clinical and genetic data were retrospectively collected from 37 TSC patients from a Brazilian University Hospital. Patients with skin signs were examined and prospectively assessed for 12 months. Results The earliest cutaneous lesions were hypomelanotic macules, which together with angiofibromas were the most frequent dermatological lesions. The total pathogenic DNA alteration ratio between TSC2 and TSC1 genes was 8:1. The frequency of a TSC2 pathogenic variant was 10-fold greater in the presence of ungual fibromas. Study limitations Small sample and a limited number of patients with TSC1 pathogenic variants. Conclusion Clinicians should be knowledgeable about TSC updated diagnostic criteria. Patients need to be followed up by a multidisciplinary team and treated accordingly. Early detection of cutaneous lesions is important for TSC diagnosis. A significant association between TSC2 gene pathogenic alterations and ungual fibromas is described. (TSC phenotypes TSCassociated associated followup follow testing presentation mutations crosssectional cross sectional study 3 Hospital 1 months macules 81. 81 8 1. 8:1 10fold fold 10 variants accordingly described 8:

A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou o RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.

A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.

A propagação do vírus Oropouche (OROV) em novas regiões, junto com um aumento de casos e o aparecimento de formas graves não reconhecidas anteriormente, suscitou preocupações importantes de saúde pública. Uma granjera embarazada de 40 anos em 30 semanas de gestação apresentou febre, mialgia e dor de cabeça, e a infecção por OROV foi confirmada por RT-qPCR. As avaliações maternas e fetais não foram avaliadas inicialmente. No entanto, na semana seguinte, o paciente notou uma diminuição dos movimentos fetais e a ecografia confirmada a morte fetal. Os diagnósticos moleculares detectam ARN de OROV em múltiplas amostras fetais. Este caso de transmissão vertical justifica a necessidade urgente de proteger as mulheres embaraçadas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais o fundo dos possíveis mecanismos patogênicos do vírus.

Resumo Fundamento: A síndrome do PRKAG2 tipicamente se manifesta na adolescência e início da idade adulta, cursando com hipertrofia ventricular esquerda, arritmias e risco de morte súbita. O achado de marcadores ecocardiográficos antes da manifestação clínica nos filhos de pais acometidos pela doença pode facilitar a estratégia de prevenção e planejamento terapêutico para esse grupo de pacientes. Objetivo: Identificar a existência de achados ecocardiográficos que se manifestem precocemente nos filhos de pais acometidos por síndrome do PRKAG2, enquanto ainda assintomáticos. Métodos: Estudo observacional transversal em que sete participantes, filhos de pais com diagnóstico estabelecido de síndrome do PRKAG2, com idades entre 9 meses e 12 anos e diagnóstico genético comprovado, foram submetidos à ecocardiografia convencional e por técnicas avançadas, tendo seus achados comparados aos de grupo controle composto por sete voluntários pareados por sexo e idade, hígidos do ponto de vista cardiovascular. Um valor de p < 0,05 foi considerado significante. Resultados: A ecocardiografia convencional mostrou valores aumentados com significância estatística no grupo caso para átrio esquerdo, septo interventricular, parede posterior do ventrículo esquerdo, massa ventricular indexada e espessura relativa da parede (p < 0,05). O strain sistólico longitudinal global obtido pelo ecocardiograma bidimensional não mostrou diferença estatisticamente significativa entre os grupos caso e controle. Nenhum dos parâmetros ao ecocardiograma tridimensional apresentou significância estatística entre os grupos. Conclusão: Crianças diagnosticadas com PRKAG2 demonstraram achados ecocardiográficos indicativos de tendência à hipertrofia cardíaca. A ecocardiografia pode ser uma ferramenta útil na avaliação e seguimento desse grupo de pacientes, antes do início de manifestações clínicas. Fundamento PRKAG adulta esquerda súbita pacientes Objetivo assintomáticos Métodos participantes 1 comprovado avançadas cardiovascular 005 0 05 0,0 significante Resultados esquerdo interventricular 0,05. . 0,05) Conclusão cardíaca clínicas 00 0,

Abstract Background: PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group. Objective: To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic. Methods: In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant. Results: Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups. Conclusion: Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations. Background PRKAG adulthood hypertrophy arrhythmias death Objective asymptomatic Methods crosssectional cross sectional study 1 years age sexmatched sex matched view 005 0 05 0.0 significant Results atrium septum mass p 0.05. . 0.05) 2dimensional dimensional 2 groups 3dimensional 3 Conclusion followup follow up manifestations 00 0.

