RESUMO INTRODUÇÃO: A manutenção do peso perdido a longo prazo é um desafio, pelo que é essencial compreender os fatores envolvidos. OBJETIVOS: Analisar o índice inflamatório da dieta de indivíduos portugueses com sucesso na gestão do peso, explorando a sua associação com a magnitude de perda de peso e o índice de massa corporal, e com indicadores de comportamento alimentar e depressão, assim como explorar a relação destas variáveis entre si. METODOLOGIA: Foram utilizados dados do Registo Nacional de Controlo do Peso (n=205; 59,5% mulheres; 38,97 ± 10,82 anos; 25,76 ± 3,99 kg/m2). A ingestão alimentar foi avaliada através do Questionário semi-quantitativo de Frequência Alimentar, a partir do qual foi calculado o índice inflamatório da dieta; o comportamento alimentar (alimentação emocional e externa) através do Dutch Eating Behaviour Questionnaire; e o nível de depressão através do Beck Depression Index. RESULTADOS: O índice inflamatório da dieta variou de -3,67 a 3,64. Observou-se uma associação negativa entre o índice inflamatório da dieta e a magnitude de perda de peso na amostra total (r=-0,151, p=0,043) e no sexo feminino (r=-0,225, p=0,021). Relativamente ao índice de massa corporal, encontrou-se uma associação positiva com o índice de depressão (r=0,276, p<0,001) e com a alimentação emocional (r=0,284, p<0,001). Adicionalmente, o índice de depressão associou-se de forma positiva com a alimentação externa (r=0,322, p<0,001) e emocional (r=0,403, p<0,001). CONCLUSÕES: Uma alimentação anti-inflamatória parece associar-se a maior magnitude de perda de peso em mulheres com sucesso na manutenção do peso perdido, o que sugere que o índice inflamatório da dieta poderá ser um fator relevante no que diz respeito à gestão do peso nesta população em particular. À medida que o índice de massa corporal aumenta, parece aumentar também o nível de depressão e a alimentação emocional não só nestas mulheres, mas também nos homens. Uma melhor compreensão da relação entre estes e outros fatores envolvidos na gestão do peso com sucesso poderá ́ contribuir para o delineamento de intervenções do estilo de vida mais apropriadas.

BACKGROUND In 2022, an outbreak of mpox that started in European countries spread worldwide through human-to-human transmission. Cases have been mostly mild, but severe clinical presentations have been reported. In these cases, tecovirimat has been the drug of choice to treat patients with aggravated disease. OBJECTIVES Here we investigated the tecovirimat susceptibility of 18 clinical isolates of monkeypox virus (MPXV) obtained from different regions of Brazil. METHODS Different concentrations of tecovirimat were added to cell monolayers infected with each MPXV isolate. After 72 hours, cells were fixed and stained for plaque visualization, counting, and measurement. The ortholog of F13L gene from each MPXV isolate was polymerase chain reaction (PCR)-amplified, sequenced, and the predicted protein sequences were analyzed. FINDINGS The eighteen MPXV isolates generated plaques of different sizes. Although all isolates were highly sensitive to the drug, two showed different response curves and IC50 values. However, the target protein of tecovirimat, F13 (VP37), was 100% conserved in all MPXV isolates and therefore does not explain the difference in sensitivity. MAIN CONCLUSIONS Our results support screening different MPXV isolates for tecovirimat susceptibility as an important tool to better use of the restricted number of tecovirimat doses available in low-income countries to treat patients with mpox.

ABSTRACT Tomato fruits are highly perishable. In this sense, adopting techniques to maintain and extend its shelf life is essential. Recent studies have used microalgae as an edible coating for fruit, as it is a nutrient-rich alternative and reduces fruit mass loss and respiration, delaying senescence. The aim of this study was to evaluate the application of microalgae-based coatings with or without the use of modified atmosphere packaging, polyvinyl chloride (PVC), in post-harvest tomato conservation. The design used was completely randomized, in a 4x2 factorial arrangement, with four coatings (no coating, coating composed of Spirulina platensis sp., Chlorella sp. and Scenedesmus sp.) and two conditions (with and without PVC), totalizing 8 treatments, with four replicates, consisting of one fruit each. Stored for 7 days at 10±2ºC and 55±5% UR and evaluated at harvest and on the last day of storage. The fruits coated with Chlorella sp. without PVC and Scenedesmus sp. associated with PVC, showed the lowest mass losses, representing a reduction of 73.79% and 78.47%, respectively, in relation to the control. In addition to mass loss, the levels of ascorbic acid (18.91 and 16.97 mg/100 g), citric acid (4.02 and 4.01), respectively, and the SS/AT ratio also stood out. The microalgae Chlorella sp. and Scenedesmus sp. can be used in coating ‘Santa Clara’ tomato fruits to maintain their physicochemical characteristics over 7 days of storage. The use of PVC film coating helped maintain these characteristics, reducing the perishability of the fruits.

