Abstract This article is based on a representative and randomly selected sample of 396 individual criminal decisions from the Federal Supreme Court, issued between January 1, 2020, and June 22, 2021, related to the COVID-19 pandemic. We tracked the petitions, the type of imprisonment, the date of judgment, the type of legal action, and the outcomes of these requests. Subsequently, we conducted a qualitative analysis of the arguments employed by the Court in reaching its decisions. The main objective of the study is to understand how the Court ruled on requests for release from incarceration and the impact of the Covid-19 pandemic in the judicial reasoning. The findings indicate that the pandemic had no relevant impact on the Court’s decision-making process. Dismissals on procedural grounds prevailed, allowing the court to avoid ruling on the merits of a claim. On the other hand, when the merits were analyzed, the pandemic was not treated as a sufficient argument for releasing a prisoner. Additionally, during the pandemic, CNJ’s Recommendation No. 62 and ADPF No. 347 had no argumentative prominence in the few decisions that granted requests for release. This research reinforces the diagnosis that the pandemic has not changed how the Judiciary deals with imprisonment. This finding contributes to understand the challenges in tackling mass incarceration in Brazil.

Resumo Este artigo é baseado em uma amostra representativa e aleatória de 396 decisões monocráticas penais do Supremo Tribunal Federal, proferidas entre 01/01/2020 e 22/06/2021, que mencionam a pandemia de Covid-19. Foram mapeados os pedidos, o tipo de prisão, a data de julgamento, o tipo de ação e o resultado dos pedidos. Em seguida, foi feita uma análise qualitativa dos argumentos utilizados pela Corte para decidir. O objetivo principal do estudo é compreender como a Corte julgou pedidos de desencarceramento e o peso da pandemia de Covid-19 na argumentação judicial. Os dados indicam que a pandemia não teve impacto relevante na forma de decidir do STF em casos de prisão. Prevaleceram os indeferimentos de pedidos de soltura, com significativa mobilização argumentativa de óbices processuais, permitindo que a Corte não se posicionasse sobre questões de mérito. Por outro lado, quando o mérito foi analisado, a pandemia não foi tratada como argumento suficiente para desencarcerar. Ademais, a pandemia, a Recomendação 62 do CNJ e a ADPF 347 não tiveram grande destaque argumentativo nas poucas decisões que concederam pedidos de desencarceramento. A pesquisa reforça o diagnóstico de que a pandemia não mudou o modo como o Judiciário lida com a prisão. Esse achado de pesquisa contribui para a compreensão dos obstáculos para o enfrentamento do superencarceramento no Brasil.

ABSTRACT Seed vigor is one of main attributes of the physiological quality from seed lot. Thus, identify which mechanisms are used by seeds of higher vigor that favor the formation of seedlings with better performance is a key aspect in agriculture. The enzyme activity of phytase and alpha-amylase favor the availability of phosphorus and sugars, respectively, during germination and can be determinants of seed vigor. Thus, the objective of the present work was to identify the association of phytase and alpha-amylase enzymes with the vigor of a seed lot of common beans. The results showed a positive correlation between seed vigor and the enzymes evaluated. Based on the findings, it can be concluded that seeds with high vigor have a high capacity to form seedlings with better performance, because they present high enzymatic activity. Also, in seed lots of the same genotype, they can be used to determine seed vigor during germination. Thus agriculture alphaamylase alpha amylase sugars respectively beans evaluated findings Also genotype

