Resumo Fundamento A incidência de ductus arteriosus patente (PCA) pode chegar a 50% em pacientes prematuros. Quando hemodinamicamente significativo, pode ser responsável por tempo de ventilação mecânica prolongado, além de importante fator de risco para o aparecimento de enterocolite necrotizante, hemorragia intraventricular e displasia broncopulmonar nessa população. Objetivo O objetivo deste estudo é descrever a experiência inicial do fechamento percutâneo de canal arterial em prematuros pesando menos de 2 kg. Métodos Trata-se de estudo prospectivo que compreendeu 14 pacientes consecutivos submetidos a fechamento percutâneo de canal arterial de março de 2020 a fevereiro de 2021 em 6 instituições no Brasil. Resultados A idade gestacional média ao nascimento foi de 28,45 ±3,14 semanas, a idade média no momento do procedimento foi de 38,85 ±17,35 dias e o peso médio de 1,41±0,41 kg. Dentre os prematuros, 79% necessitavam de ventilação mecânica e 79% tinham feito uso de, em média, 1,5 ciclos de anti-inflamatórios não esteroides. A maioria dos pacientes teve melhora dos parâmetros ventilatórios e o tempo médio de extubação foi de 12,6 ±7,24 dias. A taxa de sucesso foi de 100%. Não houve mortalidade relacionada ao procedimento. Conclusão Este estudo concluiu que o fechamento percutâneo do canal arterial em prematuros é uma realidade no Brasil, com resultados satisfatórios e baixa taxa de complicações.

Abstract Background The presence of patent ductus arteriosus can be as high as 50% in preterm babies. Hemodynamically significant patent ductus arteriosus is a common cause of delayed weaning of respiratory support and an important risk factor of necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia in this population. Objective The aim of this study is to describe an initial experience of percutaneous closure of the ductus arteriosus in preterm infants weighing less than 2 kg. Methods This was a prospective study, comprised of 14 consecutive patients submitted to percutaneous closure of ductus arteriosus between March 2020 and February 2021 in 6 institutions in Brazil. Results Mean gestational age was 28.45±3.14 weeks, mean age at the procedure was 38.85±17.35 days and mean weight was 1.41 ±0.41 kg; 79% of the patients were under mechanical ventilation, and 79% had been submitted, on average, to a 1.5 cycle of non-steroidal anti-inflammatory drugs. Most patients were weaned off of mechanical ventilation in a mean of 12.6 ±7.24 days after the procedure. Success rate was 100%. No procedure-related mortality was observed. Conclusion This study concluded that percutaneous closure of ductus arteriosus in premature babies below 2 kg has satisfactory results and a low complication rate in this study sample.

Resumo Objetivo Avaliar o efeito sistêmico do látex de Hancornia especiosa na neoformação óssea e mineralização em ratos. Métodos Para isso, primeiro o látex foi coletado, e sua composição foi analisada. No estudo, foram utilizados 30 ratos Wistar machos submetidos simultaneamente a dois procedimentos cirúrgicos: extração de incisivo e criação de um defeito de 2 mm de diâmetro no osso parietal. Os ratos foram divididos em dois grupos: controle sistêmico (CS) e látex sistêmico (XS), aos quais foi administrado, oral e diariamente, 1,5 mL de água ou uma solução contendo 50% de água e 50% de látex por gavagem, respectivamente. Após 15 dias do tratamento, os animais foram eutanizados, e suas amostras, coletadas. Resultados Os resultados foram analisados estatisticamente, e o nível de significância foi fixado em 0,05. Mostramos que o látex de H. speciosa continha cálcio. A administração oral e diária deste látex por 15 dias aumentou o conteúdo de cálcio e fósforo de osso basal e de osso recém-formado no alvéolo mandibular de ratos. Conclusão Este foi um estudo pioneiro, que demonstrou o potencial do látex de H. speciosa no aumento da mineralização óssea. Nossos resultados podem ajudar na concepção e no desenvolvimento de uma droga natural.

