Abstract Inflammatory bowel disease (IBD) is a problem that directly affects the quality of life of patients suffering from this condition. Monitoring the serum level of infliximab (IFX) (TDM) is an important tool for guiding therapeutic decisions in IBD patients. The purpose of this study was to determine the significance of quantitatively measuring the serum level of IFX (TDM) and antibody to IFX (ATI). Methods and materials: Prospective observational study involving 40 IBD patients on IFX therapy, including 14 Proactive (week 06 of the induction phase) and 26 Reactive (maintenance phase). Immediately prior to the infusion, blood samples were drawn and measured using a Bulhlmann rapid test instrument. Serum concentrations of IFX were categorized as supratherapeutic (>7.0 micrograms/ml), therapeutic (between 3.0 and 7.0 micrograms/ml), and subtherapeutic (3.0 micrograms/ml). When the serum concentration of IFX was 3 mcg/ml (subtherapeutic), the ATI was measured. 25 patients with CD and 15 patients with UC were evaluated. Only three of the twenty patients with subtherapeutic serum levels had a positive ATI, and both were reactive; two had CD and one had UC. There was a statistically significant difference between reactive and proactive patients with respect to levels of CRP (p = 0.042), with proactive DNS patients suffering greater alterations in CRP and albumin.

RESUMEN Las dos primeras décadas del siglo XXI en Brasil se caracterizaron por un aumento de la participación salarial, que estuvo asociado en gran medida al mayor poder de negociación de los trabajadores resultante de los cambios institucionales y de la reducción del desempleo. Mostramos que el sector extranjero también desempeñó un papel clave en este proceso y exploramos cómo cambiaron sus efectos sobre la distribución del ingreso interno a lo largo de los años. Destacamos la importancia de la industria y, en particular, del sector manufacturero en la mayor participación salarial. En el inicio del periodo la moneda nacional depreciada no comprometió la participación de los beneficios debido al bajo poder de negociación de los trabajadores, mientras que durante los años de moneda nacional apreciada el conflicto distributivo se atenuó. Sin embargo, la depreciación de la moneda después de 2011 se produjo en una estructura económica más dependiente de las importaciones y con un alto poder de negociación de los trabajadores, presionando a la baja los márgenes de beneficio.

ABSTRACT The first two decades of the 21stcentury in Brazil were characterized by an increase in the wage share, which was largely associated with the higher workers’ bargaining power that resulted from institutional changes and lower unemployment. We show that the foreign sector also played a key role in this process and explore how its effects on the domestic income distribution changed over the years. We highlight the importance of the industry and, in particular, the manufacturing sector to the higher wage share. At the beginning of the period the depreciated domestic currency did not compromise the profit share due to the low bargaining power of workers, while during the years of appreciated domestic currency the distributive conflict was attenuated. Yet, the currency depreciation after 2011 occurred in an economic structure more dependent on imports and with high workers’ bargaining power, thus pressuring downwards profit margins.

ABSTRACT Tahiti lime is a species of great economic importance worldwide. In Brazil, production is concentrated in the states of São Paulo and Pará, where it is usually grafted onto the Rangpur lime. This study aimed to analyze the effects of different irrigation depths on the fruit yield, phenology, and gas exchange of Tahiti lime trees grafted onto Swingle citrumelo. Irrigation was performed during the first year at four different irrigation depths in a random block design with five blocks and four treatments to maintain the soil matric potential in the following ranges: T1: below -50 kPa, T2: from -30 to -50 kPa, T3: from -10 to -30 kPa, and T4: above -10 kPa. The flowering, carbon assimilation rate (A), stomatal conductance (gs), transpiration (E), and fruit yield were measured. Fruits were harvested earlier in the most irrigated treatment, T4, and the yield increased from 2.22 to 6.89 kg per plant from T1 to T4. The average fruit weight escalated from 78.6 to 96.1 g from T1 to T4, and carbon assimilation increased from 6.89 to 9.51 μmol CO2m-2s-1 from T1 to T4.

