Resumo Background: A disseção endoscópica da submucosa (DES) é uma técnica minimamente invasiva para resseção em bloco de tumores superficiais, independentemente do seu tamanho. No entanto, nas neoplasias superficiais gastrointestinais gigantes, o risco de cancro invasivo está aumentado e a DES é tipicamente desafiante. Apesar do incremento da literatura acerca de resseções gigantes, dados da sua eficácia e segurança são ainda escassos. Objetivo: Descrição de outcomes de DES de um centro português e comparação com estudos internacionais. Análise de eventuais fatores de risco influenciando os outcomes. Métodos: Revisão retrospetiva de um centro, usando a sua base de dados prospectivamente colhida, incluindo pacientes com resseções rectais por DES maiores que 10 cm, entre janeiro 2016 e dezembro 2021. Dados clínicos, endoscópicos e patológicos foram colhidos e analisados. A literatura foi revista através do PubMed, para comparação com resultados internacionais. A análise dos resultados e estatística foi realizada, utilizando o Microsoft Excel e SPSS, para a identificação de fatores de risco com impacto significativo nos outcomes. Resultados: O estudo incluiu um total de 15 resseções retais, com uma média de diâmetros de 140,9 mm (intervalo 105-270), correspondendo a lesões 125,9 mm (intervalo 87-238). A taxa de resseção em bloco foi de 100% (n = 15). Segundo os critérios da ESGE, o procedimento foi curativo em 53,3% (n = 8), não curativo com alto risco em 13,3% (n = 2) e com risco de recorrência local em 33,3% (n = 5). Eventos adversos ocorreram em 26,7% (n = 4): 1 microperfuração e 3 estenoses, a maioria geridas endoscopicamente. Os 5 casos não curativos com risco de recorrência local ficaram apenas sob vigilância. Nas ressecções não curativas de alto risco, um paciente foi submetido a cirurgia e outro a quimioradioterapia adjuvante. O follow-up (média de 16 meses) demonstrou uma taxa de recorrência de 0%. A análise estatística demonstrou o tamanho da ressecção ≥20 cm como fator de risco significativo para perfuração (p value 0.067); e envolvimento de ≥ 90% da circunferência do lúmen e tempo de procedimento ≥4h como fatores de risco significativos para estenose (p value 0.029 e 0.009, respetivamente). Conclusão: Apesar de desafiante, a DES para lesões gigantes parece eficaz e segura, com uma taxa de complicações importante, possíveis de tratamento endoscópico. A caracterização rigorosa destas lesões é crucial para predizer e evitar complicações ou a necessidade de escalada terapêutica.

Abstract Background: Endoscopic submucosal dissection (ESD) is a minimally invasive technique for en bloc resection of superficial neoplastic lesions, independent of their size. However, for giant gastrointestinal superficial neoplasia, the risk of invasive cancer is higher, and ESD is typically challenging. Despite the increasing literature on giant resections, data on their efficacy and safety are still lacking. Objective: The aim of this study was to describe ESD outcomes from a Portu-guese center, compare them with other international studies, and analyze the possible risk factors influencing outcomes. Methods: We conducted a retrospective single-center review using a prospectively collected database, including patients with rectal ESD resections larger than 10 cm, between January 2016 and December 2021. Clinical, procedural, and pathological data were collected and analyzed. Revision of the literature for comparison with international results was done through PubMed. Data were analyzed and statistical analysis performed, using Microsoft Excel and SPSS, to identify significant risk factors. Results: The study included 15 rectal resections, with a mean diameter of 140.9 mm (range 105-270), corresponding to lesions of 125.9 mm (87-238). The overall en bloc resection rate was 100% (n = 15). According to ESGE criteria, procedure was considered curative in 53.3% (n = 8), non-curative with high risk in 13.3% (n = 2), and local-risk recurrence in 33.3% (n = 5). Adverse events occurred in 26.7% (n = 4): 1 minor perforation and 3 stenosis, most endoscopically managed. For non-curative resections with local-risk recurrence, surveillance without adjuvant therapy was performed in all cases. For high-risk non-curative resections, surgery was performed in 1 patient and adjuvant chemoradiation therapy in another. Follow-up (mean 16 months) demonstrated a recurrence rate of 0%. Statistical analysis revealed resection size ≥20 cm as a risk factor for perforation (p value 0.067), and involvement of ≥90% of the circumference and procedural time ≥4 h as risk factors for stenosis (p value 0.029 and 0.009, respectively). Conclusions: Although challenging, ESD for giant lesions seems effective and safe, with a still relevant rate of complications, which were mostly endoscopically treated. Rigorous characterization of lesions is crucial to predict and avoid complications or the need for therapy escalation.

