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ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

https://doi.org/10.1590/s1677-5538.ibju.2023.0065

Perception of entrepreneurs regarding public policies in fighting Covid-19
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Bezerra, Claudia M. S.

; Ramos, Heidy R.

; Bezerra, Eudes V.

; Teixeira, Marco A. C.

; Magalhães, Marcos F.

RAM. Revista de Administração Mackenzie

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2023, Volume 24 N. 6 elocation eRAMD230068

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Purpose: The research analyzed the perception of entrepreneurs in the cities of São Paulo and São Luis regarding if the public policies implemented during the pandemic were sufficient to face the Covid-19 crisis and how they contributed to the survival of micro, small and medium-sized enterprises (MSMEs), in adverse situations. Originality/value: Faced with the advance of the Covid-19 contagion curve, governments worldwide have adopted measures to contain the disease. Such efforts negatively impacted organizations, especially MSMEs, which are more susceptible to the effects of the crisis. In these situations, the role of the State in promoting public policies to face the crisis is fundamental. It can represent the difference between survival and recovery versus the closure of business activities. Design/methodology/approach: A qualitative research with an exploratory, descriptive approach was developed through an empirical study carried out in two stages, combining the answers of a questionnaire in Google Forms and interviews with 48 entrepreneurs from MSMEs in the cities of São Paulo and São Luís. Content analysis was supported by Atlas.ti software. Findings: Five categories of public policies were created: 1. financial, 2. tributaries, 3. operational, 4. politicians, and 5. health. In adverse situations, government support is essential for the survival and recovery of MSMEs. It was concluded that although the support policies have been considered insufficient by surveyed entrepreneurs, those who managed to gain access reported that they were essential for maintaining the business.

Resumo Objetivo: A pesquisa analisou a percepção dos empreendedores das cidades de São Paulo e São Luís em relação às políticas públicas implementadas durante a pandemia para o enfrentamento da crise da Covid-19 e como elas contribuíram para a sobrevivência das micro, pequenas e médias empresas (MPME) em situações adversas. Originalidade/valor: Ante o avanço da curva de contágio da Covid-19, os governos de todo o mundo adotaram medidas de contenção da doença. Tais medidas trouxeram impactos negativos para as organizações, em especial para as MPME, que são mais suscetíveis aos efeitos da crise. Nessas situações, o papel do Estado na promoção de políticas públicas de enfrentamento da crise é fundamental e pode representar a diferença entre a sobrevivência e recuperação e o encerramento das atividades do negócio. Design/metodologia/abordagem: Uma pesquisa qualitativa com abordagem exploratória de caráter descritivo foi desenvolvida por meio de um estudo empírico realizado em duas etapas, combinando as respostas de um questionário no Google Forms e entrevistas com 48 empreendedores de MPME nas cidades de São Paulo e São Luís. A análise de conteúdo foi apoiada pelo software Atlas.ti. Resultados: Cinco categorias de políticas públicas foram criadas: 1. financeiras, 2. tributárias, 3. operacionais, 4. políticas e 5. de saúde. Em situações adversas, o apoio governamental é fundamental para a sobrevivência e recuperação das MPME. Concluiu-se que, embora as políticas de apoio tenham sido consideradas insuficientes pelos empreendedores pesquisados, aqueles que conseguiram ter acesso relataram que elas foram fundamentais para a manutenção do negócio.

https://doi.org/10.1590/1678-6971/eramd230068.en

Acumulaciones de restos óseos en nidos de carancho (Caracara plancus, Aves, Falconiformes) de la Patagonia Austral. Implicaciones tafonómicas y arqueológicas
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Álvarez, María C.

; Gutiérrez, María A.

; Massigoge, Agustina

; Borrero, Luis A.

; Kaufmann, Cristian A.

; Recofsky, Marcos

; Belardi, Juan B.

Revista del Museo de Antropología

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dec 2022, Volume 15 N. 3 Pages 219 - 234

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Se estudiaron los restos faunísticos no ingeridos recuperados en el interior y bajo un nido de carancho (Caracara plancus) localizado en los niveles aterrazados del interfluvio Coyle-Gallegos con el objetivo general de evaluar su papel como agente tafonómico. El nido fue construido sobre una mata de calafate (Berberis sp.), ubicada en el centro de una concentración de carcasas de guanacos (Lama guanicoe) muertos por estrés invernal en el año 2020. Durante las tareas de campo se describieron y tomaron medidas del nido y se colectó su contenido. En el laboratorio realizamos identificaciones anatómicas y taxonómicas, además de relevar distintas variables tafonómicas. Los resultados indican el predominio de restos de guanaco, seguido por zorrino (Conepatus chinga), liebre (Lepus europaeus) y choique (Rhea pennata). Gran parte de los restos están desarticulados, fracturados y presentan marcas de mamíferos carnívoros. Al considerar los nidos de carancho en el marco de la arqueología regional, se destaca que el mayor potencial de contaminación del registro con los huesos acumulados por caranchos se daría en cañadones y roqueríos. Las observaciones y los resultados de los análisis permiten reconocer la incidencia del carancho como agente formador del registro, lo cual es relevante dado que por la escasa evidencia de su accionar, no suele ser considerado al momento de evaluar las historias tafonómicas de los conjuntos arqueológicos.

