Abstract We investigated the Biogran on bone repair and metabolism at several time-intervals upon grafting into rat tibia artificial defects. The biomaterial was thoroughly characterized in vitro, and its dissolution behavior upon immersion was assessed in simulated body fluid (SBF) solution for 1, 3, 7, 14, and 30 days. Biogran was also assessed by in vitro hydroxyapatite formation in SBF solution, which is a marker for bioactive behavior. In vivo, distal and proximal bone defects were performed in the Wistar rat's right tibia and filled according to the experimental groups: I) negative control, no filling; II) positive control, 10 mg of autogenous bone; and III) 10 mg of Biogran. Animals were euthanized at 1, 2, 3, 4, 7, and 10 weeks. Bone neoformation was analyzed using histomorphometry (proximal defect), and local levels of bone morphogenetic protein 2 (BMP-2) were measured using the ELISA assay (distal defect). In vitro, the Biogran sample showed a fast dissolution rate within the first 7 days, parallel to the formation of the hydroxyapatite layer. In vivo, the sample was progressively resorbed at a higher rate within the first month until it became almost absent at week 10th. The sample presented similar or higher bone neoformation concerning the autogenous bone. BMP-2 levels were sustained in the Biogran group (around 200 pg/mg) and detected until the last experimental time with a significant difference compared with the controls. Results suggest Biogran is a candidate for hard tissue engineering even in highly active bone remodeling sites.

ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445

ABSTRACT Background: classical models of microsurgical anastomosis training are expensive and have ethical implications. Some alternatives join low cost and easiness to store. However, the translation of knowledge acquired by training in these methods into the traditional ones is not clear. This project aims to assess the feasibility of konjac noodles as a reliable microsurgery-training model. Methods: 10 neurosurgery residents performed an end-to-end anastomosis in a 2-3mm placenta artery. The anastomoses were evaluated quantitatively, recording time; and qualitatively, applying a validated score (Anastomosis Lapse Index - ALI) by three experienced neurosurgeons and verifying the presence of gross leakage through the infusion of fluorescein. Subsequently, they performed 10 non-consecutive sessions of anastomosis training in the konjac noodle. Eventually, a final anastomosis in the placenta model was performed and the same parameters were scored. Results: we observed a 17min reduction in the mean time to perform the anastomosis in the placenta model after the training in the konjac (p<0.05). There was a non-significant 20% reduction in gross leakage, but the training sessions were not able to consistently improve the ALI score. Conclusions: we demonstrate a reduction in anastomosis performing time in placental arteries after training sessions in the konjac noodle model, which can be regarded as a feasible low-cost method, particularly useful in centers with surgical microscopes only in the operation room.

ABSTRACT Introdução: modelos tradicionais de treinamento de anastomose microcirúrgica costumam ter custos elevados e implicações éticas de aquisição e manutenção, buscando-se alternativas que reúnam baixo custo e facilidade de armazenamento. Existem diferentes propostas, porém há poucas evidências de que conhecimentos adquiridos com o treinamento nessas plataformas se traduza em melhora na performance, quando estes são comparados a modelos consagrados. Este projeto objetiva avaliar a viabilidade do macarrão de konjac como modelo confiável de treinamento microcirúrgico. Métodos: 10 residentes de neurocirurgia realizaram uma anastomose término-terminal em artéria placentária humana de 2-3mm. As anastomoses foram avaliadas quantitativamente, registrando-se o tempo de confecção e qualitativamente, aplicando-se um escore validado (Anastomosis Lapse Index – ALI) por neurocirurgiões experientes e verificando-se a presença de vazamento grosseiro através da visualização no modo fluorescente injetando-se fluoresceína. Subsequentemente, realizaram 10 sessões de treinamento não consecutivos de anastomose términoterminal no modelo de konjac. Por fim, uma anastomose final foi realizada no modelo placentário e os mesmo parâmetros reavaliados. Resultados: observamos uma redução de 17 min no tempo médio de confecção da anastomose no modelo de placenta após os treinos no modelo do macarrão (p<0.05). Houve uma redução não significativa de 20% no vazamento grosseiro. As sessões de treino no macarrão não foram capazes de melhorar consistentemente o score ALI. Conclusão: o treinamento em modelo de macarrão konjac é capaz de reduzir o tempo para realização das anastomoses no modelo em placenta humana, mostrando-se alternativa viável de baixo custo e manutenção, útil em serviços que disponham de microscópio apenas no ambiente cirúrgico.

