The implementation of the National Literacy Policy (PNA, 2019) generated a series of programs and actions that called into question the Brazilian scientific knowledge developed over the last four decades in the fields of Early Childhood Education and literacy. Starting from this problem, a qualitative and documentary research was conducted, in which, through content analysis, we problematized the way in which the model classes presented in the modules of the ABC in Practice: Pre-Reading Skills Promotion Program of the Science-Based Literacy Course (ABC Course), approach or distance themselves from what has been studied about Early Childhood Education identity in contemporary times, in addition to what is being recommended by current curriculum documents. Through this study, it was possible to conclude that the said course demonstrates lack of knowledge or complete disregard for the current curriculum proposals for Early Childhood Education in Brazil that serve as the basis for the constitution of the educative step in question.

La implementación de la Política Nacional de Alfabetización (PNA, 2019) generó una serie de programas y acciones que pusieron en jaque el conocimiento científico brasileño desarrollado durante las últimas cuatro décadas en los campos de la Educación Infantil y la alfabetización. A partir de este problema, se realizó una investigación cualitativa y documental, en la que a través del análisis de contenido problematizamos la forma en que las clases modelo presentadas en los módulos del ABC en la Práctica: Programa de Promoción de Habilidades Prelectoras del Curso Alfabetización Basada en la Ciencia (Curso ABC), se acercan o se distancian de lo estudiado sobre la identidad de la Educación Infantil en la contemporaneidad, además de lo defendido por los documentos curriculares vigentes. A través de este estudio, fue posible concluir que el referido curso demuestra desconocimiento o total indiferencia por las propuestas curriculares vigentes para la Educación Infantil en Brasil que sirven de base para la constitución de la etapa educativa en cuestión.

A implementação da Política Nacional de Alfabetização (PNA, 2019) gerou uma série de programas e ações que colocaram em xeque o conhecimento científico brasileiro desenvolvido nas últimas quatro décadas nos campos da Educação Infantil e da alfabetização. Partindo dessa problemática, foi realizada uma pesquisa qualitativa e documental, na qual por meio da análise de conteúdo problematizamos a forma como as aulas modelo apresentadas nos módulos do ABC na Prática: Programa de Promoção de Competências Pré-Leitoras, do Curso Alfabetização Baseada na Ciência (Curso ABC), se aproximam ou se distanciam do que tem sido estudado sobre a identidade da Educação Infantil na contemporaneidade, além do que tem sido defendido pelos documentos curriculares vigentes. Através deste estudo foi possível concluir que o referido curso demonstra desconhecimento ou completa desconsideração pelas propostas curriculares vigentes para Educação Infantil no Brasil que servem como base para a constituição da etapa educativa em questão.

Abstract Background Levodopa is the most used and effective medication for motor symptoms of Parkinson disease (PD), its long-term use is associated with the appearance of levodopa-induced dyskinesia (LID). Uric acid (UA) is believed to play an important neuroprotective role in PD. Objective To investigate if serum UA levels are related with the presence of LIDs in PD patients. Also, we investigated the associations among UA levels and clinical features of PD. Methods We enrolled 81 PD patients (dyskinesia = 48; no dyskinesia = 33) in the present study. A blood sample was collected to evaluate serum UA levels, clinical evaluation included the following instruments: Montreal Cognitive Assessment (MoCA), Beck Depression Inventory II (BDI-II), MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Hoehn and Yahr (HY), and the sub-item 4.1 of MDS-UPDRS IV (score ≥ 1). Additional relevant clinical information was obtained by a clinical questionnaire. Results Serum UA levels were lower in the dyskinesia group when compared with the no dyskinesia group. The same result was found in the UA levels of both men and women. The multivariate analysis showed lower uric acid levels were significantly associated with having dyskinesia (odds ratio [OR] = 0.424; 95% confidence interval [CI]: 0.221-0.746; p= 0.005). Additional analysis verified that serum UA levels are inversely correlated with depressive symptoms, disease duration, MDS-UPDRS IV and time spent with dyskinesia. A positive correlation was found with age at onset of PD symptoms. Conclusions The present study provides a possible role of serum UA levels in LID present in PD patients.

