ABSTRACT Advances in treatment of structural heart disease have been disruptive to cardiovascular surgery, and there have been discussions about how to incorporate these technologies into the surgeons’ therapeutic arsenal. Transcatheter procedures, complex redo interventions, and endovascular aortic approaches are already practiced by cardiovascular surgeons in Brazil. The expansion of these techniques, coupled with recent changes in the country’s medical residency program in cardiovascular surgery, has led to an urgent need to acquire catheter-based skills. In this article, we discuss these aspects in the light of the reality of cardiovascular surgery training in Brazil. arsenal procedures interventions Brazil techniques countrys country s catheterbased catheter based skills article

ABSTRACT Introduction: Gastric tonometry is a useful tool for examining regional splanchnic perfusion as it provides an indirect assessment of the state of the liver graft. This is because splanchnic hypoperfusion is a critical parameter in the context of liver transplantation, being associated with the development of problems such as acute liver failure and multiple organ failure. Objective: To analyze the effects of gastrointestinal tonometry in the perioperative period of patients undergoing liver transplantation. Methodology This is an Integrative Review using the PubMed and VHL databases. The following descriptors were used: “Tonometry”, “Splanchnic circulation” and “Liver transplantation” with the Boolean operator “AND”, and articles of relevance to the topic were selected. Initially, 24 articles were selected, all published in the last 20 years, in Portuguese and/or English. After analysis, 6 articles matched the proposed objective. Results: It was observed that the difference between PraCO2 at the end of surgery and in the anepathic phase was greater in patients without liver graft dysfunction. A positive correlation was found between ΔpraCO2 and peak ALT after liver transplantation. In another study, it was found that the relationship between poor graft function was the presence of elevated liver enzymes, worsening synthetic liver function, coagulopathy and encephalopathy. It has also been shown that intramucosal gastric pH can predict early graft function. In a group with liver dysfunction, patients had an intramucosal gastric pH of less than 7.3 in the perioperative period, which remained low until the 24th hour postoperatively, while the group without dysfunction had an intramucosal gastric pH of more than 7.3, except in the anepathic phase when it was below this value. Conclusion: The usefulness of gastrointestinal tonometry to monitor splanchnic circulation and liver graft function during liver transplantation has been described and although support for this statement was found in some studies, this review had limitations due to the small number of articles available, which prevents it from covering a wide range of scientific evidence. Introduction Objective databases used Tonometry, Tonometry , “Tonometry” Splanchnic Liver AND, AND “AND” selected Initially 2 years andor or English analysis objective Results PraCO ΔpraCO study enzymes encephalopathy 73 7 3 7. th postoperatively value Conclusion studies available evidence “Tonometry “AND

RESUMO Introdução: A tonometria gástrica é uma ferramenta útil para examinar a perfusão esplâncnica regional por permitir o fornecimento de uma avaliação indireta do estado do enxerto hepático. Isso ocorre devido à hipoperfusão esplâncnica ser um parâmetro crítico no contexto do transplante de fígado, estando associada ao desenvolvimento de problemas como insuficiência hepática aguda e falência de múltiplos órgãos. Objetivo: Analisar os efeitos da tonometria gastrointestinal no perioperatório dos pacientes submetidos ao transplante hepático. Metodologia: Trata-se de uma Revisão Integrativa realizada nas bases de dados PubMed e BVS. Foram utilizados os descritores: “Tonometry”, “Splanchnic circulation” e “Liver transplantation”, incluindo o operador booleano “AND”, e selecionados artigos de relevância para o tema. Foram selecionados inicialmente 24 artigos, todos publicados nos últimos 20 anos, em português e/ou inglês. Após análise, seis artigos corresponderam ao objetivo proposto. Resultado: Observou-se que a diferença entre a PraCO2 no final da cirurgia e na fase anepática foi maior em pacientes sem disfunção do enxerto hepático. Foi identificada uma correlação positiva entre ΔpraCO2 e o pico de ALT após o transplante de fígado. Em outro estudo, verificou-se que a presença de enzimas hepáticas elevadas e a piora da função hepática sintética, coagulopatia e encefalopatia estava relacionada à má função do enxerto. Também foi comprovado que o pH gástrico intramucoso pode predizer a funcionalidade precoce do enxerto. Em um grupo com disfunção hepática, os pacientes apresentaram pH gástrico intramucoso abaixo de 7,3 no período perioperatório, mantendo-se baixo até a 24ª hora pós-operatória, enquanto o grupo sem disfunção apresentou pH gástrico intramucoso acima de 7,3, exceto na fase anepática, quando ficou abaixo desse valor. Conclusão: Descreve-se a utilidade da tonometria gastrointestinal para monitorar a circulação esplâncnica e a função do enxerto hepático durante o transplante hepático. Embora alguns estudos ofereçam suporte a essa afirmação, esta revisão apresenta limitações devido à quantidade restrita de artigos disponíveis, o que a impede de abranger uma ampla gama de evidências científicas. Introdução fígado órgãos Objetivo Metodologia Tratase Trata se BVS descritores Tonometry, Tonometry , “Tonometry” Splanchnic circulation Liver transplantation, transplantation transplantation” AND, AND “AND” tema 2 anos eou ou inglês análise proposto Resultado Observouse Observou PraCO ΔpraCO estudo verificouse verificou sintética 73 7 3 7, mantendose mantendo ª pósoperatória, pósoperatória pós operatória, operatória pós-operatória valor Conclusão Descrevese Descreve afirmação disponíveis científicas “Tonometry “AND

