ABSTRACT Purpose We assessed the prognostic impact of the 2012 Briganti nomogram on prostate cancer (PCa) progression in intermediate-risk (IR) patients presenting with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b treated with robot assisted radical prostatectomy eventually associated with extended pelvic lymph node dissection. Materials and Methods From January 2013 to December 2021, data of surgically treated IR PCa patients were retrospectively evaluated. Only patients presenting with the above-mentioned features were considered. The 2012 Briganti nomogram was assessed either as a continuous and a categorical variable (up to the median, which was detected as 6%, vs. above the median). The association with PCa progression, defined as biochemical recurrence, and/or metastatic progression, was evaluated by Cox proportional hazard regression models. Results Overall, 147 patients were included. Compared to subjects with a nomogram score up to 6%, those presenting with a score above 6% were more likely to be younger, had larger/palpable tumors, presented with higher PSA, underwent tumor upgrading, harbored non-organ confined disease, and had positive surgical margins at final pathology. PCa progression, which occurred in 32 (21.7%) cases, was independently predicted by the 2012 Briganti nomogram both considered as a continuous (Hazard Ratio [HR]:1.04, 95% Confidence Interval [CI]:1.01-1.08;p=0.021), and a categorical variable (HR:2.32; 95%CI:1.11-4.87;p=0.026), even after adjustment for tumor upgrading. Conclusions In IR PCa patients with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b, the 2012 Briganti nomogram independently predicts PCa progression. In this challenging subset of patients, this tool can identify prognostic subgroups, independently by upgrading issues. 201 (PCa intermediaterisk intermediate risk (IR 10ngmL ngmL 10ng mL ng <10ng/mL 3 cTb cT b dissection 2021 abovementioned mentioned median 6 vs median. . median) recurrence andor or models Overall 14 included younger largerpalpable larger palpable tumors nonorgan non organ disease pathology 21.7% 217 21 7 (21.7% cases Hazard HR1.04, HR104 HR 1.04, 1 04 [HR]:1.04 95 CI1.011.08p=0.021, CI101108p0021 CIp CI 1.01 1.08 p=0.021 , 01 08 p 0 021 [CI]:1.01-1.08;p=0.021) HR2.32 HR232 2.32 2 (HR:2.32 95%CI1.114.87p=0.026, 95CI111487p0026 95%CI 1.11 4.87 p=0.026 11 4 87 026 95%CI:1.11-4.87;p=0.026) subgroups issues 20 202 21.7 (21.7 HR1 HR1.04 HR10 104 1.04 [HR]:1.0 9 CI1 011 08p CI1.011.08p=0.021 CI101108p002 101 1.0 108 p0021 p=0.02 02 [CI]:1.01-1.08;p=0.021 HR2 HR2.3 HR23 232 2.3 (HR:2.3 114 87p 95%CI1.114.87p=0.026 95CI111487p002 95CI 111 1.1 487 4.8 p0026 8 95%CI:1.11-4.87;p=0.026 21. (21. HR1.0 10 [HR]:1. CI1.011.08p=0.02 CI101108p00 1. p002 p=0.0 [CI]:1.01-1.08;p=0.02 HR2. 23 2. (HR:2. 95%CI1.114.87p=0.02 95CI111487p00 48 4. 95%CI:1.11-4.87;p=0.02 (21 HR1. [HR]:1 CI1.011.08p=0.0 CI101108p0 p00 p=0. [CI]:1.01-1.08;p=0.0 (HR:2 95%CI1.114.87p=0.0 95CI111487p0 95%CI:1.11-4.87;p=0.0 (2 [HR]: CI1.011.08p=0. CI101108p p0 p=0 [CI]:1.01-1.08;p=0. (HR: 95%CI1.114.87p=0. 95CI111487p 95%CI:1.11-4.87;p=0. ( [HR] CI1.011.08p=0 p= [CI]:1.01-1.08;p=0 (HR 95%CI1.114.87p=0 95%CI:1.11-4.87;p=0 [HR CI1.011.08p= [CI]:1.01-1.08;p= 95%CI1.114.87p= 95%CI:1.11-4.87;p= CI1.011.08p [CI]:1.01-1.08;p 95%CI1.114.87p 95%CI:1.11-4.87;p

