ABSTRACT Introduction Obstructive azoospermia occurs when there is a blockage in the male reproductive tract, leading to a complete absence of sperm in the ejaculate. It constitutes around 40% of all cases of azoospermia (1, 2). Blockages in the male reproductive tract can arise from either congenital or acquired factors, affecting various segments such as the epididymis, vas deferens, and ejaculatory ducts (3). Examples of congenital causes encompass conditions like congenital bilateral absence of the vas deferens and unexplained epididymal blockages (4). Acquired instances of obstructive azoospermia may result from factors like vasectomy, infections, trauma, or unintentional injuries caused by medical procedures (5). This complex condition affecting male fertility, presents two main treatment options: microsurgical reconstruction and surgical extraction of sperm followed by in vitro fertilization (IVF). Microsurgical reconstruction proves to be the most cost-effective option for treating obstructive azoospermia when compared with assisted reproductive techniques (6, 7). However, success rates of reconstruction defined by patency are as high as 99% for vasovasostomy (VV) but decline to around 65% if vasoepididymostomy (VE) is required (8, 9). Thus, continued refinement in technique is necessary in order to attempt to improve patency for patients undergoing VE. In this video, we show a comprehensive demonstration of microsurgical VE, highlighting the innovative epididymal occlusion stitch. The goal of this innovative surgical technique is to improve outcomes for VE. Materials and Methods The patient is a 39-year-old male diagnosed with obstructive azoospermia who presents for surgical reconstruction via VE. His partner is a 37-years-old female with regular menstrual cycles. The comprehensive clinical data encompasses a range of factors, including FSH levels, results from semen analysis, and outcomes from testicular sperm aspiration. This thorough exploration aims to provide a thorough understanding of our innovative surgical technique and its application in addressing complex cases of obstructive azoospermia. Results The procedure was started on the right, the vas deferens was identified and transected. The abdominal side of the vas was intubated and a vasogram performed, there was no obstruction. There was no fluid visible from the testicular side of the vas for analysis, thus we proceeded with VE. Upon inspection of the epididymis dilated tubules were identified. After selecting a tubule for VE, two 10-0 nylon sutures were placed, and it was incised. Upon inspection of the fluid motile sperm was identified. After VE, we performed a novel epididymal occlusion stitch technique. This was completed distal to the anastomosis by placing a 7-0 prolene through the tunica of the epididymis from the medial to lateral side. This stitch was then tightened down with the goal to largely occlude the epididymis so that sperm will preferentially travel through the anastomosis. The steps were then repeated on the left. At 3-month follow up, the patient had no change in testicular size as compared with preoperative size (18cc), he had no testicular or incisional discomfort, and on semen analysis he had presence of motile sperm. After 3 months post-surgery, the patient had motile sperm seen on semen analysis. Discussion The introduction of a novel epididymal occlusion stitch demonstrates a targeted strategy to enhance the success of microscopic VE. Encouragingly, a 3-month post-surgery follow-up reveals the presence of motile sperm, reinforcing the potential efficacy of our approach. This is promising given the historical lower patency, delayed time to patency, and higher delayed failure rates that patients who require VE experience (10). In total, 40% of all azoospermia cases can be attributed to obstruction. The conventional treatments for obstructive azoospermia involve microsurgical reconstruction and surgical sperm retrieval followed by IVF. While microsurgical reconstruction has proven to be economically viable, the quest for enhanced success rates has led to the exploration of innovative techniques. Historically, the evolution of VV and VE procedures, initially performed in the early 20th century, laid the foundation for contemporary microsurgical approaches (11). Notably, the microscopic VV demonstrated significant improvements in patency rates and natural pregnancy likelihood, as evidenced by the seminal Vasovastomy Study Group study in 1991 (8). In contemporary literature, success rates particularly for VE remain unchanged for the past three decades since the original published success rates by the Vasectomy Reversal Study Group (12). VE is associated with a longer time to patency as well with patients taking 2.8 to 6.6 months to have sperm return to ejaculate as compared to 1.7 to 4.3 months for those undergoing VV. Additionally, of those patients who successfully have sperm return to the ejaculate after VE up to 50% will have delayed failure compared to 12% for those undergoing VV who are patent. Finally, of those who experience delayed failure after undergoing VE it usually occurs earlier with studies reporting as early as 6 months post-operatively (20). Given the lack of improvement and significantly worsened outcomes with VE further surgical refinement is a constant goal for surgeons performing this procedure. Conclusion: In conclusion, this video is both a demonstration and a call to action for commitment to surgical innovation. We aim to raise the bar in VE success rates, ultimately bringing tangible benefits to patients and contributing to the ongoing evolution of reproductive medicine. The novel epididymal occlusion stitch emerges as a beacon of progress, promising not only enhanced safety but also potential reductions in patency time. Surgical excellence and methodological refinement, as exemplified in this video, lay the foundation for a future where male reproductive surgery continues to break new ground. 40 1, 1 (1 2. 2 . 2) 3. (3) 4. 4 (4) vasectomy infections trauma 5. 5 (5) fertility options IVF (IVF) costeffective cost effective 6, (6 7. 7 7) However 99 (VV 65 (VE 8, 8 (8 9. 9 9) Thus 39yearold yearold 39 year old 37yearsold yearsold 37 years cycles levels aspiration right transected obstruction 100 10 0 10- placed incised 70 7- left 3month month 18cc, 18cc cc , (18cc) discomfort postsurgery, postsurgery post surgery, Encouragingly followup approach 10. (10) total viable Historically th century 11. 11 (11) Notably likelihood 199 8. (8) literature 12. 12 (12) 28 66 6. 17 1. 43 Additionally 50 patent Finally postoperatively operatively 20. 20 (20) Conclusion conclusion innovation medicine progress ground ( (3 (4 (5 (IVF (18cc (10 (11 19 (12 (20 (2

