RESUMEN Objetivos. Evaluar la exactitud de gota gruesa (GG) frente a la reacción en cadena de la polimerasa (PCR) cuantitativa para la malaria asociada al embarazo (MAE). Materiales y métodos. Se realizó una revisión sistemática de pruebas diagnósticas en nueve bases de datos. Se evaluó la calidad metodológica con QUADAS. Se estimó sensibilidad, especificidad, cociente de probabilidad positivo (CPP) y negativo (CPN), razón de odds diagnóstica (ORD) y área bajo la curva ROC. Se determinó la heterogeneidad con el estadístico Q de Der Simonian-Laird y la incertidumbre con el porcentaje de peso de cada estudio sobre el resultado global. Resultados. Se incluyeron diez estudios con 5691 gestantes, 1415 placentas y 84 neonatos. En los estudios con nPCR (PCR anidada) y qPCR (PCR cuantitativa) como estándar, los resultados de exactitud diagnóstica fueron estadísticamente similares, con sensibilidad muy baja (50 y 54%, respectivamente), alta especificidad (99% en ambos casos), alto CPP y deficiente CPN. Usando nPCR la OR diagnóstica fue 162 (IC95%=66-401) y el área bajo la curva ROC fue 95%, mientras que con qPCR fueron 231 (IC95%=27-1951) y 78%, respectivamente. Conclusiones. Mediante un protocolo exhaustivo se demostró el bajo desarrollo de investigaciones sobre la exactitud diagnóstica de la GG en MAE. Se demostró que la microscopía tiene un desempeño deficiente para el diagnóstico de infecciones asintomáticas o de baja parasitemia, lo que afianza la importancia de implementar otro tipo de técnicas en el seguimiento y control de las infecciones por malaria en las gestantes, con el fin de lograr el control y posible eliminación de la MAE.

ABSTRACT Objective. To evaluate the accuracy of thick smear (TS) versus quantitative polymerase chain reaction (PCR) for pregnancy-associated malaria (PAM). Materials and methods. We carried out a systematic review of diagnostic tests in nine databases. Methodological quality was evaluated with QUADAS. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the ROC curve were estimated. Heterogeneity was determined with the Der Simonian-Laird Q method and uncertainty with the weighted percentage of each study on the overall result. Results. We included 10 studies with 5691 pregnant women, 1415 placentas and 84 neonates. In the studies with nested PCR (nPCR) and quantitative PCR (qPCR) as the standard, the diagnostic accuracy results were statistically similar, with very low sensitivity (50 and 54%, respectively), high specificity (99% in both cases), high PLR and poor NLR. When nPCR was used, the DOR was 162 (95%CI=66-401) and the area under the ROC curve was 95%, while with qPCR it was 231 (95%CI=27-1951) and 78%, respectively. Conclusions. We demonstrated that research on the diagnostic accuracy of TS in PAM is limited. Microscopy showed poor performance in the diagnosis of asymptomatic or low parasitemia infections, which reinforces the importance of implementing other types of techniques for the follow-up and control of malaria infections in pregnant women, in order to achieve the control and possible elimination of PAM.

ABSTRACT Objective. To evaluate the accuracy of thick smear (TS) versus quantitative polymerase chain reaction (PCR) for pregnancy-associated malaria (PAM). Materials and methods. We carried out a systematic review of diagnostic tests in nine databases. Methodological quality was evaluated with QUADAS. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the ROC curve were estimated. Heterogeneity was determined with the Der Simonian-Laird Q method and uncertainty with the weighted percentage of each study on the overall result. Results. We included 10 studies with 5691 pregnant women, 1415 placentas and 84 neonates. In the studies with nested PCR (nPCR) and quantitative PCR (qPCR) as the standard, the diagnostic accuracy results were statistically similar, with very low sensitivity (50 and 54%, respectively), high specificity (99% in both cases), high PLR and poor NLR. When nPCR was used, the DOR was 162 (95%CI=66-401) and the area under the ROC curve was 95%, while with qPCR it was 231 (95%CI=27-1951) and 78%, respectively. Conclusions. We demonstrated that research on the diagnostic accuracy of TS in PAM is limited. Microscopy showed poor performance in the diagnosis of asymptomatic or low parasitemia infections, which reinforces the importance of implementing other types of techniques for the follow-up and control of malaria infections in pregnant women, in order to achieve the control and possible elimination of PAM.