Resumo O estudo analisou como as inflexões político-econômicas de financiamento e de estruturação do Sistema Único de Saúde podem ter afetado as condições de implementação de ações de prevenção e controle da obesidade (PCO) na atenção primária à saúde (APS) no estado do Rio de Janeiro (ERJ) entre 2014 e 2021. Fundamentou-se em referenciais de análise de políticas, considerando contexto de implementação, antecedentes históricos, mecanismos de indução e incentivos governamentais para o desenvolvimento das ações de PCO. Baseou-se em dois projetos realizados nos 92 municípios do ERJ entre 2014 e 2018 (PPSUS-ERJ) e 2019-2021 (PEO-ERJ), pautados em análise documental, entrevistas e grupos focais com profissionais e gestores da APS. Até 2016, percebe-se os impactos positivos da estruturação da APS e dos mecanismos de indução federais. No entanto, as inflexões na expansão e no financiamento da APS contribuíram para o enfraquecimento de unidades, equipes e estratégias, além de uma retração de recursos para as ações estaduais e municipais. Entre 2016-2018, a crise política e financeira do ERJ foi potencializada pelas crises nacionais, e os contrapontos positivos desde então foram os mecanismos de indução e recursos federais que permaneceram, além das áreas técnicas da SES-ERJ e do cofinanciamento estadual.

Abstract The present study aimed to analyze how these changes, both at the national and state levels, could affect the conditions of the implementation of obesity prevention and control (OCP) actions in primary health care (PHC) in the Rio de Janeiro State from 2014 to 2021. This study was based on policy analysis methods that emphasize the understanding of the implementation contexts, as well as the induction mechanisms and government incentives for the development of actions and integration of two projects that analyzed the OPC actions in PHC in the 92 municipalities of RJS between 2014 and 2018 (PPSUS-RJS) and between 2019 and 2021 (PEO-RJS). The results indicate that, by 2016, it was possible to observe the positive impacts of the structuring of PHC and the federal induction mechanisms in RJS. However, inflections in the expansion and funding of PHC contributed to the weakening of units, teams, and strategies, and led to retraction of resources for both state and municipal actions. Between 2016-2018, RJS’s political and financial scenario deteriorated due to national crises, and the positive counterpoints since then were the induction mechanisms and federal resources that remained, in addition to the technical areas of the RJS-HD and state co-financing resources.

Abstract The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.

Resumo O objetivo foi analisar os fatores associados ao uso dos serviços odontológicos no Brasil. A estratégia de revisão incluiu as bases PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de repositórios e bancos de dissertações e teses. Os estudos foram selecionados usando a estratégia PEO (população/exposição/desfechos). O desfecho deste estudo foi o uso dos serviços odontológicos no último ano pela população brasileira, tratado como variáveis dicotômicas para as análises: ≤ 1 ano e > 1 ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, estimando-se razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Foram selecionados 94 estudos. A maioria (98%) tinha delineamento transversal, sendo 63% oriundos de dados primários. Para a metanálise, 25 estudos foram incluídos. O uso dos serviços odontológicos no último ano esteve associado com maior escolaridade (≥ 8 anos de estudo) (RP = 0,49, (IC95%: 0,39-0,60)); maior renda familiar (≥ 2 salários-mínimos) (RP = 0,79, (IC95%: 0,74-0,84)); e residir na zona urbana (RP = 0,79, (IC95%: 0,64-0,97)). A oferta de serviços odontológicos no Sistema Único de Saúde precisa ser ampliada entre pessoas com menor renda, menor escolaridade e moradores da zona rural.

Resumo O objetivo foi analisar os fatores associados ao uso dos serviços odontológicos no Brasil. A estratégia de revisão incluiu as bases PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de repositórios e bancos de dissertações e teses. Os estudos foram selecionados usando a estratégia PEO (população/exposição/desfechos). O desfecho deste estudo foi o uso dos serviços odontológicos no último ano pela população brasileira, tratado como variáveis dicotômicas para as análises: ≤ 1 ano e > 1 ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, estimando-se razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Foram selecionados 94 estudos. A maioria (98%) tinha delineamento transversal, sendo 63% oriundos de dados primários. Para a metanálise, 25 estudos foram incluídos. O uso dos serviços odontológicos no último ano esteve associado com maior escolaridade (≥ 8 anos de estudo) (RP = 0,49, (IC95%: 0,39-0,60)); maior renda familiar (≥ 2 salários-mínimos) (RP = 0,79, (IC95%: 0,74-0,84)); e residir na zona urbana (RP = 0,79, (IC95%: 0,64-0,97)). A oferta de serviços odontológicos no Sistema Único de Saúde precisa ser ampliada entre pessoas com menor renda, menor escolaridade e moradores da zona rural.

