ABSTRACT Objective: To investigate the association between body mass index (BMI), obesity, clinical outcomes, and mortality following coronary artery bypass grafting (CABG) in Brazil using a large sample with one year of follow-up from the Brazilian Registry of Cardiovascular Surgeries in Adults (or BYPASS) Registry database. Methods: A multicenter cohort-study enrolled 2,589 patients submitted to isolated CABG and divided them into normal weight (BMI 20.0-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obesity (BMI > 30.0 kg/m2) groups. Inpatient postoperative outcomes included the most frequently described complications and events. Collected post-discharge outcomes included rehospitalization and mortality rates within 30 days, six months, and one year of follow-up. Results: Sternal wound infections (SWI) rate was higher in obese compared to normal-weight patients (relative risk [RR]=5.89, 95% confidence interval [CI]=2.37-17.82; P=0.001). Rehospitalization rates in six months after discharge were higher in obesity and overweight groups than in normal weight group (χ2=6.03, P=0.049); obese patients presented a 2.2-fold increase in the risk for rehospitalization within six months compared to normal-weight patients (RR=2.16, 95% CI=1.17-4.09; P=0.045). Postoperative complications and mortality rates did not differ among groups during time periods. Conclusion: Obesity increased the risk for SWI, leading to higher rehospitalization rates and need for surgical interventions within six months following CABG. Age, female sex, and diabetes were associated with a higher risk of mortality. The obesity paradox remains controversial since BMI may not be sufficient to assess postoperative risk in light of more complex and dynamic evaluations of body composition and physical fitness. Objective BMI, , (BMI) (CABG followup follow up or BYPASS database Methods cohortstudy cohort study 2589 2 589 2,58 20.024.9 200249 20.0 24.9 20 0 24 9 20.0-24. kg/m2, kgm2 kgm kg/m2 kg m2 m 25.029.9 250299 25.0 29.9 25 29 25.0-29. 300 30. events postdischarge post 3 days followup. up. Results SWI (SWI normalweight relative RR=5.89, RR589 RR =5.89, 5 89 [RR]=5.89 95 CI=2.3717.82 CI2371782 CI =2.37 17.82 37 17 82 [CI]=2.37-17.82 P=0.001. P0001 P P=0.001 . 001 P=0.001) χ2=6.03, χ2603 χ χ2 6 03 (χ2=6.03 P=0.049 P0049 049 P=0.049) 2.2fold 22fold fold 2.2 RR=2.16, RR216 16 (RR=2.16 CI=1.174.09 CI117409 CI=1.17 4.09 1 4 09 CI=1.17-4.09 P=0.045. P0045 P=0.045 045 P=0.045) periods Conclusion Age sex fitness 258 58 2,5 024 20.024. 20024 200 20. 249 24. 20.0-24 kg/m 029 25.029. 25029 250 25. 299 29. 25.0-29 RR=5.89 RR58 =5.89 8 [RR]=5.8 3717 CI=2.3717.8 CI237178 237 =2.3 1782 17.8 [CI]=2.37-17.8 P000 P=0.00 00 χ2=6.03 χ260 (χ2=6.0 P=0.04 P004 04 2fold 22 2. RR=2.16 RR21 (RR=2.1 174 CI=1.174.0 CI11740 CI117 CI=1.1 409 4.0 CI=1.17-4.0 2, 02 20.024 2002 20.0-2 25.029 2502 25.0-2 RR=5.8 RR5 =5.8 [RR]=5. 371 CI=2.3717. CI23717 23 =2. 178 17. [CI]=2.37-17. P00 P=0.0 χ2=6.0 χ26 (χ2=6. RR=2.1 RR2 (RR=2. CI=1.174. CI1174 CI11 CI=1. 40 4. CI=1.17-4. 20.02 20.0- 25.02 25.0- RR=5. =5. [RR]=5 CI=2.3717 CI2371 =2 [CI]=2.37-17 P0 P=0. χ2=6. (χ2=6 RR=2. (RR=2 CI=1.174 CI1 CI=1 CI=1.17-4 RR=5 =5 [RR]= CI=2.371 CI237 = [CI]=2.37-1 P=0 χ2=6 (χ2= RR=2 (RR= CI= CI=1.17- RR= [RR] CI=2.37 CI23 [CI]=2.37- P= χ2= (χ2 (RR [RR CI=2.3 CI2 [CI]=2.37 (χ CI=2. [CI]=2.3 CI=2 [CI]=2. [CI]=2 [CI]= [CI] [CI

