Land use to agriculture and planted forests strongly affect the genetic diversity of Baccharis crispa Spreng., a native herb of South America.

Human population growth constantly requires an increase in the production of food and products from the timber industry. To meet this demand, agriculture and planted forests are advancing over natural areas. In view of this, it is necessary to know the effects of land use for different purposes (grain production, pastures, planted forests, fruit production and among other uses) on the genetic diversity of populations of native species. This knowledge can assist in land use planning as well as in the development of conservation strategies for native species. In this study, we evaluated the effect of land use for agriculture (mainly for cereal production) and planted forests on the genetic diversity of Baccharis crispa Spreng., a herb native to South America. To achieve our goals, we compared population genetic data obtained with three molecular markers (microsatellites, inter-simple sequence repeat and isoenzymes) with data on land use for agriculture and planted forests from 15 different locations. Our results showed that regardless of the molecular marker used, the greater the use of land for agriculture and planted forests, the lower was the genetic diversity of B. crispa populations. Baccharis crispa is a semi-perennial species that needs at least one year to reach its reproductive period, which is prevented in agricultural areas due to the land being turned over or dissected with herbicides every 6 months. In the studied regions, the planted forests are of eucalypt and/or pine, which besides being species with a high production of allelopathic substances, produce strong shading and B. crispa is a species that inhabits open grassland that needs a high incidence of sunlight for development. The data obtained in our study can assist in the decision-making to use land in order to reconcile the production of supplies for humanity and for the conservation of nature.

Clinical aspects of vertigo and dizziness: what should the radiologist know?

Dizziness and vertigo are common complaints in both emergency and outpatient settings, requiring careful evaluation to determine appropriate diagnosis and treatment. Differentiating between peripheral and central causes of dizziness is crucial for effective management. Peripheral causes, such as vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Ménière's disease, are contrasted with central causes like stroke, demyelinating diseases, and posterior fossa tumors. Diagnostic approaches include assessing nystagmus patterns, the vestibulo-ocular reflex (VOR), and the HINTS Plus test. Vestibular disorders are classified as acute, episodic, or chronic based on duration and symptom presentation. Imaging plays a significant role in identifying central causes when clinical findings are inconclusive. This paper provides a comprehensive overview of the clinical evaluation and diagnostic methods for dizziness and vertigo, with emphasis on distinguishing peripheral from central etiologies.

Immunostaining for Mismatch Repair Complex Proteins Impacts on Clinical-Pathological Characteristics and Prognosis of Adenoid Cystic Carcinoma of Salivary Glands.

OBJECTIVE: To evaluate the influence of MMR proteins on clinicopathological characteristics and prognosis of salivary gland adenoid cystic carcinoma (ACC). METHOD: The solid pattern of ACC showed lower expression for MSH2 (p = 0.039). Significant imbalance in MSH2/MSH6 immunostaining was observed in all histological patterns (p < 0.001), and imbalance in PMS2/MLH1 immunostaining was observed in the cribriform pattern (p = 0.011). The presence of capsule was associated with high expression of MSH6 (p = 0.019), MLH1 (p = 0.045) and PMS2 (p = 0.009). The absence of cribriform pattern (p = 0.002) and capsule pattern (p = 0.025), as well as low expression for MSH6 (p = 0.006) and PMS2 (p = 0.037) were associated with lower overall survival. In multivariate analysis, loss of MSH2 (p = 0.039) and MLH1 (p = 0.017) were significantly associated with worse overall survival. RESULTS: Twenty-four ACC were clinical-pathologically evaluated and we perform immunohistochemistry for MSH2, MSH6, PMS2 and MLH1. Percentage counting of positive cells was performed in 10 fields of each histological pattern (cribriform, tubular and solid) and the averages of the 30 fields were considered for evaluation with other clinical-pathological variables (Kruskal-Wallis/Dunn, Friedman/Dunn, chi-square, Log-Rank Mantel-Cox tests and Cox regression; SPSS v20.0, p < 0.05). DISCUSSION: Salivary glands' ACC shows imbalance of the MMR complex and loss of expression of its components is associated with the overall survival of these patients.

Host repair polymorphisms and H. pylori genes in gastric disease outcomes: Who are the guardian and villains?