ABSTRACT BACKGROUND: A bibliometric analysis covering only the production of original studies or considering world production until 2022 has yet to be conducted. The creation and advancement of vaccines have also influenced research priorities, demonstrating the need for a new approach to this subject. OBJECTIVES: To analyze worldwide scientific production related to coronavirus disease 2019 (COVID-19) and the aged and to describe what has already been produced. DESIGN AND SETTING: Bibliometric analysis with a quantitative approach. METHOD: The search terms “COVID-19,” “SARS-CoV-2,” “Aged,” and “Elderly” were used to retrieve articles from the Web of Science database. A total of 684 articles were included in the analysis. Data were imported into RStudio Desktop Software and linked to R Software. The Bibliometrix R package and VOSviewer software were used for analysis. RESULTS: Most articles were published in 2020. These were produced by 4,937 authors and published in 379 journals. The keyword most used by the authors was “COVID-19.” Publications from 77 countries were obtained. China had the highest article production ranking, and Spain collaborated the most. The articles addressed the implications of the pandemic on the aged, the relationship between vaccination in the aged, and the implications for the disease itself. CONCLUSION: Further research should be conducted, mainly concerning vaccines and vaccination of the aged, owing to the need for and importance of immunization in this risk group, including assessing the long-term effects of vaccines.

RESUMO Objetivo Descrever o perfil dos casos de mpox na cidade do Rio de Janeiro, entre junho e novembro de 2022. Métodos Estudo descritivo de dados secundários das fichas de notificação de mpox. Foram analisados dados socioeconômicos, clínicos e espaciais. Resultados Dos 928 casos, 93,7% foram do sexo masculino, 85,0% homem cisgênero, 65,6% homossexual, 41,8% entre 30 e 39 anos e 41,0% brancos. Apresentavam imunodepressão por doença 34,5%, e 41,9% informaram sorologia positiva prévia para vírus da imunodeficiência humana. Os sinais e sintomas mais prevalentes foram: lesões cutâneas (96,6%), especialmente com manifestações múltiplas (67,8%) e em região genital (46,1%), além de febre (58,3%), adenomegalia (43,3%) e cefaleia (38,7%). A maioria das notificações ocorreu na rede pública (81,3%) e na atenção hospitalar (51,3%). Conclusão O estudo revelou maior incidência de mpox entre homens cisgênero, autodeclarados de cor branca e homossexual. A maioria dos casos teve apresentação leve evoluindo para cura sem hospitalização.

RESUMEN Objetivo Describir el perfil de los casos de mpox en la ciudad de Río de Janeiro entre junio y noviembre de 2022. Métodos Estudio descriptivo de datos secundarios de los formularios de notificación de mpox. Se analizaron datos socioeconómicos, clínicos y espaciales. Resultados De los 928 casos, 93,7% eran hombres, 65,6% homosexuales, 41% blanca, y 41,8% de 30 a 39 años. Estaban inmunocomprometidos debido a una enfermedad 34,5%, y 41,9% reportaron serología positiva para virus de inmunodeficiencia humana. Signos y síntomas más prevalentes fueron: lesiones cutáneas (96,6%), con manifestaciones múltiples (67,8%) y en la región genital (46,1%), además de fiebre (58,3%), adenomegalia (43,3%) y cefalea (38,7%). Mayoría de las notificaciones ocurrieron en la red pública (81,3%) y atención hospitalaria (51,3%). Conclusión El estudio reveló alta incidencia de mpox, especialmente entre hombres jóvenes, cisgénero y homosexuales. Mayoría de los casos tuvieron una presentación leve, progresando hasta la curación sin hospitalización.

