Abstract Sepsis is characterized by inadequate microvascular tissue perfusion, leading to organ dysfunction and death. Adenosine levels increase during inflammation and tissue hypoxia, potentially influencing cardiovascular parameters through activation of four receptors coupled to the G protein (A 1 , A 2A , A 2B , and A 3 ). Caffeine a non-selective adenosine receptor antagonist and it might prevent the cardiovascular collapse associated with sepsis. This study aimed to assess caffeine effect on sepsis-induced cardiovascular changes in rats. Animals were submitted to cecal ligation and puncture (CLP) to induce sepsis. Two, 8, and 14 hours after the procedure, CLP and sham groups were assigned to receive caffeine (30 mg/kg, s.c.) or vehicle. Twenty-four hours later, biochemical, and hemodynamic parameters were evaluated in addition to survival rate. Sepsis resulted in hypotension, hyporesponsiveness to vasoconstrictors, reduced renal blood flow, and increased blood glucose and lactate levels. Caffeine prevented changes in glycemic levels, but not in the cardiovascular alterations induced by sepsis. Caffeine also shows no discernible impact on markers of organ dysfunction or tissue perfusion. Thus, while caffeine maintained glycemic levels, it did not mitigate sepsis-induced cardiovascular collapse, organ dysfunction, or affect mortality rates. Therefore, caffeine does not provide significant improvements during sepsis. perfusion death hypoxia B . ) nonselective non selective sepsis sepsisinduced rats (CLP Two 8 procedure 30 (3 mgkg mg kg mg/kg s.c. sc s c vehicle Twentyfour Twenty later biochemical rate hypotension vasoconstrictors flow Thus rates Therefore ( s.c

Trata-se de pesquisa qualitativa realizada com processos judiciais de execução penal que analisa como os atores judiciais e penitenciários articulam discursos sobre trabalho e educação nas prisões brasileiras. A pesquisa tem por objetivo perceber as dinâmicas suscitadas pela remição da pena através dessas atividades. Considerando que os pedidos de remição ocupam um lugar privilegiado para análise das dinâmicas de governo e gestão do fluxo prisional, identificou-se ambivalências entre a centralidade do ideal ressocializador, como organizador das interações entre os atores, e o deslocamento de trabalho e educação, como operadores burocráticos do fluxo da execução. Tratase Trata se brasileiras atividades prisional identificouse identificou ressocializador

This is qualitative research carried out with judicial processes of criminal execution which analyzes how judicial and penitentiary actors articulate the discourses on work and education in contemporary Brazilian prisons. This research aims to perceive the dynamics raised by good time credits from these activities. Considering that these credit requests represent a privileged place for analyzing the dynamics of government and bureaucratic management of the prison flow, important ambivalences were identified between the centrality of the rehabilitative ideal, as an organizer of the interactions between the actors, and the displacement of work and education as bureaucratic operators of the criminal execution flow. prisons activities flow ideal

Resumo Este artigo tem o objetivo de investigar quais os limites para o reconhecimento da condição de foragido no discurso judicial e as suas consequências na decretação, na manutenção ou na revogação da prisão preventiva. O artigo utiliza duas principais estratégias para responder ao problema proposto. A primeira consiste na elaboração de uma revisão de literatura sobre fuga e prisão processual, mapeando os contornos e as ausências sobre esse tema na literatura científica. Nota-se a ausência de um tratamento concreto a respeito dos significados e limites para o reconhecimento da fuga no processo penal. A segunda estratégia consiste em uma análise empírica de decisões do Superior Tribunal de Justiça (STJ), proferidas entre 2020 e 2021. Como resultados da pesquisa, pode-se afirmar que o STJ tem posições que ora limitam o sentido da fuga, como a distinção entre não localização e fuga, ora relativizam suas consequências, a exemplo das fugas distantes no tempo, ora reafirmam o sentido da fuga como justificativa para imposição de prisões processuais, como o caso de permanência da fuga no momento da decisão. Nesse sentido, o artigo contribui para a compreensão dos sentidos que o Poder Judiciário atribui à categoria da fuga ao longo do processo penal. decretação preventiva proposto processual científica Notase Nota se penal STJ, , (STJ) 202 2021 pesquisa podese pode tempo processuais decisão (STJ 20 2