ABSTRACT Purpose: Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the use of statin could cause a reduction in testosterone levels. The objective was to evaluate whether the continued use of statins in patients with hypercholesterolemia causes a deficiency in testosterone and other sex hormones. Materials and Methods: Systematic Review with Meta-analysis, performed in Embase, Medline and Cochrane databases, until May 2023; PROSPERO CRD42021270424protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement. There were selected comparative studies, prospective cohorts (CP), randomized clinical trials (RCT) and cross-sectional studies (CSS) with comparison of testosterone levels before and after statin administration and between groups. Bias analysis were evaluated with Cochrane Tool, The Newcastle-Ottawa Scale (NOS), and using the Assess the Quality of Cross-sectional studies (AXIS) tool. Results: There were found on MedLine, Embase and Cochrane, after selected comparative studies, 10CP and 6RCT and 6CSS for the meta-analysis. In the Forrest plot with 6CSS, a correlation between patients with continuous use of statins and a reduction in total testosterone was evidenced with a statistically significant reduction of 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p<0.00001). In the analysis with 5RCT, a reduction in the mean total testosterone in patients who started continuous statin use was evidenced, with a statistical significance of 13.12ng/dL (95%CI=[1.16,25.08],I²=0%,p=0.03). Furthermore, the analysis of all prospective studies with 15 articles showed a statistically significant reduction in the mean total testosterone of 9.11 ng/dL (95%CI=[0.16,18.06],I²=37%,p=0.04). A reduction in total testosterone has been shown in most studies and in its accumulated analysis after statin use. However, this decrease was not enough to reach levels below normal. Conclusion: Statins use causes a decrease in total testosterone, not enough to cause a drop below the normal range and also determines increase in FSH levels. No differences were found in LH, Estradiol, SHBG and Free Testosterone analysis. Purpose dyslipidemia cholesterol hormones Methods Metaanalysis, Metaanalysis Meta analysis, Meta-analysis databases 2023 CRD42021270424protocol CRDprotocol CRD protocol stages statement CP, CP , (CP) RCT (RCT crosssectional cross sectional CSS (CSS groups Tool NewcastleOttawa Newcastle Ottawa NOS, NOS (NOS) Crosssectional Cross AXIS (AXIS tool Results MedLine metaanalysis. metaanalysis meta meta-analysis 5502ngdL ngdL 55 02ng dL ng 95%CI=39.40,70.64,I²=91%,p<0.00001. 95CI39407064I²91p000001 CIIp 95%CI= 39.40,70.64 ,I²=91%,p<0.00001 . 95 CI 39 40 70 64 I² 91 p 0 00001 I (95%CI=[39.40,70.64],I²=91%,p<0.00001) 5RCT 1312ngdL 13 12ng 95%CI=1.16,25.08,I²=0%,p=0.03. 95CI1162508I²0p003 1.16,25.08 ,I²=0%,p=0.03 1 16 25 08 03 (95%CI=[1.16,25.08],I²=0%,p=0.03) Furthermore 911 9 11 9.1 95%CI=0.16,18.06,I²=37%,p=0.04. 95CI0161806I²37p004 0.16,18.06 ,I²=37%,p=0.04 18 06 37 04 (95%CI=[0.16,18.06],I²=37%,p=0.04) However Conclusion LH Estradiol 202 (CP (NOS 5 95%CI=39.40,70.64,I²=91%,p<0.00001 95CI39407064I²91p00000 95CI 95%CI 39407064 39.40,70.6 I²91p000001 Ip ,I²=91%,p<0.0000 3 4 7 6 0000 (95%CI=[39.40,70.64],I²=91%,p<0.00001 95%CI=1.16,25.08,I²=0%,p=0.03 95CI1162508I²0p00 1162508 1.16,25.0 I²0p003 ,I²=0%,p=0.0 2 (95%CI=[1.16,25.08],I²=0%,p=0.03 9. 95%CI=0.16,18.06,I²=37%,p=0.04 95CI0161806I²37p00 0161806 0.16,18.0 I²37p004 ,I²=37%,p=0.0 (95%CI=[0.16,18.06],I²=37%,p=0.04 20 95%CI=39.40,70.64,I²=91%,p<0.0000 95CI39407064I²91p0000 3940706 39.40,70. I²91p00000 ,I²=91%,p<0.000 000 (95%CI=[39.40,70.64],I²=91%,p<0.0000 95%CI=1.16,25.08,I²=0%,p=0.0 95CI1162508I²0p0 116250 1.16,25. I²0p00 ,I²=0%,p=0. (95%CI=[1.16,25.08],I²=0%,p=0.0 95%CI=0.16,18.06,I²=37%,p=0.0 95CI0161806I²37p0 016180 0.16,18. I²37p00 ,I²=37%,p=0. (95%CI=[0.16,18.06],I²=37%,p=0.0 95%CI=39.40,70.64,I²=91%,p<0.000 95CI39407064I²91p000 394070 39.40,70 I²91p0000 ,I²=91%,p<0.00 00 (95%CI=[39.40,70.64],I²=91%,p<0.000 95%CI=1.16,25.08,I²=0%,p=0. 95CI1162508I²0p 11625 1.16,25 I²0p0 ,I²=0%,p=0 (95%CI=[1.16,25.08],I²=0%,p=0. 95%CI=0.16,18.06,I²=37%,p=0. 95CI0161806I²37p 01618 0.16,18 I²37p0 ,I²=37%,p=0 (95%CI=[0.16,18.06],I²=37%,p=0. 95%CI=39.40,70.64,I²=91%,p<0.00 95CI39407064I²91p00 39407 39.40,7 I²91p000 ,I²=91%,p<0.0 (95%CI=[39.40,70.64],I²=91%,p<0.00 95%CI=1.16,25.08,I²=0%,p=0 1162 1.16,2 I²0p ,I²=0%,p= (95%CI=[1.16,25.08],I²=0%,p=0 95%CI=0.16,18.06,I²=37%,p=0 0161 0.16,1 I²37p ,I²=37%,p= (95%CI=[0.16,18.06],I²=37%,p=0 95%CI=39.40,70.64,I²=91%,p<0.0 95CI39407064I²91p0 3940 39.40, I²91p00 ,I²=91%,p<0. (95%CI=[39.40,70.64],I²=91%,p<0.0 95%CI=1.16,25.08,I²=0%,p= 116 1.16, ,I²=0%,p (95%CI=[1.16,25.08],I²=0%,p= 95%CI=0.16,18.06,I²=37%,p= 016 0.16, ,I²=37%,p (95%CI=[0.16,18.06],I²=37%,p= 95%CI=39.40,70.64,I²=91%,p<0. 95CI39407064I²91p 394 39.40 I²91p0 ,I²=91%,p<0 (95%CI=[39.40,70.64],I²=91%,p<0. 95%CI=1.16,25.08,I²=0%,p 1.16 (95%CI=[1.16,25.08],I²=0%,p 95%CI=0.16,18.06,I²=37%,p 01 0.16 (95%CI=[0.16,18.06],I²=37%,p 95%CI=39.40,70.64,I²=91%,p<0 39.4 I²91p ,I²=91%,p< (95%CI=[39.40,70.64],I²=91%,p<0 1.1 0.1 95%CI=39.40,70.64,I²=91%,p< 39. ,I²=91%,p (95%CI=[39.40,70.64],I²=91%,p< 1. 0. 95%CI=39.40,70.64,I²=91%,p (95%CI=[39.40,70.64],I²=91%,p

ABSTRACT: This retrospective study evaluated the impact of the clinical presentation of pyometra on the morbidity and mortality of the affected bitches. The medical records of 47 bitches surgically treated for pyometra between May and December 2017 were evaluated. The admission data were analyzed to classify the animals according to the clinical presentation of pyometra, presence of systemic inflammatory response syndrome (SIRS) and organic dysfunctions (cardiovascular, neurological, renal, and hemostatic). The outcomes were recorded for up to 14 days. The overall mortality rate was 13%. Open and closed pyometra were identified in 62% (n= 29) and 38% (n= 18) of the cases, respectively. The SIRS was present in 44 (94%) bitches, and 27 (57%) had at least one organ dysfunction. The most prevalent dysfunction was hemostatic, followed by neurological, cardiovascular, and renal dysfunction. The clinical presentation of pyometra and the presence of SIRS did not correlate with each other, or with the presence of organ dysfunction and mortality. However, cumulative organ dysfunction (r=0.532, P=<0.001) and the presence of neurological (r= -0.371; P=0.012) and renal dysfunction (r=0.303; P=0.041) were correlated with mortality. Thus, the identification of organ dysfunction through physical examination and routine laboratory analysis proved to be more effective in identifying and predicting the critically ill patients than the SIRS criteria or clinical presentation of the disease. ABSTRACT 4 201 (SIRS cardiovascular (cardiovascular hemostatic. hemostatic . hemostatic) 1 days 13 13% 62 n= n (n 29 38 18 cases respectively 94% 94 (94% 2 57% 57 (57% other However r=0.532, r0532 r 0 532 (r=0.532 P=<0.001 P0001 P 001 r= (r 0.371 0371 371 -0.371 P=0.012 P0012 012 r=0.303 r0303 303 (r=0.303 P=0.041 P0041 041 Thus disease 20 6 3 9 (94 5 (57 r=0.532 r053 53 (r=0.53 P=<0.00 P000 00 0.37 037 37 -0.37 P=0.01 P001 01 r=0.30 r030 30 (r=0.30 P=0.04 P004 04 (9 (5 r=0.53 r05 (r=0.5 P=<0.0 P00 0.3 03 -0.3 P=0.0 r=0.3 r03 (r=0.3 ( r=0.5 r0 (r=0. P=<0. P0 0. -0. P=0. r=0. (r=0 P=<0 -0 P=0 r=0 P=< - P=

RESUMO: O objetivo deste estudo retrospectivo foi avaliar o impacto da apresentação clínica da piometra na morbimortalidade das cadelas afetadas. Foram avaliados os registros clínicos de 47 cadelas tratadas cirurgicamente para piometra entre maio e dezembro de 2017. Os dados recolhidos na admissão foram analisados para classificar os animais quanto à apresentação clínica da piometra, presença de critérios da Síndrome da Resposta Inflamatória Sistêmica (SRIS) e disfunções orgânicas - cardiovascular, neurológica, renal e hemostática. Foi registrado o desfecho durante 14 dias. A mortalidade global foi de 13%. Piometra aberta e fechada foram identificadas em 62% (n= 29) e 38% (n= 18) respectivamente. SRIS esteve presente em 44 (94%) cadelas e 27 (57%) tiveram pelo menos uma disfunção orgânica. A disfunção mais prevalente foi a hemostática, seguida da neurológica, cardiovascular e renal. A apresentação clínica da piometra e a presença de SRIS não se correlacionaram entre si ou com presença de disfunção orgânica e mortalidade. No entanto, a quantidade de disfunções orgânicas (r=0.532, P=<0.001) e a presença das disfunções neurológica (r= -0.371; P=0.012) e renal (r=0.303; P=0.041) foram correlacionados com mortalidade. Assim, a identificação de disfunções orgânicas através do exame físico e análises laboratoriais de rotina mostrou-se mais eficaz na identificação e previsão de pacientes críticos do que os critérios de SRIS ou a apresentação clínica da doença. RESUMO afetadas 4 2017 (SRIS hemostática 1 dias 13 13% 62 n= n (n 29 38 18 respectivamente 94% 94 (94% 2 57% 57 (57% entanto r=0.532, r0532 r 0 532 (r=0.532 P=<0.001 P0001 P 001 r= (r 0.371 0371 371 -0.371 P=0.012 P0012 012 r=0.303 r0303 303 (r=0.303 P=0.041 P0041 041 Assim mostrouse mostrou doença 201 6 3 9 (94 5 (57 r=0.532 r053 53 (r=0.53 P=<0.00 P000 00 0.37 037 37 -0.37 P=0.01 P001 01 r=0.30 r030 30 (r=0.30 P=0.04 P004 04 20 (9 (5 r=0.53 r05 (r=0.5 P=<0.0 P00 0.3 03 -0.3 P=0.0 r=0.3 r03 (r=0.3 ( r=0.5 r0 (r=0. P=<0. P0 0. -0. P=0. r=0. (r=0 P=<0 -0 P=0 r=0 P=< P=

