ABSTRACT Introduction: Postoperative bleeding is one of the main causes of complications in cardiovascular surgery, which highlights the importance of ensuring adequate intraoperative hemostasis, providing a better patient outcome. This study aimed to improve the prevention of postoperative bleeding in the Cardiovascular Surgery Department of the Hospital Estadual Mário Covas (Santo André, Brazil) using an adapted version of the Papworth Haemostasis Checklist to assess the impact of this standardization on bleeding rate, postoperative complications, reoperation, and mortality. Methods: This is a non-randomized controlled clinical trial, whose non-probabilistic sample consisted of patients undergoing cardiac surgery in the abovementioned service within a two-year interval. The Papworth Haemostasis Checklist was adapted to the Brazilian laboratory parameters and the questions were translated into Portuguese. This checklist was used before the surgeon started the chest wall closure. Patients were followed up until 30 days after surgery. A P-value < 0.05 was considered statistically relevant. Results: This study included 200 patients. After the checklist, a reduction in 24-hour drain output, postoperative complications, and reoperation was observed, although statistical significance was not reached. Finally, there was a significant reduction in the number of deaths (8 vs. 2; P=0.05). Conclusion: The use of the adapted checklist in our hospital proved to be an effective intervention to improve the prevention of postoperative bleeding, with a direct impact in the number of deaths in the study period. The reduction in deaths was possible thanks to the reduction in the bleeding rate, postoperative complications, and reoperations for bleeding. Introduction hemostasis outcome Santo André Brazil rate mortality Methods nonrandomized non randomized trial nonprobabilistic probabilistic twoyear two year interval Portuguese closure 3 Pvalue P value 005 0 05 0.0 relevant Results 20 24hour hour 24 output observed reached Finally 8 ( vs 2 P=0.05. P005 P=0.05 . P=0.05) Conclusion period 00 0. P00 P=0.0 P0 P=0. P=0 P=

RESUMO Objetivo: Avaliar estudantes de medicina do terceiro e sexto anos no Brasil em relação a seu conhecimento e atitudes sobre as políticas MPOWER da OMS para redução do uso do tabaco. Métodos: A Pesquisa Global de Estudantes de Profissões da Saúde da OMS foi aplicada em cinco coortes de estudantes de medicina avaliados no terceiro e sexto anos da graduação, entre 2008 e 2015. Foram feitas comparações entre os dois anos da graduação em relação às proporções de estudantes que experimentaram ou fizeram uso de produtos de tabaco nos últimos 30 dias antes da pesquisa; conhecimento e cumprimento das políticas antifumo no campus universitário; treinamento formal sobre estratégias de cessação do tabagismo; e autorreconhecimento como modelo de comportamento para pacientes/sociedade. Resultados: Dos 943 estudantes que preencheram a pesquisa, aproximadamente 6% haviam fumado cigarro nos últimos 30 dias antes da pesquisa. Ao compararmos o terceiro e sexto anos da graduação, observamos um aumento significativo na proporção de estudantes que tinham conhecimento sobre estratégias de cessação do tabagismo (22,74% vs. 95,84%; p < 0,001) e na daqueles que reconheciam seu papel como modelo para pacientes/sociedade (84,5% vs. 89,7%; p = 0,023). O conhecimento dos estudantes sobre as políticas de tabagismo existentes no campus universitário associou-se ao aumento no autorreconhecimento como modelo de comportamento (diferença absoluta ajustada = 6,7%; p ajustado = 0,050). Conclusões: O conhecimento sobre estratégias de cessação do tabagismo e a autorreconhecimento como modelo de comportamento para pacientes/sociedade aumentaram ao longo da graduação e estão associados à implementação de políticas antifumo.

