Abstract Primary cutaneous anaplastic large-cell lymphoma (C-ALCL) is a rare subtype of non-Hodgkin lymphoma, CD30 positive that does not exhibit extracutaneous manifestations at the time of diagnosis. The emergence of solitary papules or nodules, on the trunk and extremities, characterizes the disease. This case reports a 58-year-old female who presented with a rapidly enlarging nodule on her right calf. The biopsy revealed a malignant neoplasm of large cells. The morphological features, combined with the immunohistochemical profile, revealed a CD30-positive and anaplastic lymphoma kinase-negative lymphoproliferative disorder, consistent with C-ALCL. Shortly after the first excision, new lesions manifested in violaceous papules and nodules, and a new biopsy was performed, confirming the initial diagnosis. The patient underwent radiotherapy for 4 weeks and the lesions regressed but recurred about a year after. The patient is currently under treatment. The main goal is to emphasize the importance of considering this diagnosis as a possibility in large-cell cutaneous lymphomas.

Resumo O linfoma anaplásico de grandes células cutâneo primário (C-ALCL) é um linfoma não-Hodgkin raro com expressão do antígeno CD30 e que não possui manifestações extracutâneas no momento do diagnóstico. O surgimento de pápulas ou nódulos solitários, localizados principalmente no tronco e nas extremidades, são característicos da doença. Neste relato de caso, discorre-se sobre paciente do sexo feminino, 58 anos, com lesão em panturrilha direita de aspecto nodular com crescimento acelerado. Na biópsia, anatomopatológico evidenciou neoplasia maligna de células linfoides/epitelioides. Os aspectos morfológicos, associados ao perfil imunoistoquímico, revelaram desordem linfoproliferativa CD30 positiva em pele, compatível com C-ALCL. Após primeira exérese, surgimento de novas lesões dolorosas em placa de coloração violácea, com realização de nova biópsia. Foi realizada radioterapia durante quatro semanas e as lesões regrediram, porém, recidivaram cerca de um ano após o tratamento. Houve indicação de um novo ciclo de radioterapia para a paciente. A excepcionalidade do C-ALCL justifica o desenvolvimento desse relato de caso, a fim de salientar a importância de se considerar este diagnóstico como uma possibilidade nos linfomas cutâneos de grandes células.

ABSTRACT Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic diseases that result from the deregulation of the mucosal immune system of the gastrointestinal tract. The use of biological therapies, including infliximab (IFX), is one of the strategies to treat both CD and UC. The IFX treatment is monitored by complementary tests, namely: fecal calprotectin (FC); C-reactive protein (CRP); and endoscopic and cross-sectional imaging. Besides, serum IFX evaluation and antibody detection are also used. Objective: To evaluate trough levels (TL) and antibodies in a population with inflammatory bowel (IBD) disease undergoing treatment with IFX, and the factors that might impact the treatment effectiveness. Methods: Retrospective, cross-sectional study with patients with IBD that were assessed for TL and antibody (ATI) levels in a southern Brazilian hospital, from June 2014 to July 2016. Results: The study assessed 55 patients (52.7% female) submitted to serum IFX and antibody evaluations (95 blood samples, 55 first test; 30 second test, and 10 as third testing. Forty-five (47.3%) cases were diagnosed with CD (81.8%), and ten with UC (18.2%). Serum levels were adequate in 30 samples (31.57%), subtherapeutic in 41 (43.15%), and supratherapeutic in 24 (25.26%). IFX dosages were optimized for 40 patients (42.10%), maintained for 31 (32.63%), and discontinued for 7 (7.60%). The intervals between infusions were shortened in 17.85% of the cases. In 55 tests (55.79%), the therapeutic approach was exclusively defined according to IFX and/or serum antibody levels. The assessment of patients one year later indicated that: the approach was maintained with IFX for thirty-eight patients (69.09%); the class of biological agent was changed for eight (14.54%); changes using the same class of biological agent occurred for two patients (3.63%); the medication was discontinued and not replaced for three patients (5.45%), and four patients (7.27%) were lost to follow-up. Conclusion: There were no differences in TL between groups with or without immunosuppressants, serum albumin (ALB), erythrocyte sedimentation rate (ESR), FC, CRP, and endoscopic and imaging examinations. Current therapeutic approach could be maintained for almost 70% of patients. Thus, serum and antibody levels are a useful tool in the follow-up of patients undergoing maintenance therapy and after treatment induction in patients with inflammatory bowel disease.

