Thermal tolerance as a driver of reef fish community structure at the isolated tropical Mid-Atlantic Ridge Islands.

Reef fish communities are shaped by historical and ecological factors, including abiotic and biotic mechanisms at different spatial scales, determining species composition, abundance and biomass. The oceanic islands in the Mid-Atlantic Ridge (St. Peter and St. Paul's Archipelago - SPSPA, Ascension, and St. Helena), exhibiting differences in community structure along a 14-degree latitudinal and a 10 °C thermal gradient. We investigate the influence of sea surface temperature, area, age, isolation and phosphate on reef fish community structures. Reef fish trophic structure varies significantly across the islands, with planktivores and herbivore-detritivores showing the highest abundances in SPSPA and Ascension, while less abundant in St. Helena, aligning with the thermal gradient. Variations in reef fish community structures were predominantly influenced by thermal regimes, corroborating the expansion of species' thermal niche breadth at higher latitudes and lower temperatures. This study highlights that in addition to biogeographic factors, temperature is pivotal on shaping oceanic island reef fish community structure.

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review.

Background Spinal epidural abscess is a rare but serious condition that can cause spinal cord compression and neurological deficits. Case Description and Methods The article reports a case of a 31-year-old patient who presented with an infectious cellulitis in the left hand, which progressed to a spinal epidural abscess. The diagnosis was confirmed by clinical examination and magnetic resonance imaging. Treatment involved laminectomy, after which the patient had complete recovery of neurological deficits. This article is a case report with a literature review. Patient data and images were collected by the researchers who participated in the patient's care. The literature was reviewed by one of the researchers based on the search for articles in the PubMed database. For the research, the following keywords were inserted: "Spinal epidural empyema," "Spinal epidural abscess." Conclusion Spinal epidural abscess is often underdiagnosed, which can lead to delays in treatment and serious complications. The relationship between cellulitis and spinal epidural abscess may be related to the spread of infection through the lymphatic or blood system.

Comparação de fórmulas para cálculo da taxa de filtração glomerular estimada e seus limiares diagnósticos para doença renal crônica em pessoas idosas: um estudo transversal / Comparison of formulas for calculating estimated glomerular filtration rate and its diagnostic thresholds for chronic kidney disease in older adults: a cross-sectional study

Resumo Objetivo Avaliar e comparar as fórmulas CKD-EPI, BIS1 e MDRD e o limiar diagnóstico de 45 e 60 ml/min/1,73m2 em pacientes idosos. Método Estudo observacional do tipo transversal, de caráter descritivo e analítico. Foram incluídos pacientes atendidos em ambulatório de referência entre janeiro/2020 e junho/2022, com idade ≥65 anos. Foram excluídos pacientes com apenas uma dosagem de creatinina ou com alterações transitórias da TFG. Resultados Observou-se que entre o grupo de pacientes com idade entre 65-74 anos e 75-84 anos as estimativas da TFG feitas pela fórmula CKD-EPI foram superiores às fórmulas BIS1 e MDRD. Enquanto, no grupo de pacientes com 85-94 anos a CKD-EPI não apresentou diferença quando comparada com MDRD, permaneceu com estimativas maiores apenas quando comparada com a BIS1. Observamos maior dispersão entre CKD-EPI e BIS1, mostrando menor concordância entre essas fórmulas, confirmada pelo teste Kappa (76,7%) e a concordância quase perfeita entre CKD-EPI e MDRD. Conclusão A fórmula BIS1 apresentou melhor correlação da diminuição da TFGe conforme o avanço das faixas etárias, podendo-se relacionar com o processo de envelhecimento renal fisiológico, podendo ser uma ferramenta auxiliar na estimativa da TFG em idosos, auxiliando no diagnóstico mais preciso da DRC, assim como, no planejamento de intervenções que possam retardar a progressão da DRC e prever risco de mortalidade por doenças cardiovasculares.

Abstract Objective To evaluate and compare the CKD-EPI, BIS1 and MDRD formulas and diagnostic thresholds of 45 and 60 ml/min/1.73m2 in older patients. Method A cross-sectional, descriptive, analytical observational study was conducted. Patients aged ≥65 years treated at a referral outpatient clinic between January 2020 and June 2022, were assessed. Patients with only one creatinine level or with transient GFR abnormalities were excluded. Results The GFR estimates using the CKD-EPI formula were higher than both the BIS1 and MDRD formulas in patient groups aged 65-74 years and 75-84 years. In the group of patients aged 85-94 years, the CKD-EPI showed no difference when compared with the MDRD, yielding higher estimates only compared with the BIS1. Greater dispersion was found between the CKD-EPI and BIS1, showing less agreement between these formulas, as confirmed by the Kappa test (76.7%), while there was almost perfect agreement between the CKD-EPI and MDRD. Conclusion The BIS1 formula showed stronger correlation of the decrease in eGFR with advancing age, reflecting the physiological renal aging process and serving as a potentially useful tool for estimating GFR in older adults. The formula can help provide a more accurate diagnosis of CKD and aid planning of interventions to slow the progression of CKD and predict the risk of mortality from cardiovascular diseases.