Resumo Fundamento: O fondaparinux é um anticoagulante eficaz e seguro usado no tratamento de síndromes coronarianas agudas (SCAs). No entanto, devido à baixa representatividade de indivíduos obesos em ensaios clínicos, os efeitos de se aplicar os resultados desse medicamento nesta população continuam incertos. Objetivos: Comparar o fondaparinux à enoxaparina no tratamento de obesos com SCA. Métodos: Este é um estudo do tipo coorte retrospectivo, incluindo indivíduos obesos (IMC ≥ 30 Kg/m2) internados com Infarto do Miocárdio sem Elevação do Segmento ST (IAMSSST) ou Angina Instável (AI) e tratados com fondaparinux ou enoxaparina entre 2010 e 2020. Os grupos que receberam fondaparinux e enoxaparina foram comparados quanto suas características clínicas e laboratoriais usando o teste do qui-quadrado e o teste de Mann-Whitney, conforme apropriado. A incidência dos desfechos primários (morte, reinfarto, acidente vascular cerebral, sangramento maior) foi comparada entre os grupos. Um p<0,05 foi considerado estatisticamente significativo em todas as análises. Resultados: Um total de 367 pacientes obesos com IAMSSST ou AI foi incluído, dos quais 258 usaram fondaparinux e 109 usaram enoxaparina. A idade média foi 64 ± 12 anos, 52,9% eram do sexo masculino. A prevalência e diabetes, hipertensão, dislipidemia, doença arterial coronariana prévia, acidente vascular cerebral prévio, e implementação de estratégia invasiva foi similar entre os grupos. A incidência do desfecho primário foi 4,7% no grupo fondaparinux e 5,5% no grupo enoxaparina (p = 0,729). Não houve diferença entre os grupos quando os componentes do desfecho primário foram analisados separadamente. Conclusão: Em uma amostra de pacientes obesos com IAMSSST ou AI, não houve diferença na ocorrência do desfecho composto (morte, acidente vascular cerebral, reinfarto, sangramento maior) entre os pacientes que utilizaram fondaparinux ou enoxaparina. Fundamento SCAs. SCAs . (SCAs) entanto clínicos incertos Objetivos SCA Métodos retrospectivo IMC 3 Kg/m2 Kgm2 Kgm Kg m2 m (IAMSSST (AI 201 2020 quiquadrado qui quadrado MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney apropriado morte, morte (morte reinfarto maior p005 p 0 05 p<0,0 análises Resultados 36 incluído 25 10 6 1 anos 529 52 9 52,9 masculino diabetes hipertensão dislipidemia prévia prévio 47 4 7 4,7 55 5 5,5 0,729. 0729 0,729 729 0,729) separadamente Conclusão (SCAs Kg/m 20 202 p00 p<0, 2 52, 4, 5, 072 0,72 72 p0 p<0 07 0,7 p< 0,

