RESUMO Objetivo Verificar a prevalência das queixas vocais e a associação com os fatores sociodemográficos, econômicos, ocupacionais e comportamentais entre a população de Agentes Comunitários de Saúde (ACS). Método Trata-se de um estudo transversal e analítico, realizado no município de Montes Claros, MG, no qual participaram 674 ACS. Para os aspectos sobre o uso da voz foi aplicado o Índice de Triagem de Distúrbio de Voz (ITDV) e os demais dados contemplavam as condições sociodemográficas, econômicas, ocupacionais e comportamentais. Realizou-se a análise bivariada, pelo teste do qui-quadrado de Pearson, e a regressão múltipla de Poisson com variância robusta para verificar a associação entre as variáveis. Resultados Houve alta prevalência de queixas vocais, sendo as mais citadas: garganta seca, pigarro, cansaço ao falar e rouquidão. Verificou-se associação significativa entre: sexo feminino, falta de sono reparador, uso de bebidas alcóolicas, autoavaliação da saúde regular a muito ruim e ansiedade. Conclusão Houve uma porcentagem significativa de queixas vocais e os fatores associados encontrados nortearão ações de promoção da saúde vocal e geral.

ABSTRACT Purpose To verify the prevalence of vocal complaints and their association with sociodemographic, economic, occupational, and behavioral factors among the population of Community Health Agents (CHA). Methods This is a cross-sectional and analytical study conducted in the city of Montes Claros, MG, in which 674 CHA participated. Data were collected via a self-administered questionnaire that includes sociodemographic, economic, behavioral, occupational, and voice-use aspects based on the Screening Index for Voice Disorder (SIVD). Bivariate analysis was performed by Pearson's chi-square test and Poisson multiple regression with robust variance to verify the association between the variables. Results There was a high prevalence of vocal complaints, the most cited being dry throat, throat clearing, tiredness when talking, and hoarseness. We observed a significant association between female gender, lack of restful sleep, alcohol use, regular to very poor self-rated health, and anxiety. Conclusion There was a significant percentage of vocal complaints, and the associated factors found will guide actions to promote vocal and general health.

Resumo: Introdução: As Diretrizes Curriculares Nacionais para os cursos de Graduação em Medicina (DCN) de 2014 definem que o(a) graduando(a) deve ser formado(a) para abordar a diversidade biológica, étnico-racial, de gênero e orientação sexual. Entretanto, essa temática costuma ser invisibilizada, reiterando a LGBTI+fobia institucional que perpetua desigualdades e iniquidades no ensino e cuidado em saúde. Essa situação se tornou mais explícita durante a pandemia da Covid-19. Objetivo: Analisar as DCN sob a ótica das diversidades de gênero e sexual, de modo a problematizar “o que” e “como” pode ser aprimorado na educação médica em relação às questões LGBTI+. Desenvolvimento: Considerando que a aprendizagem de adultos ocorre a partir da problematização de vivências do cotidiano, serão apresentados três casos relativos ao atual momento da pandemia da Covid-19, com base nos quais se podem abordar temas sobre a saúde LGBTI+ no curso médico. Após, serão problematizadas algumas competências específicas sobre saúde LGBTI+ que podem ser aprimoradas durante a formação médica, inclusive no período da pandemia da Covid-19, a fim de visibilizar a temática LGBTI+ no currículo como uma estratégia de combater a LGBTI+fobia na escola médica e promover o cuidado integral em saúde. Conclusão: É possível abordar sobre a saúde LGBTI+ a partir de situações vivenciadas durante a pandemia da Covid-19. Entretanto, é necessário ter clareza de como as DCN se traduzem em competências específicas sobre saúde LGBTI+. Essa pode ser uma das estratégias a fim de tornar os currículos mais acolhedores e compromissados com as necessidades de saúde dessa população.

Abstract: Introduction: The 2014 National Curriculum Guidelines (“DCNs”) determine that undergraduates should be trained to address biological, ethnic-racial, gender and sexual orientation diversity. However, academic medical training only occasionally addresses this theme, which perpetuates inequality and prevents physicians from being adequately trained to serve this population. The reorganization of curricular activities due to the Covid-19 pandemic may have aggravated this situation and this invisibility emphasizes institutional LGBTI+phobia. Objective: To shed light on the LGBTI+ theme in academic medical training is one of the strategies to tackle LGBTI+phobia in medical school. This essay will analyze the “DCNs” from the perspective of gender and sexual diversity, recommending related competencies on LGBTI+ health that should feature in the course, including the Covid-19 pandemic period. Development: We will present three cases related to the current moment of the Covid-19 pandemic, from which topics on LGBTI + health could be discussed in academic medical training. After analyzing the DCNs and the needs arising from these cases, some competencies in LGBTI+ health will be proposed for undergraduate medicine students; considering that adult learning results from critically questioning everyday experiences. Conclusion: we believe that it is possible to approach LGBTI+ health from situations experienced during the Covid-19 pandemic. However, it is necessary to be clear how the DCNs translate to LGBTI+ health-related skills. This might be one of the strategies to make academic medical training more welcoming and committed to the health needs of this group.

