Investigating specialized plant metabolites, traditionally referred to as ‘secondary metabolites’ present in leaf extracts of cashew trees (Anacardium occidentale) resistant and susceptible to anthracnose disease was carried out using metabolomics combined with chemometric tools. We used clones of dwarf-cashew with the following variations of characteristics: resistant and healthy (CCP 76, BRS 226, BRS 189), susceptible and healthy (BRS 265), and another clone also susceptible but affected by the disease (BRS 265). The UPLC-QTOF-MSE (ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry) analysis of the leaves of Anacardium clones allowed us to annotate a total of 39 metabolites. The multiple orthogonal partial discriminant analysis of the least-squares (OPLS-DA) allowed twelve metabolites to be potential biomarkers of differentiation among the clones studied. Namely, the triene-(17:3)-anacardic acid found on CCP 76 and BRS 189 clones, respectively, is the main candidate for biomarker of resistance. While catechin, B-type procyanidin isomers, and procyanidin dimer monogallate identified in BRS 265 are significant potential biomarkers of susceptibility.

ABSTRACT COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient.

ABSTRACT Juvenile glaucoma and retinoschisis are rare diseases alone. They occur bilaterally with early onset, resulting in severe visual loss. Juvenile glaucoma is mainly described in males, with high intraocular pressure, and juvenile retinoschisis is characterized by the formation of retinal cysts. This case reports a 16-year-old male patient with progressive visual loss that presents an association of both pathologies, which is an uncommon and severe involvement. After adequate diagnosis and drug treatment, the condition improved and did not require surgical intervention.

RESUMO O glaucoma e a retinosquise juvenis são doenças raras isoladamente. Ocorrem bilateralmente com início precoce, resultando em grave perda visual. O glaucoma juvenil é descrito principalmente no sexo masculino, com pressão intraocular elevada, e a retinosquise juvenil é caracterizada por formação de cistos retinianos. Este caso relata um paciente do sexo masculino de 16 anos com perda visual progressiva que apresentou a associação de ambas as patologias, tratando-se este de um acometimento incomum e grave. Após diagnóstico e tratamento medicamentoso adequado, evoluiu com melhora do quadro, não necessitando de intervenção cirúrgica.

Abstract: This study aimed to compare the use of connective tissue grafts (CTG) and platelet-rich fibrin (PRF) associated with the tunnel technique (TT) for the treatment of multiple gingival recessions (GR). Fourteen patients with multiple bilateral GR [type 1 recession (RT 1)] in the maxillary incisors, canines, and/or premolars were included. The TT was performed on both sides (split-mouth model); CTG (36 GR) was used on one side, and on the other, PRF (36 GR) was used. Clinical parameters, including recession depth (RD), probing depth, clinical attachment level (CAL), and keratinized gingiva thickness/width (GT/KTW), were obtained at baseline and after 1, 3, 6, and 16 months. Lower RD (0.81 ± 0.68 vs. 1.23 ± 0.71 mm) and CAL (2.54 ± 0.63 vs. 2.73 ± 0.82 mm) were observed for CTG compared to PRF after 16 months. Higher GT was obtained for CTG compared to PRF after 3 (1.81 ± 0.56 vs 1.43 ± 0.47 mm) and 6 months (1.67 ± 0.61 vs. 1.38 ± 0.55 mm, p < 0.05). The recession coverage (RC) was higher for CTG (55.42% ± 37.14) in comparison to PRF (29.53% ± 34.08) after 16 months (p < 0.05). Similarly, CTG presented a more complete coverage of the recession (15; 41.66%) than PRF (9; 24.32%). There were no significant differences between the groups in terms of surgery time, postoperative pain, or healing patterns. Greater esthetic satisfaction was obtained with CTG. It was concluded that CTG combined with TT showed clinical and esthetic results superior to those of PRF in multiple GR treatments.

Resumen: Las relaciones familiares son extremadamente importantes en el desarrollo humano y pueden actuar como factores protectores o de riesgo para la emergencia de cogniciones disfuncionales y problemas emocionales y de comportamiento (PEC). El objetivo del presente estudio fue investigar las relaciones entre las percepciones del conflicto y de la afectividad familiares sobre las cogniciones disfuncionales y los PEC de 371 adolescentes de 11 a 16 años, así como el papel mediador de las cogniciones disfuncionales en la relación entre la percepción familiar y los PEC. Los datos se recolectaron en las escuelas de los participantes, utilizando instrumentos de autoinforme. Se realizaron análisis de correlación, de comparación entre grupos y de regresión. La percepción sobre el conflicto familiar tuvo un efecto indirecto y significativo en la mayoría de los PEC, teniendo las cogniciones disfuncionales el papel de mediación parcial. La afectividad familiar tuvo un efecto menos significativo y totalmente mediado por las cogniciones.

