ABSTRACT The global reemergence of measles in 2018–2019 reinforces the relevance of high-coverage immunization to maintain the disease elimination. During an outbreak in the Sao Paulo State in 2019, several measles cases were reported in individuals who were adequately vaccinated according to the current immunization schedule recommends. This study aimed to assess measles IgG antibody seropositivity and titers in previously vaccinated adults. A cross-sectional study was conducted at CRIE-HC-FMUSP (Sao Paulo, Brazil) in 2019. It included healthy adults who had received two or more Measles-Mumps-Rubella vaccines (MMR) and excluded individuals with immunocompromising conditions. Measles IgG antibodies were measured and compared by ELISA (Euroimmun®) and chemiluminescence (LIASON®). The association of seropositivity and titers with variables of interest (age, sex, profession, previous measles, number of measles-containing vaccine doses, interval between MMR doses, and time elapsed since the last MMR dose) was analyzed. A total of 162 participants were evaluated, predominantly young (median age 30 years), women (69.8%) and healthcare professionals (61.7%). The median interval between MMR doses was 13.2 years, and the median time since the last dose was 10.4 years. The seropositivity rate was 32.7% by ELISA and 75.3% by CLIA, and a strong positive correlation was found between the tests. Multivariate analyses revealed that age and time since the last dose were independently associated with positivity. Despite being a single-center evaluation, our results suggest that measles seropositivity may be lower than expected in adequately immunized adults. Seropositivity was higher among older individuals and those with a shorter time since the last MMR vaccine dose.

Abstract Background Evidence indicates a strong link between Zika virus (ZikV) and neurological complications. Acute myelitis, optic neuritis, polyneuropathy, and encephalomyelitis that mimic inflammatory idiopathic demyelination disorders (HDD) after ZikV infection have been reported in Brazil. Objective The present study aims to investigate the possible occurrence of molecular mimicry between ZikV antigens and Multiple Sclerosis (MS) autoantigens, the most frequent HDD of the central nervous system (CNS). Methods A retrospective cohort study with 305 patients admitted due to suspected arbovirus infection in Rio de Janeiro was performed, all subjects were submitted to neurological examination, and a biological sample was collected for serologic and molecular diagnostic. Bioinformatics tools were used to analyze the peptides shared between ZikV antigens and MS autoantigens. Results Of 305 patients, twenty-six were positive for ZikV and 4 presented IDD patterns found in MS cases. Sequence homology comparisons by bioinformatics approach between NS5 ZikV and PLP MS protein revealed a homology of 5/6 consecutive amino acids (CSSVPV/CSAVPV) with 83% identity, deducing a molecular mimicry. Analysis of the 3D structures revealed a similar conformation with alpha helix presentation. Conclusions Molecular mimicry between NS5 Zika virus antigen and PLP MS autoantigens emerge as a possible mechanism for IDD spectrum in genetically susceptible individuals.

Resumo Antecedentes Evidências indicam uma forte ligação entre o vírus Zika (ZikV) e complicações neurológicas. Mielite aguda, neurite óptica, polineuropatia e encefalomielite que mimetizam distúrbios inflamatórios de desmielinização idiopáticos (DDII) após infecção por ZikV têm sido relatadas no Brasil. Obejtivo O presente estudo tem como objetivo investigar a possível ocorrência de mimetismo molecular entre antígenos do ZikV e autoantígenos da Esclerose Múltipla (EM), a DDII mais frequente do sistema nervoso central (SNC). Métodos Foi realizado um estudo de coorte retrospectivo com 305 pacientes internados por suspeita de infecção por arbovirus no Rio de Janeiro, todos os indivíduos foram submetidos a exame neurológico e coleta de amostra biológica para diagnóstico sorológico e molecular. Ferramentas de bioinformática foram usadas para analisar os peptídeos compartilhados entre antígenos do ZikV e autoantígenos da EM. Resultados Dos 305 pacientes, vinte e seis foram positivos para ZikV e 4 apresentaram padrão IDD encontrado em casos de EM. As comparações de homologia de sequência por abordagem de bioinformática entre a proteína NS5 ZikV e PLP EM revelaram uma homologia de 5/6 aminoácidos consecutivos (CSSVPV/CSAVPV) com 83% de identidade, deduzindo um mimetismo molecular. A análise das estruturas 3D revelou uma conformação semelhante com apresentação em alfa-hélice. Conclusões O mimetismo molecular entre o antígeno NS5 do vírus Zika e o autoantígeno PLP da EM surge como um possível mecanismo para o espectro IDD em indivíduos geneticamente suscetíveis.

