RESUMO Em meio a pautas sustentáveis, as fontes de energia renováveis apresentam um forte papel, em especial, a energia eólica. No entanto, a implantação dos empreendimentos eólicos produz transformações nas comunidades, causando impactos em diferentes áreas e processos de vulnerabilização. O estudo objetiva problematizar os relatos da população camponesa referentes aos processos de vulnerabilização em área de influência da implantação dos empreendimentos eólicos em um município pernambucano. Trata-se de uma pesquisa observacional, descritiva de abordagem qualitativa, realizada em uma comunidade camponesa localizada no município de Caetés, Pernambuco, Brasil. A coleta de dados foi realizada mediante entrevista semiestruturada. A análise de dados partiu da técnica de análise de conteúdo na modalidade temática. Observou-se que a chegada e o funcionamento dos aerogeradores coincidiram com o surgimento de sinais e sintomas, como os problemas auditivos e de pele, ansiedade, tontura e cefaleia. Tal situação permite considerar uma provável ligação entre os impactos causados pelas torres eólicas, já descritos na literatura, com aqueles presentes nos relatos dos participantes. É necessário prudência no momento de planejamento e construção de complexos eólicos, uma vez que tais agravos à saúde podem se comportar como temporários ou permanentes, levando a comunidade local a um sofrimento constante. sustentáveis papel especial eólica entanto comunidades pernambucano Tratase Trata observacional qualitativa Caetés Pernambuco Brasil semiestruturada temática Observouse Observou sintomas pele ansiedade cefaleia eólicas literatura participantes permanentes constante

ABSTRACT Amid sustainable agendas, renewable energy sources play a strong role, especially wind energy. However, the implementation of wind farms produces transformations in communities, causing impacts in different areas and vulnerability processes. The study aims to problematize the reports of the peasant population regarding the processes of vulnerability in the area of influence of the implementation of wind farms in a municipality in Pernambuco. This is an observational, descriptive research with a qualitative approach, carried out in a peasant community, located in the municipality of Caetés, Pernambuco, Brazil. Data collection was carried out through semi-structured interviews. Data analysis was based on the content analysis technique in the thematic modality. It was observed that the arrival and operation of the wind turbines coincided with the emergence of signs and symptoms, such as hearing and skin problems, anxiety, dizziness and headache. This situation allows us to consider a probable connection between the impacts caused by wind towers, already described in the literature, and those present in the participants’ reports. Prudence is necessary when planning and building wind farms, since such health problems can be temporary or permanent, leading the local community to constant suffering. agendas role However communities Pernambuco observational approach Caetés Brazil semistructured semi structured interviews modality symptoms anxiety headache towers literature participants permanent suffering

Abstract Knee osteoarthritis (OA) is an inflammatory and degenerative condition resulting in articular cartilage destruction and functional loss. Its prevalence has grown considerably due to increased life expectancy and obesity, and its diagnosis relies on evaluation, medical examination, and confirmation by supplementary radiographic images. Knee OA is multifactorial and influenced by several local, systemic, and external aspects. In addition, its progress and therapeutic responses highly depend on the characteristics of each subject. The initial recommendation is drug treatment and alternative therapies to improve quality of life. However, if these treatments are unsuccessful, one must consider surgical treatment. Surgical options include arthroscopies, osteotomies, and partial and total arthroplasties, while non-surgical treatments include medications and alternative therapies such as infiltrations, acupuncture, and physical exercise. It is worth highlighting that biomarkers can be a significant strategy for early disease detection, assessment of disease activity, prediction of prognosis, and monitoring a better response to therapy. Nevertheless, this topic must be the focus of further research to confirm its findings. (OA loss obesity evaluation examination images local systemic aspects addition subject However unsuccessful arthroscopies osteotomies arthroplasties nonsurgical non infiltrations acupuncture exercise detection activity prognosis therapy Nevertheless findings

