Abstract Objective: To develop growth charts for weight-for-age, height-for-age, and body mass index (BMI)-for-age for both genders aged 2 to 18 years for Brazilian patients with Williams-Beuren Syndrome (WBS). Methods: This is a multicenter, retrospective, and longitudinal study, data were collected from the medical records of boys and girls with a confirmed diagnosis of WBS in three large university centers in the state of Sao Paulo, Brazil. Growth charts stratified by gender and age in years were developed using LMSchartmaker Pro software. The LMS (Lambda Mu Sigma) method was used to model the charts. The quality of the settings was checked by worm plots. Results: The first Brazilian growth charts for weight-for-age, height-for-age, and BMI-for-age stratified by gender were constructed for WBS patients aged 2 to 18 years. Conclusion: The growth charts developed in this study can help to guide family members and to improve the health care offered by health professionals. Objective weightforage, weightforage weight age, weight-for-age heightforage, heightforage height height-for-age BMIforage BMI 1 WilliamsBeuren Williams Beuren WBS. . (WBS) Methods multicenter retrospective Paulo Brazil software Lambda Sigma plots Results Conclusion professionals (WBS

RESUMEN En este artículo se describen las principales características de la temporada invernal 2022-2023 en Cuba. Para la conformación del mismo se utilizaron los resúmenes que cada Centro Meteorológico Provincial tras el paso de los frentes fríos por las provincias del país. Además, se utilizaron los Estados Generales del Tiempo realizados por el Centro de Pronósticos del Instituto de Meteorología, así como los datos cronológicos sobre los frentes fríos del archivo que también lleva a cabo este centro. La temporada invernal 2022-2023 se inició el día 19 de octubre de 2022, con la llegada a Cuba del primer frente frío y se extendió hasta el 30 de abril de 2023, día en que afectó el FF No. 15 y último de esta temporada invernal. La misma fue clasificada como poco activa con relación al valor climático (19 FF por temporada), encontrándose en ella 10 frente fríos que fueron clasificados como clásicos, 2 revesinos y uno secundario por su tipo. En cuanto a la intensidad, 13 frentes fríos fueron débiles y 2 moderados, sin presentarse ningún frente frío fuerte en esta temporada. Además, solo dos de los frentes fríos de la temporada afectaron todo el territorio nacional, encontrándose que el 60 % de estos sistemas invernales se disiparon en la región central.

ABSTRACT This article describes the esential characteristics of the 2022-2023 winter season in Cuba. To create it, the summaries provided by each Provincial Meteorological Center after the passage of the cold fronts through the provinces of the country were used. In addition, the documents of the General Weather made by the Forecast Center of the Institute of Meteorology were used, as well as chronological data of cold fronts from the archive also belongs to this center. The 2022-2023 winter season began on October 19, 2022, with the arrival in Cuba of the first cold front and extended until April 30, 2023, the day on which the FF No 15 and last of this winter season affected. It was classified as not very active in relation to the climatic value (19 FF per season), finding 10 cold fronts that were classified as classic, 2 revesinos and one secondary due to its type. Regarding intensity, 13 cold fronts were weak and 2 moderate, without presenting any strong cold front this season. In addition, only two of the season's cold fronts affected the entire national territory, with 60% of these winter systems dissipating in the central region.

En esta investigación se estudiaron los costes de transporte por visita ambulatoria en pacientes remitidos para evaluación quirúrgica especializada en un hospital de atención terciaria en Río de Janeiro, Brasil. Es un estudio descriptivo con responsables de pacientes pediátricos programados para consulta de cirugía pediátrica, en el que se cuestionaron factores relacionados con el coste del transporte y los costes de oportunidad (pérdida de remuneración, alimentación, pago de cuidadores de otros niños, gastos de otros cuidadores). Aproximadamente la mitad de los pacientes tenían hasta 5 años de edad; cerca de 2/3 presentaban enfermedades de resolución quirúrgica simple y definitiva, 181 familias (89,17%) con renta familiar mensual de hasta BRL 1.999,00. La proporción de familias que se benefician de transporte gratuito varía entre el 4,26% y el 15,56% para los pacientes que viven hasta a 100 km del hospital (45,83% para los pacientes que viven a más de 100 km de la institución). Ciento setenta y seis (87,13%) cuidadores declaran gastos de alimentación, 12 (5,94%) pagan a los cuidadores de sus otros hijos en el día de la consulta y 80 (39,6%) declaran pérdida de salario por la jornada laboral. De los casos de alta complejidad, el 9,33% de las madres entrevistadas habían abandonado su actividad remunerada habitual. Los gastos de transporte para una consulta de cirugía pediátrica en un hospital de referencia de Río de Janeiro cuestan de media el 4,42% del salario mínimo vigente, con una media de 217,32 minutos de tiempo de viaje/consulta. Los gastos de alimentación y la pérdida de salario por ausencia en el trabajo también implican una importante carga económica o pérdida de salario para el paciente en cada cita. Brasil remuneración niños cuidadores. . cuidadores) edad 23 2 3 2/ definitiva 18 89,17% 8917 89 17 (89,17% 199900 1 999 00 1.999,00 426 4 26 4,26 1556 15 56 15,56 10 45,83% 4583 45 83 (45,83 institución. institución institución) 87,13% 8713 87 13 (87,13% 5,94% 594 94 (5,94% 8 39,6% 396 39 6 (39,6% laboral complejidad 933 9 33 9,33 habitual 442 42 4,42 vigente 21732 217 32 217,3 viajeconsulta viaje viaje/consulta cita 89,17 891 (89,17 19990 99 0 1.999,0 4,2 155 15,5 45,83 458 (45,8 87,13 871 (87,13 5,94 59 (5,94 39,6 (39,6 93 9,3 44 4,4 2173 21 217, 89,1 (89,1 1999 1.999, 4, 15, 45,8 (45, 87,1 (87,1 5,9 (5,9 39, (39, 9, 89, (89, 199 1.999 45, (45 87, (87, 5, (5, (39 (89 19 1.99 (4 (87 (5 (3 (8 1.9 ( 1.

