ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.

ABSTRACT Introduction: Overweight and obesity are public health problems worldwide. Alcoholic beverages could increase total energy intake causing an increase in body weight. However, few authors have pointed out the association between this habit and excess weight in this population. The objective of this study was to determine the association between alcohol consumption and excess weight in university students from 10 Latin American countries during the COVID-19 pandemic. Methodology: A cross-sectional and multicenter study was carried out with 4,539 university students enrolled in ten Latin American countries. To assess alcohol consumption, the question Do you consume alcoholic beverages? (1 portion 1 glass of 200 ml). Body mass index (BMI) kg/m2 was determined from self-reported weight and height. To determine if excess weight was associated with alcohol consumption, a logistic regression analysis was used, adjusted for age, sex, year of study, socioeconomic level, physical activity, and smoking. Results: Among students with normal nutritional status, 59.6% did not consume alcohol, while among those with a BMI ≥25 kg/m2 it was 55.1%. Students who consumed 2 or more servings of alcohol per day had a 2.18 times greater risk of being overweight (OR: 2.18 [95% CI: 1.26 to 3.77]), compared with those who did not consume alcohol. Conclusion: It was observed that those students who consumed more alcohol were more likely to be overweight.

RESUMEN Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso.

Abstract This study aimed to use the petiole residues of miriti to partially replace pine wood and evaluate the effects of this incorporation on the physical and mechanical properties of the particleboards. Panels were produced with 0, 25, 50, and 75% of miriti in partial replacement of wood and 12% of urea-formaldehyde adhesive. The chemical-physical properties of miriti residues showed potential particleboard production as they were similar to those of pinewood. For the physical properties, the panels were classified as low density. There was an increase in the compression ratio and, consequently, in the hygroscopicity . For the mechanical properties, it was observed that the modulus of elasticity (MOE) and modulus of rupture (MOR) did not show any statistical differences. For perpendicular traction (PT), there was a significant reduction in 50%. Considering a general analysis of the physical and mechanical properties, up to 40% of mirti can be substituted, as in this situation they meet the properties mentioned in CS-236-66, except for PT for commercialization of the panels.

Resumo O objetivo deste trabalho foi utilizar os resíduos do pecíolo do miriti em substituição parcial da madeira de pinus e avaliar os efeitos dessa incorporação nas propriedades físicas e mecânicas dos painéis aglomerados. Os painéis foram produzidos com 0, 25, 50 e 75% de miriti em substituição parcial de madeira e 12% de adesivo uréia-formaldeído. As propriedades físico-químicas dos resíduos de miriti mostraram potencial de produção de aglomerados, uma vez que foram semelhantes às do pinus. Quanto às propriedades físicas, os painéis foram classificados como de baixa densidade. Houve aumento na taxa de compressão e, consequentemente, na higroscopicidade. Para as propriedades mecânicas, observou-se que o módulo de elasticidade (MOE) e o módulo de ruptura (MOR) não houve diferença estatística. Para tração perpendicular (TP) houve redução significativa de 50%. Considerando uma análise geral das propriedades físicas e mecânicas, é possível uma substituição em até 40% de miriti, pois nessa situação atendem as propriedades mencionadas na CS-236-66, com exceção da TP para a comercialização dos painéis.

Abstract The study aimed to evaluate relative validity and reproducibility of seven WHO indicators of dietary practices in children aged 6-23.9 months. Data from probabilistic sample of children who used primary healthcare services in Rio de Janeiro, Brazil were collected using a 24h dietary recall (24HR) and a closed questionnaire (Q1) on feeding in the day before the study. The last one was reapplied (Q2) around 16 days later. Validity was assessed by comparing the prevalence rates estimated by 24HR and Q1 and calculating the positive (PPV) and negative (NPV) predictive values, sensitivity (Se), specificity (Sp), and accuracy index (AI) for the resulting indicators. For reproducibility, estimated prevalence rates based on Q1 and Q2 were compared and the kappa index and prevalence-adjusted bias-adjusted kappa were estimated. Of the seven estimated indicators, the prevalence of two was overestimated (Continued breastfeeding: 50.0% vs 40.0%; Sweet beverage consumption: 65.1% vs 52.7%) and the prevalence of one was underestimated (Zero vegetable or fruit consumption: 6.5% vs 18.1%). For most indicators, Se and PPV were higher than Sp and NPV. The prevalence rates determined with Q1 and Q2 were similar for 6 indicators. More than half showed good, very good or excellent agreement.