SUMMARY OBJECTIVE: The aim of this study was to investigate whether the degree of urbanization influences the prevalence of chronic kidney disease in Brazilian indigenous people. METHODS: This is a cross-sectional study conducted between 2016 and 2017 in northeastern Brazil and includes individuals aged between 30 and 70 years from two specific indigenous groups who volunteered to participate in the study: the Fulni-ô people (lowest degree of urbanization) and the Truká group (greater degree of urbanization). Cultural and geographical parameters were used to characterize and measure the magnitude of urbanization. We excluded individuals with known cardiovascular disease or renal failure who required hemodialysis. Chronic kidney disease was defined as a single measurement of an estimated glomerular filtration rate <60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. RESULTS: A total of 184 indigenous people from the Fulni-ô group and 96 from the Truká group with a median age of 46 years (interquartile range: 15.2) were included. We found a chronic kidney disease rate of 4.3% in the total indigenous population, generally affecting an older population: 41.7% over 60 years old (p<0.001). The Truká people had a chronic kidney disease prevalence of 6.2%, with no differences in kidney dysfunction across age groups. The Fulni-ô participants had a chronic kidney disease prevalence of 3.3%, with a higher proportion of kidney dysfunction in older participants (of the six Fulni-ô indigenous people with chronic kidney disease, five were older). CONCLUSION: Our results suggest that a higher degree of urbanization seems to negatively influence the prevalence of chronic kidney disease in Brazilian indigenous people.

Abstract This study aimed to evaluate the effects of chronic use of fluoxetine on the amount of orthodontic tooth movement and tissue changes in rats. A total of 192 Wistar rats were divided into 4 groups: S, 0.9% saline solution; F, 20 mg/kg of fluoxetine; SM, 0.9% saline solution with orthodontic movement; and FM, 20 mg/kg of fluoxetine with orthodontic movement. After 30 days of daily saline or fluoxetine administration, an orthodontic device (25cN) was used to mesially displace the first molar in animals of the groups SM and FM. The animals were euthanized 2, 7, 14, and 28 days after placement of the orthodontic appliances and animals of groups S and F were euthanized at the same time. The assessment of tooth movement was made in gypsum castings, the collagen neoformation was assessed by polarization microscopy, the number of osteoclasts and root resorption were evaluated using tartrate-resistant acid phosphatase, and presence of hyalinized areas was assessed by hematoxylin-eosin staining. Fluoxetine did not affect the amount of tooth displacement, percentage of collagen, number of osteoclasts, and presence of hyalinized areas (P>0.05). There was a higher frequency of root resorption areas in the FM group than in the SM group only on the second day (P<0.05). The findings of this study show that chronic use of 20 mg/kg fluoxetine does not affect the amount of tooth movement, collagen neoformation, number of osteoclasts, or hyalinized areas and does not affect root resorption until the last day of orthodontic movement.

Abstract: Introduction: Traditional communities are groups of socially organized individuals with common economic, socio-environmental, and cultural behaviors. Brazil’s indigenous communities are a prime example of these groups, suffering the impact of urbanization, the growth of chronic diseases, epidemics, and increased food insecurity. Experience report: To describe the health team’s experiences in the use of a data management tool for care in an indigenous community in northeastern Brazil. Methodology: This is an experience report on the use of a digital tool to assist actions in a traditional community. The health team was divided into community health agents and medical students. Discussion: The description of the experiences and analysis of the narratives resulted in identifying 258 citations, classified into 12 categories related to the study scope. Of these, issues related to benefits of the tool were the most commonly mentioned (43.41%), where the subgroups addressed different reflections. The second most cited category referred to the tool’s limitations (15.11%), with the need for an internet connection being the critical point. This research, therefore, shows the tool’s advantages in health care but also explains weaknesses inherent to its use, raising important issues of this experience and stimulating similar practices. Conclusion: This experience report, as a scientific method, addresses essential experienced issues related to the practical applicability of a digital tool in an indigenous community. Although it is undeniable that there are obvious points of weakness, these did not compromise the positive result of the experience, and care was improved.