RESUMO: Introdução: O Escore Finlandês de Risco de Diabetes (FINDRISC) é um instrumento que inicialmente foi desenvolvido para predizer o risco de desenvolver diabetes mellitus tipo 2 em adultos. Esse instrumento é simples, rápido de aplicar, não invasivo e de baixo custo. Os objetivos deste estudo foram descrever o processo de tradução e adaptação transcultural do FINDRISC para o português do Brasil e avaliar a sua confiabilidade teste-reteste. Metodologia: O projeto foi conduzido de acordo com as recomendações dos Princípios de Boas Práticas para o Processo de Tradução e Adaptação Transcultural de Medidas de Resultados Relatados pelo Paciente desenvolvidas pela ISPOR. Uma vez desenvolvida a versão final em português brasileiro (FINDRISC-Br), realizou-se a avaliação da confiabilidade usando uma amostra não aleatória de 83 indivíduos atendidos em uma unidade de atenção básica. Cada participante foi entrevistado por nutricionistas registradas treinadas em duas ocasiões com intervalo médio de 14 dias. A avaliação da confiabilidade foi realizada por meio da análise do nível de concordância entre as respostas do teste-reteste, utilizando-se o coeficiente kappa de Cohen e o coeficiente de correlação intraclasse (CCI). Resultados: As etapas das diretrizes da ISPOR foram seguidas consecutivamente sem maiores problemas. Em relação à avaliação da confiabilidade do teste-reteste, o questionário como um todo apresentou confiabilidade adequada (kappa de Cohen = 0,82; IC95% 0,72 - 0,92 e CCI = 0,94; IC95% 0,91 - 0,96). Conclusão: O FINDRISC foi traduzido e adaptado transculturalmente para o português do Brasil seguindo procedimentos padronizados. O FINDRISC-Br já está disponível para uso e tem potencial para ser usado como ferramenta de rastreamento em diferentes cenários brasileiros.

ABSTRACT: Introduction: The Finnish Diabetes Risk Score (FINDRISC) is a tool that was initially developed to predict the risk of developing type 2 diabetes mellitus in adults. This tool is simple, quick to apply, non-invasive, and low-cost. The aims of this study were to perform a translation and cultural adaptation of the original version of FINDRISC into Brazilian Portuguese and to assess test-retest reliability. Methodology: This work was done following the ISPOR Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes Measures. Once the final Brazilian Portuguese version (FINDRISC-Br) was developed, the reliability assessment was performed using a non-random sample of 83 individuals attending a primary care health center. Each participant was interviewed by trained registered dieticians on two occasions with a mean interval of 14 days. The reliability assessment was performed by analyzing the level of agreement between the test-retest responses of FINDRISC-Br using Cohen’s kappa coefficient and the intraclass correlation coefficient (ICC). Results: The steps of ISPOR guidelines were consecutively followed without major problems. Regarding the reliability assessment, the questionnaire as a whole presented adequate reliability (Cohen’s kappa = 0.82, 95%CI 0.72 - 0.92 and ICC = 0.94, 95%CI 0.91 - 0.96). Conclusion: FINDRISC was translated into Brazilian Portuguese and culturally adapted following standard procedures. FINDRISC-Br has thus become available for use and has potential as a screening tool in different Brazilian settings and applications.