Objective: To associate abandonment of tuberculosis treatment with the variables of access to health services in the state of São Paulo was estimated. Methods: was an epidemiological observational study with data to individuals diagnosed with tuberculosis, residing in the state of São Paulo in the period 2012 to 2017. Generalized Estimating Equations models were used to analyze the relationships between independent variables and noncompliance with tuberculosis treatment over time. Results: A prevalence of over 12% of noncompliance with tuberculosis treatment was identified. Individuals residing in medium and large-sized municipalities had, 2.64 (95% CI: 2.15-3;24) and 4.48 (CI 95%: 4.62-5.55) times more risk, respectively, of abandoning TB treatment when compared with those living in small cities (p&lt;0.05). Moreover, presence of Psychosocial Care Centers did not contribute to the reduction of treatment abandonment [1.20 (1.03-1.40) p&lt;0.05]. Conclusions: Was an association between municipal size and abandonment of tuberculosis treatment.

Introdução: Estimou-se a associação entre o abandono do tratamento da tuberculose com variáveis de acesso ao serviço de saúde no estado de São Paulo. Métodos: Trata-se de um estudo epidemiológico ecológico com fonte de dados secundários de indivíduos diagnosticados com tuberculose, no período de janeiro/2012 a dezembro/2017 residentes no estado de São Paulo. A variável desfecho é o abandono do tratamento da tuberculose. Foram efetuadas análises e considerada a distribuição de Poisson, estimados os riscos relativos brutos e ajustados, dispostas em dois blocos de variáveis considerando nível de significância de 5%. Resultados: Identificou-se uma prevalência superior a 12% no abandono do tratamento da TB no estado de São Paulo no período estudado. Indivíduos residentes em municípios de médio e grande porte têm, respectivamente, 2,64 (IC95%: 2,15-3,24) e 4,48 (IC95%: 4,62-5,55) vezes mais risco de abandonar o tratamento da TB quando comparados ao que vivem em municípios pequeno porte (p&lt;0,05), bem como, municípios com a presença do CAPS não contribuíram para a diminuição do abandono [1,20 (1,03-1,40) p&lt;0,05]. Conclusão: houve associação entre o porte municipal e o abandono do tratamento de Tuberculose.

Abstract The Higher Education Institutions (HEIs) in Brazilian, in particular universities permanently develop several actions that are provided in the MOOC format on different platforms. The purpose of this study is to propose an artifact with the MOOCs courses available as well as the platforms used by universities. This study adopts the Design Science Research methodology, to develop the artifact. We searched all MOOCs courses offered for free and with the issuance of certificates by 68 Brazilian public universities. The results of this study is a portal web with all the MOOCS courses of the HEIs. The artifact was demonstrated and evaluated and the impact that it provides on training and as a knowledge enhancer was perceived. This study suggests the creation of a unique platform for Brazilian public universities as a punctualizing ecosystem to knowledge management for access by society in general.

Resumo As universidades desenvolvem permanentemente diversas ações de desenvolvimento que são disponibilizadas no formato de MOOC em várias plataformas. O objetivo deste estudo é propor um artefato com os cursos MOOCs disponibilizados bem como as plataformas utilizadas que são ofertadas. Esse estudo adota a metodologia Design Science Research, para desenvolver o artefato. Nesse sentido, foram pesquisados todos os cursos MOOCs oferecidos gratuitamente e com emissão de certificado pelas 68 universidades federais brasileiras. Os resultados desse estudo é um artefato em formato de um portal com web com todos os cursos MOOCS das IES. O artefato foi demonstrado e avaliado com docentes de IES e percebeu-se o impacto que ele proporciona na capacitação e como potencializador do conhecimento. Esse estudo sugere a criação de uma plataforma única disponibilizada pelas universidades públicas brasileiras como um ecossistema potencializador da gestão do conhecimento para acesso da sociedade em geral.

ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, and myotomy is one of the most used treatment techniques. However, symptom persistence or recurrence occurs in 9 to 20% of cases. AIMS: This study aims to provide a practical approach for managing the recurrence or persistence of achalasia symptoms after myotomy. METHODS: A critical review was performed to gather evidence for a rational approach for managing the recurrence or persistence of achalasia symptoms after myotomy. RESULTS: To properly manage an achalasia patient with significant symptoms after myotomy, such as dysphagia, regurgitation, thoracic pain, and weight loss, it is necessary to classify symptoms, stratify severity, perform appropriate tests, and define a treatment strategy. A systematic differential diagnosis workup is essential to cover the main etiologies of symptoms recurrence or persistence after myotomy. Upper digestive endoscopy and dynamic digital radiography are the main tests that can be applied for investigation. The treatment options include endoscopic dilation, peroral endoscopic myotomy, redo surgery, and esophagectomy, and the decision should be based on the patient’s individual characteristics. CONCLUSIONS: A good clinical evaluation and the use of proper tests jointly with a rational assessment, are essential for the management of symptoms recurrence or persistence after achalasia myotomy. BACKGROUND disorder techniques However 20 cases AIMS METHODS RESULTS dysphagia regurgitation pain loss severity strategy investigation dilation surgery esophagectomy patients s characteristics CONCLUSIONS assessment 2

RESUMO RACIONAL: A acalasia é um distúrbio da motilidade esofágica e a miotomia é uma das técnicas de tratamento mais utilizadas. No entanto, a persistência ou recorrência dos sintomas ocorre em 9 a 20%. OBJETIVOS: Este estudo visa fornecer uma abordagem prática para o manejo da recorrência ou persistência dos sintomas de acalasia após miotomia. MÉTODOS: Foi realizada uma revisão crítica para reunir evidências para uma abordagem racional no manejo da recorrência ou persistência dos sintomas de acalasia após miotomia. RESULTADOS: Para o manejo adequado de um paciente com acalásia com sintomas significativos após miotomia, como disfagia, regurgitação, dor torácica e perda de peso, é necessário classificar os sintomas, estratificar a gravidade, realizar exames adequados e definir uma estratégia de tratamento. Uma investigação diagnóstica diferencial sistemática é essencial para cobrir as principais etiologias de recorrência ou persistência dos sintomas após a miotomia. A endoscopia digestiva alta e a radiografia digital dinâmica são os principais exames que podem ser aplicados para investigação. As opções de tratamento incluem dilatação endoscópica, POEM (miotomia endoscópica oral), remiotomia e esofagectomia, e a decisão deve ser baseada nas características individuais do paciente. CONCLUSÕES: Uma boa avaliação clínica e a utilização de exames adequados, juntamente com uma avaliação racional, são essenciais para o manejo da recorrência ou persistência dos sintomas após miotomia por acalasia. RACIONAL utilizadas entanto 20 20% OBJETIVOS MÉTODOS RESULTADOS disfagia regurgitação peso gravidade oral, oral , oral) esofagectomia CONCLUSÕES 2

Abstract The Higher Education Institutions (HEIs) in Brazilian, in particular universities permanently develop several actions that are provided in the MOOC format on different platforms. The purpose of this study is to propose an artifact with the MOOCs courses available as well as the platforms used by universities. This study adopts the Design Science Research methodology, to develop the artifact. We searched all MOOCs courses offered for free and with the issuance of certificates by 68 Brazilian public universities. The results of this study is a portal web with all the MOOCS courses of the HEIs. The artifact was demonstrated and evaluated and the impact that it provides on training and as a knowledge enhancer was perceived. This study suggests the creation of a unique platform for Brazilian public universities as a punctualizing ecosystem to knowledge management for access by society in general.