RESUMEN Introducción: Eventos como los Juegos Paralímpicos dejan una serie de legados en las sociedades anfitrionas. Esto también es aplicable al desarrollo de conocimiento científico asociado, especialmente en el campo de la biomecánica deportiva. Objetivo: El objetivo de este estudio es investigar la producción científica brasileña en el campo de la biomecánica en deportes paralímpicos durante el ciclo que precedió y siguió a los Juegos Paralímpicos de Río 2016. Además, el estudio tiene como propósito brindar ideas para futuros esfuerzos de investigación. Métodos: La búsqueda se realizó en la Plataforma Lattes, utilizando los filtros “ Assunto “ y “Doutores” y las palabras clave “Paralímpico” y “Paralympic”. En total, se identificaron 723 autores que publicaron artículos relacionados con el tema. Posteriormente, se accedió a los currículos y se clasificaron e identificaron los artículos, lo que resultó en 37 artículos que cumplieron con todos los criterios de inclusión. Resultados: Los resultados indican que: a) Brasil experimentó un aumento en el número de publicaciones después de Londres 2012; b) La mayoría de estas producciones (87%) provienen de Instituciones Públicas; c) Después de Río 2016, hubo una mayor participación de otras regiones de Brasil en la producción de conocimiento en el área; d) Las modalidades individuales, como levantamiento de pesas y atletismo, fueron las más investigadas, a pesar del estatus de referencia de Brasil en algunas modalidades colectivas; e) Las mujeres siguen siendo una minoría, tanto como participantes en investigaciones como autoras de publicaciones; f) Las producciones demuestran altos niveles de calidad; g) Las técnicas de investigación más utilizadas en biomecánica fueron la cinemática y la dinamometría. Conclusión: El campo de la biomecánica en deportes paralímpicos ha sido significativamente beneficiado por el legado generado por los Juegos Paralímpicos de Río 2016. Como desafíos futuros para los investigadores, se destacan los siguientes aspectos: mantener la calidad de las producciones, ampliar los estudios para incluir modalidades colectivas, aumentar la participación de otras entidades federadas en la producción del conocimiento en este campo, promover una mayor equidad de género e incorporar nuevas técnicas de investigación en biomecánica. Nivel de Evidencia II; Estudio de Revisión. Introducción anfitrionas asociado deportiva Objetivo 2016 Además Métodos Lattes Doutores “Doutores Paralímpico “Paralímpico Paralympic. Paralympic . “Paralympic” total 72 tema Posteriormente 3 inclusión Resultados 2012 b 87% 87 (87% Públicas c área d individuales atletismo investigadas colectivas minoría f g dinamometría Conclusión investigadores aspectos II Revisión 201 “Paralympic 7 8 (87 20 (8 2 (

ABSTRACT Introduction: Events such as the Paralympic Games leave a series of legacies in the host societies. This is also applicable to the development of associated scientific knowledge, particularly in the field of sports biomechanics. Objective: The objective of this study is to investigate the Brazilian scientific production in the field of biomechanics in Paralympic sports during the cycle that preceded and followed the Rio 2016 Paralympic Games. Additionally, the study aims to provide insights for future research endeavors. Methods: The search was conducted on the Lattes Platform, utilizing the filters “Assunto” and “Doutores” and the keywords “Paralímpico” and “Paralympic.” In total, 723 authors were identified who published articles related to the topic. Subsequently, the curricula were accessed, and the articles were sorted and identified, resulting in 37 articles that met all inclusion criteria. Results: The results indicate that: a) Brazil witnessed an increase in the number of publications after London 2012; b) The majority of these productions (87%) originate from Public Institutions; c) There was a greater participation of other regions of Brazil in the production of knowledge in the area after Rio 2016; d) Individual modalities such as powerlifting and athletics were the most researched, despite Brazil's reference status in some collective modalities; e) Women remain a minority, both as participants in research and as authors of publications; f) The productions demonstrate high levels of quality; g) The most commonly used research techniques in biomechanics were kinematics and dynamometry. Conclusion: The field of biomechanics in Paralympic sports has significantly benefited from the legacy generated by the Rio 2016 Paralympics. As future challenges for researchers, the following aspects stand out: maintaining the quality of productions, expanding studies to include collective modalities, increasing the participation of other federated entities in the production of knowledge in this field, promoting greater gender equity, and incorporating new research techniques in biomechanics. Level of Evidence II; Review Study. Introduction societies Objective 201 Additionally endeavors Methods Platform Assunto “Assunto Doutores “Doutores Paralímpico “Paralímpico Paralympic. “Paralympic. total 72 topic Subsequently accessed 3 criteria Results 2012 b 87% 87 (87% Institutions c d researched Brazils s e minority f g dynamometry Conclusion Paralympics researchers out equity II Study 20 “Paralympic 7 8 (87 2 (8 (

RESUMO Introdução: Eventos como os Jogos Paralímpicos deixam uma série de legados nas sociedades que as sediam. Não seria diferente quando se trata do desenvolvimento do conhecimento científico associado, em especial a biomecânica do esporte. Objetivo: Investigar a produção científica brasileira produzida em biomecânica no esporte paralímpico no ciclo que antecedeu e sucedeu os Jogos Paralímpicos Rio 2016, além de fornecer insights para novos estudos. Métodos: Foram realizadas buscas na Plataforma Lattes, sendo habilitados os filtros “Assunto” e “Doutores”, com as palavras-chave “Paralímpico” e “Paralympic”. Ao todo, foram encontrados 723 autores que publicaram artigo(s) relacionado(s) com o tema. Após acessar os currículos, os artigos foram triados e identificados, resultando em 37 artigos que preencheram todos os critérios de inclusão. Resultados: Os resultados mostram que a) Após Londres-2012, o Brasil tem aumentado o número de publicações; b) Grande parte das produções (87%) são oriundas de Instituições Públicas, c) Após Rio-2016 houve uma maior participação de outras regiões do Brasil na produção do conhecimento na área, d) Apesar do Brasil ser referência em algumas modalidades coletivas, modalidades individuais como o powerlifting e o atletismo, são as mais pesquisadas, e) Mulheres ainda são minoria, tanto como participantes das pesquisas quanto na autoria das publicações, f) As produções atingem elevados extratos de qualidade, g) As técnicas de pesquisa em biomecânica mais utilizadas foram a cinemática e dinamometria. Conclusão: A biomecânica no esporte paralímpico tem se valido do legado gerado pelas paralimpíadas Rio-2016. Como desafios futuros para os pesquisadores, destacam-se: manutenção da qualidade das produções, ampliação dos estudos para as modalidades coletivas, aumento da participação de outros entes federados na produção do conhecimento na área, promoção de uma maior equidade de gênero e incorporação de novas técnicas de pesquisa em biomecânica. Nível de Evidência II; Estudo de Revisão. Introdução sediam associado Objetivo 2016 Métodos Lattes Assunto “Assunto Doutores, Doutores , “Doutores” palavraschave palavras chave Paralímpico “Paralímpico Paralympic. Paralympic . “Paralympic” todo 72 artigo s artigo(s relacionados relacionado relacionado(s tema currículos identificados 3 inclusão Resultados Londres2012, Londres2012 Londres 2012, 2012 Londres-2012 publicações b 87% 87 (87% Públicas c Rio2016 Rio-201 área d coletivas atletismo pesquisadas minoria f g dinamometria Conclusão Rio2016. 2016. pesquisadores destacamse destacam destacam-se II Revisão 201 “Doutores “Paralympic 7 Londres201 Londres-201 8 (87 Rio201 Rio-20 20 Londres20 Londres-20 (8 Rio20 Rio-2 2 Londres2 Londres-2 ( Rio2 Rio- Londres-

RESUMEN Introducción: El entrenamiento tradicional en hipoxia intermitente mejora el rendimiento deportivo tras cortos periodos de exposición, sin embargo, la exposición aguda a la hipoxia intermitente conduce a una disminución de la intensidad del entrenamiento y de la calidad técnica. La solución para superar estos efectos negativos puede ser realizar los esfuerzos en normoxia y los intervalos entre esfuerzos en hipoxia, manteniendo la calidad del entrenamiento y los beneficios de la hipoxia. Objetivo: Este estudio pretendía evaluar las respuestas fisiológicas agudas a la exposición a la hipoxia durante la recuperación entre esfuerzos de alta intensidad. Materiales y métodos: Estudio aleatorizado, a ciegas y controlado con placebo. Dieciséis hombres realizaron una prueba de ejercicio graduado para determinar su intensidad máxima y dos sesiones de entrenamiento por intervalos de alta intensidad. Los intervalos de entrenamiento podían ser en hipoxia (HRT), FIO2: 0,136 o normoxia (NRT), FIO2: 0,209. Durante el intervalo de dos minutos entre los diez esfuerzos de un minuto, se midieron constantemente la saturación periférica de oxígeno (SpO2), la frecuencia cardiaca (FC), el lactato en sangre ([La]) y la glucemia ([Glu]). Resultados: Hubo diferencias en la FC (TRN = 120 ± 14 lpm; TRH = 129 ± 13 lpm, p < 0,01) y la SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p < 0,01). No hubo diferencias en [La] y [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) y TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusión: Se evidenció la posibilidad de incluir hipoxia sólo en los intervalos de recuperación como estímulo adicional al entrenamiento sin disminuir la calidad del mismo. Nivel de Evidencia II; Ensayo Clínico Aleatorizado de Baja Calidad. Introducción embargo técnica Objetivo métodos aleatorizado placebo HRT, HRT , (HRT) FIO2 FIO 0136 0 136 0,13 NRT, NRT (NRT) 0209 209 0,209 minuto SpO2, SpO (SpO2) FC, (FC) ([La] Glu. Glu . ([Glu]) Resultados 12 1 lpm 0,01 001 01 969 96 9 96, 1,0% 10 862 86 2 86, 35 3 5 3,5% 0,01. [La [Glu 4,4 44 4 (4, 17 7 1, mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3, 05 0, 5,2 52 (5, 20 2, 40 4, 08 8 mmol.l1, 0,17. 017 0,17 0,17) Conclusión mismo II Calidad (HRT 013 0,1 (NRT 020 0,20 (SpO2 (FC ([La ([Glu] 0,0 00 1,0 3,5 (4 l1 mmol.l- 5, (5 02 0,2 (SpO ([Glu (