ABSTRACT Objective: To evaluate third- and sixth-year medical students in Brazil in terms of their knowledge of and attitudes toward the WHO MPOWER policies to reduce tobacco use. Methods: The WHO Global Health Professions Student Survey was applied in five cohorts of medical students evaluated in their third and sixth years of medical school, between 2008 and 2015. Comparisons were drawn between the two years of medical school in terms of the proportions of students who experimented with or used tobacco products in the last 30 days prior to the survey; knowledge of and compliance with smoke-free policies on the university campus; formal training on smoking cessation strategies; and self-recognition as role models for patients/society. Results: Of the 943 students who completed the survey, approximately 6% had smoked cigarettes in the last 30 days prior to the survey. Comparing the third and sixth years of medical school, we observed a significant increase in the proportion of students who were knowledgeable about smoking cessation strategies (22.74% vs. 95.84%; p < 0.001) and in that of those who recognized their role as models for patients/society (84.5% vs. 89.7%; p = 0.023). Student knowledge of the smoking policies on the university campus was associated with an increase in self-recognition as role models (adjusted absolute difference = 6.7%; adjusted p = 0.050). Conclusions: Knowledge of smoking cessation strategies and self-recognition as role models for patients/society increase over the course of medical school and are associated with the implementation of smoke-free policies.

ABSTRACT Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin’s lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples.

Resumo Este artigo busca identificar contribuições da bioética para enfrentar conflitos relacionados à tomada de decisão em tempos de pandemia. Trata-se de texto elaborado a partir de reflexões pessoais dos autores em diálogo com a literatura de diferentes perspectivas da bioética. Com fundamento em relatos históricos, argumenta-se que, durante epidemias, a sociedade passa a atuar em modo de excepcionalidade, o que exige argumentação mais apurada para se posicionar ante os conflitos que surgem. Analisam-se então diferentes vertentes teóricas – principialismo, personalismo, utilitarismo e bioética social –, recolhendo de cada uma elementos que podem nortear a tomada de decisão. Com base nessas contribuições, propõem-se parâmetros para a atuação dos profissionais da saúde, reconhecendo igual valor em cada vida humana, com o propósito de salvar o maior número de pessoas possível. Por fim, aponta-se para a responsabilidade de agentes políticos.

Abstract This article aims to identify the contribution of bioethics to resolve decision-making conflicts in healthcare in times of pandemic. The research was based on the authors’ personal reflections in a dialogue with the literature and different bioethical perspectives. Historical accounts show that when a society is experiencing an epidemic it starts to function in a mode of social exceptionality, reinforcing the need for a more appropriate form of reasoning before the ethical conflicts that may arise from this situation. Some approaches to bioethics – principlism, personalism, utilitarianism and social bioethics – are briefly examined in order to obtain the elements for guiding the decision-making process. Finally, we suggest some parameters for health professionals, recognizing the value of all human lives, to save as many lives as possible.

Resumen Este artículo tiene como objetivo identificar la contribución de la bioética para hacer frente a los conflictos relacionados con la toma de decisiones en tiempos de pandemia. Se trata de un texto elaborado con base en las reflexiones personales de los autores en diálogo con la literatura de diferentes perspectivas de la bioética. Con base en los relatos históricos, se argumenta que, durante epidemias, la sociedad pasa a actuar en modo de excepcionalidad, lo que requiere una argumentación más precisa para posicionarse ante los conflictos que surgen. Se analizan entonces diferentes vertientes teóricas –el principialismo, el personalismo, el utilitarismo y la bioética social–, recogiendo de cada una los elementos que pueden orientar la toma de decisiones. Con base en dichas contribuciones, se proponen parámetros para la actuación de los profesionales de la salud, reconociendo el mismo valor en cada vida humana, con el propósito de salvar al mayor número posible de personas. Por fin, se apunta hacia la responsabilidad de los agentes políticos.

