Abstract Winged scapula is usually caused by neurological injuries to both the spinal nerve and the long thoracic nerve. Its presence as a result of a ventral scapular tumor makes initial diagnosis difficult. We present the case of a young woman with limited external shoulder rotation, no known traumatic history, and images consistent with a soft tissue lesion dependent on subscapular muscle aponeurosis, which was confirmed by biopsy as a desmoid tumor. Although it is a benign, self-limiting tumor, it has an alarmingly high rate of relapse after resection, so many treatments are available, and many teams choose to closely monitor the patient’s prognostic factors and functional limitations, obtaining satisfactory outcomes and, in some series, superior to those of surgical treatment.

Resumen La escápula alada suele producirse por lesiones neurológicas tanto del nervio espinal como del nervio torácico largo. La aparición a causa de un tumor ventral de la escápula dificulta su diagnóstico inicial. Presentamos el caso de una mujer joven, con limitación para la rotación externa del hombro, sin antecedentes traumáticos conocidos, evolución progresiva e imagen compatible con una lesión de partes blandas dependiente de la aponeurosis del músculo subescapular confirmada por biopsia como un tumor desmoide. Aunque se trata de un tumor benigno y autolimitado, tiene una inquietante alta tasa de recidivas después de la resección, por lo que se dispone de numerosos tratamientos y muchos grupos optan por hacer un seguimiento médico estrecho de los factores pronósticos y las limitaciones funcionales del paciente, con lo que obtienen resultados satisfactorios y, en algunas series, superiores a los del tratamiento quirúrgico.

Resumo Introdução: Recomenda-se o tratamento da infecção por Helicobacter pylori (H. pylori) nos candidatos a transplante devido à associação entre esta infecção e distúrbios gastrointestinais, que podem aumentar significativamente a morbidade após transplante renal com o uso de imunossupressão. O objetivo deste estudo foi analisar a taxa de erradicação do H. pylori após tratamento antimicrobiano em pacientes com doença renal crônica, candidatos a transplante renal. Métodos: Realizou-se um estudo de coorte prospectivo multicêntrico. Incluímos todos os pacientes adultos com doença renal crônica atendidos em nossa instituição. Na avaliação pré-transplante, 83 pacientes foram submetidos a uma endoscopia digestiva alta com 2 métodos diagnósticos para detecção do H. pylori: histologia e teste rápido de urease. No total, 33 pacientes com infecção por H. pylori receberam tratamento com 20 mg de omeprazol, 500 mg de amoxicilina e 500 mg de claritromicina uma vez ao dia durante 14 dias. Outra endoscopia digestiva alta foi realizada 8 a 12 semanas após o término do tratamento para verificação da resposta. Resultados: O estudo mostrou prevalência de H. pylori em 51 (61,4%) pacientes. A histologia foi positiva em 50 (98%) pacientes e o teste rápido de urease foi positivo em 31 (60,8%). A taxa de erradicação da infecção foi 48,5% (16 pacientes). Conclusões: Após o esquema triplo antimicrobiano de longo prazo utilizado, houve uma alta taxa de prevalência de H. pylori e baixa taxa de erradicação. A associação do teste rápido de urease com a histologia da mucosa gástrica não aumentou a taxa de detecção do H. pylori.

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.

Resumo A injúria renal aguda (IRA) é uma das complicações da dengue menos estudadas, mas que acarreta altas taxas de mortalidade e prolongamento do tempo de internação. Devido à gravidade dessa complicação, ao risco de desenvolvimento de doença renal crônica (DRC) e ao número crescente de casos de dengue relatados no mundo, particularmente nas regiões tropicais e subtropicais da África, Sudeste Asiático e América do Sul, incluindo o Brasil, foi proposta esta revisão narrativa que objetivou atualizar a epidemiologia da IRA associada à dengue, elucidar os principais mecanismos fisiopatológicos da IRA causada pela infecção do vírus da dengue, assim como discutir informações úteis sobre a prevenção e o manejo da IRA em pacientes com dengue.

