ABSTRACT This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher’s exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

Resumo Introdução: As Práticas Integrativas e Complementares em Saúde (PICS) trazem uma proposta de cuidado centrada no sujeito que valoriza os saberes tradicionais e os mecanismos naturais de manutenção e recuperação da saúde, e vêm se expandindo após a publicação da Política Nacional de PICS (PNPIC) e pela definição das estratégias da OMS para as Medicinas Tradicionais e Complementares (MTCI). Tais ações políticas podem repercutir na formação em saúde e implicar em um posicionamento de resistência e discussão epistemológica nas IES por parte dos docentes e formadores. Objetivos: Conhecer o entendimento de coordenadores e professores dos cursos de graduação em saúde sobre a inserção das PICS na formação em saúde e a sua interface com as políticas públicas. Metodologia: Estudo exploratório-descritivo, elaborado a partir de um questionário eletrônico estruturado (REDCap), aplicado a coordenadores e professores dos cursos de graduação em saúde da Bahia. Resultados/Discussão: Os professores e coordenadores identificam as PICS como práticas promotoras do cuidado ampliado, integral, complementar e alternativo, as reconhecem como racionalidades em saúde distintas do modelo biomédico e estimulam a inserção destas na formação discente, com a finalidade de sensibilizá-los para outras possibilidades de cuidado e autocuidado, atuação profissional e conhecimento das políticas públicas em PICS. Considerações Finais: Este trabalho analisa a complexidade envolvida nos processos de formação em saúde e discute a necessidade de fortalecimento das ações de formação em PICS no campo das políticas públicas, do SUS e como respostas às demandas de cuidado da sociedade contemporânea, especialmente fragilizada pela vivência recente de uma pandemia.

Abstract Introduction: Integrative and Complementary Health Practices (PICS) bring a subject-centered care proposal that values traditional knowledge and natural mechanisms for health maintenance and recovery and has been expanding in recent decades, following the publication of the National Policy of Integrative and Complementary Practices (PNPIC) and the definition of WHO strategies for Traditional and Complementary Medicines (MTCI). Such political actions can have repercussions on health education and imply a position of resistance and epistemological discussion within the universities by teachers and trainers. Objectives: Know the understanding of coordinators and teachers of undergraduate health courses in the State of Bahia about the insertion of PICS in health education and their interface with public policies. Methodology: Exploratory-descriptive study, constructed from a structured electronic questionnaire, developed at REDCap, applied to coordinators and professors of undergraduate health courses in the state of Bahia. Results/Discussion: Teachers and course coordinators identify PICS as practices that promoting expanded, integrative, complementary, and alternative care, recognizing them as health rationalities distinct from the biomedical model. Final Considerations: This paper analyzes the complexity involved in health education processes and discusses the need to strengthen training actions in PICS in the field of public policies according to the principles of the Public Heath, but also as responses to the care demands of contemporary society, especially weakened by the recent experience of a pandemic.

ABSTRACT The oral involvement in the Hematopoietic Stem Cell Transplantation is well described in the literature. The goal of the dental treatment and management of the oral lesions related to the HSCT is to reduce the harm caused by preexisting oral infection or even the worsening of oral acute/chronic GVHD and late effects. The aim of this guideline was to discuss the dental management of patients subjected to HSCT, considering three phases of the HSCT: pre-HSCT, acute phase, and late phase. The literature published from 2010 to 2020 was reviewed in order to identify dental interventions in this patient population. The selected papers were divided into three groups: pre-HSCT, acute and late, and were reviewed by the SBTMO Dental Committee's members. When necessary, an expertise opinion was considered for better translating the guideline recommendations to our population dental characteristics. This manuscript focused on the pre-HSCT dental management. The objective of the pre-HSCT dental management is to identify possible dental situations that On behalf of the Dental Committee of the Brazilian Society of Gene Therapy and Bone Marrow Transplantation (SBTMO) can worsening during the acute phase after the HSCT. Each guideline recommendations were made considering the Dentistry Specialties. The clinical consensus on dental management prior to HSCT provides professional health caregivers with clinical setting-specific information to help with the management of dental problems in patients to be subjected to HSCT.

