ABSTRACT The prevalence of nephrolithiasis is increasing worldwide. Despite advances in understanding the pathogenesis of lithiasis, few studies have demonstrated that specific clinical interventions reduce the recurrence of nephrolithiasis. The aim of this review is to analyze the current data and potential effects of iSGLT2 in lithogenesis and try to answer the question: Should we also “gliflozin” our patients with kidney stone disease? worldwide lithiasis iSGLT question gliflozin “gliflozin disease

RESUMO A prevalência da nefrolitíase está aumentando em todo o mundo. Apesar dos avanços na compreensão da patogênese da doença litiásica, poucos estudos demonstraram que intervenções clínicas específicas diminuem a recorrência da nefrolitíase. O objetivo desta revisão é analisar os dados atuais e efeitos potenciais dos iSGLT2 na doença litiásica e tentar responder à pergunta: devemos também “gliflozinar” os litiásicos? mundo iSGLT pergunta gliflozinar “gliflozinar litiásicos

ABSTRACT The prevalence of nephrolithiasis is increasing worldwide. Despite advances in understanding the pathogenesis of lithiasis, few studies have demonstrated that specific clinical interventions reduce the recurrence of nephrolithiasis. The aim of this review is to analyze the current data and potential effects of iSGLT2 in lithogenesis and try to answer the question: Should we also “gliflozin” our patients with kidney stone disease? worldwide lithiasis iSGLT question gliflozin “gliflozin disease

RESUMO A prevalência da nefrolitíase está aumentando em todo o mundo. Apesar dos avanços na compreensão da patogênese da doença litiásica, poucos estudos demonstraram que intervenções clínicas específicas diminuem a recorrência da nefrolitíase. O objetivo desta revisão é analisar os dados atuais e efeitos potenciais dos iSGLT2 na doença litiásica e tentar responder à pergunta: devemos também “gliflozinar” os litiásicos? mundo iSGLT pergunta gliflozinar “gliflozinar litiásicos

Classes of Recommendation Class I: Conditions for which there is conclusive evidence and, failing that, general agreement that a given procedure is safe and useful/effective. Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the safety and usefulness/efficacy of a procedure. Class IIa: Weight or evidence/opinion in favor of the procedure. Most approve. Class IIb: Safety and usefulness/efficacy less well established, with divergence of opinions. Class III: Conditions for which there is evidence and/or general agreement that a procedure is not useful/effective and, in some cases, may be harmful. Levels of Evidence Level A: Data derived from multiple large, concordant randomized trials and/or robust meta-analyses of randomized trials. Level B: Data derived from less robust meta-analyses, from a single randomized trial and/or from observational studies. Level C: Data derived from consensus opinion of experts. I usefuleffective useful effective II andor usefulnessefficacy usefulness efficacy IIa evidenceopinion approve IIb established opinions III cases harmful A large metaanalyses meta analyses B metaanalyses, analyses, studies C experts

Classes de Recomendação Classe I: Condições para as quais há evidências conclusivas e, na sua falta, consenso geral de que o procedimento é seguro e útil/eficaz. Classe II: Condições para as quais há evidências conflitantes e/ou divergência de opinião sobre a segurança e utilidade/eficácia do procedimento. Classe IIa: Peso ou evidência/opinião a favor do procedimento. A maioria aprova. Classe IIb: Segurança e utilidade/eficácia menos estabelecidas, havendo opiniões divergentes. Classe III: Condições para as quais há evidências e/ou consenso de que o procedimento não é útil/eficaz e, em alguns casos, pode ser prejudicial. Níveis de Evidência Nível A: Dados obtidos a partir de múltiplos estudos randomizados de bom porte, concordantes e/ou de metanálise robusta de estudos randomizados. Nível B: Dados obtidos a partir de metanálise menos robusta, a partir de um único estudo randomizado e/ou de estudos observacionais. Nível C: Dados obtidos de opiniões consensuais de especialistas. I falta útileficaz útil eficaz II eou utilidadeeficácia utilidade eficácia IIa evidênciaopinião evidência aprova IIb estabelecidas divergentes III casos prejudicial porte B observacionais C especialistas