Abstract Acute kidney injury (AKI) is one of the least studied complications of dengue, but it carries high mortality rates and prolonged hospital stay. Due to the severity of this complication, the risk of developing chronic kidney disease (CKD) and the increasing number of dengue cases reported worldwide, particularly in the tropical and subtropical regions of Africa, Southeast Asia and South America, including Brazil, we embarked on this narrative review, aimed to update the epidemiology of AKI associated with dengue, elucidate the main pathophysiological mechanisms of AKI caused by the dengue virus infection, as well as discuss useful information on the prevention and management of AKI in patients with dengue.

RESUMEN Las características de la anatomía de la hoja proporcionan evidencias importantes sobre la transición entre las vías C3 y C4. La fotosíntesis C4 surgió para reducir la tasa de fotorrespiración C3, concentrando el CO2 alrededor del sitio de la Rubisco y utilizando estructuras y maquinaria ya presentes en las plantas C3. En monocotiledóneas, se observa un alto número de linajes C4, la mayoría de ellas filogenéticamente relacionadas con grupos C3. El género C3 Apochloa, que pertenece a la subtribu Arthropogoninae, está relacionado con dos géneros C4 Coleataenia and Cyphonanthus. En este contexto, el objetivo fue evaluar cuatro especies de Apochloa para establecer las características anatómicas relacionadas con la evolución de la via C4 en este grupo. Se colectaron hojas completamente expandidas de A. euprepes, A. lorea, A. molinioides y A. poliophylla y se determinaron las características de las células del mesófilo (M) y del haz de la vaina (HV) a partir de secciones transversales de la hoja. Las especies presentaron una anatomía rústica de Kranz con células HV agrandadas y de distribución radial, con pocas organelas organizadas en posición centrífuga. Aunque las modificaciones de las células HV están probablemente relacionadas con el mantenimiento del estado hídrico de la planta, se puede inferir que facilitan el establecimiento de la fotosíntesis en los géneros C4 relacionados.

ABSTRACT Leaf anatomy characteristics provide important evidences about the transition between C3 and C4 pathways. The C4 photosynthesis pathway allowed to reduce the C3 photorespiratory rate, concentrating CO2 around the Rubisco site and using structures and machinery already presented in C3 plants. In monocots, it is observed a high number of C4 lineages, most of them phylogenetically related to C3 groups. The genus Apochloa (C3), subtribe Arthropogoninae, is related to two C4 genera Coleataenia and Cyphonanthus. The aim of this study was to evaluate four Apochloa species in order to establish anatomical characteristics related to the evolution of C4 pathway in this group. By means of transverse sections fully expanded leaves of A. euprepes, A. lorea, A. molinioides, and A. poliophylla were collected and the characteristics of the mesophyll (M) and bundle sheath (BS) cells were determined. These species showed a rustic Kranz anatomy with enlarged and radial arranged BS cells, which have few organelles organized in a centrifugal position. Although the modifications of BS cells are probably related to the maintenance of plant water status, we also discuss the evolution for the establishment of C4 photosynthesis in the related C4 genera.

The Zika virus is a flavivirus spread by the Aedes aegypti mosquito, which also transmits dengue and chikungunya. Current forms of control include elimination of mosquito breeding sites, use of insecticides, repellents and other means. The present study developed new adsorbent materials based on silica and biomaterials capable of releasing an Aedes aegypti mosquito repellent. The materials synthesized were characterized by Fourier-Transform Infrared, thermogravimetric analysis, Scanning Electron Microscopy and Brunauer, Emmett and Teller analysis and tested with citronella, an essential oil widely recognized as a natural insect repellent. The materials presented type IV isotherms, with type H1 hysteresis, characteristic of mesoporous materials, with pore diameters of between 50 Å and 80 Å. Materials based on silica-chitosan-glutaraldehyde dried in an oven (SCGO) and silica-chitosan-glutaraldehyde dried under a vacuum (SCGV) were found to produce more controlled release of citronella essential oil. The bioassay test was performed using a horizontal double-choice olfactometer. The adsorbent SCGO remained stable for the four hours of the bioassay, while the commercial repellent became ineffective after two hours of release. The production of a prototype in the form of bracelets, stickers releasing a volatile repellent is therefore proposed as a method for the control of the mosquito in urban areas.

