Abstract Introduction: Postoperative nausea and vomiting is still a common complication. Serotonin receptor antagonists are commonly used in clinical practice for antiemetic prophylaxis. Interin-dividual variations in drug response, including single nucleotide polymorphisms, are related to pharmacokinetic and pharmacodynamic changes in these drugs and may lead to a poor therapeutic response. This study aimed to evaluate the influence of CYP2D6 isoenzyme and ABCB1 gene polymorphisms on the frequency of postoperative nausea and vomiting with the use of ondansetron or palonosetron. Methods: A randomized, double-blind clinical trial including 82 women aged 60 years or over undergoing laparoscopic cholecystectomy was conducted. Patients were randomized to receive either ondansetron or palonosetron for postoperative nausea and vomiting prophylaxis. DNA was extracted from saliva. Genetic polymorphisms were analyzed by real-time polymerase chain reaction. The following polymorphisms were analyzed: rs3892097 C/T, rs1128503 A/G, rs16947A/G, rs1065852 A/G, rs1045642 A/G, rs2032582 C/A, and rs20325821 C/A. Results: Overall, vomiting, and severe nausea occurred in 22.5% and 57.5% of patients, respectively. In the palonosetron group, patients with the GG genotype (rs16947 A/G) experienced more severe nausea (p = 0.043). In the ondansetron group, patients with the M genotype (rs16947 A/G) presented mild nausea (p = 0.034), and those with the AA genotype (rs1065852 A/G) experienced more vomiting (p = 0.034). Conclusion: A low antiemetic response was observed with ondansetron in the presence of the AA genotype (rs16947 A/G) and the AA genotype (rs1065852 A/G), and a low therapeutic response was found with palonosetron in the presence of the GG genotype (rs16947 A/G) in laparoscopic cholecystectomy. Register: ClinicalTrials.gov. Introduction complication prophylaxis Interindividual Interin dividual CYPD CYP D CYP2D ABCB Methods doubleblind double blind 8 6 conducted saliva realtime real time reaction rs rs389209 CT C T C/T rs112850 AG G A/G rs16947AG rsAG rs16947A rs16947A/G rs106585 rs104564 rs203258 CA C/A Results Overall 225 22 5 22.5 575 57 57.5 respectively group rs16947 (rs1694 p 0.043. 0043 0.043 . 0 043 0.043) 0.034, 0034 0.034 , 034 0.034) (rs106585 0.034. Conclusion Register ClinicalTrialsgov ClinicalTrials gov ClinicalTrials.gov rs38920 rs11285 rsA rs10658 rs10456 rs20325 2 22. 57. rs1694 (rs169 004 0.04 04 003 0.03 03 (rs10658 rs3892 rs1128 rs1065 rs1045 rs2032 rs169 (rs16 00 0.0 (rs1065 rs389 rs112 rs106 rs104 rs203 rs16 (rs1 0. (rs106 rs38 rs11 rs10 rs20 rs1 (rs (rs10 rs3 rs2

