Abstract Objective This study aimed to evaluate the cytotoxicity and synergistic effect of epigallocatechin gallate (EGCG) and fosfomycin (FOSFO) on biofilms of oral bacteria associated with endodontic infections. Methodology This study determined minimum inhibitory and bactericidal concentration (MIC/MBC) and fractionated inhibitory concentration (FIC) of EGCG and FOSFO against Enterococcus faecalis, Actinomyces israelii, Streptococcus mutans, and Fusobacterium nucleatum. Monospecies and multispecies biofilms with those bacteria formed in polystyrene microplates and in radicular dentin blocks of bovine teeth were treated with the compounds and control chlorhexidine (CHX) and evaluated by bacterial counts and microscopy analysis. Toxicity effect of the compounds was determined on fibroblasts culture by methyl tetrazolium assays. Results The combination of EGCG + FOSFO demonstrated synergism against all bacterial species, with an FIC index ranging from 0.35 to 0.5. At the MIC/FIC concentrations, EGCG, FOSFO, and EGCG+FOSFO were not toxic to fibroblasts. EGCG+FOSFO significantly reduced monospecies biofilms of E. faecalis and A. israelli, whereas S. mutans and F. nucleatum biofilms were eliminated by all compounds. Scanning electron microscopy of multispecies biofilms treated with EGCG, EGCG+FOSFO, and CHX at 100x MIC showed evident biofilm disorganization and substantial reduction of extracellular matrix. Confocal microscopy observed a significant reduction of multispecies biofilms formed in dentin tubules with 84.85%, 78.49%, and 50.6% of dead cells for EGCG+FOSFO, EGCG, and CHX at 100x MIC, respectively. Conclusion EGCG and fosfomycin showed a synergistic effect against biofilms of oral pathogens related to root canal infections without causing cytotoxicity.

Abstract The present work aimed to evaluate the influence of different eucalyptus hybrids on the edaphic macrofauna community. It is hypothesized that the density and diversity of edaphic fauna are influenced by the quantity and quality of the litter deposited by the different hybrids on the soil surface. The study area is in the city of Vitória da Conquista (BA) and consists of seven eucalyptus hybrids, one from sexual reproduction (seminal) and six from asexual (clonal) reproduction. Sampling of the soil macrofauna was performed by the Tropical Soil Biology and Fertility method. All visible invertebrates were collected and identified at the level of large taxonomic groups. The relative density, group richness, and diversity index were calculated. Hybrids did not influence the total density and richness of the soil macrofauna. However, it was possible to observe changes in litter accumulation and composition, and as a result in the diversity indexes and in the presence or absence of macrofauna groups. Among the studied hybrids, those from Eucalyptus urophylla (seminal, 1335 and 1249) promote greater macrofauna diversity and favor the occurrence of detritivores organisms, suggesting the occurrence of better quality and more palatable litter for the edaphic fauna.

RESUMO - O armazenamento de diásporos possibilita disponibilizar mudas para atender os programas de reflorestamento ou de recuperação de áreas degradadas, principalmente para espécies perenes que não produzem diásporos regularmente ou quando a germinação dos mesmos é difícil e demorada. Objetivou-se verificar o potencial fisiológico de diásporos de Schinopsis brasiliensis armazenados em dois ambientes por 12 meses, com posterior escarificação manual do endocarpo. O delineamento experimental adotado foi o inteiramente casualizado, em esquema fatorial 2 × 7 × 2, com dois ambientes (natural e geladeira) e sete períodos (0; 2; 4; 6; 8; 10 e 12 meses) de armazenamento, e duas condições físicas do endocarpo (intacto e escarificado). Foram avaliados o teor de água, emergência, índice de velocidade e tempo médio de emergência, comprimento, massa seca da parte aérea e do sistema radicular e diamêtro do coleto das plântulas. O armazenamento por 12 meses não supera a dormência tegumentar dos diásporos de S. brasilensis. A escarificação manual após o armazenamento em ambiente natural favorece a emergência e a velocidade de estabelecimento das plântulas. Independente da condição de armazenamento, os diásporos apresentam maior capacidade germinativa aos cinco meses. O declínio no desenvolvimento das plântulas, independente da condição de armazenamento dos diásporos, ocorre antes da perda da capacidade germinativa.