Potencialidades e desafios sobre o programa de provimento de médicos em um estado do Nordeste brasileiro / Potentialities and challenges of the doctors provision program in a State inNortheast Brazil

A Paraíba conta com a segunda maior cobertura de Atenção Básica (AB) do país, todavia ainda enfrenta a tendência nacional da disparidade na concentração de médicos entre as macrorregiões de saúde. A ampliação no provimento destes profissionais ao longo dos anos, rendeu ao Estado um incremento quantitativo, entre 2012 e 2015, de 21%, dos quais 3% decorreram do Programa Mais Médicos (PMM). O objetivo deste artigo é avaliar a percepção dos médicos e gestores participantes do programa na Paraíba, apontando potencialidades e fragilidades. Trata-se de um estudo exploratório-descritivo, qualitativo, no qual foram entrevistados médicos e gestores de 13 municípios da Paraíba. Realizaram-se entrevistas com roteiro semiestruturado, as quais foram gravadas, transcritas e analisadas através da análise de conteúdo, com a classificação sistemática dos relatos. Médicos e gestores concordaram quanto ao impacto positivo do programa no acesso ao serviço e na qualidade do cuidado da AB. Os gestores relataram diferenciais dos médicos participantes em relação aos não participantes do programa: maior comprometimento profissional, perfil mais voltado à AB e uma relação com a comunidade marcada pela proximidade e pelo vínculo. Os médicos destacaram como incentivos relevantes a maior autonomia, estabilidade contratual e boa remuneração. Ambos grupos se queixaram de problemas no deslocamento, alta demanda de atendimento e dificuldade na fixação de médico no interior. Os médicos cubanos foram descritos como profissionais de alta dedicação e humanização, porém, houve críticas quanto à linguagem e às condutas terapêuticas. As entrevistas analisadas permitem inferir que o Mais Médicos trouxe mudanças que ultrapassam a presença do médico na Unidade de Saúde da Família, pois levou a impactos na qualidade do cuidado, no vínculo com a comunidade, bem como na relação da equipe.

The Paraíbahas the second largest coverage of Primary Care (AB) in the country, however it still faces the national trend of disparity in the concentration of physicians between health macro-regions. The expansion in the provision of these professionals over the years, gave the State a quantitative increase, between 2012 and 2015, of 21%, of which 3% resulted from the More Doctors Program (PMM). The objective of this article is to evaluate the perception of doctors and managers participating in the programin the Paraíba, pointing out strengths and weaknesses. This is an exploratory-descriptive, qualitative study, in which physicians and managers from 13 municipalities of the 20th century were interviewed. Interviews were carried out with a semi-structured script, which were recorded, transcribed and analyzed through content analysis, with the systematic classification of reports. Physicians and managers agreed on the positive impact of the program on access to the service and quality of PC care. Managers reported differences between participating physicians and non-participants in the program: greater professional commitment, a profile more focused on PC and a relationship with the community marked by proximity and bonding. Physicians highlighted greater autonomy, contractual stability and good remuneration as relevant incentives. Both groups complained of problems with commuting, high demand for care and difficulty finding a doctor in the countryside. Cuban doctors were described as professionals of high dedication and humanization, however, there was criticism regarding the language and therapeutic approaches. The interviews analyzed allow us to infer that Mais Médicos brought about changes that go beyond the presence of the doctor in the Family Health Unit,as it led to impacts on the quality of care, on the bond with the community, as well as on the team's relationship.