Abstract This study aimed to investigate the epidemiological and pathological findings of type 1 and 2 abomasal ulcers in cattle with different primary comorbidities. A total of 201 animals; 40/201 (20%) were young cattle under the age of two years and 161/201 (80%) were adult cattle over the age of two years, which were hospitalized for clinical care 152/201 (75,62%), 19/201 (9,45%) obstetric care, 17/201 (8,46%) surgical care and 13/201 (6,47%) for anatomopathological diagnosis, being euthanized or had natural death. The diagnosis of ulcers was based on the result of the post-mortem examination (macroscopic and histopathological analysis). Histopathological examination was performed on 201 fragments of ulcers and classified as type 1 or type 2. Of these, 193/201 (96.01%) corresponded to type 1 ulcers, of which 12/193 (5.97%) corresponded to subtype 1a lesions, 101/193 (50.25%) to subtype 1b, 77/ 193 (38.31%) to subtype 1c, 03/193 (1.49%) to subtype 1d, while 08/201 (3.98%) were type 2 ulcers. The ulcers were characterized by a focal, focally extensive, multifocal or diffuse inflammatory process, mainly by mononuclear cells. Abomasitis associated with ulcerated mucosa was found in 160/201 (79.60%). In 26/201 (12.93%) the abomasitis had diffuse foci of multifocal lymphocytic proliferation by atypical lymphocytes. Digestive and reproductive comorbidities were seen more frequently in cattle with type 1 or type 2 ulcers. The Subtype 1b focal ulcers and subtype 1a and 1b multifocal ulcers were more prevalent. In addition to the presence of comorbidities, most cases occur in the dry period, associated with feeding with higher amounts of concentrates and silages.

Resumo Objetivou-se estudar os achados epidemiológico e anatomopatológico de úlceras do abomaso tipo 1 e 2 em bovinos com diferentes comorbidades primárias. Um total de 201 animais; 40/201 (20%) eram bovinos jovens com idade inferior a dois anos e 161/201 (80%) eram bovinos adultos com idade superior a dois anos, os quais foram internados para atendimento clínico 152/201 (75,62%), 19/201 (9,45%) obstétrico, 17/201 (8,46%) para atendimento clínico-cirúrgico e 13/201 (6,47%) para diagnóstico anatomopatológico, sendo eutanasiados ou tiveram morte natural. O diagnóstico das úlceras foi baseado no exame post-mortem (análise macroscópica e histopatológica). O exame histopatológico foi realizado em 201 fragmentos de úlceras e classificado como tipo 1 ou do tipo 2. Destes, 193/201 (96,01%) corresponderam a úlceras tipo 1, das quais, 12/193 (5,97%) corresponderam a lesões subtipo 1a, 101/193 (50,25%) a subtipo 1b, 77/193 (38,31%) a subtipo 1c, 03/193 (1,49%) ao subtipo 1d, enquanto 08/201 (3,98%) foram úlceras tipo 2. As úlceras foram caracterizadas por processo inflamatório focal, focalmente extenso, multifocais ou difusos, principalmente por células mononucleares. Abomasite associada à mucosa ulcerada foi encontrada em 160/201 (79,60%). Em 26/201 (12,93%) a abomasite apresentava focos difusos de proliferação linfocítica multifocal por linfócitos atípicos. As comorbidades digestivas e reprodutivas foram observadas com maior frequência em bovinos com úlceras tipo 1 ou tipo 2. As úlceras focais subtipo 1b e úlceras multifocais subtipo 1a e 1b foram mais prevalentes. Além da presença de comorbidades, a maioria dos casos ocorrerem no período seco, associados à alimentação com maiores aportes de concentrados e silagens.