Essential oils (EO) have diverse applications, such as antibacterial and antifungal activity. However, they are susceptible to oxidation in the presence of air, light, and moisture. In addition, they are thermally unstable. In this sense, it is necessary to develop techniques to increase the lifespan of EO. In this work, EO was obtained from cloves and characterized by different techniques. The major compounds found were eugenol (83%), eugenol acetate (9%), and β-caryophyllene (8%). The EO was encapsulated by extrusion using a microfluidic device. The sodium alginate was used as wall material, and the CaCl2 solution was used as a crosslinking agent. The microcapsule presented sizes of 164.7 ± 0.3 μm, with an encapsulation yield of 64 ± 14%. Functional characteristic groups of EO were observed in the microcapsule by infrared and Raman spectroscopies. The microcapsule increased the thermal decomposition of the EO from 162 to 230 °C. Release kinetics of the capsule was performed, with an equilibrium time of 72 h and release of 54% of the EO. Finally, the pure EO and encapsulated EO-microcapsules were applied in the Aedes aegypti larvae control, showing mean lethal concentration necessary to eliminate 50% (LC50) values of 74.4 and 96.9 μg mL-1 and lethal concentration necessary to eliminate 90% (LC90) of 106.2 and 133.3 μg mL-1 for pure EO and encapsulated EO, respectively. Therefore, it was concluded that these microcapsules have the potential for application in the Aedes aegypti larvae control.

Abstract The purpose of this pictorial essay is to describe the recommendations of the 2021 World Health Organization classification for adult-type and pediatric-type gliomas and to discuss the main modifications in relation to the previous (2016) classification, exemplified by imaging, histological, and molecular findings in nine patients followed at our institutions. In recent years, molecular biomarkers have gained importance in the diagnosis and classification of gliomas, mainly because they have been shown to correlate with the biological behavior and prognosis of such tumors. It is important for neuroradiologists to familiarize themselves with this new classification of central nervous system tumors, so that they can use this knowledge in evaluating and reporting the imaging examinations of patients with glioma.

Resumo O propósito deste ensaio iconográfico é descrever e discutir as novas recomendações da Organização Mundial da Saúde de 2021, referente aos gliomas dos tipos adulto e infantil, e suas principais diferenças com a classificação anterior (2016), exemplificadas com imagens de nove casos de pacientes atendidos nas nossas instituições. Recentemente, há uma crescente significância dos marcadores moleculares no diagnóstico e classificação dos gliomas e tumores do sistema nervoso central, principalmente pela correlação com o comportamento biológico e o prognóstico. É importante que os neurorradiologistas estejam familiarizados com a nova classificação dos tumores do sistema nervoso central para a prática clínica, na avaliação e emissão de laudos e opiniões nas imagens dos pacientes com gliomas.

Abstract Objective: To evaluate the functional status of individuals with Osteogenesis Imperfecta (OI) followed up at a reference center in the state of Bahia. Materials and methods: This is an observational, cross-sectional, descriptive study, which evaluated individuals with OI, based on a non-probabilistic sampling. To assess motor function, the Motor Function Measure (MFM) score was used, in addition to the measurement of muscle strength using the Medical Research Council (MRC) score. Functional performance was measured using the Pediatric Assessment of Disability Inventory, Computerized Adaptive Testing (PEDI-CAT). Results: Thirty-one individuals aged between two and 18 years old were evaluated. The overall score of MFM was 74.2%, and the lowest score was found in participants with type III OI (56.3%). The median of the MRC index was 80. The mobility domain was the most affected in the PEDI-CATevaluation, with a mean T score of 23.9, (14.2 in type III OI). Conclusions: Among the evaluated individuals, functional alterations were identified, reduced global gross motor functionality and muscle strength, impacting the mobility domain, with the most relevant findings in individuals with type III OI.

