ABSTRACT Purposes: This study aimed to determine the association of the long-term refractive outcomes of cataract surgery with self-reported visual function obtained using Catquest-9SF. Methods: Patients recruited from the cataract outpatient clinic of VER MAIS Oftalmologia underwent a complete ophthalmologic examination. Patients who were diagnosed with cataract with indications for phacoemulsification and intraocular lens implantation received the Catquest-9SF questionnaire before and after surgery at 30 days and 1 year. Results: A total of 133 patients were recruited, but 32 patients were lost to follow-up; finally, data from 101 patients (48 men, 53 women) were analyzed. The crude variance explained by the data was 69.9%, and the unexplained variance in the first contrast was 2.39 eigenvalues (>2); thus, these results are different from those expected from random data. The people separation index was 2.95 (>2), and the people trust value was 0.9 (>0.8). These indices were evaluated in the assessment of skill levels. Visual acuity was the main variable that correlated with the Catquest score. Conclusions: The Catquest-9SF translated into Portuguese proved to be a one-dimensional and psychometrically valid tool to assess visual dysfunction in patients with cataract, and it is successful in objectively quantifying improvements after surgery. The results of this tool could be predictive and concordant of visual acuity improvement.

RESUMO Objetivo: Associar os resultados refrativos a longo prazo da cirurgia de catarata e a função visual autorreferida pelo questionário Catquest-9SF. Métodos: Paciente recrutados no ambulatório de catarata da VER MAIS Oftalmologia, foram submetidos a exame oftalmológico completo. Após diagnóstico de catarata com indicação de tratamento cirúrgico com facoemulsificação e implante de lente intraocular, o questionário foi aplicado antes da intervenção, 30 dias após cirurgia e 1 ano após, novamente. Resultados: Foram recrutados 133 pacientes. No decorrer do seguimento, 32 pacientes foram perdidos e ao final foram analisados os dados de 101 pacientes, dos quais 48 foram homens e 53 foram mulheres. A variância bruta explicada por dados foi de 69,9% e a inexplicada em primeiro contraste por 2,39 eigenvalores, sendo maior que 2, o que nos mostra que são resultados differentes dos esperados de dados aleatórios. O índice de separação de pessoas foi de 2.95 (>2) e o valor de confiança de pessoas foi de 0,9 (>0,8). Estes índices são os valores mínimos aceitáveis na diferenciação de níveis de habilidade. Acuidade visual foi a principal variável correlacionada com o score do Catquest. Conclusões: O Catquest-9SF traduzido para o português se demonstrou unidimensional e uma ferramenta psicometricamente válida para avaliar disfunção visual em pacientes com catarata, além de ter tido sucesso para quantificar objetivamente melhoras após a intervenção cirúrgica. Essa ferramenta pode ser utilizada como preditiva e concordante da melhora da acuidade visual.

RESUMEN Introducción: Más de dos millones de personas en el mundo reciben tratamiento sustitutivo renal; la infección sanguínea representa una amenaza significativa, siendo la segunda causa de muerte en estos pacientes. La tasa de supervivencia depende en gran medida del tipo de acceso vascular utilizado. Objetivo: Determinar las complicaciones en pacientes con catéter de hemodiálisis en relación al sitio de inserción. Materiales y Métodos: Estudio de cohorte prospectivo, analítico, con medición de la frecuencia de complicaciones de pacientes con catéter de hemodiálisis a nivel yugular y femoral. Las variables se obtuvieron de los expedientes clínicos de pacientes internados ≥18 años. Resultados: Se incluyeron 203 pacientes, 66,01% masculinos; una edad media de 52 ± 15 años. 123 pacientes portaban catéter yugular y 80 pacientes, femoral. La curación se realizó cada 3 ± 5 días. La duración media de catéteres antes de signos de infección fue 4 ± 4 semanas en femorales y 9 ± 12 semanas en yugulares. Las bacterias gram positivas predominaron en los hemocultivos; aquellos con acceso femoral presentaron bacteriemia en mayor porcentaje. El cultivo de punta de catéter presentó una baja sensibilidad. Pacientes con catéter femoral presentaron mayor frecuencia de complicaciones. De las complicaciones infecciosas, la más frecuente fue el choque séptico en los portadores de catéteres femorales 57,50% vs los yugulares 4,88%. Otros: endocarditis, 7,32% en yugulares vs 2,50% en femorales; y finalmente la espondilodiscitis, con un 7,50% en femorales. La mortalidad fue mayor en aquellos con catéter femoral, 35% vs 8,94% en yugulares. Conclusión: Se ha evidenciado que el catéter femoral presenta mayor incidencia de complicaciones como choque séptico y bacteriemia, directamente relacionado con mayor tasa de mortalidad.