RESUMO A lima ácida Tahiti é uma espécie de grande importância econômica em todo o mundo. Em território brasileiro, a produção concentra-se nos estados de São Paulo e Pará, onde geralmente é enxertada em limão-cravo. Este estudo tem como objetivo analisar o efeito de diferentes lâminas de irrigação na produção de frutos, fenologia e trocas gasosas de lima ácida Tahiti enxertada em citrumelo Swingle. A irrigação foi realizada durante o primeiro ano, com quatro lâminas de irrigação diferentes em um delineamento de blocos ao acaso com 5 blocos e 4 tratamentos, para manter o potencial matricial do solo nas seguintes faixas: T1: abaixo de -50 kPa, T2: de -30 a -50 kPa , T3: de -10 a -30 kPa e T4: acima de -10 kPa. Foram medidos florescimento, taxa de assimilação de carbono (A), condutância estomática (gs), transpiração (E) e produção de frutos. Os frutos foram colhidos mais cedo no tratamento mais irrigado, T4, e a produtividade aumentou de 2,22 para 6,89 kg por planta de T1 para T4. O peso médio dos frutos aumentou de 78,6 para 96,1 g de T1 para T4. A assimilação de carbono aumentou de 6,89 para 9,51 μmol CO2 m-2 s-1 de T1 para T4.

ABSTRACT Children have an increased likelihood of becoming carriers of the chronic hepatitis B virus. A total of 1,381 children and adolescents were assessed in five municipalities of Maranhao State, Brazil, for detection of anti-HBc, HBsAg and anti-HBs serologic markers and sociodemographic and behavioral features. Among those who were HBsAg negative and anti-HBc negative, the proportion of anti-HBs positives was calculated after the individuals had completed the vaccination schedule. The robust variance of the Poisson’s regression model was used in order to have adjusted tables and calculate the prevalence ratio. Multivariate analysis was performed to identify the factors associated with the prevalence of anti-HBc with or without HBsAg and the vaccine response. It was observed that 163 children were anti-HBc positive and nine individuals were HBsAg positive. The factors associated with the infection were: municipality of residence (residing in Morros municipality or Humberto de Campos municipality), residence in a rural area, aged between 13 and 15 years old, and illicit drug use. The percentage of individuals who were anti-HBc negative and received all three doses of the vaccine was 48.5%. Among these, only 276 (38.9%) had antibodies at protective concentrations. In an adjusted analysis, Morros municipality presented an increased positivity of vaccine response (p < 0.001), and the age ranging between 6 and 10 years old presented a reduced frequency of response. This study reveals a high prevalence of current and past HBV infection within the targeted age group which, in addition to the low vaccination coverage and serological responses, raises concerns about the management of prevention measures, especially the quality of vaccination in these locations.

ABSTRACT Objective To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic. Methods In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic. Results In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p<0.001], had a lower SAPS 3 Score [45 (42-52) versus 49 (43-57); p<0.001], lower SOFA Score on intensive care unit admission [3 (1-6) versus 4 (2-6); p=0.018], lower Charlson Comorbidity Index [0 (0-1) versus 1 (0-2); p<0.001], and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves. Conclusion In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission.

ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.

Abstract Objective To validate the content of nursing diagnosis/outcome and intervention statements for the care of people with heart failure. Method This is methodological study, according to the steps for building terminology subsets in Brazil. Survey conducted from 2019-2020. Statements and interventions were organized according to the mid-range theory for nursing in cardiovascular rehabilitation. Results a total of 58 experts participated in the study. A total of 39 nursing diagnoses/outcomes and 168 interventions were validated. The statements with the highest agreement were related to rehabilitation care followed by the supervised cardiovascular rehabilitation program. Conclusion The study validated the content of statements of a terminology subset for people with heart failure, and allowed the composition of a nursing language based on a classification system recognized worldwide.