Abstract: Family relationships are extremely important for human development and may act as either protective or risk factors for the emergence of dysfunctional cognitions and emotional and behavioral problems (EBP). This study aimed to investigate the relationships between perception of family conflict and affectivity, dysfunctional cognitions, and the EBP of 371 adolescents aged 11 to 16 years, as well as the mediating role played by dysfunctional cognitions in the relationship between family perception and EBP. Data were collected at the participants’ schools using self-report instruments. Analyses of correlation, between-group comparison, and regression were conducted. The perception of family conflict had an indirect and significant effect on most of the EBP, with dysfunctional cognitions presenting a partial mediation role. Family affectivity had a less significant effect on the EBP and was totally mediated by cognition.

Resumo: As relações familiares são de extrema importância no desenvolvimento humano, podendo atuar como fatores de proteção ou de risco para o surgimento de cognições disfuncionais e de problemas emocionais e comportamentais (PEC). O objetivo do presente estudo foi investigar as relações entre a percepção de conflito e de afetividade familiares, as cognições disfuncionais e os PEC de 371 adolescentes de 11 a 16 anos, além do papel mediador das cognições na relação entre a percepção de família e os PEC. Os dados foram coletados nas escolas dos participantes, por meio de instrumentos de autorrelato. Foram conduzidas análises de correlação, de comparação entre grupos e de regressão. A percepção de conflito familiar apresentou efeito indireto e significativo sobre a maioria dos PEC, tendo as cognições disfuncionais papel de mediação parcial. A afetividade familiar apresentou efeito menos significativo e totalmente mediado pelas cognições.

Resumo Pará é o principal estado produtor de cacau do Brasil. Para fornecer uma imagem abrangente da Pegada de Carbono do cacau produzido nas regiões Transamazônica e Xingu do estado do Pará, foi utilizada a metodologia do protocolo Green House Gas para calcular as emissões de gases de efeito estufa, com enfoque no impacto das mudanças climáticas. A Pegada de Carbono foi calculada com base em dados originais coletados nos cultivos de cacau convencional e orgânico nessas regiões. Foram analisadas as etapas de colheita, fermentação e secagem, com coleta de dados em nove fazendas, três de cada tipo de produção agrícola: convencional, orgânica e orgânica-fairtrade. A fruta é colhida manualmente, sendo a casca deixada no campo para fertilização natural, sem compostagem. A pequena quantidade de insumos, como herbicidas, inseticidas e fertilizantes, é usada apenas em fazendas com produção convencional de cacau. Eliminando o uso de fertilizantes nitrogenados e implementando um método eficiente de compostagem sem emissão de metano no ar, a Pegada de Carbono seria de apenas 2,01 kg CO2 eq./kg de cacau, uma redução total de 81%.

Abstract Pará is the main cocoa producing state in Brazil. To provide a comprehensive picture of the carbon cootprint from cocoa production (conventional and organic cultivation systems in Brazilian Trans-Amazon and Xingu regions), the Greenhouse Gas (GHG) Protocol methodology was used to calculate greenhouse gas emissions with a focus on the impact of climate changes. The carbon footprint was calculated based on original data collected in the conventional and organic cocoa cultivation of the Trans-Amazon and Xingu regions in the State of Pará. The harvesting, fermentation and drying steps were analyzed, with data collection in nine farms, three of each type of agricultural production: conventional; organic; and organic-fairtrade. The fruit is harvested manually, the husk is left at the field for natural fertilization without composting. The small amount of inputs, such as herbicides, insecticides and fertilizers, are used only on farms with cocoa conventional production. Eliminating the use of nitrogen fertilizers and implementing an efficient method of composting without the emission of methane in the air, the carbon footprint will be only 2.01 kg CO2 eq./kg cocoa, i.e., total reduction of 81%.

Abstract BRS A502 is an upland rice cultivar with a medium cycle, high resistance to lodging, superior yield potential and grains of excellent industrial and cooking quality. The cultivar is indicated for crop rotation and succession in areas under intensive agriculture in the main field crop regions of Brazil.