ABSTRACT Introduction: More than two million people in the world receive renal replacement treatment; Blood infection represents a significant threat, being the second cause of death in these patients. The survival rate depends largely on the type of vascular access used. Objective: Determine complications in patients with hemodialysis catheter in relation to the insertion site. Materials and Methods: Prospective, analytical cohort study, measuring the frequency of complications in patients with hemodialysis catheters at the jugular and femoral levels. The variables were obtained from the clinical records of hospitalized patients ≥18 years of age. Results: 203 patients were included, 66.01% male; an average age of 52 ± 15 years. 123 patients had a jugular catheter and 80 patients had a femoral catheter. Healing was carried out every 3 ± 5 days. The mean duration of catheters before signs of infection was 4 ± 4 weeks in femoral and 9 ± 12 weeks in jugular. Gram-positive bacteria predominated in blood cultures; those with femoral access had bacteremia in a higher percentage. Catheter tip culture had low sensitivity. Patients with a femoral catheter had a higher frequency of complications. Of the infectious complications, the most frequent was septic shock in those with femoral catheters 57.50% vs jugular catheters 4.88%. Others: endocarditis, 7.32% in jugular vs 2.50% in femoral; and finally spondylodiscitis, with 7.50% in femoral bones. Mortality was higher in those with a femoral catheter, 35% vs. 8.94% in jugular catheters. Conclusion: It has been shown that the femoral catheter has a higher incidence of complications such as septic shock and bacteremia, directly related to a higher mortality rate.

Abstract This case report describes a favorable healing outcome of the immediate management of an oblique tooth root fracture in the middle third concomitant with coronal fragment extrusion in a permanent maxillary left central incisor of a healthy 14-year-old female patient. The clinical exam showed incisal irregularity, local bleeding, increased mobility, and axial displacement of the maxillary left central incisor. The coronal fragment was repositioned and stabilized with a flexible splint for four weeks. The parents and the patient received medication prescriptions and instructions. Clinical and radiographic conditions remained satisfactory at the 4-week, 6-month, and 12-month follow-ups. Thermal and percussion tests confirmed pulp vitality after 12 months. Hard tissue formation between segments was observed in the radiographic examination and cone-beam computed tomography. In conclusion, the immediate conservative therapeutic showed satisfactory clinical and radiographic results.

Resumo Este relato de caso descreve resultados de cicatrização favorável para o tratamento imediato de fratura dentária radicular oblíqua no terço médio concomitante à extrusão do fragmento coronal de um incisivo central superior esquerdo permanente de uma paciente saudável de 14 anos de idade. O exame clínico demonstrou irregularidade incisal, sangramento local, aumento da mobilidade e deslocamento axial do incisivo central superior esquerdo. O fragmento coronal extruído foi reposicionado e estabilizado com contenção flexível por quatro semanas. Prescrições de medicamentos e instruções foram dadas aos pais e ao paciente. As condições clínicas e radiográficas permaneceram satisfatórias nos acompanhamentos de 4 semanas, 6 meses e 12 meses. A vitalidade pulpar foi confirmada por testes térmicos e de percussão após 12 meses. A formação de tecido duro entre os segmentos fraturados foi observada no exame radiográfico e na tomografia computadorizada de feixe cónico. Em conclusão, a terapêutica conservadora imediata apresentou resultados clínicos e radiográficos satisfatórios.

