RESUMO Introdução: Trauma facial apresenta relevância estética, social e econômica. Conhecer sua epidemiologia permite formular medidas de prevenção, educação e sistematização de atendimento. Métodos: Triagem, através do sistema de informação hospitalar, buscando pacientes que necessitaram de cirurgia para fratura de face entre abril de 2015 e abril de 2020. Foram, então, coletados dados epidemiológicos. Resultados: Foram selecionados 141 pacientes. A média de idade foi 34 anos, com maioria do sexo masculino (85%). A etiologia predominante foi acidente com veículo automotor e a fratura cirúrgica mais prevalente foi a de órbita (67%). A mediana de tempo entre o trauma e a cirurgia foi de 18 dias. Sessenta pacientes apresentaram lesões associadas à fratura de face, com destaque para as ortopédicas e neurológicas. Conclusão: A etiologia mais comum de fraturas faciais cirúrgicas foi acidente de trânsito, sendo o sexo masculino mais afetado. As fraturas de órbita foram as mais tratadas cirurgicamente.

ABSTRACT Introduction: Facial trauma presents aesthetic, social and economic relevance. Knowing its epidemiology makes it possible to formulate measures for prevention, education and systematization of care. Methods: Research through the hospital information system, looking for patients who needed to undergo surgery for face fracture between April 2015 and April 2020. Epidemiological data were then collected. Results: 141 patients were selected. The average age was 34 years, with most males (85%). The predominant etiology was motor vehicle accidents, and the most prevalent surgical fracture was orbit (67%). The median time between trauma and surgery was 18 days. Sixty patients had injuries associated with facial fractures, especially orthopedic and neurological injuries. Conclusion: The most common etiology of surgical facial fractures was a traffic accident, predominantly among men. Orbit fractures were the most surgically treated.

Resumo Objetivo: Avaliar a taxa de progressão das lesões císticas renais complexas Bosniak II-F e a taxa de neoplasia maligna nas lesões ressecadas cirurgicamente. Materiais e Métodos: Realizamos uma pesquisa no banco de dados da nossa instituição reunindo lesões císticas renais complexas classificadas como Bosniak II-F em exames de tomografia computadorizada ou ressonância magnética, de janeiro de 2008 a abril de 2016. Foram utilizados exames de acompanhamento (tomografia computadorizada ou ressonância magnética) para avaliar a progressão na categoria Bosniak, com um mínimo de seis meses de estabilidade. Os relatórios de patologia foram utilizados como referência para avaliar a taxa de neoplasia maligna de lesões ressecadas cirurgicamente. Resultados: Um total de 152 lesões em 143 pacientes foi incluído na análise final. Sete lesões foram reclassificadas em estudos de acompanhamento (4,6%) e o tempo médio de progressão foi de 20 meses (1 mês a 4 anos). Três pacientes tiveram cistos ressecados cirurgicamente, todos diagnosticados como carcinoma de células renais: um do subtipo células claras e dois papilíferos, todos de baixo grau. As 145 lesões restantes permaneceram inalteradas, com seguimento médio de 28 meses (6 a 118 meses). Conclusão: A taxa de progressão nos cistos categoria Bosniak II-F foi baixa. Mesmo as lesões que tiveram upgrade da categoria de Bosniak no seguimento permaneceram estáveis, indicando um comportamento indolente. Nossos dados apoiam a ideia de tratamento conservador do cisto renal Bosniak II-F.

Abstract Objective: To evaluate progression rate of Bosniak category IIF complex renal cysts and the malignancy rate among surgically resected cysts. Materials and Methods: We performed a database search for complex renal cysts classified as Bosniak category IIF on computed tomography or magnetic resonance imaging between January 2008 and April 2016. Follow-up examinations (computed tomography or magnetic resonance imaging) were used in order to evaluate progression (Bosniak category reclassification) and stability, the latter being defined as remaining stable for a minimum of six months. Pathology reports were used as the reference to assess the malignancy rate of surgically resected cysts. Results: A total of 152 cysts in 143 patients were included in the final analysis. Seven cysts (4.6%) were reclassified on follow-up studies, and mean time to progression was 20 months (range, 1 month to 4 years). Three cysts were surgically resected. All three were diagnosed as low-grade malignant renal cell carcinomas (RCCs): one clear cell RCC and two papillary RCCs. The remaining 145 cysts remained unchanged after a mean follow-up period of 28 months (range, 6 to 118 months). Conclusion: The progression rate in Bosniak category IIF cysts was low. Even lesions that were upgraded on follow-up remained stable, indicating an indolent behavior. Our data support the idea of conservative management of Bosniak IIF renal cyst.

