Abstract Chives are one of the most popular spice plants in world cuisine. It is usually produced by small producers, often in an organic farming system. However, research with chives in this production system is lacking. The purpose of this study was to evaluate the production of chives with the use of organic fertilizers before planting and in top dressing. Seven treatments were evaluated, resulting from the factorial 2x3+1, with two organic fertilizers (castor bean cake and hoof and horn powder) x 3 application modes (100% before planting; 100% in top dressing; 50% before planting and 50% in top dressing) + 1 control (without these organic fertilizers). The experimental design was in randomized blocks, with five replications and plots of 1 m2. The relative index of chlorophyll (“Spad” index), height, number of leaves, fresh and dry weight of the plants were evaluated. All treatments of the factorial were better than the control, showing that these organic fertilizers improve production in chives. It is recommended to use the hoof and horn powder in installments (50% before planting and 50% in top dressing) or 100% in top dressing, the latter option being more interesting for reducing the need for labor, with just one application moment.

ABSTRACT Intrahepatic biliary proliferations represent a spectrum from reactive (ductular reaction, some with atypical architecture), hamartomatous (von Meyenburg complex), benign (bile duct adenoma) and precursor/borderline entities (biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct) to fully malignant (cholangiocarcinoma) neoplasms. Clinical pictures and even imaging patterns may be similar, requiring refined studies aiming at histopathological and immunohistochemistry for more precise diagnosis, essential for correct patient management. This article discusses updated concepts and definitions of most relevant entities aiming more specifically at the differential diagnosis in practice, focusing on morphology and immunohistochemistry, with a discussion of potential markers to help distinguishing between benign and malignant lesions.

RESUMO As proliferações biliares intra-hepáticas representam um espectro que abrange desde entidades reativas (reação ductular, algumas com arquitetura atípica), hamartomatosas (complexo de von Meyenburg), benignas (adenoma de ductos biliares) e precursoras/limítrofes (neoplasia intraepitelial biliar, neoplasia papilar intraductal de ducto biliar) até neoplasias totalmente malignas (colangiocarcinoma). Os quadros clínicos e até mesmo os padrões de imagem podem ser semelhantes, exigindo estudos refinados visando critério histológicos e imuno-histoquímicos para diagnósticos mais precisos, essenciais para o correto manejo do paciente. Este artigo discute conceitos atualizados e definições das entidades mais relevantes visando mais especificamente ao diagnóstico diferencial na prática, com foco na morfologia e imuno-histoquímica, com discussão de potenciais marcadores para ajudar na distinção entre lesões benignas e malignas.

ABSTRACT Inside the Brazilian semi-arid region (Caatinga biome) there are vegetation refuges from other biomes that are present mainly at greater elevations in ancient geological formations such as Chapada do Araripe. This study aimed to understand the structure, diversity and floristic similarity of a fragment of humid forest in order to support conservation strategies for this community in Chapada do Araripe, southern Ceará (708m Alt.), an area of relevant ecological, cultural and scenic value. In 13 parcels of 25x25m (0.8 ha) all individuals with DBH ≥ 5cm were inventoried, observing total height. Floristic similarity was observed using the Jaccard method, comparing it with seven other areas in different regions of the Brazil. Sixty-six species were found distributed in 34 families, in a total of 1,544 individuals with DA=1,997.30 ind.ha-1 and AB =32,618 m²ha-1. Fabaceae (25.75%) and Myrtaceae (6%) had the highest number of species and Brosimum gaudichaudii had the highest IVI. The Shannon index (H') was 3.13 and the Pielou equability (J') was 0.75. The beta diversity, compared with other areas of humid forest (core and disjunct), was considered high and the statistics showed greater similarity with the area of the mesoregion of Pernambuco forest. The results allow the characterization of the area as a vegetational refuge of humid forest, corroborating the Refuge Theory and showing strong penetration of savanna species (“Cerradão”, Cerrado, Caatinga/“Carrasco”), emphasizing the action of climatic impulses that occurred in the Quaternary and pointing to the need to conservation strategies due to accelerated anthropism.