SUMMARY Objective: To establish the infections associated with health care in surgically treated patients, without considering operative site (ISO) infections. Materials and methods: A search of the literature was performed in MEDLINE, CENTRAL, LILACS databases in addition to unpublished literature, identifying studies related to infections associated with health care in adult patients who underwent surgery. Results: In the search performed, 25 articles were selected, from which the results were extracted. The most frequent IAAS in the studies reviewed were: ventilator-associated pneumonia (36%), pneumonia associated with health care (32%), urinary tract infections by urinary catheter (48%), infections associated with venous catheter (8 %). Conclusion: Infections associated with health care in patients brought to surgical procedures, most frequently found are ventilator-associated pneumonia, pneumonia associated with health care, urinary tract infection by catheter and venous catheter-associated infections. However, they continue to generate questions, since ISO is the most documented, suggesting more studies and research.

RESUMEN Objetivo: Establecer las infecciones asociadas a la atención de la salud en pacientes intervenidos quirúrgicamente, sin tener en cuenta las infecciones del sitio operatorio (ISO). Materiales y métodos: Se realizó una búsqueda de la literatura en las bases de datos de MEDLINE, CENTRAL, LILACS además de la literatura gris, para identificar estudios relacionados con infecciones asociadas a la atención de la salud en pacientes adultos que fueron intervenidos quirúrgicamente. Resultados: En la búsqueda realizada se seleccionaron 25 artículos de los cuales se extrajeron los resultados. Las IAAS más frecuentes en los estudios revisados fueron: neumonía asociada al ventilador (36%), neumonía asociada al cuidado de la salud (32%), infecciones de tracto urinario por catéter urinario (48%), infecciones asociadas a catéter venoso (8%). Conclusión: Las infecciones asociadas a la atención de la salud frecuentemente encontradas en pacientes llevados a procedimientos quirúrgicos son la neumonía asociada al ventilador, neumonía asociada al cuidado de la salud, la infección del tracto urinario por catéter y las infecciones asociadas a catéter venoso, sin embargo, las infecciones de sitio operatorio (ISO) son las más documentadas, situación que requiere mayor atención y abordaje a través de otros estudios de investigación.

Abstract: This article provides a framework of understanding about adversity and consequences at the psychosocial, community and social exclusion levels, an important relationship in the approach to the social phenomena that are faced in the intervention from the community social psychology. The study was approached from a qualitative methodology, managing to compile the report of seven professional Psychologists and Social Workers with experience in armed conflicts and victims of political violence in Chile, Colombia, Palestine and Spain. The analysis was of content and was carried out with the use of the atlas ti software. Among its main results, different types of adversities are recognized at the individual and collective level and their consequences at the level of family relationships, health and social exclusion.

Resumen: El presente artículo tiene como objetivo analizar la comprensión de los contextos de adversidad y sus consecuencias psicosociales en profesionales inmersos en estos escenarios. El estudio se abordó desde una metodología cualitativa logrando recopilar el relato de siete profesionales Psicólogos y Trabajadores Sociales con experiencia en conflictos armados y víctimas de violencia política en Chile, Colombia, Palestina y España. Se realizó un análisis de contenido cuyos resultados muestran la emergencia de categorías que presentan como principales características de los contextos de adversidad la violencia, crisis familiares, la exclusión social, y los factores de riesgo de la niñez y adolescencia. Las categorías emergentes muestran efectos a nivel individual, con un impacto negativo en la salud y estrategias de afrontamiento de acercamiento-evitación, y a nivel colectivo, con desconfianza en relaciones interpersonales y perpetuación del contexto de exclusión. Se discute la importancia del abordaje de estas consecuencias individuales y colectivas, en especial de la exclusión, que deberían ser abordadas de manera diferenciada por la intervención desde la Psicología Social Comunitaria.

ABSTRACT Searching for novel sources of resistance to head blast is essential to strengthen wheat production in the Cerrado´s biome. The objective of this work was to evaluate disease intensity measures and yield for 2NS and non-2NS carriers wheat genotypes with varying heading times in Minas Gerais, Brazil. A total of fourteen wheat genotypes, two susceptible and twelve resistant to head blast, were sown in 2014, 2015, and 2017 at the Sertãozinho Experimental Station of Empresa de Pesquisa Agropecuária de Minas Gerais (Epamig) during three sowing dates without fungicide applications. The experimental design was a randomized complete block with three replicates. Blast incidence, severity, disease index and grain yield were influenced by the cycle of wheat genotypes and the sowing date, with the highest disease intensities and the lowest yields in the earliest sowing date. Blast incidence and disease index correlated negatively with grain yield and positively with percent yield losses. The group of wheat genotypes with higher grain yield (between 2,104.7 and 2,917.8 kg ha-1) and lower yield losses (between 44.3 and 54.8%) includes BR 18 as well as other five that do not carry the 2NS/2AS translocation: BRS Angico, PF 909, BRS 229, Embrapa 27, and CPAC 07340.