Abstract Objective The present study evaluated the profile of germline mutations present in patients who underwent genetic counseling for risk assessment for breast cancer (BC), ovarian cancer (OC), and endometrial cancer (EC) with a possible hereditary pattern. Methods Medical records of 382 patients who underwent genetic counseling after signing an informed consent form were analyzed. A total of 55.76% of patients (213/382) were symptomatic (personal history of cancer), and 44.24% (169/382) were asymptomatic (absence of the disease). The variables analyzed were age, sex, place of birth, personal or family history of BC, OC, EC, as well as other types of cancer associated with hereditary syndromes. The Human Genome Variation Society (HGVS) nomenclature guidelines were used to name the variants, and their biological significance was determined by comparing 11 databases. Results We identified 53 distinct mutations: 29 pathogenic variants, 13 variants of undetermined significance (VUS), and 11 benign. The most frequent mutations were BRCA1 c.470_471delCT, BRCA1 c.4675 + 1G > T, and BRCA2 c.2T> G. Furthermore, 21 variants appear to have been described for the first time in Brazil. In addition to BRCA1/2 mutations, variants in other genes related to hereditary syndromes that predispose to gynecological cancers were found. Conclusion This study allowed a deeper understanding of the main mutations identified in families in the state of Minas Gerais and demonstrates the need to assess the family history of non-gynecological cancer for risk assessment of BC, OC, and EC. Moreover, it is an effort that contributes to population studies to evaluate the cancer risk mutation profile in Brazil. BC , (BC) OC (OC) EC (EC pattern 38 5576 55 76 55.76 213/382 213382 213 (213/382 cancer, cancer) 4424 44 24 44.24 169/382 169382 169 (169/382 absence disease. disease . disease) age sex birth HGVS (HGVS 1 databases 5 2 VUS, VUS (VUS) benign BRCA c470471delCT cdelCT c 470 471delCT delCT c.470_471delCT c4675 4675 c.467 G T c2T cT 2T c.2T Furthermore Brazil BRCA12 BRCA1/ found nongynecological non Moreover (BC (OC 3 557 7 55.7 213/38 21338 (213/38 442 4 44.2 169/38 16938 16 (169/38 (VUS 47 c467 467 c.46 55. 213/3 2133 (213/3 44. 169/3 1693 (169/3 c46 46 c.4 213/ (213/ 169/ (169/ c4 c. (213 (169 (21 (16 (2 (1 (

Resumo Objetivo O presente estudo avaliou o perfil de mutações germinativas presentes em pacientes submetidas a aconselhamento genético para avaliação de risco para câncer de mama (CM), câncer de ovário (OC) e câncer de endométrio (CE) com possível padrão hereditário. Métodos Foram analisados os prontuários de 382 pacientes que realizaram aconselhamento genético após consentimento informado. Um total de 55,76% dos pacientes (213/382) eram sintomáticos (história pessoal de câncer), e 44,24% (169/382) eram assintomáticos (ausência da doença). As variáveis analisadas foram idade, sexo, naturalidade, história pessoal ou familiar de CM, OC, CE bem como outros tipos de câncer associados a síndromes hereditárias. As diretrizes de nomenclatura da Human Genome Variation Society (HGVS) foram usadas para nomear as variantes e seu significado biológico foi determinado pela comparação de 11 bancos de dados. Resultados Identificamos 53 mutações distintas: 29 variantes patogênicas, 13 variantes de significado indeterminado e 11 benignas. As mutações mais frequentes foram BRCA1 c.470_471delCT, BRCA1 c.4675 + 1G > T e BRCA2 c.2T > G. Além disso, 21 variantes parecem ter sido descritas pela primeira vez no Brasil. Além das mutações BRCA1/2, foram encontradas variantes em outros genes relacionados a síndromes hereditárias que predispõem a cânceres ginecológicos. Conclusão Este estudo permitiu conhecer melhor as principais mutações identificadas nas famílias do estado de Minas Gerais e demonstra a necessidade de avaliar a história familiar de câncer não ginecológico para avaliação do risco de CM, OC e CE. Além disso, é um esforço que contribui com estudos populacionais para avaliar o perfil de mutações de risco para câncer no Brasil. CM , (CM) (OC (CE hereditário 38 informado 5576 55 76 55,76 213/382 213382 213 (213/382 câncer, câncer) 4424 44 24 44,24 169/382 169382 169 (169/382 ausência doença. doença . doença) idade sexo naturalidade HGVS (HGVS 1 dados 5 distintas 2 patogênicas benignas BRCA c470471delCT cdelCT c 470 471delCT delCT c.470_471delCT c4675 4675 c.467 G c2T cT 2T disso Brasil BRCA12 BRCA1/2 ginecológicos (CM 3 557 7 55,7 213/38 21338 (213/38 442 4 44,2 169/38 16938 16 (169/38 47 c467 467 c.46 BRCA1/ 55, 213/3 2133 (213/3 44, 169/3 1693 (169/3 c46 46 c.4 213/ (213/ 169/ (169/ c4 c. (213 (169 (21 (16 (2 (1 (

