Abstract Intense soil preparation and disturbance in crops, over time, reduces the quantity and quality of soil organic matter. Given this context, this work aimed to determine soil carbon stocks and labile fractions under agroforestry system (AFS) and toposequences in an altitude marsh, Taquaritinga do Norte, Pernambuco, Brazil. The study was carried out at the Yaguara farm, and the areas studied were native forest with 4.57 ha and coffee plantation in shade with native forest with 25.59 ha. Soil samples were collected in four trenches measuring 1.5 x 1.5 x 0.60 m, with a distance of 50 meters. Soils were collected at depths of 0-20, 20-40 and 40-60 cm, followed by chemical, physical and density analyzes to determine soil carbon stocks and labile fractions. The area with shaded coffee showed higher values of soil carbon stocks at depths of 0-20 cm and 20-40 cm. At a depth of 40-60 cm, the AFS top toposequence showed the highest carbon stock with 11.73 Mg ha-1, followed by the area with native vegetation with 10.6 Mg ha-1, slope with 9.23 Mg ha-1 and pediment with 7.00 Mg ha-1. It was found that the top toposequence with shaded coffee exhibited a greater stock of labile carbon at depth 0-20 cm with a value of 1.06 Mg ha-1, followed by the bedding areas (SAF) with 0.88 Mg ha-1, native forest with 0.79 Mg ha-1 and slope with 0.67 g kg-1. However, the area of native vegetation showed the highest value of labile carbon at a depth of 40-60 cm. It was concluded that the area with shaded coffee in the top toposequence showed great capacity to increase total carbon stocks and labile carbon stocks of soil organic matter.

Resumo O intenso preparo e revolvimento do solo em cultivos, com o tempo, reduz a quantidade e a qualidade da matéria orgânica do solo. Diante desse contexto, este trabalho teve como objetivo determinar os estoques de carbono do solo e frações lábeis sob sistema agroflorestal (SAF) e topossequências em brejo de altitude, em Taquaritinga do Norte, Pernambuco, Brasil. O estudo foi desenvolvido na fazenda Yaguara, e as áreas estudadas foram mata nativa com 4,57 ha e plantio de café sombreado com mata nativa com 25,59 ha. As amostras de solos foram coletadas em quatro trincheiras 1,5 x 1,5 x 0,60 m, com distância de 50 metros. Foram coletados solos nas profundidades de 0-20, 20-40 e 40-60 cm, seguido de análises químicas, físicas e densidade para determinação dos estoques de carbono no solo e frações lábeis. A área com café sombreado apresentou maiores valores de estoques de carbono no solo nas profundidades de 0-20 cm e 20-40 cm. Na profundidade de 40-60 cm, a topossequência de topo do SAF apresentou maior estoque de carbono com 11,73 Mg ha-1, seguido da área com vegetação nativa com 10,6 Mg ha-1 , encosta com 9,23 Mg ha-1 e pedimento com 7,00 Mg ha-1. Verificou-se que a topossequência de topo com café sombreado exibiu maior estoque de carbono lábil na profundidade 0-20 cm com o valor de 1,06 Mg ha-1, sucedido das áreas de pedimento (SAF) com 0,88 Mg ha-1, mata nativa com 0,79 Mg ha-1e encosta com 0,67 Mg ha-1. No entanto, a área de vegetação nativa apresentou o maior valor de carbono lábil na profundidade de 40-60 cm. Concluiu-se que a área com café sombreado na topossequência topo mostrou grande capacidade para elevar os estoques de carbono total e estoques de carbono lábil da matéria orgânica do solo.