Resumen Objetivo Validar el contenido de los enunciados de diagnósticos/resultados e intervenciones de enfermería para el cuidado de personas con insuficiencia cardíaca. Método Estudio metodológico, de acuerdo con los pasos para la elaboración de subconjuntos terminológicos en Brasil. Investigación realizada de 2019 a 2020. Los enunciados e intervenciones fueron organizados según la teoría de rango medio en enfermería para rehabilitación cardiovascular. Resultados Participaron en el estudio 58 especialistas. Se validaron 39 diagnósticos/resultados y 168 intervenciones. Los enunciados con mayor concordancia se relacionaron con el cuidado rehabilitador, seguido por el programa de rehabilitación cardiovascular supervisado. Conclusión El estudio validó el contenido de los enunciados de un subconjunto terminológico para personas con insuficiencia cardíaca y permitió la elaboración de un lenguaje propio de enfermería basado en un sistema de clasificación reconocido mundialmente.

Resumo Objetivo Validar o conteúdo dos enunciados de diagnósticos/resultados e intervenções de enfermagem para o cuidado à pessoa com insuficiência cardíaca. Método Estudo metodológico, de acordo com os passos para construção de Subconjuntos Terminológicos no Brasil. Pesquisa realizada de 2019-2020. Os enunciados e intervenções foram organizados conforme a teoria de médio alcance para enfermagem em reabilitação cardiovascular. Resultados Participaram do estudo 58 especialistas. Foram validados 39 diagnósticos/resultados e 168 intervenções. Os enunciados com maior concordância estiveram relacionados ao cuidado reabilitador seguido do programa de reabilitação cardiovascular supervisionado. Conclusão O estudo validou o conteúdo dos enunciados de um subconjunto terminológico para pessoas com insuficiência cardíaca e permitiu a composição de uma linguagem própria da enfermagem com base em um sistema de classificação reconhecido mundialmente.

Abstract Coffee is currently one of the main commodities traded in the world. Brazil is the largest producer and exporter of the grain. Fungal diseases are very common in coffee crops and control represents a large part of coffee production costs. The climate is an essential factor in the development of a disease such as phoma leaf spot. This disease is favored by high atmospheric humidity and mild temperatures. In this context, this study aimed to carry out the climatic favorability zoning for one of the main coffee diseases (Phoma ssp.) of the coffee-growing region in Brazil. The study was conducted in the main traditional coffee growing regions, i.e., the states of Paraná (PR), São Paulo (SP), Rio de Janeiro (RJ), Espírito Santo (ES), Minas Gerais (MG), Goiás (GO), and Bahia (BA), totaling 2730 municipalities. Air temperature and daily precipitation data for the current scenario were collected from the WorldClim version 2.1 platform for the latest climatological normal in GeoTIFF format. Future climate variables were obtained by the WorldClim 2.1 platform for the IPSL-CM6A-LR global climate model for the periods 2021-2040, 2041-2060, 2061-2080, and 2081-2100 and the scenarios SSP-1 2.6, SSP-2 4.5, SSP-3 7.0, and SSP-5 8.5, respectively. Thus, zoning was carried out using software of geographic information systems (QGIS), automated with the Python language. Also, graphs were prepared to better represent the results. About 54.77% of the coffee-producing region presented relatively favorable conditions for the development of Phoma leaf spot, 30.55% favorable, 3.20% highly, and 11.48% showed no climate conditions for the occurrence of the disease. The climate conditions from October to March favored the occurrence of phoma leaf spot. The Phoma spp. Leaf spot will probably reduce its occurrence in all future scenarios due to the loss of favorable climate conditions. During the period 2081-2100, 85.03% of the entire region would be unfavorable to the development of homas pp. For the most pessimistic scenario (SSP-5 8.5). Climate changes will provide unsuitable conditions for the development of Phoma spp.