ABSTRACT In Brazil, the COVID-19 burden was substantial, and risk factors associated with higher in-hospital mortality rates have been extensively studied. However, information on short-term all-cause mortality and the factors associated with death in patients who survived the hospitalization period of acute SARS-CoV-2 infection is limited. We analyzed the six-month post-hospitalization mortality rate and possible risk factors of COVID-19 patients in a single center in Brazil. This is a retrospective cohort study focused on a six-month follow-up. The exclusion criteria were death during hospitalization, transference to another hospital, and age under 18. We collected data from the charts of all hospitalized patients from March 2020 to December 2020 with a positive RT-PCR test for SARS-CoV-2, resulting in a sample size of 106 patients. The main outcome was death after hospitalization, whereas comorbidities and demographics were evaluated as risk factors. The crude post-hospitalization death rate was 16%. The first 30 days of follow-up had the highest mortality rate. In a Cox regression model for post-hospitalization mortality, previous chronic kidney disease (HR, 4.06, 95%CI 1.46 – 11.30) and longer hospital stay (HR 1.01, 95%CI 1.00 – 1.02) were the only factors statistically associated with death. In conclusion, a high six-month all-cause mortality was observed. Within the six-month follow-up, a higher risk of death was observed for patients who had prior CKD and longer hospital stay. These findings highlight the importance of more intensive medical surveillance during this period. Brazil COVID19 COVID 19 COVID-1 substantial inhospital studied However shortterm short term allcause cause SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- limited sixmonth six month posthospitalization post followup. followup follow up. up 18 202 RTPCR RT PCR SARSCoV2, 2, 10 16 16% 3 HR, HR 406 4 06 4.06 95CI CI 95 146 1 46 1.4 11.30 1130 11 101 01 1.01 100 00 1.0 1.02 102 02 conclusion followup, up, COVID1 COVID- SARS-CoV 20 40 0 4.0 9 14 1. 11.3 113 4. 11.

ABSTRACT Drimys brasiliensis Miers, popularly known as cataia, is a tree species native to the Atlantic Forest that has phytochemical, phytotherapeutic, aromatic and economic importance, with wide use in folk medicine. It is considered a species of difficult multiplication via seeds, presenting dormancy due to embryonic immaturity. Thus, the objective of this study was to analyze the vegetative rescue, in vitro establishment and propagation by way of cuttings of Drimys brasiliensis. For the rescue, the girdling techniques were applied at 30 and 90 cm from the ground, semi-girdling at 30 cm from the ground and pruned branches conditioned vertically and horizontally, being evaluated the shoot emission capacity. With the shoots obtained by vegetative rescue, the explants used for in vitro establishment were made, evaluating different immersion times in sodium hypochlorite 1.0 % (v/v) (0, 10, 15 and 20 minutes). The percentages of total, bacterial, fungal contamination and phenolic oxidation were evaluated. On the cuttings, shoots from vegetative rescue, from the aerial part of an adult individual and from detached branches were tested and placed in a mini-tunnel. The percentage of cuttings survival, percentage of cuttings with callus and percentage of rooting were evaluated. Regarding the vegetative rescue, the technique of pruned branches resulted in the induction of shoots, highlighting the branches conditioned vertically (100%). In the in vitro establishment, the immersion in sodium hypochlorite (1%) for 20 minutes proved to be efficient in the control of fungal contamination, however, no significant differences were observed in relation to the control of bacterial contamination. In cuttings, the use of cuttings from pruned branches or girdling/semi-girdling showed potential for these techniques in the cloning of the species, obtaining results close to 10% rooting. In general, the species has the potential for vegetative propagation, however, adjustments are necessary in the in vitro establishment and cutting protocols. Miers cataia phytochemical phytotherapeutic importance medicine seeds immaturity Thus rescue 3 9 semigirdling semi horizontally capacity made 10 1 0 1. v/v vv v (v/v 0, (0 2 minutes. . minutes) total minitunnel. minitunnel mini tunnel. tunnel mini-tunnel survival 100%. 100 100% (100%) 1% (1% however girdling/semigirdling girdlingsemigirdling girdling/semi general protocols ( (100% (1 girdlingsemi (100 (10

RESUMO Drimys brasiliensis Miers, conhecida popularmente por cataia, é uma espécie arbórea nativa da Mata Atlântica que apresenta importância fitoquímica, fitoterapêutica, aromática e econômica, com amplo uso na medicina popular. É considerada uma espécie de difícil multiplicação via sementes, apresentando dormência por imaturidade embrionária. Assim, objetivou-se com este estudo analisar o resgate vegetativo, estabelecimento in vitro e a propagação via estaquia de Drimys brasiliensis. Para o resgate, realizou-se a aplicação das técnicas de anelamento a 30 e 90 cm do solo, semianelamento a 30 cm do solo e galhos podados acondicionados vertical e horizontalmente, sendo avaliada a capacidade de emissão de brotações. Com as brotações obtidas pelo resgate vegetativo, foram confeccionados os explantes utilizados para o estabelecimento in vitro, avaliando diferentes tempos de imersão em hipoclorito de sódio 1,0 % (v/v) (0, 10, 15 e 20 minutos). Foram avaliadas as percentagens de contaminação total, bacteriana, fúngica e oxidação fenólica. Na estaquia foram testadas brotações oriundas do resgate vegetativo, da parte aérea de indivíduo adulto e de galhos destacados e acondicionados em mini-túnel. Avaliaram-se a porcentagem de sobrevivência das estacas, porcentagem de estacas com calos e porcentagem de enraizamento. Em relação ao resgate vegetativo, a técnica de galhos podados resultou na indução de brotações, destacando os galhos acondicionados verticalmente (100%). No estabelecimento in vitro, a imersão em hipoclorito de sódio (1%) por 20 minutos se mostrou eficiente no controle da contaminação por fungos, entretanto, não foram observadas diferenças significativas em relação ao controle de contaminação bacteriana. Na estaquia, o uso de estacas provenientes de galhos podados ou anelamento/semianelamento mostrou potencial para estas técnicas na clonagem da espécie, obtendo resultados próximos a 10% de enraizamento. No geral, a espécie apresenta potencial de propagação vegetativa, contudo, são necessários ajustes nos protocolos de estabelecimento in vitro e estaquia. Miers cataia fitoquímica fitoterapêutica econômica popular sementes embrionária Assim objetivouse objetivou vegetativo realizouse realizou 3 9 horizontalmente 10 1 0 1, v/v vv v (v/v 0, (0 2 minutos. . minutos) total bacteriana fenólica minitúnel. minitúnel mini túnel. túnel mini-túnel Avaliaramse Avaliaram enraizamento 100%. 100 100% (100%) 1% (1% fungos entretanto anelamentosemianelamento geral vegetativa contudo ( (100% (1 (100 (10