Abstract Introduction: In recent years, there has been an increase in the number of medical schools in Brazil and, concomitantly, the interest in improving the quality of teaching in medicine has increased. One question resulting from this change is whether this increase in medical schools will imply the training of professionals capable of meeting the demands of contemporary society. One way to answer this question is to know the profile of the institutions’ graduates. Objective: To evaluate the profile of medical graduates trained at a higher education institution in northeast Brazil. Method: A cross-sectional field research study with a quantitative approach was carried out. Graduates of the medical course of a higher education institution, graduated from 2012 to 2019, were evaluated through a questionnaire sent via e-mail, with multiple choice questions. The study was approved by the institution’s ethics committee. Results: A total of 127 questionnaires were analyzed, which corresponds to a response rate of 13.8%; females predominated, representing 67.7% of the sample. Knowledge about the National Curriculum Guidelines during undergraduate school was reported by 24.2% of the participants. Most graduates demonstrated satisfaction with the course taken and a feeling of being prepared for professional work as a generalist. Regarding medical residency, 90.5% of the graduates attended this type of specialization program. Professional performance of graduates in the Family Health Strategy and in the Brazilian Unified Health System (SUS) was identified in 66.9% and 84.3%, respectively. A feeling of aptitude and ability to deal with health education, health management and health care for the population was identified in most graduates. Conclusion: We identified good satisfaction at the end of the course and a feeling of confidence for professional performance in most graduates. Improvement through medical residency is a frequent goal among graduates. The SUS is a field of work for most of these professionals. In addition, skills recommended by the National Curriculum Guidelines were perceived by them at the end of undergraduate school. Future studies with larger and multicenter samples are needed to assess the profile of graduates in Brazil.

Resumo Introdução: Nos últimos anos, ocorreu um aumento da quantidade de faculdades médicas no Brasil, e, concomitante a isso, houve a ampliação do interesse em melhorar a qualidade do ensino na Medicina. Um questionamento resultante dessa mudança é se esse aumento de faculdades de Medicina implicará a formação de profissionais capazes de atender às demandas da sociedade contemporânea. Uma forma de responder a esse questionamento é conhecer o perfil dos egressos das instituições. Objetivo: Este estudo teve como objetivo avaliar o perfil dos egressos médicos formados em uma instituição de ensino superior do Nordeste do Brasil. Método: Realizou-se um estudo transversal do tipo pesquisa de campo com abordagem quantitativa. Egressos do curso de Medicina de uma instituição de ensino superior, formados no período de 2012-2019, foram avaliados por meio de um questionário enviado via e-mail, com perguntas de múltipla escolha. O estudo foi aprovado pelo Comitê de Ética da instituição. Resultado: Analisaram-se 127 questionários, o que corresponde a uma taxa de resposta de 13,8%, e o sexo feminino predominou ao representar 67,7% da amostra. O conhecimento sobre as Diretrizes Curriculares Nacionais durante a graduação foi relatado por 24,2% dos participantes. A maioria dos egressos demonstrou satisfação com o curso realizado e sentimento de preparo para atuação profissional como generalista. Em relação à residência médica, 90,5% dos egressos realizaram esse tipo de programa de especialização. A atuação profissional dos egressos na Estratégia Saúde da Família e no Sistema Único de Saúde (SUS) foi identificada em 66,9% e 84,3%, respectivamente. Sentimento de aptidão e de habilidade para lidar com educação em saúde, gestão da saúde e atenção à saúde da população foi identificado na maioria dos egressos. Conclusão: Identificamos uma boa satisfação ao final do curso e um sentimento de confiança para atuação profissional na maioria dos egressos. Aperfeiçoamento por meio de residência médica é um objetivo frequente entre os egressos. O SUS é um campo de trabalho para a maioria destes. Além disso, aptidões recomendadas pelas Diretrizes Curriculares Nacionais foram percebidas pelos egressos ao final da graduação. Futuros trabalhos com amostras maiores e multicêntricos são necessários para a avaliação do perfil dos egressos no Brasil.