ABSTRACT Introduction: Traditional intermittent hypoxia training improves sport performance after short periods of exposure, but acute exposure to intermittent hypoxia leads to decreased training intensity and technical quality. The solution to overcome these negative effects may be to perform efforts in normoxia and the intervals between efforts in hypoxia, maintaining the quality of training and the benefits of hypoxia. Objective: This study aimed to evaluate the acute physiological responses to hypoxia exposure during recovery between high intensity efforts. Materials and methods: Randomized, one-blind, placebo-controlled study. Sixteen men performed a graded exercise test to determine their maximal intensity and two sessions of high-intensity interval training. The training intervals could be in hypoxia (HRT), FIO2: 0.136 or normoxia (NRT), FIO2: 0.209. During the two-minute interval between the ten one-minute efforts, peripheral oxygen saturation (SpO2), heart rate (HR), blood lactate ([La]), blood glucose ([Glu]) were constantly measured. Results: There were differences in HR (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p < 0.01) and SpO2 (TRN = 96.9 ± 1.0%; TRH = 86.2 ± 3.5%, p < 0.01). No differences in [La] and [Glu] TRN (4.4 ± 1.7 mmol.l-1; 3.9 ± 0.5 mmol.l-1) and TRH (5.2 ± 2.0 mmol.l-1; 4.0 ± 0.8 mmol.l-1, p = 0.17). Conclusion: The possibility of including hypoxia only in the recovery intervals as an additional stimulus to the training, without decreasing the quality of the training, was evidenced. Level of Evidence II; Randomized Clinical Trial of Minor Quality. Introduction Objective methods oneblind, oneblind one blind, blind one-blind placebocontrolled placebo controlled highintensity HRT, HRT , (HRT) FIO2 FIO 0136 0 136 0.13 NRT, NRT (NRT) 0209 209 0.209 twominute minute oneminute SpO2, SpO (SpO2) HR, (HR) La, La ([La]) Glu ([Glu] measured Results 12 1 bpm 0.01 001 01 969 96 9 96. 1.0% 10 862 86 2 86. 35 3 5 3.5% 0.01. . [La [Glu 4.4 44 4 (4. 17 7 1. mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3. 05 0. 5.2 52 (5. 20 2. 40 4. 08 8 mmol.l1, 1, 0.17. 017 0.17 0.17) Conclusion evidenced II Quality (HRT 013 0.1 (NRT 020 0.20 (SpO2 (HR ([La] ([Glu 0.0 00 1.0 3.5 (4 l1 mmol.l- 5. (5 02 0.2 (SpO ([La (

RESUMO Introdução: O treinamento de hipóxia intermitente tradicional melhora o desempenho esportivo após curtos períodos de exposição, porém a exposição aguda à hipóxia intermitente leva à diminuição da intensidade do treinamento e da qualidade técnica. A solução para superar esses efeitos negativos pode ser realizar esforços em normóxia e os intervalos entre os esforços em hipóxia, mantendo a qualidade do treinamento e os benefícios da hipóxia. Objetivo: Este estudo teve como objetivo avaliar as respostas fisiológicas agudas à exposição de hipóxia durante a recuperação entre esforços de alta intensidade. Materiais e métodos: Estudo aleatório e one-blinded, com efeito placebo controlado. Dezesseis homens realizaram um teste de exercício graduado para determinar sua intensidade máxima e duas sessões de treinamento intervalado de alta intensidade. Os intervalos de treinamento podem ser em hipóxia (TRH), FIO2: 0,136 ou normóxia (TRN), FIO2: 0,209. Durante os dois minutos de intervalo entre os dez esforços de um minuto, foram medidos constantemente a saturação periférica de oxigênio (SpO2), frequência cardíaca (FC), lactato sanguíneo ([La]), glicemia ([Glu]). Resultados: Houve diferenças na FC (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p <0,01) e SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p <0,01). Sem diferenças em [La] e [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) e TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusão: Evidenciou-se a possibilidade de incluir a hipóxia apenas nos intervalos de recuperação como um estímulo adicional ao treinamento, sem diminuir a qualidade do treinamento. Nível de Evidência II; Estudo Clínico Randomizado de Menor Qualidade. Introdução técnica Objetivo métodos oneblinded, oneblinded one blinded, blinded one-blinded controlado TRH, , (TRH) FIO2 FIO 0136 0 136 0,13 TRN, (TRN) 0209 209 0,209 minuto SpO2, SpO (SpO2) FC, (FC) La, La ([La]) Glu. Glu . ([Glu]) Resultados 12 1 bpm <0,01 001 01 969 96 9 96, 1,0% 10 862 86 2 86, 35 3 5 3,5% <0,01. [La [Glu 4,4 44 4 (4, 17 7 1, mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3, 05 0, 5,2 52 (5, 20 2, 40 4, 08 8 mmol.l1, 0,17. 017 0,17 0,17) Conclusão Evidenciouse Evidenciou se II Qualidade (TRH 013 0,1 020 0,20 (SpO2 (FC ([La] ([Glu] <0,0 00 1,0 3,5 (4 l1 mmol.l- 5, (5 02 0,2 (SpO ([La ([Glu <0, ( <0 <

Abstract This work evaluates the impact of different agricultural systems on the humic fractions of organic matter (SOM) and soil aggregation in a medium-textured soil in a subtropical region of Brazil. Three managed areas and a reference area were evaluated: permanent pasture (PP), no-till (NT), no-till+Brachiaria (NT+B) and native forest (NF). Deformed soil samples were collected in the layers 0-0.05; 0.05-0.10; 0.10-0.20 and 0.20-0.40 m, and unformed soil samples in the layers 0-0.05 and 0.05-0.10 m. After collection, total organic carbon (TOC) analysis, chemical fractioning of SOM and aggregate stability analysis were performed. The PP area presented the highest TOC and C-FA contents in the first three layers evaluated. In the 0.10-0.20 m layer, the C-HUM contents in the NT+B area were 1.9 times higher than in the NT area, and in 0.20-0.40 m they were 6.6 times higher. The PP area obtained the best structural indicators, especially higher WMD, GMD and % of macroaggregates. The two areas using direct seeding presented a percentage of macroaggregates higher than 37.28% in the superficial layer. The PP management provided increases in TOC levels and, consequently, humic substances, besides the formation of more stable aggregates. The NT+B system showed promise in increasing TOC and humic substances, especially at depth, even with a short implementation period. The increase in TOC and humic substances provided by the grasses contributes to the formation of more stable aggregates and, consequently, to the improvement of the quality of medium-textured agricultural soils. (SOM mediumtextured medium textured Brazil evaluated PP, , (PP) notill no till NT, (NT) notill+Brachiaria notillBrachiaria till+Brachiaria Brachiaria NTB B (NT+B NF. NF . (NF) 00.05 0005 0 0.05 05 0.050.10 005010 0.10 10 0.100.20 010020 0.20 20 0.10-0.2 0.200.40 020040 0.40 40 0.20-0.4 0-0.0 0.05-0.1 collection (TOC performed CFA C FA layer CHUM HUM 19 1 9 1. 66 6 6. indicators WMD 3728 37 28 37.28 consequently depth period soils (PP (NT tillBrachiaria (NF 00 00.0 000 005 0.0 050 0.050.1 00501 010 0.1 100 0.100.2 01002 020 0.2 2 0.10-0. 200 0.200.4 02004 040 0.4 4 0.20-0. 0-0. 0.05-0. 372 3 37.2 00. 0. 0.050. 0050 01 0.100. 0100 02 0.10-0 0.200. 0200 04 0.20-0 0-0 0.05-0 37. 0.050 0.100 0.10- 0.200 0.20- 0- 0.05-