Abstract Objective To evaluate the systemic effect of Hancornia speciosa latex on bone neoformation and mineralization in rats. Methods For that, the latex was first collected, and its composition was analyzed. A total of 30 male Wistar rats were used, which were simultaneously submitted to two surgical procedures: extraction of an incisor and creation of a defect with 2 mm in diameter in the parietal bone. The rats were divided into two groups: systemic control (SC) systemic latex (SX) which were administered, orally and daily, 1.5 mL of water or a solution containing 50% of water and 50% of latex by gavage, respectively. After 15 days of the treatment, the animals were euthanized and their samples were collected. Results The results were statistically analyzed, and the level of significance was set at 0.05. We showed that H. speciosa latex contained calcium. The oral and daily administration of the latex for 15 days increased the contents of calcium and phosphorus in the basal bone and newly-formed bone in the mandibular alveolus of rats. Conclusion The present was a pioneer study demonstrating the potential of H. speciosa latex in increasing bone mineralization. Our results may aid in the conception and development of a natural drug.

Abstract Background: the biological activity of vitamin D depends on the activity of its receptor or VDR. On the other hand, the activity of this receptor is influenced by its state of methylation. The objective of this study was to verify if the BsmI polymorphism of the VDR gene influences its methylation profile in adolescents. Secondly, it was to verify if the status of some metabolic factors (oxidative stress, inflammation, lipid profile, and glycemia) in the serum, and gender-adjusted vitamin D levels are independent factors with an influence on the VDR methylation profile. Methods and results: the study included 198 adolescents of both sexes, aged 15-19 years, who underwent testing for VDR gene methylation polymorphisms, serum vitamin D levels, and metabolic, oxidative stress, and systemic inflammation markers. It was observed that the BB genotype was less methylated than the other groups (26.1 % versus 30.3 %, and 29.3 % for Bb and bb, respectively), although without statistical differences between them. The odds ratio indicated a protection of 13 % (partially methylated) for vitamin D status, while alpha glycols increased the risk ratio (of being partially methylated) by 3 %. MDA was protective at a 28 % chance of risk that adolescents with higher levels of lipid peroxidation would be hypomethylated. Conclusion: we conclude that the methylation profile of the VDR gene is not influenced by the different BsmI polymorphism genotypes, and that serum vitamin D and serum markers of oxidative stress and inflammation can modulate this profile.

Resumen Antecedentes: la actividad biológica de la vitamina D depende de la actividad de su receptor, el VDR. Por otro lado, la actividad de este receptor está influenciada por su estado de metilación. El objetivo de este estudio es verificar si el polimorfismo BsmI del gen VDR influye en el perfil de metilación del mismo en los adolescentes. En segundo lugar, verificar si los factores metabólicos (estrés oxidativo, inflamación, perfil lipídico y glucemia) del suero y la vitamina D ajustada por sexo actúan independientemente de los polimorfismos sobre el perfil de metilación del VDR. Métodos y resultados: el estudio incluyó a 198 adolescentes de ambos sexos, de 15 a 19 años de edad, que se sometieron a análisis de polimorfismos de metilación del gen VDR, niveles de vitamina D, marcadores metabólicos, estrés oxidativo e inflamación sistémica. Se observó que el genotipo BB estaba menos metilado que los otros grupos (26,1 % contra 30,3 % y 29,3 % para Bb y bb respectivamente), aunque sin diferencias estadísticas entre ellos. El odds ratio indicó una protección del 13 % (parcialmente metilado) para el estado de la vitamina D, mientras que los alfa glicoles aumentaron el índice de riesgo (de estar parcialmente metilado) en un 3 %. La MDA fue protectora con un 28 % de probabilidad de riesgo de que los adolescentes con niveles más altos de peroxidación lipídica fueran hipometilados. Conclusión: concluimos que el perfil de metilación del gen VDR no está influenciado por los diferentes genotipos del polimorfismo BsmI y que la vitamina D y los marcadores de estrés oxidativo e inflamación en el suero pueden modular este perfil.