Resumo: Introdução: As comunidades tradicionais são grupos de indivíduos socialmente organizados que partilham comportamentos econômicos, socioambientais e culturais comuns. Entre elas, destacam-se as comunidades indígenas no Brasil, que vêm sofrendo o impacto da urbanização, do crescimento de doenças crônicas e epidemias e do aumento da insegurança alimentar. Relato de experiência: Este estudo teve como objetivo descrever as experiências da equipe de saúde, quanto ao uso de uma ferramenta de gestão de dados na assistência, em uma comunidade indígena no Nordeste brasileiro. Trata-se de um relato de experiência do uso de uma ferramenta digital nas ações assistenciais em uma comunidade tradicional. A equipe de saúde foi dividida em dois grupos: agentes comunitários de saúde e estudantes de Medicina. Discussão: A descrição das experiências e a análise das narrativas resultaram na identificação de 258 citações, que foram classificadas em 12 categorias, relacionadas ao objeto de estudo. Dentre estas, as questões ligadas aos benefícios da ferramenta foram as mais mencionadas (43,41%), em que os subgrupos abordaram diferentes reflexões. A segunda categoria mais citada se referia às limitações da ferramenta (15,11%), sendo a necessidade do sinal de internet o ponto crítico. Ou seja, esta pesquisa mostra vantagens da ferramenta na atenção à saúde, mas também explicita fragilidades inerentes ao seu uso, de modo a trazer questões importantes dessa vivência e estimular práticas semelhantes. Conclusão: Esse relato de experiência, como método científico, traz importantes questões vivenciadas, relacionadas à aplicabilidade prática de uma ferramenta digital em uma comunidade indígena. Apesar de ser inegável que há pontos de fragilidade evidentes, eles não comprometeram o resultado afirmativo da vivência, melhorando a assistência.

Abstract The objective of this work was to select sweet potato (Ipomoea batatas) genotypes with leaves with potential to be used for human consumption. Twenty-six experimental genotypes and four commercial cultivars were tested in a randomized complete block design with three replicates and ten plants per plot. The trial was carried out in the municipality of Lavras, in the state of Minas Gerais, Brazil. Leaf shape and lobe, aerial-part yield, edible-leaf yield, edible-leaf percentage, edible-leaf dry mass, and latex production, as well as leaf total chlorophyll, pH, soluble solids contents, titratable acidity, total phenolic compounds, and anthocyanin contents, were evaluated. Roots were characterized as to their pulp and peel colors. Fifteen genotypes presented the highest aerial-part (29.6 to 51.8 Mg ha-1) and edible leaf (7.8 to 12.7 Mg ha-1) yields. In the biochemical analysis, high contents of chlorophyll, total phenolics, and anthocyanins were observed. In addition, pH, soluble solids, and leaf titratable acidity did not differ significantly among the evaluated genotypes. Leaves of ten genotypes are recommended for human consumption.

Resumo O objetivo deste trabalho foi selecionar genótipos de batata-doce (Ipomoea batatas) com folhas com potencial para serem usadas para consumo humano. Vinte e seis genótipos experimentais e quatro cultivares comerciais foram testados em delineamento de blocos ao acaso, com três repetições e dez plantas por parcela. O ensaio foi realizado no município de Lavras, no estado de Minas Gerais, Brasil. Foram avaliados formato e lóbulo da folha, produção da parte aérea, produção de folhas comestíveis, percentagem de folha comestível, massa seca de folha comestível e produção de látex, bem como clorofila total, pH, conteúdo de sólidos solúveis, acidez titulável, compostos fenólicos totais e teor de antocianinas das folhas. As raízes foram caracterizadas quanto às cores da sua polpa e casca. Quinze genótipos apresentaram as maiores produtividades de parte aérea (29,6 a 51,8 Mg ha-1) e de folhas comestíveis (7,8 a 12,7 Mg ha-1). Nas análises bioquímicas, foram observados altos teores de clorofila, compostos fenólicos totais e antocianinas. Além disso, pH, sólidos solúveis e acidez titulável foliar não diferiram significativamente entre os genótipos avaliados. As folhas de dez genótipos são recomendadas para alimentação humana.

