Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children. (PA approach crosssectional cross sectional study 1200 1 200 1,20 8.1±1.0 8110 8 0 (8.1±1. old municipality (BMI overweight s conducted software 0.847, 0847 0.847 , 847 (0.847) 0.349, 0349 0.349 349 (0.349) 0.564, 0564 0.564 564 (0.564) 0.662 0662 662 (0.662 observed 0.212 0212 212 (-0.212 0.387, 0387 0.387 387 (-0.387) 0.492, 0492 0.492 492 (-0.492) 0.557. 0557 0.557 . 557 (-0.557) Additionally 1.789 1789 789 (1.789 values 2.239 2239 2 239 (2.239 1.230 1230 230 (1.230 lowincome low income 120 20 1,2 8.1±1. 811 (8.1±1 084 0.84 84 (0.847 034 0.34 34 (0.349 056 0.56 56 (0.564 0.66 066 66 (0.66 0.21 021 21 (-0.21 038 0.38 38 (-0.387 049 0.49 49 (-0.492 055 0.55 55 (-0.557 1.78 178 78 (1.78 2.23 223 23 (2.23 1.23 123 (1.23 12 1, 8.1±1 81 (8.1± 08 0.8 (0.84 03 0.3 3 (0.34 05 0.5 5 (0.56 0.6 06 6 (0.6 0.2 02 (-0.2 (-0.38 04 0.4 4 (-0.49 (-0.55 1.7 17 7 (1.7 2.2 22 (2.2 1.2 (1.2 8.1± (8.1 0. (0.8 (0.3 (0.5 (0. (-0. (-0.3 (-0.4 (-0.5 1. (1. 2. (2. 8.1 (8. (0 (-0 (1 (2 8. (8 ( (-

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda. (AF rede Tratase Trata se 1200 1 200 1.20 8,1±1,0 8110 8 0 (8,1±1, anos município (IMC sobrepeso Jasp 0,847, 0847 0,847 , 847 (0,847) 0,349, 0349 0,349 349 (0,349) 0,564 0564 564 (0,564 0,662. 0662 0,662 . 662 (0,662) 0,212, 0212 0,212 212 (-0,212) 0,387, 0387 0,387 387 (-0,387) 0,492 0492 492 (-0,492 0,557. 0557 0,557 557 (-0,557) Adicionalmente 1,789 1789 789 (1,789 intermediação 2,239 2239 2 239 (2,239 1,230. 1230 1,230 230 (1,230) renda 120 20 1.2 8,1±1, 811 (8,1±1 084 0,84 84 (0,847 034 0,34 34 (0,349 0,56 056 56 (0,56 066 0,66 66 (0,662 021 0,21 21 (-0,212 038 0,38 38 (-0,387 0,49 049 49 (-0,49 055 0,55 55 (-0,557 1,78 178 78 (1,78 2,23 223 23 (2,23 123 1,23 (1,230 12 1. 8,1±1 81 (8,1± 08 0,8 (0,84 03 0,3 3 (0,34 0,5 05 5 (0,5 06 0,6 6 (0,66 02 0,2 (-0,21 (-0,38 0,4 04 4 (-0,4 (-0,55 1,7 17 7 (1,7 2,2 22 (2,2 1,2 (1,23 8,1± (8,1 0, (0,8 (0,3 (0, (0,6 (-0,2 (-0,3 (-0, (-0,5 1, (1, 2, (2, (1,2 8,1 (8, (0 (-0 (1 (2 8, (8 ( (-

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Abstract Systemic Arterial Hypertension is a multifactorial clinical condition associated with severe outcomes such as stroke and death. One of the main modifiable risk factor for hypertension is an unhealthy diet, often characterized by the consumption of ultraprocessed foods such as sweetened beverages. We aimed to investigate the relationship between the consumption of sweetened beverages, both sugar-sweetened and artificially sweetened, and the prevalence of hypertension in adults. A cross-sectional, household, population-based study with 1,162 adults from two Brazilian cities were carried out. The consumption of food groups and sweetened beverages was obtained by food frequency questionnaire and other data were self-reported. Weight, height, and waist circumference were measured. The association between sweetened beverages consumption and hypertension was analyzed using Poisson regression models, expressed as Prevalence Ratio. The prevalence of hypertension was 16.7%, with no significant difference between genders. The prevalence of consumption of sweetened beverages was 70.3% in men and 54.6% in women, being significantly higher in men. Women who consumed sugar-sweetened and artificially sweetened beverages 6 to 7 days per week had 92% higher prevalence of hypertension compared to those who did not consume or consumed at a lower frequency. Furthermore, women who consumed artificially sweetened beverages at least 1 time per week had 3.36 times higher prevalence of hypertension. The habitual consumption of sweetened beverages may be an important risk factor for hypertension, especially the consumption of diet beverages, which are often marketed as healthier than sugar-sweetened beverages.