Abstract Non-ingested faunal remains recovered inside and under a carancho (Caracara plancus) nest located in the terraced levels of the Coyle-Gallegos interfluve are studied to evaluate its role as a taphonomic agent. The nest was built on a calafate (Berberis sp.) bush, located in the center of a concentration of guanaco (Lama guanicoe) carcasses killed by winter stress in 2020. The nest was described and measured during the fieldwork, and its contents were collected. In the laboratory, anatomical and taxonomic identifications were made, in addition to surveying different taphonomic variables. The results indicate the predominance of guanaco remains, followed by hog-nosed skunk (Conepatus chinga), hare (Lepus europaeus), and lesser rhea (Rhea pennata). Most of the remains are disarticulated and fractured, showing carnivorous mammal marks. When considering the carancho nests in the framework of regional archaeology, it should be noted that the greatest potential for contamination of the record with bones accumulated by caranchos would be in canyons and rocky areas. The observations and the results of the analyses allow us to recognize the incidence of the carancho as a record-forming agent, which is relevant given that, due to the scarce evidence of its action, it is not usually considered when evaluating the taphonomic histories of archaeological assemblages.

https://doi.org/10.31048/1852.4826.v15.n3.37850

Main and moderated effects of multimorbidity and depressive symptoms on cognition
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de Araujo, Jacyra Azevedo Paiva

; Xavier, Érika Fialho Morais

; Rodrigues, Elisângela da Silva

; Machado, Daiane Borges

; Barreto, Marcos E.

; Kanaan, Richard A.

; Barreto, Mauricio L.

; Castro-de-Araujo, Luis Fernando Silva

Brazilian Journal of Psychiatry

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dec 2022, Volume 44 N. 6 Pages 644 - 649

Abstract: En | Text: En | PDF: En

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition. Methods: We used a large (n=2,681) dataset to assess whether depressive symptomatology moderates the effect of multimorbidity on cognition using structural equation modelling. Results: It was found that the more depressive symptoms and chronic conditions, the worse the cognitive performance, and the higher the educational level, the better the cognitive performance. We found a significant but weak (0.009; p = 0.04) moderating effect. Conclusion: We have provided the first estimate of the moderating effect of depression on the relation between multimorbidity and cognition, which was small. Although this moderation has been implied by many previous studies, it was never previously estimated.

https://doi.org/10.47626/1516-4446-2022-2601

[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio Rassi Jr., Anis Moraes Oliveira, Gláucia M. Lemos Correia, Luís Claudio Novaes Ramos Jr., Alberto Hasslocher-Moreno, Alejandro Marcel Luquetti Ostermayer, Alejandro Sousa, Andréa Silvestre de Amato Vincenzo de Paola, Angelo Sobral de Sousa, Antonio Carlos Pinho Ribeiro, Antonio Luiz Correia Filho, Dalmo Moraes de Souza, Dilma do Socorro Cunha-Neto, Edecio J. A. Ramires, Felix Bacal, Fernando Pereira Nunes, Maria do Carmo Martinelli Filho, Martino Ibrahim Scanavacca, Maurício Magalhães Saraiva, Roberto Alves de Oliveira Júnior, Wilson M. Lorga-Filho, Adalberto de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Adriana V. L. Sarabanda, Alvaro Yecê das Neves Pinto, Ana Assis Lopes do Carmo, André Schmidt, André Costa, Andréa Rodrigues da Ianni, Barbara Maria Markman Filho, Brivaldo Eduardo Rochitte, Carlos Thé Macedo, Carolina Mady, Charles Chevillard, Christophe Bittencourt das Virgens, Cláudio Marcelo Nery de Castro, Cleudson De Paoli de Carvalho Britto, Constança Felícia Pisani, Cristiano do Carmo Rassi, Daniela C. Sobral Filho, Dario Rodrigues Almeida, Dirceu A. Bocchi, Edimar T. Mesquita, Evandro de Souza Nogueira Sardinha Mendes, Fernanda Pereira, Francisca Tatiana Sperandio da Silva, Gilberto Marcelo de Lima Peixoto, Giselle Glotz de Lima, Gustavo H. Veloso, Henrique Turin Moreira, Henrique Bellotti Lopes, Hugo Masciarelli Francisco Pinto, Ibraim Pinto Dias, João Carlos Bemfica, João Marcos Silva-Nunes, João Paulo Soares Barreto-Filho, José Augusto Kerr Saraiva, José Francisco Lannes-Vieira, Joseli Menezes Oliveira, Joselina Luzia V. Armaganijan, Luciana Martins, Luiz Cláudio C. Sangenis, Luiz Henrique Barbosa, Marco Paulo Almeida-Santos, Marcos Antônio Simões, Marcos Vinicius Shikanai-Yasuda, Maria Aparecida Vieira Moreira, Maria da Consolação Higuchi, Maria de Lourdes Costa Monteiro, Maria Rita de Cássia Felix Mediano, Mauro Felippe Maia Lima, Mayara T. Oliveira, Maykon Moreira Dias Romano , Minna Nitz, Nadjar de Tarso Jorge Medeiros, Paulo Vieira Alves, Renato Alkmim Teixeira, Ricardo Coury Pedrosa, Roberto Aras, Roque Morais Torres, Rosália dos Santos Povoa, Rui Manoel Rassi, Sérgio Gabriel Salles Xavier, Sérgio Marinho Martins Alves , Silvia B. N. Tavares, Suelene Lima Palmeira, Swamy da Silva Junior, Telêmaco Luiz da Rocha Rodrigues, Thiago Madrini Junior, Vagner Maia da Costa , Veruska Dutra, Walderez