ABSTRACT Plant soil covers bring many benefits to the soil, like physical, chemical and biological quality. It may behave differently if kept on the ground or if incorporated. The objective of this research was to evaluate the effect of cover crops under no-tillage and conventional tillage systems on curly lettuce production. The treatments were in a split plot: three plant coverings in the plot [lupines, black oats, 70% lupines + 30% black oats (consortium)] and in the subplots two cropping systems [no-tillage and conventional tillage (plowing and harrowing)]. The consortium of black oat + lupine in conventional planting produced more than the other treatments and lettuce yield of 69.4 t/ha. The no-tillage in the present study is in its third economic crop cycle and possibly has not yet acquired all the benefits in the soil profile. physical quality incorporated notillage no production lupines, [lupines 70 30 (consortium) plowing harrowing. harrowing . harrowing)] 694 69 4 69. tha t ha t/ha profile 7 3 (consortium harrowing) 6

RESUMO As coberturas vegetais proporcionam muitos benefícios para o solo quanto à qualidade física, química e biológica. Pode comportar-se de forma diferente se mantido no solo ou se incorporado. Assim, objetivou-se avaliar o efeito de coberturas vegetais em sistema de plantio direto e convencional na produção da alface crespa. Os tratamentos foram em parcela subdividida: três coberturas vegetais na parcela [tremoço, aveia preta, 70% de tremoço + 30% de aveia preta (consórcio)] e na subparcela dois sistemas de cultivo [plantio direto e convencional (aração e gradagem)]. O consórcio como coberturas vegetais de aveia preta + tremoço em plantio convencional produziu mais do que os outros tratamentos e apresentou produtividade de alface de 69,4 t/ha. O plantio direto no presente estudo está em seu terceiro ciclo de cultura econômica e, portanto, possivelmente ainda não tenha adquirido todos os benefícios no perfil do solo. física biológica comportarse comportar incorporado Assim objetivouse objetivou crespa subdividida tremoço, [tremoço 70 30 (consórcio) aração gradagem. gradagem . gradagem)] 694 69 4 69, tha t ha t/ha portanto 7 3 (consórcio gradagem) 6

Abstract Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far. disease IL17 IL 17 IL-1 diseases cancer rejection ILA A ILRA RA saliva additive, additive (additive dominant recessive. . recessive) rs (rs224104 C allele, allele , rs87957 rs960661 T rs224104 group rs3819025 (rs381902 rs227591 G respectively 2 0.026 0026 0 026 0.65 065 65 0.043 0043 043 0.88. 088 0.88 88 0.88) disorder. disorder disorder) rs91786 0.036 0036 036 0.67. 067 0.67 67 0.67) rs1760661 0.042 0042 042 0.47. 047 0.47 47 0.47) knowledge far IL1 1 IL- (rs22410 rs8795 rs96066 rs22410 rs381902 (rs38190 rs22759 0.02 002 02 0.6 06 6 0.04 004 04 08 0.8 8 rs9178 0.03 003 03 rs176066 0.4 4 (rs2241 rs879 rs9606 rs2241 rs38190 (rs3819 rs2275 0.0 00 0. rs917 rs17606 (rs224 rs87 rs960 rs224 rs3819 (rs381 rs227 rs91 rs1760 (rs22 rs8 rs96 rs22 rs381 (rs38 rs9 rs176 (rs2 rs2 rs38 (rs3 rs17 (rs rs3 rs1