Resumen La Hipertensión Arterial Sistémica es una condición clínica multifactorial asociada a resultados graves como el ictus y la muerte. Uno de los principales factores de riesgo modificables de la hipertensión es una dieta poco saludable, a menudo caracterizada por el consumo de alimentos ultraprocesados como las bebidas endulzadas. Nuestro objetivo fue investigar la relación entre el consumo de bebidas endulzadas, tanto azucaradas como edulcoradas artificialmente, y la prevalencia de hipertensión en adultos. Se realizó un estudio transversal, domiciliario y poblacional con 1,162 adultos de dos ciudades brasileñas. El consumo de grupos de alimentos y bebidas endulzadas se obtuvo mediante cuestionario de frecuencia de alimentos y los demás datos fueron autoinformados. Se midieron el peso, la talla y el perímetro de la cintura. La asociación entre el consumo de bebidas endulzadas y la hipertensión se analizó mediante modelos de regresión de Poisson, expresados como Ratio de Prevalencia. La prevalencia de hipertensión fue del 16,7%, sin diferencias significativas entre géneros. La prevalencia de consumo de bebidas endulzadas fue del 70,3% en los hombres y del 54,6% en las mujeres, siendo significativamente mayor en los hombres. Las mujeres que consumían bebidas azucaradas y edulcoradas artificialmente entre 6 y 7 días a la semana tenían 92% mayor prevalencia de hipertensión que las que no consumían o consumían con una frecuencia menor. Además, las mujeres que consumían bebidas edulcoradas al menos 1 vez por semana tenían una prevalencia de hipertensión 3,36 veces mayor. Así pues, el consumo habitual de bebidas endulzadas puede ser un importante factor de riesgo de hipertensión, especialmente el consumo de bebidas dietéticas, que a menudo se comercializan como más saludables que las bebidas azucaradas.

SARS-CoV-2, which caused the coronavirus pandemic in 2019 (COVID-19), is a beta-coronavirus, and its infection in host cells can activate innate and adaptive immune responses through the activation of several pro-inflammatory cytokines. Thus, in this study we established the relationship between the severity and immunopathology of COVID-19 through the main inflammatory cytokines. Results show that tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ) and interleukins (IL), such as IL-6, are stimulated by the activation of T cell subsets, which results in immune-mediated cellular destruction. Several cytokines reduce the immune response and predispose to a pro-inflammatory and auto-reactive state, including IL-1β, IL-1RA, IL-7, IL-8, IL-9, IL-10, and associated inflammatory markers (LDH, GM-CSF and VEGF). These higher cytokine levels end up favoring tissue damage in multiple systems, including lungs, heart, gastrointestinal, brain, kidneys and other organs. Increasingly, a greater impact of the markers IL-6, ferritin, pro-calcitonin, lactic dehydrogenase, D-dimer and hypoalbuminemia was observed in patients with severe infection of the disease. In general, the data analyzed confirmed that COVID-19 severity is not caused simply by the viral infection, but rather by immune response and aberrant inflammation. In this way, this study allows a contribution to clinical practice, and it shows that it is essential to carry out in-depth studies about the immunopathology of COVID-19, in order to determine the severity markers involved in the pathogenesis of the viral infection.

O SARS-CoV-2, causador da doença coronavírus 2019 (COVID-19), é um beta-coronavírus, e sua infecção nas células do hospedeiro pode ativar respostas imunes inata e adaptativa, por meio da secreção de várias citocinas pró-inflamatórias. Assim, estabelecemos neste estudo a correlação da gravidade e imunopatologia da COVID-19 com as principais citocinas inflamatórias. Resultados mostram que o fator de necrose tumoral alfa (TNF-α), interferon-gama (IFN-γ) e interleucinas (IL), como a IL-6, são estimulados pela ativação de subconjuntos de células T, o que resulta em destruição celular imunomediada. Sendo que, diversas citocinas deprimem a resposta imune sadia, e predispõem a um estado pró-inflamatório e auto-reativo, dentre elas, IL-1β, IL-1RA, IL-7, IL-8, IL-9, IL-10, e os marcadores inflamatórios associados (LDH, GM-CSF e VEGF). Isso acaba por favorecer danos teciduais em múltiplos sistemas, como no pulmonar, cardíaco, gastrointestinal, cerebral, renal, dentre outros. Acrescenta-se que foi observado um impacto maior dos marcadores IL-6, ferritina, pró-calcitonina, desidrogenase láctica, D-dímero e hipoalbuminemia em pacientes com infecção grave da doença. De forma geral, pela análise de dados, verificou-se que a gravidade da doença COVID-19 parece ser modulada não apenas pela infecção viral, mas também por respostas imunes e inflamatórias aberrantes no hospedeiro. Dessa forma, este estudo permite contribuir para o auxílio da prática clínica, sendo imprescindível a realização de estudos aprofundados acerca da imunopatologia da COVID-19, a fim de que se determine os marcadores de gravidade envolvidos na patogênese da infecção viral.

