RESUMO O selênio (Se) é um mineral antioxidante e tem sido incluído em formulações de rações para peixes na forma orgânica de hidróxi-selenometionina (OH-SeMet). Este estudo avaliou como diferentes concentrações dessa substância, suplementada na dieta, atuam no músculo do tambaqui (Colossoma macropomum) antes e após um estressor (transporte). Os peixes juvenis foram divididos em cinco tratamentos recebendo a suplementação de 0,0; 0,3; 0,6; 0,9; 1,2 mg kg-1 de Se por 75 dias. Após esse período, os peixes ficaram expostos ao transporte por quatro horas. A amostragem de tecido muscular para medição dos parâmetros bioquímicos ocorreu no dia 75, antes do transporte, e uma semana após o transporte (dia 83). A atividade das enzimas superóxido dismutase e glutationa-S-transferase não se alterou. A suplementação com 1,2 mg kg-1 de Se aumentou o nível de glutationa reduzida antes do transporte, e 0,9 e 1,2 mg kg-1 de Se reduziram os níveis de substâncias reativas ao ácido tiobarbitúrico antes e após o transporte. Após o transporte, observamos redução nos níveis de glutationa reduzida nos peixes tratados com 0,3, 0,6 e 1,2 mg kg-1, redução nos níveis de ácido ascórbico nos peixes alimentados com 0,6 mg kg-1 de Se e redução na concentração de proteínas totais nos peixes alimentados com 0,3 mg kg-1 Se, em comparação com os níveis antes do transporte. Conclui-se que a presença de diferentes concentrações de Se na dieta dos peixes promoveu diferentes padrões de resposta ao estado redox, minimizando os danos oxidativos gerados pelo evento estressor. (Se hidróxiselenometionina hidróxi selenometionina OHSeMet. OHSeMet OH SeMet . (OH-SeMet) substância Colossoma macropomum (transporte) 0,0 00 0 03 3 06 6 09 9 12 1 2 1, kg1 kg kg- 7 dias período horas 83. 83 83) glutationaStransferase S transferase alterou 0, kg1, Concluise Conclui redox (OH-SeMet (transporte 8

ABSTRACT Selenium (Se) is an antioxidant mineral and has been included in fish feed formulations in the organic form of hydroxy-selenomethionine (OH-SeMet). This study evaluated how different concentrations of this substance, supplemented in the diet, act on tambaqui (Colossoma macropomum) muscle before and after a stressor (transportation). Juvenile fishes were divided into five treatments receiving 0.0; 0.3; 0.6; 0.9; 1.2 mg kg-1 Se supplementation for 75 days. After that period, the fish were exposed to transportation for four hours. Sampling of muscle tissue for the measurement of biochemical parameters occurred on day 75, prior to transportation, and one week after transportation (day 83). The activity of enzymes superoxide dismutase and glutathione-S-transferase did not change. Supplementation with 1.2 mg kg-1 Se increased the level of reduced glutathione before transportation, and 0.9 and 1.2 mg kg-1 Se reduced the level of thiobarbituric acid reactive substances levels before and after transportation. After transportation, we observed reduced glutathione levels in fish treated with 0.3, 0.6 and 1.2 mg kg-1, reduced ascorbic acid level in fish fed 0.6 mg kg-1 Se, and reduced total protein concentration in fish fed 0.3 mg kg-1 Se, as compared to the levels before transportation. In conclusion, the presence of different concentrations of Se in the fish diet promoted different patterns of response to redox status, minimizing oxidative damage generated by the stressor event. (Se hydroxyselenomethionine hydroxy selenomethionine OHSeMet. OHSeMet OH SeMet . (OH-SeMet) substance Colossoma macropomum (transportation) 0.0 00 0 03 3 06 6 09 9 12 1 2 1. kg1 kg kg- 7 days period hours 83. 83 83) glutathioneStransferase S transferase change 0. kg1, 1, conclusion status event (OH-SeMet (transportation 8