RESUMO Objetivo: Traduzir e validar o questionário de olho seco e lentes de contato (CLDEQ-8) para o português e descrever o impacto das lentes de contato gelatinosas na superfície ocular. Métodos: Estudo transversal e descritivo com o objetivo de (1) traduzir e validar o CLDEQ-8 para o português e (2) aplicar o CLDEQ-8 em um grupo de usuários de lentes de contato, juntamente com uma ampla avaliação do impacto das lentes gelatinosas na superfície ocular. A avaliação do impacto das lentes gelatinosas foi realizada em uma amostra composta por 81 indivíduos, divididos em dois grupos: 61 usuários de lente de contato (Grupo A) e um grupo controle de 20 não usuários (Grupo B). Como critério de exclusão: usuário de lentes de contato rígidas, doenças sistêmicas ou oculares prévias, uso de medicamentos que podem causar danos a superfície ocular e cirurgias oculares prévias. Resultados: Para a tradução e validação do questionário CLDEQ-8, os valores de concordância Kappa foram iguais ou superiores a 0,7 em todas as perguntas, o que implica em uma boa concordância entre as versões em português e inglês. Considerando a avaliação da superfície ocular dos sujeitos, todos os parâmetros diferiram nos usuários de lente de contato em comparação com os controles (com p<0,05), exceto naqueles relacionados ao volume lacrimal, como altura do menisco lacrimal e teste de Schirmer. Conclusões: Este estudo forneceu uma versão traduzida para o português e validada do questionário CLDEQ-8, que representa uma importante ferramenta na avaliação de usuários de lente de contato. A avaliação da superfície ocular realizada demonstra a relação entre o uso de lentes de contato gelatinosas e os distúrbios da superfície ocular.

ABSTRACT Purpose: To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. Methods: We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. Results: For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. Conclusions: This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.

Abstract Background: Elderly patients may present with visual function impairment after surgery, which may increase the incidence of postoperative delirium and falls and decrease their quality of life. The aim of this study was to assess visual function in elderly patients after long-duration nonocular surgery to determine the incidence and risk factors for visual function impairment after surgery. Methods: This prospective and observational study included patients aged between 60 and 80 years who had been scheduled for elective non-ocular surgery expected to last longer than 120 minutes under general anaesthesia. Ocular examinations were performed before surgery, on post-operative day 3 and on post-operative day 21 and consisted of a LogMAR-Snellen chart test, a Jager chart test, biomicroscopy, optical tonometry, ocular motility assessment and fundoscopy. Baseline characteristics of all patients as well as intraoperative and postoperative data were collected. Results: A total of 107 patients were included in the final analysis. Visual function impairment was diagnosed in 21 patients (19.6%) at POD 3. Of those, 7 patients (6.5%) still presented with visual changes at POD 21. On POD 3, compared with that at baseline, visual acuity assessed by the Snellen chart test had decreased in these patients. Significant differences regarding refraction tests and intraocular pressure measures were also found. Multivariable analysis identified diabetes mellitus, duration of surgery, hypotension during anaesthesia induction, lower peripheral oxygen saturation at the end of the procedure and body mass index as independent risk factors for postoperative visual impairment. Conclusion: In elderly patients undergoing long-duration non-ocular procedures under general anaesthesia, the incidence of visual function impairment was considerably high. Most patients recovered to baseline visual function, but clinically significant visual changes may still be present 3 weeks after surgery. Obesity, diabetes mellitus, and the duration of surgical and anaesthetic techniques appear to increase the risk of visual impairment after surgery.

RESUMO: Este artigo tem como objetivo discutir as percepções sobre o turismo de moradores de uma comunidade periférica, localizada no município de Caxias do Sul-RS (Brasil). A pesquisa considerou a revisão bibliográfica, cobrindo aspectos históricos que caracterizam o turismo como uma prática marcada pela exclusão, e abordagens teóricas que a ignoram. Posteriormente, seguindo as técnicas propostas pelo Discurso do Sujeito Coletivo (DSC), foram ouvidos onze moradores da comunidade Cooperativa Habitacional Marianinha de Queiroz. A sistematização dos resultados em discursos sínteses permitiu compreender que os entrevistados associam o turismo: (a) à lógica da inclusão, quando afirmam que viajar de férias é diversão e lazer; e (b) à exclusão, quando lembram que o turismo é um prazer reservado às pessoas com poder aquisitivo. Segundo Milton Santos, a exclusão afeta o desenvolvimento da cidadania; nesses termos, considera-se que a exclusão da prática do turismo também contribui para esse deficit cidadão.