Abstract The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.

Abstract The Paranaguá Estuarine Complex (PEC) is one of Brazil's largest southwest Atlantic estuarine systems, possessing a rich microalgae diversity that remains to be fully explored. Therefore, due to the increasing interest in the microalgae biotechnological potential, this study isolated and identified diatoms found in the PEC. The diatoms were purified and analyzed with light and scanning electron microscopy for morphological identification, while DNA sequences were used for molecular identification. Although a diatoms rich diversity was obtained, only a few were viable after the cultivation period. The two best-selected strains were identified as belonging to two genera, Nitzschia and Navicula. The rbcL region was found to be the most informative for species identification. Morphological and molecular analyses allowed for the identification of species Nitzschia inconspicua and Navicula pseudoantonii, which was understood as the first report of N. pseudoantonii in the American continent.

Abstract Background Contrast-induced nephropathy (CIN) is defined as worsening renal function, represented by an increase in serum creatinine of ≥ 25% or ≥ 0.5 mg/dL up to 72 h after exposure to iodinated contrast medium (ICM). The most effective preventive measure to date is intravenous hydration (IVH). Little is known about the effectiveness of outpatient oral hydration (OH). Objetive To investigate whether outpatient OH with water is as effective as IVH with 0.9% saline solution in preventing CIN in elective coronary procedures. Methods In this retrospective observational study, we analyzed the medical records and laboratory data of individuals undergoing percutaneous coronary procedures with ICM. Data collected between 2012 and 2015 refer to individuals who underwent IVH and those collected between 2016 and 2020 (after implementation of an OH protocol) correspond to individuals who underwent OH at home before and after coronary procedures as instructed by the nursing team. Statistical significance was established at α = 0.05. Results In total, 116 patients were included in this study: 58 in the IVH group and 58 in the OH group. An incidence of CIN of 15% (9/58) was observed in the group that received IVH and an incidence of 12% (7/58) was seen in the group that received OH (p = 0.68). Conclusion The OH protocol, performed by the patient, appears to be as effective as the in-hospital IVH protocol for the renal protection of individuals susceptible to CIN in elective coronary interventions. These findings should be put to test in larger trials.

Resumo Fundamento A nefropatia induzida por contraste (NIC) é definida como deterioração da função renal, representada por um aumento da creatinina sérica ≥25% ou ≥0,5 mg/dL até 72 horas após a exposição ao meio de contraste iodado (MCI). A medida preventiva mais eficaz até o momento é a hidratação venosa (HV). Pouco se sabe sobre a eficácia da hidratação oral (HO) ambulatorial. Objetivo Investigar se a HO ambulatorial com água é tão eficaz quanto a HV com solução salina a 0,9% na prevenção de NIC em procedimentos coronarianos eletivos. Métodos Neste estudo observacional retrospectivo, foram analisados prontuários médicos e dados laboratoriais para coletar dados de indivíduos submetidos a procedimentos coronarianos percutâneos com MCI. Os dados coletados entre 2012 e 2015 avaliaram indivíduos que foram submetidos à HV e entre 2016 e 2020 (após a implementação de um protocolo de HO), os indivíduos que foram submetidos à HO em casa antes e depois de procedimentos coronarianos, conforme orientação da equipe de enfermagem. A significância estatística adotada foi de α=0,05. Resultados No total, 116 pacientes foram incluídos neste estudo, 58 no grupo HV e 58 no grupo HO. Observou-se incidência de NIC de 15% (9/58) no grupo que recebeu HV e 12% (7/58) no grupo que recebeu HO (p=0,68). Conclusão O protocolo de HO realizado pelo paciente parece ser tão eficaz quanto o protocolo de HV hospitalar na proteção renal de indivíduos suscetíveis a desenvolver NIC em intervenções coronarianas eletivas. Essas descobertas devem ser testadas em ensaios mais abrangentes.

