Introduction: Cholesteatoma, although relatively rare, presents significant challenges in clinical practice. Despite decades of research, its cause remains complex and elusive. Objective: This review aimed to summarize key findings on the epidemiology, pathophysiology, diagnosis and surgical management of cholesteatoma, highlighting current knowledge gaps and emerging trends in the field. Method: Narrative review carried out in the PubMed and Scielo databases. The search used the following keywords: “cholesteatoma, petros apex, minimally invasive surgical procedures”. The inclusion criteria comprised review articles, pre-clinical and clinical research published, written in Portuguese and English and available in complete text. The selected articles were analyzed based on the technologies covered, future perspectives, challenges, diseases mentioned and the central idea of the article. Result: 36 articles were included. Conclusion: Cholesteatoma is important in medical practice, despite being relatively uncommon in the general population. However, there are still doubts about its cause, but its diagnosis has been expanded through imaging tests in an attempt to reduce “second-look” operations and avoid them. Another field with constant growth is surgical treatment, since the complex anatomy requires that new techniques be managed to reduce injuries to important and vital structures in the region.

Introdução: O colesteatoma, embora relativamente raro, apresenta desafios significativos na prática clínica. Apesar de décadas de pesquisa, sua causa permanece complexa e evasiva. Objetivo: Esta revisão pretendeu resumir as principais descobertas sobre a epidemiologia, fisiopatologia, diagnóstico e manejo cirúrgico do colesteatoma, destacando lacunas de conhecimento atuais e tendências emergentes no campo. Método: Revisão narrativa realizada nas bases PubMed e Scielo. A busca utilizou as seguintes palavras-chave: “colesteatoma, ápice petros, procedimentos cirúrgicos minimamente invasivos” e suas versões ao inglês Os critérios de inclusão compreenderam artigos de revisão, pesquisas pré-clínicas e clínicas publicados, escritos em português e inglês e disponíveis em texto completo. Os artigos selecionados foram analisados com base nas tecnologias abordadas, perspectivas futuras, desafios, doenças referidas e ideia central do artigo. Resultado: Foram incluídos 36 artigos. Conclusão: O colesteatoma tem importância na prática médica, apesar de ser relativamente pouco frequente na população em geral. No entanto, ainda existem dúvidas sobre sua causa, mas seu diagnóstico tem sido ampliado atavés de exames de imagem na tentativa de redução das operações de “segundo-olhar”, evitando-as. Outro campo com crescimento constante é o tratamento cirúrgico, uma vez que a anatomia complexa exige que novas técnicas sejam manejadas para diminuir lesões de estruturas importantes e vitais da região.

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±

Abstract The impact of GnRH treatment on the day of TAI in beef cows has received limited investigation, especially concerning its association with estrus expression. Consequently, two experiments were conducted to assess the potential of GnRH treatment on the day of TAI to enhance fertility according to the expression or not of estrus in beef cows. Experiment 1 aimed to determine ovulation rate and luteal function, while Experiment 2 aimed to determine the effect of the two GnRH treatment approaches on pregnancy rate. In Experiment 1, multiparous Brangus suckling cows (n = 17) were submitted to an 8-day TAI protocol. Estrus occurrence was evaluated based on chalk removal on D10 (TAI) and cows were assigned to receive GnRH (25µg lecirelin; im) according to the group: GnRH (n = 7), regardless of estrus expression; or selectGnRH (n = 10), only cows not detected in estrus. Ovulation rate occurring until 77h after IVD removal did not differ (p = 0.17) between GnRH (85.7%; 6/7) and selectGnRH (100%; 10/10). Also, corpus luteum size and serum progesterone concentration were not affected (p>0.05) by treatments. In Experiment 2, crossbred taurine suckled cows (n = 384) were submitted to the same protocol as described in Experiment 1 and were randomly allocated to GnRH or selectGnRH groups. There was no difference in P/AI between groups (selectGnRH = 55.6%; GnRH = 54.3%; p = 0.7) 30 days after TAI. As expected, there was a pronounced effect (p<0.0001) of estrus expression on P/AI (Estrus = 61.5%; No estrus = 33.0%), regardless of group. In summary, ovulation timing and rate and luteal function did not differ between groups. Also, GnRH administration only in cows that do not show estrus is recommended, considering hormone savings and similar conception rate. investigation Consequently n 17 8day 8 D D1 (TAI 25µg µg lecirelin im group 7, 7 , 7) 10, 10 10) h 0.17 017 0 85.7% 857 85 (85.7% 6/7 67 6 100% 100 (100% 10/10. 1010 10/10 . 10/10) Also p>0.05 p005 05 (p>0.05 treatments 384 PAI P AI 55.6% 556 55 54.3% 543 54 3 0.7 07 expected p<0.0001 p00001 0001 (p<0.0001 61.5% 615 61 5 33.0%, 330 33.0% 33 33.0%) summary recommended 0.1 01 85.7 (85.7 6/ (100 101 10/1 p>0.0 p00 (p>0.0 38 55.6 54.3 0. p<0.000 p0000 000 (p<0.000 61.5 33.0 85. (85. (10 10/ p>0. p0 (p>0. 55. 54. p<0.00 p000 00 (p<0.00 61. 33. (85 (1 p>0 (p>0 p<0.0 (p<0.0 (8 ( p> (p> p<0. (p<0. p<0 (p<0 p< (p<

ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5

Abstract Background A cost of illness (COI) study aims to evaluate the socioeconomic burden that an illness imposes on society as a whole. This study aimed to describe the resources used, patterns of care, direct cost, and loss of productivity due to systemic lupus erythematosus (SLE) in Brazil. Methods This 12-month, cross-sectional, COI study of patients with SLE (ACR 1997 Classification Criteria) collected data using patient interviews (questionnaires) and medical records, covering: SLE profile, resources used, morbidities, quality of life (12-Item Short Form Survey, SF-12), and loss of productivity. Patients were excluded if they were retired or on sick leave for another illness. Direct resources included health-related (consultations, tests, medications, hospitalization) or non-health-related (transportation, home adaptation, expenditure on caregivers) hospital resources. Costs were calculated using the unit value of each resource and the quantity consumed. A gamma regression model explored cost predictors for patients with SLE. Results Overall, 300 patients with SLE were included (92.3% female, mean [standard deviation (SD)] disease duration 11.8 [7.9] years), of which 100 patients (33.3%) were on SLE-related sick leave and 46 patients (15.3%) had stopped schooling. Mean (SD) travel time from home to a care facility was 4.4 (12.6) hours. Antimalarials were the most commonly used drugs (222 [74.0%]). A negative correlation was observed between SF-12 physical component and SLE Disease Activity Index (- 0.117, p = 0.042), Systemic Lupus International CollaboratingClinics/AmericanCollegeofRheumatology Damage Index (- 0.115, p = 0.046), medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific drugs/day (- 0.113, p = 0.051), and lost productivity (- 0.570, p < 0.001). For the mental component, a negative correlation was observed with medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific medications/day (- 0.113, p = 0.051), and missed appointments (- 0.232, p < 0.001). Mean total SLE cost was US$3,123.53/patient/year (median [interquartile range (IQR)] US$1,618.51 [$678.66, $4,601.29]). Main expenditure was medication, with a median (IQR) cost of US$910.62 ($460, $4,033.51). Mycophenolate increased costs by 3.664 times (p < 0.001), and inflammatory monitoring (erythrocyte sedimentation rate or C-reactive protein) reduced expenditure by 0.381 times (p < 0.001). Conclusion These results allowed access to care patterns, the median cost for patients with SLE in Brazil, and the differences across regions driven by biological, social, and behavioral factors. The cost of SLE provides an updated setting to support the decision-making process across the country. (COI whole (SLE Brazil 12month, 12month month 12 month, 12-month crosssectional, crosssectional cross sectional, sectional cross-sectional ACR 199 Criteria questionnaires (questionnaires records covering profile morbidities 12Item Item Survey SF12, SF12 SF , SF-12) healthrelated health related consultations, consultations (consultations tests medications hospitalization nonhealthrelated non transportation, transportation (transportation adaptation caregivers consumed Overall 30 92.3% 923 92 3 (92.3 female standard SD 118 11 8 11. 7.9 79 7 9 [7.9 years, years years) 10 33.3% 333 33 (33.3% SLErelated 4 15.3% 153 15 (15.3% schooling (SD 44 4. 12.6 126 6 (12.6 hours 222 (22 74.0%. 740 74.0% . 74 0 [74.0%]) SF-1 ( 0117 117 0.117 0.042, 0042 0.042 042 0.042) CollaboratingClinicsAmericanCollegeofRheumatology CollaboratingClinics AmericanCollegeofRheumatology 0115 115 0.115 0.046, 0046 0.046 046 0.046) medicationsday day comorbidities co 0272 272 0.272 0.001, 0001 0.001 001 0.001) SLEspecific specific drugsday 0113 113 0.113 0.051, 0051 0.051 051 0.051) 0570 570 0.570 0.001. 0232 232 0.232 US312353patientyear USpatientyear US 123 53 year interquartile IQR US161851 1 618 51 US$1,618.5 $678.66, 67866 678 66 [$678.66 $4,601.29. 460129 $4,601.29 601 29 $4,601.29]) medication (IQR US91062 910 62 US$910.6 $460, 460 ($460 $4,033.51. 403351 $4,033.51 033 $4,033.51) 3664 664 3.66 erythrocyte Creactive C reactive protein 0381 381 0.38 biological social factors decisionmaking decision making country 19 SF1 92.3 (92. 7. [7. 33.3 (33.3 15.3 (15.3 12. (12. 22 (2 74.0 [74.0%] SF- 011 0.11 004 0.04 04 027 27 0.27 000 0.00 00 005 0.05 05 057 57 0.57 023 23 0.23 patientyear 5 US16185 61 US$1,618. $678.66 6786 67 [$678.6 46012 $4,601.2 60 2 $4,601.29] US9106 91 US$910. $460 ($46 40335 $4,033.5 03 366 3.6 038 38 0.3 92. (92 [7 33. (33. 15. (15. (12 74. [74.0% 01 0.1 0.0 02 0.2 0.5 US1618 US$1,618 $678.6 [$678. 4601 $4,601. US910 US$910 $46 ($4 4033 $4,033. 36 3. 0. (9 [ (33 (15 (1 [74.0 US161 US$1,61 $678. [$678 $4,601 US91 US$91 $4 ($ 403 $4,033 (3 [74. US16 US$1,6 $678 [$67 $4,60 US9 US$9 $ 40 $4,03 [74 US1 US$1, $67 [$6 $4,6 US$ $4,0 US$1 $6 [$ $4,