Abstract Background: Fontan circulation can be associated with significant morbidity, especially Protein-Losing Enteropathy (PLE). Echocardiographic parameters can provide valuable diagnostic information about a patient's risk of developing PLE after Fontan surgery. Objectives: To describe echocardiographic/ultrasonographic parameters associated with PLE in patients after Fontan surgery through a systematic review with meta-analysis. Methods: A literature search was performed in electronic databases to identify relevant studies about echocardiographic parameters and PLE prediction in children after Fontan surgery. The search terms used were: “echocardiography”, “ultrasonography”, “Fontan,” and “protein-losing enteropathy”. A p < 0.05 was considered statistically significant. Results: A total of 653 abstracts were obtained from electronic databases and bibliographic references. From these, six articles met criteria to be included in the qualitative analysis and three in the quantitative (meta-analysis). The resistance index in the superior mesenteric artery was described in three studies, and the quantitative analysis showed statistical significance (p < 0.001). Other echocardiographic and ultrasonographic parameters were also described, albeit in single studies not allowing a meta-analysis. Conclusion: This systematic review with meta-analysis identified echocardiographic and ultrasonographic parameters related to PLE in patients with Fontan physiology. Vascular ultrasonography seems to play a prominent role in this aspect, but additional studies are needed to increase the degree of evidence.

Abstract INTRODUCTION: Snakebites in the Brazilian Amazon are caused mostly by snakes from the Bothrops genus and envenomated patients may suffer from tissue complications. METHODS: This study aimed to identify risk factors for severe tissue complications (STC) in patients with Bothrops snakebite in the Amazonas state, Brazil. RESULTS: Snakebites that were classified as severe and affected female patients with comorbidities presented greater risks of developing STCs. In addition, hospitalizations of patients with STC exceeded 5 days. CONCLUSIONS: Clinical and epidemiological characteristics can prove essential for assessing the evolution of STC and clinical prognosis of patients with Bothrops snakebites.

Abstract Objective: to verify the association of serum concentrations of 25-hydroxyvitamin D and glycemic levels with the genetic variants rs1544410 and rs2228570 of the VDR gene in adolescents from the Northeast region of Brazil. Materials and methods: a cross-sectional epidemiological study with 208 adolescents from public schools in the city of João Pessoa (Paraíba, Brazil) between 15 and 19 years of age. Blood samples were collected for DNA extraction and analysis of polymorphisms rs1544410 and rs2228570, as well as biochemical analyses (25-hydroxyvitamin D, parathyroid hormone, calcium and glycemia). Results: the mean age was 17.7 (± 1.14) years. Half of adolescents had sufficient serum levels of 25-hydroxyvitamin D and the other half had insufficient/deficient vitamin. The most frequent genotypic distribution was bb and Ff and of lesser frequency BB and ff. There was a significant relationship between the genotypes of rs1544410 and glycemia values (p = 0.049) in the relationships between the genotypes BBxbb (p = 0.012) and Bbxbb (p = 0.037); (p = 0.036, OR = 2.15, 95 % CI = 1.05-4.41), and in the BB+Bb group analysis when compared to the bb (p = 0.025, OR = 1.89, 95 % CI = 1.08-3.29) presented higher risk of glycemia above the median. On the other hand, when Bb+bb was analyzed in relation to BB, adolescents had a greater chance of blood glucose below the median (p = 0.025, OR = 0.66, CI = 0.47-0.95). Conclusion: this study showed a significant relation of glycemia with the distribution of rs1544410 polymorphism genotypes.