ABSTRACT Radiation-induced brachial plexus neuropathy (RIBPN) is a rare and delayed non-traumatic injury to the brachial plexus, which occurs following radiation therapy to the chest wall, neck, and/or axilla in previously treated patients with cancer. The incidence of RIBPN is more common in patients treated for carcinoma of the breast and Hodgkin lymphoma. With the improvement in radiation techniques, the incidence of injury to the brachial plexus following radiotherapy has dramatically reduced. The currently reported incidence is 1.2% in women irradiated for breast cancer. The progression of symptoms is gradual in about two-thirds of cases; the patients may initially present with paresthesia followed by pain, and later progress to motor weakness in the affected limb. We present the case of a 68-year-old female patient with breast cancer submitted to surgery, chemotherapy, and radiotherapy in the year 2000. Eighteen years later, she developed symptoms and signs compatible with RIBPN and was successfully submitted to omentoplasty for pain control. Omentoplasty is an alternative treatment for RIBPN refractory to conservative treatment, which seems to be effective in improving neuropathic pain. However, postoperative worsening of the motor strength is a real possibility, and all candidates for this type of surgery must be informed about the risk of this complication.

Abstract This study aims to find the best conditions for the extraction of Zingiber officinale essential oil using the supercritical fluid extraction (SFE), steam distillation (SD) and hydrodistillation (HD) techniques, regarding the maximum oil yield. For the HD technique is evaluated the best ratio between plant mass and water volume and for SFE and SD the pressure condition was investigated. Principal Component Analysis (PCA) was used to evaluate the similarity between the composition of the essential oil in different pressures and extraction methods. The experimental extraction curve was plotted and three different mathematical models were used to fit the data for SD and SFE methods, obtaining the relevant mass transfer parameters. The essential oil compounds were identified by gas chromatography coupled with mass spectrometry (GC-MS), being α-zingiberene the main component with different contents (from 11.9 to 28.9%). The best condition for the SFE was 100 bar, 40 °C (0.0508 goil/gplant) with 19.34% of α-zingiberene; for the SD, 3 bar (133 °C) (0.00616 goil/gplant) with 28.9% of α-zingiberene; and HD, the volume of 750 mL (0.006988 goil/gplant) with 15.70% of α-zingiberene, all measured on a dry basis.

RESUMO Este é um estudo de caso que objetivou analisar, na perspectiva da saúde coletiva, o processo de desenvolvimento do equipamento médico para o tratamento do pé diabético realizado pela parceria entre o Ministério da Saúde (MS) e a Universidade de Brasília (UnB) no período de dezembro de 2016 a janeiro de 2019. A análise observou o comportamento do grupo de pesquisa responsável pela produção da tecnologia dura mediante as dificuldades em transformar a pesquisa em um produto com viés mercadológico capaz de ser assimilado na cobertura do Sistema Único de Saúde (SUS), concomitantemente à participação da saúde coletiva na superação de alguns entraves. Utilizou-se como estudo de caso a parceria entre o MS e a UnB apoiado no modelo de investigação qualitativa com ênfase em processos metodológicos de tipologia mista, mas com prioridade aos métodos de observação participante cuja unidade de análise está vinculada à saúde coletiva. Os resultados observados evidenciaram que a contribuição da saúde coletiva na produção da tecnologia dura minimizou lacunas para a provável transformação da ideia em produto assimilável pelo SUS. A participação da saúde coletiva diminuiu os espaços entre as áreas do conhecimento envolvidas, aproximando a universidade da iniciativa privada e dos órgãos reguladores.

ABSTRACT This is a case study that is aimed at analyzing, from the perspective of public health, the process of development of medical equipment for the treatment of diabetic foot performed by the partnership between the Ministry of Health (MS) and the University of Brasilia (UnB) from December 2016 to January 2019. The analysis observed the behavior of the research group responsible for the production of hard technology in the face of the difficulties in transforming the research into a product with market potential that can be assimilated into the coverage of the Brazilian Unified Health System (SUS), concomitantly with the participation of public health in overcoming some barriers. The partnership between MS and UnB was used as a case study, supported in the qualitative research model with emphasis on methodological processes of mixed typology, but prioritizing participatory observation methods whose unit of analysis is linked to public health. The results showed that the contribution of public health on the production of hard technology minimized gaps for the probable transformation of the idea into a product assimilated by SUS. The participation of public health narrowed the gaps between the areas of knowledge involved, bringing the university closer to a private initiative and regulating institutions.

RESUMO Este é um estudo de caso que objetivou analisar, na perspectiva da saúde coletiva, o processo de desenvolvimento do equipamento médico para o tratamento do pé diabético realizado pela parceria entre o Ministério da Saúde (MS) e a Universidade de Brasília (UnB) no período de dezembro de 2016 a janeiro de 2019. A análise observou o comportamento do grupo de pesquisa responsável pela produção da tecnologia dura mediante as dificuldades em transformar a pesquisa em um produto com viés mercadológico capaz de ser assimilado na cobertura do Sistema Único de Saúde (SUS), concomitantemente à participação da saúde coletiva na superação de alguns entraves. Utilizou-se como estudo de caso a parceria entre o MS e a UnB apoiado no modelo de investigação qualitativa com ênfase em processos metodológicos de tipologia mista, mas com prioridade aos métodos de observação participante cuja unidade de análise está vinculada à saúde coletiva. Os resultados observados evidenciaram que a contribuição da saúde coletiva na produção da tecnologia dura minimizou lacunas para a provável transformação da ideia em produto assimilável pelo SUS. A participação da saúde coletiva diminuiu os espaços entre as áreas do conhecimento envolvidas, aproximando a universidade da iniciativa privada e dos órgãos reguladores.

ABSTRACT This is a case study that is aimed at analyzing, from the perspective of public health, the process of development of medical equipment for the treatment of diabetic foot performed by the partnership between the Ministry of Health (MS) and the University of Brasilia (UnB) from December 2016 to January 2019. The analysis observed the behavior of the research group responsible for the production of hard technology in the face of the difficulties in transforming the research into a product with market potential that can be assimilated into the coverage of the Brazilian Unified Health System (SUS), concomitantly with the participation of public health in overcoming some barriers. The partnership between MS and UnB was used as a case study, supported in the qualitative research model with emphasis on methodological processes of mixed typology, but prioritizing participatory observation methods whose unit of analysis is linked to public health. The results showed that the contribution of public health on the production of hard technology minimized gaps for the probable transformation of the idea into a product assimilated by SUS. The participation of public health narrowed the gaps between the areas of knowledge involved, bringing the university closer to a private initiative and regulating institutions.

Abstract This paper presents the results of a petrographic and diagenetic study of the laminated limestones of the upper part of the Aptian to Albian Crato Formation, northeast of Brazil. The applied techniques were optical microscopy, cathodoluminescence and scanning electron microscopy (SEM) coupled to a wavelength-dispersive spectrometer (WDS). Petrographic analysis has revealed that most of the laminated limestones are calcilutites with a dominance of a micritic matrix, indicating a low-energy depositional environment. Microstructures such as microfaults, microfractures, microslumps, and loop bedding were observed. Based on textural, structural and paleontological features, seven microfacies were recognized: massive limestone, limestone with parallel laminations, limestone with undulated laminations, limestone with slumps, limestone with loop bedding, limestone with ostracods and limestone with peloids. In addition, the processes of cementation, dissolution, replacement, recrystallization and compaction, which are related to different diagenetic stages, were also recognized. The diagenetic constituents found in the sections include calcite, pyrite, silica and sulfates. We can conclude that a large part of the microstructures (microfaults, microfractures, microslumps and loop bedding) can be related to local seismicity, probably due to the reactivation of the Patos Shear Zone. The diagenetic constituents indicate an early to late diagenesis (eogenetic, mesogenetic and telogenetic stage).

RESUMO: Existem poucos estudos sobre a diversidade microbiana em solos de mamona no ambiente semiárido tropical. Os produtos de mamona têm sido amplamente utilizados em todo o mundo e justificam a importância comercial da ricinocultura no semiárido nordestino brasileiro. Como não há qualquer tipo de fertilização, ou manutenção de resíduos da cultura nos solos de mamona do presente estudo, presume-se que a comunidade de diazotróficas forneça o nitrogênio (N) nesses solos. Avaliou-se a estrutura e diversidade de comunidades de diazotróficas em solos de mamona do semiárido tropical em: i-Mamona com 50 anos de cultivo, consorciada com milho (CB-50); ii-Mamona com 10 anos de cultivo sem consórcio (CB-10) e iii-solo sob vegetação de Caatinga preservada (CAA). Realizou-se avaliação de redução do acetileno a etileno (ARA) e o perfil do gene nifH foi separado por eletroforese em gel de poliacrilamida com gradiente desnaturante (DGGE). A diversidade de diazotróficas foi estimada pelos índices de Shannon (H’) e Simpson (D). Com base na manutenção dos estoques de nitrogênio no solo e da biomassa microbiana ao longo do tempo, a atividade dos diazotróficos de vida livre foi determinante na entrada de N nesses solos. O gene nifH esteve presente e seus perfis agruparam os tratamentos CB-50 com CAA, reforçando a fixação de N pelos diazotróficos, os quais apresentaram maior diversidade nos solos cultivados, mesmo após a mudança de uso da terra para o plantio de mamona.

ABSTRACT: There are few studies of microbial diversity in castor bean soils in tropical semiarid environmental. Castor bean products have been widely used around the world justifying the commercial importance of ricinoculture in Brazil’ northeastern semiarid. There is no fertilization or maintenance of litter on the soils from the present study, so we hypothesized that the free-living diazotrophs microorganisms drive the nitrogen (N) input into these soils. We evaluated the communities’ structure and diversity of diazotrophs in tropical semiarid soils with i-Castor bean 50 years of cultivation intercropping with maize (CB-50); ii-Only Castor bean 10 years of cultivation (CB-10) and iii-soil under Caatinga vegetation (CAA). Nitrogenase enzyme activity was performed by the acetylene reduction assay (ARA) and the community profile of nifH gene was separated by denaturing gradient gel polyacrylamide electrophoresis (DGGE). Diazotrophs diversity was estimated by the Shannon (H’) and Simpson (D) indexes. Based on the maintenance of soil N stocks and N-microbial biomass over time, the activity of free-living diazotrophs was determinant in the N-input into these soils. The nifH gene was present and its profiles grouped the CB-50 with CAA treatments, so it reinforced the N-fixing by diazotrophs, which presented a greater diversity in the cultivated soils, even after the land use change for the castor bean implementation.

RESUMO JUSTIFICATIVA E OBJETIVOS: Avaliar a prevalência e os fatores associados à dor neuropática em pacientes oncológicos. MÉTODOS: Estudo transversal prospectivo realizado no período de agosto de 2016 a julho de 2017. Participaram 267 pacientes oncológicos maiores de 18 anos que apresentavam dor, e excluídos os pacientes diabéticos e portadores de dor crônica pregressa sem relação com a neoplasia atual. Foram obtidas informações demográficas e sobre a doença no prontuário e diretamente com o paciente. Posteriormente foi aplicado o questionário Douleur Neuropathique en 4 questions e a escala numérica da dor. RESULTADOS: A prevalência da dor neuropática na população de estudo foi de 53%. A idade média dos pacientes foi 55,3 anos. Dos 267 pacientes, 76% eram do sexo feminino. Não houve diferença significativa de ocorrência de dor neuropática entre os sexos, idade, tipo histológico do câncer e o tipo de tratamento. Dos pacientes, 35,5% que realizaram quimioterapia tinham dor neuropática, não havendo diferença estatística entre os tipos de quimioterapia realizada. Vinte e quatro pacientes que referiam dor no local do tratamento radioterápico apresentaram o diagnóstico de dor neuropática. Do total, 63 pacientes que referiam dor na área cirúrgica, 36 foram classificados com dor neuropática. Observou-se tendência crescente de dor neuropática quando os tratamentos foram associados. A intensidade dessa dor foi referida como moderada a intensa pela maioria dos pacientes nos diversos tipos de tratamento: quimioterapia, radioterapia e cirurgia. CONCLUSÃO: Quando comparada a outros estudos, foi observada alta prevalência de dor neuropática, em mais da metade dos pacientes avaliados

ABSTRACT BACKGROUND AND OBJECTIVES: To evaluate the prevalence and factors associated with neuropathic pain in cancer patients METHODS: A prospective cross-sectional study conducted from August 2016 to July 2017, with 267 cancer patients above 18 years of age, with pain. Diabetic patients and patients with previous chronic pain unrelated to the current neoplasia were excluded. The demographic and disease information was obtained from the medical records and directly with the patient. The Douleur Neuropathique en 4 questions questionnaire and the numeric pain scale were later applied. RESULTS: The prevalence of neuropathic pain in the study population was 53%. The average age of patients was 55.3 years. Of the 267 patients, 76% were female. There was no significant difference in the occurrence of neuropathic pain among gender, age, histological type of cancer and type of treatment. Of the patients, 35.5% who underwent chemotherapy had neuropathic pain, and there was no statistical difference between the types of chemotherapy performed. Twenty-four patients who reported pain at the radiotherapy site were diagnosed with neuropathic pain. Of the total, 63 patients who reported pain at the surgical site, 36 were classified with neuropathic pain. An increasing trend of neuropathic pain was observed when treatments were associated. The intensity of this pain was reported as moderate to severe by the majority of patients in the various types of treatment: chemotherapy, radiotherapy, and surgery. CONCLUSION: When compared to other studies, a high prevalence of neuropathic pain was observed in more than half of the patients evaluated.

Resumo Foi realizado um estudo de mapeamento de áreas de incidência e previsões para os casos de dengue na área urbana de Belém em que, para a realização de previsões de ocorrências de dengue, foi utilizada a Taxa de Incidência de Dengue (TID) relacionada à precipitação pluviométrica com uso de modelo multivariado baseado na metodologia de Box e Jenkins de séries temporais. O período do estudo foi de 5 anos (2007-2011). Os resultados das análises dos dados da TID e precipitação mostraram que, o aumento na TID é acompanhada por um aumento na precipitação, demonstrando uma relação direta entre essas variáveis no período de estudo, nos bairros da área urbana de Belém, dentre eles com maior destaque para os bairros Marco, Guamá e Pedreira. O modelo de previsão construído para a TID apresentou um bom ajuste com resultados satisfatórios podendo, neste caso, ser utilizado na previsão da dengue.

Abstract It was conducted a mapping study of the areas of incidence and predictions for dengue cases in the urban area of Belém, where the Dengue Incidence Rate (DIR) related to rainfall precipitation was used to forecast dengue occurrences using a multivariate model based on the Box and Jenkins time series methodology. The study period was 5 years (2007-2011). The results of the DIR data analysis and precipitation showed that the increase in DIR is accompanied by an increase in precipitation, demonstrating a direct relationship between these variables in the period under consideration, in the neighborhoods of the urban area of Belém, with greater emphasis in the neighborhoods of Marco, Guamá and Pedreira. The predictive model built for the DIR showed a good fit with satisfactory results and, in this case, can be used to predict dengue.

RESUMO. O objetivo do presente trabalho foi avaliar a inclusão de maniçoba à silagem de cana de açúcar na composição químico bromatológica e cinética de degradação in vitro. Foi elaborado experimento em delineamento inteiramente casualizado com quatro tratamentos (níveis de inclusão: 0, 20, 30 e 40%) e seis repetições. As silagens foram analisadas quanto à sua composição químico bromatológica, energia digestível, energia metabolizável, nutrientes digestíveis totais, produção de gases in vitro e determinação dos parâmetros de degradabilidade. A silagem com maior nível de inclusão apresentou melhor composição bromatológica (p < 0,05) que a silagem sem maniçoba para PB, FDN, FDA e MM (6,49, 56,64, 38,66 e 4,52% versus 2,21, 70,96, 49,95 e 2,78%). Maior conteúdo de EM (2,35 MJ kg-1 MS versus 1,85 MJ kg-1 MS), ED (2,87 Mcal kg-1 MS versus 2,25 Mcal kg-1 MS) e NDT (65,16% versus 51,11%), respectivamente. Os maiores valores de produção de gás também foram observados em silagens com adição de maniçoba em função dos maiores conteúdos de CNF (34,87%). À medida que se aumentou a proporção de maniçoba, houve incremento da fração a, da fração b e, consequentemente, maior degradabilidade efetiva da matéria seca (46,56%). A adição de maniçoba melhorou o valor nutritivo da silagem de cana de açúcar.