The contribution of concentric electrode-evoked potentials and nociceptive withdrawal reflex to the routine neurophysiological assessment of neuropathic pain: cross-sectional study / A contribuição dos potenciais evocados por eletrodo concêntrico e reflexo de retirada nociceptiva para a avaliação neurofisiológica de rotina da dor neuropática: estudo observacional transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Conventional electrodiagnostic studies (EDX) are frequently used to support the diagnosis of peripheral neuropathic pain. However, routine EDX has poor diagnostic yield for identifying small fiber neuropathy, which may be cause of neuropathic pain in some patients. This study aimed to assess the gain in diagnostic yield brought by adding pain-related evoked potentials with concentric electrode (CN-PREP) and nociceptive withdrawal reflex (NWR) assessments to EDX. METHODS: Transversal observational accuracy study which included patients referred to routine EDX in a tertiary-care hospital who reported chronic neuropathic pain in their lower limbs. Besides routine EDX, subjects underwent CN-PREP and NWR assessments. Diagnostic yield and tolerability were examined and compared between test studies. RESULTS: The study enrolled 100 patients (54% female), with 57 ± 12 years. EDX was altered in 47% of all patients. The addition of CN-PREP alone, and NWR combined with CN-PREP increased diagnostic yield to 69% and 72%, respectively. CN-PREP proved to be well tolerable, while NWR was associated with higher test-related pain intensity and discontinuation rate (9% vs. 0%). Considering EDX as the reference test, CN-PREP sensitivity was 85.1% and specificity 58.5%. CONCLUSION: Combining CN-PREP with the routine EDX for patients with neuropathic pain is feasible and results in increased diagnostic yield. Conversely, the addition of NWR to the aforementioned tests provides little improvement to this yield and is less tolerable to the patient. Further studies are needed to determine the actual sensitivity and specificity of CN-PREP when compared to the gold-standard for small fiber neuropathy diagnosis, i.e. intraepidermal nerve fiber density assessment.

RESUMO JUSTIFICATIVA E OBJETIVOS: Estudos convencionais de eletrodiagnóstico (EDX) são frequentemente usados para apoiar o diagnóstico de dor neuropática periférica. No entanto, o EDX de rotina tem baixo rendimento diagnóstico para identificar neuropatia de pequenas fibras. O objetivo deste estudo foi avaliar o ganho no rendimento diagnóstico pela adição de avaliações de potenciais evocados relacionados à dor com eletrodo concêntrico (CN-PREP) e reflexo de retirada nociceptiva (NWR) ao EDX. MÉTODOS: Estudo de precisão observacional transversal que incluiu pacientes encaminhados para EDX de rotina com dor neuropática crônica em membros inferiores. Além do EDX de rotina, os indivíduos foram submetidos às avaliações CN-PREP e NWR. O rendimento diagnóstico e a tolerabilidade foram examinados e comparados entre os estudos de teste. RESULTADOS: O estudo envolveu 100 pacientes (54% mulheres), com 57 ± 12 anos. O EDX estava alterado em 47%. A adição de CN-PREP sozinho e NWR combinado com CN-PREP aumentou o rendimento diagnóstico para 69% e 72%, respectivamente. O CN-PREP provou ser bem tolerável, enquanto o NWR foi associado a maior intensidade de dor relacionada ao teste e taxa de descontinuação (9% vs. 0%). Considerando o EDX como teste de referência, a sensibilidade do CN-PREP foi de 85,1% e a especificidade de 58,5%. CONCLUSÃO: A combinação do CN-PREP com o EDX de rotina para pacientes com dor neuropática é viável e resulta em maior rendimento diagnóstico. Já a adição de NWR aos testes mencionados fornece pouca melhora nesse rendimento e é menos tolerável para o paciente. Mais estudos são necessários para determinar a real sensibilidade e especificidade do CN-PREP quando comparado ao padrão-ouro para diagnóstico de neuropatia de pequenas fibras, ou seja, a avaliação da densidade de fibras nervosas intraepidérmicas.

REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia.

Fibromyalgia syndrome (FS) is a disorder characterized by widespread musculoskeletal pain and psychopathological symptoms, often associated with central pain modulation failure and dysfunctional adaptive responses to environmental stress. The Radio Electric Asymmetric Conveyer (REAC) technology is a neuromodulation technology. The aim of this study was to evaluate the effects of some REAC treatments on psychomotor responses and quality of life in 37 patients with FS. Tests were conducted before and after a single session of Neuro Postural Optimization and after a cycle of 18 sessions of Neuro Psycho Physical Optimization (NPPO), using evaluation of the functional dysmetria (FD) phenomenon, Sitting and Standing (SS), Time Up and Go (TUG) tests for motor evaluation, Fibromyalgia Impact Questionnaire (FIQ) for quality of life. The data were statistically analyzed, and the results showed a statistically significant improvement in motor response and quality of life parameters, including pain, as well as reduced FD measures in all participants. The study concludes that the neurobiological balance established by the REAC therapeutic protocols NPO and NPPO improved the dysfunctional adaptive state caused by environmental and exposomal stress in FS patients, leading to an improvement in psychomotor responses and quality of life. The findings suggest that REAC treatments could be an effective approach for FS patients, reducing the excessive use of analgesic drugs and improving daily activities.

Improving Functional Capacity and Quality of Life in Parkinson's Disease Patients through REAC Neuromodulation Treatments for Mood and Behavioral Disorders.