ABSTRACT Pseudomyogenic hemangioendothelioma is an ultra-rare vascular sarcoma that most commonly affects young adults, with a male predominance. It is diagnosed using a combination of imaging studies, histopathological examinations, and immunohistochemical staining. Surgical excision is the mainstay of treatment for pseudomyogenic hemangioendothelioma, with the goal of achieving a wide local excision and reducing the risk of recurrence. The role of systemic therapies is not well established because of the rarity of pseudomyogenic hemangioendothelioma, uncertainty regarding its response to currently approved medications, and lack of randomized controlled trials. We describe the case of an 18-year-old male patient diagnosed with multifocal pseudomyogenic hemangioendothelioma of the left lower limb who was treated with everolimus in addition to denosumab, achieving a partial response that was consolidated with resection, radiofrequency ablation, and radiotherapy of multiple local lesions, achieving a long-lasting response. Following subsequent disease progression, the patient responded favorably to pazopanib, with no significant toxicities. ultrarare ultra rare adults predominance studies examinations staining recurrence medications trials 18yearold yearold 18 year old denosumab resection ablation lesions longlasting long lasting progression pazopanib toxicities 1

ABSTRACT Objective Currently programmed cell death protein 1 (PD-1) inhibitors in combination with other therapies are being evaluated to determine their efficacy in cancer treatment. However, the effect of PD-ligand (L) 1 expression on disease outcomes in stage III (EC III) non-small cell lung cancer is not completely understood. Therefore, this study aimed to assess the influence of PD-L1 expression on the outcomes of EC III non-small cell lung cancer. Methods This study was conducted on patients diagnosed with EC III non-small cell lung cancer who underwent treatment at a tertiary care hospital. PD-L1 expression was determined using immunohistochemical staining, all patients expressed PD-L1. Survival was estimated using the Kaplan-Meier method. Relationships between variables were assessed using Cox proportional regression models. Results A total of 49 patients (median age=69 years) with EC III non-small cell lung cancer and PD-L1 expression were evaluated. More than half of the patients were men, and most were regular smokers. The patients were treated with neoadjuvant chemotherapy, surgery, or sequential or combined chemotherapy and radiotherapy. The median progression-free survival of the entire cohort was 14.2 months, and the median overall survival was 20 months. There was no significant association between PD-L1 expression and disease progression, clinical characteristics, or overall survival. Conclusions PD-L1 expression was not correlated with EC III non-small cell lung cancer outcomes. Whether these findings differ from the association with immune checkpoint inhibitors remains to be addressed in future studies. PD1 PD (PD-1 However PDligand ligand L (L nonsmall non small understood Therefore PDL1 PDL L1 PD-L hospital staining PDL1. L1. KaplanMeier Kaplan Meier method models 4 age69 age 69 age=6 years men smokers surgery radiotherapy progressionfree progression free 142 14 2 14. months characteristics studies (PD- age6 6 age= (PD

OBJECTIVES: To evaluate the efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma (HCC). METHODS: We analyzed data from a cohort of patients with advanced HCC treated using systemic treatment according to the local institutional protocol. Patients were divided into two groups, Group A, individuals <70 years of age, and Group B, individuals 70 years of age or older at the time of treatment initiation. Efficacy, measured based on overall survival (OS) and time to treatment failure (TTF), and toxicity were compared between groups. RESULTS: A total of 238 patients with advanced HCC who received sorafenib between 2007 and 2018 were evaluated. The median age for Group A was 59.1 years and that for Group B 73.6 years. The major prognostic characteristics were balanced between the groups. There were no significant differences in OS between Group A (8.0 months, 95%CI 6.34-9.3) and Group B (9.0 months, 95%CI 5.38-12.62), p=0.433, or in TTF between Group A (3.0 months, 95%CI 2.39-3.60) and Group B (3.0 months, 95%CI 1.68-4.32), p=0.936. There were no significant differences between Groups A and B with respect to the incidence of adverse events or treatment discontinuation because of toxicity. CONCLUSION: Efficacy and safety of sorafenib did not differ significantly between younger and older patients with HCC. Our data suggest that age alone should not restrict clinical decision-making for patients with advanced HCC.

