Abstract This study analyzed the construction process of the chosen name and related aspects among transgender individuals from a medium-sized municipality in southern Brazil. Qualitative data from a descriptive and exploratory mixed-method study was used. Self-declared trans people aged 18 or over were included. Three focus groups were conducted with ten participants. These individuals, aged between 19 and 52 years, have a documented chosen name, but half have not yet changed their civil records. The content analysis technique produced two categories: “construction of the chosen name as an instrument for validating the transgender identity” and “impacts of the construction of the chosen name on self-acceptance and on family and social relationships.” The results reinforce the importance of respecting the name as a way of contributing to the gender affirmation of transgender individuals. The name was linked to the experiences, individuality and values of these individuals. Its proper use, much more than respect for legislation, meant respect for the different possibilities of human existence. It is expected that the results presented can be used as a tool for recognizing the issues and nuances that permeate the construction of the chosen name and contribute to identity validation.

Resumo O trabalho analisou o processo de construção do nome social e aspectos relacionados em pessoas trans de um município de porte médio do Sul do Brasil. Foram utilizados dados qualitativos de um estudo de método misto descritivo e exploratório. Incluíram-se pessoas autodeclaradas trans com 18 anos ou mais. Foram conduzidos três grupos focais com dez participantes. Estes, com idade variando entre 19 e 52 anos, apresentam nome social documentado, porém metade ainda não fez a alteração nos registros civis. A técnica da análise de conteúdo produziu duas categorias: “construção do nome social como instrumento de validação da identidade trans” e “impactos da construção do nome social na autoaceitação e nas relações familiares e sociais”. Os resultados reforçam a importância do respeito ao nome como forma de contribuição para a afirmação de gênero de sujeitos trans. O nome esteve atrelado às suas vivências, individualidades e valores. Seu uso adequado, muito mais do que o cumprimento de uma legislação, significou respeito às possibilidades diversas da existência humana. Espera-se que os resultados apresentados possam ser utilizados como ferramenta de reconhecimento acerca das questões e nuances que permeiam a construção do nome social, bem como contribuam para a validação identitária.

ABSTRACT: Purple-fleshed sweet potato is a tuber rich in anthocyanins, which are phenolic pigments that confer color and present bioactive capacity. Moreover, its incorporation into dairy products can bring technological and functional benefits. Thus, this article evaluated the impact of the addition of lyophilized purple-fleshed sweet potato powder- LP (0% - Control, 2%, and 4%) on the physical, chemical, and technological characteristics of Greek yogurt. LP showed in vitro antioxidant and bioactive capacity by DPPH (20.64 ± 1.61 μmol TE g-1), FRAP (112.93 ± 4.38 μmol TE g-1), total phenolic content (103.66 ± 3.35 mg GAE g-1), and total anthocyanin content (51.10 ± 1.87 mg cyanidin 3-glucoside 100 g-1). Additionally, the assays demonstrated that the LP has 16.82 ± 0.63% of resistant starch. The fortification of Greek yogurt with LP reduced the syneresis, indicating that LP increased the water retention capacity. LP also inhibited the post-acidification process, increasing apparent viscosity, hardness, and gumminess, and promoting a stable pink coloration throughout the storage (P < 0.05). At the 4% level, the yogurt was firmer and showed greater chewiness, which is highly desirable for Greek yogurt. Therefore, the results suggested that lyophilized purple-fleshed sweet potato powder is a potential multifunctional natural ingredient.