RESUMO No interior da região semiárida brasileira (bioma Caatinga), há ocorrência de refúgios de vegetação de outros biomas que se apresentam principalmente em topos de formações geológicas do período Pré-Cambriano, como a Chapada do Araripe. Este trabalho objetivou o conhecimento da estrutura, diversidade e similaridade florística de um fragmento de mata úmida na Chapada do Araripe, sul do Ceará (708m Alt.), visando subsidiar estratégias de conservação dessa comunidade, área de relevante valor ecológico, cultural e paisagístico. Em 13 parcelas de 25x25m (0,8 ha), foram inventariados todos os indivíduos com DAP ≥ 5cm, observando-se altura total. A similaridade florística foi observada pelo método de Jaccard a partir da comparação com outras sete áreas em diferentes regiões do Brasil. Foram encontradas 66 espécies distribuídas em 34 famílias, num total de 1.544 indivíduos com DA=1.997,30 ind.ha-1 e AB=32,618 m²ha-1. Fabaceae (25,75%) e Myrtaceae (6%) apresentaram maior número de espécies e Brosimum gaudichaudii apresentou maior IVI. O índice de Shannon (H’) foi 3,13 e a equabilidade de Pielou (J’) foi 0,75. A diversidade beta, comparada com outras áreas de mata úmida (core e disjuntas), foi considerada alta e a estatística apontou maior similaridade com área da mesorregião da mata pernambucana. Os resultados permitem caracterizar a área como refúgio vegetacional de mata úmida, corroborando com a teoria dos refúgios e evidenciam forte penetração de espécies savânicas (cerradão, cerrado, caatinga/carrasco) enfatizando a atuação de impulsos climáticos ocorridos no Quaternário e apontando para a necessidade de estratégias de conservação devido ao antropismo acelerado.

Abstract Fecal Immunochemical Test (FIT) followed by a colonoscopy is an efficacious strategy to improve the adenoma detection rate and Colorectal Cancer (CRC). There is no organized national screening program for CRC in Brazil. The aim of this research was to describe the implementation of an organized screening program for CRC through FIT followed by colonoscopy, in an urban low-income community of São Paulo city. The endpoints of the study were: FIT participation rate, FIT positivity rate, colonoscopy compliance rate, Positive Predictive Values (PPV) for adenoma and CRC, and the rate of complications. From May 2016 to October 2019, asymptomatic individuals, 50-75 years old, received a free kit to perform the FIT. Positive FIT (≥ 50 ng/mL) individuals were referred to colonoscopy. 10,057 individuals returned the stool sample for analysis, of which (98.2%) 9,881 were valid. Women represented 64.8% of the participants. 55.3% of individuals did not complete elementary school. Positive FIT was 7.8% (776/9881). The colonoscopy compliance rate was 68.9% (535/776). There were no major colonoscopy complications. Adenoma were detected in 63.2% (332/525) of individuals. Advanced adenomatous lesions were found in 31.4% (165/525). CRC was diagnosed in 5.9% (31/525), characterized as adenocarcinoma: in situ in 3.2% (1/31), intramucosal in 29% (9/31), and invasive in 67.7% (21/31). Endoscopic treatment with curative intent for CRC was performed in 45.2% (14/31) of the cases. Therefore, in an urban low-income community, an organized CRC screening using FIT followed by colonoscopy ensued a high participation rate, and high predictive positive value for both, adenoma and CRC.

RESUMO O fósforo tem importância fundamental para o suprimento energético necessário para o metabolismo vegetal, mas ainda é pouco estudado em culturas importantes, como a mandioca. Objetivou-se avaliar o acúmulo e a eficiência do uso do fósforo em diferentes cultivares de mandioca no semiárido. Foram conduzidos dois experimentos em duas safras agrícolas, 2018/2019 e 2019/2020, em Mossoró-RN. O delineamento experimental foi em blocos ao acaso, em parcelas subdivididas, com quatro repetições. Nas parcelas, foram aplicadas no sulco de cultivo cinco doses de fósforo (P) (0; 60; 120; 180 e 240 kg ha-1 de P2O5), e, nas subparcelas quatro cultivares de mandioca (Água Morna, BRS Gema de Ovo, Recife e Venâncio). As cultivares Água Morna e Recife exportam mais fósforo através de suas raízes. As cultivares Venâncio e Água Morna apresentam maior eficiência agronômica quando adubadas com 60 kg ha-1 de P2O5. A eficiência aparente de recuperação do P apresentou a seguinte ordem: ‘BRS Gema de Ovo’ > ‘Água Morna’ > ‘Venâncio’ > ‘Recife’, com maiores índices na dose de 60 kg ha-1 de P2O5.