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Publication date: 2022-10-11

Abstract: En Pt

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.

Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;

https://doi.org/10.1590/SciELOPreprints.4820

Perfil clínico-patológico de pacientes con cáncer hepatobiliar en dos hospitales de referencia en Lima, Perú
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Machicado, Claudia

; Guerrero, Harold A.

; Casas, Fresia

; Pajuelo, Monica J.

; Acevedo, Laura

; Samame, Juan Carlos

; Medina, Nicolas

; Machicado, Jorge D.

; Marcos, Luis A.

Revista de Gastroenterología del Perú

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jan 2022, Volume 42 N. 1 Pages 25 - 32

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Objective: The aim of the study was to describe the clinicopathological profile of patients diagnosed with liver, bile ducts or gallbladder cancer. Materials and methods: Between 2006 and 2017, 89 patients (57% female; mean age: 62 years-old) with these cancers were diagnosed at two national hospitals in Lima, Peru. Results: Most patients (64%) had advanced stages of disease. Anemia was more frequent in patients with bile duct and liver cancer and in advanced stages. Hypertension (HTN) was frequent among liver cancer patients (32%). The analysis by age showed that HTN was more frequent in patients over 50 years. Likewise, people under 50 years had more frequent history of previous infections (50%), Hepatitis B (HBV) being the most common. Conclusions: This study describes the baseline clinicopathological characteristics of a malignancy poorly studied in Peru.

RESUMEN Objetivo: El objetivo del estudio fue describir las características clínico-patológicas de individuos diagnosticados de cáncer de hígado, vías biliares o vesícula. Materiales y métodos: Entre el 2006 y 2017, se diagnosticaron 89 pacientes (57% mujeres; media: 62 años) con estos canceres en dos hospitales nacionales de Lima, Perú. Resultados: Los resultados mostraron que, independientemente del tipo de cáncer, 64% de los participantes habían sido diagnosticados en estadios avanzados. La anemia fue más frecuente en los pacientes con cáncer de vías biliares e hígado y en estadios avanzados. Se observó mayor frecuencia (32%) de hipertensión arterial (HTA) en el grupo con cáncer de hígado. El análisis por edad mostró que en los pacientes mayores de 50 años la HTA fue más frecuente. Asimismo, sujetos menores de 50 años reportaron antecedentes de infecciones previas en mayor frecuencia (50%), siendo Hepatitis B (HBV) la más común. Conclusiones: Este estudio describe las características clínico-patológicas de base de una neoplasia poco estudiada en el ámbito nacional.

https://doi.org/10.47892/rgp.2022.421.1380

MOLECULAR NETWORKING-BASED DEREPLICATION OF AMBUIC ACID DERIVATIVES FROM THE MARINE FUNGUS PESTALOTIOPSIS SP. 4A11
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Kellner Filho, Luis C.

; Assis, Rhenner N. A.

; Santos, Aline O. dos

; Targanski, Sabrina K.

; Siqueira, Kátia A.

; Medeiros, Livia S. de

; Angolini, Célio F. F.

; Silva, Felipe M. A. da

; Soares, Marcos A.

; Dias, Gustavo M.

; Silva, Marcio L. A.

; Cunha, Wilson R.

; Pauletti, Patricia M.

; Koolen, Hector H. F.

; Januario, Ana H.