RESUMO A colecistite aguda (CA) é um processo inflamatório agudo da vesícula biliar que pode estar associado a complicações potencialmente graves, como empiema, gangrena, perfuração da vesícula biliar e sepse. O tratamento padrão para a CA é a colecistectomia laparoscópica. No entanto, para um pequeno grupo de pacientes com CA, o risco de colecistectomia laparoscópica pode ser muito alto, principalmente em idosos com doenças graves associadas. Nestes pacientes críticos, a colecistectomia percutânea ou a drenagem endoscópica da vesícula biliar guiada por ultrassom podem ser uma opção terapêutica temporária, como ponte para a colecistectomia. O objetivo deste artigo de posicionamento do Colégio Brasileiro de Cirurgia Digestiva é apresentar novos avanços no tratamento da CA em pacientes cirúrgicos de alto risco, para auxiliar cirurgiões, endoscopistas e clínicos a selecionar o melhor tratamento para os seus pacientes. A eficácia, segurança, vantagens, desvantagens e resultados de cada procedimento são discutidos. As principais conclusões são: a) Pacientes com CA e risco cirúrgico elevado devem ser tratados preferencialmente em hospitais terciários onde a experiência e os recursos cirúrgicos, radiológicos e endoscópicos estão disponíveis. b) A modalidade de tratamento ideal para pacientes com elevado risco cirúrgico, deve ser individualizada, com base nas condições clínicas e na experiência disponível. c) A colecistectomia laparoscópica continua sendo uma excelente opção de tratamento, principalmente em hospitais em que a drenagem da vesícula biliar percutânea ou endoscópica não está disponível. d) A colecistostomia percutânea e a drenagem endoscópica da vesícula biliar devem ser realizadas apenas em hospitais bem equipados e com radiologista intervencionista e/ou endoscopista experientes. e) O cateter de colecistostomia deve ser removido após a resolução da CA. No entanto, em pacientes que não têm condição clínica para realizar colecistectomia, o cateter pode ser mantido por um período prolongado ou mesmo definitivamente. f) Se o cateter de colecistostomia for mantido por longo período de tempo podem ocorrer várias complicações, como sangramento, fístula biliar, obstrução, dor no local de inserção, remoção acidental do cateter e CA recorrente. g) O tempo de espera ideal entre a colecistostomia e a colecistectomia ainda não foi estabelecido, e vai desde imediatamente após a melhoria clínica, até meses após. h) Longos períodos de espera entre colecistostomia e colecistectomia podem estar associados a novos episódios de CA, múltiplas readmissões hospitalares e aumento dos custos. Finalmente, ao selecionar a melhor opção de tratamento, outros aspectos também devem ser considerados, como custos, disponibilidade dos procedimentos no centro médico e o desejo do paciente. O paciente e sua família devem ser completamente informados sobre todas as opções de tratamento, para que possam ajudar a tomar a decisão final. (CA empiema gangrena sepse entanto associadas críticos temporária cirurgiões eficácia segurança vantagens discutidos disponíveis b individualizada disponível c d eou experientes definitivamente f sangramento obstrução inserção recorrente g estabelecido h custos Finalmente considerados final