BACKGROUND Leishmania RNA virus 1 (LRV1) is commonly found in South American Leishmania parasites belonging to the subgenus Viannia, whereas Leishmania RNA virus 2 (LRV2) was previously thought to be restricted to the Old-World pathogens of the subgenus Leishmania. OBJECTIVES In this study, we investigated the presence of LRV2 in strains of Leishmania (L.) infantum, the causative agent of visceral leishmaniasis (VL), originating from different hosts, clinical forms, and geographical regions. METHODS A total of seventy-one isolates were screened for LRV2 using semi-nested reverse transcription-polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. FINDINGS We detected LRV2 in two L. infantum isolates (CUR268 and HP-EMO) from canine and human cases, respectively. MAIN CONCLUSIONS To the best of our knowledge, this is the first detection of LRV2 in the New World. LRV1 LRV (LRV1 Viannia (LRV2 OldWorld Old World study L (L. VL, VL , (VL) hosts forms regions seventyone seventy one seminested semi nested transcriptionpolymerase transcription RTPCR RT PCR (RT-PCR RNAdependent dependent RdRp (RdRp gene CUR268 CUR (CUR26 HPEMO HP EMO HP-EMO cases respectively knowledge (LRV (L (VL CUR26 (CUR2 CUR2 (CUR

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the ‘Patient Exercise Booklet’ and the ‘Personal Exercise Guide’, to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents ‘Patient Exercise Booklet’ and ‘Personal Exercise Guide’ of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity. (SARAH personalized 12week week 12 RA. . (RA) Patient Booklet Personal Guide, Guide , home CVI. (CVI) semantic idiomatic conceptual equivalences 08 0 8 0.8 49 4 9 4.9 population 1 (RA (CVI 0. 4.

Abstract Background ST-segment elevation myocardial infarction (STEMI) is defined by symptoms accompanied by typical electrocardiogram changes. However, the characterization of ischemic symptoms is unclear, especially in subgroups such as women and the elderly. Objectives To analyze the typification of ischemic symptoms, temporal metrics and observe the occurrence of in-hospital outcomes, in the analysis of predictive scores, in patients with STEMI, in a drug-invasive strategy. Methods Study involving 2,290 patients. Types of predefined clinical presentations: typical pain, atypical pain, dyspnea, syncope. We measured the time between the onset of symptoms and demand for care and the interval between arrival at the medical unit and thrombolysis. Odds-ratios (OR; CI-95%) were estimated in a regression model. ROC curves were constructed for mortality predictors. The adopted significance level (alpha) was 5%. Results Women had a high prevalence of atypical symptoms; longer time between the onset of symptoms and seeking care; delay between arrival at the emergency room and fibrinolysis. Hospital mortality was 5.6%. Risk prediction by Killip-Kimball classification: AUC: [0.77 (0.73-0.81)] in class ≥II. Subgroups studied [OR (CI-95%)]: women [2.06 (1.42-2.99); p=0.01]; chronic renal failure [3.39 (2.13-5.42); p<0.001]; elderly [2.09 (1.37-3.19) p<0.001]; diabetics [1.55 (1.04-2.29); p=0.02]; obese 1.56 [(1.01-2.40); p=0.04]: previous stroke [2.01 (1.02-3.96); p=0.04] correlated with higher mortality rates. Conclusion Despite higher mortality rates in some subgroups, significant disparity persists in women, with delays in symptom recognition and prompt thrombolysis. We highlight the applicability of the Killip-Kimball score in prediction, regardless of the clinical presentation. STsegment ST segment STEMI (STEMI changes However unclear inhospital hospital outcomes scores druginvasive drug invasive strategy 2290 2 290 2,29 presentations pain dyspnea syncope thrombolysis Oddsratios Odds ratios OR (OR CI95% CI95 CI 95% 95 CI-95% model predictors alpha (alpha 5 5% fibrinolysis 56 6 5.6% KillipKimball Killip Kimball classification AUC 0.77 077 0 77 [0.7 0.730.81 073081 0.73 0.81 73 81 (0.73-0.81) II ≥II (CI-95%)] 2.06 206 06 [2.0 1.422.99 142299 1.42 2.99 1 42 99 (1.42-2.99) p=0.01 p001 p 01 p=0.01] 3.39 339 3 39 [3.3 2.135.42 213542 2.13 5.42 13 (2.13-5.42) p<0.001 p0001 001 p<0.001] 2.09 209 09 1.373.19 137319 1.37 3.19 37 19 (1.37-3.19 1.55 155 55 [1.5 1.042.29 104229 1.04 2.29 04 29 (1.04-2.29) p=0.02 p002 02 p=0.02] 156 1.5 1.012.40 101240 1.01 2.40 40 [(1.01-2.40) p=0.04 p004 2.01 201 1.023.96 102396 1.02 3.96 96 (1.02-3.96) presentation 229 2,2 CI9 9 CI-95 5.6 0.7 07 7 [0. 730 0.730.8 07308 073 081 0.8 8 (0.73-0.81 (CI-95%) 2.0 20 [2. 422 1.422.9 14229 142 1.4 299 2.9 4 (1.42-2.99 p=0.0 p00 3.3 33 [3. 135 2.135.4 21354 213 2.1 542 5.4 (2.13-5.42 p<0.00 p000 00 373 1.373.1 13731 137 1.3 319 3.1 (1.37-3.1 15 [1. 042 1.042.2 10422 104 1.0 2.2 (1.04-2.29 1. 012 1.012.4 10124 101 240 2.4 [(1.01-2.40 023 1.023.9 10239 102 396 3.9 (1.02-3.96 22 2, CI-9 5. 0. [0 0.730. 0730 08 (0.73-0.8 (CI-95% 2. [2 1.422. 1422 14 (1.42-2.9 p=0. p0 3. [3 2.135. 2135 21 54 (2.13-5.4 p<0.0 1.373. 1373 31 (1.37-3. [1 1.042. 1042 10 (1.04-2.2 1.012. 1012 24 [(1.01-2.4 1.023. 1023 (1.02-3.9 CI- [ 0.730 (0.73-0. (CI-95 1.422 (1.42-2. p=0 2.135 (2.13-5. p<0. 1.373 (1.37-3 1.042 (1.04-2. 1.012 [(1.01-2. 1.023 (1.02-3. (0.73-0 (CI-9 (1.42-2 p= (2.13-5 p<0 (1.37- (1.04-2 [(1.01-2 (1.02-3 (0.73- (CI- (1.42- (2.13- p< (1.37 (1.04- [(1.01- (1.02- (0.73 (CI (1.42 (2.13 (1.3 (1.04 [(1.01 (1.02 (0.7 (1.4 (2.1 (1. (1.0 [(1.0 (0. (2. (1 [(1. (0 (2 ( [(1 [(

