Abstract Studies investigating the effects of different modalities of exercises on the immune system are scarce. Therefore, the aim of this study was to compare the effects of eight weeks of resistance and aerobic training on the proliferation of T and B lymphocytes from mice. Eighteen male C56BL6/J mice were divided into groups (n=6), sedentary, aerobic, and resistance training. After 8 weeks, animals were euthanized, and their splenocytes were labeled and cultured with and without stimulation. Lymphocyte proliferation (CD4+, CD8+ and CD21/CD35+) was evaluated by flow cytometry. The mice subjected to resistance exercise exhibited greater proliferation for total, CD8+ and B lymphocytes (p<0.05), but not CD4+ cells (p>0.05), compared with their sedentary counterparts. We found significant correlations between maximum load and total, CD8+ and B lymphocytes proliferation rates (p<0.05). In conclusion, our results showed that resistance training promoted an improvement in the immune response associated with CD8+ and B lymphocytes.

Abstract Objective: The aim of this study was to investigate the association between iron deficiency anemia and sleep duration in the first year of life. Methods: A total of 123 infants were investigated, with sleep being evaluated at 3, 6, and 12 months of age and anemia at birth and 6 months. The cutoff points for anemia and short sleep duration were hemoglobin <11 g/dL (at birth and/or 6 months) and <10 h (at 3, 6, and 12 months), respectively. The comparison of the average sleep time between infants with and without anemia was performed using the Student’s t-test, and logistic regression models were also used to verify differences in the sleep duration (short/not short) between the groups. Linear regression analyses were conducted to determine the association between sleep duration and hemoglobin values. The analyses were adjusted for potential confounders. Results: Children with anemia were more likely to be short sleepers [odds ratio (95% confidence interval (CI)): 4.02 (1.02–15.76); p≤0.05], and for each unit increase in hemoglobin values, the sleep duration increased by 16.2 min [β (95%CI): 0.27 (0.00–0.55); p≤0.05), regardless of family income, maternal schooling, gender, and body mass index at birth. Conclusions: Our results suggest that iron deficiency anemia is associated with short sleep duration in the first year of life and indicate the need for longitudinal investigations, with longer follow-up, to verify the impact of anemia on sleep duration at subsequent ages.

RESUMO Objetivo: Investigar a associação entre a anemia por deficiência de ferro e a duração do sono no primeiro ano de vida. Métodos: Foram avaliadas 123 crianças, sendo o sono investigado aos três, seis e 12 meses de idade e a anemia ao nascimento e aos seis meses. Utilizaram-se como pontos de corte para anemia e curta duração de sono, respectivamente, hemoglobina<11 g/dL (nascimento e/ou seis meses) e tempo total <10 h (3, 6 e/ou 12 meses). A comparação do tempo médio de sono entre as crianças com e sem anemia foi realizada pelo teste t de Student e modelos de regressão logística foram usados para verificar diferenças na duração do sono (curta/não curta) entre os grupos. Análises de regressão linear foram conduzidas para determinar a associação entre a duração do sono e valores de hemoglobina. As análises foram ajustadas para potenciais confundidores. Resultados: As crianças com anemia tiveram maior chance de apresentar curta duração do sono [odds ratio — OR (intervalo de confiança — IC95%): 4,02 (1,02–15,76); p≤0,05]. Para cada unidade de aumento nos valores da hemoglobina, o tempo de sono aumentou em 16,2 min [β (IC95%): 0,27 (0,00–0,55); p≤0,05), independentemente de renda familiar, escolaridade materna, sexo e índice de massa corporal ao nascimento. Conclusões: Nossos resultados sugerem que a anemia ferropriva está associada à curta duração do sono no primeiro ano de vida e indicam a necessidade de investigações longitudinais, com maior tempo de seguimento, para verificar o impacto da anemia na duração do sono em idades subsequentes.