RESUMO Contexto: A doença de Crohn e a colite ulcerativa são doenças crônicas nas quais existem desregulação do sistema imune da mucosa do trato gastrointestinal. Uma das terapias usadas no tratamento dessas doenças são as medicações biológicas, entre elas o Infliximabe. A monitorização do tratamento dos pacientes com Iinfliximabe é feita por exames complementares: calprotectina fecal, pesquisa de atividade inflamatória, exames endoscópicos e imagem. Utiliza-se, também a dosagem do nível sérico do Infliximabe e a pesquisa de anticorpos. Objetivo: Analisar uma população com doenças inflamatórias intestinais, em tratamento com Infliximabe, submetida a avaliação do nível sérico do Infliximabe e do anticorpo, além de possíveis fatores que possam alterar ou contribuir no tratamento. Métodos: Trata-se de estudo retrospectivo, transversal, realizado por meio da revisão dos prontuários dos pacientes com doença inflamatória intestinal, em um hospital sul-brasileiro, no período de junho de 2014 até julho de 2016, que foram submetidos a avaliação dos níveis séricos de Infliximabe e do anticorpo. Resultados: Foram incluídos 55 pacientes, submetidos a dosagem do Infliximabe e do anticorpo, totalizando 95 coletas sanguíneas. Destes, 55 realizaram uma primeira coleta, 30 tiveram uma segunda amostra coletada e 10 coletaram uma terceira vez. Vinte e nove pacientes eram do sexo feminino (52,7%) e vinte e seis do sexo masculino (43.2%). Quarenta e cinco (47,3%) casos tinham diagnóstico de doença de Crohn (81,8%) e 10 de colite ulcerativa (18,2%). Em relação ao nível sérico encontrou-se nível adequado em 30 coletas (31,57%), subterapêutico em 41 coletas (43,15%) e supraterapêutico em 24 coletas (25,26%). A prescrição foi otimizada em 40 (42,10%) casos, mantida em 31 (32,63%) pacientes, suspensa em 7 (7,60%) ou que o intervalo entre as infusões fosse aumentado (17,85%). Na análise geral, em 53 coletas (55,79%) a conduta foi definida em função exclusivamente da dosagem sérica do Infliximabe e/ou do anticorpo, já em relação, apenas a primeira coleta obteve-se 33 (60%) pacientes. Avaliando-se os pacientes um ano após, obteve-se: em 38 (69,09%) pacientes a conduta foi mantida com Infliximabe e, em 8 (14,54%) foi optado por troca de classe, em 2 (3,63%) foi optado por troca da medicação na mesma classe, em 3 (5,45%) pacientes a medicação foi suspensa e não foi substituída e, em 4 (7,27%), perdeu-se o seguimento. Conclusão: Não encontrou-se diferença entre os níveis de Infliximabe entre os grupos com ou sem imunossupressor, albumina sérica, velocidade de hemossedimentação, Calprotectina, Proteína C reativa, exames endoscópicos e exames de imagem. A conduta atual pode ser mantida em quase 70% dos pacientes. Concluindo, a dosagem do nível sérico e do anticorpo é ferramenta útil no acompanhamento dos pacientes em terapia de manutenção e após a indução de tratamento em pacientes com Doença Inflamatória Intestinal.

ABSTRACT Regarding the Brazilian textile industry, part of the northeast region stands out as the second-largest textile manufacturing hub in the country. Despite its importance, this industrial activity has been bringing relevant environmental concerns regarding the disposal of textile effluents, especially from industrial laundries. This waste contains many chemicals and among them are various types of heavy metals. To assess environmental risks associated with heavy metals, pollutant transfer needs to be investigated. This study evaluated the retention and mobility of heavy metals Cd and Cu in alluvial soil, through soil column tests. The up-flow column percolation tests were performed using a nonreactive tracer (KBr) at a concentration of 0.3 mol L-1 and injecting a metallic solution containing Cu and Cd at 100 and 60 mg L-1, respectively. The injection flow rate was 0.75 mL min-1. The hydro-dispersive parameters were obtained by modeling the observed breakthrough curves with the convection-dispersion equation (CDE) and the two-region model, also referred to as the MIM (Mobile-IMmobile waters) model. The transport parameters were obtained from the two-site model (TSS). All elution curves were fitted to the models with the CXTFIT 2.0 program. The Two-Site Sorption Model was the best for the case studied, with R2 of 0.985 and 0.995 for Cu and Cd, respectively. The values of R were considerably higher than the unit, presenting an average of 2.138 for Cu and 1.907 for Cd. This indicates a delay of these contaminants when leaving the column, which is caused by the interaction of these chemical compounds with the soil. The values obtained for parameter D were 3.469 for Cu and 5.205 for Cd. Thus, the metals in this study present a risk of groundwater contamination for the local alluvial aquifers. The main reason for that is the physicochemical features of the soil, such as high sand content (85 %) and low OM content (2.1 %). The results also indicated greater retention and less mobility for Cu than for Cd, pointing to a greater risk for Cd.