Abstract This work aims to investigate the limits for the recognition of the condition of fugitive in the judicial discourse and its consequences in the decree, maintenance or revocation of preventive detention. The article uses two main strategies to answer the proposed problem. The first consists in the elaboration of a literature review on escape and procedural arrest, mapping the contours and absences on this topic in the scientific literature. It is noted the absence of a concrete treatment regarding the meanings and limits for the recognition of the scape in the criminal process. The second strategy consists of an empirical analysis of decisions of the Superior Court of Justice (STJ), issued between 2020 and 2021. As a result of the research, it can be said that the STJ has positions that sometimes limit the sense of escape, such as the distinction between non-location and escape, sometimes relativize their consequences, like the escapes distant in time, and sometimes reaffirm the meaning of the escape as a justification for the imposition of procedural arrests, as in the case of permanence of the escape at the time of the decision. In this sense, the article contributes to the understanding of the meanings that the Judiciary attributes to the category of escape throughout the criminal process. decree detention problem arrest process STJ, , (STJ) 202 2021 research nonlocation non location arrests decision (STJ 20 2

Abstract Adenosine is an important regulator within the cardiovascular system and modulates various processes through four distinct G protein-coupled receptors (A1, A2A, A2B, and A3), causing hypotension and reduced renal blood flow, which contributes to ischemia tissue and organ dysfunction. Caffeine causes most of its biological effects by blocking adenosine receptors. Although caffeine is vastly used as a pharmacological tool in basic research, there is a lack of studies characterizing the caffeine doses necessary for blocking the cardiovascular effects of adenosine. Therefore, we evaluated the effect of different doses of caffeine (10, 30 and 100 mg/kg, s.c) on the cardiovascular changes induced by adenosine. In addition, the adenosine response was evaluated at different times (4 and 8 hours) after caffeine administration. The bolus injection of increasing doses of adenosine dose-dependently reduced blood pressure, renal blood flow and heart rate. The dose of 30 mg/kg was the most effective in blocking adenosine-induced cardiovascular events. However, the higher dose of caffeine (100 mg/kg) fails to block the adenosine effect on heart rate. The effect of caffeine lasts for 4 hours. Therefore, caffeine in the dose of 30 mg/kg can block the effects of adenosine for up to 4 hours. These data provide valuable information on the dose and frequency of caffeine administration for future studies in rats. proteincoupled protein coupled A1, A1 A (A1 A2A AA A2B AB B A3, A3 , A3) dysfunction research Therefore 10, 10 (10 3 mgkg mg kg s.c sc s c addition ( hours dosedependently dependently pressure rate adenosineinduced events However rats (A 1 (1

Resumo A doença de von Hippel-Lindau (VHL) é uma desordem autossômica dominante monogênica com mutações na linha germinativa do antioncogene VHL, no braço curto do cromossomo três (3p25-26). Afeta 1:36.000-50.000 indivíduos, com penetrância superior a 90% aos 65 anos de idade. Embora tenha início e apresentação variáveis, com pleiotropismo mesmo entre membros da mesma família que partilham uma mutação específica, usualmente manifesta-se de início em adultos jovens e predispõe ao desenvolvimento de tumores benignos e malignos no sistema nervoso central (SNC) e órgãos viscerais. Clinicamente, o diagnóstico pode ser realizado em uma das seguintes circunstâncias: a) em pacientes com história familiar de doença de VHL e pelo menos um dos tumores característicos relacionados à síndrome (como hemangioblastomas retinianos ou do SNC, carcinoma de células renais de células claras, tumores neuroendócrinos pancreáticos e tumores do saco endolinfático); b) dois ou mais hemangioblastomas do SNC; c) um hemangioblastoma retiniano ou do SNC mais pelo menos um tumor característico visceral relacionado à síndrome, excluindo-se cistos renais e epididimários. Nesse contexto, a imagem ocupa importante papel no diagnóstico e acompanhamento desses pacientes. Este ensaio iconográfico apresenta imagens características de manifestações abdominais de tumores relacionados à doença de VHL que todos os radiologistas devem conhecer.