RESUMEN Objetivos. Evaluar la exactitud de gota gruesa (GG) frente a la reacción en cadena de la polimerasa (PCR) cuantitativa para la malaria asociada al embarazo (MAE). Materiales y métodos. Se realizó una revisión sistemática de pruebas diagnósticas en nueve bases de datos. Se evaluó la calidad metodológica con QUADAS. Se estimó sensibilidad, especificidad, cociente de probabilidad positivo (CPP) y negativo (CPN), razón de odds diagnóstica (ORD) y área bajo la curva ROC. Se determinó la heterogeneidad con el estadístico Q de Der Simonian-Laird y la incertidumbre con el porcentaje de peso de cada estudio sobre el resultado global. Resultados. Se incluyeron diez estudios con 5691 gestantes, 1415 placentas y 84 neonatos. En los estudios con nPCR (PCR anidada) y qPCR (PCR cuantitativa) como estándar, los resultados de exactitud diagnóstica fueron estadísticamente similares, con sensibilidad muy baja (50 y 54%, respectivamente), alta especificidad (99% en ambos casos), alto CPP y deficiente CPN. Usando nPCR la OR diagnóstica fue 162 (IC95%=66-401) y el área bajo la curva ROC fue 95%, mientras que con qPCR fueron 231 (IC95%=27-1951) y 78%, respectivamente. Conclusiones. Mediante un protocolo exhaustivo se demostró el bajo desarrollo de investigaciones sobre la exactitud diagnóstica de la GG en MAE. Se demostró que la microscopía tiene un desempeño deficiente para el diagnóstico de infecciones asintomáticas o de baja parasitemia, lo que afianza la importancia de implementar otro tipo de técnicas en el seguimiento y control de las infecciones por malaria en las gestantes, con el fin de lograr el control y posible eliminación de la MAE.

Abstract Mucopolysaccharidosis (MPS) is a heterogeneous group of rare, chronic, progressive and systemic inherited disorders resulting from deficiency or lack of lysosomal enzymes responsible for the degradation of glycosaminoglycans. Products of nitrosative stress have been previously detected in blood and urine samples of patients with MPS. However, it is unclear whether they are present in the saliva of MPS patients and also if they correlate with salivary parameters such as flow and pH. This study compared the salivary levels of NOX (NO2- + NO3-), nitrite (NO2-), protein (albumin), erythrocyte and leukocyte numbers, as well as the salivary flow rate and pH values of samples obtained from 10 MPS patients and 10 healthy subjects. MPS patients exhibited higher salivary levels of NOX and NO2- when compared to healthy subjects (p < 0.05). Albumin was only detected in six saliva samples of MPS patients and, erythrocytes and leukocytes were detected in 60% and 40% of the MPS patients, respectively. In addition, salivary flow rate and pH averages were statistically lower in this group when compared to healthy samples (p < 0.05). Overall, the data indicates that the salivary levels of NO products can be used in combination with other heath indicators to monitor MPS disorders.

Abstract The environmental and health risks associated with the application of synthetic chemical inputs in agriculture increased the demand for technologies that allow higher performance and quality of vegetable crops by implementing synergistic materials with the principles of sustainability. In this work, the seed coating with the biomass of Dunaliella salina incorporated in a bioplastic film of Manihot esculenta (cassava) was evaluated as an initial growth and secondary compounds stimulator of Coriandrum sativum (coriander) plants. The obtained results demonstrated that the coating stimulated an increase in the germination percentage (28.75%) and also in concentration of bioactive compounds, such as the six-fold increment of caffeic acid (13.33 mg 100 g-1). The carbohydrates, lipids, and proteins present in the microalgae biomass seem to be responsible for these increments once they are known for providing energy to the seedling development and coordinating the secondary metabolites synthesis. As conclusion, we consider the coating with biomass of D. salina an alternative for crop improvement that contributes to the development of sustainable agricultural practices.