Abstract Background The surveillance of Chagas disease (CD) based on public participation is carried out through the detection and notification of insects suspected of being vectors of CD to Triatomine Information Posts (TIPs). Objective To understand the ideas and conceptions of residents in rural areas of the municipalities of the Micro-region of Health de Itaúna (MHI) regarding aspects related to CD, its vectors, and health services. Method In 2016, four focus groups were conducted in the municipalities of MHI. These focus groups were recorded, transcribed, and analyzed using the content analysis technique. In this process, units of analysis, both within each focus group and between them, were identified and categorized. Results It was found that some residents have a good understanding of the nature of CD transmission and of the morphological characteristics and habits of the vectors, in addition to an understanding of the forwarding of the vector to TIPs, and the diagnosis of CD. Reports of the absence of education and health interventions related to CD were also found. Conclusion Understanding the conceptions and ideas about CD of populations in endemic areas is fundamental to developing future strategies involving public participation.

Resumo Introdução A vigilância da doença de Chagas (DC), baseada na participação popular, ocorre por meio da detecção e notificação de insetos suspeitos de serem vetores da DC aos Postos de Informação de Triatomíneos (PITs). Objetivo Compreender as ideias e concepções dos moradores em áreas rurais dos municípios da Microrregião de Saúde de Itaúna (MSI) em relação a aspectos relacionados à DC, seus vetores e serviços de saúde. Método Em 2016, foram realizados quatro grupos focais nos municípios da MSI. Esses grupos focais foram gravados, transcritos e analisados utilizando a técnica de análise de conteúdo. Neste processo, identificamos e categorizamos unidades de análise tanto dentro de cada grupo focal quanto entre eles. Resultados Descobrimos que há compreensão por parte de alguns moradores sobre a natureza da transmissão da DC, as características morfológicas e hábitos dos vetores, o encaminhamento do vetor para os PITs e o diagnóstico da DC. Também encontramos relatos da ausência de intervenções educacionais e de saúde relacionadas à DC. Conclusão Compreender as concepções e ideias sobre a DC das populações em áreas endêmicas é fundamental para desenvolver futuras estratégias envolvendo a participação popular.

Resumen: Se realizó un estudio para evaluar la variación en el pH, la disponibilidad y las asociaciones químicas de Cd en dos Latosoles previamente contaminados, modificados con enmiendas minerales y orgánicas. Los Latosoles fueron contaminados con Cd y enmendados con vermicompost, torta de filtro de caña de azúcar, torta de palmiste, cal, roca fosfórica y zeolita. La disponibilidad de cadmio se evaluó mensualmente en las mezclas de suelo contaminadas / enmienda de suelo, empleando los extractantes DTPA y Mehlich-3 durante doce meses de incubación. Al final de este período, se realizó un procedimiento de extracción secuencial en las mezclas para identificar las formas de Cd presentes en las diversas fracciones geoquímicas. La cal inmovilizó el Cd en una extensión mayor (60%), siendo el metal transferido a las fracciones menos disponibles. El extractante Mehlich-3 tuvo una alta correlación (0.96 **) con la fracción disponible examinada por el procedimiento de extracción secuencial. En general, las enmiendas orgánicas produjeron pequeños efectos sobre el pH final de las mezclas suelo / enmiendas del suelo, en comparación con el pH inicial del suelo. Las enmiendas minerales mejoraron el pH del suelo y el efecto más pronunciado se produjo con el uso de cal.

Summary: A study was performed to evaluate the variation in pH, availability, and chemical associations of Cd in two previously contaminated Latosols amended with mineral and organic amendments. The Latosols were contaminated with Cd and amended with vermicompost, sugarcane filter cake, palm kernel pie, lime, phosphate rock, or zeolite. Cadmium availability was evaluated monthly in the contaminated soil/soil amendment mixtures with the DTPA and Mehlich-3 extractants for twelve months of incubation. At the end of this period, a sequential extraction procedure was performed in the mixtures to identify the Cd forms present in the several geochemical fractions. Lime immobilized Cd at a larger extension (60%), being the metal transferred to less available fractions. The Mehlich-3 extractant had a high correlation (0.96**) with the available fraction examined by the sequential extraction procedure. In general, organic amendments produced small effects on the final pH of soil/soil amendment mixtures as compared with the initial soil pH. Mineral amendments caused enhancement of soil pH and the most pronounced effect occurred with the use of lime.