Abstract Von Hippel-Lindau (VHL) disease is a monogenic autosomal dominant disorder with germline mutations of the VHL anti-oncogene on the short arm of chromosome 3 (3p25-26). It affects 1:36,000-50,000 individuals, with a penetrance greater than 90% at 65 years of age. Although of variable onset and presentation, with pleiotropism even among members of the same family who share a specific mutation, VHL disease usually manifests initially in young adults. It predisposes to the development of benign and malignant tumors of the central nervous system (CNS) and visceral organs. The clinical diagnosis of VHL disease can be made in the following circumstances: a) in patients with a family history of the disease and at least one of the tumors characteristic of it (e.g., retinal or CNS hemangioblastomas, clear cell renal cell carcinoma, pancreatic neuroendocrine tumors, and endolymphatic sac tumors); b) in patients with two or more CNS hemangioblastomas; c) or in patients with a retinal or CNS hemangioblastoma plus at least one visceral tumor characteristic of the disease, excluding renal and epididymal cysts. Imaging plays an important role in the diagnosis and follow-up of patients with VHL disease. This pictorial essay presents characteristic images of abdominal manifestations of VHL disease-related tumors that all radiologists should be aware of.

Abstract A doença de von Hippel-Lindau (VHL) é uma síndrome hereditária autossômica dominante rara que afeta a linha germinativa do gene VHL, um gene supressor tumoral. A doença de VHL é caracterizada pelo desenvolvimento multissistêmico de uma variedade de tumores benignos e malignos, especialmente no sistema nervoso central (SNC). Dentre eles, destacam-se hemangioblastomas retinianos e do SNC, e o tumor do saco endolinfático. Os diferentes locais dos tumores justificam a diversidade de sinais e sintomas relacionados à doença, que usualmente se manifestam com a idade média de 33 anos. Apesar dos avanços da medicina, a expectativa de vida média desses pacientes é de 49 anos. Exames de imagem têm papel fundamental no diagnóstico e são essenciais no seguimento dos pacientes com doença de VHL. Este ensaio iconográfico descreve as manifestações características dos tumores do SNC relacionados à doença de VHL que todos os residentes de radiologia devem saber.

Abstract Von Hippel-Lindau (VHL) disease is a rare, autosomal dominant inherited syndrome that affects the germline of the VHL gene, a tumor suppressor gene. VHL disease is characterized by the multisystemic development of a variety of benign and malignant tumors, especially in the central nervous system (CNS). Such tumors include retinal and CNS hemangioblastomas, as well as endolymphatic sac tumors. The various tumor sites are responsible for the diversity of signs and symptoms related to the disease. The mean age at symptom onset is 33 years. Despite medical advances, the average life expectancy of patients with VHL disease is 49 years. Imaging plays a pivotal role in the clinical diagnosis and is essential to the follow-up of patients with VHL disease. This pictorial essay describes characteristic CNS manifestations of VHL disease-related tumors that all radiology residents should be aware of.

RESUMO Contexto A doença arterial obstrutiva periférica apresenta alta prevalência, sendo associada a elevado risco de eventos cardiovasculares. A intervenção cirúrgica ou endovascular faz-se necessária na isquemia crítica do membro. Objetivos Avaliar a distribuição de realização de revascularizações abertas e endovasculares nas diferentes regiões do Brasil, analisando os custos para o sistema de saúde e a mortalidade relacionada a esses procedimentos. Métodos Foi realizado um estudo epidemiológico observacional transversal descritivo para avaliar as cirurgias abertas e endovasculares realizadas no sistema público de saúde do Brasil entre 2010 e 2020. Os dados foram coletados através do Departamento de Informática do SUS (Datasus). Resultados No período analisado, foram registradas 83.218 internações para realização de cirurgias abertas e endovasculares, com um custo total de R$ 333.989.523,17. Houve predominância das internações para os procedimentos percutâneos (56.132) em relação aos cirúrgicos convencionais (27.086). As Regiões Sudeste e Sul concentraram a maior parte do total de procedimentos realizados no país (83%), enquanto a Região Norte foi a que apresentou a menor taxa de internação. Observou-se uma tendência decrescente para os procedimentos abertos, e uma tendência crescente para os endovasculares. A média de permanência hospitalar foi menor nos procedimentos endovasculares (5,3 dias) em relação aos abertos (10,2 dias). Além disso, notou-se uma maior taxa de mortalidade hospitalar relacionada à revascularização aberta em relação à endovascular (5,24% versus 1,56%). Conclusões As técnicas endovasculares consistiram em uma abordagem dominante no tratamento cirúrgico da isquemia crítica, apresentando menor taxa de mortalidade hospitalar e menor tempo de internação quando comparada às cirurgias abertas.