In this study, we investigated the costs of transportation for each outpatient consultation in patients referred to specialized surgical evaluation in a tertiary hospital in Rio de Janeiro, Brazil. Descriptive study with guardians of pediatric patients scheduled for pediatric surgery, questioning transportation cost, and opportunity costs (loss of remuneration, food, payment of caregivers for other children, expenses for other companions). About half patients were aged up to five years; about two thirds had diseases of simple and definitive surgical resolution; and 181 families (89.17%) presented monthly family income up to BRL 1,999.00. The proportion of families that benefited from free transportation ranged from 4.26% to 15.56% for patients living up to 100 km away from the hospital (45.83% for patients living more than 100 km away from the institution). A total of 176 (87.13%) guardians reported expenses buying food, 12 (5.94%) paid caregivers to the other children on the day of the consultation, and 80 (39.6%) reported loss of remuneration for the working day. Among the high complexity cases, 9.33% of the mothers have given up their regular paid employment. Transportation expenses for a pediatric surgery consultation at a reference hospital in Rio de Janeiro cost about 4.42% of the current minimum wage, spending around 217.32 minutes of displacement/consultation. Expenses with food and loss of remuneration due to absence at work also entail significant financial charges or loss of remuneration for the patient at each consultation. Brazil companions. companions . companions) years resolution 18 89.17% 8917 89 17 (89.17% 199900 1 999 00 1,999.00 426 4 26 4.26 1556 15 56 15.56 10 45.83% 4583 45 83 (45.83 institution. institution institution) 87.13% 8713 87 13 (87.13% 5.94% 594 5 94 (5.94% 8 39.6% 396 39 6 (39.6% cases 933 9 33 9.33 employment 442 42 4.42 wage 21732 217 32 217.3 displacementconsultation displacement displacement/consultation 89.17 891 (89.17 19990 99 0 1,999.0 2 4.2 155 15.5 45.83 458 (45.8 87.13 871 (87.13 5.94 59 (5.94 39.6 3 (39.6 93 9.3 44 4.4 2173 21 217. 89.1 (89.1 1999 1,999. 4. 15. 45.8 (45. 87.1 (87.1 5.9 (5.9 39. (39. 9. 89. (89. 199 1,999 45. (45 87. (87. 5. (5. (39 (89 19 1,99 (4 (87 (5 (3 (8 1,9 ( 1,

Nesta pesquisa, estudamos os custos de transporte por consulta ambulatorial em pacientes referenciados para avaliação cirúrgica especializada em um hospital terciário no Rio de Janeiro, Brasil. Trata-se de um estudo descritivo com responsáveis por pacientes pediátricos agendados para consulta de cirurgia pediátrica, questionando fatores ligados ao custo de transporte e de oportunidade (perda de remuneração, alimentação, pagamento de cuidadores para outros filhos, despesas para outros acompanhantes). Aproximadamente metade dos pacientes tinham até 5 anos de idade, cerca de 2/3 apresentavam doenças de resolutividade cirúrgica simples e definitiva e 181 famílias (89,17%) contavam com renda familiar mensal de até R$ 1.999,00. A proporção de famílias beneficiadas por transporte gratuito variou entre 4,26-15,56% para pacientes morando até 100km de distância do hospital (45,83% para pacientes com residência a mais de 100km da instituição). Dos responsáveis, 176 (87,13%) relataram despesas para alimentação, 12 (5,94%) pagavam cuidadores para os outros filhos no dia da consulta e 80 (39,6%) referiram perda do pagamento do dia de trabalho. Dos casos de alta complexidade, 9,33% das mães entrevistadas abriram mão de exercer atividade remunerada regular. As despesas com transporte para uma consulta em cirurgia pediátrica em um hospital de referência do Rio de Janeiro custam em média 4,42% do salário mínimo vigente, com uma média de 217,32 minutos de deslocamento por consulta. Despesas com alimentação e perda de remuneração pela ausência no trabalho também implicam encargos financeiros ou perda de remuneração significativos para o paciente em cada consulta. pesquisa Brasil Tratase Trata se acompanhantes. acompanhantes . acompanhantes) idade 23 2 3 2/ 18 89,17% 8917 89 17 (89,17% R 199900 1 999 00 1.999,00 4,2615,56% 4261556 4,26 15,56% 4 26 15 56 4,26-15,56 km 45,83% 4583 45 83 (45,83 instituição. instituição instituição) 87,13% 8713 87 13 (87,13% 5,94% 594 94 (5,94% 8 39,6% 396 39 6 (39,6% complexidade 933 9 33 9,33 regular 442 42 4,42 vigente 21732 217 32 217,3 89,17 891 (89,17 19990 99 0 1.999,0 2615 4,2615,56 426155 426 4,2 1556 15,56 4,26-15,5 45,83 458 (45,8 87,13 871 (87,13 5,94 59 (5,94 39,6 (39,6 93 9,3 44 4,4 2173 21 217, 89,1 (89,1 1999 1.999, 261 4,2615,5 42615 4, 155 15,5 4,26-15, 45,8 (45, 87,1 (87,1 5,9 (5,9 39, (39, 9, 89, (89, 199 1.999 4,2615, 4261 15, 4,26-15 45, (45 87, (87, 5, (5, (39 (89 19 1.99 4,2615 4,26-1 (4 (87 (5 (3 (8 1.9 4,261 4,26- ( 1.