ABSTRACT Phosphorus is of fundamental importance for the energy supply necessary for plant metabolism, but it is still understudied for important agricultural crops such as cassava. The objective of this study was to evaluate the accumulation and efficiency of phosphorus use in different cassava cultivars in the semiarid region. Two experiments were carried out during two agricultural seasons 2018/2019 and 2019/2020 in Mossoró, Rio Grande do Norte state, Brazil. The experimental design was randomized blocks, in split plots, with four replicates. In the plots, five doses of phosphorus (P) (0, 60, 120, 180, and 240 kg ha-1 of P2O5) were applied in the planting furrow, and four cassava cultivars (Água Morna, BRS Gema de Ovo, Recife, and Venâncio) were cultivated in the subplots. The cultivars Água Morna and Recife export more phosphorus through their roots. The cultivars Venâncio and Água Morna show greater agronomic efficiency when fertilized with 60 kg ha-1 of P2O5. The apparent P recovery efficiency presented the following order: ‘BRS Gema de Ovo’ > ‘Água Morna’ > ‘Venâncio’ > ‘Recife’, with higher indices at the dose of 60 kg ha-1 of P2O5.

RESUMO Contexto A hepatite C é um relevante problema de saúde pública. A doença pode permanecer clinicamente silenciosa tanto na forma aguda como na crônica e as infecções crônicas podem progredir para doenças avançadas, tais como cirrose e carcinoma hepatocelular (CHC), requerendo tratamentos dispendiosos, comprometendo a qualidade de vida do paciente e até mesmo levando à morte. Por esta razão, é uma das indicações mais frequentes para o transplante hepático. Apesar da introdução do tratamento com antivirais de ação directa (AAD) representar um progresso notável, muitos pacientes não receberam o tratamento e continuam infectados, e mesmo aqueles que eliminaram a infecção viral devem ser seguidos devido às lesões hepáticas anteriores, especialmente no que diz respeito às alterações da arquitetura lobular e dos vasos sanguíneos e linfáticos. Objetivo Avaliar os aspectos imuno-histoquímicos dos brotos linfáticos e dos vasos linfáticos “maduros” com variáveis histológicas de lesão hepática atribuíveis ao vírus da hepatite C (VHC) e à doença gordurosa. Métodos O presente estudo incluiu 72 biópsias hepáticas em pacientes com hepatite C crônica. Foram analisadas alterações estruturais relativas a “estadiamento” e “atividade”. Reações imuno-histoquímicas foram realizadas com anticorpo D2-40 anti-podoplanina. As principais variáveis histológicas também foram semiquantificadas, de modo a permitir a procura de possíveis associações entre os critérios histológicos e imunohistoquímicos, bem como com os genótipos 1 e 3 do VHC. Resultados Os achados histológicos mostraram que os diferentes graus de alterações estrutural estavam bem representados nesta casuística. A atividade necro-inflamatória lobular/parenquimatosa foi predominantemente leve à moderada. A maioria dos casos não apresentava grandes evidências de doença gordurosa, que foi encontrada significativamente mais elevada nos casos infectados com o genótipo 3 do VHC. A quantidade de brotos linfáticos portais aumentou com a progressão de alterações estruturais, sendo máxima na cirrose. Os brotos linfáticos portais, bem como os vasos linfáticos “maduros” portais também mostraram um aumento paralelo ao aumento do grau de infiltrado inflamatório portal/septal. No presente estudo, não foi encontrada qualquer associação significativa entre a proporção de brotos linfáticos portais ou vasos linfáticos maduros portais e o grau de atividade periportal/periseptal. Não foram detectadas relações significativas entre os brotos linfáticos/vasos maduros e a atividade inflamatória periportal ou atividade inflamatória parenquimatosa, nem com infecções devido ao genótipo 1 ou 3 do VHC. Conclusão A reação imunohistoquímica com anticorpo monoclonal D2-40 possibilitou a visualização e a semiquantitação de brotos e vasos linfáticos “maduros” nas amostras obtidas por biópsia hepática. A quantidade de linfáticos aumentou ao longo do processo fibrogênico, significativamente relacionada com a progressão da doença hepática e máxima na cirrose. Não foram detectadas relações significativas com a atividade necro-inflamatória periportal ou parenquimatosa.