Resumo Antecedentes A levodopa é a medicação mais utilizada e eficaz para os sintomas motores da doença de Parkinson (DP); seu uso a longo prazo está associado ao aparecimento de discinesia induzida por levodopa (LID). Acredita-se que o ácido úrico desempenhe um importante papel neuroprotetor na DP. Objetivo Investigar se os níveis séricos de AU estão relacionados com a presença de LID em pacientes com DP. Além disso, investigamos as associações entre os níveis de AU e as características clínicas da DP. Métodos Foram incluídos 81 pacientes com DP (discinesia = 48; sem discinesia = 33) no presente estudo. Uma amostra de sangue foi coletada para avaliar os níveis séricos de AU, a avaliação clínica incluiu os seguintes instrumentos: Avaliação Cognitiva de Montreal (MoCA), Inventário de Depressão de Beck (BDI-II), MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Hoehn and Yahr (HY) e o subitem 4.1 da MDS-UPDRS IV (escore ≥ 1). Informações clínicas relevantes adicionais foram obtidas por meio de um questionário clínico. Resultados Os níveis séricos de AU foram menores no grupo com discinesia quando comparados ao grupo sem discinesia. O mesmo resultado foi encontrado nos níveis de AU de homens e mulheres. A análise multivariada mostrou que níveis mais baixos de ácido úrico foram significativamente associados a ter discinesia (odds ratio [OR] = 0,424; intervalo de confiança (IC) de 95%: 0,221-0,746; p= 0,005). Análises adicionais verificaram que os níveis séricos de AU estão inversamente correlacionados com sintomas depressivos, duração da doença, MDS-UPDRS IV e tempo gasto com discinesia. Uma correlação positiva foi encontrada com a idade de início dos sintomas da DP. Conclusões O presente estudo fornece um possível papel dos níveis séricos de AU na LID presente em pacientes com DP.

RESUMO: A conidiobolomicose apresenta ampla distribuição geográfica, com predominância em regiões tropicais úmidas, afeta várias espécies e apresenta taxa de mortalidade significativa. O gênero Conidiobolus está agora dividido em quatro gêneros: Capillidium, Conidiobolus, Microconidiobolus e Neoconidiobolus. Não há relatos confirmados de infecção por esses fungos em equídeos no Brasil. Relata-se o caso de uma mula com rinite rinofacial causada por Neoconidiobolus lamprauges no Rio de Janeiro, Brasil. A mula apresentava uma massa que semiocluía as narinas bilateralmente, dificuldade respiratória e emagrecimento. O exame histológico de biópsia da massa da narina revelou áreas de necrose multifocais com imagens negativas de hifas fúngicas em meio à reação de Splendore-Hoeppli, circundadas por macrófagos, eosinófilos, neutrófilos e células gigantes multinucleadas. O exame histoquímico metenamina prata de Grocott revelou hifas de parede fina, raramente septadas, com ramificação irregular, grau variável de paralelismo, e diâmetro médio de 12 μm (± 3,63) e dilatações balonosas terminais. O diagnóstico etiológico foi realizado pela associação da imuno-histoquímica e da amplificação do fragmento de DNA de N. lamprauges pela reação em cadeia da polimerase. A conidiobolomicose deve ser incluída no diagnóstico diferencial das causas de rinite em equídeos, principalmente em regiões tropicais.

ABSTRACT: Conidiobolomycosis has a wide distribution, predominantly in humid tropical regions, affecting several species with significant mortality rates. The genus Conidiobolus is now divided into four genera: Capillidium, Conidiobolus, Microconidiobolus, and Neoconidiobolus. There are no confirmed reports of infection by these fungi in Equidae in Brazil. We present a rhinofacial rhinitis caused by Neoconidiobolus lamprauges in a mule from Rio de Janeiro, Brazil. The mule presented bilateral semi-occlusion of the nostrils, difficulty breathing, and weight loss. The histological examination of the nostril biopsied mass revealed multifocal necrotizing areas with nonstained images of fungal hyphae in the Splendore-Hoeppli reaction and surrounded by macrophages, eosinophils, neutrophils, and multinucleated giant cells. The Grocott methenamine silver staining revealed thin-walled, rarely septated, irregular branching hyphae, with a varying diameter of 12 μm (± 3.63 μm), and terminal ballooning dilations. The determining etiology of this rhinitis was based on the hyphae staining by immunohistochemistry and by amplifying the DNA fragment of N. lamprauges by polymerase chain reaction. Conidiobolomycosis should be included in the differential diagnosis of the causes of rhinitis in equids, mainly in tropical regions.

