Abstract Tea is identified as the second most consumed drink in the world, and its frequent intake is related to several benefits to human health, considering its antimutagenic, anticarcinogenic, antimicrobial, anti-inflammatory, antihistamine, diuretic, calming, and above all, antioxidant effects. These effects are often associated with the action of the phenolic compounds contained in these infusions. In Brazil, among the most consumed infusions are the teas of chamomile (Matricaria chamomilla L.), lemongrass (Cymbopogon citratus (D.C.) Stapf), lemon balm (Melissa officinalis L.), anise (Pimpinella anisum L.), yerba mate (Ilex paraguariensis A. St.-Hil), peppermint (Mentha piperita L.), and green/black tea (Camellia sinensis L.). Therefore, said popularity is the reason why the mentioned species were chosen to be evaluated on inflammatory enzymes. The activity of phospholipases A2 was reduced by more than 25% after treatment with black tea and yerba mate. The most significant inhibition of protease activity was observed after incubation with black tea (40.74%), green tea (31.48%) and yerba mate (25.93%). Infusions of black and green tea reduced hemolysis in semisolid and liquid media, and for the latter, reductions of up to 50% of hemolytic activity were observed, indicating an anti-inflammatory potential of the samples. Plasma incubations with green tea, black tea and lemon balm and subsequent addition of venom (1:10 ratio; tea:PBS, v:v) prolonged the coagulation time of citrated plasma by approximately twice compared to the positive control. All controls with pure tea had a thrombolytic character, in higher proportions than the venom control, especially chamomile (273.55% dissolution). Phenolic compounds derived from phenolic acids, flavonoids, and tannins are identified as the main agents that promote the biological effects observed in this study. This is mainly due to their anti-catalytic properties exerted on inflammatory enzymes and as chelating agents of enzymatic co-factors. The evaluated teas showed potential for nutraceutical use, thus pointing to the possibility of use as an adjuvant in the treatment of diseases linked to hemostasis.

ABSTRACT Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of nutritional status on clinical outcome, graft survival (GS) and mortality risk in kidney transplant patients (KTP). Methods: In this retrospective cohort study including 451 KTP, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The patients were stratified into 3 groups according to the final score: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. The patients were monitored after transplantation at least 1 to 10 years. Results: Stratifying the 451 patients based on the pretransplant risk score, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p = 0.012). The incidence of infection in the patients from G3 was higher than patients from G1 and G2 (p = 0.030). G3 recipients showed worse GS than G1 patients (p = 0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996). Conclusions: KTP with higher malnutrition risk score were associated with worse outcomes and GS. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for kidney transplant.

RESUMO Antecedentes: A prevalência de pacientes desnutridos antes do transplante e a influência da desnutrição nos desfechos do enxerto e do paciente permanecem subestimadas, embora estejam associadas a maior morbimortalidade pós-operatória. Este estudo buscou desenvolver uma ferramenta simples de triagem nutricional e avaliar o impacto do estado nutricional no desfecho clínico, sobrevida do enxerto (SE) e risco de mortalidade em pacientes transplantados renais (PTR). Métodos: Neste estudo de coorte retrospectivo incluindo 451 PTR, desenvolvemos um escore usando medidas antropométricas, clínicas e laboratoriais tomadas na avaliação pré-transplante. Os pacientes foram estratificados em 3 grupos segundo a pontuação final: G1 (0-1 ponto) = baixo risco, G2 (2-4 pontos) = risco moderado e G3 (>5 pontos) = alto risco de desnutrição. Eles foram monitorados por pelo menos 1 a 10 anos após o transplante. Resultados: Os 451 pacientes foram estratificados em G1, G2 e G3, que consistiram em 90, 292 e 69 pacientes, respectivamente. Os pacientes do G1 mantiveram os menores níveis de creatinina sérica na alta hospitalar em relação aos demais (p = 0,012). A incidência de infecção nos pacientes do G3 foi maior que nos pacientes do G1 e G2 (p = 0,030). Os pacientes do G3 apresentaram SE pior do que os pacientes do G1 (p = 0,044) e um risco quase três vezes maior de perda do enxerto (HR 2,94; IC 95% 1,084-7,996). Conclusões: PTR com maior escore de risco de desnutrição foram associados a piores desfechos e menor SE. A ferramenta de triagem nutricional é fácil de usar na prática clínica para avaliar pacientes em preparação para transplante renal.

Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

Abstract Introduction: to reduce the prevalence of overweight and obesity, lifestyle interventions, particularly in nutritional education programs, should be prioritized among university students. Monitoring sedentary behavior is an important step toward preventing and controlling obesity. Therefore, we assessed the reliability and validity of an online questionnaire on sedentary behavior among university students from low-income regions. Methods: this cross-sectional methodological feasibility study evaluated the psychometric properties of the South American Youth/Child Cardiovascular and Environmental (SAYCARE) questionnaire. We administered this questionnaire in an online format to 195 and 117 university students (aged between 17 and 53 years) to assess its validity and reliability, respectively. The questionnaire measures the daily time spent watching TV, playing electronic games, using a computer, studying and passive commuting on weekdays and weekends. The questionnaire involved two stages (Q1 and Q2) separated by an interval of 2 weeks. Reliability was assessed using Spearman's correlation analysis. The structural validity of the construct was evaluated by exploratory factor analysis. Results: all variables showed acceptable reliability (Spearman's rho > 0.30 and p < 0.05). Regarding construct structural validity, the exploratory factor analysis identified 4 factors (variance explained: 71.4 %) and did not exclude any items. Conclusion: the online SAYCARE questionnaire exhibited acceptable reliability and structural validity for assessing sedentary behavior among university students from low-income regions.

Resumen Introducción: para reducir la prevalencia del sobrepeso y la obesidad, las intervenciones en el estilo de vida, particularmente en los programas de educación nutricional, deben priorizarse entre los estudiantes universitarios. Por lo tanto, monitorear el comportamiento sedentario es un paso importante para prevenir y controlar la obesidad. Nuestro objetivo fue investigar la confiabilidad y validez de un cuestionario online sobre comportamiento sedentario entre estudiantes universitarios de regiones de escasos recursos. Métodos: este estudio transversal de factibilidad metodológica evaluó las propiedades psicométricas del cuestionario South American Youth/Child Cardiovascular and Environmental (SAYCARE). Administramos este cuestionario en formato online a 195 y 117 estudiantes universitarios (de entre 17 y 53 años) para evaluar su validez y confiabilidad, respectivamente. El cuestionario midió el tiempo diario del estudiante viendo televisión, jugando a juegos electrónicos, usando una computadora, estudiando y viajando pasivamente entre semana y fines de semana. El cuestionario fue respondido en dos etapas (Q1 y Q2), con un intervalo de 2 semanas. La fiabilidad se evaluó mediante el coeficiente de correlación de Spearman. La validez estructural del constructo se evaluó mediante análisis factorial exploratorio. Resultados: todas las variables mostraron una confiabilidad aceptable (rho de Spearman > 0,30 y p < 0,05). En la validez estructural del constructo, el análisis factorial exploratorio encontró 4 factores (varianza explicada del 71,4 %) y ningún ítem fue excluido. Conclusión: el cuestionario SAYCARE, en formato online, exhibió una confiabilidad y validez estructural aceptables para evaluar el comportamiento sedentario entre estudiantes universitarios de regiones de escasos recursos.

ABSTRACT The Crop-Livestock Integration system has sustainable potential. But pests such as the defoliating caterpillar Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) can reduce the productivity of this system. The objective was to report transgenic maize and Brachiaria brizantha (A. Rich.) (Poaceae) plants attacked by S. frugiperda in the Crop-Livestock Integration system. Feroz VIP3 ® transgenic maize (SYN8A98 TLTG Viptera) and B. brizantha MG-5 Xaraés plants attacked by S. frugiperda were evaluated 20 days after planting, weekly and for 28 days. The transgenic maize plants were less attacked by S. frugiperda than those of B. brizantha. The negative impact of this pest on B. brizantha suggests the planning and adopting strategies for its control, such as the use of traps, resistant cultivars, and biological or chemical products, minimizing losses in animal production and, consequently, in human food.

Abstract In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics.