ABSTRACT Background Viral hepatitis C is a significant public health challenge. The disease may remain clinically silent in both acute and chronic forms, and chronic infections may progress to advanced disease such as cirrhosis and hepatocellular carcinoma, requiring costly treatment, compromising the patient’s quality of life and even leading to death. For this reason, it is one of the most frequent indications for liver transplantation. Although treatment with direct-acting antivirals represents remarkable progress, many patients are still infected and even those who cleared the viral infection must be followed due to their previous hepatic lesions, especially regarding the disturbances of lobular architecture and the sanguineal and lymphatic vessels. Objective To assess immunohistochemical aspects of lymphatic sprouts and mature lymphatic vascularity with histological variables of liver injury attributable to hepatitis C virus (HCV) and fatty disease. Methods The present study included 72 liver biopsies of cases with chronic hepatitis C. Morphologic changes reflecting “staging” and “activity” were analyzed. Immunohistochemical reactions were performed with monoclonal antibody D2-40 anti-podoplanin. Major histological variables were also semiquantified so as to enable the search for possible associations among histological and Immunohistochemical criteria, as well as with genotypes 1 and 3 of HCV. Results Histological findings showed that the different degrees of strutural changes were well represented in this casuistic. Intralobular/parenchymal necro-inflammatory activity was predominantly mild to moderate. Most cases did not show major evidences of fatty disease, which was found significantly higher in cases infected with HCV genotype 3. The amount of portal lymphatic sprouts increased along with the progression of structural changes, maximal at cirrhosis. Portal lymphatic sprouts as well as portal mature lymphatic vessels also showed an increase parallel to the increase in the degree of portal/septal inflammatory infiltrate. In the present study, no significant association was found between the proportion of portal lymphatic sprouts or portal mature lymphatic vessels and the degree of periportal/periseptal activity. No significant relations were detected between lymphatic sprouts/mature vessels and periportal or parenchymal inflammatory activity, nor with infections due to HCV genotype 1 or 3. Conclusion Visualization and semiquantitation of sprouts and mature lymphatic vessels were clearly yielded by Immunohistochemical staining with monoclonal antibody D2-40. The amount of lymphatics was increased along fibrogenic process, significantly related to progression of liver disease and maximal at cirrhosis. No significant relations were detected with necro-inflammatory activity at interface or in the parenchyma.

BACKGROUND Leishmania (Mundinia) enriettii is a species commonly found in the guinea pig, Cavia porcellus. Although it is a dermotropic species, there is still an uncertainty regarding its ability to visceralise during Leishmania life cycle. OBJECTIVE Here, we investigated the ability of L. enriettii (strain L88) to visceralise in lungs, trachea, spleen, and liver of C. porcellus, its natural vertebrate host. METHODS Animals were infected sub-cutaneously in the nose and followed for 12 weeks using histological (hematoxilin-eosin) and molecular tools (polymerase chain reaction-restriction fragment length polymorphism - PCR-RFLP). To isolate parasite from C. porcellus, animals were experimentally infected for viscera removal and PCR typing targeting hsp70 gene. FINDINGS Histological analysis revealed intense and diffuse inflammation with the presence of amastigotes in the trachea, lung, and spleen up to 12 weeks post-infection (PI). Molecular analysis of paraffin-embedded tissues detected parasite DNA in the trachea and spleen between the 4th and 8th weeks PI. At the 12th PI, no parasite DNA was detected in any of the organs. To confirm that the spleen could serve as a temporary site for L. enriettii, we performed additional in vivo experiments. During 6th week PI, the parasite was isolated from the spleen confirming previous histopathological and PCR observations. MAIN CONCLUSION Leishmania enriettii (strain L88) was able to visceralise in the trachea, lung, and spleen of C. porcellus.