Gastric cancer (GC) is the fourth-leading cause of cancer-related mortality. The intestinal subtype of GC comes after the cascade of Correa, presenting H. pylori infection as the major etiological factor. One of the main mechanisms proposed for the progression from a more benign gastric lesion to cancer is DNA damage caused by chronic inflammation. Polymorphisms in DNA repair genes can lead to an imbalance of host DNA damage and repair, contributing to the development of GC. From there, we evaluated the risk of polymorphisms in DNA repair system genes in progressive gastric diseases and their association with the H. pylori genotype. This study included 504 patients from two public hospitals in Brazil's north and northeast regions. The samples were classified into active and inactive gastritis, metaplasia, and GC. Polymorphisms in the DNA repair genes MLH1-93G > A, APE1 2197 T > G, XRCC1 28,152 G > A, MGMT 533 A > G, and XRCC3 18,067C > T were investigated by RFLP-PCR and H. pylori genotype by PCR. Statistical analyses were conducted using EPINFO 7.0., SNPSTAT, and CART software. The XRCC1 (GA) polymorphic allele stood out because it was associated with a lower risk of more severe gastric disease progression. Haplotypes of XRCC1 (GA) associated with some genotypes of MGMT, XRCC3, MLH1, and APE1 also showed protection against the progression of gastric diseases. XRCC3 (CT) showed a decreased risk of gastric disease progression in women, while a risk 1.3x to GC was observed in the MLH1 (A) polymorphic allele. The interaction between H. pylori genes and the host showed that the H. pylori cagE gene was the most important virulence factor associated with a worse clinical outcome, even overlapping with the XRCC1 polymorphism, where the MLH1 polymorphism response varied according to vacA alleles. Our results show the relevance of XRCC1 G > A for genome integrity, sex influence, and interaction between H. pylori virulence factors and XRCC1 and MLH1 genotypes for gastric lesion outcomes in Brazilian populations.

Time series and risk factors associated with mortality in women with cervical cancer from 2000 to 2021.

Introduction: Cervical cancer is a significant public health problem worldwide. The development of cervical neoplasms is associated with persistent infection by oncogenic subtypes of the HPV virus, which are responsible for around 70% of cervical cancers.A study carried out in Brazil between 2002 and 2021 recorded 133,429 deaths from cervical cancer.. Methodology: An observational, retrospective, cross-sectional, quantitative study was carried out using data collected by the Cancer Registry Service of the Haroldo Juaçaba Hospital/Ceará Cancer Institute (HHJ/ICC) over 22 years. Results: The sample consisted of 9096 women. The mean age was 51.4 ± 15.5, ranging from 15 to 100, with a median age of 60 years. Median overall survival was 59.77. The most frequent histological type was squamous cell carcinoma, with 8023 (88.2 %) cases. Around 25 % of patients (n = 2270) entered the service with stage 4A. The most common treatment was radiotherapy combined with chemotherapy (n = 3270, 35.9 %), followed by surgical removal (n = 1909, 21.0 %).In multivariate analysis, age (p = 0.019), race (p = 0.016), low level of education (p < 0.001), tumor location, staging (p < 0.001), and treatment (p = 0.011) were risk factors independently associated with a higher chance of death in the sample studied. Conclusion: The sociodemographic characteristics of mortality from cervical cancer in patients followed up at the Haroldo Juaçaba Hospital (HHJ/ICC) highlight the higher frequency of deaths in women aged over 60, indigenous and black, with low levels of education, as well as clinical variables related to tumor location, staging and type of treatment.

Endophytic fungi associated with Araucaria angustifolia (Bertol.) Kuntze.

The diversity of endophytes and their ecological relationships with the endangered conifer Araucaria angustifolia (a critically endangered species) are unrevealed. This study aimed to characterize the diversity of endophytic fungi associated with A. angustifolia. To this end, we analyzed 90 fragments from five individuals collected from a mixed localized fragment in Guarapuava-PR, Brazil. The total DNA of 61 morphotypes was extracted and the Internal Transcribed Spacer (ITS) region was amplified and sequenced. The sequence analysis allowed the identification of 37 genera belonging to the phylum Ascomycota and the classes Eurotiomycetes, Dothideomycetes, and Sordariomycetes, divided into 11 orders and 13 families. Most of the isolated fungi belonged to the Sordariomycetes class (40%) and to the Xylaria genus (14%), while Eurotiomycetes was the minority class within the community. Our results reveal the high endophytic richness supporting the life cycle of A. angustifolia and reinforce the necessity for the conservation of this conifer, as many genetic resources can be lost owing to its irrational exploration.

Impact of L-PRF on pain and healing outcomes in lower third molar surgery: a randomized split-mouth trial.