Química Nova

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2022, Volume 45 N. 3 Pages 268 - 274

Abstract: En | Text: En | PDF: En

Ambuic acid (AA) is a highly-modified cyclohexenone and known as a promising inhibitor of quorum sensing in methicillin-resistant Staphylococcus aureus, and is thus a candidate as an antivirulence drug. This molecule is mainly produced by the species of Pestalotiopsis and, since its discovery twenty years ago, only a restricted amount of AA-derivatives have been described. Despite being a promising subject, methods for the analysis of modified AA-analogues via mass spectrometry remain unexplored. In order to adress this question, the marine fungus Pestalotiopsis sp. 4A11 associated with the ascidian Didemnum perlucidum was grown in a solid rice medium and its crude extract was chemically studied. From this extract, AA and 10-hydroxy ambuic acid (10-HAA) were isolated and identified using NMR spectroscopy with the aim of obtaining model compounds for the MS analysis. These served as reference compounds (seeds) to guide the dereplication of other AA-analogues via LC-MS/MS-based molecular networking. Based on the manual interpretation of the fragmentation pathways of the seeds and related compounds observed in the networks, six AA-derivatives were dereplicated in the extract. Furthermore, three analogues with unprecedented chemical formulas were proposed as putative unprecedented AA-derivatives. The fragmentation annotation proposed represents a fast and feasible method for characterizing AA-derivatives.

https://doi.org/10.21577/0100-4042.20170819

Comparison between oil spill images and look-alikes: an evaluation of SAR-derived observations of the 2019 oil spill incident along Brazilian waters
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LENTINI, CARLOS ALESSANDRE D.

; MENDONÇA, LUÍS FELIPE F. DE

; CONCEIÇÃO, MARCOS REINAN A.

; LIMA, ANDRÉ T.C.

; VASCONCELOS, RODRIGO N. DE

; PORSANI, MILTON JOSÉ

Anais da Academia Brasileira de Ciências

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2022, Volume 94 elocation e20211207

Abstract: En | Text: En | PDF: En

Abstract Three SAR-derived observations of dark surface patches along the Northeastern Brazilian coastline by the end of 2019 were misreported in the Brazilian media as oil spill-related. Unfortunately, these observations were misled by false positives or look-alikes. Therefore, this paper aims to technically evaluate these look-alike classes by analyzing image attributes found to be helpful to the identification of ocean targets, including oil spills, rain cells, biofilms, and low wind conditions. We use image augmentation to extend our dataset size and create the probability density function curves. The processing includes image segmentation, optimal attribute extraction, and classification with random forest classifiers. Our results contrast with the open-source oil spill detection system and patch classifier methodology called “RIOSS.” Analysis of the feature probability density functions based on optimal attributes is promising since we could capture most of the false positive targets in the three SAR-reported images in 2019. The only exception was the biofilm slick observed on October 28th, where the RIOSS mistakenly classified this organic patch as a low wind region with oil spots. This pitfall is acceptable at this project stage since we had only five biogenic film samples to train the algorithm.

https://doi.org/10.1590/0001-3765202220211207

Denosumab como tratamiento neoadyuvante del tumor de células gigantes del hueso. Indicaciones, resultados y efectos adversos
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Latorre, Marcos R.

; Albergo, José I.

; Farfalli, Germán L.

; Roitman, Pablo D.

; Plantalech, Luisa

; Ayerza, Miguel A.

; Aponte-Tinao, Luis A.

Medicina (Buenos Aires)

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oct 2021, Volume 81 N. 5 Pages 767 - 773

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Giant cell tumor of bone is an intermediate, locally aggressive and rarely metastasiz ing, primary bone neoplasia. In recent years denosumab emerged as a treatment alternative for this pathology. The objective of this work was to analyze its indications as well as the clinical outcomes, side effects and local recurrence rates in patients diagnosed with giant cell tumor of bone, who received denosumab as neoadjuvant treatment. Between 2010 and 2018, 80 patients with giant cell tumor were analyzed, of whom 14 received deno sumab as a neoadjuvant treatment. The minimum follow-up was 12 months. In 8 patients it was a primary tumor, while 6 showed tumor recurrence. In all cases, clinical improvement was evident. Thirteen patients presented radiographic changes, and 11 showed complete histological response. A local recurrence was evidenced in 6 of 14 patients, and at least one adverse effect related to denosumab (including tumor malignancy) was identified in 7. Despite being a useful tool for treating giant cell tumor, the use of denosumab is associated with a higher rate of local recurrences and is not free of adverse effects.