ABSTRACT: The objective of the present study was to detect the genetic diversity of Anaplasma marginale strains in naturally infected calves from a rural property located in the northeastern region of the state of Pará, Eastern Amazon, which has a history of mortality due to anaplasmosis. Fourteen calves positive for A. marginale were selected using a semi-nested polymerase chain reaction for the target msp1α gene, with asymptomatic (n=3) and symptomatic (n=11) infections. After sequencing the samples, two genotypes were verified in the E and C regions and the structures in tandem repeats were determined. Nine different strains were found: eight related to the E genotype (α-β-β-Γ = one animal, asymptomatic; 16-F-17-F-F = two animals, symptomatic; α-β-F-F-F-F = one animal, asymptomatic; 31-62-62-61 = one animal, symptomatic; τ-10-3 = three animals, two symptomatic and one asymptomatic; α-β-β-β = one animal, symptomatic; τ-22 -13-18 = two animals, both symptomatic; β-β-β-BRA1-31 = two animals, both symptomatic), and one related to genotype C (23-24-25-31-27-27 = one animal, asymptomatic). Genotype E was predominant in 92.86% of the samples (13/14), followed by genotype C (7.14%). This study made it possible to detect the genetic diversity of A. marginale in calves from the selected dairy farm, in addition to identifying the BRA1 sequence in the animals of the present study, which was recently diagnosed in Minas Gerais, demonstrating the dispersion of A. marginale strains in herds from different Brazilian states. Genetic diversity of A. marginale was observed in both symptomatic and asymptomatic calves. There were no significant differences when clinical signs were compared to the genotype verified in the infected animals. The prevalence of pathogenicity was not observed.

RESUMO: O objetivo do presente trabalho foi detectar a diversidade genética de cepas de Anaplasma marginale em bezerros naturalmente infectados oriundos de uma propriedade rural localizada na região nordeste do estado do Pará, Amazônia Oriental, a qual apresentava histórico de mortalidade devido à anaplasmose. Foram selecionados 14 bezerros positivos para A. marginale pela técnica de semi-nested PCR (nPCR) para o alvo no gene msp1α, com infecção assintomática (n=3) e sintomáticos (n=11). Após o sequenciamento das amostras foram verificados dois genótipos nas regiões E e C, e determinadas as estruturas em tandem repeats. Nove diferentes estirpes foram encontradas, sendo oito relacionadas ao genótipo E (α-β-β-Γ = um animal, assintomático; 16-F-17-F-F = dois animais, sintomáticos; α-β-F-F-F-F = um animal, assintomático; 31-62-62-61 = um animal, sintomático; τ-10-3 = três animais, dois sintomáticos e um assintomático; α-β-β-β = um animal, sintomático; τ-22-13-18 = dois animais, sintomáticos; β-β-β-BRA1-31 = dois animais, sintomáticos) e uma relacionada ao genótipo C (23-24-25-31-27-27 = um animal, assintomático). O genótipo E foi predominante em 92,86% das amostras (13/14), seguido pelo genótipo C (7,14%). O estudo possibilitou a detecção da diversidade genética de A. marginale em bezerros dessa propriedade leiteira, além de identificar a sequência BRA1 nos animais do presente estudo, a qual foi diagnosticada recentemente em Minas Gerais, o que demonstra a dispersão das estirpes de A. marginale nos rebanhos de diferentes estados brasileiros. A diversidade genética de A. marginale foi observada tanto em bezerros sintomáticos quanto em assintomáticos e não houve diferença significativa quando se comparou os sinais clínicos ao genótipo verificado no animal infectado, não observando a prevalência de patogenicidade de estirpes.