Parkinson's disease is a neurological disorder that affects both motor and non-motor functions, including depression, anxiety, and cognitive decline. Currently, it remains a challenge to distinguish the correlation between these aspects and their impact on one another. To try to clarify these reciprocal influences, in this study we have used specific radio electric asymmetric conveyer (REAC) technology neuromodulation treatments for behavioral mood disorders and adjustment disorders. In particular, we employed the neuro-postural optimization (NPO) and neuro-psycho-physical optimization (NPPOs) treatments. The study enrolled randomly 50 subjects of both genders previously diagnosed with Parkinson's disease for at least six months. Prior to and following REAC NPO and NPPOs treatments, we assessed the subjects using functional dysmetria (FD) evaluation, five times sit to stand test (FTSST) for postural stability, and the 12-item Short-Form Health Survey (SF-12) for quality of life (QLF) evaluation. The positive results produced by the REAC NPO and NPPOs neuromodulation treatments, specific for mood and adaptation disorders, on dysfunctional motor disorders, and quality of life confirm how the non-motor components can condition the symptomatology of Parkinsonian motor symptoms. These results also highlight the usefulness of REAC NPO and NPPOs treatments in improving the overall quality of life of these patients.

REAC Antalgic Neuro Modulation in Chronic Post Herpetic Neuralgia.

BACKGROUND: Chronic post-herpetic neuralgia (CPHN) is a symptomatic condition that afflicts adults and elderly individuals. The chronicity of this symptomatology can be conditioned by the epigenetic modifications induced by the virus on the processes of neurotransmission and sensitivity to pain. The aim of this study is to investigate whether manipulating endogenous bioelectrical activity (EBA), responsible for neurotransmission processes and contributing to the induction of epigenetic modifications, can alleviate pain symptoms. METHODS: This manipulation was carried out with the antalgic neuromodulation (ANM) treatment of radioelectric asymmetric conveyer (REAC) technology. Pain assessment before and after treatment was performed using a numerical analog scale (NAS) and a simple descriptive scale (SDS). RESULTS: The results of the analysis showed an over four-point decrease in NAS scale score and over one point decrease in SDS scale score, with a statistical significance for both tests of p < 0.005. CONCLUSIONS: The results obtained in this study demonstrate how REAC ANM manipulation of EBA can lead to improvement in epigenetically conditioned symptoms such as CPHN. These results should prompt further research to expand knowledge and ensure optimized therapeutic outcomes.

TimeFISH: Long-term assessment of reef fish assemblages in a transition zone in the Southwestern Atlantic.

The TimeFISH database provides the first public time-series dataset on reef fish assemblages in the southwestern Atlantic (SWA), comprising 15 years of data (2007-2022) based on standardized Underwater Visual Censuses (UVCs). The rocky reefs covered by our dataset are influenced by pronounced seasonal cycles of ocean temperatures with warm tropical waters from the Brazil Current in the summer (~27°C) and colder waters from the La Plata River Plume discharge and upwelling from the South Atlantic Central Water in the winter (~18°C). These oceanographic conditions characterize this area as the southernmost tropical-subtropical climatic transition zone in the Atlantic Ocean. As a result, reef fish assemblages are comprised of both tropical and subtropical species. All records included in TimeFISH were collected using UVCs, a nondestructive method that allows the estimation of fish species richness, abundance, and body size distributions. UVCs were performed through 40 m2 belt transects by scuba diving in nine locations along the southern Brazilian coast (25-29°S). Four of these locations lie within the boundaries of the no-entry Arvoredo Marine Biological Reserve, where fishing and recreational activities are forbidden, and the remaining locations are unprotected from these activities. During each belt transect, a diver swam at a constant depth above and parallel to the reef, identifying fish species, counting the number of individuals, and estimating the total body length (Lt in cm) of all detected individuals. All fish individuals in the water column (up to 2 m above the substratum) and at the bottom were targeted. In total, 202,965 individuals belonging to 163 reef fish species and 53 families were recorded across 1857 UVCs. All survey campaigns were funded by either public or mixed capital (private-public) sources, including seven grants from the Brazilian federal and Santa Catarina state governments. Part of the data has already been used in multiple MS.c. and Ph.D. theses and scientific articles. TimeFISH represents an important contribution for future studies aiming to examine temporal and spatial variations of reef fish assemblages in transition zones. No copyright restrictions apply to the use of this data set, other than citing this publication.

The Role of Plant Latex in Virus Biology.

At least 20,000 plant species produce latex, a capacity that appears to have evolved independently on numerous occasions. With a few exceptions, latex is stored under pressure in specialized cells known as laticifers and is exuded upon injury, leading to the assumption that it has a role in securing the plant after mechanical injury. In addition, a defensive effect against insect herbivores and fungal infections has been well established. Latex also appears to have effects on viruses, and laticifers are a hostile environment for virus colonization. Only one example of successful colonization has been reported: papaya meleira virus (PMeV) and papaya meleira virus 2 (PMeV2) in Carica papaya. In this review, a summary of studies that support both the pro- and anti-viral effects of plant latex compounds is provided. The latex components represent a promising natural source for the discovery of new pro- and anti-viral molecules in the fields of agriculture and medicine.