ABSTRACT Storage of diaspores makes it possible to provide seedlings for reforestation programs or restoration of degraded areas, especially for perennial species that do not regularly produce diaspores or when germination is difficult and slow. The objective of the present study was to verify the physiological potential of Schinopsis brasiliensis diaspores stored in two environments for 12 months, with subsequent manual scarification of the endocarp. The experimental design was entirely randomized, using a 2 × 7 × 2 factorial scheme, with two environments (natural and refrigerator), seven periods (0, 2, 4, 6, 8, 10 and 12 months) of storage, and two physical conditions of the endocarp (intact and scarified). The study analyzed water content, emergence, speed index and mean emergence time, length and dry mass of the aerial part and root system, and collar diameter of the seedlings. The 12 month storage did not overcome the tegument dormancy of S. brasiliensis diaspores. After storage in the natural environment, manual scarification favored emergence and the seedlings' speed of establishment. The diaspores presented increased germination capacity at five months and decreased seedling development before losing their germination capacity, regardless of storage conditions.

Abstract Radio-Frequency Identification (RFID) is one of the leading enabling technologies of the Internet of Things (IoT) at low cost and high granularity scenarios. The cost of implementing IoT applications concerns the development and operation of receiver systems for reading labels. In this paper, we propose a low-cost receiver system based on off-the-shelf components allied to the development of a microstrip antenna. The proposed system is capable of receiving and processing digital signals scattered back from a passive RFID tag. The proposal relies on a Python application embedded in Raspberry Pi hardware, in which a bank of digital filters processes the signal. The proposal separates the received signal into sub-bands and implements a decision-maker that detects and codes radiofrequency carriers’ presence in sub-bands. Simulation using artificial random noise proves that the proposed and implemented decision-maker achieves 92% reliability for a Signal-to-Noise ratio between 1.6 dB and 2.3 dB. The evaluation of the printed dipole antennas pair for the RFID receiver system indicates a return loss of 19.22 dB for operation at 915 MHz.

Abstract The aim of this study is to investigate if Sargassum-associated herbivorous amphipods Cymadusa filosa Savigny, 1816 and Sunamphitoe pelagica (H. Milne Edwards, 1830) present differences in their population parameters at sites located at different distances from a state marina, which is the main source of pollution (especially heavy metals) in an impacted bay. The study was conducted at four beach sites within Flamengo Bay, Ubatuba municipality, northern coast of São Paulo State, Brazil. The beaches are Lamberto and Ribeira close to the pollution source and Flamengo and Santa Rita, which are more distant. We observed the predominance of juveniles in the populations of C. filosa and S. pelagica, followed by females, with the sex ratio for both species being favored toward females, and the highest densities of individuals were observed during the summer. Sunamphitoe pelagica presented lower density, smaller ovigerous females and egg volumes at Lamberto beach, indicating a possible higher sensitivity to metal pollution for this species. Cymadusa filosa showed no clear alteration of density, number of ovigerous females and egg volumes between sites. Our results emphasize the importance of studying the life history and reproductive parameters of herbivorous amphipods, showing how these parameters can be altered in contaminated areas.

RESUMO Objetivos: Comparar a viabilidade celular e a espessura do disco de LASIK confeccionado por três laseres de femtosegundo, em córneas humanas de banco de olhos. Métodos: Quarenta e cinco botões córneo-esclerais humanos de banco de olhos (15 córneas em cada grupo) foram examinados, após a criação de disco de LASIK com 120 mm de espessura, utilizando-se o iFS IntraLase® 150kHz (IL), o Femto LDV® Z6 (LDV), ou o Wavelight® FS200 200kHz (FS200). Tomografia de coerência óptica do seguimento anterior (OCT Visante®) foi usada para medir a espessura dos discos. A viabilidade celular foi avaliada por meio de imuno-histoquímica para apoptose dos ceratócitos, com anti-caspase 3. Resultados: O desvio padrão da espessura planejada do disco foi inferior a 10 mm em todos os grupos. Houve diferença estatisticamente significante da espessura do disco horizontalmente a +3,00 mm (p=0,0124), -0,5 mm (p=0,0082) e -1,00 mm (p=0,0425), a partir do vértice corneal, e a +0,5 mm (p=0,0240), a partir da borda do disco, em córneas tratadas por LDV e IL, e horizontalmente a -0,5 mm a partir do vértice corneal, entre LDV e FS200 (p=0,0082). A média de apoptose dos ceratócitos foi (13,09 ± 1,10), (15,59 ± 3,28) e (17,72 ± 1,49), em córneas tratadas pelo IL, FS200 e LDV, respectivamente (p<0,001). Conclusão: Todos os três laseres de femtosegundo estudados produziram disco de LASIK com predictibilidade de espessura. A média de apoptose dos ceratócitos foi baixa em todos os grupos.