Resumo O presente trabalho teve como objetivo avaliar o impacto de diferentes sistemas agrícolas sobre as frações húmicas da matéria orgânica (MOS) e a agregação do solo, sob solo de textura média em uma região subtropical do Brasil. Foram avaliadas três áreas manejadas e uma área de referência: pastagem permanente (PP), plantio direto (PD), plantio direto+Brachiaria (PD+B) e mata nativa (NF). Foram coletadas amostras de solo deformadas nas camadas 0-0,05; 0,05-0,10; 0,10-0,20 e 0,20-0,40 m, e amostras de solo indeformadas nas camadas 0-0,05 e 0,05-0,10 m. Após a coleta, foram realizadas análises de carbono orgânico total (COT), fracionamento químico da MOS; análise de estabilidade de agregados. A área PP apresentou os maiores teores de COT e C-AF nas três primeiras camadas avaliadas. Na camada de 0,10-0,20 m os teores de C-HUM na área PD+B foram 1,9 vezes maiores que na área PD, e em 0,20-0,40 m foram 6,6 vezes maiores. A área PP obteve os melhores indicadores estruturais, especialmente maior DMP, DMG e % de macroagregados. As duas áreas com plantio direto apresentaram percentual de macroagregados superior a 37,28% na camada superficial. O manejo do PP proporcionou aumentos nos teores de COT e, consequentemente, de substâncias húmicas, além da formação de agregados mais estáveis. O sistema PD+B mostrou-se promissor no aumento do COT e das substâncias húmicas, principalmente em profundidade, mesmo com um curto período de implantação. O aumento do COT e das substâncias húmicas proporcionado pelas gramíneas contribui para a formação de agregados mais estáveis e, consequentemente, para a melhoria da qualidade dos solos agrícolas de textura média. MOS (MOS Brasil referência PP, , (PP) PD (PD) diretoBrachiaria Brachiaria PDB B (PD+B NF. NF . (NF) 00,05 0005 0 0,05 05 0,050,10 005010 0,10 10 0,100,20 010020 0,20 20 0,10-0,2 0,200,40 020040 0,40 40 0,20-0,4 0-0,0 0,05-0,1 coleta COT, (COT) CAF C AF CHUM HUM 19 1 9 1, 66 6 6, estruturais DMP 3728 37 28 37,28 superficial consequentemente mostrouse mostrou se profundidade implantação (PP (PD (NF 00 00,0 000 005 0,0 050 0,050,1 00501 010 0,1 100 0,100,2 01002 020 0,2 2 0,10-0, 200 0,200,4 02004 040 0,4 4 0,20-0, 0-0, 0,05-0, (COT 372 3 37,2 00, 0, 0,050, 0050 01 0,100, 0100 02 0,10-0 0,200, 0200 04 0,20-0 0-0 0,05-0 37, 0,050 0,100 0,10- 0,200 0,20- 0- 0,05-

Abstract Humans are exposed to natural compounds such as phytoestrogens primarily through diet and supplements. These compounds promote health by alleviating the symptoms and illnesses associated with menopause and arthritis. Diosgenin (DSG) occurs naturally in plants such as Dioscorea villosa (DV) and binds to estrogen receptors, so it may have similar effects to this hormone, including against arthritis. Thus, we investigated the effect of chronic treatment with dry extract of DV and its phytoestrogen DSG on ovariectomized mice with arthritis. We found that dry extract of Dioscorea villosa (DV) contains the phytoestrogen diosgenin (DSG) in its composition. Furthermore, arthritic mice treated with DV and DSG showed reduced neutrophil accumulation in the articular cartilage. Also, the dry extract of DV administered orally (v.o) did not alter the leukocyte count in the joints or promote changes in the reproductive tract. However, DSG altered these parameters, with possible beneficial effects by reducing symptoms related to reproductive aging. Thus, oral treatment with dry extract of DV and subcutaneous (s.c) treatment with DSG showed promise by acting against inflammation caused by arthritis and reducing symptoms in the reproductive tract due to menopause. supplements (DSG (DV receptors hormone Thus composition Furthermore cartilage Also v.o vo v o (v.o However parameters aging s.c sc s c (s.c

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics. challenge approach expertise protocols SBA (SBA neonates experts patients opinions assessment preparation positioning preoxygenation, preoxygenation pre oxygenation, oxygenation pre-oxygenation trauma paramountly tools laryngoscopy bronchoscopy devices education simulations technologies

RESUMEN Objetivo: identificar factores sociodemográficos, condiciones clínicas y parámetros de sarcopenia que predicen la hospitalización y la muerte en personas mayores con deterioro cognitivo. Método: estudio observacional longitudinal realizado con 170 personas mayores con deterioro cognitivo evaluados entre 2019 y 2021. Las variables predictoras fueron las características sociodemográficas, las condiciones clínicas y los parámetros de sarcopenia. La sarcopenia se puso en práctica mediante la fuerza de los músculos de prensión manual (dinamometría), la masa muscular (circunferencia de la pantorrilla) y la prueba Timed Up and Go. La ocurrencia de hospitalización y muerte dentro del año posterior a la evaluación del anciano configuró las variables predichas. Los análisis se realizaron mediante estadística descriptiva las pruebas t de Student independiente, U de Mann-Whitney, chi-cuadrado y regresión logística univariada. Resultados: la mayoría de los participantes fueron del sexo femenino (±77,57 años), con bajo nivel educativo, sedentarios, el 15,9% con sarcopenia y el 13% con antecedentes de hospitalización. Se identificó que el nivel de escolaridad tuvo efecto en la ocurrencia de hospitalización (U=1.423,5, p=0,027) y muerte (U=647,0, p=0,025) al año de seguimiento. Además, existe asociación entre el antecedente de hospitalización en los últimos 6 meses y la ocurrencia de hospitalización [χ2(1)=4,729; p=0,030] y muerte [χ2(1)=3,919; p=0,048] al año de seguimiento. Se identificó que el antecedente de hospitalización en los últimos 6 meses se asoció con la ocurrencia de hospitalización en un año de seguimiento (OR=2,963; IC95% 1,076-8,165, p=0,036). Conclusión: un antecedente de hospitalización en los últimos seis meses se asocia con la ocurrencia de hospitalización mayor a un año en personas mayores con deterioro cognitivo. Objetivo sociodemográficos Método 17 201 2021 sociodemográficas dinamometría, dinamometría , (dinamometría) circunferencia pantorrilla Go predichas independiente MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney chicuadrado chi cuadrado univariada Resultados ±77,57 7757 77 57 (±77,5 años, años años) educativo sedentarios 159 15 9 15,9 13 U=1.423,5, U14235 1 423 5 (U=1.423,5 p=0,027 p0027 p 0 027 U=647,0, U6470 647 (U=647,0 p=0,025 p0025 025 Además χ21=4,729 χ214729 χ χ2 =4,729 4 729 [χ2(1)=4,729 p=0,030 p0030 030 χ21=3,919 χ213919 =3,919 3 919 [χ2(1)=3,919 p=0,048 p0048 048 OR=2,963 OR2963 OR 2 963 (OR=2,963 IC95 IC 1,0768,165, 10768165 1,076 8,165, 076 8 165 1,076-8,165 p=0,036. p0036 p=0,036 . 036 p=0,036) Conclusión 20 202 (dinamometría ±77,5 775 7 (±77, 15, U=1.423,5 U1423 42 (U=1.423, p=0,02 p002 02 U=647,0 U647 64 (U=647, χ21 χ21=4,72 χ21472 4729 =4,72 72 [χ2(1)=4,72 p=0,03 p003 03 χ21=3,91 χ21391 3919 =3,91 91 [χ2(1)=3,91 p=0,04 p004 04 OR=2,96 OR296 96 (OR=2,96 IC9 0768 1,0768,165 1076816 1076 1,07 8165 8,165 07 16 1,076-8,16 ±77, (±77 U=1.423, U142 (U=1.423 p=0,0 p00 U=647, U64 (U=647 χ21=4,7 χ2147 472 =4,7 [χ2(1)=4,7 χ21=3,9 χ2139 391 =3,9 [χ2(1)=3,9 OR=2,9 OR29 (OR=2,9 1,0768,16 107681 107 1,0 816 8,16 1,076-8,1 ±77 (±7 U=1.423 U14 (U=1.42 p=0, p0 U=647 U6 (U=64 χ21=4, χ214 47 =4, [χ2(1)=4, χ21=3, χ213 39 =3, [χ2(1)=3, OR=2, OR2 (OR=2, 1,0768,1 10768 10 1, 81 8,1 1,076-8, ±7 (± U=1.42 U1 (U=1.4 p=0 U=64 (U=6 χ21=4 =4 [χ2(1)=4 χ21=3 =3 [χ2(1)=3 OR=2 (OR=2 1,0768, 8, 1,076-8 ± ( U=1.4 (U=1. p= U=6 (U= χ21= = [χ2(1)= OR= (OR= 1,0768 1,076- U=1. (U=1 U= (U [χ2(1) (OR U=1 [χ2(1 [χ2( [χ2 [χ

