Abstract Introduction: The association of hepatitis delta virus (HDV) infection with positive autoantibodies and autoimmune features has been known for decades. However, to date, very few cases of clinical autoimmune hepatitis (AIH) have been reported in association with HDV infection, most of them being in the context of treatment with peginterferon. Case Report: This case refers to a 46-year-old woman born in Guinea-Bissau who moved to Portugal in 2018 to investigate complaints of diffuse abdominal discomfort and nausea. Her initial work-up, including laboratory and liver histology, was consistent with type 1 AIH. She had HBe antigen-negative chronic hepatitis B virus infection with negative DNA and also a positive total anti-HDV antibody, with negative IgM and undetectable RNA. Therefore, after initiating prophylactic tenofovir difumarate, she was started on prednisolone followed by azathioprine, which was later stopped due to presumed hepatotoxicity. Repeated histology showed signs of viral superinfection, and she was treated with acyclovir due to a positive herpes simplex IgM, with HDV RNA remaining negative. A third flare in transaminases prompted the introduction of mycophenolate mofetil (MMF) after a thorough exclusion of additional causes of liver disease. About 6 months later, during another bout of hepatitis, HDV RNA was finally positive and classified as genotype 5. MMF was stopped, and, considering a contraindication to interferon, the patient was offered therapy with bulevirtide, which she refused for personal reasons as she is currently living in her home country. Discussion: This is a challenging case of autoimmune or “autoimmune-like” hepatitis, probably induced by chronic HDV infection. High suspicion of HDV was essential because, had the case been interpreted as refractory AIH, with escalation of immunosuppression, a more severe course of the viral infection might have ensued. Recently, HDV suppression with bulevirtide was shown to reverse autoimmune liver disease. We hypothesize that the same could have happened to our patient, had she accepted this treatment.

Resumo Introdução: A associação da infeção pelo vírus da hepatite delta (VHD) com a presença de autoanticorpos e outros aspetos de autoimunidade é conhecida desde há várias décadas. Contudo, até à data, muito poucos casos de hepatite autoimune (HAI) clínica foram reportados em relação com a infeção VHD, sendo a maioria destes no contexto de terapêutica com interferão peguilado. Caso clínico: O caso refere-se a uma mulher de 46 anos natural da Guiné-Bissau, que se mudou para Portugal em 2018 para investigação de queixas de desconforto abdominal difuso e náuseas. A avaliação laboratorial inicial e a histologia hepática foram compatíveis com HAI tipo 1. A doente apresentava também infeção crónica a VHB (vírus da hepatite B) antigénio HBe negativa, com DNA negativo, e anti-VHD (vírus da hepatite delta) total positivo, com IgM negativo e RNA indetetável. Assim, após início de tenofovir difumarato profilático, foi iniciada terapêutica com prednisolona seguida de azatioprina, que posteriormente se interrompeu por presumível hepatotoxicidade. Uma segunda biópsia mostrou aspetos de superinfeção viral e como tal a doente foi tratada com aciclovir, tendo em conta IgM positivo para Herpes Simplex, mantendo-se o RNA VHD negativo. Um terceiro flare de transaminases motivou o início de micofenolato de mofetil, após extensa investigação e exclusão de outras causas de doença hepática. Cerca de 6 meses mais tarde, durante novo episódio de hepatite, o RNA VHD revelou-se finalmente positivo e este foi classificado como genotipo 5. O MMF foi suspenso e, considerando a contra-indicação para interferão, foi proposto à doente tratamento com bulevirtide, que esta recusou, alegando motivos pessoais, visto estar atualmente a residir no seu país de origem. Discussão: Este é um caso desafiante de hepatite autoimune, ou autoimune-like, provavelmente induzida pela infeção crónica pelo VHD. Um elevado índice de suspeição para VHD foi essencial porque, se o caso tivesse sido interpretado como HAI refratária, com incremento de imunossupressão, poderia ter-se verificado um agravamento da hepatite viral. Recentemente, foi reportado que a supressão do VHD pelo bulevirtide pode reverter a doença hepática autoimune. Questionamo-nos se o mesmo poderia ter sucedido com a nossa doente, caso esta tivesse aceite este tratamento.

