ABSTRACT: One of the main issues related to the management of forage legumes is the fact that these plants can be found in a broad diversity of morphology, structures and growth habits. This study evaluated the structural and productive characteristics of forage legumes with different growth habits [Clitoria ternatea L.; Desmanthus pernambucanus (L.) Thellung; and Stylosanthes spp. cv. Campo Grande], in response to two harvesting frequencies (60 and 90 days). The experimental design was completely randomized in blocks, with a split-plot scheme and four replications (n=4). The type of forage legume influenced the number of secondary branches, the number of leaves per branch, leaf area index (LAI), light interception (LI), percentage of leaves and stems (%), leaf/stem ratio, and pod production (P<0.05). D. pernambucanus had the lowest LI and LAI (P < 0.05). Stylosanthes spp. cv. Campo Grande and C. ternatea showed a greater leaf percentage and leaf/stem ratio (P < 0.05). There was an effect of the harvesting frequency on the percentage of stems, leaves, pod production, and total production (P < 0.05). Longer harvesting frequencies affected differently these legumes, especially the accumulation of stems in D. pernambucanus, which displayed an intense increase after 60 days of growth. The choice of the best harvesting frequency for these legumes evaluated should consider the proposal of the usage. In our study, it was shown that harvesting at 60 days did not affect the total forage mass accumulated, which possibly is the most advantageous choice. ABSTRACT morphology Clitoria L. L (L. Thellung spp cv Grande, , Grande] (6 9 days. . days) blocks splitplot split plot n=4. n4 n n=4 4 (n=4) branches branch LAI, (LAI) LI, (LI) %, % (%) leafstem stem P<0.05. P005 P P<0.05 0 05 (P<0.05) D 0.05. 005 0.05 0.05) C 6 usage accumulated (L ( n= (n=4 (LAI (LI (% P00 P<0.0 (P<0.05 00 0.0 (n= P0 P<0. (P<0.0 0. (n P<0 (P<0. P< (P<0 (P<

RESUMO: Uma das principais questões relacionadas ao manejo de leguminosas forrageiras é o fato de que essas plantas podem ser encontradas em uma ampla diversidade de morfológica, estruturais e de hábitos de crescimento. O objetivo deste estudo foi avaliar características morfológicas, estruturais e produtivas de leguminosas forrageiras com diferentes hábitos de crescimento [Clitoria ternatea L.; Desmanthus pernambucanus (L.) Thellung; e Stylosanthes spp. cv. Campo Grande], em resposta a duas frequências de colheita (60 e 90 dias). O delineamento experimental foi inteiramente casualizado em blocos, com esquema de parcelas subdivididas e quatro repetições (n=4). O tipo de leguminosa forrageira influenciou no número de ramos secundários, número de folhas por ramo, índice de área foliar (IAF), interceptação luminosa (IL), porcentagem de folhas e colmos (%), razão folha/colmo e produção de vagens (P<0,05). D. pernambucanus apresentou os menores IL e IAF (P<0,05). Stylosanthes spp. cv. Campo Grande e C. ternatea apresentaram maior porcentagem de folhas e relação folha/colmo (P<0,05). Houve efeito da frequência de colheita na porcentagem de produção de hastes, folhas e vagens e na produção total (P<0,05). Frequências de colheita mais longas afetaram de forma diferente as leguminosas forrageiras avaliadas, principalmente o acúmulo de caules em D. pernambucanus, que apresentou aumento intenso após 60 dias de crescimento. A escolha da melhor frequência de colheita para essas leguminosas avaliadas deve levar em consideração a sua forma de uso. No presente estudo, foi demonstrado que a colheita aos 60 dias não afetou a massa forragem total acumulada, o que possivelmente é a escolha mais vantajosa. RESUMO morfológica morfológicas Clitoria L. L (L. Thellung spp cv Grande, , Grande] (6 9 dias. . dias) blocos n=4. n4 n n=4 4 (n=4) secundários ramo IAF, (IAF) IL, (IL) %, % (%) folhacolmo folha colmo P<0,05. P005 P P<0,05 0 05 (P<0,05) D C hastes 6 uso acumulada vantajosa (L ( n= (n=4 (IAF (IL (% P00 P<0,0 (P<0,05 (n= P0 P<0, (P<0,0 (n P<0 (P<0, P< (P<0 (P< (P