RESUMO: Introdução: O Escore Finlandês de Risco de Diabetes (FINDRISC) é um instrumento que inicialmente foi desenvolvido para predizer o risco de desenvolver diabetes mellitus tipo 2 em adultos. Esse instrumento é simples, rápido de aplicar, não invasivo e de baixo custo. Os objetivos deste estudo foram descrever o processo de tradução e adaptação transcultural do FINDRISC para o português do Brasil e avaliar a sua confiabilidade teste-reteste. Metodologia: O projeto foi conduzido de acordo com as recomendações dos Princípios de Boas Práticas para o Processo de Tradução e Adaptação Transcultural de Medidas de Resultados Relatados pelo Paciente desenvolvidas pela ISPOR. Uma vez desenvolvida a versão final em português brasileiro (FINDRISC-Br), realizou-se a avaliação da confiabilidade usando uma amostra não aleatória de 83 indivíduos atendidos em uma unidade de atenção básica. Cada participante foi entrevistado por nutricionistas registradas treinadas em duas ocasiões com intervalo médio de 14 dias. A avaliação da confiabilidade foi realizada por meio da análise do nível de concordância entre as respostas do teste-reteste, utilizando-se o coeficiente kappa de Cohen e o coeficiente de correlação intraclasse (CCI). Resultados: As etapas das diretrizes da ISPOR foram seguidas consecutivamente sem maiores problemas. Em relação à avaliação da confiabilidade do teste-reteste, o questionário como um todo apresentou confiabilidade adequada (kappa de Cohen = 0,82; IC95% 0,72 - 0,92 e CCI = 0,94; IC95% 0,91 - 0,96). Conclusão: O FINDRISC foi traduzido e adaptado transculturalmente para o português do Brasil seguindo procedimentos padronizados. O FINDRISC-Br já está disponível para uso e tem potencial para ser usado como ferramenta de rastreamento em diferentes cenários brasileiros.

ABSTRACT: Introduction: The Finnish Diabetes Risk Score (FINDRISC) is a tool that was initially developed to predict the risk of developing type 2 diabetes mellitus in adults. This tool is simple, quick to apply, non-invasive, and low-cost. The aims of this study were to perform a translation and cultural adaptation of the original version of FINDRISC into Brazilian Portuguese and to assess test-retest reliability. Methodology: This work was done following the ISPOR Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes Measures. Once the final Brazilian Portuguese version (FINDRISC-Br) was developed, the reliability assessment was performed using a non-random sample of 83 individuals attending a primary care health center. Each participant was interviewed by trained registered dieticians on two occasions with a mean interval of 14 days. The reliability assessment was performed by analyzing the level of agreement between the test-retest responses of FINDRISC-Br using Cohen’s kappa coefficient and the intraclass correlation coefficient (ICC). Results: The steps of ISPOR guidelines were consecutively followed without major problems. Regarding the reliability assessment, the questionnaire as a whole presented adequate reliability (Cohen’s kappa = 0.82, 95%CI 0.72 - 0.92 and ICC = 0.94, 95%CI 0.91 - 0.96). Conclusion: FINDRISC was translated into Brazilian Portuguese and culturally adapted following standard procedures. FINDRISC-Br has thus become available for use and has potential as a screening tool in different Brazilian settings and applications.

BACKGROUND Oxidative stress is responsible for generating DNA lesions and the 8-oxoguanine (8-oxoG) is the most commonly lesion found in DNA damage. When this base is incorporated during DNA replication, it could generate double-strand DNA breaks and cellular death. MutT enzyme hydrolyzes the 8-oxoG from the nucleotide pool, preventing its incorporation during DNA replication. OBJECTIVES To investigate the importance of 8-oxoG in Leishmania infantum and L. braziliensis, in this study we analysed the impact of heterologous expression of Escherichia coli MutT (EcMutT) enzyme in drug-resistance phenotype and defense against oxidative stress. METHODS Comparative analysis of L. braziliensis and L. infantum H2O2 tolerance and cell cycle profile were performed. Lines of L. braziliensis and L. infantum expressing EcMutT were generated and evaluated using susceptibility tests to H2O2 and SbIII, cell cycle analysis, γH2A western blotting, and BrdU native detection assay. FINDINGS Comparative analysis of tolerance to oxidative stress generated by H2O2 showed that L. infantum is more tolerant to exogenous H2O2 than L. braziliensis. In addition, cell cycle analysis showed that L. infantum, after treatment with H2O2, remains in G1 phase, returning to its normal growth rate after 72 h. In contrast, after treatment with H2O2, L. braziliensis parasites continue to move to the next stages of the cell cycle. Expression of the E. coli MutT gene in L. braziliensis and L. infantum does not interfere in parasite growth or in susceptibility to SbIII. Interestingly, we observed that L. braziliensis EcMutT-expressing clones were more tolerant to H2O2 treatment, presented lower activation of γH2A, a biomarker of genotoxic stress, and lower replication stress than its parental non-transfected parasites. In contrast, the EcMutT is not involved in protection against oxidative stress generated by H2O2 in L. infantum. MAIN CONCLUSIONS Our results showed that 8-oxoG clearance in L. braziliensis is important to avoid misincorporation during DNA replication after oxidative stress generated by H2O2.

