RESUMEN Introducción: la necrosis pancreática se presenta entre 10 y 20 % de los pacientes con pancreatitis aguda, tiene una mortalidad de 10 a 25 % y si se agrega infección a la necrosis entre 40 y 70 %. Objetivo: describir el manejo clínico quirúrgico de la necrosis pancreática infectada en el Servicio de Cirugía General del Hospital Nacional entre el periodo 2021-2022. Metodología: estudio observacional descriptivo de corte temporal transversal. En pacientes internados en el Servicio de Cirugía General del Hospital Nacional por pancreatitis aguda grave con necrosis pancreática infectada. Resultados: se analizaron un total de 30 pacientes. La media de edad fue de 39 años. Predominó en nuestra población pacientes de sexo masculino en el 56.67 %. En cuanto a las comorbilidades asociadas un 33.3 % los pacientes presentaron principalmente Diabetes mellitus tipo 2 e Hipertensión arterial; en menor medida Obesidad en un 23.3 %. De la población en estudio 76.6 % recibieron tratamiento quirúrgico y 23.33% tratamiento médico principalmente antibiótico terapia. De los pacientes sometidos a tratamiento quirúrgico 9 fueron a necrosectomia abierta, 7 a drenaje percutáneo, y en menor medida drenaje biliar y endoscópico. En cuanto a la mortalidad por necrosis pancreática infectada encontramos un 10 % de mortalidad. Discusión: la mayor parte de los pacientes con pancreatitis aguda grave sufren de necrosis pancreática; la necrosis pancreática infectada se asocia con mayor riesgo de mortalidad y en su mayoría requieren tratamientos invasivos. Conclusión: el manejo mínimamente invasivo en el tratamiento inicial de la necrosis pancreática infectada podría resolver la mayoría de los casos sin necesidad de realizar necrosectomia; reservando esta última solo a los que fracasan en el tratamiento inicial.

ABSTRACT Introduction: pancreatic necrosis occurs between 10 and 20 % of patients with pancreatitis, has a mortality of 10 to 25 % and if infection is added to the necrosis between 40 and 70 %. Objective: to describe the surgical and clinical management of infected necrotizing pancreatitis in patients admitted to the General Surgery Service of the Hospital Nacional between the period 2021-2022. Methodology: this was an observational, descriptive and cross-section study with a temporal cut. We included patients admitted to the general surgery service of the National Hospital with severe acute pancreatitis with infected necrotizing pancreatitis. Results: a total of 30 patients were included. The mean age was 39 years. Male patients prevailed in our population in 56.67 %. Regarding the associated comorbidities, 33.3 % of the patients presented mainly type 2 diabetes mellitus and arterial hypertension; to a lesser extent Obesity in 23.3 %. In the study population, 76.6 % received surgical treatment and 23.33 % medical treatment, mainly antibiotic therapy. Of the patients who underwent surgical treatment, 9 were open necrosectomy, 7 had percutaneous drainage, and to a lesser extent biliary and endoscopic drainage. Regarding mortality due to infected necrotizing pancreatitis, we found a 10% mortality. Discussion: most of the patients with severe acute pancreatitis suffer from necrotizing pancreatitis; infected necrotizing pancreatitis is associated with increased risk of mortality and most require invasive treatment. Conclusion: minimally invasive management in the initial treatment of infected necrotizing pancreatitis, which could resolve most cases without the need to perform necrosectomy; the latter should be reserved for those who fail the initial treatment.

ABSTRACT Purpose: Recently, hyaluronic acid (HA) was proposed as a promising option for the treatment of acquired lower eyelid cicatricial ectropion. However, this effect was not confirmed by quantitative assessments. This study aimed to assess the effect of hyaluronic acid on the treatment of acquired lower eyelid cicatricial ectropion. Methods: Eight patients with acquired lower eyelid cicatricial ectropion (13 eyelids) were treated with a single 1 mL injection of hyaluronic acid in the preseptal area of the lower eyelid. Evaluation of symptoms and biomicroscopic exam was performed before and 30 days after hyaluronic acid injection. Quantitative analysis of the lower eyelid position (with and without lid traction) was determined before and 30 days after hyaluronic acid injection through standard photographs analyzed using the ImageJ. Results: All patients experienced partial improvement of symptoms. The lower eyelid position was significantly lifted after hyaluronic acid injection with a significant reduction of medial and lateral angles, reduction of the margin reflex distance, and total and medial ocular fissure area. However, signs of lid margin inflammation and corneal punctate keratitis persisted. Conclusions: Hyaluronic acid injected in the pre-septal area of the lower eyelid improved acquired lower eyelid cicatricial ectropion symptoms and significantly lifted the position of the lower eyelid. Further studies, with a large number of participants and a long-term follow-up period, are needed to better determine the permanency of the effects of hyaluronic acid injections on the treatment of acquired lower eyelid cicatricial ectropion.