ABSTRACT Objective: to identify sociodemographic factors, clinical conditions and sarcopenia parameters that predict hospital admission and death in older adults with cognitive impairment. Method: this is a longitudinal observational study carried out with 170 older adults with cognitive impairment assessed between 2019 and 2021. Predictor variables were sociodemographic characteristics, clinical conditions and sarcopenia parameters. Sarcopenia was operationalized through handgrip muscle strength (dynamometry), muscle mass (calf circumference) and the Timed Up and Go test. Occurrence of hospital admission and death within one year after assessment of older adults were the predicted variables. Analyzes were carried out using descriptive statistics, independent Student’ t-test, Mann-Whitney U test, chi-square test and univariate logistic regression. Results: most participants were female (±77.57 years old), with low education, sedentary, 15.9% with sarcopenia and 13% with a history of hospital admission. It was identified that education level had an effect on occurrence of hospital admission (U=1,423.5, p=0.027) and death (U=647.0, p=0.025) within one-year follow-up. Furthermore, there is an association between history of hospital admission in the last 6 months and occurrence of hospital admission [χ2(1)=4.729; p=0.030] and death [χ2(1)=3.919; p=0.048] within one year follow-up. It was identified that history of hospital admission in the last 6 months was associated with occurrence of hospital admission within one-year follow-up (OR=2.963; 95%CI 1.076-8.165, p=0.036). Conclusion: history of hospital admission in the last six months is associated with occurrence of hospital admission over a year in older adults with cognitive impairment. Objective factors Method 17 201 2021 characteristics dynamometry, dynamometry , (dynamometry) calf circumference statistics Student ttest, ttest t t-test MannWhitney Mann Whitney chisquare chi square regression Results ±77.57 7757 77 57 (±77.5 old, old old) sedentary 159 15 9 15.9 13 U=1,423.5, U14235 1 423 5 (U=1,423.5 p=0.027 p0027 p 0 027 U=647.0, U6470 647 (U=647.0 p=0.025 p0025 025 oneyear followup. followup follow up. up Furthermore χ21=4.729 χ214729 χ χ2 =4.729 4 729 [χ2(1)=4.729 p=0.030 p0030 030 χ21=3.919 χ213919 =3.919 3 919 [χ2(1)=3.919 p=0.048 p0048 048 OR=2.963 OR2963 OR 2 963 (OR=2.963 95CI CI 95 1.0768.165, 10768165 1.076 8.165, 076 8 165 1.076-8.165 p=0.036. p0036 p=0.036 . 036 p=0.036) Conclusion 20 202 (dynamometry ±77.5 775 7 (±77. 15. U=1,423.5 U1423 42 (U=1,423. p=0.02 p002 02 U=647.0 U647 64 (U=647. χ21 χ21=4.72 χ21472 4729 =4.72 72 [χ2(1)=4.72 p=0.03 p003 03 χ21=3.91 χ21391 3919 =3.91 91 [χ2(1)=3.91 p=0.04 p004 04 OR=2.96 OR296 96 (OR=2.96 0768 1.0768.165 1076816 1076 1.07 8165 8.165 07 16 1.076-8.16 ±77. (±77 U=1,423. U142 (U=1,423 p=0.0 p00 U=647. U64 (U=647 χ21=4.7 χ2147 472 =4.7 [χ2(1)=4.7 χ21=3.9 χ2139 391 =3.9 [χ2(1)=3.9 OR=2.9 OR29 (OR=2.9 1.0768.16 107681 107 1.0 816 8.16 1.076-8.1 ±77 (±7 U=1,423 U14 (U=1,42 p=0. p0 U=647 U6 (U=64 χ21=4. χ214 47 =4. [χ2(1)=4. χ21=3. χ213 39 =3. [χ2(1)=3. OR=2. OR2 (OR=2. 1.0768.1 10768 10 1. 81 8.1 1.076-8. ±7 (± U=1,42 U1 (U=1,4 p=0 U=64 (U=6 χ21=4 =4 [χ2(1)=4 χ21=3 =3 [χ2(1)=3 OR=2 (OR=2 1.0768. 8. 1.076-8 ± ( U=1,4 (U=1, p= U=6 (U= χ21= = [χ2(1)= OR= (OR= 1.0768 1.076- U=1, (U=1 U= (U [χ2(1) (OR U=1 [χ2(1 [χ2( [χ2 [χ

RESUMO Objetivo: identificar fatores sociodemográficos, condições clínicas e parâmetros de sarcopenia preditores de hospitalização e óbito em idosos com comprometimento cognitivo. Método: estudo observacional longitudinal realizado com 170 idosos com comprometimento cognitivo avaliados entre 2019 e 2021. As variáveis preditoras foram características sociodemográficas, condições clínicas e parâmetros de sarcopenia. A sarcopenia foi operacionalizada por meio da força muscular de preensão palmar (dinamometria), da massa muscular (circunferência da panturrilha) e do teste Timed Up and Go. A ocorrência de hospitalização e óbito até um ano após a avaliação do idoso configuraram as variáveis preditas. Procedeu-se análises por estatística descritiva, testes t-student independente, U Mann Whitney, Qui-Quadrado e de regressão logística univariada. Resultados: a maioria dos participantes era do sexo feminino (±77,57 anos), de baixa escolaridade, sedentários, 15,9% com sarcopenia e 13% com histórico de internação. Foi identificado que o nível de escolaridade teve efeito sobre a ocorrência de hospitalização (U=1423,5, p=0,027) e de óbito (U=647,0, p=0,025) no seguimento de um ano. Além disso, há associação do histórico de internação nos últimos 6 meses com a ocorrência de hospitalização [χ2(1)=4,729; p=0,030] e de óbito [χ2(1)=3,919; p=0,048] no seguimento de um ano. Identificou-se que o histórico de internação nos últimos 6 meses associou-se com a ocorrência de hospitalização em um ano de seguimento (OR=2,963; IC95% 1,076-8,165, p=0,036). Conclusão: o histórico de internação nos últimos seis meses está associado à ocorrência de hospitalização ao longo de um ano em idosos com comprometimento cognitivo. Objetivo sociodemográficos Método 17 201 2021 sociodemográficas dinamometria, dinamometria , (dinamometria) circunferência panturrilha Go preditas Procedeuse Procedeu se descritiva tstudent t student independente Whitney QuiQuadrado Qui Quadrado univariada Resultados ±77,57 7757 77 57 (±77,5 anos, anos anos) sedentários 159 15 9 15,9 13 U=1423,5, U14235 1423 5 (U=1423,5 p=0,027 p0027 p 0 027 U=647,0, U6470 647 (U=647,0 p=0,025 p0025 025 disso χ21=4,729 χ214729 χ χ2 1 =4,729 4 729 [χ2(1)=4,729 p=0,030 p0030 030 χ21=3,919 χ213919 =3,919 3 919 [χ2(1)=3,919 p=0,048 p0048 048 Identificouse Identificou associouse associou OR=2,963 OR2963 OR 2 963 (OR=2,963 IC95 IC 1,0768,165, 10768165 1,076 8,165, 076 8 165 1,076-8,165 p=0,036. p0036 p=0,036 . 036 p=0,036) Conclusão 20 202 (dinamometria ±77,5 775 7 (±77, 15, U=1423,5 U1423 142 (U=1423, p=0,02 p002 02 U=647,0 U647 64 (U=647, χ21 χ21=4,72 χ21472 4729 =4,72 72 [χ2(1)=4,72 p=0,03 p003 03 χ21=3,91 χ21391 3919 =3,91 91 [χ2(1)=3,91 p=0,04 p004 04 OR=2,96 OR296 96 (OR=2,96 IC9 0768 1,0768,165 1076816 1076 1,07 8165 8,165 07 16 1,076-8,16 ±77, (±77 U=1423, U142 14 (U=1423 p=0,0 p00 U=647, U64 (U=647 χ21=4,7 χ2147 472 =4,7 [χ2(1)=4,7 χ21=3,9 χ2139 391 =3,9 [χ2(1)=3,9 OR=2,9 OR29 (OR=2,9 1,0768,16 107681 107 1,0 816 8,16 1,076-8,1 ±77 (±7 U=1423 U14 (U=142 p=0, p0 U=647 U6 (U=64 χ21=4, χ214 47 =4, [χ2(1)=4, χ21=3, χ213 39 =3, [χ2(1)=3, OR=2, OR2 (OR=2, 1,0768,1 10768 10 1, 81 8,1 1,076-8, ±7 (± U=142 U1 (U=14 p=0 U=64 (U=6 χ21=4 =4 [χ2(1)=4 χ21=3 =3 [χ2(1)=3 OR=2 (OR=2 1,0768, 8, 1,076-8 ± ( U=14 (U=1 p= U=6 (U= χ21= = [χ2(1)= OR= (OR= 1,0768 1,076- U=1 U= (U [χ2(1) (OR [χ2(1 [χ2( [χ2 [χ