Abstract INTRODUCTION: Trachoma is the leading cause of blindness in the world, especially in undeveloped countries, due to its association with poor socioeconomic and sanitation conditions. This study aimed to estimate the prevalence of trachoma among students from the Jequitinhonha Valley, Minas Gerais, one of the poorest regions in Brazil, and to identify associated factors. METHODS: This is a cross-sectional study that utilized clinical evaluation and a socioeconomic questionnaire applied to a random and representative sample of elementary school students from the Jequitinhonha Valley, Minas Gerais, Brazil. Participants underwent conjunctival scraping and direct immunofluorescence was used to confirm the presence of the bacteria. Five or more elementary bodies in the conjunctival scrape was considered a positive result. In the study, 36.6% positive samples were detected. A culture of the conjunctival scrape, considered to be the "gold standard", was not performed due to cost and complexity. Bivariate analyses were performed, followed by binary logistic regression analysis to define the associated variables. RESULTS: In the present study, 478 students comprised the sample. The prevalence of trachoma was 6.3% and was higher among students who lived in unfinished houses (no plastering, painting, flooring, and unfinished bathrooms) (OR, 2.27; 95% CI, 1.12-6.48) without sewage systems (OR = 9.49; 95% CI = 3.52-25.60) and studied in rural areas (OR, 3.37; 95% CI, 1.53-7.35). CONCLUSIONS: The prevalence of trachoma among the students aged 7 to 16 years old, from public and private schools, is not negligible and is especially associated with inadequate living conditions.

Resumo O objetivo deste estudo foi avaliar o processo de implementação e os resultados alcançados em uma intervenção para promoção de sentido da vida entre adolescentes. Participaram da pesquisa 47 adolescentes de ambos os sexos, com idades entre 15 e 17 anos, distribuídos não randomicamente em dois grupos: experimental (N=22) e controle (N=25). A avaliação de processo incluiu medidas de satisfação, validade social, engajamento e compreensão das atividades por parte dos adolescentes. Foram realizadas também avaliações de pré e pós testes: os participantes dos dois grupos responderam inicialmente aos instrumentos Questionário Sentido de Vida e Escala de Afetos Positivos e Negativos. Após 6 encontros semanais, que objetivaram promover o sentido de vida, ambos os grupos foram submetidos a uma retestagem com os mesmos instrumentos. Os resultados sugeriram um aumento na percepção de sentido de vida; diminuição de afetos negativos e a existência de planos futuros específicos, indicando evidências favoráveis à eficácia da intervenção. De forma geral, constatou-se uma adesão dos adolescentes ao programa de intervenção, bem como uma avaliação positiva do mesmo.

Abstract The objective of this study was to evaluate the implementation process and achievements in an intervention to promote meaning of life among adolescents. The participants were 47 adolescents of both sexes, aged 15 and 17, not randomly allocated into two groups: experimental (N = 22) and control (N = 25). The process of evaluation included satisfaction measures, social validity, engagement and understanding of activities by the teenagers. They were also carried out pre and post tests ratings: the participants of the two groups responded initially to the instruments Questionnaire Sense of Life and Affect Scale Positive and Negative. After 6 weekly meetings, which aimed to promote the sense of life, both groups were subjected to retesting with the same instruments. The results suggested an increase in the perception of meaning of life and decreased negative affect, indicating evidence supporting the effectiveness of the intervention. Overall, there was a membership of teenagers to the intervention program, as well as a positive evaluation.

Resumen El objetivo del estudio fue evaluar el proceso de implementación y los resultados obtenidos, en una intervención para la promoción del sentido de la vida en adolescentes. En este estudio, participaron 47 adolescentes de ambos sexos, con edades entre los 15 y 17 años, distribuídos no randomicamente en dos grupos: experimental (n=22) y control (n=25). La evaluación del proceso incluyó medidas de satisfacción, validez social, adhesión y comprensión de las actividades por parte de los adolescentes. También se realizaron evaluaciones pre y post-tests: los participantes de ambos grupos respondieron inicialmente al Cuestionario de Sentido de la vida y a la Escala de Afectos Positivos y Negativos. Después de 6 reuniones semanales, destinadas a promover el sentido de la vida, ambos grupos fueron evaluados con los mismos instrumentos. Los resultados sugieren un incremento en la percepción del sentido de la vida y una reducción del afecto negativo, proporcionando evidencia favorable a la eficacia de la intervención. En general, se observó una adecuada adhesión de los adolescentes al programa de intervención, así como una evaluación positiva de la misma. Los hallazgos parecen indicar evidencias favorables de la eficacia de la intervención para la promoción del sentido de la vida en adolescentes.