RESUMO Objetivo: Recentemente, o ácido hialurônico foi proposto como promissor no tratamento do ectrópio cicatricial adquirido da pálpebra inferior. No entanto, não foram feitas avaliações quantitativas para confirmar este efeito, motivo que levou a realização do presente estudo que visou avaliar o efeito do ácido hialurônico no tratamento do ectrópio cicatricial adquirido da pálpebra inferior. Métodos: Oito portadores de ectrópio cicatricial adquirido da pálpebra inferior (13 pálpebras) foram tratados com uma única dose de 1 mL de ácido hialurônico, injetada na área pré-septal da pálpebra inferior. Os sintomas e o exame biomicroscópico foram realizados antes e 30 dias após a injeção do ácido hialurônico. A análise quantitativa da posição palpebral inferior (com e sem tração palpebral) foi determinada antes e 30 dias após a injeção do ácido hialurônico por meio de fotografias que foram analisadas usando o programa ImageJ. Resultados: Todos os pacientes apresentaram melhora parcial dos sintomas. A posição da pálpebra inferior foi elevada significativamente após a injeção do ácido hialurônico, com redução significativa dos ângulos medial e lateral, da distância entre o reflexo pupilar e a margem da pálpebra inferior, da área de fissura palpebral total e da área medial. No entanto, sinais de inflamação da margem palpebral e ceratite puntata da córnea persistiram. Conclusões: O ácido hialurônico injetado na área pré-septal da pálpebra inferior, melhorou os sintomas do ectrópio cicatricial adquirido da pálpebra inferior e elevou significativamente a posição da pálpebra inferior. Estudos com maior número de participantes e período de acompanhamento mais longo são necessários para melhor determinar os efeitos das injeções de ácido hialurônico a longo prazo no tratamento do ectrópio cicatricial adquirido da pálpebra inferior.

Abstract We describe the toxicity of multiwalled carbon nanotubes (MWCNTs) in two aquatic species: Danio rerio and Artemia salina. Fish were exposed to 25 mg L-1, 50 mg L-1, and 100 mg L-1 MWCNTs for 7 days. After exposure, the gills from D. rerio showed lamellar fusion and epithelial lifting in the secondary lamellae, and vasodilation in the primary lamellae. In the gills, heat shock protein 70 and Bax (pro apoptotic member) were stained more intensely in the treated groups than in the control group. The nauplii of A. salina were exposed to 25 µg L-1, 50 µg L-1, and 100 µg L-1 MWCNTs for 96 h. After exposure, the nauplii from the control group presented 20 % mortality, whereas the 25 µg mL-1, 50 µg mL-1, and 100 µg L-1 groups had 46.7 %, 70 %, and 100 % mortality, respectively. The nauplii exposed to 25 µg mL1 and 50 µg mL1 MWCNTs had black aggregates in the intestine because of the uptake of nanomaterials. In addition, the 25 µg mL-1 and 50 µg mL-1 MWCNT groups had black aggregates attached onto the body surface, appendages of the second pair, and mandibles.The results revealed the toxic effects of MWCNTs on the two aquatic organisms, and both species showed great potential for toxicological evaluation of MWCNTs in aquatic environments.

ABSTRACT The use of carp pituitary extract (CPE) in fish reproduction may have drawbacks, whereas analogues of mammalian (aGnRHm) or salmon (aGnRHs) gonadotropins containing dopamine inhibitor (DI) may offer greater advantages. The objective of this study was to evaluate the effect of different hormone inducers on the reproduction of Prochilodus brevis males. A total of 44 specimens of P. brevis were divided into six groups, namely, CPE 4.0 mg; saline solution 1.0 mL; aGnRHm + DI 0.3 mg and 0.5 mg; and aGnRHs + DI 0.25 mL and 0.35 mL kg-1 of live weight. The number of ejaculates, seminal volume, curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP), sperm morphology and concentration, and membrane and DNA integrity were determined. Sample normality was examined using the Shapiro-Wilk test, and homogeneity using the Levene test. Analysis of variance (ANOVA) was conducted, followed by Tukey's test to compare means, with statistical significance set at p < 0.05. Notably, all fish induced with CPE 4.0 and aGnRHm + DI demonstrated ejaculation, yielding a greater seminal volume. Sperm concentration under aGnRHs + DI 0.35 exceeded that with aGnRHm + DI 0.3 and CPE 4.0. Regarding velocity, aGnRHm + DI 0.3 outperformed aGnRHs + DI 0.35 in VCL, while aGnRHm + DI 0.3 and 0.5 and aGnRHs + DI 0.25 led to higher VSL than aGnRHs 0.35. Additionally, VAP was elevated under aGnRHm + DI 0.3 and CPE, in contrast to aGnRHs + DI 0.35. Improved sperm morphology was observed with aGnRHm + DI 0.5 and aGnRHs + DI 0.25 compared to aGnRHm + DI 0.3. The remaining parameters did not differ significantly.