ABSTRACT The cultivation of Coffea arabica L. in a low-altitude region is a sustainable alternative for diversifying the income of farmers. On account of the variability of available cultivars, the use of indirect selection through initial vegetative development may be an auxiliary tool for identifying the most suitable genotypes for this environment. This study aimed to identify the dwarf Arabica coffee cultivars with better initial development in a low-altitude region and the morphological traits with greater relevance for the early selection of cultivars with high yield potential. The experiment was installed in the northeast of São Paulo, Brazil. The experimental design used was randomized blocks with four replications. The treatments consisted of 17 dwarf Arabica coffee cultivars. There is variability among dwarf Arabica coffee cultivars for initial vegetative development. The growth and increase in the number of nodes of the plagiotropic branch can be used in early selection to identify cultivars with greater yield potential. The cultivars IAC Obatã 4739, Obatã IAC 1669-20, and Tupi IAC 1669-33 present higher initial vegetative performance in low-altitude environments. The results obtained are useful to breeders and producers for choosing the cultivars best adapted to cultivation in this environment.

Abstract Despite the availability of in-office bleaching gels with a 6% concentration of hydrogen peroxide (HP), these gels have not been evaluated in younger patients. They are commercially available with a tip, associated or not with a brush, where the tip with a brush spreads the gel over the entire surface to have a smaller thickness (thin layer) since the manufacturers indicate the application of a thin layer of gel. Objective This randomized, split-mouth, double-blind clinical trial evaluated the efficacy of in-office bleaching with 6% HP in adolescents using different application tips, as well tooth sensitivity (TS) and aesthetic self-perception. Methodology Sixty participants were randomized for 6% HP self-mixing bleaching gel tip design: without brush and with brush. In-office bleaching was performed in 3 sessions of 50 minutes. Color change was evaluated using a digital spectrophotometer (ΔE ab , ΔE 00 , and ΔWI D ) and color guide (ΔSGU), the absolute risk and intensity of TS with a visual analogue scale and aesthetic self-perception with the oral aesthetic scale (a=0.05). Results The groups achieved similar bleaching regardless of the application tip (p>0.05). However, only for ΔWI D , a significant mean difference (MD) was observed in the third week (MD 2.3; 95% CI 1.2 to 3.3; p < 0.001) and at one month (MD 1.6; 95% CI 0.6 to 2.6; p < 0.03) favoring the tip without brush. Regarding TS, 45% in the tip-without-brush group and 33% in the tip-with-brush group reported TS (odds ratio 0.61; 95% CI 0.29 to 1.28; p<0.02), with low TS intensity (MD 0.05; 95% CI -0.06 to 0.17; p>0.36). All patients reported improved aesthetic self-perception after bleaching (MD -1.3; 95% -1.8 to -0.9; p<0.001). Conclusions Regardless of the tip used bleaching with 6% HP achieved a bleaching efficacy and improved the aesthetic self-perception. However, a lower risk of TS for application using the tip with brush was observed.

RESUMO Objetivo: Descrever a implementação de uma comunidade compassiva nas favelas da Rocinha e Vidigal, localizadas na cidade do Rio de Janeiro. Método: Relato da experiência da implementação de uma Comunidade Compassiva a partir das bases conceituais da Organização Mundial da Saúde, amparada pelas diretrizes da extensão universitária. Resultados: Inicialmente, lideranças locais e moradores foram recrutados e receberam treinamento sobre cuidados paliativos. Posteriormente, profissionais de saúde de diferentes especialidades engajaram-se no projeto por meio da prática do voluntariado. Foram instituídas visitas domiciliares na modalidade interconsulta e “apadrinhamentos” por moradores e profissionais de saúde às pessoas em cuidados paliativos e familiares. Por fim, a Rede de Atenção à Saúde do território foi integrada de forma a reconhecer o projeto como rede de apoio. Conclusão: Destacamos a experiência como trabalho vivo em saúde, que envolve relações e processos criativos, os quais mobilizam o saber técnico estruturado e as relações entre as pessoas e as tecnologias leve-duras e leves, tornando factível o reconhecimento de potências no território. Objetivo Vidigal Janeiro Método universitária Resultados Inicialmente Posteriormente engajaramse engajaram se voluntariado apadrinhamentos “apadrinhamentos familiares fim apoio Conclusão criativos leveduras leve duras leves