RESUMO Os frutos do tomateiro têm alta perecibilidade havendo a necessidade da adoção de técnicas que mantenham e prolonguem sua vida útil pós-colheita. Estudos recentes têm utilizado microalgas como recobrimento comestível em frutos, por ser uma alternativa rica em nutrientes e reduzir perda de massa e respiração do fruto e assim retardar a senescência. Objetivou-se avaliar a aplicação de revestimentos a base de microalgas com ou sem o uso de embalagem com atmosfera modificada (policloreto de vinila) na conservação pós-colheita de tomate. O delineamento utilizado foi inteiramente casualizado, em arranjo fatorial 4x2, com quatro revestimentos (sem revestimento, revestimento com Spirulina platensis sp., Chlorella sp. e Scenedesmus sp.) e duas condições [com e sem PVC (policloreto de vinila)], totalizando 8 tratamentos, com quatro repetições, constituída por um fruto cada. Armazenados por 7 dias a 10±2ºC e 55±5% UR e avaliados na colheita e no último dia de armazenamento. Os frutos recobertos com Chlorella sp. sem o PVC e Scenedesmus sp. associado ao PVC, tiveram as menores perdas de massa, representando redução de 73,79% e 78,47%, respectivamente, em relação ao controle. Além da perda de massa, também tiveram destaque nos teores de ácido ascórbico (18,91 e 16,97 mg/100 g). As microalgas Chlorella sp. e Scenedesmus sp. podem ser utilizadas no revestimento de frutos do tomateiro ‘Santa Clara’ para manter suas características físico-químicas ao longo de 7 dias de armazenamento. A utilização do recobrimento com filme PVC auxilia na manutenção dessas características, diminuindo a taxa de perecibilidade dos frutos.

Resumen Pinus pseudostrobus es una conífera ampliamente aprovechada en el estado de Michoacán para la extracción de resina; sin embargo, los métodos actuales de resinación son empíricos y sin conocimiento de la producción potencial. A partir de variables dasométricas y con el uso del método de mínimos cuadrados ordinarios (MCO) y modelos de efectos mixtos (MEM), se evaluó un modelo de predicción para estimar la producción de resina. A 215 árboles resineros, se les midió el diámetro normal, diámetro de copa y altura total, además se cuantificó la producción de resina por cara (2 186 caras) en un intervalo altitudinal de 2 226 a 2 785 m. Posterior a depurar la base de datos y a construir la variable combinada (d 2 At), se ajustó un modelo lineal de tipo logarítmico en el programa R ® bajo dos enfoques estadísticos: MCO y MEM. Al incluir la covariable de altitud en los MEM como variable de agrupación, se tiene una ganancia estadística promedio de 17 % con respecto a MCO. No hubo incumplimiento de los supuestos de regresión de normalidad y homocedasticidad. Se propone un modelo con parámetros globales para estimar el rendimiento de resina promedio y tres variantes con parámetros aleatorios, en las cuales la altitud de 2 500 m presenta la mayor producción. La productividad estimada y su relación con los intervalos altitudinales puede utilizarse para el establecimiento de plantaciones forestales resineras o en la elaboración de planes de gestión forestal para la especie en la Comunidad Indígena de Nuevo San Juan Parangaricutiro, Michoacán.

Abstract Pinus pseudostrobus is a conifer widely used in the state of Michoacán for the extraction of resin; however, current resin extraction methods are empirical and without knowledge of the potential production. Based on mensuration variables and using the ordinary least squares (OLS) method and mixed effects models (MEM), a predictive model for estimating resin production was evaluated. The normal diameter, crown diameter and total height of 215 resin trees were measured; in addition, the resin production per face (2 186 faces) was quantified in an altitudinal range of 2 226 to 2 785 m. After debugging the database and constructing the combined variable (d2tH), a logarithmic linear model was adjusted under two statistical approaches ―OLS and MEM―, using the R® software. By including the altitude covariate in the MEM as a grouping variable, there is an average statistical gain of 17 % with respect to the OLS approach. No issues of non-compliance with the normality regression or homoscedasticity assumptions were observed. A model with global parameters is proposed to estimate the average resin yield for the region and three variants with random parameters, where the altitude of 2 500 m has the highest production. The estimated productivity and its relationship with the altitudinal ranges can be a guideline for the establishment of forest plantations for resin extraction purposes or the development of forest management plans for the species in the Indigenous Community of Nuevo San Juan Parangaricutiro, Michoacán.

Resumen Objetivo: Evaluar la efectividad, la seguridad, la calidad de vida y la satisfacción de pacientes con psoriasis palmo-plantar (PP) no pustulosa tratados con espuma de calcipotriol y betametasona dipropionato (Cal/BD). Material y métodos: Estudio observacional, prospectivo. Se incluyeron pacientes adultos con diagnóstico de psoriasis no controlada con afectación PP para los que estuviera indicado iniciar tratamiento tópico con Cal/BD. Las variables recogidas fueron: demográficas (sexo y edad), antropométricas (índice de masa corporal (IMC)), relacionadas con la patología (Body Surface Area (BSA) categorizado como <10% o bien ≥10%) y relacionadas con el tratamiento (tratamientos farmacológicos previos). Para evaluar la efectividad y la seguridad del tratamiento se empleó el Palmoplantar Psoriasis Area Severity Index (PPASI) y el Physician’s Global Assessment (PGA), y se recogió la incidencia y gravedad de los efectos adversos. Para valorar la calidad de vida se utilizó el Dermatology Life Quality Index (DLQI), así como el Treatment Satisfaction Questionnaire for Medication (TSQM-14) para valorar la satisfacción del paciente con el tratamiento a las 4 semanas. Las variables de efectividad y de calidad de vida se evaluaron al inicio y a las 4 semanas de tratamiento, calculándose la diferencia en términos absolutos entre ambas. Resultados: Se incluyeron 19 pacientes (11 mujeres) con una edad de 59 (RIQ 11,4) años y un IMC de 25,9 (RIQ 6,0) kg/m2, todos ellos con un BSA <10%, previamente pretratados con tratamientos tópicos (74%; 14/19), acitretino (48%; 9/19) e inmunosupresores (26%; 5/19), entre otros. La mediana de reducción de PPASI fue de 3,6 (RIQ 7,8) (p=0,0284), mientras que la mediana de reducción del PGA fue de 1,0 (RIQ 2,0) (p=0,0047). Ningún paciente presentó reacciones adversas relacionadas con el tratamiento. La mediana de reducción del DLQI fue de 3,0 (RIQ 4,0) (p=0,1592). La satisfacción global del paciente fue de 76,9 (RIQ 32,2) sobre 100. Conclusiones: La espuma de Cal/BD para administración tópica en pacientes con psoriasis PP demuestra ser efectiva y segura, obteniendo un buen resultado en términos de satisfacción global del paciente con la medicación, sin demostrarse diferencias en términos de calidad de vida.