ABSTRACT Objective To describe the profile of cases of mpox in the city of Rio de Janeiro between June and November 2022. Methods This was a descriptive study of secondary data obtained from mpox notification forms. Socioeconomic, clinical and spatial data were analyzed. Results Of the 928 cases, 93.7% were male, 85.0% cisgender male, 65.6% homosexual, 41.8% between 30 and 39 years old, and 41.0% were of White race/skin color. A total of 34.5% had immunosuppression due to illness, and 41.9% reported their HIV status as being positive. The most prevalent signs and symptoms were: skin lesions (96.6%), especially with multiple manifestations (67.8%) in the genital region (46.1%), in addition to fever (58.3%), adenomegaly (43.3%) and headache (38.7%). Most notifications occurred in public services (81.3%) and in hospital care (51.3%). Conclusion The study revealed high incidence of mpox, especially among young, cisgender and homosexual men. Most cases were mild, with genital lesions, progressing to cure without hospitalization. Person-to-person transmission was predominant.

Abstract In recent decades, there have been significant advances in the diagnosis of diffuse gliomas, driven by the integration of novel technologies. These advancements have deepened our understanding of tumor oncogenesis, enabling a more refined stratification of the biological behavior of these neoplasms. This progress culminated in the fifth edition of the WHO classification of central nervous system (CNS) tumors in 2021. This comprehensive review article aims to elucidate these advances within a multidisciplinary framework, contextualized within the backdrop of the new classification. This article will explore morphologic pathology and molecular/genetics techniques (immunohistochemistry, genetic sequencing, and methylation profiling), which are pivotal in diagnosis, besides the correlation of structural neuroimaging radiophenotypes to pathology and genetics. It briefly reviews the usefulness of tractography and functional neuroimaging in surgical planning. Additionally, the article addresses the value of other functional imaging techniques such as perfusion MRI, spectroscopy, and nuclear medicine in distinguishing tumor progression from treatment-related changes. Furthermore, it discusses the advantages of evolving diagnostic techniques in classifying these tumors, as well as their limitations in terms of availability and utilization. Moreover, the expanding domains of data processing, artificial intelligence, radiomics, and radiogenomics hold great promise and may soon exert a substantial influence on glioma diagnosis. These innovative technologies have the potential to revolutionize our approach to these tumors. Ultimately, this review underscores the fundamental importance of multidisciplinary collaboration in employing recent diagnostic advancements, thereby hoping to translate them into improved quality of life and extended survival for glioma patients.

Resumo Nas últimas décadas, houve avanços significativos no diagnóstico de gliomas difusos, impulsionados pela integração de novas tecnologias. Esses avanços aprofundaram nossa compreensão da oncogênese tumoral, permitindo uma estratificação mais refinada do comportamento biológico dessas neoplasias. Esse progresso culminou na quinta edição da classificação da OMS de tumores do sistema nervoso central (SNC) em 2021. Esta revisão abrangente tem como objetivo elucidar esses avanços de forma multidisciplinar, no contexto da nova classificação. Este artigo irá explorar a patologia morfológica e as técnicas moleculares/genéticas (imuno-histoquímica, sequenciamento genético e perfil de metilação), que são fundamentais no diagnóstico, além da correlação dos radiofenótipos da neuroimagem estrutural com a patologia e a genética. Aborda sucintamente a utilidade da tractografia e da neuroimagem funcional no planejamento cirúrgico. Destacaremos o valor de outras técnicas de imagem funcional, como ressonância magnética de perfusão, espectroscopia e medicina nuclear, na distinção entre a progressão do tumor e as alterações relacionadas ao tratamento. Discutiremos as vantagens das diferentes técnicas de diagnóstico na classificação desses tumores, bem como suas limitações em termos de disponibilidade e utilização. Além disso, os crescentes avanços no processamento de dados, inteligência artificial, radiômica e radiogenômica têm grande potencial e podem em breve exercer uma influência substancial no diagnóstico de gliomas. Essas tecnologias inovadoras têm o potencial de revolucionar nossa abordagem a esses tumores. Em última análise, esta revisão destaca a importância fundamental da colaboração multidisciplinar na utilização dos recentes avanços diagnósticos, com a esperança de traduzi-los em uma melhor qualidade de vida e uma maior sobrevida.

ABSTRACT Overcoming malnutrition in all its forms, which is also manifested in the obesity epidemic, is one of the priorities of the 2030 Agenda and the Sustainable Development Goals. This article presents reflections on food insecurity in Brazil, based on topics such as population growth, climate change, biodiversity and traditional and regenerative food systems; it also addresses the role of social initiatives to guarantee the Human Right to Adequate Food. The Nutrition and Poverty Research Group, Planetary Health - Brazil Group, and the Center for Artificial Intelligence (C4AI) - AgriBio Axis, assume that the organized and systemic resumption of the initiatives mentioned out in this position paper can contribute to the articulation between research, public policies and services, to combat all forms of malnutrition, as a complex and priority problem to ensure social welfare.