Resumo O café é atualmente uma das principais commodities negociadas no mundo. O Brasil é o maior produtor e exportador do grão. Doenças fúngicas são muito comuns nas lavouras de café, e o controle representa uma grande parte dos custos de produção do café. O clima é um fator essencial no desenvolvimento de uma doença, como a mancha de folha de phoma. Essa doença é favorecida pela alta umidade atmosférica e temperaturas amenas. Nesse contexto, este estudo teve como objetivo realizar o zoneamento da favorabilidade climática para uma das principais doenças do café (Phoma ssp.) na região cafeeira do Brasil. O estudo foi conduzido nas principais regiões tradicionais de cultivo de café, ou seja, nos estados do Paraná (PR), São Paulo (SP), Rio de Janeiro (RJ), Espírito Santo (ES), Minas Gerais (MG), Goiás (GO) e Bahia (BA), totalizando 2730 municípios. Dados de temperatura do ar e precipitação diária para o cenário atual foram coletados da plataforma WorldClim versão 2.1 para a última normal climatológica no formato GeoTIFF. Variáveis climáticas futuras foram obtidas pela plataforma WorldClim 2.1 para o modelo climático global IPSL-CM6A-LR para os períodos 2021-2040, 2041-2060, 2061-2080 e 2081-2100, e os cenários SSP-1 2.6, SSP-2 4.5, SSP-3 7.0 e SSP-5 8.5, respectivamente. Assim, o zoneamento foi realizado usando software de sistemas de informação geográfica (QGIS), automatizado com a linguagem Python. Além disso, gráficos foram preparados para melhor representar os resultados. Cerca de 54,77% da região produtora de café apresentou condições relativamente favoráveis para o desenvolvimento da mancha de folha de Phoma, 30,55% favorável, 3,20% altamente e 11,48% não apresentou condições climáticas para a ocorrência da doença. As condições climáticas de outubro a março favoreceram a ocorrência da mancha de folha de phoma. A mancha de folha de Phoma spp. provavelmente reduzirá sua ocorrência em todos os cenários futuros devido à perda de condições climáticas favoráveis. Durante o período 2081-2100, 85,03% de toda a região seria desfavorável ao desenvolvimento de Phoma spp. para o cenário mais pessimista (SSP-5 8.5). As mudanças climáticas proporcionarão condições inadequadas para o desenvolvimento de Phoma spp.

RESUMO A previsão de vazão desempenha um papel importante para garantir o fornecimento confiável de eletricidade em países altamente dependentes da energia hidrelétrica. Este artigo propõe uma abordagem inovadora que integra vários modelos hidrológicos, modelos climáticos e dados observacionais para desenvolver um sistema abrangente de previsão. Três famílias de modelos foram empregadas: modelos climáticos de previsão sazonal integrados com modelos hidrológicos chuva-vazão; modelos estocásticos ou de aprendizado de máquina que utilizam variáveis endógenas e modelos estocásticos ou de aprendizado de máquina que consideram variáveis exógenas. A abordagem do hiper-multimodelo conseguiu aumentar com sucesso o desempenho geral dos cenários gerados com uso dos modelos individuais. A qualidade dos cenários finais gerados estava diretamente relacionada ao desempenho dos modelos individuais. Portanto, a estrutura proposta tem o potencial de melhorar a previsão hidrológica para o setor de eletricidade brasileiro com o uso de modelos individuais mais refinados e calibrados. hidrelétrica empregadas chuvavazão chuva chuva-vazão exógenas hipermultimodelo hiper multimodelo Portanto calibrados

ABSTRACT Streamflow forecasting plays an important role in ensuring the reliable supply of electricity in countries heavily reliant on hydropower. This paper proposes a novel framework that integrates various hydrological models, climate models, and observational data to develop a comprehensive forecasting system. Three families of models were employed: seasonal forecasting climate models integrated with hydrological rainfall-runoff models; stochastic or machine learning models utilizing endogenous variables, and stochastic or machine learning models that consider exogenous variables. The hyper-multimodel framework could successfully increase the overall performance of the scenarios generated through the use of the individual models. The quality of the final scenarios generated was directly connected to the performance of the individual models. Therefore, the proposed framework has potential to improve hydrological forecast for the Brazilian electricity sector with the use of more refined and calibrated individual models. hydropower system employed rainfallrunoff rainfall runoff variables hypermultimodel hyper multimodel Therefore