Resumo O estudo avaliou a validade relativa e a reprodutibilidade de sete indicadores da OMS sobre alimentação de crianças de 6-23,9 meses. Dados de amostra probabilística de usuários de serviços básicos de saúde na cidade do Rio de Janeiro, Brasil, foram coletados por meio de recordatório alimentar de 24 horas (R24h) e questionário fechado (Q1) sobre alimentação no dia anterior ao estudo. Este último foi reaplicado (Q2) em torno de 16 dias depois. A validade foi avaliada comparando-se as prevalências estimadas pelo R24h e Q1 e calculando-se os valores preditivos positivo (VPP) e negativo (VPN), sensibilidade (Se), especificidade (Esp) e índice de acurácia (IA) dos indicadores resultantes. Para reprodutibilidade, as prevalências estimadas com base em Q1 e Q2 foram comparadas e estimados o índice kappa e o kappa ajustado pela prevalência. Dos sete indicadores estimados, houve superestimação da prevalência de dois (aleitamento continuado: 50,0% versus 40,0%; consumo de bebidas adoçadas: 65,1% vs. 52,7%) e subestimação da prevalência de um (não consumo de frutas e hortaliças: 6,5% vs. 18,1%). Para a maioria deles, Se e VPP foram maiores do que Esp e VPN. As prevalências determinadas com Q1 e Q2 foram semelhantes para seis indicadores. Mais da metade dos indicadores apresentaram concordância boa, muito boa ou excelente.

Abstract Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rare neurodegenerative genetic disease that affects children in early life. Its classic form is rapidly progressive, leading to death within the first 10 years. The urge for earlier diagnosis increases with the availability of enzyme replacement therapy. A panel of nine Brazilian child neurologists combined their expertise in CLN2 with evidence from the medical literature to establish a consensus to manage this disease in Brazil. They voted 92 questions including diagnosis, clinical manifestations, and treatment of the disease, considering the access to healthcare in this country. Clinicians should suspect CLN2 disease in any child, from 2 to 4 years old, with language delay and epilepsy. Even though the classic form is the most prevalent, atypical cases with different phenotypes can be found. Electroencephalogram, magnetic resonance imaging, molecular and biochemical testing are the main tools to investigateand confirm the diagnosis. However, we have limited access to molecular testing in Brazil, and rely on the support from the pharmaceutical industry. The management of CLN2 should involve a multidisciplinary team and focus on the quality of life of patients and on family support. Enzyme replacement therapy with Cerliponase α is an innovative treatment approved in Brazil since 2018; it delays functional decline and provides quality of life. Given the difficulties for the diagnosis and treatment of rare diseases in our public health system, the early diagnosis of CLN2 needs improvement as enzyme replacement therapy is available and modifies the prognosis of patients.