ABSTRACT Acute cholecystitis (AC) is an acute inflammatory process of the gallbladder that may be associated with potentially severe complications, such as empyema, gangrene, perforation of the gallbladder, and sepsis. The gold standard treatment for AC is laparoscopic cholecystectomy. However, for a small group of AC patients, the risk of laparoscopic cholecystectomy can be very high, mainly in the elderly with associated severe diseases. In these critically ill patients, percutaneous cholecystostomy or endoscopic ultrasound gallbladder drainage may be a temporary therapeutic option, a bridge to cholecystectomy. The objective of this Brazilian College of Digestive Surgery Position Paper is to present new advances in AC treatment in high-risk surgical patients to help surgeons, endoscopists, and physicians select the best treatment for their patients. The effectiveness, safety, advantages, disadvantages, and outcomes of each procedure are discussed. The main conclusions are: a) AC patients with elevated surgical risk must be preferably treated in tertiary hospitals where surgical, radiological, and endoscopic expertise and resources are available; b) The optimal treatment modality for high-surgical-risk patients should be individualized based on clinical conditions and available expertise; c) Laparoscopic cholecystectomy remains an excellent option of treatment, mainly in hospitals in which percutaneous or endoscopic gallbladder drainage is not available; d) Percutaneous cholecystostomy and endoscopic gallbladder drainage should be performed only in well-equipped hospitals with experienced interventional radiologist and/or endoscopist; e) Cholecystostomy catheter should be removed after resolution of AC. However, in patients who have no clinical condition to undergo cholecystectomy, the catheter may be maintained for a prolonged period or even definitively; f) If the cholecystostomy catheter is maintained for a long period of time several complications may occur, such as bleeding, bile leakage, obstruction, pain at the insertion site, accidental removal of the catheter, and recurrent AC; g) The ideal waiting time between cholecystostomy and cholecystectomy has not yet been established and ranges from immediately after clinical improvement to months. h) Long waiting periods between cholecystostomy and cholecystectomy may be associated with new episodes of acute cholecystitis, multiple hospital readmissions, and increased costs. Finally, when selecting the best treatment option other aspects should also be considered, such as costs, procedures available at the medical center, and the patient’s desire. The patient and his family should be fully informed about all treatment options, so they can help making the final decision. (AC empyema gangrene sepsis However high diseases highrisk surgeons endoscopists effectiveness safety advantages disadvantages discussed radiological b highsurgicalrisk c d wellequipped well equipped andor endoscopist e definitively f occur bleeding leakage obstruction site g months h readmissions costs Finally considered center s desire options decision

Resumo Fundamento O tecido adiposo epicárdico (TAE) é aumentado em comorbidades comuns na insuficiência cardíaca (IC). Dessa forma, o TAE teria o potencial de mediar efeitos que levam à deterioração da função cardíaca. Objetivos Esta metanálise tem o objetivo de investigar se a quantidade de TAE em todos os tipos de IC e cada tipo de IC são significativamente diferentes dos pacientes de controle. Métodos Esta metanálise seguiu as diretrizes da Meta-analysis of Observational Studies in Epidemiology (Metanálise de estudos observacionais em epidemiologia). A pesquisa foi realizada nos bancos de dados MEDLINE, Embase e Lilacs até novembro de 2020. Dois autores realizaram a triagem, a extração de dados e a avaliação de qualidade. Um p-valor <0,05 foi definido como estatisticamente significativo. Resultados Foram incluídos oito estudos observacionais, compreendendo 1248 pacientes no total, dos quais 574 eram de controle, 415 tinham IC com fração de ejeção reduzida (ICFER) e 259 tinham IC com fração de ejeção de faixa média ou preservada (ICFEfm ou ICFEP). A quantidade de TAE não era diferente entre todos os tipos de IC e o grupo de controle (DMP = -0,66, IC 95%: -1,54 a 0,23, p =0,14) . Analisando cada fenótipo de IC separadamente, pacientes com ICFER tinham TAE reduzido em comparação aos pacientes de controle (DMP = 1,27, IC 95%: - 1,87 a -0,67, p <0,0001), enquanto os pacientes com ICFEfm ou ICFEP tiveram TAE aumentado em comparação aos pacientes de controle (DMP = 1,24, IC 95%: 0,99 a 1,50, p <0,0001). Conclusão A quantidade de TAE não era significativamente diferente entre todos os tipos de IC e o grupo de controle. Em pacientes com ICFER o volume de TAE era reduzido, enquanto em pacientes com ICFEP e ICFEfm, a quantidade de TAE era significativamente aumentada. Número de registro PROSPERO: CRD42019134441.