Resumo Fundamento Os distúrbios de condução (DC) são a complicação mais frequente após a substituição da válvula aórtica transcateter (TAVR) e ainda não há consenso sobre seu tratamento. Objetivo Avaliar novos DC e implante de marca-passo definitivo (MPD) após a TAVR e avaliar a porcentagem de estimulação ventricular (EV) até 1 ano de acompanhamento. Métodos Pacientes submetidos a TAVR de outubro de 2014 a novembro de 2019 foram cadastrados; pacientes com MPD anterior foram excluídos. Dados clínicos, do procedimento, do ECG e do MPD foram coletados até 1 ano após o implante. O nível de significância adotado para a análise estatística foi 0,05%. Resultados Um total de 340 indivíduos foram submetidos a TAVR. O DC mais comum foi bloqueio de ramo esquerdo novo (BRE; 32,2%), sendo que 56% destes foram resolvidos após 6 meses. O bloqueio do ramo direito (BRD) foi o maior fator de risco para bloqueio atrioventricular avançado (BAV) [RC=8,46; p<0,001] e implante de MPD [RC=5,18; p<0,001], seguido de BAV de baixo grau prévio [RC=2,25; p=0,016 para implante de MPD]. Em relação às características do procedimento, válvulas de gerações mais recentes e procedimentos de válvula-em-válvula foram associados a menos DC. No total, 18,5% dos pacientes tiveram MPD implantado após a TAVR. Na primeira avaliação do MPD, pacientes com BAV avançado tinham uma porcentagem mediana de EV de 80%, e, após um ano, de 83%. Em relação aos pacientes com BRE e BAV de baixo grau, a EV mediana foi mais baixa (6% na primeira avaliação, p=0,036; 2% após um ano, p = 0,065). Conclusão O BRE foi o DC mais frequente após a TAVR, com mais da metade dos casos se resolvendo nos primeiros 6 meses. O BRD foi o principal fator de risco para BAV avançado e implante de MPD. O BAV avançado foi associado a uma porcentagem mais alta de EV no acompanhamento de 1 ano.

Abstract Background Conduction disturbances (CD) are the most frequent complication after transcatheter aortic valve replacement (TAVR), and there continues to be a lack of consensus on their management. Objective To assess new CD and permanent pacemaker (PPM) implantation after TAVR and to evaluate the ventricular pacing percentage (VP) up to 1 year of follow-up. Methods Patients who underwent TAVR from October 2014 to November 2019 were enrolled; patients with previous PPM were excluded. Clinical, procedure, ECG, and PPM data were collected up to 1 year after implantation. The significance level adopted in the statistical analysis was 0.05. Results A total of 340 patients underwent TAVR. The most frequent CD was the new left bundle branch block (LBBB; 32.2%), which 56% resolved after 6 months. Right bundle branch block (RBBB) was the biggest risk factor for advanced atrioventricular block (AVB) [OR=8.46; p<0.001] and PPM implantation [OR=5.18, p<0.001], followed by previous low-grade AVB [OR=2.25; p=0.016 for PPM implantation]. Regarding procedure characteristics, newer generation valves and valve-in-valve procedures were associated with fewer CDs. Overall, 18.5% of patients had a PPM implanted post-TAVR. At first PPM evaluation, patients with advanced AVB had a median percentage of VP of 80% and 83% at one year. Regarding patients with LBBB plus low-grade AVB, median VP was lower (6% at first assessment, p=0.036; 2% at one year, p = 0.065). Conclusion LBBB was the most frequent CD after TAVR, with more than half being resolved in the first six months. RBBB was the major risk factor for advanced AVB and PPM implantation. Advanced AVB was associated with a higher percentage of VP at 1 year of follow-up.