RESUMO O combate à má alimentação em todas as suas formas, que também se expressa na epidemia da obesidade, é uma das prioridades da Agenda 2030 e dos Objetivos de Desenvolvimento Sustentável. Este artigo traz elementos sobre insegurança alimentar no Brasil, a partir de temas relativos ao crescimento populacional, mudanças climáticas, biodiversidade e sistemas alimentares tradicionais e regenerativos; trata também do papel dos movimentos sociais para a garantia do Direito Humano à Alimentação Adequada. O Grupo de Pesquisa em Nutrição e Pobreza, o Saúde Planetária Brasil, e o Centro de Inteligência Artificial (C4AI) - Eixo AgriBio, entendem que a retomada organizada e sistêmica das frentes apontadas neste artigo de posicionamento, pode constituir um caminho para a articulação entre pesquisa, serviço e políticas públicas na direção do combate à fome e às demais manifestações da má alimentação, enquanto problema complexo prioritário para a garantia do bem-estar social.

Resumo Introdução: A colonoscopia é eficaz a detetar e remover lesões do colon e reto. Contudo, após uma colonoscopia normal, podem ser detetadas neoplasias durante o intervalo de vigilância recomendado entre colonoscopias. O objetivo do estudo foi identificar características e fatores de risco para o desenvolvimento de cancro colorretal pós-colonoscopia - subtipo de intervalo. Material e Métodos: Estudo retrospetivo e unicêntrico realizado entre janeiro de 2018 e dezembro de 2019 que incluiu todos os doentes diagnosticados de novo com cancro colorretal. Variáveis clínicas, demográficas e endoscópicas foram obtidas após consulta do processo clínico. Doentes com diagnóstico de cancro colorretal entre duas colonoscopias consecutivas, realizadas no intervalo de vigilância recomendado, foram considerados como tendo cancro colorretal pós-colonoscopia - subtipo de intervalo. Foi, então, realizada a comparação entre o grupo de doentes com cancro color-retal não pós colonoscopia - subtipo de intervalo e o grupo de doentes com cancro colorretal pós colonoscopia - subtipo de intervalo. Resultados: Durante o período de estudo, 491 doentes foram diagnosticados de novo com cancro colorretal. Destes, 61 (12.4%) foram considerados como tendo cancro colorretal pós-colonoscopia - subtipo de intervalo. O cancro colorretal pós-colonoscopia - subtipo de intervalo foi três vezes mais prevalente no colon proximal (p = 0.014) e associou-se a presença de dois ou mais fatores de risco cardiovasculares (aOR = 0.45; p = 0.016), colecistectomia no passado (aOR = 10.09; p = 0.0.19) e história familiar de cancro colorretal num familiar de primeiro grau (aOR = 4.25; p = 0.006). Aquando da análise dos fatores de risco cardiovasculares isolados, observou-se um fator protetor aquando da ausência de to-dos os fatores de risco cardiovasculares (aOR = 20; p = 0.034). A curva ROC associada ao modelo multivariado revelou um poder preditivo de 77.8% (p < 0.001). Conclusão: O cancro colorretal pós-colonoscopia - subtipo de intervalo é mais comum no colon proximal e em doentes com história familiar (em familiares de primeiro grau) de cancro colorretal, dois ou mais fatores de risco cardiovasculares e história de colecistectomia. Todos estes fatores de risco são facilmente detetáveis na prática clínica e podem ser de extrema importância no controlo, a curto e longo prazo, do cancro colorretal pós-colonoscopia.