Abstract Objective: The aim of the present study was to evaluate the clinical features, Hepatocellular Carcinoma (HCC) screening, treatment modalities, and Overall Survival (OS) in a series of Non-Alcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma (NAFLD-HCC) Brazilian patients. Methods: This was a cross-sectional study at the Instituto do Cancer do Estado de São Paulo, at the Faculdade de Medicina da Universidade de São Paulo with the approval of the local research ethics committee. NAFLD patients with HCC diagnosed, from May 2010 to May 2019, were included. Results: A total of 131 patients were included. Risk factors for NAFLD were present in 94.7% of the patients. Only 29% of patients were in the HCC screening program before diagnosis. HCC treatment was performed in 84.7% of patients. Cumulative survival at the end of the first year was 72%, second-year 52%, and fifth-year 32%. HCC screening before diagnosis was not significantly associated with higher cumulative survival. The independent factors associated with shorter general survival were BCLC C-D, p < 0.001, and the size of the largest nodule > 42 mm, p = 0.039. Conclusions: Although the efficacy of screening in our population regarding overall survival was hampered due to the sample size (29% had screening), BCLC stages C‒D and the size of the largest nodule larger than 42 mm were identified as independent factors of worse prognosis.

OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and outcomes. Upon searching for tumor heterogeneity, we compared the findings of primary tumors with their matched lymph node metastases. We collected data from 183 patients who underwent cystectomy for high-grade muscle-invasive urothelial carcinoma, and representative areas from the tumors and from 76 lymph node metastasis were organized in tissue microarrays. RESULTS: Basal immunohistochemical subtype (CK5 positive and CK20 negative, or CK5 positive and GATA3 negative) was associated with the squamous variant. The luminal immunohistochemical subtype (CK5 negative and CK20 positive, or CK5 negative and GATA3 positive) was associated with micropapillary and plasmacytoid variants. Remarkably, only moderate agreement was found between the immunohistochemical subtypes identified in bladder tumors and their lymph node metastasis. No significant difference in survival was observed when using either combination of the markers. CONCLUSION: This study demonstrates that these three routinely used immunohistochemical markers could be used to stratify urothelial carcinomas of the bladder into basal and luminal subtypes, which are associated with several differences in clinicopathological features.

RESUMO Fibroína (FB) e nanocelulose bacteriana (BC) são produtos naturais que podem ser usados na biomedicina, nas indústrias eletrônicas e de alimentos e outras áreas. Todos eles apresentam biocompatibilidade, podendo ser utilizados para diversos fins. A mistura de fibroína e nanocelulose bacteriana foi projetada para produzir um material biocompatível para ser aplicado com um dispositivo médico. Por esse motivo, o objetivo deste trabalho foi avaliar as propriedades estruturais da mistura de BC e FB. Assim, FB foi extraída do Bombyx mori e a BC foi produzida por processo de fermentação utilizando Gluconacetobacter xylinus. As membranas compostas de BC-FB foram produzidas por contato de imersão por 24 horas, a 25 °C, em 100 rpm, sem agente reticulante. Após a produção, as amostras de membrana foram secas e caracterizadas por espectroscopia de Infravermelho com Transformada de Fourier (espectroscopia FTIR), propriedades mecânicas, eficiência de intumescimento, microscopia eletrônica de varredura (MEV) e microtomografia computadorizada (µCt). Os resultados indicam que as membranas porosas com ligações de hidrogênio obtidas apresentaram morfologia porosa anisiotrópica, fechada e interconectada. As características morfométricas, que se assemelham a um favo de mel e consistem em uma estrutura longa com alta conectividade e alta porosidade total, amplificam as áreas de aplicações da mistura BC-FB, com potencial utilização com dispositivos optoeletrônicos, em áreas que variam desde ambiental à engenharia tecidual. Além disso, a produção por contato de imersão permitirá o processo de alta qualidade e o desenvolvimento de material de rótulo verde.

ABSTRACT Fibroin (FB) and bacterial nanocellulose (BC) are natural products, being used in biomedicine, electronics, food industries and other areas. Both show biocompatibility, able to be used for many different purposes. The blending of fibroin and bacterial nanocellulose was design to produce a biocompatible material to be applied with a medical device. For this reason, the objective of this work was to evaluate the structure properties of the blending of BC and FB. Thus, FB was extracted from Bombyx mori and BC was produced by fermentation process utilizing Gluconacetobacter xylinus. The membranes composed of BC-FB were produced by immersion contact for 24 hours, at 25°C, in 100rpm; without crosslinking agent. After the production the membrane samples were dried and characterized by Fourier transform infrared spectroscopy (FTIR spectroscopy), mechanical proprieties, swelling efficiency, scanning electron microscopy (SEM) and computerized microtomography (µCt). Results indicate that the hydrogen-bonded porous membranes obtained displayed anisiotropic, closed and interconnected porous morphology. The morphometric characteristics, which resemble a honeycomb and consist of a long structure with high connectivity and high total porosity, amplify the areas of BC-FB blend applications, with potential utilization with optoelectronic devices, in areas ranging from environmental to tissue engineering. Furthermore, the production by immersion contact will allow the upscale process and the development of green label material.

OBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection. METHODS: This observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients. RESULTS: Seropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis ≥3 versus ≤2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of ≥1.45 (p=0.003), and Fibrosis-4 score of ≥3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups. CONCLUSIONS: This prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection.

Resumo Objetivos Medir o valor médio do ângulo de Southwick utilizando dois métodos diferentes, manual (1) e digital (2), e estabelecer um valor de normalidade. Métodos Estudo primariamente descritivo, realizado com 100 crianças e adolescentes. Foram excluídos indivíduos que apresentavam queixa ortopédica nos quadris e/ou joelhos, ou alterações de marcha. Para cada paciente, foi realizada uma radiografia na incidência lateral de Lowenstein, totalizando 100 radiografias e 200 quadris. O ângulo de Southwick foi medido de duas formas pelo mesmo pesquisador: pelo método convencional (1), traçando-se as retas com lápis e medindo o ângulo com o uso de goniômetro e negatoscópio, e por meio do editor de imagem GNU Image Manipulation Program (GIMP; código aberto), versão 2.7.0 (2), no qual foram traçadas as linhas e aferidos os ângulos de ambos os quadris em cada radiografia. Posteriormente, buscou-se avaliar a correlação entre os dois métodos e verificar o ângulo médio de Southwick correlacionando-o categoricamente por gênero, faixa etária e índice de massa corpórea (IMC) em adolescentes e crianças assintomáticos. Todas as radiografias foram autorizadas pelos responsáveis. O estudo foi aprovado pelo comitê de ética das instituições em que a pesquisa foi realizada. Resultados A média do ângulo de Southwick obtida pelo método convencional foi de 8,7º (±2,0º), e pelo método digital, foi de 9,9º (±1,8º). O ângulo obtido pelas duas formas teve significância estatística (p < 0,001). A maioria da população estudada (95%) tinha índice de massa corpórea (IMC) > 18,5, e a média dos ângulos esteve dentro do valor previamente estabelecido como normal (∼ 10º). Conclusão Demonstrou-se, pela primeira vez, utilizando uma amostra substanciosa, um valor normal do ângulo de Southwick medido em indivíduos assintomáticos. Além disso, o editor de imagem mostrou ser um método confiável para mensuração do ângulo de Southwick.

Abstract Objectives To measure the mean value of the Southwick angle using two different methods, the manual (1) and digital (2) methods, and to establish a normality value. Methods A primarily descriptive study with 100 children and adolescents. Individuals with orthopedic complaints regarding the hips and/or knees or gait alterations were excluded. For each patient, an X-ray was performed on the lateral incidence of Lowenstein, totaling 100 radiographs and 200 hips. The Southwick angle was measured in two different ways by the same researcher: the conventional method (1), tracing the lines with pencils and measuring the angle with the use of a goniometer and negatoscope, and through the GNU Image Manipulation Program (GIMP) image editor (open source), version 2.7.0 (2), in which the lines were plotted and the angles of both hips were gauged on each radiograph. Later, we sought to evaluate the correlation between the two methods and to verify the mean Southwick angle by categorically correlating it by gender, age group and body mass index (BMI) in asymptomatic children and adolescents. All radiographs were authorized by the children and adolescents' parents/legal guardians. The study was approved by the ethics committee of the institutions in which the research was conducted. Results The mean of the Southwick angles obtained by the conventional method was of 8.7º (±2.0º), and, by the digital method, it was of 9.9º (±1.8º). The angle obtained by the two methods was statistically significant (p < 0.001). The majority of the studied population (95%) had a body mass index (BMI) > 18.5, and the mean of the angles was within the previously established value (∼ 10º). Conclusion For the first time, using a substantial sample size, a normal value for the Southwick angle measured in asymptomatic individuals was demonstrated. In addition, the image editor proved to be a reliable method to measuring the Southwick angle.