ABSTRACT Background: Despite optimized medical therapy, contemporary risk of surgery in inflammatory bowel diseases (IBD) after 10 years of diagnosis is 9.2% in patients with ulcerative colitis (UC) and 26.2% in Crohn’s disease, (CD) in the biological era. Objective: This consensus aims to detail guidance to the most appropriate surgical procedures in different IBD scenarios. In addition, it details surgical indications and perioperative management of adult patients with CD and UC. Methods: Our consensus was developed by colorectal surgeons and gastroenterologists representing the Brazilian Study Group of Inflammatory Bowel Diseases (GEDIIB), with the Rapid Review methodology being conducted to support the recommendations/statements. Surgical recommendations were structured and mapped according to the disease phenotypes, surgical indications, and techniques. After structuring the recommendations/statements, the modified Delphi Panel methodology was used to conduct the voting by experts in IBD surgery and gastroenterology. This consisted of three rounds: two using a personalized and anonymous online voting platform and one face-to-face presential meeting. Whenever participants did not agree with specific statements or recommendations, an option to outline possible reasons was offered to enable free-text responses and provide the opportunity for the experts to elaborate or explain disagreement. The consensus of recommendations/statements in each round was considered to have been reached if there was ≥80% agreement. Results and conclusion: This consensus addressed the most relevant information to guide the decision-making process for adequate surgical management of CD and UC. It synthesizes recommendations developed from evidence-based statements and state-of-art knowledge. Surgical recommendations were structured and mapped according to the different disease phenotypes, indications for surgery and perioperative management. Specific focus of our consensus was given to elective and emergency surgical procedures, determining when to indicate surgery and which procedures may be the more appropriate. The consensus is targeted to gastroenterologists and surgeons interested in the treatment and management of adult patients with CD or UC and supports decision-making of healthcare payors, institutional leaders, and/or administrators.

RESUMO Contexto: Apesar da terapia medicamentosa otimizada, o risco contemporâneo de cirurgia nas doenças inflamatórias intestinais (DII) após 10 anos do diagnóstico é de 9,2% em pacientes com retocolite ulcerativa (RCU) e de 26,2% na doença de Crohn (DC) na era biológica. Objetivo: Este consenso visa detalhar as orientações para os procedimentos cirúrgicos mais adequados em diferentes cenários da DII. Além disso, detalha as indicações cirúrgicas e o manejo perioperatório de pacientes adultos com DC e RCU. Métodos: Nosso consenso foi desenvolvido por cirurgiões colorretais e gastroenterologistas representantes da Organização Brasileira de Doença de Crohn e Colite (GEDIIB), com a metodologia de revisão rápida sendo conduzida para respaldar as recomendações. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os fenótipos da doença, indicações cirúrgicas e técnicas. Após a estruturação das recomendações, a metodologia modificada do Painel Delphi foi utilizada para conduzir a votação por especialistas em cirurgia de DII e gastroenterologia. Esta consistiu em três rondas: duas com recurso a uma plataforma de votação online personalizada e anônima e uma reunião presencial. Sempre que os participantes não concordavam com afirmações ou recomendações específicas, era oferecida uma opção de delinear possíveis razões para permitir respostas em texto livre e dar a oportunidade para os especialistas elaborarem ou explicarem a discordância. O consenso de recomendações/declarações em cada rodada foi considerado alcançado se houve concordância ≥80%. Resultados e conclusão Este consenso abordou as informações mais relevantes para orientar o processo de tomada de decisão para o manejo cirúrgico adequado de DC e RCU. Ele sintetiza recomendações desenvolvidas a partir de evidências e conhecimento de alto nível. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os diferentes fenótipos da doença, indicações para cirurgia e manejo perioperatório. O foco específico do nosso consenso foi dado aos procedimentos cirúrgicos eletivos e de emergência, determinando quando indicar a cirurgia e quais procedimentos podem ser os mais adequados. O consenso é direcionado a gastroenterologistas e cirurgiões interessados no tratamento e manejo de pacientes adultos com DC ou RCU e apoia a tomada de decisões de pagadores de saúde, líderes institucionais e/ou administradores.

It is well documented that Chagas disease (CD) can pose a public health problem to countries. As one of the World Health Organization Neglected Tropical Diseases undoubtedly calls for comprehensive healthcare, transcending a restricted biomedical approach. After more than a century since their discovery, in 1909, people affected by CD are still frequently marginalised and/or neglected. The aim of this article is to tell the story of their activism, highlighting key historical experiences and successful initiatives, from 1909 to 2019. The first association was created in 1987, in the city of Recife, Brazil. So far, thirty associations have been reported on five continents. They were created as independent non-profit civil society organisations and run democratically by affected people. Among the common associations’ objectives, we notably find: increase the visibility of the affected; make their voice heard; build bridges between patients, health system professionals, public health officials, policy makers and the academic and scientific communities. The International Federation of Associations of People Affected by CD - FINDECHAGAS, created in 2010 with the input of the Americas, Europe and the Western Pacific, counts as one of the main responses to the globalisation of CD. Despite all the obstacles and difficulties encountered, the Federation has thrived, grown, and matured. As a result of this mobilisation along with the support of many national and international partners, in May 2019 the 72nd World Health Assembly decided to establish World Chagas Disease Day, on 14 April. The associative movement has increased the understanding of the challenges related to the disease and breaks the silence around Chagas disease, improving surveillance, and sustaining engagement towards the United Nations 2030 agenda.