Neuro Postural Optimization Neuromodulation Treatment of Radio Electric Asymmetric Conveyer Technology on Stress and Quality of Life in Institutionalized Children in a Capital City of the Brazilian Amazon.

Background The deviation from perfect bilateral symmetry is defined as fluctuating asymmetry (FA) and is a common phenomenon among living organisms. This deviation from perfection is thought to reflect the environmental pressures experienced during development and, therefore, the FA represents an epigenetic measure of the environmental stress, which affects all living beings from conception, progressively affecting all aspects of life. Rinaldi and Fontani hypothesized that the FA morpho-functional changes are originated by an adaptive motor behavior determined by functional alterations in the cerebellum and neural circuits, not caused by a lesion, but induced by the experienced environmental stress. They identified in the asymmetric activation of symmetrical muscle groups, detectable even in healthy subjects, the expression of the dysfunctional adaptation state of the subject and named this clinical semeiotic phenomenon functional dysmetria (FD). On these premises, they developed the radio electric asymmetric conveyer (REAC) technology, a neuromodulation technology aimed at optimizing the best neuro-psycho-motor strategies in relation to environmental interaction. Neuro postural optimization (NPO) is a neurobiological stimulation treatment administered with the REAC technology and it has been specifically studied to treat the state of dysfunctional adaptation that is revealed through the presence of FD. Aim The purpose of this study was to verify whether a single administration of the REAC NPO treatment can trigger the improvement of the capacity of stress management and the quality of life in a population of children housed in a group home in Macapá, Brazil. Materials and methods The sample of this study consisted of nine children (six boys and three girls) in the age group of 6-11 years, which represented the totality of the children present in the structure. The children was investigated for the assessment of the presence of functional dysmetria and with the Pediatric Quality of Life Inventory TM 4.0 (PedsQL) before and one week after the administration of the REAC NPO. Results The stable disappearance of FD was found in all children at follow-up. In addition, improvements were found in stress management and quality of life, in the physical, emotional, social, and scholastic aspects evaluated with PedsQL. Conclusions It was seen that the REAC NPO neurobiological modulation treatment induced the stable disappearance of FD and triggered the initial improvement of neurophysical aspects also in a population of children housed in a group home in the Amazon region of Macapá, Brazil.

Use of medicines for covid-19 treatment in patients with loss of kidney function: a narrative review / Medicamentos utilizados no tratamento da covid-19 em pacientes com perda da capacidade funcional renal: uma revisão rápida da literatura

ABSTRACT Covid-19 has been identified as the cause of acute respiratory disease with interstitial and alveolar pneumonia, but it can affect several organs, such as kidneys, heart, blood, nervous system and digestive tract. The disease-causing agent (Sars-CoV-2) has a binding structure to the angiotensin-converting enzyme 2 (ACE2) receptor, enabling entry into cells that express ACE2, such as the pulmonary alveolar epithelial cells. However, studies also indicate the possibility of damage to renal cells, since these cells express high levels of ACE2. Currently, there is no evidence to indicate a specific treatment for covid-19. Several drugs have been used, and some of them may have their excretion process altered in patients with abnormal kidney function. To date, there are no studies that assist health professionals in adjusting the dose of these drugs. Thus, this study aims to review and discuss the topic, taking into account factors associated with kidney injury in covid-19, as well as pharmacokinetic aspects and dose recommendations of the main drugs used for covid-19.

RESUMO A covid-19 foi identificada como a causa de doença respiratória aguda com pneumonia intersticial e alveolar, mas que pode afetar vários órgãos, como rim, coração, sangue, sistema nervoso e trato digestivo. O agente causador da doença (Sars-CoV-2) tem uma estrutura de ligação ao receptor da enzima de conversão da angiotensina 2 (ACE2), permitindo a entrada em células que expressam ACE2, como as células epiteliais alveolares pulmonares. Porém, estudos também indicam a possibilidade de lesão das células renais, uma vez que essas células expressam altos níveis de ACE2. Atualmente, não existem evidências para a indicação de um tratamento específico para a covid-19. Vários medicamentos vêm sendo utilizados, e alguns podem ter o processo de eliminação alterados em pacientes com comprometimento renal. Até o momento, não há estudos que auxiliem os profissionais de saúde no ajuste de dose desses medicamentos. Assim, este estudo tem como objetivo revisar e discutir o tema, levando em consideração os fatores relacionados à lesão renal na covid-19, bem como aspectos farmacocinéticos e recomendações de doses dos principais medicamentos utilizados para covid-19.