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract Difficult airway management 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 with updated recommendations for the management of difficult airway in adults. These recommendations were developed based on the consensus of a group of expert anesthesiologists, aiming to provide strategies for managing difficulties during tracheal intubation. They are based on evidence published in international guidelines and opinions of experts. The report underlines the essential steps for proper difficult airway management, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and maintaining arterial oxygenation. Additional strategies for using advanced tools, such as video laryngoscopy, flexible bronchoscopy, and supraglottic devices, are discussed. The report considers recent advances in understanding crisis management, and the implementation seeks to further patient safety and improve clinical outcomes. The recommendations are outlined to be uncomplicated and easy to implement. The report underscores the importance of ongoing education, training in realistic simulations, and familiarity with the latest technologies available. challenge approach expertise protocols SBA (SBA adults anesthesiologists intubation experts assessment preparation positioning preoxygenation, preoxygenation pre oxygenation, oxygenation pre-oxygenation trauma tools laryngoscopy bronchoscopy devices discussed outcomes implement education simulations available

Abstract The Federal University of Goiás (UFG) and the University of Brasília (UnB), in partnership with the company Eletrobras Furnas, have developed research and, based on this, extension projects aimed at education in a broad sense, in which they seek to disseminate and popularise technical-scientific knowledge. This paper aims to present and evaluate educational actions carried out in the area of soil science and geotechnics applied to engineering, geography, and the environment. To do so, the educational experiences developed within the scope of two extension projects are shared. Besides that, the relevance of publishing books and primer, with language adapted to lay society, within the scope of research projects, is analysed. The results collected regarding the effectiveness of the extension actions as a tool for learning point to a positive evaluation by the students. Furthermore, social networks are an important tool for scientific dissemination and have the potential to disseminate knowledge more widely than in a classroom course. By comparing the number of citations in Google Scholar of the books and booklets with the papers arising from these projects, one can observe the reach of this type of publication, although its purpose is the popularisation of science, with reach in places not considered in the technical-scientific publication metrics. Finally, for effective scientific development, it is necessary to have public policies, effective interaction between universities, research centres and schools, and the participation of professional associations, funding and evaluation agencies, Education Departments and the Ministry of Education, Science, Technology, and Innovation. UFG (UFG UnB, UnB , (UnB) Furnas sense technicalscientific technical engineering geography environment so shared that primer society analysed students Furthermore course metrics Finally development policies universities schools associations agencies Science Technology Innovation (UnB

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group. HMR (HMR SARS (SARS COVID19 COVID 19 COVID-1 202 2021 FUs (FUs northnortheast north northeast NNE N NE region care 1yearold yearold 1 year old COVID1 COVID- 20 2

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo. Objetivouse Objetivou se TMH (TMH SRAG (SRAG COVID19 COVID 19 COVID-1 202 2021 Utilizouse Utilizou (UFs NorteNordeste Norte Nordeste Norte/Nordeste NNE N NE N/NE grupo COVID1 COVID- 20 2

RESUMEN: El objetivo de este artículo es analizar la Ley de Cuotas (Ley 12.711/12) y otras acciones afirmativas implementadas por el Colegio Pedro II (CPII) y sus contribuciones a la ampliación de las oportunidades educativas. Buscamos responder a dos preguntas principales: ¿cuáles fueron las acciones afirmativas adoptadas en sus procesos selectivos de ingreso a lo largo del tiempo? Y ¿qué cambios se perciben en el perfil sociodemográfico de los ingresantes, especialmente después de la Ley de Cuotas? El estudio es exploratorio y documental, con análisis descriptivos, a partir de datos secundarios obtenidos de la página web del CPII y de los microdatos del Censo Escolar. Tomamos como referencia tres cohortes de ingresantes en 6º de Primaria y en 1º de Bachillerato Regular e Integrado, en los años 2012, 2014 y 2016. Los principales resultados muestran que, desde 2005, el CPII adopta una política de acción afirmativa para el ingreso de alumnos con la reserva del 50% de las vacantes para egresados de escuelas públicas. A partir de 2013, se implementó la Ley de Cuotas en la Escuela Secundaria Integrada y Regular, agregando a los criterios ya existentes en la escuela pública, los criterios de renta, raza/color y persona con discapacidad. El análisis del perfil sociodemográfico de los alumnos refuerza la contribución de las políticas de acción afirmativa del CPII y de la Ley de Cuotas en la ampliación de las oportunidades de acceso, especialmente para los alumnos negros. RESUMEN 12.711/12 1271112 12 711 (CPII educativas cuáles tiempo qué documental descriptivos Escolar º Integrado 2012 201 2016 que 2005 50 públicas 2013 pública renta razacolor raza color discapacidad acceso negros 12.711/1 127111 1 71 20 200 5 12.711/ 12711 7 2 12.711 1271 12.71 127 12.7 12.