RESUMO O objetivo deste trabalho foi avaliar quatro cepas de Trichoderma spp. (T. harzianum IBLF 006 WP, T. harzianum IBLF 006 SC, T. harzianum ESALQ 1306 e T. asperellum URM 5911) na promoção do crescimento de plântulas em laboratório e na produtividade de alface americana em campo. O delineamento experimental foi inteiramente casualizado com quatro tratamentos (cepas): IBLF 006 WP, IBLF 006 SC, ESALQ 1306 e URM 5911 e um tratamento sem inoculação com Trichoderma que foi incluído como testemunha. Cada tratamento teve 200 sementes, dispostas em quatro repetições. Para tanto, sementes de alface cv. Astra foram tratadas com 2 mL de suspensão de Trichoderma (2,5 x 108 conídios mL-1 para cada 100 g de sementes) e submetidas a teste de crescimento em laboratório até os 7 dias após o semeio. Para o experimento em campo realizou-se a abertura dos sulcos, os quais receberam 5 x 107 conídios mL-1 com auxílio de um pulverizador manual, seguido de transplantio de mudas (4 a 6 folhas) de alface americana cv. Mauren e colheita aos 40 dias após o transplantio. Cada tratamento foi composto por quatro repetições (1,2 x 1,2 m, com 16 plantas em cada parcela) dispostas em blocos casualizados. Em ambos incluiu-se uma testemunha sem aplicação de Trichoderma. Avaliou-se o comprimento da parte aérea, da raiz e total, massas fresca e seca da parte aérea, da raiz e total, razão de massa da parte aérea, razão de massa da raiz e razão parte aérea/sistema radicular. No experimento em laboratório avaliou-se o percentual de germinação, enquanto que no experimento em campo avaliou-se a altura, diâmetro do caule, diâmetro da cabeça, número de folhas e produtividade. A cepa T. harzianum ESALQ 1306 proporcionou melhor crescimento de alface americana em laboratório, o que foi confirmado em campo, cuja produtividade (50,2 t ha-1) foi superior às demais cepas (41,38 a 44,23 t ha-1) e à testemunha (30,18 t ha-1).

ABSTRACT The aim of this study was to evaluate four strains of Trichoderma spp. (T. harzianum IBLF 006 WP, T. harzianum IBLF 006 SC, T. harzianum ESALQ 1306 and T. asperellum URM 5911) for seedling growth promotion in laboratory and head lettuce yield in field conditions. The experiment was carried out in a completely randomized design with four treatments (strains): IBLF 006 WP, IBLF 006 SC, ESALQ 1306 and URM 5911 and a non-inoculated (without Trichoderma) control. Each treatment consisted of 200 seeds, arranged in four replicates. Lettuce seeds cv. Astra were treated with 2 mL Trichoderma suspension (2.5 x 108 conidia mL-1 per each 100 g seeds) and submitted to growth assay in laboratory up to 7 days after sowing. For field experiment, we opened furrows, which were manually sprayed with 5 x 107 conidia mL-1. Afterwards, seedlings were transplanted (4 to 6 leaves of head lettuce cv. Mauren) and harvested 40 days later. Each treatment consisted of four replicates (1.2 x 1.2 m, 16 plants per plot) arranged in randomized blocks. In both experiments, a control without Trichoderma application was included, and we evaluated shoot length, root and total length, shoot, root and total fresh mass and shoot, root and total dry mass, shoot mass ratio, root mass ratio and shoot/root ratio. The germination (%) was evaluated by laboratory tests, whereas in field experiment, height, stem diameter, head diameter, number of leaves and yield were evaluated. The T. harzianum strain ESALQ 1306 provided the best head lettuce growth rate in laboratory test, which was confirmed in field experiment, in which the productivity (50.2 t ha-1) was superior when compared to the other strains (41.38 to 44.23 t ha-1) and the control (30.18 t ha-1).

El objetivo del trabajo fue evaluar el efecto del uso de diferentes dietas con alto contenido de grano sobre el comportamiento ingestivo de corderos en confinamiento. Se utilizaron 32 corderos machos castrados de la raza Texel destetados con aproximadamente 50 días de edad. Los tratamientos fueron cuatro dietas en base a diferentes granos de cereales no procesados: maíz, avena blanca, avena negra y arroz con cáscara. Los corderos alimentados en base a grano de maíz mostraron menos tiempo a las actividades de rumia y masticación, dedicando más tiempo al ocio. Además de eso, estos corderos presentaron mayor consumo de materia seca (0,885 kg/día), menor eficiencia de alimentación en términos de FDN y mejor eficiencia de rumia de la MS (226,05 g MS/h) y de la FDN (33,61 g FDN/h) frente a los corderos de los otros tres tratamientos. El comportamiento ingestivo de corderos en confi namiento con el uso de dietas con alto contenido de grano basado en maíz, avena blanca, avena negra y arroz con cáscara se somete a cambios causados principalmente por el consumo voluntario de alimento y la proporción de FDN presente en las dietas experimentales.