RESUMO O melão de São Caetano (Momordica charantia) é um fruto exótico que se adaptou muito bem aos solos do Brasil, podendo ser encontrado em praticamente todas as regiões. Diversas vantagens relacionadas com o consumo desse fruto podem ser reportadas, destacando-se sua atividade antifúngica, redução de índices glicêmicos, e também pelo conteúdo de pigmentos naturais, como o licopeno e o β-caroteno, tornando-o promissor como alimento funcional. Partindo da demanda por alimentos dessa natureza, esta pesquisa objetivou a caracterização biométrica, físico-química, compostos bioativos e capacidade antioxidante da polpa e sementes do melão de São Caetano, coletados na região sudoeste do estado de Goiás. Os frutos foram coletados de plantas localizadas em uma área de vegetação nativa do Campus Rio Verde do Instituto Federal Goiano, e as avaliações ocorreram de outubro de 2020 a abril de 2021. Observou-se elevada variabilidade de dimensões e massas, altas concentrações de flavonoides, taninos, carotenoides, fenólicos totais e capacidade antioxidante. De acordo com os resultados, o melão de São Caetano pode ser utilizado como matéria prima para o desenvolvimento de formulações alimentícias com características funcionais e de fármacos potencialmente eficazes no tratamento de diabetes e de doenças causadas por processos oxidativos.

ABSTRACT The bitter melon (Momordica charantia) is an exotic fruit that has adapted very well to the Brazilian soils, and can be found on practically all regions. Several advantages related to consumption of this fruit can be reported, highlighting its antifungal activity, reduction of glycemic indexes, and also due to the content of natural pigments, such as lycopene and β-carotene, making it promising as a functional food. Based on the demand for foods of this nature, this research aimed at the biometric characterization, physicochemical, bioactive compounds and the pulp and seeds’ antioxidant capacity of bitter melon, collected in the southwest region of Goias. The fruits were collected from plants inside a native vegetation area on Campus Rio Verde at the Instituto Federal Goiano, and the evaluations were carried out from October 2020 to April 2021. The fruits showed high variability in dimensions and weight, high concentrations of flavonoids, tannins, carotenoids, total phenolics and antioxidant capacity. According to results, the bitter melon can be used as a raw material to develop food formulations with functional characteristics and drugs potentially effective in the treatment of diabetes and diseases caused by oxidative processes.

RESUMO Objetivo: avaliar o perfil clínico-epidemiológico, o tratamento e a evolução de pacientes com fraturas do côndilo occipital (FCO) em um dos maiores centros especializados em trauma na América Latina. Método: este é um estudo observacional retrospectivo de FCO identificadas em casos de trauma que foram atendidos no período de Dezembro de 2011 a Dezembro de 2019 pela equipe de trauma de centro de trauma Tipo 3. Resultados: um total de vinte e oito fraturas do côndilo occipital foram identificadas em 26 pacientes. A incidência foi inferior a 0.2% ao ano e mais comum em pacientes do sexo masculino (proporção 4:1) envolvidos em acidentes de trânsito. A idade média foi de 42.08 anos. O Tipo II de Anderson e Montesano e o Tipo 1 de Tuli foram os mais frequentes (67.9% e 89.3%, respectivamente) e nenhum caso teve instabilidades C0C1C2. Todos os pacientes foram tratados com colar cervical por período de 3 a 6 meses. Cerca de 65% dos pacientes apresentaram boa evolução (Escala de Resultados de Glasgow maior ou igual a 4), e a gravidade da lesão cerebral foi o principal determinante para os resultados negativos. Conclusão: os achados deste estudo são similares a dados disponíveis na literatura. O uso de colar cervical para estabilização externa é reforçado para o tratamento de lesões estáveis, mesmo quando bilaterais. A avaliação dos resultados do acompanhamento dos pacientes na amostra estudada pode contribuir com informações úteis para o tratamento de fraturas de côndilo occipital.

