Abstract Objective To evaluate the rates of precancerous lesions, colposcopy referral, and positive predictive value (PPV) by age groups of a population-based screening with DNA-HPV testing. Methods The present demonstration study compared 16,384 HPV tests performed in the first 30 months of the program with 19,992 women tested in the cytology screening. The colposcopy referral rate and PPV for CIN2+ and CIN3+ by age group and screening program were compared. The statistical analysis used the chi-squared test and odds ratio (OR) with 95% confidence interval (95%CI). Results The HPV tests were 3.26% positive for HPV16-HPV18 and 9.92% positive for 12 other HPVs with a 3.7 times higher colposcopy referral rate than the cytology program, which had 1.68% abnormalities. Human Papillomavirus testing detected 103 CIN2, 89 CIN3, and one AIS, compared with 24 CIN2 and 54 CIN3 detected by cytology (p < 0.0001). The age group between 25 and 29 years old screened by HPV testing had 2.4 to 3.0 times more positivity, 13.0% colposcopy referral, twice more than women aged 30 to 39 years old (7.7%; p < 0.0001), and detected 20 CIN3 and 3 early-stage cancer versus 9 CIN3 and no cancer by cytology screening (CIN3 OR= 2.10; 95%CI: 0.91 -5.25; p = 0.043). The PPV of colposcopy for CIN2+ ranged from 29.5 to 41.0% in the HPV testing program. Conclusion There was a significant increase in detections of cervix precancerous lesions in a short period of screening with HPV testing. In women < 30 years old, the HPV testing exhibited more positivity, high colposcopy referral rate, similar colposcopy PPV to older women, and more detection of HSIL and early-stage cervical cancer.

Resumo Objetivo Avaliar as taxas de lesões pré-cancerosas, encaminhamento para colposco pia e valor preditivo positivo (VPP) por faixas etárias de rastreamento populacional com teste DNA-HPV. Métodos O presente estudo de demonstração comparou 16.384 testes de HPV realizados nos primeiros 30 meses do programa com 19.992 mulheres testadas no rastreio citológico. Os programas foram comparados por taxa de encaminhamento de colposcopia e VPP para NIC2+ e NIC3+ por faixa etária. A análise estatística utilizou o teste de qui-quadrado e odds ratio (OR, na sigla em inglês) com intervalo de confiança (IC) de 95%. Resultados Os testes de HPV foram 3,26% positivos para HPV16-HPV18 e 9,92% positivos para 12 outros HPVs, com uma taxa de encaminhamento de colposcopia 3,7 vezes maior do que o programa de citologia, que teve 1,68% de anormalidades. O teste de HPV detectou 103 NIC2, 89 NIC3 e um AIS, em comparação com 24 NIC2 e 54 NIC3 detectados por citologia (p < 0,0001 ). O rastreio por teste de HPV no grupo etário 25 a 29 anos teve 2,4 a 3,0 vezes mais positividade, 13,0% de encaminhamento para colposcopia, 2 vezes mais que mulheres de 30 a 39 anos (7,7%; p < 0,0001 ), e detectou 20 NIC3 e 3 cânceres em estágio inicial versus nove NIC3 e nenhum câncer pelo rastreio citológico (NIC3 OR= 2,10; 96%CI: 0,91 -5,25; p = 0,043). O VPP da colposcopia para NIC2+ variou de 29,5 a 41,0% no programa de teste de HPV. Conclusão Houve um aumento significativo na detecção de lesões pré-cancerosas do colo do útero em um curto período de rastreamento com teste de HPV. Em mulheres < 30 anos, o teste de HPV exibiu mais positividade, alta taxa de encaminhamento para colposcopia com VPP semelhante a mulheres mais velhas, e mais detecção de HSIL e de câncer cervical em estágio inicial.

