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 Objetivou-se sintetizar e avaliar a produção do conhecimento sobre os fatores significativamente associados à fragilidade em idosos hospitalizados. Para isso, foram consultadas as bases de dados Medical Literature and Retrieval System Online (Medline), Literatura Latino-Americana em Ciências da Saúde (Lilacs) e Índice Bibliográfico Español em Ciencias de la Salud (Ibecs), de 2012 a 2016, cuja análise de 20 artigos identificou fatores associados à fragilidade: maior mortalidade hospitalar e após alta, longa hospitalização, reinternação, transferências, idade avançada, sexo feminino e viuvez, além de fatores psicossociais, físicos e/ou funcionais. Espera-se que os resultados da revisão facilitem o aprimoramento de práticas e a tomada de decisão das equipes multiprofissionais que prestam assistência ao idoso no ambiente hospitalar.

ABSTRACT This review aimed to synthesize and evaluate the production of knowledge about factors significantly associated with frailty in hospitalized elderly. Therefore, the Medical Literature and Retrieval System Online (Medline), Literatura Latino-Americana em Ciências da Saúde (Lilacs) and Índice Bibliográfico Español em Ciencias de la Salud (Ibecs) databases were consulted from 2012 to 2016, whose analysis of twenty articles identified the following factors associated with frailty: increased hospital and post-discharge mortality, prolonged hospitalization, rehospitalization, transfers, advanced age, women and widows, as well as psychosocial, physical and / or functional factors. It is expected that the results of the review will facilitate improvement of the practices and the decision-making of the multiprofessional teams that provide elderly care in the hospital.

RESUMO Objetivou-se sintetizar e avaliar a produção do conhecimento sobre os fatores significativamente associados à fragilidade em idosos hospitalizados. Para isso, foram consultadas as bases de dados Medical Literature and Retrieval System Online (Medline), Literatura Latino-Americana em Ciências da Saúde (Lilacs) e Índice Bibliográfico Español em Ciencias de la Salud (Ibecs), de 2012 a 2016, cuja análise de 20 artigos identificou fatores associados à fragilidade: maior mortalidade hospitalar e após alta, longa hospitalização, reinternação, transferências, idade avançada, sexo feminino e viuvez, além de fatores psicossociais, físicos e/ou funcionais. Espera-se que os resultados da revisão facilitem o aprimoramento de práticas e a tomada de decisão das equipes multiprofissionais que prestam assistência ao idoso no ambiente hospitalar.

ABSTRACT This review aimed to synthesize and evaluate the production of knowledge about factors significantly associated with frailty in hospitalized elderly. Therefore, the Medical Literature and Retrieval System Online (Medline), Literatura Latino-Americana em Ciências da Saúde (Lilacs) and Índice Bibliográfico Español em Ciencias de la Salud (Ibecs) databases were consulted from 2012 to 2016, whose analysis of twenty articles identified the following factors associated with frailty: increased hospital and post-discharge mortality, prolonged hospitalization, rehospitalization, transfers, advanced age, women and widows, as well as psychosocial, physical and / or functional factors. It is expected that the results of the review will facilitate improvement of the practices and the decision-making of the multiprofessional teams that provide elderly care in the hospital.

A pitaia ainda é uma cultura carente de estudos e informações que subsidiem a definição/adaptação de sistemas de produção mais adequados às condições edafoclimáticas brasileiras, embora nos últimos anos tenha havido aumento de sua expansão agrícola, tanto no Brasil quanto em outros países. Assim, o objetivo deste estudo foi avaliar o efeito da adubação mineral sobre o crescimento de mudas de pitaia e, dessa maneira, obter informações direcionadas para a definição de manejos de fertilização adequados à exploração agrícola da cultura. Para isto, foram testadas cinco doses de nitrogênio (N) (0; 150; 300; 450 e 600 mg dm-3) e potássio (K) (0; 75; 150; 225 e 300 mg dm-3), sendo os níveis de cada nutriente arranjados em esquema fatorial 5x5, com quatro blocos. Para a interação significativa a (p<0,05), procedeu-se ao ajuste em superfícies de resposta do tipo Y = β0 + β1(A) + β2(A)² + β3(B) + β4(B)² + β5(A).(B) + e. As estimativas das correlações fenotípicas foram obtidas considerando apenas o intervalo das doses de N e K, que promoveram as melhores respostas do acesso de pitaia para os caracteres estudados. Ao término do presente estudo, foi constatado que a aplicação de doses crescentes de N e K, e a interação NxP afetam os teores de ambos os nutrientes no solo, o sistema radicular e a parte aérea, influenciando, desse modo, sobre o crescimento inicial das plantas de pitaia. Os rendimentos mais satisfatórios ocorrem quando há 0,7 mmol dm-3 de K no solo, e 20 - 25 g kg-1 de N com 30 - 40 g kg-1 de K na parte aérea. Esses valores foram obtidos para a aplicação de 300 - 450 mg dm-3 de N com 150 - 225 mg dm-3 de K. O somatório do comprimento dos cladódios (SCC) e a massa seca do sistema radicular (MSSR) são as variáveis explicativas que apresentam maiores efeitos diretos sobre a massa seca dos cladódios (MSC).