ABSTRACT: The article discusses the perceptions of residents of a peripheral community in the city of Caxias do Sul-RS (Brazil) in relation to tourism. The research conducted a bibliographic review, covering historical aspects that characterize tourism as a practice of the elite, and theoretical approaches that ignore the exclusion of the majority of people. Eleven residents of the community known as the Cooperativa Habitacional Marianinha de Queiroz were interviewed, using the techniques of Collective Subject Discourse (DSC). Analysis of the discourses revealed that the interviewees associate tourism with: (a) inclusion, stating that traveling on vacation is for fun and leisure; and (b) exclusion, recalling that tourism is a pleasure reserved for people with higher purchasing power. According to Milton Santos, exclusion affects the development of citizenship; in these terms, we consider that the exclusion in tourism also contributes to this citizenship deficit.

RESUMEN: Este artículo tiene como objetivo discutir las percepciones de los residentes en una comunidad periférica ubicada en el municipio de Caxias do Sul-RS (Brasil), sobre el turismo. El camino de la investigación se estableció a partir de revisión bibliográfica, abarcando los aspectos históricos que caracterizan el turismo como práctica marcada por la exclusión, y enfoques teóricos, que lo ignoran. Posteriormente, siguiendo las técnicas propuestas por el Discurso del Sujeto Colectivo (DSC), once residentes en la comunidad Cooperativa de Habitacional Marianinha de Queiroz fueron oídos. La sistematización de los resultados en discursos síntesis permitió comprender que estos residentes asocian el turismo: (a) con la lógica de la inclusión, cuando afirman que viajar en vacaciones es diversión y ocio; y (b) exclusión, cuando presentan que el turismo es un placer reservado a las personas con poder adquisitivo. Según Milton Santos, la exclusión afecta el desarrollo de la ciudadanía, y en estos términos consideramos que la exclusión turística es también una manifestación de la imposibilidad de experimentar los beneficios de ser ciudadano.

Abstract: A circular bead produced by a laser beam (CLW) is a method of joining superposed sheets by scanning circularly a laser beam. Among the various applications, it could be highlighted the welding of austenitic stainless steel AISI 304 sheets for heat exchangers. This work aims to report the effect of fiber laser CLW in tensile shear strength of superposed sheets as well as the corrosion behavior in relation to the process parameters. It was carried out circular beads using stainless steel AISI 304 sheets varying the laser power and speed. The samples were then submitted to optical and electronic microscopy, tensile-shear tests and electrochemical experiments. Among the experimental conditions, the weld sample with 800 W power and 50 mm/s speed presented an ultimate tensile strength of 159 MPa, 17% higher than the sample with the lowest result. The corrosion rate, corrosion and pitting potentials did not change significantly in the welded joint with different conditions compared to the base metal.

Objetivo: analisar as evidências científicas disponíveis sobre os diferentes métodos de reprocessamento e as condições necessárias para reuso de máscara respiratória facial do tipo N95 ou equivalente. Método: revisão integrativa da literatura. Para elaboração da questão foi utilizada a estratégia PICO. A busca ocorreu em quatro bases de dados PubMed, Sci Verse Scopus, Web of Science e EMBASE considerando qualquer período de tempo. Resultados: foram incluídos 32 estudos dos 561 identificados e apresentados em duas categorias: “condições para reuso” e “reprocessamento das máscaras”. Das pesquisas avaliadas, sete (21,8%) abordaram o reuso da máscara respiratória facial do tipo N95 ou equivalente e 25 (78,1%) avaliaram diferentes métodos de reprocessamento: irradiação germicida ultravioleta (14); peróxido de hidrogênio (8); métodos a vapor (14); utilização do calor seco (5) e métodos químicos (hipoclorito de sódio (6), etanol (4) e cloreto de sódio com bicarbonato de sódio e dimetildioxirano (1). Destacamos que um mesmo artigo utilizou diferentes métodos. Conclusão: não foram encontradas evidências que sustentam o reprocessamento seguro de máscaras respiratórias faciais. Ainda, o reuso é contraindiciado devido ao risco de autocontaminação e vedação inadequada.