ABSTRACT Purpose To develop on intervention process to identify children at risk of dyslexia, based on the Response to Intervention model. Specifically, to identify the pattern of changes in post-intervention performance in tasks of phonological awareness, working memory, lexical access, reading and writing; and to analyze which cognitive functions had a significant effect on the discriminating students at risk of dyslexia. Method Sample of 30 participants with Reading and writing difficulties, aged 8-11, from public/private schools, students from 3rd to 5th grade. Participants were submitted to a battery of cognitive-linguistic tests, before and after 12 intervention sessions. To monitor their performance, five reading and writing lists of words and pseudowords were applied. We qualitatively and quantitatively analyzed the differences in pre- and post-intervention performance of each participant; and among participants in the post-assessment, to understand the patterns of dyslexia vs non-dyslexia groups. Results There were statistically significant changes in: rapid automatized naming, narrative text comprehension, phonological awareness, rate and typology of hits/misses in reading and writing, and reading speed. Being the last three variables the most sensitive to discriminate the two groups, all with less post-intervention gains for the dyslexia group. Conclusions The intervention focused on the stimulation of phonological skills and explicit and systematic teaching of graphophonemic correspondences contributed positively to the evolution of the group's participants. The intervention response approach favored the identification of children with a profile at risk for dyslexia, as distinct from children with other learning difficulties. model Specifically postintervention post awareness memory access 3 difficulties 811, 811 8 11, 11 8-11 publicprivate public private schools rd th grade cognitivelinguistic linguistic tests 1 sessions applied pre participant postassessment, postassessment assessment, assessment post-assessment nondyslexia non groups naming comprehension hitsmisses hits misses speed group s 81 8-1 8-

Resumo Objetivo desenvolver um processo de intervenção para identificação de crianças em risco para dislexia, baseado no modelo de resposta à intervenção. Especificamente, identificar o perfil de mudança no desempenho pós-intervenção em tarefas de consciência fonológica, memória operacional, acesso lexical, leitura, escrita; e analisar quais funções cognitivas tiveram efeito significativo para discriminação de estudantes em risco para dislexia. Método amostra composta por 30 participantes com dificuldades na leitura e escrita, entre 8 e 11 anos, de escola pública ou particular, estudantes do 3º ao 5º ano. Todos foram submetidos a uma bateria de testes cognitivo-linguísticos, antes e após a realização de 12 sessões de intervenção. Para monitoramento do desempenho foram aplicadas cinco listas de leitura e escrita de palavras/pseudopalavras. Foram realizadas análises, qualitativas e quantitativas, das diferenças de desempenho pré e pós-intervenção; e entre os participantes na pós avaliação, para compreensão de grupos perfil em risco para dislexia vs não-dislexia. Resultados ocorreram mudanças estatisticamente significativas em nomeação automática rápida, compreensão de texto, consciência fonológica, taxa e tipologia de acertos/erros na leitura/escrita e velocidade de leitura. Sendo essas três últimas variáveis as que se mostraram mais discriminativas dos grupos, todas com menos ganhos na pós-intervenção para o grupo com perfil em risco de dislexia. Conclusão a intervenção com foco na estimulação das habilidades fonológicas e ensino explícito das correspondências grafofonêmicas contribuiu para a evolução dos participantes. A abordagem de resposta à intervenção favoreceu a identificação de crianças com perfil em risco para dislexia, as diferenciando de crianças com outras dificuldades de aprendizagem. Especificamente pósintervenção fonológica operacional lexical 3 1 anos particular º ano cognitivolinguísticos, cognitivolinguísticos cognitivo linguísticos, linguísticos cognitivo-linguísticos palavraspseudopalavras palavras pseudopalavras palavras/pseudopalavras análises quantitativas avaliação nãodislexia. nãodislexia não não-dislexia rápida texto acertoserros acertos erros leituraescrita aprendizagem

ABSTRACT Introduction: Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. Methods: In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. Results: Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. Conclusion: The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings. Introduction worldwide However infection hospitalization morbimortality Also Methods context transplantations (PBM program pillars 1 (1 manner period 2 (2 s 3 (3 tolerance demand Results complications Thus Conclusion comprehensive evidencebased hospitals highcomplexity complexity Saúde settings (

Abstract Objective: To outline the epidemiological profile of tibial fractures treated in a tertiary hospital and explore associations between the characteristics of the fractures and the clinical outcome of postoperative complications. Methods: Retrospective cross-sectional study involving adult patients diagnosed with tibial fractures who underwent surgical and/or conservative treatment in a tertiary hospital between January 2019 and December 2021. The variables sex, age, mechanism of injury, type and classification of fracture, associated injuries, personal history, length of hospital stay, surgical treatment, post-surgical complications (infections, loss of synthesis material, surgical wound dehiscence) and death. Results: The sample consisted of 100 individuals, with an average age of 35.8 years, 86% of whom were male, with a higher prevalence of motorcycle accidents. The most common treatment was intramedullary stem, and type C fractures, which are more complex, were more associated with complications. Conclusion: Given the predominance of motorcycle accidents involving young people, there is a need for intervention in accident prevention policies, aiming to reduce the incidence, as well as the morbidity and mortality, of these individuals and, consequently, to reduce costs to the health system. Level of evidence III, Retrospective Study. Objective Methods crosssectional cross sectional andor or 201 2021 sex injury fracture injuries history stay postsurgical post infections, infections (infections material dehiscence death Results 10 358 35 8 35. years 86 male stem complex Conclusion people policies incidence mortality consequently system III Study 20 202 1 3 2