Resumen El tumor de células gigantes óseo es una neoplasia de agresividad local intermedia, que raramente metastatiza. En los últimos años el denosumab, anticuerpo monoclonal humano, surgió como una alternativa de tratamiento para esta enfermedad, al bloquear el comportamiento lítico tumoral. El objetivo de este trabajo fue determinar sus indicaciones y efectos adversos, analizando también los resultados oncológicos, y las tasas de recurrencia local en pacientes con diagnóstico de tumor de células gigantes óseo que recibieron denosumab como tratamiento neoadyuvante. Entre 2010 y 2018 se analizaron 80 pacientes con tumor de células gigantes, de los cuales 14 recibieron denosumab como tratamiento neoadyuvante. El seguimiento mínimo fue 12 meses. En 8 pacientes se trató de un tumor primario, mientras que 6 fueron pacientes con recidiva tumoral. En todos los casos se evidenció una mejoría clínica. Trece presentaron cambios radiográficos, y 11 respuesta histológica completa. En 6 de 14 pacientes se evidenció una recurrencia local y en 7 se identificó al menos un efecto adverso relacionado con el denosumab (incluyendo una malignización tumoral). A pesar de ser una herramienta útil para el tratamiento del tumor de células gigantes, el uso de denosumab está asociado a mayor tasa de recurrencias locales y no está exento de efectos adversos.

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Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos

; Feitosa Filho, Gilson Soares

; Petriz, João Luiz

; Furtado, Remo Holanda de Mendonça

; Précoma, Dalton Bertolim

; Lemke, Walmor

; Lopes, Renato Delascio

; Timerman, Ari

; Marin Neto, José A.

; Bezerra Neto, Luiz

; Gomes, Bruno Ferraz de Oliveira

; Santos, Eduardo Cavalcanti Lapa

; Piegas, Leopoldo Soares

; Soeiro, Alexandre de Matos

; Negri, Alexandre Jorge de Andrade

; Franci, Andre

; Markman Filho, Brivaldo

; Baccaro, Bruno Mendonça

; Montenegro, Carlos Eduardo Lucena

; Rochitte, Carlos Eduardo

; Barbosa, Carlos José Dornas Gonçalves

; Virgens, Cláudio Marcelo Bittencourt das

; Stefanini, Edson

; Manenti, Euler Roberto Fernandes

; Lima, Felipe Gallego

; Monteiro Júnior, Francisco das Chagas

; Correa Filho, Harry

; Pena, Henrique Patrus Mundim

; Pinto, Ibraim Masciarelli Francisco

; Falcão, João Luiz de Alencar Araripe

; Sena, Joberto Pinheiro

; Peixoto, José Maria

; Souza, Juliana Ascenção de

; Silva, Leonardo Sara da

; Maia, Lilia Nigro

; Ohe, Louis Nakayama

; Baracioli, Luciano Moreira

; Dallan, Luís Alberto de Oliveira

; Dallan, Luis Augusto Palma

; Mattos, Luiz Alberto Piva e

; Bodanese, Luiz Carlos

; Ritt, Luiz Eduardo Fonteles

; Canesin, Manoel Fernandes

; Rivas, Marcelo Bueno da Silva

; Franken, Marcelo

; Magalhães, Marcos José Gomes

; Oliveira Júnior, Múcio Tavares de

; Filgueiras Filho, Nivaldo Menezes

; Dutra, Oscar Pereira

; Coelho, Otávio Rizzi

; Leães, Paulo Ernesto

; Rossi, Paulo Roberto Ferreira

; Soares, Paulo Rogério

; Lemos Neto, Pedro Alves

; Farsky, Pedro Silvio

; Cavalcanti, Rafael Rebêlo C.

; Alves, Renato Jorge

; Kalil, Renato Abdala Karam

; Esporcatte, Roberto

; Marino, Roberto Luiz

; Giraldez, Roberto Rocha Corrêa Veiga

; Meneghelo, Romeu Sérgio

; Lima, Ronaldo de Souza Leão

; Ramos, Rui Fernando

; Falcão, Sandra Nivea dos Reis Saraiva

; Dalçóquio, Talia Falcão

; Lemke, Viviana de Mello Guzzo

; Chalela, William Azem

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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jul 2021, Volume 117 N. 1 Pages 181 - 264

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210180 3052 downloads

11.

The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA

; BACCARO, FABRICIO

; CRONEMBERGER, CECILIA

; HIPÓLITO, JULIANA

; BARROS, CLAUDIA FRANCA

; RODRIGUES, DOMINGOS DE JESUS

; NECKEL-OLIVEIRA, SELVINO

; OVERBECK, GERHARD E.

; DRECHSLER-SANTOS, ELISANDRO RICARDO

; ANJOS, MARCELO RODRIGUES DOS

; FERREGUETTI, ÁTILLA C.

; AKAMA, ALBERTO

; MARTINS, MARLÚCIA BONIFÁCIO

; TOMAS, WALFRIDO MORAES

; SANTOS, SANDRA APARECIDA

; FERREIRA, VANDA LÚCIA

; CUNHA, CATIA NUNES DA

; PENHA, JERRY

; PINHO, JOÃO BATISTA DE

; SALIS, SUZANA MARIA

; DORIA, CAROLINA RODRIGUES DA COSTA

; PILLAR, VALÉRIO D.