ABSTRACT The genus Psidium is recognized for its economic value and the species that produce essential oils with notable biological activities. This study investigated the characteristics of the essential oil from the leaves of Psidium myrtoides and Psidium cattleyanum under different drying temperatures. We aimed to understand how drying temperatures affect the yield and composition of the essential oil, as well as its biological activity. The oils obtained from the leaves of P. myrtoides and P. cattleyanum dried in an oven at 40°C showed the highest yields (0.86% and 1.07%, respectively). β-caryophyllene was the major compound in all essential oils of P. myrtoides and P. cattleyanum, except in the oil extracted from P. myrtoides leaves dried at room temperature, where the major compound was α-bisabolol (14.46%). Different phytotoxic effects were observed using the emulsion of these oils in bioassays with Lactuca sativa and Sorghum bicolor, which were associated with the chemical composition and synergy of the identified compounds. The essential oil emulsion from leaves dried at room temperature of both species showed greater phytotoxic activity in the bioassays. Thus, optimizing drying conditions to maximize yield and synergy of compounds from the essential oils of P. myrtoides and P. cattleyanum is an important step in developing environmentally friendly natural agrochemicals. activities P 40C C 40 0.86% 086 0 86 (0.86 107 1 07 1.07% respectively. respectively . respectively) βcaryophyllene β caryophyllene αbisabolol α bisabolol 14.46%. 1446 14.46% 14 46 (14.46%) bicolor Thus agrochemicals 4 0.86 08 8 (0.8 10 1.07 144 14.46 (14.46% 0.8 (0. 1.0 14.4 (14.46 0. (0 1. 14. (14.4 ( (14. (14 (1