Resumo Fundamento O infarto do miocárdio com elevação do segmento-ST (IAMCSST) é definido por sintomas acompanhados por alterações típicas do eletrocardiograma. Entretanto, a caracterização dos sintomas isquêmicos não é clara, principalmente em subgrupos, como mulheres e idosos. Objetivos Analisar a tipificação dos sintomas isquêmicos, métricas temporais e observar a ocorrência de desfechos intra-hospitalares, em análise dos escores preditivos, em pacientes com IAMCSST, em estratégia fármaco-invasiva. Métodos Estudo envolvendo 2.290 pacientes. Tipos de apresentações clínicas pré-definidas: dor típica, dor atípica, dispnéia, sincope. Medimos o tempo entre o início dos sintomas à demanda pelo atendimento e o intervalo entre a chegada à unidade-médica e trombólise. Odds-ratios (OR; IC-95%) foram estimadas em modelo de regressão. Curvas ROCs foram construídas para preditores de mortalidade. Nível de significância adotado (alfa) foi de 5%. Resultados Mulheres apresentaram alta prevalência de sintomas atípicos; maior tempo entre o início dos sintomas e a procura por atendimento; atraso entre a chegada ao pronto-socorro e a fibrinólise. A mortalidade hospitalar foi de 5,6%. Predição de risco pela classificação Killip-Kimball: AUC: [0,77 (0,73-0,81)] em classe ≥II. Subgrupos estudados [OR (IC-95%)]: mulheres [2,06 (1,42-2,99); p=0,01]; insuficiência renal crônica [3,39 (2,13-5,42); p<0,001]; idosos [2,09 (1,37-3,19) p<0,001]; diabéticos [1,55 (1,04-2,29); p=0,02]; obesos 1,56 [(1,01-2,40); p=0,04]; acidente vascular cerebral prévio [2,01 (1,02-3,96); p=0,04] correlacionaram-se com maiores taxas de mortalidade. Conclusão Apesar das mais altas taxas de mortalidade em alguns subgrupos, disparidade significativa persiste nas mulheres, com atrasos no reconhecimento dos sintomas e trombólise imediata. Destaca-se a aplicabilidade do escore Killip-Kimball na predição, independentemente da apresentação clínica. segmentoST segmento ST IAMCSST (IAMCSST eletrocardiograma Entretanto clara subgrupos intrahospitalares, intrahospitalares intra hospitalares, hospitalares intra-hospitalares preditivos fármacoinvasiva. fármacoinvasiva fármaco invasiva. invasiva fármaco-invasiva 2290 2 290 2.29 prédefinidas pré definidas pré-definidas típica atípica dispnéia sincope unidademédica unidade médica Oddsratios Odds ratios OR (OR IC95% IC95 IC 95% 95 IC-95% regressão alfa (alfa 5 5% atípicos prontosocorro pronto socorro fibrinólise 56 6 5,6% KillipKimball Killip Kimball AUC 0,77 077 0 77 [0,7 0,730,81 073081 0,73 0,81 73 81 (0,73-0,81) II ≥II (IC-95%)] 2,06 206 06 [2,0 1,422,99 142299 1,42 2,99 1 42 99 (1,42-2,99) p=0,01 p001 p 01 p=0,01] 3,39 339 3 39 [3,3 2,135,42 213542 2,13 5,42 13 (2,13-5,42) p<0,001 p0001 001 p<0,001] 2,09 209 09 1,373,19 137319 1,37 3,19 37 19 (1,37-3,19 1,55 155 55 [1,5 1,042,29 104229 1,04 2,29 04 29 (1,04-2,29) p=0,02 p002 02 p=0,02] 156 1,5 1,012,40 101240 1,01 2,40 40 [(1,01-2,40) p=0,04 p004 2,01 201 1,023,96 102396 1,02 3,96 96 (1,02-3,96) correlacionaramse correlacionaram se imediata Destacase Destaca predição clínica 229 2.2 IC9 9 IC-95 5,6 0,7 07 7 [0, 730 0,730,8 07308 073 081 0,8 8 (0,73-0,81 (IC-95%) 2,0 20 [2, 422 1,422,9 14229 142 1,4 299 2,9 4 (1,42-2,99 p=0,0 p00 3,3 33 [3, 135 2,135,4 21354 213 2,1 542 5,4 (2,13-5,42 p<0,00 p000 00 373 1,373,1 13731 137 1,3 319 3,1 (1,37-3,1 15 [1, 042 1,042,2 10422 104 1,0 2,2 (1,04-2,29 1, 012 1,012,4 10124 101 240 2,4 [(1,01-2,40 023 1,023,9 10239 102 396 3,9 (1,02-3,96 22 2. IC-9 5, 0, [0 0,730, 0730 08 (0,73-0,8 (IC-95% 2, [2 1,422, 1422 14 (1,42-2,9 p=0, p0 3, [3 2,135, 2135 21 54 (2,13-5,4 p<0,0 1,373, 1373 31 (1,37-3, [1 1,042, 1042 10 (1,04-2,2 1,012, 1012 24 [(1,01-2,4 1,023, 1023 (1,02-3,9 IC- [ 0,730 (0,73-0, (IC-95 1,422 (1,42-2, p=0 2,135 (2,13-5, p<0, 1,373 (1,37-3 1,042 (1,04-2, 1,012 [(1,01-2, 1,023 (1,02-3, (0,73-0 (IC-9 (1,42-2 p= (2,13-5 p<0 (1,37- (1,04-2 [(1,01-2 (1,02-3 (0,73- (IC- (1,42- (2,13- p< (1,37 (1,04- [(1,01- (1,02- (0,73 (IC (1,42 (2,13 (1,3 (1,04 [(1,01 (1,02 (0,7 (1,4 (2,1 (1, (1,0 [(1,0 (0, (2, (1 [(1, (0 (2 ( [(1 [(