Resumo As universidades desenvolvem permanentemente diversas ações de desenvolvimento que são disponibilizadas no formato de MOOC em várias plataformas. O objetivo deste estudo é propor um artefato com os cursos MOOCs disponibilizados bem como as plataformas utilizadas que são ofertadas. Esse estudo adota a metodologia Design Science Research, para desenvolver o artefato. Nesse sentido, foram pesquisados todos os cursos MOOCs oferecidos gratuitamente e com emissão de certificado pelas 68 universidades federais brasileiras. Os resultados desse estudo é um artefato em formato de um portal com web com todos os cursos MOOCS das IES. O artefato foi demonstrado e avaliado com docentes de IES e percebeu-se o impacto que ele proporciona na capacitação e como potencializador do conhecimento. Esse estudo sugere a criação de uma plataforma única disponibilizada pelas universidades públicas brasileiras como um ecossistema potencializador da gestão do conhecimento para acesso da sociedade em geral.

The objective of the present research is to suggest how to design, according to Capes' evaluation rules, Academic and Professional programs in the areas of Engineering-III and Public and Business Administration, Accounting Sciences and Tourism. The objective is to help in the planning of these graduate Programs such that they are sustainable from an evaluation point of view. The evaluation rules vary a lot among the different areas of Capes, which makes a general study for all areas of knowledge impossible. Therefore, it was decided to consider the areas of Engineering III and Public and Business Administration, Accounting Sciences and Tourism, as these are areas that tend to have great interest in professional programs. A comparative study of the evaluation criteria will be carried out, seeking to identify the ideal profile of professors for the Academic and Professional Programs in the two areas analyzed. It is important to remember that Capes introduced changes in the evaluation in 2021, seeking to align this evaluation with international declarations on this topic and to have a greater focus on quality instead of quantity of products. Other criteria related to institutional objectives and missions must be taken into account in this process, but it is a situation that must be studied individually and it is not possible to include them in the present study.

El objetivo de la presente investigación es sugerir cómo diseñar, según las reglas de evaluación de la Capes, programas Académicos y Profesionales en las áreas de Ingeniería-III y Administración Pública y Empresarial, Ciencias Contables y Turismo. El objetivo es ayudar en la planificación de estos programas de posgrado para que sean sostenibles desde el punto de vista de la evaluación. Las reglas de evaluación varían mucho entre las distintas áreas de la Capes, lo que imposibilita un estudio general para todas las áreas de conocimiento. Entonces, se decidió considerar las áreas de Ingeniería III y Administración Pública y de Empresas, Ciencias Contables y Turismo, por ser áreas que suelen tener gran interés en los programas profesionales. Se realizará un estudio comparativo de los criterios de evaluación, buscando identificar el perfil ideal de profesores para los Programas Académicos y Profesionales en las dos áreas analizadas. Es importante recordar que Capes introdujo cambios en la evaluación en 2021, buscando alinear esta evaluación con las declaraciones internacionales sobre este tema y tener un mayor enfoque en la calidad en lugar de la cantidad de productos. En este proceso se deben tener en cuenta otros criterios relacionados con los objetivos y misiones institucionales, pero es una situación que se debe estudiar individualmente y no es posible incluirlos en el presente estudio.

O objetivo do presente trabalho é sugerir formas de fazer um planejamento, de acordo com as regras avaliativas da Capes, de programas acadêmicos e profissionais nas áreas de Engenharias-III e Administração Pública e de Empresas, Ciências Contábeis e Turismo. O objetivo é ajudar no planejamento desses Programas de pós-graduação para que sejam sustentáveis do ponto de vista de avaliação. As regras avaliativas variam bastante entre as diferentes áreas da Capes, o que torna impossível um estudo geral para todas as áreas do conhecimento. Sendo assim, optou-se por considerar as áreas de Engenharias III e Administração Pública e de Empresas, Ciências Contábeis e Turismo, pois são áreas que tendem a despertar grande interesse por programas profissionais. Será feito um estudo comparativo dos critérios de avaliação, buscando identificar o perfil ideal de docentes para os Programas Acadêmico e Profissional nas duas áreas analisadas. É importante lembrar que a Capes introduziu mudanças na avaliação em 2021, buscando alinhar a avaliação com manifestos internacionais sobre o assunto e ter um foco maior em qualidade do que em quantidade de produtos. Outros critérios ligados aos objetivos e missões institucionais devem ser levados em conta nesse processo, mas é uma situação que deve ser estudada individualmente e não é possível incluí-las no presente estudo.