RESUMO O gênero Psidium é reconhecido pelo seu valor econômico e por suas espécies produtoras de óleos essenciais, com notáveis atividades biológicas. Este estudo investigou as características do óleo essencial das folhas de Psidium myrtoides e Psidium cattleyanum sob diferentes temperaturas de secagem. O objetivo foi entender como as temperaturas de secagem afetam o rendimento e a composição do óleo essencial, além de sua atividade biológica, utilizando bioensaios com Lactuca sativa e Sorghum bicolor para avaliar os efeitos fitotóxicos. Os óleos obtidos das folhas de P. myrtoides e P. cattleyanum secas em estufa a 40°C apresentaram os maiores rendimentos, sendo 0,86% e 1,07%, respectivamente. O β-cariofileno foi o composto majoritário com maior área relativa em todos os óleos essenciais de P. myrtoides e P. cattleyanum, exceto, no óleo extraído de folhas secas em temperatura ambiente de P. myrtoides, cujo composto majoritário foi o alfa-bisabolol (14,46%). Assim como a alteração do perfil químico dos óleos essenciais, houve diferentes efeitos fitotóxicos utilizando a emulsão desses óleos. Esses efeitos, foram associados a composição química e a sinergia destes compostos. A emulsão de óleo essencial de folhas secas à temperatura ambiente de ambas as espécies mostrou maior atividade fitotóxica nos bioensaios. Assim, a otimização das condições de secagem para maximizar o rendimento e a sinergia dos compostos dos óleos essenciais de P. myrtoides e P. cattleyanum é um passo importante no desenvolvimento de agroquímicos naturais e sustentáveis. biológicas biológica P 40C C 40 rendimentos 086 0 86 0,86 107 1 07 1,07% respectivamente βcariofileno β cariofileno exceto alfabisabolol alfa bisabolol 14,46%. 1446 14,46% . 14 46 (14,46%) sustentáveis 4 08 8 0,8 10 1,07 144 14,46 (14,46% 0, 1,0 14,4 (14,46 1, 14, (14,4 (14, (14 (1 (

ABSTRACT Objectives: To evaluate the impact of COVID-19 pandemics on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents after 1 year of socio-economic restrictions. Materials and Methods: An electronic survey was e-mailed to all postgraduate (PG) students registered by the Brazilian Society of Urology. The survey included an assessment of socio-demographic, clinical practice, educational, health-related and behavior parameters. We also evaluated which subareas of urology were predominantly affected. A similar survey was adapted and sent to the directors of all urology residency programs. Results: COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. Urology residents reported >50% decrease in multiple surgical modalities. We highlight kidney transplantation surgeries (66.2%), minor surgeries (62.3%), endoscopic surgeries (42.6%) and reconstructive surgeries (38.8%). This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. Furthermore, PG students faced stressful situations that caused worsening of mental and physical health, such as getting redirected to assistance of COVID-19 patients (66.9%), and high rate of infection by SARS-CoV-2 (58.2%). Conclusions: The COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. PG students faced stressful situations that caused worsening of mental and physical health such as redirection to assistance of COVID-19 patients, concern about their own contamination and of family members. Objectives COVID19 COVID 19 COVID-1 practice socioeconomic socio economic restrictions Methods emailed e mailed (PG sociodemographic, sociodemographic demographic, demographic socio-demographic healthrelated related parameters affected programs Results Brazil 50 >50 modalities 66.2%, 662 66.2% , 66 2 (66.2%) 62.3%, 623 62.3% 62 3 (62.3%) 42.6% 426 42 6 (42.6% 38.8%. 388 38.8% . 38 8 (38.8%) Furthermore 66.9%, 669 66.9% 9 (66.9%) SARSCoV2 SARSCoV SARS CoV SARS-CoV- 58.2%. 582 58.2% 58 (58.2%) Conclusions members COVID1 COVID- 5 >5 66.2 (66.2% 62.3 (62.3% 42.6 4 (42.6 38.8 (38.8% 66.9 (66.9% SARS-CoV 58.2 (58.2% > 66. (66.2 62. (62.3 42. (42. 38. (38.8 (66.9 58. (58.2 (66. (62. (42 (38. (58. (66 (62 (4 (38 (58 (6 ( (3 (5