Abstract Background The SARS-COV2 pandemic has deeply affected the availability for training and competing for recreational and professional athletes. However, to date, the disease’s course among the athletic population has not been *studied . Objectives To compare the observed and expected rates of hospitalization for COVID-19 and to establish relationships between demographics and sportive characteristics of an athletic sample, and the COVID-19 infection rate. Material and Methods This study uses cross-sectional data sampling through an online questionnaire to collect data from recreational and professional athletes. Based on self-reports, athletes were grouped in COVID-19 and Non-COVID-19 cases. To decrease detection bias for each four patients who reported being hospitalized, one additional virtual patient was added to the sample. The observed rate of hospitalization (ORH) was compared with age expected rate of hospitalization (ERH) from the literature data. A multivariate model (MM) was developed to establish independent relationships between the prevalence of COVID-19 cases and the variables mentioned above. The statistical significance level was defined for a p-value<0.05. Results Answers from 1,701 individuals were analyzed. The COVID-19 group was comprised of 99 (5.8%) individuals, four of whom reported having been hospitalized. ORH and ERH were respectively of 5.0% and 18.1% (p=0.001). In the MM female gender (OR=2.02, 95% CI 1.28 to 3.19), cycling (OR=2.91, 95% CI 1.58 to 5.39), swimming (OR=2.97, 95% CI 1.14 to 7.74), and triathlon (OR=2.10, 95% CI 1.13 to 3.91) were independently associated with a COVID-19 prevalence. Conclusion Self-reported rates of hospitalization for COVID-19 among athletes were much lower than expected. The prevalence of positive cases of COVID-19 was independently higher for cyclists, triathletes, and swimmers than for runners.

Abstract Introduction The China Health Authority alerted the World Health Organization (WHO) of several cases of pneumonia, and the WHO has declared the novel coronavirus (COVID-19) a global pandemic. Mastoidectomy is a high-risk aerosol generating procedure with the potential to expose the surgeon to infectious particles. Objective Aim to develop a low-cost prototype for a barrier device that can be used during mastoidectomy. Methods Describe the steps involved during otological emergency, requiring immediate surgical procedure, in untested patients. The Otorhinolaryngology Surgical Team of Walter Cantídio Hospital developed the barrier for particle dispersion presented here. Results During surgery, the prototype did not compromise visualization of the surgical field and instrumentation. Microscope repositioning was not compromised or limited by tent Instrumentation and instrument pouch under the Microscope-Tent (MT) performed surgery. After surgery, the plastic sheet was removed simply, without requiring strength. Bone dust and irrigation droplets were collected on the tent. Conclusion Our team developed and practiced, in an otologic emergency, a low-cost and reproducible barrier device that can be used in mastoidectomy in COVID-19 patients. Further tests on efficacy may be necessary.

Abstract INTRODUCTION: We aimed to study intraspecific variation in Triatoma costalimai, a potential vector of Chagas disease present in Brazil and Bolivia. METHODS: We analyzed phenotypic (connexivum color patterns, wing morphometrics) and genetic variation (16S mtDNA) of three Brazilian T. costalimai populations. We compared 16S sequences with those of putative Bolivian T. costalimai and its sister species, T. jatai. RESULTS: Brazilian populations had different connexivum color patterns and forewing shapes. A 16S mtDNA haplotype network showed a clear separation of Brazilian T. costalimai from both T. jatai and Bolivian T. costalimai. CONCLUSIONS: We report considerable variability in T. costalimai populations.