RESUMO Nenhum outro aspecto isolado influencia tanto o desenvolvimento e produção da soja quanto a época de semeadura, porém a resposta de diferentes cultivares em datas de semeadura distintas depende de sua sensibilidade às condições ambientais às quais estão expostas. Assim, objetivou-se no presente estudo avaliar a adaptabilidade e a estabilidade de dezessete genótipos de soja na produtividade, bem como nos teores de óleo e proteína nos grãos em função de diferentes épocas de semeadura. Utilizou-se o delineamento em blocos casualizados com três repetições, em esquema fatorial com 17 genótipos (Conquista, CD 223 AP, Elite, Garantia, linhagem “Bioagro”, M-Soy 8400, M-soy 8001, Nambu, Sambaíba, Esplendor, UFVS 2006, UFVS 2005, UFVTN 102, UVF 18, UFV 16, Valiosa e Vencedora) e cinco datas de semeadura (SD1 = 11/3, SD2 = 11/20, SD3 = 12/07, SD4 = 23/12 e SD5 = 09/01). Os genótipos M-Soy 8001, UFV 18 e Garantia apresentam elevados teores de óleo, com adaptação a todas as datas semeadura e estabilidade nas datas mais favoráveis. Os genótipos da linhagem “Bioagro” e os genótipos CD 223 AP e "Garantia" são adaptados e estáveis em todas as datas de semeadura e possuem maiores teores de proteína, independente das datas de semeadura. Os genótipos Elite, Nambu e Garantia estão adaptados e estáveis em nas datas mais favoráveis de semeadura e apresentam alto rendimento de grãos, nas semeaduras realizadas no início de dezembro. O Genótipo Garantia é o mais adequado às condições de cultivo da região centro-norte do estado de São Paulo.

ABSTRACT No isolated factor influences soybean development and production more than the sowing date, but the responses of cultivars sown on different sowing dates depends on their sensitivity to environmental conditions. Thus, this study evaluated the adaptability and stability of 17 soybean genotypes in relation to yield, as well as to the grain oil and protein contents as a function of different sowing times. The experiment was designed in randomized blocks with three replications and a 17 × 5 factorial scheme. The genotypes were: Conquista, CD 223 AP, Elite, Garantia, Bioagro lineage, M-Soy 8400, M-soy 8001, Nambu, Sambaíba, Esplendor, UFVS 2006, UFVS 2005, UFVTN 102, UVF 18, UFV 16, Valiosa, Vencedora, and the five sowing dates were: SD1 = 11/3, SD2 = 11/20, SD3 = 12/07, SD4 = 12/23, and SD5 = 01/09. The M-Soy 8001, UFV 18 and Garantia genotypes showed high oil contents, with adaptation to all sowing dates and stability when sown on the most favorable dates. The Bioagro lineage, CD 223 AP, and Garantia genotypes were adapted and stable when sown on all sowing dates and had higher protein contents than the other genotypes, regardless of the sowing date. The Elite, Nambu, and Garantia genotypes were adapted and stable when sown on the most favorable sowing dates and presented high grain yields when sown in early December. The findings indicate that the Garantia genotype is the most suitable for the growing conditions of the central-north region of the state of São Paulo.

RESUMO Os efluentes e resíduos industriais galvânicos são uma preocupação mundial, por terem em sua composição metais-traço altamente tóxicos, prejudiciais ao meio ambiente e à saúde humana. Neste artigo, é apresentado um panorama da indústria de semijoias folheadas de Juazeiro do Norte, Ceará, considerando-se os processos de produção e a concentração de metais-traço nos efluentes, bem como o resíduo sólido galvânico, gerados pelo setor. Dados primários de produção foram obtidos em 11 empresas por meio de questionário técnico. As concentrações de metais-traço foram obtidas por espectrofotometria de absorção atômica de chama. Os resultados demonstraram ineficiência no tratamento dos efluentes para cobre, níquel, cromo, chumbo e zinco. As concentrações médias de metais no resíduo sólido galvânico foram de 239 g Cu kg-1, 99 g Zn kg-1, 23,8 g Ni kg-1, 6,6 g Pb kg-1, 0,2 g Cr kg-1, 1,7 g Cd kg-1, 1,0 g Mn kg-1 e 8,2 g Fe kg-1. Os resultados evidenciaram a necessidade da adoção de medidas para o controle de qualidade dos processos de tratamento dos efluentes, com vistas à sustentabilidade do setor.