RESUMEN La conservación enfocada en especies endémicas es prioritaria dada su alta vulnerabilidad. Para lograrla resulta imprescindible conocer la historia natural de las especies. El Gorrión Serrano (Xenospiza baileyi), catalogado en peligro de extinción, es una de las aves endémicas más vulnerables de México (valor de vulnerabilidad máximo = 20). Su estudio ha sido intermitente y la información asociada a su historia natural se encuentra dispersa, no publicada o es de difícil acceso. En este trabajo se sistematizó, examinó y actualizó el conocimiento relacionado con la historia natural de X. baileyi. Se compilaron estudios sobre esta especie para identificar vacíos en torno a su investigación. Se lograron integrar aspectos de la historia natural de X. baileyi relacionados con su taxonomía, descripción, distribución, hábitat, demografía, dispersión, territorialidad, alimentación, interacciones ecológicas, perchas, vocalizaciones, ciclo reproductivo, cortejo, nido, huevos, pollos y amenazas. Además, se incluyó información nueva resultante de actividades de monitoreo comunitario sobre esta especie, lo cual permitió denotar la importancia de la inclusión comunitaria para el manejo y conservación de la especie y su hábitat. Esta información resulta fundamental para optimizar su estudio y orientar las acciones urgentes en torno a su conservación.

ABSTRACT The conservation of endemic species deserves priority attention given their high vulnerability. Information about the natural history of species is essential for achieving conservation goals. The Sierra Madre Sparrow (Xenospiza baileyi) is an endangered species that is considered to be one of the most vulnerable endemic birds of Mexico (maximum vulnerability value = 20). Its study has been intermittent and the information about its natural history is disperse, unpublished, or difficult to access. This work systematized, evaluated, and updated the knowledge regarding the natural history, taxonomy, description, distribution, habitat, demography, dispersion, territoriality, feeding behavior, ecological interactions, perches, vocalizations, breeding cycle, courtship displays, nest, eggs, nestlings, and threats to the conservation of X. baileyi. In addition, we included novel information generated through community-based monitoring activities, which also highlighted the relevance of including local communities for managing and conserving the species and its habitat. This information is key for optimizing research and guiding urgent conservation actions on the species.

Anesthesiology became the first Chilean medical specialty certification board to incorporate an objective structured clinical examination (OSCE) into its certification system. The main reason for the introduction of an OSCE is to include an evaluation that allow candidates to demonstrate what they really “do” in clinical practice domains. Inherent in this justification is that the OSCE detects competences that are not well evaluated in current written and oral exams. This article describes the process of implementing an OSCE in Anesthesiology certification and a description of its application after one year of operation.

RESUMO Unidades de diálise são ambientes potencialmente propensos à disseminação da Covid-19. Os pacientes não podem suspender o tratamento, e são frequentemente portadores de comorbidades, o que confere maior risco e pior prognóstico. A Sociedade Brasileira de Nefrologia elaborou esse documento de boas práticas, cujas recomendações técnicas tratam de medidas gerais que podem ser implementadas para reduzir o risco de transmissão e evitar a disseminação da doença na unidade.

ABSTRACT Dialysis units are environments potentially prone to the spread of Covid-19. Patients cannot suspend treatment, and they often have comorbidities, which assigns them a higher risk and worse prognosis. The Brazilian Society of Nephrology prepared this document of good practices, whose technical recommendations deal with general measures that can be implemented to reduce the risk of transmission and prevent the spread of the disease in the unit.