RESUMO O objetivo desta pesquisa foi verificar quais comportamentos táticos podem predizer a eficiência defensiva de jogadores de futebol de elite. A amostra foi composta por 533 sequências defensivas de seleções semifinalistas da Copa do Mundo FIFA 2014. Foi construído um instrumento ad-hoc com as variáveis: “zona de recuperação da bola”, “pressão defensiva”, “redução de profundidade”, “tempo defensivo gasto”, “número de corredores ocupados”, “número de faltas cometidas” e “número de faltas sofridas”. As sequências táticas foram analisadas com o software Match Vision Studio Premium. A regressão logística multinomial foi aplicada para predizer as chances de sucesso e fracasso de ações coletivas defensivas (P < 0,05). A recuperação da bola na zona defensiva do campo teve aumento de 19 vezes das chances de finalização de gol em comparação com a zona ofensiva média (OR = 19,39; P < 0,01). Por outro lado, reduzir a profundidade defensiva resultou em diminuição de 71% das chances de fazer um gol (OR = 0,29; P < 0,01). Além disso, cada falta cometida aumentou as chances de falha na fase defensiva (OR = 5,39; P < 0,01). Os times que recuperaram a bola longe dos próprios gols e coordenaram sua última linha defensiva para deixar os atacantes em posição de impedimento tiveram sucesso na recuperação da bola. Nível de Evidência IV; Série de casos.

ABSTRACT The purpose of this research was to verify which tactical behaviors can predict defensive efficiency among elite football players. The sample was composed of 533 defensive sequences from national teams that were semifinalists in the FIFA World Cup 2014. An ad-hoc instrument was built with the variables: “ball recovery zone”, “defensive pressure”, “removing depth”, “defensive time spent”, “number of occupied corridors”, “number of fouls committed”, and “number of times fouled”. The tactical sequences were analyzed using Match Vision Studio Premium software. Multinomial logistic regression was applied to predict the chances of success and failure of collective defensive actions (P < 0.05). Recovering the ball in the defensive zone of the field had a 19-times better chance of goal completion compared to recovering the ball in the middle offensive zone (OR = 19.39; P < 0.01). On the other hand, removing defensive depth resulted in a decrease of 71% in the chances of completing a goal (OR = 0.29; P < 0.01). Moreover, every foul committed increased the chances of failure in the defensive phase (OR = 5.39; P < 0.01). Teams that recovered the ball far from their own goals and coordinated their last defensive line to leave attackers in an offside position had success in getting the ball back. Level of Evidence IV; Case series.

RESUMEN El objetivo de esta investigación fue verificar qué comportamientos tácticos pueden predecir la eficiencia defensiva entre los jugadores de fútbol de élite. La muestra estuvo compuesta por 533 secuencias defensivas de selecciones semifinalistas en la Copa Mundial de la FIFA 2014. Se construyó un instrumento ad-hoc con las variables: “zona de recuperación del balón”, “presión defensiva”, “reducción de profundidad”, “tiempo defensivo empleado”, “número de pasillos ocupados”, “número de faltas cometidas” y “número de faltas sufridas”. Las secuencias tácticas se analizaron utilizando el software Match Vision Studio Premium. Se aplicó la regresión logística multinomial para predecir las posibilidades de éxito y fracaso de las acciones colectivas defensivas (P <0,05). La recuperación del balón en las zonas defensivas del campo representó un aumento de 19 veces las posibilidades de finalización del gol en comparación con la zona ofensiva media (OR = 19,39; P <0,01). Por otro lado, eliminar la profundidad defensiva resultó en una disminución del 71% de las posibilidades de marcar un gol (OR = 0,29; P <0,01). Además, cada falta cometida aumentaba las posibilidades de falla en la fase defensiva (OR = 5,39; P <0,01). Los equipos que recuperaron el balón lejos de sus propios arcos y coordinaron su última línea defensiva para dejar a los atacantes en posición de fuera de juego, tuvieron éxito en la recuperación del balón. Nivel de Evidencia IV; Serie de casos.