ABSTRACT: Canine leishmaniasis (CanL) is a multifaceted disease triggered by the protozoan Leishmania infantum, characterized by diverse clinical presentations, including osteoarticular complications. Immune-mediated joint diseases invariably initiate at the synovial membrane, implicating its pivotal role in arthritis pathogenesis. This study aimed to investigate the influence of natural L. infantum infection on synovial fluid characteristics and the expression of immune markers, including TLR-2, FOXP3, and COX-2, in the synovial membrane. Twenty naturally infected dogs (NID) with L. infantum were sourced from the Zoonosis Surveillance Unit (ZSU). Clinical-orthopedic assessments were conducted, encompassing lameness, joint edema, crepitus, patellar luxation, and the drawer test. Synovial fluid (SF) parameters, including volume, appearance, viscosity, total nucleated cell count (TNC), neutrophil count, and total protein (TP) content, were determined. After anesthesia and euthanasia, synovial membrane specimens were obtained. SF protein concentrations categorized dogs into three groups: GI (2 to 2.5g/dL), GII (2.5 to 6.0g/dL), and GIII (>6g/dL). Inflammatory infiltrates and synovial membrane changes were assessed, and immunohistochemistry evaluated TLR-2, FOXP3, and COX-2 marker expressions. Clinical evaluations revealed various osteoarticular abnormalities in NID dogs, including lameness (55%), joint edema (25%), crepitus (30%), patellar luxation (20%), and positive drawer test (25%). Post mortem examinations revealed bilateral subchondral bone, meniscus, and trochlea erosion in 30% of cases. Amastigotes of L. infantum were identified extracellularly and within macrophages (60%). An inflammatory infiltrate was predominant in 70% of dogs, with varying intensity among the groups. Mononuclear cells, chiefly macrophages and lymphocytes, and neutrophils comprised the infiltrate. TLR-2 and COX-2 expression levels were elevated in GIII compared to GII and GI. Conversely, FOXP3 showed moderate expression in GI and minimal expression in GII and GIII. This study underscores the contributory role of L. infantum infection in the development of joint lesions in CanL. Additionally, alterations in the expression of immune markers TLR2, FOXP3, and COX2 within the synovial membrane imply the perpetuation and exacerbation of the inflammatory processes, shedding light on the intricate pathogenesis of CanL-induced arthritis. ABSTRACT CanL (CanL presentations complications Immunemediated Immune mediated L TLR2 TLR 2, 2 FOXP COX2, COX (NID ZSU. ZSU . (ZSU) Clinicalorthopedic orthopedic conducted (SF parameters volume appearance viscosity TNC, TNC , (TNC) TP (TP content determined euthanasia obtained groups ( 2.5g/dL, 25gdL gdL 2.5g/dL 5g dL g 2.5g/dL) 2.5 25 5 (2. 6.0g/dL, 60gdL 6.0g/dL 6 0g 6.0g/dL) >6g/dL. 6gdL >6g/dL 6g (>6g/dL) assessed COX- expressions 55%, 55 55% (55%) 25%, 25% (25%) 30%, 30 (30%) 20%, 20 20% (20%) 25%. bone meniscus cases 60%. 60 60% (60%) 70 cells lymphocytes TLR- Conversely Additionally processes CanLinduced induced (ZSU (TNC 2. (>6g/dL (55% (25% 3 (30% (20% (60% 7 (55 (25 (30 (20 (60 (5 (3 (6

