Resumo Relatamos uma série de casos de quatro pacientes consecutivos, admitidos com emergências relacionadas a aneurismas aortoilíacos em um período de 3 dias e submetidos a tratamento endovascular. A primeira paciente, do sexo feminino, com 81 anos e com histórico de aneurisma da aorta, apresentou dor abdominal iniciada nos últimos 12 dias. O segundo paciente era do sexo masculino, com 63 anos e foi admitido com hematêmese 3 dias antes da admissão, com angiotomografia demonstrando fistula aortoentérica. A terceira paciente, do sexo feminino e com 77 anos, foi admitida com quadro de ruptura de aneurisma da artéria ilíaca comum direita. O quarto paciente consecutivo apresentou dor abdominal iniciada 2 semanas antes da internação e aneurisma roto da aorta. Todos os quatro pacientes apresentaram emergências aortoilíacas e receberam alta sem complicações maiores ou mortalidade cirúrgica. O relato desta série de casos demonstra que, apesar da situação pandêmica da COVID-19, uma vez que as cirurgias eletivas diminuíram, as urgências vasculares aumentaram.

Abstract In this paper, we describe a case series of four patients who were admitted with emergencies related to aortic aneurysms over a 3-day period and were treated with endovascular repair. The first patient was an 81-year-old female with a history of abdominal pain and a ruptured aortic aneurysm diagnosed by AngioCT-scan. The second patient was a 63-year-old male with a history of oral digestive bleeding and an AngioCT-scan showing an aortoenteric fistula. The third patient was a 77-year-old female with sudden-onset abdominal pain and ruptured right common iliac aneurysm. The fourth patient presented with abdominal pain and an AngioCT-scan showed aortic rupture. All four patients were discharged with no major complications or surgical mortality. These case series show that despite the Covid-19 pandemic situation, since elective surgeries decreased, vascular emergencies have increased.

Resumo Introdução O câncer de mama é o mais incidente, prevalente e com maior taxa de mortalidade entre as neoplasias malignas que acometem mulheres em todo o mundo, excluindo câncer de pele não melanoma. No Brasil, com exceção da região Norte, representa a mais frequente neoplasia maligna feminina. Objetivo Estimar a cobertura de mamografias e analisar a qualidade e adequação às diretrizes técnicas nacionais do exame mamográfico em mulheres residentes na Região Metropolitana (RM) ou Interior do Estado (IE) de São Paulo, entre 2010 e 2012 Método Estudo descritivo realizado a partir de dados do SISMAMA e SIA-SUS referentes ao período de 2010 a 2012. Resultados Na RM paulista, não foi atingida a meta preconizada para a razão de mamografias em 2011 e 2012. Foi observado aumento do tempo de espera para acesso à mamografia diagnóstica e para a liberação deste resultado, e redução da capacidade de confirmação diagnóstica para as lesões suspeitas de malignidade no triênio. Já no IE, a meta preconizada para a razão de mamografias foi alcançada durante o período avaliado, com melhora da cobertura de biópsias em 2012. Em ambos (RM e IE), foi constatado elevado percentual de mamografia realizada fora da faixa etária preconizada (cerca de 35%). Conclusão Os resultados evidenciam a necessidade de adequações no rastreamento realizado no estado de São Paulo para que as ações de detecção precoce sejam efetivas. Destaca-se a importância da implantação de um rastreamento organizado e do aprimoramento do sistema de informação em saúde que possibilite o monitoramento e avaliação das ações, e contribua para o aperfeiçoamento da Política Nacional de Prevenção e Controle do Câncer de Mama.

Abstract Background Breast cancer is the most incident, prevalent and the leading cause of female cancer death worldwide. In Brazil is the most commonly diagnosed female cancer, except in the North region. Objective To evaluate coverage, quality and adequacy to the technical guidelines of breast cancer control actions indicators in women residing in the Metropolitan Region (MR) or in the Inland Towns of São Paulo, Brazil, between 2010 and 2012. Method Descriptive study based on SISMAMA data from 2010 to 2012 was carried out. Results MR did not reach the recommended target for the mammography ratio in 2011 and 2012, which presented a considerable percentage of mammogram beyond the recommended age range, increased the waiting time for access to diagnostic mammography and for obtain this result, and reduced the capacity diagnostic confirmation for lesions suspected of malignancy during the triennium. Inland towns achieved the recommended target for the mammography ratio over the period and improved biopsy coverage in 2012. Conclusion The results highlighted requirement for adjustments in the screening actions in the state of São Paulo that allow the practice of early detection actions more effective, reinforce the relevance of the available Information Systems and their continuous improvement, as well as contribute to stimulate the evaluation practice and of the reviewing of the National Cancer Prevention and Control Policy.