Summary Objective: To evaluate effectiveness, safety, quality of life and satisfaction of patients with non-pustular palmo-plantar (PP) psoriasis treated with calcipotriol and betamethasone (Cal/BD) foam. Material and methods: Observational, prospective study. We included adult patients with a diagnosis of uncontrolled PP psoriasis in which topical treatment was indicated. Demographic (sex and age), anthropometric (body mass index (BMI)), related to the pathology (Body Surface Area (BSA) categorized as <10% or ≥10%) and related to the treatment (previous pharmacological treatments) variables were studied. To evaluate effectiveness and safety of the treatment, Palmoplantar Psoriasis Area Severity Index (PPASI) and Physician’s Global Assessment (PGA) were used, and the incidence and severity of the adverse effects were collected. To assess quality of life, Dermatology Life Quality Index (DLQI) was used, as well as Treatment Satisfaction Questionnaire for Medication (TSQM-14) to assess patient satisfaction with treatment at the 4th week. The variables of effectiveness and quality of life were evaluated at the beginning and at 4th week of treatment, calculating the difference in absolute terms between them. Results: We included 19 patients (11 women) with a median of 59 (IQR 11.4) years old and a BMI of 25.9 (IQR 6.0) kg/m2. All the patients showed a BSA <10% and were previously treated with topical treatments (74%; 14/19), acitretin (48%; 9/19) and immunosuppressants (26%; 5/19), among others. The median reduction in PPASI was 3.6 (IQR 7.8) (p=0.0284), while the median reduction in PGA was 1.0 (IQR 2.0) (p=0.0047). No patient presented adverse reactions related with the medication. The median reduction in DLQI was 3.0 (IQR 4.0) (p=0.1592). The overall satisfaction of the patient was 76.9 (IQR 32.2) over 100. Conclusion: Cal/BD foam for topical administration in patients with PP psoriasis shows to be effective and safe, obtaining a good result in terms of overall patient satisfaction with the medication, without obtaining differences in terms of quality of life.

RESUMO A melancia é tradicionalmente cultivada por semeadura direta, porém, em função do alto valor das sementes de materiais melhorados, o transplantio de mudas é alternativa promissora. Este trabalho teve como objetivo avaliar, em dois ciclos de produção, o desempenho agronômico da melancia por semeadura direta e transplantio de mudas. Os experimentos foram conduzidos em campo, entre maio e setembro de 2015 e de 2016 no Setor de Horticultura da Escola de Agronomia da Universidade Federal de Goiás. O ciclo de produção de 2015 foi em delineamento de blocos ao acaso (DBC) com quatro repetições em esquema fatorial 2x4 (dois híbridos: Manchester e Talisman e dois tipos de cultivos: semeadura direta e mudas com 15, 20 e 25 dias). Na safra de 2016 foi em DBC com seis repetições. Os tratamentos foram constituídos por três datas de semeadura direta (0, 5 e 10 dias) e três idades de mudas (15, 20 e 25 dias). Avaliou-se número de folhas, altura e massa seca por muda de diferentes idades e comprimento de ramas e a incidência de viroses ao longo do ciclo da cultura. Quando o teste F (5%) foi significativo para idade da muda, realizou-se análise de regressão, e quando houve efeito da cultivar foi aplicado o teste de Tukey (5%). Métodos de plantio (semeadura direta versus mudas) foram comparados por contrastes ortogonais. Em 2016, avaliou-se o início do florescimento, e em ambos os experimentos foi determinado o ciclo médio da cultura em cada tratamento. Na fase de colheita avaliaram-se: comprimento e largura do fruto, massa do fruto, espessura da parte branca do fruto e teor de sólidos solúveis. Mudas com maior idade (25 dias) apresentaram superioridade em relação ao número de folhas e massa seca da muda no dia do transplantio. Variáveis associadas à produtividade e qualidade dos frutos não foram influenciadas pelos tratamentos. Não houve diferença significativa com relação à incidência de viroses nos dois ciclos de produção. A semeadura direta reduziu o ciclo da melancia nos dois experimentos, entretanto, sem alteração da produção e qualidade dos frutos. Considerando que o custo de implantação de lavouras de melancia é fator relevante, os resultados obtidos reafirmam a importância da semeadura direta como o método mais viável ao plantio de melancia, considerando a facilidade do método e também a redução dos custos com a produção de mudas e operações de transplantio.

ABSTRACT Watermelon is traditionally grown under direct sowing system. However, due to high costs of good quality seeds of improved cultivars, seedling transplanting is a promising alternative for watermelon production. This study aimed at evaluating, during two production cycles, the performance of watermelon under direct sowing cultivation system and seedling transplanting. The field trials were carried out from May to September, 2015 and 2016, at Setor de Horticultura da Escola de Agronomia of Universidade Federal de Goiás. In 2015, the experimental design was randomized blocks (DBC) with four replicates in a 2x4 factorial scheme (two hybrids: Manchester and Talisman, and two planting methods: direct sowing and transplanting 15-, 20- and 25-day old seedlings). In 2016, the experimental design was DBC with six replicates. The treatments consisted of three direct sowing dates (0, 5 and 10 days) and three different seedling ages (15, 20 and 25 days). Number of leaves, plant height and dry mass of seedlings of different ages, vine length and virus incidence along the crop cycle were evaluated. Upon significant F-test (5%) for seedling age, regression analysis was performed, and when cultivar effect was significant, Tukey test (5%) was used. Planting methods (direct sowing X seedlings) were compared by orthogonal contrasts. In 2016, the beginning of flowering was evaluated, and in both trials, the average crop cycle for each treatment was determined. Fruit length and width, fruit mass, thickness of the white part of the rind, and soluble solids content were evaluated at harvesting. The 25-day old seedlings had higher number of leaves, as well as, higher dry mass, comparing with seedlings on the transplanting day. Yield and fruit quality were not influenced by treatments. No significant differences for virus disease incidence were detected, in both production cycles. Direct sowing reduced the crop cycle in both field trials, with no differences in production and quality of fruits. Considering the costs of establishing watermelon fields as relevant, the results suggest the importance of direct sowing as the most viable method for watermelon cultivation, due to the ease of the process, as well as, reduction in costs related to seedling production and transplanting operations.