Resumo Objetivo Nosso objetivo é mostrar como a diversidade é vista e como pode ser representada como um conjunto de significados e crenças e esquemas interpretativos dentro de uma teoria do movimento social. Referencial teórico Nosso estudo está fundamentado em teorias de diversidade e de movimentos sociais. Metodologia Por meio de um estudo bibliométrico, analisamos 121 artigos publicados em 89 periódicos da área de gestão e estratégia. Os estudos foram classificados e analisados de acordo com sua distribuição em duas linhas de pesquisa. A primeira linha compreende estudos que correlacionam padrões de diferenças sociais. A segunda linha inclui estudos de diversidade desenvolvidos com base em paradigmas de pesquisa crítica sobre características relacionadas a grupos sociais específicos ou minorias. Resultados Considerando as duas linhas de pesquisa que predominam nos estudos da diversidade humana, elas apresentam focos claramente distintos em relação aos objetivos; esta pesquisa descreveu a configuração das publicações nestas linhas. Propomos quatro proposições de análise organizacional e estudos de estratégia considerando a diversidade como um movimento social. Implicações práticas e sociais da pesquisa Nosso trabalho possui uma implicação teórica, incluindo um novo conceito de organização – e nossa implicação prática é a possibilidade de um caminho inclusivo para a diversidade no contexto organizacional. Contribuições Este trabalho de pesquisa fornece insights informativos sobre o estudo dos movimentos sociais como categoria de diversidade. Também complementa a compreensão da diversidade humana como tema de interesse nos estudos organizacionais. Ele serve como informação útil para melhorar o desenvolvimento dos temas da diversidade no ambiente de trabalho.

Abstract Purpose Our aim is to demonstrate how diversity is seen and how it could be represented as a set of meanings and beliefs and interpretative schemes within a social movement theory. Theoretical framework Our study is grounded in diversity and social movement theories. Design/methodology/approach Through a bibliometric study, we analyzed 121 papers published in 89 journals in the management and strategy field. The studies were classified and analyzed according to their distribution in two lines of research. The first line comprises studies that correlate patterns in social differences. The second line includes diversity studies developed based on critical research paradigms regarding characteristics related to specific social groups or minorities. Findings Considering the two lines of research that predominate in studies of human diversity, which clearly present different focuses in relation to their objectives, this research described the configuration of publications in these lines. We offer four propositions for organizational analysis and strategy studies considering diversity as a social movement. Practical & social implications of research Our work has a theoretical implication by including a new concept of organization and our practical implication lies in the possibilities for an inclusive way to view diversity in the organizational context. Originality/value This research paper provides informative insights in studying social movements as a category of diversity. It also complements the understanding of human diversity as a topic of interest in organization studies. This serves as good information to improve the development of themes of diversity in the workplace.