ABSTRACT Introduction: Coarctation of the aorta (CoA) is a narrowing of the thoracic aorta that often manifests as discrete stenosis but may be tortuous or in long segment. The study aimed to evaluate pre and post-surgical aspects of pediatric patients submitted to CoA surgical correction and to identify possible predisposing factors for aortic recoarctation. Methods: Twenty-five patients were divided into groups according to presence (N=8) or absence (N=17) of recoarctation after surgical correction of CoA and evaluated according to clinical-demographic profile, vascular characteristics via computed angiotomography (CAT), and other pathological conditions. Results: Majority of males (64%), ≥ 15 days old (76%), ≥ 2.5 kg (80%). There was similarity between groups with and without recoarctation regarding sex (male: 87% vs. 53%; P=0.277), age (≥ 15 days: 62.5 vs. 82%; P=0.505), and weight (≥ 2.5 kg: 87.5 vs. 76.5; P=0,492). Altered values of aortic root/Valsalva diameter, proximal transverse arch, and distal isthmus, and normal values for aorta prevailed in preoperative CAT. Normal values for the aortic root/Valsalva sinus diameter were observed with and without recoarctation, the same for both groups regarding ascending and descending aorta in postoperative CAT. No significant difference for altered values of proximal transverse arch and alteration in distal isthmus was observed. Conclusion: No predictive risk for recoarctation was observed. CTA proved to be important in CoA diagnosis and management, since CoA is mainly related with altered diameter of aortic root/sinus of Valsalva and proximal and distal aortic arch/isthmus, however, it failed to show predictive risk for recoarctation. Introduction (CoA segment postsurgical post Methods Twentyfive Twenty five N=8 N8 N 8 (N=8 N=17 N17 17 (N=17 clinicaldemographic clinical demographic profile CAT, CAT , (CAT) conditions Results 64%, 64 64% (64%) 1 76%, 76 76% (76%) 25 2 5 2. 80%. 80 80% . (80%) male (male 87 vs 53% 53 P=0.277, P0277 P P=0.277 0 277 P=0.277) ( 625 62 62. 82% 82 P=0.505, P0505 P=0.505 505 P=0.505) 875 87. 76.5 765 P=0,492. P0492 P=0,492 492 P=0,492) rootValsalva root Conclusion management rootsinus archisthmus arch/isthmus however N= (N= N=1 N1 (N=1 (CAT 6 (64% 7 (76% (80% P027 P=0.27 27 P050 P=0.50 50 76. P049 P=0,49 49 (N (64 (76 (80 P02 P=0.2 P05 P=0.5 P04 P=0,4 4 (6 (7 (8 P0 P=0. P=0, P=0 P=

ABSTRACT Clinical data: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. Chest radiography: Cardiomegaly with prevalence of pulmonary vascular network. Electrocardiogram: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. Echocardiogram: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. Computed tomography: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. Diagnosis: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. Operation: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment. data Infant age female weight radiography network Electrocardiogram block Echocardiogram septum orifices QpQs Qp Qs Qp/Qs cava cavity mesentericcaval mesenteric caval fibrosis Diagnosis mesentericportal veins Operation 6 arrest period evident complications th day treatment

Furanaphthoquinones are well known in medicinal chemistry for exhibiting relevant structural heterogeneity and bioactivities. In this work, it was synthesized a series of furanaphthoquinones through a tandem reaction between lawsone (8) and cyclic ketones in the presence of morpholine. This strategy provides an efficient and general method for synthesizing furanaphthoquinones with activity against the epimastigote form of Trypanosoma cruzi (T. cruzi), the parasite that causes Chagas disease. Compound 9b was the better prototype, and it exhibited high potency for causing parasite death, showed reduced acute toxicity towards mammalian cells, and was capable of rupturing the epimastigote plasma membrane and acting on sterol 14α-demethylase (CYP51). Additionally, 9b reduced trypomastigote viability by 99% after 24 h. Candidate 9b demonstrated the best and most promising profile when bound to CYP51.