Use of medicines for covid-19 treatment in patients with loss of kidney function: a narrative review.

Covid-19 has been identified as the cause of acute respiratory disease with interstitial and alveolar pneumonia, but it can affect several organs, such as kidneys, heart, blood, nervous system and digestive tract. The disease-causing agent (Sars-CoV-2) has a binding structure to the angiotensin-converting enzyme 2 (ACE2) receptor, enabling entry into cells that express ACE2, such as the pulmonary alveolar epithelial cells. However, studies also indicate the possibility of damage to renal cells, since these cells express high levels of ACE2. Currently, there is no evidence to indicate a specific treatment for covid-19. Several drugs have been used, and some of them may have their excretion process altered in patients with abnormal kidney function. To date, there are no studies that assist health professionals in adjusting the dose of these drugs. Thus, this study aims to review and discuss the topic, taking into account factors associated with kidney injury in covid-19, as well as pharmacokinetic aspects and dose recommendations of the main drugs used for covid-19.

Successful hair removal on intraoral grafts using the diode laser: Report of two cases.

AIM: The aim of this study was to describe the successful epilation of intraoral grafts using the diode laser system. METHODS AND RESULTS: Two male patients at a 12-month follow-up - who underwent radical resection of oral cancer located in the mouth floor and tongue followed by reconstruction with cutaneous flap - showed hypertrichosis in the graft region, leading to dysphagia and dysphonia. The diode (980 nm) laser was performed for both cases in order to remove the ectopic hair. Excellent aesthetic and functional outcomes with total hair removal and alteration of the tissue surface were achieved. CONCLUSIONS: There is no currently standard protocol for the laser epilation use on hairy grafts because each graft required a different number of sessions for total epilation. The diode laser system appears to be a successful therapeutic option for patients suffering from hypertrichrosis in the oral cavity.

Estado atual do tratamento medicamentoso de trombose venosa profunda na cirurgia vascular do HSPM / Current status of drug treatment for deep vein thrombosis in vascular surgery in HSPM

Durante décadas a única opção para o tratamento medicamentoso das condições tromboembólicas venosas foi o uso das heparinas seguido dos antagonistas da vitamina K, como a varfarina sódica, que se demonstravam efetivos no tratamento de tais condições, porém essa medicação possui algumas desvantagens como: janela terapêutica estreita, interações com outras medicações e alimentos, além do fato de requerer monitorização laboratorial periódica. Com o surgimento dos novos anticoagulantes orais, tais drogas apareceram como uma alternativa ao tratamento da TVP, demonstrando através de diversos estudos sua não inferioridade em relação a eficácia da anticoagulação, bem como uma série de vantagens quando comparados ao tratamento convencional. Nesse sentido, este projeto se propõe a avaliar a prática clínica da cirurgia vascular do HSPM no tratamento medicamentoso da TVP e demonstrar com o que já se tem descrito na literatura sobre a atual participação e benefícios dos novos anticoagulantes orais no manejo da TVP. Para isso foram utilizados os prontuários eletrônicos do HSPM acerca de pacientes internados pela Cirurgia Vascular com TVP no intervalo entre junho de 2020 a junho de 2021 para o levantamento da medicação administrada. Também foram utilizados dados da literatura de referência para respaldar a comparação entre os anticoagulantes convencionais e os novos anticoagulantes. Os resultados obtidos apontam para a baixa utilização dos novos anticoagulantes orais no HSPM, sendo oferecido a apenas 5 dos 55 pacientes internados no intervalo de um ano, isso porque o SUS não fornece a medicação, tendo como justificativa o impacto orçamentário sem ganho significativo de eficácia. A literatura consultada, no entanto, relata a segurança e eficácia satisfatória dos novos anticoagulantes orais, e indica que apesar desses medicamentos serem mais caros que a varfarina, há considerável redução dos custos relativos à internação e/ou acompanhamento médico. Assim, conclui-se que essas novas drogas são boas alternativas ao tratamento convencional, porém deve haver adequação ao quadro do paciente, às suas condições socioeconômicas e à disponibilidade do SUS. Palavras-chave: Novos anticoagulantes orais. Trombose. Varfarina. Trombose venosa profunda. Xarelto

Severe coral bleaching of Siderastrea stellata at the only atoll in the South Atlantic driven by sequential Marine Heatwaves / Branqueamento severo de Siderastrea stellata no único atol do Atlântico Sul impulsionado por ondas de calor marinhas sequenciais