RESUMO Objetivo Analisar a correlação entre os eixos estruturantes do psiquismo no roteiro IRDI (Indicadores de Referência ao Desenvolvimento Infantil) e na aquisição da linguagem por meio dos Sinais Enunciativos de Aquisição da Linguagem (SEAL) quanto ao papel do bebê e da mãe nas protoconversações iniciais. Método A amostra contou com 77 bebês, que concluíram todas as avaliações no IRDI e no SEAL. Os resultados obtidos por meio desses dois instrumentos foram analisados por meio do coeficiente de Spearman e do teste de U de Mann-Whitney, considerando valor de p<= 0,05. Resultados Identificou-se correlação significativa entre as alterações nos indicadores relacionados à função materna (suposição de sujeito, estabelecimento da demanda e alternância presença/ausência) e as alterações nos sinais enunciativos dos bebês e das mães. Não houve correlação significativa na relação isolada do eixo função paterna e a presença de atraso na aquisição da linguagem. Conclusão Houve correlação significativa entre os eixos de função materna do roteiro IRDI e risco à linguagem pelo SEAL.

ABSTRACT Purpose To analyze the correlation between the psychism structuring pillar in the RIID (Reference Indicators of Infant Development) script and language acquisition through Enunciative Signs of Language Acquisition (ESLA) as to the role of the baby and the mother in early protoconversations. Methods The sample included 77 infants, who completed all the RIID and ESLA assessments. The results obtained from these two instruments were analyzed using Spearman's coefficient and the Mann-Whitney U test, considering a p-value < 0.05. Results A significant correlation was identified between changes in the indicators related to the maternal function (assumption of subject, establishment of demand and presence/absence alternation) and changes in the enunciative signals of babies and mothers. There was no significant correlation in the isolated relation of the paternal function pillar and the presence of delayed language acquisition. Conclusion There was a significant correlation between the pillars of maternal function of the RIID script and language risk by ESLA.

ABSTRACT Objective: This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. Material and Methods: 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. Results: V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. Conclusion: V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.

RESUMO Objetivo: Este estudo cruzado e randomizado avaliou os índices periodontais de dois tipos de contenções 3x3 (uma contenção aço V-Loop de 0,032” modificada e uma contenção convencional de fio coaxial aço de 0,0215”) após colagem, por seis meses. Além disso, foram registradas a taxa de falha na colagem e um questionário sobre conforto, facilidade de limpeza e preferência geral. Material e Métodos: Foram incluídos nesse estudo 15 pacientes que usaram ambas as contenções por seis meses cada, com intervalo de quinze dias entre cada contenção fixa. Foram registrados os seguintes índices periodontais: Índice de Placa (IP), Índice de Cálculo (IC) e Índice Gengival (IG). Os pacientes responderam a um questionário para avaliar o conforto, a facilidade de limpeza e a preferência geral pelo tipo de contenção. A taxa de falha de colagem também foi avaliada. Resultados: A contenção V-Loop apresentou maior IP (p<0,05) em comparação ao fio coaxial convencional. Entretanto, IC e IG não apresentaram diferenças estatisticamente significativas entre as contenções testadas. A contenção convencional de fio coaxial 0,0215” foi escolhida como a mais confortável (p<0,05), embora não tenham sido encontradas diferenças estatisticamente significativas para todas as outras respostas do questionário. Eventos de falha de colagem foram mais observados na contenção V-Loop 3 x 3 (p<0,002) em comparação com a contenção coaxial convencional de 0,0215”. Conclusão: A contenção V-Loop apresentou maior IP (p<0,05), maior taxa de falha de colagem e foi menos confortável em comparação ao fio coaxial convencional 0,0215”.

ABSTRACT Introduction: Lipodystrophy is an important complication of HIV and has different clinical manifestations, such as lipoatrophy of the face, buttocks, and limbs and accumulation of fat in the abdominal and cervical regions. Lipodystrophy has aesthetic and psychosocial consequences, stigmatizing and affecting patients’ quality of life. The objective is to evaluate the epidemiology and treatments performed in patients treated at the HIV-related Lipodystrophy Outpatient Clinic at Hospital das Clínicas da Faculdade de Medicina de Botucatu. Method: The study was conducted retrospectively, with port analysis of patients treated between June 2012 and December 2019, at Hospital das Clínicas da Faculdade de Medicina de Botucatu, in Botucatu, S P, Brazil. Results: The medical records of 153 individuals were analyzed, 79 male and 74 female patients. The mean age was 45.6 years. The referrals came from 48 cities in four states. Caucasian patients accounted for 74.5% of the consultations. The complaint of facial lipodystrophy was reported by 52.9% of the patients. The most common invasive procedure was facial filling with polymethylmethacrylate (PMMA) in 62 patients. Gluteal implants were the most common surgery on six occasions. Conclusion: The data found show a higher proportion of female patients with complaints of lipodystrophy when compared to general data of patients with HIV. The white race was predominant, and the main complaint of lipodystrophy was facial atrophy. Facial filling with PMMA was the most common procedure.