; PODGAISKI, LUCIANA R.

; MENIN, MARCELO

; BÍGIO, NARCÍSIO COSTA

; ARAGÓN, SUSAN

; MANZATTO, ANGELO GILBERTO

; VÉLEZ-MARTIN, EDUARDO

; SILVA, ANA CAROLINA BORGES LINS E

; IZZO, THIAGO JUNQUEIRA

; MORTATI, AMANDA FREDERICO

; GIACOMIN, LEANDRO LACERDA

; ALMEIDA, THAÍS ELIAS

; ANDRÉ, THIAGO

; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA

; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA

; MESSIAS, MARILUCE REZENDE

; MARQUES, MARCIA C.M.

; PADIAL, ANDRE ANDRIAN

; MARQUES, RENATO

; BITAR, YOUSZEF O.C.

; SILVEIRA, MARCOS

; MORATO, ELDER FERREIRA

; PAGOTTO, RUBIANI DE CÁSSIA

; STRUSSMANN, CHRISTINE

; MACHADO, RICARDO BOMFIM

; AGUIAR, LUDMILLA MOURA DE SOUZA

; FERNANDES, GERALDO WILSON

; OKI, YUMI

; NOVAIS, SAMUEL

; FERREIRA, GUILHERME BRAGA

; BARBOSA, FLÁVIA RODRIGUES

; OCHOA, ANA C.

; MANGIONE, ANTONIO M.

; GATICA, AILIN

; CARRIZO, MARÍA CELINA

; RETTA, LUCÍA MARTINEZ

; JOFRÉ, LAURA E.

; CASTILLO, LUCIANA L.

; NEME, ANDREA M.

; RUEDA, CARLA

; TOLEDO, JOSÉ JULIO DE

; GRELLE, CARLOS EDUARDO VIVEIROS

; VALE, MARIANA M.

; VIEIRA, MARCUS VINICIUS

; CERQUEIRA, RUI

; HIGASHIKAWA, EMÍLIO MANABU

; MENDONÇA, FERNANDO PEREIRA DE

; GUERREIRO, QUÊZIA LEANDRO DE MOURA

; BANHOS, AUREO

; HERO, JEAN-MARC

; KOBLITZ, RODRIGO

; COLLEVATTI, ROSANE GARCIA

; SILVEIRA, LUÍS FÁBIO

; VASCONCELOS, HERALDO L.

; VIEIRA, CECÍLIA RODRIGUES

; COLLI, GUARINO RINALDI

; CECHIN, SONIA ZANINI

; SANTOS, TIAGO GOMES DOS

; FONTANA, CARLA S.

; JARENKOW, JOÃO A.

; MALABARBA, LUIZ R.

; RUEDA, MARTA P.

; ARAUJO, PUBLIO A.

; PALOMO, LUCAS

; ITURRE, MARTA C.

; BERGALLO, HELENA GODOY

; MAGNUSSON, WILLIAM E.

Anais da Academia Brasileira de Ciências

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2021, Volume 93 N. 2 elocation e20201604

Abstract: En | Text: En | PDF: En

Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.

https://doi.org/10.1590/0001-3765202120201604 1034 downloads

12.

Spontaneous splenic rupture, an unusual presentation of tuberculosis
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Marcos-Ramírez, Edson R.

; Treviño-García, Luis A.

; Téllez-Aguilera, Alejandra

; Molina-Ayala, Max

; Flores-Gutiérrez, Juan P.

; Salinas-Domínguez, Rogelio

; Muñoz Maldonado, Gerardo E.

Cirugía y cirujanos

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2021, Volume 89 Suppl. 1 Pages 1 - 5

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: Spontaneous splenic rupture from tuberculosis (TB) is a very unusual presentation within the wide range of presentations of this infectious disease. Clinical case: A 40-year-old male with a diagnosis of human immunodeficiency virus, begins with fever and pain in the left hypochondrium. A computed tomography scan was performed, showing probable splenic abscesses; suddenly, it begins with hemodynamic deterioration, exacerbation of pain, a surgical exploration was performed, showing spontaneous splenic rupture. Microscopic study of the spleen shows the presence of Mycobacterium tuberculosis. Conclusions: This is yet another presentation of TB, which can become a surgical emergency.

Resumen Introducción: La ruptura esplénica espontánea por tuberculosis es una presentación muy inusual dentro de la amplia gama de presentaciones de esta enfermedad infectocontagiosa. Caso clínico: Masculino de 40 años con diagnóstico de VIH, inicia con fiebre y dolor en hipocondrio izquierdo. Se realiza TAC evidenciando probables abscesos esplénicos; súbitamente comienza con deterioro hemodinámico, agudización del dolor, se realiza exploración quirúrgica evidenciando ruptura esplénica espontánea. Al estudio microscópico del bazo se observa presencia de Mycobacterium Tuberculosis. Conclusiones: Esta es una presentación más de la TB, la cual puede convertirse en una urgencia quirúrgica.

https://doi.org/10.24875/ciru.20000756 15 downloads

13.