ABSTRACT: The intention of this article is to analyze the Quota Law (Law 12.711/12) and other affirmative actions implemented by Colégio Pedro II (CPII) and their contributions to the expansion of educational opportunities. We seek to answer two main questions: what affirmative actions were adopted in their admission selection processes over time? And, what changes are perceived in the sociodemographic profile of entrants, especially since the Quota Law? The study is exploratory and documentary, with descriptive analyses based on secondary data obtained from the CPII website and microdata from the School Census. We used as reference three cohorts of entrants in the 6th grade of Elementary School and the 1st grade of regular and integrated High School, in the years 2012, 2014, and 2016. The main results show that since 2005, CPII has adopted an affirmative action policy for student admission with a reservation of 50% of the spots for public school graduates. Starting in 2013, the Quota Law was implemented in both the integrated and regular High School, adding to the existing public school criteria, income criteria, race/color, and disability criteria. The analysis of the students' socio-demographic profile reinforces the contribution of CPII's affirmative action policies and the Quota Law in expanding access opportunities, especially for Black/Brown students. ABSTRACT 12.711/12 1271112 12 711 (CPII opportunities questions time And documentary Census th st 2012 2014 2016 2005 50 graduates 2013 criteria racecolor race color race/color students socio demographic CPIIs s BlackBrown Black Brown 12.711/1 127111 1 71 201 200 5 12.711/ 12711 7 20 12.711 1271 2 12.71 127 12.7 12.

RESUMO: O objetivo deste artigo é analisar a Lei de Cotas (Lei 12.711/12) e demais ações afirmativas implementadas pelo Colégio Pedro II (CPII) e suas contribuições na ampliação de oportunidades educacionais. Busca-se responder a duas questões principais: quais foram as ações afirmativas adotadas em seus processos seletivos de ingresso ao longo do tempo? E quais mudanças são percebidas no perfil sociodemográfico dos ingressantes, principalmente a partir da Lei de Cotas? O estudo é exploratório e documental, com análises de cunho descritivo, a partir de dados secundários obtidos no site do CPII e nos microdados do Censo Escolar. Tomaram-se como referência três coortes de ingressantes no 6o ano do Ensino Fundamental e na 1a série do Ensino Médio Regular e Integrado, nos anos de 2012, 2014 e 2016. Os principais resultados mostram que, desde 2005, o CPII adota uma política de ação afirmativa para o ingresso dos estudantes com a reserva de 50% das vagas para egressos de escola pública. A partir de 2013, a Lei de Cotas foi implementada no Ensino Médio Integrado e Regular, acrescentando, aos critérios de escola pública já existentes, os critérios de renda, de raça/cor e de pessoa com deficiência. A análise do perfil sociodemográfico dos estudantes reforça a contribuição das políticas de ações afirmativas do CPII e da Lei de Cotas na ampliação de oportunidades de acesso, principalmente de estudantes negros. RESUMO 12.711/12 1271112 12 711 (CPII educacionais Buscase Busca se tempo documental descritivo Escolar Tomaramse Tomaram 2012 201 2016 que 2005 50 2013 acrescentando existentes renda raçacor raça cor deficiência acesso negros 12.711/1 127111 1 71 20 200 5 12.711/ 12711 7 2 12.711 1271 12.71 127 12.7 12.

ABSTRACT In ecotonal Cerrado areas, the addition of Amazonian and Atlantic Forest species mainly occurs through connections between forest areas and forest physiognomies. In this context, the biome is a unique region for research on the influence of geographical and historical factors on its biota. In tropical ecotonal regions, integrated communities can exist on soils that present variations in fertility, physical properties and depth, which results in heterogeneity of physiognomies. It was tested the hypothesis that edaphic conditions related to calcium availability are significantly related to species composition and structural parameters in two physiognomies. The study was conducted in the Cerrado of the Chapada das Mesas National Park (CMNP) in the city of Carolina, Northeast Brazil, and the sample universe consisted of 18 areas in two physiognomies. The initial hypothesis was confirmed. The results and inferences about the vegetation structure and physical-chemical parameters of the soil, suggest that the management for conservation of the CMNP must consider the particularities of the Cerrado physiognomies and the vegetation responses to environmental filters, such as edaphic conditions and associations with other organisms. context biota regions fertility depth (CMNP Carolina Brazil 1 confirmed physicalchemical chemical soil filters organisms