RESUMO: Batata-doce de polpa roxa é um tubérculo rico em antocianinas, as quais são pigmentos fenólicos que conferem cor e apresentam capacidade bioativa. Além disso, sua incorporação em produtos lácteos pode trazer benefícios tecnológicos e funcionais. Desta forma, este estudo teve como objetivo avaliar o impacto da adição de pó liofilizado de batata-doce de polpa roxa - LP (0% - Controle, 2% e 4%) nas características físicas, químicas e tecnológicas de iogurte tipo Grego. LP apresentou capacidade antioxidante e bioativa in vitro para DPPH (20.64 ± 1.61 μmol TE g-1), FRAP (112.93 ± 4.38 μmol TE g-1), teor de compostos fenólicos totais (103.66 ± 3.35 mg GAE g-1) e teor de antocianinas totais (51.10 ± 1.87 mg cyanidin 3-glucoside 100 g-1). Adicionalmente, os ensaios demonstraram que o LP possui 16,82 ± 0,63% de amido resistente. A fortificação do iogurte Grego com LP reduziu a sinérese, indicando que LP aumentou a capacidade de retenção de água, LP também inibiu o processo pós-acidificação, aumentando a viscosidade aparente, a dureza e a gomosidade, e promovendo uma coloração rosa estável durante todo o armazenamento (P < 0,05). No nível de 4%, o iogurte apresentou-se mais firme e com maior mastigabilidade, o que é altamente desejável para o iogurte tipo Grego. Assim, os resultados sugerem que o pó liofilizado de batata-doce de polpa roxa é um potencial ingrediente natural multifuncional.

ABSTRACT The aim of this study was to evaluate agronomic performance in cultivars of the Cavendish banana under the soil and climate conditions of the microregion of Assis in the state of São Paulo over three production cycles. The experiment was set up at the Fazenda São José Farm, Água do Pau d´Alho, in Palmital, São Paulo. The Grande Naine, IAC2001 and FHIA02 cultivars were evaluated, considering the following variables: cultivar; plant height; pseudostem perimeter; number of leaves at flowering and harvest; number of days from planting to flowering, from planting to harvest, and from flowering to harvest; weight of the bunch, stalk and fruit per bunch; number of hands per bunch; productivity of the fruit and pulp; weight and number of fingers on the second hand; weight, length and diameter of the finger; pulp diameter; and weight and thickness of the peel. The data were subjected to multivariate statistical techniques (principal component factor analysis, tree clustering, two-way joining, and correspondence). The results showed the extraction of three principal factors that accounted for 89.63% of the total variance of the characteristics under analysis: banana production (Factor 1), vegetative development (Factor 2), and cultivars and fruit diameter (Factor 3). The productive performance of the FHIA02 cultivar was homogeneous and inferior to that of the other cultivars, as seen in the two-way joining cluster analysis. Only the Grande Naine and IAC2001 cultivars are recommended for cultivation in the micro-region of Assis, São Paulo, with Grande Naine showing the largest fruit and, especially, the largest pulp diameter.

Resumo Introdução: Incluir doentes com doença hepática asso-ciada ao álcool (DHA) em lista ativa de transplante hep-ático (TH) é desafiante, especialmente pelo risco de recidiva de consumo de álcool pós-TH. O objetivo foi avaliar o consumo de álcool pós-TH num centro de transplantação português. Métodos: Realizamos um estudo transver-sal incluindo doentes submetidos a TH em 2019 no Hospital Curry Cabral, Lisboa, Portugal. Foi realizado um questionário previamente testado e uma tradução validada para o português do Alcohol Use Disorder Identification Test (AUDIT), através de uma chamada telefónica. O consumo de álcool foi definido pelo autorrelato do doente ou por um AUDIT positivo. Resultados: Durante 2019, 122 doentes foram submetidos a TH e 99 responderam ao questionário (junho de 2021). A idade média (SD) foi de 57 (10) anos, 70 doentes (70,7%) eram do sexo masculino e 49 (49,5%) foram submetidos a TH relacionado com DHA. Com uma mediana (IQR) de follow-up de 24 (20-26) meses após o TH-índex, 22 (22,2%) doentes admitiram algum consumo de álcool: 14 beberam mensalmente ou menos e oito beberam 2-4 vezes/mês. Nos dias em que bebiam, 18 consumiam normalmente 1-2 bebidas e os restantes não mais do que 3-4 bebidas. Um doente reportou o consumo de ≥6 bebidas em uma ocasião. Todos os doentes transplantados com consumo alcoólico pós-TH foram considerados de baixo risco (pontuação <8) de acordo com o AUDIT (mediana [IQR] de 1 [1-2]). Nenhum doente reportou problemas relacionados com o álcool, tanto autoinfligido como a terceiros. Os indivíduos transplantados com consumo alcoólico eram mais jovens (53 vs. 59 anos, p = 0,020), o motivo de TH era mais frequentemente não relacionado com DHA (72,7 vs. 44,2%, p = 0,018) e apresentavam mais tabagismo ativo (31,8 vs. 10,4%, p = 0,037) quando comparado com os abstinentes. Conclusão: Na nossa coorte, cerca de um quarto dos doentes transplantados hepáticos consumiram álcool no período pós-transplante precoce, todos com um padrão de baixo risco, de acordo com o AUDIT.

