RESUMO: O objetivo deste estudo foi avaliar se o teste do anel do leite (TAL), utilizado para o diagnóstico da brucelose em nível de rebanho leiteiro, pode ser realizado em amostras de leite com conservador (Bronopol®) coletado para contagem de células somáticas (CCS) que é utilizado para monitoramento de mastite. Foram analisadas 38 amostras de leite de tanques de expansão (ALTE) de 19 rebanhos leiteiros produtores de queijo artesanal e 36 ALTE de rebanho leiteiro livre de brucelose, utilizadas como controle negativo (CN) e controle positivo (CP), quando foi adicionado soro de animais vacinados. As amostras de leite foram coletadas em dois frascos diferentes (com e sem Bronopol®). Todos as 38 ALTE de produtores artesanais de queijo (amostras com e sem Bronopol®) foram não reagentes ao TAL, como todos os CN. Todos os CP foram reagentes ao TAL, sem interferência do Bronopol®. Os resultados mostraram que a amostra de leite utilizada para CCS apresentaram a proporção de concordância dos resultados em todas as amostras de leite (100%), ou seja, não foram observados resultados falso-positivos e falso-negativos. Os resultados indicam que o Bronopol® não interferiu na cor no momento da leitura do TAL, sugerindo que as mesmas amostras de leite poderiam ser usadas para monitorar mastite e brucelose.

ABSTRACT: This study evaluated if the milk ring test (MRT) used to the brucellosis diagnostic at dairy herd level can be done in milk samples with conservative (Bronopol®) collected to the somatic cell count (SCC) that is used to mastitis monitoring. It were analyzed 38 bulk tank milk samples (BTMS) from 19 dairy herds artisanal cheese producers and 36 BTMS from a brucellosis free dairy herd, used as negative control (NC) and positive control (PC), when was added serum from vaccinated animals. The milk samples were collected in two different bottles (with or without Bronopol®). All the 38 BTMS from artisanal cheese producers (samples with and without Bronopol®) were non-reagent to MRT, as all NC. All PC were reagent to MRT, without interference of Bronopol®. Results showed that the milk sample used to SCC presented the proportion of agreement of results in all milk samples (100%), that is, false positive and false negative results were not observed. Results indicated that Bronopol® did not interfere with the color in the time of MRT reading suggesting that the same milk samples could be used to monitoring mastitis and brucellosis.

SUMMARY OBJECTIVE: This study aimed to analyze the epidemiological profile and psychological disorder of the suicide attempt cases in Francisco Beltrão, Paraná. METHODS: This is an epidemiological descriptive/qualitative study of suicide attempts conducted between 2017 and 2020. This study used data from the Brazilian Information system for notifications involving suicide attempts (Sistema de Informação de Agravos de Notificação, SINAN) and 447 notifications were obtained. An analysis of the electronic medical record of these patients was performed in order to investigate the mental disorders, using a questionnaire. RESULTS: Of the 447 notifications, 382 were eligible for the study. Using the 95% confidence interval, there was a higher frequency of females with 71.7% aged between 18 and 35 years representing 48.4%, with 77.2% white race/color, the singles appeared in the majority with 47.6% with a history of previous suicide attempts, using exogenous intoxication as a method in the attempt with 67.5%. Regarding mental health, 66.5% of the patients had some mental disorders, with the highest prevalence of recurrent depressive disorder found in 40.6%. CONCLUSION: It was observed that there is a need for training of health professionals and implementation of programs and preventive measures aimed primarily at females aged between 18 and 35 years with mental disorders, especially with recurrent depressive disorder and with a history of previous suicide attempt.

RESUMO Introdução: Declínio cognitivo é uma condição prevalente, apesar de ainda pouco representada em estudos de países em desenvolvimento. Objetivo: Calcular a prevalência de declínio cognitivo e depressão de uma população de idosos de uma cidade do Sul do Brasil. Métodos: Nós calculamos a prevalência de demência, declínio cognitivo sem demência (DCSD) e sintomas de depressão de uma população idosa de uma cidade assistida pelo sistema público de saúde. Um estudo epidemiológico foi conduzido em Pelotas, Brasil, no contexto de atenção primária incluindo 299 idosos (idade média = 69.75±7.6 anos), apresentando baixo nível educacional (média de anos de educação = 4.16±3.17). Esses indivíduos realizaram teste de rastreio cognitivo, e seus prontuários foram analisados. Resultados: Um total de 142 (47.5%) idosos apresentaram declínio cognitivo, dos quais 104 (34.8%) destes indivíduos atenderam a critérios cognitivos de DCSD e 38 (12.7%) indivíduos atenderam a critérios cognitivos para demência. Dentre todos indivíduos que completaram o rastreio, 141 (48.4%) foram positivos para sintomas de depressão, enquanto 99 (34%) não tinham diagnóstico em seus prontuários. Conclusão: Em suma, nós descrevemos uma prevalência alta de deterioro cognitivo entre idosos em um estudo de atenção primária. Nós também achamos um grande número de idosos com sintomas de depressão sem diagnóstico.