Resumo Lipofuscinose ceróide neuronal (CLN2) é uma doença genética neurodegenerativa rara que afeta crianças nos primeiros anos de vida. A sua forma clássica é rapidamente progressiva, levando à morte nos primeiros 10 anos. A necessidade de um diagnóstico precoce aumenta com a disponibilidade do tratamento de terapia enzimática. Um painel de nove neurologistas infantis brasileiros combinou sua experiência em CLN2 com evidências da literatura médica para estabelecer um consenso no manejo desta doença no Brasil. Eles votaram 92 questões abordando diagnóstico, manifestações clínicas e tratamento, considerando o acesso à saúde no Brasil. Deve-se suspeitar de CLN2 em qualquer criança de 2 a 4 anos de idade que apresente atraso de linguagem e epilepsia. Apesar da forma clássica ser a mais prevalente, podem ser encontrados casos atípicos com diferentes fenótipos. Eletroencefalograma, ressonância magnética, testes moleculares e bioquímicos são as principais ferramentas para investigar e confirmar o diagnóstico. No entanto, o acesso aos testes moleculares é limitado no Brasil, necessitando contar com o apoio da indústria farmacêutica. O manejo da CLN2 deve envolver uma equipe multidisciplinar e focar na qualidade de vida dos pacientes e no apoio familiar. A terapia de reposição enzimática com Cerliponase alfa é um tratamento inovador aprovado no Brasil desde 2018; ele retarda o declínio funcional e proporciona qualidade de vida. Diante das dificuldades para o diagnóstico e tratamento de doenças raras em nosso sistema público de saúde, o diagnóstico precoce de CLN2 precisa de melhorias pois a terapia de reposição enzimática está disponível e modifica o prognóstico dos pacientes.

Abstract: This work aimed to evaluate the physical-mechanical properties of Pinus oocarpa wood agglomerated panels produced with different levels (0 %, 25 %, 50 %, 75 % and 100 %) of wood replacement with bean residues. For this purpose, Pinus oocarpa wood and the agricultural residue were reduced into particles and their properties of apparent density, extractives, lignin and ash content of these raw materials were determined. Then, the particles were dried to a 3 % humidity and granulometrically selected to produce panels with a density of 0,60 g/cm3. These particles were bonded using 12 % urea-formaldehyde adhesive, pressed, following normative dimensions (250 mm x 250 mm x 15 mm (width, length, and thickness)), and kept in a climate-controlled environment (20 ºC ± 2 ºC and 65 % ± 5 % RH) until the physical and mechanical tests were carried out. The research results indicated that the particles from bean residues in comparison with Pinus oocarpa wood, presented low density, lignin and holocellulose values, and higher extractives data. Furthermore, regarding the characterization of the panels, there was a trend towards uniformity in the apparent density values, an increase in the properties of compact ratio, water absorption and thickness swelling, and a decrease in their mechanical properties associated with the increase in the by-product addition to the panels. Therefore, new studies are necessary, seeking a larger study and greater knowledge of the addition effects of bean residues in particulate panels, aiming the dissemination of this sustainable process on large scale.

ABSTRACT OBJETIVE To map the international literature on Permanent Health Education initiatives to care for people with obesity. METHODS In total, six databases were searched without any language or publication period restriction according to the Joana Briggs Institute manual for evidence synthesis and the Prisma extension for scoping reviews (Prisma-ScR). Articles were independently analyzed by four reviewers and data, by two authors, which were then analyzed and discussed with our research team. RESULTS After screening 8,780 titles/abstracts and 26 full texts, 10studies met our eligibility criteria. We extracted data on methodologies, themes, definitions of obesity, outcomes, and gaps. Most initiatives came from North American countries without free or universal health systems and lasted a short period of time (70%), had multidisciplinary teams (70%), and addressed sub-themes on obesity approaches (90%). Results included changes in participants’ understanding, attitude, and procedures (80%) and gaps which pointed to the sustainability of these changes (80%). CONCLUSION This review shows the scarce research in the area and a general design of poorly effective initiatives, with traditional teaching methodologies based on information transmission techniques, the understanding of obesity as a disease and a public health problem, punctual actions, disciplinary fragmentation alien to the daily work centrality, and failure to recognize problems and territory as knowledge triggers and to focus on health care networks, line of care, the integrality of care, and food and body cultures.