Resumo Objetivo Comparar as taxas de mortalidade por COVID-19 entre gestantes ou puérperas e não gestantes durante a primeira e segunda ondas da pandemia brasileira. Métodos Na presente avaliação dos dados do Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe), incluímos mulheres com síndrome respiratória aguda grave por COVID-19: 47.768 em 2020 (4.853 obstétricas versus 42.915 não obstétricas) e 66.689 em 2021 (5.208 obstétricas versus 61.481 não obstétricas) e estimamos a frequência de óbito intra-hospitalar. Resultados Identificamos 377 óbitos maternos em 2020 e 804 em 2021. A taxa de mortalidade por COVID-19 aumentou 2,0 vezes no grupo obstétrico (de 7,7 para 15,4%) e 1,6 vezes no grupo não obstétrico (de 13,9 para 22,9%) de 2020 a 2021 (odds ratio [OR]: 0,52; intervalo de confiança [IC] 95%: 0,47–0,58 em 2020 e OR: 0,61; IC95%: 0,56–0,66 em 2021; p <0,05). Em mulheres com comorbidades, a taxa de óbitos aumentou 1,7 vezes (de 13,3 para 23,3%) e 1,4 vezes (de 22,8 para 31,4%) para os grupos obstétricos e não obstétricos, respectivamente (OR: 0,52; IC95%: 0,44–0,61 em 2020 para OR: 0,66; IC95%: 0,59–0,73 em 2021; p <0,05). Em mulheres sem comorbidades, a taxa de mortalidade foi maior para as não obstétricas (2,4 vezes; de 6,6% para 15,7%) do que para mulheres obstétricas (1,8 vezes; de 5,5 para 10,1%; OR: 0,81; IC95%: 0,69–0,95 em 2020 e OR: 0,60; IC95%: 0,58–0,68 em 2021; p < 0,05). Conclusão Houve aumento das mortes maternas por COVID-19 em 2021 em relação a 2020, principalmente naquelas com comorbidades. As taxas de mortalidade foram ainda maiores em mulheres não grávidas, com ou sem comorbidades.

Abstract Objective To compare death rates by COVID-19 between pregnant or postpartum and nonpregnant women during the first and second waves of the Brazilian pandemic. Methods In the present population-based evaluation data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe, in the Portuguese acronym), we included women with c (ARDS) by COVID-19: 47,768 in 2020 (4,853 obstetric versus 42,915 nonobstetric) and 66,689 in 2021 (5,208 obstetric versus 61,481 nonobstetric) and estimated the frequency of in-hospital death. Results We identified 377 maternal deaths in 2020 (first wave) and 804 in 2021 (second wave). The death rate increased 2.0-fold for the obstetric (7.7 to 15.4%) and 1.6-fold for the nonobstetric groups (13.9 to 22.9%) from 2020 to 2021 (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.47–0.58 in 2020 and OR: 0.61; 95%CI: 0.56– 0.66 in 2021; p < 0.05). In women with comorbidities, the death rate increased 1.7-fold (13.3 to 23.3%) and 1.4-fold (22.8 to 31.4%) in the obstetric and nonobstetric groups, respectively (OR: 0.52; 95%CI: 0.44–0.61 in 2020 to OR: 0.66; 95%CI: 0.59–0.73 in 2021; p <0.05). In women without comorbidities, the mortality rate was higher for nonobstetric (2.4 times; 6.6 to 15.7%) than for obstetric women (1.8 times; 5.5 to 10.1%; OR: 0.81; 95%CI: 0.69–0.95 in 2020 and OR: 0.60; 95%CI: 0.58–0.68 in 2021; p <0.05). Conclusion There was an increase in maternal deaths from COVID-19 in 2021 compared with 2020, especially in patients with comorbidities. Death rates were even higher in nonpregnant women, with or without comorbidities.

Resumo A fotodegradação é um processo importante para o metabolismo aquático, estando relacionado à transformação da matéria orgânica dissolvida (MOD). Em um reservatório de abastecimento de água, por exemplo, a MOD é um importante parâmetro, pois durante o tratamento de água pode ocorrer a formação de subprodutos de desinfecção. Assim, a compreensão e determinação das taxas de fotodegradação são especialmente relevantes em termos de gestão de recursos hídricos, uma vez que este processo influencia na transformação da MOD na coluna de água. No entanto, apesar de ser um processo relevante, poucos estudos foram realizados no hemisfério sul para a determinação das taxas de fotodegradação em reservatórios com tal característica climática. Sendo assim, realizamos experimentos de campo para caracterizar a MOD e avaliar as taxas de fotodegradação da MOD ‒ em diferentes profundidades e em dois períodos distintos de insolação ‒ por meio da aplicação de técnicas de espectroscopia de absorção na região UV-Vis e matrizes de excitação-emissão de fluorescência (MEE) combinadas com o teor de carbono orgânico dissolvido (COD). Foram encontradas baixas concentrações de MOD natural e de nutrientes no ambiente aquático. Nossos resultados indicam que as taxas de fotodegradação para um reservatório localizado em clima temperado oceânico foram proporcionais à disponibilidade de radiação solar, sendo mais representativas considerando a escala de tempo.