Resumen Objetivo: Describir el perfil de publicaciones en malaria asociada al embarazo en el ámbito mundial, con base en los países, tipos y años de estudio, 1925-2018. Metodología: Revisión sistemática de la literatura, mediante el seguimiento de la guía prisma y garantizando la reproducibilidad del protocolo de selección y extracción de variables. Se aplicaron doce estrategias de búsqueda en PubMed, Science Direct, SciELO y Google Scholar. Se realizó síntesis cualitativa mediante frecuencias para el país, año de estudio y tipología de investigación. Resultados: Se tamizaron 3362 publicaciones, de las cuales 617 cumplieron el protocolo. El 81,5 % fueron de África, 9,9 % de Asia y 5,3 % de América. La mayor proporción de publicaciones fue posterior al 2009. El 65,8 % fueron estudios observacionales; el 22,0 %, ensayos clínicos, y los estudios cualitativos, de evaluación económica o evaluación de programas y políticas, fueron menores al 5 %. No se hallaron estudios de pruebas diagnósticas, evaluación de programas o investigaciones cualitativas en América. Conclusión: El perfil de publicaciones evidencia el predominio de la investigación epidemiológica tradicional-positivista y su concentración en África, lo que implica retos para las agendas sanitarias y de investigación en salud pública, pero con mayor necesidad en América.

Abstract Objective: To describe the profile of publications on pregnancy-associated malaria worldwide, based on countries, types and years of study, 1925-2018. Methodology: Systematic review of the literature, by monitoring the PRISMA guide and guaranteeing the reproducibility of the variable selection and extraction protocol. Twelve search strategies were applied in PubMed, Science Direct, SciELO and Google Scholar. Qualitative synthesis was performed using frequencies for the country, year of study and type of research. Results: 3362 publications were screened, of which 617 complied with the protocol. 81.5% were from Africa, 9.9% from Asia and 5.3% from America. The highest proportion of publications was after 2009. 65.8% were observational studies; 22.0%, clinical trials, while qualitative studies, economic evaluation studies or evaluation studies of programs and policies accounted for less than 5%. No studies of diagnostic tests, evaluation of programs or qualitative research were found in America. Conclusion: The profile of publications shows the predominance of traditional-positivist epidemiological research and its concentration in Africa, which implies challenges for health and research agendas in public health, but with greater need in America.

Resumo Objetivo: Descrever o perfil das publicações sobre malária associada à gravidez no âmbito mundial, com base nos países, tipos e anos de estudo, 1925-2018. Metodologia: Revisão sistemática da literatura através do seguimento da recomendação PRISMA e garantindo a reprodutibilidade do protocolo de seleção e extração de variáveis. Foram aplicadas doce estratégias de busca em PubMed, Science Direct, SciELO e Google Scholar. Foi realizada síntese qualitativa através de frequências para o país, ano do estudo e tipologia de pesquisa. Resultados: Foram escolhidas 3362 publicações, das quais 617 cumpriram o protocolo. Um total de 81,5% foi da África, 9,9% da Ásia e 5,3% da América. O maior número proporcional de publicações foi posterior a 2009. Os estudos observacionais registraram 65,8%; os ensaios clínicos 22,0% e os estudos qualitativos, de avaliação econômica ou avaliação de programas e políticas registrados foram menores a 5%. Não foram encontrados estudos de testes diagnósticos, avaliação de programas ou pesquisas qualitativas na América. Conclusão: O perfil das publicações evidencia a predominância da pesquisa epidemiológica positivista tradicional e sua concentração na África, o que representa desafios para as agendas de saúde e de pesquisa em saúde pública, mas com uma necessidade maior na América.