Abstract Introduction: Among geriatric syndromes, cognitive impairment, urinary incontinence, nocturia, and falls stand out. Older adults with urinary incontinence are more prone to falls and exhibit fear of falling. Objective: To investigate the frequency of urinary incontinence and nocturia and evaluate the association of these variables with falls and fear of falling in older individuals with cognitive impairment. Methods: Cross-sectional study with older adults referred from Basic Health Units with cognitive impairment evaluated between 2019 and 2021. Information on urinary incontinence, nocturia, history of falls, and fear of falling provided by the participants and their caregivers was collected. Data were analyzed using Chi-square tests and univariate logistic regressions. Results: Data from 89 older adults were analyzed, of whom 58.4% had urinary incontinence, 28.1% had nocturia, 67.4% reported fear of falling, and 41.6% reported falls in the last six months. The group with urinary incontinence [χ2(1) = 5.147; p = 0.023] and the group with nocturia [χ2(1) = 4.353; p = 0.037] had significantly higher frequencies of fear of falling. No differences in the frequencies of history of falls were observed between individuals with and without urinary incontinence or nocturia (p > 0.05). Fear of falling was associated with urinary incontinence (OR = 2.833; 95% CI 1.137 – 7.062) and nocturia (OR = 3.365; 95% CI 1.033 – 10.966). Conclusion: Older adults with cognitive impairment have a high frequency of urinary incontinence, nocturia, falls, and fear of falling. Furthermore, there is an association between urinary incontinence, nocturia and fear of falling in this population. Introduction syndromes out Objective Methods Crosssectional Cross sectional 201 2021 collected Chisquare Chi square regressions Results 8 584 58 4 58.4 281 28 1 28.1 674 67 67.4 416 41 6 41.6 months χ21 χ χ2 [χ2(1 5.147 5147 5 147 0.023 0023 0 023 4.353 4353 353 0.037 0037 037 0.05. 005 0.05 . 05 0.05) OR 2.833 2833 2 833 95 1137 137 1.13 7.062 7062 7 062 3.365 3365 3 365 1033 033 1.03 10.966. 10966 10.966 10 966 10.966) Conclusion Furthermore population 20 202 58. 28. 67. 41. [χ2( 5.14 514 14 0.02 002 02 4.35 435 35 0.03 003 03 00 0.0 2.83 283 83 9 113 13 1.1 7.06 706 06 3.36 336 36 103 1.0 1096 10.96 96 [χ2 5.1 51 4.3 43 0. 2.8 11 1. 7.0 70 3.3 33 109 10.9 [χ 5. 4. 2. 7. 3. 10.

Resumo Introdução: Entre as síndromes geriátricas, destacam-se o comprometimento cognitivo, a incontinência urinária, a noctúria e as quedas. Idosos com incontinência urinária são mais propensos a cair e apresentar medo de cair. Objetivo: Investigar a frequência de incontinência urinária e noctúria e avaliar a associação dessas variáveis com a ocorrência de quedas e com o medo de cair em idosos com comprometimento cognitivo. Métodos: Estudo transversal com idosos encaminhados das Unidades Básicas de Saúde com comprometimento cognitivo avaliados entre os anos de 2019 e 2021. Foram coletadas informações sobre incontinência urinária, noctúria, histórico de quedas e medo de cair, fornecidas pelos idosos e seus acompanhantes. Os dados foram analisados por meio dos testes quiquadrado e regressões logísticas univariadas. Resultados: Foram analisados dados de 89 idosos, dos quais 58,4% apresentavam incontinência urinária, 28,1% apresentavam noctúria, 67,4% tinham medo de cair e 41,6% relataram quedas nos últimos seis meses. O grupo com incontinência urinária [2(1) = 5,147; p = 0,023] e o grupo com noctúria [χ2(1) = 4,353; p = 0,037] apresentaram frequências significativamente maiores de medo de cair. Não foram observadas diferenças das frequências de histórico de quedas entre os indivíduos com e sem incontinência ou noctúria (p > 0,05). O medo de cair mostrouse associado à incontinência (OR = 2,833; IC95% 1,137 – 7,062) e à noctúria (OR = 3,365; IC 95% 1,033 – 10,966). Conclusão: Idosos com comprometimento cognitivo apresentam alta frequência de incontinência urinária, noctúria, quedas e medo de cair. Ademais, há associação da incontinência urinária e da noctúria com o medo de cair nessa população. Introdução geriátricas destacamse destacam se Objetivo Métodos 201 2021 acompanhantes univariadas Resultados 8 584 58 4 58,4 281 28 1 28,1 674 67 67,4 416 41 6 41,6 meses 21 2 [2(1 5,147 5147 5 147 0,023 0023 0 023 χ21 χ χ2 [χ2(1 4,353 4353 353 0,037 0037 037 0,05. 005 0,05 . 05 0,05) OR 2,833 2833 833 IC95 1137 137 1,13 7,062 7062 7 062 3,365 3365 3 365 95 1033 033 1,03 10,966. 10966 10,966 10 966 10,966) Conclusão Ademais população 20 202 58, 28, 67, 41, [2( 5,14 514 14 0,02 002 02 [χ2( 4,35 435 35 0,03 003 03 00 0,0 2,83 283 83 IC9 113 13 1,1 7,06 706 06 3,36 336 36 9 103 1,0 1096 10,96 96 [2 5,1 51 [χ2 4,3 43 0, 2,8 11 1, 7,0 70 3,3 33 109 10,9 [ 5, [χ 4, 2, 7, 3, 10,

ABSTRACT: There are limited publications about canine subcutaneous mast cell tumors (MCT). International studies have shown that subcutaneous MCT has longer survival times than cutaneous MCT, with lower recurrence and metastasis rates. In addition, subcutaneous MCT has a specific histopathological classification (circumscribed, combined, or infiltrative pattern). Our study evaluated 162 cases of subcutaneous MCT diagnosed from 2014 to 2017 in Brazil. The mean age of the animals was 8.6 years, with a predominance of females and higher incidence in dogs with mixed breed (n=40), followed by Boxer (n=20), Labrador Retriever (n=14), Golden Retriever (n=11) and Pug (n=10). Regarding histopathological characterization, the most common infiltrative pattern represented 54.3% of cases, followed by circumscribed (34.8%) and combined (11%) patterns. The mean mitotic index (MI) was 1.04, with 93.9% of cases presenting MI≤4 and 53.1% MI=0. The data found in this Brazilian study regarding subcutaneous MCT does not differ from those described in American studies, suggesting similar genetic and epidemiological factors. The evaluated proliferation indices suggest that subcutaneous MCT presents slow progression and should be evaluated as a distinct form of cutaneous MCT. ABSTRACT . (MCT) rates addition circumscribed, (circumscribed pattern. pattern) 16 201 Brazil 86 8 6 8. years n=40, n40 n n=40 , 40 (n=40) n=20, n20 n=20 20 (n=20) n=14, n14 n=14 14 (n=14) n=11 n11 11 (n=11 n=10. n10 n=10 10 (n=10) characterization 543 54 3 54.3 34.8% 348 34 (34.8% 11% (11% patterns MI (MI 104 1 04 1.04 939 93 9 93.9 MI4 4 MI≤ 531 53 53.1 MI0 0 MI=0 factors (MCT n4 n=4 (n=40 n2 n=2 2 (n=20 n1 n=1 (n=14 (n=1 (n=10 5 54. 34.8 (34.8 (11 1.0 93. 53. MI= n= (n=4 (n=2 (n= 34. (34. (1 1. (n (34 ( (3

RESUMO: Há poucas informações prognósticas sobre o mastocitoma (MCT) subcutâneo em cães, apresentando maiores tempos de sobrevida e menores taxas de recidiva e metástase em comparação ao MCT cutâneo. Além disso, o MCT subcutâneo canino segue a classificação histopatológica própria, sendo subdivididos de acordo com o padrão em: circunscrito, combinado ou infiltrativo. Sendo assim, o principal objetivo desse estudo foi caracterizar a incidência e as características histopatológicas de MCT subcutâneos no Brasil. Para isso, foram avaliadas 164 amostras de MCT subcutâneos diagnosticados entre o período de 2014 a 2017 no Brasil. A média de idade dos animais foi de 8,6 anos (variação de 3 a 20 anos), com predomínio de fêmeas (64,8%) e maior incidência em cães sem raça definida (n=40), seguido de Boxer (n=20), Labrador Retriever (n=14), Golden retriever (n=11) e Pug (n=10). Em relação a caracterização histopatológica, o padrão infiltrativo foi o mais comum representando 54,3% dos casos, seguido dos padrões circunscritos (34,8%) e combinados (11%). Quanto a contagem de mitose (CM), 93,8% dos casos apresentam CM≤4 e, em 53,1%, CM=0. Os dados encontrados nesse estudo brasileiro em relação ao MCT subcutâneo reforçam outros trabalhos realizados em diferentes regiões demográficas, sugerindo fatores genéticos e epidemiológicos para a doença. Por fim, os índices de proliferação avaliados sugerem que o MCT subcutâneo apresenta progressão lenta devendo ser avaliado como uma forma distinta do MCT cutâneo. RESUMO (MCT cutâneo disso própria circunscrito assim Brasil isso 16 201 86 8 6 8, variação 2 anos, , anos) 64,8% 648 64 (64,8% n=40, n40 n n=40 40 (n=40) n=20, n20 n=20 (n=20) n=14, n14 n=14 14 (n=14) n=11 n11 11 (n=11 n=10. n10 n=10 . 10 (n=10) 543 54 54,3 34,8% 348 34 (34,8% 11%. 11% (11%) CM, CM (CM) 938 93 93,8 CM4 4 CM≤ 531 53 1 53,1% CM0 0 CM=0 demográficas doença fim 64,8 (64,8 n4 n=4 (n=40 n2 n=2 (n=20 n1 n=1 (n=14 (n=1 (n=10 5 54, 34,8 (34,8 (11% (CM 9 93, 53,1 CM= 64, (64, n= (n=4 (n=2 (n= 34, (34, (11 53, (64 (n (34 (1 (6 (3 (

