ABSTRACT Background: D-dimer levels are significantly higher in COVID-19 patients with Pulmonary Thromboembolism (PTE) as compared to those without PTE, but its clinical utility is still uncertain. Purpose: To determine the D-dimer performance for ruling out PTE in patients with COVID-19. We also assessed clinical and laboratory factors associated with the presence of PTE on CT Pulmonary Angiogram (CTPA). Methods: Retrospective study involving all patients who presented at a tertiary care hospital from March 2020 to May 2021 with severe acute respiratory syndrome from COVID-19, who underwent CTPA and had D-dimer collected within 48 hours from CTPA. The D-dimer ability to classify patients with or without PTE according to CTPA was evaluated. Results: A total of 697 patients [382 (54.8%) men; mean (SD) age, 59 (20.5) years] were included, of which 71.5% required intensive care admission, 32.4% had PTE, and 35.6% died during hospitalization. PTE was independently associated with mortality [42.5% vs. 32.3%; p = 0.038]. D-dimer levels were higher in patients with PTE [9.1 (3.9; 20) vs. 2.3 (1.2; 5.1); p < 0.001]. Using the D-dimer cutoff of 0.5 μg/mL or above, sensitivity was 98.2% and specificity 5.7%. The 0.3 μg/mL threshold was associated with 100% of sensitivity for the presence of PTE, with which 99.1% of patients had increased values. ROC curve AUC was 0.77, demonstrating moderate discriminative power of D-dimers to detect PTE. Conclusions: D-dimer levels are higher among COVID-19 hospitalized patients with PTE as compared to those without PTE and have moderate discriminative power to detect PTE, but its use to exclude PTE in this population may have limited clinical utility.

Resumo O documento que o leitor encontrará a seguir é a transcrição inédita e modernizada do manuscrito História do descobrimento da cochonilha no Brasil, editado pelo médico e químico Manuel Joaquim Henriques de Paiva entre os anos de 1774 e 1801. O propósito de Paiva, com essa versão revista e anotada do estudo pioneiro de seu irmão, o médico José Henriques Ferreira, era estimular a cultura e o comércio da cochonilha, um inseto produtor de corante avermelhado muito requisitado na Europa. A História..., portanto, fornece indícios do papel capital dos saberes ditos científicos para o fomento e engrandecimento do Reino português e de sua principal colônia.

Abstract A previously unpublished, modernized transcript of the manuscript História do descobrimento da cochonilha no Brasil (History of the discovery of the cochineal in Brazil), edited by the physician and chemist Manuel Joaquim Henriques de Paiva between 1774 and 1801, is presented. By bringing out this reviewed, annotated version of the pioneering study by his brother, the physician José Henriques Ferreira, Paiva wanted to encourage the culture and trade of the cochineal, an insect that produced a red dye that was in great demand in Europe. História... thus provides indications of the key role of so-called scientific knowledge in the development and growth of the Portuguese kingdom and their primary colony.

Resumo A crença de que a saúde do corpo estava intimamente atrelada às virtudes da alma fez-se premissa entre clérigos, religiosos, moralistas - e também entre médicos -, razão pela qual tratar os males da carne a partir de medicamentos para o espírito não foi incomum na América Portuguesa ao longo do período colonial, especialmente no século XVIII. Dos muitos “remédios” que poderiam ser aplicados àqueles corpos doentes e às almas pecaminosas, o recurso aos santos salta aos olhos como o mais eficaz, e obras como a Botica preciosa, e thesouro precioso da Lapa, escrita pelo missionário paulista Ângelo de Siqueira (1707-1776) e publicada em 1756, passam a ser cada vez mais usuais. Neste estudo, serão perscrutados os escritos produzidos por uma série de letrados católicos que, ao instruir os fiéis, prescreviam, a exemplo de Siqueira, as melhores formas de conservar ou reestabelecer, ao mesmo tempo, a saúde do espírito e do corpo.

Abstract: The belief that bodily health was closely tied to the virtues of the soul was a shared topic among clerics, religious, moralists - also among physicians -, which was why treating the ills of the flesh from the medicines for the spirit was not uncommon in Portuguese America throughout the colonial period, especially in the 18th century. Among the many “remedies” that could be applied to those sick bodies and sinful souls, claiming for the help of the saints can be highlighted as the most effective strategy, and books such as the Botica preciosa e thesouro precioso da Lapa, written by the missionary Ângelo de Siqueira (1707-1776) and published in 1756, became more and more usual. This study will examine the writings produced by a series of Catholic scholars who, in instructing the devotee, prescribed, as Siqueira, the best ways to preserve or re-establish the health of spirit and body.

<title>ABSTRACT</title><p>Treatment of neurogenic bladder (BN) aims to upper urinary tract protection. When the conservative clinical measures are insufficient, surgical treatment is indicated. Though admittedly important, the quality of life (QoL) has been little studied in these patients, there are even contradictory results. The aim of this study was to evaluate QoL before and after bladder augmentation in patients with BN refractory to medical treatment. We analyzed, prospectively, the data of 67 patients who underwent surgical treatment for BN by questionnaire SF-36® and Qualiveen® QoL before and after six months of operation. Comparisons using paired t-tests and Wilcoxon and the assumption of normality was assessed using the Shapiro-Wilk test were made. According to the analysis of the SF-36® questionnaire, the patients had higher QoL indices in the postoperative period in the areas functional capacity, general state of health, vitality, social aspects, emotional aspects and mental health (n = 67; p <0.05). The questionnaire also revealed Qualiveen® best result in quality of life index in the postoperative period, and show lower specific negative impact by urinary problems (n = 36; p <0.05). The results show that, despite not being the main objective, the bladder augmentation results in significant improvement in QoL, probably related to the perception of better health and the resolution of urinary incontinence. Thus, the bladder augmentation associated with other urologic reconstruction techniques allows the upper urinary tract protection, and contribute to a better quality of life of patients with BN.</p>