Abstract Photodegradation is an important process for aquatic metabolism, related to the dissolved organic matter (DOM) transformation in water. For example, in a water supply reservoir, DOM is an important parameter since it can react and form disinfection by-products during water treatment. Thus, the understanding and determination of photodegradation rates are especially relevant for water resources management since they can influence DOM transformation in the water column. However, besides its relevance, few studies were conducted in the southern hemisphere for photodegradation rates determination. Therefore, we carried out field experiments to characterize and evaluate DOM photodegradation rate ‒ at different depths and in two solar irradiation periods ‒ through the application of absorption spectroscopy techniques in the UV-Vis region and fluorescence excitation-emission matrices (EEM) combined with the dissolved organic carbon (DOC) measurement. Low concentrations of natural DOM and nutrients in the aquatic environment were measured during the field monitoring. Our results indicate that photodegradation rates for a temperate oceanic climate reservoir were proportional to the availability of solar radiation, being more representative considering the time scale.

Resumo O objetivo deste trabalho foi determinar as temperaturas basais, as necessidades térmicas e a duração dos principais estádios fenológicos reprodutivos do açaizeiro (Euterpe oleracea) no Nordeste do estado do Pará, na Amazônia Oriental, Brasil. O experimento foi realizado de 2017 a 2019, em plantio de açaizeiro de 10 ha, tendo-se utilizado análise de série temporal. A fenologia das plantas foi monitorada semanalmente, e as condições meteorológicas dos locais foram monitoradas diariamente. As temperaturas basais inferiores e superiores foram de 12,92 e 32,46°C, respectivamente, na prefloração; 13,50 e 32,23°C na floração; 12,14 e 32,55°C no estádio de frutos verdes; 11,64 e 32,78°C no estádio de mudança de cor dos frutos; e 11,23 e 32,94°C na maturação. A exigência térmica e a duração média para o ponto ideal de colheita do açaí foram de 3.893,15 graus-dias e 283 dias, respectivamente. A exigência térmica e a duração dos estádios da fase reprodutiva do açaizeiro são influenciadas pelo período do ano e pela variabilidade da temperatura do ar, que, quando elevada, reduz o ciclo da cultura, e, quando amena, o estende.

Abstract The objective of this work was to deter mine the base temperatures, thermal time requirements, and length of the main reproductive growth stages of acai palm (Euterpe oleracea) in the northeast of the state of Pará, in eastern Amazon, Brazil. The experiment was carried out from 2017 to 2019 in a 10 ha acai plantation, using the time-series analysis. Plant phenology was monitored weekly, and local weather conditions were monitored daily. The lower and upper base temperatures were of 12.92 and 32.46°C, respectively, for pre-flowering; 13.50 and 32.23°C for flowering; 12.14 and 32.55°C for green fruit stage; 11.64 and 32.78°C for fruit color-changing stage; and 11.23 and 32.94°C for maturation. The thermal time requirement and the average cycle length for the ideal harvest time of acai palm were 3,893.15 degree-days and 283 days, respectively. The thermal time requirement and the duration of the reproductive growth stage for acai palm are influenced by the period of the year and the variability of air temperature, which, when high, reduces the cycle of the crop, and when mild, increases it.

ABSTRACT Evaluations of biomass and nutrient contents in teak stands are necessary alternatives for avoiding early cutting to provide supplemental data for the plant module of fertilization recommendation systems. This study aimed to adjust allometric equations to estimate the accumulation of biomass and nutrient contents in teak plantations in the central region of Brazil. Plots in seminal and clonal stands contained 81 trees aged 75 months, that had not received previous fertilization or thinning. Additional clonal stands aged 15, 51 and 63 months and a seminal stand aged 63 months had been previously fertilized during implantation. Allometric equations for biomass and macronutrient contents were obtained for components of the aerial parts of trees as a function of diameter at 1.3 m height (DBH), and the possibility of using an equation or the need for specific equations was evaluated for genetic material (seminal or clonal) and the fertilization scheme (not fertilized or fertilized). The equations adjusted to the four sets of stands, all with elevated predictive capacity, did not differ among each other based on an identity test. Thus, the use of a robust equation adjusted with data from all stands is recommended to obtain estimates with a high degree of accuracy. The biomass and accumulation of macronutrients in components of the aerial parts of teak trees should be considered to obtain the nutrient contents in both the exportable components in thinned trees and the components maintained in the area and available for biogeochemical cycling.