ABSTRACT Purpose: The aim of this study was to compare the corneal cell viability and thickness of LASIK flaps created by 3 femtosecond lasers in eye-bank human corneas. Methods: Forty-five eye-bank human sclerocorneal buttons (15 corneas in each group) were examined after the creation of 120 mm-thick laser-assisted keratomileusis (LASIK) flaps with 150kHz iFS IntraLase™ (IL), Z6 Femto LDV™ (LDV), or 200kHz Wavelight™ FS200 (FS200). The thickness of the flaps was measured using anterior segment optical coherence tomography (AS-OCT; Visante™). Cell viability was blindly evaluated with immunohistochemistry for keratocyte apoptosis using anti-caspase 3 antibodies. Results: The standard deviation from the intended flap thickness was less than 10 mm in all the groups. There was a statistically significant difference in corneas treated with LDV and IL with regard to the flap thickness horizontally at +3.00 mm (p=0.0124), -0.5 mm (p=0.0082), and -1.00 mm (p=0.0425) from the corneal vertex and +0.5 mm from the flap edge (p=0.0240), and those treated with LDV and FS200 with regard to the flap thickness horizontally at -0.5 mm from the corneal vertex (p=0.0082). The mean keratocyte apoptosis numbers were 13.09 ± 1.10, 15.59 ± 3.28, and 17.72 ± 1.49 in corneas treated with IL, FS200, and LDV, respectively (p<0.001). Conclusion: All 3 assessed femtosecond lasers provided predictable LASIK flap thickness. The mean stromal keratocyte apoptosis number was low in all groups.

RESUMO: O estudo objetivou verificar a ocorrência de Leishmania spp. e Leishmania (Leishmania) infantum em cavalos de uma região endêmica para leishmaniose visceral do Brasil. Amostras de DNA de sangue e suabe conjuntival (SC) foram testadas pela PCR e pela Reação de Imunofluorescência Indireta (RIFI). Embora nenhum cavalo estivesse clinicamente doente, animais infectados por Leishmania spp. e L. (L.) infantum foram encontrados em Ilha Solteira/SP. Dos 40 cavalos, 100% (40/40) foram positivos pela PCR de sangue, 90% (36/40) pela PCR de SC, e 2,5% (01/40) no sorodiagnóstico, pela RIFI. Seis desses 40 cavalos foram positivos para L. (L.) infantum pela PCR de sangue. O sequenciamento direto e a análise dos amplicons resultaram em uma sequência para análise evolutiva. Os resultados indicam a presença de Leishmania spp. e L. (L.) infantum infectando cavalos saudáveis no Brasil. A presença de DNA de Leishmania spp. and L. (L.) infantum em cavalos saudáveis sugere que eles podem ser importantes reservatórios desses parasitas, um achado altamente relevante para a vigilância epidemiológica das doenças que causam.