Resumo A osteoartrite (OA) do joelho é uma doença inflamatória e degenerativa que ocasiona a destruição da cartilagem articular e leva à perda de funções. Sua prevalência vem crescendo consideravelmente devido ao aumento da expectativa de vida e da obesidade, e o diagnóstico pode ser feito por meio de avaliação e exames médicos, e é confirmado em imagens radiográficas complementares. Uma condição multifatorial, a OA do joelho pode ser influenciada por diversos aspectos locais, sistêmicos e externos; além disso, a sua evolução e as respostas aos tratamentos dependem muito das características de cada indivíduo. Inicialmente, recomenda-se proceder a um tratamento medicamentoso e a terapias alternativas que melhorem a qualidade de vida do paciente; mas, a partir do momento em que se verifica que tais terapias não estão proporcionando resultados satisfatórios, um tratamento cirúrgico deve ser considerado. Entre os tratamentos cirúrgicos, as artroscopias, as osteotomias e as artroplastias parciais e totais são destacadas; os métodos não cirúrgicos incluem o uso de medicamentos e de terapias alternativas, como infiltrações, acupuntura e prática de exercícios físicos. Vale ressaltar ainda que a utilização de biomarcadores pode ser uma importante estratégia para detectar precocemente a doença, avaliar sua atividade, prever um prognóstico e monitorar uma melhor resposta à terapia; porém, esse tema ainda deve ser foco de mais estudos para que os seus resultados sejam comprovados. (OA funções obesidade médicos complementares multifatorial locais externos disso indivíduo Inicialmente recomendase recomenda paciente mas satisfatórios considerado artroscopias destacadas infiltrações físicos atividade terapia porém comprovados

Abstract Objective To evaluate whether antimicrobial photodynamic therapy (aPDT) repairs bisphosphonate-related osteonecrosis of the jaw (BRONJ) modulated by the reduction of NF-kB protein in a murine model. Methodology Male Wistar rats (N=30) were divided into the following groups (n=6/group): negative control (NC); experimental osteonecrosis (ONE); ONE + photosensitizer (PS); ONE + photobiomodulation (PBM); and ONE + aPDT. Over 8 weeks, ONE was induced by zoledronic acid 250 µg/kg injections, except in the NC group, which received sterile 0.9% saline, followed by extraction of the lower left first molar. Red light laser irradiation (wavelength ~660 nm, power 50 mW, energy of 2 J, energy dose of 66.67 J/cm2 for 40 s) was performed once a week for 4 weeks. Methylene blue 0.3% was used as PS. The animals were euthanized and examined macroscopically for the presence of exposed bone and epithelial repair and microscopically by histochemical (hematoxylin-eosin and Masson’s trichrome staining) and immunohistochemical (anti-NF-kB) methods. Macroscopic and histomorphometric data were analyzed by one-way ANOVA and Tukey’s post-test (p<0.05). Results Mucosal repair, viable osteocytes, and NF-kB immunostaining were observed in the NC, ONE+PS, ONE+PBM, and ONE+aPDT groups. The ONE group showed no mucosal repair, showing empty lacunae and multifocal immunostaining for NF-kB. The ONE+PBM and ONE+aPDT groups had greater deposition of extracellular matrix and less necrotic bone tissue (p<0.05). Conclusion PBM and aPDT treatments for BRONJ were effective for bone and epithelial repair, in addition to reducing inflammation mediated by the decrease of NF-kB protein in the irradiated regions. (aPDT bisphosphonaterelated bisphosphonate related (BRONJ NFkB NF kB model N=30 N30 N 30 (N=30 n=6/group n6group ngroup n 6 (n=6/group) (NC) (ONE) PS (PS) (PBM) weeks 25 µgkg µg kg injections 09 0 9 0.9 saline molar wavelength 660 ~66 nm 5 mW J 6667 66 67 66.6 Jcm2 Jcm cm2 cm J/cm s 03 3 0.3 hematoxylineosin hematoxylin eosin Massons Masson staining antiNFkB anti (anti-NF-kB methods oneway one way Tukeys Tukey posttest post test p<0.05. p005 p p<0.05 . 05 (p<0.05) osteocytes ONEPS ONE+PS ONEPBM ONEaPDT NFkB. kB. regions N=3 N3 (N=3 (n=6/group (NC (ONE (PS (PBM 0. ~6 666 66. p00 p<0.0 (p<0.05 N= (N= ~ p0 p<0. (p<0.0 (N p<0 (p<0. p< (p<0 (p< (p