RESUMO Antecedentes: A Pandemia por COVID-19 tem trazido desafios subtanciais para a prática clínica no tratamento das doenças neuromusculares hereditárias (DNMh). A infecção não tem sido a única preocupação para os pacientes. O distanciamento social tem comprometido a assistência multidisciplinar, atividade física e tem trazido problemas mentais em decorrência do próprio isolamento. Nós apresentamos aqui um seguimento de 363 pacientes com DNMh de um centro terciário Brasileiro durante o pico da Pandemia de Covid-19. Objetivos: Mostrar a frequência e gravidade da infecção por Sars-Cov-2 em pacientes com DNMh e demonstrar os efeitos da pandemia nos hábitos de vida, na progressão da doença e no cuidado multidisciplinary. Métodos Trezentos e sessenta e três pacientes (58% homens and 42% mulheres) foram acompanhados por 3 meses através de 3 teleconsultas durante o pico da Pandemia de Covid-19 no Brasil. Resultados Houve um decréscimo no número de pacientes que faziam terapia física, respiratória e fonoaudiológica. Em muitos pacientes, o apetite (33%) e hábitos do sono (25%) se alteraram. Exercícios físicos e terapias foram interrompidas pela maioria dos pacientes. Physical exercises and therapies were interrupted for most of the patients. Eles relataram piora ou aparecimento de fadiga (17%), dor (17%), retrações (14%), e escoliose (7%). Irritabilidade, mudanças no sono, peso e apetite, sendo principalmente diminuição do apetite e peso foram mais frequentemente encontrados em pacientes que apresentaram piora clinica da doença. Houve uma baixa taxa de contaminação por Covid-19 (0.8%), e todos os pacientes infectado apresentaram quadro clinico leve. Conclusão O isolamento por si só se mostrou protetor na perspectiva de infecção por Covid-19, mas pode desencadear um cenário complexo com mudanças nos hábitos de vida e curso desfavorável da doença de base.

ABSTRACT Background The COVID-19 pandemic has brought substantial challenges for current practices in treating hereditary neuromuscular disorders (hNMDs). However, this infection has not been the only concern for these patients. Social distancing has compromised multidisciplinary assistance and physical activity, and has brought about several mental health issues. We presented a follow-up on 363 patients with hNMDs at a Brazilian tertiary center during the peak of the COVID-19 pandemic. Objective We aimed to show the frequency and severity of SARS-CoV-2 infection among hNMD patients and to demonstrate the effects of the pandemic on life habits, disease progression and multidisciplinary supportive care status. Methods Three hundred and sixty-three patients (58% male and 42% female) were followed for three months through three teleconsultations during the peak of the COVID-19 pandemic in Brazil. Results There were decreases in the numbers of patients who underwent physical, respiratory and speech therapies. For several patients, their appetite (33%) and sleep habits (25%) changed. Physical exercises and therapies were interrupted for most of the patients. They reported new onset/worsening of fatigue (17%), pain (17%), contractions (14%) and scoliosis (7%). Irritability and sleep, weight and appetite changes, and especially diminished appetite and weight loss, were more frequent in the group that reported disease worsening. There was a low COVID-19 contamination rate (0.8%), and all infected patients had a mild presentation. Conclusion The isolation by itself was protective from a COVID-19 infection perspective. However, this isolation might also trigger a complex scenario with life habit changes that are associated with an unfavorable course for the NMD.

RESUMO: Ainda não há consenso sobre qual é o protocolo mais apropriado para a produção in vivo de embriões em ovinos, apesar do crescente conhecimento. Uma abordagem para mitigar a variabilidade de resposta de ovelhas à superovulação (SOV) é iniciar a aplicação de gonadotrofinas em uma condição ovariana favorável. O presente estudo comparou três tratamentos em delineamento do tipo crossover: protocolo de SOV tradicional (TRAD) e “Dia 0” D0 SOV sem (D0-GnRH) ou com GnRH (D0+GnRH). Quinze ovelhas Santa Inês foram superovuladas com 200 mg de FSH em seis doses decrescentes e receberam PGF2α na quinta dose de FSH. As ovelhas foram submetidas a monta natural com carneiros férteis e os embriões colhidos por via cirúrgica. O número de embriões viáveis não diferiu entre os tratamentos (TRAD = 6,0 ± 4,7; D0-GnRH = 3,8 ± 6,4; D0+GnRH = 7,5 ± 6,5). Independentemente do tratamento, ovelhas com folículos ≤ 4 mm na primeira dose de FSH produziram mais embriões viáveis (9,6 ± 6,0; P < 0.05) quando comparadas aos animais que apresentavam folículos > 4 mm no início da SOV (2,9 ± 3,1 embriões viáveis). Os grupos TRAD e D0+GnRH apresentaram menor número de animais com folículos grandes (> 4 mm), no momento da primeira dose de FSH, quando comparados ao grupo D0-GnRH (P < 0,05). Em conclusão, os protocolos TRAD e D0+GnRH induziram uma condição ovariana mais favorável (folículos ≤ 4 mm) para a SOV. No entanto, os três tratamentos apresentaram eficiência semelhante em ovelhas Santa Inês.