ABSTRACT Objective: to evaluate the clinical-epidemiological characteristics, treatment, and evolution of patients with occipital condyle fracture (OCF) at one of the largest referral trauma centers in Latin America. Methods: this was a retrospective observational study of OCF identified from trauma cases admitted between December 2011 and December 2019 by the neurosurgery team at a Type 3 trauma center. Results: a total of twenty-eight occipital condyle fractures were identified in twenty-six patients. The incidence was less than 0.2% per year and more common in male patients (4:1 ratio) involved in traffic accidents. The mean age was 42.08 years. Anderson and Montesano type II and Tuli type 1 were the most frequent (67.9% and 89.3%, respectively) and no case presented C0-C1-C2 instability. All patients were treated with a cervical collar for 3 to 6 months. About 65% of the patients exhibited good progression (Glasgow Outcome Scale equal to 4), and the severity of traumatic brain injury was the main determinant for negative outcomes. Conclusion: the findings of this study are in accordance with available literature data. The use of external stabilization with a cervical collar is reinforced for the treatment of stable lesions, even when these are bilateral. Assessment of the patients’ follow-up results in the studied sample may contribute with useful information for the treatment of occipital condyle fractures.

RESUMO A toxoplasmose ocular pode se manifestar de forma atípica, rara, bilateral e associada à necrose retiniana aguda. É apresentada em pacientes imunossuprimidos, resultando em grave perda visual, se não for solucionada rapidamente. Relata-se um caso atípico de toxoplasmose ocular em paciente diabético, que, em sua internação prévia, já evidenciava aspecto sistêmico, o qual foi elucidado pelo exame clínico oftalmológico e pela anamnese. Além disso, a rotina do setor de uveítes, ao solicitar as sorologias de forma direcionada e criteriosa, foi imprescindível para o diagnóstico da toxoplasmose sistêmica associado à lesão ocular atípica bilateral, mimetizando necrose retiniana aguda com desfecho favorável.

Abstract Ocular toxoplasmosis can present with an atypical, rare, bilateral involvement, and associated with acute retinal necrosis. It occurs in immunosuppressed patients, resulting in severe visual loss, if not quickly solved. We report an atypical case of ocular toxoplasmosis in a diabetic patient, who already showed a systemic aspect in a previous hospitalization, which was elucidated by the ophthalmologic examination and history. In addition, the routine of the uveitis sector requesting serology in a directed and careful way was essential for the diagnosis of systemic toxoplasmosis associated with atypical bilateral ocular lesion, mimicking acute retinal necrosis with good outcome.

Abstract INTRODUCTION: Trypanosoma cruzi infection triggers an inflammatory process with exacerbated production of cytokines that stimulate inflammatory and anti-inflammatory signals, including the efferent anti-inflammatory signal known as the anti-inflammatory cholinergic pathway. Thus, the use of anticholinesterase drugs, such as galantamine, could minimize the inflammatory process caused by this disease. METHODS For the study at 30, 60, and 90 days, 120 Swiss mice were divided into three groups. Each group was subdivided into four subgroups: uninfected/untreated (CTRL), uninfected/treated (GAL), infected/untreated (INF), and infected/treated (GAL/INF). The infected groups were inoculated intraperitoneally with 0.1 ml of mouse blood containing 5 × 104 trypomastigote forms of the T. cruzi QM2 strain. The galantamine-treated groups received 5 mg/kg of galantamine orally, through pipetting. From each subgroup, the parameters of parasitemia, histopathological analysis, butyrylcholinesterase activity (BuChE), and functional study of the colon were evaluated. RESULTS: BuChE performance was observed when AChE was suppressed, with increased activity in the GAL/INF group similar to the INF group on the 30th day post infection, thus corroborating the absence of a significant difference in parasitic curves and histopathological analysis. CONCLUSIONS: The presence of an inflammatory process and nests of amastigotes, as well as evidence of reactivity to ACh and NOR, suggest that galantamine did not interfere with the colonic inflammatory response or even in colonic tissue parasitism at this stage of Chagas disease.

Resumo Os tumores de hipófise representam aproximadamente 15% de todos os tumores cerebrais e dependendo do tamanho, pressionam o quiasma óptico, resultando em comprometimento da função visual que se manifesta como defeitos no campo visual, diminuição da acuidade visual e da visão das cores. O objetivo do presente estudo foi relatar um caso de macroadenoma de hipófise com compressão do quiasma óptico e defeito no campo visual, tratado inicialmente como glaucoma, levando a um diagnóstico e tratamento tardio.