Resumen Objetivo: verificar la asociación de las concentraciones séricas de 25-hidroxivitamina D y los niveles de glucemia con las variantes genéticas rs1544410 y rs2228570 del gen VDR en adolescentes de la región noreste de Brasil. Materiales y métodos: se realizó un estudio epidemiológico transversal con 208 adolescentes de escuelas públicas en la ciudad de João Pessoa (Paraíba, Brasil) de entre 15 y 19 años de edad. Se recogieron muestras de sangre para la extracción de ADN y el análisis de los polimorfismos rs1544410 y rs2228570, así como para análisis bioquímicos (25-hidroxivitamina D, hormona paratiroidea, calcio y glucemia). Resultados: la edad media fue de 17,7 (± 1,14) años. La mitad de los adolescentes tenía niveles séricos suficientes de 25-hidroxivitamina D y la otra mitad, vitamina insuficiente/deficiente. La distribución genotípica más frecuente fue bb y Ff y la de menor frecuencia, BB y ff. Hubo una relación significativa entre los genotipos de rs1544410 y los valores de glucemia (p = 0,049) en las relaciones entre los genotipos BBxbb (p = 0,012) y Bbxbb (p = 0,037); (p = 0,036, OR = 2,15, IC 95 % = 1,05-4.41), y el análisis del grupo BB + Bb en comparación con el bb (p = 0,025, OR = 1,89, IC 95 % = 1,08-3,29) mostró un mayor el riesgo de glucemia, por encima de la mediana. Por otro lado, cuando se analizó Bb+bb en relación con la BB, los adolescentes tuvieron una mayor probabilidad de que la glucosa en sangre estuviera por debajo de la mediana (p = 0,025, OR = 0,66, IC = 0,47-0,95). Conclusión: este estudio mostró una relación significativa entre la glucemia y la distribución de genotipos de polimorfismo rs1544410.

Abstract Given the scarcity of studies with elderly and the existence of studies investigating the effect of vitamin D supplementation in PEH (post exercise hypotension), this study evaluated the effect of a single megadose of vitamin D on resting blood pressure (RBP) and post-exercise hypotension (PEH) in the elderly. 11 hypertensive elderly women (70.3 ± 1.7 years) received a single megadose of 200.000 IU of cholecalciferol or a placebo, orally, through capsules. On day 7, the subjects performed 30 minutes of aerobic exercise with blood pressure measurement before exercise and every 10 minutes after exercise during 60 minutes, besides cardiac autonomic modulation. RBP did not significantly change. Exercise promoted significant systolic PEH only in one moment post exercise in treated group and in the placebo group promoted significant systolic PEH at four moments. Significant diastolic PEH did not occur in any of the groups. Sympathovagal activity increased at post exercise balance in supplemented subjects at 20 min, 40 min, 50 min and 60 min when compared to rest; this increase was not observed in the placebo. A megadose of vitamin D did not reduce RBP, promoted partial inhibition of systolic PEH and increased sympathovagal balance.

Abstract Objective: this study aimed to investigate the association between serum 25-hydroxyvitamin D (25 [OH] D) and cardiometabolic risk factors in Brazilian adolescents. Methods: a cross-sectional study with 220 school adolescents aged 15 to 19 years was performed in the city of João Pessoa-PB, Brazil. The variables studied were: 25 hydroxyvitamin D (25 OH), dietary intake of vitamin D, anthropometric data (body mass index (BMI), waist circumference (WC) and waist / height ratio (RCA) and biochemistry, total cholesterol (TC), Low Density Lipoprotein (LDL), High Density Lipoproteins (HDL), triglyceride (TG), C-reactive protein (CRP), alpha acid glycoprotein (AGPA), malondialdehyde (MDA) and total antioxidant capacity (CAT), blood pressure, parathyroid hormone (PTH) and serum calcium. Enough and insufficient / deficient adolescents were compared by qui-square test and analysis of multiple lineal regression was accomplished to identify the factors cardiometabólicos associated to the concentration sérica of 25 (OH) D (p < 0,05). Results: a total of 57.3% had vitamin D insufficiency/deficiency, which was more prevalent in females (79.35%). The chi-square test revealed an evident relationship between the three indicators involved in overweight assessed in this study BMI (p = 0.01), WC (p = 0.04) and AGR (p = 0.02). There was an association between the independent variable (vitamin D) and calcium and triglyceride levels. Conclusion: a high proportion of adolescents presenting insufficiency/vitamin D deficiency was ssociated with cardiometabolic risk factors.