Resumo A causa mais frequente de ruptura esplénica é o trauma. Raramente ocorrem rupturas esplénicas atraumáticas. Os autores relatam o caso de uma ruptura esplénica atraumática após o recente consumo por via intranasal de cocaína realçando a importância de uma história clínica detalhada, já que um diagnóstico e tratamento precoces são essenciais para uma abordagem bem sucedida.

Abstract The most frequent cause of splenic rupture is trauma. Rarely do spontaneous splenic ruptures occur. The authors report the case of an atraumatic splenic rupture following a recent intranasal cocaine abuse that highlights the importance of a detailed social history, since early diagnosis and treatment can produce a positive outcome.

ABSTRACT A great challenge of scientific research with carrot in semi-arid regions is obtaining the best productive characteristics and economic conditions by optimizing the green manure amounts using spontaneous species from the Caatinga biome, such as hairy woodrose (Merremia aegyptia L.) and roostertree (Calotropis procera Ait.). Therefore, this work aimed to agronomically and economically optimize the production of carrot roots in monocropping and of their components when fertilized with equitable biomass amounts of these spontaneous species in two cropping seasons in a semi-arid environment. The experimental design was a randomized complete block design, with five treatments and five replications. The treatments consisted of equitable amounts of hairy woodrose and roostertree biomass in amounts of 16, 29, 42, 55, and 68 t ha-1 on a dry basis. In each experiment, an additional carrot treatment without fertilizer (absolute control) was planted for comparison with the other treatments to determine maximum physical and economic efficiency. Carrot fertilization was performed with the incorporation of 48.87 t ha-1 of M. aegyptia and C. procera dry biomass into the soil to obtain the maximum optimized productive efficiency (commercial productivity). The maximum optimized agroeconomic efficiency (net income) of carrot cultivation was obtained when 49.64 t ha-1 of M. aegyptia and C. procera dry biomass was added to the soil. The use of biomass from these spontaneous species from the Caatinga biome as green manure is a viable technology for tuberose producers in monocropping in semiarid environments.

RESUMO Um grande desafio na pesquisa científica com cenoura em ambiente semiárido é obter as melhores características produtivas e condições econômicas otimizando as quantidades de adubos verdes de espécies espontâneas do bioma Caatinga, como a jitirana (Merremia aegyptia L.) e a flor-de-seda (Calotropis procera Ait.). Diante disso, esse trabalho teve como objetivo otimizar agronômica e economicamente a produção de raízes de cenoura em monocultivo e de seus componentes, quando adubados com quantidades equitativas de biomassa dessas espécies espontâneas, em duas estações de cultivos em ambiente semiárido. O delineamento experimental utilizado foi em blocos completos casualizados, com cinco tratamentos e cinco repetições. Os tratamentos consistiram de quantidades equitativas de biomassa de jitirana e de flor-de-seda nas doses de 16, 29, 42, 55 e 68 t ha-1 em base seca. Em cada experimento foi plantado um tratamento adicional com cenoura sem adubo (testemunha absoluta) para efeito de comparação com os demais tratamentos para determinar a máxima eficiência física ou econômica. A adubação da cenoura foi realizada com a incorporação de 48,87 t ha-1 de biomassa seca de M. aegyptia e C. procera ao solo para obtenção da máxima eficiência produtiva otimizada (produtividade comercial). A máxima eficiência agroeconômica otimizada (renda líquida) do cultivo da cenoura foi obtida quando 49,64 t ha-1 de biomassa seca de M. aegyptia e C. procera foram adicionados ao solo. A utilização da biomassa dessas espécies espontâneas do bioma Caatinga como adubação verde é uma tecnologia viável para produtores de tuberosas em monocultivo em ambientes semiáridos.