Abstract Introduction: Diffusion tensor imaging (DTI) is an important medical imaging modality that has been useful to the study of microstructural changes in neurological diseases. However, the image noise level is a major practical limitation, in which one simple solution could be the average signal from a sequential acquisition. Nevertheless, this approach is time-consuming and is not often applied in the clinical routine. In this study, we aim to evaluate the anisotropic anomalous diffusion (AAD) filter in order to improve the general image quality of DTI. Methods A group of 20 healthy subjects with DTI data acquired (3T MR scanner) with different numbers of averages (N=1,2,4,6,8, and 16), where they were submitted to 2-D AAD and conventional anisotropic diffusion filters. The Relative Mean Error (RME), Structural Similarity Index (SSIM), Coefficient of Variation (CV) and tractography reconstruction were evaluated on Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) maps. Results The results point to an improvement of up to 30% of CV, RME, and SSIM for the AAD filter, while up to 14% was found for the conventional AD filter (p<0.05). The tractography revealed a better estimative in fiber counting, where the AAD filter resulted in less FA variability. Furthermore, the AAD filter showed a quality improvement similar to a higher average approach, i.e. achieving an image quality equivalent to what was seen in two additional acquisitions. Conclusions In general, the AAD filter showed robustness in noise attenuation and global image quality improvement even in DTI images with high noise level.

Abstract Introduction: The search for human brain templates has been progressing in the past decades and in order to understand disease patterns a need for a standard diffusion tensor imaging (DTI) dataset was raised. For this purposes, some DTI templates were developed which assist group analysis studies. In this study, complementary information to the most commonly used DTI template is proposed in order to offer a patient-specific statistical analysis on diffusion-weighted data. Methods 131 normal subjects were used to reconstruct a population-averaged template. After image pre processing, reconstruction and diagonalization, the eigenvalues and eigenvectors were used to reconstruct the quantitative DTI maps, namely fractional anisotropy (FA), mean diffusivity (MD), relative anisotropy (RA), and radial diffusivity (RD). The mean absolute error (MAE) was calculated using a voxel-wise procedure, which informs the global error regarding the mean intensity value for each quantitative map. Results the MAE values presented a low MAE estimate (max(MAE) = 0.112), showing a reasonable error measure between our DTI-USP-131 template and the classical DTI-JHU-81 approach, which also shows a statistical equivalence (p<0.05) with the classical DTI template. Hence, the complementary standard deviation (SD) maps for each quantitative DTI map can be added to the classical DTI-JHU-81 template. Conclusion In this study, variability DTI maps (SD maps) were reconstructed providing the possibility of a voxel-wise statistical analysis in patient-specific approach. Finally, the brain template (DTI-USP-131) described here was made available for research purposes on the web site (http://dx.doi.org/10.17632/br7bhs4h7m.1), being valuable to research and clinical applications.

ABSTRACT The objective of this study was to evaluate the effect of different sources of lipids in the diets of dairy cows on the intake and digestibility of nutritional fractions, and milk production and composition. The experiment was conducted in a 42-hectare area divided into eight paddocks covered with Brachiaria brizantha. Twelve crossbred Holstein × Zebu cows were distributed into three simultaneous 4 × 4 Latin squares. The treatments consisted of different sources of lipids, as follows: diet with no extra source of lipids; diet with cottonseed as the source of lipids; diet with soy oil; and diet with used frying soy oil. The intakes of dry matter, neutral detergent fiber, crude protein, total carbohydrates, and non-fibrous carbohydrates were similar for all diets. The use of lipid sources caused a decrease in the apparent digestibility of dry matter, neutral detergent fiber, non-fibrous carbohydrates, and crude protein. The levels of protein, lactose, and defatted dry matter were reduced with the use of lipid sources but did not affect milk production. The use of cottonseed, soy oil, and used frying soy oil as sources of lipids in diets for lactating cows at pasture do not improve milk production, and their use is therefore optional.