SUMMARY OBJECTIVE: To compare the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests for the identification of cognitive deficit (CD) in elderly patients with heart failure (HF). METHODS: This was a cross-sectional study with an observational design involving 43 elderly patients with HF of both sexes, treated by the Unified Health System, who were able to understand and follow the study instructions. A sociodemographic and clinical questionnaire and the MMSE and MoCA neurocognitive tests were applied. RESULTS: The mean age of the patients was 67 years; 67.44% were male; 53.49% were white; 58.14% had 1–4 years of schooling; 58.14% had an income of half to one minimum wage; 55.81% were married; 53.49% had a family history of HF; 90.7% denied smoking; 83.72% denied alcohol intake; 65.12% did not practice physical activity; 83.72% were hypertensive; 30.23% were diabetic; 57.89% had LVEF ≥ 50%; 39.53% have NYHA II; and 88.37% did not have a pacemaker. In the identification of CD, the MMSE test detected it in 25.58% of the patients, while the MoCA test identified it in 23.26% (p=0.043). CONCLUSION: It was concluded that the MMSE test performed better than the MoCA test in the identification of CD in elderly patients with HF. OBJECTIVE MiniMental Mini Mental (MMSE (MoCA (CD . (HF) METHODS crosssectional cross sectional 4 sexes System instructions applied RESULTS 6 6744 44 67.44 male 5349 53 49 53.49 white 5814 58 14 58.14 1 1– schooling wage 5581 55 81 55.81 married 907 90 7 90.7 smoking 8372 83 72 83.72 intake 6512 65 12 65.12 activity hypertensive 3023 30 23 30.23 diabetic 5789 57 89 57.89 50% 50 3953 39 39.53 II 8837 88 37 88.37 pacemaker 2558 25 25.58 2326 26 23.26 p=0.043. p0043 p p=0.043 0 043 (p=0.043) CONCLUSION (HF 674 67.4 534 5 53.4 581 58.1 558 8 55.8 9 90. 837 83.7 651 65.1 302 3 2 30.2 578 57.8 395 39.5 883 88.3 255 25.5 232 23.2 p004 p=0.04 04 (p=0.043 67. 53. 58. 55. 83. 65. 30. 57. 39. 88. 25. 23. p00 p=0.0 (p=0.04 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

ABSTRACT Hedychium coronariumJ.Koenig is a rhizomatous herbaceous species native to Asia and invasive in most states of Brazil. We aimed to evaluate the influence of H. coronariumon terrestrial herbaceous communities and natural regeneration of woody plants in a remnant of Alluvial Araucaria Forest in Curitiba - PR. The communities were sampled considering two treatments: (EC) high coverage of H. coronarium(>60%); (BC) low coverage of H. coronarium(<30%). Two communities were recorded: i) herbaceous vascular species (including subshrubs) and ii) seedlings of woody species between 15-130 cm height. In EC H. coronariumhad an average cover of 78.06%, with only five native herbaceous species and 24 native woody species. The average cover of the invasive in BC was 6.29%, with 17 native herbaceous and 37 woody native species. The most representative native herbaceous was Christella dentata(Forssk.) Brownsey & Jermy, while among the woody species Myrcia selloi(Spreng.) N.Silveira stood out for its frequency and abundance. The abundance of woody plants in the EC was approximately four times less than in the BC, showing that the high density of H. coronariumnegatively influences native plant communities. The high cover of the invasive species results in a decrease in species richness and the number of individuals in the communities, both herbaceous and woody regeneration. coronariumJKoenig coronariumJ Koenig Brazil H PR treatments (EC coronarium>60% coronarium60 coronarium >60% 60 coronarium(>60%) (BC coronarium<30%. coronarium30 <30% . 30 coronarium(<30%) recorded i including subshrubs ii 15130 15 130 15-13 height 7806 78 06 78.06% 2 629 6 29 6.29% 1 3 dentataForssk. dentataForssk dentata Forssk. Forssk dentata(Forssk. Jermy selloiSpreng. selloiSpreng selloi Spreng. Spreng selloi(Spreng. NSilveira N Silveira coronarium>60 coronarium6 >60 coronarium(>60% coronarium<30% coronarium3 <30 coronarium(<30% 1513 13 15-1 780 7 0 78.06 62 6.29 dentata(Forssk selloi(Spreng coronarium>6 >6 coronarium(>60 coronarium<30 <3 coronarium(<30 151 15- 78.0 6.2 coronarium> > coronarium(>6 coronarium<3 < coronarium(<3 78. 6. coronarium(> coronarium< coronarium(< coronarium(