Resumo A agricultura brasileira cada vez mais se consolida como um dos principais produtores mundiais de alimentos. O grande desafio deste ramo é atender a demanda global que segundo a Food and Agriculture Organization, em 2050 será 60% superior a atual. Tal desafio é agravado pelas mudanças de hábitos alimentares, mudanças climáticas e impactos ambientais. Esta pesquisa utilizou como base a Teoria da Dependência de Recursos, a qual parte do princípio que nenhuma organização é capaz de gerar sozinha todos os tipos de recursos que necessita para a sua sobrevivência e crescimento, e, por isso, depende do seu ambiente externo para a obtenção de recursos que viabilizem seu funcionamento. Dessa forma, buscou-se como objetivo geral discutir a dependência de recursos para pesquisa e inovação na agricultura em cinco Fundações de Pesquisa na região sul do Brasil. O estudo desenvolvido tem caráter descritivo e comparativo, com abordagem qualitativa. Para coleta dos dados, foram realizadas entrevistas semiestruturadas com os gestores responsáveis pelas cinco Fundações de Pesquisa selecionadas. Os resultados apontaram que, apesar da existência de linhas de financiamento e incentivos fiscais, ainda existe um predomínio de recursos privados na condução de pesquisas para inovação na agricultura. As fundações pesquisadas contam com mantenedores, os quais são responsáveis por prover os recursos não oriundos do setor público ou das receitas orgânicas da entidade.

Abstract Brazilian agriculture is increasingly consolidating as one of the world’s leading food producers. The major challenge of this branch is to meet global demand for food, which, according to the Food and Agriculture Organization (FAO), will be 60% higher in 2050 than today. This challenge is aggravated by changes in dietary habits, climate change, and environmental impacts. This research was based on the Resource Dependency Theory, which assumes that no organization is capable of generating all the types of resources that it needs for its survival and growth, and therefore depends on its external environment to obtain resources that enable its operation. The general research objective was to discuss the dependence of resources for research and innovation in agriculture in five Research Foundations in the south of Brazil. The study was descriptive and comparative, with a qualitative approach. For data collection, semi-structured interviews were conducted with the managers responsible for the five selected Research Foundations. The results pointed out that, despite the existence of financing lines and fiscal incentives, there is still a predominance of private resources in researching for innovation in agriculture. The researched foundations rely on maintainers, who are responsible for providing resources not coming from the public sector or from the entity’s organic revenues.

Resumen La agricultura brasileña se consolida cada vez más como uno de los principales productores mundiales de alimentos. El gran desafío de este ramo es atender la demanda global que, según la Food and Agriculture Organization, en 2050 será un 60% superior a la actual. Este desafío se ve agravado por los cambios de hábitos alimenticios, cambios climáticos e impactos ambientales. Esta investigación utilizó como base la teoría de la dependencia de recursos, que parte del principio de que ninguna organización es capaz de generar por sí sola todos los tipos de recursos que necesita para su supervivencia y crecimiento y, por eso, depende de su ambiente externo para la obtención de recursos que viabilicen su funcionamiento. De esta forma, se buscó como objetivo general discutir la dependencia de recursos para investigación e innovación en la agricultura en cinco fundaciones de investigación en la región sur de Brasil. El estudio desarrollado tiene carácter descriptivo y comparativo, con abordaje cualitativo. Para la recolección de los datos, se realizaron entrevistas semiestructuradas con los gestores responsables de las cinco fundaciones de investigación seleccionadas. Los resultados indicaron que, a pesar de la existencia de líneas de financiamiento e incentivos fiscales, todavía existe un predominio de recursos privados en la conducción de investigaciones para innovación en la agricultura. Las fundaciones encuestadas cuentan con patrocinadores, que son responsables de proveer los recursos no oriundos del sector público o de los ingresos orgánicos de la entidad.