Resumen Objetivo: este estudio tuvo como objetivo investigar la asociación entre la 25-hidroxivitamina D sérica (25 [OH] D) y los factores de riesgo cardiometabólico en adolescentes brasileños. Metodologia: se realizó un estudio transversal con 220 adolescentes escolares de 15 a 19 años en la ciudad de João Pessoa-PB, Brasil. Las variables estudiadas fueron: 25 hidroxivitamina D (25 OH), ingesta dietética de vitamina D, datos antropométricos (índice de masa corporal (IMC), circunferencia de la cintura (WC) y relación cintura / altura (RCA) y bioquímica, colesterol total (TC) , Lipoproteínas de baja densidad (LDL), lipoproteínas de alta densidad (HDL), triglicéridos (TG), proteína C reactiva (PCR), glicoproteína alfaácida (AGPA), malondialdehído (MDA) y capacidad antioxidante total (CAT), presión arterial, Hormona paratiroidea (PTH) y calcio sérico. Se compararon adolescentes suficientes e insuficientes / deficientes mediante la prueba de qui cuadrado y se realizó un análisis de regresión lineal múltiple para identificar los factores cardiometabólicos asociados a la concentración sérica de 25 (OH) D (p < 0,05). Resultados: un 57,3% tenía insuficiencia / deficiencia de vitamina D, que era más prevalente en las mujeres (79,35%). La prueba de ji cuadrado reveló una relación evidente entre los tres indicadores involucrados en el sobrepeso evaluados en este estudio IMC (p = 0,01), WC (p = 0,04) y AGR (p = 0,02). Hubo una asociación entre la variable independiente (vitamina D) y los niveles de calcio y triglicéridos. Conclusión: una alta proporción de adolescentes con insuficiencia de deficiencia de vitamina D de 25 (OH) D se asociaron con factores de riesgo cardiometabólico. Conclusión: una alta proporción de adolescentes con insuficiencia/deficiencia de vitamina D se asoció con factores de riesgo cardiometabólico.

Abstract Purpose To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). Methodology Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). Results The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. Conclusion The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.

Resumo Este trabalho objetivou avaliar a prevalência e a sazonalidade da infecção natural por parasitos gastrintestinais em bubalinos de aptidão leiteira de diferentes categorias, no município de Bandeirantes, Mato Grosso do Sul. Foram avaliados 41 búfalos da raça Murrah, divididos em três categorias, sendo 11 lactentes, com idade de 0 a 8 meses, 10 desmamados, de 8 a 18 meses, e 20 fêmeas adultas com idade superior a 18 meses. Os animais adultos apresentaram-se livres de parasitismo ou com carga parasitária muito baixa. A categoria lactente apresentou pico de contagem de ovos por grama de fezes (OPG=2038) em novembro, quando a precipitação acumulada foi de 69,3 mm e a temperatura 25,95 ºC, enquanto a menor contagem de ovos (167) ocorreu em maio, dois meses após pico de 234,68 mm e 20,59 ºC. Os búfalos desmamados apresentaram dois picos de OPG, de 1288 e 875, em setembro e junho, com precipitação de 41,45 e 18,4 mm e temperatura de 24,16 e 20,69 ºC, respectivamente. Foi observada correlação significativa (p=0,01) e negativa (r=-0,33) entre o OPG dos bezerros lactentes e precipitação pluviométrica. Os parasitos gastrintestinais mais frequentes foram Haemonchus sp. e Cooperia sp.

Abstract This study evaluated the prevalence and seasonality of natural infection by gastrointestinal parasites and the susceptibility of different dairy buffalo categories in Bandeirantes, state of Mato Grosso do Sul, Brazil. Forty-one Murrah buffaloes were divided into three categories, 11 suckling calves (0-8 months old), 10 weaned calves (8-18 months old), and 20 adult females over the age of 18 months. Adult animals were free from parasitism or showed very low parasite load. The suckling calves showed a peak of egg per gram of feces (EPG = 2038) in November, when the average rainfall was 69.3 mm and the temperature 25.95 ºC, while the lowest egg count (167) occurred in May, two months after the peak of 234.68 mm and 20.59 ºC. Weaned calves showed two peaks of EPG from 1288.89 and 875 in September and June, with rainfall of 41.45 and 18.4 mm, temperature 24.16 and 20.69 ºC, respectively. Significant (p = 0.01) and negative (r = -0.33) correlation between the EPG of suckling calves and precipitation was observed. The most common gastrointestinal parasites were Haemonchus sp. and Cooperia sp.