RESUMO A espécie herbácea rizomatosa Hedychium coronarium J.Koenig é de origem asiática e ocorre como invasora na maioria dos estados do Brasil. O objetivo do estudo foi avaliar a influência de H. coronarium sobre as comunidades de herbáceas terrícolas e de regeneração natural de lenhosas em um remanescente de Floresta Ombrófila Mista Aluvial em Curitiba - PR. As comunidades foram amostradas considerando-se dois tratamentos: (EC) elevada cobertura de H. coronarium(>60%); (BC) baixa cobertura de H. coronarium (<30%). Foram avaliadas duas comunidades: i) espécies herbáceas (incluindo subarbustivas) e ii) plântulas de espécies lenhosas entre 15 cm - 130 cm de altura. No EC, H. coronariumapresentou cobertura média de 78,06%, sendo registradas apenas cinco espécies herbáceas nativas e 24 lenhosas nativas. No BC, a cobertura média da invasora foi de 6,29%, com registro de 17 herbáceas nativas e 37 lenhosas nativas. A herbácea nativa mais representativa foi Christella dentata(Forssk.) Brownsey & Jermy, enquanto, dentre as lenhosas, destacou-se Myrcia selloi(Spreng.) N.Silveira por sua frequência e abundância. A abundância das lenhosas no EC foi aproximadamente quatro vezes menor que no BC, mostrando que a elevada densidade de H. coronariumexerce influência negativa nas comunidades vegetais nativas. A elevada cobertura da espécie invasora resulta na redução da riqueza de espécies e do número de indivíduos nas comunidades, tanto de herbáceas quanto da regeneração de lenhosas. JKoenig J Koenig Brasil H PR considerandose considerando se tratamentos (EC coronarium>60% coronarium60 >60% 60 coronarium(>60%) BC (BC <30%. 30 <30% . (<30%) i incluindo subarbustivas ii 1 13 altura 7806 78 06 78,06% 2 629 6 29 6,29% 3 dentataForssk. dentataForssk dentata Forssk. Forssk dentata(Forssk. Jermy enquanto destacouse destacou selloiSpreng. selloiSpreng selloi Spreng. Spreng selloi(Spreng. NSilveira N Silveira coronarium>60 coronarium6 >60 coronarium(>60% <30 (<30% 780 7 0 78,06 62 6,29 dentata(Forssk selloi(Spreng coronarium>6 >6 coronarium(>60 <3 (<30 78,0 6,2 coronarium> > coronarium(>6 < (<3 78, 6, coronarium(> (< coronarium( (

ABSTRACT The Verbal Autopsy (VA) is a questionnaire about the circumstances surrounding a death. It was widely used in Brazil to assist in postmortem diagnoses and investigate excess mortality during the Coronavirus Disease 2019 (COVID-19) pandemic. This study aimed to determine the accuracy of investigating acute respiratory distress syndrome (ARDS) using VA. This is a cross-sectional study with prospective data collected from January 2020 to August 2021 at the Death Verification Service of Sao Luis city, Brazil. VA was performed for suspected COVID-19 deaths, and one day of the week was randomly chosen to collect samples from patients without suspected COVID-19. Two swabs were collected after death and subjected to reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection. Of the 250 cases included, the VA questionnaire identified COVID-19-related ARDS in 67.2% (52.98% were positive for COVID-19). The sensitivity of the VA questionnaire was 0.53 (0.45–0.61), the specificity was 0.75 (0.64–0.84), the positive predictive value was 0.81 (0.72–0.88), and the negative predictive value was 0.44 (0.36–0.53). The VA had a lower-than-expected accuracy for detecting COVID-19 deaths; however, because it is an easily accessible and cost-effective tool, it can be combined with more accurate methods to improve its performance. (VA 201 COVID19 COVID 19 (COVID-19 pandemic (ARDS crosssectional cross sectional 202 city COVID-1 deaths COVID19. 19. transcriptionpolymerase transcription polymerase RTPCR RT PCR (RT-PCR SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- detection 25 included COVID19related COVIDrelated related 672 67 67.2 52.98% 5298 52 98 (52.98 . COVID-19) 053 0 53 0.5 0.45–0.61, 045061 0.45–0.61 , 45 61 (0.45–0.61) 075 75 0.7 0.64–0.84, 064084 0.64–0.84 64 84 (0.64–0.84) 081 81 0.8 0.72–0.88, 072088 0.72–0.88 72 88 (0.72–0.88) 044 44 0.4 0.36–0.53. 036053 0.36–0.53 36 (0.36–0.53) lowerthanexpected lower than expected however costeffective cost effective tool performance 20 COVID1 1 (COVID-1 COVID- SARS-CoV 6 67. 52.98 529 5 9 (52.9 05 0. 04506 0.45–0.6 4 (0.45–0.61 07 7 06408 0.64–0.8 8 (0.64–0.84 08 07208 0.72–0.8 (0.72–0.88 04 03605 0.36–0.5 3 (0.36–0.53 (COVID- 52.9 (52. 0450 0.45–0. (0.45–0.6 0640 0.64–0. (0.64–0.8 0720 0.72–0. (0.72–0.8 0360 0.36–0. (0.36–0.5 (COVID 52. (52 045 0.45–0 (0.45–0. 064 0.64–0 (0.64–0. 072 0.72–0 (0.72–0. 036 0.36–0 (0.36–0. (5 0.45– (0.45–0 06 0.64– (0.64–0 0.72– (0.72–0 03 0.36– (0.36–0 ( 0.45 (0.45– 0.64 (0.64– 0.72 (0.72– 0.36 (0.36– (0.45 0.6 (0.64 (0.72 0.3 (0.36 (0.4 (0.6 (0.7 (0.3 (0. (0