Abstract Background and Aims: Colonoscopy is effective to detect and remove colorectal lesions. However, after a negative colonoscopy, cancers could be detected during the interval follow-up. This study was designed to identify characteristics and risk factors for postcolonoscopy colorectal cancer - interval type. Methods: Medical records of individuals who were newly diagnosed with colorectal cancer between January 2018 and December 2019 were reviewed. Clinical, demographic, and endoscopic variables were analyzed. Those with the diagnosis of colorectal cancer between two consecutive colonoscopies performed within the appropriated surveillance range were considered to have postcolonoscopy colorectal cancer - interval type. A comparison between the group of patients with non-postcolonoscopy colorectal cancer - interval type and the group of patients with post-colonoscopy colorectal cancer - interval type was then performed. Results: During the study period, 491 patients were newly diagnosed with colorectal cancer. Among them, 61 (12.4%) had postcolonoscopy colorectal cancer - interval subtype. Postcolonoscopy colorectal cancer - interval type was three times more prevalent on the proximal colon (p = 0.014) and was associated with the presence of two or more cardiovascular risk factors (aOR = 4.25; p = 0.016), cholecystectomy in the past (aOR = 10.09; p = 0.019), and family history of colorectal cancer on a first-degree relative (aOR = 4.25; p = 0.006). Moreover, isolated cardiovascular risk factors revealed a protective effect for the absence of all cardiovascular risk factors (aOR = 20; p = 0.034). The ROC curve associated with the multivariate model revealed a predictive power of 77.8% (p < 0.001). Conclusions: Postcolonoscopy colorectal cancer - interval type is more common in the proximal colon and in patients with a family history (first-degree relative) of colorectal cancer, two or more cardiovascular risk factors, and a history of cholecystectomy. All of these are easily detectable in clinical practice and may be of extreme importance in the control of postcolonoscopy colorectal cancer in the near future.

Resumen Introducción: El seguimiento odontológico en el control prenatal representa una estrategia única con acción interdisciplinaria para la prevención de lesiones en la gestante y complicaciones durante el parto. Objetivo: Identificar la interdisciplinariedad en la atención odontológica prenatal desde la perspectiva de las personas profesionales de enfermería. Metodología: Estudio con un enfoque cualitativo basado en la hermenéutica-dialéctica de Gadamer y Habermas en seis unidades básicas de salud de una metrópolis del Nordeste de Brasil, con seis profesionales de enfermería, a través de entrevistas en profundidad en 2018. La organización de los datos se realizó mediante el análisis temático de Minayo. Resultados: A partir del análisis temático, surgieron las categorías ''El cuidado interdisciplinario de la persona profesional en medicina, odontología y enfermería''y ''Remisión de enfermería durante el prenatal odontológico”. Existen implicaciones para el desarrollo de prácticas interdisciplinarias en el prenatal odontológico, como debilidades en la continuidad del cuidado, comunicación e interacción en el equipo. Conclusión: Existe la necesidad de ampliar la integralidad para la calidad en el desarrollo de la atención de la salud de la mujer embarazada y la reducción de las complicaciones maternas y neonatales en las poblaciones de mujeres brasileñas.

Resumo Introdução: O acompanhamento odontológico no pré-natal representa estratégia singular com atuação interdisciplinar na prevenção de agravos à gestante e complicações no parto. Objetivo: Identificar a interdisciplinaridade no acompanhamento odontológico no pré-natal na perspectiva do enfermeiro. Metodologia: Estudo com abordagem qualitativa fundamentado na Hermenêutica-dialética de Gadamer e Habermas em seis Unidades de Atenção Primária à Saúde de uma metrópole do Nordeste do Brasil, com seis enfermeiros por meio de entrevistas em profundidade no ano de 2018. A organização dos dados ocorreu através da análise temática de Minayo. Resultados: Evidenciaram-se após análise temática as categorias, ''O cuidado interdisciplinar do médico, odontólogo e enfermeiro''e ''Encaminhamento do enfermeiro durante o acompanhamento odontológico no pré-natal”. Há implicações para o desenvolvimento de práticas interdisciplinares no acompanhamento odontológico no pré-natal, como fragilidades na continuidade do cuidado, na comunicação e interação na equipe. Conclusão: Há necessidade de ampliar a integralidade para qualidade no desenvolvimento de cuidados em saúde à gestante e diminuição de complicações maternas e neonatais em populações de mulheres brasileiras.

Abstract Introduction: Dental follow-up in prenatal care represents a unique strategy with interdisciplinary action for the prevention of injuries in pregnant women and complications during childbirth. Objective: To identify the interdisciplinarity in prenatal dental care from the nurses' perspective. Methodology: This will be a qualitative approach study with based on the Gadamer and Habermas's hermeneutics-dialectic in six primary health care units in a metropolis in Northeast Brazil, with six nurses through in-depth interviews in 2018. The organization of the data occurred through Minayo's thematic analysis. Results: After the thematic analysis, the categories of ''The interdisciplinary care of the doctor, dentist, and nurse''and ''Nurse referral during prenatal dental care''were evidenced. There are implications for the development of interdisciplinary practices in prenatal dental care such as weaknesses in the continuity of care, communication, and the team's interaction. Conclusion: There is a need to expand the comprehensiveness for the quality in the development of healthcare for pregnant women and the reduction of maternal and neonatal complications in populations of Brazilian women.