Abstract Background: Listing patients with alcohol-associated liver disease (ALD) for liver transplant (LT) remains challenging especially due to the risk of alcohol resumption post-LT. We aimed to evaluate post-LT alcohol consumption at a Portuguese transplant center. Methods: We conducted a cross-sectional study including LT recipients from 2019 at Curry Cabral Hospital, Lisbon, Portugal. A pretested survey and a validated Portuguese translation of the Alcohol Use Disorder Identification Test (AUDIT) were applied via a telephone call. Alcohol consumption was defined by patients’ self-reports or a positive AUDIT. Results: In 2019, 122 patients underwent LT, and 99 patients answered the survey (June 2021). The mean (SD) age was 57 (10) years, 70 patients (70.7%) were males, and 49 (49.5%) underwent ALD-related LT. During a median (IQR) follow-up of 24 (20-26) months post-index LT, 22 (22.2%) recipients consumed any amount of alcohol: 14 had a drink monthly or less and 8 drank 2-4 times/ month. On drinking days, 18 patients usually consumed 1-2 drinks and the remainder no more than 3-4 drinks. One patient reported having drunk ≥6 drinks on one occasion. All post-LT drinking recipients were considered low risk (score <8) as per the AUDIT score (median [IQR] of 1 [1-2]). No patient reported alcohol-related problems, whether self-inflicted or toward others. Drinking recipients were younger (53 vs. 59 years, p = 0.020), had more non-ALD-related LT (72.7 vs. 44.2%, p = 0.018) and active smoking (31.8 vs. 10.4%, p = 0.037) than abstinent ones. Conclusion: In our cohort, about a quarter of LT recipients consumed alcohol early posttrans-plant, all with a low-risk pattern according to the AUDIT score.

Resumo Introdução: Ao acompanhar a pessoa com câncer durante a hospitalização, o familiar ou cuidador pode carregar consigo o sofrimento dela, assumindo responsabilidades frente às suas necessidades físicas e emocionais. Esta experiência pode gerar desgaste devido à sobrecarga gerada pelo estresse que envolve a situação de doença e internação. Objetivos: Compreender a percepção de familiares e cuidadores sobre sua saúde emocional ao acompanhar o paciente com câncer no hospital; delinear as estratégias utilizadas por eles para promover o autocuidado emocional. Método: Estudo descritivo-exploratório, qualitativo, realizado em um hospital privado extra porte na cidade de São Paulo, Brasil. A amostra constituiu-se por 15 familiares e três cuidadores de pacientes com câncer hospitalizados. A coleta de dados realizou-se por meio de entrevista semiestruturada, utilizando-se a Análise Temática de Conteúdo, de Bardin, para análise dos dados. Resultados: Os discursos evidenciam a vivência de quem assume o papel de acompanhar a pessoa com câncer, tendo que lidar com as dificuldades que se apresentam no hospital e ser, ao mesmo tempo, a fonte de força para essa pessoa, além da mudança em sua rotina de vida devido as internações frequentes. Todavia, com o passar do tempo, sentem-se mais tranquilos e confiantes em assumir o papel de acompanhante, buscando estratégias que promovam o próprio cuidado emocional, como apoio religioso, prática de esportes e hobbies, meditação, yoga, atendimento psicológico, assistir televisão, ler e ouvir música, estudar e trabalhar online, entre outras. Considerações finais: Para enfrentar a sobrecarga física e emocional ao acompanhar o paciente com câncer, familiares/cuidadores utilizam várias iniciativas que favorecem o autocuidado emocional. Instituições de saúde devem promover o suporte necessário para que estas estratégias sejam valorizadas e incorporadas no cotidiano dessas pessoas que assumem o papel de acompanhante.