Objetivou-se, com esta pesquisa, investigar o desenvolvimento testicular e corporal de javalis (Sus scrofa scrofa), do nascimento aos 12 meses de idade, avaliando-se, em cada faixa etária, o peso corporal, o desenvolvimento biométrico dos testículos e o índice gonadossomático (IGS). Utilizaram-se 52 javalis machos, provenientes de um criatório comercial, devidamente regulamentado pelo IBAMA. Os animais foram pesados e divididos em 13 grupos experimentais; os testículos foram coletados por orquiectomia unilateral e, em seguida, pesados em balança analítica e mensurados comprimento, largura e espessura. Os valores de peso corporal e as medidas testiculares foram crescentes, após o nascimento, sendo sua variação mais acelerada no primeiro mês e aos nove meses. Inicialmente, o padrão de crescimento testicular, do nascimento aos nove meses de idade, acompanhou o crescimento corporal e o índice gonadossomático variou de 0,07 a 0,09%. Em seguida, entre nove e 11 meses, o valor de crescimento testicular foi superior ao de crescimento corporal e o índice gonadossomático variou de 0,09 a 0,16%. Por fim, após os 11 meses de idade, os valores crescimento corporal e dos testículos voltaram a se comportar de forma semelhante. Conclui-se que o desenvolvimento do peso corporal, a biometria testicular e o IGS tiveram crescimento mais acelerado aos nove meses de idade.

The aim of this tudy was to evaluate corporal and testicular development in wild boars (Sus scrofa scrofa) from birth to 12 months of age, evaluating body weight, biometric testicular parameters, and gonadosomatic index. Thirty-nine male wild boars from a commercial farm licensed by IBAMA were used in the study. The animals were weighed and assigned to 13 experimental groups. The testes were recovered through unilateral orchiectomy, weighed on an analytical balance and measured for length, width and thickness. Body weight and testicular measures increased with the age, up to 12 months, and were more accelerated in the first and ninth months. Initially the testicular growth pattern, between zero and nine months, followed the body growth, and the gonadosomatic index varied from 0.07 to 0.09%. Between 9 and 11 months, the testicular growth was superior to the body growth, and the gonadosomatic index varied from 0.09 to 0.16%. Finally, after 11 months of age, testicular and body growth had a similar behavior. In conclusion, body weight, testicular biometry, and gonadosomatic index development accelerated in the ninth month.

A rotura da camada íntima que marca o início da dissecção aórtica se origina na maioria dos casos na aorta torácica, sendo rara a dissecção espontânea da aorta abdominal infra-renal. As três principais causas são: iatrogênica, traumática ou espontânea. A dor abdominal e a isquemia de membros são os sintomas mais comuns e um número significativo de pacientes e´ assintomatico. O diagnóstico tem sido feito através de métodos de imagem como ultrassonografia, tomografia computadorizada, ressonância nuclear magnética e angiografia aliados ao alto índice de suspeição. Relatamos os casos de duas pacientes que apresentaram dissecção de aorta abdominal infrarrenal com quadro de dor abdominal súbita, sem sinais de irritação peritoneal com pulsos presentes e simétricos ao exame físico que deram entrada no pronto socorro do Hospital e Maternidade Celso Pierro da PUC Campinas e que foram tratadas pela equipe de Cirurgia Vascular. As duas pacientes no momento do exame apresentavam-se hipertensas e ao ultrassom apresentavam alteração da conformidade da aorta abdominal que foram tratada s cirurgicamente. Uma paciente foi tratada cirurgicamente submetida a endarterectomia da placa dissecada da aorta abdominal infrarrenal de 2,2 cm de diâmetro e 2,0 cm de extensão. A outra paciente foi submetida a revascularização da aorta abdominal bi-iliaca com prótese de Dacron 16 × 8 mm por apresentar disseccao da aorta abdominal distal. As duas pacientes apresentaram boa evolução pos-operatoria tendo alta hospitalar em bom estado geral.

The rupture of the intimal layer marks the beginning of the aortic dissection, which usually happens in the thoracic aorta. The spontaneous dissection of the infrarenal aorta is rare. The main causes are: iatrogenic, traumatic and spontaneous. Abdominal pain and limb ischemia are the commonest symptoms, and some patients are asymptomatics. The diagnosis is made by ultrasound, computed tomography, nuclear magnetic resonance and angiography, with a high suspicious index. We describe two cases of spontaneous rupture of the infrarenal aorta that were treated surgically. We report two cases of patients who were admitted to the emergency room of Celso Pierro Hospital with infrarenal abdominal aortic dissection and were treated by the vascular surgery group. They have presented sudden abdominal pain, no signs of peritoneal irritation and pulses were presents and simmetrics in physical examination The two patients during the examination were hypertensive and the ultrasound showed abnormal compliance of the abdominal aorta who were treated surgically. One patient was treated surgically with dissected plaque endarterectomy of infrarenal abdominal aorta of 2.2 cm in diameter and 2.0 cm in length. The other patient underwent revascularization of the abdominal aorta with bi-iliac Dacron graft 16 × 8 mm due to distal abdominal aortic dissection. Both patients had good postoperative evolution and they were discharged in good general condition.