Objective: to analyze the scientific evidence available on the different reprocessing methods and the necessary conditions for reuse of the N95 face respirator mask or equivalent. Method: an integrative literature review. The PICO strategy was used to elaborate the question. The search was conducted in four databases: PubMed, SciVerse Scopus, WebofScience and EMBASE, considering any period of time. Results: a total of 32 studies were included from the 561 studies identified, and they were presented in two categories: “Conditions for reuse” and “Reprocessing the masks”. Of the evaluated research studies, seven(21.8%) addressed the reuse of the N95 face respirator mask or equivalent and 25(78.1%) evaluated different reprocessing methods, namely: ultraviolet germicidal irradiation(14); hydrogen peroxide(8); vapor methods(14); using dry heat(5) and chemical methods(sodium hypochlorite[6], ethanol[4] and sodium chloride with sodium bicarbonate and dimethyldioxirane[1]). We emphasize that different methods were used in one same article. Conclusion: no evidence was found to support safe reprocessing of face respirator masks. In addition, reuse is contraindicated due to the risk of self-contamination and inadequate sealing.

Objetivo: analizar la evidencia científica disponible sobre los diferentes métodos de reprocesamiento y las condiciones necesarias para la reutilización de una mascarilla respiratoria facial N95 o equivalente. Método: revisión integradora de la literatura. Para elaborar la pregunta se utilizó la estrategia PICO. La búsqueda se realizó en cuatro bases de datos PubMed, Sci Verse Scopus, Web of Science y EMBASE sin límite de tiempo. Resultados: de los 561 estudios identificados 32 fueron incluidos y presentados en dos categorías: “condiciones de reutilización” y “reprocesamiento de mascarillas”. De las investigaciones evaluadas, siete (21,8%) abordaron la reutilización de la mascarilla respiratoria facial N95 o equivalente y 25 (78,1%) evaluaron diferentes métodos de reprocesamiento: irradiación germicida ultravioleta (14); peróxido de hidrógeno (8); métodos de vapor (14); uso de calor seco (5) y métodos químicos hipoclorito de sodio (6), etanol (4) y cloruro de sodio con bicarbonato de sodio y dimetildioxirano (1). Cabe destacar que en un mismo artículo se utilizaron métodos diferentes. Conclusión: no se encontró evidencia que apoye el reprocesamiento seguro de las mascarillas respiratorias. Además, la reutilización está contraindicada debido al riesgo de autocontaminación y sellado inadecuado.

BACKGROUND: Even students with previous academic success may face challenges that affect their academic performance. Many medical schools offer programs to students at the risk of academic failure, to ensure that they succeed in the course. OBJECTIVE AND METHODS: In this report we describe a pioneering academic tutoring program developed at a Brazilian medical school and discuss the initial results of the program based on the feedback from tutors and data regarding the progression of students in the medical course. RESULTS: In 2018, 33 students enrolled into the program. Students' performance difficulties were mainly associated with mental health problems and socioeconomic vulnerability. Of the 33 students, 27 (81.8%) were assisted by the Mental Health Support Service and 16 (48.5%) were assisted by the Social Assistance Service. In addition to the planning academic activity class load, tutors were able to assist students in solving socioeconomic issues, carrying out personal support interventions with the promotion of self-esteem, and presenting suggestions for behavioral changes in their routine. For most students (72%), the action plan proposed by the tutors was successful. Eight of the 14 (57%) students in the fourth year progressed to the final two years of in-hospital practical training (internship). CONCLUSIONS: The Academic Tutoring Program showed positive results for most of the students. Close monitoring and tutor intervention allowed students with poor academic performance to overcome the low performance cycle. These important tasks demand time and energy from tutors, and institutional recognition of these professionals is essential for the successful maintenance of the program.