ABSTRACT BACKGROUND: The effect of weight loss (WL) on histopathological aspects of non-alcoholic fatty liver disease (NAFLD) may provide further insights into the dynamics of hepatic recovery after WL. OBJECTIVE: To analyze the effects of pre-operative WL on insulin resistance- and NAFLD-related histology in individuals undergoing bariatric surgery (BS) with or without pre-operative WL. DESIGN AND SETTING: A matched cross-sectional study was conducted at a public university hospital and a private clinic in Campinas, Brazil. METHODS: An analytical, observational, cross-sectional study was conducted using prospectively collected databases of individuals who underwent BS and liver biopsy at either a public tertiary university hospital (with pre-operative WL) or a private clinic (without pre-operative WL). Random electronic matching by gender, age, and body mass index (BMI) was performed and two paired groups of 24 individuals each were selected. RESULTS: Of the 48 participants, 75% were female. The mean age was 37.4 ± 9.6. The mean BMI was 38.9 ± 2.6 kg/m2. Fibrosis was the most common histopathological abnormality (91.7%). Glucose was significantly lower in the WL group (92 ± 19.1 versus 111.8 ± 35.4 mg/dL; P = 0.02). Significantly lower frequencies of macrovesicular steatosis (58.3% versus 95.8%; P = 0.004), microvesicular steatosis (12.5% versus 87.5%; P < 0.001), and portal inflammation (50% versus 87.5%; P = 0.011) were observed in the WL group. CONCLUSION: Pre-operative WL was significantly associated with lower frequencies of macro- and mi- crovesicular steatosis, portal inflammation, and lower glycemia, indicating an association between the recent trajectory of body weight and histological aspects of NAFLD. BACKGROUND (WL nonalcoholic non alcoholic NAFLD (NAFLD OBJECTIVE preoperative pre operative resistance NAFLDrelated related (BS SETTING crosssectional cross sectional Campinas Brazil METHODS analytical observational . gender (BMI 2 selected RESULTS 4 participants 75 female 374 37 37. 96 9 6 9.6 389 38 38. 26 2. kgm2 kgm kg m2 m kg/m2 91.7%. 917 91.7% 91 7 (91.7%) 92 (9 191 19 1 19. 1118 111 8 111. 354 35 35. mg/dL mgdL mg dL 0.02. 002 0.02 0 02 0.02) 58.3% 583 58 3 (58.3 95.8% 958 95 0.004, 0004 0.004 , 004 0.004) 12.5% 125 12 5 (12.5 87.5% 875 87 0.001, 0001 0.001 001 0.001) 50% 50 (50 0.011 0011 011 CONCLUSION Preoperative Pre macro mi glycemia 9. kg/m 91.7 (91.7% ( 11 00 0.0 58.3 (58. 95.8 000 0.00 12.5 (12. 87.5 (5 0.01 01 91. (91.7 0. 58. (58 95. 12. (12 87. (91. (1 (91

ABSTRACT: The present study described the prevalence and factors associated with the seropositivity for anti-Brucella spp. antibodies in working equids in the semiarid regionofnortheastern Brazil. Blood samples were collected from 322 equids (76 horses, 155 mules and 91 donkeys). The Rose Bengal plate test (RBPT) was used as a screening method. Samples that were reactive in the RBPT were tested for confirmation using 2-mercaptoethanol (2-ME) and the standard tube agglutination test (STAT). Overall, 7.1% (23/322) of the samples were positive according to the RBPT. After confirmatory tests, the prevalence of brucellosis was found to be 6.5% (21/322). Among these cases, 33.3% (7/21) were horses, 42.8% (9/21) were mules and 23.9% (5/21) were donkeys. In the multivariate analysis, age over 10 years was considered to be a factor associated with the seropositivity (OR: 17.17; 95% CI: 2.582-164.7, P = 0.006) for anti-Brucella spp. antibodies. The significant prevalence of anti-Brucella spp. antibodies found in working equids and the wide distribution of positive animals demonstrates a worrying epidemiological situation regarding brucellosis in the study region. Age over 10 years was a risk factor associated with the seropositivity for anti-Brucella spp. antibodies in animals. ABSTRACT antiBrucella anti Brucella spp Brazil 32 76 (7 horses 15 9 donkeys . donkeys) (RBPT method 2mercaptoethanol mercaptoethanol 2 2ME ME (2-ME STAT. STAT (STAT) Overall 71 7 1 7.1 23/322 23322 23 (23/322 tests 65 6 5 6.5 21/322. 21322 21/322 21 (21/322) cases 333 33 3 33.3 7/21 721 (7/21 428 42 8 42.8 9/21 921 (9/21 239 23.9 5/21 521 (5/21 analysis OR (OR 17.17 1717 17 95 CI 2.582164.7, 25821647 2.582 164.7, 582 164 2.582-164.7 0.006 0006 0 006 region ( (STAT 7. 23/32 2332 (23/32 6. 2132 21/32 (21/322 33. 7/2 72 (7/2 4 42. 9/2 92 (9/2 23. 5/2 52 (5/2 17.1 171 582164 2.582164.7 2582164 2582 2.58 1647 164.7 58 16 2.582-164. 0.00 000 00 23/3 233 (23/3 213 21/3 (21/32 7/ (7/ 9/ (9/ 5/ (5/ 17. 58216 2.582164. 258216 258 2.5 164. 2.582-164 0.0 23/ (23/ 21/ (21/3 (9 (5 5821 2.582164 25821 25 2. 2.582-16 0. (23 (21/ 2.58216 2.582-1 (2 (21 2.5821 2.582-