Abstract: This paper investigates how the relation of cause and effect was established for the field of Lacanian psychoanalytic studies from the 1960s, a period in which Jacques Lacan inaugurated and developed, throughout Seminars 10 and 11, important formulations about the object a. From these investigations and going through Freudian elaborations about unconscious causality, we develop the hypothesis that, for Lacanian psychoanalysis, the relation of cause and effect can be interpreted as an operation of negativization crossed by the disarticulating power of the object a. Abstract 1960s s developed 1 11 causality that psychoanalysis

Resumo: O presente trabalho investiga como se estabeleceu a relação de causa e efeito para o campo de estudos psicanalíticos de orientação lacaniana datado dos anos 1960, período em que Jacques Lacan inaugurou e desenvolveu, ao longo dos seminários 10 e 11, importantes formulações acerca do objeto a. A partir dessas investigações e perpassando as elaborações freudianas sobre a causalidade inconsciente, desenvolve-se a hipótese de que, para a psicanálise de orientação lacaniana, a relação de causa e efeito pode ser interpretada como uma operação de negativização atravessada pela potência desarticuladora do objeto a. Resumo 1960 desenvolveu 1 11 inconsciente desenvolvese desenvolve 196 19

Aim The present in vitro study aimed to evaluate the bond strength of a bulk fill composite on dentin surfaces prepared with the Er: YAG laser. Methods Twenty-four permanent third molars were selected and divided into 2 groups: CP - Conventional preparation with high-speed handpiece (control) and LA (laser) - Preparation with Er: YAG laser. The occlusal surface was removed to expose coronal dentin, which was subsequently prepared with a high-speed handpiece or Er: YAG laser (350mJ, 4Hz, 1.5 ml/min water flow). Both groups were restored with Filtek One Bulk Fill (3M ESPE) composite resin. After 24 hours, the samples were evaluated for microtensile bond strength (µTBS), fracture pattern, and scanning electron microscopy (SEM). Results The data obtained in the µTBS test were submitted to t-test (α=0.05). The results showed no difference in µTBS when the different types of cavity preparation were compared (ρ=0.091). Fracture patterns revealed the prevalence of cohesive fracture in composite resin in CP (83.3%) and adhesive fracture in LA (92.1%). In the SEM analysis, the LA group demonstrated the presence of gaps between the composite resin and the irradiated dentin surface. The hybrid layer exhibited more regularity with the presence of longer and uniform resin tags in the CP group. Conclusion The type of cavity preparation did not influence the values of bulk fill composite resin µTBS to dentin. Fracture patterns and scanning electron microscopy analyses suggested less interference at the adhesive interface in preparations performed using CP. Er Twentyfour Twenty four highspeed high speed control (control (laser 350mJ, 350mJ mJ (350mJ 4Hz Hz 15 1 5 1. mlmin ml min flow. flow . flow) 3M M ESPE hours µTBS, , (µTBS) pattern SEM. (SEM) ttest t α=0.05. α005 α α=0.05 0 05 (α=0.05) ρ=0.091. ρ0091 ρ ρ=0.091 091 (ρ=0.091) 83.3% 833 83 3 (83.3% 92.1%. 921 92.1% 92 (92.1%) analysis (µTBS (SEM α00 α=0.0 (α=0.05 ρ009 ρ=0.09 09 (ρ=0.091 83.3 8 (83.3 92.1 9 (92.1% α0 α=0. (α=0.0 ρ00 ρ=0.0 (ρ=0.09 83. (83. 92. (92.1 α=0 (α=0. ρ0 ρ=0. (ρ=0.0 (83 (92. α= (α=0 ρ=0 (ρ=0. (8 (92 (α= ρ= (ρ=0 ( (9 (α (ρ= (ρ