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

RESUMO Objetivo: A quimioterapia adjuvante melhora a sobrevida de pacientes com câncer pulmonar de células não pequenas (CPCNP) ressecado. No entanto, o esquema cisplatina-vinorelbina está relacionado com risco significativo de toxicidade clinicamente relevante. Nosso objetivo foi avaliar a eficácia, segurança e viabilidade da quimioterapia adjuvante para pacientes com CPCNP em um cenário de mundo real. Métodos: Estudo retrospectivo de coorte realizado em um único centro com pacientes com CPCNP em estágio I-III submetidos a cirurgia com intuito curativo entre 2009 e 2018. A quimioterapia adjuvante foi administrada a critério dos médicos. Os pacientes foram divididos em dois grupos: quimioterapia adjuvante e sem quimioterapia adjuvante (grupo controle). Os desfechos estudados foram sobrevida global (SG) e sobrevida livre de recidiva (SLR), bem como o perfil de segurança e viabilidade do esquema cisplatina-vinorelbina em um cenário de mundo real. Resultados: O estudo envolveu 231 pacientes, 80 dos quais receberam quimioterapia adjuvante. Destes, 55 receberam o esquema cisplatina-vinorelbina. As análises de sobrevida estratificadas pelo estágio do tumor mostraram que os pacientes com CPCNP em estágio II que receberam quimioterapia adjuvante apresentaram melhor SLR (p = 0,036) e SG (p = 0,017) do que os do grupo controle. Entre os pacientes com CPCNP em estágio III que receberam quimioterapia adjuvante, a SLR foi melhor (p < 0,001) e houve uma tendência a melhor SG do que no grupo controle (p = 0,060). Dos que receberam o esquema cisplatina-vinorelbina, 29% apresentaram neutropenia febril de grau 3-4, e 9% morreram em virtude de toxicidade. Conclusões: Os resultados confirmam o efeito benéfico da quimioterapia adjuvante em pacientes com CPCNP em um contexto real. No entanto, o esquema cisplatina-vinorelbina relacionou-se com taxas alarmantes de toxicidade e alternativas mais eficazes e menos tóxicas devem ser investigadas.

ABSTRACT Objective: Adjuvant chemotherapy (AC) improves survival of patients with resected non-small cell lung cancer (NSCLC). However, the cisplatin-vinorelbine regimen has been associated with a significant risk of clinically relevant toxicity. We sought to evaluate the effectiveness, safety, and feasibility of AC for NSCLC patients in a real-world setting. Methods: This was a single-center, retrospective cohort study of patients with stage I-III NSCLC undergoing surgery with curative intent between 2009 and 2018. AC was administered at the discretion of physicians. The patients were divided into two groups: AC group and no AC (control) group. Study outcomes included overall survival (OS) and recurrence-free survival (RFS), as well as the safety profile and feasibility of the cisplatin-vinorelbine regimen in a real-world setting. Results: The study involved 231 patients, 80 of whom received AC. Of those, 55 patients received the cisplatin-vinorelbine regimen. Survival analyses stratified by tumor stage showed that patients with stage II NSCLC in the AC group had better RFS (p = 0.036) and OS (p = 0.017) than did those in the no AC group. Among patients with stage III NSCLC in the AC group, RFS was better (p < 0.001) and there was a trend toward improved OS (p = 0.060) in comparison with controls. Of those who received the cisplatin-vinorelbine regimen, 29% had grade 3-4 febrile neutropenia, and 9% died of toxicity. Conclusions: These results support the benefit of AC for NSCLC patients in a real-world setting. However, because the cisplatin-vinorelbine regimen was associated with alarming rates of toxicity, more effective and less toxic alternatives should be investigated.