ABSTRACT: There is still no consensus regarding the best protocol for in vivo embryo production in sheep despite increasing studies in this area. Moreover, there is variability in the response of ewes to superovulation (SOV). An approach to mitigate this inconsistency is to initiate gonadotropin administration under favorable ovarian conditions. The present study compared three treatments in a crossover design: a traditional SOV protocol (TRAD) and “Day 0” D0 SOV protocol with (D0+GnRH), or without Lecilerin (D0-GnRH). Fifteen Santa Inês ewes received 200 mg of FSH at six decreasing doses and PGF2α with the fifth dose of FSH. They were naturally mated with fertile rams and subjected to surgical embryo collection. The number of viable embryos was similar among the different treatments (TRAD = 6.0 ± 4.7; D0-GnRH = 3.8 ± 6.4; D0+GnRH = 7.5 ± 6.5). Regardless of the treatment method, ewes with follicles ≤ 4 mm, at the first FSH dose, produced more viable embryos (9.6 ± 6.0, P < 0.05) compared to ewes that had follicles > 4 mm at the beginning of the SOV (2.9 ± 3.1, viable embryos). Both the TRAD and D0+GnRH groups had fewer animals with large follicles (> 4 mm) at the first FSH dose than the D0-GnRH group (P < 0.05). In conclusion, both the TRAD and D0+GnRH treatments induced a more favorable ovarian condition (follicles ≤ 4 mm) for adequate SOV; although, all three treatments exhibited similar efficacies in Santa Inês sheep.

RESUMO O ácido indol-3-acético (AIA) é um fitohormônio produzido por muitas espécies de rizobactérias para mediar a colonização de plantas enquanto promove o seu crescimento. O ensaio colorimétrico é amplamente utilizado para analisar a biossíntese de AIA bacteriano por ser uma técnica simples, econômica e rápida. No entanto, a caracterização de partes ou frações de formulações de inoculantes raramente é realizada. Objetivou-se determinar a fração do inoculante que é eficaz em promover o crescimento da planta, se o crescimento de bactérias ou meios pode induzir os fitohormônioss a expandirem a zona radicular da planta e se a bacterização de sementes ou a aplicação foliar pode alterar o crescimento das plantas. As amostras de inóculo (caseiro e comercial) foram obtidas em meio de crescimento Luria-Bertani com e sem triptofano-L e os inoculantes divididos em duas frações: pellet e sobrenadante. Para a quantificação do AIA, a fração pellet foi submetida a tratamento físico (sonicação) e químico (lisozima) isoladamente e combinados. Os níveis de AIA foram avaliados por ensaio colorimétrico e o efeito sobre o crescimento das plantas determinado pela inoculação de plântulas de milho. As formulações caseira e comercial apresentaram padrões distintos, em termos de síntese de AIA. A fração sobrenadante forneceu maiores quantidades de AIA e foi eficaz em melhorar a área radicular. A lisozima foi superior à sonicação na otimização da liberação de AIA de células bacterianas. Não foram observadas diferenças significativas entre inoculação por sementes ou foliar.

ABSTRACT Indole-3-acetic acid (IAA) is a phytohormone produced by many rhizobacterial species to mediate plant colonization while promoting plant growth. The colorimetric assay is widely used to analyze the bacterial IAA biosynthesis because it is a straightforward, cost-effective and fast technique. However, the characterization of parts or fractions of inoculant formulations is rarely performed. This study aimed to determine the fraction of the inoculant that is effective in promoting the plant growth, whether the bacteria or media growth can induce the phytohormones to expand the radicular zone of the plant, and whether the seed bacterization or foliar application can alter the plant growth. The inoculum samples (homemade and commercial) were obtained in a Luria-Bertani growth medium with and without tryptophan-L and the inoculants were divided into two fractions: pellet and supernatant. For the IAA quantification, the pellet fraction was subjected to physical (sonication) and chemical (lysozyme) treatments alone and combined. The IAA levels were evaluated using the colorimetric assay, and the effect on plant growth was determined by the inoculation of maize seedlings. The homemade and commercial formulations showed distinct patterns, in terms of IAA synthesis. The supernatant fraction provided higher amounts of IAA and was effective in improving the root area. Lysozyme was superior to sonication in mediating the release of IAA from bacterial cells. No significant differences were observed between seed or foliar inoculation.

ABSTRACT Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.

ABSTRACT Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

Resumo Fundamento A intervenção coronária percutânea primária é considerada o “padrão-ouro” para reperfusão coronária. Entretanto, quando não disponível, a estratégia fármaco-invasiva é método alternativo, e o eletrocardiograma (ECG) tem sido utilizado para identificar sucesso na reperfusão. Objetivos Nosso estudo teve como objetivo examinar alterações no segmento-ST pós-lise e seu poder de prever a recanalização, usando os escores angiográficos TIMI e blush miocárdio (MBG) como critério de reperfusão ideal. Métodos Foram estudados 2.215 pacientes com infarto agudo do miocárdio com supra-ST submetidos à fibrinólise [(Tenecteplase)-TNK] e encaminhados para angiografia coronária em até 24 h pós-fibrinólise ou imediatamente encaminhados à terapia de resgate. O ECG foi realizado pré-TNK e 60 min-pós. Os pacientes foram categorizados em dois grupos: aqueles com reperfusão ideal (TIMI-3 e MBG-3) e aqueles com reperfusão inadequada (fluxo TIMI <3). Foi definido o critério de reperfusão do ECG pela redução do segmento ST >50%. Consideramos p-valor <0,05 para as análises, com testes bicaudais. Resultados O critério de reperfusão pelo ECG apresentou valor preditivo positivo de 56%; valor preditivo negativo de 66%; sensibilidade de 79%; e especificidade de 40%. Houve fraca correlação positiva entre a redução do segmento-ST e os dados angiográficos de reperfusão ideal (r = 0,21; p <0,001) e baixa precisão diagnóstica, com AUC de 0,60 (IC-95%; 0,57-0,62). Conclusão Em nossos resultados, a redução do segmento-ST não conseguiu identificar com precisão os pacientes com reperfusão angiográfica apropriada. Portanto, mesmo pacientes com reperfusão aparentemente bem-sucedida devem ser encaminhados à angiografia brevemente, a fim de garantir fluxo coronário macro e microvascular adequados.