ABSTRACT Galvanic industrial effluents and wastes are a worldwide concern, as they contain highly toxic trace metals that are harmful to the environment and human health. This article presents an overview of the clad semi jewelry industry in Juazeiro do Norte, state of Ceará, Brazil, considering the production processes and the concentration of trace metals in the effluents and galvanic sludge waste generated by the sector. Primary production data were obtained from 11 companies by a technical questionnaire. Trace metal concentrations were obtained by flame atomic absorption spectrophotometry. The results showed inefficiency in the treatment of effluents for copper, nickel, chrome, lead, and zinc. The average metal concentrations in the galvanic sludge waste were 239 g Cu kg-1, 99 g Zn kg-1, 23.8 g Ni kg-1, 6.6 g Pb kg-1, 0.2 g Cr kg-1, 1.7 g Cd kg-1, 1.0 g Mn kg-1, and 8.2 g Fe kg-1. The results evidenced the need for adopting measures concerning quality control of the effluent treatment processes aiming at the sustainability of the sector.

According to the World Health Organization (WHO), Chagas disease (CD), whose etiological agent is the Trypanosoma cruzi (T. cruzi) parasite, affects about eight million people, mainly in Latin America. The cruzain enzyme is highlighted among the main biological targets, since it is the most abundant of the cysteine protease class from T. cruzi and is involved in the entire life cycle of the parasite, essential in regulating the interaction between parasite and host. The drugs available for the treatment of CD usually have strong side effects, and the nitro(triazole/imidazole)-based heteroarylamide/sulfonamide compounds (HA/S) emerge with high antitrypanosomal potential. In this study, the quantitative structure-activity relationship (QSAR) were built using partial least squares (PLS) regression, and the results were robust and adequate for predicting and proposing five new derivatives according to the statistical parameters. The docking results suggest that the best-scored HA/S derivatives showed hydrogen bonds with the residuals that comprise the catalytic region of the enzyme. The molecular dynamics (MD) simulations, performed with different methods, revealed the strong stability of the compound obtained by the QSAR model of this study, in addition to a better binding free energy value than the HA/S obtained from literature.

Abstract INTRODUCTION: This study estimated the seroprevalence and risk factors of Chagas disease (CD) in a population of the Quixeré municipality, Ceará. METHODS: We conducted serological methods to detect the Trypanosoma cruzi infection. The other variables were evaluated by a standardized questionnaire. RESULTS: The estimated prevalence of CD was 3.7%. Male sex, age >40 years, being farmers, low education level, origin from rural areas, and being born in Quixeré were significantly associated with infection. CONCLUSION: CD persists in this rural population of Northeast Brazil. Poverty, low education, and limited information regarding CD are critical issues that need to be addressed.

Resumo O Arranjo Produtivo Local localizado no Agreste de Pernambuco vem desenvolvendo significativamente a economia da região. Apesar da sua importância, a atividade industrial traz preocupações ambientais relevantes no que diz respeito à eliminação de efluentes têxteis, principalmente das lavanderias industriais. Esses resíduos são compostos por diversos produtos químicos e, entre eles, vários tipos de metais pesados. A avaliação do comportamento de sorção de mecanismos de transporte de contaminantes como metais pesados é essencial para avaliar o risco de contaminação de aquíferos aluviais. Este estudo avaliou a sorção de metais pesados (Cu e Cd) em um depósito de sedimento aluvial no rio Capibaribe. Experimentos cinéticos e isotérmicos permitiram as análises de sorção de Cu e Cd. A cinética de sorção mostrou uma tendência de equilíbrio após 16h para Cu e 18h para Cd e foi melhor descrita por um modelo de pseudo-segunda ordem. Os dados de isoterma foram ajustados aos modelos Linear, Freundlich e Langmuir. Os modelos linear e de Freundlich descreveram satisfatoriamente as isotermas de sorção para os dois poluentes. Os metais em estudo representam risco de contaminação das águas subterrâneas de aquíferos aluviais, principalmente devido aos atributos físico-químicos do solo, como alto teor de areia (85%), baixa MO (2,1 g kg-1) e pH alcalino (8,2 ) As condições ambientais diminuem a absorção e facilitam a mobilidade do metal, aumentando muito os riscos ambientais inerentes à lixiviação de poluentes. O Cu apresentou maior afinidade com o solo estudado em todos os ensaios realizados em comparação com os resultados dos ensaios para o Cd.