ABSTRACT Some native species of the Cerrado have great ecological and economic potential. An alternative that aims to contribute to the good performance of post-planting plants is the incorporation of biochar into the soil. The objective of this work was to evaluate the effect of filter cake biochar as a soil conditioner and its influence on the growth and physiology of macaúba, araçá and cajuzinho do cerrado. The experiments were set up at Fazenda Hamilton de Abreu Navarro, Federal University of Minas Gerais, where the effect of four doses of filter cake biochar (1%, 2%, 4% and 8% v/v) and two treatments were evaluated. control: one with soil correction (7.5 g of GEOX) and mineral fertilization (380 g NPK 4:14:8 per plant) and the other without fertilization. To monitor the performance of the seedlings, evaluations were carried out at 30, 60 and 120 days after transplanting, the physiological parameters (photosynthesis, transpiration, stomatal conductance, CO2 consumed, internal carbon and electron transport rate), and morphological parameters (height and diameter), at 30, 60, 90 and 120 days after transplanting. At 120 days, the production of shoot, root and total dry biomass was evaluated. For macaúba, the application of biochar, at a dose of 2%, favored its photosynthesis. As for araçá, at 30 days after transplanting, the treatment without fertilization was better for most variables, however the treatments with biochar also had satisfactory results. The cajuzinho from the cerrado also responded positively to the application of biochar at all doses. The physiological and morphological variables responded well to treatments without fertilization and with application of biochar to the soil. Therefore, filter cake biochar can be indicated in the planting of the studied species, as well as the non-application of corrective and mineral fertilizer.

RESUMO O objetivo deste trabalho foi avaliar o efeito do biochar de torta de filtro como condicionador de solo e sua influência no crescimento e na fisiologia de macaúba, araçá e cajuzinho do cerrado. Os experimentos foram montados na Fazenda Hamilton de Abreu Navarro da UFMG, onde foram avaliados o efeito de quatro doses de biochar de torta de filtro (1%, 2%, 4% e 8% v/v) e dois tratamentos controle: um com correção do solo e adubação mineral, e o outro sem adubação. Para acompanhar o desempenho das mudas, foram realizadas avaliações aos 30, 60 e 120 dias após o transplantio, dos parâmetros fisiológicos (fotossíntese, transpiração, condutância estomática, CO2 consumido, carbono interno e taxa de transporte de elétrons), e morfológicos (altura e diâmetro), aos 30, 60, 90 e 120 dias após o transplantio. Aos 120 dias, avaliou-se a produção de biomassa seca da parte aérea, de raízes e total. Para a macaúba, a aplicação de biochar, na dose de 2%, favoreceu a sua fotossíntese. Já para o araçá, aos 30 dias após o transplantio, o tratamento sem adubação foi melhor para a maioria das variáveis, entretanto os tratamentos com biochar também tiveram resultados satisfatórios. O cajuzinho do cerrado também respondeu positivamente à aplicação de biochar em todas as doses. As variáveis fisiológicas e morfológicas responderam bem aos tratamentos sem adubação e com aplicação de biochar ao solo. Portanto, o biochar de torta de filtro pode ser indicado no plantio das espécies estudadas, assim como a não aplicação de corretivo e fertilizante mineral.

ABSTRACT: The objective of this study was to verify the impact of early childhood caries (ECC) and parental oral health literacy (OHL) on the use of oral health care services by preschool children. A population-based study was conducted with 449 dyads of preschool children aged 4-6 years and their parents/caregivers in the city of Ribeirão das Neves, Brazil. Two examiners performed the diagnosis of ECC using the International Caries Detection and Assessment System (ICDAS- Epi). The Brazilian version of the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry was administered to measure parents’ OHL. Parents/caregivers answered the question “When was your child’s last visit to the dentist?” to measure the use of oral health care services by the preschool children. The multiple logistic regression (p<0.05) revealed that children with presence of cavitated caries lesions were 1.82-fold more likely to use oral health care services (OR=1.82; 95%CI: 1.23-2.70) compared to those with absence of cavitated caries lesions. Children whose parents/caregivers had lower OHL were 34 % less likely to use oral health care services compared to those whose parents had higher OHL (OR=0.66; 95%CI: 0.45-0.99). Preschool children Dental services are used more by preschool children with presence of cavitated caries lesions and whose parents/caregivers have higher scores of OHL.