Salty Port: Environmental Conflicts Resulting from the Açu Port, Rio de Janeiro state, Brazil
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Vilani, Rodrigo Machado

; Cruz, José Luis Vianna da

; Pedlowski, Marcos A.

Ambiente & Sociedade

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2021, Volume 24 elocation e01901

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo O presente artigo tem por objetivo analisar a dinâmica que marcou a convivência entre diferentes atores no conflito ambiental causado pela salinização de águas superficiais e subterrâneas durante a implantação do Porto do Açu, no município de São João da Barra, que fica localizado na região Norte Fluminense. O trabalho procura demonstrar os vínculos entre este conflito em particular e o perfil dos grandes projetos estabelecidos para ampliar a inserção do Brasil na economia mundial enquanto exportador de produtos primários e semi beneficiados. Do ponto de vista metodológico, o trabalho recorreu a uma metodologia qualitativa baseada em levantamento bibliográfico e documental relativo aos impactos e conflitos ambientais causados pela implantação do Porto do Açu. Os resultados da pesquisa demonstram a importância de que haja um processo decisório transparente, participativo e pautado pela sustentabilidade das ações estatais no planejamento e na implantação de Grandes Projetos de Investimento.

Abstract The aim of this article is to analyze the dynamics that marked the coexistence between different actors in the environmental conflict caused by the salinization of surface and underground waters during the implantation of the Açu Port, in the municipality of São João da Barra, which is located in the Northern Fluminense region. The work seeks to demonstrate the links between this particular conflict and the profile of the major projects established to expand Brazil’s insertion in the world economy as an exporter of primary and semi-benefited products. From a methodological point of view, the work used a qualitative methodology based on a bibliographic and documentary survey related to the environmental impacts and conflicts caused by the Açu Port. The research results demonstrate the importance of having a transparent, participatory decision-making process guided by the sustainability of state actions in the planning and implementation of Large Investment Projects.

Resumen Este artículo tiene como objetivo analizar la dinámica que marcó la convivencia entre diferentes actores en el conflicto ambiental provocado por la salinización de aguas superficiales y subterráneas durante la implantación del Puerto de Açu, en el municipio de São João da Barra, que se ubica en la región Fluminense Norte. El trabajo busca enfatizar los vínculos entre este conflicto particular y el perfil de los grandes proyectos establecidos para expandir la inserción de Brasil en la economía mundial como exportador de productos primarios y semi beneficiados. El trabajo utilizó una metodología cualitativa basada en un relevamiento bibliográfico y documental relacionado con los impactos y conflictos ambientales provocados por la implantación del Puerto de Açu. Los resultados demuestran la importancia de contar con un proceso de toma de decisiones transparente, participativo y guiado por la sostenibilidad de las acciones estatales en la planificación e implementación de Grandes Proyectos de Inversión.

https://doi.org/10.1590/1809-4422asoc20200190r1vu2021l5ao 1 downloads

14.

BIOLOGICAL CONTROL IN LEAF-CUTTING ANTS, Atta sexdens (HYMENOPTERA: FORMICIDAE), USING PATHOGENIC FUNGI
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Mota Filho, Tarcísio Marcos Macedo

; Stefanelli, Luis Eduardo Pontes

; Camargo, Roberto da Silva

; Matos, Carlos Alberto Oliveira de

; Forti, Luiz Carlos

Revista Árvore

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2021, Volume 45 elocation e4516

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O controle químico com iscas tóxicas contendo o ingrediente ativo sulfluramida a 0,3% (p/p) é o principal método de controle de formigas cortadeiras dos gêneros Atta e Acromyrmex. No entanto, desde 2009, quando a sulfluramida foi incluída no Anexo B da Convenção de Estocolmo sobre Poluentes Orgânicos Persistentes, há uma intensa busca por novos métodos que sejam eficientes no controle desses insetos. Dentre os novos métodos, o controle biológico por fungos patogênicos tem mostrado resultados promissores em condições de laboratório. O objetivo deste estudo, dado o contexto apresentado, foi avaliar o potencial dos fungos Beauveria bassiana e Trichoderma harzianum no controle de Atta sexdens. Colônias de A. sexdens foram expostas aos fungos por meio de iscas formuladas fornecidas em câmara de forrageamento, ou de suspensões pulverizadas no jardim de fungos, e tiveram suas alterações comportamentais registradas durante 21 dias. Para ambas as formulações, foram utilizadas concentrações de 10 e 20% (p/p) dos fungos em estudo. Os resultados permitiram concluir que iscas contendo 10 e 20% (p/p) dos fungos B. bassiana e T. harzianum não foram eficientes no controle de colônias de A. sexdens. Por outro lado, a pulverização de suspensões de 20% (p/p) de B. bassiana e 10% e 20% (p/p) de T. harzianum foi eficiente e resultou em 100% de mortalidade das colônias aos 11, 9 e 7 dias após a aplicação, respectivamente. Esses achados indicam que os fungos B. bassiana e T. harzianum são promissores como agentes de controle de colônias de A. sexdens, quando pulverizados sobre o jardim de fungos, embora ainda existam alguns desafios quanto ao seu uso relacionados ao desenvolvimento de tecnologias para a aplicação do patógeno.