RESUMO: A leishmaniose canina (LC) é uma doença causada pelo protozoário Leishmania infantum com diversas manifestações clínicas, incluindo alterações osteoarticulares. A membrana sinovial é o local inicial de eventos patogênicos em todos os tipos de doenças articulares mediadas pelo sistema imunológico. Devido a essa relação, o objetivo foi avaliar a influência da infecção natural por L. infantum nas características do líquido sinovial e na expressão de TLR-2, FOXP3 e COX-2 na membrana sinovial. Cães naturalmente infectados por L. infantum (NID, N=20) foram obtidos na Unidade de Vigilância de Zoonoses (UVZ). Critérios clínicos ortopédicos foram avaliados, assim como foram obtidas amostras de líquido sinovial por artrocentese. O volume, aspecto, viscosidade, contagem total de células nucleadas (TNC) e contagem de neutrófilos e proteína total (PT) no líquido sinovial (LS) foram determinados. Os cães foram anestesiados e posteriormente eutanasiados para obtenção da membrana sinovial. Os animais do estudo apresentaram claudicação (55%), edema (25%), crepitação na articulação do joelho (30%) e luxação patelar medial (20%) e foram positivos no teste da gaveta (25%). Trinta por cento (30%) dos cães apresentaram erosão bilateral do osso subcondral, menisco e tróclea. Amastigotas de L. infantum foram visualizadas extracelularmente e dentro de macrófagos (60% dos animais). Os cães foram ainda divididos em três grupos de acordo com a concentração de proteína no líquido sinovial: GI: 2 a 2,5g/dL (valor de referência normal), GII: 2,5 a 6,0g/dL, GIII: >6g/dL. Infiltrado celular inflamatório, bem como aumento da camada da membrana sinovial, foram identificados em 70% (14/20) dos cães. O infiltrado inflamatório estava ausente em membranas sinoviais originadas de GI, presente em GII com intensidade moderada e presente em GIII com intensidade alta. O infiltrado inflamatório era predominantemente composto por macrófagos, linfócitos e neutrófilos. Houve um aumento na expressão dos marcadores TLR2 e COX2 em GIII em comparação com os grupos GII e GI. Contudo, em relação à expressão de FOXP3, houve uma marcação moderada em GI e apenas uma marcação leve em GII e GIII. Este trabalho reforça o papel da infecção por L. infantum no desenvolvimento de lesões articulares em cães. Além disso, nosso estudo indica que a LC modifica a expressão de TLR2, FOXP3 e COX2 na membrana sinovial, o que implica a manutenção e progressão do processo inflamatório. RESUMO (LC clínicas osteoarticulares imunológico L TLR 2, TLR-2 FOXP COX COX- NID, NID (NID N=20 N20 N 20 UVZ. UVZ . (UVZ) avaliados artrocentese volume aspecto viscosidade TNC (TNC PT (PT LS (LS determinados 55%, 55 55% , (55%) 25%, 25 25% (25%) 30% 30 (30% 20% (20% 25%. subcondral tróclea 60% 60 (60 animais. animais) 25gdL gdL 5g dL g valor normal, normal normal) 5 60gdL 6 0g 6,0g/dL 6gdL 6g >6g/dL 70 14/20 1420 14 (14/20 alta Contudo disso TLR- N=2 N2 (UVZ (55% (25% 3 (30 (20 (6 7 14/2 142 1 (14/2 N= (55 (25 (3 (2 ( 14/ (14/ (5 (14 (1

Résumé Fondé sur l’hypothèse que les femmes ont joué un rôle majeure dans les premières années de diffusion de la psychanalyse au Brésil dans l’introduction et l’expansion des idées freudiennes dans le pays, cette étude souligne leur participation prépondérant dans le mouvement psychanalytique brésilien. Pour donner de la visibilité à cet esprit pionnier, on a organisé l’étude en trois moments. Tout d’abord on contextualise la participation des femmes à la société brésilienne pendant la première moitié du XXe siècle et les premiers mouvements émancipatoires. Ensuite, on aborde la manière dont la psychanalyse, comprise comme un mouvement novateur et perturbateur, a fourni un espace d’interlocution fertile pour réfléchir à l’expansion des conquêtes des femmes dans la sphère publique et sociale. Enfin, ont articulera ces hypothèses par le biais de l’esquisse biographique de deux remarquables pionniers de la psychanalyse au Brésil: Virgínia Bicudo et Marialzira Perestrello. lhypothèse l hypothèse lintroduction introduction lexpansion expansion pays brésilien pionnier létude moments dabord d abord émancipatoires Ensuite perturbateur dinterlocution interlocution sociale Enfin lesquisse esquisse Perestrello