Abstract INTRODUCTION: In 2013, combination therapy using peginterferon, ribavirin, and boceprevir or telaprevir was introduced to treat hepatitis C virus genotype 1 infection in Brazil. The effectiveness of this therapy in four Brazilian regions was evaluated. METHODS: Clinical and virological data were obtained from patients of public health institutions in five cities, including sustained virological response (SVR) and side effects. Patients with advanced fibrosis (F3/4), moderate fibrosis (F2) for > 3 years, or extra-hepatic manifestations were treated according to Ministry of Health protocol. Treatment effectiveness was verified by using bivariate and multivariate analysis; p-values of < 0.05 were considered significant. RESULTS: Of 275 patients (64.7% men; average age, 57 years old), most (61.8%) were treatment-experienced; 53.9% had subgenotype 1a infection, 85.1% had advanced fibrosis, and 85.5% were treated with telaprevir. SVR was observed in 54.2%. Rapid virological response (RVR) was observed in 54.6% of patients (data available for 251 patients). Overall, 87.5% reported side effects and 42.5% did not complete treatment. Skin rash, severe infection, and death occurred in 17.8%, 2.5%, and death in 1.4% of cases, respectively. SVR was associated with treatment completion, RVR, and anemia. CONCLUSIONS: The effectiveness of hepatitis C virus triple therapy was lower than that reported in phase III clinical trials, possibly owing to the prioritized treatment of patients with advanced liver fibrosis. The high frequency of side effects and treatment interruptions observed supported the decision of the Brazilian authorities to suspend its use when safer and more effective drugs became available in 2015.

Resumo A insuficiência cardíaca com fração de ejeção preservada (ICFEP) é hoje uma epidemia cardiovascular emergente, sendo identificada como o principal fenótipo observado na prática clínica. Está mais associado ao sexo feminino, idade avançada e a comorbidades como hipertensão arterial, diabetes, obesidade e doença renal crônica. A amiloidose é uma desordem clínica caracterizada pelo depósito de agregados de fibrilas insolúveis originadas de proteínas que apresentam dobramento anômalo. Recentemente, têm sido descritos quadros de amiloidose senil em pacientes com ICFEP, demonstrando a necessidade de os cardiologistas clínicos investigarem esta etiologia em casos suspeitos. Deve-se aumentar a suspeição clínica de amiloidose diante dos casos de ICFEP onde os métodos de cardioimagem sejam compatíveis com o quadro de cardiomiopatia infiltrativa. Os avanços nos métodos de cardioimagem aliados à possibilidade de realização de testes genéticos e identificação do tipo do material amiloide permitem a realização do diagnóstico. O manejo dos pacientes diagnosticados pode ser feito em parceria com centros especializados no estudo de amiloidose, que, aliados às novas tecnologias, investigam a possibilidade de transplante de órgãos ou medula óssea e também o envolvimento dos pacientes em estudos clínicos que avaliam a ação das novas drogas emergentes.

Abstract Heart failure with preserved ejection fraction (HFpEF) is now an emerging cardiovascular epidemic, being identified as the main phenotype observed in clinical practice. It is more associated with female gender, advanced age and comorbidities such as hypertension, diabetes, obesity and chronic kidney disease. Amyloidosis is a clinical disorder characterized by the deposition of aggregates of insoluble fibrils originating from proteins that exhibit anomalous folding. Recently, pictures of senile amyloidosis have been described in patients with HFpEF, demonstrating the need for clinical cardiologists to investigate this etiology in suspect cases. The clinical suspicion of amyloidosis should be increased in cases of HFPS where the cardio imaging methods are compatible with infiltrative cardiomyopathy. Advances in cardio imaging methods combined with the possibility of performing genetic tests and identification of the type of amyloid material allow the diagnosis to be made. The management of the diagnosed patients can be done in partnership with centers specialized in the study of amyloidosis, which, together with the new technologies, investigate the possibility of organ or bone marrow transplantation and also the involvement of patients in clinical studies that evaluate the action of the new emerging drugs.

