Abstract Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

RESUMO Objetivos: Avaliar a mortalidade entre adolescentes e pacientes adultos jovens com doenças crônicas acompanhados em um hospital terciário na América Latina. Métodos: Foi feito um estudo retrospectivo transversal em um hospital terciário/universitário no Estado de São Paulo, Brasil. Houve mortalidade de 529/2.850(18,5%) pacientes adolescentes e adultos jovens com doenças crônicas, porém 25/529(4,7%) foram excluídos devido a prontuários médicos incompletos. Portanto, foram avaliados 504 óbitos. Resultados: Ocorrem 316/504(63%) óbitos entre pacientes no início da adolescência e 188/504(37%) pacientes no fim da adolescência/adultos jovens. As comparações adicionais entre os pacientes no início da adolescência (n = 316) e no fim da adolescência/pacientes jovens (n = 188) com doenças crônicas pediátricas na última internação mostraram que a duração média da doença [22,0 (0-173) em comparação com 43,0 (0-227) meses, p < 0,001], foi significativamente menor nos pacientes no início da adolescência em comparação com os pacientes no fim da adolescência/adultos jovens. O número médio de internação anterior foi significativamente menor no primeiro grupo [4,0 (1-45) em comparação com 6,0 (1-52), p < 0,001], ao passo que a última internação na unidade de terapia intensiva foi significativamente maior (60% em comparação com 47%, p = 0,003). Com relação a medidas de suporte, o cuidado paliativo foi significativamente menor no grupo de pacientes no início da adolescência em comparação com o grupo de pacientes no fim da adolescência (33% em comparação com 43%, p = 0,02). As frequências de terapia de substituição renal (22% em comparação com 13%, p = 0,02), agentes vasoativos (65% em comparação com 54%, p = 0,01) e transfusão de hemoderivados (75% em comparação com 66%, p = 0,03) foram significativamente maiores no primeiro grupo. As cinco etiologias mais importantes de doenças crônicas pediátricas foram: neoplasias (54,2%), doenças hepáticas/transplante (10%), vírus da imunodeficiência humana (5,9%), lúpus eritematoso sistêmico de início na infância e artrite idiopática juvenil (4,9%). Foi feita autópsia em 58/504 (11%) e a discordância entre os diagnósticos clínico e pós-morte foi comprovada em 24/58 (41,3%). Conclusões: Quase 20% dos óbitos ocorreram em adolescentes e adultos jovens com diferentes padrões de cuidados de suporte e doenças graves. A discordância entre o diagnóstico clínico e a necropsia foi frequentemente observada.

ABSTRACT Objectives: To evaluate mortality in adolescents and young adult patients with chronic diseases followed in a Latin American tertiary hospital. Methods: A cross-sectional retrospective study was performed in a tertiary/academic hospital in the state of São Paulo, Brazil. Death occurred in 529/2850 (18.5%) adolescents and young adult patients with chronic diseases, and 25/529 (4.7%) were excluded due to incomplete medical charts. Therefore, 504 deaths were evaluated. Results: Deaths occurred in 316/504 (63%) of early adolescent patients and in 188/504 (37%) of late adolescent/young adult patients. Further comparisons between early adolescents (n = 316) and late adolescent/young adult patients (n = 188) with pediatric chronic diseases at the last hospitalization showed that the median disease duration (22.0 [0-173] vs. 43.0 [0-227] months, p < 0.001) was significantly lower in early adolescents vs. late adolescent/young adult patients. The median number of previous hospitalizations was significantly lower in the former group (4.0 [1-45] vs. 6.0 [1-52], p < 0.001), whereas the last hospitalization in intensive care unit was significantly higher (60% vs. 47%, p = 0.003). Regarding supportive measures, palliative care was significantly lower in the younger group compared to the older group (33% vs. 43%, p = 0.02). The frequencies of renal replacement therapy (22% vs. 13%, p = 0.02), vasoactive agents (65% vs. 54%, p = 0.01), and transfusion of blood products (75% vs. 66%, p = 0.03) were significantly higher in the younger group. The five most important etiologies of pediatric chronic diseases were: neoplasias (54.2%), hepatic diseases/transplantation (10%), human immunodeficiency virus (5.9%), and childhood-onset systemic lupus erythematosus and juvenile idiopathic arthritis (4.9%). Autopsy was performed in 58/504 (11%), and discordance between clinical and postmortem diagnoses was evidenced in 24/58 (41.3%). Conclusions: Almost 20% of deaths occurred in adolescents and young adults with distinct supportive care and severe disease patterns. Discordance between clinical diagnosis and autopsy was frequently observed.