ABSTRACT The commercial cultivation of guava tree (Psidium guajava L.) occurs in all Brazilian regions, where fruit flies cause direct losses to production and affect fresh fruit exports due to quarantine restrictions. This study aimed to determine the incidence, diversity and population fluctuations of frugivorous fly species that infest guava trees, as well as to survey their associated parasitoids, in the Espírito santo state, Brazil. Fruits and flies captured in traps were sampled in three guava-producing regions. Anastrepha fraterculus (Wied.) was the main species associated with guava trees, particularly in the coastal region. Anastrepha chiclayae was recorded for the first time associated with guava trees in Brazil. Medfly was not considered an important species. Neosilba zadolicha was the most common Lonchaeidae species collected, but with low importance. Higher populations of frugivorous flies were found in hot and humid areas. Two population peaks of A. fraterculus were observed during October (spring) and from March to April (summer-autumn). Tephritid flies occurred in all surveyed regions, with higher infestations in the coastal area, followed by the northern and mountain regions, respectively. Doryctobracon areolatus and Aganaspis pelleranoi were the most common species of parasitoids; however, the natural biological control of frugivorous flies in guava trees was very low and had little impact on fruit fly populations. Psidium L. L regions restrictions incidence parasitoids state Brazil guavaproducing producing Wied. Wied (Wied. region collected importance areas A spring (spring summerautumn. summerautumn summer autumn . (summer-autumn) area respectively however (Wied (summer-autumn

RESUMO O cultivo comercial de goiabeira (Psidium guajava L.) ocorre em todas as regiões brasileiras, onde moscas-das-frutas causam perdas diretas na produção e afetam as exportações de frutas frescas devido a restrições quarentenárias. Objetivou-se determinar a incidência, diversidade e flutuações populacionais de espécies de moscas frugívoras que infestam goiabeira e levantar seus parasitoides associados, no estado do Espírito Santo, Brasil. Frutos e moscas capturadas por armadilhas foram amostrados em três regiões produtoras de goiaba. Anastrepha fraterculus (Wied.) foi a principal espécie associada a goiabeiras, principalmente na região litorânea. Anastrepha chiclayae foi registrada pela primeira vez associada a goiabeiras no Brasil. Medfly não foi uma espécie importante. Neosilba zadolicha foi a espécie de Lonchaeidae mais comum, mas com baixa importância. Maiores populações de moscas frugívoras foram encontradas em regiões quentes e úmidas. Dois picos populacionais de A. fraterculus foram observados em outubro (primavera) e de março a abril (verão-outono). Tefritídeos ocorreram em todas as regiões pesquisadas, com maiores infestações na área litorânea, seguida da norte e serrana, respectivamente. Doryctobracon areolatus e Aganaspis pelleranoi foram as espécies de parasitoides mais comuns; no entanto, o controle biológico natural de moscas frugívoras em goiabeira foi muito baixo e apresentou controle populacional de baixo impacto. Psidium L. L brasileiras moscasdasfrutas das quarentenárias Objetivouse Objetivou se incidência associados Santo Brasil goiaba Wied. Wied (Wied. litorânea importante comum importância úmidas A primavera (primavera verãooutono. verãooutono verão outono . (verão-outono) pesquisadas serrana respectivamente comuns entanto impacto (Wied (verão-outono