Abstract: COVID-19 rapidly spread across the world in an unprecedented outbreak with a massive number of infected and fatalities. The pandemic was heavily discussed and searched on the internet, which generated big amounts of data related to it. This led to the possibility of attempting to forecast coronavirus indicators using the internet data. For this study, Google Trends statistics for 124 selected search terms related to pandemic were used in an attempt to find which keywords had the best Spearman correlations with a lag, as well as a forecasting model. It was found that keywords related to coronavirus testing among some others, such as “I have contracted covid”, had high correlations (≥0.7) with few weeks of lag (≤4 weeks). Besides that, the ARIMAX model using those keywords had promising results in predicting the increase or decrease of epidemiological indicators, although it was not able to predict their exact values. Thus, we found that Google Trends data may be useful for predicting outbreaks of coronavirus a few weeks before they happen, and may be used as an auxiliary tool in monitoring and forecasting the disease in Brazil.

Abstract The Colombian Amazon region is part of the Neotropical rainforest (humid forest biome) covering an area of 483,163 km2 and includes tributaries of both the Amazon and Orinoco River basins. The aquatic ecosystems found there include: rivers and alluvial plains originating in Andean headwaters, on eroded soils of tropical forests in the lowlands, and Guiana Shield formations, comprising a dense fluvial drainage network in the lowlands, with Paleogene/Neogene geological formations (terra firme streams in higher places that don’t usually flood) and Paleozoic (shield streams); and Andean and Guiana Shield streams above 200–250 m a.s.l. We present here an exhaustive compilation of published information, supported by fish collections, consisting of a list of 1104 species distributed in 375 genera, 53 families, and 16 orders. We include occurrence data of these species in each sub-basin. The presence/absence species matrix was analyzed using a dendrogram and non-metric multidimensional scaling (NMDS) analysis to identify patterns of similarity between basins and sub-basins. We evaluated species composition between basins and among the different geological origins using PERMANOVA. The dendrogram shows co-occurrences of 404 species in the two basins. It also shows two clear groupings of the sub-basins of the Amazon (except Guainía-Negro drainages) and those of the Orinoco. Within the Amazon Basin, there are two nodes according to the geological origin: systems of Andean origin and those of the lowlands. The dendrogram results are consistent with the NMDS analysis, which shows a clear grouping according to the connectivity of the basins; the Guainía-Negro is included in the Amazon basin. Species distribution patterns were supported by the PERMANOVA, and differed significantly between basins (F = 4.3, R = 0.26, P = 0.003) and geological origin (F = 3.6, R = 0.23, P = 0.003). The number of species in this study represents almost a fifth of the ichthyofauna of the Neotropics and about a third of that of the Amazon River basin; clearly supporting Colombia’s status among the countries with the greatest diversity of freshwater fish species of the planet. We include here a significant number of new records (75 spp), provide a first approximation of the distribution patterns, and a framework for future biogeographical studies.

Resumo La región de la Amazonía colombiana hace parte del bosque húmero neotropical (bioma de selva húmeda) abarcando un área de 483.163 km2 e incluye afluentes de las cuencas del Amazonas y Orinoco. Los ecosistemas acuáticos encontrados allí incluyen: ríos y llanuras aluviales, originándose en cabeceras andinas, en suelos erosionados de bosques tropicales en tierras bajas y en formaciones de escudos; conformando una densa red fluvial en tierras bajas con formaciones geológicas paleógenas-neógenas (arroyos de terra firme en sitios elevados que usualmente no se inundan) y paleozoicas (arroyos de escudo); y arroyos andinos y del escudo Guayanés por encima de 200–250 m s.n.m. Presentamos aquí una recopilación exhaustiva de información publicada, sustentada por colecciones ictiológicas, consistiendo en una lista de 1104 especies distribuidas en 375 géneros, 53 familias y 16 órdenes. Incluimos datos de estas especies en cada subcuenca. La matriz de presencia/ausencia de especies fue analizada usando un dendrograma y un análisis de escalamiento multidimensional no métrico (NMDS) para identificar patrones de similitud entre cuencas y subcuencas. Se evaluó la composición de especies entre cuencas y entre los diferentes orígenes geológicos usando PERMANOVA. El dendrograma refleja coocurrencia de 404 especies en las dos cuencas. También muestra dos agrupaciones claras de las subcuencas del Amazonas (excepto Guainía-Negro) y las del Orinoco. Dentro de la cuenca amazónica existen dos nodos según el origen geológico: los sistemas de origen andino y los de tierras bajas. Los resultados del dendrograma son consistentes con el análisis NMDS, el cual muestra una clara agrupación según la conectividad de las cuencas; el Guainía-Negro está incluido en la cuenca del Amazonas. Los patrones de distribución de especies fueron respaldados por el PERMANOVA y difirieron significativamente entre cuencas (F = 4.3, R = 0.26, P = 0.003) y origen geológico (F = 3.6, R = 0.23, P = 0.003). El número de especies en este estudio representa casi la quinta parte de la ictiofauna del Neotrópico y alrededor de un tercio de la de la cuenca del río Amazonas; soportando el estatus de Colombia entre los países con mayor diversidad de especies de peces de agua dulce del planeta. Incluimos aquí un número importante de nuevos registros (75 spp), brindamos una aproximación de los patrones de distribución y un marco para futuros estudios biogeográficos.