Abstract Introduction: Rheumatoid Arthritis (RA) has adverse health consequences, its early diagnosis and optimal management require recommendations based on high quality evidence adapted to each health system. Objective: To provide evidence-based clinical recommendations for the diagnosis and initial management of RA. Methods: A Guideline Development Group (GDG) was established, including medical specialists and methodologists. The GDG formulated 10 clinical questions to be answered by this CPG. Systematic searches of published evidence in PubMed and CENTRAL were performed during December 2017 and July 2019 (including systematic reviews and -when it was considered pertinent- primary studies) were conducted. The evidence of the highest quality for answering each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology which was used in periodic work meetings by the GDG to review the evidence and formulate the recommendations, points of good clinical practice, and flowcharts. Finally, the CPG was approved with Resolution N° 132 - IETSI - ESSALUD - 2019. Results: This CPG addressed 10 clinical questions, divided into two topics: diagnosis and management. Based on these questions, 16 recommendations (5 strong and 11 weak), 28 points of good clinical practice, and 3 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the diagnosis and initial management of RA in EsSalud.

Resumen Introducción: La Artritis Reumatoide (AR) tiene adversas consecuencias en la salud su diagnóstico temprano y manejo óptimo requiere recomendaciones basadas en evidencia de alta calidad adaptadas a cada sistema de salud. Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el diagnóstico y manejo inicial de la AR. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 10 preguntas clínicas a ser respondidas por la presente GPC. Se realizaron búsquedas sistemáticas de la evidencia publicada en PubMed y CENTRAL entre diciembre 2017 a julio 2019 (revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios). Se seleccionó la evidencia de mayor calidad para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE) y en reuniones de trabajo periódicas, el GEG usó dicha metodología para revisar la evidencia y formular las recomendaciones, los puntos de buena práctica clínica y los flujogramas. Finalmente, la GPC fue aprobada con Resolución N° 132 - IETSI - ESSALUD - 2019. Resultados: La presente GPC abordó 10 preguntas clínicas, divididas en dos temas: diagnóstico y manejo. En base a dichas preguntas se formularon 16 recomendaciones (5 fuertes y 11 condicionales), 45 puntos de buena práctica clínica, y 3 flujogramas. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el diagnóstico y manejo inicial de la AR en EsSalud.

ABSTRAC The aim of this study was to determine the prevalence of hepatic dystomatosis in cattle slaughtered in the Sogamoso slaughterhouse (Boyacá, Colombia), and to define the most effective diagnostic technique to establish the presence of the parasite. A sample size of 343 individuals was established considering the monthly slaughter rate of the plant. Stool, blood and bile samples were taken, and adult parasites were collected from the bile duct. The modified Ritchie technique was used in the coproparasitological examination, the bile content was analyzed by sedimentation and a standardized in- house ELISA was implemented for serological diagnosis from adult Fasciola hepatica parasites. The results showed that 29.7% (102/343) of the individuals sampled were positive for the presence of F. hepatica in at least one of the techniques used. The post mortem evaluation presented the highest value (19.8%; 68/343), followed by the inhouse ELISA (13.7%; 47/343), detection of eggs in bile (117%; 40/343) and the coprological technique (7.3%; 25/343).

RESUMEN El objetivo del estudio fue determinar la prevalencia de distomatosis hepática en bovinos faenados en la planta de beneficio de Sogamoso (Boyacá, Colombia), y definir la técnica diagnóstica más efectiva para establecer la presencia del parásito. Se estableció un tamaño muestral de 343 individuos teniendo en cuenta la tasa de sacrificio mensual de la planta. Se tomaron muestras de heces, sangre y contenido biliar y se colectaron los parásitos adultos del ducto biliar. En el examen coproparasitológico se utilizó la técnica de Ritchie modificada, el contenido biliar fue analizado mediante sedimentación y para el diagnóstico serológico se implementó un ELISA in house estandarizado a partir de parásitos adultos de Fasciola hepatica. El 29.7% (102/343) de los individuos muestreados fueron positivos a la presencia de F. hepatica en por lo menos una de las técnicas empleadas. La evaluación post mortem presentó el valor más alto (19.8%; 68/343), seguido por el ELISA in house (13.7%; 47/343), detección de huevos en bilis (117%; 40/343) y la técnica coprológica (7.3%; 25/343).