RESUMO Introdução: A lipodistrofia é uma importante complicação do HIV e apresenta diferentes manifestações clínicas, como lipoatrofia de face, glúteos e membros, e acúmulo de gordura em região abdominal e cervical. A lipodistrofia apresenta consequências estéticas e psicossociais, que são estigmatizantes e afetam a qualidade de vida dos pacientes. O objetivo é avaliar a epidemiologia e os tratamentos realizados nos pacientes atendidos no Ambulatório de Lipodistrofia relacionada ao HIV do Hospital das Clínicas da Faculdade de Medicina de Botucatu. Método: O estudo foi realizado de maneira retrospectiva, com análise de portuário dos pacientes atendidos entre junho de 2012 e dezembro de 2019, no Hospital das Clínicas da Faculdade de Medicina de Botucatu, em Botucatu, S P, Brasil. Resultados: Os prontuários de 153 indivíduos foram analisados, sendo 79 pacientes do sexo masculino e 74 do sexo feminino. A média de idade foi 45,6 anos. Os encaminhamentos tiveram origem de 48 cidades, de quatro estados. Pacientes da raça branca totalizaram 74,5% dos atendimentos. A queixa de lipodistrofia de face foi referida por 52,9% dos pacientes. O procedimento invasivo mais realizado foi o preenchimento facial com polimetilmetacrilato (PMMA), em 62 pacientes. A inclusão de implantes glúteos foi a cirurgia mais realizada, em seis ocasiões. Conclusão: Os dados encontrados mostram maior proporção de pacientes do sexo feminino com queixa de lipodistrofia, quando comparados a dados gerais de pacientes com HIV. A raça branca foi predominante e a principal queixa de lipodistrofia foi a atrofia facial. O preenchimento facial com PMMA foi o procedimento mais realizado.

Abstract The herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) has been detected in water bodies worldwide, precluding their use for water supply. Despite this, scientific studies assessing the behavior of herbicides in water treatment systems are scarce, which motivated this study on 2,4-D removal. 2,4-D removal and its relationship with absorbance were investigated using a pilot system comprising coagulation, sedimentation, filtration, granular activated carbon (GAC) adsorption, and chlorinated disinfection. 2,4-D removal ranged from 15 to 64% after sedimentation, from negative values to 19% after filtration, and from 5 to 16% after chlorination, with total removal rates of 19 to 70%. Breakthrough curves showed an adsorption capacity of 0.70 mg g−1 GAC for a C/C0 ratio of 0.50 and a VTW/VGAC ratio of 3.598 for a breakthrough concentration of 30 ± 3 μg L−1. The positive correlation between absorbance and 2,4-D (R2 = 0.78) in the GAC column effluent indicated that absorbance can be used for early prediction of 2,4-D breakthrough. GAC column adsorption associated with coagulation produced treated water in accordance with the criteria for turbidity, apparent color, and 2,4-D concentration established by the Minister's Office/Ministry of Health — GM/MS Ordinance No. 888/2021, representing a promising technological alternative for 2,4-D removal from water treatment systems.