ABSTRACT Introduction: Flow cytometry has become an increasingly important tool in the clinical laboratory for the diagnosis and monitoring of many hematopoietic neoplasms. This method is ideal for immunophenotypic identification of cellular subpopulations in complex samples, such as bone marrow and peripheral blood. In general, 4-color panels appear to be adequate, depending on the assay. In acute leukemias (ALs), it is necessary identify and characterize the population of abnormal cells in order to recognize the compromised lineage and classify leukemia according to the WHO criteria. Although the use of eightto ten-color immunophenotyping panels is wellestablished, many laboratories do not have access to this technology. Objective and Method: In 2015, the Brazilian Group of Flow Cytometry (Grupo Brasileiro de Citometria de Fluxo, GBCFLUX) proposed antibody panels designed to allow the precise diagnosis and characterization of AL within available resources. As many Brazilian flow cytometry laboratories use four-color immunophenotyping, the GBCFLUX has updated that document, according to current leukemia knowledge and after a forum of discussion and validation of antibody panels. Results: Recommendations for morphological analysis of bone marrow smears and performing screening panel for lineage (s) identification of AL were maintained from the previous publication. The lineage-oriented proposed panels for B and T cell acute lymphoblastic leukemia (ALL) and for acute myeloid leukemia (AML) were constructed for an appropriate leukemia classification. Conclusion: Three levels of recommendations (i.e., mandatory, recommended, and optional) were established to enable an accurate diagnosis with some flexibility, considering local laboratory resources and patient-specific needs.

Abstract Background There has been little in the way of study of nonagenarians with acute kidney injury (AKI, defined in lines with KDIGO guidelines), but the rise in their life expectancy makes further study of this population necessary. The aim of this study is to assess mortality in nonagenarians with AKI during hospitalization. Methods In this retrospective study, patients with AKI during hospitalization between 2013-2014 were included. At baseline, epidemiological variables, comorbidities and treatments were collected. Analytics and mortality were studied during hospitalisation. Univariate analysis was carried out to evaluate mortality-associated variables. A logistic regression analysis was carried out to demonstrate independent predictors for mortality. Results Two hundred and sixty-four nonagenarian patients were included. Mean age was 93±3 years, 73 (27.7 %) of whom were men. During hospitalization, 79 patients (29.9 %) died. Comorbidities related to mortality were history of heart failure (p = 0.018), diastolic dysfunction (p < 0.042) and higher dependence according to the modified Barthel index (p = 0.003). The clinical variables related to mortality at hospital admission were lower systolic (p = 0.016) and diastolic blood pressure (p = 0.013), higher white blood cell count (p = 0.003), greater severity of AKI (p = 0.003) and L- lactic (p = 0.005). In an adjusted multivariate analysis, history of heart failure (OR = 2.31, 95%CI: 1.07-5.00, p = 0.036), dependence according to the Barthel index (OR = 0.80, 95%CI: 0.67-0.97, p = 0.016) and L- lactic acid (OR = 1.31, 95%IC: 1.06-1.61, p = 0.005) were independent predictors of mortality. Conclusion Heart failure, dependence according to the Barthel index and L- lactic acid at admission are independent predictors of mortality in nonagenarians hospitalized with AKI.

Resumen Fundamento El desarrollo de un fracaso renal agudo (FRA, definido siguiendo las guías KDIGO) durante una hospitalización en pacientes nonagenarios ha sido poco estudiado. El objetivo del presente estudio es analizar la mortalidad en pacientes nonagenarios hospitalizados que desarrollan un FRA. Métodos Se recogieron todos los pacientes nonagenarios que desarrollaron FRA durante el ingreso hospitalario entre 2013 y 2014. Basalmente, se recogieron variables epidemiológicas, comorbilidades y, durante el ingreso, variables analíticas y mortalidad. Se analizaron las variables asociadas a mortalidad durante el episodio de FRA y los predictores independientes mediante regresión logística. Resultados Se incluyeron 264 pacientes nonagenarios con FRA. La edad media fue 93±3 años, siendo 73 (27,7 %) varones. Durante la hospitalización fallecieron 79 pacientes (29,9 %). Las comorbilidades asociadas a mortalidad fueron la insuficiencia cardiaca (p = 0,018), la disfunción diastólica (p = 0,042) y un mayor nivel o grado de dependencia (p = 0,003). Las variables clínicas en el momento del ingreso que se asociaron a mortalidad fueron presión arterial sistólica y diastólica más baja (p = 0,016 y 0,013, respectivamente), leucocitosis (p = 0,003), mayor severidad del FRA valorado por AKIN (p = 0,003) y valor de ácido L- láctico más alto (p = 0,005). Los predictores independientes de mortalidad fueron la insuficiencia cardiaca (OR = 2,31; IC95%: 1,07-5,00; p = 0,036), la dependencia valorada por el índice de Barthel modificado (OR = 0,80; IC95%: 0,67-0,97; p < 0,016) y el L- láctico al ingreso (OR = 1,31; IC95%: 1,06-1,61; p = 0,005). Conclusión La insuficiencia cardiaca, el nivel de dependencia y el ácido L- láctico al ingreso son predictores independientes de mortalidad en pacientes nonagenarios hospitalizados con FRA.