Abstract: Threatened by global warming and extreme climatic events, such as El Niño Southern Oscillation (ENSO) and Marine Heatwaves (MHW), coral reefs worldwide faced the worst bleaching and mortality event between 2014 and 2017, induced by the 2015/2016 ENSO. We evaluated the impacts of ENSO and MHW episodes on bleaching and mortality frequencies of Siderastrea stellata at Rocas Atoll, Southwestern Atlantic, using visual censuses conducted in 2016, 2017 and 2019. Bleaching rate varied significantly along the sampling period (11.71% in 2016, 1.52% in 2017, and 88% in 2019), but mortality was always less than 4%. Bleaching events in Atlantic reefs have been constantly associated with ENSO, until these recent events of the last two years. We suggest that MHW were probably the primary driver of the observed bleaching, especially in 2019, when much higher bleaching rates were observed than in ENSO periods. Although Southwestern Atlantic massive corals are considered more resistant to thermal stress than reefs corals worldwide, the strong events registered since 2019 highlight the need for continuous monitoring to better understand coral bleaching dynamics and improve predictions on the effects of global change in the region.

Resumo: Ameaçados pelo aquecimento global e eventos climáticos extremos, como El Niño Oscilação Sul (ENSO) e Ondas de Calor Marinhas (MHW), os recifes de coral em todo o mundo enfrentaram o pior evento de branqueamento e mortalidade entre 2014 e 2017, induzido pelo ENSO 2015/2016. Nesse estudo, avaliamos os impactos dos episódios de ENSO e MHW nas frequências de branqueamento e mortalidade de Siderastrea stellata no Atol de Rocas, Atlântico Sudoeste, a partir de censos visuais realizados em 2016, 2017 e 2019. O branqueamento variou significativamente ao longo do período de amostragem (11,71% em 2016, 1,52% em 2017, e 88% em 2019), mas a mortalidade não, sendo sempre inferior a 4%. Eventos de branqueamento em recifes do Atlântico têm sido constantemente associados ao ENSO, até os eventos recentes dos últimos dois anos. Nós sugerimos que as MHW foram provavelmente o principal impulsionador do branqueamento observado, especialmente em 2019, quando as taxas de branqueamento observadas foram maiores do que nos períodos de ENSO. Embora os corais massivos do Atlântico Sudoeste sejam considerados mais resistentes ao estresse térmico quando comparados com corais recifais de outros oceanos, os fortes eventos registrados desde 2019 destacam a necessidade de monitoramento contínuo para entender melhor a dinâmica do branqueamento de corais e melhorar as previsões sobre os efeitos das mudanças globais na região.

Relationships between Recognition of Characters, Logos and Brands of Tobacco Products, Fast-Food, Soft Drinks and Alcoholic Drinks in Children / Relações entre o Reconhecimento de Personagens, Logos e Marcas de Produtos de Tabaco, Fast-Food, Refrigerantes e Bebidas Alcoólicas em Crianças / Relaciones entre el Reconocimiento de Personajes, Logos y Marcas de Productos de Tabaco, Fast-Food, Refrescos y Bebidas Alcohólicas en Niños

This research aimed to investigate relationships between the recognition of children's characters, and the association of logos and brands of tobacco products, fast-food, soft drinks and alcoholic beverages in 90 children, aged 4-9 years, from the city of Rio de Janeiro, most of whom are male (56.7%). Age range was chosen based on McNeal's model of consumer behavior which says the consumer is fully formed by the age of 8. The Instrument for assessing Cartoon and Movie Characters (IACMC, α = 0.80, M=0.75, SD=0.16), the Instrument for assessing Cartoon and Movie Logos (IACML α =0.80, M=0.58, SD=0.21) and the Instrument for Assessing Logos and Trademarks Association (IALTA, α=0.74, M=0.53, SD = 0.14) were used. The global scores for recognition of logos correlated significantly with the global scores for recognition of children's characters (r = 0.38, p< 0.01). The model path was drawn from characters to logos and from logos to fast food associations. A direct effect was drawn from fast food over soda and alcohol. Fit was X² (df = 736) = 782.97 (p = 0.112), RMSEA = 0.03 (90% C.I. [0.00, 0.04]) (p = 0.996), CFI = 0.95, TLI = 0.94. The research demonstrated the need for stricter regulations for the advertising of alcoholic beverages, soft drinks and fast-food. (AU)