Resumo: A referência às ideias políticas de Antonio Gramsci é curiosamente comum nos textos e no jargão de intelectuais conservadores no Brasil e internacionalmente. A origem dessa conexão com o pensamento gramsciano, contudo, permanece até os dias atuais desconhecida. Com vistas a elucidar esse enigma e explicar as fontes do “antigramscismo”, o presente artigo reconstrói documentalmente os primeiros percursos de circulação e tradução deste pensamento político, nas últimas décadas do século XX, particularmente na América Latina. A pesquisa mapeou seus principais irradiadores, internacional e nacionalmente, bem como as fontes, temas e argumentos dessa corrente intelectual.

Abstract: The reference to Antonio Gramsci’s political ideas is curiously common in the texts and in the jargon of intellectuals of the so-called radical rights in Brazil and abroad. The origin of this connection with Gramscian thought, however, remains unknown to this day. With a view to elucidating this enigma and explaining the sources of “antigramsciism”, this article documents the reconstruction of the first paths of circulation and translation of this political thought, in the second half of the 20th century, particularly in Latin America. The research mapped its main international and national sources of diffusion, as well as the sources, themes and arguments of this intellectual current.

Abstract Objectives The study describes a case series of hereditary angioedema with C1 Inhibitor Deficiency (C1INH-HAE) in order to corroborate six clinical warning signs “HAAAAE (H4AE)” to enable early identification of this disease. Methods The authors analyzed the C1INH-HAE cohort to analyze the clinical aspects of the present study's patients and corroborate the six clinical warning signs of the Hereditary Angioedema Brazilian Guidelines. Data regarding demographics, the onset of disease, time to diagnosis, frequency of attacks per year, organs involved, triggers, crisis duration and their outcomes, and disease treatment were collected. Then the authors developed an acronym, H4AE, to help healthcare professionals remember the warning signs. Results The authors included 98 patients in the study, with a mean age of 38.1 years, 67.3% being female, and 75.3% with a family history of HAE. HAE diagnosis was delayed, on average, 13.7 years after its initial manifestation. Exploratory laparotomy was reported by 26.9%, and orotracheal intubation by 21.3% of the present study's patients; 61.3% and 30.3% of them were admitted at least once in the hospital and in the intensive care unit, respectively. The authors constructed an acronym “H4AE” with the six warning signs of HAE: Hereditary, recurrent Angioedema, Abdominal pain, Absence of urticaria, Absence of response to antihistamines, Estrogen association. Conclusion C1INH-HAE is still underdiagnosed and associated with high morbidity. The study showed clinical features of this disease, corroborating the warning signs, which may be useful in raising awareness and improving the diagnosis of C1INH-HAE. The authors suggest the acronym “H4AE” to remind the warning signs.