RESUMO: O objetivo do presente estudo foi descrever a prevalência e os fatores associados à infecção por Brucellaspp. em equídeos de trabalho na região semiárida do Nordeste do Brasil. Amostras de sangue foram coletadas de 322 equídeos (76 equinos, 155 muares e 91 asininos). O teste de placa Rosa Bengala (RBPT) foi usado como método de triagem. As amostras que foram reativas no RBPT foram enviadas para confirmação usando 2-mercaptoetanol (2-ME) e o teste padrão de aglutinação em tubo (STAT). Ao todo, 7,1% (23/322) das amostras foram positivas segundo o RBPT. Após testes confirmatórios, a prevalência de brucelose foi de 6,5% (21/322). Destes casos, 33,3% (7/21) foram equinos, 42,8% (9/21) muares e 23,9% (5/21) asininos. Na análise multivariada, idade acima de 10 anos foi considerada fator associado à infecção (OR: 17,17; 95% CI: 2,582-164,7, P = 0.006) por Brucellas pp. A prevalência significativa de anticorpos anti-Brucella spp. encontrados em equídeos de trabalho e a ampla distribuição de animais positivos demonstra uma situação epidemiológica preocupante em relação à brucelose na região de estudo. A idade superior a 10 anos foi um fator de risco associado à infecção em animais. RESUMO Brucellaspp Brasil 32 76 (7 equinos 15 9 asininos . asininos) (RBPT triagem 2mercaptoetanol mercaptoetanol 2 2ME ME (2-ME STAT. STAT (STAT) todo 71 7 1 7,1 23/322 23322 23 (23/322 confirmatórios 65 6 5 6,5 21/322. 21322 21/322 21 (21/322) casos 333 33 3 33,3 7/21 721 (7/21 428 42 8 42,8 9/21 921 (9/21 239 23,9 5/21 521 (5/21 multivariada OR (OR 17,17 1717 17 95 CI 2,582164,7, 25821647 2,582 164,7, 582 164 2,582-164,7 0.006 0006 0 006 pp antiBrucella anti Brucella spp ( (STAT 7, 23/32 2332 (23/32 6, 2132 21/32 (21/322 33, 7/2 72 (7/2 4 42, 9/2 92 (9/2 23, 5/2 52 (5/2 17,1 171 582164 2,582164,7 2582164 2582 2,58 1647 164,7 58 16 2,582-164, 0.00 000 00 23/3 233 (23/3 213 21/3 (21/32 7/ (7/ 9/ (9/ 5/ (5/ 17, 58216 2,582164, 258216 258 2,5 164, 2,582-164 0.0 23/ (23/ 21/ (21/3 (9 (5 5821 2,582164 25821 25 2, 2,582-16 0. (23 (21/ 2,58216 2,582-1 (2 (21 2,5821 2,582-

RESUMEN Introducción: El entrenamiento tradicional en hipoxia intermitente mejora el rendimiento deportivo tras cortos periodos de exposición, sin embargo, la exposición aguda a la hipoxia intermitente conduce a una disminución de la intensidad del entrenamiento y de la calidad técnica. La solución para superar estos efectos negativos puede ser realizar los esfuerzos en normoxia y los intervalos entre esfuerzos en hipoxia, manteniendo la calidad del entrenamiento y los beneficios de la hipoxia. Objetivo: Este estudio pretendía evaluar las respuestas fisiológicas agudas a la exposición a la hipoxia durante la recuperación entre esfuerzos de alta intensidad. Materiales y métodos: Estudio aleatorizado, a ciegas y controlado con placebo. Dieciséis hombres realizaron una prueba de ejercicio graduado para determinar su intensidad máxima y dos sesiones de entrenamiento por intervalos de alta intensidad. Los intervalos de entrenamiento podían ser en hipoxia (HRT), FIO2: 0,136 o normoxia (NRT), FIO2: 0,209. Durante el intervalo de dos minutos entre los diez esfuerzos de un minuto, se midieron constantemente la saturación periférica de oxígeno (SpO2), la frecuencia cardiaca (FC), el lactato en sangre ([La]) y la glucemia ([Glu]). Resultados: Hubo diferencias en la FC (TRN = 120 ± 14 lpm; TRH = 129 ± 13 lpm, p < 0,01) y la SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p < 0,01). No hubo diferencias en [La] y [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) y TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusión: Se evidenció la posibilidad de incluir hipoxia sólo en los intervalos de recuperación como estímulo adicional al entrenamiento sin disminuir la calidad del mismo. Nivel de Evidencia II; Ensayo Clínico Aleatorizado de Baja Calidad. Introducción embargo técnica Objetivo métodos aleatorizado placebo HRT, HRT , (HRT) FIO2 FIO 0136 0 136 0,13 NRT, NRT (NRT) 0209 209 0,209 minuto SpO2, SpO (SpO2) FC, (FC) ([La] Glu. Glu . ([Glu]) Resultados 12 1 lpm 0,01 001 01 969 96 9 96, 1,0% 10 862 86 2 86, 35 3 5 3,5% 0,01. [La [Glu 4,4 44 4 (4, 17 7 1, mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3, 05 0, 5,2 52 (5, 20 2, 40 4, 08 8 mmol.l1, 0,17. 017 0,17 0,17) Conclusión mismo II Calidad (HRT 013 0,1 (NRT 020 0,20 (SpO2 (FC ([La ([Glu] 0,0 00 1,0 3,5 (4 l1 mmol.l- 5, (5 02 0,2 (SpO ([Glu (