ABSTRACT Background Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. Methods VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. Conclusion The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development. Ventilatorassociated Ventilator associated units unknown VentilatorAssociated Associated Evaluation ventilatorassociated ventilator ventilation randomized controlled openlabel, openlabel open label, label open-label shock diagnosis ventilationfree 2 pneumoniafree survival intentiontotreat intention treat perprotocol per protocol 20 margin 15 1 5 1. ventilatorfree standards highvisibility high visibility dissemination development

RESUMO Contexto A traqueobronquite associada ao ventilador é uma condição comum entre pacientes ventilados invasivamente em unidades de terapia intensiva, para a qual se desconhece atualmente a melhor estratégia de tratamento. Desenhamos o estudo VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) para avaliar se uma estratégia de tratamento antibiótico de espera vigilante não é inferior ao tratamento antibiótico de rotina para traqueobronquite associada ao ventilador em relação aos dias sem ventilador mecânico. Métodos O VATICAN é um estudo randomizado, controlado, aberto e multicêntrico de não inferioridade. Os pacientes com suspeita de traqueobronquite associada ao ventilador sem evidência de pneumonia associada ao ventilador ou instabilidade hemodinâmica devido a uma provável infecção serão designados para uma estratégia de espera vigilante, sem administração profilática de antimicrobianos contra traqueobronquite associada ao ventilador e prescrição de antimicrobianos somente em casos de pneumonia associada ao ventilador, sepse ou choque séptico, ou outro diagnóstico infeccioso, ou para uma estratégia de tratamento antimicrobiano de rotina por 7 dias. O desfecho primário será o número de dias sem ventilador mecânico em 28 dias, e um desfecho secundário importante será a sobrevida sem pneumonia associada ao ventilador. Por meio de uma estrutura de intenção de tratar com análise de sensibilidade por protocolo, a análise do desfecho primário abordará a não inferioridade com margem de 20%, o que se traduz em uma diferença de 1,5 dia sem ventilador. Outras análises seguirão uma estrutura de análise de superioridade. Conclusão O VATICAN seguirá todos os padrões éticos nacionais e internacionais. O objetivo é publicar o estudo em um periódico geral de alta visibilidade e apresentá-lo em conferências de cuidados intensivos e doenças infecciosas para divulgação. Estes resultados provavelmente serão imediatamente aplicáveis à beira do leito após a conclusão do estudo e fornecerão informações com baixo risco de viés para o desenvolvimento de diretrizes. intensiva VentilatorAssociated Ventilator Associated Evaluation randomizado controlado séptico infeccioso 2 protocolo 20 20% 15 1 5 1, superioridade internacionais apresentálo apresentá lo divulgação diretrizes

ABSTRACT Amid sustainable agendas, renewable energy sources play a strong role, especially wind energy. However, the implementation of wind farms produces transformations in communities, causing impacts in different areas and vulnerability processes. The study aims to problematize the reports of the peasant population regarding the processes of vulnerability in the area of influence of the implementation of wind farms in a municipality in Pernambuco. This is an observational, descriptive research with a qualitative approach, carried out in a peasant community, located in the municipality of Caetés, Pernambuco, Brazil. Data collection was carried out through semi-structured interviews. Data analysis was based on the content analysis technique in the thematic modality. It was observed that the arrival and operation of the wind turbines coincided with the emergence of signs and symptoms, such as hearing and skin problems, anxiety, dizziness and headache. This situation allows us to consider a probable connection between the impacts caused by wind towers, already described in the literature, and those present in the participants’ reports. Prudence is necessary when planning and building wind farms, since such health problems can be temporary or permanent, leading the local community to constant suffering.