Resumo Nas últimas décadas, houve progressos significativos no diagnóstico e no tratamento da distrofia muscular de Duchenne (DMD), considerada a distrofia muscular mais comum na infância. Diretrizes internacionais foram publicadas e revisadas recentemente. Um grupo de especialistas brasileiros desenvolveu um padrão de atendimento baseado em revisão de literatura, com recomendações graduadas pautadas em evidências compiladas em uma publicação dividida em duas partes. A implementação de melhores práticas de manejo ajudou a modificar a história natural desta doença crônica, progressiva, que, no passado, oferecia uma expectativa de vida muito limitada para crianças do sexo masculino. Desde a publicação desse consenso anterior, o diagnóstico, o tratamento com esteroides, a reabilitação e os cuidados sistêmicos ganharam novas possibilidades a partir da divulgação dos resultados de trabalhos originais em algumas dessas áreas. Além disso, as pesquisas e o desenvolvimento de novos fármacos estão em andamento, e algumas intervenções já foram aprovadas para uso em determinados países. Nesse contexto, identificamos a necessidade de rever as recomendações anteriores sobre o manejo dos pacientes brasileiros com DMD. Nosso objetivo principal foi elaborar uma atualização baseada em evidências sobre esses tópicos do consenso.

ABSTRACT The use of echocardiography by physicians who are not echocardiographers has become common throughout the world across highly diverse settings where the care of acutely ill patients is provided. Echocardiographic evaluation performed in a point-of-care manner can provide relevant information regarding the mechanism of causes of shock, for example, increasing the rates of correct diagnosis and allowing for faster informed decision-making than through evaluation methods. Considering that the accurate diagnosis of life-threatening situations is essential for professionals working with acutely ill patients, several international associations recommend that physicians responsible for critically ill patients acquire and develop the ability to perform bedside ultrasound examinations, including echocardiographic examinations. However, there is no consensus in the literature regarding which specific applications should be included in the list of skills for nonechocardiographer physicians. Taking into account the multiplicity of applications of echocardiography in different scenarios related to acutely ill patients; the differences in the published protocols, with regard to both the teaching methodology and competence verification; and the heterogeneity of training among highly diverse specialties responsible for their care at different levels, this consensus document aimed to reflect the position of representatives of related Brazilian medical societies on the subject and may thus serve as a starting point both for standardization among different specialties and for the transmission of knowledge and verification of the corresponding competencies.

RESUMO O emprego da ecocardiografia por médicos não ecocardiografistas tem se tornado comum em todo o mundo nos mais diversos ambientes em que se dá o cuidado do paciente agudamente doente. A avaliação ecocardiográfica realizada de forma point-of-care pode fornecer informações pertinentes em relação ao mecanismo das causas de choque, por exemplo, incrementando as taxas de diagnóstico correto e possibilitando a tomada de decisão fundamentada de forma mais rápida do que por meio dos métodos tradicionais de avaliação. Considerando que o diagnóstico preciso de situações ameaçadoras à vida é indispensável a profissionais atuando junto a pacientes agudamente enfermos, diversas entidades associativas internacionais recomendam que médicos responsáveis por pacientes gravemente doentes devam adquirir e desenvolver a habilidade para realizar exames ultrassonográficos à beira do leito, inclusive ecocardiográficos. Entretanto, não há consenso na literatura acerca de quais aplicações específicas devam compor o rol de habilidades do médico não ecocardiografista. Levando-se em consideração a multiplicidade de aplicações da ecocardiografia em diversos cenários relativos ao paciente agudamente enfermo; as diferenças nos protocolos publicados, tanto no que diz respeito à metodologia de ensino como de verificação de competências, bem como a heterogeneidade da formação entre as mais diversas especialidades responsáveis pelo seu cuidado em diferentes níveis, este documento de consenso teve o objetivo de refletir o posicionamento de representantes de sociedades médicas brasileiras afins acerca do tema, podendo, assim, servir de ponto de partida para a uniformização entre diferentes especialidades, bem como para a transmissão de conhecimento e a verificação das competências correspondentes.