RESUMEN: El objetivo de este estudio fue verificar el impacto de la caries de la primera infancia (CPI) y la alfabetización en salud oral de los padres (ASB) en el uso de los servicios de salud oral por parte de los niños en edad preescolar. Se realizó un estudio de base poblacional con 449 díadas de preescolares de 4 a 6 años y sus padres/cuidadores en la ciudad de Ribeirão das Neves, Brasil. Dos examinadores realizaron el diagnóstico de CPI utilizando el Sistema Internacional de Evaluación y Detección de Caries (ICDAS-Epi). Se administró la versión brasileña de Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry para medir la ASB de los padres. Los padres/cuidadores respondieron la pregunta "¿Cuándo fue la última visita de su hijo al dentista?" medir la utilización de los servicios de salud oral por parte de los preescolares. La regresión logística múltiple (p<0,05) reveló que los niños con presencia de lesiones de caries cavitadas tenían 1,82 veces más probabilidades de utilizar los servicios de salud oral (OR=1,82; IC95%: 1,23-2,70) en comparación con aquellos con ausencia de lesiones de caries cavitadas. Los niños cuyos padres/cuidadores tenían un ASB más bajo tenían un 34 % menos de probabilidades de utilizar los servicios de atención de la salud bucodental en comparación con aquellos cuyos padres tenían un ASB más alto (OR = 0,66; IC del 95%: 0,45-0,99). Los servicios dentales para niños en edad preescolar son utilizados con mayor frecuencia por niños preescolares con presencia de lesiones cariosas cavitadas y cuyos padres/cuidadores tienen puntuaciones más altas de ASB.

ABSTRACT Introduction: there are geographical differences described regarding post-thyroidectomy complications, but despite the greater knowledge of surgeons for the approach, the fear continues to be the morbidity associated with postoperative complications. Objective: to determine the incidence of complications post total thyroidectomy in the Servicio de Cirugía General of the Centro Médico Nacional-Hospital Nacional between the period between 2018 and 2022. Methodology: observational, descriptive, cross-sectional study, in retrospective time that included patients of both sexes between 18 and 70 years of age admitted to the Servicio de Cirugía General of the Hospital Nacional during the period 2018-2022 for total thyroidectomy. Patients undergoing subtotal thyroidectomy were excluded. For data collection, a data collection instrument was designed where all the variables were included, the data was obtained from the statistics service plus the clinical records of the patients studied. The data were recorded in the Microsoft Office Excel 2010 computer program and analyzed with descriptive statistics using the statistical software SPSS version 24®. Results: the mean age was 47 years, SD ± 13,504, females predominated in 87.8 % (65), the most frequent indication for total thyroidectomy was multinodular goiter 79.7 % (59). Complications were observed in 78. 4% (58), of which hypocalcemia predominated in 55.4% (41), no deaths were recorded. Conclusion: hypocalcemia continues to be the most frequent complication, coinciding with the literature.

RESUMEN Introducción: existen diferencias geográficas descritas respecto a las complicaciones post tiroidectomía, pero pese al mayor conocimiento de los cirujanos para el abordaje, el temor sigue siendo la morbilidad asociada a las complicaciones posoperatorias. Objetivo: determinar la incidencia de complicaciones post tiroidectomía total en el Servicio de Cirugía General del Centro Médico Nacional-Hospital Nacional entre el periodo comprendido entre el 2018 al 2022 Metodología: estudio observacional, descriptivo, de corte trasversal, en tiempo retrospectivo que incluyó pacientes de ambos sexos entre 18 a 70 años de edad internados en el Servicio de Cirugía General del Hospital Nacional durante el periodo 2018- 2022 para tiroidectomía total. Se excluyeron pacientes sometidos a tiroidectomía sub total. Para la recolección de datos se diseñó un instrumento recolector de datos en donde se incluyeron todas las variables, los datos fueron obtenidos del servicio de estadísticas más las fichas clínicas de los pacientes estudiados. Los datos fueron registrados en el programa informático Microsoft Office Excel 2010 y se analizó con estadística descriptiva con el software estadístico SPSS versión 24® Resultados: la media de edad fue de 47 años, DS ± 13,504, predomino el sexo femenino en 87,8 % (65), la indicación para tiroidectomía total más frecuente fue por bocio multinodular 79,7 % (59). Se observaron complicaciones en 78,4 % (58), de los cuales predominó la hipocalcemia en un 55,4 % (41), no se registraron fallecimientos. Conclusión: la hipocalcemia sigue siendo la complicación más frecuente coincidiendo con la literatura.