RESUMO Em meio a pautas sustentáveis, as fontes de energia renováveis apresentam um forte papel, em especial, a energia eólica. No entanto, a implantação dos empreendimentos eólicos produz transformações nas comunidades, causando impactos em diferentes áreas e processos de vulnerabilização. O estudo objetiva problematizar os relatos da população camponesa referentes aos processos de vulnerabilização em área de influência da implantação dos empreendimentos eólicos em um município pernambucano. Trata-se de uma pesquisa observacional, descritiva de abordagem qualitativa, realizada em uma comunidade camponesa localizada no município de Caetés, Pernambuco, Brasil. A coleta de dados foi realizada mediante entrevista semiestruturada. A análise de dados partiu da técnica de análise de conteúdo na modalidade temática. Observou-se que a chegada e o funcionamento dos aerogeradores coincidiram com o surgimento de sinais e sintomas, como os problemas auditivos e de pele, ansiedade, tontura e cefaleia. Tal situação permite considerar uma provável ligação entre os impactos causados pelas torres eólicas, já descritos na literatura, com aqueles presentes nos relatos dos participantes. É necessário prudência no momento de planejamento e construção de complexos eólicos, uma vez que tais agravos à saúde podem se comportar como temporários ou permanentes, levando a comunidade local a um sofrimento constante.

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.&nbsp; The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.&nbsp; Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG).&nbsp;

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.&nbsp; Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG).&nbsp;

ABSTRACT Background: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated. Methods: DEFENDER is an investigator-initiated, multicenter, randomized, open-label trial designed to evaluate the efficacy and safety of dapagliflozin in 500 adult participants with acute organ dysfunction who are hospitalized in the intensive care unit. Eligible participants will be randomized 1:1 to receive dapagliflozin 10mg plus standard of care for up to 14 days or standard of care alone. The primary outcome is a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and intensive care unit length of stay, up to 28 days. Safety will be strictly monitored throughout the study. Conclusion: DEFENDER is the first study designed to investigate the use of a sodium-glucose cotransporter-2 inhibitor in general intensive care unit patients with acute organ dysfunction. It will provide relevant information on the use of drugs of this promising class in critically ill patients. ClinicalTrials.gov registry: NCT05558098 Background rates Sodiumglucose Sodium glucose cotransporter2 cotransporter 2 cotransporter- outcomes sodiumglucose sodium investigated Methods investigatorinitiated, investigatorinitiated investigator initiated, initiated investigator-initiated multicenter openlabel open label 50 11 1 1: mg alone therapy stay Conclusion ClinicalTrialsgov ClinicalTrials gov registry NCT NCT0555809 5 NCT055580 NCT05558 NCT0555 NCT055 NCT05 NCT0

RESUMO Antecedentes: A doença crítica é um importante ônus permanente da assistência médica em todo o mundo e está associada a altas taxas de mortalidade. Os inibidores do cotransportador de sódio-glicose do tipo 2 têm demonstrado consistentemente benefícios nos desfechos cardiovasculares e renais. Os efeitos dos inibidores do cotransportador de sódio-glicose do tipo 2 em doenças agudas ainda não foram devidamente investigados. Métodos: O DEFENDER é um estudo de iniciativa do investigador, multicêntrico, randomizado, aberto, desenhado para avaliar a eficácia e a segurança da dapagliflozina em 500 participantes adultos com disfunção orgânica aguda hospitalizados na unidade de terapia intensiva. Os participantes aptos serão randomizados 1:1 para receber 10mg de dapagliflozina e o tratamento padrão por até 14 dias ou apenas o tratamento padrão. O desfecho primário é um composto hierárquico de mortalidade hospitalar, início de terapia renal substitutiva e tempo de internação na unidade de terapia intensiva, até 28 dias. O monitoramento da segurança será rigoroso durante todo o estudo. Conclusão: O DEFENDER é o primeiro estudo desenvolvido para investigar o uso de um inibidor do cotransportador de sódio-glicose do tipo 2 em pacientes de unidade de terapia intensiva geral com disfunção orgânica aguda. O estudo fornecerá informações relevantes sobre o uso de medicamentos dessa classe promissora em pacientes críticos. Registro ClincalTrials.gov: NCT05558098 Antecedentes sódioglicose sódio glicose renais investigados Métodos investigador multicêntrico randomizado aberto 50 11 1 1: mg hospitalar Conclusão críticos ClincalTrials.gov ClincalTrialsgov ClincalTrials gov NCT NCT0555809 5 NCT055580 NCT05558 NCT0555 NCT055 NCT05 NCT0