Abstract The study aimed to evaluate relative validity and reproducibility of seven WHO indicators of dietary practices in children aged 6-23.9 months. Data from probabilistic sample of children who used primary healthcare services in Rio de Janeiro, Brazil were collected using a 24h dietary recall (24HR) and a closed questionnaire (Q1) on feeding in the day before the study. The last one was reapplied (Q2) around 16 days later. Validity was assessed by comparing the prevalence rates estimated by 24HR and Q1 and calculating the positive (PPV) and negative (NPV) predictive values, sensitivity (Se), specificity (Sp), and accuracy index (AI) for the resulting indicators. For reproducibility, estimated prevalence rates based on Q1 and Q2 were compared and the kappa index and prevalence-adjusted bias-adjusted kappa were estimated. Of the seven estimated indicators, the prevalence of two was overestimated (Continued breastfeeding: 50.0% vs 40.0%; Sweet beverage consumption: 65.1% vs 52.7%) and the prevalence of one was underestimated (Zero vegetable or fruit consumption: 6.5% vs 18.1%). For most indicators, Se and PPV were higher than Sp and NPV. The prevalence rates determined with Q1 and Q2 were similar for 6 indicators. More than half showed good, very good or excellent agreement.

Resumo O estudo avaliou a validade relativa e a reprodutibilidade de sete indicadores da OMS sobre alimentação de crianças de 6-23,9 meses. Dados de amostra probabilística de usuários de serviços básicos de saúde na cidade do Rio de Janeiro, Brasil, foram coletados por meio de recordatório alimentar de 24 horas (R24h) e questionário fechado (Q1) sobre alimentação no dia anterior ao estudo. Este último foi reaplicado (Q2) em torno de 16 dias depois. A validade foi avaliada comparando-se as prevalências estimadas pelo R24h e Q1 e calculando-se os valores preditivos positivo (VPP) e negativo (VPN), sensibilidade (Se), especificidade (Esp) e índice de acurácia (IA) dos indicadores resultantes. Para reprodutibilidade, as prevalências estimadas com base em Q1 e Q2 foram comparadas e estimados o índice kappa e o kappa ajustado pela prevalência. Dos sete indicadores estimados, houve superestimação da prevalência de dois (aleitamento continuado: 50,0% versus 40,0%; consumo de bebidas adoçadas: 65,1% vs. 52,7%) e subestimação da prevalência de um (não consumo de frutas e hortaliças: 6,5% vs. 18,1%). Para a maioria deles, Se e VPP foram maiores do que Esp e VPN. As prevalências determinadas com Q1 e Q2 foram semelhantes para seis indicadores. Mais da metade dos indicadores apresentaram concordância boa, muito boa ou excelente.

ABSTRACT Despite the increasing use of plaster as a construction material, due to its numerous advantages when compared to cement, its use is still restricted, because of its low mechanical resistance and high solubility in water. In this context, research has been carried out related to the addition of nanomaterials to improve the mechanical and physical properties of plaster in civil construction. A highly available, low-cost nanomaterial with excellent properties is nanotalc. In this work, nanocomposites with dimensions of 40 × 40 × 160 mm were produced with ultrafine micronized nanotalc replacing plaster in proportions of 0%; 0.5%; 1%; 1.5% and 2%. The physical and mechanical properties of the nanocomposites were evaluated according to standards. The nanocomposites produced with 1% nanotalc showed satisfactory results for physical and mechanical properties, with an increase of 1.8% in apparent density and 24.12% in compressive strength, and a decrease in water absorption of 6.23%, compared to the composite without the incorporation of nanotalc. The production of nanocomposites with the incorporation of 1% nanotalc is viable and shown to be promising, presenting potential for application as linings and internal partitions, since they showed low water absorption due to the hydrophobicity of nanotalc.

Abstract This article presents evidences that there is an ongoing cycle of evictions in the Tucunduba River basin, in the Brazilian city of Belém (PA), where urbanization work has been taken place over several years, which has caused an increasing number of displaced families. It is understood that the housing provision shortage has led to an increase in cases of judicialization, which thereby contributes to further irregular occupations and, thus, a continuation of precariousness and informality. The reasons that contribute to the situation have been classified into four groups: operational/planning; political/administrative; ideological; and extra-legal. Empirical and documentary sources, interviews with technicians from public bodies and with the population threatened by eviction, and an analysis of the judicial processes demonstrate that while evictions intensify the condition of vulnerability of the families, they also serve to maintain structures that support peripheral capitalism.