ABSTRACT: This study aimed to verify the occurrence of Leishmania spp. and Leishmania (Leishmania) infantum in horses from a visceral leishmaniasis endemic area in Brazil. DNA samples from blood and conjunctival swab (CS) were tested by PCR and Indirect Immunofluorescence Antibody Test (IFAT). Although none of the horses was clinically sick, animals infected by Leishmania spp. were found and some could be characterized as infected by L. (L.) infantum. From 40 horses, 100% of the animals were positive by blood PCR, 90% (36/40) by CS PCR, and 2.5% (01/40) in serodiagnosis, by IFAT. Six from these 40 horses were L. (L.) infantum positive by blood PCR. Direct sequencing and analysis of amplicons resulted in a sequence to evolutionary analysis. Results indicate the presence of Leishmania spp. and L. (L.) infantum infecting healthy horses in Brazil. The presence of Leishmania spp. and L. (L.) infantum DNA in asymptomatic horses suggests that they can be important reservoirs of these parasites, a highly relevant finding for the epidemiological surveillance of the diseases they cause.

BACKGROUND Sporotrichosis is caused by species of the genus Sporothrix. From 1998 to 2015, 4,703 cats were diagnosed at the Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Even after the description of the Sporothrix species, the characterisation of feline isolates is not performed routinely. OBJECTIVES To characterise the clinical isolates from cats at the species level and correlate them with the clinical and epidemiological characteristics of the cats. METHODS Forty seven Sporothrix spp. isolates from cats assisted at Fiocruz from 2010 to 2011 were included. Medical records were consulted to obtain the clinical and epidemiological data. The isolates were identified through their morphological and physiological characteristics. T3B polymerase chain reaction (PCR) fingerprinting was used for molecular identification of the species. FINDINGS In phenotypic tests, 34 isolates were characterised as S. brasiliensis, one as S. schenckii and 12 as Sporothrix spp. PCR identified all isolates as S. brasiliensis. MAIN CONCLUSIONS S. brasiliensis is the only etiological agent of feline sporotrichosis in Rio de Janeiro to date. None association was found between the isolates and the clinical and epidemiological data. In addition, we strongly recommend the use of molecular techniques for the identification of isolates of Sporothrix spp.

RESUMO: A associação de compostos naturais, isolados de plantas medicinais, com antibióticos convencionais, com mecanismos de ação semelhantes, torna-se uma estratégia alternativa e viável para superar o problema da resistência. Assim, nosso objetivo foi avaliar a atividade antimicrobiana in vitro de substâncias tânicas presentes na casca de Anacardium occidentale e Anadenanthera colubrina associadas à cefalexina, sobre amostras de Staphylococcus aureus. Avaliamos essa associação por meio da determinação da concentração mínima inibitória. Dessa forma, taninos e a cefalexina foram dissolvidos de forma seriada em água destilada em concentrações variando de 0,976 mg/mL a 500 mg/mL e 2 µg/mL a 512 µg/mL, respectivamente. Quando associados, inibiram o crescimento de S. aureus formando halos que variaram de 0,9 a 46 mm com concentração mínima inibitória de 7,8 mg/mL (taninos)/ 4 µg/mL (cefalexina). O efeito resultante da associação de substâncias, natural e sintética, com mecanismos de ação semelhantes, apresentou resultados superiores aos observados quando testados isoladamente. Podemos concluir que os taninos e a cefalexina tiveram sua ação antimicrobiana potencializada quando utilizados em associação, permitindo o uso de uma menor concentração, mantendo seu efeito antibacteriano sobre cepas de S. aureus.

ABSTRACT: The association of natural compounds isolated from medicinal plants with conventional antibiotics, both with similar mechanisms of action, have become a viable alternative strategy to overcome the problem of drug resistance. This study aimed to evaluate the in vitro antimicrobial activity of tannic substances present in the bark of Anacardium occidentale and Anadenanthera colubrina against samples of Staphylococcus aureus when in combination with cephalexin. These combinations were evaluated by determining the minimum inhibitory concentration (MIC). For this purpose, tannins and cephalexin were serially dissolved in distilled water at concentrations ranging from 0.976 mg/mL to 500 mg/mL and 2 mg/mL to 512 mg/mL, respectively. When combined, the compounds inhibited S. aureus growth forming halos ranging from 0.9 to 46 mm with an MIC of 7.8 mg/mL (tannins) and 4 µg/mL (cephalexin). The resulting effect of the combination of natural and synthetic substances with similar mechanisms of action presented better results than when tested alone. Thus, the conclusion is that both the tannins and cephalexin had their antimicrobial action enhanced when used in combination, enabling the use of lower concentrations while maintaining their antibacterial effect against strains of S. aureus.