Resumen Introducción: La disnea es el síntoma más común en la insuficiencia cardíaca. En los ancianos es común en la enfermedad pulmonar obstructiva crónica y la depresión. Objetivo: Estimar la prevalencia de disnea de esfuerzo, ortopnea y disnea paroxística nocturna y su asociación con enfermedades crónicas en la atención primaria. Métodos: Estudio transversal, parte del estudio Digitalis, que incluyó a 633 individuos, entre 45 y 99 años de edad, registrados en un programa de atención primaria en Niterói, Brasil. Todos los participantes se sometieron a evaluaciones clínicas, recolección de sangre y orina, y respondieron a un cuestionario en un solo día. Se usaron autorrelatos para el diagnóstico de las enfermedades. Resultados: De los 633 individuos, el 30% presentó disnea. En el análisis crudo la enfermedad pulmonar obstructiva crónica mostró las asociaciones más fuertes con los tres tipos de disnea, seguidos por la depresión y la insuficiencia cardíaca. La enfermedad pulmonar obstructiva crónica, evaluada de forma aislada, no presentó ningún caso de disnea paroxística nocturna, y la insuficiencia cardíaca por sí sola mostró una relación muy fuerte con este tipo de disnea. Conclusiones: El comportamiento diferente de las asociaciones de los tipos de disnea con las principales enfermedades crónicas en pacientes en atención primaria puede ayudar a una mejor caracterización de los pacientes con insuficiencia cardíaca.

Abstract Background: Dyspnea is the most common symptom in heart failure. In the elderly, it is common in chronic obstructive pulmonary disease and depression. Objective: To estimate the prevalence of dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea and its association with chronic diseases in primary care. Methods: A cross-sectional study, part of the Digitalis Study, including 633 individuals, between 45 to 99 years old, registered in a primary care program in Niteroi, Brazil. All participants underwent clinical evaluations, blood and urine collection, and responded to a questionnaire in a single day. Self-reports were used for the diagnosis of diseases. Results: Of the 633 individuals, 30% had dyspnea. In the crude analysis, chronic obstructive pulmonary disease showed the strongest associations with the three types of dyspnea, followed by depression and heart failure. Chronic obstructive pulmonary disease alone did not present any cases of paroxysmal nocturnal dyspnea, and heart failure alone showed a very strong relationship with this type of dyspnea. Conclusions: The different behavior of the associations of the types of dyspnea with major chronic diseases in patients in primary care can help in the better characterization of patients with heart failure.

Resumo A atual pandemia de coronavírus já gerou danos profundos ao redor do mundo, causando grande quantidade de morbidades e mortes. Uma das manifestações das formas graves da doença é o estado trombofílico, que pode provocar danos em vários sistemas. Este artigo relata o caso de uma paciente do sexo feminino, 60 anos de idade, que foi internada em um serviço hospitalar privado com sintomas gripais inespecíficos leves, mas que progrediu com trombose arterial e isquemia de membros causada pelo SARS-CoV2. Devido à essa evolução, foi optada pela administração concomitante de heparina de baixo peso molecular e Alprostadil, com bom desfecho clínico. Nossa descrição objetiva identificar pontos-chave e sinais clínicos que evidenciem essa janela terapêutica, bem como uma opção de tratamento para as apresentações coagulatórias da COVID-19.

Abstract The current coronavirus pandemic has already taken a great toll globally, causing massive morbidity and mortality. One of its severe forms is a thrombophilic state that can damage several systems. This article reports the case of 60-year-old female patient who presented with mild flu symptoms, which turned out to be a SARS-CoV2 infection, and ended up developing arterial thrombosis with limb ischemia in a private care hospital in Sorocaba, São Paulo, Brazil. Considering this progression, we decided to intervene with low molecular weight heparin and Alprostadil, achieving a good clinical outcome. Our description aims to identify key points and clinical signs that offer evidence of the therapeutic window and a treatment option for coagulatory presentations of COVID-19.

ABSTRACT: Periapical cyst originates from an inflammatory reaction in the body that occurs due to a long-term endodontic aggression. It is more prevalent in caucasian male, during the third decade of life, in the anterior portion of the maxilla. They are commonly radiographic findings, due to their asymptomatic aspect. This study reports a Periapical Cyst in the portion corresponding to teeth 21, 22 and 23, which was treated by enucleation of the cyst, apicoectomy and retrograde root filling with Mineral trioxide aggregate (M.T.A) of teeth 21 and 22, filling of the cyst cavity with xenogeneic bone graft GenOx and a collagen membrane Gen-Derm. Observations after three months show good and rapid bone regeneration, periodontal and periapical health of the teeth involved.