Abstract Introduction: When accompanying the person with cancer during hospitalization, the family member or caregiver can carry their suffering with them, taking responsibility for their physical and emotional needs. This experience can generate exhaustion due to the overload generated by the stress that involves the illness and hospitalization situation. Objectives: To understand the perception of family members and caregivers about their emotional health when accompanying a cancer patient in the hospital; outline the strategies used by them to promote emotional self-care. Method: Descriptive-exploratory, qualitative study, carried out in an extra-sized private hospital in the city of São Paulo, Brazil. The sample consisted of 15 family members and three caregivers of hospitalized cancer patients. Data collection was carried out through semi-structured interviews, using Bardin's Thematic Content Analysis for data analysis. Results: The speeches show the experience of those who assume the role of caring for the person with cancer, having to deal with the difficulties that arise in the hospital and, at the same time, being the source of strength for that person, in addition to the change in their routine of life due to frequent hospitalizations. However, over time, they feel calmer and more confident in assuming the role of companion, seeking strategies that promote their own emotional care, such as religious support, practice of sports and hobbies, meditation, yoga, psychological care, watching television, read and listen to music, study and work online, among others. Final considerations: To face the physical and emotional overload when accompanying the cancer patient, family members/caregivers use several initiatives that favor emotional self-care. Health institutions must provide the necessary support so that these strategies are valued and incorporated into the daily lives of these people who assume the role of companions.

Abstract Background and Aims: The donor risk index (DRI) quantifies donor-related characteristics potentially associated with increased risk of early graft failure. We aimed to assess the impact of the DRI, recipient and perioperative factors on post liver transplant (LT) outcomes. Methods: This was a single-center retrospective cohort study including all adult (≥18 years) patients who underwent LT from 01/2019 to 12/2019 at Curry Cabral Hospital, Lisbon, Portugal. Primary endpoint was 1-year graft failure post LT. Associations were studied with logistic regression. Results: A total of 131 cadaveric donor LT procedures were performed in 116 recipients. Recipients’ median (IQR) age was 57 (47-64) years and 101/131 (77.1%) were males. Cirrhosis was the underlying etiology in 95/131 (81.2%) transplants. Based on 8 predefined donors’ characteristics, median (IQR) DRI was 1.96 (1.67-2.16). Following adjustment for MELDNa score pre LT and SOFA score (adjusted odds ratio [aOR], 95% confidence interval [CI] =0.91 [0.56-1.47]) or lactate (aOR [95% CI] = 2.76 [0.71-10.7]) upon intensive care unit (ICU) admission post LT, DRI was not associated with 1-year graft failure. However, higher SOFA score (aOR [95% CI] = 1.20 [1.05-1.37]) or lactate (aOR [95% CI] = 1.27 [1.10-1.46]) upon ICU admission post LT were independently associated with higher odds of 1-year graft failure. Conclusions: In a recent cohort of patients who under-went LT, DRI, despite being high, was not associated with 1-year graft failure, but SOFA score or lactate upon ICU ad-mission post LT were.