Abstract Pituitary tumors represent approximately 15% of all brain tumors and depending on size, pressure optic chiasma, resulting in impaired visual func-tion that manifests itself as defective in the visual field, decreased acuity visual and color vision. The ob-jetive of the present study was to report a case of pitui-tary macroadenoma with compression of optical chiasma and visual field de-fect, initially treated as glaucoma, leading to a late diagnosis and treatment.

Resumo As drusas de disco óptico (DDO) em crianças são frequentemente confundidas com papiledema, sendo este o principal diagnóstico diferencial. Este artigo relata o caso de uma paciente de 11 anos com DDO, no qual o quadro foi inicialmente diagnosticado como papiledema, e a paciente encaminhada para pulsoterapia. O exame fundoscópico é importante por ser o primeiro exame realizado pelo oftalmologista que é capaz de revelar algumas características das DDO que auxiliarão na diferenciação do papiledema. Nos casos de DDO, o disco óptico apresenta margens mal definidas e bordas elevadas, com vasos na margem da papila bem definidos. O diagnóstico diferencial das DDO em crianças é desafiador e requer conduta e seguimento adequados para evitar iatrogenias.

Abstract In children, optic disc drusen (ODD) are often mistaken for papilledema, this being the prin-cipal differential diagnosis. This report describes the case of an 11-year old patient with ODD, in which the condition was initially diagnosed as papilledema, and the patient referred for pulse therapy. Fundoscopic examination is important because it is the first examination conducted by the ophthalmologist that is capable of revealing some characteristics of ODD that will aid in the differentiation between this disease and papilledema. In cases of ODD, the optic disc presents blurred margins and elevation of the disc borders, with clearly defined vessels at the papilla border. The differential diagnosis of ODD in children is challenging and requires appropriate management and follow-up to avoid iatrogenesis.

Resumo Contexto A redução das dificuldades no aprendizado da técnica cirúrgica levou ao surgimento de ferramentas complementares. Este trabalho descreve a curva de aprendizado dos alunos sujeitos da pesquisa, utilizando um modelo alternativo para a prática de anastomose vascular. Objetivos Avaliar a curva de aprendizado da técnica de anastomose vascular e do desenvolvimento de habilidades manuais a partir da utilização de um modelo experimental de baixo custo. Métodos Este trabalho é um estudo experimental e prospectivo, com a realização de anastomoses vasculares do tipo terminolateral em balões de látex durante cinco fases sucessivas, iniciadas após orientação teórico-prática de uma cirurgiã vascular experiente. Os sujeitos foram seis graduandos do curso de Medicina, do terceiro ao quinto ano, da Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brasil. A interpretação do material coletado acerca da qualidade das anastomoses e do tempo utilizado seguiu a análise de agrupamento. Resultados Houve redução do tempo de realização das anastomoses de todos os alunos, com diferença estatística da fase 1 quando comparada às fases 4 e 5, bem como tendência crescente no índice de qualidade ao longo das fases. Porém, não foi detectada diferença estatística a partir do teste de Friedman, apropriado para dados com nível de mensuração ordinal (escala de 1 a 5 na avaliação da qualidade). Conclusões O modelo de treinamento utilizado foi efetivo para incremento do aprendizado dessa técnica, acreditando-se que amostras de maior tamanho ou com maior número de fases em trabalhos futuros poderiam demonstrar redução do tempo associada a melhora da qualidade da anastomose realizada com significância estatística.

Abstract Background In order to reduce difficulties with learning surgical techniques, supplementary tools for training were developed. This paper describes the learning curve followed by student volunteer research subjects who used an alternative model for practicing vascular anastomosis. Objectives To evaluate the vascular anastomosis technique learning curve and development of manual skills using a low-cost experimental model. Methods Experimental and prospective study using end-to-side vascular anastomosis in latex balloons over five successive phases, initiated after theoretical and practical guidance given by experienced vascular surgeon. The study subjects were six undergraduate medical students from Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil, in their third to fifth years of the course. Cluster analysis was used to interpret the data collected on the quality of anastomoses and the time taken. Results The time taken to perform anastomosis reduced for all students, with statistical differences from phase 1 compared to phases 4 and 5. There was also a trend to increasing scores on the quality index as the phases progressed. However, no statistical differences were detected using the Friedman test, which is appropriate for data measured with ordinal levels (quality was assessed on a scale of 1 to 5). Conclusions It was found that the training model used was effective for increasing learning of this technique. It is believed that future studies with larger samples or a higher number of phases could demonstrate both reduced time and improved quality of the anastomoses performed with statistical significance.