ABSTRACT Introduction: Traditional intermittent hypoxia training improves sport performance after short periods of exposure, but acute exposure to intermittent hypoxia leads to decreased training intensity and technical quality. The solution to overcome these negative effects may be to perform efforts in normoxia and the intervals between efforts in hypoxia, maintaining the quality of training and the benefits of hypoxia. Objective: This study aimed to evaluate the acute physiological responses to hypoxia exposure during recovery between high intensity efforts. Materials and methods: Randomized, one-blind, placebo-controlled study. Sixteen men performed a graded exercise test to determine their maximal intensity and two sessions of high-intensity interval training. The training intervals could be in hypoxia (HRT), FIO2: 0.136 or normoxia (NRT), FIO2: 0.209. During the two-minute interval between the ten one-minute efforts, peripheral oxygen saturation (SpO2), heart rate (HR), blood lactate ([La]), blood glucose ([Glu]) were constantly measured. Results: There were differences in HR (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p < 0.01) and SpO2 (TRN = 96.9 ± 1.0%; TRH = 86.2 ± 3.5%, p < 0.01). No differences in [La] and [Glu] TRN (4.4 ± 1.7 mmol.l-1; 3.9 ± 0.5 mmol.l-1) and TRH (5.2 ± 2.0 mmol.l-1; 4.0 ± 0.8 mmol.l-1, p = 0.17). Conclusion: The possibility of including hypoxia only in the recovery intervals as an additional stimulus to the training, without decreasing the quality of the training, was evidenced. Level of Evidence II; Randomized Clinical Trial of Minor Quality. Introduction Objective methods oneblind, oneblind one blind, blind one-blind placebocontrolled placebo controlled highintensity HRT, HRT , (HRT) FIO2 FIO 0136 0 136 0.13 NRT, NRT (NRT) 0209 209 0.209 twominute minute oneminute SpO2, SpO (SpO2) HR, (HR) La, La ([La]) Glu ([Glu] measured Results 12 1 bpm 0.01 001 01 969 96 9 96. 1.0% 10 862 86 2 86. 35 3 5 3.5% 0.01. . [La [Glu 4.4 44 4 (4. 17 7 1. mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3. 05 0. 5.2 52 (5. 20 2. 40 4. 08 8 mmol.l1, 1, 0.17. 017 0.17 0.17) Conclusion evidenced II Quality (HRT 013 0.1 (NRT 020 0.20 (SpO2 (HR ([La] ([Glu 0.0 00 1.0 3.5 (4 l1 mmol.l- 5. (5 02 0.2 (SpO ([La (

RESUMO Introdução: O treinamento de hipóxia intermitente tradicional melhora o desempenho esportivo após curtos períodos de exposição, porém a exposição aguda à hipóxia intermitente leva à diminuição da intensidade do treinamento e da qualidade técnica. A solução para superar esses efeitos negativos pode ser realizar esforços em normóxia e os intervalos entre os esforços em hipóxia, mantendo a qualidade do treinamento e os benefícios da hipóxia. Objetivo: Este estudo teve como objetivo avaliar as respostas fisiológicas agudas à exposição de hipóxia durante a recuperação entre esforços de alta intensidade. Materiais e métodos: Estudo aleatório e one-blinded, com efeito placebo controlado. Dezesseis homens realizaram um teste de exercício graduado para determinar sua intensidade máxima e duas sessões de treinamento intervalado de alta intensidade. Os intervalos de treinamento podem ser em hipóxia (TRH), FIO2: 0,136 ou normóxia (TRN), FIO2: 0,209. Durante os dois minutos de intervalo entre os dez esforços de um minuto, foram medidos constantemente a saturação periférica de oxigênio (SpO2), frequência cardíaca (FC), lactato sanguíneo ([La]), glicemia ([Glu]). Resultados: Houve diferenças na FC (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p <0,01) e SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p <0,01). Sem diferenças em [La] e [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) e TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusão: Evidenciou-se a possibilidade de incluir a hipóxia apenas nos intervalos de recuperação como um estímulo adicional ao treinamento, sem diminuir a qualidade do treinamento. Nível de Evidência II; Estudo Clínico Randomizado de Menor Qualidade. Introdução técnica Objetivo métodos oneblinded, oneblinded one blinded, blinded one-blinded controlado TRH, , (TRH) FIO2 FIO 0136 0 136 0,13 TRN, (TRN) 0209 209 0,209 minuto SpO2, SpO (SpO2) FC, (FC) La, La ([La]) Glu. Glu . ([Glu]) Resultados 12 1 bpm <0,01 001 01 969 96 9 96, 1,0% 10 862 86 2 86, 35 3 5 3,5% <0,01. [La [Glu 4,4 44 4 (4, 17 7 1, mmol.l1 mmoll1 mmoll mmol.l mmol l mmol.l-1 39 3, 05 0, 5,2 52 (5, 20 2, 40 4, 08 8 mmol.l1, 0,17. 017 0,17 0,17) Conclusão Evidenciouse Evidenciou se II Qualidade (TRH 013 0,1 020 0,20 (SpO2 (FC ([La] ([Glu] <0,0 00 1,0 3,5 (4 l1 mmol.l- 5, (5 02 0,2 (SpO ([La ([Glu <0, ( <0 <

ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses. Objective unit Methods 201 2019 District Brazil Results 26 detected 28 15 54% 54 (54% autumnwinter autumn winter period Childrens Children s 69 9 6. months 58% 58 (58% male 10 39% 39 (39% comorbidity 73% 73 (73% ventilation 24 90% 90 (90% 14 oseltamivir 1 7% 7 (7% deaths Conclusions avoided Moreover 20 2 (54 (58 3 (39 (73 (90 (7 (5 (3 (9 (