Resumo Apesar de muitos estudos sobre a ictiofauna do Arquipélago de Fernando de Noronha terem sido realizados, sua diversidade de peixes mesofóticos nunca foi estudada antes. Neste estudo utilizamos mergulho autônomo e mergulho técnico, vídeos subaquáticos remotos com isca e veículo operado remotamente para registrar peixes de ecossistemas rasos (≤ 30 m de profundidade) e mesofóticos (31 a 150 m de profundidade). Dezenove espécies de peixes pertencentes a 14 famílias são apresentadas aqui como novos registros, representando um aumento de 8,2% na riqueza de peixes marinhos da região, que agora possui um total de 250 espécies e 77 famílias. Esses novos registros incluem quatro prováveis novas espécies e reforçam a importância de estudos em ecossistemas mesofóticos. Nossos resultados também enfatizam a necessidade de proteção e atenção à essa ictiofauna única encontrada nesses ecossistemas profundos.

Abstract Although several studies on the ichthyofauna of the Fernando de Noronha Archipelago have been carried out, its mesophotic fish diversity has never been surveyed before. Here we used SCUBA and technical rebreather diving, baited remote underwater videos and remotely operated vehicle to record shallow (≤ 30 m depth) and mesophotic (31 to 150 m depth) fishes. Nineteen fish species belonging to 14 families are reported here as new records, representing an increase of 8.2% in marine fish richness for the region, which now has a total of 250 species and 77 families. These new records include four potential new species and highlight the importance of surveying mesophotic ecosystems, even in well studied sites. Our results also emphasize the need for protection and attention to the unique ichthyofauna found at mesophotic depths.

Abstract Introduction: epigallocatechin-3-gallate (EGCG) is the most abundant catechin contained in green tea (Camellia sinensis) and has been associated with anti-obesity and anti-cancer effects, but the exact molecular mechanisms remain elusive. In this context, this study was designed to improve the understanding of the EGCG anti-obesity and anti-cancer action. Objectives: this study was designed to examine the effects of EGCG on the expression of genes involved in obesity and cancer pathways in the peripheral blood mononuclear cells of obese women. Material and methods: this longitudinal interventional study enrolled eleven women with severe obesity that were submitted to eight weeks of green tea (decaffeinated green tea capsules with 450.7 mg of EGCG, two capsules/day) supplementation (intervention group) and ten eutrophic women as a control group. Weight (kg), body mass index (BMI, kg/m2), fat mass (kg) and gene expression (qPCR method) were assessed before and after supplementation. HIF1-alpha (HIF1-α), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) and rapamycin-insensitive companion of mTOR (RICTOR) were selected as potential targets. Results: after supplementation, body weight (114.9 ± 14.3 versus 115 ± 13.8 kg), body mass index (44.1 ± 3.7 versus 44.1 ± 3.9 kg/m2) and fat mass (47.6 ± 3.3 versus 47.3 ± 3.4 kg) did not change. EGCG upregulated the RICTOR and HIF1-α expression, however, did not modify PI3K expression. Conclusion: this study demonstrated that EGCG has a potential role to obesity and cancer related to obesity control and can be used not only for the purpose of weight loss, but also for the improvement of obesity-related comorbidities.