Resumo Introdução: O índice de risco do dador (DRI) quantifica as características relacionadas com o dador potencialmente associadas com risco acrescido de falência precoce do enxerto. Procurou-se avaliar o impacto do DRI e factores relacionados com os receptores e cirurgia nos resultados clínicos após transplante hepático (LT). Materiais e Métodos: Estudo coorte retrospectivo de centro único incluindo todos os doentes adultos (≥18 anos) que receberam LT entre 01/2019 e 12/2019 no Hospital Curry Cabral, Lisboa, Portugal. O endpoint primário foi a falência do enx-erto após um ano do LT. As associações foram estudadas com regressão logística. Resultados: Um total de 131 transplantes de dadores cadavéricos foram realizados em 116 receptores. A idade mediana (IQR) destes foi 57 (47-64) anos e 101/131 (77.1%) eram homens. A cirrose foi a etiologia subjacente em 95/131 (81.2%) transplantes. Com base nas 8 características dos dadores predefinidas, o DRI mediano (IQR) foi 1.96 (1.67-2.16). Após ajuste para o score MELDNa pre LT e o score SOFA (odds ratio ajustado [aOR], intervalo de confiança 95% [CI] = 0.91 [0.56-1.47]) ou o lactato (aOR [95% CI] = 2.76 [0.71-10.7]) após admissão na unidade de cuidados intensivos (ICU) pós LT, o DRI não se associou com a falência do enxerto um ano depois do LT. Contudo, um maior score SOFA (aOR [95% CI] = 1.20 [1.05-1.37]) ou lactato (aOR [95% CI] = 1.27 [1.10-1.46]) após admissão na ICU depois do LT associaram-se independentemente com a falência do enxerto um ano depois do LT. Conclusões: Num coorte recente de doentes submetidos a LT, o DRI, apesar de alto, não se associou com a falência precoce do enxerto precoce. Contudo, o score SOFA ou lactato após admissão na ICU depois do LT associaram-se com a falência precoce do enxerto.

Abstract The scope of this article is to analyze the timeline trend of homicides of women between 2007 and 2019, in the Southeast region of Brazil. It is a mixed ecological study of homicides in women, from 2007 to 2019, considering the years of the study and the states that that make up the Southeast region as the unit of analysis. The data were obtained via the Mortality Information System (SIM) and tabulated by TABNET. The Prais-Winten regression model was used to verify the homicide trend. There were 18,415 homicides of women between 2007 and 2019 in the Southeast region. A total of 9,691 (53.64%) were black women, 5,118 (27.8%) had 4 to 7 years of schooling and 10,841 (58.87%) were single. The annual percentage variations were: São Paulo -3.73 ; 95%CI [-6.09; -1.32], Espírito Santo -5.67 ; 95%CI [-7.11;-4.21], Rio de Janeiro -3.86; 95%CI [-9.54; 2.17] and Minas Gerais -2.11 ; 95%CI [-4.87; 0.73]. São Paulo and Espírito Santo presented decreasing homicide rates for women, while Minas Gerais and Rio de Janeiro showed stationary rates. The highest homicide rates in the period were single women, black women and women with 4 to 7 years of schooling. It is necessary to build social networks that ensure the full protection of women.

Resumo O objetivo deste artigo é analisar a tendência temporal de homicídios de mulheres no período de 2007 a 2019, na região Sudeste do Brasil. Trata-se de um estudo ecológico misto dos homicídios em mulheres, de 2007 a 2019, considerando-se como unidade de análise os anos do estudo e os estados que compõem a região Sudeste. Os dados foram obtidos via Sistema de Informação sobre Mortalidade (SIM) e tabulados pelo TABNET. Empregou-se o modelo de regressão de Prais-Winsten para verificação de tendência de homicídios. Foram registrados 18.415 homicídios de mulheres entre 2007 e 2019 na região Sudeste. Cerca de 9.691 (53,64%) eram mulheres pretas, 5.118 (27,80%) com escolaridade de 4 a 7 anos e 10.841 (58,87%) solteiras. As variações percentuais anuais foram: São Paulo -3,73; IC95% [-6,09; -1,32], Espírito Santo -5,67; IC95% [-7,11; -4,21], Rio de Janeiro -3,86; IC95% [-9,54; 2,17] e Minas Gerais -2,11; IC95% [-4,87; 0,73]. São Paulo e Espírito Santo apresentaram taxas de homicídios de mulheres decrescentes, enquanto Minas Gerais e Rio de Janeiro taxas estacionárias. As maiores taxas de homicídio no período ocorreram em mulheres solteiras, pretas e com escolaridade de quatro a sete anos. Faz-se necessária a construção de redes sociais que viabilizem a proteção integral das mulheres.