ABSTRACT Insects are fundamental to biodiversity conservation in almost all ecosystems, and their population decline, and extinction directly result from environmental impacts. These facts are aggravated by the lack of knowledge of insect biodiversity, the so-called biodiversity deficits, especially the Linnean and Wallacean shortfalls. In freshwater ecosystems, biodiversity loss is higher among aquatic insects, and caddisflies comprise one of the most vulnerable orders. In this way, research focusing on describing new caddisfly species and understanding their distribution ranges will increase knowledge of caddisfly biodiversity. In the past 14 years, the team from the Laboratório de Entomologia Aquática “Prof. Dr. Claudio Gilberto Froehlich” (LEAq, Universidade Federal da Bahia, Brazil) and collaborators have been addressing these issues, resulting in 55 described species of caddisflies. Taxa in other insect orders have also received attention and an additional 16 species have been described (eight mayflies, four stoneflies, four neuropteran spongillaflies, and antlions). Here, eight caddisfly species are described and illustrated (Atopsyche froehlichi sp. nov., Austrotinodes zeferina sp. nov., Cernotina kariri sp. nov., Neoathripsodes froehlichi sp. nov., Notalina claudiofroehlichi sp. nov., Oecetis marcus sp. nov., Phylloicus froehlichi sp. nov., and Polycentropus claudioi sp. nov.), five of them in honor of LEAq’s patron. In addition, new distributional data are presented for 10 known species. A checklist of the caddisfly fauna of Bahia state is also presented, with 138 species, around 75% and 30% of them recorded and described by the LEAq team, respectively. Currently, for caddisflies, Bahia is the fifth most species-rich state in Brazil, and the first in the Brazilian Northeast region.

Abstract The aim of this study was to evaluate and correlate modifications of vaginal mucous impedance, vulvar temperature and ultrasonographic measurements (echobiometric parameters) to parturition in pregnant Saanen does. 30 does were selected for the study and submitted to an estrus synchronization protocol and natural mating. The females were evaluated daily from Day 143 of pregnancy to parturition. For the sonographic evaluations, the following structures were measured: biparietal diameter, thoracic diameter, abdominal diameter, ocular orbit, kidney length, kidney height, cardiac area, placentome length, cervical measurement and fetal heart rate; by means of two different approaches: transrectal and transabdominal, using a 7.5 MHz linear transducer. The vaginal mucous impedance was assessed using an electric estrous detector and vulvar temperature was measured using a non-contact infrared thermometer. Statistical analysis was performed using the R-project software and the significance level was set at 5% for all tests. 25 Saanen does became pregnant, resulting in 80.33% pregnancy rate. Fetal heart rate was negatively correlated to the hours to parturition (p<0,001; r-Pearson= -0,451), as well as vaginal temperature (p= 0,001; r-Pearson= -0,275), while cervical thickness was positively correlated to hours to parturition (p<0,001; r-Pearson= 0,490). The echobiometric parameters (biparietal diameter, thoracic diameter, abdominal diameter, ocular orbit, kidney length and height, cardiac area, placentome length), as well as vaginal mucous impedance did not vary throughout the timepoints of evaluation and did not correlate to the moment of parturition. It was concluded that the parameters of fetal heartbeat, vaginal temperature and cervical effacement in the last week of pregnancy provide valuable information regarding the proximity of parturition.

Abstract Hannah Arendt’s essay entitled “The crisis in education”, published in the 1950s, ascribes the failure of school education in the United States to the educational trend known as progressive education and to the influence of Pragmatism. As it was originally prepared in the form of a conference, the text contains several gaps in the treatment of these themes. This article seeks to fill these gaps employing historiographic sources with the purpose of showing that Arendt selects certain facts to build a rhetorical situation - defined as a problematic situation that draws the attention of public opinion - to which her essay is an argumentative response. The article concludes that the objective of “The crisis in education” is not to discuss the history of education, but the relationships between adults and children in contemporary society, a subject that should be analyzed considering Arendtian concepts.

Résumé L’essai d’Hannah Arendt intitulé “La crise de l'éducation”, publié dans les années 1950, attribue l’échec de l’éducation scolaire aux États-Unis à la tendance éducative connue sous le nom d’éducation progressive et à l’influence du Pragmatisme. Préparé à l’origine sous la forme d’une conférence, le texte comporte plusieurs lacunes dans le traitement de ces thèmes. Cet article cherche à combler ces lacunes en utilisant des sources historiographiques dans le but de montrer qu’Arendt sélectionne certains faits pour construire une situation rhétorique - définie comme une situation problématique qui attire l’attention de l’opinion publique - à laquelle son essai est une réponse argumentative. L’article conclut que l’objectif de “La crise de l'éducation” n'est pas de discuter de l’histoire de l’éducation, mais des relations entre adultes et enfants dans la société contemporaine, un sujet qui devrait être analysé à la lumière des concepts arendtiens.