RESUMO: O transtorno de acumulação de animais, principalmente de cães e gatos, é uma questão complexa que ocorre em quase todas as comunidades, sendo necessário o levantamento de dados que contribuam para a compreensão da leptospirose dentro da iniciativa Saúde Única. Com o objetivo de determinar a soroprevalência deLeptospirasp. em cães e gatos provenientes de acumuladores de animais foram utilizados 71 cães e 39 gatos de 33 acumuladores do município de Patos, estado da Paraíba, semiárido do Nordeste brasileiro, utilizando-se o teste de soroaglutinação microscópica (SAM) como teste de diagnóstico. Trinta e oito animais (34,5%; IC 95% = 25,7 - 43,4%) foram sororreativos, sendo 46,5% em cães e 12,8% em gatos (P < 0,01), com maior frequência do sorogrupo Icterohaemorrhagiae em ambas as espécies. A alta soroprevalência encontrada sugere a necessidade de políticas públicas para esta população vulnerável no sentido de prevenir a transmissão de zoonoses.

ABSTRACT: Animal hoarding disorder, especially dogs and cats, is a complex issue that occurs in almost all communities, and it is necessary to collect data that contribute to the understanding of leptospirosis within the One Health initiative. In order to determine the seroprevalence of Leptospirasp., 71 dogs and 39 cats from 33 people with animal hoarding profile in the municipality of Patos, state of Paraíba, semi-arid region of Northeastern Brazil were evaluated by using the microscopic serum agglutination test (MAT) as diagnostic test. Thirty-eight animals (34.5%; 95% CI = 25.7 - 43.4%) were seroreactive, with 46.5% in dogs and 12.8% in cats (P < 0.01), with the highest frequency of the Icterohaemorrhagiae serogroup in both species. The high seroprevalence reported suggests the need for public policies for this vulnerable population in order to prevent the transmission of zoonoses.

Abstract Background The many combinations of chemotherapeutic agents and biologicals available in the Brazilian National Health System for the treatment of metastatic breast cancer require analysis that contribute to decision making. Objective The study’s primary aim was to evaluate the first-line treatment of HER2- overexpressing metastatic breast cancer from the Brazilian Unified Health System perspective using multicriteria decision analysis (MCDA). Method The treatment options evaluated were (a) pertuzumab combined with trastuzumab and docetaxel, and (b) trastuzumab in combination with docetaxel. Using the hierarchical analytical method, medical oncologists compared the relevance of five predefined criteria: overall survival, response to treatment, adverse events, cost- effectiveness, and budget impact. Results The therapeutic scheme considered more appropriate by the model was pertuzumab combined with trastuzumab and docetaxel. The most sensitive criteria were adverse events, cost-effectiveness, and budget impact. The results suggest that the classification has a close relationship with the perspective of healthcare professionals participating in the questionnaire. Conclusion Defining the treatment of an incurable disease associated with a short survival time and high-cost treatment options necessitates complex decision-making. MCDA allows the weighting of criteria and considering criteria that would be difficult to measure in other methods, such as cost-effectiveness. These aspects differ from economic models and contribute to a broader evaluation of health decision-making.

Resumo Introdução As diversas combinações de agentes quimioterápicos e biológicos disponíveis no Sistema Único de Saúde brasileiro para o tratamento do câncer de mama metastático requerem análises que contribuam para a tomada de decisões. Objetivo O objetivo principal deste estudo foi avaliar o tratamento de primeira linha para câncer de mama metastático HER2 hiperexpresso sob a perspectiva do Sistema Único de Saúde, utilizando a análise de decisão multicritérios (MCDA). Método As opções de tratamento avaliadas foram: (a) pertuzumabe em combinação com trastuzumabe e docetaxel, e (b) trastuzumabe em combinação com docetaxel. Usando o método analítico hierárquico, médicos oncologistas compararam a relevância dos cinco critérios predefinidos: sobrevida global, resposta ao tratamento, eventos adversos, custo-efetividade e impacto orçamentário. Resultados O esquema terapêutico considerado mais apropriado pelo modelo foi pertuzumabe em combinação com trastuzumabe e docetaxel. Os critérios mais sensíveis foram eventos adversos, custo-efetividade e impacto orçamentário. Os resultados sugerem que a classificação está associada à perspectiva do profissional de saúde participante do questionário. Conclusão Definir o tratamento de uma doença incurável associada a um tempo de sobrevida curto e opções de tratamento de alto custo requer uma tomada de decisão complexa. O MCDA permite ponderar e considerar critérios que seriam difíceis de medir em outros modelos de decisão. Esses aspectos contribuem para uma avaliação mais ampla da tomada de decisões em saúde.