Resumo Introdução: O acesso vascular (AV) para hemodiálise (HD) é crucial para os pacientes portadores de doença renal crônica (DRC) estágio V. Infelizmente, com o passar dos anos, um percentual não desprezível desses enfermos evolui para falência de AV por diversos motivos, o que impossibilita a confecção de novas fístulas arteriovenosas (FAV) ou o implante de cateteres venosos centrais nos sítios de punções tradicionais. Nesse cenário, o implante de cateteres translombares para hemodiálise (CTLHD) em veia cava inferior ganha destaque como medida salvadora. Objetivos: Relatar uma série de 12 casos de implante de CTLHD, sua técnica de implante, patência e complicações. Métodos: Estudo retrospectivo que analisou 12 implantes de CTLHD por radiologista intervencionista no setor de hemodinâmica do Hospital Universitário da Universidade Federal do Rio Grande do Norte (UFRN), no período de janeiro/2016 a outubro/2017. Os dados coletados consistiram em: características demográficas da população estudada, taxa de sucesso, complicações observadas, sobrevida dos pacientes, patência do cateter e desfechos clínicos. Resultados: Todos os 12 CTLHD foram implantados e utilizados com sucesso; ocorreram apenas 2 complicações associadas ao procedimento (sangramento e falha na extubação); 41,6% dos pacientes apresentaram infecção relacionada ao cateter após 98 ± 72,1 dias (6-201 dias), mas não houve necessidade de remoção; e a patência foi de 315,5 cateteres-dia (65-631 dias). Conclusão: O CTLHD é uma opção para pacientes com falência de acesso vascular, prolongando a sobrevida dos pacientes e atuando como ponte para o transplante renal.

Abstract Introduction: Vascular access (VA) in hemodialysis (HD) is essential to end-stage renal disease (ESRD) patients survival. Unfortunately, after some years in HD program, a significant number of patients may develop VA failure for many reasons. In this situation, arterial venous fistula (AVF) confection or catheters placement in traditional vascular sites (jugular, femoral or subclavian) are not feasible. In this scenario, translumbar tunneled dialysis catheter (TLDC) may be a salvage option. Objectives: To describe placement technic, complications, and patency of 12 TLDC. Methods: A retrospective study was performed to analyze 12 TLDC placement in an angiography suite using fluoroscopic guidance at the University Hospital of the Rio Grande do Norte Federal University from January 2016 to October 2017. The data collected of the total procedures performed consisted of demographic characteristics, success rates, observed complications, patient survival, and catheter patency. Results: All 12 TLDC were placed with success; there were only 2 significant periprocedure complications (major bleeding and extubation failure); 41.6% of patients presented a catheter-related first infection after 98 ± 72.1 (6-201) days, but catheter withdrawal was not necessary, mean total access patency was 315.5 (range 65 - 631) catheter-days, and catheter patency at 3, 6 and 12 months was 91 %, 75%, and 45%. Conclusion: TLDC is an option for patients with VA failure, improving survival and acting as a bridge for renal transplantation.

RESUMO Capirona decorticans (Rubiaceae) é popularmente usada para tratar verrugas, feridas, micoses e sarna, e como um componente do chá de Ayahuasca. Apesar do uso popular, são limitadas as pesquisas fitoquímicas e farmacológicas sobre a espécie. Portanto, este estudo quantificou compostos fenólicos no extrato etanólico (EE) e na fração hidrometanólica (FM) (406 e 293 mgEAG g-1, respectivamente) de folhas de C. decorticans. Identificamos flavonoides por LC-MS / MS-MMR-ESI (apigenina, rutina, luteolina, miricetina, quercetina, quercetina-3-β-D-glicosídeo, quercetrina), e avaliamos o estresse oxidativo e o efeito mutagênico/antimutagênico de EE e FM em um experimento in vivo utilizando camundongos Swiss e ciclofosfamida (CP) como um indutor de danos no DNA e estresse oxidativo. Os camundongos foram pré-tratados por 15 dias consecutivos com EE ou FM (250 mg kg-1) e injetados intraperitonealmente com CP (25 mg kg-1). Proteínas carboniladas, ácido ascórbico, catalase e substâncias reativas ao ácido tiobarbitúrico foram dosadas em tecidos hepáticos e renais. O efeito mutagênico/antimutagênico foi avaliado através do Teste de Micronúcleo. Houve carbonilação protéica no fígado de animais expostos à CP, que foi reduzida pela FM. Não houve efeito significativo sobre outros marcadores de estresse oxidativo. Os grupos tratados com os extratos apresentaram uma redução percentual significativa (EE = 96% e FM = 71%) na frequência de eritrócitos policromáticos micronucleados induzidos pela PC. O EE também apresentou mutagenicidade quando utilizado isoladamente. O EE e FM das folhas de C. decorticans apresentaram potencial antioxidante equivalente ao observado em outras espécies, não causaram estresse oxidativo, nem toxicidade, e tiveram efeito protetor e antimutagênico, embora a EE tenha apresentado mutagenicidade.