The control of fungal species in agriculture is mainly conducted with the use of contact or systemic fungicides. However, environmental and human health concerns and increased resistance of fungal species to existing fungicides have increased the pressure on researchers to find new active ingredients for fungal control which present low toxicity to non-target organisms, are environmentally safe, and can be applied at very low concentrations. It is herein described the synthesis of eleven glycerol triazole containing compounds (ten of them fluorinated derivatives) and evaluation of their fungicidal activity. Eight out of eleven synthesized compounds are novel and all of the glycerol derivatives were characterized using infrared (IR), nuclear magnetic ressonance (NMR), and mass spectrometry (MS) techniques. Theoretical calculations were also carried out and the results are discussed. Starting from glycerol, the triazole derivatives were prepared in four steps. Evaluation of them against Colletrotricum gloesporioides showed that compound 1-((2,2-dimethyl-1,3 dioxolan-4-yl)methyl)-4-(2-fluorophenyl)-1H-1,2,3-triazole (4d) (ED50 = 59.14 µg mL-1) was slightly more active than commercial fungicide tebuconazole (61.35 µg mL-1). Compound 4d presented attractive physicochemical features for agrochemical purposes as revealed by the calculated physicochemical parameters. It is believed that glycerol-fluorinated triazole derivatives can be explored towards the development of new chemicals for the control of fungal species.

Abstract Background The treatment of acute ischemic stroke with cerebral reperfusion therapy requires rapid care and recognition of symptoms. Objective To analyze the effectiveness of implementing protocols for acute ischemic stroke in reducing care time. Methods Systematic review, which was performed with primary studies in Portuguese, English, and Spanish published between 2011 and 2020. Inclusion criteria: study population should comprise people with acute ischemic stroke and studies should present results on the effectiveness of using urgent care protocols in reducing care time. The bibliographic search was conducted in June 2020 in the LILACS, MEDLINE, Embase, Scopus, CINAHL, Academic Search Premier, and SocINDEX databases. The articles were selected, and data were extracted by two independent reviewers; the synthesis of the results was performed narratively. The methodological quality of articles was evaluated through specific instruments proposed by the Joanna Briggs Institute. Results A total of 11,226 publications were found, of which 35 were included in the study. Only one study reported improvement in the symptoms-onset-to-door time after protocol implementation. The effectiveness of the therapeutic approach protocols for ischemic stroke was identified in improving door-to-image, image-to-needle, door-to-needle and symptoms-onset-to-needle times. The main limitation found in the articles concerned the lack of clarity in relation to the study population. Conclusions Several advances have been identified in in-hospital care with protocol implementation; however, it is necessary to improve the recognition time of stroke symptoms among those who have the first contact with the person affected by the stroke and among the professionals involved with the prehospital care.

Resumo Antecedentes O tratamento do acidente vascular cerebral (AVC) isquêmico com terapia de reperfusão requer rápido atendimento e reconhecimento dos sintomas. Objetivo Analisar a efetividade da implementação de protocolos para AVC isquêmico agudo na redução do tempo de atendimento. Métodos Revisão sistemática realizada com estudos primários em português, inglês e espanhol publicados entre 2011 e 2020. Critérios de inclusão: a população do estudo foi constituída por pessoas com AVC isquêmico agudo e estudos que apresentassem resultados sobre a efetividade da implantação de protocolos no tempo de atendimento. A pesquisa bibliográfica foi realizada em junho de 2020 nas bases de dados LILACS, MEDLINE, Embase, Scopus, CINAHL, Academic Search Premier e SocINDEX. A seleção dos artigos e a extração dos dados foram feitas por dois revisores independentes; a síntese dos resultados foi feita de forma narrativa. A qualidade metodológica dos artigos foi avaliada por meio de instrumentos do Joanna Briggs Institute. Resultados Foram encontradas 11.226 publicações, das quais 35 foram incluídas no estudo. Apenas um estudo relatou melhora no tempo início dos sintomas-porta após a implementação do protocolo, no entanto, foi efetiva na melhora dos tempos porta-imagem, imagem-agulha, porta-agulha e início dos sintomas-agulha. A principal limitação encontrada nos artigos diz respeito à falta de clareza quanto à população de estudo. Conclusões Vários avanços foram identificados no atendimento intra-hospitalar com implantação de protocolo; porém, é necessário melhorar o tempo de reconhecimento dos sintomas do AVC entre aqueles que têm o primeiro contato com a pessoa acometida e entre os profissionais envolvidos com o atendimento pré-hospitalar.