Abstract Objective: To evaluate prevalence, clinical manifestations, laboratory abnormalities and treatment in a multicenter cohort study including 847 childhood-onset systemic lupus erythematosus (cSLE) patients with and without diffuse alveolar hemorrhage (DAH), as well as concomitant parameters of severity. Methods: DAH was defined as the presence of at least three respiratory symptoms/signs associated with diffuse interstitial/alveolar infiltrates on chest x-ray or high-resolution computer tomography and sudden drop in hemoglobin levels. Statistical analysis was performed using Bonferroni correction (p < 0.0022). Results: DAH was observed in 19/847 (2.2%) cSLE patients. Cough/dyspnea/tachycardia/hypoxemia occurred in all cSLE patients with DAH. Concomitant parameters of severity observed were: mechanical ventilation in 14/19 (74%), hemoptysis 12/19 (63%), macrophage activation syndrome 2/19 (10%) and death 9/19 (47%). Further analysis of cSLE patients at DAH diagnosis compared to 76 cSLE control patients without DAH with same disease duration [3 (1–151) vs. 4 (1–151) months, p = 0.335], showed higher frequencies of constitutional involvement (74% vs. 10%, p < 0.0001), serositis (63% vs. 6%, p < 0.0001) and sepsis (53% vs. 9%, p < 0.0001) in the DAH group. The median of disease activity score(SLEDAI-2 K) was significantly higher in cSLE patients with DAH [18 (5–40) vs. 6 (0–44), p < 0.0001]. The frequencies of thrombocytopenia (53% vs. 12%, p < 0.0001), intravenous methylprednisolone (95% vs. 16%, p < 0.0001) and intravenous cyclophosphamide (47% vs. 8%, p < 0.0001) were also significantly higher in DAH patients. Conclusions: This was the first study to demonstrate that DAH, although not a disease activity score descriptor, occurred in the context of significant moderate/severe cSLE flare. Importantly, we identified that this condition was associated with serious disease flare complicated by sepsis with high mortality rate.

BACKGROUND The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated. METHODS The presence of ORSH on swabs taken from fomite surfaces in a Brazilian hospital was assessed using standard microbiological procedures. Antibiotic susceptibility profiles were determined by the disk diffusion method, and clonal distribution was assessed in pulsed-field gel electrophoresis (PFGE) assays. Minimum inhibitory concentrations (MICs) of oxacillin and vancomycin were evaluated via the broth microdilution method. Polymerase chain reaction (PCR) assays were performed to detect the mecA and icaAD genes. ORSH strains grown in media containing 1/4 MIC of vancomycin or oxacillin were investigated for slime production and biofilm formation on glass, polystyrene and polyurethane catheter surfaces. FINDINGS ORSH strains comprising five distinct PFGE types were isolated from sphygmomanometers (n = 5) and a thermometer (n = 1) used in intensive care units and surgical wards. ORSH strains isolated from fomites showed susceptibility to only linezolid and vancomycin and were characterised as multi-drug resistant (MDR). Slime production, biofilm formation and the survival of sessile bacteria differed and were independent of the presence of the icaAD and mecA genes, PFGE type and subtype. Vancomycin and oxacillin did not inhibit biofilm formation by vancomycin-susceptible ORSH strains on abiotic surfaces, including on the catheter surface. Enhanced biofilm formation was observed in some situations. Moreover, a sub-lethal dose of vancomycin induced biofilm formation by an ORSH strain on polystyrene. MAIN CONCLUSIONS Sphygmomanometers and thermometers are fomites for the transmission of ORSH. A sub-lethal dose of vancomycin may favor biofilm formation by ORSH on fomites and catheter surfaces.