Abstract The scope of this article is to analyze the timeline trend of homicides of women between 2007 and 2019, in the Southeast region of Brazil. It is a mixed ecological study of homicides in women, from 2007 to 2019, considering the years of the study and the states that that make up the Southeast region as the unit of analysis. The data were obtained via the Mortality Information System (SIM) and tabulated by TABNET. The Prais-Winten regression model was used to verify the homicide trend. There were 18,415 homicides of women between 2007 and 2019 in the Southeast region. A total of 9,691 (53.64%) were black women, 5,118 (27.8%) had 4 to 7 years of schooling and 10,841 (58.87%) were single. The annual percentage variations were: São Paulo -3.73 ; 95%CI [-6.09; -1.32], Espírito Santo -5.67 ; 95%CI [-7.11;-4.21], Rio de Janeiro -3.86; 95%CI [-9.54; 2.17] and Minas Gerais -2.11 ; 95%CI [-4.87; 0.73]. São Paulo and Espírito Santo presented decreasing homicide rates for women, while Minas Gerais and Rio de Janeiro showed stationary rates. The highest homicide rates in the period were single women, black women and women with 4 to 7 years of schooling. It is necessary to build social networks that ensure the full protection of women.

Resumo O objetivo deste artigo é analisar a tendência temporal de homicídios de mulheres no período de 2007 a 2019, na região Sudeste do Brasil. Trata-se de um estudo ecológico misto dos homicídios em mulheres, de 2007 a 2019, considerando-se como unidade de análise os anos do estudo e os estados que compõem a região Sudeste. Os dados foram obtidos via Sistema de Informação sobre Mortalidade (SIM) e tabulados pelo TABNET. Empregou-se o modelo de regressão de Prais-Winsten para verificação de tendência de homicídios. Foram registrados 18.415 homicídios de mulheres entre 2007 e 2019 na região Sudeste. Cerca de 9.691 (53,64%) eram mulheres pretas, 5.118 (27,80%) com escolaridade de 4 a 7 anos e 10.841 (58,87%) solteiras. As variações percentuais anuais foram: São Paulo -3,73; IC95% [-6,09; -1,32], Espírito Santo -5,67; IC95% [-7,11; -4,21], Rio de Janeiro -3,86; IC95% [-9,54; 2,17] e Minas Gerais -2,11; IC95% [-4,87; 0,73]. São Paulo e Espírito Santo apresentaram taxas de homicídios de mulheres decrescentes, enquanto Minas Gerais e Rio de Janeiro taxas estacionárias. As maiores taxas de homicídio no período ocorreram em mulheres solteiras, pretas e com escolaridade de quatro a sete anos. Faz-se necessária a construção de redes sociais que viabilizem a proteção integral das mulheres.

Abstract Background Pupil reactivity and the Glasgow Coma Scale (CCS) score are the most clinically relevant information to predict the survival of traumatic brain injury (TBI) patients. Objective We evaluated the accuracy of the CCS-Pupil score (CCS-P) as a prognostic index to predict hospital mortality in Brazilian patients with severe TBI and compare it with a model combining CCS and pupil response with additional clinical and radiological prognostic factors. Methods Data from 1,066 patients with severe TBI from 5 prospective studies were analyzed. We determined the association between hospital mortality and the combination of CCS, pupil reactivity, age, glucose levels, cranial computed tomography (CT), or the CCS-P score by multivariate binary logistic regression. Results Eighty-five percent (n = 908) of patients were men. The mean age was 35 years old, and the overall hospital mortality was 32.8%. The area under the receiver operating characteristic curve (AUROC) was 0.73 (0.70–0.77) for the model using the CCS-P score and 0.80 (0.77–0.83) for the model including clinical and radiological variables. The CCS-P score showed similar accuracy in predicting the mortality reported for the patients with severe TBI derived from the International Mission for Prognosis and Clinical Trials in TBI (IMPACT) and the Corticosteroid Randomization After Significant Head Injury (CRASH) studies. Conclusion Our results support the external validation of the CCS-P to predict hospital mortality following a severe TBI. The predictive value of the CCS-P for long-term mortality, functional, and neuropsychiatric outcomes in Brazilian patients with mild, moderate, and severe TBI deserves further investigation.