Background: Hypovitaminosis D is a frequent problem in the world and can be influenced by several factors. Objective: To estimate the prevalence of hypovitaminosis D and associated factors in adolescent students of a capital city of northeastern Brazil. Methods: Cross-sectional epidemiological study assessing 220 school adolescents of both sexes aged 15 to 19 years. A questionnaire was applied to assess sociodemographic (skin color, mother's education and receiving social benefits) and behavioral data (number of hours of sleep per day, sun exposure, physical activity and dietary vitamin D intake). Anthropometric nutritional status was assessed by BMI (body mass index) for age. Serum 25 (OH) D concentrations, PTH and serum calcium were measured by blood samples. We identified individuals with hypovitaminosis D as those with 25 (OH) D < 30 ng/dL. The analysis of factors associated with hypovitaminosis D was performed by simple and multivariate Poisson Regression. Results: The prevalence of hypovitaminosis D was 57.3%. The female population had a significantly higher prevalence than the male. In the final adjusted model, the variable independently associated with hypovitaminosis D in females was the lowest serum calcium concentrations, and for males it was BMI, in which adolescents who had overweight/obesity were 2.4 times more likely to have hypovitaminosis D than the eutrophic ones. Conclusions: The present study found a high prevalence of hypovitaminosis D in the analyzed population, especially in female adolescents. In addition, the factors independently associated with hypovitaminosis D were found to be overweight/obese in boys and low calcium concentrations in girls.

Introducción: la hipovitaminosis D es un problema frecuente en el mundo y puede verse influenciada por varios factores. Objetivo: estimar la prevalencia de hipovitaminosis D y factores asociados en adolescentes de una ciudad capital del noreste de Brasil. Métodos: estudio epidemiológico transversal que evaluó a 220 adolescentes de ambos sexos de 15 a 19 años de edad. Se aplicó un cuestionario para evaluar los datos sociodemográficos y de comportamiento. El estado nutricional antropométrico fue evaluado por IMC para la edad. Las concentraciones séricas de 25 (OH) D, PTH y calcio en suero se midieron mediante muestras de sangre. Se identificaron individuos con hipovitaminosis D como aquellos con 25 (OH) D < 30 ng/dl. El análisis de factores asociados con la hipovitaminosis D se realizó mediante Regresión de Poisson simple y multivariante. Resultados: la prevalencia de hipovitaminosis D fue del 57,3%. La población femenina tenía una prevalencia significativamente mayor que la masculina. En el modelo ajustado final, la variable independientemente asociada con la hipovitaminosis D en las mujeres fue la más baja de las concentraciones séricas de calcio, y para los hombres fue el IMC, en el que los adolescentes con sobrepeso/obesidad tenían 2,4 veces más probabilidades de tener hipovitaminosis que los eutróficos. Conclusiones: el presente estudio encontró una alta prevalencia de hipovitaminosis D en la población analizada, especialmente en adolescentes. Además, se encontró que los factores asociados de forma independiente con la hipovitaminosis D fueron el sobrepeso/obesidad en los niños y concentraciones bajas de calcio en las niñas.

