■ RESUMO Cútis laxa é uma rara doença do tecido conectivo caracterizada pela disfunção das fibras elásticas. Indivíduos acometidos por essa enfermidade queixam-se de sua aparência envelhecida. Os tratamentos se baseiam no uso de cosméticos ou em técnicas cirúrgicas, sendo a cirurgia plástica uma ferramenta de extrema relevância. A blefaroplastia tem o objetivo de melhorar a aparência senil e proporcionar rejuvenescimento na área ao redor dos olhos, fazendo com que o olhar pareça mais descansado e alerta. Trata-se de um estudo observacional retrospectivo utilizando os dados do prontuário. Relato do Caso: Paciente do sexo feminino, 17 anos, encaminhada ao serviço de Cirurgia Plástica do Hospital Universitário Walter Cantídio, Fortaleza-CE, para tratamento devido à insatisfação com a sua aparência. Submetida a uma blefaroplastia superior e inferior associada a cantopexia sem cantotomia. No período pós-operatório, foi observado resultado satisfatório para a cirurgia proposta e adequada correção das alterações existentes. Conclusão: Observa-se a importância da correção cirúrgica facial nos casos de cútis laxa, ressaltando a relevância da aplicação de técnicas cirúrgicas adequadas e o aprimoramento das mesmas nesse perfil de paciente. elásticas queixamse queixam envelhecida olhos alerta Tratase Trata prontuário Caso feminino 1 anos Cantídio FortalezaCE, FortalezaCE Fortaleza CE, CE Fortaleza-CE cantotomia pósoperatório, pósoperatório pós operatório, operatório pós-operatório existentes Conclusão Observase Observa paciente

■ ABSTRACT Cutis laxa is a rare connective tissue disease characterized by dysfunction of elastic fibers. Individuals affected by this disease complain about their aged appearance. Treatments are based on the use of cosmetics or surgical techniques, with plastic surgery being an extremely relevant tool. Blepharoplasty aims to improve the senile appearance and provide rejuvenation in the area around the eyes, making the look appear more rested and alert. This is a retrospective observational study using medical record data. Case Report: A female patient, 17 years old, was referred to the Plastic Surgery Service of the Walter Cantídio University Hospital, Fortaleza-CE, for treatment due to dissatisfaction with her appearance. She underwent upper and lower blepharoplasty associated with canthopexy without canthotomy. In the postoperative period, a satisfactory result was observed for the proposed surgery and adequate correction of existing changes. Conclusion: The importance of facial surgical correction in cases of lax skin is observed, highlighting the relevance of applying appropriate surgical techniques and improving them in this patient profile. fibers tool eyes alert data Report 1 old Hospital FortalezaCE, FortalezaCE Fortaleza CE, CE Fortaleza-CE canthotomy period changes Conclusion profile

RESUMO Contexto: A litíase biliar pode ser definida como a presença de cálculo ou barro biliar na vesícula e/ou nos ductos biliares. A doença pode ser assintomática ou sintomática, podendo levar a complicações e, consequentemente, a um pior prognóstico, como colecistite aguda, coledocolitíase, colangite e pancreatite aguda. O risco de complicações aumenta após o primeiro episódio de cólica biliar. Objetivo: Avaliação clínica-epidemiológica dos pacientes internados em enfermaria de gastroenterologia de um hospital terciário, com complicações relacionadas à litíase biliar. Métodos: Foram avaliados 158 pacientes internados no período de 1º de janeiro de 2013 a 24 de fevereiro de 2021, por meio de análise de relatório de alta e prontuário. Resultados: Houve uma predominância do sexo feminino (76,6%), e a média de idade dos pacientes foi de 51,6 anos. Homens eram significativamente mais velhos que as mulheres (P=0,005). A maioria (57,6%) apresentava alguma comorbidade, sendo as mais frequentes: hipertensão arterial sistêmica, diabetes mellitus e obesidade. A média de tempo de internação foi de 24 dias, sendo significativamente maior para os homens (P=0,046), mas sem relação direta com a idade (P=0,414). A complicação mais frequente foi a coledocolitíase, e 55,7% dos pacientes sem colecistectomia prévia apresentaram relato de cólica biliar antes da internação, em média, 1,5 anos antes. Histórico de colecistectomia prévia estava presente em 17,1% dos avaliados. Ultrassonografia abdominal, seguida de colangiorressonância magnética foram os exames complementares mais frequentemente realizados para definição diagnóstica. Em relação às medidas terapêuticas, a colangiopancreatografia endoscópica retrógrada (CPRE) foi necessária em 47,3% dos pacientes sem colecistectomia prévia e 81,4% dos pacientes com colecistectomia prévia. Dos pacientes ainda não colecistectomizados, 84% deles puderam ser submetidos ao procedimento antes da alta. Conclusão: Houve predomínio do sexo feminino. Os homens foram significativamente mais velhos do que as mulheres e tiveram uma permanência hospitalar consideravelmente mais longa. A complicação mais frequente foi a coledocolitíase, e cerca de metade dos pacientes relatou cólica biliar prévia. A CPRE foi necessária para a maioria dos pacientes.