ABSTRACT Background Peripheral artery disease (PAD) has high prevalence and is associated with high risk of cardiovascular events. Surgical or endovascular intervention is necessary in chronic limb-threatening ischemia. Objectives To evaluate the distribution of open and endovascular revascularizations in different regions of Brazil, analyzing the health system costs and mortality related to these procedures. Methods A descriptive, cross-sectional, observational, epidemiological study was carried out to evaluate open and endovascular surgeries performed on the SUS public healthcare system in Brazil, from 2010 to 2020. Data were collected from the SUS Department of Informatics (Datasus). Results Over the period analyzed, 83,218 admissions for open and endovascular surgeries were registered, with a total cost of R$ 333,989,523.17. There were more hospital admissions for percutaneous procedures (56,132) than for conventional surgery (27,086). Most of the procedures (83%) were performed in the country’s Southeast and South regions, while the North region had the lowest number of procedures. Over the period evaluated, there was a decreasing trend for open procedures and an increasing trend for endovascular procedures. The average hospital stay was shorter for endovascular procedures (5.3 days) than for open surgery (10.2 days). The analysis of mortality related to these procedures revealed a higher rate of in-hospital mortality associated with open revascularization than with endovascular (5.24% vs. 1.56%). Conclusions Endovascular techniques constituted the primary approach for revascularization treatment in critical limb-threatening ischemia, with a lower in-hospital mortality rate and shorter hospital stay when compared to open surgeries.

Resumo A sífilis é uma infeção sistémica com manifestações variáveis consoante o seu estádio clínico. Conhecida como “a grande imitadora”, a sua abordagem é ainda mais desafiante quando ocorre a reação de Jarisch-Herxheimer (JH). Esta trata-se de uma reação febril aguda autolimitada que pode ocorrer nas 24 horas após tratamento de uma infeção por espiroquetas. Reporta-se o caso de um homem de 33 anos com sífilis secundária que desenvolve uma reação de JH após três horas da administração de benzilpenicilina benzatínica 2,4 milhões de unidades internacionais, apresentando febre, agravamento do exantema inicial, dor abdominal e disfunção hepatocelular, estas últimas manifestações descritas como incomuns. Os autores discutem a fisiopatologia desta reação, as suas manifestações clínicas e recomendações de abordagem à luz da evidência atual.

Abstract Syphilis is a systemic infection with variable manifestations depending on its clinical stage. Known as "the great imitator", its management is even more defying when the Jarisch-Herxheimer reaction occurs, which is a self-limited acute febrile reaction that occurs within 24 hours after treatment for a spirochete infection. The authors describe the case of a 33-year-old man with a secondary syphilis who, three hours after the administration of benzathine benzylpenicillin 2.4 million international units, presents with fever, worsening of the initial cutaneous manifestations, abdominal pain and hepatocellular dysfunction, these last two described as unusual manifestations of this reaction. The authors discuss the pathophysiology of the Jarisch-Herxheimer reaction, its clinical manifestations and management recommendations according to the current evidence.