Resumen Partiendo de la premisa de que, en los primeros años de difusión del psicoanálisis en Brasil, la participación femenina tuvo un importante papel tanto en la introducción como en la expansión de las ideas freudianas en el país, este estudio pretende esbozar el protagonismo de las mujeres en el movimiento psicoanalítico brasileño. Para dar visibilidad a este pionero, el estudio se organizó en tres momentos. Inicialmente, se presentarán consideraciones generales sobre el contexto de la participación de las mujeres en la sociedad brasileña durante la primera mitad del siglo XX y los primeros movimientos por la emancipación de la mujer. A continuación, se abordará el modo en que el psicoanálisis proporcionó un espacio fértil de interlocución para pensar la expansión de las conquistas femeninas en la esfera pública y social. Finalmente, estas hipótesis se articularán a través de la semblanza de dos destacadas pioneras del psicoanálisis en Brasil: Virgínia Leone Bicudo y Marialzira Perestrello. Brasil país brasileño pionero momentos Inicialmente mujer continuación social Finalmente Perestrello

Abstract Based on the assumption that women played a major role during the first years of psychoanalysis dissemination in Brazil both in introducing and expanding Freudian ideas in the country, this study outlines women’s participation in the Brazilian psychoanalytic movement. To give visibility to this pioneering spirit, we divided the text in three moments. First, we contextualize women’s participation in Brazilian society during the first half of the 20th century and the first emancipatory movements. We then discuss how psychoanalysis, understood as an innovative and disruptive movement, provided a fertile space of interlocution for exploring the expansion of women’s participation in the public and social sphere. Finally, we articulate these hypotheses by means of the biographical outline of two outstanding pioneers of psychoanalysis in Brazil: Virgínia Bicudo and Marialzira Perestrello. country womens s movement spirit moments First th movements sphere Finally Perestrello

Resumo Partindo da premissa de que, nos primeiros anos de difusão da psicanálise no Brasil, a participação feminina teve importante destaque tanto na introdução quanto na expansão das ideias freudianas no país, este estudo se propõe a delinear o papel de protagonismo assumido pelas mulheres junto ao movimento psicanalítico brasileiro. Para dar visibilidade a esse pioneirismo, o estudo foi organizado em três momentos. Inicialmente, serão apresentadas considerações gerais sobre o contexto da participação da mulher na sociedade brasileira durante a primeira metade do século XX e os primeiros movimentos de emancipação feminina. Na sequência, será abordado o modo como a psicanálise, entendida neste período histórico como movimento inovador e disruptivo, proporcionou espaço fecundo de interlocução para se pensar a expansão das conquistas das mulheres na esfera pública e social. Por fim, essas hipóteses serão articuladas por meio do esboço biográfico de duas destacadas pioneiras da psicanálise no Brasil: Virgínia Leone Bicudo e Marialzira Perestrello. que Brasil país brasileiro pioneirismo momentos Inicialmente sequência disruptivo social fim Perestrello