Resumo O herbicida 2,4-diclorofenoxiacético (2,4-D) tem sido encontrado em mananciais de todo o mundo comprometendo o uso para o abastecimento público. Apesar disso, as publicações científicas que avaliam o comportamento de herbicidas em sistemas de tratamento de água são escassas e justificam o estudo para avaliar a remoção do herbicida 2,4-D com o objetivo de gerar informações para a aplicação em sistemas de tratamento de água. Foram investigadas a remoção do 2,4-D e a sua relação com absorvância em uma instalação piloto constituída de coagulação, decantação, filtração e adsorção em carvão ativado granular (GAC) seguida de desinfecção com cloro. A remoção do 2,4-D variou de 15 a 64% na decantação, de negativa a 19% na filtração e na cloração de 5 a 16% com remoção total entre 19 e 70%. Nos ensaios de adsorção, foi determinada a capacidade de adsorção de 0,70 mg de 2,4-D/g GAC para a relação C/C0 igual a 0,50 e VA/VGAC igual a 3.598, para condição de ruptura de 30 ± 3 μg L-1. A correlação positiva entre a absorvância e o 2,4-D (R2 = 0,78) no efluente da coluna de GAC indicou que a absorvância pode ser utilizada como parâmetro para previsão antecipada de ruptura do 2,4-D. A adsorção em coluna de GAC associada à coagulação produziu água tratada que atendeu aos limites estabelecidos na Portaria GM/MS nº 888/2021 para turbidez, cor aparente e 2,4-D, apresentando-se como opção tecnológica para remoção de 2,4-D em sistemas de tratamento de água.

ABSTRACT For philosophical hermeneutics, understanding is a universal phenomenon, which, therefore, is not restricted to procedural rules or any method. However, the former faces a problem when, on the one hand, it pretends to be a non-methodical way of understanding and, on the other hand, at the same time, it defends some “rules” for a proper understanding. That said, this article aims to elucidate this ambiguity and to show some possible consequences. First, we briefly show the argument in defense of the universality of hermeneutics and, therefore, how the natural sciences would be implied by it. Next, we point to some of the normative aspects that seem to compose the understanding phenomenon, as presented to us by Gadamer. Finally, we conclude that a dialogue between philosophical hermeneutics and the natural sciences is necessary not only for interpretative purposes, overcoming possible conflicts and contradictions of this philosophy, but also for contributing to scientific activity in general, making it - perhaps - more conscious and vigilant about its historicity.

RESUMO Para a hermenêutica filosófica a compreensão seria um fenômeno universal, que, portanto, não se restringiria a regras de procedimento e a nenhum método. Contudo, aquela enfrenta um problema ao, por um lado, pretender ser um modo não metódico de compreensão e, por outro, ao mesmo tempo, defender certas “regras” para uma efetiva compreensão. Isto posto, este artigo tem por objetivo elucidar essa ambiguidade e apontar para algumas possíveis consequências dessa. Para tanto, mostramos, suscintamente, o argumento em defesa da universalidade da hermenêutica, e, portanto, como as ciências naturais estariam por aquela implicadas. Em seguida, apontamos para alguns dos aspectos normativos que comporiam o fenômeno da compreensão, tal como nos é apresentado por Gadamer. Por fim, concluímos que um diálogo entre a hermenêutica filosófica e as ciências naturais não apenas é um diálogo que se faz necessário por questões exegéticas, superando possíveis conflitos e contradições deste pensamento filosófico, mas também por contribuir para a atividade científica em geral, tornando-a, quiçá, mais consciente e vigilante acerca de sua própria historicidade.

ABSTRACT Compaction caused by mechanization affects soil quality and, consequently, the development of crops. This study aimed to evaluate the effect of different degrees of soil compaction on the physiology, morphology, and anatomy of different coffee cultivars in a controlled environment. The experiment was carried out in a greenhouse, with randomized block design in a 5 × 5 factorial arrangement, with five coffee cultivars (Arara, Catuaí Amarelo IAC 62, Catuaí Vermelho 144, MGS Paraíso 2 and Mundo Novo IAC 379-19) and five degrees of compaction (68, 74, 80, 86 and 92 %), with four repetitions, totaling 100 experimental units. The following variables were evaluated in the aboveground biomass: plant height, number of leaves, diameter of the orthotropic branch, fresh mass of leaves and stem, leaf area, gas exchange, and chlorophyll a and b index; in the roots: length, surface area, volume, diameter of fine and coarse roots, fresh and dry mass of roots, as well as anatomical characteristics. Results showed that soil with degrees of compaction above 80 % negatively affected the variables evaluated. Catuaí Vermelho 144 presented the worst performance regardless of the degree of compaction, while Arara and MGS Paraíso 2 showed the best performance under the evaluated compaction degrees. Anatomical structure of the roots was modified with soil compaction, and no differences were observed among cultivars.