ABSTRACT The essential oil of Piper amalago L. is recognized for its bioactive compounds with phytotoxic potential against invasive plants. However, little is known about the role of seasonal variation in the action of these compounds. This study aimed to investigate the impact of dry and rainy seasons on the chemical composition, phytotoxic, and cytogenotoxic activity of P. amalago essential oil. Analysis of the chemical composition revealed qualitative and quantitative variations, highlighting β-elemene, germacrene A, linalool, and β-caryophyllene as major compounds. The essential oil from the rainy season showed higher yield compared to that of the dry season. In pre-emergence tests against Bidens pilosa (invasive plant) and Lactuca sativa (non-target plant), negative effects on germination and root and shoot growth were observed, with these effects being more pronounced at higher concentrations, resembling the herbicide glyphosate. The essential oil from the dry season exhibited greater phytotoxic activity on the germination and development of the aerial part of B. pilosa, associated with higher concentrations of linalool and caryophyllene oxide. Additionally, the essential oils of P. amalago induced changes in the mitotic index and aneugenic alterations in L. sativa meristematic cells. These results underscore the bioherbicidal potential of P. amalago essential oil, highlighting its greater efficacy against B. pilosa during the dry season, possibly due to higher levels of linalool and caryophyllene oxide. L plants However P variations βelemene, βelemene β elemene, elemene β-elemene A βcaryophyllene preemergence pre emergence plant nontarget non target plant, , observed glyphosate B oxide Additionally cells

Abstract The Santos Basin (SB) is the main petroliferous basin in the Brazilian continental margin and one of the most studied marine areas in Brazil. However, historical data suggest that new efforts should be carried out to acquire quantitative biological data, especially in the deep sea, to establish the baseline of essential ocean variables in different ecosystems for future monitoring programs. The Brazilian energy company Petrobras planned and executed 24 oceanographic cruises over a period of 2 years to assess the benthic (SANSED cruise) and pelagic (SANAGU cruise) systems of the SB (356 days at sea in 2019 and 2021/2022). These efforts were part of the Santos Project, which comprised a comprehensive environmental study aimed at investigating benthic and pelagic variables to characterize ecology, biogeochemistry, thermohaline properties of water masses, and ocean circulation patterns, geomorphology, and sedimentology, as well as organic and inorganic chemistry. Here we present the detailed sampling designs and the field methods employed on board, during the SB scientific cruises. All sampling protocols were based on standardized approaches. For the benthos analyses, triplicate sediment samples were performed using a GOMEX-type box corer (0.25 m²) or a large modified Van Veen grab (0.75 m²) at 100 stations ranging from 25 to 2400 m depth. At each station, 25 geochemical and physico-chemical parameters were analyzed in addition to micro-, meio-, and macrofauna and living foraminifera samples. For the pelagic system, 60 stations were selected to investigate the plankton community, ranging in size from pico- to macroplankton, through vertical, horizontal, and oblique net hauls (20, 200, and 500 μm mesh size), as well as 25 biogeochemical parameters collected with an aid of a CTD-rosette sampler. Part of this scientific information also serves the Regional Environmental Characterization Project (PCR-BS) in support of Petrobras’ Santos Basin drilling licensing process led by the Brazilian Environmental Agency – IBAMA. This project contributes to the sustainable development of the SB, in line with the guidelines of the United Nations Decade of Ocean Science for Sustainable Development. (SB Brazil However programs SANSED cruise SANAGU 356 (35 201 2021/2022. 20212022 2021/2022 . 2021 2022 2021/2022) ecology biogeochemistry masses patterns geomorphology sedimentology chemistry board approaches analyses GOMEXtype GOMEX type 0.25 025 0 (0.2 m² 0.75 075 75 (0.7 10 240 depth station physicochemical physico chemical micro, micro , micro- meio, meio meio- system 6 community pico macroplankton vertical horizontal 20, 20 (20 200 50 size, size) CTDrosette CTD rosette sampler PCRBS PCR BS (PCR-BS IBAMA Development 35 (3 2021202 2021/202 202 0.2 02 (0. 0.7 07 7 1 (2 5 3 ( 202120 2021/20 0. (0 20212 2021/2 2021/