ABSTRACT Introduction: inguinal hernia is one of the main reasons TAPP, e-TEP (Totally extraperitoneal with extended vision) for surgical consultation and its repair is one of the most common surgical procedures. Objective: to determine the experience in the laparoscopic approach of inguinal hernias by preperitoneal transabdominal technique in the Servicio de Cirugía General of the Centro Médico Nacional-Hospital Nacional. Methodology: retrospective descriptive observational study of cross-sectional time. In patients from 16 to 90 years of age with a diagnosis of inguinal hernia admitted to the Servicio de Cirugía General of the Centro Médico Nacional-Hospital Nacional for elective hernioplasty. Results: 30 hernioplasties were carried out by the TAPP technique, of which 73 % were performed in men and 27 % in women; a mean age of 48.4 years was identified, the age group most frequently being 38 to 48 years. In the pre-surgical physical examination, unilateral inguinal hernias were found in 76.6 % and bilateral in 23.3 %; in most of the patients the hernias were primary in 86.6 % and recurred in 13.3 %. Average surgical time was 93.1 minutes; with a maximum time of 120 minutes and a minimum of 60 minutes. The hospitalization time in 100 % of the patients was 48 hours. Of the post-operative complications, it is established that 76.6% did not present any type of complication; 20 % presented seroma as the main complication and 3.3 % surgical site infection. Conclusion: due to its high frequency and its impact on work and social disability, inguinal hernias represent one of the most important surgical pathologies with low rates of postoperative complications and short hospital stay.

RESUMEN Introducción: la hernia inguinal es uno de los principales motivos de consulta quirúrgica y su reparación es uno de los procedimientos más comunes en cirugía. Objetivo: determinar la experiencia en el abordaje laparoscópico de las hernias inguinales por técnica transabdominal preperitoneal en el Servicio de Cirugía General del Centro Médico Nacional-Hospital Nacional. Metodología: estudio observacional descriptivo retrospectivo de corte temporal transversal. En pacientes de 16 a 90 años de edad con diagnóstico de hernia inguinal internados en el Servicio de Cirugía General del Centro Médico Nacional-Hospital Nacional para hernioplastia electiva. Resultados: se llevaron a cabo 30 hernioplastias por técnica técnica trans-abdominal pre-peritoneal de los cuales el 73 % fue realizado en hombres y 27 % en mujeres; se identificó una media de edad de 48,4 años, el grupo etario con mayor frecuencia fue de 38 a 48 años. En el examen físico pre quirúrgico se encontraron hernias inguinales unilaterales en el 76.6 % y bilaterales en el 23.3 %; en la mayor parte de los pacientes las hernias fueron primarias en el 86.6 %y recidivada en el 13.3 %. El tiempo quirúrgico en promedio fue de 93.1 minutos; con un tiempo máximo de 120 minutos y mínimo de 60 minutos. El tiempo de hospitalización en el 100 % de los pacientes fue de 48 h. De las complicaciones post operatorias se establece que el 76.6 % no presento ningún tipo de complicación; el 20 % presentó seroma como complicación principal y 3.3 % infección del sitio quirúrgico. Conclusión: debido a su alta frecuencia y a su impacto en la incapacidad laboral y social, las hernias inguinales representan una de las patologías quirúrgicas más importantes con bajas tasas de complicaciones post operatorias y corta estancia hospitalaria.

Abstract This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Resumo Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Abstract Crusted scabies or Norwegian scabies is a severe and highly contagious clinical variant of infestation by Sarcoptes scabiei, which can evolve exuberantly, coursing with diffuse erythroderma, which makes etiological diagnosis difficult, especially by non-dermatologists. Thus, the authors present a case report of erythroderma in a 65-year-old woman, who developed intense pruritus associated with erythroderma for about 2 weeks, with an associated fever peak. She had a previous clinical history of psoriasis and psoriatic arthritis, with long-term use of immunosuppressants and systemic corticosteroids. Evaluated by dermatologists who, through direct examination by skin scraping and skin biopsy, confirmed the diagnosis of crusted scabies. Based on this case report, the importance of differential diagnoses of erythroderma is highli-ghted, especially crusted scabies, a rare dermatosis that most often affects immunocompromised, frail, institutionalized patients or patients with precarious social conditions.