The aim of this study was to evaluate the effect of using different high-grain diets on the feeding behavior of lambs finished in feedlot. 32 male castrated Texel breed and weaned at approximately 50 days of age lambs were used. The treatments were four diets based on different types of cereal grains, not processed, as follows: corn grain, white oat grain, black oat grain or grain of rice in the husk. Lambs fed diets with high corn grain spent less time ruminating and total chewing activity and remained longer time in idleness. Moreover, had higher dry matter intake, lower feeding efficiency in relation to NDF and better rumination efficiency of DM and NDF compared with lambs from the other three treatments. The feeding behavior of feedlot finished lambs with the use of high-grain diets based on corn, white oat, black oat or rice in the hulls suffer changes caused mainly by the voluntary feed intake and the proportion of NDF present in the experimental diets.

O objetivo desse trabalho foi avaliar o efeito do uso de diferentes dietas de alto grão sobre o comportamento ingestivo de cordeiros terminados em confinamento. Foram utilizados 32 cordeiros machos, castrados, da raça Texel e desmamados com aproximadamente 50 dias de idade. Os tratamentos foram quatro dietas baseadas em diferentes tipos de grãos de cereais, não processados, sendo: grão de milho, grão de aveia branca, grão de aveia preta ou grão de arroz com casca. Os cordeiros alimentados com dietas de alto grão de milho despenderam menor tempo em atividades de ruminação e de mastigação total e permaneceram maior tempo em ócio. Além disso, apresentaram maior consumo de matéria seca, menor eficiência de alimentação em relação à FDN e uma melhor eficiência de ruminação da MS e da FDN quando comparados com cordeiros dos outros três tratamentos. O comportamento ingestivo de cordeiros terminados em confinamento com o uso de dietas de alto grão a base de milho, aveia branca, aveia preta ou arroz com casca sofre alterações provocadas principalmente pelo consumo voluntário de alimento e pela proporção de FDN presente nas dietas experimentais.

In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.

INTRODUÇÃO: Estudos da condução nervosa têm sido focados para o público em geral, porém não para atletas, havendo carência de informações sobre medidas da velocidade de condução nervosa motora (VCNM) em indivíduos treinados, especialmente quando diferentes esportes são comparados. OBJETIVO: Medir a VCNM do nervo mediano e fibular comum, em três grupos de modalidades esportivas. Métodos: Foram analisados: um grupo de meio-fundistas (Gmf, n = 6), um grupo de velocistas (Gvel, n = 4) e um grupo de jogadores de handebol (Ghan, n = 5) e comparados com um grupo controle (Gcon, n = 9). Cada voluntário foi submetido a um único exame, no qual foram obtidos os dados para calcular a VCNM dos membros inferiores do Gmf e do Gvel, dos membros superiores do Ghan, e membros superiores e inferiores do Gcon. Os dados da pesquisa apresentaram distribuição normal e variâncias homogêneas, assim, utilizamos o teste t de Student para amostras independentes na comparação das médias da VCNM dos grupos de atletas com as do Gcon e as do Gvel com as do Gmf (comparações intergrupo). O teste t pareado foi usado para comparar as médias da VCNM entre membro dominante (Md) e membro não dominante (Mnd) (comparações intragrupo). RESULTADOS: Na análise intergrupo foram encontradas diferenças significativas nas comparações entre o Gvel e o Gcon e entre o Gmf e o Gcon (diferença apenas nas comparações entre os Md's). Por outro lado, a análise intragrupo, exibiu diferença significativa apenas nas comparações entre Md e Mnd do Ghan. CONCLUSÃO: O estudo sugere que a VCNM é beneficiada pelo esforço físico, principalmente em esportes com uso predominante dos membros inferiores, e que a maior utilização de um membro superior sobre outro pode levar a diferença significativa nos valores da VCNM do Md e Mnd.