RESUMO O carcinoma hepatocelular (CHC) é uma das principais causas de mortalidade relacionada a câncer no Brasil e no mundo. A Sociedade Brasileira de Hepatologia (SBH) publicou em 2015 suas primeiras recomendações sobre a abordagem do CHC. Desde então, novas evidências sobre o diagnóstico e tratamento do CHC foram relatadas na literatura médica, levando a diretoria da SBH a promover uma reunião monotemática sobre câncer primário de fígado em agosto de 2018 com o intuito de atualizar as recomendações sobre o manejo da neoplasia. Um grupo de experts foi convidado para realizar uma revisão sistemática da literatura e apresentar uma atualização baseada em evidências científicas visando que pudesse nortear a prática clínica multidisciplinar do CHC. O texto resultante foi submetido a avaliação e aprovação de todos membros da SBH através de sua homepage. O documento atual é a versão final que contêm as recomendações atualizadas e revisadas da SBH.

ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

Resumo: Estudos realizados nos países em desenvolvimento descrevem um aumento progressivo dos transtornos mentais, com grandes repercussões sociais e econômicas. O presente estudo se propõe a analisar a prevalência dos transtornos mentais comuns (TMC) e seus fatores associados nos moradores da área urbana da cidade de São Paulo, Brasil. A partir dos dados levantados pelo Inquérito de Saúde do Município de São Paulo (ISA-Capital) de 2015, foi identificada a presença de TMC com a utilização do Self-Reporting Questionnaire (SRQ-20). A associação de TMC com as variáveis sociodemográficas e de condições de saúde foi analisada pela frequência relativa, corrigida pelos respectivos pesos decorrentes de uma amostragem de conglomerados, estimando-se a prevalência e intervalos de 95% de confiança (IC95%) em cada situação e avaliando-se a significância da associação pelo qui-quadrado corrigido pela distribuição F. A prevalência de TMC encontrada foi de 19,7% (IC95%: 18,2-21,4), sendo maior nas seguintes categorias: mulheres (24,3%); pessoas com 60 anos ou mais (25,3%); praticantes da umbanda/candomblé (37,8%); viúvos (30,4%); quem nunca frequentou a escola (31,4%); inativos/desempregados (28,3%); e quem possuía renda familiar de até um salário mínimo (28,8%). Em relação às variáveis de condição de saúde, a prevalência de TMC foi maior nos indivíduos que referiram: morbidade nos últimos 15 dias (36,9%); deficiência física (21,6%); deficiência mental ou intelectual (44,4%); problema emocional ou mental (48,9%); cefaleia (33,63%); e nos portadores de uma ou mais doenças crônicas (24,1%). As informações desta pesquisa reafirmam a relevância da prevalência de TMC assim como sua associação com os grupos sociais mais vulneráveis, o que reforça a necessidade da implementação de medidas públicas de saúde mental.

Abstract: Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association’s significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.

Resumen: Estudios realizados en los países en desarrollo describen un aumento progresivo de los trastornos mentales, con grandes repercusiones sociales y económicas. El presente estudio se propone analizar la prevalencia de los trastornos mentales comunes (TMC) y sus factores asociados en los habitantes del área urbana de la ciudad de São Paulo, Brasil. A partir de los datos recabados por la Encuesta de Salud en el Municipio de São Paulo (ISA-Capital) de 2015, se identificó la presencia de TMC con la utilización del Self-Reporting Questionnaire (SRQ-20). La asociación de TMC con las variables sociodemográficas y de condiciones de salud se analizó a través de la frecuencia relativa, corregida por los respectivos pesos derivados de una muestra de conglomerados, estimándose la prevalencia y intervalos de confianza (IC95%) y evaluándose la significancia de la asociación por el chi-cuadrado, corregido por la distribución F. La prevalencia de TMC encontrada fue de 19,7% (IC95%: 18,2-21,4), siendo mayor en mujeres (24,3%); personas con 60 años o más (25,3%); practicantes de umbanda/candomblé (37,8%); viudos (30,4%); que nunca asistieron a la escuela (31,4%); inactivos/desempleados (28,3%); quienes tenía una renta familiar de hasta un salario mínimo (28,8%); individuos que informaron morbilidad durante los últimos 15 días (36,9%); deficiencia física (21,6%); deficiencia mental o intelectual (44,4%); problema emocional o mental (48,9%); cefalea (33,63%); y en los portadores de una o más enfermedades crónicas (24,1%). La información de esta investigación reafirma la relevancia de la prevalencia de TMC, así como su asociación con los grupos sociales más vulnerables, lo que refuerza la necesidad de la implementación de medidas públicas de salud mental.