Abstract The growing concern in minimizing the disorderly disposal of waste in nature has been influencing measures that seek to give new environmentally sustainable and economically viable purposes for these materials. The use of steel slag aggregate in road paving emerges as an alternative for reducing the storage of this material in industrial yards, as well as contributing to a significant reduction in the cost of building a flexible road pavement. This study aimed to verify the technical feasibility of using ferronickel slag as an aggregate in the composition of hot mix asphalt. To this end, physical, chemical, mineralogical and environmental characterization tests of ferronickel slag were performed. The asphalt mixtures were dosed in accordance with the Marshall methodology, using the DNIT Range C with the use of ferronickel slag in the granulometric portions corresponding to the coarse aggregate, fine and filler, and the petroleum asphalt cement (PAC) 50/70. Based on the results, it can be stated that ferronickel slag demonstrates technical feasibility to be used as an aggregate in the composition of hot mix asphalt, meeting the requirements established by Brazilian standardization. In addition, it is an excellent environmental alternative because it uses a material previously treated as an environmental liability, avoiding the exploration of new natural deposits of stone aggregates.

Resumo: Introdução: O número de cursos de Medicina no Brasil e a quantidade de vagas ofertadas cresceram consideravelmente nos últimos anos. A partir de 2013, essa expansão tinha o objetivo de atingir sobretudo o interior do país. Objetivo: Considerando que existem diversos interesses em torno dessa expansão e que essa realidade influencia diretamente as políticas de educação e saúde do país, o objetivo deste estudo foi analisar a quantidade e a distribuição, em 2020, desses cursos e vagas nos municípios brasileiros. Método: Trata-se de estudo transversal com dados disponibilizados pelo Ministério da Educação e pelo Instituto Brasileiro de Geografia e Estatística (IBGE). As variáveis estudadas foram números de cursos, número de vagas e características dos municípios das escolas médicas, como tamanho da população, Índice de Desenvolvimento Humano (IDH) e distância em relação à capital do respectivo estado. Resultados: Há 328 cursos em atividade que ofertam 35.480 vagas para ingressantes em Medicina. Ocorre diferença quando se analisam instituições públicas ou privadas e instituições gratuitas ou pagas. Há maior oferta de vagas em cursos pagos (74,1%) e em municípios de interior (69,8%). No interior, 27,8% das vagas são ofertadas por municípios distantes de um a 100 km da capital. A menor parte das vagas (7,9%) é ofertada em municípios de IDH médio, sendo o restante em municípios de IDH alto ou muito alto. O aumento do IDH está relacionado à maior proporção de cursos privados ofertando vagas de Medicina. Observou-se que não há correspondência entre o número absoluto de vagas e a população da Região Norte, o que ocorre nas demais regiões do país. Conclusões: A formação médica está sob várias influências, a exemplo das tendências econômicas e políticas. Essa discussão precisa levar em consideração a regionalização e a democratização do acesso. Observou-se tendência de as instituições públicas se destinarem a municípios mais distantes. Apesar de maior homogeneidade entre as regiões, a Região Sudeste ainda concentra quase metade das vagas. Além disso, o aumento do número de vagas em cursos privados evoca o questionamento sobre o perfil de estudantes que têm a oportunidade de acessar essa graduação.

Abstract: Introduction: The number of medical schools in Brazil, as well as the number of vacancies offered at these schools, has grown considerably in the last few years. Since 2013, this increasehas aimedat reaching especially the rural and underserved areas of the country. Objective: Considering that there are many different interests concerning this debate and that this reality directly influences the education and health policies of the country, the aim of this study was to evaluate the number and the distribution of the medical courses,as well as vacancies in these schools in 2020, presenting an updated overview of the Brazilian medical schools. Methods: This was a cross-sectional study, based on data gathered from the Brazilian Ministry ofEducation and Institute of Geography and Statistics (IBGE) website. The utilized variables were the number of courses, number of vacancies offered in each course, characteristics of the cities where the medical schools are located, such as population size, Human Development Index (HDI) and distance to the capital city of each state. Results: Among the institutions that have already initiated their activities, there are 328 active courses, offering 35.480 vacancies for Medical School applicants. There is a difference when analyzing public or private institutions and paid or tuition-free institutions. There is a greater offer of paid courses (74,1%) and of courses located in the countryside (69,8%). Among the courses in the countryside, 27,8% of the vacancies are offered within 100 km of the capital city. Only 7,9% of the annual vacancies are offered in cities with a medium HDI, and the remainder are offered in cities with high or very high HDI. The increase in HDI is related to the higher proportion of private courses offering medical vacancies. It was observed that there is no correspondence between the absolute number of vacancies and the population of the North region, differentfrom what occurs in the other regions of the country. Conclusions: Medical training is under many influences, such as economic and political trends. This discussion needs to consider the regionalization and democratization of access. It was observed that public institutions tend to be located in municipalities that are farther away from the capitals. Even though there is now greater homogeneity between the regions, the Southeast still concentrates almost half of the vacancies in medical courses. Also, the increase in the number of vacancies in private courses brings up the reflection about the socioeconomic profile of medical students who have the opportunity to gain access to this level of education.