RESUMEN: El quiste periapical se origina de una reacción inflamatoria que ocurre debido a una agresión endodóntica a largo plazo. Es más frecuente en el varón caucásico, durante la tercera década de la vida, en la porción anterior del maxilar. Son comúnmente hallazgos radiográficos, debido a su aspecto asintomático. En este estudio informamos acerca de un quiste periapical, en la porción correspondiente a los dientes 21, 22 y 23, que se trató mediante enucleación, apicectomía y relleno de raíz retrógrada con agregado de trióxido mineral (MTA) de los dientes 21 y 22, relleno de la cavidad del quiste con injerto óseo xenogénico Gen-Ox y una membrana de colágeno GenDerm. Las observaciones después de tres meses mostraron una buena y rápida regeneración ósea, con conservación de la salud periodontal y periapical de los dientes involucrados.

Resumo Objetivo Analisar o efeito da talidomida na progressão de lesões endometrióticas induzidas experimentalmente em ratas e caracterizar o padrão de proliferação celular pela marcação imunohistoquímica de Antígeno Nuclear de Célula Proliferativa (PCNA) no endométrio eutópico e ectópico. Métodos Quinze ratas Wistar foram submetidas a laparotomia para indução de endometriose por ressecção de um corno uterino, isolamento do endométrio e fixação de um segmento do tecido ao peritônio pélvico. Após quatro semanas, os animais foram divididos em 3 grupos: controle (I), 10 mg/kg/dia (II) e 1 mg/kg/dia (III) de talidomida intraperitoneal por um período de 10 dias. As lesões foram resseccionadas juntamente com o corno uterino oposto para análise da glândula endometrial e do estroma. O tecido endometrial eutópico e ectópico foi submetido à imunohistoquímica para análise da proliferação celular por marcação com PCNA e o índice de proliferação celular (CPI) foi calculado como o número de células marcadas por 1.000 células. Resultados O grupo I apresentou média de CPI de 0,248 ± 0,0513 na glândula e de 0,178 ± 0,046 no estroma. Em contraste, os grupos II e III apresentaram CPI significativamentemenor, isto é, 0,088 ± 0,009 e 0,080 ± 0,021 para a glândula (p < 0,001) e 0,0945 ± 0,0066 e 0,075 ± 0,018 para o estroma (p < 0,001), respectivamente. Além disso, a área de lesãomédia do Grupo I foi de 69,2mm2, valor significativamentemaior em relação ao Grupo II (49,4mm2, p = 0,023) e Grupo III (48,6mm2, p = 0,006). Não houve diferença estatisticamente significante entre os Grupos II e III. Conclusão A talidomida mostrou-se eficaz na redução da área da lesão e CPI dos implantes de endometriose experimental tanto na dose de 1mg/kg/dia quanto na dose de 10 mg/kg/dia.

Abstract Objective To analyze the effect of thalidomide on the progression of endometriotic lesions experimentally induced in rats and to characterize the pattern of cell proliferation by immunohistochemical Proliferating Cell Nuclear Antigen (PCNA) labeling of eutopic and ectopic endometrium. Methods Fifteen female Wistar rats underwent laparotomy for endometriosis induction by resection of one uterine horn, isolation of the endometrium and fixation of a tissue segment to the pelvic peritoneum. Four weeks after, the animals were divided into 3 groups: control (I), 10mg/kg/day (II) and 1mg/kg/day (III) intraperitoneal thalidomide for 10 days. The lesion was excised together with the opposite uterine horn for endometrial gland and stroma analysis. Eutopic and ectopic endometrial tissue was submitted to immunohistochemistry for analysis of cell proliferation by PCNA labeling and the cell proliferation index (CPI) was calculated as the number of labeled cells per 1,000 cells. Results Group I showed a mean CPI of 0.248 ± 0.0513 in the gland and of 0.178 ± 0.046 in the stroma. In contrast, Groups II and III showed a significantly lower CPI, that is, 0.088 ± 0.009 and 0.080 ± 0.021 for the gland (p < 0.001) and 0.0945 ± 0.0066 and 0.075 ± 0.018 for the stroma (p < 0.001), respectively. Also, the mean lesion area of Group I was 69.2mm2, a significantly higher value compared with Group II (49.4mm2, p = 0.023) and Group III (48.6mm2, p = 0.006). No significant difference was observed between Groups II and III. Conclusion Thalidomide proved to be effective in reducing the lesion area and CPI of the experimental endometriosis implants both at the dose of 1mg/kg/day and at the dose of 10 mg/kg/day.