RESUMO Objetivo: Avaliar a fadiga e a qualidade de vida relacionada à saúde de pacientes com câncer colorretal em quimioterapia. Método: estudo descritivo, realizado com 69 pacientes entre janeiro a setembro/2019, em um hospital público de Minas Gerais. Instrumentos utilizados: questionário sociodemográfico e clínico, Quality of Life Questionnaire-Core30 e Escala de Fadiga de Piper, analisados segundo medidas de frequência, média e desvio padrão pelo softwarePSPP. Resultados: A maioria era mulheres, acima de 60 anos, casadas, aposentadas, donas de casa, com médio nível de escolaridade. Os escores de estado geral de saúde, das funções social, física, emocional e desempenho de papel foram considerados satisfatórios (médias50-70), da função cognitiva foi boa (média>70); sintomas mais prevalentes foram perda de apetite, fadiga, dor e insônia. Quanto à fadiga, todas as dimensões tiveram média <4, considerado fadiga leve. Conclusão: A qualidade de vida apresentou escores satisfatórios e a fadiga foi classificada como leve nos pacientes em quimioterapia.

ABSTRACT Objective: To evaluate fatigue and health-related quality of life of colorectal cancer patients undergoing chemotherapy. Method: Descriptive study conducted with 69 patients between January and September/2019 in a public hospital in Minas Gerais. Instruments used: sociodemographic and clinical questionnaire, Quality of Life Questionnaire-Core30 and Piper Fatigue Scale, analyzed according to measures of frequency, mean and standard deviation by the software PSPP. Results: Most patients were women over 60 years old, married, retired and housewives, with an average level of education. The scores of general health status, social, physical, emotional and role functioning were considered satisfactory (means 50 to 70), cognitive function was good (mean higher than 70); the most prevalent symptoms were loss of appetite, fatigue, pain and insomnia. As for fatigue, all dimensions had a mean value <4, considered mild fatigue. Conclusion: Quality of life had satisfactory scores and fatigue was classified as mild in patients undergoing chemotherapy.

RESUMEN Objetivo: Evaluar la fatiga y la calidad de vida relacionada con la salud de los pacientes con cáncer colorrectal sometidos a quimioterapia. Método: Estudio descriptivo, realizado con 69 pacientes entre Enero y Septiembre/2019 en un hospital público de Minas Gerais. Instrumentos utilizados: cuestionario sociodemográfico y clínico, Quality of Life Questionnaire-Core30 y Piper Fatigue Scale, analizados según medidas de frecuencia, media y desviación estándar por el software PSPP. Resultados: La mayoría eran mujeres, mayores de 40 años, casadas, jubiladas y amas de casa, con un nivel medio de educación. Los puntajes del estado general de salud, las funciones social, física, emocional y desempeño del papel se consideraron satisfactorias (media 50 a 70), la función cognitiva fue buena (media superior a 70); los síntomas más prevalentes fueron pérdida de apetito, fatiga, dolor e insomnio. En cuanto a la fatiga, todas las dimensiones tienen una media de <4, considerada fatiga leve. Conclusión: La calidad de vida presentaba puntuaciones satisfactorias y la fatiga se clasificó como leve en pacientes sometidos a quimioterapia.

ABSTRACT Clinical data: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. Chest radiography: Cardiomegaly with prevalence of pulmonary vascular network. Electrocardiogram: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. Echocardiogram: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. Computed tomography: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. Diagnosis: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. Operation: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment.