ABSTRACT Capirona decorticans (Rubiaceae) is popularly used to treat warts, wounds, mycoses and scabies, and is also a component of the Ayahuasca tea. Despite its popular use, the phytochemical and pharmacological research on this species is limited. Therefore, this work quantified phenolic compounds in the ethanolic extract (EE) and hydromethanolic fraction (FM) (406, 293 mgEAG g-1, respectively) from leaves of C. decorticans. We identified flavonoids by LC-MS/MS-MMR-ESI (apigenin, rutin, luteolin, miricetin, quercetin, quercetin-3-β-D-glucoside, quercetrin), and evaluated oxidative stress and mutagenic/antimutagenic effect of EE and FM through an in vivo experiment using Swiss mice and cyclophosphamide (CP) as an inducer of DNA damage and oxidative stress. Mice were pretreated for 15 consecutive days with EE or FM (250 mg kg-1) and then intraperitoneally injected with CP (25 mg kg-1). Carbonylated proteins, ascorbic acid, catalase and thiobarbituric acid-reactive substances were measured in hepatic and renal tissues. The mutagenic/antimutagenic effect was evaluated through the Micronucleus Test. Protein carbonylation in the liver of animals exposed to CP was reduced by FM. There was no significant effect on other markers of oxidative stress. The groups treated with the extracts showed a significant percentage reduction (EE = 96% and FM = 71%) in the frequency of micronucleated polychromatic erythrocytes induced by CP. EE showed mutagenicity when used alone. The EE and FM of C. decorticans leaves showed antioxidant potential equivalent to that observed in other species, did not cause oxidative stress, nor toxicity, and had a protective and antimutagenic effect, although the EE showed signs of mutagenicity.

Resumo Este artigo analisa o impacto da instalação do Complexo Hidroelétrico da Madeira sobre a saúde da população do município de Porto Velho (Amazônia, Brasil) no período de 2001 a 2010. A incidência de um conjunto de doenças foi avaliada em relação às mudanças ocorridas no ambiente humano e natural, em comparação com a fase anterior à instalação dos empreendimentos hidrelétricos. A avaliação da sensibilidade ambiental e da vulnerabilidade da população foi realizada com base em uma matriz de indicadores socioeconômicos, ambientais e de saúde. A transmissão das doenças: malária, Aids, leishmaniose e dengue - foi afetada de diferentes formas pela implantação das usinas hidrelétricas em um contexto de intervenção governamental limitada em termos de infraestrutura de saneamento e de serviços de saúde, desmatamento, diferentes formas de uso e cobertura do solo, além de processos de migração na área de influência das usinas hidrelétricas.

Abstract This article analyses the health impact of the installation of the Madeira Hydroelectric Complex to the population of Porto Velho county (Amazon, Brazil) between 2001 and 2010. The incidence of a selected list of diseases was evaluated with regard to changes that took place in the human and natural environment, compared to the phase prior to the installation of the hydroelectric power projects. An assessment of environmental responsiveness and the population’s vulnerability was carried out based on a matrix of socioeconomic, health, and environmental indicators. Malaria, Aids, leishmaniosis and dengue transmission were differentially affected by the implementation of the hydroelectric power plants in a context of limited government intervention in terms of sanitation and health care infrastructure, deforestation, different forms of land use and cover, in addition to migration processes within the area influenced by the hydroelectric power plants.

Resumen Este artículo analiza el impacto de la instalación del Complejo Hidroeléctrico del rio Madeira sobre la salud de la población del municipio de Porto Velho (Amazonía, Brasil) entre 2001 y 2010. Se evaluó la incidencia de algunas enfermedades respecto a los cambios ocurridos en ambiente humano y natural, en comparación con la fase previa a la instalación de los proyectos. Se realizó una evaluación de la respuesta ambiental y de la vulnerabilidad de la población a partir de una matriz de indicadores socioeconómicos, ambientales y sanitarios. La transmisión de malaria, SIDA, leishmaniosis y dengue se vieron afectados de diferentes modos por la implementación de las centrales hidroeléctricas en un contexto de intervención limitada del Estado en materia de infraestructura de saneamiento, servicios de salud y la deforestación, cambios en el uso y cobertura del suelo, además de la migración en el área bajo influencia de las centrales hidroeléctricas.