Resumo Objetivo: Traçar o perfil epidemiológico das fraturas de tíbia tratadas em um Hospital de nível terciário e explorar associações entre a caraterística da fratura e o desfecho clínico de complicações pós-operatórias. Métodos: Estudo transversal retrospectivo, envolvendo pacientes adultos, com diagnóstico de fratura de tíbia que realizaram tratamento cirúrgico e/ou conservador em um hospital de nível terciário entre janeiro de 2019 e dezembro de 2021. Foram analisadas as variáveis sexo, idade, mecanismo de lesão, tipo e classificação de fratura, lesões associadas, antecedentes pessoais, tempo de internação hospitalar, tratamento cirúrgico, complicações pós cirúrgicas (infecções, perda do material de síntese, deiscência de ferida operatória) e óbito. Resultados: A amostra foi composta por 100 indivíduos, com média de idade de 35,8 anos, sendo 86% do gênero masculino, com maior prevalência de acidente motociclístico. O tratamento mais realizado foi a Haste intra-medular e as fraturas do tipo C, mais complexas, foram mais associadas às complicações. Conclusão: Diante da predominância de acidentes motociclísticos envolvendo o público jovem há necessidade de intervenção de políticas de prevenção de acidentes, visando diminuir a incidência, bem como a morbidade e mortalidade desses indivíduos e consequentemente a diminuição de custos ao sistema de saúde. Nível de evidência III, Estudo Retrospectivo. Objetivo pósoperatórias. pósoperatórias operatórias. operatórias pós-operatórias Métodos retrospectivo adultos eou ou 201 2021 sexo lesão pessoais hospitalar infecções, infecções (infecções síntese operatória óbito Resultados 10 358 35 8 35, anos 86 masculino motociclístico intramedular intra medular C complexas Conclusão incidência saúde III Retrospectivo 20 202 1 3 2

Abstract Objective: To investigate the performance of 27 children with phenylketonuria (PKU) in tests of Executive Functions (EF) and Social Cognition (SC), and their associations with metabolic control inferred by phenylalanine (Phe) levels. Methods: The PKU group was dichotomized according to baseline Phe-levels into; "classical PKU"(n = 14), with Phe-levels above 1200 µmol/L (> 20 mg/dL); and "mild PKU" (n = 13) with Phe-between 360 and 1200 µmol/L (6-20 mg/dL). The neuropsychological assessment focused on the EF and SC subtests of the NEPSY-II battery and intellectual performance. Children were compared to age-matched healthy participants. Results: Participants with PKU presented significantly lower Intellectual Quotient (IQ) compared to controls (p = 0.001). Regarding EF analysis adjusted by age and IQ, significant differences between groups were observed only in the executive attention subtests (p = 0.029). The SC set of variables was significantly different between groups (p = 0.003), as in the affective recognition task (p < 0.001). In the PKU group, the relative variation of Phe-achieved 32.1 ± 21.0%. Relative Phe-variation was correlated only with measures of Working Memory (p < 0.001), Verbal Fluency (p = 0.004), Inhibitory Control (p = 0.035) and Theory of Mind (p = 0.003). Conclusions: Phonological Verbal Fluency, Working Memory, Inhibitory Control, and Theory of Mind were shown to be most vulnerable when there is non-ideal metabolic control. Variations in the level of Phe-may have a selective negative effect on Executive Functions and Social Cognition, but not on intellectual performance. Objective 2 (PKU (EF SC, , (SC) Phe (Phe levels Methods Phelevels into classical PKUn n 14, 14 14) 120 µmolL µmol L > ( mg/dL mgdL mg dL mg/dL) mild 13 Phebetween 36 620 6 (6-2 mg/dL. . NEPSYII NEPSY II agematched matched participants Results IQ (IQ p 0.001. 0001 0.001 0 001 0.001) 0.029. 0029 0.029 029 0.029) 0.003, 0003 0.003 003 0.003) Pheachieved achieved 321 32 1 32. 210 21 21.0% Phevariation 0.001, 0.004, 0004 0.004 004 0.004) 0.035 0035 035 0.003. Conclusions nonideal non ideal Phemay may (SC 12 3 62 (6- 000 0.00 00 002 0.02 02 21.0 0.03 03 (6 0.0 21. 0.