Abstract Aims: This study aimed to measure light-intensity physical activity (LPA) patterns in adolescents according to weekdays and school period and investigated associations between LPA patterns and associated factors. Methods: This is a cross-sectional study with 388 students of both genders, selected from public schools from Londrina city, Parana state. LPA was measured using accelerometry for seven consecutive days and was analyzed by the time spent in very short (15 to 30 s), short (30 to 60 s), intermediate (1 to 3 min), and long bouts (≥ 3 min). Results: Approximately 22% of the total daily time was spent in LPA. The time in LPA accumulated in short or intermediate bouts was higher than the time accumulated in very short or long bouts (P < 0.05). Gender was associated with short (β= 2.180; 95% confidence interval [CI], 0.357 to 4.003) and intermediate bouts (β = 2.822; 95% CI, 0.681 to 4.964), girls presented higher daily time. Age was inversely associated with very short (β = −0.925; 95% CI, −1.676 to −0.175) and intermediate bouts (β = −1.985; 95% CI, −3.579 to −0.390). The total time in LPA and time accumulated in very short, short, and intermediate bouts was higher in the school period when compared to the non-school period (P < 0.05). Conclusion: It could be concluded that the LPA patterns are predominantly composed of time spent in bouts between 30 seconds and three minutes. Gender, age, and school period appear to influence the LPA pattern in adolescents.

Abstract The reutilization of waste is a valuable alternative for the preservation of natural resources and the environment. In this sense, Basic Oxygen Furnace (BOF) steel slag is one of the most residues generated in steel the industry. It is estimated that for each ton of steel produced, about 150 kg of steel slag is generated in the BOF process. Generally, the newly produced BOF steel slag is volumetrically unstable, presenting expansive characteristics, and for this reason, its application should be based on stabilization studies. The main objective of this research was to analyze the chemical stabilization process of BOF steel slag by means of carbonation of the material. For this purpose, an experimental method based on hydration and carbonation in 2-meter high slag piles, moistened with sprinklers and instrumented with leaf wetting, temperature, precipitation and carbon dioxide content sensors was used. A control stack was also set up to accompany the stabilization process through the conventional procedure, in which the material is disposed of in large stacks and subjected to the weather conditions for long periods. The laboratory campaigns were developed in the laboratories of the Federal University of Ouro Preto. Thus, through the results obtained, it was possible to conclude that the stabilization method based on hydration and carbonation for the BOF steel slag was efficient, reducing the free lime content to values well below those prescribed internationally.

RESUMO Os adenomas túbulo-vilosos da ampola duodenal são neoplasias raras. Neste trabalho apresentamos um caso com correlação radiológico-endoscópica e patológica, tendo a paciente sido submetida à duodenopancreatectomia com boa evolução pós-operatória. Com os avanços dos métodos de imagem, em especial da ressonância magnética e ultrassonografia endoscópica, aspectos locorregionais, além da invasão extraluminal, linfovascular e metastática, têm sido discutidos de maneira crescente como contribuintes na decisão terapêutica. Essa evolução contribui para o melhor estadiamento destas lesões e é especialmente útil para selecionar candidatos elegíveis ao tratamento endoscópico.