Resumo Introdução: O fígado gordo associado a disfunção metabólica (FGADM) é uma causa crescente de doença hepática crónica. Em 2020, o score Fibroscan-AST (FAST) foi validado internacionalmente como uma nova ferramenta capaz de identificar pacientes com esteatohepatite que beneficiam de terapêuticas adicionais, baseado nos achados da elastografia hepática transitória (EHT) e níveis séricos de aspartato aminotransferase (AST). Os autores procuraram identificar, em pacientes com FGADM, que fatores metabólicos predizem um score-FAST maior. Métodos: Estudo retrospetivo de pacientes com FGADM submetidos a EHT durante 2 anos consecutivos. Pacientes sem uma amostra de AST colhida nos 6 meses prévios à EHT foram excluídos. O score-FAST foi calculado, estratificando o risco do paciente como baixo (<0,35), moderado (0,35-0,67) ou alto (>0,67). Resultados: A amostra incluiu 117 pacientes, 53% do sexo feminino, com uma idade média de 53 anos. Em análise multivariada, pacientes com Diabetes Mellitus tipo 2 (DMT2) (p < 0,001), dislipidemia (p = 0,046) e hábitos tabágicos (p = 0,037) apresentaram valores de score-FAST significativamente maiores. Além disso, os pacientes diabéticos apresentaram não só valores de score-FAST significativamente maiores, como também foram mais frequente classificados como pertencendo ao grupo de alto risco, de acordo com os critérios deste score (OR = 9,2; 95%IC = 1,8-45,5; p = 0,007). Conclusões: Calculando o score-FAST, pacientes com FGADM e DMT2 apresentaram um risco significativamente maior. Esta ferramenta validada poderá ser utilizada para selecionar os pacientes com DMT2 e FGADM que poderão beneficiar de seguimento especializado.

Abstract Background: Metabolic-associated fatty liver disease (MAFLD) is an increasingly prevalent cause of chronic liver disease. In 2020, the FibroScan-AST (FAST) score was internationally validated as a new tool able to identify patients with steatohepatitis who benefit the most from further therapies, based on liver transient elastography (LTE) findings and serum levels of aspartate aminotransferase (AST). We aimed to identify, in MAFLD patients, which metabolic features may predict a higher FAST score. Methods: Retrospective study of consecutive patients with MAFLD submitted to LTE for two consecutive years. Patients without an AST sample collected within 6 months of the LTE were excluded. FAST score was calculated, stratifying the patient’s risk as low (<0.35), medium (0.35-0.67), or high (>0.67). Results: The sample included 117 patients, 53.0% of the female gender, with a mean age of 53 years. On multivariate analysis, patients with type 2 diabetes (T2DM) (p < 0.001), dyslipidemia (p = 0.046), and smoking habits (p = 0.037) presented with significantly higher FAST score values. Furthermore, diabetic patients did not only present significantly higher FAST scores but were also more frequently assigned to the high-risk group according to FAST score criteria (OR = 9.2; 95% CI = 1.8-45.5; p = 0.007). Conclusions: Calculating the FAST score, patients with T2DM presented a significantly higher risk of having significant fibrosis and steatohepatitis. Physicians may rely on this validated instrument to more easily identify which patients with T2DM and MAFLD benefit the most from a specialized follow-up.

SUMMARY: The COVID-19 pandemic caused several changes in the teaching of human anatomy, among them the use of different teaching methodologies based on E-learning. However, studies evaluating electronic tools have not provided clear evidence of effective student learning. Thus, this was the first study to evaluate medical students after completing human anatomy courses in the E- learning modality. We recruited first term (Group A, n=25) and second term (Group B, n=13) medical students. We applied a practical assessment based on 50 human anatomy markingson real anatomical specimens and cadavers, to be completed in Questionnaire 01 (Phase I). After detecting low scores on Questionnaire 01 by both groups, we applied a practical and face-to-face tutoring system for 14 days (Phase II). Afterwards, we re-evaluated both groups by repeating the same scores (Questionnaire 02, Phase III). According to the paired analysis of questionnaires 01 and 02 by Student's T-test, both groups showed significant increase in the final scores obtained in questionnaire 02 (Phase III). The evidence showed that the remote format lecture system weakened the learning and retention process of basic anatomical knowledge by medical students. On the other hand, in-person practical teaching proved to be efficient in the formative process of the students, a fact proven by the significant increase in the scores of the students in the 02 questionnaire, for both groups.

RESUMEN: La pandemia por COVID-19 provocó varios cambios en la enseñanza de la anatomía humana, entre ellos el uso de diferentes metodologías de enseñanza basadas en E-learning. Sin embargo, los estudios que evalúan las herramientas electrónicas no han proporcionado evidencia clara de un aprendizaje efectivo de los estudiantes. Este fue el primer estudio que evaluó a estudiantes de medicina luego de cursar cursos de anatomía humana en la modalidad E-learning. Reclutamos estudiantes de medicina de primer término (Grupo A, n=25) y segundo término (Grupo B, n=13). Se aplicó una evaluación práctica basada en 50 marcas de anatomía humana sobre especímenes anatómicos reales y cadáveres, para ser completado en el Cuestionario 01 (Fase I). Tras detectar puntuaciones bajas en el Cuestionario 01 por parte de ambos grupos, se aplicó un sistema de tutorías prácticas y presenciales durante 14 días (Fase II). Posteriormente, reevaluamos ambos grupos repitiendo las mismas puntuaciones (Cuestionario 02, Fase III). Según el análisis apareado de los cuestionarios 01 y 02 por la prueba T de Student, ambos grupos mostraron aumento significativo en los puntajes finales obtenidos en el cuestionario 02 (Fase III). La evidencia mostró que el sistema de conferencias en formato remoto debilitó el proceso de aprendizaje y retención de conocimientos anatómicos básicos por parte de los estudiantes de medicina. Por otro lado, la docencia práctica presencial demostró ser eficiente en el proceso formativo de los alumnos, hecho que demuestra el aumento significativo de las puntuaciones de los alumnos en el cuestionario 02, para ambos grupos.

