RESUMO Introdução: A Síndrome da Apneia Obstrutiva do Sono (SAOS) é um problema de saúde pública de alta prevalência e com impacto na qualidade de vida, complicações anestésicas e doenças cardiovasculares. Diante da dificuldade de acesso à realização da polissonografia, é necessário validar outros métodos para a triagem diagnóstica da SAOS na prática clínica no cenário brasileiro, como o questionário STOP-Bang. Objetivos: Validar o questionário STOP-Bang em brasileiros e avaliar os melhores pontos de corte. Método: Após tradução e retrotradução, o STOP-Bang foi aplicado em 71 indivíduos previamente submetidos à polissonografia e classificados em controles e em SAOS leve, moderada e grave. Resultados: A maioria da amostra foi de homens (59,2%), com 48,9±13,9 anos, brancos (79%) e com circunferência do pescoço >40 cm (73,8%). O escore STOP-Bang foi maior na SAOS leve (mediana/interquartis 25-75%: 5/3,5-6), moderada (4,5/4-5) e grave (5/4-6) versus controles (2,5/1-4). A Curva Característica de Operação do Receptor (ROC) indicou que os escores 3, 4 e 6 apresentam os melhores valores de especificidade (100, 80 e 92,9%) e sensibilidade aceitável (60, 66,7 e 50%) nos subgrupos de SAOS leve, moderada e grave, respectivamente. Na análise da amostra com SAOS (IAH ] ≥5, <15, ≥15 - <30, ≥30), o ponto de corte de 6 no STOP-Bang detectou melhor a SAOS. Conclusão: A versão brasileira do STOP-Bang identificou pacientes apneicos com menor sensibilidade e maior especificidade em relação a estudos anteriores. Diferentes pontos de corte melhorariam o desempenho para detectar pacientes com SAOS mais grave.

ABSTRACT Background: Obstructive Sleep Apnea Syndrome (OSAS) is a public health problem of high prevalence and impacts on quality of life, anesthetic complications and cardiovascular diseases. In view of the difficulty in accessing the polysomnography, it is necessary to validate other methods for OSAS diagnostic screening in clinical practice in our country, such as the STOP-Bang questionnaire. Objective: To validate the STOP-Bang questionnaire in Brazilians and evaluate optimal cutoff points. Methods: After translation and back-translation, STOP-Bang questionnaire was applied to 71 individuals previously submitted to polysomnography and classified into control, mild, moderate or severe OSAS. Results: The majority of patients was male (59.2%), white (79%), aged 48.9±13.9 years, and with neck circumference >40 centimeters (73.8%). STOP-Bang score was higher in OSAS mild (median/inter-quartis 25-75%: 5/3.5-6), moderate (4.5/4-5) and severe (5/4-6), versus control (2.5/1-4). The receiver operating characteristic (ROC) curve indicate that scores 3, 4 and 6, present the best specificity values (100, 80 and 92.9%) with acceptable sensitivity (60, 66.7 and 50%) in the mild, moderate and severe OSAS subgroups, respectively. In OSAS group analysis (Apnea Hypopnea Index [AHI] ≥5, <15, ≥15 - <30, ≥30), STOP-Bang cutoff point of 6 was optimal to detect OSAS. Conclusion: STOP-Bang Brazilian version identified OSAS patients with lower sensitivity and higher specificity compared to previous studies. Different cutoff points would improve the performance to detect patients with more severe OSAS.