Resumo Este estudo teve como objetivo analisar a dinâmica da estrutura de espécies arbóreas e relacionar as mudanças com as condições edáficas em fitofisionomias de cerrado stricto sensu (de 2010 a 2015), cerradão (de 2010 a 2015) e floresta estacional semidecidual (de 2011 a 2015) em Curvelo, Minas Gerais. O inventário florestal considerou amostragens do tipo sistemática em 15 unidades amostrais de 20 × 50 metros no cerrado stricto sensu (CSS), 10 unidades amostrais 20 × 50m no cerradão (CD), CAS ≥ 15,7cm) e 25 unidades amostrais de 10 × 40m na floresta estacional semidecidual (FES - CAP ≥ 15,7 cm). Amostras de solo foram coletadas em todas as unidades amostrais para caracterização química e granulométrica. Nas três fitofisionomias, o número de indivíduos ingressantes foi inferior ao de egressos. No CSS, a área basal no inventário final foi superior à área basal inicial (23,675 - 25,845m2/ha), devido ao incremento expressivo dos sobreviventes. Ocorreram reduções na área basal no CD (19,322 - 17,008 m2/ha) e na FES (28,183 - 28,148 m2/ha), decorrente da alta taxa de mortalidade. Nas três fitofisionomias, a mortalidade foi maior nas primeiras classes diamétricas. De forma lenta, o CSS e CD estão se recuperando pós-distúrbio (fogo), estão surgindo novos indivíduos (recrutas) e crescimento diamétrico dos sobreviventes. Durante o intervalo de 5 anos, não foi possível identificar a recuperação do número de indivíduos, enquanto a FES sem distúrbio do fogo, a perda de indivíduos pela mortalidade e a inclusão de novos indivíduos pelo recrutamento foram mais equilibradas.

Abstract This study aimed to analyze the structural dynamics of tree species and to relate changes with edaphic conditions in the phytophysiognomies of cerrado stricto sensu (from 2010 to 2015), cerradão (from 2010 to 2015) and seasonal semideciduous forest (from 2011 to 2015) in Curvelo, state of Minas Gerais, Brazil. Forest inventories involved systematic sampling in 15 sample units (20 × 50m) in cerrado strict sensu (CSS), 10 sample units (20 × 50m) in cerradão (CD; CAS ≥ 15.7 cm) and 25 sample units (10 × 40m) in semideciduous seasonal forest (SSF; CAP ≥ 15.7 cm). Soil samples were collected in all sample units for the chemical and granulometric characterization. The number of individuals entering was lower than the total recruitment in all phytophysiognomies. Basal area in the final inventory of CSS was higher than initial basal area (23.675 - 25.845m2/ha), due to a significant increase in the surviving individuals. There were reductions in the basal area for DC (19.322 - 17.008 m2/ha) and SSF (28.183 - 28.148 m2/ha), due to high mortality rates. The mortality was higher for the first diametric classes in all three phytophysiognomies. Individual recruitment and diametric growth of survivors during post fire disturbance recovery was slow for CSS and CD. The number of individuals recovering during a 5-year interval could not be determined, however, without fire disturbance, the loss of individuals due to mortality and the recruitment of new individuals in FES were more balanced.