Resumo Antecedentes A reatividade pupilar e o escore da Escala de Coma de Glasgow (ECC) representam as informações clínicas mais relevantes para predizer a sobrevivência de pacientes com traumatismo cranioencefálico (TCE). Objetivo Avaliar a acurácia da ECC com resposta pupilar (ECC-P) como índice prognóstico para predizer mortalidade hospitalar em pacientes brasileiros acometidos por TCE grave e compará-lo com um modelo combinando ECC e resposta pupilar com fatores prognósticos radiológicos. Métodos Foram analisados dados de 1.066 pacientes com TCE grave de 5 estudos prospectivos. Foi determinada a associação entre mortalidade hospitalar e a combinação de ECC, reatividade pupilar, idade, níveis glicêmicos, tomografia computadorizada (TC) de crânio ou o escore ECC-P por regressão logística binária multivariada. Resultados Oitenta e cinco por cento (n = 908) dos pacientes eram homens. A média de idade foi de 35 anos e a mortalidade hospitalar geral foi de 32,8%. A AUROC (em português, Curva Característica de Operação do Receptor) foi de 0,73 (0,70–0,77) para o modelo utilizando o escore ECC-P e de 0,80 (0,77–0,83) para o modelo incluindo variáveis clínicas e radiológicas. O escore ECC-P mostrou acurácia semelhante na previsão da mortalidade relatada para pacientes com TCE grave derivados dos estudos International Mission for Prognosis and Clinical Trials in TBI (IMPACT, na sigla em inglês) e Corticosteroid Randomization After Significant Head Injury (CRASH, na sigla em inglês). Conclusão Nossos resultados apoiam a validação externa da ECC-P para prever a mortalidade hospitalar após um TCE grave. O valor preditivo da ECC-P para mortalidade a longo prazo, resultados funcionais e neuropsiquiátricos em pacientes brasileiros com TCE leve, moderado e grave precisam ser investigados.

Abstract BACKGROUND: The fibromyalgia impact questionnaire (FIQ) relates to the functional capacity, professional situation, psychological disorders, and physical symptoms, and can identify the factors that determine the impact of the syndrome and characteristics of its carriers; the higher the score, the greater the impact of fibromyalgia on the quality of life. OBJECTIVE: To evaluate the impact of fibromyalgia on the quality of life of individuals with fibromyalgia, who were categorized according to the FIQ during the coronavirus disease pandemic. DESIGN AND SETTING: A cross-sectional study was conducted at an institution of higher education in Taquara, RS, Brazil. METHODS: A quantitative study was carried out, with the application of a sociodemographic and clinical questionnaire, and the FIQ in 163 Brazilian individuals with a medical diagnosis of fibromyalgia. Data were collected using SurveyMonkey software. RESULTS: Of the female carriers, 98.2% were living in urban areas, working, and under pharmacological and complementary treatment. The FIQ results showed that seven of the 10 items had the maximum score. The items “physical function” and “feel good” had intermediate scores, and the item “missed work” had a low score. The average total score was 79.9 points, indicating that fibromyalgia had a severe impact on the participants’ lives. A severe impact of fibromyalgia was observed in 61.3% of the participants, a moderate impact in 30.7%, and a low impact in 8%. CONCLUSION: The survey findings suggest a severe impact in the majority of the Brazilian fibromyalgic population.