Nesta pesquisa, estudamos os custos de transporte por consulta ambulatorial em pacientes referenciados para avaliação cirúrgica especializada em um hospital terciário no Rio de Janeiro, Brasil. Trata-se de um estudo descritivo com responsáveis por pacientes pediátricos agendados para consulta de cirurgia pediátrica, questionando fatores ligados ao custo de transporte e de oportunidade (perda de remuneração, alimentação, pagamento de cuidadores para outros filhos, despesas para outros acompanhantes). Aproximadamente metade dos pacientes tinham até 5 anos de idade, cerca de 2/3 apresentavam doenças de resolutividade cirúrgica simples e definitiva e 181 famílias (89,17%) contavam com renda familiar mensal de até R$ 1.999,00. A proporção de famílias beneficiadas por transporte gratuito variou entre 4,26-15,56% para pacientes morando até 100km de distância do hospital (45,83% para pacientes com residência a mais de 100km da instituição). Dos responsáveis, 176 (87,13%) relataram despesas para alimentação, 12 (5,94%) pagavam cuidadores para os outros filhos no dia da consulta e 80 (39,6%) referiram perda do pagamento do dia de trabalho. Dos casos de alta complexidade, 9,33% das mães entrevistadas abriram mão de exercer atividade remunerada regular. As despesas com transporte para uma consulta em cirurgia pediátrica em um hospital de referência do Rio de Janeiro custam em média 4,42% do salário mínimo vigente, com uma média de 217,32 minutos de deslocamento por consulta. Despesas com alimentação e perda de remuneração pela ausência no trabalho também implicam encargos financeiros ou perda de remuneração significativos para o paciente em cada consulta.

En esta investigación se estudiaron los costes de transporte por visita ambulatoria en pacientes remitidos para evaluación quirúrgica especializada en un hospital de atención terciaria en Río de Janeiro, Brasil. Es un estudio descriptivo con responsables de pacientes pediátricos programados para consulta de cirugía pediátrica, en el que se cuestionaron factores relacionados con el coste del transporte y los costes de oportunidad (pérdida de remuneración, alimentación, pago de cuidadores de otros niños, gastos de otros cuidadores). Aproximadamente la mitad de los pacientes tenían hasta 5 años de edad; cerca de 2/3 presentaban enfermedades de resolución quirúrgica simple y definitiva, 181 familias (89,17%) con renta familiar mensual de hasta BRL 1.999,00. La proporción de familias que se benefician de transporte gratuito varía entre el 4,26% y el 15,56% para los pacientes que viven hasta a 100 km del hospital (45,83% para los pacientes que viven a más de 100 km de la institución). Ciento setenta y seis (87,13%) cuidadores declaran gastos de alimentación, 12 (5,94%) pagan a los cuidadores de sus otros hijos en el día de la consulta y 80 (39,6%) declaran pérdida de salario por la jornada laboral. De los casos de alta complejidad, el 9,33% de las madres entrevistadas habían abandonado su actividad remunerada habitual. Los gastos de transporte para una consulta de cirugía pediátrica en un hospital de referencia de Río de Janeiro cuestan de media el 4,42% del salario mínimo vigente, con una media de 217,32 minutos de tiempo de viaje/consulta. Los gastos de alimentación y la pérdida de salario por ausencia en el trabajo también implican una importante carga económica o pérdida de salario para el paciente en cada cita.

In this study, we investigated the costs of transportation for each outpatient consultation in patients referred to specialized surgical evaluation in a tertiary hospital in Rio de Janeiro, Brazil. Descriptive study with guardians of pediatric patients scheduled for pediatric surgery, questioning transportation cost, and opportunity costs (loss of remuneration, food, payment of caregivers for other children, expenses for other companions). About half patients were aged up to five years; about two thirds had diseases of simple and definitive surgical resolution; and 181 families (89.17%) presented monthly family income up to BRL 1,999.00. The proportion of families that benefited from free transportation ranged from 4.26% to 15.56% for patients living up to 100 km away from the hospital (45.83% for patients living more than 100 km away from the institution). A total of 176 (87.13%) guardians reported expenses buying food, 12 (5.94%) paid caregivers to the other children on the day of the consultation, and 80 (39.6%) reported loss of remuneration for the working day. Among the high complexity cases, 9.33% of the mothers have given up their regular paid employment. Transportation expenses for a pediatric surgery consultation at a reference hospital in Rio de Janeiro cost about 4.42% of the current minimum wage, spending around 217.32 minutes of displacement/consultation. Expenses with food and loss of remuneration due to absence at work also entail significant financial charges or loss of remuneration for the patient at each consultation.