ABSTRACT Chemical control using toxic baits containing the active ingredient sulfluramid at 0.3% (w/w) is the main method for controlling leaf-cutting ants of the genera Atta and Acromyrmex. However, since 2009, when sulfluramid was included in Annex B of the Stockholm Convention on Persistent Organic Pollutants, there has been an intense search for new methods that are efficient in controlling these insects. Among said new methods, biological control using pathogenic fungi has shown promising results in laboratory conditions. The objective of this study, given the context presented, was to assess the potential of the fungi Beauveria bassiana and Trichoderma harzianum in controlling Atta sexdens. Colonies of A. sexdens were exposed to the fungi by means of formulated baits provided in a foraging chamber, or of suspensions sprayed on the fungus garden, and had their behavioral changes recorded for 21 days. For both formulations, concentrations of 10 and 20% (w/w) of the fungi being studied were used. The results allowed concluding that baits containing 10 and 20% (w/w) of the fungi B. bassiana and T. harzianum were not efficient in controlling colonies of A sexdens. On the other hand, spraying suspensions of 20% (w/w) of B. bassiana and 10% and 20% (w/w) of T. harzianum was efficient and resulted in 100% mortality of the colonies 11, 9 and 7 days after application, respectively. These findings indicate that the fungi B. bassiana and T. harzianum are promising as agents for the control of A. sexdens colonies, when sprayed on the fungus garden, although there are still some challenges as to their use related to the development of technologies for the application of the pathogen.

https://doi.org/10.1590/1806-908820210000016 254 downloads

15.

Sepsis y choque séptico en los servicios de urgencias de México: estudio multicéntrico de prevalencia puntual
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Gorordo-Delsol, Luis A.

; Merinos-Sánchez, Graciela

; Estrada-Escobar, Ricardo A.

; Medveczky-Ordoñez, Nikolett I.

; Amezcua-Gutiérrez, Marcos A.

; Morales-Segura, Ma. Angélica

; Uribe-Moya, Silvia E.

Gaceta médica de México

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dec 2020, Volume 156 N. 6 Pages 495 - 501

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: Sepsis is one of the main reasons for consultation at emergency departments. Objective: To identify the prevalence of sepsis in emergency departments of Mexico. Method: Cross-sectional study with a 30-day follow-up of patients diagnosed with sepsis or septic shock; demographic variables, management and outcomes were analyzed. Results: In 68 emergency departments analyzed, 2379 patients were attended to, out of whom 307 had sepsis. The prevalence of sepsis was 12.9 %, and overall mortality was 16.93 %, which in the cases of sepsis was 9.39 %, and in those of septic shock, 65.85 %; no significant differences were identified in demographic variables or type of hospital. A significantly higher fluid balance was observed within the first three hours in those patients who died, as well as a lack of adherence to international resuscitation recommendations. Conclusions: A high prevalence of sepsis was found in Mexican emergency departments. Mortality of patients with septic shock was similar and even higher than that internationally reported.

Resumen Introducción: La sepsis es una de las principales causas de consulta en los servicios de urgencias médicas. Objetivo: Identificar la prevalencia de la sepsis en servicios de urgencias médicas de México. Método: Estudio transversal con seguimiento a 30 días de los pacientes con diagnóstico de sepsis o choque séptico; se analizaron las variables demográficas, el manejo y los desenlaces. Resultados: En 68 servicios de urgencias médicas analizados se atendió a 2379 pacientes, de los cuales 307 presentaron sepsis. La prevalencia de la sepsis fue de 12.9 %, con mortalidad global de 16.93 %, que en los casos de sepsis fue de 9.39 % y en los de choque séptico, de 65.85 %; no se identificaron diferencias significativas en las variables demográficas o tipo de hospital. Se observó balance hídrico alto en las primeras tres horas y falta de apego a las recomendaciones internacionales de reanimación superior en los pacientes que fallecieron. Conclusiones: Se encontró alta prevalencia de la sepsis en los servicios de urgencias médicas mexicanos. La mortalidad de los pacientes con choque séptico fue similar e, incluso, mayor a la reportada internacionalmente.

https://doi.org/10.24875/gmm.19005468 1572 downloads

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