Abstract Introduction: Reinke’s Edema (RE) is a laryngeal lesion related to excessive tobacco smoking, voice overuse, and laryngopharyngeal reflux. Although the risk of malignancy has been considered low in literature, RE is classified among precancerous lesions. Objectives: We investigated DNA Copy Number Alterations (CNAs) in specimens of RE and its potential association with malignant progression. Methods: We used array-based comparative genomic hybridization (aCGH, Agilent 4 × 180 K platform) to study eight RE cases. All patients were heavy tobacco users for at least 30 years, and none of them progressed to cancer in the follow-up (>8 years). Two RE presented mild dysplasia, one moderate dysplasia, and no histological alterations were found in the remaining five cases. CNAs were compared with the Database of Genomic Variants (DGV) and genes mapped on altered regions had their functions annotated. Results: Six of eight patients showed different rare copy number alterations on chromosomes 2q37.3, 4q13.1, 4q13.3, 7q11.22, 10p14, and 13q34. A gain of the whole chromosome 8 were detected in one case. Of interest, four of eight RE cases showed copy number imbalances involving genes previously described in several tumor types (RASA3, COL6A3, LINC00707, LINP1, SMR3A, and SMR3B). Conclusion: The genomic imbalances herein found in RE have the potential to contribute to the phenotype but with limited or no risk of cancer. A long-term follow-up in a large series of patients could clarify the mechanisms involved in the malignant progression of RE. Level of evidence: 4.

Abstract Introduction Laryngeal leukoplakia corresponds to a white lesion in the mucosa developed by the deposit of keratin in the epithelium, potentiated by chronic smoking. It is considered a preneoplastic lesion. Surgery is the most adopted treatment; however, non-surgical treatment is advocated by some authors. Objective To evaluate the effectiveness of vitamin A in the management of vocal fold leukoplakia. Methods Patients with videolaryngoscopy diagnosis of vocal fold leukoplakia were selected. The endoscopic images were photographed and with the aid of the ImageJ software (National Institutes of Health, Bethesda, MD, USA), the proportion of the size of the leukoplakia was calculated. Eligible patients were prescribed 50,000U of vitamin A, twice daily for 2 months, at which point videolaryngostroboscopy was repeated for comparative analysis between pre and posttreatment. The efficacy of the treatment was classified as: outcome I – complete improvement of the lesion, outcome II – partial improvement, and outcome III – no difference or increased lesion size. Results Fifteen patients (eight women, seven men) were included, six of whom had bilateral lesions. Smoking was reported in 86.8% of patients. Complete improvement of the lesion was found in 7 cases (33.4%, outcome I), partial improvement in 6 (28.6%, outcome II), and worsening of the injury in 8 (38.1%, outcome III). Of the latter, 6 underwent microsurgery; histopathology indicated absence of dysplasia in 3, and mild dysplasia in 3. Conclusions In this study, the treatment with vitamin A at a dose of 100,000 IU daily for 2 months was effective in reducing the laryngeal leukoplakia size in 62% of cases.

Abstract Introduction Dysphonia and lower pitch after surgery of Reinke edema are common. They are caused especially due to chronic smoking but, probably, other factors should be associated. Objectives To evaluate the results of laryngeal microsurgery in patients with Reinke edema, following a standardized postoperative guidance protocol in our service. Methods Retrospective study. Thirty patients (3 males; 27 females) were included, 70% between 41 and 60 years old. The parameters analyzed in the pre- and postoperative (between 4 and 6 months) of patients undergoing laryngeal microsurgery for Reinke edema were: smoking, vocal symptoms, videolaryngostroboscopy, voice therapy, perceptual and acoustic vocal evaluation, histopathological report. Results Smoking was reported by 100% of the patients and maintained in the postoperative period by 80%. Complete improvement of symptoms in the postoperative period was reported by 43% of them, partial improvement by 40%, and maintenance by 17%. There was low adherence to voice therapy in the pre- and postsurgery. Postoperative videolaryngoscopy indicated congestion (19), atrophy and bowed vocal fold (1), subepithelial edema (2), and normal findings (8). The histological findings were subepithelial edema, enlargement of vessels, inflammation, epithelial hyperplasia, and thickening of the basement membrane. The perceptual and acoustic vocal analyzes indicated improvement of the analyzed parameters. Conclusions The maintenance of some vocal symptoms and laryngeal alterations in videolaryngoscopy after microsurgery of Reinke edema is frequent, even in patients who follow the recommendations of vocal rest and control of gastroesophageal reflux. Vocal symptoms are attributed to changes in the laryngeal mucosa caused by chronic smoking, aggravated by the maintenance of addiction in the postoperative period.