Abstract Hypoparathyroidism (HP) is a rare metabolic disorder and causes hypocalcemia because parathyroid hormone secretion is inadequate to mobilize calcium from bone and reabsorb calcium from kidney and gut. Anterior neck surgery is the most common cause of acquired HP and autoimmune HP is the next most common form in adults. The duration, severity, and rate of development of hypocalcemia determine the clinical presentation. A variety of organs can be affected by calcification, more frequently kidneys, but also joints, eyes, skin, vasculature, and other organ systems and, although rarely seen, intracerebral calcifications. We report four cases of bilateral basal ganglia calcifications (BGC) also known as Fahr’s syndrome related to hypoparathyroidism. Fahr’s syndrome is characterized by bilateral symmetrical calcification of areas of the brain that control movements including basal ganglia, thalamus, and others; it is a rare inherited or sporadic neurological disorder with a prevalence of less than 1/1.000.000. Main symptoms related to bilateral BGC include extra-pyramidal and cerebellar disorders, cognitive impairment, epileptic seizures, and psychiatric changes. BGC has been established as a possible outcome of HP. Its prevalence, demonstrated in the HP cohorts, varied significantly from 12 up to 74%. Currently, computed tomography (CT) is the most valuable method for diagnosis. The treatment include symptomatic support and identification of causes, but there is no specific treatment limiting the progression of calcification in the basal ganglia. Especially in HP, an early treatment can prevent calcification and neurophysiological disorders. (HP gut adults duration severity presentation kidneys joints eyes skin vasculature seen (BGC Fahrs Fahr s hypoparathyroidism thalamus others 11000000 1 000 1/1.000.000 extrapyramidal extra pyramidal disorders impairment seizures changes cohorts 74 74% Currently CT (CT diagnosis 1100000 00 1/1.000.00 7 110000 0 1/1.000.0 11000 1/1.000. 1100 1/1.000 110 1/1.00 11 1/1.0 1/1. 1/1 1/

Resumo O hipoparatireoidismo (HP) é um distúrbio metabólico raro e causa hipocalcemia, pois a secreção do paratormônio é inadequada para mobilizar o cálcio dos ossos e reabsorver o cálcio dos rins e intestino. A cirurgia cervical anterior é a causa mais comum de HP adquirido. O HP autoimune é a segunda causa mais comum em adultos. A duração, gravidade e taxa de desenvolvimento da hipocalcemia determinam a apresentação clínica. Diversos órgãos podem ser afetados pela calcificação, mais frequentemente os rins, mas também articulações, olhos, pele, vasculatura e outros órgãos e, embora raramente vista, calcificações intracerebrais. Relatamos quatro casos de calcificações dos gânglios da base (CGB) bilaterais, também conhecidas como síndrome de Fahr relacionadas ao hipoparatireoidismo. A síndrome de Fahr é caracterizada pela calcificação bilateral simétrica de áreas do cérebro que controlam os movimentos incluindo os gânglios da base, tálamo e outros; é um distúrbio neurológico raro, hereditário ou esporádico, com uma prevalência 1/1.000.000. Os principais sintomas relacionados à CGB bilateral incluem distúrbios extrapiramidais e cerebelares, comprometimento cognitivo, convulsões e alterações psiquiátricas. A CGB foi estabelecida como uma possível consequência do HP. Sua prevalência, demonstrada nas coortes de HP, variou significativamente de 12 a 74%. Atualmente, a tomografia computadorizada (TC) é o método mais valioso para o diagnóstico. O tratamento inclui suporte sintomático e identificação de causas, mas não há tratamento específico limitando a progressão da calcificação nos gânglios da base. Especialmente no HP, um tratamento precoce pode prevenir calcificações e distúrbios neurofisiológicos. (HP intestino adquirido adultos duração clínica articulações olhos pele vista intracerebrais (CGB bilaterais esporádico 11000000 1 000 1/1.000.000 cerebelares cognitivo psiquiátricas 74 74% Atualmente TC (TC diagnóstico causas neurofisiológicos 1100000 00 1/1.000.00 7 110000 0 1/1.000.0 11000 1/1.000. 1100 1/1.000 110 1/1.00 11 1/1.0 1/1. 1/1 1/

RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação acarreta quadros clínicos associados, como a dor musculoesquelética (DME), que causa sofrimento e interfere na vida do paciente. Por isso, o desenvolvimento de métodos diagnósticos para mensurar essas alterações são incentivados, como a eletroencefalografia quantitativa (EEGq). O objetivo deste estudo foi comparar o padrão eletroencefalográfico das ondas cerebrais Alpha (8-12 Hz) em pessoas com amputação com DME não relacionada à dor no membro fantasma e sem DME. MÉTODOS: Estudo realizado entre janeiro e fevereiro de 2022, com 20 pessoas com amputação divididas igualmente em dois grupos (Grupo Controle e Grupo com relato de DME não relacionada ao segmento amputado). Avaliou-se intensidade e interferência da dor (Inventário Breve de Dor), presença de sinais e sintomas de sensibilização central (SC) (Inventário de SC) e a EEGq (avaliados com olhos abertos) com análise espectral para medir a amplitude da onda Alpha, standardized Low Resolution brain electromagnetic Tomography (sLORETA) para identificar o local de geração diferencial da referida onda e Phase-Amplitude Coupling (PAC) para identificar sua interação com ondas rápidas. RESULTADOS: As pessoas com amputação e relato de DME apresentaram baixa gravidade e interferência de dor. Não se identificou diferença entre os indivíduos em relação a presença de sinais e sintomas associados à SC. Quanto à atividade elétrica, o Grupo Dor apresentou menor amplitude da onda Alpha em relação ao Grupo Controle (p=0,01), especificamente na região parieto-occipital. CONCLUSÃO: Pessoas com amputação e relato de DME não relacionada ao membro fantasma apresentaram atividade elétrica (ativação) reduzida da onda cerebral Alpha no córtex sensorial.