RESUMO Populações do patógeno da mela da soja (Rhizoctonia solani AG-1 IA) são altamente diferenciadas geneticamente ao longo de um gradiente latitudinal nas mais importantes regiões de cultivo de soja do Brasil. Entretanto, os processos evolutivos que guiaram a adaptação regional são ainda desconhecidos. O objetivo deste trabalho foi avaliar a importância relativa da variação genética neutra e da seleção natural sobre a divergência e adaptação regional de populações de R solani AG-1 IA da soja. Para tanto, comparou-se a diferenciação fenotípica por caracteres quantitativos (QST) e a diferenciação genética neutra (baseada em dados de microssatélites) entre três pares de populações (FST). Como medidas de respostas fenotípicas do fungo (caracteres quantitativos), estimou-se a tolerância ao estresse de temperatura e a tolerância a um fungicida cúprico de amplo espectro de ação (oxicloreto de cobre) sob condições ótimas (25 °C) e de temperatura elevada (33,5 °C). No geral houve aumento da variância genética com um efeito positivo sob a herdabilidade para tolerância ao fungicida cúprico na temperatura de estresse. As diferenças genéticas entre populações foram os principais determinantes da adaptação térmica em R. solani AG-1 IA (h2 > 0.70). A análise da estrutura genética neutra (FST) indicou subdivisão entre os três pares de populações. Embora a comparação de FST com os dados QST entre pares de populações não tenha seguido um único padrão, a maioria dos valores de QST estimados não diferiram significativamente de FST, indicando que, para os caracteres quantitativos estudados, a neutralidade (ou evolução neutra) teve importante papel na adaptação regional das populações do patógeno.

ABSTRACT Populations of the soybean leaf blight pathogen (Rhizoctonia solani AG-1 IA) are highly genetically differentiated along a latitudinal gradient in the major soybean growing regions of Brazil. However, the evolutionary processes leading to regional adaptation are still unknown. The objective of this study was to evaluate the relative importance of neutral genetic variation and natural selection on the divergence and regional adaptation of populations of the soybean-infecting pathogen R. solani AG-1 IA. Therefore, we compared the phenotypic differentiation in quantitative traits (QST) and the neutral genetic differentiation (FST, based on microsatellites data) among three pairs of populations. As measures of phenotypic responses of the fungus (quantitative traits), we estimated the tolerance to temperature stress and the tolerance to a broad-spectrum fungicide (copper oxychloride) under optimal (25 °C) and high temperature conditions (33.5 °C). In general there was an increase in genetic variance with a positive effect on the heritability for tolerance to copper fungicide under temperature stress. The genetic differences among populations were the main determinants of thermal adaptation in R. solani AG-1 IA (h2 > 0.70). The analysis of neutral genetic structure (FST) indicated subdivision between the three pairs of populations. Although population pairwise comparisons between FST and QST values did not follow a single pattern, the majority of QST values did not differ significantly from FST, indicating that, for the quantitative characters studied, neutrality (or neutral evolution) had a major role in the regional adaptation of R. solani AG-1 IA populations.

OBJECTIVE: To evaluate the role of intraocular fluid analysis as a diagnostic aid for uveitis. METHODS: Twenty-eight samples (27 patients including 3 HIV-infected patients) with active (n=24) or non-active (n=4) uveitis were submitted to aqueous (AH; n=12) or vitreous humor (VH) analysis (n=16). All samples were analyzed by quantitative PCR for herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV) and Toxoplasma gondii. RESULTS: The positivity of the PCR in AH was 41.7% (5/12), with 50% (2/4) in immunocompetent and 67% (2/3) in HIV+ patients. The positivity of the PCR in VH was 31.2% (5/16), with 13% (1/8) in immunocompetent and 50% (4/8) in immunosuppressed HIV negative patients. The analysis was a determinant in the diagnostic definition in 58% of HA and 50% of VH. CONCLUSION: Even in posterior uveitis, initial AH analysis may be helpful. A careful formulation of possible clinical diagnosis seems to increase the chance of intraocular sample analysis being meaningful.

<title>ABSTRACT</title><sec><title>Purpose:</title><p>To describe our experience with percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys and analyze factors that can impact on intra-operative bleeding and postoperative complications.</p></sec><sec><title>Materials and Methods:</title><p>We reviewed our stone database searching for patients with solitary kidney who underwent PCNL from Jan-05 through Oct-13. Demographic data, stone characteristics, and intra- and postoperative outcomes were recorded. Spearman correlation was performed to assess which variables could impact on bleeding and surgical complications. Linear and logistic regressions were also performed.</p></sec><sec><title>Results:</title><p>Twenty-seven patients were enrolled in this study. The mean age and BMI were 45.6 years and 28.8Kg/m², respectively; 45% of cases were classified as Guys 3 (partial staghorn or multiple stones) or 4 (complete staghorn) – complex cases. Stone-free rate was 67%. Eight (29.6%) patients had postoperative complications (five of them were Clavien 2 and three were Clavien 3). On univariate analysis only number of tracts was associated with increased bleeding (p=0.033) and only operative time was associated with a higher complication rate (p=0.044). Linear regression confirmed number of access tracts as significantly related to bleeding (6.3, 95%CI 2.2-10.4; p=0.005), whereas logistic regression showed no correlation between variables in study and complications.</p></sec><sec><title>Conclusions:</title><p>PCNL in solitary kidneys provides a good stone-free rate with a low rate of significant complications. Multiple access tracts are associated with increased bleeding.</p></sec>