Resumo Este artigo apresenta evidências de que existe um ciclo de remoções em curso na Bacia do Tucunduba, em Belém (PA), onde obras de urbanização se prolongam há anos, implicando um número crescente de famílias deslocadas. Compreende-se que a falta de provisão habitacional para as famílias removidas a partir de casos judicializados colabora para que novas ocupações irregulares ocorram e para que a precariedade e a informalidade se perpetuem. Os fatores que contribuem para a construção desse quadro foram organizados em quatro grupos: operacionais/de planejamento; político/administrativos; ideológicos; e extralegais. Fontes empíricas e documentais, entrevistas com técnicos de órgãos públicos e com a população ameaçada de remoção e análises de processos judiciais mostram que as remoções, ao mesmo tempo que aprofundam a condição de vulnerabilidade das famílias, servem para manter estruturas funcionais para a periferia do capitalismo.

ABSTRACT OBJETIVE To map the international literature on Permanent Health Education initiatives to care for people with obesity. METHODS In total, six databases were searched without any language or publication period restriction according to the Joana Briggs Institute manual for evidence synthesis and the Prisma extension for scoping reviews (Prisma-ScR). Articles were independently analyzed by four reviewers and data, by two authors, which were then analyzed and discussed with our research team. RESULTS After screening 8,780 titles/abstracts and 26 full texts, 10studies met our eligibility criteria. We extracted data on methodologies, themes, definitions of obesity, outcomes, and gaps. Most initiatives came from North American countries without free or universal health systems and lasted a short period of time (70%), had multidisciplinary teams (70%), and addressed sub-themes on obesity approaches (90%). Results included changes in participants’ understanding, attitude, and procedures (80%) and gaps which pointed to the sustainability of these changes (80%). CONCLUSION This review shows the scarce research in the area and a general design of poorly effective initiatives, with traditional teaching methodologies based on information transmission techniques, the understanding of obesity as a disease and a public health problem, punctual actions, disciplinary fragmentation alien to the daily work centrality, and failure to recognize problems and territory as knowledge triggers and to focus on health care networks, line of care, the integrality of care, and food and body cultures.

ABSTRACT Objective: To measure the prognostic value of peripheral ischemic microvascular reserve in the context of persistent sepsis-induced hyperlactatemia and measure its influence on the temporal dynamics of lactate and the strength of association between these variables. Methods: This post hoc analysis of the peripheral perfusion index/postocclusive reactive hyperemia trial, an observational cohort study that enrolled patients with sepsis who persisted with lactate levels ≥ 2mmol/L after fluid resuscitation (with or without shock). Peripheral ischemic microvascular reserve was evaluated using the association of the peripheral perfusion index and postocclusive reactive hyperemia techniques. The cutoff point of ∆ peripheral perfusion index peak values (%) defined the groups with low (≤ 62%) and high peripheral ischemic microvascular reserve (> 62%). Results: A total of 108 consecutive patients with persistent sepsis-induced hyperlactatemia were studied. The high peripheral ischemic microvascular reserve group showed higher 28-day mortality than the low peripheral ischemic microvascular reserve group (p < 0.01). The temporal dynamics of lactate within the first 48 hours showed a rapid decrease in lactate levels in the low peripheral ischemic microvascular reserve group (p < 0.01). However, this result was not reproduced in the linear mixed effects model. A weak correlation between peripheral ischemic microvascular reserve (%) and lactate level (mmol/L) was observed within the first 24 hours (r = 0.23; p < 0.05). Conclusion: The prognostic value of high peripheral ischemic microvascular reserve was confirmed in the context of persistent sepsis-induced hyperlactatemia. Although there was a weak positive correlation between peripheral ischemic microvascular reserve value and lactate level within the first 24 hours of sepsis diagnosis, the low peripheral ischemic microvascular reserve group appeared to have a faster decrease in lactate over the 48 hours of follow-up.

