RESUMO Objetivos: Identificar os principais desfechos hospitalares dos pacientes submetidos à correção cirúrgica de escoliose neuromuscular, avaliar as taxas de complicação e o cumprimento de metas de mobilidade depois do uso de um protocolo gerenciado. Métodos: Trata-se de um estudo longitudinal e retrospectivo, com dados obtidos seis meses depois da aplicação do protocolo em 103 pacientes de ambos os sexos submetidos à correção cirúrgica de escoliose neuromuscular, em um hospital de nível terciário em São Paulo, nos períodos de junho a dezembro de 2018 (pré-protocolo) e entre maio e setembro de 2019 (pós-protocolo). Foram excluídos os dados dos pacientes submetidos a outras cirurgias ortopédicas de coluna previamente. Além dos dados para caracterização epidemiológica das doenças de base, foram analisadas as características clínicas e complicações. Resultados: Dos 103 pacientes avaliados, 53,4% eram do sexo feminino, média de idade de 14,9 anos, o diagnóstico mais frequente paralisia cerebral, ângulo médio da curvatura de 75° e as comorbidades mais observadas foram doenças pulmonares (25%). O protocolo atingiu adesão parcial dos profissionais, e depois da implementação, observou-se diminuição significativa da dor e da síndrome da resposta inflamatória sistêmica (SIRS), prevenção da imobilidade e baixa taxa de infecção. Conclusões: O uso de um protocolo com foco em pacientes submetidos à correção de escoliose neuromuscular, reduziu as complicações por SIRS e dor, manteve a taxa de infecção de sítio cirúrgico baixa e preveniu a imobilidade a curto prazo. Nível de evidência III; Estudo Retrospectivo.

ABSTRACT Objectives: To identify the main hospital outcomes of patients undergoing surgical correction of neuromuscular scoliosis and to assess complication rates and achievement of mobility goals after the use of a managed protocol. Methods: This is a longitudinal, retrospective study, with data obtained six months after the application of a protocol in 103 patients of both sexes submitted to surgical correction of neuromuscular scoliosis, at a tertiary level hospital in São Paulo, between June and December 2018 (pre-protocol) and between May and September 2019 (post-protocol). Data from patients who had previously undergone other orthopedic spine surgeries were excluded. In addition to the data for epidemiological characterization of the underlying diseases, the clinical characteristics and complications were analyzed. Results: Of the 103 patients evaluated, there was a predominance of females (53.4%) and a mean age of 14.9 years. The most frequent diagnosis was cerebral palsy, the mean angle of curvature was 75°, and the most frequently observed comorbidities were lung diseases (25%). The protocol was partially adhered to by professionals and after its implementation, there was a significant decrease in pain and the systemic inflammatory response syndrome (SIRS), prevention of immobility and a low rate of infection. Conclusions: The use of a protocol focused on patients undergoing correction of neuromuscular scoliosis led to reduced complications of SIRS and reduced pain; kept the surgical site infection rate low, and prevented short-term immobility. Level of evidence III; Retrospective study.

RESUMEN Objetivos: Identificar a los principales resultados hospitalarios de los pacientes sometidos a corrección quirúrgico de escoliosis neuromuscular, evaluar las tasas de complicación y el cumplimiento de metas de movilidad tras la implementación de un protocolo gestionado. Métodos: Se trata de un estudio longitudinal y retrospectivo, con dados obtenidos después de 6 meses de la aplicación de un protocolo en 103 pacientes de ambos sexos, sometidos a corrección quirúrgica de escoliosis neuromuscular, en un hospital de nivel terciario en São Paulo, en los periodos de junio a diciembre de 2018 (pre-protocolo) y mayo a septiembre de 2019 (postprotocolo). Se excluyeron los datos de los pacientes que se habían sometido previamente a otras cirugías ortopédicas de la columna vertebral Además de los dados para la caracterización epidemiológica de las enfermedades de base, se analizaron las características clínicas y las complicaciones. Resultados: De los 103 pacientes evaluados, el 53,4% eran mujeres, con una media de edad de 14,9 años, el diagnóstico más frecuente fue parálisis cerebral, el ángulo de curvatura promedio de 75° y las comorbilidades más observadas fueron las enfermedades pulmonares (25%). El protocolo logró una adhesión parcial de los profesionales, y tras su implementación, se observó una disminución significativa del dolor y del síndrome de respuesta inflamatoria sistémica (SRIS), prevención de la inmovilidad y una baja tasa de infección. Conclusiones: El uso de un protocolo centrado en pacientes sometidos a corrección de escoliosis neuromuscular redujo las complicaciones por SIRS y dolor, mantuvo baja la tasa de infección del sitio quirúrgico y previno la inmovilidad a corto plazo. Nivel de evidencia III; Estudio Retrospectivo.