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (

Objective: To test the efficacy of a dissonance-based (DB) intervention in targeting risk factors for eating disorders (EDs) and predisposing factors for muscle dysmorphia (MD) symptoms in body-dissatisfied Brazilian men over 1 year of follow-up and evaluate whether reductions in body-ideal internalization would mediate the intervention’s impact on ED and MD symptoms. Methods: Participants were randomized to a two-session DB intervention (n=89) or assessment-only control (AOC) (n=91), and completed validated measures assessing body-ideal internalization, body dissatisfaction, ED, and MD symptoms at baseline, post-intervention, 1-month, 6-month, and 1-year follow-ups. Results: The DB condition showed significantly greater reductions in MD symptoms and body dissatisfaction compared with the AOC group over a 1-year follow-up, while significant differences were not observed for body-ideal internalization and ED symptoms. Changes in body-ideal internalization from baseline to 1-month follow-up completely mediated the relationship between condition and the changes observed in both ED and MD symptoms. Conclusion: These results provide further evidence of the efficacy of the tested intervention through 1-year follow-up in reducing body dissatisfaction and MD symptoms, but no such result was observed for body-ideal internalization and EDs. Our findings provide support for theoretical models of eating pathology and MD symptoms in Brazilian men. Clinical Trial Registration: Brazilian Registry of Clinical Trials (ReBEC): RBR-27dc264. Objective dissonancebased dissonance based (DB EDs (EDs (MD bodydissatisfied dissatisfied followup follow up bodyideal ideal interventions s Methods twosession two session n=89 n89 n 89 (n=89 assessmentonly assessment only (AOC n=91, n91 n=91 , 91 (n=91) postintervention, postintervention post intervention, post-intervention 1month, 1month month month, 6month, 6month 6 6-month 1year followups. followups ups. ups follow-ups Results followup, up, Conclusion Registration ReBEC (ReBEC) RBR27dc264. RBR27dc264 RBRdc RBR 27dc264. 27dc264 dc RBR-27dc264 n=8 n8 8 (n=8 n9 n=9 9 (n=91 (ReBEC RBR27dc26 27dc26 RBR-27dc26 n= (n= (n=9 RBR27dc2 27dc2 RBR-27dc2 (n RBR27dc 27dc RBR-27dc

Abstract Background: Respiratory responses to extubation can cause serious postoperative complications. Beta-blockers, such as metoprolol, can interfere with the cough pathway. However, whether metoprolol can effectively control respiratory reflexes during extubation remains unclear. The objective of this study is to evaluate the efficacy of intravenous metoprolol in attenuating respiratory responses to tracheal extubation. Methods: Randomized, double-blinded, placebo-controlled trial. Setting: Tertiary referral center located in Brasília, Brazil. Recruitment: June 2021 to December 2021. Sample: 222 patients of both sexes with an American Society of Anesthesiologists (ASA) physical status I-III aged 18–80 years. Patients were randomly assigned to receive intravenous metoprolol 5 mg IV or placebo at the end of surgery. The primary outcome was the proportion of patients who developed bucking secondary to endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes included coughing, bronchospasm, laryngospasm, Mean Blood Pressure (MAP), and Heart Rate (HR) levels. Results: Two hundred and seven participants were included in the final analysis: 102 in the metoprolol group and 105 in the placebo group. Patients who received metoprolol had a significantly lower risk of bucking (43.1% vs. 64.8%, Relative Risk [RR = 0.66], 95% Confidence Interval [95% CI 0.51–0.87], p = 0.003). In the metoprolol group, 6 (5.9%) patients had moderate/severe coughing compared with 33 (31.4%) in the placebo group (RR = 0.19; 95% CI 0.08–0.43, p < 0.001). Conclusion: Metoprolol reduced the risk of bucking at extubation in patients undergoing general anesthesia compared to placebo. Background complications Betablockers, Betablockers Beta blockers, blockers Beta-blockers pathway However unclear Methods Randomized doubleblinded, doubleblinded double blinded, blinded double-blinded placebocontrolled controlled trial Setting Brasília Brazil Recruitment 202 Sample 22 ASA (ASA IIII I III 1880 18 80 18–8 years surgery bronchospasm laryngospasm MAP, MAP , (MAP) HR (HR levels Results analysis 10 43.1% 431 43 1 (43.1 vs 648 64 8 64.8% RR 0.66, 066 0.66 0 66 0.66] 95 [95 0.51–0.87, 051087 0.51–0.87 51 87 0.51–0.87] 0.003. 0003 0.003 . 003 0.003) 5.9% 59 9 (5.9% moderatesevere moderate severe 3 31.4% 314 31 4 (31.4% 0.19 019 19 008043 08 0.08–0.43 0.001. 0001 0.001 001 0.001) Conclusion 20 2 188 18– (MAP 43.1 (43. 64.8 06 0.6 [9 05108 0.51–0.8 000 0.00 00 5.9 (5.9 31.4 (31.4 0.1 01 00804 0.08–0.4 43. (43 64. 0. [ 0510 0.51–0. 0.0 5. (5. 31. (31. 0080 0.08–0. (4 051 0.51–0 (5 (31 008 0.08–0 ( 05 0.51– (3 0.08– 0.51 0.08 0.5