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation causes associated clinical conditions, such as musculoskeletal pain (MSP), which causes sufering and interferes in the patient’s life. Therefore, the development of diagnostic methods to measure these changes are encouraged, such as quantitative electroencephalography (qEEG). The aim of the study was to compare the electroencephalographic pattern of Alpha brain waves (8-12 Hz) in individuals with amputation with MSP unrelated to phantom limb pain and without MSP. METHODS: Study conducted between January and February 2022, with 20 people with amputations divided equally into two groups (Control Group and with MSP report not related to the amputated segment). Pain intensity and interference were evaluated (Brief Pain Inventory), as well as the presence of central sensitization (CS) signs and symptoms (CS inventory) and qEEG (assessed with eyes open) with spectral analysis to measure the amplitude of the Alpha wave, standardized Low Resolution brain electromagnetic Tomography (sLORETA) to identify the differential generation site of said wave and Phase-Amplitude Coupling (PAC) to identify its interaction with fast waves. RESULTS: People with amputation and MSP reported mild pain severity and interference. No diference was identifed between individuals regarding the presence of signs and symptoms associated with CS. Regarding electrical activity, the Pain Group had lower Alpha wave amplitude compared to the Control Group (p=0.01), specifically in the parieto-occipital region. CONCLUSION: People with amputation and reported MSP unrelated to the phantom limb had reduced electrical activity (activation) of the Alpha brain wave in the sensory cortex.

Abstract Curcumin, contained at Turmeric (Curcumalonga), can exert many beneficial pleiotropic activities in the gastrointestinal tract. This study evaluated the antioxidant and anti-inflammatory activity of C. longa on 5-fluorouracil (5-FU)-induced oral mucositis (OM) in hamsters. Phytochemical analysis of crude C. longa extract (CLE) was performed to detect the presence of curcumin by TLC and HPLC. Golden Syrian hamsters were orally pre-treated with CLE (5, 50, or 100mg/kg). Cheek pouch samples were subjected to macroscopic and histopathological evaluation. ELISA was performed to quantify the inflammatory cytokines IL-1β and TNF-α. Superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) levels were assessed by ultraviolet-visible spectroscopy analysis. Behavior analysis was conducted by the open field test. Curcumin content in the CLE was 0.55%m/m ± 0.0161 (2.84%). The group treated with 5mg/kg CLE showed healing evidence with macroscopic absence of ulceration (p<0.05) and microscopic aspect of re-epithelialization, discrete inflammatory infiltrate and absence of edema. Treatment with 5mg/kg CLE significantly increased GSH levels, and reduced MDA levels and SOD activity (p˂0.05), and decreased IL-1β (p˂0.05) and TNF-α (p˂0.01) levels. A significant reduction in walking distance, ambulation, speed, and rearing was observed for motor activity. Curcumin reduced oxidative stress, inflammation, and motor activity in hamsters with 5-FU-induced OM.

RESUMO Objetivo: Analisar a incidência, a dose de ocorrência, o grau, a severidade e os fatores de risco associados para o desenvolvimento de radiodermatite, por área da mama irradiada, em mulheres com câncer de mama, durante a radioterapia hipofracionada. Método: Estudo observacional, prospectivo e longitudinal, conforme diretrizes do Strengthening the Reporting of Observational studies in Epidemiology, realizado entre maio de 2019 e maio de 2021. Resultados: Participaram do estudo 104 mulheres, 73,1% (IC95%: 64–82) desenvolveram sinais de radiodermatite durante o tratamento. A maioria (63,5%, IC95%: 54–73) desenvolveu eritema na região axilar com cerca de 36,5 Grays. Mulheres com mamas volumosas e usuárias de estatinas possuem maior chance de desenvolver radiodermatite. Entretanto, mulheres com a cor da pele classificada como Fototipo III (pele morena clara) possuem menor chance de desenvolver radiodermatite, sendo a cor da pele um fator protetor. Conclusão A incidência de radiodermatite em mulheres com câncer de mama durante a radioterapia hipofracionada é expressiva. Sugere-se, portanto, o desenvolvimento de protocolos para o manejo desta radiotoxicidade, considerando a dose cumulativa e fatores de risco associados.

ABSTRACT Objective: To analyze the incidence, dose of occurrence, grade, severity, and associated risk factors for the development of radiodermatitis, by area of the irradiated breast, in women with breast cancer, during hypofractionated radiotherapy. Method: Observational, prospective, and longitudinal study, according to the guidelines of the Strengthening the Reporting of Observational studies in Epidemiology, carried out between May 2019 and May 2021. Results: A total of 104 women participated in the study, and 73.1% (95%CI: 64–82) developed signs of radiodermatitis during treatment. The majority (63.5%, 95%CI: 54–73) developed erythema in the axillary region with about 36.5 Grays. Women with large breasts and statin users are more likely to develop radiodermatitis. However, women with Phototype III skin color classification (light brown skin) are less likely to develop radiodermatitis, with skin color being a protective factor. Conclusion: The incidence of radiodermatitis in women with breast cancer during hypofractionated radiotherapy is significant. Therefore, the development of protocols for the management of this radiotoxicity is suggested, considering the cumulative dose and associated risk factors.