ABSTRACT Bacurizeiro (Platonia insignis) is a fruit of the Amazon that, due to anthropic actions, has been suffering serious damage to its genetic diversity. We analyzed the genetic diversity and structure of seven bacurizeiro populations distributed among four Brazilian states and two biomes, the Amazon and Cerrado, based on eight nuclear (ncSSR) and three chloroplast (cpSSR) microsatellite markers. Higher heterozygosity values were found for the Northern populations of Japurá and Marapanim, and the Northeast population of Chapadinha when using ncSSR. Higher diversity indices were also observed for these populations with cpSSR, although higher haplotypic diversity parameters were detected for the two Northern populations. Genetic structure analysis showed the formation of two well defined groups: I - populations from Maranhão and Piauí (Cerrado) and II - populations from Amazonas and Pará (Amazon). Positive and significant correlations were identified between genetic and geographical distances for both ncSSR (r = 0.09; p = 0.0010) and cpSSR (r = 0.11; p = 0.0008), in agreement with the genetic structure analysis. The high genetic structure among populations probably reflects the divergent natural and human selection pressures to which bacurizeiros are subjected in both the Amazon and Cerrado biomes, with higher diversity maintained in the Amazon populations.

Amostras de sete diferentes localidades do gênero Pimelodella foram geneticamente analisadas, duas cavernícolas (exclusivamente subterrâneas, alto rio Tocantins e rio São Francisco) e cinco epígeas (provenientes da bacia do alto Paraná). Análises citogenéticas revelaram o mesmo número diploide (2n=46) para todas as espécies, além de similaridades no número e localização das regiões organizadoras de nucléolo e bandas C. FISH com sondas de rDNA 5S e marcação com CMA3 indicaram diferenças significativas entre as espécies estudadas. A aplicação da técnica de PCR-RFLP nos genes mitocondriais ATPase 6 e 8 permitiu a construção de um fenograma de evolução mínima identificando uma estreita relação evolutiva entre as espécies estudadas.

Samples from seven different locations of the genus Pimelodella were genetically examined, two caves (exclusively subterranean, upper Tocantins River and São Francisco River) and five epigean (from upper Paraná River basin). Cytogenetic analyses revealed the same diploid number (2n=46) for all species besides similarities in both number and location of nucleolar organizer regions and C bands. FISH with 5S rDNA probes and CMA3 staining indicated significant differences among the studied species. Application of PCR-RFLP in ATPase 6 and 8 mitochondrial genes allowed building a minimum evolution phenogram identifying the close evolutionary relationship among groups. Both chromosomal and molecular data were useful to infer the relationships among studied Pimelodella species.

A população do Centro da cidade de São Paulo é marcada pela pobreza e por problemas sociais. Não é diferente no bairro do Bom Retiro, onde um grande número de imigrantes - em especial de países sul-americanos, como Bolívia e Paraguai - trabalha em oficinas de costura. Eles são explorados de tal forma que é possível observar vestígios de trabalho escravo, explicitados pelo fato de muitos trabalharem de forma ilegal em nosso país. Nessa população com alta vulnerabilidade, verifica-se alta frequência de crianças com carências nutricionais, já que o trabalho das mães as impede de cuidar adequadamente dos filhos. Buscou-se solucionar essa situação por meio de um projeto que mediasse as relações entre essa população necessitada e a Unidade Básica de Saúde da região, de forma a criar uma fonte de informação, sob a forma de uma cartilha, para instruir essas mães imigrantes quanto aos seus direitos nas políticas de saúde brasileiras e ao seu papel no desenvolvimento dos filhos, no contexto da participação de alunos da Faculdade de Ciências Médicas da Santa Casa no Programa de Reorientação da Formação Profissional em Saúde (Pró-Saúde).

The population in the central area of the city of São Paulo is marked by poverty and social problems. The picture is not so different in the neighborhood of Bom Retiro where we __ have a high amount of immigrants (especially from South American countries like Bolivia and Paraguay)__ working in sewing. They are exploited by their bosses, such that it is possible to verify __ residual__ characteristics of slave labor, explicit__ by the illegality of their work status in our country. Looking at this highly vulnerable population, one can also see the high incidence of children suffering from nutritional deficiencies, since the work of the mothers prevents them from _____ adequately caring for their children. __ A solution was sought out through a project to mediate the relationship between this population in need and the Basic Health Unit in the region, creating a source of information in the form of a booklet to educate these immigrant mothers in regards to their rights in health public policies in Brazil and in relation to their role in the development of their children. This was developed by students from the School of Medical Sciences of Santa Casa in the Reorientation of the Formation of the Health Care Professional Program (Programa de Reorientação da Formação Profissional em Saúde - Pró-Saúde).