Abstract Fabry disease, caused by deficient alpha-galactosidase A lysosomal enzyme activity, remains challenging to health-care professionals. Laboratory diagnosis in males is carried out by determination of alpha-galactosidase A activity; for females, enzymatic activity determination fails to detect the disease in about two-thirds of the patients, and only the identification of a pathogenic mutation in the GLA gene allows for a definite diagnosis. The hurdle to be overcome in this field is to determine whether a mutation that has never been described determines a ‘‘classic’’ or ‘‘nonclassic’’ phenotype, because this will have an impact on the decision-making for treatment initiation. Besides the enzymatic determination and GLA gene mutation determination, researchers are still searching for a good biomarker, and it seems that plasma lyso-Gb3 is a useful tool that correlates to the degree of substrate storage in organs. The ideal time for treatment initiation for children and nonclassic phenotype remains unclear.

RESUMO: Os Sapajus sp apresentam aspectos cognitivos, uso de ferramentas, comportamento social e memória, além de aspectos anatômicos, similares à primatas do Velho Mundo, como chimpanzés e babuínos, fatos inesperados para estes animais, que são primatas do Novo Mundo. Aspectos evolutivos convergentes devem ter ocorrido entre Sapajus e primatas do Velho Mundo que devem ser verificados não somente em termos de análise do comportamento, mas da estrutura anatômica. A região pélvica pode fornecer dados para a verificação de tendências evolucionárias, pois assumir a posição bípede é uma das características associadas ao uso de ferramentas pelos humanos primitivos e pongídeos. Para descrever a estrutura muscular profunda da pelve, foram utilizados oito espécimes de Sapajus libidinosus. O músculo glúteo médio em S. libidinosus, diferente de humanos, é totalmente recoberto pelo glúteo máximo, é alongado em relação aos humanos e chimpanzés, putativamente pela pelve alongada dos S. libidinosus. O músculo glúteo máximo se assemelha, considerando origem e inserção mais aos babuínos do que em humanos e chimpanzés, uma vez que em babuínos esse músculo está associado à postura semibípede e à cauda. Os músculos glúteo mínimo, piriforme, gêmeo superior, obturador interno, gêmeo inferior e quadrado estão posicionados nesta ordem em relação ao eixo crânio-caudal com todos seus tendões convergindo para uma inserção comum no trocânter maior. Os músculos da região glútea de S. libidinosus são semelhantes ao babuíno principalmente no que se refere ao músculo glúteo máximo, o que reflete o parentesco evolutivo desses animais.

ABSTRACT: New World primates Sapajus sp. unexpectedly display cognitive aspects, tool use, social behavior, memory and anatomical aspects similar to Old World primates, such as chimpanzees and baboons. Convergent evolutionary aspects must have occurred between Sapajus and Old World primates and should be verified not only in terms of behavior analysis, but also of anatomical structure. The pelvic region can provide data for evolutionary verification trends, since taking standing position is one of the characteristics associated to the use of tools by early humans and pongids. We used eight specimens of Sapajus libidinosus to describe the deep muscular structure of the pelvis. Unlike humans, the gluteus medius muscle in S. libidinosus is completely covered by the gluteus maximus and elongated as compared to humans and chimpanzees, putatively by the elongated pelvis of S. libidinosus. Considering origin and insertion, the gluteus maximus muscle resembles more its counterpart in baboons than in humans and chimpanzees, since this muscle in baboons is associated to semibiped posture and to the tail. Gluteus minimum, piriformis, superior gemellus, internal shutter, gemellus and lower square muscles are positioned in this order in relation to the cranial-caudal axis, with all of its tendons converging for a common insertion in the greater trochanter. The muscles of the gluteal region of S. libidinosus are similar to the baboon, especially regarding the gluteus maximus, which points to the evolutionary kinship of these animals.