Resumo: Estudos realizados nos países em desenvolvimento descrevem um aumento progressivo dos transtornos mentais, com grandes repercussões sociais e econômicas. O presente estudo se propõe a analisar a prevalência dos transtornos mentais comuns (TMC) e seus fatores associados nos moradores da área urbana da cidade de São Paulo, Brasil. A partir dos dados levantados pelo Inquérito de Saúde do Município de São Paulo (ISA-Capital) de 2015, foi identificada a presença de TMC com a utilização do Self-Reporting Questionnaire (SRQ-20). A associação de TMC com as variáveis sociodemográficas e de condições de saúde foi analisada pela frequência relativa, corrigida pelos respectivos pesos decorrentes de uma amostragem de conglomerados, estimando-se a prevalência e intervalos de 95% de confiança (IC95%) em cada situação e avaliando-se a significância da associação pelo qui-quadrado corrigido pela distribuição F. A prevalência de TMC encontrada foi de 19,7% (IC95%: 18,2-21,4), sendo maior nas seguintes categorias: mulheres (24,3%); pessoas com 60 anos ou mais (25,3%); praticantes da umbanda/candomblé (37,8%); viúvos (30,4%); quem nunca frequentou a escola (31,4%); inativos/desempregados (28,3%); e quem possuía renda familiar de até um salário mínimo (28,8%). Em relação às variáveis de condição de saúde, a prevalência de TMC foi maior nos indivíduos que referiram: morbidade nos últimos 15 dias (36,9%); deficiência física (21,6%); deficiência mental ou intelectual (44,4%); problema emocional ou mental (48,9%); cefaleia (33,63%); e nos portadores de uma ou mais doenças crônicas (24,1%). As informações desta pesquisa reafirmam a relevância da prevalência de TMC assim como sua associação com os grupos sociais mais vulneráveis, o que reforça a necessidade da implementação de medidas públicas de saúde mental.

Abstract: Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association’s significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.

Resumen: Estudios realizados en los países en desarrollo describen un aumento progresivo de los trastornos mentales, con grandes repercusiones sociales y económicas. El presente estudio se propone analizar la prevalencia de los trastornos mentales comunes (TMC) y sus factores asociados en los habitantes del área urbana de la ciudad de São Paulo, Brasil. A partir de los datos recabados por la Encuesta de Salud en el Municipio de São Paulo (ISA-Capital) de 2015, se identificó la presencia de TMC con la utilización del Self-Reporting Questionnaire (SRQ-20). La asociación de TMC con las variables sociodemográficas y de condiciones de salud se analizó a través de la frecuencia relativa, corregida por los respectivos pesos derivados de una muestra de conglomerados, estimándose la prevalencia y intervalos de confianza (IC95%) y evaluándose la significancia de la asociación por el chi-cuadrado, corregido por la distribución F. La prevalencia de TMC encontrada fue de 19,7% (IC95%: 18,2-21,4), siendo mayor en mujeres (24,3%); personas con 60 años o más (25,3%); practicantes de umbanda/candomblé (37,8%); viudos (30,4%); que nunca asistieron a la escuela (31,4%); inactivos/desempleados (28,3%); quienes tenía una renta familiar de hasta un salario mínimo (28,8%); individuos que informaron morbilidad durante los últimos 15 días (36,9%); deficiencia física (21,6%); deficiencia mental o intelectual (44,4%); problema emocional o mental (48,9%); cefalea (33,63%); y en los portadores de una o más enfermedades crónicas (24,1%). La información de esta investigación reafirma la relevancia de la prevalencia de TMC, así como su asociación con los grupos sociales más vulnerables, lo que refuerza la necesidad de la implementación de medidas públicas de salud mental.