Abstract Introduction: End-to-end anastomosis and extended end-to-end anastomosis are typically used as surgical approaches to coarctation of the aorta (CoAo) with access at the subclavian artery or an interposition graft. The objective of this study is to analyze the impact of surgical and anatomical characteristics and techniques on early outcomes after surgical treatment of CoAo without cardiopulmonary bypass through left thoracotomy. Methods: This is a quantitative, observational, and cross-sectional analysis of patients who underwent repair of CoAo between July 1, 2010 and December 31, 2017. Seventy-two patients were divided into three groups according to age: 34 in group A (≤ 30 days), 24 in group B (31 days to one year), and 14 in group C (≥ 1 year to 18 years). Results: Aortic arch hypoplasia was associated in 30.8% of the cases, followed by ventricular septal defect (13.2%). The preductal location was more frequent in group A (73.5%), ductal in group B (41.7%), and postductal in group C (71.4%). Long coarcted segment was predominant in groups A and C (61.8% and 71.4%, respectively) and localized in group B (58.3%). Extended end-to-end anastomosis technique was prevalent (68%), mainly in group A (91.2%). Mortality in 30 days was 1.4%. Conclusion: Most of the patients were children under one year of age, and extended end-to-end anastomosis was the most used technique, secondary to arch hypoplasia. Further, overall mortality was low in spite of moderate morbidity in the first 30 postoperative days. Introduction Endtoend End end endtoend (CoAo graft thoracotomy Methods quantitative observational crosssectional cross sectional 201 31 2017 Seventytwo Seventy two age 3 ≤ ( days, , days) 2 (3 year, year) ≥ years. years . years) Results 308 8 30.8 cases 13.2%. 132 13.2% 13 (13.2%) 73.5%, 735 73.5% 73 5 (73.5%) 41.7%, 417 41.7% 41 7 (41.7%) 71.4%. 714 71.4% 71 4 (71.4%) 61.8% 618 61 (61.8 respectively 58.3%. 583 58.3% 58 (58.3%) 68%, 68 68% (68%) 91.2%. 912 91.2% 91 (91.2%) 1.4% Conclusion Further 20 30. 13.2 (13.2% 73.5 (73.5% 41.7 (41.7% 71.4 (71.4% 61.8 6 (61. 58.3 (58.3% (68% 91.2 9 (91.2% 1.4 13. (13.2 73. (73.5 41. (41.7 71. (71.4 61. (61 58. (58.3 (68 91. (91.2 1. (13. (73. (41. (71. (6 (58. (91. (13 (73 (41 (71 (58 (91 (1 (7 (4 (5 (9

Resumo O estudo objetivou descrever características do trabalho remoto, situação de saúde mental e qualidade de sono na pandemia da Covid-19 em docentes da Bahia. Foi conduzido websurvey, seguindo protocolo CHERRIES, com professoras/es de todos os níveis de ensino da rede particular do estado. Participaram 1.444 docentes, de 18 julho a 30 de julho de 2020. Predominaram mulheres (76,1%), 21-41 anos (61,6%), negras (71,9%), dez anos ou mais na profissão (56,9%). Na pandemia, 51,4% relataram alterações no contrato de trabalho e 76,8%, aumento da jornada laboral. O ambiente domiciliar e equipamentos tinham baixo nível de adequação ao trabalho remoto: espaço físico (19,6%), mobiliário (21,7%), nível de ruído (17,2%), computadores (44,5%) e internet banda larga (36,7%). Entre as mulheres, 42,3% referiram sobrecarga doméstica alta; entre os homens, 17,4%. As mulheres apresentaram situação de saúde preocupante, destacando-se crises de ansiedade (53,7%), mau humor (78,0%), transtornos mentais comuns (69,0%) e qualidade do sono ruim (84,6%). A pandemia remodelou as formas de exercer o ofício docente. O trabalho, transferido para a casa, se sobrepôs às atividades domésticas e familiares, produzindo consequências à saúde docente que, mesmo pouco conhecidas, são alarmantes. Os resultados fortalecem a necessidade de ações de enfrentamento para situações de calamidade pública, medidas de regulação do trabalho remoto e proteção à saúde docente.

Abstract The study aimed to describe characteristics of remote work, mental health status and sleep quality in the COVID-19 pandemic among teachers in Bahia, Brazil. A websurvey was conducted, following the CHERRIES protocol, with teachers from all levels of education in the state’s private network. A total of 1,444 professors participated, from June 18 to July 30, 2020. There was a predominance of women (76.1%), 21-41 years (61.6%), black (71.9%), ten years or more in the profession (56.9%). In the pandemic, 51.4% reported changes in the employment contract and 76.8%, an increase in working hours. The home environment and equipment had a low level of suitability for remote work: physical space (19.6%), furniture (21.7%), noise level (17.2%), computers (44.5%) and internet broadband (36.7%). Among women, 42.3% reported high housework burden; among men, 17.4%. The women presented a worrying health situation, highlighting anxiety crises (53.7%), bad mood (78.0%), common mental disorders (69.0%) and poor sleep quality (84.6%). The pandemic remodeled the ways of exercising the teaching profession. The work, transferred to the home, was superimposed on domestic and family activities, producing consequences for the health of teachers that, although little known, are alarming. The results strengthen the need for actions to deal with situations of public calamity, measures to regulate remote work and protect teachers’ health.