RESUMO Objetivo: Avaliar a vigilância da síndrome respiratória aguda grave em uma unidade pediátrica. Métodos: Estudo descritivo dos casos de síndrome respiratória aguda grave, notificados e com a detecção de vírus respiratório em amostra de nasofaringe de pacientes internados entre 2013 e 2019, em um hospital de referência do Distrito Federal. Resultados: Um total de 269 crianças tiveram algum vírus detectado, resultando em 280 vírus, sendo 152 (54%) vírus sincicial respiratório. A detecção do vírus sincicial respiratório foi maior durante o período de outono-inverno. A mediana da idade das crianças foi de 6,9 meses, 156 (58%) eram do sexo masculino, 104 (39%) tinham comorbidade, 197 (73%) necessitaram de ventilação mecânica, 241 (90%) receberam antibióticos e 146 (54%) oseltamivir. Ocorreram 19 (7%) óbitos. A mediana do tempo desde o início dos sintomas até a coleta da amostra foi de 5 dias, e do tempo da coleta até o resultado foi de 6 dias. Conclusões: O sistema necessita reduzir o tempo do resultado final para que seja possível evitar o uso inadequado de antibióticos e antivirais. Ademais, o impacto das pneumonias virais foi relevante e o sistema deve ser flexível suficiente para incluir vírus emergentes, para ser útil na resposta às emergências de saúde pública causada por vírus respiratórios. Objetivo pediátrica Métodos 201 2019 Federal Resultados 26 detectado 28 15 54% 54 (54% outonoinverno. outonoinverno outono inverno. inverno outono-inverno 69 9 6, meses 58% 58 (58% masculino 10 39% 39 (39% comorbidade 73% 73 (73% mecânica 24 90% 90 (90% 14 oseltamivir 1 7% 7 (7% óbitos dias Conclusões antivirais Ademais emergentes respiratórios 20 2 (54 (58 3 (39 (73 (90 (7 (5 (3 (9 (

ABSTRACT. The objective of this work is to identify which carcass and cut characteristics have the best discriminatory power, between sexes and slaughter weights, through discriminant analysis. Were used 32 goats, with initial average weights of 3.11 kg for males and 3.06 kg, for females, for animals slaughtered at 70 days; 3.65 kg for males and 3.25 kg for females for animals slaughtered at 100 days of weight. Objective assessments consisted of morphometric measurements: external carcass length (ECL); internal carcass length (ICL); leg length (LEL); chest width (CHW); croup width (CRW); thigh perimeter (THP); croup perimeter (CRP); chest perimeter (CHP); chest depth (CHD); internal chest depth (ICD) using the hypsometer and flexible tape (Truper®). In the total of 18 primary variables evaluated, the following variables were included in the discriminant model, using the stepwise method: empty body weight, chest depth, chest width, thigh circumference, neck, loin, leg length, and rump width. The discriminant analysis was efficient to discriminate and identify the carcass and cut characteristics with better discriminatory power between the sex and slaughter weight of the animals. ABSTRACT 3 goats 311 11 3.1 306 06 3.0 7 365 65 3.6 325 25 3.2 10 measurements ECL (ECL) ICL (ICL) LEL (LEL) CHW (CHW) CRW (CRW) THP (THP) CRP (CRP) CHP (CHP) CHD (CHD) ICD (ICD Truper®. Truper Truper® . (Truper®) 1 evaluated model method circumference neck loin 31 3. 30 0 36 6 2 (ECL (ICL (LEL (CHW (CRW (THP (CRP (CHP (CHD (Truper® (Truper

Abstract Rendu-Osler-Weber syndrome, also known as hereditary hemorrhagic telangiectasia, is an autosomal dominant hereditary disorder. It is characterized by presence of multiple arteriovenous malformations (AVMs) and telangiectasias. This article reports two cases of patients with Rendu-Osler-Weber syndrome who had pulmonary AVMs and underwent successful endovascular treatment. A brief review of the literature shows that up to 50% of patients with the syndrome have pulmonary AVMs and there is usually a positive family history in these patients. These pulmonary AVMs are multiple in 30% of cases and are associated with the most severe disease complications. Most patients are asymptomatic, even in the presence of AVMs with right-left shunts. When these shunts exceed 25% of the total blood volume, dyspnea, cyanosis, digital clubbing, and extracardiac murmurs may occur. Endovascular treatment is safe and offers control of complications from hereditary hemorrhagic telangiectasia and is currently the treatment of choice for these lesions. RenduOslerWeber Rendu Osler Weber disorder (AVMs telangiectasias 50 30 asymptomatic rightleft right left 25 volume dyspnea cyanosis clubbing occur lesions 5 3 2