RESUMO Introdução: A presença de metastização ganglionar no câncer colorretal é determinante como fator de prognóstico e para planear o tratamento. A relação entre a presença de gordura visceral e o prognóstico não está totalmente documentada na literatura. Assim, pretende-se avaliar a existência de relação entre obesidade visceral e a presença de metástases ganglionares e o prognóstico de doentes com câncer colorretal. Materiais e métodos: Construiu-se uma amostra de 68 doentes operados por câncer colorretal no Hospital de Braga, entre 1/1/2007 e 31/12/2007, e registaram-se os seus dados clínico-patológicos e de seguimento. As áreas de gordura visceral, gordura subcutânea e gordura total foram medidas na tomografia computorizada pré-operatória. Obesidade visceral foi definida como um razão da gordura visceral relativamente à área total de gordura >0,29. Calculou-se a razão de linfonodos metastizados. Resultados: Verificou-se uma associação significativa entre obesidade visceral e sexo masculino (p = 0,032). A sobrevida dos pacientes, aos 5 e 10 anos de seguimento, foi superior naqueles com obesidade subcutânea em ambos períodos, contudo não significativa. Verificou-se uma associação significativa entre a sobrevivência em função da razão de linfonodos metastizados, aos 5 e 10 anos (p = 0,03 e p = 0,002; respectivamente), com maior sobrevivência quando a razão de linfonodos metastizados = 0% e pior quando ≥ 18%. Conclusão: Neste estudo não se observou uma associação significativa entre a obesidade visceral e o número de linfonodos metastizados nem com a sobrevida aos 5 e 10 anos.

ABSTRACT Introduction: The presence of lymph node metastasis in colorectal cancer is determinant for prognosis and for treatment planning. The relationship between visceral fat and the prognosis is not fully documented in the literature, so this study intended to evaluate whether there is a relationship between the presence of visceral obesity and the presence of lymph node metastases and the prognosis of patients with colorectal cancer. Materials and methods: A sample of 68 patients who underwent surgery for colorectal cancer at Hospital de Braga between 1/1/2007 and 31/12/2007 was constructed, and their clinical and pathological data were recorded. Visceral fat, subcutaneous, and total fat areas were measured on preoperative computed tomography. Visceral obesity was defined as a ratio of visceral fat to total fat area >0.29. The ratio of metastatic lymph node (; number of metastatic lymph node/number of lymph node examined) was calculated. Results: There was a significant association between visceral obesity and male sex (p = 0.032). Patient survival at 5 and 10 years of follow-up was higher in patients with subcutaneous obesity in both periods, but not significant. There was a significant association between the ratio of metastatic lymph node and survival at 5 and 10 years (p = 0.03 and p = 0.002, respectively), with higher survival when ratio of metastatic lymph node = 0% and worse for ≥ 18%. Conclusion: In this study, no significant association was observed between visceral obesity and the number of metastatic lymph node, nor with survival at 5 and 10 years.

Abstract This aim of this study was to characterize five varieties of avocado for their proximal composition, physical properties, fatty acids composition, antioxidant capacity, carotenoids and minerals. Quintal variety presented the best result for total lipids, physical properties, carotenoids and minerals. All the varieties presented a predominance of monounsaturated fatty acids (60%). The major monounsaturated fatty acid was oleic acid. Among the varieties analyzed, Breda variety had greater activity results for FRAP (145%) and DPPH (1.1200 µmol TE/g) assays, Quintal had higher values for ABTS analysis, Ouro Verde presented better results for ORAC assay (23%), and Margarida had the best result for L-ORAC analysis (200 µmol ET/g).

RESUMOAs recomendações propostas pela Comissão de Síndrome de Sjögren da Sociedade Brasileira de Reumatologia para tratamento da síndrome de Sjögren foram baseadas em uma revisão sistemática da literatura nas bases de dados Medline (PubMed) e Cochrane até outubro de 2014 e opinião de especialistas na ausência de artigos sobre o assunto. Foram incluídos 131 artigos classificados de acordo com Oxford & Grade. Essas recomendações foram elaboradas com o objetivo de orientar o manejo adequado e facilitar o acesso aos tratamentos para aqueles pacientes com adequada indicação de recebê-los, considerando o contexto socioeconômico brasileiro e os medicamentos disponíveis no país.