During biodiesel storage, chemical reactions may occur, producing sludges. The aim of this study was to characterize the chemical and microbial composition of the sludge found in a biodiesel storage tank. The material was collected in a biodiesel production plant. The sludge chemical characterization was performed by Fourier transform infrared (FTIR) spectroscopy, flame atomic absorption spectroscopy (FAAS), gas chromatography (GC), and the microbial investigation used culture-dependent techniques. The deteriogenic potential of the native microbial community was evaluated using the sludge as a microbial inoculum in a 60 day experiment. The microbial growth, biodiesel degradation, pH alterations, and the detection of esters in the aqueous phase were evaluated. The chemical analysis indicated the sludge composition as fatty acids esters and metallic ions; sterols glycosides were not detected. Seven bacteria and five fungi species were obtained from the sludge. The microbial growth analysis indicated that the native community does not have high biodiesel deteriogenic capacity.

Education mediated by technology facilitates the access to information and can reach more people, including a broader range of socio-economic groups and ages, and at a low-cost. The website "Babies Portal - Speech-Language Pathology/Audiology and Dentistry" (http://portaldosbebes.fob.usp.br) was developed to provide parents with information on communication procedure disorders and oral health, enabling them to prevent and identify any changes in development early while looking for the best treatment. Objective: The objective is to describe the development and evaluation of the content pertaining to the oral functions featured in the "Babies Portal". Methods: The first stage consisted of a literature review, development/selection of illustrations and an evaluation of the possible external links that could be available. In the second stage, 10 speech-language and hearing pathologists (group A) and five parents of babies (group B) evaluated the website via an online form, which included ethical and personal information and questions about the quality, technical information and comparative prior knowledge acquired after the access. In the first stage, there was the construction of five sections ("The Oral Functions", "Breastfeeding", "Food", "Pacifier, baby bottle and finger sucking" and "Breath") based on scientific studies, presenting objective information, content links prepared by the Ministry of Health and a Dentistry section in the "Babies Portal" website. Videos, static and dynamic images were also distributed throughout the sections. Results: Regarding the second stage, 90% of all speech-language and hearing pathologists judged a good/excellent quality for all sections and classified the technical quality as very good. By their turn, 88% of the parents (group B) reported that the website helped or helped very much in understanding the contents, and 80% rated the quality as good or excellent. Conclusions: Five sections concerning the oral functions were structured, and the results collected from groups A and B suggest that the content provided is adequate and reliable.

BACKGROUND Studies on health-related quality of life are based on the increasingly evident need for medical care not to be limited to preventing death, but to focus instead on the value of health. OBJECTIVE This study aimed to measure the health-related quality of life in hemophilia, using the Hemophilia- Specific Quality of Life (Haem-A-QoL) questionnaire and describe the socioeconomic characteristics and health conditions of these patients. METHODS The Brazilian version of the Hemophilia-Specific Quality of Life questionnaire was administered to hemophiliac adults, treated in an on-demand regime at the Juiz de Fora Regional Blood Center - HEMOMINAS Foundation. The patients were interviewed about demographic and socioeconomic data and their understanding of the questionnaire. Clinical data were collected from medical records. The Mann-Whitney U test was used for statistical analysis. The level of significance was set for p-values < 0.05. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS, version 15.0). RESULTS Thirty-nine patients were evaluated. The mean age was 36.8 years. 84.6% had hemophilia A; 20.5% of the patients had hemophilia classified as mild, 41% as moderate and 38.5% as severe. The records of 10.5% of the patients registered seropositivity for anti-HIV and 57.9% for anti-HCV. Target joints were detected in 69.2%. The mean total Hemophilia-Specific Quality of Life score was 35.55. 'Sports and leisure'and 'Physical health'were the most impaired dimensions and the dimension 'Relationship and partners'was the least impaired. The Hemophilia-Specific Quality of Life scores showed good discriminant validity for hemophilia severity (p-value = 0.001), HIV-infection (p-value = 0.02), HCV-infection (p-value = 0.01) and the presence of target joints (p-value < 0.001). CONCLUSION Health-related quality of life in hemophilia, measured by the Hemophilia-Specific Quality of Life questionnaire, was influenced by the presence of arthropathy and infectious diseases transmitted by blood products. Rehabilitation measures should be encouraged in order to improve the quality of life of these patients.

Introduction  Plenty of information about health is available on the Internet; however, quality and legibility are not always evaluated. Knowledge regarding orofacial functions can be considered important for the population because it allows proper stimulus, early diagnosis, and prevention of the oral myofunctional alterations during early infancy. Objective  The aim was evaluate the quality, legibility, and range of Web sites available in Brazilian Portuguese regarding the orofacial functions. Methods  Selected Web sites with information directed to parents/caregivers of babies regarding breast-feeding, feeding after 6 months, deleterious oral habits, and breathing and speech were studied. The Web sites were evaluated through the application of Flesch Reading Ease Test and aspects of the Health on the Net (HON) modified code (HONCode); the range of the subjects addressed was compared with other aspects of infant development. Results  From the access of 350 pages of the Internet, 35 Web sites were selected and 315 excluded because they did not meet the inclusion criteria. In relation to legibility, Web sites scored an average of 61.23% in the Flesch Test, and the application of the modified HONCode showed an average of 6.43 points; an average of 2.49 subjects were found per Web site evaluated, with information on breast-feeding being more frequent and subjects such as breathing and speech less frequent. Conclusions  Web sites that deal with orofacial functions presented standard legibility classification. Only half of the ethical principles were considered by the modified HONCode in their majority, and most addressed subjects after “breast-feeding” were presented with restricted range.