RESUMEN Objetivo: Describir la implementación de una comunidad compasiva en las favelas de Rocinha y Vidigal, ubicadas en la ciudad de Río de Janeiro. Método: Relato de la experiencia de implementación de una Comunidad Compasiva a partir de las bases conceptuales de la Organización Mundial de la Salud, sustentada en lineamientos de extensión universitaria. Resultados: Inicialmente, se reclutaron y capacitaron a líderes locales y residentes en cuidados paliativos. Posteriormente, profesionales de la salud de diferentes especialidades se involucraron en el proyecto a través del voluntariado. Se instituyeron visitas domiciliarias en la modalidad de interconsulta y “patrocinios” por parte de residentes y profesionales de salud a personas en cuidados paliativos y familiares. Finalmente, se integró la Red de Atención a la Salud del territorio para reconocer el proyecto como una red de apoyo. Conclusión: Destacamos la experiencia como trabajo vivo en salud, que involucra relaciones y procesos creativos, que movilizan saberes técnicos estructurados y relaciones entre personas y tecnologías ligeras-duras y ligeras, posibilitando el reconocimiento de poderes en el territorio. Objetivo Vidigal Janeiro Método universitaria Resultados Inicialmente Posteriormente voluntariado patrocinios “patrocinios familiares Finalmente apoyo Conclusión creativos ligerasduras ligeras duras

ABSTRACT Objective: To describe the implementation of a compassionate community in Rocinha and Vidigal slums, located in the city of Rio de Janeiro. Method: Report on the experience of implementing a Compassionate Community based on the World Health Organization conceptual bases, supported by university extension guidelines. Results: Initially, local leaders and residents were recruited and trained in palliative care. Subsequently, health professionals from different specialties engaged in the project through volunteering. Home visits were instituted in the form of interconsultation and “sponsorships” by residents and health professionals to people in palliative care and family members. Finally, the health care network in the territory was integrated in order to recognize the project as a support network. Conclusion: We highlight the experience as living work in health, which involves relationships and creative processes, which mobilize structured technical knowledge and relationships between people and soft-hard and soft technologies, making it possible to recognize powers in the territory. Objective slums Janeiro Method bases guidelines Results Initially Subsequently volunteering sponsorships “sponsorships members Finally Conclusion processes softhard hard technologies

Abstract Background: Lupus nephritis (LN) is a major source of morbidity and mortality in patients with systemic lupus erythematosus (SLE), with 10–25% of patients progressing to end-stage renal disease (ESRD). Objective: This study aims to elucidate the predictive capabilities of 24-h proteinuria (24PTU) and serum creatinine (sCr) after 12 months of treatment with respect to long-term renal outcomes in LN in a single-center cohort of LN patients. Methods: A retrospective analysis was performed on 214 patients diagnosed with LN followed in our center. Values of 24PTU and sCr were assessed at baseline and after 3, 6 and 12 months, and after 5 years and/or the last evaluation. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months or longer. End-stage renal disease (ESRD) was defined as the need for permanent dialysis. Receiver operating characteristics curves (ROC) were used to test the best cut-off value of 24PTU and sCr at 12 months who predict bad long-term renal outcomes. Results: The mean follow-up period was 11.2 ± 7.2 years. The best cut-off values for 24PTU and sCr as predictor of CKD were, respectively, 0.9 g/24 h and 0.9 mg/dL. ROC curve for 24PTU had a slightly lower performance than ROC curve for sCr as predictor for CKD (PTU AUC = 0.68; sCr AUC = 0.70), but sensitivity and specificity were better for 24PTU (24PTU: sensitivity = 63.5%, specificity = 71.2%; sCr: sensitivity = 54.8%, specificity = 75.3%). When the outcome was ESRD the best cut-off points were 0.9 g/24hs and 1.3 mg/dL for 24PTU and sCr, respectively, and the curve performance was better for 24PTU (PTU AUC = 0.72; sCr AUC = 0.61). Conclusions: In this ethnically diverse population with LN followed for a long time (> 10 years), levels of 24PTU > 0.9/day at 12 months was a good predictor of bad long-term renal outcome. The serum creatinine > 0.9 mg/dL and > 1.3 mg/dL at 12 months were also good predictors of CKD and ESRD, respectively. Patients with 24PTU < 0.9 g/day and sCr < 1.3 mg/dL at 12 months are not likely to develop ESRD because of the high negative predictive values (NPV) (93.2% and 82%). 24PTU and sCr are relevant as components for a treat-to-target strategy for LN treatment, since their high NPV corroborates their importance as good predictors of long-term renal outcome.