Abstract Background: Fondaparinux is an effective and safe anticoagulant in the treatment of acute coronary syndromes (ACS). However, due to the low representation of obese individuals in clinical trials, the effects of applying the results of this drug to this population remain uncertain. Objectives: To compare Fondaparinux to Enoxaparin in the treatment of obese patients with ACS. Methods: This is a retrospective cohort study, including obese individuals (BMI ≥ 30 Kg/m2) admitted with non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina (UA) and treated with Fondaparinux or Enoxaparin between 2010 and 2020. The Fondaparinux and Enoxaparin groups were compared for their clinical and laboratory characteristics using chi-square and Mann-Whitney tests, as appropriate. The incidence of primary outcomes (death, reinfarction, stroke, major bleeding) was compared between groups. P-value < 0.05 was considered significant for all analyses. Results: A total of 367 obese patients with NSTEMI or UA were included, of whom 258 used Fondaparinux and 109 used Enoxaparin. Mean age was 64 ± 12 years, and 52.9% were male. The prevalence of diabetes, hypertension, dyslipidemia, prior coronary artery disease, prior stroke, and implementation of invasive strategy was similar between groups. The incidence of the primary outcome was 4.7% in the Fondaparinux group and 5.5% in the Enoxaparin group (p = 0.729). There was no difference between groups when analyzing the components of the primary outcome separately. Conclusion: In a sample of obese patients with NSTEMI or UA, there was no difference in the occurrence of the composite outcome (death, stroke, reinfarction, major bleeding) between patients who used Fondaparinux or Enoxaparin. Background ACS . (ACS) However trials uncertain Objectives Methods study BMI 3 Kg/m2 Kgm2 Kgm Kg m2 m nonSTsegment non ST segment (NSTEMI (UA 201 2020 chisquare chi square MannWhitney Mann Whitney tests appropriate death, death (death reinfarction stroke bleeding Pvalue P value 005 0 05 0.0 analyses Results 36 included 25 10 6 1 years 529 52 9 52.9 male diabetes hypertension dyslipidemia disease 47 4 7 4.7 55 5 5.5 p 0.729. 0729 0.729 729 0.729) separately Conclusion (ACS Kg/m 20 202 00 0. 2 52. 4. 5. 072 0.72 72 07 0.7

Introduction: Cholesteatoma, although relatively rare, presents significant challenges in clinical practice. Despite decades of research, its cause remains complex and elusive. Objective: This review aimed to summarize key findings on the epidemiology, pathophysiology, diagnosis and surgical management of cholesteatoma, highlighting current knowledge gaps and emerging trends in the field. Method: Narrative review carried out in the PubMed and Scielo databases. The search used the following keywords: “cholesteatoma, petros apex, minimally invasive surgical procedures”. The inclusion criteria comprised review articles, pre-clinical and clinical research published, written in Portuguese and English and available in complete text. The selected articles were analyzed based on the technologies covered, future perspectives, challenges, diseases mentioned and the central idea of the article. Result: 36 articles were included. Conclusion: Cholesteatoma is important in medical practice, despite being relatively uncommon in the general population. However, there are still doubts about its cause, but its diagnosis has been expanded through imaging tests in an attempt to reduce “second-look” operations and avoid them. Another field with constant growth is surgical treatment, since the complex anatomy requires that new techniques be managed to reduce injuries to important and vital structures in the region.

Introdução: O colesteatoma, embora relativamente raro, apresenta desafios significativos na prática clínica. Apesar de décadas de pesquisa, sua causa permanece complexa e evasiva. Objetivo: Esta revisão pretendeu resumir as principais descobertas sobre a epidemiologia, fisiopatologia, diagnóstico e manejo cirúrgico do colesteatoma, destacando lacunas de conhecimento atuais e tendências emergentes no campo. Método: Revisão narrativa realizada nas bases PubMed e Scielo. A busca utilizou as seguintes palavras-chave: “colesteatoma, ápice petros, procedimentos cirúrgicos minimamente invasivos” e suas versões ao inglês Os critérios de inclusão compreenderam artigos de revisão, pesquisas pré-clínicas e clínicas publicados, escritos em português e inglês e disponíveis em texto completo. Os artigos selecionados foram analisados com base nas tecnologias abordadas, perspectivas futuras, desafios, doenças referidas e ideia central do artigo. Resultado: Foram incluídos 36 artigos. Conclusão: O colesteatoma tem importância na prática médica, apesar de ser relativamente pouco frequente na população em geral. No entanto, ainda existem dúvidas sobre sua causa, mas seu diagnóstico tem sido ampliado atavés de exames de imagem na tentativa de redução das operações de “segundo-olhar”, evitando-as. Outro campo com crescimento constante é o tratamento cirúrgico, uma vez que a anatomia complexa exige que novas técnicas sejam manejadas para diminuir lesões de estruturas importantes e vitais da região.