RESUMO Objetivo: o estudo se debruçou na identificação da relação entre as motivações psicológicas e da imagem do destino na escolha do destino turístico do segmento LGBT+. Design/ Metodologia/ Abordagem: A pesquisa foi operacionalizada por meio de uma survey com um total de 239 respondentes. sendo destes. 89 autodefinidos LGBT+. Para a análise de dados foram utilizadas análises estatísticas univariadas e bivariadas. Resultados: (1) ambos os públicos valorizam o lazer como principal motivação psicológica para a escolha do destino turístico; (2) as infraestruturas e o ambiente socioeconômico e a imagem afetiva são as dimensões mais importantes da imagem do destino; (3) as motivações psicológicas aumentam a avaliação da imagem de destino de turistas autodefinidos LGBT +; (4) não houve diferença significativa entre a escolha do destino turístico entre heterossexuais e o público LGBT +. Originalidade: estudos anteriores focam em análises de consumo de destinos turísticos de LGBT+, mas não a compreensão das principais motivações psicológicas e sua associação com a imagem do destino, tampouco, verificam se de fato há diferenças entre o público LGBT+ e heterossexuais. Este estudo respondeu esta lacuna.

ABSTRACT Purpose: this study aimed to identify the relationship between psychological motivations and destination image of self-defined LGBT+ tourists’ destination choice. Design/ methodology/ approach: The study was operationalized through a survey with 239 respondents. Which 89 were self-defined as LGBT+. Statistical univariate and bivariate analyses were used for data analysis. Findings: (1) both targets value leisure as the primary psychological motivation for choosing the travel destination; (2) infrastructures and socio-economic environment and affective image are the most critical dimensions of destination image; (3) the psychological motivations increase the destination image of self-defined LGBT+ tourists’; (4) there was no significant difference between the choice of tourist destination between heterosexuals and the LGBT +. Originality/value: Previous studies have focused on analyzes of consumption of LGBT + tourist destinations, but not understanding the main psychological motivations and their association with the image of the destination, either check whether there are in fact differences between the LGBT + and heterosexual audiences. This study answered to this gap.

Resumo O mefenpyr-diethyl é um safener de ação foliar do grupo químico das pyrazolines e após a sua absorção, ocorre à metabolização e desintoxicação de herbicidas em plantas tratadas. Estudos demonstraram efeito protetor desse safener para o herbicida fenoxaprop-P-ethyl em gramíneas. Assim, o objetivo desse trabalho foi avaliar se o mefenpyr-diethyl em mistura de tanque possui resposta protetora ao haloxyfop-methyl em grama batatais não perenizada. O experimento foi realizado em casa de vegetação em delineamento inteiramente casualizado, com cinco repetições com esquema fatorial 10x2, sendo dez doses do haloxyfop-methyl (0.00; 0,24; 0,49; 0,97; 1,95; 3,90; 7,79; 15,59; 31,28 e 62,35 g ha-1 i.a.), na presença ou ausência do mefenpyr-diethyl (50 g ha-1 i.a.) em mistura de tanque. Foram realizadas avaliações de fitointoxicação e taxa de transporte de elétrons (ETR) aos 7, 14, 21 e 28 dias após a aplicação (DAA), além de altura e biomassa seca da parte aérea das plantas aos 28 DAA. De maneira geral, houve aumento da fitointoxicação das plantas em função do aumento do herbicida haloxyfop-methyl. A aplicação de mefenpyr-diethyl por sua vez, proporcionou menores níveis de fitointoxicação, menores reduções de ETR, altura e biomassa seca quando comparadas as plantas não tratadas. Estes resultados mostram a ação protetora de mefenpyr-diethyl em mistura em tanque com baixas doses de haloxyfop-methyl em grama batatais não perenizada.

Abstract Mefenpyr-diethyl is a foliar-acting safener of the pyrazoline chemical group, and after its absorption, the metabolization and detoxification of herbicides occur in treated plants. Studies have demonstrated the protective effect of this safener for the herbicide fenoxaprop-P-ethyl in grass. Thus, this work aimed to evaluate whether a tank mixture of mefenpyr-diethyl has a protective response to haloxyfop-methyl in non-perennial bahiagrass. The experiment had a completely randomized design and was carried out in a greenhouse, using five replications with a 10x2 factorial scheme and ten doses of haloxyfop-methyl (0.00, 0.24, 0.49, 0.97, 1.95, 3.90, 7.79, 15.59, 31.28, and 62.35 g a.i. ha-1) in the presence or absence of a tank mixture of mefenpyr-diethyl (50 g a.i. ha-1). Phytotoxicity and electron transport rate (ETR) were evaluated at 7, 14, 21, and 28 days after application (DAA), in addition to plant height and dry biomass at 28 DAA. In general, phytotoxicity increased due to the higher levels of the herbicide haloxyfop-methyl. The application of mefenpyr-diethyl, in turn, provided lower levels of phytotoxicity, as well as lower reductions in ETR, height, and dry biomass when compared to untreated plants. These results show the safener action of a tank mixture of mefenpyr-diethyl on low doses of haloxyfop-methyl in non-perennial bahiagrass.