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy. Objective COVID19 COVID 19 COVID-1 Brazil Methods Experts methodologists guideline andor ADOLOPMENT eCOVID19 eCOVID e e-COVID-1 platform Results Twentyone Twenty one generated authorization imdevimab infection hydroxychloroquine plasma colchicine made Conclusion recommended recommendation evidencebased economy COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos. Objetivo COVID19 COVID 19 COVID-1 Brasil Métodos especialistas metodologistas baseouse baseou se eou GRADE ADOLOPMENT eCOVID19 eCOVID e-COVID-1 RecMap Resultados Chegaramse Chegaram 2 baricitinibe invasiva anticoagulantes tromboembolismo imdevimabe bacteriana hidroxicloroquina convalescente ritonavir rendesivir Conclusão COVID19, 19, condicional usados recursos COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

ABSTRACT The ecological structure of forest fragments is closely related to the dynamics of biological flows directly dependent on the decomposition of the litterfall, which is the main mechanism of recycling nutrients to plants. In this sense, the objective of the present work was to quantify the annual litterfall productionduring the period from April 2013 to March 2014 in Mata do Bebo, an Atlantic Forest fragment located in Macaíba, Rio Grande do Norte. 10 conical collectors were used to obtain the data on the litter contribution, with an average opening area of 0.128 m2, placed 1 m above the ground. The material was collected monthly, dried at air temperature for 48 h, and separated into four fractions: leaves, bark and branches, reproductive material; and miscellaneous material. After separation, the fractions were weighed and stored. The total contribution of litter was uninterrupted and totaled 5,038.72 kg ha-1 yea-1, with the highest production in September, at the beginning of the dry season, and the lowest in July. The foliar fraction made the largest contribution, with 3,744.26 kg ha-1 yean1, followed by the reproductive material, which reached 846.29 kg ha-1 year-1, branches and bark, with 396.10 kg ha-1 year-1, and miscellaneous material, with 52,069 kg ha-1 year-1. The correlations of litterfall production with rainfall and temperature were negative. The litterfall production in the fragment was lower than that obtained in other remaining Atlantic Forest areas, possibly because it is located in a region considered an ecotone between the Caatinga and Atlantic Forest biomes, besides the anthropic effect to which it has been submitted for decades.

RESUMEN La estructura ecológica de un fragmento de bosque está estrechamente relacionada con la dinámica de los flujos biológicos, ya que depende directamente de la descomposición de la hojarasca, que representa el principal mecanismo de disponibilidad y retorno de nutrientes a las plantas. El objetivo de este trabajo fue cuantificar la producción anual de hojarasca en un fragmento de Bosque Atlántico en el noreste de Brasil. Para obtener datos sobre la producción de hojarasca se utilizaron 10 colectores cónicos con una superficie media de 0,128 m 2 , situados a 1 m de altura. El material se recogía mensualmentg, se secaba a temperatura ambiente durante 48 h y se separaba en fracciones: hojas, corteza, ramas, material de reproducción y miscelánea. Después de la separación las fracciones fueron pesadas y almacenadas. La producción de hojarasca fue ininterrumpida y ascendió a un total de 5.038,72 kg ha -1 .año~ 1 , con la mayor producción en septiembre, al comienzo del período seco, y la menor en julio. La fracción foliar fue la que presentó el mayor aporte en la producción de la hojarasca, con 3.744,26 kg ha -1 año- 1 , seguida del material de reproducción que alcanzó a 846,29 kg ha -1 año -1 , las ramas y las cáscaras con 396,10 kg ha -1 añoy material misceláneo con 52.069 kg ha -1 año -1 . Las correlaciones de la producción de hojarasca con la lluvia y la temperatura resultaron negativas. La producción de hojarasca en el fragmento fue menor que la obtenida en otras zonas del Bosque Atlántico, posiblemente porque se encuentra en una región considerada un ecotono con la Caatinga, además del efecto antrópico al que ha estado sometido durante décadas.