Abstract Lotic environments are subjected to the impacts of human activities in an intense way in urban regions and one of the ways to assist in the environmental diagnosis is through the knowledge of the composition of bioindicator organisms, including microalgae. The objective of this work was to qualitatively characterize the Chlorophyceae Class Wille, providing descriptions and meristic data of the specimens as well as the environmental conditions in which the taxa were recorded. Water and phytoplankton samplings were carried out quarterly in 2020, in nine supply rivers, distributed in three river basins in the western region of Paraná (Paraná III basin, Piquiri basin and Baixo Iguaçu basin). The studied rivers were classified as oligotrophic or mesotrophic and the taxa were mostly rare. Thirty-six taxa belonging to the Chlorophyceae class were recorded, distributed in five families: Hydrodictyaceae Dumortier, Neochloridaceae Ettl & Komárek, Radiococcaceae Fott ex P.C.Silva, Scenedesmaceae Oltmanns, Selenastraceae Blackman & Tansley. These taxa have mainly cenobial representatives, with about 70% of the individuals in this thallus configuration, followed by 22% colonies and 8% unicellular thallus. Among the identified species, five occurred only in mesotrophic sites, warning for environments with tendencies to elevate their trophic, since they are genera previously associated with these conditions. Ten new citations were recorded for the State of Paraná, namely: Pseudopediastrum boryanum var. longicorne (Reinsch) P.M.Tsarenko, Radiococcus skujae I.Kostikov, T.Darienko, A.Lukesová & L.Hoffmann, Desmodesmus perforatus (Lemmermann) E.Hegewald, Desmodesmus subspicatus (Chodat) E.Hegewald & A.W.F.Schmidt, Scenedesmus indicus Philipose ex Hegewald, Engelberg & Paschma, Ankistrodesmus bernardii Komárek, Monoraphidium capricornutum (Printz) Nygaard, Monoraphidium caribeum Hindák, Raphidocelis danubiana var. elegans (Playfair) Taşkin & Alp, Selenastrum rinoi Komárek & Comas. Taxonomic studies, such as this one, are an important tool for understanding the flora, and in addition to contributing to the registration of species in aquatic ecosystems, they serve as a basis for ecological studies and other approaches used to preserve biodiversity in these places.

Resumo Ambientes lóticos são ecossistemas muito vulneráveis aos impactos das atividades humanas, especialmente em regiões urbanas, e uma das formas para auxiliar no diagnóstico ambiental é utilizando o conhecimento da composição dos organismos bioindicadores, dentre eles as microalgas. O objetivo foi caracterizar qualitativamente as microalgas enquadradas na Classe Chlorophyceae Wille, fornecendo descrições e dados merísticos dos espécimes bem como as condições ambientais em que os táxons foram registrados. Foram realizadas amostragens de água e de fitoplâncton trimestralmente no ano de 2020, em nove rios de abastecimento, distribuídos em três bacias hidrográficas da região oeste do Paraná (bacia do Paraná III, bacia do Piquiri e bacia do Baixo Iguaçu). Os rios estudados foram enquadrados como oligotróficos ou mesotróficos e os táxons apresentaram em sua maioria ocorrência rara. Foram registrados 36 táxons pertencentes a classe Chlorophyceae distribuídos em cinco famílias: Hydrodictyaceae Dumortier, Neochloridaceae Ettl & Komárek, Radiococcaceae Fott ex P.C.Silva, Scenedesmaceae Oltmanns, Selenastraceae Blackman & Tansley. Esses táxons possuem representantes principalmente cenobiais, apresentando cerca de 70% dos indivíduos nessa configuração de talo, seguido por 22% de colônias e 8% de talos unicelulares. Entre as espécies identificadas, cinco ocorreram somente em locais mesotróficos, advertindo para ambientes com tendências a elevar sua trofia, visto que são gêneros já associados anteriormente a essas condições. Foram registradas 10 novas citações para o Estado do Paraná, sendo estas: Pseudopediastrum boryanum var. longicorne (Reinsch) P.M.Tsarenko, Radiococcus skujae I.Kostikov, T.Darienko, A.Lukesová & L.Hoffmann, Desmodesmus perforatus (Lemmermann) E.Hegewald, Desmodesmus subspicatus (Chodat) E.Hegewald & A.W.F.Schmidt, Scenedesmus indicus Philipose ex Hegewald, Engelberg & Paschma, Ankistrodesmus bernardii Komárek, Monoraphidium capricornutum (Printz) Nygaard, Monoraphidium caribeum Hindák, Raphidocelis danubiana var. elegans (Playfair) Taşkin & Alp, Selenastrum rinoi Komárek & Comas. Trabalhos taxonômicos, como este, são uma importante ferramenta para o conhecimento da flora, e além de contribuir no registro das espécies nos ecossitemas aquáticos, servem como base para estudos ecológicos e demais abordagens utilizadas na preservação da biodiversidade nesses locais.