RESUMEN Objectivo: Analizar la incidencia, dosis de ocurrencia, grado, severidad y factores de riesgo asociados para el desarrollo de radiodermatitis, por área de la mama irradiada, en mujeres con cáncer de mama, durante radioterapia hipofraccionada. Método: Estudio observacional, prospectivo y longitudinal, según las directrices del Strengthening the Reporting of Observational studies in Epidemiology, realizado entre mayo de 2019 y mayo de 2021. Resultados: Participaron del estudio 104 mujeres, el 73,1% (IC 95%: 64–82) desarrollaron signos de radiodermatitis durante el tratamiento. La mayoría (63,5%, IC95%: 54–73) desarrolló eritema en la región axilar con alrededor de 36,5 Grays. Las mujeres con senos grandes y usuarias de estatinas tienen más probabilidades de desarrollar radiodermatitis. Sin embargo, las mujeres con color de piel clasificado como Fototipo III (piel morena clara) tienen menos probabilidades de desarrollar radiodermatitis, siendo el color de piel un factor protector. Conclusión: La incidencia de radiodermatitis en mujeres con cáncer de mama durante la radioterapia hipofraccionada es significativa. Por lo tanto, se sugiere el desarrollo de protocolos para el manejo de esta radiotoxicidad, considerando la dosis acumulada y los factores de riesgo asociados.

Abstract The objective of this study was to evaluate the production, fat and fatty acids of milk as well as the diameter, classification and quantity of the milk fat globules (MFG) of goats consuming a diet with 15% of crude glycerin. Twelve multiparous Saanen goats weighing 40 ± 6 kg and 90 ± 5 days of lactation were used. The experimental design was completely randomized with two treatments (0 and 15% inclusion of glycerin). In this way, each milk sample is classified according to the percentage of milk fat globules that were included in these three size categories. For the variables milk production, fat, diameter, medium and large fat globules and amount of globules showed a significant effect of the inclusion of glycerin in the diet (p < 0.05). Fifteen fatty acids were found, mostly saturated. For caprylic, palmitic, and linoleic fatty acids, there was no significant influence of the inclusion of glycerin (p > 0.05). Can recommend the use of 15% double-distilled glycerin in the feeding of lactating goats increased milk production, the amount of fat, increased the size of the milk fat globule. Regarding the saturated and polyunsaturated fatty acids, they kept the level of 15% of glycerin.

ABSTRACT Determination of the chromosome base number of a taxon is fundamental to understanding karyotypic variation and its implications for the evolution of that group. This usually requires careful evaluation of cytological literature and robust phylogenetic support. The base number for the family Rutaceae (x = 9 or x = 18) has long been the subject of debate. Here, we analyzed the banding pattern, rDNA sites, and genome size of Dictyoloma vandellianum, subfamily Cneoroideae, the sister group of the remaining Rutaceae, and revised critical points about the chromosome base number of the family. We found that this species has n = 9, which differs from the n = 18 possessed by other cytologically known Cneoroideae species. Thus, n = 9 occurs in the main clades of Rutaceae and is the most probable base number of the family. The hypothesis of x = 18 as the base number is no longer sustainable, although n = 18 is very common in Rutaceae. Moreover, the fluorescent banding pattern and the relatively large genome size (1C = 1.3 pg) of D. vandellianum suggest that its chromosomal organization is highly divergent from Aurantieae, the only large Rutaceae clade where species with n = 9 are greatly dominant.

Resumo: Introdução: A Organização Mundial da Saúde definiu a obrigatoriedade do direcionamento das atividades de educação, pesquisa e serviços para atender às preocupações prioritárias de saúde como responsabilidade social das escolas médicas. Considerando a emergência em saúde pública em decorrência da Covid-19, decidiu-se utilizar a telemedicina e implementar o ensino remoto para continuar a programação curricular e prestar apoio à gestão municipal a partir do pressuposto da social accountability. Relato de experiência: A dois meses do fim da graduação, discentes de Medicina acompanharam as 43 instituições de longa permanência para idosos (Ilpis) - públicas e privadas - do município de São José do Rio Preto com o intuito de monitorar residentes e funcionários em relação à Covid-19. Por meio de ligações diárias para as Ilpis, eles solicitaram ao representante de cada unidade, geralmente enfermeiro responsável, ou ao proprietário do estabelecimento informações sobre os principais sintomas da Covid-19 detectados nos moradores e funcionários das instituições. Cotidianamente, essas informações eram registradas numa plataforma on-line, na planilha de organização do trabalho, e depois relatadas para a Secretaria Municipal de Saúde (SMS) e discutidas com o professor responsável pela mentoria. Um plano de contingência para a Covid-19 foi elaborado pela equipe, autorizado pela SMS e repassado às Ilpis, para orientá-las durante a pandemia. Discussão: A Covid-19 apontou as fragilidades, as limitações e a capacidade de adaptação do sistema educacional de saúde, o que possibilitou o aprimoramento da formação dos novos médicos. Durante o monitoramento, os discentes encontraram diversos desafios: dificuldade no contato telefônico com algumas Ilpis, informações omitidas ou fornecidas de forma equivocada pelos funcionários e atrasos na comunicação de casos suspeitos. Contudo, o contato diário permitiu reconhecer as Ilpis que se apresentavam mais adequadas e as que necessitavam de investigação e orientação, criando vínculo com as Ilpis. Conclusão: Durante a pandemia, foi possível realizar ações na lógica da social accountability, evidenciando que o teleatendimento é uma ferramenta que, ao mesmo tempo que mantém os internos nos cenários de práticas, presta assistência à comunidade e à gestão municipal durante a pandemia.