RESUMEN Los microorganismos endofíticos tienen gran interés biotecnológico, con características aplicables a diferentes áreas y potencialmente útiles en la agricultura. El presente estudio determinó el potencial biotecnológico de los hongos endofíticos, aislados de las hojas de Sapindus saponaria, en el control de hongos fitopatógenos y evaluación de su producción de enzimática. La taxonomía molecular fue realizada por la secuencia de la región ITS1-5.8S-ITS2 del ADN ribosomal, identificando los géneros Phomopsis, Sordariomycetes, Diaporthe y Colletotrichum. El antagonismo in vitro contra fitopatógenos mostró mejores resultados contra Fusarium solani y proporcionó índices de inhibición de entre el 41,8 % y el 67,5 %. El linaje endofítico SS81 (Diaporthe citri) presentó el mayor índice de antagonismo contra los patógenos. Contra Glomerella sp. y Moniliophthora perniciosa, las tasas de inhibición variaron entre el 18,7 % y el 57,4 % y entre el 38,3 % y el 64,8 %, respectivamente. El ensayo enzimático reveló que el linaje SS65 (Diaporthe sp.) produjo 1,16 UI μmol / min de amilasa; el linaje SS77 (Diaporthe sp.) produjo 2,74 UI μmol / min de pectinasa; y el linaje SS08 (Diaporthe sp.) produjo 1,51 UI μmol / min de celulasa. Así, el presente estudio evidencia la importancia de los endófitos aislados con propiedades fitoprotectoras como alternativas para el control biológico y como fuentes naturales de productos con interés biotecnológico.

ABSTRACT Endophyte microorganisms have great biotechnological interest, with features applicable to different areas and are potentially useful in agriculture. The current study determines the biotechnological potential of endophytic fungi, isolated from leaves of Sapindus saponaria, to control phytopathogenic fungi and evaluate their enzyme production. Molecular taxonomy was performed by sequencing of the ITS1-5.8S-ITS2 ribosomal DNA region, identifying the genera Phomopsis, Sordariomycetes, Diaporthe, and Colletotrichum. In vitro antagonism against phytopathogens showed better results against Fusarium solani and provided inhibition indices between 41.8 % and 67.5 %. The endophytic strain SS81 (Diaporthe citri) presented the highest antagonism index against the pathogen. Against Glomerella sp. and Moniliophthora perniciosa, inhibition rates ranged between 18.7 % and 57.4 % and between 38.3 % and 64.8 %, respectively. Enzyme assays revealed that strain SS65 (Diaporthe sp.) produced 1.16 UI μmol/min of amylase; strain SS77 (Diaporthe sp.) produced 2.74 UI μmol/min of pectinase, and strain SS08 (Diaporthe sp.) produced 1.51 UI μmol/min of cellulase. Thus, the current study shows evidence the importance of isolated endophytes with phytoprotective properties of plants with medicinal properties as alternatives for biological control and natural sources of products with biotechnological interest.

ABSTRACT This study aimed at establishing the morphological characteristics and morphometric indexes of Pêga donkeys, utilizing 47 animals, of which 22 were adults and 25 were growing donkeys. Prior to taking their measurements, the animals were restrained and made to stand squarely. The morphological data were measured, and the following morphometric indexes were determined: body index (BI), meloscopic index (MI), dactylothoracic index (DTI), weight in cannon index (WCI), conformation index (CFI), and real live weight (RLW). The experimental design was subdivided into plots and repeated in time, in which the animals represented the plot and the data collection times were the subplots. No sex effect was noted for the morphological measurements and morphometric indexes of growing donkeys. The effect of growth period was observed for all the variables. At birth, donkeys weighed around 14.86% of the weight of dams, and at six months they reached up to 40.37%. For the height taken at the withers, the animals at birth were 67.77% of the height of dams, and at six months they achieved up to 84.45%. Based on the morphometric indexes, it is suggested that adult and growing Pêga donkeys can be classified as being suited for both saddle and draft activities and possess a higher load capacity when compared with horses. A few indexes including BI, MI, and RLW need to be adjusted to be suitably used in rating the donkeys.