RESUMEN Objetivo. Evaluar los conocimientos sobre alimentación saludable (AS) de los estudiantes del área de la salud y los factores asociados al entorno universitario. Materiales y métodos. Se trata de un estudio transversal con 512 estudiantes universitarios (≥ 18 años) matriculados en nueve carreras de grado en salud. Se llevó a cabo de abril a noviembre de 2017. Se aplicaron el Instrumento Evaluativo de la promoción de la salud en la universidad y el Cuestionario Internacional de Actividad Física. Además, se midió el peso, talla y perímetro abdominal. Se realizaron análisis bivariados y multivariados utilizando SPSS versión 23.0. Resultados. Se encontró que la mayoría de los estudiantes universitarios de las nueve carreras de salud tenían conocimientos insuficientes sobre alimentación saludable (71,9%; n=368). Sin embargo, la mayor proporción de estudiantes con conocimientos suficientes se encontraron en el área de nutrición (15,3%; n=22), seguidos de aquellos del área de educación física (12,5%; n=18). El menor porcentaje de estudiantes con conocimientos suficientes se encontró en la carrera de medicina (8,3%; n=12). En el análisis multivariado se evidenció que el conocimiento suficiente sobre alimentación saludable estaba relacionado con la participación en actividades de alimentación saludable (p=0,012; RP=1,94), participación en actividades que aborden la autoestima y el autoconocimiento (p=0,046; RP=0,59) y con tener exceso de peso (p=0,036; RP=1,53). Conclusión. Se evidenció un bajo porcentaje de estudiantes de salud con conocimientos suficientes sobre alimentación saludable. Sin embargo, la participación en actividades de alimentación saludable, autoestima y autoconocimiento en la universidad logró mejorar el nivel de conocimiento. Se recomienda el desarrollo de proyectos universitarios que abarquen la tríada psicológica, alimentaria y corporal, involucrando así todas las carreras de salud, con el objetivo de mejorar la salud y la calidad de vida de los universitarios.

ABSTRACT Objective. To assess the healthy eating (HE) knowledge of health students and the factors associated with the university environment. Materials and methods. This was a cross-sectional study of 512 university students (≥ 18 years) enrolled in nine undergraduate health careers. It was conducted from April to November 2017. The Instrument for Assessment of Health Promotion in Universities and the International Physical Activity Questionnaire were used. In addition, we measured weight, height and waist circumference. Bivariate and multivariate analyses were carried out with SPSS version 23.0. Results. We found that most university students from the nine health careers had insufficient knowledge about healthy eating (71.9%; n=368). However, the highest proportion of students with sufficient knowledge was found in the career of nutrition (15.3%; n=22), followed by those in the physical education career (12.5%; n=18). The lowest percentage of students with sufficient knowledge was found in the career of medicine (8.3%; n=12). Multivariate analysis showed that sufficient knowledge about healthy eating was related to participation in healthy eating activities (p=0.012; PR=1.94), participation in activities addressing self-esteem and self-knowledge (p=0.046; PR=0.59) and being overweight (p=0.036; PR=1.53). Conclusion. A low percentage of health students had sufficient knowledge about healthy eating. However, participation in healthy eating, self-esteem and self-knowledge activities at the university managed to improve the level of knowledge. We recommend the development of university projects that include the psychological, food and body triad, thus involving all health careers, with the aim of improving the health and quality of life of university students.

Abstract Background Depression is an important nonmotor symptom of Parkinson's disease (PD) and has been associated with the motor symptoms in these individuals. Objectives To determine whether there are relationships between depressive symptoms and abnormalities in axial postural alignment and axial motor deficits, especially postural instability, and trunk rigidity in PD. Methods In this cross-sectional study, 65 individuals were evaluated using the Beck Depression Inventory-II (BDI-II) for the analysis of depressive symptoms and underwent a postural assessment of head, trunk, and hip sagittal alignment through computerized photogrammetry. The MDS-UPDRS was used to assess clinical aspects of PD, the Trunk Mobility Scale was used to assess axial rigidity, and the MiniBESTest to assess balance. To determine the relationship between depressive symptoms and postural alignment, multiple linear regression analysis was performed. Results The participants with depressive symptoms had more severe motor deficits as well as greater trunk rigidity and worse postural instability (p < 0.05). When the postural angles were compared between men and women using Student's t-test, it was found that men had greater flexion angles of the head (p = 0.003) and trunk (p = 0.017). Using multiple linear regression analysis corrected for the age and sex of the participants, we verified that the anterior trunk inclination was significantly larger in the PD population with depressive symptoms (R2 = 0.453, β = 0.116, and p = 0.045). Conclusion PD individuals with depressive symptoms have more severe flexed trunk posture, mainly in older men. Additionally, more severe depressive symptoms are associated with worsening postural instability, trunk rigidity and motor deficits in this population.