Abstract: Introduction: The World Health Organization defined the compulsory need to redirect all educational, research and public health service activities of medical schools to meet all priority health needs, attributing to them this social responsibility role. Due to the emergency situation in the public health system caused by the COVID-19 pandemic, as a measure of social accountability, remote medical care services and online education were adopted in order to continue following the curricular program and to provide assistance to local city governments. Experience report: Two months before graduation, medical students followed-up on the monitoring of residents and COVID-19 healthcare professionals of forty-three ILPIs (Long-Term Elderly Care Facilities) in the city of Sao Jose do Rio Preto, state of Sao Paulo, Brazil. The medical students made daily telephone calls to all these ILPI units, requesting information, generally from the head nurses and owners, about the main COVID-19 symptoms that were detected in the residents and employees of these facilities. All the collected information was discussed daily with the teacher in charge of mentoring the program, fed into an online database and into a work schedule chart, then relayed to the local Municipal Health Secretariat. A COVID-19 contingency plan was devised by the team, authorized by the Local Health Secretariat and then presented to the ILPIs, aiming to offer them the best guidance throughout the pandemic. Discussion: the COVID-19 pandemic revealed the Health Education System’s fragilities, limitations and capacity to adapt to this crisis, thus largely contributing to improving the training of new medical doctors. During the program, medical students faced many challenges, especially regarding the difficulty to contact some ILPIs by telephone, omitted or erroneous information provided by employees in these facilities and delays in reporting suspected cases. In spite of this scenario, daily contact with these facilities allowed the team to identify the ILPIs that were more adequately prepared and the ones that needed auditing and further supervision. Also, this daily contact established a bond between the team and the ILPIs. Conclusion: During the pandemic, it was possible to perform actions according to the logic of social accountability, demonstrating that remote online medical practice is a tool capable of both maintaining interns in contact with the practical aspects of medical care and providing medical assistance to the community and to the local government.

ABSTRACT The study aimed to verify the effect of diet and environmental temperature on traits of milk fat globules (MFG) of goats. The experiment was conducted in climatic chambers, where we housed 12 Alpine goats with a mean age of 4.02±1.78 years, live weight of 41.8±4.59 kg, and average milk production of 2.16±0.59 kg. The animals were subjected to two different controlled temperatures, T1 = 26 ℃ (thermoneutral) and T2 = 34 ℃ (stress), and diets with different energy levels (low, medium, and high). A milk sample of each animal was collected at 6.00 h, coinciding with milking. The effect of temperature and diet was verified on MFG. The highest MFG was observed at 26 ℃ and medium energy diet. The MFG reached lower values with the diet of medium energy and high temperature (34 ℃). On average, 35% of MFG is smaller than 2 μm, 50% is medium in size (2-5 μm), and 15% is large (>5 μm), with a maximum size of 9.57 μm. The higher prevalence of medium-sized MFG is indicative of excellent milk digestibility. The increase in dietary energy levels promoted both the fat and diameter of fat globules. The higher fat and the larger globules would positively affect the cheese-making aptitude and make it suitable for production of hard cheeses. The increase in dietary energy levels for goats promotes an increase in the diameter of fat globules and milk fat (%), essential traits to the cheese industry.

Abstract Executive dysfunctions are central symptoms in different neurological, developmental, and context-related conditions. The assessment of these functions is then essential in neuropsychological pediatric clinical practice. Given the need for reliable and valid evaluation batteries for clinical practice in Brazil, this study aimed to present the pieces of evidences of reliability of the Child Executive Functions Battery (CEF-B). A total of 230 Brazilian children with typical development aged between 7 and 12 years participated in the study. Internal consistency was determined by the split-half method, Cronbach's α, and Ω. In addition, measurements of test-retest reliability and intraclass coefficient were also performed. Retest indicators were mostly weak and moderate (between .43 and .75). Overvall, coefficients show a satisfactory internal consistency reliability for planning and inhibition measures (between .72 and .92). Considering the measures of WM, results were also satisfactory for both α and Ω indexes. This study revealed that the CEF-B has satisfactory internal consistency reliability coefficients. However, several tests have shown low reliability assessed through the test-retest method. In general, findings reveal interesting pieces of initial evidence of reliability of the Brazilian version. The methodological approach could be improved in future studies by including children with executive disorders.