Resumo Sideroxylon obtusifolium (Roem. & Schult.) T.D.Penn., da família Sapotaceae, é uma das mais importantes espécies de ocorrência na Caatinga. O conhecimento do seu ciclo reprodutivo por meio do estudo fenológico é importante porque possibilita a elaboração de estratégias para sua conservação e seu uso sustentável. O objetivo nesta pesquisa foi avaliar as fenofases de Sideroxylon obtusifolium e a sua relação com as condições ambientais locais. O estudo foi realizado na fazenda Santa Rosa do Espólio, localizada no município de Boa Vista, estado da Paraíba (PB), em 26 indivíduos da espécie, avaliados a cada quinze dias durante 30 meses. A partir do percentual de intensidade de Fournier e do índice de atividade, foram registradas a presença e ausência das fenofases brotamento, botão floral, floração, frutificação e senescência foliar. Pela correlação de Spearman, não houve efeito significativo entre os caracteres fenológicos avaliados e as variáveis ambientais de temperatura e umidade relativa do ar, com forte oscilação na intensidade e no índice de atividade nos 30 meses de avaliações. A análise de correlação indicou efeito significativo entre a intensidade de brotamento com a precipitação pluviométrica. A senescência foi registrada em todos os indivíduos de Sideroxylon obtusifolium durante todo o período de avaliação, com a máxima intensidade (88%) registrada nos meses de janeiro e fevereiro de 2017. As fases de botão floral, floração (flor em antese) e frutificação tiveram um padrão de ocorrência mais uniforme de agosto de 2014 até agosto de 2016, entretanto com intensidades e índices de atividades decrescentes. Os eventos fenológicos da Sideroxylon obtusifolium apresentaram irregularidade, o que pode ter sido influenciado pelo baixo índice pluviométrico registrado na área de estudo durante o período de avaliação.

Abstract Sideroxylon obtusifolium (Roem. & Schult.) T.D.Penn., belongs to the Sapotaceae family and is one of the most important species of the Caatinga biome. The knowledge of its reproductive cycle through the phenological study is important because it allows the elaboration of strategies for its conservation and its sustainable use. The objective of this study was to evaluate the phenological stages of Sideroxylon obtusifolium and their relationship with the local environmental conditions. The study was carried out at ‘Santa Rosa do Espólio’ farm, located in the municipality of Boa Vista - PB state - at 26 individuals of the species, evaluated every fifteen days for 30 months. From the percentage of Fournier intensity and the activity index the presence and absence of the stages of budding, floral bud, flowering, fruitification and leaf senescence were recorded. The Spearman correlation did not present a significant effect between the phenological characters evaluated and the environmental variables of temperature and relative humidity, with a strong oscillation in intensity and activity index in the 30 months of evaluations. The correlation analysis indicated a significant effect between budding intensity and rainfall. Senescence was recorded in all individuals of Sideroxylon obtusifolium during the entire evaluation period, with the highest intensity (88%) recorded in January and February of 2017. The flower bud, flowering (anthesis) and fruitification stages, a more uniform occurrence pattern was observed from August of 2014 until August of 2016. However, with decreasing intensities and activity indexes. The phenological events of Sideroxylon obtusifolium presented irregularities which may have been influenced by the low rainfall recorded in the study area during the evaluation period.

Abstract This study aimed to evaluate the effect of synchronization with prostaglandin F2α in Baixadeiro mares during the rainy and dry seasons. Fourteen mares were synchronized by administering two doses of 1 mL prostaglandin PGF 2α and monitored by rectal palpation and ultrasound for the assessment of follicular development and uterine echotexture. Of this total, nine mares allowed the collection of blood, in which the blood was collected by venipuncture of the jugular vein to determine progesterone (P4) by ELISA. Mares showed no differences (P > 0.05) in weight, body score condition (BSC), tone, uterine edema, frequency of ovulation, synchronization interval, estrus, and the total number of follicles between periods. However, there was a difference in large increased follicle diameter (P < 0.05) during the dry season. The average concentrations of P4 in mares differed (P < 0.05) between the pre- and post-ovulatory phases for both seasons and after ovulation, with higher concentrations in the rainy season. Furthermore, statistical differences in daily light (P < 0.05) were observed between the dry and rainy periods. Thus, we conclude that mares from the genetic grouping Baixadeiro showed no reproductive seasonality, though there was a difference in luminosity between the rainy and dry seasons. The treatment with two doses of PGF 2α was effective in synchronizing the mares, promoting the return of estrus in the dry and rainy periods. The mares remaining cyclically active throughout the year provided there were appropriate forage availability and quality levels to allow for normal values of body weight and condition.