Resumen El estudio tuvo como objectivo describir las características del trabajo remoto, la situación de salud mental y la calidad del sueño en la pandemia de Covid-19 entre docentes de Bahia. Se condujo una encuesta websurvey, siguiendo el protocolo CHERRIES, con profesoras y profesores de todos los niveles educativos de la red privada del estado/departamento. Contestaron a la encuesta 1.444 docentes, del 18 de junio hasta el 30 de julio de 2020. Predominaron mujeres (76,1%), de 21-41 años de edad (61,6%), negras (71,9%), con diez años o más de profesión (56,9%). En la pandemia, el 51,4% informó cambios en los contratos de trabajo y el 76, 8%, un aumento en la jornada laboral. El ambiente domiciliario y los equipos tenían un bajo nivel de adecuación para el trabajo remoto: espacio físico (19,6%), mobiliario (21,7%), nivel de ruido (17,2%), ordenadores (44,5%) y internet banda ancha (36,7%). Entre las mujeres, el 42,3% refirió una alta sobrecarga de trabajo doméstico; entre los hombres, 17,4% lo informó. Las mujeres presentaron una situación de salud preocupante, mayormente crises de ansiedad (53,7%), mal humor (78,9%), trastornos mentales comunes (69,0%) y mala calidad del sueño (84,6%). La pandemia remodeló las formas de ejercer el oficio docente. El trabajo, transferido al hogar, se ha sobrepuesto a las actividades domésticas y de la família, produciendo consecuencias a la salud de los docentes que, aun poco conocidas, son alarmantes. Los resultados refuerzan la necesidad de acciones para el enfrentamiento de situaciones de calamidad pública, de medidas de regulación del trabajo remoto y de protección a la salud docente.

Resumo Objetivo investigar a associação entre a qualidade do sono e o workaholism em docentes de pós-graduação stricto sensu. Métodos estudo transversal desenvolvido com docentes de todas as grandes áreas de conhecimento de uma universidade pública localizada na Região Sul do Brasil. A coleta de dados ocorreu no período de maio a agosto de 2018, por meio de formulário eletrônico contendo um questionário de caracterização sociodemográfica e ocupacional, a Dutch Work Addiction Scale e o Pittsburgh Sleep Quality Index. Foram convidados os 790 docentes de pós-graduação stricto sensu da referida instituição, dos quais 196 consentiram a participação na pesquisa. Os dados foram analisados descritivamente e por regressão logística binária univariada e múltipla, adotando-se nível de significância de 95%. Resultados a qualidade do sono ruim esteve associada ao trabalho excessivo (ORaj:2,056; p=0,026) e ao workaholism (ORaj:2,056; p=0,040). Qualidade subjetiva do sono, latência do sono, duração do sono, distúrbios do sono e sonolência diurna associaram-se significativamente ao trabalho excessivo e compulsivo, bem como ao workaholism. Conclusão as altas demandas de trabalho características do processo de trabalho dos docentes em nível stricto sensu podem repercutir na baixa qualidade do sono, visto que os docentes workaholics apresentaram duas vezes a chance de apresentarem má qualidade do sono.

Abstract Objective to investigate the association between sleep quality and workaholism in stricto sensu graduate professors. Methods a cross-sectional study developed with professors from all major areas of knowledge at a public university located in the South Region of Brazil. Data collection took place from May to August 2018, using an electronic form containing a questionnaire for sociodemographic and occupational characterization, the Dutch Work Addiction Scale and the Pittsburgh Sleep Quality Index. The 790 stricto sensu graduate professors of the institution were invited, of whom 196 consented to participate in the research. Data were analyzed descriptively and by univariate and multiple binary logistic regression, adopting a significance level of 95%. Results poor sleep quality was associated with overwork (ORAdj: 2,056; p=0.026) and workaholism (ORAdj: 2,056; p=0.040). Subjective sleep quality, sleep latency, sleep duration, sleep disorders and daytime sleepiness were significantly associated with over and compulsive work, as well as workaholism. Conclusion high work demands characteristic of the professors’ work process at stricto sensu level may have an impact on the low sleep quality, since workaholic professors presented twice the chance of presenting poor sleep quality. Descriptors Worker’s health; Sleep; Professors; Graduate Education; Work conditions.