This study explored the effects of L-PRF on pain, soft tissue healing, periodontal condition, and post-extraction bone repair of mandibular third molars (3Ms). A randomized, prospective, triple-blind, split-mouth clinical trial was conducted with 34 volunteers. Eligible patients were randomly allocated into two treatments: G1 (without L-PRF), G2 (alveoli filled with L-PRF), in which the removal of bilateral 3Ms was performed at the same surgical time. Outcomes were assessed according to a visual analogue scale (pain), soft tissue scoring system (wound healing), periodontal probing of mandibular second molar. Bone repair was determined by volumetric analysis (ITK-SNAP software) and fractal analysis (ImageJ software). An intention-to-treat approach to Statistical analysis was used. L-PRF reduced pain in the 7-day postoperative follow-up (p = 0.019) and not only improved soft tissue healing after 1 month of follow-up (p = 0.021), but also probing depth (distal face) in 3 months postoperatively (p = 0.011). Significant alveolar reduction occurred in 3 months after surgery in both treatments (p < 0.05), however, this was more significant in G1 (p = 0.016). The fractal dimension showed no statistical differences. L-PRF improved postoperative clinical parameters of pain, soft tissue healing, and periodontal condition, suggesting that it has a beneficial effect on preserving the alveolar ridge and accelerating the initial repair process.

Inhibition of influenza virus infection in mice by pulmonary administration of a spray dried antiviral.

Increasing resistance to antiviral drugs approved for the treatment of influenza urges the development of novel compounds. Ideally, this should be complemented by a careful consideration of the administration route. 6'siallyllactosamine-functionalized ß-cyclodextrin (CD-6'SLN) is a novel entry inhibitor that acts as a mimic of the primary attachment receptor of influenza, sialic acid. In this study, we aimed to develop a dry powder formulation of CD-6'SLN to assess its in vivo antiviral activity after administration via the pulmonary route. By means of spray drying the compound together with trileucine, a dispersion enhancer, we created a powder that retained the antiviral effect of the drug, remained stable under elevated temperature conditions and performed well in a dry powder inhaler. To test the efficacy of the dry powder drug against influenza infection in vivo, infected mice were treated with CD-6'SLN using an aerosol generator that allowed for the controlled administration of powder formulations to the lungs of mice. CD-6'SLN was effective in mitigating the course of the disease compared to the control groups, reflected by lower disease activity scores and by the prevention of virus-induced IL-6 production. Our data show that CD-6'SLN can be formulated as a stable dry powder that is suitable for use in a dry powder inhaler and is effective when administered via the pulmonary route to influenza-infected mice.

Digoxin attenuates bisphosphonate related osteonecrosis of the jaws by RORγt-dependent Th17 response in male rats.

OBJECTIVE: The study aimed to evaluate digoxin, an RORγt inhibitor, in Medication-Related Osteonecrosis of the Jaws (MRONJ) in male rats treated with zoledronic acid (ZA). STUDY DESIGN: Forty male Wistar rats were divided into a negative control group (0.1 mL/kg saline), a positive control group (ZA, 0.20 mg/kg), and three test groups treated with ZA and digoxin at 1 (DG1), 2 (DG2), or 4 (DG4) mg/kg. These groups received treatment three times weekly. ZA was administered intravenously on days 0, 7, and 14, followed by extraction of the left lower first molar on day 42, a final ZA dose on day 49, and euthanasia on day 70. Analyses included radiographic, histomorphometric, and immunohistochemical evaluation of the mandibles, western blotting of gingiva, and mechanical tests on femurs. Statistical analysis was performed using ANOVA/Bonferroni tests (P < .05). RESULTS: Digoxin reduced radiolucency of MRONJ (P < .001), inflammatory cells, empty osteocyte lacunae (P < .001), apoptotic osteoclasts (P < .001), and Caspase-3-positive osteocytes (P = .021). ZA increased immunoreactivity for most markers except c-Fos, while digoxin reduced interleukin 17, TNF-α, IL-6, IL-2, FOXP3, c-Jun, NFκB (P < .001), TGF-ß (P = .009), RANKL (P = .035), and OPG (P = .034). Digoxin also reversed RORγt expression (P < .001), increased diarrhea scores (P = .028), renal and cardiac indexes (P < .001), and enhanced femur mechanical properties (P < .013). CONCLUSIONS: Digoxin attenuated MRONJ by inhibiting RORγt and reducing the Th17 response.

Risk Factors associated with noncarious cervical lesions.