RESUMO A geração de cenários sintéticos de vazões afluentes é particularmente importante em países como o Brasil, onde a geração de energia hidrelétrica desempenha um papel fundamental e é crucial lidar adequadamente com a incerteza da vazão futura. Este artigo apresenta um esforço colaborativo do setor elétrico brasileiro para aprimorar os modelos de geração de cenários de vazão, com foco em horizontes de até um ano. Cinco instituições propuseram metodologias diversas e a sua eficácia foi avaliada através de uma avaliação comparativa estruturada. Os resultados revelam os pontos fortes e as áreas de possíveis aprimoramentos em cada modelo. O modelo GHCen apresentou o melhor desempenho, destacando-se nas análises de curto prazo e de média móvel, enquanto o modelo PARX demonstrou desempenho superior em regiões específicas do Brasil. O PAR(p)-A, metodologia oficial no Brasil, foi o segundo melhor modelo na análise de médias móveis. Este artigo oferece informações valiosas para países que enfrentam desafios semelhantes de programação hidrotérmica e geração de cenários. Brasil futura ano estruturada destacandose destacando se móvel PARpA, PARpA PAR p A, PAR(p)-A móveis

ABSTRACT Synthetic streamflow scenario generation is particularly important in countries like Brazil, where hydroelectric power generation plays a key role and properly handling the uncertainty of future streamflow is crucial. This paper showcases a collaborative effort within the Brazilian electrical sector to enhance streamflow scenario models, focusing on horizons up to one year. Five institutions proposed diverse methodologies, and their effectiveness was evaluated using a comparative framework. The results reveal the strengths and areas for improvement in each model. GHCen emerged as the top performer, excelling in both short-term and moving average analyses, while the PARX model demonstrated superior performance in specific regions. The PAR(p)-A, which is the official methodology in Brazil, was the second-best model in the moving average analysis. This research offers valuable insights for countries facing similar hydrothermal scheduling and scenario generation challenges. Brazil crucial models year methodologies framework performer shortterm short term analyses regions PARpA, PARpA PAR p A, A PAR(p)-A secondbest second best analysis challenges

Abstract Background The surgery with total mesorectal excision recommended by R. J. Heald in 1982 is the gold standard. Rectal cancer (RC) surgery has a morbidity rate ranging from 6 to 35%, and it can cause functional issues such as sexual, urinary, and bowel dysfunction in the long term. Neoadjuvant chemoradiotherapy (CRT) has been gaining ground in patients with lesions in the middle and lower rectum. The aim of the present study is to present the experience of a reference service in the treatment of RC. Patients and Methods A retrospective study involving 53 patients diagnosed with RC between January 2017 and December 2019 with follow-up until December 2020. We examined tumor location, disease stage, digital rectal exam findings, carcinoembryonic antigen (CEA), therapeutic modality offered, and follow-up time. Results A total of 32% of the patients were men and 68% were women, with a mean age of 60 years old. Location: upper rectum in 6 cases, middle rectum in 21 cases, and lower rectum in 26 cases with evolution from 9.8 to 13.5 months. The most frequent complaints were hematochezia and constipation. A total of 36 patients underwent neoadjuvant therapy: 11 complete clinical response (CCR) (30.5%), 20 (55.5%) partial clinical response (PCR), and no response in 5 patients (14%). The follow-up ranged from 12 to 48 months, with a mean of 30.5 months. A total of 25% of the patients had RC that went beyond the mesorectal fascia, and 22.64% had metastases in other parts of the body when they were diagnosed. Conclusion Neoadjuvant radio and chemotherapy present themselves as an alternative in the treatment of rectal cancer. In 36 patients, 30.5% had a complete clinical response, 55.5% had a partial clinical response, and 14% had no response. It was worth doing the “Watch and Wait” (W&W) to sample. A definitive colostomy was avoided. However, it is necessary to expand the study to a larger follow-up and more patients. Additionally, it is necessary to implement a multicenter study.

RESUMO As doenças priônicas são uma importante causa de demências rapidamente progressivas. Entre elas, a mais comum é a doença de Creutzfeldt-Jakob (DCJ) esporádica. É uma enfermidade rara e incurável, com rápida progressão para óbito. Objetivo: Descrever a abordagem diagnóstica de uma paciente com doença de Creutzfeldt-Jakob. Métodos: O diagnóstico é estabelecido pelo quadro clínico associado a alterações características na ressonância magnética cerebral, no eletroencefalograma e pela análise de alterações específicas no líquido cefalorraquidiano. Resultados: O presente relato descreve o caso de um paciente de 53 anos na cidade de Fortaleza (CE). O diagnóstico foi feito com base na condição clínica e por meio de testes diagnósticos, incluindo proteína 14-3-3 e análise Real-Time Quaking-Induced Conversion (RT QUIC). O diagnóstico diferencial foi realizado com outras causas rapidamente progressivas, como doenças infecciosas e imunomediadas. Conclusões: Por fim, foi estabelecido o diagnóstico de provável DCJ esporádica.