RESUMO Objetivo: identificar a gravidade de pacientes admitidos em uma emergência de trauma. Método: estudo transversal e retrospectivo realizado com 115 pacientes com trauma, classificados como laranja (Sistema de Manchester), no período de junho de 2013 a julho de 2014. Os dados foram apresentados por média e desvio padrão, além dos testes Qui-quadrado de Pearson, One-Way ANOVA e Tukey. Resultados: da amostra, 81,7% eram do sexo masculino, com idade média de 39,46±19,71 anos. Maior ocorrência por trauma maior (48,7%) e traumatismo cranioencefálico (37,4%). No desfecho final e MEWS, a maioria dos casos que obtiveram escore de 1 a 3 foi encaminhada ao centro cirúrgico e à CTI. Conclusão: o MEWS inicial foi de 2 a 3 pontos, havendo evolução significativa do quadro de gravidade dos pacientes atendidos após 6 horas, sendo que aproximadamente metade dos indivíduos avaliados sofreu intervenção cirúrgica, indicando que a escala é um bom preditivo de gravidade.

ABSTRACT Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

RESUMEN Objetivo: identificar la gravedad de los pacientes ingresados en un trauma de emergencia. Método: estudio transversal y retrospectivo realizado en 115 pacientes con traumatismos clasificados como naranja (sistema de triage Manchester) a partir de junio de 2013 hasta julio de 2014. Los datos se presentaron como media y desviación estándar, y prueba de chi-cuadrado Pearson, ANOVA de una vía y Tukey. Resultados: 81,7% de hombres, edad media 39,46±19,71 años. Mayor incidencia de traumatismos graves (48,7%) y lesión cerebral traumática (37,4%). En el resultado final y MEWS (modified early warning score - puntuación de alerta temprana modificada), la mayoría de los casos tenían una puntuación de 1-3 y se remitieron a la sala de operaciones y UCI (unidad de cuidados intensivos). Conclusión: la puntuación inicial MEWS fue de 2 a 3 puntos, con un aumento importante en la gravedad de la situación de los pacientes atendidos después de 6 horas, y aproximadamente la mitad de los individuos se sometieron a la cirugía, lo que indica que la escala es un buen predictor de la gravedad.

ABSTRACT Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

RESUMEN Objetivo: identificar la gravedad de los pacientes ingresados en un trauma de emergencia. Método: estudio transversal y retrospectivo realizado en 115 pacientes con traumatismos clasificados como naranja (sistema de triage Manchester) a partir de junio de 2013 hasta julio de 2014. Los datos se presentaron como media y desviación estándar, y prueba de chi-cuadrado Pearson, ANOVA de una vía y Tukey. Resultados: 81,7% de hombres, edad media 39,46±19,71 años. Mayor incidencia de traumatismos graves (48,7%) y lesión cerebral traumática (37,4%). En el resultado final y MEWS (modified early warning score - puntuación de alerta temprana modificada), la mayoría de los casos tenían una puntuación de 1-3 y se remitieron a la sala de operaciones y UCI (unidad de cuidados intensivos). Conclusión: la puntuación inicial MEWS fue de 2 a 3 puntos, con un aumento importante en la gravedad de la situación de los pacientes atendidos después de 6 horas, y aproximadamente la mitad de los individuos se sometieron a la cirugía, lo que indica que la escala es un buen predictor de la gravedad.

RESUMO Objetivo: identificar a gravidade de pacientes admitidos em uma emergência de trauma. Método: estudo transversal e retrospectivo realizado com 115 pacientes com trauma, classificados como laranja (Sistema de Manchester), no período de junho de 2013 a julho de 2014. Os dados foram apresentados por média e desvio padrão, além dos testes Qui-quadrado de Pearson, One-Way ANOVA e Tukey. Resultados: da amostra, 81,7% eram do sexo masculino, com idade média de 39,46±19,71 anos. Maior ocorrência por trauma maior (48,7%) e traumatismo cranioencefálico (37,4%). No desfecho final e MEWS, a maioria dos casos que obtiveram escore de 1 a 3 foi encaminhada ao centro cirúrgico e à CTI. Conclusão: o MEWS inicial foi de 2 a 3 pontos, havendo evolução significativa do quadro de gravidade dos pacientes atendidos após 6 horas, sendo que aproximadamente metade dos indivíduos avaliados sofreu intervenção cirúrgica, indicando que a escala é um bom preditivo de gravidade.