Background: Noncarious cervical lesions (NCCLs) is the dental structure loss unrelated to caries. The aim was to investigate the possible relationship between bruxism, age, gender, daily routine and dietary habits and NCCL, and correlate with sensitivity and position in the dental arch. Material and Methods: 245 patients aged between 18 and 40 participated in the survey, in which a questionnaire focused on parafunctional habits, erosion, abrasion, dental abfraction and acidic diet was conducted. Facial symmetry analysis, masseter hypertrophy, occlusion evaluation, and presence of wear facets and NCCL. Data were expressed as absolute and percentage frequency and were analyzed using the Fisher's Exact/Chi-square tests and a multinomial logistic regression model. Results: NCCLs was observed in 46.6 % in the participants. Bruxism was observed in 64% of the individuals, and stress in 33%. Wear facets and acidic diets were reported in 75% and 60% of the sample, respectively. There was no significant relationship between NCCL and gender (p = 0.74), bruxism (p = 0.33), stress (p = 0.52), wear facets (p = 0.73), and acidic diets (p = 0.39). Age over 30 years was more strongly associated with NCCL (p< 0.001). Conclusions: Age showed a direct correlation with noncarious cervical lesions. Factors including gender and dietary and parafunctional habits, such as bruxism, were not differential regarding the presence of NCCL. Key words:Tooth wear, non-carious cervical lesions, bruxism.

Effectiveness of trans-sinus dental implants in the complete arch rehabilitation of the edentulous maxilla: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Systematic reviews to determine the effectiveness of oral rehabilitation with trans-sinus dental implants in patients with an atrophic maxilla are lacking. PURPOSE: The purpose of this systematic review was to determine the effectiveness of trans-sinus dental implants installed in patients with an atrophic maxilla. MATERIAL AND METHODS: Searches were conducted in 5 databases including the nonpeer-reviewed literature up to March 2024 by 2 independent reviewers according to established inclusion and exclusion criteria and according to the question: Can trans-sinus implants be a suitable option for the rehabilitation of the atrophic maxilla? The meta-analysis was carried out using the Revman software program for the variables implant loss and marginal bone loss using a 95% confidence interval. The risk of bias in the studies was determined using the ROBINS I tool. RESULTS: A total of 1884 articles were initially found in the researched databases, of which 4 were included in this systematic review. Three were observational studies, and 1 a randomized clinical trial. A total of 144 participants with 658 implants were evaluated (207 trans-sinus) with a 97.2% effectiveness. No statistically significant difference was found in effectiveness when comparing trans-sinus implants and conventional implants (P=.14, I2: 0%), and also no statistically significant difference was found in relation to marginal bone loss between the groups (P=.47, I2: 91%). None of the studies analyzed presented a low risk of bias. CONCLUSIONS: The use of trans-sinus implants in the rehabilitation of atrophic edentulous jaws represents a suitable option with a high success rate. However, the small number of controlled studies on the subject and the high risk of bias are important factors that must be considered before choosing this therapy. New controlled studies with high methodological rigor must be carried out to determine the effectiveness of trans-sinus implants in the rehabilitation of atrophic jaws.

Wastewater treatment process using immobilized microalgae.

Microalgae biomass products are gaining popularity due to their diverse applications in various sectors. However, the costs associated with media ingredients and cell harvesting pose challenges to the scale-up of microalgae cultivation. This study evaluated the growth and nutrient removal efficiency (RE) of immobilized microalgae Tetradesmus obliquus in sodium alginate beads cultivated in swine manure-based wastewater compared to free cells. The main findings of this research include (i) immobilized cells outperformed free cells, showing approximately 2.3 times higher biomass production, especially at 10% effluent concentration; (ii) enhanced organic carbon removal was observed, with a significant 62% reduction in chemical oxygen demand (383.46-144.84 mg L-1) within 48 h for immobilized cells compared to 6% in free culture; (iii) both immobilized and free cells exhibited efficient removal of total nitrogen and total phosphorus, with high REs exceeding 99% for phosphorus. In addition, microscopic analysis confirmed successful cell dispersion within the alginate beads, ensuring efficient light and substrate transfer. Overall, the results highlight the potential of immobilization techniques and alternative media, such as biodigested swine manure, to enhance microalgal growth and nutrient RE, offering promising prospects for sustainable wastewater treatment processes.

Effect of Knee Angle, Contractile Activity, and Intensity of Force Production on Vastus Lateralis Stiffness: A Supersonic Shear Wave Elastography Pilot Study.