RESUMO Objetivo: Avaliar o valor prognóstico da reserva microvascular isquêmica periférica no contexto da hiperlactatemia persistente induzida pela sepse, determinar sua influência na dinâmica temporal de lactato e analisar a força da associação entre essas variáveis. Métodos: Análise post hoc do estudo de índice de perfusão periférica/hiperemia reativa pós-oclusiva caracterizada por uma coorte observacional que incluiu pacientes com sepse que persistiram com níveis de lactato ≥ 2mmol/L após a ressuscitação volêmica (com ou sem choque). A reserva microvascular isquêmica periférica foi mensurada utilizando-se a associação dos métodos do índice de perfusão periférica e hiperemia reativa pós-oclusiva. O ponto de corte dos valores da ∆ índice de perfusão periférica de pico (%) definiu os grupos com baixa (≤ 62%) e alta (> 62%) reserva microvascular isquêmica periférica. Resultados: Estudaram-se 108 pacientes consecutivos com hiperlactatemia persistente induzida pela sepse. O grupo com alta reserva microvascular isquêmica periférica apresentou maior mortalidade aos 28 dias em relação ao grupo com baixa reserva microvascular isquêmica periférica (p < 0,01). A dinâmica temporal de lactato nas primeiras 48 horas mostrou redução rápida dos níveis de lactato no grupo com baixa reserva microvascular isquêmica periférica (p < 0,01). No entanto, esse resultado não foi reproduzido no modelo de efeitos mistos lineares. Observou-se fraca correlação (%) entre os valores da reserva microvascular isquêmica periférica e níveis de lactato (mmol/L) nas primeiras 24 horas (r = 0,23; p < 0,05). Conclusão: O valor prognóstico da alta reserva microvascular isquêmica periférica foi confirmado no contexto da hiperlactatemia persistente induzida por sepse. Embora tenha sido observada uma baixa correlação positiva entre os valores da reserva microvascular isquêmica periférica e os níveis de lactato nas primeiras 24 horas do diagnóstico de sepse, o grupo com baixa reserva microvascular isquêmica periférica pareceu apresentar redução mais rápida do lactato nas 48 horas de seguimento.

RESUMO Objetivo: Avaliar possíveis mecanismos atribuídos ao valor prognóstico da reserva microvascular isquêmica periférica em pacientes com sepse. Métodos: Este estudo de coorte observacional incluiu 46 pacientes consecutivos com sepse em uma unidade de terapia intensiva entre novembro de 2020 e outubro de 2021. Após a ressuscitação volêmica com fluidos, avaliou-se a reserva microvascular isquêmica periférica mediante a associação dos testes hiperemia reativa pós-oclusão e índice de perfusão periférica. Adicionalmente, amostras de sangue venoso periférico foram coletadas para avaliar os níveis dos neuropeptídeos substância P e peptídeo relacionado ao gene da calcitonina no membro superior do paciente antes e imediatamente após o teste de hiperemia reativa pós-oclusão. Resultados: Não houve correlação estatisticamente significativa (p > 0,05) entre os valores basais ou variações dos níveis de neuropeptídeos e a reserva microvascular isquêmica periférica. Conclusão: Embora o peptídeo relacionado ao gene da calcitonina e a substância P possam desempenhar papel prognóstico na sepse, esses neuropeptídeos não parecem contribuir para a reserva microvascular isquêmica periférica.

ABSTRACT Objective: To evaluate the mechanisms attributed to the prognostic value of peripheral ischemic microvascular reserve in patients with sepsis. Methods: This observational cohort study enrolled 46 consecutive septic patients in the intensive care unit between November 2020 and October 2021. After fluid resuscitation, the peripheral ischemic microvascular reserve was evaluated using the association of postocclusion reactive hyperemia with the peripheral perfusion index. Additionally, peripheral venous blood samples were used to evaluate the neuropeptide calcitonin gene-related peptide and substance P levels in the upper limb before and immediately after postocclusion reactive hyperemia Results: There was no statistically significant correlation (p > 0.05) between basal values (pg/mL) or variations from neuropeptide levels (%) and the peripheral ischemic microvascular reserve (%). Conclusion: Although calcitonin gene-related peptide and substance P may have a prognostic role in sepsis, these neuropeptides do not appear to contribute to peripheral ischemic microvascular reserve.