ABSTRACT Zika virus (ZIKV) clinical presentation and frequency/duration of shedding need further clarification. Symptomatic ZIKV-infected individuals identified in two hospitals in Sao Paulo State, Brazil, were investigated regarding clinical characteristics, shedding in body fluids, and serodynamics. Ninety-four of 235 symptomatic patients (Site A: 58%; Site B: 16%) had Real-Time PCR-confirmed ZIKV infection; fever, headache and gastrointestinal symptoms were less frequent, and rash was more frequent compared to ZIKV-negative patients. Real-Time PCR in serum had worse performance compared to plasma, while urine had the highest sensitivity. Shedding in genital fluids and saliva was rare. IgM positivity was the highest <14 days after the symptoms onset (86%), decreasing >28 days (24%); IgG positivity increased >14 days (96%) remaining positive in 94% of patients >28 days. ZIKV prevalence varied importantly in two neighboring cities during the same transmission season. Urine Real-Time PCR can improve diagnostic sensitivity; serum testing is less useful. Accurate serological tests are needed to improve diagnosis and surveillance.

Resumo O presente artigo discute o resgate das experiências liminares no cotidiano, entendendo esse tipo de experiência como zona de passagem entre um estado e outro, de acordo com Walter Benjamin. Voltamo-nos a pensar sobre o que resta desses momentos de passagem para o sujeito da multidão, o qualquer um que devém todo mundo, nas palavras de Deleuze e Guattari. Lançamos, a partir disso, a possibilidade de um olhar mais aguçado ao cotidiano e uma forma de pensar que tome como modelo a temporalidade própria do limiar: um pensar devagar e por desvio, envolvido pelo tempo da espera e da infância.

Abstract This article discusses the reclaiming of the threshold experiences in daily life, understanding this kind of experience as a zone of transition between one state and another, according to Walter Benjamin. We turn to think about what is left of those moments of passage for the subject of the crowd, that anybody who becomes everybody, to use the words of Deleuze and Guattari. From that, we consider the possibility of a sharper look at the everyday life and a way of thinking that takes the temporality of the threshold as a model: to think slowly and through detours, a thinking involved by a time of waiting and of childhood.

Resumo O cuidado integrado é um modelo cujo diferencial é a presença de uma coordenação de ações assistências realizadas de forma contínua. Seu objetivo é melhorar a qualidade de vida de uma população, principalmente de idosos e de portadores de doenças crônicas. Há muita discussão a respeito dos resultados desse modelo em função das diferentes práticas encontradas. Este artigo se propõe a demonstrar os resultados de um modelo de cuidado integrado, através de uma coorte retrospectiva, pertencente a uma operadora de saúde da cidade do Rio de Janeiro. Neste artigo, os indicadores de desempenho utilizados foram o número de idas a emergência e o número de internações. Foi verificado uma redução em ambos indicadores, contudo há a necessidade de melhorias na metodologia de avaliação para o alcance de resultados mais robustos.

Abstract Integrated care is a model whose differential is the presence of a coordination of actions of health. Its goal is to improve the quality of life of a population, especially the elderly with chronic diseases. There is a many discussion about the results of this model in view of the different practices found. This paper proposes to demonstrate the results of an integrated care model, through a retrospective cohort, belonging to a health care provider in Brasil. The performance indicators used were the number of emergency trips and the number of hospitalizations. There was a reduction in both indicators, however, there is a need for improvements in the evaluation methodology to achieve more robust results.