RESUMO Objetivo: Comparar a previsibilidade refrativa pós-operatória do IOLMaster 500 e Pentacam HR com base nos valores de ceratometria e profundidade de câmara anterior nos olhos com indicação de implante de lentes intraoculares multifocais. Métodos: Estudo retrospectivo realizado em 118 olhos tratados com facoemulsificação e implante de lentes intraoculares multifocal. Apenas os olhos que atingiram a emetropia na refração dinâmica no 30º dia pós-operatório foram incluídos. A fórmula de Haigis foi usada em cada caso para calcular o poder das lentes intraoculares, e a lente intraocular com a refração alvo mais próxima da emetropia foi implantada. Cenários de cálculo de quatro lentes foram testados pela combinação de medidas de ceratometria e profundidade de câmara anterior obtidas usando os dois dispositivos. Resultados: IOLMaster 500 e Pentacam HR diferiram quanto à média de ceratometria (D 0,07 ± 0,03 D; p=0,0065) e profundidade de câmara anterior (D 0,08 ± 0,01 mm; p<0,001). Na análise da covariância, as seguintes diferenças foram obtidas usando a fórmula de Haigis quando confrontadas com os valores biométricos obtidos pela inserção dos valores de ceratometria e profundidade de câmara anterior, respectivamente: Penta/IOL x IOL/Penta (0,13 ± 0,03; p<0,0001); Penta/Penta x IOL/Penta (0,13 ± 0,03; p<0,0001); Penta/IOL x IOL/IOL (0,11 ± 0,03; p=0,001); Penta/Penta x IOL/IOL (0,11 ± 0,03; p=0,002); IOL/IOL x IOL/Penta (0,02 ± 0,03; p=0,865); Penta/IOL x Penta/Penta (0,002 ± 0,03; p=0,99). A diferença foi menor ao medir a profundidade da câmara anterior usando o IOLMaster 500, independentemente de qual dispositivo foi usado para medir a ceratometria. Conclusões: O Pentacam HR diferiu significativamente do IOLMaster 500 no cálculo de ceratometria. Quanto à profundidade da câmara anterior, os dois dispositivos foram igualmente precisos.

ABSTRACT Purpose: To compare the postoperative refractive predictability of IOLMaster 500 and Pentacam HR on the basis of keratometry and anterior chamber depth values in eyes with an indication for multifocal intraocular lens (IOL) implantation. Methods: This was a retrospective study conducted on 118 eyes treated with phacoemulsification and multifocal intraocular lens implantation. Only the eyes that achieved emmetropia in the dynamic refraction performed on postoperative day 30 were included. Haigis’ formula was used in each case to calculate the intraocular lens power, and the intraocular lens with the target refraction closest to emmetropia was implanted. Four lens calculation scenarios were tested by combining keratometry and anterior chamber depth measurements obtained using the two devices. Results: IOLMaster 500 and Pentacam HR differed with regard to mean keratometry (D 0.07 ± 0.03 D; p=0.0065) and anterior chamber depth (D 0.08 ± 0.01 mm; p<0.001). In the analysis of covariance, the following differences were obtained using the Haigis’ formula when confronted with the biometric values obtained by inserting keratometry and anterior chamber depth values, respectively: Penta/IOL x IOL/Penta (0.13 ± 0.03; p<0.0001); Penta/Penta × IOL/Penta (0.13 ± 0.03; p<0.0001); Penta/IOL × IOL/IOL (0.11 ± 0.03; p=0.001); Penta/Penta × IOL/IOL (0.11 ± 0.03; p=0.002); IOL/IOL × IOL/Penta (0.02 ± 0.03; p=0.865); and Penta/IOL × Penta/Penta (0.002 ± 0.03; p=0.99). The difference was smaller when measuring the anterior chamber depth using the IOLMaster 500, regardless of which device was used to measure keratometry. Conclusions: Pentacam HR significantly differed from IOLMaster 500 when calculating keratometry. As regards the anterior chamber depth, the two devices were equally accurate.

RESUMO Objetivo: Este estudo objetivou analisar o uso potencial Balão de Oclusão Endovascular da Aorta para Ressuscitação (REBOA) em um hospital brasileiro. Métodos: Foi realizada uma revisão da literatura e uma análise retrospectiva de todas as avaliações cirúrgicas de emergência para pacientes com suspeita de hemorragia maciça internados em um hospital brasileiro, de 1 de abril de 2017 a 31 de março de 2018. Os critérios de elegibilidade do REBOA foram: origem abdominal e/ou pélvica, choque hemorrágico e acima de 18 anos de idade. Os critérios de exclusão foram: acima de 70 anos e doença terminal pré-existente ou comorbidades significativas. Resultados: No período, foram solicitadas 90 avaliações. Em 14 ocasiões (15,6%) havia indicação para o uso do REBOA. Os casos em que isso foi possível foram devidos a causas ginecológicas/obstétricas em 11 casos (78,6%) e cirurgia oncológica eletiva em três casos (21,4%). Conclusões: O REBOA é ainda pouco utilizado em nosso país, mas pode ser uma ferramenta de extrema importância, e talvez o último recurso em pacientes extremamente graves, até que o tratamento definitivo, cirúrgico, endovascular ou endoscópico seja efetuado.