OBJECTIVES: Intestinal neovascularization and abnormal abdominal arterial flow rates have been reported in Crohn's disease. The aim of this study was to evaluate Doppler sonography as a method for assessing Crohn's disease activity based on changes in splanchnic hemodynamics. METHODS: Forty-eight patients with Crohn's disease, 22 healthy volunteers and 12 patients with irritable bowel syndrome were evaluated by Doppler ultrasound for flow parameters of the aorta and superior mesenteric artery. This evaluation included the cross-sectional area, maximum flow volume, peak systolic velocity, end diastolic velocity, resistance and the pulsatility index. Disease activity was classified according to the Crohn's disease activity index. RESULTS: Most measurements in the aorta and superior mesenteric artery were significantly different between Crohn's disease patients and both control groups. Only the aortic maximum flow volume (CC = 0.37, p = 0.009) and aortic peak systolic velocity (CC = 0.30, p = 0.035) showed a significant positive correlation with the Crohn's disease activity index. The determination of cut-off points for the aortic maximum flow volume and peak systolic velocity measurements increased the sensitivity (80 and 75% for flow volume and velocity, respectively), specificity (57 and 75%), accuracy (67 and 75%) and positive (57 and 68%) and negative (80 and 81%) predictive values. These cut-off values permitted the correct classification of most of the patients with Crohn's disease with respect to disease activity. None of the superior mesenteric artery measurements were able to discriminate patients in relation to disease activity. CONCLUSION: The aortic maximum flow volume and peak systolic velocity levels estimated by Doppler sonography reflected disease activity in Crohn's disease. Doppler sonography of the aorta is therefore a novel noninvasive adjunct method that may be useful in the clinical follow-up of patients with Crohn's disease.

Têm-se levantado à hipótese de que cultivares de soja RR possuem teores de lignina superiores aos convencionais, o que proporciona maior resistência a danos mecânicos e maior impermeabilidade do tegumento das sementes. Objetivou-se avaliar a qualidade fisiológica e o teor de lignina no tegumento das sementes de soja convencional e RR colhidas em três épocas, em Lavras-MG. Para tanto, as sementes colhidas nos estádios R7, R8 e após 20 dias de retardamento da colheita (R8+20), foram submetidas aos testes para avaliação da qualidade fisiológica e teor de lignina. As cultivares convencionais e RR avaliadas foram: BRS 133 vs BRS 245 RR, BRS 134 vs BRS 247 RR, Conquista vs Valiosa RR, Celeste vs Baliza RR e Jataí vs Silvânia RR. Foram realizados os testes de peso de mil sementes, germinação, envelhecimento acelerado, condutividade elétrica, dano mecânico, índice de velocidade de emergência, germinação após a imersão das sementes em água e teor de lignina no tegumento de sementes. Com exceção do teor de lignina no tegumento de sementes para o contraste Jataí vs Silvânia RR, não foram observadas diferenças entre os materiais RR e convencional, tendo, neste caso, a cv Silvânia RR apresentado resultados superiores aos da convencional. No entanto, houve diferença de comportamento entre os cultivares quanto à tolerância ao retardamento da colheita. Observou-se redução significativa na porcentagem de germinação e vigor das sementes avaliadas com o retardamento da colheita.

One has raised the hypothesis that the RR soybean cultivars posses lignin contents higher than those of the conventional ones. The present work was conducted with the purpose of evaluating the physiological quality and lignin content in the coat of the conventional and RR soybean seeds collected in three times in Lavras-MG. To that end, the seeds collected at stages R7, R8 and after 20 days of collection delay (R8+20) were submitted to the tests for evaluation of the physiological quality and lignin content. The evaluated conventional and RR cultivars were : BRS 133 vs BRS 245 RR, BRS 134 vs BRS 247 RR, BRS Conquista vs BRS Valiosa RR, BRS Celeste vs BRS Baliza RR and Jataí vs BRS Silvânia RR. The tests of 1000-seed weight, germination, accelerated aging, electrical conductivity, mechanical injury, emergence velocity index, germination after water seed soaking and lignin content in the coat seeds were performed. With the exception of the lignin content in the coat seeds for the contrast Jataí vs Silvânia RR, no differences between the RR and conventional materials were observed, the RR cultivar having presented results superior to those of the conventional one. Nevertheless, there was behavioral difference among the cultivars as to the tolerance to harvest delay. Significant reduction was observed in evaluated germination percentage and vigor of seeds with the collection delay.

Apesar do aumento de casos de jovens com anorexia nervosa, essa temática ainda constitui um tabu no universo masculino. O objetivo deste estudo é investigar o modo como um adolescente com anorexia nervosa atípica experiencia seu corpo e imagem corporal. Utilizou-se de entrevista individual semiestruturada, audiogravada e transcrita literalmente, com o paciente, sua mãe e nutricionista, além de consulta ao prontuário médico. Conclui-se que o jovem apresenta conflitos relacionados ao seu corpo e imagem corporal.