Pitaya is still a culture lacking of research and information that support the definition/adaptation of production systems adapted to Brazilian soils and climate, although in recent years there has been an increase in its agricultural expansion, as in Brazil as in other countries. Thus, the aim of this study was to evaluate the effect of mineral fertilization on the early growth of pitaya and then to obtain directed information to the definition of adequate fertilization managements of the culture. For this purpose, we tested five doses of nitrogen (N) (0, 150, 300, 450 and 600 mg dm-3) and potassium (K) (0, 75, 150, 225 and 300 mg dm-3) , and the levels of each nutrient, arranged in a 5x5 factorial design with four blocks. For a significant interaction (p<0.05) it was proceeded an adjustment in response surfaces of type Y = β0 + β1(A) + β2(A)² + β3(B) + β4(B)² + β5(A).(B) + e. Estimates of phenotypic correlations were obtained considering only the range of N and K that promoted the best answers to the access pitaya traits. At the end of this study it was found that the application of increasing doses of N and K, and the interaction NxP affected the levels of both nutrients in the soil, roots and shoots, thus influencing the early growth of the pitaya plants. The most satisfactory yields occur when there is 0.7 mmol dm-3 of K in the soil, and 20 - 25 g kg-1 of N with 30 - 40 g kg-1 of K in the shoot. These values were obtained for the application 300 - 450 mg dm-3 of N with 150 - 225 mg dm-3 of K. The sum of the length of cladodes (SCC) and the dry mass of the root system (DMRS) are the explanatory variables that have large direct effects on the dry weight of cladodes (DWC).

Com o objetivo de avaliar a interferência da relação fósforo-zinco sobre o crescimento inicial de pitaia para fornecer informações que subsidiem a definição de sistemas de produção mais adequados para a exploração desta cultura no Brasil, realizou-se o experimento, testando cinco doses de P (0; 75; 150; 225 e 300 mg dm-3) e Zn (0; 2; 4; 6 e 8 mg dm-3), sendo os níveis de cada nutriente arranjados em esquema fatorial 5x5, com quatro blocos. Para a interação significativa (p<0,05), procedeu-se ao ajuste em superfícies de resposta do tipo Y = β0 + β1(A) + β2(A)² + β3(B) + β4(B)² + β5(A).( B) + e. As estimativas das correlações fenotípicas foram obtidas considerando apenas o intervalo das doses de P e Zn que promoveram as melhores respostas do acesso de pitaia para os caracteres estudados. A aplicação de P e Zn, e a interação P x Zn afetam a disponibilidade de ambos os nutrientes no substrato, sistema radicular e parte aérea, influenciando, assim, o crescimento inicial de plantas de pitaia. Os rendimentos mais satisfatórios ocorrem quando há 60 - 75 mg de P dm-3 e 3,0 - 4,0 mg de Zn dm-3 no substrato, e 4,5 - 6,0 g kg-1 de P e 150 mg de Zn kg-1 na parte aérea. Esses níveis foram obtidos para a combinação de 150 - 225 mg dm-3 de P, com 4 - 6 mg dm-3 de Zn. Os teores de P e Zn na parte aérea e o somatório do comprimento dos cladódios (SCC) säo os caracteres explicativos que apresentam maiores efeitos diretos sobre a massa seca dos cladódios (MSC).