ABSTRACT: Elephantopus mollis, popularly known as elephant paw or sussuaiá, is a species that has recently emerged as a weed affecting grain crops. This study aimed to evaluate the differential sensitivity of biotypes of E. mollis obtained from agricultural and nonagricultural areas and to determine the best combinations of herbicides applied at different stages of development for controlling this species. Three experiments were conducted. In the differential sensitivity experiment, 10 herbicides were used in 2 biotypes in 2 stages of development. The dose-response experiment was conducted using 8 doses of 7 herbicides. The field experiment was conducted in an area with weed issues to validate the results of previous experiments. The biotype from the agricultural area showed lower sensitivity to herbicides than the biotype from the nonagricultural area. The contact herbicides initially presented better control; however, the weed shortly showed re-growth due to the presence of buds in the plant crown. Isolated application of 2.4-D amine at doses between 1005 and 1675 g a.e. ha−1 demonstrated 25% control. When 2,4-D amine was followed by paraquat application (400 g a.i. ha−1), the control observed was between 51% and 68%. The best treatment for the control of completely developed weeds is 2,4-D amine + glyphosate mixture (1340 + 1080 g a.e. ha−1), followed by sequential paraquat application.

RESUMO: Popularmente conhecida como pata de elefante ou sussuaiá, Elephantopus mollis, é uma espécie que recentemente surgiu como uma planta daninha em lavouras de cultivos de grãos. Objetivou-se com este estudo avaliar a sensibilidade diferencial de biótipos de E. mollis oriundos de áreas agrícolas e não agrícolas e determinar as melhores combinações de herbicidas aplicados em diferentes estádios de desenvolvimento para o controle desta espécie. Foram realizados três experimentos. No experimento de sensibilidade diferencial foram utilizados dez herbicidas em dois biótipos em duas fases de desenvolvimento. O experimento de dose resposta foi conduzido com oito doses de sete herbicidas. O experimento a campo foi realizado em uma área que apresenta problemas com a planta daninha para validar os resultados dos experimentos anteriores. O biótipo oriundo de área agrícola apresentou menor sensibilidade aos herbicidas quando comparado ao biótipo oriundo de área não agrícola. Os herbicidas de contato inicialmente apresentam controle superior, mas logo a planta apresenta rebrote em função de gemas presentes no colo da planta. A aplicação isolada de 2,4-D com doses entre 1005 e 1675 g e.a ha-1 possui controle de 25%. Quando o 2,4-D é seguido da aplicação de paraquat (400 g i.a ha-1) o controle passa a ser entre 51 e 68%. O melhor tratamento para o controle de plantas desenvolvidas é a mistura de 2,4-D + glyphosate (1340 + 1080 g e.a ha-1) com aplicação sequencial de paraquat.