Resumen Objetivo Investigar la relación entre la calidad del sueño y workaholism en docentes de posgrado stricto sensu. Métodos Estudio transversal que se llevó a cabo con docentes de todas las grandes áreas de conocimiento de una universidad pública ubicada en la región Sur de Brasil. La recolección de datos se realizó en el período de mayo a agosto de 2018, mediante formulario electrónico que contenía un cuestionario de caracterización sociodemográfica y ocupacional, la Dutch Work Addiction Scale y el Pittsburgh Sleep Quality Index. Se invitó a los 790 docentes de posgrado stricto sensu de la institución mencionada, de los cuales 196 aceptaron participar en la investigación. Los datos fueron analizados descriptivamente y por regresión logística binaria univariada y múltiple, con un nivel de significación de 95 %. Resultados La mala calidad de sueño se relacionó con el trabajo excesivo (ORaj:2,056; p=0,026) y con el workaholism (ORaj:2,056; p=0,040). La calidad subjetiva del sueño, la latencia del sueño, la duración del sueño, los trastornos de sueño y la somnolencia diurna se relacionan significativamente con el trabajo excesivo y compulsivo, así como con el workaholism. Conclusión Las altas demandas de trabajo, características del proceso laboral de los docentes de nivel stricto sensu, pueden repercutir en la baja calidad del sueño, ya que los docentes workaholics presentan el doble de probabilidad de tener un sueño de mala calidad.

Abstract Objective to investigate the association between sleep quality and workaholism in stricto sensu graduate professors. Methods a cross-sectional study developed with professors from all major areas of knowledge at a public university located in the South Region of Brazil. Data collection took place from May to August 2018, using an electronic form containing a questionnaire for sociodemographic and occupational characterization, the Dutch Work Addiction Scale and the Pittsburgh Sleep Quality Index. The 790 stricto sensu graduate professors of the institution were invited, of whom 196 consented to participate in the research. Data were analyzed descriptively and by univariate and multiple binary logistic regression, adopting a significance level of 95%. Results poor sleep quality was associated with overwork (ORAdj: 2,056; p=0.026) and workaholism (ORAdj: 2,056; p=0.040). Subjective sleep quality, sleep latency, sleep duration, sleep disorders and daytime sleepiness were significantly associated with over and compulsive work, as well as workaholism. Conclusion high work demands characteristic of the professors’ work process at stricto sensu level may have an impact on the low sleep quality, since workaholic professors presented twice the chance of presenting poor sleep quality. Descriptors Worker’s health; Sleep; Professors; Graduate Education; Work conditions.

Resumen Objetivo Investigar la relación entre la calidad del sueño y workaholism en docentes de posgrado stricto sensu. Métodos Estudio transversal que se llevó a cabo con docentes de todas las grandes áreas de conocimiento de una universidad pública ubicada en la región Sur de Brasil. La recolección de datos se realizó en el período de mayo a agosto de 2018, mediante formulario electrónico que contenía un cuestionario de caracterización sociodemográfica y ocupacional, la Dutch Work Addiction Scale y el Pittsburgh Sleep Quality Index. Se invitó a los 790 docentes de posgrado stricto sensu de la institución mencionada, de los cuales 196 aceptaron participar en la investigación. Los datos fueron analizados descriptivamente y por regresión logística binaria univariada y múltiple, con un nivel de significación de 95 %. Resultados La mala calidad de sueño se relacionó con el trabajo excesivo (ORaj:2,056; p=0,026) y con el workaholism (ORaj:2,056; p=0,040). La calidad subjetiva del sueño, la latencia del sueño, la duración del sueño, los trastornos de sueño y la somnolencia diurna se relacionan significativamente con el trabajo excesivo y compulsivo, así como con el workaholism. Conclusión Las altas demandas de trabajo, características del proceso laboral de los docentes de nivel stricto sensu, pueden repercutir en la baja calidad del sueño, ya que los docentes workaholics presentan el doble de probabilidad de tener un sueño de mala calidad.