Resumen Introducción: la obesidad se asocia con altos niveles de estrés oxidativo (EO) e inflamación. Existe mucha evidencia de que algunos polifenoles, como el té verde, tienen un impacto positivo en el estado del sistema operativo y consecutivamente en la inflamación. Objetivos: los propósitos de este estudio fueron: a) acceso a biomarcadores de EO en mujeres obesas y de peso normal; y b) evaluar si la suplementación con té verde tiene impacto en los biomarcadores de citoquinas inflamatorias y de EO de mujeres obesas. Métodos: evaluamos mujeres obesas (índice de masa corporal - IMC ≥ 40 kg/m²) y peso normal (IMC entre 18,5 y 24,9 kg/m²). Se utilizaron muestras de sangre para acceder al malondialdehído (MDA), la capacidad antioxidante equivalente de Trolox (TEAC) y las citoquinas inflamatorias. Elegimos al azar pacientes obesos (18 individuos) y luego les dimos suplementos de té verde durante 8 semanas. El análisis estadístico incluyó las pruebas de Shapiro-Wilk, Wilcoxon, t pareadas e independientes, p < 0,05 se consideraron significativas. Resultados: se reclutaron 42 mujeres obesas (IMC: 48,2 ± 9,3 kg/m2) y 21 de peso normal (IMC: 22,5 ± 2 kg/m2) con una edad promedio de 36,2 ± 9,1 años. Los niveles séricos de MDA fueron más altos en las personas obesas (2,52 ± 0,31 µmol/L) que en las mujeres eutróficas (2,13 ± 0,26 µmol/L; p = 0.000). Por otro lado, se observaron valores de TEAC más bajos en obesos (0,75 ± 0,06 mM) que en el grupo eutrófico (0,78 ± 0,04 mM; p = 0,009). Después de la intervención del té verde, la MDA disminuyó 4,7% y el TEAC aumentó 10%. Los niveles séricos de interleucina-6 (IL-6) disminuyeron 12,7% después del tratamiento (p = 0,03). Conclusiones: el grupo obeso tenía menor capacidad antioxidante que el eutrófico. La suplementación con té verde mejoró TEAC y MDA y redujo los niveles séricos de IL-6 en mujeres obesas.

ABSTRACT Background: The coexistence of decompensated heart failure (DHF) and acute renal failure (ARF) is associated with longer hospital stay and greater mortality. Objectives: The aim of this study was to evaluate whether kinetic glomerular filtration rate (KeGFR) estimated with Chen´s equation can predict the development of ARF or mortality during hospitalization in patients with DHF. Methods: We conducted a retrospective study of consecutive patients with estimated kinetic glomerular filtration rate using serum creatinine levels on admission and at 24 hours. The primary endpoint was a composite of ARF or mortality, and a ROC curve was built to find the cutoff value with the best sensitivity and specificity to predict events. Acute renal failure was defined according to the KDIGO guideline. Patients were followed-up throughout hospitalization and those with a history of chronic renal failure were excluded from the study. Results: Among 813 patients, 190 were excluded due to chronic renal failure and 608 patients were analyzed. Median age was 81 years (IQR 25-75%: 73-87) and 48% were men; 25.5% were diabetics, 76% had hypertension, 19.4% had history of prior myocardial infarction and 46.8% presented left ventricular systolic dysfunction defined as left ventricular ejection fraction <45%. Median creatinine level on admission was 1.05 mg/dl. The incidence of the composite event was 41.1%. Age, sex and comorbidities were similar in patients with and without the composite event, but KeGFR was significantly lower in this group of patients (median: 50.7 ml/min vs. 57.9 ml/min, p<0.01) and resulted an independent predictor of mortality. The analysis of the ROC curve revealed that a cutoff point of 60 ml/kg/min for KeGFR (AUC 0.60) had the best diagnostic accuracy to predict the composite event and was present in 58.9% of the patients. Age, female sex, hypertension and diabetes were predictors of the composite event. Conclusions: Kinetic glomerular filtrate rate can be used as an independent predictor of the composite event, but has no clinical relevance due to its low specificity.