With the aim to evaluate the role of zinc-phosphorus ratio in the initial growth of pitaia for provide information that supports the definition of production systems more suitable for the exploitation of this crop in Brazil an experiment was carried out, testing five levels of P (0, 75, 150, 225 and 300 mg dm-3) and Zn (0, 2, 4, 6 and 8 mg dm-3) were each nutrient levels, arranged in 5x5 factorial design with four blocks. For significant interaction (p <0.05) proceeded adjustment in response surfaces of type Y = β0 + β1 (A) + β2 (A)² + β3 (B) + β4 (B) ² + β5 (A). (B) + e. Estimates of phenotypic correlations were obtained considering only the range of doses of P and Zn that promoted the best answers to the access pitaya traits. Application of P and Zn, and P x Zn interaction affect both the availability of nutrients in the soil, roots and shoots, thus influencing the early growth of pitaya. The most satisfactory yields occur when there is 60 - 75 mg P dm-3 and 3.0 - 4.0 mg dm-3 of Zn in the soil and 4.5 to 6.0 g kg-1 and 150 mg of P Zn kg-1 in shoots. These levels were obtained for the combination of 150 to 225 mg dm-3 with P 4 - 6 mg dm-3 of Zn. The levels of P and Zn in the shoot and the sum of the length of cladodes (SCC) are the characters that have greater explanatory direct effects on dry weight of cladodes (MSC).

OBJECTIVE: Immunosuppressed patients are at risk of microsporidiosis, and this parasitosis has an increased rate of dissemination in this population. Our objective was to evaluate the presence of microsporidiosis and other intestinal parasites in rheumatic disease patients undergoing anti-tumor necrosis factor/disease-modifying anti-rheumatic drug treatment. METHODS: Ninety-eight patients (47 with rheumatoid arthritis, 31 with ankylosing spondylitis and 11 with psoriatic arthritis) and 92 healthy control patients were enrolled in the study. Three stool samples and cultures were collected from each subject. RESULTS: The frequency of microsporidia was significantly higher in rheumatic disease patients than in control subjects (36 vs. 4%, respectively; p<0.0001), as well as in those with rheumatic diseases (32 vs. 4%, respectively; p<0.0001), ankylosing spondylitis (45 vs. 4%, respectively; p<0.0001) and psoriatic arthritis (40 vs. 4%, respectively; p<0.0001), despite a similar social-economic class distribution in both the patient and control groups (p = 0.1153). Of note, concomitant fecal leukocytes were observed in the majority of the microsporidia-positive patients (79.5%). Approximately 80% of the patients had gastrointestinal symptoms, such as diarrhea (26%), abdominal pain (31%) and weight loss (5%), although the frequencies of these symptoms were comparable in patients with and without this infection (p>0.05). Rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis disease activity parameters were comparable in both groups (p>0.05). The duration of anti-tumor necrosis factor/disease-modifying anti-rheumatic drugs and glucocorticoid use were also similar in both groups. CONCLUSION: We have documented that microsporidiosis with intestinal mucosa disruption is frequent in patients undergoing concomitant anti-tumor necrosis factor/disease-modifying anti-rheumatic drug therapy. Impaired host defenses due to the combination of the underlying disease and the immunosuppressive therapy is the most likely explanation for this finding, and this increased susceptibility reinforces the need for the investigation of microsporidia and implementation of treatment strategies in this population.

OBJETIVO: Avaliar as complicações imediatas da aplicação de agentes anti-TNFα no Centro de Dispensação de Medicação deAlto Custo do HC-FMUSP. PACIENTES E MÉTODOS: Foram incluídos todos os pacientes que receberam agentes anti-TNFα entre agosto/2007 e março/2009.As complicações imediatas (até 1 hora após o término da aplicação) foram classificadas em leves (cefaleia, rash, tontura, prurido, náuseas), moderadas (febre, urticária, palpitação, dor torácica, dispneia, variação da pressão arterial de 20 a 40 mmHg) ou graves (febre com calafrios, dispneia com sibilância, variação da pressão arterial > 40 mmHg). RESULTADOS: Foram avaliados 242 pacientes: 94 (39%) com artrite reumatoide, 64 (26%) com espondilite anquilosante, 32 (13%) com artrite psoriásica, 26 (11%) com artrite idiopática juvenil e 27 (11%) com outros diagnósticos. O número total de aplicações foi de 3.555, sendo 992 (28%) de adalimumabe, 1.546 (43%) de etanercepte e 1.017 (29%) de infliximabe. Complicações imediatas foram observadas em 39/242 (16%) pacientes. As complicações ocorreram em 45/3.555 (1,2%) aplicações. Estas foram mais frequentes com infliximabe comparado com adalimumabe (3,7% vs. 0,5%, P < 0,0001), e com etanercepte (3,7% vs. 0,25%, P < 0,0001). As complicações foram: leves 14/45 (31%), moderadas 21/45 (47%) e graves 10/45 (22%); ocorreram principalmente nos primeiros seis meses de tratamento (56%) e nas aplicações endovenosas, predominantemente na primeira hora de infusão (76%). CONCLUSÃO: As reações agudas, apesar de raras, são potencialmente graves e ocorrem principalmente nas primeiras aplicações tanto no uso de medicações endovenosas como de subcutâneas. É necessário realizar mais estudos para definir a necessidade de aplicação dos imunobiológicos via subcutânea em locais capacitados para atendimento de emergências.