Abstract Introduction: The coronavirus (COVID-19) pandemic in higher education has had disturbing consequences on the lives and mental health of students. We intend to evaluate the levels of anxiety, depression, and stress of nursing students at the Polytechnic Institute of Santarem. Method: Exploratory, observational, descriptive, and correlational study. Students: 183 students, selected by convenience sampling. Measurement instrument: Anxiety, Depression and Stress Scale - EADS-21 validated for the Portuguese population, applied between November 19 and December 4, 2020. The collected data were analyzed using the IBM SPSS Statistics for Windows Software, version 27.0. Conclusions: The findings showed that most students had a normal level of depression (82.5%), anxiety (88.0%) and stress (94.0%). About 1.6% of students reported a moderate level of stress; 5.5% and 1.6% a moderate and severe level, respectively, of anxiety and 6% and 0.5% depression a moderate and severe level, in due order. Significant differences were found between means (Student's t test) in the comparison between gender (p < 0.001), with the highest scores, in the three dimensions, in the female gender that presented more stress (M = 7.59 + 4.728), depression (M = 5.83 + 4.503) and anxiety (M =3.87 + 3.869), that is, the affective states of the female gender were more negative.

Resumen Introducción: La pandemia del coronavirus (COVID-19) en la educación superior ha tenido consecuencias preocupantes en la vida y salud mental de los estudiantes. Pretendemos evaluar los niveles de ansiedad, depresión y estrés de estudiantes de enfermería del Instituto Politécnico de Santarém. Método: Estudio exploratorio, observacional, descriptivo y correlacional. Estudiantes: 183 estudiantes, seleccionados por muestreo por conveniencia. Instrumento de medición: Escala de Ansiedad, Depresión y Estrés - EADS-21 validada para la población portuguesa, aplicada entre el 19 de noviembre y el 4 de diciembre de 2020. Los datos recolectados fueron analizados utilizando el software IBM SPSS Statistics para Windows, versión 27.0. Conclusiones: Los hallazgos mostraron que la mayoría de los estudiantes presentaba un nivel normal de depresión (82,5%), ansiedad (88,0%) y estrés (94,0%). Alrededor del 1,6% de los estudiantes reportaron un nivel moderado de estrés; 5,5% y 1,6% un nivel moderado y severo, respectivamente, de ansiedad y 6% y 0,5% depresión un nivel moderado y severo, en su debido orden. Se encontraron diferencias significativas entre las medias (prueba t de Student) en la comparación entre género (p < 0,001), con las puntuaciones más altas, en las tres dimensiones, en el género femenino que presentó más estrés (M = 7,59 + 4,728), depresión (M = 5,83 + 4,503) y ansiedad (M =3,87 + 3,869), es decir, los estados afectivos del género femenino fueron más negativos.

Resumo Introdução: A pandemia do coronavírus (COVID-19) no ensino superior causou consequências perturbadoras na vida e na saúde mental dos estudantes. Pretendemos avaliar os níveis de ansiedade, depressão e stress dos estudantes de enfermagem do Instituto Politécnico de Santarém. Método: Estudo exploratório, observacional descritivo e correlacional. Estudantes: 183 estudantes, selecionados por amostragem de conveniência. Instrumento de medida: Escala de Ansiedade, Depressão e Stress - EADS-21 validada para a população portuguesa, aplicada entre 19 de novembro e 4 de dezembro de 2020. Os dados recolhidos foram analisados com o Software IBM SPSS Statistics for Windows, versão 27.0. Conclusões: Os achados mostraram que a maioria dos estudantes apresentou um nível normal de depressão (82,5%), ansiedade (88,0%) e stress (94,0%). Cerca de 1,6% dos estudantes relataram nível moderado de stress; 5,5% e 1,6% um nível moderado e grave, respetivamente, de ansiedade e 6% e 0,5% depressão um nível moderado e grave, na devida ordem. Foram encontradas diferenças significativas entre as médias (teste t de Student) na comparação entre género (p < 0,001), com os maiores scores, nas três dimensões, no género feminino que apresentou mais stress (M = 7,59 + 4,728), depressão (M = 5,83 + 4,503) e ansiedade (M =3,87 + 3,869), ou seja, os estados afetivos do género feminino foram mais negativos.