Abstract The Local Production Arrangement, located in the Pernambuco’s Agreste state, has been significantly developing the region's economy. Despite its importance, industrial activity has caused relevant environmental concerns regarding the disposal of textile effluents, especially from industrial laundries. This waste is made up of many chemicals, and among them are various types of heavy metals. The evaluation of the sorption behavior of contaminant transport mechanisms such as heavy metals is essential to assess the risk of contamination of alluvial aquifers. This study evaluated the sorption of heavy metals (Cu and Cd) in an alluvial sediment deposit in the Capibaribe River. Kinetics and isotherm experiments allowed the analyses of Cu and Cd sorption. Kinetics sorption showed an equilibrium tendency after 16 h for Cu and 18 h for Cd and was better described by a pseudo-second order model. The isotherm data were adjusted to the Linear, Freundlich and Langmuir models. Both linear and Freundlich models satisfactorily described sorption isotherms for the two pollutants. The metals in the study represent a risk of contamination of the groundwater of alluvial aquifers, mainly due to physicochemical attributes of the soil, such as high sand content (85%), low MO (2.1 g kg-1) and alkaline pH (8.2). The environmental conditions decrease absorption and facilitate metal mobility, greatly increasing the environmental risks inherent in pollutant leaching. Cu showed a higher affinity with the soil studied in all assays performed compared with the results of the tests for Cd.

ABSTRACT Chagas disease (CD) is a neglected tropical highly morbid disease that can have a negative impact on the quality of life (QoL). The purpose of this study was to conduct an integrative review to analyze the QoL of patients with CD in the chronic phase of the disease, as well as the instruments used and the effect of different interventions. The review was carried out based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and Science Direct databases. An analysis of the reference list of the included articles was also carried out. Publications in all languages have been included. Two independent reviewers selected the eligible articles and extracted the data. A total of 1,479 articles were identified, and after applying the inclusion criteria 18 articles were included. Four different instruments were used to assess QoL and the most used was the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention showed a positive impact on the patients’ QoL, and the Environment domain had the lowest score. Heterogeneity of instruments and lack of methodology standardization for assessing QoL was observed. QoL proved to be an important indicator for the planning and monitoring of patients with CD, however it is suggested that the instruments for its assessment should be the ones recommended by the validation studies. This process will allow the comparison of data between investigations.

Resumen Introducción. Luego de la implementación de medidas de control de la transmisión vectorial por Triatoma infestans en Brasil, hubo una reducción en el número de nuevos casos de la enfermedad de Chagas (EC). Actualmente, en el continente americano la incidencia anual de EC es de 28 000 casos, pero cabe señalar que aún existe una gran cantidad de adultos mayores que padecen los síntomas y signos de la fase crónica de esta enfermedad. Objetivo. Caracterizar el perfil clínico y epidemiológico de pacientes chagásicos en fase crónica atendidos en un centro de referencia ubicado en el estado de São Paulo, Brasil. Materiales y métodos. Estudio transversal y descriptivo. Se analizaron las historias clínicas de 62 pacientes chagásicos crónicos atendidos en el Hospital das Clínicas de Marília. Resultados. No hubo diferencias significativas con respecto a sexo, edad y tiempo de diagnóstico. Los problemas cardiacos fueron el signo clínico más reportado. Se observó una diferencia significativa en el caso de la forma indeterminada de la enfermedad, siendo más predominante en los hombres. Por otra parte, el estadio B1 fue más frecuente en las mujeres, mientras que el estadio B2 fue predominante en los hombres. Conclusión. El diagnóstico tardío de la EC puede aumentar la probabilidad de presentar complicaciones digestivas. Sin embargo, las manifestaciones clásicas de esta enfermedad y sus comorbilidades pueden ser controladas siempre que se cuente con atención médica integral (multidisciplinar), ya que de esta forma se retrasa su evolución y, en consecuencia, se mejora la calidad de vida de estos pacientes.

Abstract Introduction: After implementing measures to control vector transmission by Triatoma infestans in Brazil, the number of new cases of Chagas disease (CD) decreased. Currently, the American continent has an annual incidence of 28 000 cases, but a large number of older adults are still affected by the chronic phase of this disease. Objective: To characterize the clinical and epidemiological profile of patients in the chronic phase of CD treated at a reference center located in the state of São Paulo, Brazil. Materials and methods: A cross-sectional, descriptive study was conducted based on the analysis of the medical records of 62 patients in the chronic phase of CD and treated at the Hospital das Clínicas de Marília. Results: No significant differences were found regarding sex, age and time of diagnosis. Cardiac problems were the most reported clinical sign. A significant difference was observed in the case of the indeterminate form of the disease, which was more predominant in males. In addition, functional classification B1 of CD was more common in women, while B2 predominated in men. Conclusion: A late diagnosis of CD may increase the chances of presenting digestive complications. However, the classic manifestations of the disease and its comorbidities can be successfully managed as long as comprehensive (multidisciplinary) medical care is provided, since this would help delay the course of the disease and, consequently, improve the patients' quality of life.