ABSTRACT Background: Gallstones are the presence of bile clay in the gallbladder or bile ducts. The disease can be asymptomatic or symptomatic and can lead to complications and consequently a worse prognosis, such as acute cholecystitis, choledocholithiasis, cholangitis, and acute pancreatitis. The risk of complications increases after the first episode of biliary colic. Objective: A clinical-epidemiological evaluation of patients admitted to a gastroenterology ward of a tertiary care hospital with gallstone-related complications. Methods: We evaluated 158 patients admitted through discharge reports and medical records analysis from January 1, 2013, to February 24, 2021. Results: The female sex was predominant (76.6%), and the mean age of patients was 51.6 years. Men were significantly older than women (P=0.005). Most (57.6%) had some comorbidity, the most frequent being systemic arterial hypertension, diabetes mellitus, and obesity. The mean hospitalization time was 24 days, significantly longer in men (P=0.046) but without a direct relationship with age (P=0.414). The most frequent complication was choledocholithiasis, and 55.7% of patients without previous cholecystectomy had a report of biliary colic before admission, on average 1.5 years previously. A history of a prior cholecystectomy was present in 17.1% of those evaluated. Abdominal ultrasonography followed by magnetic resonance cholangiography was the most frequently performed exam for diagnostic definition. Regarding therapeutic measures, endoscopic retrograde cholangiopancreatography was necessary for 47.3% of patients without previous cholecystectomy and 81.4% of patients who have already had a cholecystectomy. Among patients not yet cholecystectomized, 84% underwent the procedure before discharge. Conclusion: The female patients were predominant. Men were significantly older than women and had more extended hospital stays. The most frequent complication was choledocholithiasis, and around half of the patients reported previous biliary colic. endoscopic retrograde cholangiopancreatography has been necessary for the majority of the patients.

SUMMARY OBJECTIVE: Risk stratification of sudden cardiac death in patients with coronary artery disease is of great importance. We evaluated the association between ventricular repolarization and induction of malignant ventricular arrhythmias on electrophysiological study of patients with coronary artery disease. METHODS AND RESULTS: A total of 177 patients (65±10.1 years, 83.6% male, mean left ventricular ejection fraction [LVEF] 37.5±13.6%) were analyzed. For each 10 ms increment in the QT interval, there was a 7% increase in malignant ventricular arrhythmias inducibility; QT cutoff point of 452 ms had an accuracy of 0.611 for predicting malignant ventricular arrhythmias (p=0.011). Male gender (odds ratio [OR]=4.18, p=0.012), LVEF <35% (OR=2.32, p=0.013), amiodarone use (OR=2.01, p=0.038), and prolonged QT (OR=1.07, p=0.023) were associated with malignant ventricular arrhythmias. In patients with ventricular dysfunction, QT >452 ms was associated with significantly increased risk of malignant ventricular arrhythmias (OR=5.44, p=0.0004). In those with LVEF ³35%, QT dispersion (QTd) was significantly higher in patients with inducible malignant ventricular arrhythmias. QTd >20 ms had 0.638 accuracy and 81.3% negative predictive value in predicting malignant ventricular arrhythmias. CONCLUSION: QT interval is an independent factor associated with malignant ventricular arrhythmias in patients with coronary artery disease. The combination of ventricular dysfunction and prolonged QT interval is associated with a 5.44-fold increase of malignant ventricular arrhythmias induction. Male gender, amiodarone use, and decreased left ventricular ejection fraction are also associated with increased risk of inducibility of malignant ventricular arrhythmias on the electrophysiological study.