ABSTRACT Introduction: Voiding diary (VD) is an important tool in the evaluation of children with voiding symptoms. Voiding frequency, maximal voided volume (MVV), average voided volume (AVV) and nocturnal volume (NV) can be extracted and are valuable in diagnosing and monitoring these disorders. Recently, ICCS has reduced the period of data recording on VD from 3 to 2 days. We hypothesized that one day voiding diary would be enough for guiding treatment. Materials and Methods: Children with overactive bladder (OAB) and primary monosymptomatic enuresis (PMNE) were oriented to fulfill a 3-day VD. Data obtained from VD were evaluated for the first day (1dVD), the first two days (2dVD), and all 3 days (3dVD) and compared according to the MVV, AVV, frequency, NV and expected bladder capacity (EBC). The Friedman, Student's t test and the Fisher's exact was used. ANOVA was used for multiple comparisons. We also used Pearson correlation test. Results: Ninety-eight children were included, 59 had PMNE and 30 OAB. Frequency, AVV and VN were similar regardless how many days the voiding episodes were recorded. Only MVV was higher by a mean of only 32 mL on 3dVD compared to 1dVD. A 1dVD has a sensitivity of 93,9% and a positive likelihood ratio of 2.2. As for the correlation of MVV and EBC it was observed that in 83% of children, MVV was lower than EBC. MVV corresponds to 67% and 69% of EBC in children with PMNE and OAB, respectively. Conclusion: We believe that 1dVD is sufficient to assess these children. It has a high sensitivity and good correlation to 3dVD in evaluating these children. Bladder capacity in this population, evaluated by maximum voided volume, was close to 68% of that obtained by the EBC.

ABSTRACT The objective of this work was to evaluate the physiological variables of the cultivar Opuntia stricta (Haw.) Haw in the first cycle and in the regrowth, under different frequencies of drip irrigation, cultivated in the Agreste da Paraíba mesoregion. Therefore, a randomized block design was used, with 2 treatments (irrigation frequencies) and 4 replications (blocks), with each treatment repeated 3 times within the block (triplicate) totaling 24 experimental plots. For physiological variables, data were evaluated by analysis of variance (ANOVA) and means compared by t test at 5% probability using SAS ® (2002). The present study shows that the stress of environmental conditions had a greater impact on the frequency of irrigation every 28 days, since the forage cactus irrigated every 7 days had the highest internal concentration of CO2; CO2 absorption rate; instant efficiency in water use; intrinsic efficiency of water use; instantaneous carboxylation efficiency, both in the first cycle and in the regrowth period. Respiratory rate and stomatal conductance did not differ between irrigation frequencies for both cycles, showing the good adaptation of the cultivar to the semiarid region.

Abstract Background Spatial orientation is a cognitive domain frequently compromised in patients with Alzheimer disease (AD) and may be one of its first clinical manifestations. Some studies have shown that allocentric integration with egocentric spatial information seems to be impaired in this pathology. There is no consensus on how best to assess spatial orientation and traditional tests lack ecological validity, but, recently, virtual reality (VR) has provided new opportunities for this assessment. Objectives To analyze the applicability and stability of an immersive virtual task developed to assess spatial orientation, the Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) in older adults with and without mild cognitive impairment. Methods Forty-three older adults were included in the study, 24 without cognitive impairment and 19 with mild cognitive impairment. Applicability was assessed by the Witmer and Singer Sense of Presence Questionnaire and a questionnaire for adverse events of cybersickness. To assess stability, participants were assessed twice with an interval of 7 to 14 days, and the intraclass correlation coefficient was calculated between visits. The t test or the Mann-Whitney test was used to compare applicability and stability between groups. Results There was no significant difference between the groups regarding applicability. A strong correlation between the first and second day of testing was found in the mild cognitive impairment group. Conclusion The SOIVET-Maze task showed excellent applicability and good stability, favoring its clinical application for the evaluation of spatial orientation in older adults.