Resumen El ensayo de Hannah Arendt titulado “La crisis en la educación”, publicado en la década de 1950, atribuye el fracaso de la educación escolar en los Estados Unidos a la tendencia educativa conocida como educación progresiva y a la influencia del Pragmatismo. Al haberse preparado originalmente en forma de conferencia, el texto contiene varias lagunas en el tratamiento de estos temas. Este artículo busca llenar estos vacíos a través de fuentes historiográficas con el propósito de mostrar que Arendt selecciona ciertos hechos para construir una situación retórica - definida como una situación problemática que capta la atención de la opinión pública - a la que el ensayo es una respuesta argumentativa. El artículo concluye que el objetivo de “La crisis en la educación” no es discutir la historia de la educación, sino las relaciones entre adultos y niños en la sociedad contemporánea, tema que debe ser analizado a la luz de conceptos arendtianos.

Resumo O ensaio de Hannah Arendt intitulado “A crise na educação”, publicado na década de 1950, atribui o fracasso da educação escolar nos Estados Unidos à corrente educacional denominada educação progressiva e à influência do Pragmatismo. Por ser elaborado originalmente na forma de conferência, o texto contém várias lacunas no tratamento desses temas. Este artigo procura suprir tais lacunas por meio de fontes historiográficas com o propósito de mostrar que Arendt seleciona determinados fatos para construir uma situação retórica - definida como uma situação problemática que chama a atenção da opinião pública - para a qual o ensaio é uma resposta argumentativa. O artigo conclui que o objetivo de “A crise na educação” não é discorrer sobre a história da educação, mas sobre as relações entre adultos e crianças na sociedade contemporânea, assunto que deve ser analisado à luz dos conceitos arendtianos.

Abstract Context: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. Objectives: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. Design: This was a longitudinal, prospective and controlled trial study. Methods: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) – 17 non-athlete and untrained UTA and Group 2 (G2) – 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. Results: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. Conclusion: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.

ABSTRACT Differential diagnosis of coronavirus disease 2019 (COVID-19) from other febrile diseases is one of several challenges imposed by the pandemic. We present a case of severe malaria and COVID-19 coinfection in a non-malaria-endemic region. A 44-year-old female with malaise, fever, hypotension, jaundice, and enlarged liver and spleen was admitted to the intensive care unit. Reverse transcription-quantitative PCR results for severe acute respiratory syndrome coronavirus 2 were positive. Rapid tests, microscopy, and quantitative PCR were positive for Plasmodium vivax. Cytokine storm profiles were identified. We could not determine whether the severe vivax malaria in our patient was triggered by COVID-19 coinfection.

Abstract The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

ABSTRACT Objective Compare the results of medial unicompartmental knee arthroplasty (UKA) using a mobile platform and total knee arthroplasty (TKA) in patients with isolated medial osteoarthritis. Methods Retrospectivecross-sectional study. Preoperative radiographs of 602 patientswho underwent knee arthroplastybetween February 2017 and February 2020 were evaluated. Isolated medial osteoarthritis was found in 125 patients. Of these, 57 underwent UKA and 68 TKA. With chart analysis and telephone interviews, we compared patients’ clinical outcomes and degree of satisfaction. The statistical analysis used a confidence level of 5%. Results The group of UKA patients obtained 65.8% of favorable results against 79.1% of those undergoing TKA in the function questionnaire (p<0.0001). The complication rate was statistically similar between the groups(p>0.5). Most patients were satisfied or very satisfied in both groups (88.6% of UKA and 91.2% of TKA) (p>0.999). Conclusion Patients submitted to UKA or TKA have presented the same degree of satisfaction and rate of postoperative complications when comparing patients with isolated medial osteoarthritis. UKA patients had less favorable results onthe clinical functional questionnaire than patients undergoing total arthroplasty. Level Of Evidence III;Retrospective Study.

RESUMO Objetivo Comparar os resultados da artroplastia unicompartimental do joelho (UKA) medial com plataforma móvel e artroplastia total do joelho (TKA) em pacientes com osteoartrose medial isolada. Métodos Estudo transversal retrospectivo. Foram avaliadas radiografias pré-operatórias de 602 pacientes submetidos à artroplastia de joelho entre fevereiro de 2017 e fevereiro de 2020. A osteoartrose medial isolada foi encontrada em 125 pacientes, destes em 57 haviam sido submetidos a UKA e 68 TKA. Com análise de prontuários e entrevistas telefônicas comparamos os resultados clínicos e o grau de satisfação dos pacientes. A análise estatística utilizou nível de confiança de 5%. Resultados O grupo de pacientes com UKA obteve 65,8% de resultados favoráveis contra 79,1% daqueles submetidos à TKA no questionário de função (p<0,0001). A taxa de complicações foi estatisticamente semelhante entre os grupos (p>0,5). A maioria dos pacientes estava satisfeita ou muito satisfeita em ambos os grupos (88,6% de UKA e 91,2% de TKA) (p>0,999). Conclusão Pacientes submetidos a UKA ou TKA apresentaram o mesmo grau de satisfação e taxa de complicações pós-operatórias quando comparados pacientes com osteoartrite medial isolada. Os pacientes da UKA apresentaram resultados menos favoráveis ao questionário clínico funcional do que os pacientes submetidos à artroplastia total. Nível de Evidência III; Estudo Retrospectivo.

ABSTRACT Echocardiography in critically ill patients has become essential in the evaluation of patients in different settings, such as the hospital. However, unlike for other matters related to the care of these patients, there are still no recommendations from national medical societies on the subject. The objective of this document was to organize and make available expert consensus opinions that may help to better incorporate echocardiography in the evaluation of critically ill patients. Thus, the Associação de Medicina Intensiva Brasileira, the Associação Brasileira de Medicina de Emergência, and the Sociedade Brasileira de Medicina Hospitalar formed a group of 17 physicians to formulate questions relevant to the topic and discuss the possibility of consensus for each of them. All questions were prepared using a five-point Likert scale. Consensus was defined a priori as at least 80% of the responses between one and two or between four and five. The consideration of the issues involved two rounds of voting and debate among all participants. The 27 questions prepared make up the present document and are divided into 4 major assessment areas: left ventricular function, right ventricular function, diagnosis of shock, and hemodynamics. At the end of the process, there were 17 positive (agreement) and 3 negative (disagreement) consensuses; another 7 questions remained without consensus. Although areas of uncertainty persist, this document brings together consensus opinions on several issues related to echocardiography in critically ill patients and may enhance its development in the national scenario.

RESUMO A ecocardiografia do paciente grave tem se tornado fundamental na avaliação de pacientes em diferentes cenários e ambientes hospitalares. Entretanto, ao contrário de outras áreas relativas ao cuidado com esses pacientes, ainda não existem recomendações de sociedades médicas nacionais acerca do assunto. O objetivo deste documento foi organizar e disponibilizar opiniões de consenso de especialistas que possam auxiliar a melhor incorporação dessa técnica na avaliação de pacientes graves. Dessa forma, a Associação de Medicina Intensiva Brasileira, a Associação Brasileira de Medicina de Emergência e a Sociedade Brasileira de Medicina Hospitalar compuseram um grupo de 17 médicos para formular questões pertinentes ao tópico e debater a possibilidade de consenso de especialistas para cada uma delas. Todas as questões foram elaboradas no formato de escala Likert de cinco pontos. Consenso foi definido, a priori, como um somatório de, ao menos, 80% das respostas entre um e dois ou entre quatro e cinco. A apreciação das questões envolveu dois ciclos de votação e debate entre todos os participantes. As 27 questões elaboradas compõem o presente documento e estão divididas em 4 grandes áreas de avaliação: da função ventricular esquerda; da função ventricular direita; diagnóstica dos choques e hemodinâmica. Ao fim do processo, houve 17 consensos positivos (concordância) e 3 negativos (discordância); outras 7 questões persistiram sem consenso. Embora persistam áreas de incerteza, este documento reúne opiniões de consenso para diversas questões relativas à ecocardiografia do paciente grave e pode potencializar seu desenvolvimento no cenário nacional.