Resumo A síndrome de Rendu-Osler-Weber, também conhecida como telangiectasia hemorrágica hereditária, é uma doença hereditária autossômica dominante. Ela é caracterizada pela presença de múltiplas malformações arteriovenosas e telangiectasias. Este artigo relata dois casos de pacientes com síndrome de Rendu-Osler-Weber que apresentaram malformações arteriovenosas pulmonares e foram submetidos a tratamento endovascular com sucesso. Uma breve revisão da literatura mostra que até 50% dos pacientes com a síndrome têm malformações arteriovenosas pulmonares e geralmente há um histórico familiar positivo nesses pacientes. Em 30% dos casos, elas são múltiplas e estão associadas a complicações mais graves da doença. A maioria dos pacientes é assintomática, mesmo na presença de malformações arteriovenosas com shunt direito-esquerdo. Quando esses shunts excedem 25% do volume total de sangue, podem surgir dispneia, cianose, baqueteamento digital e sopros extracardíacos. O tratamento endovascular oferece segurança e controle das complicações da telangiectasia hemorrágica hereditária, sendo atualmente o tratamento de escolha para essas lesões. RenduOslerWeber, RenduOslerWeber Rendu Osler Weber, Weber dominante telangiectasias sucesso 50 30 assintomática direitoesquerdo. direitoesquerdo direito esquerdo. esquerdo direito-esquerdo 25 sangue dispneia cianose extracardíacos lesões 5 3 2

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics. challenge approach expertise protocols SBA (SBA neonates experts patients opinions assessment preparation positioning preoxygenation, preoxygenation pre oxygenation, oxygenation pre-oxygenation trauma paramountly tools laryngoscopy bronchoscopy devices education simulations technologies

ABSTRACT This study aimed to investigate the effects of xylanase (Xyl) individually or in combination with B. subtilis and B. licheniformis associated or not with yeast cell wall in pig diets with a reduction of 100 kcal/kg of metabolizable energy (ME) content. Pig performance, bone parameters, intestinal morphometry, and bioeconomic indices were evaluated. A total of 75 pigs (25 females and 50 barrows; 25.02±3.21 kg) obtained from crossing Large White × Landrace were used. The experimental design consisted of randomized blocks, with five treatments and five blocks, totaling 25 experimental units subjected to treatments: basal diet (B); basal diet with reduction of 100 kcal/kg of ME (BEM); BEM with supplementation of xylanase (0.01%; BX); BX with supplementation of direct-fed microbials (composed of B. subtilis and B. licheniformis; 0.02%; BXM); and BX supplemented with 0.10% of symbiotic (which includes B. subtilis, B. licheniformis, and yeast cell wall; BXS). There were no differences in bone parameters. The BEM diet resulted in a lower villus height:crypt depth ratio in the jejunum than that seen upon using the BXS diet as feed. In the first period, pigs fed BEM diet had a 12% higher average daily feed intake than those fed the BXM diet. There were no differences in the pig performance during the second period. Over the total period, pigs fed BEM diet had greater FCR compared with pigs fed BXM diet. The inclusion of feed additives in diets with reduced ME content contributes to the maintenance of performance and characteristics of the metacarpus and jejunum of growing pigs and provides better bioeconomic indices. Xyl (Xyl B 10 kcalkg kcal kg (ME parameters morphometry evaluated 7 (2 5 barrows 2502321 02 3 21 25.02±3.2 used blocks 2 (B) (BEM) 0.01% 001 0 01 (0.01% BX) directfed direct composed 0.02% 002 BXM) 010 0.10 which BXS. . BXS) heightcrypt height crypt period 12 1 ( 250232 25.02±3. (B (BEM 0.01 00 (0.01 0.02 0.1 25023 25.02±3 0.0 (0.0 0. 2502 25.02± (0. 250 25.02 (0 25.0 25.

ABSTRACT In economic terms the lettuce (Lactuca sativa L.) is considered relevant among the vegetable crops. The diversity of cultivars available today, their varying climatic requirements and climatic differences between the different producing regions, lettuce may present seasonal variations in supply and prices during agricultural years. The aim of this work was to study the seasonal variation of lettuce supply and prices practiced in the state of Minas Gerais, in the period between January 2012 and December 2017. The data were obtained from CeasaMinas and processed by the centralized moving geometric mean methodology, obtaining the minimum, average and maximum indexes for supply and prices practiced. Lettuce showed a marked seasonal variation in supply and prices, and Ceasa Great-BH presented the highest seasonal variation of price and supply indices practiced. The variations in supply and prices in the hot and rainy season, in relation to the dry season, are markedly more accentuated. It was observed that there is a relationship that follows the “Law of supply”, where in the cold periods of the year the lowest prices associated with the lowest offers were presented and in the hot periods of the year, the highest prices associated with the largest offers were presented. Lactuca L. L crops today regions years Gerais 201 2017 methodology minimum GreatBH Great BH season accentuated Law supply, , supply” 20 2

ABSTRACT Objective: Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival. Methods: We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America. Results: We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation. Conclusion: In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials. Objective exchange however injury strategies ≤ ( 8mLkg mLkg 8mL kg mL weight 30cmH2O cmHO cmH O syndrome However levels 2 ventilatorfree ventilator free survival Methods multicenter multinational 28day 28 followup follow up pressurefraction fraction 300mmHg mmHg America Results 42 countries mortality sedation Conclusion trials 4