ABSTRACT Aim: To evaluate the potential use of REBOA in a Brazilian hospital. Methods: We performed a retrospective analysis of all requests for emergency surgical evaluation for patients with suspected massive hemorrhage, hospitalized in a private Brazilian general hospital, from April 1, 2017 to March 31, 2018. Inclusion criteria for REBOA eligibility were: suspected abdominal and/or pelvic bleeding, hemorrhagic shock and older than 18 years of age. Exclusion criteria were: older than 70 years of age, and pre-existing terminal disease or significant comorbidities. Results: 90 evaluations were requested during the study period. However, according to our inclusion/exclusion criteria, only on 14 occasions (15.6%) there was a recommendation for the use of REBOA. Gynecological/obstetric conditions were the indication in 11 cases (78.6%) and elective oncologic surgery in three cases (21.4%). Conclusions: The use of REBOA is not common in our country, but it can be an essential tool, and perhaps the last resource in extremely severe conditions until the definitive surgical, endovascular or endoscopic treatment is performed.

Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.

Falhas de ¡nformacáo em hospitais podem ocasionar erros na identificacáo de pacientes e na administraçáo de medicamentos. A rastreabilidade executada pela tecnología de comunicacáo sem fio RFID (Radio Frequency Identification) pode auxiliar com o controle eletrónico de dados, gerando ¡nformaçáo precisa das atividades. Este artigo discute urna aplicacáo da rastreabilidade no ambiente hospitalar, utilizando a tecnología RFID para estabelecer o controle da ¡nformaçáo na administracáo medicamentosa, evitando que sejam ministrados medicamentos diferentes dos prescritos ou que sejam enviados ao paciente errado.

Failures of information in hospitals can lead to errors in patient identification and medication administration. Traceability performed by RFID (Radio Frequency Identification) technology can aid in electronic data control, generating accurate information on activities. This article discusses an application of traceability in the hospital environment, using RFID technology to establish control of information in medication administration, avoiding the delivery of medications other than those prescribed or sent to the wrong patient.

Las fallas de información en hospitales pueden ocasionar errores en la identificación de pacientes y en la administración de medicamentos. La rastreabilidad ejecutada por la tecnología de comunicación inalámbrica RFID (Radio Frequency Identification) puede ayudar con el control electrónico de datos, generando información precisa de las actividades. Este artículo discute una aplicación de la trazabilidad en el ambiente hospitalario, utilizando la tecnología RFID para establecer el control de la información en la administración medicamentosa, evitando que se dicten medicamentos diferentes de los prescritos o que sean enviados al paciente equivocado.

RESUMO Objetivo: O objetivo desta revisão foi apresentar e discutir as variações anatômicas e anomalias congênitas do apêndice vermiforme e mesoapêndice relatados nos últimos anos e suas associações com apendicite aguda e outras patologias associadas. Métodos: A busca foi realizada nas seguintes bases de dados: Pubmed, Science Direct e Scielo. Resultados: Trinta e sete estudos foram incluídos nesta revisão. Entre as anormalidades do apêndice vermiforme identificada estão agenesia e duplicidade e, variações anatômicas relacionadas ao comprimento e posicionamento. A duplicidade apendicular foi a anormalidade mais incidente, principalmente do Tipo B2, associada à apendicite aguda, seguida de agenesia do Tipo III. O primeiro caso de agenesia associada à apendicite aguda e à duplicidade de apêndice do tipo vólvulo foi identificado. A posição mais frequente foi a retrocecal em adultos e a pélvica em crianças. No mesoapêndice, foram identificadas variações anatômicas em seu posicionamento, formato, ausência e comprimento. Conclusão: Esta revisão procurou apresentar e discutir as variações anatômicas e anomalias congênitas do apêndice vermiforme e mesoapêndice relatados nos últimos anos e suas associações com apendicite aguda e outras patologias associadas contribuindo para o auxílio no diagnóstico clínico e intervenções cirúrgicas em pacientes com suspeita apendicite aguda.