Resumen Antecedentes. La incidencia de carcinomatosis peritoneal (CP) secundaria a cáncer gastrointestinal o ginecológico ha aumentado y tiene peor pronóstico en comparación con otros sitios de metástasis. El índice de carcinomatosis peritoneal (ICP) establece la supervivencia global en pacientes con tumores gastrointestinales o ginecológicos y carcinomatosis. Objetivo. Evaluar la relación del ICP con la supervivencia global (SG) y la supervivencia libre de recurrencia (SLR) en pacientes tratados con cirugía citorreductora (CCR) más quimioterapia intraperitoneal e hipertemia (HIPEC). Método. Estudio descriptivo, retrolectivo, de 80 expedientes de pacientes con CP. Se incluyeron tumores de colon, ovario, apendicular, pseudomixomas y gástricos con CP tratados con CCR + HIPEC. Se determinaron la SG y la SLR de acuerdo con el tipo de adenocarcinoma y el grado de diferenciación, en meses, en pacientes con ICP > 15 y con ICP < 15 considerando el tumor de origen. Resultados. Los pacientes con tumores de ovario y pseudomixoma con ICP < 15 tenían una SG > 70 meses, frente a 4 meses con tumores gástricos. Conclusiones. El ICP y la histología son predictores de la SG. Las pacientes con tumores ováricos con ICP < 15 tienen mayor SG, igual que los pseudomixomas. La SLR fue mayor en los pacientes con ICP < 15.

Abstract Background. The peritoneal carcinomatosis (PC) secondary to gastrointestinal or gynecological cancer has increased its incidence. It has a worse prognosis compared to other sites of metastasis. The peritoneal carcinomatosis index (PCI) establishes overall survival in patients with gastrointestinal or gynecological tumors and carcinomatosis. Objective. To evaluate the relationship of PCI to overall survival (OS) and recurrence-free survival (RFS) in patients treated with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). Method. A descriptive, retrolective study of 80 charts of patients with CP was conducted. We included patients with colon, ovarian, appendicular, pseudomyxoma and gastric tumors with CP treated with CRS plus HIPEC. The OS and RFS were determined according to the type of adenocarcinoma and the degree of differentiation. The OS and RFS were determined in months in patients with PCI > 15 PCI as well as in patients with PCI < 15 considering the tumor of origin. Results. Patients with ovarian tumors and pseudomyxoma with PCI < 15 presented OS > 70 months, compared to patients with gastric tumors (4 months). Conclusions. The PCI and histology are predictors of OS. Patients with ovarian tumors and PCI < 15 have higher OS, similar to pseudomyxomas. RFS was also higher in patients with PCI < 15.

ABSTRACT The aim of this study was to evaluate the effect of adding ascorbic acid (AA) to the vitrification medium of bovine preantral follicles (PFs) subjected previously to cooling at 4 °C for 4 h or 24 h. Ovaries were collected from Nelore heifers at 14 months of age. In the laboratory, ovarian fragments were removed from the cortical region and distributed to fragments as fresh control (C0h), and fragments to cooling at 4 ºC for 4 and 24 hours in TCM-199 plus HEPES and antibiotics. Of the cooled fragments, two were fixed as controls for each cooling time (C4h, C24h), and the remaining fragments were distributed in four vitrification treatments, using the TCM-199 medium associated with ethylene glycol and dimethyl sulfoxide (V), sucrose (VSUC) or ascorbic acid (VAA), and the treatment with ethylene glycol, dimethyl sulfoxide, sucrose and AA (VSUC+AA). After 72 h, fragments were warmed and fixed for histological analysis and mechanical follicular isolation. No difference (p>0.05) between C0h and C4h for morphologically normal PFs was detected (99.3 and 96.0%, respectively). Vitrification reduced the morphological integrity and follicular viability in all treatments compared to C0h; nevertheless, VAA treatment maintained the follicular viability like C24h (p>0.05). It is concluded that bovine PFs were conserved efficiently at 4 °C during 4 h, and the addition of ascorbic acid to the vitrification medium improved survival rates and kept the morphological integrity of the follicles.