PROPÓSITO: Este estudo compara os efeitos do treinamento de força (TF) com ou sem a suplementação de lipídios ômega 3 (W-3) ou triglicérides de cadeia média (TCM), nos indicadores metabólicos em um teste de exaustão (TE). MÉTODOS: Grupo W-3 (GW-3: n = 7, 26,7 ± 6 anos de idade; 82,6 ± 10kg) e grupo TCM (GTCM: n = 5, 18,8 ± 1,3 ano de idade; 74,6 ± 9,7kg) com 11 meses mínimos em TF. Houve dois momentos de TE: depois de 28 dias somente com TF e coletas de sangue antes (M1a) e após (M1d), e após mais 28 dias de TF mais a suplementação com W-3 ou TCM e repetindo o mesmo procedimento (M2a e M2d). RESULTADOS: O hematócrito (Ht), osmolalidade (Os), sódio (Na+) e pressão de dióxido de carbono (PCO2) não tiveram mudanças significativas em nenhum momento, grupo ou D M2 (P > 0,05). A pressão de oxigênio (PO2) aumentou significativamente após TE nos dois momentos e grupos (P < 0,05). Glicose e bicarbonato (HCO3) tiveram aumento no M1 para o GW-3 e o HCO3 no M2 para o GTCM (P < 0,05), sem outras mudanças. A lactato desidrogenase (LDH) aumentou significativamente somente no M2 para o GW-3 (P < 0,05) e o pH caiu no M1 para ambos grupos (P < 0,05), sem outras mudanças significativas. CONCLUSÃO: Os TE per se alteraram a maioria dos indicadores metabólicos, mas houve grande desvio padrão. O teste induziu a acidose e a suplementação de ácidos graxos não interferiu.

OBJECTIVE: This study compares the effects of strength training (ST) with or without supplementation of omega-3 lipids (W-3) or medium chain triglycerides (MCT) in metabolic indicators in the exhaustion test (ET). METHODS: The subjects 12 males with minimum 11 months of ST of experience were divided in group W-3 (GW-3: n = 7, 26.7 ± 6.0 years old; 82.6 ± 10 kg) and group MCT (GMCT: n = 5, 18.8 ± 1.3 years old; 74.6 ± 9.7 kg). There were 2 moments of ET: after 28 days only with ST and blood collection samples before (M1b) and after (M1a), and after 28 more days of ST plus supplementation with 4 g/d of W-3 or 4 g/d of MCT repeating the same procedure (M2b and M2a). RESULTS: The hematocrite (Ht), osmolality (Os), sodium (Na+) and PCO2 showed no significant change at any moment, group or D M2 (P > 0.05). The PO2 increased significantly after ET in two moments and groups (P < 0.05). The glucose and HCO3 had significant increase in M1 to GW-3 and HCO3 in M2 to GMCT (P < 0.05), without other changes. The LDH increased significantly only in M2 to GW-3 (P < 0.05) and pH decreased in M1 to both groups (P < 0.05), without other significant changes. CONCLUSIONS: The ET per se altered the major metabolic indicators but a great standard deviation occurred. The tests induced acidosis without influencing fat acids supplementation.

PROPÓSITO: Este estudio compara los efectos de entrenamiento de fuerza (TF) con o sin la suplementación de lípidos omega 3 (W-3) o triglicéridos de cadena media (TCM), los indicadores metabólicos en un test de agotamiento (TE). MÉTODOS: Grupo W-3 (GW-3: n = 7, 26,7 ± 6 años de idade; 82,6 ± 10 kg) y grupo TCM (GTCM: n = 5, 18,8 ± 1,3 año de edad; 74,6 ± 9,7 kg) con 11 meses mínimos en TF. Hubo 2 momentos de TE: después de 28 días solamente con TF y colectas de sangre antes (M1a) y después (M1d), y después de mas de 28 días de TF más la suplementación con W-3 o TCM y repitiendo el mismo procedimiento (M2a e M2d). RESULTADOS: El hematocrito (Ht), osmolalidad (Os), sodio (Na+) y presión de dióxido de carbono (PCO2) no tuvieron cambios significativos en ningún momento, grupo de D M2 (P > 0,05). La presión de oxígeno (PO2) aumentó significativamente después TE los dos momentos y grupos (P < 0,05). Glucosa y bicarbonato (HCO3) tuvieron un aumento en M1 para el GW-3 y el HCO3 el M2 para el GTCM (P < 0,05), sin otros cambios. La lactato desidrogenasa (LDH) aumentó significativamente solamente en el M2 para el GW-3 (P < 0,05) y el pH cayó en el M1 para ambos grupos (P < 0,05), sin otros cambios significativos. CONCLUSIÓN: Los TE per se se alteraron en la mayoría de los indicadores metabólicos, mas ha habido un gran desvío padrón. El test indujo una acidosis y la suplementación de ácidos grasos no interfirió.