Abstract Aplasia cutis congenita (ACC) is a rare congenital condition characterised by the absence of skin, with or without the absence of underlying structures. Can appear as an isolated lesion or associated with other congenital malformations. The approach can be conservative or surgical. We report a case of a full-term male newborn with two adjacent ulcerated lesions with well-demarcated limits in the upper occipital region (20 and 4-5 mm diameter). Other alterations that could be associated with aplasia cutis were identified at examination, so the patient was referred to several consultations, and other system involvement was excluded. Re-evaluation at the first month of life revealed complete healing and conservative treatment was kept. After identification of ACC should be excluded other associated congenital malformations. Particularly if large skin defects or bone involvement is detected (higher risk of complications and mortality).

Resumo A aplasia cutis congenita (ACC) é uma condição congénita rara caracterizada pela ausência de pele, com ou sem atingimento de estruturas subjacentes. É maioritariamente um defeito benigno isolado, mas pode estar associado a outras malformações congénitas. O tratamento pode ser conservador ou cirúrgico. Descreve-se o caso de um recém-nascido do sexo masculino, de termo, que ao nascimento apresentava duas lesões ulceradas adjacentes com limites definidos, na região occipital (20 e 4-5 mm de diâmetro). No exame objetivo foram identificadas outras alterações que podiam ser associadas à ACC pelo que foi encaminhado para diversas consultas, tendo sido excluído o envolvimento multissistémico. Na reavaliação dermatológica no primeiro mês de vida apresentava cicatrização completa das lesões sob tratamento conservador. Após a identificação da ACC, devem ser excluídas outras malformações congénitas associadas, particularmente se grandes defeitos cutâneos ou envolvimento ósseo (associados a um maior risco de complicações e mortalidade).

Abstract This case aims to highlight the importance of not neglecting anamnesis through pandemic times and to recognize the symptoms of a probable antidepressant withdrawal. A 41-year-old woman with a history of depressive syndrome and hyperthyroidism. Medicated daily with paroxetine 20 mg, bisoprolol 2.5 mg and thiamazole 5 mg. By self-initiative, she abruptly suspended paroxetine, which she was taking for 3 years. After 3 days, she presented with dizziness, dyspnea, tiredness, abdominal pain and diarrhea. Given the contact with SARS-CoV-2 infection cases in the workplace, a laboratory test for SARS-CoV-2 was requested and the result was negative. In TraceCOVID-19 surveillance, the patient reported the suspension of paroxetine and was indicated immediate resumption, with consequent total complaints regression. The case described mimics the clinic of a COVID-19 infection, thus emphasizing the complexity of diagnosing paroxetine withdrawal syndrome.

Resumo Este caso pretende realçar a importância de não descurar a anamnese em tempos de pandemia e a familiarização com os sintomas sugestivos de abstinência de antidepressivos. Mulher, 41 anos, com antecedentes de síndrome depressiva e hipertiroidismo. Medicada diariamente com paroxetina 20 mg, bisoprolol 2,5 mg e tiamazol 5 mg. Por autoiniciativa, suspendeu de forma abrupta a paroxetina, que cumpria há 3 anos. Passados 3 dias, iniciou quadro de tonturas, dispneia, cansaço, dor abdominal e diarreia. Dado o contexto de casos de infeção por SARS-CoV-2 no local de trabalho, foi pedido o teste laboratorial para SARS-CoV-2 cujo resultado foi negativo. No âmbito da vigilância TraceCOVID-19, a utente referiu a suspensão da paroxetina tendo tido indicação para retoma imediata, com consequente regressão total das queixas. O caso descrito mimetiza a clínica de uma infeção COVID-19, enfatizando, assim, a complexidade do diagnóstico da síndrome de abstinência de paroxetina.