Resumo Antecedentes A orientação espacial é um domínio cognitivo frequentemente comprometido em pacientes com doença de Alzheimer (DA) e pode ser uma das suas primeiras manifestações clínicas. Alguns estudos demonstraram que a integração alocêntrica com informações espaciais egocêntricas parece prejudicada nessa patologia. Não há um consenso sobre qual a melhor forma de avaliar a orientação espacial e os testes tradicionais carecem de validade ecológica; porém, recentemente, a realidade virtual (RV) proporcionou novas oportunidades para esta avaliação. Objetivos Analisar a aplicabilidade e estabilidade de uma tarefa virtual imersiva desenvolvida para avaliar a orientação espacial, o Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) em idosos com e sem comprometimento cognitivo leve. Métodos Quarenta e três idosos foram incluídos no estudo, 24 sem comprometimento cognitivo e 19 com comprometimento cognitivo leve. A aplicabilidade foi avaliada pelo Witmer and Singer Sense of Presence Questionnaire e um questionário para eventos adversos de cybersickness. Para avaliar a estabilidade, os participantes foram avaliados 2 vezes com intervalo de 7 a 14 dias, e o coeficiente de correlação intraclasse foi calculado entre as visitas. O teste t ou o teste de Mann-Whitney foi utilizado para comparar a aplicabilidade e estabilidade entre os grupos. Resultados Não houve diferença significativa entre os grupos quanto à aplicabilidade. Uma forte correlação entre o primeiro e o segundo dia de teste foi encontrada no grupo de comprometimento cognitivo leve. Conclusão A tarefa SOIVET-Maze apresentou excelente aplicabilidade e boa estabilidade, favorecendo sua aplicação clínica para avaliação da orientação espacial em idosos.

RESUMO Objetivo: Comparar o desempenho de indicadores antropométricos para identificar o excesso de gordura corporal (GC) em adolescentes. Métodos: Estudo metodológico com amostragem probabilística por conglomerados, por sorteio das escolas e turmas. A coleta de dados incluiu características sociodemográficas e medidas antropométricas. O índice de massa corporal (IMC), a relação cintura-estatura (RCE), o índice de conicidade (IC) e a circunferência da cintura (CC) foram calculados. O percentual de gordura corporal (%GC) foi calculado com base na espessura das dobras cutâneas e utilizado como padrão-ouro. Para analisar os dados, foram utilizadas estatísticas descritivas, teste t de Student, curva Receiver Operating Characteristic (ROC) e índice de Youden. Foi calculado o coeficiente de correlação entre os indicadores e o %GC. Resultados: Participaram do estudo 997 adolescentes de escolas municipais. Identificou-se, pelo IMC, que 10,6% dos adolescentes apresentavam sobrepeso e 4,7%, obesidade. O IMC, a CC e a RCE apresentaram a maior acurácia para predizer a gordura corporal. Todos os indicadores antropométricos apresentaram especificidade superior à sensibilidade para diagnosticar excesso de GC no sexo masculino. A CC apresentou a maior sensibilidade em ambos os sexos. O IC apresentou a menor área sob a curva ROC e a menor sensibilidade em ambos os sexos, mas especificidade equivalente aos demais indicadores. Conclusões: IMC, RCE e CC apresentaram a melhor capacidade de predizer excesso de GC em adolescentes e os melhores coeficientes de correlação. Essas ferramentas podem ser consideradas formas de rastreamento na identificação do excesso de GC em adolescentes.

Abstract Objective: To compare the performance of anthropometric indicators that identify excess body fat (BF) in adolescents. Methods: This is a methodological study that used probability cluster sampling through school and class draws. Data collection included sociodemographic characteristics and anthropometric measures. Body mass index (BMI), waist-to-height ratio (WtHR), conicity index (C index), and waist circumference (WC) were calculated. Body fat percentage (BF%) was calculated from skinfold thickness and used as the gold standard. To analyze the data, descriptive statistics, Student’s t-test, Receiver Operating Characteristic (ROC) curve, and Youden’s index were used, in addition to correlation coefficient calculation between the indicators and BF%. Results: A total of 997 adolescents enrolled in municipal secondary schools participated in the study. By calculating the BMI, we found that 10.6% of adolescents were overweight, and 4.7% were obese. BMI, WC, and WtHR had the highest accuracy to predict body fatness. All the anthropometric indicators had higher specificity than sensitivity to diagnose excess BF in males. WC had the highest sensitivity in both genders. C index had the smallest area under the ROC curve and the lowest sensitivity in both genders, but its specificity was equivalent to that of the other indicators. Conclusions: BMI, WtHR, and WC were the best anthropometric indicators to predict excess BF in adolescents and had the best correlation coefficients. These tools can be considered in the screening to detect excess BF in adolescents.