Resumo Os recursos hídricos subterrâneos têm sido utilizados em grande escala em todo o território brasileiro. No sul do estado do Amazonas, sua utilização é exclusiva em vários municípios, porém esta região é caracterizada pelo precário quadro de saneamento básico. Considerando-se tal importância das águas subterrâneas, foi realizado um estudo com o objetivo de classificar e mapear a vulnerabilidade à contaminação da água subterrânea sob área urbana e adjacências do município de Humaitá, sul do Estado do Amazonas. A aplicação do método GOD (Groundwater occurrence; Overall lithology of the unsaturated zone; and Depth of the water table), permitiu identificar as classes de vulnerabilidade na área. Os resultados obtidos revelaram a existência de média e alta vulnerabilidade à contaminação do aquífero na área, indicando a fragilidade do sistema aquífero que abastece o município, e a necessidade da adoção de políticas públicas que visem à proteção dos recursos hídricos subterrâneos da região.

Abstract Groundwater has been used intensively throughout Brazil. In southern Amazonas state, the water supplies of some municipalities are derived exclusively from wells. Yet this region generally has no wastewater treatment, leading to potential contamination of the underground water. We classified and mapped the vulnerability of groundwater supplies to contamination in the urban and peri-urban area of Humaitá in southern Amazonas State. We used the GOD method (Groundwater occurrence; Overall Lithology of the unsaturated zone; Depth of the water table) to score vulnerability classes. The results revealed the existence of average and high vulnerability of aquifer contamination in the area, indicating the fragility of the aquifer system that supplies the municipality, and showing the need for public policies aimed at the protection of the region's groundwater resources.

O Índice de Área Foliar (IAF) é determinante nos processos de trocas de massa e energia nos ecossistemas, sendo fundamental para o entendimento das mudanças no clima regional e na dinâmica do ecossistema. O objetivo deste trabalho foi analisar, por meio da geoestatística, a variabilidade e dependência espacial dos valores de índice de área foliar (IAF) em áreas naturais de campo 'baixo', campo 'alto' e floresta de transição no Sul do Amazonas. Os valores de IAF foram determinados numa malha regular com 33 pontos para cada área estudada, e a aquisição dos dados foi feita pelo analisador de dossel LAI-2000, que permite se calcular a estrutura da vegetação com base na radiação que penetra na copa das árvores. Os valores médios do IAF variaram de acordo com a área estudada, com maiores valores na floresta (4,42 m²m-2), seguida pelo campo alto (2,03 m²m-2) e campo baixo (1,72 m²m-2). Em todas as áreas os valores de IAF mostraram dependência espacial com o uso da krigagem entre as amostras e apresentam distribuição espacial diferenciada em cada área estudada: o grau de dependência espacial foi moderado na floresta de transição e fraco para os campos naturais, sendo que no campo alto a distância limite em que os pontos estão correlacionados é de 35,3 m. No mapa de krigagem foi possível observar manchas com valores altos e baixos distribuídos de forma diferenciada entre as áreas estudadas.

The Leaf Area Index (LAI) has strong influence on ecosystems' energy and mass exchange and is fundamental to the understanding of regional climate changes and ecosystem dynamics. The main goal of this work was to establish, based on geostatistical analyses, the variability and spatial dependence of LAI in the natural fields and transitional forest in southern Amazonas State, in Brazil. The LAI was measured in a regular grid with 33 points at each studied area. Field measurements were done using the canopy analyser LAI-2000, which calculates the structure of the vegetation based on the radiation beneath the tree canopy. The average values of LAI varied according to the studied sites: the highest values were found in the transitional forest (4.42 m²m-2), followed by the high (2.03 m²m-2) and low (1.72 m²m-2) natural fields. All studied sites showed spatial dependence according to the kriging methods, but with different degrees of dependence: spatial dependence was moderate at the transition forest and weak at the natural fields. In the more arboreal open field, the maximum limit at which the points are correlated reached a distance of 35.3 m. The kriging maps proved to be very important tools for describing the spatial distribution of LAI in the Amazon.