ABSTRACT AIMS to compare the influence of menopause on body fat, induced by a physical training program. METHODS Twenty-one sedentary women, 10 postmenopausal (MN; 54.6 ± 5.1 years, 42.9 ± 4.1 % body fat) and 11 in the ovulatory state (OS; 35.1 ± 5.4 years, 44.1 ± 5.5 % body fat), performed a training program with aerobic exercise (12 weeks, five times / week, 60 minutes per session). Before and after this program, the following measurements were taken: sum of skin fold (∑D), body fat percentage (%F), waist-hip ratio (WHR) and abdominal circumference (AC). RESULTS MN and OS significantly reduced ΣD (38.5 ± 25.1 mm and 27.7 ± 19.4 mm, respectively), but without differences between the groups. MN group women obtained relative reduction in the suprailiac fold, significantly greater than OS (25 ± 10 vs. 11.5 ± 12 mm), and also a greater reduction in the %F (13.5 ± 8% vs. 6.6 ± 6%). There were very slight reductions in WHR in both groups (0.009 ± 0.02 and 0.005 ± 0.03 in MN and OS, respectively), as well as AC (reduction of 3.5 ± 3 cm and 3.9 ± 2.9 cm for MN and OS), with no differences between groups. CONCLUSION The postmenopausal women responded to a training program with a greater reduction of body fat, but in only one of four evaluated body composition variables.

ABSTRACT The objective of this study was to evaluate the effect of prebiotic fructooligosaccharide (FOS) supplementation on the development of Mangalarga Marchador suckling foals. Sixteen Mangalarga Marchador foals, from birth to 75 days of age, were evaluated in a completely randomized design, with two treatments (experimental group and control group) with eight repetitions (animals). The foals were evaluated through body weight, morphometric, and circumferential measures. The daily, weekly, and cumulative weight gains were recorded and the morphometric measures were: withers height, croup height, body length, mid-back height, mid-back width, and thorax, shin, knee, and forearm circumferences. The mean body weight was 32.3 and 77.9 kg at birth and 75 days of age, respectively. The mean withers height was 86 and 103.8 cm at birth and 75 days of age, respectively, and the mean body length was 63.9 cm at birth, reaching 89.1 cm at 75 days of age. No significant differences in the FOS supplementation or interaction of age versus supplementation between the experimental and control groups were observed for any of the parameters evaluated. However, there were significant differences between the ages. Supplementation with prebiotic FOS does not affect the development of the Mangalarga Marchador suckling foals from birth to 75 days of age.

Resumo O objetivo deste trabalho foi caracterizar e analisar as comunidades e infracomunidades de metazoários parasitos de corvinas capturadas no Reservatório de Promissão, Rio Tietê, município de Borborema (21° 67′S, 49° 14′O), Estado de São Paulo. Foram examinados 50 espécimes, capturados por pescadores profissionais no mês de março de 2015, e os parasitas coletados foram quantificados, preparados e montados para identificação taxonômica e análise das comunidades de parasitos. Os peixes analisados no estudo apresentaram comprimento padrão médio de 25,2 ± 2,2 cm e peso médio de 328,82 ± 89,03 g. Foram coletados 5227 espécimes de parasitas metazoários, sendo 2880 (55,1%) Diplectanum piscinarius (Monogenoidea: Diplectanidae) e 2347 (44,9%) metacercárias de Austrodiplostomum compactum (Digenea, Diplostomidae), ambos com prevalência de 100% e abundância parasitária de 57,6 e 46,9, respectivamente. Foi encontrada baixa diversidade parasitária (riqueza de espécies=2), com índice de Simpson (D) igual a 0,505 e baixos valores dos índices de Shannon (H’=0,688) e de diversidade de Margalef (I=0,177). O índice de dominância de Berger-Parker (d=0,551) indicou uma leve dominância do monogenético D. piscinarius. Houve correlação positiva intermediária, avaliada pelo coeficiente de Pearson, entre a abundância parasitária de D. piscinarius e comprimento padrão (r=0,43) e peso (r=0,51) dos hospedeiros.

Abstract This study focused on the characterization and analysis of communities and infra-communities of metazoan parasites of Plagioscion squamosissimus caught in Promissão Reservoir in the Tietê River in Borborema (21°39′58”S, 49°8′49”W), state of São Paulo, Brazil. Fifty adult specimens caught by professional fishermen in March 2015 were necropsied. The fish presented an average standard length of 25.2 ± 2.2 cm and average weight of 328.82 ± 89.03 g. A total of 5,227 specimens of metazoan parasites were collected: 2,880 (55.1%) adult Diplectanum piscinarius (Monogenoidea: Diplectanidae) and 2,347 (44.9%) Austrodiplostomum compactum metacercariae (Digenea, Diplostomidae), both with 100% prevalence and mean abundance of 57.6 and 46.9, respectively. Parasite diversity was low (species richness = 2), with a Simpson index (D) equal to 0.505, and low values of Brillouin (HB = 0.687) and Margalef diversity (I = 0.117) indices. Berger-Parker’s index of dominance (p = 0.551) indicated a slight dominance of the monogenean parasite D. piscinarius. There was a positive correlation, assessed by Pearson coefficient between parasite abundance of D. piscinarius and standard length (r = 0.43) and weight (r = 0.51) of hosts.