Supersonic shear image (SSI) ultrasound elastography provides a quantitative assessment of tissue stiffness using the velocity of shear waves. SSI's great potential has allowed researchers in fields like biomechanics and muscle physiology to study the function of complex muscle groups in different conditions. The aim of this study is to use SSI to investigate changes in the stiffness of the vastus lateralis (VL) muscle as a consequence of passive elongation, isometric contraction, and repeated muscle activity. In a single session, 15 volunteers performed a series of isometric, concentric, and eccentric contractions. SSI images were collected from the VL to assess its stiffness before and after the contractions and at various knee angles. Two-way within-subjects ANOVA was used to test the effects of muscle contraction type and knee angle on VL stiffness. Linear regression analysis was employed to assess the relationship between muscle stiffness and the intensity of isometric contractions. After maximal contractions, VL stiffness increased by approximately 10% compared to baseline values, and following maximal isometric (p < 0.01) and eccentric contractions (p < 0.05). Yet, there was no change in VL shear modulus at the end of concentric contractions. The relaxed VL shear modulus increased with knee flexion both before and after the knee extensor contractions (p < 0.001). A linear relationship between the shear modulus and the degree of isometric contraction was observed, although with notable individual variation (R2 = 0.125). Maximal contractile activity produces modest increases in relaxed muscle stiffness. The SSI-measured shear modulus increases linearly with the degree of isometric contraction.

Myopic shift in pediatric cataract surgery associated with age and surgical complications.

PURPOSE: To investigate predictors for myopic shift after pediatric cataract surgery after at least 3 years follow-up. STUDY DESIGN: Cross-sectional and retrospective study. METHODS: This study included patients treated for congenital or infantile cataract operated up to 5 years of age between 2010 and 2017. Patients were recruited for ophthalmologic evaluation. Surgical and medical data were acquired in medical charts. STATISTICAL ANALYSIS: Univariate and multivariate regressions were performed to look for potential risk factors for myopic shift. RESULTS: This study evaluated 81 eyes of 50 patients, with 62 (77%) being bilateral cases, 48 (59%) with intraocular lens implantation, and 37 (74%) patients being strabismic. Age at surgery was 7.7 (3.7-30.5) months and at evaluation was 93.5 (55.1-113.0) months. Total myopic shift was Symbol -4.32 ± 3.25 D, significantly greater in patients operated on up to 6 months of life (-5.73 ± 3.14 D). The distant best-corrected visual acuity (BCVA) was 0.6 (0.3-1.0) log of minimum angle of resolution (logMAR). Regarding myopic shift, in univariate analysis, older age at surgery is a protective factor (+0.08 D for each month older, P = 0.001). The presence of strabismus (-2.52 D, P = 0.014), aphakia (-2.45 D, P = 0.006), distant BCVA (-0.15 D per 0.1 logMAR, P = 0.024), and surgical complications (-3.02 D, P = 0.001) are risk factors. In multivariate analysis, older age at surgery (+0.06 D, P = 0.012) and surgical complications (-2.52 D, P = 0.001) remain significant. CONCLUSION: In pediatric cataract surgery, myopic shift is greater when surgery is performed in a younger age and if associated with surgical complications.

Can milk replacer allowance affect animal performance, body development, metabolism, and skeletal muscle hypertrophy in pre-weaned dairy kids?

We aimed to evaluate performance, body development, metabolism, and expression of genes related to skeletal muscle hypertrophy in non-castrated male dairy kids fed with different levels of MR during the pre-weaning period. Sixty newborn male kids, not castrated, from Saanen and Swiss Alpine breeds, with an average body weight (BW) of 3.834 ± 0.612 kg, were distributed in a randomized block design. Breeds were the block factor in the model (random effect). Kids were allocated into 2 nutrition plans (n = 30 kids per treatment) categorized as follows: low nutritional plan (LNP; 1L MR/kid/day) or high nutritional plan (HNP; 2L MR/kid/day). All kids were harvested at 45 d of life. The majority of nitrogen balance variables were affected by the nutritional plan (P < 0.050). Morphometric measures and body condition score (2.99 - LNP vs. 3.28 - HNP) were affected by nutritional plan (P < 0.050), except hip height, thoracic depth and hip width. The nutritional plan affected the body components (P < 0.050), except esophagus and trachea. Animal performance and carcass traits were influenced by nutritional plan (P < 0.050), except carcass dressing (48.56% on average). Nutritional plan affected (P < 0.050) some blood profile variables as the total cholesterol (141.35 vs. 113.25 mg/dL), triglycerides (60.53 vs. 89.05 mg/dL), LDL (79.76 vs. 33.66 g/mL) and IGF-1 (17.77 vs. 38.55 ng/mL) for LNP and HNP respectively. Hypertrophy was greater in HNP than LNP animals (P < 0.050), being represented by the proportion of sarcoplasm (39.76 vs. 31.99%). LNP had a greater mTOR abundance than HNP (P = 0.045), but AMPK was not affected by the nutritional plan. Our findings show that a higher milk replacer allowance enhances animal performance, body development, metabolic parameters, and cellular hypertrophy in pre-weaned dairy kids.