RESUMO Introdução/enquadramento/objetivos: O Dinamómetro é um instrumento acessível na aquisição e utilização, pelo que a generalidade das empresas prestadoras de Serviços externos o possui e o utiliza às vezes. Contudo, a bibliogafia sobre este método não é muito abundante. Pretendeu-se com esta revisão resumir os dados mais pertinentes sobre esta técnica, refletir se a mesma está a ser adequadamente utilizada na Saúde Ocupacional e quais as suas potencialidades neste contexto. Metodologia: Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em janeiro de 2021, nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive e MedicLatina”. Conteúdo: A avaliação da força de preensão da mão pode ser utilizada para quantificar especificamente as limitações no membro superior, inferir a capacidade de trabalho após acidente/doença/cirurgia e/ou perceber a evolução de um processo de reabilitação. A quantificação da força pode ser alterada por muitos fatores. Existem diversos tipos de Dinamómetros: uns fixos, complexos, exigentes, dispendiosos e outros portáteis, simples, económicos e sem exigirem treino especial. Algumas recomendações protocolares para a correta execução do teste são razoavelmente consensuais. Estão publicados valores orientadores das quantificações obtidas em alguns países, por idades, sexo e/ou divisão por mão esquerda/direita ou dominante/não dominante, mas que não são aceites como referências absolutas. Discussão e Conclusões: Por vezes alguns trabalhadores são avaliados pela Dinamometria; contudo, ainda que seja um procedimento simples a nível técnico, parte dos indivíduos que a executam não apresentam conhecimentos suficientes para atenuar/controlar algumas variáveis que podem enviesar o resultado. Para além disso, não se encontram valores de referência com os quais possamos comparar um valor único obtido, ficando a dúvida se a validade do exame servirá apenas para analisar os diversos valores obtidos num mesmo trabalhador (nas mãos esquerda/direita, dominante/não dominante e/ou ao longo do tempo, em função do envelhecimento ou de circunstâncias médicas que tenham a capacidade de diminuir a força: patologias, acidentes e/ ou respetivas reabilitações). Estão publicadas sugestões de valores encontrados para alguns países que, na falta de valores referência consensualmente aceites, poderão servir como orientação. O exame bem executado permite perceber a capacidade física de trabalho, de forma a uma melhor gestão dos condicionamentos pelo Médico do Trabalho, atribuição de tarefas da parte da chefia ou até para uma contestação fundamentada em relação a um eventual processo de acidente laboral.

ABSTRACT Introduction/background/objectives: The dynamometer is an accessible instrument in the acquisition and use, reason why the majority of companies that provide external services have it and sometimes use it. However, the bibliography on this method is not very abundant. The purpose of this review was to summarize the most pertinent data on this technique and reflect on whether it is being used properly in Occupational Health and what are its potential in this context. Methodology: This is a Bibliographic Review, initiated through a research carried out in January 2021, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive and MedicLatina”. Content: The handgrip strength assessment can be used to specifically quantify the limitations in the upper limb, infer the ability to work after an accident/illness/surgery, and/or perceive the evolution of a rehabilitation process. The quantification of force can be altered by many factors. There are several types of Dynamometers: some are fixed, complex, demanding, expensive and others are portable, simple, economical and without requiring special training. There are some consensual protocol recommendations for the correct execution of the test. Some guiding values for the quantifications obtained in some countries are published, by age, sex and/or division by left/right or dominant/non-dominant hand, but which are not accepted as absolute references. Discussion and Conclusions: Sometimes some workers are evaluated by Dynamometry; however, even though it is a simple procedure at a technical level, some of the individuals who perform it do not have enough knowledge to mitigate/control some variables that may skew the result. In addition, there are no reference values with which we can compare a single value obtained, leaving the doubt whether the validity of the exam will only serve to analyze the different values obtained in the same worker (in the left/right, dominant/non-dominant hands and/or over time, depending on aging or medical circumstances that can reduce strength, as pathologies, accidents and/ or respective rehabilitation. Suggestions of values were found for some countries that, in the absence of consensually accepted reference values, it can serve as a guide. The well-executed exam allows to perceive the physical capacity of work, to better manage the conditionings by the Occupational Physician, assign tasks or even to a more reasoned contestation in relation to a work accident process.

Background: Pharmaceutical services in Brazil provide access, supply, and rational use of drugs for all population and an effort has been made to improve the quality of these services. Biological drugs are high-cost drugs supplied in Brazil that can inhibit disease progression and improve the quality of life of psoriatic arthritis (PsA) patients. However, some patients did not achieve therapeutic goals. Objective: To evaluate the medication adherence and persistence of PsA patients treated with tumor necrosis factor inhibitors (anti-TNF) drugs and their associated factors. Methods: A prospective observational study was performed at a single-specialty pharmacy in Belo Horizonte, Brazil. Medication adherence, persistence, and clinical outcomes were evaluated at 12 months of follow-up. Medication persistence was historically compared to overall PsA patients treated in Brazil. Associated factors were identified through log-binomial regression. Results: One hundred ninety-seven PsA patients were included in the study, of whom 147 (74.6%) and 142 (72.1%) had medication adherence and persistence, respectively. Patients treated with infliximab presented the highest adherence (90.5%) and persistence rate (95.2%) in comparison to patients treated with other drugs, except for adalimumab versus infliximab for adherence outcome. All clinical measures significantly improved in patients with medication adherence and persistence. Medication persistence was higher for patients attended by specialty pharmacy than other PsA patients in Brazil. The associated factors to higher medication adherence were lower disease activity by BASDAI, being non-white race, and intravenous drug use. The associated factors to higher medication persistence were lower disease activity by Bath Ankylosing Spondylitis Activity Index (BASDAI), intravenous drug use, non-use of corticoids and non-steroidal anti-inflammatory drugs, and comorbidity. Conclusions: Patients with medication adherence and persistence had significant improvements in clinical measures, functionality, and quality of life. High medication adherence and persistence to biological therapy were observed and associated with lesser disease activity at baseline. Also, medication persistence to PsA patients attended in specialty pharmacy was higher than the overall PsA population in Brazil, which indicates the importance of pharmaceutical services to provide health care and promote the effectiveness and safety of biological therapies.