INTRODUÇÃO: O infarto agudo do miocárdio (IAM) permanece com elevados índices de morbidade e mortalidade e representa problema de saúde pública. Analisamos os resultados e os preditores de risco de eventos adversos hospitalares em pacientes submetidos a intervenção coronária percutânea (ICP) eletiva pós-fibrinólise. MÉTODOS: Foram selecionados 303 pacientes com diagnóstico de IAM submetidos a reperfusão farmacológica e transferidos para um centro terciário para realização de ICP eletiva. RESULTADOS: A população era predominantemente masculina (76,6%), com média de idade de 59,4 + 11,1 anos, 18,1% eram diabéticos e 86,8% estavam em Killip I. Estreptoquinase foi empregada em 91,7%, o tempo médio de realização da ICP eletiva foi de 5,6 + 3,7 dias após a fibrinólise e o fluxo TIMI 3 (74,2%) foi o mais prevalente. Os stents foram implantados em 97,7% dos pacientes e o sucesso angiográfico foi de 95,3%. Mortalidade ocorreu em 3,3% dos pacientes; reinfarto, em 3,6%; revascularização da lesão-alvo, em 1,3%; e sangramentos maiores, em 2%. A análise multivariada apontou sexo feminino, idade > 65 anos, fluxo TIMI 1, presença de trombos no vaso tratado, Killip > I e disfunção grave do ventrículo esquerdo como preditores independentes de eventos adversos hospitalares. CONCLUSÕES: A estratégia de reperfusão farmacológica seguida de transferência para realização de ICP apresenta baixas taxas de eventos adversos hospitalares e é alternativa interessante à ICP primária no cenário nacional. Necessita, no entanto, políticas públicas para aperfeiçoar a logística de manuseio desses pacientes e dispô-la de maneira eficiente a todos os hospitais de baixa e média complexidades nacionais.

BACLGROUND: Acute myocardial infarction (AMI) has a high morbidity and mortality and represents a public health problem. We analyzed the results and predictors of in-hospital adverse events in patients undergoing elective percutaneous coronary intervention (PCI) after fibrinolysis. METHODS: Three hundred and three patients with diagnosis of AMI undergoing pharmacological reperfusion and transferred to a tertiary center for elective PCI were selected. RESULTS: The population included mostly men (76.6%), with mean age of 59.4 + 11.1 years, 18.1% were diabetic and 86.8% were in Killip class I. Streptokinase was used in 91.7%, the mean time to perform elective PCI was 5.6 + 3.7 days after fibrinolysis and TIMI 3 flow was achieved in 74.2% of the patients. Stents were implanted in 97.7% and angiographic success was obtained in 95.3% of the cases. Mortality was observed in 3.3%, reinfarction in 3.6%, target lesion revascularization in 1.3%, and major bleedings in 2% of the patients. Multivariate analysis indicated female gender, age > 65 years, TIMI 1 flow, thrombus in the treated vessel, Killip > I and severe left ventricular dysfunction were independent predictors of in-hospital adverse events. CONCLUSIONS: The pharmacological reperfusion strategy followed by transfer to perform elective PCI had low in-hospital adverse event rates and is an interesting alternative to primary PCI in Brazil. However, public policies are required to improve the logistics to better handle these patients and have them available to all low and medium complexity national hospitals.

Objetivou-se estabelecer a zona de conforto térmico para ovinos da raça Santa Inês por meio da comparação das respostas fisiológicas em diferentes opções de temperatura em câmara bioclimática. O experimento teve duração de 71 dias e foi conduzido utilizando-se sete borregas da raça Santa Inês por tratamento. Os tratamentos foram as faixas de temperatura de 10, 15, 20, 25, 30, 35 e 40°C, com três repetições (dias de exposição) e cinco dias de intervalo. O delineamento experimental utilizado foi o inteiramente casualizado. Os dados meteorológicos coletados foram temperatura de bulbo seco, temperatura de bulbo úmido e temperatura de globo negro e os fisiológicos, frequência respiratória, frequência cardíaca, temperatura retal, temperatura timpânica, taxa de sudação e pressão arterial. Os mecanismos fisiológicos de dissipação de calor mostraram-se eficientes em manter a homeotermia dos animais em todas as temperaturas avaliadas. A temperatura de 25°C pode ser considerada a zona de conforto térmico para borregas da raça Santa Inês em ambiente com umidade relativa de 65%.