Abstract The Environmental Planning studies of the Territory (EPeT) provide a zoning model and at the same time a tool that demands the territorial planning process to articulate policies and planning actions compatible with the expectations of sustainability. In order to delimit and describe “environmental systems” (EPeT) of the Upper Arroyo Tandileofú Basin (study area), a work was carried out supported by soil cartography. For this work a methodological sequence was followed developing intermediate thematic maps up to the Environmental Planning studies of the Territory map that integrated the previous ones. The methodological sequence began with the Superficial Morphological Zoning, followed by the Edaphic Zoning. These maps derived from the Morphoedáphic Zoning. The latter map was correlated with vegetation, getting the Morpho-Phytoedic Zoning or Ecological Zoning. Then the Current Land Use (CLU) was incorporated. This made it possible to analyze the relationship between society and nature in the study area and to identify possible environmental problems derived from this relationship, and prepare the (EPeT) map of the study area. The results obtained: -made it possible to interpret the internal heterogeneity of the ecological-landscape systems and obtain 7 ecological subsystems; -the (CLU) study and mapping showed that the lands are mainly occupied by mixed crop-livestock farming (46,4%), crop activity (31,3%) and dairy farm activity (12.4%); -with the (EPeT) of study area they were obtained 16 types of cartographic units that describe territorial entities with ecological restrictions and potentialities, with the spatial structure and functions of types and forms of the (CLU). In conclusion, it is possible to infer and correlate topographic-landscape information by analyzing the soil cartography and the information of each system and subsystem represented, and the methodology highlights the use of resources and products that arise from Cartographic Science in territorial management and planning tasks.

Resumen Los estudios de Ordenación Ambiental del Territorio (OAT) constituyen un modelo de zonificación y a la vez una herramienta que demanda el proceso de ordenación territorial para articular políticas y acciones de planeamiento compatibles con las expectativas del desarrollo sustentable. Con el fin de delimitar y describir “sistemas ambientales” de la OAT de la Cuenca Superior del Arroyo Tandileofú (CSAT) se siguió una secuencia metodológica, apoyada en cartografía de suelos, mediante la cual se elaboraron mapas temáticos intermedios y un mapa de OAT que integra los anteriores. La secuencia comenzó con la Zonificación Morfológica Superficial, a lo que le sucedió la Zonificación Edáfica derivando en la Zonificación Morfoedáfica; a esta última, se la correlacionó con la vegetación, resultando el mapa de Zonificación Morfo-FitoEdáfica o Zonificación Ecológica; luego, se incorporó el Uso Actual de las Tierras (UAT), lo que permitió analizar las relaciones sociedad-naturaleza en la CSAT e identificar potenciales problemas ambientales producto de esta relación y elaborar el mapa de OAT de la CSAT. Los resultados obtenidos posibilitaron interpretar la heterogeneidad interna de los sistemas ecológico-paisajísticos y obtener siete subsistemas ecológicos; el estudio y mapeo del UAT demostró que las tierras están principalmente ocupadas por actividades agropecuarias mixtas (46,4%), agrícolas (31,3%) y tamberas (12,4%); la OAT de la Cuenca permitió obtener 16 tipos de unidades cartográficas que describen entidades territoriales con restricciones y potencialidades ecológicas de cada paisaje/sitio, con la estructura espacial y funciones de tipos y formas del UAT. A modo de conclusión, es posible inferir y correlacionar la información topográfico-paisajística analizando las cartas de suelos y las descripciones de cada sistema y subsistema representados en ellas; la metodología propuesta enfatiza y pone en valor el uso de los recursos y productos que surgen de la Ciencia Cartográfica en las tareas de gestión y planificación territorial.