Resumo Antecedentes A depressão é um sintoma não motor importante da doença de Parkinson (DP) e tem sido associada aos sintomas motores nesses indivíduos. Objetivos Determinar se existem relações entre sintomas depressivos e anormalidades no alinhamento postural axial e déficits motores axiais, especialmente instabilidade postural e rigidez de tronco na DP. Métodos Neste estudo transversal, 65 indivíduos foram avaliados pelo BDI-II para análise de sintomas depressivos e submetidos à avaliação postural do alinhamento sagital de cabeça, tronco e quadril por meio de fotogrametria computadorizada. A MDS-UPDRS avaliou os aspectos clínicos, TMS avaliou rigidez axial e o MiniBESTest equilíbrio. Para determinar a relação entre sintomas depressivos e alinhamento postural, realizou-se uma análise de regressão linear múltipla. Resultados Os participantes com sintomas depressivos apresentaram déficits motores mais graves, bem como maior rigidez de tronco e pior instabilidade postural (p < 0,05). Quando comparados os ângulos posturais entre homens e mulheres pelo teste t de Student, verificou-se que os homens apresentaram maiores graus de flexão da cabeça (p = 0,003) e do tronco (p = 0,017). Por meio da análise de regressão linear múltipla corrigida para a idade e sexo dos participantes, verificamos que a inclinação anterior do tronco foi significativamente maior nos indivíduos com DP com sintomas depressivos do que sem sintomas depressivos (R2 = 0,453, β = 0,116 e p = 0,045) Conclusão Indivíduos com DP com sintomas depressivos apresentam postura de tronco flexionado mais severa, principalmente em homens mais idosos. Além disso, os sintomas depressivos mais graves pioram significativamente a instabilidade postural, a rigidez do tronco e os déficits motores nessa população.

RESUMO Objetivo: Avaliar a síndrome do doente eutireóideo como fator prognóstico em pacientes na unidade de terapia intensiva, detectar fatores que possam influenciar a mortalidade e desenvolver uma equação para calcular a probabilidade de morte. Métodos: Este foi um estudo de coorte longitudinal, observacional e não concorrente realizado na unidade de terapia intensiva da Fundação Santa Casa de Misericórdia do Pará. Realizou-se coleta de 20mL de sangue em 100 adultos sem endocrinopatia previamente documentada para a dosagem do hormônio estimulante da tireoide, da tetraiodotironina livre, da tri-iodotironina livre e da tri-iodotironina reversa. Resultados: A maioria dos pacientes era do sexo feminino, com idades entre 20 e 29 anos. A maioria dos pacientes que morreram era mais velha (idade mediana de 48 anos), e 97,5% deles possuíam a síndrome do doente eutireóideo. A síndrome do doente eutireóideo esteve relacionada à morte, às comorbidades, à idade e ao tempo de internação (mediana de 7,5 dias) na unidade de terapia intensiva. A baixa dosagem de hormônio estimulante da tireoide estava associada à morte. Os pacientes com dosagem da tri-iodotironina livre menor que 2,9pg/mL tinham maior probabilidade de morrer e, naqueles que morreram, a dosagem de tri-iodotironina reversa era maior que 0,2ng/mL. A tri-iodotironina livre apresentou maior sensibilidade e acurácia, e a tri-iodotironina reversa teve maior especificidade para prever a mortalidade. Com base nos resultados e pontos de corte, desenvolveu-se uma fórmula de regressão logística múltipla para calcular a probabilidade de morte. Conclusão: Sugere-se verificar oportunamente a dosagem da triiodotironina livre e reversa em pacientes graves e aplicar a equação proposta.