■ ABSTRACT Introduction: Breast augmentation is one of the most performed procedures in Plastic Surgery worldwide. Mastopexy with prosthesis is also a widely performed procedure reserved for other patient profiles. Many complications can be avoided when studying risk factors for unfavorable outcomes. Method: This is a retrospective study carried out through the analysis of medical records of patients who underwent primary breast augmentation and mastopexy with breast implants from January 2018 to December 2020. Results: Of the 112 patients who underwent mammoplasty with the implant during the study period, 76 patients underwent primary breast augmentation (67.86%), and 36 underwent mastopexy with breast implant (32.14%). Patients undergoing mastopexy had a higher average age compared to those undergoing breast augmentation (p<0.001) and had smaller volumes of breast implants (p=0.002). The most common complications in both groups include surgical wound dehiscence, more common after mastopexy with prosthesis. Conclusion: Breast augmentation performed as a single procedure has a higher rate of complications when compared to breast augmentation performed individually. However, the greater number of early complications observed with the combined procedure is the sum of the two distinctly individual procedures and not an exponential increase.

■ RESUMO Introdução: A mamoplastia de aumento é uma dos procedimentos mais realizados em Cirurgia Plástica em todo o mundo. A mastopexia com prótese também é um procedimento amplamente realizado, reservado para outro perfil de pacientes. Muitas complicações podem ser evitadas quando se estudam os fatores de risco para desfechos desfavoráveis. Método: Trata-se de um estudo retrospectivo realizado por meio da análise de prontuários de pacientes submetidas a mamoplastia primária de aumento e mastopexia com implantes mamários no período de janeiro de 2018 a dezembro de 2020. Resultados: Das 112 pacientes submetidas a mamoplastia com implante mamário no período do estudo, 76 foram submetidas a mamoplastia de aumento primária (67,86%) e 36 pacientes a mastopexia com implante mamário (32,14%). As pacientes submetidas a mastopexia apresentaram maior média de idade em relação àquelas submetidas a mamoplastia de aumento (p<0,001) e apresentaram menores volumes de implantes mamários (p=0,002). As complicações mais comuns em ambos os grupos incluem a deiscência da ferida operatória, mais comum após mastopexia com prótese. Conclusão: A mastopexia de aumento realizada em procedimento único apresenta maior índice de complicações quando comparada à mamoplastia de aumento realizada individualmente. No entanto, o maior número de complicações precoces observadas no procedimento combinado é a soma dos dois procedimentos distintamente individuais e não um aumento exponencial.

■ ABSTRACT Objective: Analyze the available variables on the Department of Informatics of the Unified Health System (DATASUS) platform of hospitalized burn older people and compare older people over and under 80. Method: A retrospective study collected data in DATASUS from January 2009 to December 2019. Patients aged 60-79 years or older and 80 years or older were included in the study, with variables such as time average hospitalization, healthcare costs, and mortality rate. Results: During the studied period, 168,955 patients aged 60-79 and 50,410 aged 80 or over suffered burns. The highest mortality occurs in flame accidents, followed by contact burns, third-place scalds, and electrical burns (p=0.01). The incidence of hospitalizations in people over 80 is higher than in those aged 60-79 (p<0.001). There was a directly proportional relationship between age and length of stay only in the most advanced age groups. It was also possible to verify that the higher the health costs, the higher the mortality rate. Conclusion: The length of stay is longer in older patients, and the longer average stay is related to a higher mortality rate. Furthermore, a greater number of days of hospitalization does not result in a lower mortality rate, showing that prevention and adequate management of supplies are more important than a large investment in treatment.