RESUMEN Introducción: La coexistencia de insuficiencia cardíaca descompensada (ICD) e insuficiencia renal aguda (IRA) conlleva internaciones más prolongadas y, en algunos casos, mayor mortalidad. Objetivos: Evaluar si la tasa de filtrado glomerular dinámico (TFGD) calculada mediante la fórmula de Chen permite predecir el desarrollo de IRA o muerte durante la internación en pacientes con ICD. Material y métodos: Estudio retrospectivo de pacientes consecutivos. Se calculó la TFGD utilizando los valores de creatinina del ingreso y a las 24 h. Se realizó una curva ROC para hallar el punto que con mejor sensibilidad y especificidad predijera eventos. Se evaluó un punto final de evento combinado (EC) definido como el desarrollo de IRA o muerte. Se definió la IRA de acuerdo a la guía KDIGO. El seguimiento fue hospitalario. El criterio de exclusión principal fue la existencia de antecedentes de insuficiencia renal crónica. Resultados: De un total de 813 pacientes, 190 fueron excluidos por tener insuficiencia renal crónica. Se analizaron 608 pacientes. Edad (mediana): 81 años (RIC 25-75%: 73-87), hombres: 48%, diabéticos: 25,5%, hipertensos: 76%, infarto previo: 19,4%, disfunción sistólica (Fey < 45%): 46,8%, creatinina de ingreso (mediana): 1,05 mg/dl. La incidencia de EC fue de 41,1%. La edad, el sexo y la presencia de comorbilidades no incidieron en la tasa de presentación de EC, pero la TFGD de este grupo de pacientes fue significativamente menor (mediana: 50,7 ml/min, vs. 57,9 ml/min, p < 0,01) y esta variable fue un predictor independiente de mortalidad. El mejor valor por curva ROC para EC de la TFGD fue 60 ml/min (ABC 0,60) y estuvo presente en el 58,9% de los pacientes. Fueron predictores de ello la edad, el sexo femenino y la presencia de HTA y de diabetes. Conclusiones: La TFGD resulta ser un predictor independiente de EC intrahospitalarios en la ICD; sin embargo, presenta escasa relevancia clínica por su baja especificidad.

ABSTRACT The aim of this study was to know the problematic posed by a significant range of patients hospitalized for heart failure in private urban centers which do not receive patients referred with end-stage disease. Baseline characteristics and outcome of 865 consecutive elderly patients hospitalized due to heart failure were analyzed in two of the above-mentioned centers. Mean age was 81 years and 48% were women. Heart failure was of coronary etiology in 25.5% of cases and chagasic in 0.4%, and 78% of patients were hypertensive. Average comorbidities were 3 per patient. Half of the patients had preserved systolic function. Systolic blood pressure on admission was 145 mmHg and ≥ 170 mmHg in 25% of cases. Average hospital stay was 6 days and in-hospital mortality 6.13%. The one-year evolution of these patients is a matter of great concern, with 70% of readmissions and 40.12% mortality. It should be pointed out that half of the post discharge deaths were not due to heart failure.

RESUMEN El objetivo del trabajo es conocer la problemática de una franja significativa de pacientes hospitalizados por insuficiencia cardíaca en centros urbanos privados que no son receptores de derivaciones de pacientes en estadios avanzados. Se analizaron las características basales y la evolución de 865 pacientes consecutivos hospitalizados por insuficiencia cardíaca en dos centros con las características precitadas. Se trata de una población anciana -mediana de edad 81 años- 48% mujeres. La etiología coronaria era de 25,5%, y la chagásica, 0,4% y el 78%, hipertensos. El promedio de comorbilidades fue de 3 por paciente. La mitad tenía función sistólica preservada. La presión sistólica de ingreso fue de 145mmHg, y en el 25% fue ≥ 170 mmHg. La estadía promedio fue 6 días, y la mortalidad intrahospitalaria 6,13%. Es muy preocupante la evolución de estos pacientes al año, con un 70% de reinternación y 40,12% de mortalidad. Debe destacarse que cerca de la mitad de los fallecimientos posalta no fueron debido a insuficiencia cardíaca.