ABSTRACT Objective: To assess euthyroid sick syndrome as a prognostic factor in patients in the intensive care unit; to detect factors that may affect mortality; and to develop an equation to calculate death probability. Methods: This was a longitudinal, observational, nonconcurrent cohort study developed in the intensive care unit of Fundação Santa Casa de Misericórdia do Pará. One hundred adults with no prior documented endocrinopathy were submitted to a 20mL blood sample collection for the measurement of thyroid stimulating hormone, free tetraiodothyronine, free triiodothyronine and reverse triiodothyronine. Results: Most patients were female, aged 20 to 29 years. Most patients who died were older (median age of 48 years), and euthyroid sick syndrome was present in 97.5% of them. Euthyroid sick syndrome was related to death, comorbidities, age and length of stay in the intensive care unit (median of 7.5 days). There was an association between lower thyroid stimulating hormone and death. Patients with free triiodothyronine levels below 2.9pg/mL were more likely to die; reverse triiodothyronine rates were above 0.2ng/mL in those who died. Free triiodothyronine had greater sensitivity and accuracy, and reverse triiodothyronine had greater specificity to predict mortality. Based on the results and cutoff points, a multiple logistic regression formula was developed to calculate the probability of death. Conclusion: The main limitation of this study is the fact that it was conducted in a reference hospital for maternal and child care; therefore, there was a greater number of female patients and, consequently, a sampling bias existed. However, opportune measurement of free and reverse triiodothyronine levels in critical patients and application of the proposed equation are suggested.

Abstract Background: There are only a few reports of acute respiratory distress syndrome (ARDS) in patients with SARS-CoV-2 in pediatrics. This study aimed to describe the characteristics of critically ill pediatric patients with COVID-19, the frequency of ARDS, ventilatory mechanics and results of prone position. Methods: We conducted a retrospective, observational study of patients admitted to the pediatric intensive care unit (PICU) between April 1 to September 30, 2020. Results: Thirty-four patients were admitted to pediatric intensive care unit, 31.7% were SARS-CoV-2 positive. 13 presented ARDS, 11 required invasive mechanical ventilation, and seven were pronated as an oxygenation strategy. All patients classified as severe ARDS were pronated. Obesity was the most important comorbidity. The complications associated with ARDS were multisystemic inflammatory syndrome (8 vs. 4; p < 0.05) and acute kidney injury (8 vs. 3; p < 0.05). Procalcitonin was higher in patients with ARDS, as were the days of stay in PICU (p < 0.05). The success of the pronation maneuver was achieved 8 hours later , with the following results: arterial oxygen partial pressure to fractional inspired oxygen ratio 128 vs. 204, oxygenation index 8.9 vs. 5.9, static lung compliance 0.54 vs. 0.70 ml/cmH2O/kg, plateau pressure 24 vs. 19 cmH2O (p < 0.05). The use of narcotics was higher in the group with ARDS plus pronation 124 vs. 27 hours in the non-pronated (p < 0.01). Mortality associated with SARS-CoV-2 was 5.8%. Conclusions: ARDS was presented in 38.2% of the children admitted to PICU and was more frequent in obese patients. Pronation, performed in severe cases, improved oxygenation and lung mechanics indexes. No patient died of ARDS.

Resumen Introducción: Existen pocos reportes de síndrome de dificultad respiratoria aguda (SDRA) con COVID-19 en pacientes pediátricos. El objetivo de este estudio fue describir las características de los pacientes pediátricos críticamente enfermos con COVID-19, la frecuencia del SDRA, la mecánica ventilatoria y los resultados de la posición prona. Métodos: Se llevó a cabo un estudio retrospectivo y observacional de los pacientes ingresados del 1 de abril al 30 de septiembre de 2020. Resultados: Ingresaron 34 pacientes a la unidad de terapia intensiva pediátrica (UTIP) con prueba positiva para SARS-CoV-2. De ellos, 13 presentaron SDRA, 11 requirieron ventilación mecánica invasiva y siete fueron pronados como estrategia de oxigenación. Todos los pacientes clasificados como SDRA graves fueron pronados. La obesidad fue la comorbilidad más importante. Las complicaciones asociadas con SDRA fueron el síndrome inflamatorio multisistémico (p < 0.05) y la lesión renal aguda (p < 0.05). La procalcitonina fue mayor en los pacientes con SDRA, al igual que los días de estancia en la UTIP (p < 0.05). El éxito de la maniobra de pronación se alcanzó 8 horas después.Los resultados observados fueron los siguientes relación presión arterial de oxígeno/fracción inspirada de oxígeno 128 vs. 204, índice de oxigenación 8.9 vs. 5.9, distensibilidad pulmonar estática 0.54 vs. 0.70 ml/cmH2O/kg, y presión meseta 24 vs. 19 cmH2O (p < 0.05). El uso de narcóticos fue mayor en el grupo de SDRA más pronación que en los no pronados (124 vs. 27 h; p < 0.01). La mortalidad asociada con SARS-CoV-2 fue del 5.8%. Conclusiones: El SDRA se presentó en el 38.2% de los niños admitidos a UTIP, y con mayor frecuencia en los pacientes con obesidad. La maniobra de pronación aplicada en los casos severos, mejoró la oxigenación de la mécanica pulmonar. Ninguno de los pacientes falleció por SDRA.