Contextualização: A avaliação adequada da musculatura do assoalho pélvico (MAP) é essencial para o delineamento do tratamento correto. No entanto, atualmente não existe um método de avaliação dessa região que seja considerado como padrão-ouro. Objetivo: Verificar a correlação entre a palpação digital, a pressão de contração, a atividade eletromiográfica e as variáveis ultrassonográficas da MAP. Método: Neste estudo transversal, foram avaliadas 80 mulheres com idades entre 18 e 35 anos, nulíparas e sem relatos de disfunção de assoalho pélvico. Foram avaliados a função muscular por meio da palpação digital, a pressão de contração, a atividade eletromiográfica, o diâmetro bilateral do músculo bulbocavernoso e o deslocamento do colo vesical em relação à sínfise púbica por meio da ultrassonografia bidimensional. Para a análise estatística, foi realizada a Correlação de Pearson (p<0,05). Resultados: Observou-se uma correlação positiva forte entre a função e a pressão de contração da MAP (0,90). Observou-se também uma correlação positiva moderada entre essas duas variáveis e a atividade eletromiográfica da MAP (0,59 and 0,63, respectivamente), bem como entre o deslocamento do colo vesical e a sínfise púbica (0.51 e 0.60, respectivamente). Conclusões: Os achados deste estudo permitem concluir que existe correlação entre as variáveis ultrassonográficas e a função muscular, a pressão de contração e a atividade eletromiográfica da MAP em mulheres jovens nulíparas. A correlação forte existente entre a palpação digital e a pressão de contração indica que, na ausência de equipamentos, a perineometria pode ser facilmente substituída pela palpação digital da MAP.

Background: The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05). Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively). Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.

RESUMO OBJETIVO: Investigar fatores de risco para o desenvolvimento de doença renal crônica e óbito dois anos após transplante hepático. MÉTODO: Associações entre parâmetros clínicos e laboratoriais e o desenvolvimiento de doença renal crônica e sobrevida dois anos pós-transplante hepático foram analisados em uma coorte de 148 pacientes adultos, com cirrose hepática, submetidos consecutivamente a transplante de fígado em centro de referência no Brasil. RESULTADOS: A idade mediana ao transplante hepático foi 56 (limites, 20-73) anos, e 105 (70,9%) pacientes eram do gênero masculino. A prevalência de doença renal crônica dois anos pós-transplante hepático foi: estádio 1 ou ausência de doença renal, 27,5%; estádio 2, 33,8%; estádio 3, 34,6%; estádios 4-5, 4,7%. Quatro variáveis apresentaram associação independents com o estádio de doença renal crônica, dois anos pos-transplante hepático: (i) idade ao transplante hepático, (ii) gênero masculino, (iii) mediana dos níveis de tacrolimus nos primeiros três meses pós-transplante hepático e (iv) mediana das concentrações séricas de creatinina nos primeiros seis meses pós-transplante hepático. Duas variáveis apresentaram associação independents com óbito dois anos pós-transplante hepático: permanência em Unidade de Terapia Intensiva por três ou mais dias após a cirurgia de transplante, e mediana das concentrações séricas de creatinina nos primeiros seis e três meses após o transplante hepático igual ou superior a 1,3 mg/dL. CONCLUSÕES: Administração da menor dose eficaz de tacrolimus e adoção de medidas para preservar a função renal são medidas importantes para se reduzir o risco de desenvolvimento de doença renal crônica, tardiamente, após o transplante de fígado, especialmente nos pacientes que apresentam fatores de risco.

OBJECTIVE: To investigate risk factors for the development of chronic kidney disease and death two years postliver transplantation. METHOD: Associations between clinical and laboratory parameters and the development of chronic kidney disease and survival two years post-liver transplant were analyzed in a cohort of 148 adult patients with hepatic cirrhosis consecutively submitted to liver transplantation in a referral Brazilian center. RESULTS: Median age at liver transplantation was 56 (range, 20-73) years, and 105 (70.9%) patients were males. The prevalence of chronic kidney disease at two years post-liver transplantation was: stage 1 or no chronic kidney disease, 27.5%; stage 2, 33.8%; stage 3, 34.6%; stages 4-5, 4.7%. Four variables were independently associated with the stage of chronic kidney disease two years after liver transplantation: (i) age (at liver transplantation), (ii) male gender, (iii) median tacrolimus levels in the first three months post-liver transplantation, and (iv) median of serum creatinine in the first six months post-liver transplantation. Two variables showed independent association with death in two years post-liver transplantation: (i) stay in Intensive Care Unit for three or more days after the liver transplantation surgery and (ii) median of serum creatinine levels in the first six months post-liver transplantation equal or higher than 1.3 mg/dL. CONCLUSIONS: Administration of the lowest effective dose of tacrolimus and adoption of strategies to spare renal function are important measures to reduce the risk of late chronic kidney disease and death post-liver transplantation especially in high risk patients.