Abstract Background Hip fractures in the older adults lead to increased morbidity and mortality. Although a low bone mineral density is considered the leading risk factor, it is essential to recognize other factors that could affect the risk of hip fractures. This study aims to evaluate the contribution of clinical characteristics, patient-reported outcomes, and muscle and aerobic capacity for hip fractures in community-dwelling older adults. Methods This is a retrospective cohort study with real world-data from subjects ≥ 60 years old attending an outpatient clinic in Minas Gerais, Brazil, from May 1, 2019, to August 22, 2022. Data about clinical characteristics (multimorbidity, medications of long-term use, sedative and or tricyclic medications, number of falls), patient-reported outcomes (self-perception of health, self-report of difficulty walking, self-report of vision problems, and self-report of falls) and muscle and aerobic capacity (calf circumference, body mass index, and gait speed) were retrieved from an electronic health record. The association of each potential risk factor and hip fracture was investigated by a multivariable logistic regression analysis adjusted for age and sex. Results A total of 7,836 older adults were included with a median age of 80 years (IQR 72–86) and 5,702 (72.7%) were female. Hip fractures occurred in 121 (1.54%) patients. Multimorbidity was associated with an increased risk of hip fracture (OR = 1.12, 95%CI 1.06–1.18) and each episode of fall increased the chance of hip fracture by 1.7-fold (OR = 1.69, 95%CI 1.52–1.80). Patient-reported outcomes associated with increased fracture risk were regular or poor self-perception of health (OR = 1.59, 95%CI 1.06–2.37), self-report of walking difficulty (OR = 3.06, 95%CI 1.93–4.84), and self-report of falls (OR = 2.23, 95%CI 1.47–3.40). Body mass index and calf circumference were inversely associated with hip fractures (OR = 0.91, 95%CI 0.87–0.96 and OR = 0.93, 95%CI 0.88–0.97, respectively), while slow gait speed increased the chance of hip fractures by almost two-fold (OR = 1.80, 95%CI 1.22–2.66). Conclusion Our study reinforces the importance of identified risk factors for hip fracture in community-dwelling older adults beyond bone mineral density and available fracture risk assessment tools. Data obtained in primary care can help physicians, other health professionals, and public health policies to identify patients at increased risk of hip fractures. mortality patientreported patient reported communitydwelling community dwelling worlddata world data 6 Gerais Brazil 1 2019 22 2022 multimorbidity, multimorbidity (multimorbidity longterm long term use falls, , selfperception self perception selfreport report problems record sex 7836 7 836 7,83 8 IQR 72–86 7286 72 86 5702 5 702 5,70 72.7% 727 (72.7% female 12 1.54% 154 54 (1.54% 112 1.12 95CI CI 95 1.06–1.18 106118 06 18 1.7fold 17fold fold 1.7 169 69 1.69 1.52–1.80. 152180 1.52–1.80 . 52 1.52–1.80) Patientreported Patient 159 59 1.59 1.06–2.37, 106237 1.06–2.37 2 37 1.06–2.37) 306 3 3.06 1.93–4.84, 193484 1.93–4.84 93 4 84 1.93–4.84) 223 23 2.23 1.47–3.40. 147340 1.47–3.40 47 40 1.47–3.40) 091 0 91 0.91 087096 87 96 0.87–0.9 093 0.93 088097 88 97 0.88–0.97 respectively, respectively respectively) twofold two 180 1.80 1.22–2.66. 122266 1.22–2.66 66 1.22–2.66) tools physicians professionals 201 202 783 83 7,8 72–8 728 570 70 5,7 72.7 (72.7 1.54 15 (1.54 11 1.1 9 1.06–1.1 10611 7fold 17 1. 16 1.6 15218 1.52–1.8 1.5 10623 1.06–2.3 30 3.0 19348 1.93–4.8 2.2 14734 1.47–3.4 09 0.9 08709 0.87–0. 08809 0.88–0.9 1.8 12226 1.22–2.6 20 78 7, 72– 57 5, 72. (72. (1.5 1.06–1. 1061 1521 1.52–1. 1062 1.06–2. 3. 1934 1.93–4. 2. 1473 1.47–3. 0. 0870 0.87–0 0880 0.88–0. 1222 1.22–2. (72 (1. 1.06–1 106 152 1.52–1 1.06–2 193 1.93–4 147 1.47–3 087 0.87– 088 0.88–0 122 1.22–2 (7 (1 1.06– 10 1.52– 19 1.93– 14 1.47– 08 0.87 0.88– 1.22– ( 1.06 1.52 1.93 1.47 0.8 0.88 1.22 1.0 1.9 1.4 1.2

Abstract Erythroxylum is common in the Brazilian Cerrado. Species from this genus have ecological, pharmacological and popular medical importance. Based on this information, the aims of this study was to perform a descriptive and quantitative morphoanatomical study of Erythroxylum tortuosum leaves present in two environments: cerrado sensu stricto and campo rupestre. To carry out these studies, 24 fully developed leaves were collected and fixed from individuals across both environments. For the quantitative anatomy study, the following measurements were made: leaf area, length, width and mass; stomatal density; polar and equatorial diameter of the stomata; thickness of the leaf blade, mesophyll, epidermis and cuticles on the adaxial and abaxial surfaces; and thickness of the spongy and palisade parenchyma; specific leaf area, leaf mass area and foliar tissue density. This species shows a bald and uniseriate epidermis when viewed in cross section. Stomata are paracytic and occur only on abaxial surfaces. The mesophyll is dorsiventral type, with a dense vascular system, and the vascular bundle is collateral type. The general pattern of the veins is pinnate camptodrome and brochidodrome, with dense veins and pseudosecondary ribs. Significant differences were found for almost all analysed variables, suggesting that different environmental conditions may influence plant development. Cerrado ecological importance information environments rupestre studies 2 made length density stomata blade surfaces parenchyma section type system brochidodrome ribs variables development