ABSTRACTThe recommendations proposed by the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjögren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 articles classified according to Oxford & Grade were included. These recommendations were developed in order to guide the management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, São Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n = 24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, São Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n = 6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey's test (p ≤0.05). Similar weight losses ranging from 5% to 10% occurred in all groups. The therapeutic group had significantly lower clinical and histological scores than the other groups at Day 10. This study showed that positive effects on oral mucositis management were obtained only when LPT was applied in the therapeutic protocol (from D+5 to D+15 after chemotherapy).

A investigação fitoquímica dos frutos maduros de Solanum caavurana Vell. (Solanaceae) forneceu um novo alcaloide esteroidal do tipo espirosolano, caavuranamida, juntamente com os alcaloides 4-tomatiden-3-ona e 5α-tomatidan-3-ona. Suas estruturas foram elucidadas através de métodos espectroscópicos. As atividades antiproliferativa e antimicrobiana para o extrato etanólico e subfrações provenientes de partição e de extração ácido-base foram investigadas. A caavuranamida apresentou atividade antibacteriana similar ao controle positivo cloranfenicol contra Rhodococcus equi.

Phytochemical investigation of the ripe fruits of Solanum caavurana Vell. (Solanaceae) afforded a novel steroidal alkaloid with spirosolane-type skeleton, named as caavuranamide, together with the alkaloids 4-tomatiden-3-one and 5α-tomatidan-3-one. Their structures were elucidated on the basis of spectroscopic methods. The antiproliferative and antimicrobial activities for the ethanolic extract, sub-fractions obtained from partition and acid-base treatment were also evaluated. Caavuranamide showed antibacterial activity similar to the chloramphenicol positive control against Rhodococcus equi.

OBJETIVO: Avaliar um método estratégico nas aulas práticas, utilizando micro câmeras e monitores de vídeo para transmitir demonstrações da técnica operatória, comparando-o com o método de ensino aprendizagem clássico. METODOLOGIA: Foram aplicados 52 questionários direcionados aos alunos do 4º ano (grupo 1) submetidos a esta nova prática e aos do 3º ano (grupo 2) submetidos a metodologia de ensino tradicional. Este questionário também possibilitou detectar os principais problemas enfrentados pelos discentes durante o aprendizado desta etapa operatória. RESULTADOS: A fase de cirurgia de acesso foi considerada de difícil execução por ambos os grupos (G1- 30,8 % e G2- 34,6%), sendo a manobra de localização dos orifícios de entrada dos canais a etapa mais complicada. Quanto à avaliação da metodologia empregada no 3º ano, 23,1% dos alunos a consideraram excelente, 38,4% ótima, e 38,5% boa, ao passo que nenhum dos estudantes (0%) consideraram o método como regular, ruim ou péssimo. Uma menor ocorrência de erros (P<0,05), foi relatada pelos alunos do 3º ano (G1- 50% e G2- 34.6%). CONCLUSÃO: A nova estratégia de ensino favoreceu a aprendizagem, diminuiu a incidência de erros e foi considerada eficaz pelos alunos.

PURPOSE: To evaluate a strategic method of real time visual demonstration of the operatory procedures using an intraoral camera system and monitor videos, comparing them to those of conventional laboratory classes. METHODS: Fifty-two structured, multiple choice questionnaires were applied to undergraduate students of the 4th year (G1) and 3rd year (G2) submitted to the traditional and strategic teaching methods, respectively. These tests were also able to detect the main problems faced by the students during the training of this operatory phase. RESULTS: Students of both groups (G1- 30.8% and G2- 34.6%) considered the access cavity to be one of the most difficult phase of endodontic treatment. The results of the evaluation among the 3rd year students demonstrated that 23.1% graded the new method as excellent, 38.4% as very good and 38.5 % as good, whereas none of the students (0%) considered the method to be regular, bad or very bad. A minor accident occurrence (P<0.05) was reported by the 3rd year students (G1- 50% and G2- 34.6%). CONCLUSION: The new strategy was found to favor learning, reduce the incidence of errors and was appraised as efficient by the students.