Two Siluriformes species endemic to the São Francisco River basin were characterized by conventional and differential cytogenetic analyses involving C-banding, Ag-nucleolar organizer region (NOR) and chromomycin A3 (CMA3) staining, and FISH (fluorescent in situ hybridization) with 18S and 5S rDNA probes. Conorhynchus conirostris presents a higher diploid number (2n = 60) than those detected in Pimelodidae representatives, whereas Lophiosilurus alexandri, with a karyotype of 2n = 54 chromosomes, presents a chromosomal constitution similar to that found in the family Pseudopimelodidae. Plesiomorphic characteristics such as single NORs at terminal positions are found in both species, as revealed by CMA3 and silver nitrate staining, and FISH with a 18S rDNA probe. C-banding evidenced centromeric and telomeric heterochromatic blocks distributed over most of the chromosomes with a conspicuous heterochromatin segment in a pair of submetacentric chromosomes in L. alexandri. Such karyotype data, if compared to the cytogenetic pattern of other Siluriformes species, can be partially related to their degree of endemism, favorable to the occurrence and fixation of chromosomal rearrangements. The present study in representatives from these two Siluriformes families from the São Francisco River contributes to a better understanding of the karyotype evolution in species of this important order of Neotropical fishes.

Pimelodidae is one of the most representative of Neotropical catfish families. However, these fish are still poorly studied in terms of cytogenetics, especially regarding the application of more accurate techniques such as the chromosomal localization of ribosomal genes. In the present work, fluorescent in situ hybridization with 5S and 18S rDNA probes was employed for rDNA site mapping in Pimelodus sp., P. fur and P. maculatus from the São Francisco River in the Três Marias municipality - MG. The results from the application of the 18S probe confirmed the previous data obtained by silver nitrate staining, identifying a simple nucleolar organizing region system for these species. However, the labeling results from the 5S rDNA probe demonstrated a difference in the number and localization of these sites between the analyzed species. The obtained data allowed inferences on the possible processes involved in the karyotypic evolution of this genus.

Cariótipos e outros marcadores cromossômicos de três espécies do gênero Pimelodus denominadas, P. fur, P. maculatus e Pimelodus sp., do município de Três Marias, Minas Gerais, Brasil, foram analisados utilizando técnicas de coloração diferenciais (Bandamento C, coloração por nitrato de prata e CMA3). O número diplóide observado foi 2n = 56 em P. maculatus e Pimelodus sp., enquanto em P. fur 2n = 54. O cariótipo de P. fur consistiu em 32M + 8SM + 6ST + 8A com número fundamental (NF) igual a 100, o de P. maculatus 32M + 12SM + 12A com NF = 112, e o de Pimelodus sp. possuía 32M + 12Sm + 6ST + 6A com NF = 106. As regiões organizadoras nucleolares (RONs) foram detectadas invariavelmente, para as três espécies, na região telomérica do braço longo do 20º par cromossômico, estas se mostraram positivamente coradas pela CMA3 e heterocromáticas. Nenhuma diferença cromossômica entre os sexos foi detectada e o padrão de bandamento C foi espécie-específico Inferências sobre a evolução cariotípica dentro do gênero Pimelodus e os possíveis rearranjos cromossômicos envolvidos neste processo são discutidos.

Karyotypes and other chromosomal markers were investigated in three species of the catfish genus Pimelodus, namely P. fur, P. maculatus and Pimelodus sp., from municipality of Três Marias, Minas Gerais, Brazil, using differential staining techniques (C-banding, Silver nitrate and CMA3 staining). The diploid chromosome number was 2n = 56 in P. maculatus and Pimelodus sp., while in P. fur 2n = 54. The karyotype of P. fur consisted in 32M + 8SM + 6ST + 8A with fundamental number (NF) of 100, that of P. maculatus 32M + 12SM + 12A with NF = 112, and that of Pimelodus sp. had 32M + 12Sm + 6ST + 6A with NF = 106.The nucleolar organizer regions (NORs) in all three species were invariably detected in telomeres of longer arm of the 20th chromosome pair. These sites were also positive after CMA3 and C-banding. No heteromorphic sex chromosomes were detected and C-banding pattern was species specific. Inferences about the karyotype differentiation in Pimelodus and putative chromosomal rearrangements are hypohesized.