ABSTRACT The objective of this study was to assess seed health and the effect of plant extracts on Fusarium oxysporum f. sp. vasinfectum mycelial growth and sporulation, plant pathogen reduction in seeds and fusariosis control in okra seedlings. Health was assessed by the Blotter Test, after immersing the seeds in natural extracts and plating. To verify the mycelial growth of the plant pathogen, the extracts were incorporated in PDA culture medium and the pathogen was added and assessed, including the spore count. In the greenhouse, the seeds were immersed in the extracts, sown and at 15 days they were sprayed with extracts, at 21 days inoculated with the pathogen and disease severity on the seedlings was assessed 7 days later. There were higher incidences of Fusarium sp. and Rhizopus stolonifer in the seeds of the cultivars Valença and Santa Cruz 47. The extracts that resulted in lower pathogen incidence was basil, in cv. Valença and cinnamon and neem, in cv. Santa Cruz 47. The neem treatment presented the best inhibition percentage and the lowest sporulation mean in mycelial growth of the pathogen. Neem presented higher disease incidence control in the seedlings of cv. Valença and basil on the seedlings of cv. Santa Cruz 47.

Abstract This article aims to analyze trends in research on Ergology in Brazil published from 1997 to 2019, considering the nature of the publication and the potential impact of the databases in which they are published. Studies related to occupational health indicate the growing influence of Ergology in the understanding of the world of work, a fact evidenced in previous bibliometric research, of lesser breadth and scope of the databases investigated, which is why we intend to cover gaps and broaden the analysis with more up-to-date data. Using descriptors peculiar to Ergology, surveys were conducted in the Web of Science, Scopus and SciELO databases, in journals not indexed to the databases cited, and in academic productions available in the Capes catalog. The projection of Brazil in studies on Ergology was revealed, with the Southeast being the region with the highest concentration of authors and volume of publications. However, the interrelationship between researchers tends to be limited to the institutions in which they work. There is a prevalence of theses and dissertations to the detriment of articles in productions related to Ergology. Publications point to interdisciplinarity - with a predominance of Occupational Health, Education, and Psychology - and tend to feature in vehicles of lesser scientific relevance.

Resumo Este artigo tem como objetivo analisar as tendências das pesquisas sobre a Ergologia no Brasil publicadas no período de 1997 a 2019, considerando a natureza da publicação e o potencial de impacto das bases em que estão veiculadas. Estudos relacionados à saúde do trabalhador indicam a crescente influência da Ergologia na compreensão do mundo do trabalho, fato evidenciado em pesquisas bibliométricas anteriores, de menor abrangência e escopo das bases apuradas, razão pela qual se pretende cobrir lacunas e ampliar a análise com dados mais atualizados. Com o uso de descritores peculiares à Ergologia, foram realizados levantamentos nas bases Web of Science, Scopus e SciELO, em periódicos não indexados às bases citadas e em produções acadêmicas disponíveis no catálogo da Capes. Constatou-se a projeção do Brasil nos estudos sobre a Ergologia, sendo o Sudeste a região com maior concentração de autores e de volume de publicações. Contudo, a inter-relação entre pesquisadores tende a limitar-se às instituições em que atuam. Há prevalência de teses e dissertações em detrimento de artigos nas produções ligadas à Ergologia. As publicações apontam para a interdisciplinaridade - com predomínio da Saúde do Trabalhador, Educação, e Psicologia - e tendem a permanecer em veículos de menor relevância científica.

Resumo Este artigo tem como objetivo analisar as tendências das pesquisas sobre a Ergologia no Brasil publicadas no período de 1997 a 2019, considerando a natureza da publicação e o potencial de impacto das bases em que estão veiculadas. Estudos relacionados à saúde do trabalhador indicam a crescente influência da Ergologia na compreensão do mundo do trabalho, fato evidenciado em pesquisas bibliométricas anteriores, de menor abrangência e escopo das bases apuradas, razão pela qual se pretende cobrir lacunas e ampliar a análise com dados mais atualizados. Com o uso de descritores peculiares à Ergologia, foram realizados levantamentos nas bases Web of Science, Scopus e SciELO, em periódicos não indexados às bases citadas e em produções acadêmicas disponíveis no catálogo da Capes. Constatou-se a projeção do Brasil nos estudos sobre a Ergologia, sendo o Sudeste a região com maior concentração de autores e de volume de publicações. Contudo, a inter-relação entre pesquisadores tende a limitar-se às instituições em que atuam. Há prevalência de teses e dissertações em detrimento de artigos nas produções ligadas à Ergologia. As publicações apontam para a interdisciplinaridade - com predomínio da Saúde do Trabalhador, Educação, e Psicologia - e tendem a permanecer em veículos de menor relevância científica.