Resumo O objetivo do presente estudo foi revisar sistematicamente estudos que analisaram a associação da prática de atividade física de pais e filhos. Foi realizada uma busca sistemática em cinco bases de dados (Medline, Embase, Cinahl, Lilacs e SciELO), por meio da combinação de termos sobre crianças e adolescentes, atividade física e suporte social, sendo restrita a estudos contendo amostras brasileiras e escritos em Inglês e/ou Português. Foram incluídos treze estudos na presente revisão e foi observada associação positiva da prática de atividade física de pais e filhos na maioria dos estudos (n=11). Somente dois estudos não observaram associação significativa da atividade física de pais e filhos, contudo não foram observadas associações negativas. Foram observadas diferentes associações de acordo com o gênero tanto dos pais quanto dos filhos. Estes achados ressaltam a importância da prática de atividade física dos pais como incentivo à prática de atividade física dos filhos em amostras brasileiras. Estratégias de promoção da prática de atividade física em crianças e adolescentes de ambos os sexos devem considerar o suporte social como um fator importante, especialmente a respeito da prática de atividade física dos pais.

Abstract The aim of this study was systematically review the researches in regard the association of PA of parents and the PA of their children. A literature search was performed in five databases (Medline, Embase, Cinahl, Lilacs and SciELO) using combined terms about youth, PA and social support, with restriction to publications with Brazilian sample and to English and Portuguese language. Thirteen studies were included in this review and was observed a positive association of parental PA and the PA of their children for the majority of the studies (n=11). Only two studies did not observed significant association between PA of parents and their children and, otherwise, it was not observed negative associations in the review. It was observed different associations according to the gender of both parents and children. This findings support the importance for the practice of PA by parents as encouragement for the practice of PA by their children among Brazilians. The strategies to promote the increase in practice of physical activity of children and adolescents of both genders may consider the social support as an important factor, especially in relation to the practice of PA of their parents.

Abstract OBJECTIVE: To determine the prevalence of overactive bladder and the degree of impact it has on the quality of life of patients recruited from five hospital centers in Mexico City. MATERIALS AND METHODS: A descriptive, observational, cross-sectional study was conducted through the prospective collection of patient data from the General Medicine, Family Medicine, or Internal Medicine outpatient consultation at five hospital centers in Mexico City, within the time frame of January and December 2017. Participants were asked to fill out the validated Spanish version of the ICIQ-OAB questionnaire at that same consultation, one time only. The patients were divided into ten-year age groups starting at 18 years of age. The data were analyzed through descriptive statistics. RESULTS: There were questionnaires from 352 participants at the time of the intermediate analysis. A total of 72% (n = 253) reported urgency as the key symptom of overactive bladder (78 vs 66% in women and men, respectively, p<0.05). Moderate-severe symptoms were reported in 16% of the patients above the age of 57 years. Severe symptoms were more frequent in women (68%). A total of 31% of the patients described a moderate-severe impact on quality of life. The main concomitant symptom was nicturia (81%) but urge incontinence was the most bothersome symptom for patients (32%). CONCLUSION: The prevalence of urgency (the cardinal symptom of overactive bladder) was high in a population in Mexico City.

Resumen OBJETIVO: Determinar la prevalencia de vejiga hiperactiva y su repercusión (grado de afección) en la calidad de vida de pacientes captados en cinco centros hospitalarios de la Ciudad de México. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal y observacional, efectuado mediante la recolección prospectiva de expedientes provenientes de la consulta externa de Medicina General, Medicina Familiar o Medicina Interna de cinco centros hospitalarios de la Ciudad de México, entre enero y diciembre de 2017. Se solicitó a los participantes responder el cuestionario ICIQ-OAB (versión validada en español), en una sola ocasión y durante la misma visita. Los pacientes se dividieron por grupos etarios decenales a partir de 18 años. Para el análisis de los datos se utilizó estadística descriptiva. RESULTADOS: Al momento del análisis intermedio, se contó con las encuestas de 352 participantes. El 72% (n = 253) reportó urgencia urinaria, como síntoma cardinal de vejiga hiperactiva (78 vs 66% en mujeres y hombres, respectivamente, p<0.05). Los síntomas moderados-severos se reportaron en 16% de los pacientes mayores de 57 años de edad. Los síntomas severos fueron más frecuentes en mujeres (68%). El 31% de los casos refirió afección moderada-severa en la calidad de vida. El principal síntoma concomitante fue nicturia (81%); sin embargo, la incontinencia urinaria de urgencia provocó mayor molestia en los pacientes (32%). CONCLUSIÓN: La urgencia urinaria (síntoma cardinal de vejiga hiperactiva) es una alteración con elevada prevalencia en la población de la Ciudad de México.