Objective: To assess mortality during the COVID-19 pandemic according to social vulnerability by areas of Belo Horizonte (BH), aiming at strategies for vaccination. Methods: Ecological study with mortality analysis, according to census tracts classified by the Health Vulnerability Index, a composite indicator that includes socioeconomic and sanitation variables. Deaths due to natural causes and COVID-19 were obtained from the “Mortality Information System”, between the 10th and 43rd epidemiological weeks (EW) of 2020. Excess mortality was calculated by a time series model, considering observed deaths by EW, between 2015 and 2019, for census tracts. Mortality rates (MR) were calculated and age-standardized =using population estimates from 2010 census. Results: Excess mortality in BH was 16.1% (n =1524): 11.0%, 18.8% and 17.3% in the low, intermediate and high vulnerability areas, respectively. The differences between observed and expected age-standardized MR by natural causes were equal to 59/100,000 inhabitants in BH, increasing from 31 to 77 and 95/100,000 inhabitants, in the areas of low, intermediate and high vulnerability, respectively. There was an aging gradient in COVID-19 MR, ranging from 4 to 611/100,000 inhabitants among individuals of 20-39 years and 75+ years. The COVID-19 MR per 100,000 elderly (60+ years) was 292 in BH, increasing from 179 to 354 and 476, in the low, intermediate and high vulnerability areas, respectively. Conclusion: Inequalities in mortality, particularly among the elderly, combined with the limited supply of doses, demonstrate the importance of prioritizing socially vulnerable areas during vaccination against COVID-19.

Objetivo: Avaliar a mortalidade por áreas de Belo Horizonte (BH) durante a pandemia de COVID-19 conforme vulnerabilidade social, visando estratégia de vacinação. Métodos: Estudo ecológico com análise de mortalidade, segundo setores censitários classificados pelo Índice de Vulnerabilidade da Saúde, composto por indicadores de saneamento e socioeconômicos. Óbitos por causas naturais e COVID-19 foram obtidos do Sistema de Informação sobre Mortalidade, entre a 10ª e 43ª semana epidemiológica (SE) de 2020. Calculou-se o excesso de mortalidade por modelo de série temporal, considerando as mortes observadas por SE, entre 2015 e 2019, por setor censitário. Taxas de mortalidade (TM) foram calculadas e padronizadas por idade a partir de estimativas populacionais do IBGE. Resultados: Houve 16,1% (n=1524) de excesso de mortalidade em BH: 11,0%, 18,8% e 17,3% nas áreas de baixa, média e elevada vulnerabilidade, respectivamente. As diferenças entre TM observadas e esperadas por causas naturais, padronizadas por idade, foi igual a 59/100.000 habitantes em BH, aumentando de 31 para 77 e 95/100.000, nas áreas de baixa, média e elevada vulnerabilidade, respectivamente. Houve gradiente de aumento com a idade nas TM por COVID-19, variando de 4 a 611/100.000 habitantes entre as idades de 20-39 anos e 75+ anos. A TM por COVID-19 por 100.000 idosos (60+ anos) foi igual a 292, aumentando de 179 para 354 e 476, nos setores de baixa, média e elevada vulnerabilidade, respectivamente. Conclusão: Desigualdades na mortalidade, mesmo entre idosos, aliadas à baixa oferta de doses, demonstram importância de priorizar áreas socialmente vulneráveis durante a vacinação contra COVID-19.

RESUMO No Brasil, a abobrinha-de-moita (Cucurbita pepo L.) é uma olerícola de importância socioeconômica que tem sofrido prejuízos crescentes, devido principalmente aos danos causados pela infecção pelo zucchini yellow mosaic virus (ZYMV). Embora a ocorrência do cucumber mosaic virus (CMV) seja menos frequente, em plantas de C. pepo ‘Caserta’ ele pode causar sintomas como mosqueado, mosaico, distorção de folhas e frutos, além de redução do desenvolvimento das plantas. Para minimizar o prejuízo, a medida de manejo mais utilizada é a aplicação preventiva, porém ineficiente, de inseticidas, visando ao controle da população de afídeos, vetores desses vírus. Assim, a busca por formas de controle ambientalmente menos danosas tem sido alvo de investigação. Este estudo visou avaliar a ação de extratos foliares de espécies nativas de Caryophyllales, como inibidoras da infecção pelo CMV e ZYMV em C. pepo e como indutoras de resistência. Extratos de folhas frescas (EFs) de Guapira opposita, Pisonia ambigua (Nyctaginaceae), Gallesia integrifolia e Seguieria langsdorffii (Phytolaccaceae), previamente avaliados no patossistema tobacco mosaic virus / Nicotiana glutinosa, foram submetidos a diluições progressivas e pulverizados em folhas cotiledonares de C. pepo, 30 min antes da inoculação com o CMV e ZYMV. EFs de G. integrifolia não induziram qualquer inibição em nenhum dos patossistemas. EFs de G. opposita induziram inibição da infecção das plantas inoculadas com o ZYMV inferior a 50%. Na concentração de 1:40, inibiu a infecção das plantas pelo CMV em 70%. Como os extratos foliares de P. ambigua e S. langsdorffii induziram altas porcentagens de inibição, essas espécies foram selecionadas para avaliação de indução de resistência, em experimentos de pré-tratamentos. Os EFs inibiram a infecção de ZYMV e CMV em C. pepo, quando aplicados até 48 h antes da inoculação. Os EFs de S. langsdorffii e G. opposita, também testada para esse sistema, foram eficientes quando aplicados até 72 h antes da inoculação do CMV. Constatou-se que os EFs podem ser preparados a partir de folhas secas e mantidos a -20°C por, pelo menos três anos, conservando a sua atividade inibidora. Esses resultados expandem as possibilidades de manejo das principais viroses da abobrinha-de-moita, de maneira sustentável, sem causar danos ao ambiente, aos produtores e aos consumidores.