RESUMO Objetivo: avaliar o papel da idade no risco de complicações pós-operatórias de pacientes submetidas à reconstrução mamária unilateral pós-mastectomia, com ênfase na perda total da reconstrução. Métodos: estudo retrospectivo de pacientes submetidas à reconstrução mamária, cujas variáveis incluídas foram: dados oncológicos e da técnica de reconstrução, complicações pós-operatórias, incluindo perda da reconstrução e complicações da ferida operatória. As pacientes foram divididas de acordo com a classificação da Política Nacional do Idoso e Estatuto do Idoso em dois grupos: jovens (idade <60 anos) e idosas (60 anos ou mais). Também foram agrupadas de acordo com a classificação da Organização Mundial da Saúde: jovens (idade <44 anos); meia-idade (idade 45-59 anos); idosas (idade 60-89 anos) e velhice extrema (90 anos ou mais). A classificação do risco cirúrgico da Sociedade Americana de Anestesiologistas foi aplicada para investigar o papel do estado físico pré-operatório como possível preditor de complicações. Resultados: das 560 pacientes operadas, 94 (16,8%) apresentavam 60 anos ou mais. Observou-se taxa de complicações locais de 49,8%, a maioria, limitadas. As incidências de necrose, infecção e deiscência foram de 15,5%, 10,9% e 9,3%, respectivamente. Pacientes com 60 anos ou mais apresentaram chance de complicação 1,606 vezes maior do que as jovens. Quarenta e cinco (8%) pacientes apresentaram perda da reconstrução e não houve diferença estatisticamente significante na média de idade das pacientes que apresentaram ou não esse desfecho (p=0,321). Conclusão: em pacientes selecionadas, a reconstrução mamária pode ser considerada segura; a maioria das complicações documentadas foi limitada e pode ser tratada conservadoramente.

ABSTRACT Objective: to evaluate the role of age in the risk of postoperative complications in patients submitted to unilateral breast reconstruction after mastectomy, with emphasis on total reconstruction loss. Methods: we conducted a retrospective study of patients submitted to breast reconstruction, whose variables included: oncological and reconstruction data, postoperative complications, including loss of reconstruction and complications of surgical wound. We divided the patients into two groups, according to the classification of the Brazilian National Elderly Policy and the Statute of the Elderly: young (age <60 years) and elderly (60 years or more). We also grouped them according to the World Health Organization classification: young people (age <44 years), middle age (45-59 years); elderly (age 60-89 years) and extreme advanced age (90 years or older). We applied the surgical risk classification of the American Society of Anesthesiologists to investigate the role of the preoperative physical state as a possible predictor of complications. Results: of the 560 patients operated on, 94 (16.8%) were 60 years of age or older. We observed a local complication rate of 49.8%, the majority being self-limited. The incidences of necrosis, infection and dehiscence were 15.5%, 10.9% and 9.3%, respectively. Patients older than 60 years presented a chance of complication 1.606 times greater than the younger ones. Forty-five (8%) patients had loss of the reconstruction; there was no statistically significant difference in the mean age of the patients who presented this result or not (p=0.321). Conclusion: in selected patients, breast reconstruction can be considered safe; most documented complications were limited and could be treated conservatively.

Resumo Pretendemos problematizar arte e loucura, inicialmente discutindo a experiência do pesquisador em relação às imagens do mundo, com o testemunho e a figura do louco e, consequentemente, com o fora que ela evoca. Em seguida nos colocamos diante do muro, situação-limite na qual a loucura enquanto catástrofe e a arte enquanto via poética vêm compor um limiar, ausência que Blanchot transpõe à linguagem para dar a ver outras constelações possíveis, tanto de palavras quanto de seus inomináveis. Por fim, com Walter Benjamin, pomos a história da loucura a contrapelo, e, mergulhados no Ateliê de Escrita do Hospital Psiquiátrico São Pedro, desvelamos que a arte pode, na relação com a loucura, tornar-se a linguagem essencial na perigosa travessia em direção à experiência, transpondo a vivência desse estado assustador para trazer ao mundo outro sentido, reconhecendo outros modos de existência que podem vir a ser outras poéticas de vida.

Abstract We intend to problematize art and madness. We begin by discussing the experience of the researcher in relation to images of the world, to witnessing and to the image of the insane, and then inevitably to the outside they evoke. Subsequently, we stand before a wall, a limit situation in which madness as catastrophe and art as poetics compose a threshold, an absence which Blanchot transposes to language to bring other possible constellations into view, both as words and as their unnamable others. Finally, with Walter Benjamin, we touch upon the grain of the history of madness - immersed in the Writing Workshop at the São Pedro Psychiatric Hospital, in Porto Alegre, Brazil, we reveal that, in relation to madness, art can become the essential language of the perilous passage towards experience, transposing the experience of this horrific state to bring another sense to the world, recognizing other modes of existence which may come to be other poetics of life.