Despite an increase in the number of adolescents suffering from anorexia nervosa, there is not doubt that obesity and overeating are still taboo among men and boys. This study consists of an investigation as to how an adolescent boy with atypical experiences in anorexia nervosa sees his body and body image. Semi-structured individual interviews with the patient, his mother and his nutritionist were carried out and his medical report was analyzed. The conclusion was that the young man experienced conflicts regarding his body and distortions of his bodily image.

A pesar del aumento de casos de jóvenes con anorexia nerviosa, esa temática todavía es un tabú en el universo masculino. El objetivo de este trabajo es investigar la manera como un joven con anorexia nervosa atípica vivencia su cuerpo e imagen corporal. Los datos fueron recolectados por entrevistas semi-estructuradas, audiograbadas y transcritas literalmente, con el paciente, su madre y nutricionista, además de consultas al prontuario médico. Se concluye que este joven presenta conflictos relacionados a su cuerpo e imagen corporal.

En dépit de l'augmentation des cas d'anorexie nerveuse chez les jeunes, cette thématique reste encore un tabou dans l'univers masculin. Notre but est d'analyser comment un adolescent souffrant d'anorexie nerveuse atypique perçoit son corps et son image corporelle. La collecte des données a été faite à l'aide d'entretiens individuels semi-structurés enregistrés et transcrits littéralement, avec le patient, sa mère et la nutritionniste, ainsi que l'analyse du dossier médical. On conclut que ce jeune présente des conflits par rapport à son corps et à son image corporelle.

OBJETIVO: Relatar as características da citologia de impressão de nevos conjuntivais referidos como mais perceptíveis. MÉTODOS: Trinta e cinco pacientes que notaram uma lesão conjuntival que se tornou mais perceptível, por mudança de cor ou de tamanho, foram avaliados. Ao exame biomicroscópico foi feito o diagnóstico clínico de nevo, sendo obtidas amostras de citologia de impressão das lesões com auxílio do papel filtro de acetato de celulose, coradas com PAS, H&E e Papanicolaou. Para os indivíduos que optaram também pela remoção da lesão, o tecido foi enviado para análise histopatológica. RESULTADOS: O exame de citologia de impressão revelou ninhos ou blocos de células névicas na camada epitelial, acompanhados ou não de células caliciformes em 32 casos (91,4%). Dez pacientes (28,5%) tiveram a lesão removida, sendo o diagnóstico histopatológico de nevo composto (um na carúncula, um na prega semilunar e seis na conjuntiva bulbar) e nevo subepitelial (dois na conjuntiva bulbar). CONCLUSÃO: A análise pela microscopia óptica das amostras de citologia de impressão confirmou o diagnóstico clínico ao demonstrar características típicas das camadas superficiais do nevo conjuntival em 91,4% dos pacientes. Nos nevos amelanóticos a citologia pode auxiliar no diagnóstico diferencial de outras lesões não pigmentadas. A técnica não substitui o exame histopatológico, mas pode ser útil na avaliação de células névicas em crianças e adultos.

PURPOSE: To report the impression cytology features of conjunctival nevi reported as more noticeable. METHODS: 35 patients who reported that a conjunctival lesion had become more noticeable after color or size change were enrolled. On slit-lamp examination, a clinical diagnosis of nevus was made and lesions underwent impression cytology using acetate cellulose strips and a combined staining with PAS, H&E and Papanicolaou. At patient's or parents' request, excision of the lesion was performed and the tissue was submitted to histopathological study. RESULTS: Impression cytology examination revealed nests or cluster of nevus cells within the epithelium layer containing or not mucous-secreting goblet cells in 32 cases (91.4%). Ten patients (28.5%) had the tumor removed and histopathological diagnosis was compound nevus in 8 eyes (1 from caruncle, 1 from plica semilunaris and 6 from bulbar conjunctiva) and subepithelial nevus from bulbar conjunctiva (2 eyes). CONCLUSION: Optical microscopy analysis of the impression cytology specimens confirmed the clinical diagnosis by demonstrating typical histopathological features of the superficial layers from conjunctival nevi in 91.4% of the cases. For amelanotic nevi IC can also allow a differential diagnosis from other nonpigmented lesions. The technique does not replace histopathological examination, but additionally, may assist in evaluating nevus cells in children and adults.