Resumo A escabiose crostosa ou sarna Norueguesa é uma variante clínica severa e altamente contagiosa da infestação pelo Sarcoptes scabiei, a qual pode evoluir exuberantemente cursando com eritrodermia difusa, o que dificulta o diagnóstico etiológi-co, principalmente por parte de médicos não-dermatologistas. Dessa forma, os autores apresentam um relato de um caso de eritrodermia em uma mulher de 65 anos, evoluindo com quadro de prurido intenso associado à eritrodermia, há cerca de 2 semanas, com pico febril associado. Apresentava história clínica pregressa de psoríase e artrite psoriásica, com uso de imunossupressores e corticoides sistémicos por longo prazo. Avaliada por dermatologistas que, por meio de exame direto por raspado cutâneo e biópsia de pele, confirmaram diagnóstico de escabiose crostosa. A partir do caso reportado, ressalta-se a importância dos diagnósticos diferenciais da eritrodermia, sobretudo a escabiose crostosa, uma dermatose rara, que afeta mais frequentemente doentes imunodeprimidos, com fragilidade, institucionalizados ou com condições sociais precárias.

ABSTRACT BACKGROUND AND OBJECTIVES: Identifying pain sites is essential to managing patients with Widespread Pain. Several instruments have been developed, including pain drawings, a grid system and computerized methods. However, it is not yet known whether the Widespread Pain Index matches an automated method (painMAP) for quantifying the number of pain areas. Therefore, this study aimed to identify the relationship between the Widespread Pain Index and the painMAP software to measure pain sites in participants with Widespread Pain. METHODS: A pre-planned secondary analysis of data collected from 311 patients with musculoskeletal pain was conducted. The Widespread Pain Index and the painMAP software assessed pain sites. Spearman’s correlation coefficient investigated the correlation between the Widespread Pain Index and the painMAP software. RESULTS: A total of 98 participants with Widespread Pain were included in this study. Most participants were female (67; 83.7%), with a mean age of 57,7±11,5 years, mean height of 1.6 (0.1) meters and mean weight of 73.2 (11.8) kilograms. The mean pain intensity was 6.7 (2.0), and the pain duration was 92.3 (96.3) months. The mean number of pain sites in the Widespread Pain Index was 10.1 (3.7), and in the painMAP software, it was 11.7 (8.8). A weak positive correlation (rho = 0.26, 95% CI 0.45 to 0.04, p = 0.022) between the Widespread Pain Index and the painMAP software was found. CONCLUSION: The Widespread Pain Index and the painMAP software showed a weak correlation for assessing pain sites in participants with Widespread Pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: A identificação dos locais de dor é um aspecto essencial no manejo de pacientes com Dor Espalhada. Vários instrumentos foram desenvolvidos, incluindo desenhos de dor, um sistema de grade e métodos computadorizados. No entanto, ainda não se sabe se o Índice de Dor Espalhada coincide com um método automatizado (painMAP) para quantificar o número de áreas de dor. Portanto, este estudo teve como objetivo identificar a relação entre o Índice de Dor Espalhada e o painMAP para medir as áreas doloridas em participantes com esse quadro de dor. MÉTODOS: Uma análise secundária pré-planejada de dados coletados de 311 pacientes com dor musculoesquelética foi realizada. O Índice de Dor Espalhada e o painMAP avaliaram as áreas de dor. O coeficiente de correlação de Spearman foi utilizado para investigar a correlação entre o Índice de Dor Espalhada e o software painMAP. RESULTADOS: Um total de 98 participantes com Dor Espalhada foram incluídos neste estudo. A maioria dos participantes era do sexo feminino (67;83,7%), com média de idade de 57,7±11,5 anos, média de altura de 1,6 (0,1) metros e média de peso de 73,2 (11,8) quilogramas. A média de intensidade da dor foi de 6,7 (2,0) e da duração da dor de 92,3 (96,3) meses. O número médio de áreas de dor no Índice de Dor Espalhada foi de 10,1(3,7) e no software painMAP foi de 11,7 (8,8). Uma correlação positiva fraca (rho=0,26, IC de 95% 0,45-0,04, p=0,022) entre o Índice de Dor Espalhada e o painMAP foi encontrada. CONCLUSÃO: O Índice de Dor Espalhada e o painMAP mostraram correlação positiva fraca para avaliar as áreas de dor em participantes com dor espalhada.