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.

RESUMO Os atributos do solo podem ser facilmente alterados pelo uso e manejo, comprometendo a capacidade produtiva das áreas. O objetivo da pesquisa foi avaliar a variabilidade e inter-relações dos atributos físicos, químicos e estruturais do solo em agroecossistemas no Semiárido Potiguar Brasileiro, apontando os atributos mais sensíveis na distinção dos ambientes por meio da análise multivariada. A pesquisa foi realizada na comunidade rural de Piracicaba, município de Upanema, Rio Grande do Norte, região Semiárida Brasileira. Foram selecionados quatro agroecossistemas: Área de Mata nativa (AMN), Área de consórcio milho feijão (ACMF), Área de Pastagem (AP) e Área de Cajueiro (AC). Foram coletadas amostras de solo indeformadas e deformadas nas camadas 0,00-0,10, 0,10-0,20 e 0,20-0,30 (m), e realizadas as análises dos atributos físicos, químicos e estruturais. Os dados foram submetidos a técnicas de estatística multivariada, por meio da matriz de correlação, análise de agrupamento, análise fatorial e componentes principais. A análise fatorial revelou os atributos mais sensíveis na distinção dos agroecossistemas, sendo microporosidade, capacidade de campo (CC), ponto de murcha permanente (PMP), água disponível (AD), areia, argila, grau de floculação (GF), Ca2+, Mg2+ e soma de bases (SB) (F1) e densidade do solo (DS), porosidade total (PT), macroporosidade, condutividade elétrica (CE) e carbono orgânico total (COT) (F2). A análise de agrupamento formou três grupos distintos. O COT foi discriminante para agrupar as áreas de mata nativa e de cajueiro, evidenciando a influência do manejo do solo. Os demais ambientes foram agrupados pela diferenciação da textura influenciando na variabilidade dos atributos.

ABSTRACT The soil attributes can be easily changed according to its management and use, compromising the productive capacity of the areas. The objective of this research was to evaluate the variability and interrelationships of soil physical, chemical and structural attributes in agroecosystems in the Brazilian Semiarid region (Rio Grande do Norte State), pointing out the most sensitive attributes in the environment distinction through multivariate analysis. The research was carried out in the rural community of Piracicaba, Upanema municipality, Rio Grande do Norte State, Brazil. Four agroecosystems were selected: Native Forest Area (ANF), Corn Bean Consortium Area (ACBC), Pasture Area (AP) and Cashew Area (AC). Undisturbed and deformed soil samples were collected in the 0.00-0.10, 0.10-0.20 and 0.20-0.30 m layers, and the physical, chemical and structural attributes were analyzed. The data were submitted to multivariate statistical techniques, using the correlation matrix, cluster analysis, factor analysis and principal component analysis. Factorial analysis revealed the most sensitive attributes in distinguishing agroecosystems: microporosity, field capacity (FC), permanent wither point (PWP), available water (AW), sand, clay, flocculation degree (GF), Ca2+, Mg2+ and sum of bases (SB) (F1) and soil density (SD), total porosity (PT), macroporosity, electrical conductivity (EC) and total organic carbon (TOC) (F2). Cluster analysis formed three distinct groups. The TOC was discriminant to group the native forest and cashew tree areas, showing the influence of soil management. The other environments were grouped according to the texture differentiation, influencing the attributes variability.

Abstract Solar thermal energy is one of the ways of using solar radiation that can be applied to meet the energy needs for heating. To achieve efficient photothermal conversion, selective surfaces are applied to solar collectors to absorb more radiation and minimize heat loss. The present work produced absorber surfaces from black chromium electrodeposition on stainless steel substrate, the main parameter evaluated was the deposition time and its effect on optical and morphological properties. In this sense, the techniques of characterization UV-Vis-NIR Spectroscopy, Infrared Spectroscopy, X-Ray Diffraction, Optical Profilometry and Thermogravimetric analysis were used. It was observed a great influence of the electrodeposition time in the absorptance of the films, where films with deposition times of 2 to 10 minutes obtained absorptances greater than 92%. The metallic Cr phase was identified in the films, and it is estimated that chromium oxides may have been formed in the amorphous form. With increasing time, the roughness oscillated due to the constant nucleation of chromium throughout the process. Furthermore, a 5% mass loss indicates good thermal stability of the film up to 400 °C.

ABSTRACT Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks.