ABSTRACT Brazil is one of the world's largest guava (Psidium guajava) producing countries, but the economic performance of this crop can be negatively affected by the damage caused by Ceratitis capitata (Diptera: Tephritidae). The main methods for controlling C. capitata are based on broad-spectrum insecticide applications. However, the negative effects of using this control method stimulate the development of sustainable alternatives, such as the use of essential oils (EO). In this sense, the objective of the present study was to evaluate the repellent activity of EO of citronella (Cymbopogon nardus), clove (Syzygium aromaticum), and copaiba (Copaifera officinalis) for repellency of C. capitata in Paluma guava fruits and determine their effects on postharvest fruit quality, under laboratory-controlled conditions. The fruits were treated with citronella, clove, and copaiba EO and placed in covered plastic containers attached to the ends of arenas of 20 cm diameter and 15 cm height. The fruit physical and chemical analysis was carried out based on the same oils applied in the repellent test. The C. nardus essential oil presented a greater repellency of C. capitata females. The EO applications proved to be a good strategy for maintaining the fruit post-harvest quality.

RESUMO O Brasil está entre os maiores produtores mundiais de goiaba (Psidium guajava), mas o rendimento econômico dessa cultura pode ser negativamente afetado pelos danos causados por Ceratitis capitata (Diptera: Tephritidae). Os principais métodos de controle de C. capitata são baseados em aplicações de inseticidas de amplo espectro. Porém, os efeitos negativos do uso desse controle estimulam o desenvolvimento de alternativas sustentáveis, como o uso de óleos essenciais. Nesse sentido, o presente estudo teve como objetivo avaliar a atividade repelente dos óleos essenciais de citronela (Cymbopogon nardus), cravo (Syzygium aromaticum) e copaíba (Copaifera officinalis) em fruto de goiabeiras Paluma contra C. capitata e determinar suas influências na qualidade pós-colheita desses frutos trabalhados. Em condições controladas de laboratório, os frutos foram tratados com óleos essenciais de citronela, cravo e copaíba e acondicionados em recipientes de plástico com dimensões de 20 cm de diâmetro e 15 cm de altura. A análise físico-química dos frutos foi realizada com base nos mesmos óleos aplicados no teste de repelência. O óleo essencial de C. nardus apresentou maior repelência às fêmeas de C. capitata. A aplicação de óleos essenciais, mostrou-se uma estratégia para manutenção da qualidade póscolheita.

Resumen Introducción: La insuficiencia cardiaca en pacientes con fibrilación auricular no valvular (FANV) es de dos a tres veces más frecuente que en individuos sin FANV. Objetivo: Identificar los factores de riesgo cardiometabólico (FRCM) y el tratamiento antitrombótico de pacientes con FANV e insuficiencia cardiaca con fracción de expulsión reducida (IC-FEr), y determinar si existen diferencias conforme al sexo. Métodos: En forma global y de acuerdo con el sexo se analizaron FRCM, riesgo protrombótico, riesgo de sangrado y terapia antitrombótica. Resultados: De 1423 pacientes con FANV, 336 tuvieron IC-FEr. Las mujeres promediaron mayor edad que los hombres. No hubo diferencia entre los sexos respecto al tipo de FANV o uso de anticoagulantes orales directos. La hipertensión arterial sistémica fue más frecuente en mujeres. Un 3.6 % de los pacientes reportó antecedente de ataque isquémico transitorio y 10 % de evento vascular cerebral, sin diferencias en cuanto al sexo. El porcentaje de hombres con riesgo embólico elevado fue mayor, pero sin tratamiento antitrombótico, en comparación con las mujeres. Conclusiones: Se encontraron diferencias significativas de acuerdo con el sexo en pacientes con FANV e IC-FEr, tanto en FRCM y algunas comorbilidades, como en el tratamiento antitrombótico de acuerdo con el riesgo embólico y de sangrado.

Abstract Introduction: Heart failure in patients with non-valvular atrial fibrillation (NVAF) is two to three times more common than in individuals without NVAF. Objective: To identify cardiometabolic risk factors (CMRF) and antithrombotic treatment in patients with NVAF and heart failure with reduced ejection fraction (HFrEF), and to determine if there were differences according to gender. Methods: CMRF, pro-thrombotic risk, bleeding risk, and antithrombotic therapy were globally analyzed and according to gender. Results: Out of 1,423 patients with NVAF, 336 had HFrEF. On average, females were older than males. There was no difference between genders with regard to the type of NVAF or direct oral anticoagulants use. Hypertension was more common in women. History of transient ischemic attack was reported in 3.6% of the patients and cerebrovascular event in 10%, without differences in terms of gender. The percentage of men with elevated embolic risk was higher, but without antithrombotic treatment, in comparison with women. Conclusions: Significant differences were found according to gender in patients with NVAF and HFrEF, both in CMRF and some comorbidities, as well as in antithrombotic treatment according to embolic and bleeding risk.

Resumen El efecto solvatocrómico es la modificación del espectro de absorción de un soluto al variar el solvente. El presente trabajo evaluó las características solvatocrómicas de Malvidina-3-glucósido clorhidrato. El método para obtener longitudes de onda máxima fue por barridos espectrales. En estándar primario CAS N° 7228-78.6, la variación fue determinada en mezclas binarias de etanol-agua: 40,55 y 70%v/v. El efecto solvatocrómico al modificar el pH del solvente (agua) fue evaluado en colorante natural y estabilizado. Los resultados indican que los enlaces hidrógeno intermoleculares entre Malvidina-3-glucósido y las mezclas binarias de etanol-agua son responsables de los cambios solvatocrómicos: 565,2586 ± 3.2784nm, 472,5498 ± 2.5128nm y 457,3589 ± 6.2586nm, producidos por las combinaciones analizadas. Al estabilizar antocianinas en una matriz quelante los cambios solvatocrómicos producidos al variar el pH del solvente agua, son no significativos en comparación con el colorante natural sin estabilizar.

Abstract The solvatochromic effect is the modification of the absorption spectrum of a solute by varying the solvent. This research evaluated the solvatochromic characteristics of Malvidin-3-glucoside hydrochloride. The method to obtain maximum wavelengths was by spectral scanning. In primary standard CAS No. 7228-78.6, the variation was determined in binary mixtures of ethanol-water: 40,55, and 70%v/v. The solvatochromic effect when modifying the pH of the solvent (water) was evaluated in natural dye and stabilized. The results suggest that the intermolecular hydrogen connections between Malvidin-3-glucoside and the ethanol-water binary mixtures are responsible for the solvatochromic changes: 565.2586 ± 3.2784nm, 472.5498 ± 2.5128nm and 457.3589 ± 6.2586nm, produced by the analyzed combinations. When anthocyanins are stabilized in a chelating matrix, the solvatochromic changes produced by varying the pH of the water solvent are not significant compared to the unstabilized natural dye.

ABSTRACT This paper has the objective of characterizing and studying the mineralogical behavior and the ceramic properties of aggregates produced from bauxite waste, as a function of the addition of calcium oxide that has been dumped in deposits of bauxite residue, which, in the long term, can represent a considerable increase in the concentrations of this oxide present in the waste deposit. Besides bauxite residue and calcium oxide, clay was also used. Proof bodies were prepared with the addition of 0% and 10% of calcium oxide. The proof bodies were conformed by pelletizing in a rotating cylinder. The physical and technological properties determined were Water absorption, apparent porosity, apparent specific mass. The raw materials were submitted to X-ray diffraction tests (XRD), Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TG). The microstructure of the ceramics was analyzed by Scanning Electron Microscopy (SEM) and XRD. DSC was also realized for the formulations composed of bauxite residue and clay with and without the addition of calcium oxide. According to the results, the addition of calcium oxide caused an increase in the apparent porosity of the aggregates, and consequently, an increase of water absorption, while there was also an increase in the apparent specific mass. In terms of mineralogy, the presence of calcium oxide demonstrated to be directly associated with changes in the mineral phases by comparing the proof bodies produced with and without the addition of the oxide, evidenced mainly by the disappearance of phases such as quartz and mullite and the emergence of magnetite.

RESUMO O objetivo deste trabalho foi avaliar a influência da adição do óxido de cálcio na redução da temperatura de sinterização e nas propriedades cerâmicas de agregado sintético à base de resíduo de bauxita. Foram utilizados resíduo de bauxita, óxido de cálcio e argila para a produção de corpos de prova com a adição de 0% e 10% de óxido de cálcio. As propriedades físicas determinadas foram: absorção de água, porosidade aparente e massa específica aparente, e as matérias-primas foram submetidas a ensaios de Difração de raios X (DRX), Calorimetria Exploratória Diferencial (DSC) e Análise Termogravimétrica. A microestrutura das cerâmicas foi avaliada por Microscopia Eletrônica de Varredura (MEV) e DRX, e foi realizado o ensaio de DSC nas formulações compostas por resíduo de bauxita e argila com e sem a adição de óxido de cálcio. Os resultados indicaram que a adição do óxido de cálcio aumentou a porosidade aparente e, por consequência, a absorção de água, enquanto houve também o aumento da massa específica aparente. Quanto à mineralogia, a presença do óxido de cálcio mostrou-se diretamente ligada às alterações das fases minerais, evidenciado principalmente pelo desaparecimento de fases como quartzo e mulita e o surgimento de magnetita.

RESUMO Aspectos biológicos e capacidade predatória de Doru luteipes foram avaliados em função do predatismo de Spodoptera frugiperda. O experimento foi conduzido em laboratório com condições de temperatura média de 25 ± 1 °C, umidade relativa de 70 ± 10% e fotoperíodo de 12:12 horas (Luz: Escuro). Para avaliação dos parâmetros biológicos de D. luteipes foram fornecidos uma dieta padrão, ovos e lagartas (1°, 2°, 3°, 4°, 5° ou 6° instares) de S. frugiperda. O delineamento estatístico foi inteiramente casualizado, com 10 repetições para cada tratamento. As ninfas (1°, 2° e 3° instares) e machos e fêmeas adultos de D. luteipes foram individualizados em placas de Petri (9 cm de diâmetro), tendo como alimento padrão (testemunha) dieta artificial. Ninfas de 1° e 3° instares do predador duraram 4,5 e 6,9 dias respectivamente, contudo pereceram. A sobrevivência das ninfas de D. luteipes é alta, contudo houve variação consumindo os diferentes instares das lagartas de S. frugiperda. Adultos de D. luteipes não consumiram lagartas de 4°, 5° e 6° instares da presa. Houve diferença significativa para alimentação de D. luteipes com dieta artificial, ovos e lagartas de S. frugiperda para os parâmetros número de ovos, pré-oviposição. O maior consumo de machos e fêmeas de D. luteipes ocorre quando são alimentados com ovos da presa.

ABSTRACT Biological aspects and predatory capacity of Doru luteipes was assessed as a function of predation on Spodoptera frugiperda. The experiment was conducted under laboratory conditions of mean temperature of 25 ± 1 °C, relative humidity of 70 ± 10%, and 12:12 h (Light: Dark) photoperiod. To evaluate the biological parameters of D. luteipes, artificial diet, eggs and caterpillar (1st, 2nd, 3rd, 4th, 5th or 6th instars) of S. frugiperda were supplied. The completely randomized statistical design was used, with 10 replicates for each treatment. The nymphs (1st, 2nd and 3rd instars) and adult males and females of D. luteipes were individualized in Petri dish (9 cm diameter), with artificial diet as standard food (control). Nymphs of the 1st and 3rd instars of the predator lasted 4.5 and 6.9, days respectively, but they perished. The survival of D. luteipes is high, but there was variation when consuming the different instars of the caterpillar of S. frugiperda. Adults of D. luteipes did not consume caterpillars of the 4th, 5th and 6th instars of the prey. There was a significant difference for the feeding of D. luteipes with artificial diet, eggs and caterpillar of S. frugiperda with respect to the parameters number of eggs and preoviposition. Higher consumption of male and female D. luteipes occurs when they are fed with prey eggs.

RESUMO O objetivo deste trabalho foi comparar as assembleias de besouros de solo entre dois locais no Planalto da Borborema. Dados de georreferenciamento e climáticos foram usados para comparar as condições locais com as assembleias de besouros. Foram coletados 483 indivíduos, classificados em 75 espécies/ morfoespécies, pertencentes a 23 famílias de Coleoptera. As coletas na face leste do Planalto da Borborema (Areia-PB) totalizaram 332 indivíduos (58 espécies/morfoespécies) pertencentes a 21 famílias. No lado oeste (Cabaceiras-PB) foram coletados 151 indivíduos, 24 espécies/morfoespécies pertencentes a oito famílias. Entre as 75 morfótipos/espécies coletadas, 51 ocorreram exclusivamente na face oriental do Planalto e 17 ocorreram exclusivamente na face oeste. Entre eles, apenas sete morfoespécies foram amostradas em ambas as áreas. A diferença de composição de espécies de besouros entre os lados oeste e leste do Planalto da Borborema sugere que o posicionamento e variações climáticas mantêm e promovem altos níveis de diversidade de besouros no nordeste do Brasil.

ABSTRACT The objective of this work was to compare soil beetle (Coleoptera) species composition between two sites on the Borborema Plateau in Northeastern Brazil. We collected 483 individuals belonging to 23 Coleoptera families and 75 species/morphospecies. On the east face of the Borborema Plateau (Areia-PB) we collected a total of 332 individuals representing 58 species/morphospecies and 21 families. On the west face (Cabaceiras-PB) we collected 151 individuals representing 24 species/morphospecies and eight families. Among the 75 total species/morphospecies collected, 51 occurred exclusively on the eastern face of the plateau and 17 occurred exclusively on the west face. Only seven morphospecies were sampled in both areas. The marked difference in beetle assemblage species composition between the west and east sides of the Borborema Plateau suggests that the positioning and climatic variations maintain and promote high levels of beetle diversity in northeastern Brazil.

RESUMO Um dos principais serviços ecossistêmicos prestados à agricultura em todo o mundo é a redução de pragas por inimigos naturais. No entanto, a composição da paisagem afeta várias dimensões do controle de pragas, e o habitat não agrícola ao redor dos campos agrícolas mostra respostas variáveis entre diferentes regiões do globo. Nesse trabalho, danos por herbivoria e abundância de pragas foram comparados entre duas paisagens com distintas cobertura e uso do solo (1 - conservada, com alta complexidade estrutural; e 2- degradada, com baixa complexidade). As observações de campo foram realizadas em plantios experimentais de goiabeiras, no Cariri Paraibano, uma das regiões mais secas da Caatinga. Os resultados obtidos demonstram que danos provocados por insetos da ordem Orthoptera, especialmente gafanhotos, bem como sua abundância, foram significativamente menores na paisagem com de alta complexidade estrutural. Portanto, esses resultados apoiam a hipótese que danos às culturas e a abundância de pragas são menores em paisagens com alta complexidade estrutural. Além disso, os resultados são muito importantes para as regiões semiáridas, pois fornecem informações sobre a relação entre a estrutura da paisagem e os danos à cultura em uma lacuna regional. Como as regiões semiáridas são ecossistemas criticamente ameaçados em todo o continente americano, paisagens agrícolas sustentáveis com ações de restauração florestal podem ajudar essas regiões a alcançar o desenvolvimento sustentável.

ABSTRACT One of the major ecosystem services delivered to agriculture worldwide is the reduction of pests by natural enemies. However, the landscape composition affects multiple dimensions of pest control, and non-crop habitat surrounding farm fields shows variable responses across geographies. Here, crop damage and pest abundance were compared between local farms with two antagonistic land cover and land use aspects (1- High conservation, landscape with high structural complexity; 2- High degradation, landscapes with low complexity). The field data were collected at experimental guava orchards in the Cariri Paraibano, one of the driest regions in the Brazilian Caatinga. The results show that damage caused by orthopterans and their abundance was significantly smaller in the landscape with high structural complexity. Therefore, the results support the hypothesis that crop damage and pest abundance are smaller in landscapes with high structural complexity. Additionally, the results are very important for the dryland regions as they provide information about the relationship between landscape structure and crop damage plus pest abundance in a regional gap. As drylands are critically endangered in all American continents, sustainable agricultural landscapes with the application of natural cover restoration can help drylands to achieve sustainable development.

Abstract Introduction: POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) is a monoclonal gammopathy with polyneuropathy as a mandatory criterion. Objective: To describe potential associations between clinical expression and electrodiagnostic patterns in POEMS syndrome. Method: Observational, retrospective, and cross-sectional study of cases cared in a referral center diagnosed with POEMS syndrome from 2009-2019. Results: Eleven cases (8 men) were analyzed. Median age at diagnosis was 40 years (range: 31–51, mean: 37.19 ± 15.67 years). Mean latency at diagnosis was 9.7 ± 8.37 months. In all subjects, initial clinical manifestation was polyneuropathy. Most patients had an axonal pattern (n = 5), followed by demyelinating (n = 4), and mixed (n = 2). Monoclonal gammopathy was observed in all patients (6 λ, and 5 κ cases, immunoglobulin [Ig] G: 72%, IgA: 18%, IgM: 9%). Medical Research Council sum score was lower in the axonal pattern (median: 37.00, vs. 45.5, p = 0.024). There were no differences in the systemic involvement between electrophysiological patterns. Conclusion: Electrophysiological patterns are unlikely to have a clear extra-neurological clinical correspondence; however this will need to be definitively proven with a larger sample size.

Resumen Introducción: El síndrome POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) es una gammapatía monoclonal con polineuropatía como criterio obligatorio. Objetivo: Describir las potenciales asociaciones entre la expresión clínica y los patrones de electrodiagnóstico en el síndrome POEMS. Método: Estudio observacional, retrospectivo y transversal de los casos atendidos en un centro de referencia con diagnóstico de síndrome de POEMS de 2009 a 2019. Resultados: Se analizó a 11 pacientes (8 hombres). La mediana de la edad al diagnóstico fue de 40 años (rango: 31-51, media: 37.19 ± 15.67 años). La latencia media al diagnóstico fue de 9.7 ± 8.37 meses. En todos la manifestación clínica inicial fue la polineuropatía. La mayoría de los pacientes presentaron un patrón axonal (n = 5), seguido del desmielinizante (n = 4) y mixto (n = 2). La gammapatía monoclonal se observó en todos (6 casos l λ 5 κ, inmunoglobulina [Ig] G: 72%, IgA: 18%, IgM: 9%). El Medical Research Council sum score fue menor en el patrón axonal (medianas: 37.00 vs. 45.5, p = 0.024). No se presentaron diferencias en la afección sistémica entre patrones electrofisiológicos. Conclusión: Es poco probable que los patrones electrofisiológicos tengan una correspondencia clínica extraneurológica clara, sin embargo, esto deberá probarse de forma definitiva con un mayor tamaño de muestra.

ABSTRACT Background: The recognition of stroke symptoms by patients or bystanders directly affects the outcomes of patients with acute cerebrovascular disease. Objective: The objective of the study was to assess the predictive value of the medical history and clinical features recognized by the patients’ bystanders to classify neurovascular syndromes in pre-hospital settings. Methods: We included 150 stroke patients of two Mexican referral centers: 50 with acute ischemic stroke (AIS), 50 with intracerebral hemorrhage (ICH), and 50 with subarachnoid hemorrhage (SAH). The performance of clinical prediction rules (CPR) to identify the stroke types was evaluated with features recognized by the patients’ bystanders before hospital arrival. The impact of CPRs on early arrival and in-hospital mortality was also analyzed. Results: Overall, 72% of the patients had previous medical evaluations in other centers before final referral to our hospitals, and therefore, only 45% had a final onset-to-door time <6 h, even when the first medical assessment had occurred in ≤1 h in 75% of cases. Clinical features noticed by the patients’ bystanders had low positive predictive values (PPV) for any stroke type. The CPR “language or speech disorder + focal motor deficit” had 93% sensitivity and a negative predictive value (NPV) of 84% to distinguish AIS. In SAH, headache alone showed a sensitivity of 84% and NPV of 97%. No CPR had an adequate performance on ICH. CPRs were not associated with final onset-to-door time. Altered consciousness, age ≥65 years, indirect arrival with stops before final referral, and atrial fibrillation increased in-hospital mortality. Conclusion: Clinical features referred by the witness of a neurovascular emergency have limited PPV, but adequate NPV in ruling-out AIS and SAH among stroke types. The use of CPRs had no impact on onset-to-door time or in-hospital mortality when the final arrival to a third-level center occurs with previous medical referrals.

Abstract Background and objective: Assessing the effect of chronic sleep deprivation on essential neuropsychological tests, including executive functions for performance such as selective attention, inhibitory control, processing velocity, and working memory among internal medicine residents with chronic sleep deprivation in a highly demanding academic program Methods: We conducted a prospective study measuring neuropsychological performance among internal medicine postgraduate year 1 residents in Mexico City. The study was conducted from 2012 to 2013. We used Stroop test, as well as Wechsler Adult Intelligence Scale (WAIS III) to evaluate executive functions. We performed neuropsychological assessments at the beginning of residency, and again 12 months after the baseline assessment. Results: Chronic sleep deprivation causes an alteration in selective attention, working memory, processing speed, and inhibition. This results in longer time to perform a task, as well as impaired attention during performance of a task Conclusions: Our findings suggest that limiting the workload of residents and giving them longer off-duty hours would reflect on better and safer patient care. Nevertheless, it is still controversial that medical errors due to fatigue cause damages to patients.

Resumen Antecedentes y objetivo: Evaluar el efecto de la privación crónica del sueño en pruebas neuropsicológicas esenciales, que incluyen funciones ejecutivas para el desempeño como atención selectiva, control inhibitorio, velocidad de procesamiento y memoria de trabajo entre residentes de medicina interna con privación crónica del sueño en un programa académico altamente exigente. Métodos: Realizamos un estudio prospectivo que midió el desempeño neuropsicológico en residentes del primer año de posgrado en medicina interna en la Ciudad de México. El estudio se realizó de 2012 a 2013. Utilizamos la prueba de Stroop, así como WAIS III para evaluar las funciones ejecutivas. Realizamos evaluaciones neuropsicológicas al comienzo de la residencia y nuevamente 12 meses después de la evaluación inicial. Resultados: La privación crónica del sueño provoca una alteración en la atención selectiva, la memoria de trabajo, la velocidad de procesamiento y la inhibición. Esto da como resultado un mayor tiempo para realizar una tarea, así como una atención deteriorada durante la realización de una tarea. Conclusiones: Nuestros hallazgos sugieren que limitar la carga de trabajo de los residentes y darles más horas fuera de servicio se reflejaría en una mejor y más segura atención al paciente. Sin embargo, todavía es controvertido que los errores médicos debidos a la fatiga causen daños a los pacientes.

Abstract Background: Wallenberg syndrome (WS) is a classic neurologic disorder secondary to vascular pathology of the vertebrobasilar circulation. Methods: Consecutive patients > 18 years with WS and isolated lateral medullary infarction syndrome were included from two Mexican hospitals. Risk factors, initial signs, symptoms, radiological findings, and acute treatment were evaluated; the prognosis was assessed using the Glasgow Outcome Scale. Results: Twenty-six patients were studied in a 26-year period (1988-2014); 17 patients were men (67%); and the average age was 45 years (range 19-77). Fourteen patients were under 45 years old (54%). The most common risk factors were dyslipidemia (41%) and hypertension (37%). The main initial symptoms were vertigo-dizziness (89%) gait ataxia (70%), and crossed-sensory deficit; and the main signs were crossed-sensitive deficit (93%), Horner syndrome (85%), and nystagmus (82%). In the bivariate analysis, age under 45 years was associated with a vertebral arterial dissection (p = 0.001), and age > 45 with atherothrombotic etiology (p = 0.01). About 96% of patients presented good recovery at an average of 17 months follow-up. Conclusion: Non-atherosclerotic vasculopathy was the main cause of WS-ILBI in young people. The clinical characteristics were similar to those reported in other series with a usually benign prognosis.

Resumen Antecedentes: El síndrome de Wallenberg (SW) es un diagnóstico clásico en neurología, generalmente secundario a patología vascular de la circulación vertebro-basilar. Métodos: Se incluyeron a pacientes mexicanos consecutivos mayores de 18 años de edad con síndrome de SW e infarto bulbar lateral aislado (SW-IBLA) en dos hospitales mexicanos. Se evaluaron los factores de riesgo, signos y síntomas iniciales, hallazgos radiológicos, tratamiento agudo y pronóstico mediante el Glasgow Outcome Scale (GOS). Resultados: Se estudiaron 26 pacientes en un periodo de 26 años (1988-2014); Diecisiete pacientes fueron hombres (67%); el promedio de edad fue de 45 años (rango 19-77). Catorce pacientes fueron menores de 45 años (54%). Los factores de riesgo más frecuentes fueron dislipidemia (41%) e hipertensión arterial (37%). Los principales síntomas al inicio fueron vértigo-mareo (89%) y ataxia para la marcha (70%), así como déficit sensorial cruzado (93%), síndrome de Horner (85%) y nistagmo (82%) a la exploración neurológica. En el análisis bivariado, la edad menor a 45 años se asoció a disección arterial vertebral (p = 0.001), y la edad > 45 a etiología aterotrombótica (p = 0.01). El 96% de los pacientes presentaron buena recuperación en un seguimiento promedio de 17 meses. Conclusión: La vasculopatía no ateroesclerosa fue la principal causa de SW-IBLA en jóvenes. Las características clínicas para esta localización fueron similares a lo reportado en otras series con un pronóstico habitualmente benigno.

RESUMO O trabalho teve por objetivo caracterizar, por meio de índices faunísticos, as populações de moscas-das-frutas no Brejo Paraibano, e analisar se essas populações são similares entre si. A pesquisa foi desenvolvida em oito municípios situados na Mesorregião do Agreste Paraibano e Microrregião do Brejo Paraibano, nos quais foram selecionadas duas propriedades rurais de cada município, georreferenciadas, identificadas segundo o critério de diversidade de espécies frutíferas. Cada município foi considerado como tendo uma população das moscas-das-frutas com características próprias, determinadas pelos índices faunísticos de frequência, constância, dominância, índices de diversidade de Shannon-Wiener e de Margalef, além de equitabilidade. Foram capturados 3.159 espécimes de moscas-das-frutas, dos quais 85,57% pertenciam ao gênero Anastrepha e 14,43% o gênero Ceratitis. Foram capturadas onze espécies de moscas-das-frutas nas armadilhas. Anastrepha fraterculus foi a espécie mais frequente, dominante e constante, estando presente em todas as localidades; seguida das espécies A. obliqua, A. sororcula e Ceratitis capitata. Os municípios estudados apresentam similaridade de 54%, o que indica alta semelhança entre as áreas. A maioria das espécies capturadas no presente estudo ocorre em baixa frequência populacional.

ABSTRACT The objective of this study was to characterize, through faunistic indices, the populations of fruit flies in the Brejo Paraibano microregion and analyze whether these populations are similar to one another. The study was conducted in eight municipalities located in the Agreste Paraibano mesoregion and Brejo Paraibano microregion, Paraíba state, Brazil, where two rural properties of each municipality were selected, georeferenced and identified according to the diversity criterion of fruit species. Each municipality was assumed to have a population of fruit flies with its own characteristics, determined by the faunistic indices of frequency, constancy, dominance, Shannon-Wiener and Margalef diversity indices, as well as evenness. 3.159 specimens of fruit flies were captured, of which 85.57% belonged to the genus Anastrepha and 14.43% to the genus Ceratitis. 11 species of fruit flies were captured in the traps. Anastrepha fraterculus was the most frequent, dominant and constant species, being present in all locations; followed by A. obliqua, A. sororcula and Ceratitis capitata. The studied municipalities have a similarity of 54%, which indicates a high similarity between the areas. Most species captured in the present study occur at low population frequency.

RESUMO CONTEXTO: As doenças inflamatórias intestinais (DII) são afecções inflamatórias crônicas de caráter recorrente, cujas taxas de incidência e prevalência têm aumentado, inclusive no Brasil. A longo prazo, são responsáveis por danos estruturais que impactam na qualidade de vida, morbidade e mortalidade dos pacientes. OBJETIVO: Avaliar o perfil dos médicos que atendem pacientes com DII, assim como as características deste atendimento, demandas não atendidas e dificuldades. MÉTODOS: Um questionário contendo 17 variáveis foi elaborado e enviado para médicos, selecionados a partir do cadastro da Comissão das Estaduais do Grupo de Estudos da Doença Inflamatória Intestinal do Brasil (GEDIIB), totalizando 286 médicos de 101 cidades brasileiras distribuídas por 21 estados e Distrito Federal. RESULTADOS: A maioria dos médicos que respondeu o questionário foram Gastroenterologistas e Coloproctologistas. Mais de 60% tinham até 20 anos de atuação na especialidade e 53,14% trabalhavam em três locais ou mais. A dificuldade no acesso ou liberação de medicamentos ficou evidenciada neste questionário, assim como a dificuldade no encaminhamento para profissionais não médicos que atuam em DII. Mais de 75% dos médicos relataram dificuldades para realização de enteroscopia por duplo balão e cápsula endoscópica, e 67,8% para realização da calprotectina. Em relação ao número de pacientes atendidos por cada médico, foi evidenciado que não há uma concentração de pacientes sob a responsabilidade de poucos médicos. O infliximabe e o adalimumabe foram os biológicos mais utilizados e ficou evidenciada prescrição maior de derivados de 5-ASA para retocolite ulcerativa quando comparada à doença de Crohn. Os corticoides foram prescritos para uma parcela menor de pacientes em ambas doenças. Os temas “falha a terapia biológica” e “novas drogas” foram referidos como aqueles com maior prioridade para discussão em eventos científicos. Em relação às possíveis diferenças entre cada região e o restante do país, os médicos da região Norte relataram maior dificuldade no acesso a exames complementares e os médicos da região Nordeste, maior dificuldade no acesso ou liberação de medicamentos. CONCLUSÃO: Os dados obtidos por meio deste estudo mostram o perfil do atendimento médico especializado em DII e podem se constituir em ferramenta útil para para elaboração de políticas governamentais e para sociedade brasileira como um todo.

ABSTRACT BACKGROUND: Inflammatory bowel diseases (IBD) are chronic inflammatory affections of recurrent nature whose incidence and prevalence rates have increased, including in Brazil. In long term, they are responsible for structural damage that impacts quality of life, morbidity and mortality of patients. OBJECTIVE: To describe the profile of physicians who treat IBD patients as well as the characteristics of IBD care, unmet demands and difficulties. METHODS: A questionnaire containing 17 items was prepared and sent to 286 physicians from 101 Brazilian cities across 21 states and the Federal District, selected from the register of the State Commission of the “Study Group of Inflammatory Bowel Disease of Brazil” (GEDIIB). RESULTS: The majority of the physicians who answered the questionnaire were gastroenterologists and colorectal surgeons. More than 60% had up to 20 years of experience in the specialty and 53.14% worked at three or more locations. Difficulties in accessing or releasing medicines were evident in this questionnaire, as was referrals to allied healthy professionals working in IBD-related fields. More than 75% of physicians reported difficulties in performing double-balloon enteroscopy and capsule endoscopy, and 67.8% reported difficulties in measuring calprotectin. With regard to the number of patients seen by each physician, it was shown that patients do not concentrate under the responsibility of few doctors. Infliximab and adalimumab were the most commonly used biological medicines and there was a higher prescription of 5-ASA derivatives for ulcerative colitis than for Crohn’s disease. Steroids were prescribed to a smaller proportion of patients in both diseases. The topics “biological therapy failure” and “new drugs” were reported as those with higher priority for discussion in medical congresses. In relation to possible differences among the country’s regions, physicians from the North region reported greater difficulty in accessing complementary exams while those from the Northeast region indicated greater difficulty in accessing or releasing medicines. CONCLUSION: The data obtained through this study demonstrate the profile of specialized medical care in IBD and are a useful tool for the implementation of government policies and for the Brazilian society as a whole.