RESUMO Objetivo: Descrever e discutir um raro caso de tamponamento cardíaco na presença de Lúpus Eritematoso Sistêmico (LES) e infecção por Citomegalovírus (CMV) em um paciente pediátrico, as associações entre estas duas entidades, a abordagem diagnóstica e os possíveis tratamentos neste cenário. Descrição do caso: Paciente com nove anos de idade, sexo feminino, foi admitida no departamento de emergência com dispneia grave, hipofonese de bulhas, turgência jugular, instabilidade hemodinâmica e palidez intensa. Estava em acompanhamento ambulatorial prévio por quadro de dispneia leve, poliartrite, febre e manifestações cutâneas variadas há seis meses. Ecodopplercardiograma revelou efusão pericárdica. A paciente foi submetida à pericardiocentese seguida por drenagem pleuropericárdica em selo d’água, sem intercorrências. A investigação prosseguiu com o preenchimento de critérios clínico-laboratoriais para LES e a presença de antigenemia para CMV de 15/200.000 células. Foram iniciadas medicações para controle do LES e do CMV, com boa resposta clínico-laboratorial. Comentários: O LES pediátrico manifesta-se comumente de maneira mais grave, gerando alta morbimortalidade. Tamponamento cardíaco pode ser uma das primeiras manifestações do LES, que pode também ser precipitada por agentes infecciosos, como o CMV, levando à confusão diagnóstica e retardando o correto tratamento do paciente. Mudanças na terapêutica apropriada também devem ser consideradas na presença de ambas as condições. Com base nisso, apresentamos um caso de LES juvenil agravado por infecção por CMV e a manifestação pouco usual de tamponamento cardíaco.%

ABSTRACT Objective: To describe a rare case of cardiac tamponade in a pediatric patient with systemic lupus erythematosus (SLE) and cytomegalovirus (CMV) infection, and to discuss the relationship between these morbidities, the diagnostic approach, and the possible treatments. Case description: A 9-year-old girl presented to the emergency department with severe dyspnea, muffled heart sounds, jugular vein distention, hemodynamic instability, and intense pallor. She had previously been followed up at the outpatient clinic for a six-month history of mild respiratory distress, polyarthritis, fever, and various cutaneous manifestations. Doppler echocardiogram revealed pericardial effusion. The patient was submitted to pericardiocentesis followed by water seal pleuropericardial drainage, with no complications. The investigation continued, with fulfillment of clinical and laboratory SLE criteria plus CMV antigenemia of 15/200,000 cells. Medications to control CMV infection and SLE were then initiated, with good clinical and laboratory response. Comments: Pediatric SLE commonly manifests in a more severe form, accounting for high morbimortality. Cardiac tamponade could be one of the first manifestations of SLE, which can also be precipitated by infectious agents, such as CMV, leading to diagnostic confusion and misleading the treatment. Changes in therapeutics must also be considered in the presence of both conditions. This study presents a juvenile SLE case aggravated by a CMV infection with the unusual manifestation of cardiac tamponade.%