ResumoO propósito do presente estudo foi comparar o efeito do uso do sistema âncora bilateralmente e unilateralmente (mão dominante e mão não dominante) em idosos em duas condições visuais (com e sem visão disponível). Para tanto, 14 idosos ficaram na posição semi tandem sobre uma plataforma de força. Eles realizaram oito condições experimentais combinando o uso do sistema âncora (duas mãos, mão dominante, mão não dominante e sem âncora) e a disponibilidade de visão (com e sem). Os resultados da área da elipse ajustada ao deslocamento do centro de pressão (CP) e da velocidade média de oscilação do CP mostraram que as condições realizadas com a âncora nas duas mãos e com a âncora na mão não dominante reduziram a oscilação corporal e a velocidade de oscilação em comparação à condição sem âncora. Além disso, a presença de visão também reduziu a área da elipse e a velocidade média de oscilação. No geral, portanto, o sistema âncora se mostrou um instrumento eficaz que permitiu aos participantes idosos diminuírem a oscilação corporal, favorecendo a melhora do equilíbrio. Apesar disso, o efeito da adição de informação háptica foi similar nas diferentes condições visuais testadas, sugerindo que a informação háptica adicional fornecida por meio do sistema âncora tem um peso constante e, portanto, não varia em função das alterações da disponibilidade de visão. Além disso, esses resultados contradizem estudos anteriores que utilizaram o paradigma do toque leve. Diferenças entre os paradigmas do toque leve e do sistema âncora e assimetrias inter-hemisféricas em tarefas de percepção háptica foram usados para explicar essas contradições.

AbstractThe purpose of this study was to compare the effect of using the anchor system bilaterally and unilaterally (dominant and non-dominant hands), in older adults, in two visual conditions (with and without vision). Fourteen older adults were positioned in a semi-tandem position on a force plate, where they performed tasks under eight experimental conditions that employed the anchor system (two-handed, dominant hand, non-dominant hand, and without anchor), both with and without vision. The results, illustrated through the ellipse area adjusted to the displacement of the center of pressure (COP) and the mean sway velocity of the COP, showed that tasks performed with the anchor system held by both hands, and the anchor system held by the non-dominant hand, reduced both body sway and velocity when compared to the condition without the anchor. Furthermore, the task conditions with vision also reduced the ellipse area and the mean sway velocity. Overall, the anchor system is a tool that effectively allowed the older adults to decrease body sway. The effect of adding haptic information was similar throughout the different visual conditions tested, suggesting that the additional haptic information provided by the anchor system had a constant impact and did not vary with changes in the availability of vision. These results add new insights to the field of haptics when compared to findings of previous studies that use the light touch paradigm. Differences between the paradigms of light touch and the anchor system-and inter-hemispheric asymmetries in haptic perception tasks-were used to explain these insights.

OBJETIVO: Avaliar a resposta da embolização arterial tireoidiana como terapêutica para o hipertireoidismo primário. MATERIAIS E MÉTODOS: Cinco mulheres com falha ao tratamento farmacológico com tionamida foram submetidas a vaso-oclusão em três artérias dominantes tireoidianas (avaliadas por ultrassonografia Doppler e arteriografia) e acompanhadas até 8 semanas após o procedimento (três acompanhadas até 16 semanas) com ultrassonografia Doppler, calcemia, função tireoidiana e controle clínico. RESULTADOS: Nenhuma alcançou remissão permanente de doença após 8 semanas. Houve recidiva de hipertireoidismo em 24 semanas, mesmo com redução do volume tireoidiano de 49,5 ± 15,2% em 16 semanas. Não encontramos complicações, mas radioiodo foi necessário após 24 semanas em três das pacientes acompanhadas. CONCLUSÃO: Nas pacientes que concluíram o protocolo, a vaso-oclusão arterial com polivinil álcool nas três artérias dominantes permitiu redução volumétrica do bócio, entretanto, foi ineficiente em controlar o hipertireoidismo.

OBJECTIVE: To evaluate the therapeutic response to thyroid arterial embolization for primary hyperthyroidism. MATERIALS AND METHODS: Five women whose pharmacological treatment with thionamides failed to control Graves' disease were submitted to embolization of three dominant thyroid arteries (following assessment with ultrasound Doppler and arteriography) and followed-up at the 1st, 8th and 16th weeks after the procedure, with ultrasound Doppler, calcium blood test, thyroid function test and clinical examination. Three of the patients completed 16-week follow-up. RESULTS: None of the patients achieved permanent remission after 8 weeks. Disease recurrence was observed at the 24th week, despite the decrease in thyroid volume (49.5 ± 15.2%) observed at the 16th week. Complications were not observed, but radioiodine therapy was required for three of the patients followed-up. CONCLUSION: Embolization of three dominant thyroid arteries with polyvinyl alcohol allowed reduction in goiter volume in the three patients who completed the protocol, but was not effective to control hyperthyroidism.