The objective was to establish the thermal comfort zone for Santa Ines sheep by comparing the physiological responses at different options of temperatures in bioclimatic chamber. The experiment lasted 71 days and was conducted with the use of seven Santa Ines lambs per treatment. The treatments were temperature ranges of 10, 15, 20, 25, 30, 35 and 40ºC with tree replicates (exposure days) and a five-day interval. The experimental design was completely randomized. Meteorological data collected were: dry bulb temperature; wet bulb temperature and black globe temperature. Physiological data analyzed were: respiratory rate, heart rate, rectal temperature, tympanic temperature, sweating rate and blood pressure. The physiological mechanisms of heat dissipation are shown to be effective in maintaining the homeothermy of the animals studied at all temperatures. The temperature of 25ºC can be determined as the thermal comfort zone for Santa Ines lambs in an environment with relative humidity of 65%.

INTRODUÇÃO: O termo "fractal" é derivado do latim fractus, que significa "irregular" ou "quebrado", considerando a estrutura observada como tendo uma dimensão não-inteira. Há muitos estudos que empregaram a Dimensão Fractal (DF) como uma ferramenta de diagnóstico. Um dos métodos mais comuns para o seu estudo é a "Box-plot counting" (Método de contagem de caixas). OBJETIVO: O objetivo do estudo foi tentar estabelecer a contribuição da DF na quantificação da rejeição celular miocárdica após o transplante cardíaco. MÉTODOS: Imagens microscópicas digitalizadas foram capturadas na resolução 800x600 (aumento de 100x). A DF foi calculada com auxílio do "software ImageJ", com adaptações. A classificação dos graus de rejeição foi de acordo com a "Sociedade Internacional de Transplante Cardíaco e Pulmonar" (ISHLT 2004). O relatório final do grau de rejeição foi confirmado e redefinido após exaustiva revisão das lâminas por um patologista experiente externo. No total, 658 lâminas foram avaliadas, com a seguinte distribuição entre os graus de rejeição (R): 335 (0R), 214 (1R), 70 (2R), 39 (3R). Os dados foram analisados estatisticamente com os testes Kruskal-Wallis e curvas ROC sendo considerados significantes valores de P < 0,05. RESULTADOS: Houve diferença estatística significativa entre os diferentes graus de rejeição com exceção da 3R versus 2R. A mesma tendência foi observada na aplicação da curva ROC. CONCLUSÃO: ADF pode contribuir para a avaliação da rejeição celular do miocárdio. Os valores mais elevados estiveram diretamente associados com graus progressivamente maiores de rejeição. Isso pode ajudar na tomada de decisão em casos duvidosos e naqueles que possam necessitar de intensificação da medicação imunossupressora.

INTRODUCTION: The term "Fractal" is derived from the Latin fractus meaning "irregular" or "broken" considering the observed structure with a non-integer dimension. There are many studies which employed the Fractal Dimension (FD) as a diagnostic tool. One of the most common methods for its study is the "Box Counting Method". OBJECTIVE: The aim of the present study was to try to establish the contribution of FD in the quantification of myocardial cellular rejection after cardiac transplantation. METHODS: Microscopic digital images were captured at 800x600 resolution (magnification 100x). FD was calculated with the aid of "ImageJ software" with adaptations. The classification of the degrees of rejection was in agreement with the "International Society for Heart and Lung Transplantation" (ISHLT 2004). The final report of the degree of rejection was confirmed and redefined after an exhaustive review of the slides by an external experienced pathologist. 658 slides were evaluated with the following distribution among the degrees of rejection (R): 335 (0R); 214 (1R); 70 (2R); 39 (3R). The data were statistically analyzed with Kruskal-Wallis tests and ROC curves being considered significant values of P < 0.05. RESULTS: There was significant statistical difference between the various degrees of rejection with the exception of R3 versus R2. The same trend was observed in applying the ROC curve. CONCLUSION: FD may contribute to the assessment of myocardial cellular rejection. Higher values are directly associated with progressively higher degrees of rejection. This may help in decision making of doubtful cases and those which contemplate the intensification of immunosuppressive medication.