Resumo Erythroxylum é um gênero bastante comum nos Cerrados Brasileiros. Espécies deste gênero possuem grande importância ecológica, farmacológica e na medicina popular. Baseado nestas informações, o objetivo deste trabalho foi realizar um estudo morfoanatômico descritivo e quantitativo das folhas de Erythroxylum tortuosum presentes em duas fitofisionomias: cerrado stricto sensu e campo rupestre. Para a realização dos estudos, 24 folhas completamente expandidas foram coletadas e fixadas de indivíduos presentes nos dois ambientes. Para o estudo da anatomia quantitativa, as seguintes medidas foram obtidas: área foliar, largura, comprimento e massa foliar; densidade estomática, diâmetro polar e equatorial do estômato; espessura da lâmina foliar, mesofilo, epiderme e cutícula das faces adaxial e abaxial; e espessura do parênquima paliçádico e esponjoso; área foliar específica, área de massa foliar e densidade dos tecidos foliares. Esta espécie apresenta epiderme glabra e unisseriada, quando vista em secção transversal. Os estômatos são paracíticos e ocorrem apenas na face abaxial. O mesofilo é dorsiventral, com um sistema vascular denso e feixe vascular é do tipo colateral. O padrão geral da venação é pinada, camptódroma e broquidódroma, com veias densas e nervuras pseudosecundárias. Diferenças significativas foram encontradas em quase todas as variáveis analisadas, sugerindo que condições ambientais diferentes podem influenciar o desenvolvimento da planta. Brasileiros ecológica popular informações fitofisionomias rupestre estudos 2 ambientes quantitativa obtidas largura estomática estômato abaxial esponjoso específica foliares unisseriada transversal dorsiventral colateral pinada broquidódroma pseudosecundárias analisadas planta

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1

Abstract We estimated genetic parameters of two Pinus caribaea var. caribaea progeny tests based on growth traits aiming at the identification of the best selection strategy. This study was conducted in two progeny tests located in Selvíria (MS), Brazil. Tests were set up in block design, one with 76 progenies (area 1) and the other with 99 progenies (area 2). Genetic parameters were estimated using the SELEGEN software through REML/BLUP method. To estimate the genetic gain through selection, four selection methods and ten selection intensities were tested. The intensity of selection that maximizes genetic gain and genetic diversity was calculated by the optimization point. Significant variation was observed between and with progeny for all traits in area 2 and only within plots for height in area 1. Higher values of heritability were observed in area 1. Considering the optimization of selection, the best selection method for both areas was the individual. var strategy MS, MS , (MS) Brazil design 7 1 9 2. . 2) REMLBLUP REML BLUP tested point individual (MS

Resumo: O Espectro do Acretismo Placentário é uma patologia de alta morbimortalidade, com incidência crescente nos últimos anos e ganhando relevância devido ao aumento da taxa de cesarianas, sendo este o seu principal fator de risco. Descrevemos o caso de uma paciente de 32 anos com acretismo placentário, diagnosticado por ultrassonografia com 31 semanas de idade gestacional, na qual a cirurgia foi planejada passo a passo com a equipe multidisciplinar, com a colocação de balões nas artérias hipogástricas e um cateter duplo jack antes da cirurgia e realizando um estadiamento intraoperatório detalhado. Uma revisão e atualização da bibliografia, enfatizando o planejamento detalhado da cirurgia e a abordagem em equipes composta por profissionais de várias especialidades médicas.