Resumen Los procesos erosivos tienen graves impactos sobre el ambiente, generando importantes pérdidas económicas, sociales y de biodiversidad. Este trabajo tiene como objetivo analizar la fragilidad ambiental asociada a los procesos erosivos en la cuenca del arroyo La Onça, en Coxim, Mato Grosso do Sul-Brasil. La metodologia se sustenta en la cartografia de los suelos, la inclinación de las pendientes, las áreas prioritarias para la conservación de la biodiversidad y la intensidad de la lluvia, con vistas a evaluar la fragilidad potencial que, unida al mapa del uso y cobertura de la tierra por la superposición booleana ponderada, permite obtener la fragilidad ambiental. Para validar este modelo se realizó la identificación de los sitios con erosión, a partir de una imagen de alta resolución y el levantamiento de las áreas llamadas "suelos con exposición extrema" mediante la identificación de áreas que presentan el menor grado de protección del suelo. Los resultados muestran el predominio en la cuenca de las zonas con fragilidad ambiental media (59,61 %) y alta (23,66 %), asociada a una gran concentración de los procesos erosivos en áreas de baja cobertura vegetal, identificadas en el mapa de uso y cobertura de la tierra como áreas de pastos. Ideas destacadas: Articulo de investigación que tiene como premisa el análisis de la fragilidad ambiental asociada a los procesos erosivos dentro de la cuenca del arroyo La Onça (Coxim-Ms). Se utilizaron geotecnologias para el análisis sistémico, estableciendo medidas dirigidas a ayudar en la toma de decisiones para el manejo y conservación del área.

Resumo Os processos erosivos ocasionam severos impactos ao ambiente, gerando perdas económicas, sociais e de biodiversidade. Este trabalho analisa a fragilidade do ambiente a processos erosivos na bacia hidrográfica do córrego da Onça, em Coxim-MS. A metodologia se fundamentou em mapeamentos de solos, declividade, áreas prioritárias à conservação da biodiversidade e na intensidade pluviomètrica para avaliar a fragilidade potencial e no mapeamento de uso e cobertura da terra que, por meio de sobreposição booleana ponderada resultou um mapeamento da fragilidade ambiental. Para validar esse modelo, foram identificados, pontualmente, as feições erosivas a partir de uma imagem de alta resolução e também um levantamento, com enfoque nas áreas nominadas de "solos com exposição extrema", que teve como objetivo a identificação de áreas que apresentam o menor grau de proteção/cobertura do solo. Os resultados apontaram o predominio de média (59,61 %) e alta (23,66 %), associadas a grandes concentrações de processos erosivos em área de "solo com exposição extrema", áreas de baixa cobertura vegetal, classificadas no uso e cobertura da terra com as classes de pastagem. Ideias destacadas: Artigo de investigação que tem como premissa a análise da fragilidade ambiental associada aos processos erosivos na bacia do córrego da Onça (Coxim-MS), empregando-se as geotecnologias para a análise sistêmica do ambiente, estabelecendo medidas propositivas, que auxiliem na tomada de decisões para o manejo e conservação da área.

Abstract Erosive processes cause severe impacts on the environment, causing economic, social, and biodiversity losses. This paper aims to analyze the fragility of the environment to erosive processes in the Onça river basin, in Coxim-MS. The methodology was based on soil mapping, slope, priority areas for biodiversity conservation, and rainfall intensity to evaluate the potential fragility and land use and land cover, that by means of a boolean weighted overlap with the potential fragility resulted in the mapping of the environmental fragility. To validate the environmental fragility model, the erosive features were identified from a high-resolution image and a making, focusing on the areas named "soils with extreme exposure" from a classification, which had as its only aim to identify areas with the lowest degree of protection/ground cover. The results pointed to the predominance of medium (59.61 %) and high (23.66 %) environmental fragility, associated with high concentrations of erosive processes in "soil with extreme exposure" area, which are areas of low vegetation cover, classified by use. and land cover with the pasture classes. Main ideas: Research article that has as premise the analysis of environmental fragility to erosive processes within the watershed of the Onça stream (Coxim-MS), using geotechnologies for the systemic analysis of the environment, establishing propositional measures that assist in taking decisions for the management and conservation of the area.