RESUMO Objetivo: Descrever e comparar as variáveis da aptidão física de acordo com o cumprimento da recomendação de atividade física, medida por acelerometria. Métodos: A amostra foi composta de 120 escolares, sendo 57 meninos e 63 meninas, de 9 a 11 anos de idade. As variáveis analisadas foram: peso, estatura, índice de massa corpórea (IMC), dobras cutâneas, circunferências, agilidade, flexibilidade, velocidade e força de membros superiores, inferiores e abdominal. A atividade física foi mensurada de forma objetiva por meio de acelerômetro. Os escolares foram divididos em dois grupos: “cumpre a recomendação” (≥60min/dia) e “não cumpre a recomendação” (<60min/dia). Para verificar a normalidade dos dados, foi utilizado o teste de Kolmogorov-Smirnov. A comparação dos valores médios dos escolares que cumprem ou não a recomendação de atividade física foi feita pelos testes t de Student e U de Mann-Whitney. O nível de significância adotado foi de p<0,05. Resultados: Os escolares que cumpriram a recomendação, comparados com os que não cumpriram, apresentaram valores significativamente menores para adiposidade (somatória das sete dobras cutâneas), peso corporal, IMC e força abdominal. Não foram encontradas diferenças significativas nas variáveis de velocidade e agilidade; quanto à força de membros superiores (MMSS), constatou-se que ela foi maior em quem não cumpriu a recomendação. Conclusões: Crianças que cumpriram a recomendação de atividade física apresentaram melhor composição corporal e força abdominal que as crianças que não cumpriram.

Abstract Objective: To describe and compare physical fitness variables according to compliance with the recommendations of physical activity, measured by accelerometry. Methods: The sample gathered 120 students, 57 boys and 63 girls aged 9 to 11 years. The variables analyzed were: weight, stature, BMI, skinfolds, waist circumference, agility, flexibility, speed and strength of upper and lower limbs, and abdominal strength. Physical activity was measured objectively using an accelerometer. The students were divided into two groups: “complies with recommendations” (≥60min/day) and “does not comply with recommendations” (<60min/day). To verify the normality of the data, the Kolmogorov-Smirnov test was used. The mean values of students who do or do not comply with the physical activity recommendation were compared using Student's t and U-Mann Whitney tests. The level of significance was set at p<0.05. Results: The students who followed the recommendation showed significantly lower values compared to those who did not for adiposity (sum of 7 skinfolds); body weight; body mass index (BMI) and abdominal strength. No significant differences were found in the variables of speed and agility, and the upper limbs’ strength was greater in subjects who did not comply with recommendations. Conclusions: Students who complied with physical activity recommendations had better body composition and more abdominal strength than those who did not.

ABSTRACT The urine bag is a thermo-labile medical-hospital device used in clinical/surgical procedures in urine drainage and collection. As it is a thermolabile material, it is commonly sterilized by ethylene oxide, a highly toxic, mutagenic and carcinogenic cyclic ether gas. Currently, several countries require, through documents and standards, the quantification of ethylene oxide in medical and hospital devices. Thus, this work describes the development and validation of a method employed for the quantification of ethylene oxide (ETO) in urine bags. The method was developed based on the guidelines of ISO 10993-7, ANVISA and INMETRO. The work range, linearity, limits of detection and quantification, repeatability, intermediate precision and selectivity were evaluated. Statistical tools such as Levene's test, Grubbs, residual analysis, F-test of two variances, paired sample T test and ANOVA table, were also applied to evaluate the method. The linearity of the work range (10 – 400 mg.L-1) showed an adequate correlation coefficient (r > 0.9993), with a homoscedastic profile with absence of outliers while the limit of detection and quantification were 1,95 and 6,5 mg.L-1 respectively. After validation, 45 samples of urine bags of different batches were evaluated, which demonstrated levels of ETO below the limit of detection (1,95 mg.L-1). The results highlight a simple method that meets several regulations with a wide working range, high sensitivity and capability to quantify ETO not only in urine bags but also in other medical devices.

ABSTRACT Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients’ demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student’s t test, for paired data. Linear correlation analysis was performed based on Spearman’s coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset’s lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset’s lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.

Resumen: Objetivo: evaluar la correlación entre las principales medidas de alineación sacropélvica y la reducción de la retroversión pélvica y evaluar la eficacia de Lamartina Square en la elección del nivel de instrumentación proximal. Métodos: muestra compuesta por 21 pacientes con espondilolistesis L5-S1 de alto grado sometidos a artrodesis con instrumentación desde enero de 2004 hasta diciembre de 2016. Se registraron datos demográficos de los pacientes, tipo de cirugía, complicaciones, parámetros de alineación sagital, Índice de Severidad y Cuadrado de Lamartina antes de la cirugía y en el último seguimiento. Los datos procesados en SPSS 22.0, con diferentes medias, se calcularon mediante la prueba t de Student, para datos pareados. Se realizó un análisis de correlación lineal basado en el coeficiente de Spearman. P <0,05 fue estadísticamente significativo. Resultados: hubo mejoría significativa en los ángulos de deslizamiento y cifosis lumbosacra de Dubousset (> 100° en el último control postoperatorio). Hubo una reducción significativa en la tasa de deslizamiento (<50 %) y en el índice de gravedad L4 y L5, que destacó una fuerte correlación con la inclinación pélvica, la falta de coincidencia y el ángulo de deslizamiento. El índice de gravedad también mostró una fuerte correlación inversa entre el ángulo de cifosis lumbosacra de Dubousset y la pendiente sacra. Conclusión: L5 Severity Index y Lamartina Square son variables importantes para la planificación preoperatoria de pacientes con espondilolistesis lumbar de alto grado. Nivel de Evidencia IV; Serie de Casos.