OBJECTIVE: To evaluate the immediate complications of anti-TNFα drugs at the "Center for Dispensation of High Cost Medications" of HC-FMUSP. PATIENTS AND METHODS: All patients who received anti-TNFα agents between August 2007 and March 2009 were included in this study. Immediate complications (up to 1 hour after the injection) were classified as mild (headache, rash, dizziness, itching, nausea), moderate (fever, urticaria, palpitation, chest pain, dyspnea, blood pressure variations between 20 and 40 mmHg), or severe (fever with chills, dyspnea with wheezing, variations in blood pressure > 40 mmHg). RESULTS: Two hundred and forty-two patients were evaluated: 94 (39%) with rheumatoid arthritis, 64 (26%) with ankylosing spondylitis, 32 (13%) with psoriatic arthritis, 26 (11%) with juvenile idiopathic arthritis; and 27 (11%) with other diagnoses. A total of 3,555 injections were administered: 992 (28%) adalimumab, 1,546 (43%) etanercept, and 1,017 (29%) infliximab. Immediate adverse events were observed in 39/242 (16%) patients. Injectionrelated complications were observed in 46/3,555 (1.2%) injections. They were more common with infliximab than adalimumab (3.7% vs. 0.5%, P < 0.0001) and etanercept (3.7% vs. 0.25%, P < 0.0001). Complications were classified as mild 14/45 (31%), moderate 21/45 (47%), and severe 10/45 (22%), and occurred mainly in the first six months of treatment (56%) and after intravenous injections, especially (76%) in the first hour. CONCLUSION: Although rare, acute reactions can be severe, being observed more commonly after the initial injections, both intravenous and subcutaneous. More studies are necessary to define whether those immunobiological agents should be administered only in facilities capable of managing medical emergencies.

RESUMO A ocorrência de isolados de Botrytis cinerea Persoon ex Fries, agente causal do tombamento em mudas de Eucalyptus spp., resistentes aos fungicidas sistêmicos benomil, procimidone e thiabendazole, foi avaliada verificando-se o efeito de doses crescentes dos fungicidas sobre o desenvolvimento micelial e a germinação de conídios do referido fitopatógeno. Os experimentos foram conduzidos em laboratório da Universidade Federal de Santa Maria (UFSM). Os tratamentos foram constituídos de quatro dosagens de cada fungicida (dose zero, meia dose, dose inteira e dose dupla). As análises foram realizadas sobre os valores de crescimento micelial obtidos no quinto dia, quando a testemunha atingiu o máximo crescimento, e 24 e 48 horas, para a verificação da percentagem de germinação de conídios. Para avaliação da resistência, compararam-se os resultados obtidos em dois isolados de B. cinerea, um proveniente de um viveiro comercial no Rio Grande do Sul (IB-1) e outro isolado (IB-2), obtido junto ao Departamento de Fitotecnia da UFSM. Os resultados mostraram que o isolado IB-1 cresceu e germinou sob todas as concentrações de benomil, enquanto o isolado IB-2 foi inibido em todas as concentrações, indicando que o primeiro isolado é resistente a benomil.

ABSTRACT The occurrence of fungicide resistant isolates of Botrytis cinerea Persoon ex Fries causal agent of Eucalypt seedling damping off, was evaluated in laboratory tests conducted at the Universidade Federal de Santa Maria (UFSM). To evaluate the fungicide effects on the mycelium growth and conidium germination, three active ingredients were tested: benomyl, procimidone and thiabendazole. The treatments consisted of four dosages for each fungicide: zero (control), one half of the recommended dosage, full dosage and twice the dosage. The evaluations were done every 24 hours during 7 days for the mycelium growth, and at 24 and 48 hours for spore germination. To determine the occurrence of resistance two isolates were compared, one from a commercial nursery in Rio Grande do Sul (IB-1), and the other (wild) (IB-2) from the Vegetable Crops Department, UFSM, Santa Maria, RS. The isolate IB-1 grew on all concentrations of benomyl, while the wild isolate was inhibited at all concentrations, indicating that the first isolate was resistant to benomyl.