Resumo Introdução: A tuberculose (TB) é uma possível complicação grave do transplante de órgãos sólidos, associada à alta mortalidade e morbidade. A TB pós-transplante tem patogênese variada com muitas abordagens para sua prevenção, que é a forma mais importante de reduzir sua incidência. O tratamento da TB em receptores de órgãos é um desafio devido à toxicidade dos medicamentos e à interação com imunossupressores. Relato de caso: uma mulher de 18 anos que foi submetida a transplante renal de um doador falecido e recebeu alta com função renal adequada foi readmitida no 37º dia de pós-operatório com febre. A TC mostrou sinais de TB miliar e coleção de fluidos além de fistulização do enxerto através da pele. A paciente apresentou BAAR positivo no fluido drenado e bacilo de Koch na urina. Ela foi tratada com um esquema de quatro medicamentos (rifampicina, isoniazida, pirazinamida e etambutol), com ótima resposta e função de enxerto preservada. Fomos informados de que o receptor do rim contralateral também apresentou TB pós-transplante, implicando em uma origem derivada do doador. Conclusão: A TB é um importante diagnóstico diferencial para complicações infecciosas em pacientes após transplante de órgãos sólidos, especialmente em regiões endêmicas. Sua apresentação clínica inicial pode não ser específica e deve ser suspeitada na presença de febre ou formação de coleções de fluidos. A suspeita de TB é a chave para o diagnóstico precoce e desfechos satisfatórios na TB pós-transplante.

Abstract Introduction: Tuberculosis (TB) is a possible serious complication of solid organ transplantation, associated with high mortality and morbidity. Post-transplant TB has varied pathogenesis with many approaches to its prevention, which is the most important way to reduce its incidence. Treatment of TB in organ recipients is challenging because of drug toxicity and interaction with immunosuppressants. Case report: an 18-year-old woman that underwent kidney transplantation from a deceased donor and was discharged with fair renal function was readmitted at 37th postoperative day with fever. CT showed signs of miliary TB and fluid collection besides graft fistulization through the skin. The patient presented positive BAAR in the drained fluid and Koch's bacillus in the urine. She was treated with a four-drug regimen (rifampicin, isoniazid, pyrazinamide, and etambutol), with great response and preserved graft function. We were informed that the recipient of the contralateral kidney also presented post-transplant TB, implying in a donor-derived origin. Conclusion: TB is an important differential diagnosis for infectious complications in patients after solid-organ transplantation, especially in endemic regions. Its initial clinical presentation can be unspecific and it should be suspected in the presence of fever or formation of fluid collections. The suspicion of TB is the key to early diagnosis and satisfactory outcomes in post-transplant TB.

Resumen Este estudio es parte de una investigación cualitativa, cuyo objetivo es analizar la formación de identidad política en tres generaciones de mujeres de la comunidad quilombola Cajá dos Negros, ubicada en el área rural de la ciudad de Batalha - AL. Los participantes de la investigación fueron tres residentes de la comunidad (18 años, 26 años, mujer adulta y 60 años), que experimentaron luchas y confrontaciones con el sistema de dominación y la búsqueda de la ruptura de las estructuras sociales racistas y sexistas en sus trayectorias. Para la producción de información, utilizamos la observación participante, los diarios de campo y las entrevistas semiestructuradas como instrumentos. El análisis de las narrativas y observaciones registradas comenzó desde el método de análisis de contenido, a través de la profundización del preanálisis, la exploración del material, en el que se construyeron dos categorías temáticas: la identidad política de Quilombola en la formación subjetiva de las mujeres negras y la expresión de la identidad política en diferentes generaciones. Como un espacio comunitario fortalecido, las mujeres presentadas en el estudio son vecinas, amigas de la vida y compañeras en la lucha, características que permiten el desbloqueo político en la afirmación de una identidad colectiva, negra y ancestral. Los análisis apuntan a los matices de las elaboradas producciones de identidad, que son renovadas por cada generación, con características únicas para cada una de ellas, pero que aún mantienen elaboraciones de pertenencia, lucha y transformación de sus vidas y la comunidad. cualitativa Negros AL 18 (1 años 2 6 , años) trayectorias información participante instrumentos contenido preanálisis material temáticas fortalecido vecinas colectiva ancestral generación ellas pertenencia 1 (