Corrigendum to "Addressing docking pose selection with structure-based deep learning: Recent advances, challenges and opportunities" [Comput Struct Biotechnol J vol. 23 (2024) 2141-2151].

[This corrects the article DOI: 10.1016/j.csbj.2024.05.024.].

Health and Wellness Characteristics of Employees Enrolled in a Workplace Wellness Study in the United Arab Emirates: A Descriptive Analysis of a Pilot Study.

INTRODUCTION: Modifiable health behaviors have the power to increase (or decrease) the risk of chronic diseases, impacting a population's health. Health and wellness programs can potentially play a major role in initiating and supporting positive changes in health behaviors, which may lead to reducing the risk of premature mortality. A better understanding of the health and well-being status of the population is crucial to the design of proper and effective interventions. This pilot study aimed to describe the health and well-being status of a cohort of employees in the United Arab Emirates (UAE). METHODS: This pilot study reports the demographic characteristics, body composition, cardiovascular fitness, functional fitness, biological age, and well-being of employees from a large health sector company enrolled in a workplace wellness study in the UAE. Employees were invited to participate in an intervention that was designed to validate the efficacy of weekly health and wellness challenges. Descriptive statistics were used to describe the employees' distribution. RESULTS: Of the 123 selected, 116 employees participated in the study. The mean age of participants was 39.2 years old, 80% of them were non-Emirati, and the majority were from Middle-Eastern and South Asian ethnicities. The prevalence of overweight, obesity, hypercholesterolemia, hyperlipidemia, prediabetes, and diabetes was 35%, 29%, 34%, 79%, 30%, and 7%, respectively. Almost half of the participants (47%) were prehypertensive for systolic blood pressure (BP), 80% had the fitness category of poor-very poor, and the majority (60%) reported exercising <150 minutes/week. The mean functional fitness score was 12.2 points, which indicated an increased risk of injury with physical activity. CONCLUSION: The findings of this pilot study suggest that despite the advancements in healthcare in the UAE, several key preventable risk factors are still prevalent in its population. The introduction of comprehensive health and wellness programs at a broader scale holds the potential to facilitate the adoption of healthier lifestyle behaviors, thereby contributing to improvements in the overall quality of life across the population.

Litigation in access to universal health coverage for children and adolescents in Brazil.

Background: Brazil's Unified Health System (SUS) ensures universal, equitable, and excellent quality health coverage for all. The broad right to health, supported by the Constitution, has led to excessive litigation in the public sector. This has negatively impacted the financial stability of SUS, created inequality in children and adolescents' access to healthcare, and affected communication between the healthcare system and the judiciary. The enactment of Law Number 13.655 on 25 April 2018, proposed significant changes in judicial decisions. This study aimed to investigate decision-making changes in health litigation involving children and adolescents following the implementation of the new normative model. Methods: The study is cross-sectional, analyzing 3753 national judgment documents from all State Courts of Brazil, available on their respective websites from 2014 to 2020. It compares regional legal decisions before and after the promulgation of Law Number 13.655/2018. Data tabulation, statistical analysis, textual analysis, coding, and counting of significant units in the collected documents were performed. The results of data cross-referencing are presented in tables and diagrams. Results: The majority (96.86%) of legal claims (3635 cases) received partial or total provision of what was prescribed by the physician. The Judiciary predominantly handled these cases individually. The analysis indicates that the decisions made did not adhere to the norms established in 2018. Conclusion: Regional heterogeneity in health litigation was observed, and there was no significant variability in decisions during the studied period, even after the implementation of the new normative paradigm in 2018. Technical-scientific support was undervalued by the magistrates. Prioritizing litigants undermines equity in access to Universal Health Coverage for children and adolescents.