ABSTRACT. The aim of this study was to assess the effect of increasing periods of coexistence of weed plants with Urochloa ruziziensis on the canopy structure and productivity of a pasture already established with this forage species. The experiment was a randomized blocks design with four replications, and treatments consisted of seven increasing periods of coexistence of forage grass with weed plants: 0 (control), 15, 30, 45, 60, 75 and 90 days after regrowth (DAR). The main morpho-structural and productive characteristics of the forage plants were determined at the end of the experimental period (90 DAR). The ratio of the first green leaf height to the tiller height increases, while the leaf to stem ratio diminishes as the period of interaction with the infesting community increases. The number of green leaves per tiller and the tiller height diminishes as the period of coexistence with weed plants increases. The presence of weed plants interferes negatively with all parameters of the grass canopy structure and productivity of a grazing land already established with Urochloa ruziziensis, suggesting that measures of control of the infesting community should be adopted up to 17 days of regrowth of the forage plant.

Resumo Fundamento: A mortalidade por doenças cardiovasculares (DCV) vem mostrando tendência à estabilização em alguns países, incluindo o Brasil e o estado do Rio de Janeiro, após décadas de queda. Não encontramos análises detalhadas dessa tendência para o estado do Rio de Janeiro. Objetivo: Analisar as tendências da mortalidade prematura e tardia por doenças do aparelho circulatório (DAC), doença isquêmica do coração (DIC) e doença cerebrovascular (DCBV) por sexo nas regiões de saúde do estado do Rio de Janeiro e capital (1996-2016). Métodos: Dados de óbitos e população foram obtidos no DATASUS/MS. Taxas foram compensadas por códigos mal definidos, corrigidos pelos códigos cardiovasculares mal definidos e ajustadas por sexo e idade pelo método direto. O Joinpoint Trend Analysis Software foi empregado para calcular a variação percentual anual (APC) e variação percentual anual média (AAPC). Foram consideradas para o estudo APC e AAPC significativamente diferentes de zero, calculadas por um teste de student com significância de 5%. Resultados: A mortalidade por DIC estabilizou ou até aumentou em pelo menos 50% das localidades analisadas (EAPC ≥0). Nas regiões Norte e Noroeste, nenhuma mudança foi observada. Para DCBV, apenas uma região apresentou estabilidade na mortalidade (EAPC próximo a 0). Para as outras regiões, a taxa continuou a diminuir (APC <0) até 2016. Conclusão: Esses resultados observados no Rio de Janeiro devem se repetir em várias regiões brasileiras e apontam para a necessidade de uma resposta na abordagem dos comportamentos no estilo de vida. Os médicos da atenção primária devem estar familiarizados com a tendência desfavorável da doença isquêmica do coração entre os adultos mais jovens e rastrear ativamente os fatores de risco para DCV, com atenção especial às mulheres.

Abstract Background: Cardiovascular disease (CVD) mortality, after several decades of decrease, has shown a tendency towards the stabilization in some countries, including Brazil and Rio de Janeiro state. This new tendency was not further analyzed by gender, age group and region of the Rio de Janeiro state. Objective: To analyze the trends of premature and late mortality from CVD, ischemic heart disease (IHD) and cerebrovascular disease (CBVD) by gender in the city of Rio de Janeiro (capital) and the health regions of Rio de Janeiro state (from 1996 to 2016. Methods: Data on deaths and the population were obtained from DATASUS/MS. The rates were compensated by ill-defined codes, corrected by Ill-Defined Cardiovascular codes and gender and age-adjusted by the direct method (reference population – population of the state of Rio de Janeiro - 2000 census). The Joinpoint Trend Analysis Software was employed. Results: IHD mortality stabilized or even increased for at least 50% of the analyzed areas (EAPC≥0). No change was observed. in the “North” and “Northwest” regions For CBVD, just one region showed stability regarding mortality (EAPC close to 0). For the other regions, the rate continued to decrease (APC<0) until 2016. Conclusion: These results observed in Rio de Janeiro are possibly appropriate to various Brazilian regions and demonstrate that a serious public health response is needed to address lifestyle behaviors. Primary care physicians should also be familiar with the unfavorable tendency in coronary heart disease among younger adults in recent years and actively screen for risk factors for cardiovascular disease, paying special attention to women.