RESUMO Objetivo: Linfo-histiocitose hemofagocítica (LHH) é uma síndrome caracterizada pela hiperativação de linfócitos T citotóxicos, células natural killer e macrófagos, levando à secreção de citocinas pró-inflamatórias. Linfo-histiocitose hemofagocítica associada a Leishmaniose Visceral é um quadro de grande desafio para o diagnóstico, considerando que os sintomas são semelhantes, podendo levar ao óbito pacientes não tratados. Nosso objetivo é descrever uma série de casos de Leishmaniose Visceral com LHH admitidos em um hospital de referência para doenças infecciosas. Descrição do caso: Todos os 115 casos de Leishmaniose Visceral encaminhados ao centro de referência em doenças infecciosas pediátricas foram revistos para identificar os casos de LHH. Cinco casos (4,5%) foram confirmados com LHH e apresentaram febre, esplenomegalia, citopenia, hipertrigliceridemia ou hipofibrinogenemia, aumento de ferritina e hemafagocitose em medula óssea. Comentários: Deve-se suspeitar de LHH em crianças com doenças infecciosas que não respondem adequadamente ao tratamento ou em pacientes com sintomas graves, principalmente em áreas endêmicas da leishmaniose.%

ABSTRACT Objective: Hemophagocytic lymphohistiocytosis syndrome (HLHS) is characterized by an immunological hyperactivation of cytotoxic T cells, natural killer cells, and macrophages, leading to the secretion of proinflammatory cytokines. HLHS associated with Visceral Leishmaniasis might be difficult to diagnose once symptoms are similar, resulting in the death of untreated patients. Our aim is to describe a series of cases of Visceral Leishmaniasis with HLHS admitted to a referral hospital for infectious diseases. Case description: All 115 cases of Visceral Leishmaniasis referred to a referral center for pediatric infectious diseases were reviewed to identify the cases of HLHS. Five cases (4.5%) were confirmed with HLHS and they presented fever, splenomegaly, cytopenia, hypertriglyceridemia or hypofibrinogenemia, increased ferritin and hemophagocytosis in the bone marrow. Comments: It important to rule out HLHS in children with infectious diseases that do not respond adequately to treatment or in patients with severe symptoms, especially in leishmaniasis endemic areas.%

Resumo O texto aborda os circuitos de sociabilidade de homens que fazem sexo com homens, na Região Metropolitana do Recife durante o primeiro ano da pandemia de COVID-19. Em março de 2020, com a chegada da doença ao Brasil, um primeiro movimento foi caracterizado pelo deslocamento das interações para a dimensão on-line. A partir de junho, após distanciamento social mais rigoroso, as interações sexuais offline, a social na casa de amigos, a volta aos bares e a sociabilidade na rua foram sendo, nessa ordem, retomadas na esteira do que acontecia na sociedade abrangente. No descompasso entre o discurso negacionista do presidente da República e o protagonismo do governo estadual em implantar as medidas de distanciamento social, nas contradições geradas pela leniência em relação à aglomeração no transporte público na ida para o trabalho e nas tentativas de contenção das aglomerações de lazer, produziu-se um novo normal caracterizado pelo negacionismo, a onipotência e o fatalismo. Entre setembro de 2020 e fevereiro de 2021, o que mais se viu foram festas, circulação ostensiva das pessoas e ausência do uso de máscara, impulsionando os números de infectados e de mortos, na normalização de uma crise sanitária sem precedentes no Brasil.

Abstract The text addresses the sociability circuits of ‘men who have sex with men’ in the Metropolitan Region of Recife during the first year of the COVID-19 pandemic. In March 2020, with the arrival of the epidemic in Brazil, a first movement was characterized by the shift of interactions to the online dimension. From June onwards, after stricter social distancing, offline sexual interactions, social interactions at friends’ houses, the return to bars and sociability on the street were resumed in that order, in the wake of what was happening in the broader society. In the mismatch between the negationist speech of the President of the Republic and the role of the state government in implementing measures of social distancing; in the contradictions generated by the leniency regarding crowding in public transport on the way to and from work and the attempts to contain the crowds seeking leisure activities, a ‘new normal’ emerged and was marked by negativism, omnipotence and fatalism. Between September 2020 and February 2021, what were most evident were parties, ostensive circulation of people and the lack of mask use, boosting the numbers of the infected and the dead, in the normalization of an unprecedented health crisis in Brazil.