RESUMEN El objetivo del estudio fue evaluar el efecto de la adición de ácido ascórbico (AA) al medio de vitrificación de folículos preantrales (FPs) bovinos previamente enfriados a 4 °C durante 4 o 24 h. Se recolectaron ovarios de novillas Nelore a los 14 meses de edad. En el laboratorio se extrajeron fragmentos de ovario de la región cortical y se distribuyeron a fragmentos para control fresco (C0h), y fragmentos para refrigeración a 4 ºC por 4 y 24 horas en TCM-199 más HEPES y antibióticos. De los fragmentos enfriados, dos se fijaron como controles para cada tiempo de enfriamiento (C4h, C24h), y los restantes se distribuyeron en cuatro tratamientos de vitrificación, utilizando el medio TCM-199 asociado con etilenglicol y dimetilsulfóxido (V), sacarosa (VSUC) o ácido ascórbico (VAA), y el tratamiento con etilenglicol, dimetilsulfóxido, sacarosa y AA (VSUC+AA). Después de72h, los fragmentos se calentaron y fijaron para el análisis histológico y el aislamiento folicular mecánico. No se detectó diferencia (p>0.05) entre C0h y C4h para FPs morfológicamente normales (99.3 y96.0%, respectivamente). La vitrificación redujo la integridad morfológica y la viabilidad folicular en todos los tratamientos en comparación con C0h; sin embargo, el tratamiento VAA mantuvo la viabilidad folicular similar a C24h (p>0.05). Se concluye que los FAs bovinos se conservaron eficientemente a 4 °C durante 4 h, y la adición de ácido ascórbico al medio de vitrificación mejoró las tasas de supervivencia y mantuvo la integridad morfológica folicular.

Background: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. Aim: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. Material and Methods: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. Results: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. Conclusions: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.

Resumen El presente trabajo tiene por objeto explorar cómo incorporan el componente ético en sus procesos de enseñanza/aprendizaje un grupo de escuelas de Derecho de la región occidental de México y, a partir de esto, concluir algunas propuestas respecto a lo que las escuelas de Derecho pueden hacer para potencializar la ética en la enseñanza jurídica. El trabajo está dividido en cinco apartados: en la primera parte, abordamos la cuestión de para qué sirve la ética a la educación jurídica; en la segunda parte, analizamos el papel de la ética en las instituciones de educación superior; en la tercera parte, presentamos el escenario de principios y/o valores que expresamente asumen estas instituciones; en la cuarta parte, reconstruimos sus estrategias de adhesión a estos principios y/o valores; y, finalmente, en la quinta parte, realizamos algunas propuestas para que la ética se incorpore a la enseñanza del Derecho. En general, argumentamos que la ética sirve al Derecho más allá de un sentido instrumental, toda vez que, con base a ella, guiamos nuestras vidas y la toma de las mejores decisiones. Se proponen acciones concretas para la inclusión de la ética profesional en el curriculum y para el desarrollo de acciones que permitan que la adhesión de las instituciones a la ética se convierta en una realidad palpable.

Abstract The purpose of this paper is to explore how a group of law schools in the western region of Mexico incorporate the ethical component in their teaching/learning processes and, from this, to conclude some proposals regarding what law schools can do to enhance ethics in legal education. The paper is divided into five sections: in the first part, we address the question of what ethics is used for in legal education; in the second part, we analyze the role of ethics in institutions of higher education; in the third part, we present the scenario of principles and/or values expressly assumed by these institutions; in the fourth part, we reconstruct their strategies of adherence to these principles and/or values; finally, in the fifth part, we make some proposals for ethics to be incorporated into the teaching of law. In general, we argue that ethics serves law beyond an instrumental sense, since, based on it, we guide our lives and the making of the best decisions. Concrete actions are proposed for the inclusion of professional ethics in the curriculum and for the development of actions that allow the adherence of institutions to ethics to become a palpable reality.