O objetivo do presente trabalho foi avaliar dois protocolos de desinfestação na micropropagação em três cultivares de bananeira. Utilizaram-se mudas das cultivares de bananeira Prata Anã, FHIA 18 e SH3640. Os protocolos 1 e 2 de desinfestação (Des. 1 e Des. 2) foram realizados utilizando-se os seguintes produtos: solução fungicida de Derosol, álcool comercial, solução de hipoclorito de sódio e de hipoclorito de cálcio e tween 20, apresentando variações na concentração dos produtos em cada um dos protocolos. As avaliações para a porcentagem de contaminação foram realizadas diariamente por meio do número total de tubos contaminados e não contaminados. O delineamento foi em blocos casualizados, com quatro repetições, em um sistema fatorial. As contaminações que ocorreram foram causadas exclusivamente por bactérias. Independentemente do tratamento utilizado, os índices de contaminação foram superiores a 29% para as três cultivares testadas. Estes resultados indicam a necessidade de adequar novas metodologias de assepsias de explantes de bananeira.

The purpose of this work was to evaluate two protocols of disinfestations in the micropropagation on young plants of three banana cultivars: Prata-Anã, FHIA 18 and SH3640. Protocols 1 and 2 of disinfestations (Dis. 1 and Dis. 2) were carried out using the products: fungicidal solution of Derosol, commercial alcohol, solution of sodium hypo chlorite and calcium hypo chlorite and tween 20, presenting variations in their concentration in every one of the protocols. The evaluations for contamination rate were taken daily by means of the total number of contaminated and non-contaminated tubes. A random block design in a factorial scheme with four repetitions was used. Exclusively bacteria had caused all contamination. Independently of the used treatment the contamination levels had been up to 29% for all the three cultivars tested. These results indicate the necessity of adjusting the new methodologies of asepses of banana explants.

Entre as fruteiras cultivadas, o cajueiro destaca-se no contexto socioeconômico, pelo alto valor nutritivo e comercial dos seus produtos, cuja produção e industrialização garantem expressivo fluxo de renda, além da geração de milhares de empregos. O objetivo deste trabalho foi avaliar as características físico-químicas dos pedúnculos e das castanhas de clones de cajueiro-anão precoce implantados na Região Norte de Minas Gerais. Foram analisados pedúnculos e castanhas provenientes da Unidade Experimental da Embrapa Negócios Tecnológicos, no município de Nova Porteirinha (MG). Foram utilizados os clones CCP 76, CCP 06, CCP 1001 e CCP 09, correspondendo a quatro tratamentos. O delineamento experimental utilizado foi o inteiramente casualizado com cinco repetições de campo e quatro frutos por parcela foram avaliados. Os pedúnculos foram colhidos em setembro de 2002 e transportados em bandejas de colheita para o laboratório de Fisiologia Pós-colheita da Universidade Estadual de Montes Claros (UNIMONTES), situado no Campus de Janaúba (MG). Foram realizadas avaliações de características físico-químicas, submetidas à análise de variância e ao teste de Tukey. Dentre os materiais avaliados, observaram-se, nos pedúnculos do clone CCP 76, características desejáveis para a comercialização in natura, coloração laranja intenso, formato piriforme, boas características químicas e pedúnculos com firmeza adequada, possibilitando maior conservação pós-colheita. Apesar de boas características químicas, verificou-se no clone CCP 09 pedúnculos de coloração laranja pouco intenso e baixa firmeza. Pedúnculos com maior diâmetro tendem a ser menos firmes em pós-colheita.

Among the cultivated fruit trees, cashew is distinguished in social and economic context for the high nutritional and commercial value of its parts, whose production and industrialization guarantee an expressive income flow, besides generating thousands of jobs. This study aimed at evaluating physical-chemical characteristics of precocious dwarf cashew nuts and stalks from Experimental Unit of EMBRAPA Technological Business, located in Nova Porteirinha district, State of Minas Gerais. Clones CCP 76, CCP 06, and CCP 1001 e CCP 09 were utilized corresponding to the four treatments. The experiment was designed in a completely-randomized block with five replications and four fruits per parcel. The stalks were harvested in September of 2002 and carried in harvest trays to Laboratory of Plant Physiology and Post-harvest Technology of Universidade Estadual de Montes Claros (UNIMONTES), situated in Campus of Janaúba-MG. Physical and Chemical characteristics were evaluated and subjected to variance analysis and Tukey test. Amongst evaluated materials, stalks of CCP 76 clone showed appropriate aspect of market purposes in nature, with deep orange coloration; pear-shaped format, good chemical features and stalks with adjusted firmness, making possible greater post-harvest conservation. Although good characteristics, the clone CCP 09 presented little intense orange coloration and low firmness. Probably the larger diameter stalk is minor firmness at post-harvest will be.