INTRODUCTION: Electrodiagnostic tests such as nervous conduction studies are mainly aimed at the general public, not at athletes. Therefore, information about motor nervous conduction velocity (MNCV) is scarce for trained subjects, especially when different sports are compared. OBJECTIVE: to measure the MNCV of the median and common fibular nerves in three groups of sport modalities. Methods: A group of middle distance runners (M RG, n=6), a group of sprinter runners (S RG, n=4) and a group of handball players (H G, n=5) were analyzed and compared to a control group (C G, n=9). Each volunteer was submitted to a single examination where data necessary to measure MNCV from the lower limbs of M RG and of S RG; upper limbs of H G and both upper and lower limbs of C G were collected. Data analysis presented normal distribution and homogeneous variances in all cases; therefore, a Student's t test for independent samples was used to compare means of MNCV of the athlete groups and the C G, as well as in the mean comparison of S RG and M RG (intergroup comparison). The paired Student's t test was used to compare MNCV means of the dominant limb (DL) and non-dominant limb (NDL) (intragroup comparison). RESULTS: Significant differences were found in the comparison between S RG and CG and between M RG and CG, but only in the DL comparison in the last case. On the other hand, in the intragroup comparison, there was significant difference only in the comparison between D L and N DL of the H G. CONCLUSION: This study suggests that MNCV benefits from physical exercise, especially in those sports where lower limbs are predominantly used. It also suggests that greater use of one upper limb over the other could lead to significant differences in MNCV values of D L and N DL.

OBJECTIVE: Outline the clinical profile of children and adolescents (0-14 years) treated at a hospital in Fortaleza, Ceará, based on the criteria of a ACCR protocol in Pediatrics. METHODS: Documental study, with a sample of 627 reports of emergency randomly selected, processed and analyzed in SPSS 17.0. RESULTS: Most of the children proceeded from the Regional Executive Office III (65.63%), male (57.33%), aged 1 to 5 years (51.63%) and adequate weight (53.42%). There was an association between risk assessment and the specialty clinical medicine (p <0.001), with the highest percentage rating from yellow to blue in medical clinic. The prevalent complaint was fever with yellow classification. CONCLUSION: By means of risk rating, the nurse can identify the degree of clinical commitment of patients, the appropriate and exceeding demand of the institution, providing the necessary care, according to the level of complexity of each case.

OBJETIVO: Trazar el perfil clínico de niños y adolescentes (0 a 14 años) atendidos en un hospital de Fortaleza, Ceará, basándose en los criterios de un protocolo de ACCR en Pediatría. MÉTODOS: Estudio documental, con muestras de 627 boletines de atendimiento de emergencia escogidos aleatoriamente, procesados y analizados en el SPSS 17.0. RESULTADOS: Grande parte de los niños fue procedente de la Secretaría Ejecutiva Regional III (65,63%), del sexo masculino (57,33%), con edades entre 1 y 5 años (51,63%) y peso adecuado (53,42%). Hubo asociación entre la clasificación de riesgos y la especialidad clínica médica (p<0,001), con mayor porcentual de clasificación de amarilla para azul en la clínica médica. La queja prevalente fue fiebre con clasificación amarilla. CONCLUSIÓN: Por medio de la clasificación de riesgo, el enfermero puede identificar el grado de comprometimiento clínico de los pacientes, la demanda apropiada y excedente de la institución, proporcionando la atención necesaria, de acuerdo con el nivel de complejidad de cada caso.

OBJETIVO: Traçar o perfil clínico de crianças e adolescentes (0 a 14 anos) atendidos num hospital de Fortaleza, Ceará, baseando-se nos critérios de um protocolo de ACCR em Pediatria. MÉTODOS: Estudo documental, com amostra de 627 boletins de atendimento de emergência escolhidos aleatoriamente, processados e analisados no SPSS 17.0. RESULTADOS: Grande parte das crianças foi procedente da Secretaria Executiva Regional III (65,63%), do sexo masculino (57,33%), faixa etária de 1 a 5 anos (51,63%) e peso adequado (53,42%). Houve associação entre a classificação de risco e a especialidade clínica médica (p<0,001), com maior percentual de classificação de amarela para azul na clínica médica. A queixa prevalente foi febre com classificação amarela. CONCLUSÃO: Por meio da classificação de risco, o enfermeiro pode identificar o grau de comprometimento clínico dos pacientes, a demanda apropriada e excedente da instituição, proporcionando a atenção necessária, de acordo com o nível de complexidade de cada caso.