ABSTRACT In Brazil, zucchini (Cucurbita pepo) is a socioeconomically important vegetable affected by damage caused primarily by zucchini yellow mosaic virus (ZYMV). Although the occurrence of cucumber mosaic virus (CMV) is less frequent, in C. pepo ‘Caserta’ plants it can cause symptoms such as mottle, mosaic, leaf and fruit distortion, as well as reduced plant development. To minimize the damage, the most widely used management technique is the preventive, albeit inefficient, application of insecticides, aimed at controlling aphids, the vectors of this virus. Thus, the search for more effective and less environmentally harmful control methods has been the target of investigations. The purpose of the present study was to assess the action of the extracts of four native Caryophyllales species, as inhibitors of infection by CMV and ZYMV in C. pepo, in addition to evaluating the possible induced resistance in this species. Fresh leaf extracts (LEs) of Guapira opposita, Pisonia ambigua (Nyctaginaceae), Gallesia integrifolia and Seguieria langsdorffii (Phytolaccaceae), previously assessed in the tobacco mosaic virus / Nicotiana glutinosa pathosystem, were submitted to progressive dilutions sprayed on cotyledonary C. pepo leaves 30 min before inoculation with CMV and ZYMV. Leaf extracts of G. integrifolia did not induce inhibition in any of the pathosystems assessed. Guapira opposita LEs inhibited the infection of plants inoculated with ZYMV below 50% but inhibited CMV infection by 70% at a concentration of 1:40. Given that leaf extracts of P. ambigua and S. langsdorffii induced high percentage inhibition, evident in the number of asymptomatic plants and confirmed by serological tests, these species were selected to assess induced resistance in pre-treatment experiments. The LEs were efficient in inhibiting ZYMV and CMV infection in C. pepo when applied up to 48 h before inoculation. The LEs of S. langsdorffii and G. opposita, also tested for this system, were efficient when applied up to 72 h before CMV inoculation. The LEs can be prepared from dry leaves and maintained at -20°C for at least three years, conserving their inhibitory activity. These results expand the possibilities for producers and consumers alike in the sustainable management of the main zucchini viruses, without damaging the environment.

SUMMARY Objective: COVID-19 is associated with lung damage and a high mortality rate in hospitalised patients. Corticoids may reduce the evolution to respiratory failure and death. This study aims to assess the effect on the ICU admission rate of a change in corticosteroid treatment strategy, administering low versus high doses. Methods: A retrospective, observational study was designed. Confirmed COVID-19 patients indicated to start treatment with corticosteroids were enrolled. To study the association between the type of corticosteroid used and admission to the ICU, a binary logistic regression model was constructed. This model included variables that could cause confusion or influence the response: gender, age, comorbidities, and analytical data. Results: From 190 admitted patients, 127 were enrolled in the study. In both groups, patients received a minimum of two doses of corticosteroids during admission. 12.4% (12/97) of the patients who received methylprednisolone (high doses) were subsequently admitted to the ICU, compared to 30.0% (9/30) of the patients who received dexamethasone (low doses). In the logistic regression model constructed, the type of corticosteroid (low-dose dexamethasone) (p=0.002), male gender (p=0.023), age over 50 years (p=0.014) and IL-6 level >70 pg/mL (p=0.004) remained as predictive factors for admission to the ICU. Conclusions: In the studied population of patients hospitalised for COVID-19, the use of high-dose methylprednisolone is associated with a lower rate of admission to the ICU than the administration of low-dose dexamethasone.

RESUMEN Objetivo: La COVID-19 está asociada a daño pulmonar y alta tasa de mortalidad en pacientes ingresados. Los corticoides pueden reducir la progresión a insuficiencia respiratoria y muerte. El objetivo del presente estudio es evaluar el efecto sobre la tasa de ingreso en UCI tras el cambio de estrategia en el tratamiento con corticoides, administración de bajas dosis frente a altas dosis. Métodos: Se diseñó un estudio retrospectivo observacional en el que se seleccionaron pacientes COVID-19 confirmado con indicación de inicio de tratamiento con corticoides. Para estudiar la asociación entre el tipo de corticoide utilizado y el ingreso en UCI, se construyó un modelo de regresión logística binaria en el que se incluyeron variables que podrían causar confusión o influir en la respuesta: sexo, edad, comorbilidades y datos analíticos. Resultados: De 190 pacientes ingresados, 127 se incluyeron en el estudio. En ambos grupos los pacientes recibieron un mínimo de dos dosis de corticoides durante el ingreso. El 12,4% (12/97) de los pacientes que recibieron metilprednisolona (altas dosis) ingresaron posteriormente en UCI, frente al 30,0% (9/30) de los pacientes que recibieron dexametasona (bajas dosis). En el modelo de regresión logística construido permanecieron como factores predictivos de ingreso en UCI el tipo de corticoide (dexametasona a bajas dosis) (p=0,002), el sexo masculino (p=0,023), edad superior a 50 años (p=0,014) y nivel de IL-6 >70 pg/mL (p=0,004). Conclusiones: En la población estudiada de pacientes hospitalizados por COVID-19, el uso de metilprednisolona a altas dosis se asocia a una menor tasa de ingreso en UCI que dexametasona a bajas dosis.