Abstract This is a report of the first Brazilian experience with the Perceval sutureless aortic prosthesis in two patients with severe aortic stenosis. Transesophageal echocardiography was used during the procedure. The aortotomy was performed 1 cm above the sinotubular junction, followed by leaflets removal and decalcification. Correct valve size was selected, device released and an accommodation balloon used. The cardiopulmonary bypass times were 47 and 38 min and the cross-clamp times were 38 and 30 min. There was a significant decrease in mean gradients (41 and 75 mmHg preoperatively; 7 and 8 mmHg postoperatively). There was no major complication or paravalvular leak.

O objetivo deste trabalho foi avaliar o potencial das espécies arbóreas Cordia africana Lam.,Mimosa caesalpineafolia Benth., Acacia angustissima (Mill.) Ktze. e Anadenanthera colubrina (Vell.) Brenan na fitoestabilização de metais pesados presentes em um substrato contaminado. Foram selecionados, aleatoriamente, quatro exemplares de cada espécie para realização do estudo. Amostras de substrato na projeção da copa de cada exemplar arbóreo foram coletadas nas profundidades de 0-10; 10-30 e 30-50 cm, para determinação da concentração pseudototal e fracionamento químico de metais pesados. De cada indivíduo, foram coletados dados referentes à profundidade das raízes, DAP (diâmetro a altura do peito), diâmetro de copa e altura das plantas. Amostras de folha, caule, casca e raiz foram coletadas para determinação dos metais pesados zinco (Zn), manganês (Mn), cádmio (Cd), chumbo (Pb) e cobre (Cu) nas diferentes partes da planta. A concentração de Cd no substrato foi acima do valor de investigação definido pelo CONAMA (3,0 mg kg-1), evidenciando contaminação com esse elemento. Os maiores teores dos metais pesados foram encontrados na fração residual (F5), indicando baixa disponibilidade destes elementos no substrato. Com relação ao Cd, elevadas concentrações também foram encontradas na fração trocável F2, considerada uma fração em que os contaminantes se apresentam com certa mobilidade e biodisponibilidade. As espécies vegetais estudadas apresentaram desenvolvimento dentro dos padrões normais, mostrando tolerância a áreas contaminadas com Cd, que tendeu a se acumular nas raízes das plantas, com exceção da Córdia - africana.

This study aims to evaluate the potential of tree species Cordia africana Lam.,Mimosa caesalpineafolia Benth., Acacia angustissima (Mill.) Ktze. and Anadenanthera colubrina (Vell.) Brenan in the phytostabilization of heavy metal from a substrate contaminated. Four specimens of each tree specie were randomly determined for evaluations. Substrate samples were collected in the projection of the canopy trees of each specimen at depths 0-10, 10-30 and 30-50 cm for determining pseudototal concentration and chemical fractionation of heavy metals.Were collected data on roots depth, diameter at breast height, canopy diameter and plant height for each specimen. Samples of root, stem, bark and leaf were collected for analysis of heavy metals zinc (Zn), manganese (Mn), cadmium (Cd), lead (Pb) and copper (Cu). The Cd concentration in the substrate was above the investigation value defined by CONAMA (3,0 mg kg-1), showing contamination with this element. However, the highest concentrations of other studied heavy metals were found in the residual fraction (F5), indicating low availability of these elements in the substrate. High concentrations of Cd were also found in the exchangeable fraction F2, which is considered a fraction in which contaminants are present with some mobility and bioavailability. The plants showed development within the normal patterns, showing tolerance to Cd-contaminated areas, which tended to accumulate in the roots, except in the Córdia - africana.