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

Abstract Among the different methods used for semen collection from domestic cats, the pharmacological collection by urethral catheterization becomes disruptive. Medetomidine is the elected α2-adrenoceptor agonist for that, but in several countries, it is not commercially available. This study aimed to evaluate the efficacy of detomidine compared to medetomidine in collecting semen by urethral catheterization in domestic cats. Urethral catheterization was performed on 13 mongrel cats using a disposable semi-rigid tomcat urinary catheter. Of the 19 semen collections performed with medetomidine induction, 94.7% were successful, while with detomidine induction, only 56.3% of 16 were successful. The values semen samples variables were as follows for volume - 10.56 ± 0.4 vs 8.88 ± 0.5 mL, motility - 171.67 ± 0.79 vs 49.77 ± 3.45%, vigor – 4.1 ± 0.03 vs 3.10 ± 0.1 and concentration - 3.24 ± 0.19 vs 2.15 ± 0.13 ×109 sperm/mL respectively for medetomidine and detomidine group. The failure in semen collections with detomidine was mainly due to azoospermic samples, poor urethral relaxation, insufficient volume, or contamination of urine. The sperm concentration was also lower in the detomidine group (P <0.05) when compared to medetomidine. However, when the volume of semen collected was compared, we found no statistical differences. Despite its low performance in collecting semen from cats, detomidine may be an alternative when medetomidine is not accessible.

Resumo O objetivo deste trabalho foi avaliar o tamanho da planta, a produção e a qualidade dos frutos da laranjeira-doce ‘Valência’ (Citrus sinensis) enxertada sobre diversos porta-enxertos híbridos de trifoliateiro, para selecionar genótipos de alto desempenho. Vinte genótipos de porta-enxertos foram avaliados, tendo incluído híbridos de trifoliateiro com tangerineiras (citrandarins) e com pomeleiros (citrumelos), além do limoeiro 'Cravo'. O experimento foi implantado na região noroeste do estado do Paraná, Brasil, em espaçamento 6.0×2.5 m, em solo arenoso, sob condições de clima subtropical e sem irrigação. O modelo estatístico utilizado foi o delineamento em blocos ao acaso, com quatro repetições e quatro plantas por parcela. O tamanho da planta e a produção e a qualidade dos frutos foram analisados durante três safras consecutivas. Os dados foram submetidos à análise de variância, e as médias foram agrupadas pelo teste de Scott-Knott. Também foram realizados a análise de componentes principais e o agrupamento dos porta-enxertos por meio da classificação hierárquica de clusters. Os citrumeleiros F.80-18, F.80-5 e F.80-3 e o citrandarineiro IPEACS-239 são opções adequadas de porta-enxertos para a laranjeira 'Valência', com plantas anãs e alta eficiência produtiva. Esses porta-enxertos, exceto F.80-18, também são opções adequadas para a obtenção de laranjas com boas propriedades industriais.

Abstract The objective of this work was to evaluate tree size, production, and fruit quality of ‘Valência’ sweet orange (Citrus sinensis) grafted on various trifoliate orange rootstocks, in order to select genotypes with a high performance. Twenty rootstock genotypes were evaluated, including trifoliate orange hybrids with mandarin (citrandarins) and with grapefruit (citrumelos), as well as ‘Rangpur’ lime. The experiment was implemented in the northwestern region of the state of Paraná, Brazil, in a 6.0×2.5 m spacing, in a sandy soil under subtropical and rainfed conditions. The statistical model used was the randomized complete block design with four replicates and four trees per plot. Tree size and fruit yield and quality were analyzed during three consecutive harvest seasons. Data were subjected to the analysis of variance, and means were grouped by the Scott-Knott test. Principal component analysis and agglomerative hierarchical clustering were also carried out. F.80-18, F.80-5, and F.80-3 citrumelos and IPEACS-239 citrandarin are adequate rootstock options for ‘Valência’ sweet orange, with dwarf trees and a high production efficiency. These rootstocks, except F.80-18, are also adequate options to obtain oranges with good industrial properties.

Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.