ABSTRACT Prion diseases are an important cause of rapidly progressive dementias. Among them, the most common is sporadic Creutzfeldt-Jakob disease (CJD). It is a rare and incurable disease, with rapid progression to death. Objective: To describe the diagnostic approach of a patient with Creutzfeldt-Jakob disease. Methods: The diagnosis is established through the clinical picture associated with characteristic changes in the brain magnetic resonance imaging, the electroencephalogram, and analysis of specific changes in the cerebrospinal fluid. Results: The present report describes the case of a 53-year-old patient in the city of Fortaleza-CE. The diagnosis was made based on the clinical condition and through diagnostic tests, including 14-3-3 protein and RT QUIC analysis. Differential diagnosis was performed with other rapidly progressive causes, such as infectious and immune-mediated diseases. Conclusions: The diagnosis of probable sporadic CJD was established.

Abstract BACKGROUND: Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic. DESIGN AND SETTING: This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states. METHODS: Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020. RESULTS: A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month. CONCLUSION: The pandemic caused a negative impact on meningitis notifications in Brazil.

Resumen Los cambios en el uso del suelo provocan un mosaico de áreas en el paisaje con diferentes usos y coberturas. Esta condición compromete las reservas de nutrientes del suelo, especialmente el fósforo (P). En ese sentido, este estudio tuvo como objetivo determinar las concentraciones de fósforo extraíble y total en 04 clases de suelo (Argisol Amarillo, Neosol Litólico, Entisol y Planosol), 04 usos y coberturas del suelo (Caatinga Nativa Abierta, Caatinga Nativa Densa, Agricultura y Pastos), en 04 profundidades (0-10, 10-20, 20-30 y 30-40 cm). Para determinar el P extraíble se utilizó el Mehlich 1 y la lectura colorimétrica. El fósforo total se determinó por digestión de azufre y colorimetría. Los resultados de las concentraciones de P extraíble y total fueron mayores para las clases Argisol y Planosol. Se observó que hubo reducciones en las concentraciones de P extraíble entre las capas del suelo a medida que se profundizaba el perfil del suelo. Las profundidades entre 0 y 20 cm generalmente mostraron concentraciones más altas de fósforo extraíble y total en la agricultura. Entre las cuatro clases de suelo estudiadas, los valores promedio más altos de existencias de P extraíble y total se presentaron en los Neosoles y Planosoles Litólicos, principalmente debido al uso agrícola. La deficiencia de P ha sido un factor limitante para la productividad agrícola y, especialmente en la región de Agreste de Pernambuco, donde las principales clases de suelo con cobertura natural tienen niveles bajos de P disponible y total.

Abstract Changes in land use cause a mosaic of areas in the landscape with different uses and coverage. This condition compromises soil nutrient stocks, especially phosphorus (P). In this sense, this study aimed to determine the concentrations of extractable and total phosphorus in 04 soil classes (Yellow Argisol, Litholic Neosol, Entisol and Planosol), 04 uses and covers (Open Native Caatinga, Dense Native Caatinga, Agriculture and Pasture) of the soil, in 04 depths (0-10, 10-20, 20-30 and 30-40 cm). To determine the extractable P, the Mehlich 1 and colorimetric reading were used. Total phosphorus was determined by sulfur digestion and colorimetry. The results of extractable and total P concentrations were higher for the Argisol and Planosol classes. It was observed that there were reductions in extractable P concentrations between the soil layers as the soil profile deepened. Depths between 0-20 cm generally showed higher concentrations of extractable and total phosphorus in agriculture. Among the four soil classes studied, the highest average values of extractable and total P stocks occurred in Litholic Neosols and Planosols, mainly due to agricultural use. P deficiency has been a limiting factor to agricultural productivity and, especially in the Agreste region of Pernambuco, where the main soil classes under natural cover have low levels of available and total P.