Abstract Background Epicardial adipose tissue (EAT) is increased in comorbidities common in heart failure (HF). In this sense, EAT could potentially mediate effects that lead to an impaired cardiac function. Objectives This meta-analysis aims to investigate if the amount of EAT in all-types of HF and each HF phenotype is significantly different from control patients. Methods This meta-analysis followed the Meta-analysis Of Observational Studies in Epidemiology guidelines. The search was performed in the MEDLINE, Embase, and Lilacs databases until November 2020. Two authors performed screening, data extraction, and quality assessment. A p-value <0.05 was defined as statistically significant. Results Eight observational studies were included, comprehending 1,248 patients in total, from which 574 were controls, 415 had HF with reduced ejection fraction (HFrEF) and 259 had HF with mid-range or preserved ejection fraction (HFmrEF or HFpEF). The amount of EAT was not different between all types of HF and the control group (SMD = -0.66, 95% CI: -1.54 to 0.23, p =0.14). Analyzing each HF phenotype separately, patients with HFrEF had a reduced EAT when compared to the controls (SMD= -1.27, 95% CI: - 1.87 to -0.67, p <0.0001), while patients with HFmrEF or HFpEF showed an increased EAT when compared to controls (SMD= 1.24, 95% CI: 0.99 to 1.50, p <0.0001). Conclusion The amount of EAT was not significantly different between all types of HF and the control group. In patients with HFrEF, the EAT volume was reduced, whereas in HFpEF and HFmrEF, the amount of EAT was significantly increased. PROSPERO registration number: CRD42019134441.

Resumo O tratamento da doença de Parkinson (DP) constitui um desafio, especialmente por ser considerado muito individualizado. A Academia Brasileira de Neurologia (ABN) identificou a necessidade de disseminar o conhecimento sobre o manejo do tratamento da DP, adaptando as melhores evidências à realidade brasileira. Assim, foi realizada uma revisão sobre as principais orientações de tratamento publicadas, baseada nas recomendações elaboradas por um grupo de especialistas em transtornos do movimento do departamento científico da ABN.

ABSTRACT The treatment of Parkinson's disease (PD) is challenging, especially since it is considered highly individualized. The Brazilian Academy of Neurology has recognized the need to disseminate knowledge about the management of PD treatment, adapting the best evidence to the Brazilian reality. Thus, the main published treatment guidelines were reviewed based on the recommendations of group from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology.

Neste trabalho, medimos o raio da Terra reproduzindo o histórico experimento de Eratóstenes, realizado por volta de 240 a.C., nas antigas cidades de Siena e Alexandria. Aqui, obtemos as medidas nas cidades do Rio de Janeiro-RJ e Teresina-PI, cidades cujas coordenadas de longitude são muito próximas. Utilizando equipamentos simples, como fios de prumo e cartolinas, medimos, de forma simultânea, a inclinação dos raios solares sobre a superfície da Terra quando o Sol está no ponto mais alto do céu. Através de dados de satélites – para a determinação da distância (latitude) entre as cidades – e pelas medidas obtidas para a diferença dos ângulos em cada cidade, estimamos o raio médio volumétrico da Terra com um erro de 0 , 5% em relação aos valores da literatura. Ademais, a partir da diferença do horário em que o Sol fica no ponto mais alto do céu nos locais de medida, estimamos a velocidade angular de rotação da Terra em torno do seu próprio eixo. Com isso, apresentamos (de forma didática e simples) como obter a curvatura média do planeta, assumindo uma superfície de forma aproximadamente esférica, além da sua velocidade de rotação.

In this work, we measure the volumetric mean radius of the Earth, reproducing the historical experiment of Eratosthenes, carried out around 240 BC, in the ancient cities of Siena and Alexandria. Here, we perform measurements in the cities of Rio de Janeiro-RJ-Brazil and Teresina-PI-Brazil, whose longitude coordinates are close. Using simple equipment, such as plumb lines and rulers, we simultaneously measure the height of an object and its shadow’s length at midday, when the Sun is at its highest elevation, in order to obtain the shadow angle. After determining the distance (latitude) between cities from satellite data, we use the measured shadow angles to estimate the volume mean radius of the Earth, from basic trigonometric arguments, finding a result whose error is 0.5% with respect to the literature. Furthermore, from the difference of time in which the Sun is at the highest point in the sky in each location, we also estimate the Earth’s angular velocity. In summary, we pedagogically present how to obtain the mean curvature of the planet, assuming an approximately spherical surface, in addition to its angular velocity.