Resumen Nuestra intención es de problematizar el arte y la locura, inicialmente discutiendo la experiencia del investigador en relación con las imágenes del mundo, el testimonio y la figura del loco, y por lo tanto con el afuera que ella evoca. Seguidamente, nos ponemos delante de un muro, una situación extrema en la que la locura como catástrofe y el arte como vía poética componen un umbral, una ausencia que Blanchot transpone en lenguaje para revelar las otras constelaciones posibles tanto como palabras, tanto como innombrables otros. Por último, con Walter Benjamin, ponemos la historia de la locura a contra pelo, y sumergidos en el Taller de escritura del Hospital Psiquiátrico São Pedro de Porto Alegre, Brasil, desvelamos que, en relación con la locura, el arte puede convertirse en el lenguaje esencial de ese peligroso pasaje que nos conduce a la experiencia, que transpone lo vivido en este estado aterrador para dar otro sentido al mundo, reconociendo otros modos de existencia que pueden llegar a ser otras poéticas de vida.

Résumé Nous désirons problématiser l’art et la folie, initialement en discutant l’expérience du chercheur par rapport aux images du monde, avec le témoignage et l’image du fou, et, par conséquent, l’extérieur qu’elle évoque. Puis, on se pose devant le mur, situation extrême dans laquelle la folie comme catastrophe et l’art comme voie poétique composent un seuil viennent à construire un seuil, absence que Blanchot transpose en langage afin de révéler d’autres constellations possibles tant comme des mots, tant comme ses innombrables. Enfin, avec Walter Benjamin, nous prenons l’histoire de la folie à contre-poil, et plongés dans l’Atelier d’écriture de l’Hôpital psychiatrique de São Pedro, à Porto Alegre au Brésil, nous révélons que l’art, par rapport à la folie, peut devenir le langage essentiel de la traversée dangereuse vers l’expérience, en transposant le vécu de cet état terrifiant, afin de donner un autre sens au monde, tout en reconnaissant d’autres modes d’existence qui pourraient devenir d’autres poétiques de vie.

Resumo A desnutrição é uma doença extremamente prevalente em pacientes internados, chegando a acometer 50% deles, 47% dos pacientes cirúrgicos e entre 39 e 73% dos portadores de doença arterial periférica, com grande impacto na morbimortalidade desses pacientes. A desnutrição possui grande relevância no desfecho clínico desses pacientes durante a internação, estando associada a maior incidência de infecções, demora na cicatrização das feridas, diminuição do status de deambulação, maior tempo de internação e mortalidade. Entretanto, o diagnóstico de desnutrição ou risco nutricional desses pacientes tem sido um desafio. A avaliação nutricional subjetiva global revelou-se, até o momento, o padrão ouro como método de triagem de pacientes cirúrgicos internados devido à sua praticidade e acurácia. O objetivo deste trabalho é revisar métodos utilizados na avaliação do estado nutricional e da triagem nutricional de pacientes internados e caracterizar a importância dessa avaliação nos desfechos clínicos dos pacientes com arteriopatias.

Abstract Malnutrition is an extremely common disease among hospitalized patients, with prevalence rates as high as 50% overall, 47% among surgical patients and from 39 to 73% among patients with peripheral arterial disease. It has a major impact on morbidity and mortality among these patients. Malnutrition is very relevant to these patients’ clinical outcomes and is associated with a higher incidence of infections, slower wound healing, lower rates of mobility, longer hospital stays and greater mortality. However, diagnosing malnutrition or nutritional risk in these patients has proven to be a challenge. To date, subjective global nutritional assessment remains the gold standard screening method for use with hospitalized surgical patients because of its practicality and accuracy. The objective of this study is to review methods used for assessment of nutritional status and for nutritional screening of hospitalized patients and determine the importance of these assessments to the clinical outcomes of patients with arteriopathies.