Abstract This study is part of a qualitative research aiming to analyze the political identity formation along three generations of women from the Cajá dos Negros quilombola community, located in the rural area of the municipality of Batalha, state of Alagoas. The research participants were three residents of the community (18-year-old, 26-year-old adult, and 60-year-old woman), who experienced struggles and confrontations with the system of domination and the search for the rupture of racist and sexist social structures in their trajectories. To produce information, we used participant observation, field diaries, and semi-structured interviews as instruments. The analysis of the registered narratives and observations were based on the content analysis method, by deepening the pre-analysis, exploring the material, in which two thematic categories were constructed: the quilombola political identity in the subjective formation of black women and the expression of political identity in different generations. As a strengthened community space, the women focused on in the study are neighbors, lifelong friends, and companions in the struggle, features that enable the political unlocking in affirming a collective, black, and ancestral identity. The analyses point to the nuances of the elaborated identity productions, which are renewed by each generation, with unique characteristics to each one of them, but which still maintain elaborations of belonging, struggle, and transformation of their lives and of the community. Batalha Alagoas 18yearold, 18yearold yearold 18 year old, old (18-year-old 26yearold 26 adult 60yearold 60 woman, woman , woman) trajectories information observation diaries semistructured semi structured instruments method preanalysis, preanalysis pre analysis, pre-analysis material constructed space neighbors friends struggle collective productions generation them belonging 1 2 6

Resumo Este estudo parte de uma pesquisa de cunho qualitativo, objetivando analisar a formação da identidade política ao longo de três gerações de mulheres da comunidade quilombola Cajá dos Negros, situada na zona rural da cidade de Batalha, Alagoas. As participantes da pesquisa foram três moradoras da comunidade (jovem de 18 anos, adulta de 26 anos e uma idosa de 60 anos), que apresentaram, em suas trajetórias, vivências de lutas e enfrentamentos ao sistema de dominação e de busca pelo rompimento de estruturas sociais racistas e sexistas. Para a produção das informações, foram utilizados, como instrumentos, a observação participante, os diários de campo e as entrevistas semiestruturadas. A análise das narrativas e observações registradas foram amparadas no método de análise de conteúdo, mediante o aprofundamento da pré-análise, exploração do material, quando foram construídas duas categorias temáticas: a identidade política quilombola na formação subjetiva de mulheres negras e a expressão da identidade política nas diferentes gerações. Como um espaço comunitário fortalecido, as mulheres focalizadas no estudo são vizinhas, amigas de vida e companheiras de luta, feições que possibilitam os destraves políticos na afirmação de uma identidade coletiva, negra e ancestral. As análises apontam as nuances das produções identitárias elaboradas, as quais se renovam a cada geração, com características singulares a cada uma delas, mas que mantêm em si elaborações de pertencimento, luta e transformação de suas vidas e da comunidade. qualitativo Negros Batalha Alagoas jovem 1 2 6 , anos) apresentaram trajetórias sexistas informações utilizados instrumentos participante semiestruturadas conteúdo préanálise, préanálise pré análise, pré-análise material temáticas fortalecido vizinhas coletiva ancestral elaboradas geração delas pertencimento

ABSTRACT Background and aims: Treatment of hepatitis C with direct antiviral agents (DAA) is associated with almost 95% of sustained virological response. However, some patients need retreatment. In Brazil, it should be done according to the Ministry of Health guidelines, frequently updated to include newly available drugs. This study aimed to conduct a national survey about the characteristics and outcomes of retreatment of hepatitis C in previously non-responders to DAAs. Patients and methods: Institutions from all over the country were invited to participate in a national registry for retreatment, including information about clinical and epidemiological characteristics of the patients, type and outcomes of retreatment regimens. Only patients previously treated with interferon-free regimens were included. Results: As previous treatments the distribution was: SOF/DCV (56%), SOF/SIM (22%), 3D (11%), SOF/LED (6%) and SOF/RBV (5%). For retreatment the most frequently used drugs were SOF/GP (46%), SOF/DCV (23%) and SOF/VEL (11%). From 159 patients retreated, 132/159 (83%) had complete information in the registry and among them only seven patients were non-responders (SVR of 94.6%). All retreatments were well tolerated, without any serious adverse events or interruptions. Conclusion: The retreatment of patients previously non-responders to DAAs was associated with high rate of SVR in this sample of Brazilian patients. This finding allows us to conclude that the retreatment options available in the public health system in Brazil are effective and safe and are an important component of the strategy of elimination of hepatitis C in our country.