Resumen: El espectro acretismo placentario es una patología que cursa con una alta morbimortalidad, viéndose en los últimos años un incremento en su incidencia y cobrando relevancia por la tasa de cesáreas en aumento, siendo su principal factor de riesgo. Se describe el caso de una paciente de 32 años, portadora de acretismo placentario, diagnosticado mediante ecografía a las 31 semanas de edad gestacional, donde se logró planificar paso a paso la cirugía con equipo, colocando previo a la cirugía balones en arterias hipogástricas y catéter doble Jota, haciendo una estadificación intraoperatoria detallada. A propósito del caso clínico se realiza una revisión y actualización de la patología, enfatizando en la planificación detallada de la cirugía y el abordaje con equipos de referencia.

Abstract: Placenta Accreta Spectrum is a condition associated with high morbidity and mortality. In recent years, there has been an increase in its incidence, highlighting its importance due to the rising rate of cesarean sections which is its main risk factor. A case is described of a 32-year-old patient with placenta accreta, diagnosed via ultrasound at 31 weeks of gestation. The surgery was meticulously planned with the team, including the placement of balloons in the hypogastric arteries and a double-J catheter, allowing for detailed intraoperative staging. In relation to the clinical case, a review and update of the pathology is carried out, emphasizing the detailed planning of the surgery and the approach in specialized teams.

Resumo: Neste artigo, realizamos a primeira análise sistemática e abrangente da incorporação dos Estudos sobre as Mulheres, de Género e Feministas (EMGF) nos currículos do ensino superior em Portugal. Mediante uma análise de conteúdo dos planos de estudo dos cursos e dos programas das unidades curriculares disponíveis nos websites das instituições, mapeamos um quadro de incorporação incipiente, acessória e precária dos EMGF, típica de fases precoces da institucionalização do campo. O estudo evidencia que há ainda um longo caminho a percorrer para uma efetiva e consistente integração dos EMGF no ensino superior no país.

Abstract: In this article, we conduct the first systematic and comprehensive analysis of the incorporation of Women’s, Gender and Feminist Studies (WGFS) in higher education curricula in Portugal. Through a content analysis of course syllabi and study program plans available on institutional websites, we draw a picture of incipient, accessory and precarious incorporation of WGFS, typical of the early stages of the field’s institutionalization. The study shows that there is still a long way to go for an effective and consistent integration of WGFS in higher education in the country.

Abstract Background: meeting the needs of families with a member who has a Neuromuscular Disorder (ND), enables an improvement in their quality of life, minimizing the possibility of illness and allowing greater family contribution to their functions. Objectives: characterize the needs of families with a member who has a ND in the functional dimension. Methodology: a quantitative, descriptive, cross-sectional study was carried out with an intentional sample of 30 families. The operative matrix of the Dynamic Model of Family Assessment and Intervention (MDAIF) was used as a data collection instrument. Data processing and analysis were performed by descriptive statistics. Results: most members who have a ND are dependent on self-care, clothing, hygiene and using the bathroom; families have saturation of home care role and caregiver role. Conclusion: family nurses will be able to help families by creating programs that allow: -the readjustment of family roles where there is saturation; -the possibility of working and supporting caregivers; -specific training regarding the people who have a ND.

Resumo Enquadramento: dar resposta às necessidades das famílias com membro Portador de Patologia Neuromuscular (PPN), possibilita uma melhoria na qualidade de vida dos mesmos, minimizando a possibilidade de doença e permite maior contribuição familiar nas suas funções. Objetivos: este estudo tem como objetivo caracterizar as necessidades das famílias com membro PPN, na sua dimensão funcional. Metodologia: foi realizado um estudo quantitativo, descritivo, transversal, com amostra intencional de 30 famílias. Utilizámos um formulário construído com base na matriz operativa do Modelo Dinâmico de Avaliação e Intervenção Familiar (MDAIF) como instrumento de colheita de dados. Tratamento e análise de dados efetuados pela estatística descritiva. Resultados: os membros portadores de patologia neuromuscular, na sua maioria são dependentes no autocuidado vestuário, higiene e uso do sanitário; a família apresenta a saturação do papel do cuidado doméstico e a saturação do papel de prestador de cuidados. Conclusão: o enfermeiro de família poderá dar resposta às famílias com a criação de programas que permitam: -reajuste dos papeis familiares onde existe saturação; -possibilidade de trabalhar e dar apoio ao prestador de cuidados; -formação específica no que respeita aos cuidados ao membro PPN.