Abstract This article aims to analyze trends in research on Ergology in Brazil published from 1997 to 2019, considering the nature of the publication and the potential impact of the databases in which they are published. Studies related to occupational health indicate the growing influence of Ergology in the understanding of the world of work, a fact evidenced in previous bibliometric research, of lesser breadth and scope of the databases investigated, which is why we intend to cover gaps and broaden the analysis with more up-to-date data. Using descriptors peculiar to Ergology, surveys were conducted in the Web of Science, Scopus and SciELO databases, in journals not indexed to the databases cited, and in academic productions available in the Capes catalog. The projection of Brazil in studies on Ergology was revealed, with the Southeast being the region with the highest concentration of authors and volume of publications. However, the interrelationship between researchers tends to be limited to the institutions in which they work. There is a prevalence of theses and dissertations to the detriment of articles in productions related to Ergology. Publications point to interdisciplinarity - with a predominance of Occupational Health, Education, and Psychology - and tend to feature in vehicles of lesser scientific relevance.

Abstract Dengue is a viral disease whose number of cases has increased in Brazil. This study aimed to characterize the spatio-temporal distribution patterns of the reported dengue infection cases in the state of Alagoas (AL), Northeastern Brazil (NEB). The data of the officially reported dengue cases from 2000 to 2015 was retrieved from the State Health Secretariat of Alagoas (SESAL), which captures national demographic and health data from the System for the Reporting of Notifiable Conditions (SINAN). After applying the Kernel Density Estimation (KDE) function, maps were generated based on the Inverse Distance Weighting (IDW) interpolation method. By using the clusters analysis (CA) technique, three homogeneous groups of dengue in AL were determined. Next, the LN (Lognormal), GUM (Gumbel) and GEV (Generalized Extreme Value) probability distributions were applied to monthly model dengue case data in AL, with the LN continuous probability distribution standing out. Maceió and Arapiraca have a higher number of dengue cases than other cities, being the main reason for their interpretation as separate groups. The coefficients of determination (R2) of dengue cases analysis as a function of month of each year for the studied years were low (between 0.03 and 0.63) and many regression slopes were not significant. Pearson's correlation coefficient (r) between dengue and the Human Development Index (HDI) of LA was considered moderate (0.53) and the correlation between dengue and demographic density was high (0.76). The importance of constant monitoring and assistance for these areas is reinforced.

ABSTRACT COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient.

Abstract Background: Serological evaluation performed by double agar gel immunodiffusion test (DID) is used for diagnosis, evaluation of severity, management of paracoccidioidomycosis patients, and development of new clinical studies. For these reasons, the Botucatu Medical School of UNESP maintains a serum bank at the Experimental Research Unit with patient clinical data. This study aimed to evaluate the influence of the freeze-thaw cycle and different blood matrices on the titration of circulating antibodies. Methods: The study included 207 patients with confirmed (etiology-demonstrated) or probable (serology-demonstrated) paracoccidioidomycosis, and DID was performed with culture filtrate from Paracoccidioides brasiliensis B339 as antigen. First experiment: the antibody levels were determined in serum samples from 160 patients with the chronic form and 20 with the acute/subacute form, stored at -80oC for more than six months. Second experiment: titers of 81 samples of serum and plasma with ethylenediaminetetraacetic acid (EDTA) or heparin, from 27 patients, were compared according to matrix and effect of storage at -20oC for up to six months. Differences of titers higher than one dilution were considered discordant. Results: First experiment: test and retest presented concordant results in serum stored for up to three years, and discordant titers in low incidence in storage for four to six years but high incidence when stored for more than six years, including conversion from reagent test to non-reagent retest. Second experiment: serum, plasma-EDTA and plasma-heparin samples showed concordant titers, presenting direct correlation, with no interference of storage for up to six months. Conclusions: Storage at -80oC for up to six years has no or little influence on the serum titers determined by DID, permitting its safe use in studies depending on this parameter. The concordant titrations in different blood matrices demonstrated that the plasma can be used for immunodiffusion test in paracoccidioidomycosis, with stability for at least six months after storage at -20oC.