INTRODUÇÃO: A utilização do tubo valvulado é a operação clássica para a reconstrução da raiz da aorta. O objetivo deste trabalho é avaliar a reconstrução da aorta ascendente com a preservação da valva aórtica. MÉTODOS: Entre 1996 e 2008, 54 pacientes consecutivos (66,7% do sexo masculino), com idade média de 48 ± 14 anos, foram submetidos à reconstrução da aorta ascendente e preservação da valva aórtica (40 remodelamentos e 14 reimplantes). O Euroscore médio foi de 4 ± 1,25 e 29,6% eram portadores de síndrome de Marfan. O tempo médio de seguimento foi de 4,1 anos (49 dias até 10,9 anos). Foram avaliados por parâmetros clínicos e ecocardiográficos. Para a análise dos dados foram utilizados os testes t de Student pareado, o não-paramétrico de McNemar e a curva de sobrevida de Kaplan-Meyer. RESULTADOS: A mortalidade hospitalar foi de 5,6%. O tempo médio de internação foi de 9 ± 4 dias. Houve um óbito tardio não relacionado (2%). A sobrevida e sobrevida livre de reoperação nos 11 anos de seguimento foram respectivamente de 94,4% e 96%. Houve melhora da classe funcional (P=0,002) (78% CF I), redução da insuficiência aórtica (P<0,001) (78% sem ou com refluxo discreto), redução dos diâmetros sistólico e diastólico, dos volumes sistólico final e diastólico final do ventrículo esquerdo, respectivamente P=0,004; P<0,001; P=0,036 e P<0,001. Dois pacientes foram submetidos à troca de valva aórtica (3,9%) com 4 e 10 anos da operação. Não foram observados fenômenos tromboembólicos, hemorrágicos ou endocardite durante o seguimento. CONCLUSÃO: A reconstrução da raiz da aorta com a preservação da valva aórtica é uma alternativa eficaz ao uso do tubo valvulado.

INTRODUCTION: The composite mechanical valve conduit replacement is the standardized operation for aneurysms of the aortic root. The objective of this study is to evaluate the long-term surgical results of aortic valve-preserving procedures to the root reconstruction. METHODS: From 1996 to 2008, 54 consecutive patients underwent two different techniques of valve-sparing aortic root operation (40 Yacoub operations and 14 David operations). Mean age was 48 ± 14 years (range 17 to 74). 36 patients (66.7%) were male and 16 (29.6%) experienced Marfan's syndrome. The mean Euroscore was 4 ± 1.25. The mean follow up time was 4.1 years (from 49 days to 10.9 years). Clinical and echocardiographic parameters were analysed. T-Student paired test, the McNemar Non Parametric test and the Kaplan-Meyer Outcome Curves have been used. RESULTS: The hospital mortality was 5.6% and the average hospitalization time was 9±4 days. One non related late death (2%) was reported. The actuarial survival and freedom from reoperation were respectively 94.4% and 96% within 11 years of follow-up. There were benefits in reduction of functional class (P=0.002; 78% CF I), in reduction of aortic regurgitation (P<0.001; 78% with or without discrete reflux), in reduction of systolic and diastolic diameters, end-sytolic and end-diastolic volumes of left ventricle (respectively P=0.004; P<0.0001; P=0.036 and P<0.001). Two (3.9%) patients required aortic valve replacement due to severe aortic regurgitation during this same period. No thromboembolic, endocarditis or bleeding events were reported during the follow-up. CONCLUSION: The valve-sparing operation for aortic root aneurysms is an effective alternative to the use of a mechanical valve conduit replacement.

This study evaluated the antiulcer activity of an ethanolic extract of Encholirium spectabile (ES-EtOH) by using different standard experimental models of induced acute gastric ulceration. ES-EtOH (100 mg/kg p.o) protected the gastric mucosa against ulceration that was induced by absolute ethanol (53%), ethanol/HCl (75 %), ibuprofen (52 %) and ischemia/reperfusion (43 %). It also restored catalase activity and non-protein sulfhydryl group concentration in the gastric wall of mice that had been treated with ethanol. The pre-treatment of mice with N-nitro-L-arginine (70 mg/kg i.p.) abolished the protective activity of ES-EtOH, which indicates that prostaglandins, antioxidant compounds and nitric oxide synthase activity are involved in the gastroprotective activity of the extract.