Resumo Objetivo investigar a associação entre a qualidade do sono e o workaholism em docentes de pós-graduação stricto sensu. Métodos estudo transversal desenvolvido com docentes de todas as grandes áreas de conhecimento de uma universidade pública localizada na Região Sul do Brasil. A coleta de dados ocorreu no período de maio a agosto de 2018, por meio de formulário eletrônico contendo um questionário de caracterização sociodemográfica e ocupacional, a Dutch Work Addiction Scale e o Pittsburgh Sleep Quality Index. Foram convidados os 790 docentes de pós-graduação stricto sensu da referida instituição, dos quais 196 consentiram a participação na pesquisa. Os dados foram analisados descritivamente e por regressão logística binária univariada e múltipla, adotando-se nível de significância de 95%. Resultados a qualidade do sono ruim esteve associada ao trabalho excessivo (ORaj:2,056; p=0,026) e ao workaholism (ORaj:2,056; p=0,040). Qualidade subjetiva do sono, latência do sono, duração do sono, distúrbios do sono e sonolência diurna associaram-se significativamente ao trabalho excessivo e compulsivo, bem como ao workaholism. Conclusão as altas demandas de trabalho características do processo de trabalho dos docentes em nível stricto sensu podem repercutir na baixa qualidade do sono, visto que os docentes workaholics apresentaram duas vezes a chance de apresentarem má qualidade do sono.

Abstract Clinical data: Infant, 7 months, female, referred to our department at one month of age, suspecting of congenital heart disease for further investigation. Chest radiography: Demonstrates cardiomegaly and prominent pulmonary vascular markings. Electrocardiography: Shows right ventricular hypertrophy and left anterior fascicular block. Echocardiography: Evidenced common atrioventricular valve with two orifices and the left superior pulmonary vein draining on the brachiocephalic vein. Computed tomography angiography: This complementary imaging exam was performed to confirm the diagnosis. Diagnosis: The patient presented an association between AVSD and PAPVC, a rare combination. The clinical picture of heart failure was preponderant, characterized by need for diuretics and complementary exams findings, and early surgical treatment was indicated. Operation: The operation was performed through a median sternotomy with 123 minutes of cardiopulmonary bypass and 89 minutes of cross-clamping time. The patient had no postoperative complications, remaining 10 days hospitalized.

Introdução: A deficiência de vitamina D é mais comum na doença inflamatória intestinal (DII) que na população geral. Contudo, existem dados controversos sobre fatores preditivos da deficiência de vitamina D e a potencial associação com a atividade da doença. Os objetivos deste estudo foram determinar a prevalência e fatores preditivos da deficiência de vitamina D e aferir possível associação à atividade da doença. Métodos: Desenhou-se um estudo observacional prospetivo incluindo doentes com DII entre janeiro e julho/2016. Foram consideradas as orientações da The Endocrine Society para definir níveis de 25-hidroxivitamina D (25-OH-D) sérica como: deficientes (< 20 ng/mL, sendo <10 ng/mL deficiência grave [DG]), insuficientes (21-29 ng/mL) e adequados (> 30 ng/mL). Resultados: Foram incluídos 152 doentes (52% homens; 47.2 ± 17.3 anos), dos quais 70% com Doença de Crohn (DC). Do total, 37% estavam medicados com immunossupressores e 17% com biológicos. A maioria (88.2%) estava em ambulatório. O nível sérico de 25-OH-D foi 17.1 ± 8 ng/mL (DC: 16.7 ± 8 ng/mL vs. Colite ulcerosa: 17.6 ± 7 ng/mL, p = 0.1). Verificaram-se níveis inadequados em 90.8% (deficiência: 68.4%; insuficiência: 22.4%). Registou-se correlação negativa significativa entre níveis de 25-OH-D e idade (r = -0.2, p = 0.04), proteína C-reativa (PCR) (r = -0.22, p = 0.004) e índice Harvey-Bradshaw (iHB) (r = -0.32, p = 0.001). Doentes com DG apresentaram níveis mais elevados de PCR (0.6 vs. 1.4 mg/dL, p = 0.03), velocidade de sedimentação (VS) (22 vs. 31 mm/h, p = 0.03) e iHB (2 vs. 5, p < 0.001), e mais baixos de hemoglobina (13.6 vs. 12.7 g/dL, p = 0.02). Não se verificou associação entre deficiência de vitamina D e sexo, tipo, extensão e duração da doença, cirurgia, e outras medidas de atividade da doença como VS, hemoglobina (estas duas exceto para DG), calprotectina fecal ou classificação Truelove e Witts. Conclusões: Registou-se prevalência alta de níveis inadequados de vitamina D na DII, particularmente de deficiência (68.4%). Parece existir associação entre níveis mais baixos de vitamina D e maior atividade da doença, nomeadamente na DC.