ABSTRACT Aim: The purpose of this review was to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies. Methods: The search was carried out in the following databases: PubMed, Science Direct, and SciELO. Results: Thirty-seven studies were included in this review. Among the abnormalities of the vermiform appendix identified are agenesis and duplicity, and anatomical variations were related to length and positioning. Appendicular duplicity was a more frequent abnormality, mainly Type B2, associated with acute appendicitis, followed by agenesis, Type III. The first case of agenesis associated with acute appendicitis and volvulus-type duplicity of the appendix was identified. The most frequent position was retrocecal in adults and pelvic in children. In the mesoappendix, anatomical variations in its positioning, shape, absence, and length were identified. Conclusion: This review sought to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies, contributing to aid in clinical diagnosis and surgical interventions in patients with suspected acute appendicitis.

BACKGROUND The severity of chronic chagasic cardiomyopathy (CCC), the most frequent clinical outcome of Chagas disease (CD), has been associated with cytokine-enriched heart tissue inflammation, and high serum levels of transforming growth factor (TGFβ), interferon-gamma (IFNγ), and tumour necrosis factor (TNF). Conversely, increased interleukin (IL)-10 serum concentrations have been associated with asymptomatic CD. Cytokines and cytokine-related gene polymorphisms may control cytokine expression and have been proposed to contribute to CCC outcomes. OBJECTIVES We evaluated the association of 13 cytokine-related genes (TGFB: rs8179181, rs8105161, rs1800469; IL10: rs1800890, rs1800871, rs1800896; IFNG: rs2430561; TNF: rs1800629; BAT1: rs3853601; LTA: rs909253, rs2239704; TNFR1: rs767455; TNFR2: rs1061624) with risk and progression of CCC. FINDINGS Four hundred and six seropositive patients from CD endemic areas in the state of Pernambuco, north-eastern Brazil, were classified as non-cardiopathic (A, 110) or cardiopathic (mild, B1, 163; severe, C, 133). We found no evidence of TGFB, IL10, TNF, or TNFR1/2 gene polymorphisms associated with CCC risk or progression. Only BAT1 rs3853601 −22G carriers (B1 vs. C: OR = 0.5; p-value = 0.03) and IFNG rs2430561 +874AT (A vs. C: OR = 0.7; p-value = 0.03; A vs. B1+C: OR = 0.8; p-value = 0.02) showed a significant association with protection from cardiopathy in a logistic regression analysis with adjustment for gender and ethnicity; however, the association disappeared after performing adjustment for multiple testing. A systematic review of TNF rs1800629 −308G>A publications included five studies for meta-analysis (534 CCC and 472 asymptomatic patients) and showed no consensus in pooled odds ratio (OR) estimates for A allele or A carriers (OR = 1.4 and 1.5; p-values = 0.14 and 0.15, respectively). In CD patients, TNF serum levels were increased, but not affected by the TNF rs1800629 −308A allele. MAIN CONCLUSIONS Our data suggest no significant contribution of the analysed gene variants of cytokine-related molecules to development/severity of Chagas' heart disease, reinforcing the idea that parasite/host interplay is critical to CD outcomes.

Abstract This work aims to reduce the energy consumption and thus increase the availability of blast furnace compressors of a steelmaking company, located in Alto Paraopeba region in Minas Gerais state, Brazil, through the elimination of waste points in the compressed air distribution. In order to develop this work, an ultrasound test in the compressed air line was performed to identify and quantify leaks in the flow. Once the leaks were identified, they were eliminated through corrective maintenance and improvements, and then the energy consumption scenarios before and after the improvements were compared. As a result, the average monthly electricity consumption in the reporting period decreased by 57.2%. In addition, one compressor was set aside in stand-by condition, as in the original plant. Thus, one can prove the efficiency in eliminating of waste points in compressed air distribution, since the reduction of energy consumption is important for the company to remain competitive, as the cost of electric energy affects the final price of the final products.