JUSTIFICATIVA E OBJETIVOS: O uso de heparina de baixo peso molecular (HBPM) na profilaxia ou terapêutica de diversas doenças ou síndromes é de grande importância na prática clínica. O objetivo deste estudo foi avaliar a segurança e a eficácia da enoxaparina sódica, teste (ENOX-T) comparada ao medicamento de referência (ENOX-R). MÉTODO: Foi realizado estudo prospectivo, aleatório, comparativo, unicêntrico e aberto envolvendo pacientes com indicação de profilaxia ou tratamento antitrombótico. Foram incluídos 100 pacientes divididos em 2 braços: profilático (n = 50) e terapêutico (n = 50) divididos em 2 grupos para cada braço (grupo 1: ENOX-R e grupo 2: ENOX-T). Analisou-se em cada segmento os dados clínicos e laboratoriais. A atividade do anti-fator Xa foi aferida em três momentos: basal (1ª avaliação); 1º ou 2º dia (2ª avaliação) e 5º a 7º dia (3ª avaliação). O ultra-som Doppler dos membros inferiores foi realizado na 2ª ou 3ª avaliação do braço profilático. RESULTADOS: Os resultados demonstraram homogeneidade dos grupos nos 2 braços (profilático e terapêutico) quanto a sexo, idade, índice de massa corpórea, creatinina sérica e Apache II. Os valores do anti-fator Xa nos braços profilático e terapêutico demonstraram eficácia adequada dos medicamentos, sem diferença clínica ou estatística entre ambos. A ocorrência de eventos adversos não mostrou diferença clínica ou estatística entre os medicamentos. No braço profilático o ultra-som de membros inferiores acrescentou informações úteis sobre a eficácia dos fármacos estudados. CONCLUSÕES: A enoxaparina sódica teste (ENOX-T) foi segura e eficaz nos pacientes analisados e equivalente ao medicamento de referência (ENOX-R).

BACKGROUND AND OBJECTIVES: Use of low molecular weight heparins (LMWH), either prophylactic or therapeutic, is of most importance in several syndromes and diseases in daily clinical practice. Our objective in this clinical trial was to evaluate safety and efficacy of test sodium enoxaparin (ENOX-T) compared to the reference drug (ENOX-R). METHODS: We conducted a prospective, randomized, comparative, unicentric and open-labeled trial including patients with either prophylactic or therapeutic anti-thrombotic indications. A total of 100 patients were enrolled in two branches: prophylactic (n=50) and therapeutic (n=50) and two groups for each branch (group 1: ENOX-R and group 2: ENOX-T). We analyzed clinical and laboratory data in each segment. Anti-factor Xa was measured in three different moments: baseline (1st evaluation); 1st or 2nd day (2nd evaluation) and 5th to 7th day (3rd evaluation). Doppler-sonography of inferior limbs was performed on all patients in prophylactic group on 2nd or 3rd evaluation. RESULTS: The data showed that both branches (prophylactic and therapeutic) were homogenous in regard of sex, age, body mass index (BMI), serum creatinine and APACHE II severity score at admission. Anti-factor Xa results, in both prophylactic and therapeutic branches, showed expected efficacy to both drugs, without any clinical or statistical difference between them. Adverse events incurred in both groups in a similar way, without any clinical or statistical difference between them. In prophylactic branch, Doppler-sonography of inferior limbs added useful information on drugs efficacy. CONCLUSIONS: We conclude that test sodium enoxaparin (ENOX-T) was effective and safe in our patient's cohort and equivalent to reference drug (ENOX-R).

Evaluation of hepatic fibrosis is usually performed by histopathological examination of biopsies. However, this is an invasive and potentially dangerous procedure. Several studies have proposed serum biological markers of hepatic fibrosis. This communication evaluates the use of serum cytokines as markers of hepatic fibrosis in hepatitis C, schistosomiasis, and co-infection.