Resumo Introdução: O objetivo primário deste estudo foi comparar o efeito da simulação de alta-fidelidade versus autoestudo baseado em resolução de casos no computador, a aquisição de habilidades sobre hipertermia maligna em residentes de anestesiologia do primeiro ano. Métodos: Após a aprovação do Comitê de Ética institucional, 31 residentes de anestesiologia do primeiro ano foram inscritos neste estudo prospectivo, randômico e encoberto. Os participantes foram randomizados para um ambiente de simulação de alta-fidelidade (SAF) ou um estudo de caso (EC) em computador sobre hipertermia maligna. Após a intervenção, o desempenho de todos os indivíduos foi avaliado através de um ambiente de simulação de alta-fidelidade utilizando uma rubrica de avaliação previamente validada. Além disso, uma pesquisa de satisfação e testes de conhecimento foram aplicados. Por fim, uma entrevista semiestruturada foi realizada para avaliar a autopercepção do processo de raciocínio e da tomada de decisão. Resultados: Vinte e oito residentes do primeiro ano concluíram o estudo com sucesso. Os escores dos residentes na aquisição de habilidades no manejo da hipertermia maligna foram globalmente maiores no Grupo SAF que no Grupo EC, mas a significância foi em quatro dos oito elementos da rubrica de desempenho: reconhecer os sinais e sintomas (p = 0,025), priorizaras ações iniciais do manejo (p = 0,003), reconhecer complicações (p = 0,025) e comunicação (p = 0,025). As médias dos escores nos questionários de conhecimento pré- e pós-teste melhoraram de 74% para 85% no Grupo SAF e diminuíram de 78% para 75% no Grupo EC (p = 0,032). Em relação à análise qualitativa, não houve diferença nos fatores que influenciaram o processo de raciocínio e de tomada de decisão dos alunos com ambas as estratégias de ensino. Conclusão: O treinamento baseado em simulação com um ambiente de alta-fidelidade de hipertermia maligna foi superior ao estudo de caso em computador, melhorou o conhecimento e as habilidades no manejo de crises de hipertermia maligna, com um nível de satisfação muito bom entre os residentes de anestesia.

Abstract Introduction: The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. Methods: After institutional ethical committee approval, 31 first year anesthesiology residents were enrolled in this prospective randomized single-blinded study. Participants were randomized to either a High Fidelity Simulation Scenario or a computer-based Case Study about malignant hyperthermia. After the intervention, all subjects' performance in was assessed through a high fidelity simulation scenario using a previously validated assessment rubric. Additionally, knowledge tests and a satisfaction survey were applied. Finally, a semi-structured interview was done to assess self-perception of reasoning process and decision-making. Results: 28 first year residents finished successfully the study. Resident's management skill scores were globally higher in High Fidelity Simulation versus Case Study, however they were significant in 4 of the 8 performance rubric elements: recognize signs and symptoms (p = 0.025), prioritization of initial actions of management (p = 0.003), recognize complications (p = 0.025) and communication (p = 0.025). Average scores from pre- and post-test knowledge questionnaires improved from 74% to 85% in the High Fidelity Simulation group, and decreased from 78% to 75% in the Case Study group (p = 0.032). Regarding the qualitative analysis, there was no difference in factors influencing the student's process of reasoning and decision-making with both teaching strategies. Conclusion: Simulation-based training with a malignant hyperthermia high-fidelity scenario was superior to computer-based case study, improving knowledge and skills in malignant hyperthermia crisis management, with a very good satisfaction level in anesthesia residents.