RESUMO JUSTIFICATIVA E OBJETIVOS: A identificação dos locais de dor é um aspecto essencial no manejo de pacientes com Dor Espalhada. Vários instrumentos foram desenvolvidos, incluindo desenhos de dor, um sistema de grade e métodos computadorizados. No entanto, ainda não se sabe se o Índice de Dor Espalhada coincide com um método automatizado (painMAP) para quantificar o número de áreas de dor. Portanto, este estudo teve como objetivo identificar a relação entre o Índice de Dor Espalhada e o painMAP para medir as áreas doloridas em participantes com esse quadro de dor. MÉTODOS: Uma análise secundária pré-planejada de dados coletados de 311 pacientes com dor musculoesquelética foi realizada. O Índice de Dor Espalhada e o painMAP avaliaram as áreas de dor. O coeficiente de correlação de Spearman foi utilizado para investigar a correlação entre o Índice de Dor Espalhada e o software painMAP. RESULTADOS: Um total de 98 participantes com Dor Espalhada foram incluídos neste estudo. A maioria dos participantes era do sexo feminino (67;83,7%), com média de idade de 57,7±11,5 anos, média de altura de 1,6 (0,1) metros e média de peso de 73,2 (11,8) quilogramas. A média de intensidade da dor foi de 6,7 (2,0) e da duração da dor de 92,3 (96,3) meses. O número médio de áreas de dor no Índice de Dor Espalhada foi de 10,1(3,7) e no software painMAP foi de 11,7 (8,8). Uma correlação positiva fraca (rho=0,26, IC de 95% 0,45-0,04, p=0,022) entre o Índice de Dor Espalhada e o painMAP foi encontrada. CONCLUSÃO: O Índice de Dor Espalhada e o painMAP mostraram correlação positiva fraca para avaliar as áreas de dor em participantes com dor espalhada.

ABSTRACT BACKGROUND AND OBJECTIVES: Identifying pain sites is essential to managing patients with Widespread Pain. Several instruments have been developed, including pain drawings, a grid system and computerized methods. However, it is not yet known whether the Widespread Pain Index matches an automated method (painMAP) for quantifying the number of pain areas. Therefore, this study aimed to identify the relationship between the Widespread Pain Index and the painMAP software to measure pain sites in participants with Widespread Pain. METHODS: A pre-planned secondary analysis of data collected from 311 patients with musculoskeletal pain was conducted. The Widespread Pain Index and the painMAP software assessed pain sites. Spearman’s correlation coefficient investigated the correlation between the Widespread Pain Index and the painMAP software. RESULTS: A total of 98 participants with Widespread Pain were included in this study. Most participants were female (67; 83.7%), with a mean age of 57,7±11,5 years, mean height of 1.6 (0.1) meters and mean weight of 73.2 (11.8) kilograms. The mean pain intensity was 6.7 (2.0), and the pain duration was 92.3 (96.3) months. The mean number of pain sites in the Widespread Pain Index was 10.1 (3.7), and in the painMAP software, it was 11.7 (8.8). A weak positive correlation (rho = 0.26, 95% CI 0.45 to 0.04, p = 0.022) between the Widespread Pain Index and the painMAP software was found. CONCLUSION: The Widespread Pain Index and the painMAP software showed a weak correlation for assessing pain sites in participants with Widespread Pain.

ABSTRACT OBJECTIVE To investigate associations among race/color, gender, and intrinsic capacity (IC) (total and by domains) in middle-aged and older adults from a Brazilian cohort. As a secondary objective, we investigate these associations across Brazilian regions. METHODS This is a cross-sectional study conducted with baseline data from the 2015–2016 Brazilian Longitudinal Study of Aging (ELSI-Brazil). IC was investigated via cognitive (verbal fluency), physical (gait velocity/handgrip), and psychosocial (Center for Epidemiological Studies Depression) domains. Moreover, IC sensory domain was evaluated via self-reported sensory disease diagnoses (vision and/or hearing impairment) and race/color was identified via self-reported criteria. RESULTS We evaluated a total of 9,070 participants (aged ≥ 50 years). Black and Brown participants were 80% and 41% more likely to show a worse IC cognitive domain than white controls, respectively (OR = 1.80, 95%CI: 1.42–2.28, p < 0.001 and OR = 1.41, 95%CI: 1.21–1.65, p < 0.001). Moreover, Black and Brown women had almost a threefold greater chance of showing a worse IC than white men (OR = 2.91, 95%CI: 1.89–4.47, p < 0.001 and OR = 2.51, 95%CI: 2.09 - 3.02, p < 0.001) and a 62% (OR = 1.62, 95%CI: 1.02–2.57) and 32% (OR = 1.32, 95%CI: 1.10–1.57) greater risk of falling below our IC score cutoff point than white women. We found the greatest differences in the Brazilian South, whereas its North showed the lowest associations among race/color, gender, and IC. CONCLUSION IC racial and gender disparities reinforce the need for public health policies to guarantee equality during aging. Promoting greater access to good health care requires understanding how racism and sexism can contribute to health inequities and their consequences in different Brazilian regions.