Abstract Background Primary percutaneous coronary intervention is considered the “gold standard” for coronary reperfusion. However, when not available, the drug-invasive strategy is an alternative method and the electrocardiogram (ECG) has been used to identify reperfusion success. Objectives Our study aimed to assess ST-Segment changes in post-thrombolysis and their power to predict recanalization and using the angiographic scores TIMI-flow and Myocardial Blush Grade (MBG) as an ideal reperfusion criterion. Methods 2,215 patients with ST-Segment Elevation Myocardial Infarction (STEMI) undergoing fibrinolysis [(Tenecteplase)-TNK] and referred to coronary angiography within 24 h post-fibrinolysis or immediately referred to rescue therapy were studied. The ECG was performed pre- and 60 min-post-TNK. The patients were categorized into 2 groups: those with ideal reperfusion (TIMI-3 and MBG-3) and those with inadequate reperfusion (TIMI and MBG <3). The ECG reperfusion criterion was defined by the reduction of the ST-Segment >50%. A p-value <0.05 was considered for the analyses, with bicaudal tests. Results The ECG reperfusion criterion showed a positive predictive value of 56%; negative predictive value of 66%; sensitivity of 79%; and specificity of 40%. There was a weak positive correlation between ST-Segment reduction and ideal reperfusion angiographic data (r = 0.21; p <0.001) and low diagnostic accuracy, with an AUC of 0.60 (95%CI: 0.57-0.62). Conclusion The ST-Segment reduction was not able to accurately identify patients with adequate angiographic reperfusion. Therefore, even patients with apparently successful reperfusion should be referred to angiography soon, to ensure adequate macro and microvascular coronary flow.

Resumo Fundamento De acordo com o pensamento diagnóstico tradicional, indivíduos muito idosos estão mais predispostos a desenvolver sintomas atípicos em síndromes coronarianas agudas. Objetivo Testar a hipótese de que indivíduos muito idosos estão mais predispostos a manifestações de dor torácica atípica devido à doença arterial coronariana obstrutiva (DAC). Métodos O Registro de dor torácica inclui pacientes internados com dor torácica aguda. Primeiramente, foi construído o índice de tipicidade dessa manifestação clínica: a soma de 12 características de sintomas (8 sintomas típicos e 4 sintomas atípicos). No subgrupo de pacientes com etiologia coronariana, o índice de tipicidade foi comparado entre octogenários e não octogenários. A significância estatística foi definida por p<0,05. Resultados 958 pacientes foram incluídos no registro, sendo que 486 (51%) tinham etiologia supostamente coronariana. Nesse grupo, 59 (12%) octogenários (idade 84±3,5; 50% homens) foram comparados a 427 pacientes com idade <80 (60±12 anos; 71% homens). O índice de tipicidade em octogenários foi 3,42±1,92, que é semelhante ao de não octogenários (3,44±1,74; p=0,092 na análise univariada e p=0,80 após ajuste para sexo pela análise de variância — ANOVA). Também não houve diferença estatisticamente significativa quando a amostra foi dividida em idade mediana (62 anos; 3,41±1,77 vs. 3,49 ± 1,77; p=0,61). Não houve associação linear estatisticamente significativa entre idade e índice de tipicidade (r=- 0,05; p=0,24). A análise de regressão logística para predição de DAC na amostra geral de 958 pacientes não mostrou interação do índice de tipicidade com a idade numérica (p=0,94), octogenários (p=0,22) ou idade acima da mediana (p=0,74). Conclusão Em pacientes com dor torácica aguda de etiologia coronariana, a idade avançada não influencia o quadro clínico típico.

Abstract Background According to traditional diagnosis thinking, very elderly individuals are more predisposed to develop atypical symptoms in acute coronary syndromes. Objective To test the hypothesis that very elderly individuals are more predisposed to atypical chest pain manifestations due to obstructive coronary artery disease (CAD). Methods The Registry of Thoracic Pain includes patients admitted with acute chest pain. Firstly, the typicality index of this clinical manifestation was constructed: the sum of 12 symptom characteristics (8 typical and 4 atypical symptoms). In the subgroup of patients with coronary etiology, the typicality index was compared between octogenarian and non-octogenarian individuals. Statistical significance was defined by p<0.05. Results 958 patients were included in the registry, and 486 (51%) had a supposedly coronary etiology. In this group, 59 (12%) octogenarians (age 84±3.5, 50% men) were compared to 427 patients aged <80 (60±12 years, 71% men). The typicality index in octogenarians was 3.42±1.92, which is similar to that of non-octogenarians (3.44±1.74; p=0.92 in univariate analysis and p=0.80 after adjustment for sex by analysis of variance — ANOVA). There was also no statistically significant difference when the sample was divided into median age (62 years; 3.41±1.77 vs. 3.49 ± 1.77; p=0.61). There was no statistically significant linear association between age and typicality index (r=- 0.05; p=0.24). Logistic regression analysis for prediction of CAD in the general sample of 958 patients showed no interaction of typicality index with numeric age (p=0.94), octogenarians (p=0.22) or age above median (p=0.74). Conclusion In patients with acute chest pain of coronary etiology, advanced age does not influence the typical clinical presentation.