Resumo O objetivo deste trabalho foi avaliar as correlações fenotípicas entre características agronômicas de alho (Allium sativum) e realizar análise de trilha, tendo-se utilizado a produtividade comercial de bulbos como característica principal. O experimento foi conduzido sob condições de campo em duas safras (2018 e 2019), no município de Diamantina, no estado de Minas Gerais, Brasil. Um total de 13 genótipos de alho foram avaliados, sendo 11 experimentais e 2 cultivares comerciais. Utilizou-se o delineamento experimental de blocos ao acaso, com quatro repetições. Foram avaliadas características relacionadas à biometria da planta e à produção de bulbos. Foram realizadas as correlações fenotípicas e a análise de trilha das características estudadas. As correlações fenotípicas que apresentaram efeito positivo significativo ocorreram entre produção comercial de bulbos e altura de planta, diâmetro do bulbo, número de bulbos comerciais, massa média de bulbo total, massa média de bulbo comercial, produtividade total de bulbos e número de bulbilhos por bulbo. No entanto, apenas o número de bulbos comerciais e o diâmetro do bulbo tiveram efeitos significativos (direto e indireto) sobre a produtividade comercial de bulbos. Portanto, em programas de melhoramento de genótipos na região estudada, a seleção deve buscar maior diâmetro de bulbos e maior número de bulbos comerciais para incrementar a produtividade comercial.

Abstract The objective of this work was to evaluate the phenotypic correlations between agronomic characters of garlic (Allium sativum) and to carry out the path analysis, using commercial bulb yield as the main character. The experiment was conducted under field conditions in two harvests (2018 and 2019) in the municipality of Diamantina, in the state of Minas Gerais, Brazil. A total of 13 garlic genotypes were evaluated, of which 11 were experimental and 2 were commercial cultivars. The experimental design used was randomized complete blocks with four replicates. Characters related to plant biometry and bulb yield were evaluated. The phenotypic correlations and the path analysis of the studied characters were carried out. The phenotypic correlations that showed significant positive effects occurred between commercial bulb yield and plant height, bulb diameter, number of commercial bulbs, mean total bulb mass, mean commercial bulb mass, total bulb yield, and number of bulbils per bulb. However, only number of commercial bulbs and bulb diameter had significant effects (direct and indirect) on commercial bulb yield. Therefore, in genotype genetic breeding programs in the studied region, selection should seek a larger diameter of bulbs and a higher number of commercial bulbs to increase commercial yield.

ABSTRACT The growing consumer demand for sweet potato roots results in the need for genotypes with higher yields and better root quality. Thus, the objective of this study was to agronomically evaluate sweet potato genotypes via mixed models to select superior genotypes for human consumption and predict their selection gains. The study had a partially balanced triple lattice design with three replicates. As treatments, 92 sweet potato genotypes from the Universidade Federal de Lavras germplasm bank selected in the first selection cycle were evaluated along with eight controls, namely, Brazlândia Roxa, Princesa, Uruguaiana, BRS Amélia, Beauregard, UFVJM-57, UFVJM-58, and UFVJM-61. The treatments were ranked by the mixed linear model via restricted maximum likelihood (REML) and best linear unbiased prediction (BLUP). We highlighted the 15 best genotypes for each agronomic trait, then identified the best ones overall considering all quantitative and qualitative traits. High heritability was found for the trait commercial root yield (56.31%). For all traits, there were selection gains relative to the population mean. The use of mixed models was efficient for the selection of superior sweet potato genotypes. The genotypes 2018-19-464, 2018-72-1409, 2018-72-1428, 2018-19-443, 2018-36-807, 2018-72-1418, 2018-19-455, 2018-72-1376, 2018-54-1137, 2018-54-1114, 2018-65-1249, and 2018-28-556 have good traits related to commercial root yield and root quality and may be recommended for human consumption.