Resumo: Objetivo: avaliar a correlação entre as principais medidas do alinhamento sacropélvico com a retroversão pélvica e avaliar a efetividade do Lamartina Square na escolha do nível proximal de intrumentação. Métodos: amostra com 21 pacientes com espondilolistese de alto grau L5-S1, submetidos à artrodese com instrumentação, de 01/2004 a 12/2016. Os dados demográficos dos pacientes, tipos de cirurgias, complicações, parâmetros do alinhamento sagital, Severity Index e Lamartina Square foram registrados antes da cirurgia e no último acompanhamento. Dados processados no SPSS 22.0 com as diferenças das médias calculadas utilizando-se o teste t de Student para dados emparelhados. A análise da correlação linear foi realizada pelo coeficiente de Spearman. Significantes as análises com p < 0,05. Resultados: melhora significativa do ângulo de deslizamento e de cifose lumbosacral de Dubousset´s (> 100° no ultimo seguimento pósoperatório). Redução significativa da porcentagem de deslizamento ( e do severity index em L4 e L5. Este teve uma forte correlação direta com: tilt pélvico, mismatch, ângulo de deslizamento, porcentagem de deslizamento e uma forte inversa com: ângulo de cifose lumbosacral de Dubousset´s e o slope sacral. Conclusão: O Severity Index de L5 e o Lamartina Square devem ser consideradas variáveis importantes no planejamento pré-operatório de pacientes com espondilolistese lombar de alto grau.

ABSTRACT Objective The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

Resumen Introducción: el trastorno mineral y óseo (TMO) es una complicación grave de la enfermedad renal crónica (ERC) que aumenta el riesgo de muerte por causas cardiovasculares y deteriora la calidad de vida de los pacientes afectados. Objetivo: evaluar la prevalencia de la DMO en pacientes con RDC y la asociación entre la tasa de filtración glomerular estimada (TFGe) y los indicadores de DMO (calcio, fósforo y PTH) en pacientes no dialíticos. Materiales y métodos: estudio seccional de una cohorte de dos años de pacientes renales crónicos adultos y ancianos en tratamiento conservador. La DMO se identificó por los valores séricos de: PTH (> 150 pg/mL) y/o hipocalcemia (Ca < 8,8mg/ dl) y/o hiperfosfatemia (P > 4,6 mg/dl). El análisis estadístico utilizado: regresión de Poisson; T de Student, Mann Whitney y correlaciones de Pearson y Spearman con un nivel de significación del 5%. Resultados: la prevalencia de DMO fue del 54,6% (n=41) (IC 95%: 43,45 - 65,43), más frecuente en mujeres, alfabetizadas, de edad avanzada, no bebedoras, no fumadoras, sedentarias y de color de piel blanca. Las correlaciones entre el P y la PTH con el GFRe fueron significativas, inversas, de fuerza moderada (p= <0,005 y p = 0,003; coeficientes de correlación = - 0,312 y - 0,379 respectivamente). Discusión: los resultados de este estudio evidencian lagunas en el seguimiento de la DMO-DRC por parte de la atención primaria, lo que requiere una revisión de las prácticas clínicas. Conclusión: se identificó una fuerte prevalencia de la DMO en las primeras fases de la ERC, además de correlaciones entre el aumento de los niveles de fósforo y PTH y el empeoramiento de la función renal.

Abstract Introduction: mineral and bone disorder (BMD) is a serious complication of chronic kidney disease (CKD) that increases risks for death from cardiovascular causes and impairs quality of life of affected patients. Objective: to evaluate the prevalence of BMD in patients with CKD and the association between estimated Glomerular Filtration Rate (eGFR) and BMD indicators (calcium, phosphorus and PTH) in non-dialysis patients. Materials and Methods: sectional study of a two-year cohort of chronic renal adults and elderly patients on conservative treatment. BMD was identified by serum values of: PTH (> 150 pg/mL) and/or hypocalcemia (Ca < 8.8mg/dl) and/or hyperphosphatemia (P > 4.6 mg/dl). The statistical analysis used: Poisson regression; Student's T, Mann Whitney and Pearson and Spearman correlations with 5% significance level. Results: BMD prevalence was 54.6% (n=41) (95% CI: 43.45 - 65.43), more frequent in women, literate, elderly, non-drinkers, non-smokers, sedentary and white skin color. Correlations between P and PTH with GFRe were significant, inverse, moderate strength (p= <0.005 and p = 0.003; correlation coefficients = - 0.312 and - 0.379 respectively). the findings of this study highlighted gaps in the monitoring of BMD-DRC by primary care, requiring a review of clinical practices. Conclusion: robust prevalence of BMD in the early stages of CKD was identified, in addition to correlations between increased phosphorus and PTH levels and worsening kidney function.