Resumen Marco contextual: responder a las necesidades de las familias con un miembro con Patología Neuromuscular (PPN), posibilita una mejora en su calidad de vida, minimizando la posibilidad de enfermedad y permitiendo una mayor contribución familiar a sus funciones. Objetivos: este estudio tiene como objetivo caracterizar las necesidades de las familias con un miembro con Patología Neuromuscular (PPN), en su dimensión funcional. Metodología: se realizó un estudio cuantitativo, descriptivo, transversal, con una muestra intencional de 30 familias. Se utilizó un formulario construido sobre la matriz operativa del Modelo Dinámico de Evaluación e Intervención Familiar (MDAIF) como instrumento de recolección de datos. Procesamiento y análisis de datos realizado por estadística descriptiva. Resultados: la mayoría de los afiliados con patología neuromuscular son dependientes del autocuidado, vestimenta, higiene y uso del baño; la familia presenta la saturación del rol de cuidado doméstico y la saturación del rol de cuidador. Conclusión: la enfermera de la familia podrá responder a las familias con la creación de programas que permitan: - reajuste de los roles familiares donde hay saturación; -posibilidad de trabajar y apoyar al cuidador; -formación específica respecto al cuidado de la persona con PPN.

ABSTRACT Throughout life, the lens produces new fibers arranged concentrically, which increase its anteroposterior diameter and weight, making its nucleus more compact and hardened. Hypermature cataract is an advanced stage of this fiber proliferation, which can trigger a variety of complications. Spontaneous rupture of the anterior lens capsule evolving with anterior displacement of the nucleus is a rare complication, with few cases published in the literature. We describe the case of a 68-year-old female patient, who presented spontaneous rupture of the anterior lens capsule with anterior displacement of the nucleus in the left eye, without a history of ocular trauma. The patient underwent phacoemulsification and clinical control of intraocular pressure, improving her condition. life concentrically weight hardened proliferation complications complication literature 68yearold yearold 68 year old eye trauma pressure condition 6

RESUMO Ao longo da vida, o cristalino produz novas fibras dispostas de forma concêntrica, que aumentam seu diâmetro anteroposterior e peso, tornando seu núcleo mais compacto e endurecido. A catarata hipermadura é uma forma de progressão avançada dessa proliferação de fibras, que pode desencadear uma variedade de complicações. A ruptura espontânea da cápsula anterior do cristalino, evoluindo com deslocamento anterior do núcleo, é uma complicação rara e com poucos casos publicados na literatura. Descrevemos o caso de uma paciente do sexo feminino, 68 anos, que apresentou ruptura espontânea da cápsula anterior do cristalino com deslocamento anterior do núcleo em olho esquerdo sem histórico de trauma ocular. A paciente foi submetida à facoemulsificação do cristalino e ao controle da pressão intraocular, evoluindo com melhora do quadro clínico. vida concêntrica peso endurecido complicações literatura feminino 6 anos ocular intraocular clínico

Abstract Clinical practice guidelines (CPG) are developed to align standards of health care around the world, aiming to reduce the incidence of misconducts and enabling more effective use of health resources. Considering the complexity, cost, and time involved in formulating CPG, strategies should be used to facilitate and guide authors through each step of this process. The main objective of this document is to present a methodological guide prepared by the Epidemiology Committee of the Brazilian Society of Rheumatology for the elaboration of CPG in rheumatology. Through an extensive review of the literature, this study compiles the main practical recommendations regarding the following steps of CPG drafting: distribution of working groups, development of the research question, search, identification and selection of relevant studies, evidence synthesis and quality assessment of the body of evidence, the Delphi methodology for consensus achievement, presentation and dissemination ofthe recommendations, CPG quality assessment and updating. This methodological guide serves as an important tool for rheumatologists to develop reliable and high-quality CPG, standardizing clinical practices worldwide. (CPG world resources complexity cost process rheumatology literature drafting groups question search studies achievement updating highquality high worldwide

Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t). ADA DADA (DADA2 fashion antiTNF anti TNF 1 DASA clinical laboratory collected here median years ALPSlike ALPS like CVID (CVID found responses condition Moreover t. t . (t) (DADA (t