ABSTRACT. The objective this study was to evaluate the effect of maniçoba supplementation in sugar cane silage with respect to chemical-bromatological composition and the in vitro degradation kinetics of the silage. This experiment was conducted in a completely randomized design with four treatments (maniçoba levels: 0, 20, 30, and 40%) and six repetitions. Silage samples were analyzed for their chemical-bromatological composition, digestible energy, metabolizable energy, total digestible nutrients, in vitro gas production and degradability parameters. The silage with higher inclusion level had better bromatological composition (p < 0.05) than the silage without maniçoba for CP, NDF, ADF and MM (6.49, 56.64, 38.66 and 4.52% versus 2.21, 70.96, 49.95 and 2.78%). Higher ME content (2.35 MJ kg-1 MS versus 1.85 MJ kg-1 MS), DE (2.87 Mcal kg-1 MS versus 2.25 Mcal kg-1 MS) and TDN (65.16% versus 51.11%), respectively. The highest values for gas production were also observed in silage with added maniçoba due to higher NFC content (34.87%). With an increase in the proportion of maniçoba, there was an increase in the soluble a fraction, b fraction, and thus a higher effective degradability of dry matter (46.56%). The addition of maniçoba improves the nutritive value of sugarcane silage.

Tuberculosis (TB) is an infectious disease in which the molecular typing methods allow to have important information about the dynamics of transmission and to assist properly in disease control. Although the ERIC-PCR (Enterobacterial repetitive intergenic consensus-PCR) assay is fast and easy to perform, scarce studies have reported its use in epidemiological studies in TB outbreaks. In this study, we aimed to genotype Mycobacterium tuberculosis and M. bovis isolates by ERIC-PCR and compare its discriminatory power with two other classically used methods: 12 loci-MIRU (Mycobacterial Interspersed Repetitive Units) and Spoligotyping. The M. tuberculosis isolates studied were from northwestern and southwestern and M. bovis from northwestern Parana, Brazil. ERIC-PCR rendered banding patterns with great diversity (1 to 12 bands) of molecular sizes, ranging from 100 to 1600 bp. ERIC-PCR showed to be fast, simple and affordable to differentiate isolates. ERIC-PCR would be an important tool in the epidemiology of TB as screening in case of outbreak, which demands rapid intervention. However if any doubt persist, as it may occur with the application of only one genotypic method, other genotyping methods should be applied and carefully interpreted, always with additional epidemiological information.

RESUMO Objetivo: A restauração da sensibilidade em pacientes com lesão completa do plexo braquial é muito importante. O objetivo desse estudo foi avaliar a recuperação sensitiva em cirurgia do plexo braquial utilizando o nervo intercostobraquial (NICB) como doador. Métodos: Onze pacientes foram submetidos a reconstrução sensitiva usando o NICB como doador para a contribuição lateral do nervo mediano, com tempo de acompanhamento pós-operatório médio de 41 meses. Um protocolo de avaliação foi realizado. Resultados: Quatro pacientes perceberam o filamento 1-verde. Os filamentos 2-azul, 3-roxo e 4-vermelho foram percebidos por um, dois e três pacientes, respectivamente. Um paciente não apresentou recuperação sensitiva. Dois pacientes obtiveram recuperação S3, dois S2+, seis S2 e um S0, pela escala de Highet. Conclusão: O procedimento usando o NICB como doador promove boa intensidade de recuperação sensitiva e bons resultados são obtidos quanto ao local de percepção em pacientes com avulsão completa do plexo braquial.

ABSTRACT Objective: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor. Methods: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed. Results: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient. Conclusion: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.