Esta pesquisa teve como objetivo investigar relações entre o reconhecimento de personagens infantis e a associação de logos e marcas de produtos de tabaco, fast-food, refrigerantes e bebidas alcoólicas em 90 crianças, entre 4-9 anos, da cidade do Rio de Janeiro, sendo a maioria do sexo masculino (56,7%). A escolha da faixa etária se baseou no modelo de comportamento consumidor proposto por McNeal, o qual diz que o consumidor se encontra plenamente formado aos 8 anos de idade. Utilizou-se o Instrumento de Avaliação de Personagens de Desenho Animado e Filme (IACMC, α = 0.80, M=0.75, DP= 0.16), o Instrumento de Avaliação de Logos de Desenho Animado e Filme (IACML α = 0.80, M = 0.88, DP = 0.21) e o Instrumento de Avaliação da Associação de Logos e Marcas (IALTA, α = 0.74, M = 0.53, DP = 0.14). As pontuações globais para reconhecimento de logos correlacionaram-se significativamente com as pontuações globais para reconhecimento de personagens infantis (r = 0.38, p<0.01). O modelo foi desenhado a partir de personagens para logotipos e destes para associações de fast-food. Um efeito direto foi extraído de fast-food com refrigerante e álcool. O ajuste foi X² (df = 736) = 782.97 (p = 0.112), RMSEA = 0.03 (90% de CC [0.00, 0.04]) (p = 0.996), CFI = 0.95, TLI = 0.94. A pesquisa demonstrou a necessidade de regulamentação mais rígida para a publicidade de bebidas alcoólicas, refrigerantes e fast-food. (AU)

Este estudio investigó las relaciones entre el reconocimiento de personajes infantiles y la asociación de logos y marcas de productos de tabaco, fast-food, refrescos y bebidas alcohólicas en 90 niños, de entre 4 y 9 años, de la ciudad de Río de Janeiro, la mayoría de los cuales son hombres (56,7%). El rango de edad se eligió según el modelo de comportamiento del consumidor de McNeal que dice que el consumidor está completamente formado a la edad de 8 años. Se utilizó el Instrumento de Evaluación de Personajes de Dibujo Animado y Película (IACMC, α = 0.80, M = 0.75, DE = 0.16), el Instrumento de Evaluación de Logos de Dibujo Animado y Película (IACML α = 0.80, M= 0.88, DE = 0.21) y el Instrumento de Evaluación de la Asociación de Logos y Marcas (IALTA, α = 0.74, M = 0.53, DE = 0.14). Las puntuaciones globales para el reconocimiento de logos se correlacionaron significativamente con el reconocimiento de personajes infantiles (r = 0.38, p<0.01). El modelo fue diseñado a partir de personajes para logotipos y de éstos para fast-food. Un efecto directo fue extraído de fast-food con refrigerante y alcohol. El ajuste fue X² (df = 736) = 782.97 (p = 0.112), RMSEA =0.03 (90% de CC [0.00, 0.04]) (p = 0.996), CFI =0.95, TLI = 0.94. La investigación demostró la necesidad de reglamentación más rígida para la publicidad de bebidas alcohólicas, refrescos y fast-food. (AU)

Brazilian Consortium for the Study on Renal Diseases Associated With COVID-19: A Multicentric Effort to Understand SARS-CoV-2-Related Nephropathy.

Kidney involvement appears to be frequent in coronavirus disease 2019 (COVID-19). Despite this, information concerning renal involvement in COVID-19 is still scarce. Several mechanisms appear to be involved in the complex relationship between the virus and the kidney. Also, different morphological patterns have been described in the kidneys of patients with COVID-19. For some authors, however, this association may be just a coincidence. To investigate this issue, we propose assessing renal morphology associated with COVID-19 at the renal pathology reference center of federal university hospitals in Brazil. Data will come from a consortium involving 17 federal university hospitals belonging to Empresa Brasileira de Serviços Hospitalares (EBSERH) network, as well as some state hospitals and an autopsy center. All biopsies will be sent to the referral center for renal pathology of the EBSERH network. The data will include patients who had coronavirus disease, both alive and deceased, with or without pre-existing kidney disease. Kidney biopsies will be analyzed by light, fluorescence, and electron microscopy. Furthermore, immunohistochemical (IHC) staining for various inflammatory cells (i.e., cells expressing CD3, CD20, CD4, CD8, CD138, CD68, and CD57) as well as angiotensin-converting enzyme 2 (ACE2) will be performed on paraffinized tissue sections. In addition to ultrastructural assays, in situ hybridization (ISH), IHC and reverse transcription-polymerase chain reaction (RT-PCR) will be used to detect Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) in renal tissue. For the patients diagnosed with Collapsing Glomerulopathy, peripheral blood will be collected for apolipoprotein L-1 (APOL1) genotyping. For patients with thrombotic microangiopathy, thrombospondin type 1 motif, member 13 (ADAMTS13), antiphospholipid, and complement panel will be performed. The setting of this study is Brazil, which is second behind the United States in highest confirmed cases and deaths. With this complete approach, we hope to help define the spectrum and impact, whether immediate or long-term, of kidney injury caused by SARS-CoV-2.