■ RESUMO Objetivo: Realizar uma análise das variáveis disponíveis na plataforma do Departamento de Informática do Sistema Único de Saúde (DATASUS) de idosos queimados internados, e comparar entre idosos maiores e menores de 80 anos. Método: Estudo retrospectivo realizado por coleta de dados no DATASUS no período de janeiro de 2009 a dezembro de 2019. Foram incluídos no estudo pacientes com idade igual ou superior a 60-79 anos e igual ou maior a 80 anos, sendo avaliadas variáveis como tempo médio de internação, custos com saúde e taxa de mortalidade. Resultados: No período estudado, sofreram queimaduras 168.955 pacientes com 60-79 anos e 50.410 com 80 anos ou mais. A maior mortalidade ocorre nos acidentes com chama, seguidos por queimadura de contato, terceiro lugar escaldado e por último queimadura elétrica (p=0,01). A incidência de internações em pessoas com mais de 80 anos é maior do que entre 60-79 anos (p<0,001). Houve relação diretamente proporcional entre idade e tempo de internação apenas nas faixas etárias mais avançadas. Também foi possível verificar que, quanto maiores os custos com saúde, maior a taxa de mortalidade. Conclusão: O tempo de internação é maior em pacientes mais velhos e a maior média de dias de internação está relacionada a maior taxa de mortalidade. Além disso, um maior número de dias de internação não resulta em menor taxa de mortalidade, mostrando que a prevenção e a gestão adequada dos insumos são mais importantes do que grande investimento no tratamento.

■ ABSTRACT Introduction: Binder’s syndrome can also be known as maxillonasal dysplasia and it is a congenital malformation characterized by nasomaxillary hypoplasia resulting from an underdevelopment of the middle facial skeleton. The current incidence or prevalence is still unknown, but it affects approximately one child in every 10,000 births. The diagnosis can be clinical or associated with prenatal ultrasonography, characterized by a flattened nose and abnormal maxillary convexity. The treatment is surgical to correct aesthetic and functional abnormalities. Case Report: Patient diagnosed with Binder’s syndrome at the age of 14, without other associated malformations, with aesthetic and functional nasal complaints. Surgical correction began with the extraction of a block of the sixth costal cartilage on the left, with a nasal opening on the columellar margin, in the pattern of an open rhinoplasty, and tissue dissection in the sub-SMAS plane. After preparing the nasal receptor area, a block of cartilage was sculpted for reconstruction of the nasal dorsum, alar grafts and septal cartilage grafts. There was an improvement in the projection of the nasal tip and nasal dorsum. Conclusion: Rhinoplasty can be a challenging surgery in these patients, and the literature indicates that the best option is autologous reconstruction with costal cartilage. It is necessary to individualize each case to schedule nasal grafts and restructuring, and functional improvement in these cases is also essential.

■ RESUMO Introdução: A síndrome de Binder também pode ser conhecida como displasia maxilonasal e é uma malformação congênita caracterizada por hipoplasia nasomaxilar devido a um subdesenvolvimento do esqueleto facial médio. A atual incidência ou prevalência ainda é desconhecida, mas afeta aproximadamente um recém-nascido vivo em cada 10.000 nascimentos. O diagnóstico pode ser clínico ou associado a ultrassonografia pré-natal, caracterizada por nariz achatado e convexidade anormal da maxila. O tratamento é cirúrgico para correção das anormalidades estéticas e funcionais. Relato de Caso: Paciente que recebeu diagnóstico de síndrome de Binder aos 14 anos, sem outras malformações associadas, com queixa estética e funcional nasal. A correção cirúrgica foi iniciada pela extração de um bloco da sexta cartilagem costal à esquerda, com abertura nasal na margem columelar, no padrão de uma rinoplastia aberta, e dissecados os tecidos no plano subSMAS. Após preparo da área receptora nasal, foram esculpidos bloco de cartilagem para reconstrução do dorso nasal, enxertos alares e enxerto de cartilagem septal. Houve melhora de projeção da ponta nasal e alongamento nasal. Conclusão: A rinoplastia pode ser uma cirurgia desafiadora nesses pacientes, sendo a reconstrução autóloga com o uso de cartilagem costal indicada pela literatura como a melhor opção. É necessário individualizar cada caso para programação de enxertos e reestruturação nasal, sendo fundamental também a melhora funcional desses casos.