RESUMO Objetivo: Pacientes com insuficiência respiratória aguda frequentemente necessitam de ventilação mecânica para reduzir o trabalho respiratório e melhorar a troca gasosa; no entanto, a ventilação mecânica pode exacerbar a lesão pulmonar. As estratégias de ventilação protetora, caracterizadas por baixo volume corrente (≤ 8mL/kg de peso corporal previsto) e pressão de platô limitada abaixo de 30cmH2O, mostraram melhores desfechos em pacientes com síndrome do desconforto respiratório agudo. No entanto, na transição para a ventilação espontânea, manter o volume corrente dentro dos níveis de proteção pode ser desafiador, e não está claro se o volume corrente baixo durante a ventilação espontânea afeta os desfechos dos pacientes. Desenvolvemos um protocolo de estudo para estimar a prevalência de ventilação com volume corrente baixo nas primeiras 24 horas de ventilação espontânea em pacientes com insuficiência respiratória aguda hipoxêmica e sua associação com dias livres da ventilação mecânica e sobrevida. Métodos: Desenhamos um estudo de coorte multicêntrico, multinacional, com seguimento de 28 dias, que incluirá pacientes com insuficiência respiratória aguda, definida como pressão parcial de oxigênio/fração inspirada de oxigênio < 300mmHg, em transição para ventilação espontânea em unidades de terapia intensiva na América Latina. Resultados: Pretendemos incluir 422 pacientes em 10 países. Os desfechos primários são a prevalência de baixo volume corrente nas primeiras 24 horas de ventilação espontânea e dias livres da ventilação mecânica no dia 28. Os desfechos secundários são mortalidade hospitalar e na unidade de terapia intensiva, incidência de assincronia e retorno à ventilação controlada e sedação. Conclusão: Neste estudo, avaliaremos a prevalência de volume corrente baixo durante a ventilação espontânea e sua associação com os desfechos clínicos, o que pode informar a prática clínica e futuros ensaios clínicos. Objetivo gasosa entanto pulmonar protetora ≤ ( 8mLkg mLkg 8mL kg mL previsto 30cmH2O cmHO cmH O agudo desafiador 2 sobrevida Métodos multicêntrico multinacional oxigêniofração fração 300mmHg mmHg Latina Resultados 42 1 países sedação Conclusão clínicos 4

ABSTRACT BACKGROUND AND OBJECTIVES: The mechanisms underlying nociplastic pain, such as fibromyalgia (FM), are not fully understood, however, it is believed that altered sensory processing and pain modulation play prominent roles in the maintenance of nociplastic pain. The hypothesis is that changes in the primary somesthetic cortex (S1) contribute to the generalized pain character of FM. The objective of this study was to evaluate the involvement of the primary somesthetic cortex in humans with fibromyalgia, as well as to investigate possible associations between S1 changes and clinical signs and symptoms of FM. CONTENTS: For this integrative review, the following databases were used: Pubmed and Web of Science, including observational studies carried out in humans with FM. In total, 541 studies were identified and four were included. The majority of studies are case-control studies, published between 2016 and 2022. In total, data from 161 individuals were included in this review. It was identified that there are morphological changes, hyperactivation and increased functional connectivity between S1 and periaqueductal gray matter and between S1 and anterior cingulate cortex. CONCLUSION: Patients with FM present morphological changes and hyperactivation in S1, as well as increased functional connectivity between S1 and periaqueductal gray matter and S1 and limbic system. Furthermore, different bilateral somatotropic subregions (legs, chest, fingers, hands, face and back) showed reduced functional connectivity in patients with FM. These regions are often presented as “tender points” in FM. OBJECTIVES FM, , (FM) understood however S (S1 CONTENTS review used Science total 54 casecontrol case control 201 2022 16 CONCLUSION system Furthermore legs, legs (legs chest fingers hands back tender points (FM (S 5 20 202 1 2

RESUMO JUSTIFICATIVA E OBJETIVOS: Os mecanismos subjacentes à dor nociplástica, como a fibromialgia (FM), não são totalmente compreendidos, contudo acredita-se que o processamento sensorial e a modulação da dor alterados desempenham papéis proeminentes para a manutenção da dor nociplástica. Com a hipótese de que alterações no córtex somestésico primário (S1) contribuam para o caráter de dor generalizada da FM, o objetivo deste estudo foi avaliar o envolvimento do córtex somestésico primário em humanos com FM, bem como investigar possíveis associações entre alterações de S1 com sinais e sintomas clínicos da FM. CONTEÚDO: Para esta revisão integrativa, foram utilizadas as seguintes bases de dados: Pubmed e Web of Science, incluindo estudos observacionais realizados em humanos com FM. No total, 541 estudos foram identificados e quatro foram incluídos. A maioria dos estudos são do tipo caso-controle, publicados entre 2016 e 2022. Ao todo, dados de 161 indivíduos foram incluídos. Foi identificado que há alterações morfológicas, hiperativação e aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e entre S1 e córtex cingulado anterior. CONCLUSÃO: Pacientes com FM apresentam alterações morfológicas e hiperativação em S1, bem como aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e S1 e sistema límbico. Ademais, diferentes sub-regiões somatotrópicas bilaterais (pernas, tórax, dedos, mãos, face e costas) apresentaram redução da conectividade funcional em pacientes com FM. Essas regiões são frequentemente apresentadas como “tender points” na FM. OBJETIVOS nociplástica , (FM) compreendidos acreditase acredita se S (S1 CONTEÚDO integrativa Science total 54 incluídos casocontrole, casocontrole caso controle, controle caso-controle 201 2022 todo 16 anterior CONCLUSÃO límbico Ademais subregiões sub pernas, pernas (pernas tórax dedos mãos costas tender points (FM (S 5 20 202 1 2