ABSTRACT. Agricultural production in semi-arid regions is limited due to water availability. In addition, the water quality available for irrigation is often compromised due to the high salt content present. Millet is a forage species considered tolerant to water deficit and moderately salt tolerant. In view of the above, the objective was to evaluate the growth of millet under water and saline stress associates. The experiment was carried out in a randomized block design, in a 4x3 factorial scheme, composed of four levels of water replacement, based on crop evapotranspiration (ETc): 25%.ETc, 50%.ETc, 75%.ETc and 100%.ETc and three levels of water salinity (0.03, 2.0 and 4.0 dS m-1). With 25%.ETc independent of salinity, all morphological characteristics of millet were affected, occurring death of plants in the initial growth phase. In the absence of salt and greater availability of water, greater plant growth occurred. With respect to salinity, there was a reduction in the increment of all variables evaluated, with the highest reduction at the highest saline level (4.0 dS m-1). Water and salt stresses, when associated, reduce the growth of millet, since concentrations above 2.0 dS m-1 and less than 50%.ETc compromise its full development, providing declines in yield.

ABSTRACT. An experiment was carried out to evaluate the requirement of digestible methionine for growing pullets at growth phase (7 to 12 weeks of age). A completely randomized design was distributed in five treatments, six replicates, and 15 pullets per experimental unit. 450 Dekalb White pullets from the 7th weeks of age, with an average initial weight of 313.14 ± 12.49 g were used. Dietary treatments consisted in five diets supplemented with DL-Methionine which resulted in five levels of digestible methionine (0.266, 0.294, 0.322, 0.350, and 0.378 %). Performance, serological blood, histopathology and histomorphometry data were evaluated. Quadratic responses were observed for final live weight (p < 0.0143), weight gain (p < 0.0073), feed conversion ratio (p < 0.0058), glycogen deposition in the liver (p < 0.0001), gamma-glutamyl transferase enzyme activity (p < 0.0008), and villus height (p < 0.0024) with digestible dMet levels. In conclusion, the use of 0.343 % dMet, corresponding to a dMet:dLys ratio 55, is recommended for white-egg pullets from 7 to 12 weeks of age.

Abstract The extraction of information from point cloud is usually done after the application of classification methods based on the geometric characteristics of the objects. However, the classification of photogrammetric point clouds can be carried out using radiometric information combined with geometric information to minimize possible classification issues. With this in mind, this work proposes an approach to the classification of photogrammetric point cloud, generated by correspondence of aerial images acquired by Remotely Piloted Aircraft System (RPAS). The proposed approach for classifying photogrammetric point clouds consists of a pixel-supervised classification method, based on a decision tree. To achieve this, three data sets were used, one to define which attributes allow discrimination between the classes and the definition of the thresholds. Initially, several attributes were extracted based on a training sample. The average and standard deviation values for the attributes of each class extracted were used to guide the decision tree definition. The defined decision tree was applied to the other two point clouds to validate the approach and for thematic accuracy assessment. The quantitative analyses of the classifications based on kappa coefficient of agreement, applied to both validation areas, reached values higher than 0.938.

The objective of this study was to determine the chlorine nutritional requirement of Japanese Quails during the laying phase, based on performance and egg quality parameters. A total of 240 Japanese quails were distributed according to a randomized block design, with five treatments and six replicates, with 8 birds each. The experiment lasted 84 days, divided in four cycles of 21 days each. Treatments consisted of a basal diet formulated to meet the nutritional requirements, except for chlorine, and four supplementation levels with ammonium chloride, generating the levels 0.8; 1.6; 2.4; 3.2 and 4.0 g/kg. The parameters evaluated were: feed intake (g/bird/day), egg production (egg/bird/day), egg weight (g), egg mass (g), egg mass conversion (g/g), conversion per dozen eggs (kg/dz), weight of yolk (g/100 g of egg), albumen (g/100g of egg) and shell (g/100 g of egg), specific gravity (g/cm³) and shell thickness (mm). As a result of this study, feed intake, egg weight, weights of albumen, yolk, shell and specific gravity were not affected by treatments. There was a quadratic behavior for egg production, egg mass, egg mass conversion, conversion per dozen eggs and shell thickness according to the chlorine levels in the diets, with the requirements for those parameters established at 1.54; 1.37; 1.39 and 2.78 g/kg, respectively. The recommendation is 1.39 g/kg of chlorine and 244.22 mEq/kg of electrolyte balance in diets for Japanese quails.