ABSTRACT Background: Inflammatory bowel disease (IBD) is an immune-mediated disorder that includes Crohn’s disease (CD) and ulcerative colitis. CD is characterized by a transmural intestinal involvement from the mouth to the anus with recurrent and remitting symptoms that can lead to progressive bowel damage and disability over time. Objective: To guide the safest and effective medical treatments of adults with CD. Methods: This consensus was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn's disease and Colitis (GEDIIB)). A systematic review of the most recent evidence was conducted to support the recommendations/statements. All included recommendations and statements were endorsed in a modified Delphi panel by the stakeholders and experts in IBD with an agreement of at least 80% or greater consensus rate. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological interventions) were mapped according to the stage of treatment and severity of the disease in three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus is targeted towards general practitioners, gastroenterologists, and surgeons interested in treating and managing adults with CD and supports the decision-making of health insurance companies, regulatory agencies, and health institutional leaders or administrators.

RESUMO Contexto: A doença inflamatória intestinal (DII) é uma doença imunomediada que inclui a doença de Crohn (DC) e a retocolite ulcerativa. A DC é caracterizada por um envolvimento intestinal transmural da boca ao ânus com sintomas recorrentes e remitentes que podem levar a danos intestinais progressivos e incapacidade ao longo do tempo. Objetivo: Orientar os tratamentos médicos mais seguros e eficazes de adultos com DC. Métodos: Este consenso foi desenvolvido por autores que representam gastroenterologistas e cirurgiões brasileiros especialistas em doenças colorretais (GEDIIB, Organização Brasileira de Doença de Crohn e Colite). Uma revisão sistemática das evidências mais recentes foi realizada para apoiar as recomendações/declarações. Todas as recomendações e declarações incluídas foram endossadas em um painel Delphi modificado pelas partes interessadas e especialistas em DII com uma concordância de pelo menos 80% ou mais. Resultados e conclusão: As recomendações médicas (intervenções farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso é direcionado a clínicos gerais, gastroenterologistas e cirurgiões interessados em tratar e gerenciar adultos com DC e apoia a tomada de decisões de companhias de seguro de saúde, agências reguladoras e líderes ou administradores de instituições de saúde.

ABSTRACT Background: Inflammatory bowel diseases are immune-mediated disorders that include Crohn’s disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer. Objective: This consensus aims to provide guidance on the most effective medical management of adult patients with UC. Methods: A consensus statement was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn’s Disease and Colitis [GEDIIB]). A systematic review including the most recent evidence was conducted to support the recommendations and statements. All recommendations/statements were endorsed using a modified Delphi Panel by the stakeholders/experts in inflammatory bowel disease with at least 80% or greater consensus. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological) were mapped according to the stage of treatment and severity of the disease onto three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus targeted general practitioners, gastroenterologists and surgeons who manage patients with UC, and supports decision-making processes by health insurance companies, regulatory agencies, health institutional leaders, and administrators.

RESUMO Contexto: As doenças inflamatórias intestinais são doenças imunomediadas que incluem a doença de Crohn (DC) e a retocolite ulcerativa (RCU). A RCU é uma doença progressiva que acomete a mucosa colorretal causando sintomas debilitantes levando a alta morbidade e incapacidade laboral. Como consequência da inflamação crônica do cólon, a RCU também está associada a um risco aumentado de câncer colorretal. Objetivo: Este consenso visa fornecer orientações sobre o manejo médico mais eficaz de pacientes adultos com RCU. Métodos: As recomendações do consenso foram desenvolvidas por gastroenterologistas e cirurgiões colorretais referências no Brasil (membros da Organização Brasileira para Doença de Crohn e Colite [GEDIIB]). Uma revisão sistemática, incluindo as evidências mais recentes, foi conduzida para apoiar as recomendações. Todas as recomendações foram endossadas pelas partes interessadas/especialistas em doença inflamatória intestinal usando um Painel Delphi modificado. O nível de concordância para alcançar consenso foi de 80% ou mais. Resultados e conclus ão: As recomendações médicas (farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso foi direcionado a clínicos gerais, gastroenterologistas e cirurgiões que tratam pacientes com RCU e apoia os processos de tomada de decisão por companhias de seguro de saúde, agências reguladoras, líderes institucionais de saúde e administradores.