Resumen El objetivo del estudio fue analizar las concentraciones de zinc y cobre en músculo (n = 14) e hígado (n = 72) de Rhizoprionodon terraenovae, especie de tiburón de mayor captura y consumo en el litoral de Campeche, México. De acuerdo con la longitud total (LT), los organismos analizados fueron adultos (LT = 89.8 ± 13.7 cm), quienes presentaron las mayores concentraciones (mg/kg de peso húmedo) de oligoelementos en hígado: zinc (16.23 ± 8.45) > cobre (2.32 ± 0.84); mientras que en músculo: zinc (6.48 ± 2.89) > cobre (0.39 ± 0.14). No se encontraron diferencias significativas en las concentraciones de oligoelementos por tejido entre sexos, ni una correlación significativa con la LT de los organismos. Ambos metales se correlacionaron positivamente en cada tejido. Se registró una biodisminución de 0.22 mg/kg en cobre y 9.58 mg/kg en zinc en el hígado del año 2015 al 2019, probablemente por incremento de metalotioneínas. Las concentraciones de ambos oligoelementos en músculo estuvieron por debajo de los límites máximos establecidos por normas internacionales. En conclusión, los niveles de zinc y cobre, actualmente, no implican riesgos para la salud de R. terraenovae (hígado), ni para la de la sociedad en caso de consumo (músculo).

Abstract The aim of this study was to analyze the concentrations of zinc and copper in the muscle (n = 14) and liver (n = 72) of Rhizoprionodon terraenovae, a shark species with the highest capture and consumption rate in the coast of Campeche, México. According to the total length (TL), the organisms analyzed were adults (TL= 89.8 ± 13.7 cm). The highest concentrations (mg/kg of wet weight) of trace elements were in liver: zinc (16.23 ± 8.45) > copper (2.32 ± 0.84); while in muscle: zinc (6.48 ± 2.89) > copper (0.39 ± 0.14). No significant differences were found in concentrations of trace elements by tissue between sexes, nor a significant correlation with the TL of the organisms. Both metals were positively correlated in each tissue. A biodiminution of 0.22 mg/kg in copper and 9.58 mg/kg in zinc was registered in the liver from 2015 to 2019, probably due to an increase of metallothioneins. The concentrations of both trace elements in muscle were below the maximum limits established by International Standards. In conclusion, the levels of zinc and copper currently do not imply risks for the health of R. terraenovae (liver), nor its consumption (muscle) for society.

Resumen: Introducción: La primera infancia es una fase marcada por un intenso desarrollo infantil, con la mejora de las habilidades motoras, cognitivas y sensoriales. Así, los niños están expuestos a riesgos y, por lo tanto, los cuidados deben ser redoblados para prevenir accidentes, especialmente en el propio hogar. Objetivos: Identificar los riesgos a los que están expuestos los niños, así como trabajos científicos que aborden la prevención de accidentes domésticos en la primera infancia. Métodos: Se trata de una revisión integrativa de la literatura realizada en las siguientes bases de datos: LILACS, MEDLINE, BDENF y SciELO. La evaluación, del nivel de evidencia de los artículos encontrados se obtuvo por medio del método Oxford Center for Evidence-based Medicine. Resultados: Diez artículos cumplieron con los criterios de búsqueda establecidos. Los accidentes domésticos que se destacaron en los artículos fueron: caídas, quemaduras, envenenamiento y caídas de televisión. Con relación al ambiente familiar, fue notorio que la mayoría de las familias en los estudios analizados eran de bajos ingresos. Conclusión: Los padres o responsables de los niños son fundamentales para prevenir accidentes domésticos por diversas causas. Además, el papel de los profesionales de la salud es fundamental para desarrollar o potencializar programas de prevención, principalmente dirigidos a personas en situación de vulnerabilidad social o económica, con el fin de capacitar a la población en la identificación y minimización de riesgos.

Abstract: Introduction: Early childhood is a phase marked by intense child development, with improved motor, cognitive and sensory skills. Given this, children are exposed to risks and, therefore, must redouble care to prevent accidents, especially at home. Aim: To identify the risks to which children are exposed, as well as scientific works that address the prevention of domestic accidents in early childhood. Methods: This is an integrative literature review conducted in the following databases: LILACS, MEDLINE, BDENF, and SciELO. The level of evidence of the articles found was assessed using the Oxford Center for Evidence-based Medicine method. Results: Ten articles met the established search criteria. The domestic accidents that stood out in the articles were: falls, burns, poisoning, and tipping over television sets. Regarding the family environment, it was clear that most families in the analyzed studies were of low income. Conclusion: Parents or guardians of children are essential to prevent domestic accidents from various causes. In addition, the role of health professionals is necessary to develop or enhance prevention programs, mainly aimed at the socially or economically vulnerable, to train the population in identifying and minimizing risks.