Resumo Introdujo: o objetivo foi avaliar a prevalencia do distúrbio mineral e ósseo em pacientes com doenca renal crónica e a associate entre Taxa de Filtrado Glomerular estimada (TFGe) e os indicadores do distúrbio mineral e ósseo (DMO) (cálcio, fósforo e PTH) em pacientes renais crónicos nao dialíticos. Materiais e Métodos: estudo seccional da linha de base de uma coorte de dois anos, com adultos e idosos renais crónicos em tratamento conservador. Para identificado do DMO utilizamos os seguintes valores séricos: PTH (> 150 pg/mL) e/ou hipocalcemia (Ca < 8,8mg/dl) e/ou hiperfosfatemia (P > 4,6 mg/dl). Na análise estatística utilizou-se: regressao de Poisson; T de Student, Mann Whitney e correlacóes de Pearson e Spearman. Nivel de significancia foi de 5%. Resultados: prevalencia de DMO de 54,6% (n=41) (IC 95%: 43,45 - 65,43). A maior prevalencia de DMO foi em pessoas do sexo feminino, alfabetizadas, idosas, nao etilistas, nao tabagistas, sedentárias e de cor de pele branca, porém, sem diferenca estatística entre os grupos com e sem DMO. As correlacóes entre P e PTH com TFGe foram significativas, inversas, de forca moderada (p= <0,005 e p = 0,003; coeficientes de correlato = - 0,312 e - 0,379 respectivamente). Discussao: os achados desse estudo mostraram que existe uma lacuna no acompanhamento do DMO-DRC pela atencao primária e a prática clínica deve ser revista. Conclusao: identificou-se prevalencia robusta de DMO nos estágios precoces da DRC, além de correlacóes significativas entre o aumento dos níveis de fósforo e PTH e piora das funcóes renais.

Abstract The use of Pinus spp. as mineral addition or partial replacement of Portland cement, can provide the mitigation of CO2 emissions and the obtaining of carbon credits, through the clean development mechanism. This work assessed the potential for reducing CO2 emissions, through two approaches. The first approach used the ACM 0005 UNFCCC methodology, in a scenario to assess the feasibility of implementing a clean development mechanism project - CDM, covering the State of Paraná, using the ashes of Pinus spp. in partial replacement of clinker, in the production of Portland cement. The second approach analyzed the potential for reducing CO2 emissions, covering the Brazilian territory, using the ashes of Pinus spp. in partial replacement of Portland cement in the mixing of concrete, mortar and pastes. Elevations in CO2 emissions were observed due to the increase in the average distances in the transport of ash, in both approaches (128 km and 100 km, respectively). Even so, in the overall emission balances, reduction potentials were observed (10,800 t and 20,546 t of CO2, respectively). The results obtained allowed inferring the feasibility of implementing CDM projects and obtaining carbon credits through certified emission reductions - CERs.

Resumo A utilização das cinzas de Pinus spp. como adição mineral ou substituição parcial ao cimento Portland pode proporcionar a mitigação de emissões de CO2 e a obtenção de créditos de carbono, através do mecanismo de desenvolvimento limpo. Este trabalho pretendeu avaliar o potencial de redução de emissões de CO2, através de duas abordagens. A primeira abordagem utilizou a metodologia ACM 0005 UNFCCC, em um cenário para avaliar a viabilidade de implementação de um projeto do mecanismo de desenvolvimento limpo - MDL, com abrangência para o Estado do Paraná, utilizando as cinzas de Pinus spp. em substituição parcial ao clínquer, na produção do cimento Portland. A segunda abordagem analisou o potencial de redução de emissões de CO2, com abrangência para o território brasileiro, utilizando as cinzas de Pinus spp. em substituição parcial ao cimento Portland na mixagem de concretos, argamassa e pastas. Foram observadas elevações nas emissões de CO2, pelo aumento nas distâncias médias no transporte das cinzas, nas duas abordagens (128 km e 100 km, respectivamente). Mesmo assim, nos balanços gerais das emissões, foram observados potenciais de redução (10.800 t e 20.546 t de CO2, respectivamente). Os resultados obtidos permitiram inferir pela viabilidade da implementação de projetos de MDL e da obtenção de créditos de carbono através da redução certificada de emissões - RCEs.