Abstract The adaptations of plants to different environments are closely related to their wood anatomical traits. This study investigated the wood anatomy of a montane forest community and compared it with anatomical data from three other areas in the Atlantic Forest biome (montane and lowland forest). Samples from 23 montane forest species were processed and analyzed according to standard wood anatomy techniques. Quantitative xylem traits were measured and conductivity parameters were calculated. Wood anatomical data for 76 species from other areas were obtained from previous studies and incorporated into the analyses. Shared wood features indicated ecological trends related to the forest formations. Species of the sampled montane forest were discriminated into groups based on their qualitative and quantitative features, especially those related to ray and xylem conduction traits. Hydraulic traits were also important for distinguishing forest communities along the altitudinal gradient. The montane forest communities had lower conductivity and higher hydraulic safety than the lowland forest community. Apart from these differences, all the studied communities are in the Atlantic Forest biome and present traits related to high hydraulic efficiency and vulnerability, as expected for this tropical region. forest. . forest) 2 techniques calculated 7 analyses formations gradient differences vulnerability region

Resumo As adaptações das plantas aos diferentes ambientes estão intimamente relacionadas aos atributos anatômicos da madeira. Este estudo investigou a anatomia da madeira de uma comunidade de floresta montana e comparou-a com dados anatômicos de outras três áreas do bioma Mata Atlântica (floresta montana e floresta de terras baixas). Amostras de 23 espécies da floresta montana foram processadas e analisadas de acordo com técnicas padrão de anatomia da madeira. Atributos quantitativos do xilema foram medidos e parâmetros de condutividade foram calculados. Dados anatômicos da madeira de 76 espécies de outras áreas foram obtidos de estudos anteriores e incorporados às análises. As características compartilhadas da madeira indicaram tendências ecológicas relacionadas às formações florestais. Espécies amostradas da floresta montana foram discriminadas em grupos com base em suas características qualitativas e quantitativas, especialmente aquelas relacionadas aos raios e a condução Atributos hidráulicos foram importantes para distinguir as comunidades florestais no gradiente altitudinal. As comunidades da floresta montana tiveram menor condutividade e maior segurança hidráulica do que a comunidade da floresta de terras baixas. Apesar dessas diferenças, todas as comunidades estudadas estão na Mata Atlântica e apresentam alta eficiência hidráulica e vulnerabilidade, como esperado para esta região tropical. comparoua comparou baixas . baixas) 2 calculados 7 análises quantitativas altitudinal diferenças vulnerabilidade tropical

ABSTRACT Viticulture is the main agricultural production in the São Francisco Valley, Brazil; however, farm soil management systems require large volumes of fertilizer that could contribute to climate change. Therefore, using plant growth-promoting rhizobacteria (PGPR) has been reported to reduce or replace plant input. This study aimed to evaluate the bacteria in the rhizosphere of Vitis vinifera cultivated in the São Francisco Valley in Pernambuco, Brazil, and to characterize the mechanisms that promote plant growth. The PGPR with the greatest biotechnological potential was identified using sequencing. The bacteria were isolated from tryptic soy agar (TSA) culture medium inoculated with 100 µL of a serial dilution. The isolates obtained were characterized phenotypically and tested for their ability to solubilize phosphate, promote biological nitrogen fixation (BNF), and produce indole-3 acetic acid (IAA), biofilms, and antibiotic factors against Xanthomonas campestris pv. viticola. A total of 423 bacteria were obtained, of which 99 presented positive results for at least one of the growth-promotion mechanisms, representing 6.85% for phosphate solubilizers, 0.74% for BNF, 5.7% for IAA synthesizers, 11.27% for biofilm producers, and 4.01% for promoting antibiosis against X. campestris pv. viticola. Isolates 3.19 and 31.14; 3.17 and 17.04; 5.35 and 5.42; and 5.37 identified as Stenotrophomonas, Bacillus, Pseudomonas, and Clostridium, respectively, presented a biotechnological potential for future experiments to promote vine growth. Brazil however change Therefore growthpromoting growth (PGPR input Pernambuco sequencing TSA (TSA 10 dilution BNF , (BNF) indole3 indole 3 indole- IAA, (IAA) biofilms pv viticola 42 9 growthpromotion promotion 685 6 85 6.85 solubilizers 074 0 74 0.74 57 5 7 5.7 synthesizers 1127 11 27 11.27 producers 401 4 01 4.01 X 319 19 3.1 31.14 3114 31 14 317 17 17.04 1704 04 535 35 5.3 5.42 542 537 37 Stenotrophomonas Bacillus Pseudomonas Clostridium respectively 1 (BNF (IAA 68 8 6.8 07 0.7 5. 112 2 11.2 40 4.0 3. 31.1 311 17.0 170 53 5.4 54 6. 0. 11. 4. 31. 17.

RESUMO A viticultura é a principal produção agrícola do Vale do São Francisco, Brasil; no entanto, os sistemas agrícolas de manejo dos solos requerem grandes volumes de fertilizantes que podem contribuir para as alterações climáticas. Portanto, foi relatado que o uso de rizobactérias promotoras de crescimento de plantas (RPCP) reduz ou substitui insumos vegetais. Este estudo teve como objetivo avaliar as bactérias da rizosfera de Vitis vinifera cultivada no Vale do São Francisco, em Pernambuco, Brasil, e caracterizar os mecanismos que promovem o crescimento das plantas. As RPCP com maior potencial biotecnológico foram identificadas por meio de sequenciamento. As bactérias foram isoladas em meio de cultura Agar Triptona de Soja (TSA) inoculado com 100 µL de uma diluição seriada. Os isolados obtidos foram caracterizados fenotipicamente e testados quanto à capacidade de solubilizar fosfato, promover fixação biológica de nitrogênio (FBN) e produzir ácido indol-3 acético (AIA), biofilmes e fatores antibióticos contra Xanthomonas campestris pv. vitícola. Um total de 423 bactérias foi obtido, das quais 99 apresentaram resultados positivos para pelo menos um dos mecanismos de promoção de crescimento, representando 6,85% para solubilizadores de fosfato, 0,74% para FBN, 5,7% para sintetizadores de AIA, 11,27% para produtores de biofilme e 4,01% para promoção de antibiose contra X. campestris pv. vitícola. Os isolados 3.19 e 31.14; 3.17 e 17.04; 5.35 e 5.42; e 5.37 identificados como Stenotrophomonas, Bacillus, Pseudomonas e Clostridium, respectivamente, apresentaram potencial biotecnológico para futuros experimentos para promover o crescimento de videiras. Francisco Brasil entanto climáticas Portanto (RPCP vegetais Pernambuco sequenciamento TSA (TSA 10 seriada fosfato FBN (FBN indol3 indol 3 indol- AIA , (AIA) pv vitícola 42 obtido 9 685 6 85 6,85 074 0 74 0,74 57 5 7 5,7 1127 11 27 11,27 401 4 01 4,01 X 319 19 3.1 31.14 3114 31 14 317 17 17.04 1704 04 535 35 5.3 5.42 542 537 37 Stenotrophomonas Bacillus Clostridium respectivamente videiras 1 (AIA 68 8 6,8 07 0,7 5, 112 2 11,2 40 4,0 3. 31.1 311 17.0 170 53 5. 5.4 54 6, 0, 11, 4, 31. 17.

ABSTRACT Purpose: To analyze the average time between submission and acceptance of national journals in seven Brazilian surgery journals from 2017 to 2022. Methods: It consists of a cross-sectional and observational study with a quantitative approach to analyze the acceptance time of articles approved by Brazilian journals on general surgery and its subspecialties, including Acta Cirúrgica Brasileira, Jornal Vascular Brasileiro, Arquivos Brasileiros de Cirurgia de Digestiva, Revista do Colégio Brasileiro de Cirurgiões, Journal of Coloproctology, Revista Brasileira de Cirurgia Plástica, and International Brazilian Journal of Urology. Results: The journals with the lowest average waiting times were Revista do Colégio Brasileiro de Cirurgiões, Acta Cirúrgica Brasileira, and Journal of Coloproctology, respectively, and, with the lowest interquartile range there is Acta Cirúrgica Brasileira. There was no significant difference between the pre-pandemic and pandemic periods. The study designs with the highest and lowest means were, respectively, ideas and innovations – also with the highest interquartile range – and expert opinion, while with the lowest interquartile range was technical skill. Conclusions: The acceptance time for articles in Brazilian surgery journals is extremely variable. Identifying these discrepancies highlights the importance of understanding editorial processes and seeking ways to improve consistency and efficiency in reviewing articles. Purpose 201 2022 Methods crosssectional cross sectional subspecialties Digestiva Cirurgiões Coloproctology Plástica Urology Results respectively prepandemic pre periods opinion skill Conclusions variable 20 202 2