Resumo: Introdução: A primeira infância é uma fase marcada por intenso desenvolvimento infantil, com o aperfeiçoamento de habilidades motoras, cognitivas e sensoriais. Em vista disso, as crianças são expostas a riscos e portanto, cuidados devem ser redobrados para prevenir acidentes, em especial no próprio lar. Objetivos: Identificar os riscos a que as crianças são expostas, bem como os trabalhos científicos que abordam a prevenção de acidentes domésticos na primeira infância. Métodos: Trata-se de uma revisão integrativa da literatura conduzida nas bases de dados: LILACS, MEDLINE, BDENF e SciELO. A avaliação, do nível de evidência dos artigos encontrados, foi obtida por meio do método Oxford Centre for Evidence-based Medicine. Resultados: Dez artigos atenderam aos critérios de busca estabelecidos. Os acidentes domésticos que se destacaram nos artigos foram: quedas, queimaduras, envenenamento e tombamento em aparelhos televisivos. Em relação ao ambiente familiar, foi notório que a maioria das famílias dos estudos analisados eram de baixa renda. Conclusão: Os pais ou responsáveis pelas crianças são essenciais para prevenir acidentes domésticos de variadas causas. Além disso, a atuação dos profissionais de saúde é primordial para desenvolver ou potencializar programas de prevenção, principalmente voltados para aqueles que são vulneráveis social ou economicamente, a fim de capacitar a população quanto à identificação e minimização dos riscos.

ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient’s risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

ABSTRACT Monkeypox (MPX) transmission outside non-endemic countries has been reported since May 2022, rapidly evolving into a multi-country outbreak. A potential role of sexual contact in transmission dynamics, as well as a predominance of anogenitallesions, are remarkable features of current cases. Screening for sexually transmitted infections (STIs) plays an important role in the evaluation of patients with suspected MPX infection. Herein we report the first case of a patient diagnosed with both MPX and acute HIV infection in Latin America. He had no major complications during his clinical course, and antiretroviral therapy was promptly initiated. Diagnosis of acute HIV requires a high level of suspicion and appropriate laboratory investigation. Health practitioners need to consider this diagnosis while evaluating patients with suspected MPX with a recent unprotected sexual contact.

ABSTRACT The present study explored the predictive values of milk leukocyte differentials (MLD) as a basis for improving the diagnosis of intramammary infections (IMIs) and subclinical mastitis. Quarter milk samples were collected for bacteriological analysis, quarter somatic cell count (qSCC), and MLD. The MLD were assessed using the cytospin technique, direct microscopic smears, and flow cytometry. The predictive values of each single leukocyte population and useful potential indices that could better reflect immune complexity were also calculated. Changes in the percentage of any leukocyte alone failed to substantially improve the predictive value of qSCC in diagnosing IMIs. Although certain parameters increased the area under the receiver operating characteristic curve (ROC curve) as a result of increased specificity values, a slight reduction in sensitivity was observed. The so-called CD8 complex was a unique parameter which improved both the sensitivity (78.79 %) and the specificity (80.77 %) in IMI diagnosis, resulting in the highest area under the ROC curve (0.87). To diagnose subclinical mastitis, the percentage of macrophages and the sum of the percentage PMNLs and T CD8+ cells divided by the percentage of macrophages showed the highest predictive values (sensitivity = 79.63, specificity = 73.68, and area under the ROC curve = 0.83) in the differentiation of the inflammatory condition status of cows. In conclusion, this study provides further insights into using T CD8+ lymphocytes in diagnosing bovine IMIs, combined with PMNLs and macrophages. The antidromic trend of macrophages vs. PMNLs and T CD8+ lymphocytes due to the increasing qSCCs was crucial to differentiating quarters under both inflammatory and non-inflammatory conditions.