Background and Aims: Vitamin D deficiency is more common in inflammatory bowel disease (IBD) patients than in the general population. However, there are conflicting data about predictive factors of vitamin D deficiency and its potential association with disease activity. The aims of this study were to determine the prevalence and predictive factors of vitamin D deficiency and to evaluate a possible association with disease activity. Methods: A prospective observational study was conducted, including patients with IBD from January to July 2016. The Endocrine Society guidelines were considered for defining levels of serum 25-hydroxyvitamin D (25-OH-D) as follows: deficient (< 20 ng/mL, < 10 ng/mL being severe deficiency), insufficient (21-29 ng/mL), and adequate (> 30 ng/mL). Results: A total of 152 patients (52% men; 47.2 ± 17.3 years) were included, of whom 70% had Crohn’s disease (CD). Thirty-seven percent of patients were on immunosuppressors and 17% were on biologics. The majority were outpatients (88.2%). Mean 25-OH-D levels were 17.1 ± 8 ng/mL (CD: 16.7 ± 8 ng/mL vs. ulcerative colitis: 17.6± 7 ng/mL, p = 0.1). Inadequate levels were present in 90.8% of patients (deficiency: 68.4%; insufficiency: 22.4%). A significant negative correlation between 25-OH-D levels and age (r = -0.2, p = 0.04), C-reactive protein (CRP) levels (r = -0.22, p = 0.004), and Harvey-Bradshaw index (HBi) (r = -0.32, p = 0.001) was found. Patients with severe deficiency showed a higher CRP (0.6 vs. 1.4 mg/dL, p = 0.03), erythrocyte sedimentation rate (ESR) (22 vs. 31 mm/h, p = 0.03), and HBi (2 vs. 5, p < 0.001) and lower hemoglobin (13.6 vs. 12.7 g/dL, p = 0.02). There was no association between vitamin D deficiency and gender, type, extent, and duration of disease, surgery, and other measures of disease activity, such as ESR, haemoglobin (these 2 items except for severe deficiency), fecal calprotectin, or Truelove and Witts classification. Conclusions: There is a high prevalence of inadequate levels of vitamin D in IBD patients, particularly deficiency (68.4%). There seems to exist an association between lower levels of vitamin D and higher disease activity, especially in CD.

Electrochemical methods are powerful in the characterization and design of redox-modulating agents. We, herein, report the electrochemical investigation, in aprotic medium, of eleven synthetic 3-thio-substituted-nor-beta-lapachones, along with the determination of cytotoxic activity and correspondent selectivity index, against several cancer cell lines and one normal cell. Four of the quinones are novel compounds. The redox behavior is representative of two independent systems: the easy reduction of the quinone moiety and, at far more negative potential, the reductive cleavage of the C-S-C bonding; and the anodic part controlled by the oxidation of the sulfur moiety. The compounds have shown relevant cytotoxic activity, with emphasis on 3-phenyl-thio-2,2-dimethyl-2,3-dihydronaphtho[1,2-b]furan-4,5-dione (compound 2), which mechanism of molecular action was shown to be related to reactive oxygen species (ROS) release. Despite the absence of a linear correlation, there is a trend: the majority of the thionaphthoquinones, with values of first wave reduction potential, less negative than -0.65 V, were active. The less electrophilic compound (3-(cyclohexylthio)-2,2-dimethyl-2,3-dihydronaphtho[1,2-b]furan-4,5-dione, cyclohexyl derivative) is also the less cytotoxic toward cancer cells. Agents containing chalcogens and quinones can be used to attack entities with a disturbed redox balance.