SUMMARY Tubulovillous adenomas of the duodenal ampulla are rare neoplasms. The present report describes a case with radiological-endoscopic and pathological correlation in which the patient underwent duodenal pancreatectomy with good postoperative progression. With advanced imaging methods, especially magnetic resonance and endoscopic ultrasound, locoregional aspects and extraluminal, lymphovascular, and metastatic invasion have been increasingly discussed as contributors to therapeutic decision making. This progression improves lesion staging and is especially useful in selecting eligible candidates for endoscopic treatment.

RESUMO O surgimento de carcinoma hepatocelular em pacientes portadores de hepatite C na ausência de cirrose é de ocorrência pouco comum. Demonstramos a importância da ressonância magnética (RM) morfofuncional com contraste hepatoespecífico por meio da descrição de uma paciente do sexo feminino, assintomática, portadora do vírus da hepatite C (VHC), que se apresentou com nódulo detectado na ultrassonografia. Realizou tomografia computadorizada inconclusiva, sem sinais de hepatopatia crônica. A RM com contraste hepatoespecífico, ao proporcionar informações funcionais, somado ao superior contraste tecidual inerente ao método, destaca-se pela maior acurácia, com a possiblidade de não se recorrer a métodos diagnósticos invasivos. Com o acúmulo de experiência e divulgação dessa nova modalidade diagnóstica no meio médico, sua utilização e outros potenciais benefícios da RM morfofuncional com contraste hepatoespecífico podem vir a se estabelecer, beneficiando pacientes com lesões hepáticas focais desafiadoras.

SUMMARY Hepatocellular carcinoma in patients with hepatitis C in the absence of cirrhosis is uncommon. We demonstrate the importance of morphofunctional magnetic resonance imaging (MRI) with a hepatospecific contrast agent by describing an asymptomatic female patient with HCV, who presented with a nodule detected on ultrasound. She underwent inconclusive computed tomography, presenting no signs of chronic liver disease. MRI with hepatospecific contrast providing functional information combined with the superior tissue contrast inherent to this method stands out for its greater accuracy with the possibility of not resorting to invasive diagnostic methods. With increasing experience and the dissemination of this new diagnostic modality in the medical field, its use and other potential benefits of morphofunctional MRI with hepatospecific contrast agents may be established, benefiting patients with challenging focal liver lesions.

Overview and aims: Early-stage cervical cancer has a good prognosis, with survival rates at 5 years >90%. However, while offering the potential for disease cure, treatment often results in the loss of future fertility or impacts the ovarian function. The aim of this study is to examine the characteristics, treatment and survival outcomes of reproductive-aged women with early-stage cervical cancer at a tertiary care center over a period of 10 years. Study design, Population and Methods: Data from patients with early stage cervical cancer (< stage IB1< 2cm) aged 40 years and younger treated between 2008 and 2017 at that institute were collected. Variables selected included patient demographics, tumor information, treatment types, obstetrical outcomes and survival outcomes. Descriptive analysis and a binary logistic regression model were performed using SPSS v. 23.0. Results: In 2008-2017 period, a total of 75 women with stage IA1IB1 (< 2 cm) cervical cancer and ≤40 years at diagnosis were treated. Sixty five percent (49) were squamous carcinomas and 29% (22) adenocarcinomas. Surgical treatment was the first-line option for all patients: 8% (6) cervical conization, 7% (5) trachelectomy with pelvic laparoscopic lymphadenectomy, 21% (16) simple extrafascial hysterectomy and 64% (48) radical hysterectomy. Overall, irrespective of the type of surgical treatment, 75% (56) had conservation of ovaries. In a multivariable analysis, squamous cell carcinoma histology was a predictor of ovarian conservation (adjusted OR 11.03, 95% CI 2.66-45,61, p 0.001) on radical hysterectomy. Three of the patients submitted to trachelectomy got pregnant, one of which had a preterm delivery. Recurrence of the disease was reported in 4% (3) of the cases, only one case of mortality was disease-related. Conclusions: Despite the small case series, our study found a high proportion of reproductive-aged women with early-stage cervical cancer submitted to ovary-sparing surgical treatment, with promising results concerning to recurrence, mortality and pregnancy rates.