RESUMO As crises de angioedema são causas comuns de atendimentos nas emergências, e devido ao potencial de gravidade, é importante que os profissionais que atuam nesses serviços conheçam suas causas e abordagem. Os mecanismos envolvidos no angioedema sem urticas podem ser histaminérgicos ou mediados por bradicinina. As causas mais comuns de angioedema mediado por histamina são alimentos, medicamentos, ferroada de insetos e idiopática. Quando o mediador é a bradicinina, os desencadeantes são os inibidores da enzima conversora de angiotensina e fatores relacionados ao angioedema adquirido com deficiência do inibidor de C1 ou angioedema hereditário que são menos comuns, mas muito importantes pela possibilidade de desfecho fatal. O angioedema hereditário é uma doença rara, caracterizada por crises de edema que acometem o tecido subcutâneo e mucosas de vários órgãos, manifestando-se principalmente por crises de angioedema e dor abdominal. Esse tipo de angioedema não responde ao tratamento usual com adrenalina, anti-histamínicos e corticosteroides. Assim, se não identificados e tratados adequadamente, esses pacientes têm risco de morte por edema de laringe estimado em 25% a 40%. O tratamento do angioedema hereditário mudou drasticamente nos últimos anos, com o desenvolvimento de novos e eficientes fármacos para as crises: inibidor de C1 derivado de plasma, inibidor de C1 recombinante humano, antagonista do receptor B2 da bradicinina (icatibanto) e o inibidor da calicreína (ecalantide). No Brasil, até o momento, estão liberados para uso o inibidor de C1 derivado de plasma e o icatibanto. O manejo correto desses pacientes na emergência evita cirurgias desnecessárias e, principalmente, desfechos fatais.

ABSTRACT Angioedema attacks are common causes of emergency care, and due to the potential for severity, it is important that professionals who work in these services know their causes and management. The mechanisms involved in angioedema without urticaria may be histamine- or bradykinin-mediated. The most common causes of histamine-mediated angioedema are foods, medications, insect sting and idiopathic. When the mediator is bradykinin, the triggers are angiotensin-converting enzyme inhibitors and factors related to acquired angioedema with deficiency of C1-inhibitor or hereditary angioedema, which are less common, but very important because of the possibility of fatal outcome. Hereditary angioedema is a rare disease characterized by attacks of edema that affect the subcutaneous tissue and mucous membranes of various organs, manifesting mainly by angioedema and abdominal pain. This type of angioedema does not respond to the usual treatment with epinephrine, antihistamines and corticosteroids. Thus, if not identified and treated appropriately, these patients have an estimated risk of mortality from laryngeal edema of 25% to 40%. Hereditary angioedema treatment has changed dramatically in recent years with the development of new and efficient drugs for attack management: plasma-derived C1 inhibitor, recombinant human C1-inhibitor, bradykinin B2 receptor antagonist (icatibant), and the kallikrein inhibitor (ecallantide). In Brazil, plasma-derived C1 inhibitor and icatibant have already been approved for use. Proper management of these patients in the emergency department avoids unnecessary surgery and, especially, fatal outcomes.

Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.

ABSTRACT: Italian ryegrass (Lolium multiflorum Lam.) is a troublesome weed widely found in temperate Brazilian fields with several herbicide-resistant populations. Soil seed bank is the main source of future infestations and can be strongly affected by agricultural practices, such as crop rotation and tillage system. Therefore, this study evaluated the long-term effects of different crop rotation and tillage systems on the seed bank of Italian ryegrass. Data were collected in 2012 and 2013 in a field managed since 1985 under conventional-tillage and no-tillage and subjected to three cropping systems (monoculture, total, and partial rotation) compared to the control plot. The samples were collected at three soil depths (0-5, 5-10, and 10-20 cm) using a cylindrical soil sampler, and infestations in the field were evaluated with a sample frame of 1 m2. All cropping systems reduced the soil seed bank of Italian ryegrass, regardless of soil management and sampling depths comparing to the control plot. Total and partial rotation were more effective than soil tillage to reduce the seed bank. A larger number of seeds was observed on the surface layer (0-5 cm) for all cropping systems with more uniform distribution in the soil profile in conventional-tillage. Infestation of Italian ryegrass was greater for monoculture under no-tillage in both years, whereas in total and partial rotation, regardless of soil tillage, infestations remained below 40 seedlings m−2. Thus, strategies to reduce the soil seed bank and infestations of Italian ryegrass should focus on cropping systems with crop rotation and no-tillage.

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.