The authors report the case of a 39 year-old female, who presented with 10 years history of intense progressive pain, hypoesthesia in hypotenar region and motor deficit in the left hand. The physical exam showed hypotenar muscles atrophy, "claw hand", and Tinel's sign in the forearm (8 cm distal from the medial epicondyle). Magnetic resonance imaging showed a mass lesion along ulnar nerve path in the forearm. Surgical treatment was, then, suggested. Nerve conduction could not be registered during intra-operative stimulation. Microsurgical resection of the damaged nerve fascicles and sural nerve grafting were performed. Histopathological diagnosis was difficult and could only be confirmed as localized hypertrophic mononeuropathy after revision of the biopsied material. The patient is being followed up and she is showing signs of hypoesthesia improvement in addition to complete remission of the pain.

Objetivo. Presentar un caso de mononeuropatía hipertrófica localizada. Descripción. Paciente de 39 años de edad, que presenta una historia de dolor intenso y progresivo, hipoestesia en la región tenar y déficit motor en la mano izquierda. El examen físico mostró atrofia hipotenar, mano en garra cubital y signo de Tinel en el antebrazo (8 cm distal a la epitróclea). Intervención. La IRM mostró una masa a lo largo del recorrido del nervio cubital en el antebrazo. Se sugirió entonces tratamiento quirúrgico. No se obtuvo registro de conducción nerviosa durante la estimulación intraoperatoria, por lo cual se resecó la zona de fascículos afectados y se reemplazó la lesión por injertos autólogos extraídos de nervio sural. El diagnóstico histopatológico fue difícultoso y después devarias revisiones se concluyó que se trataba de una mononeuropatía hipertrófica localizada. Conclusión. La paciente se encuentra actualmente bajo seguimiento y está mostrando signos de mejoría de la anestesia junto a remisión completa del dolor.

The authors report the case of a 39 year-old female, who presented with 10 years history of intense progressive pain, hypoesthesia in hypotenar region and motor deficit in the left hand. The physical exam showed hypotenar muscles atrophy, "claw hand", and Tinel's sign in the forearm (8 cm distal from the medial epicondyle). Magnetic resonance imaging showed a mass lesion along ulnar nerve path in the forearm. Surgical treatment was, then, suggested. Nerve conduction could not be registered during intra-operative stimulation. Microsurgical resection of the damaged nerve fascicles and sural nerve grafting were performed. Histopathological diagnosis was difficult and could only be confirmed as localized hypertrophic mononeuropathy after revision of the biopsied material. The patient is being followed up and she is showing signs of hypoesthesia improvement in addition to complete remission of the pain.

Objetivo. Presentar un caso de mononeuropatía hipertrófica localizada. Descripción. Paciente de 39 años de edad, que presenta una historia de dolor intenso y progresivo, hipoestesia en la región tenar y déficit motor en la mano izquierda. El examen físico mostró atrofia hipotenar, mano en garra cubital y signo de Tinel en el antebrazo (8 cm distal a la epitróclea). Intervención. La IRM mostró una masa a lo largo del recorrido del nervio cubital en el antebrazo. Se sugirió entonces tratamiento quirúrgico. No se obtuvo registro de conducción nerviosa durante la estimulación intraoperatoria, por lo cual se resecó la zona de fascículos afectados y se reemplazó la lesión por injertos autólogos extraídos de nervio sural. El diagnóstico histopatológico fue difícultoso y después devarias revisiones se concluyó que se trataba de una mononeuropatía hipertrófica localizada. Conclusión. La paciente se encuentra actualmente bajo seguimiento y está mostrando signos de mejoría de la anestesia junto a remisión completa del dolor.

The aim of this work is to establish a relationship between schistosomiasis prevalence and social-environmental variables, in the state of Minas Gerais, Brazil, through multiple linear regression. The final regression model was established, after a variables selection phase, with a set of spatial variables which contains the summer minimum temperature, human development index, and vegetation type variables. Based on this model, a schistosomiasis risk map was built for Minas Gerais.