RESUMO Objetivo: mapear a produção científica sobre o acometimento de pacientes pela COVID-19 e a ocorrência do acidente vascular cerebral. Método: scoping review, conforme o referencial proposto pelo Instituto Joanna Briggs, com a utilização das bases de dados LILACS, MEDLINE, WoS, EMBASE, CINAHL e SCOPUS, no período de abril a setembro de 2020. Utilizaram-se os descritores coronavirus infections, stroke, nervous system diseases e inpatients, por meio do Medical Subject Headings. Resultados: incluíram-se 24 estudos que evidenciaram sintomas clínicos específicos do acidente vascular cerebral em pacientes com COVID-19, como disartria, paralisia facial, déficit sensório, cefaleia, hemiparesia e ataxia. O acometimento entre o Acidente Vascular Cerebral e a COVID-19 foi constatado pelos exames de proteína-C reativa, D-dímero, tomografia computadorizada, ressonância magnética, dentre outros, e por condutas assistenciais voltadas para os achados nos exames, associando-se a três desfechos clínicos, tendo por base a zona de isquemia cerebral acometida e o tempo de manifestação viral de cada paciente. Conclusão: mapearam-se as manifestações clínicas específicas de pacientes que evoluíram para o quadro de Acidente Vascular Cerebral posterior a COVID-19, bem como condutas diagnósticas e terapias utilizadas, além de identificar o dano neurológico a partir do resultado clínico desses pacientes.

ABSTRACT Objective: to map the scientific production on patients infected by COVID-19 and the occurrence of stroke. Method: a scoping review, according to the framework proposed by the Joanna Briggs Institute, using the LILACS, MEDLINE, WoS, EMBASE, CINAHL and SCOPUS databases, from April to September 2020. The following keywords were used: coronavirus infections, stroke, nervous system diseases and inpatients, based on the Medical Subject Headings. Results: 24 studies that evidenced specific clinical symptoms of stroke such as dysarthria, facial paralysis, sensory deficit, headache, hemiparesis and ataxia in patients with COVID-19 were included. The association between stroke and COVID-19 was found by the following exams: C-reactive protein, D-dimer, computed tomography and, magnetic resonance, among others, as well as by care procedures focused on the findings in the exams, associated with three clinical outcomes, based on the brain ischemia zone affected and the time of viral manifestation of each patient. Conclusion: the specific clinical manifestations of patients who suffered a stroke after COVID-19 were mapped, as well as diagnostic procedures and therapies used, in addition to identifying neurological damage based on the clinical outcome of these patients.

RESUMEN Objetivo: mapear la producción científica sobre la afectación de pacientes a raíz del COVID-19 y la incidencia de accidente cerebrovascular. Método: una scoping review, conforme al referencial propuesto por el Instituto Joanna Briggs, con uso de las siguientes bases de datos: LILACS, MEDLINE, WoS, EMBASE, CINAHL y SCOPUS, entre abril y septiembre de 2020. Se utilizaron los descriptores coronavirus infections, stroke, nervous system diseases e inpatients, por medio de los Medical Subject Headings. Resultados: se incluyeron 24 estudios que pusieron en evidencia síntomas clínicos específicos del accidente cerebrovascular en pacientes con COVID-19, como ser disartria, parálisis facial, déficit sensorial, cefalea, hemiparesia y ataxia. La afectación entre el Accidente cerebrovascular y el COVID-19 fue constatada por medio de los exámenes de proteína-C reactiva, D-dímero, tomografía computada y resonancia magnética, entre otros, y por conductas asistenciales dirigidas a los resultados de los exámenes, asociándose a tres resultados clínicos, y teniendo como base la zona de isquemia cerebral afectada y el tiempo de manifestación viral de cada paciente. Conclusión: se mapearon las manifestaciones clínicas específicas de pacientes que evolucionaron al cuadro de Accidente cerebrovascular posterior a COVID-19, al igual que conductas diagnósticas y terapias utilizadas, además de identificar el daño neurológico a partir del resultado clínico de estos pacientes.