Resumo Objetivo Avaliar o desempenho de cirurgiões na ressecção de deformidades tipo CAME fazendo uso de um simulador realista de cirurgia artroscópica. Métodos Um simulador artroscópico foi criado a partir de materiais de baixo custo com auxílio de uma impressora 3D GTMax Core A1 e dos programas Invesalius e Meshmixer 2017, que foram utilizados para criar peças de cabeça de fêmur em material ABS, com a presença de uma deformidade tipo CAME, a fim de mimetizar uma situação de impacto femoroacetabular. Após as operações serem realizadas por 16 cirurgiões, os fêmures foram comparados a um modelo prévio com e outro sem deformidade pelo programa Cloudcompare, sendo avaliados ao final parâmetros como diferença volumétrica entre os fêmures operados, com e sem deformidade, distância mínima e máxima entre eles, porcentagem da deformidade ressecada, tempo estimado para ressecção total da deformidade, além de uma análise qualitativa feita com base nas imagens e gráficos fornecidos pelo programa representando as áreas das peças efetivamente ressecadas. Resultados A velocidade média de resseção foi de 34,66mm3/minuto (DP = 46 mm3/min, max = 147,33 mm3/min; min = −2,66 mm3/min). A média de ressecção obtida foi de 26,2% (DP = 34,7%, max = 111%; min = −2%). A análise qualitativa demonstrou uma hiporresecção das deformidades e, por vezes, hiperresecção de áreas não deformadas. O simulador foi muito bem avaliado pelos cirurgiões, tendo uma sensação tátil bem semelhante à cirurgia real segundo os mesmos. Conclusão Simuladores artroscópicos se mostraram muito úteis no treinamento de cirurgiões menos experientes. artroscópica D 2017 ABS femoroacetabular 1 Cloudcompare operados eles ressecada ressecadas 3466mm3minuto mmminuto 34 66mm3 minuto mm DP 4 mm3min mmmin mm3 mm3/min 14733 147 33 147,3 266 2 66 −2,6 mm3/min. . mm3/min) 262 26 26,2 347 7 34,7% 111% 111 −2%. −2% −2%) vezes deformadas mesmos experientes 201 3 66mm 1473 14 147, 6 −2, 26, 34,7 11 −2 20 34, −

Abstract Objective To evaluate surgeons’ performance in resecting CAM-type deformities using a realistic arthroscopic surgery simulator. Methods An arthroscopic simulator was created using low-cost materials with the help of a GTMax Core A1 3D printer and the programs Invesalius and Meshmixer 2017, which were used to develop femoral head parts in ABS material, with the presence of a CAM-type deformity, to mimic a femoroacetabular impact situation. After the operations were performed by 16 surgeons, the femurs were compared to a previous model with deformity and another without, using Cloudcompare, and parameters such as the volumetric difference between the operated femurs, with and without deformity, the minimum and maximum distance between them, the percentage of the deformity resected, the estimated time for total resection of the deformity, as well as a qualitative analysis based on the images and graphs provided by the program representing the areas of the parts resected, were evaluated at the end. Results The average resection speed was 34.66 mm3/min (SD = 46 mm3/min, max = 147.33; min = −2.66). The average resection rate was 26.2% (SD = 34.7%, max = 111; min = −2). Qualitative analysis showed hyporesection of deformities and sometimes hyperresection of nondeformed areas. The simulator was highly rated by the surgeons, with a tactile sensation very similar to real surgery, according to them. Conclusion Arthroscopic simulators have proved very useful in training less experienced surgeons. surgeons CAMtype CAM type lowcost low cost A D 2017 material situation 1 Cloudcompare them resected end 3466 34 66 34.6 mm3min mmmin mm3 mm SD 4 147.33 14733 147 33 −2.66. 266 −2.66 . 2 −2.66) 262 26 26.2 347 7 34.7% 111 −2. −2 −2) 201 346 3 6 34. 147.3 1473 14 −2.6 26. 34.7 11 − 20 147.