Sickle cell anemia in the state of Maranhão: a haplotype study.

Sickle cell anemia (SCA) is the most severe form of sickle cell disease caused by homozygosity of the ßS-gene (S/S or ßSßS) and has worldwide distribution. Six polymorphic sites in the ß-globin gene cluster were analyzed from a sample of 56 chromosomes of patients with SCA from the state of Maranhão, northeastern Brazil. PCR-RFLP showed that the CAR haplotype was predominant with a frequency of 64.28%, followed by the BEN haplotype (28.57%). Atypical haplotypes were identified at a frequency of 7.15%. Genotypes CAR/CAR, BEN/BEN, and CAR/BEN were present in 46.43%, 10.71%, and 35.71% of patients, respectively. ß-Globin haplotype determination is important not only for the monitoring and prognosis of patients with SCA, but it also serves to inform anthropological studies that contribute to elucidating any peculiarities associated with African influences that contributed to the ethnological, economic, cultural, and social formation of Brazil. The high frequency of the CAR/CAR and CAR/BEN haplotypes in this study, which are associated with low levels of fetal hemoglobin, may ultimately reflect a severe clinical course and poor prognosis in patients with SCA in Maranhão.

Altered mRNA Splicing, Chondrocyte Gene Expression and Abnormal Skeletal Development due to SF3B4 Mutations in Rodriguez Acrofacial Dysostosis.

The acrofacial dysostoses (AFD) are a genetically heterogeneous group of inherited disorders with craniofacial and limb abnormalities. Rodriguez syndrome is a severe, usually perinatal lethal AFD, characterized by severe retrognathia, oligodactyly and lower limb abnormalities. Rodriguez syndrome has been proposed to be a severe form of Nager syndrome, a non-lethal AFD that results from mutations in SF3B4, a component of the U2 small nuclear ribonucleoprotein particle (U2 snRNP). Furthermore, a case with a phenotype intermediate between Rodriguez and Nager syndromes has been shown to have an SF3B4 mutation. We identified heterozygosity for SF3B4 mutations in Rodriguez syndrome, confirming that the phenotype is a dominant disorder that is allelic with Nager syndrome. The mutations led to reduced SF3B4 synthesis and defects in mRNA splicing, primarily exon skipping. The mutations also led to reduced expression in growth plate chondrocytes of target genes, including the DLX5, DLX6, SOX9, and SOX6 transcription factor genes, which are known to be important for skeletal development. These data provide mechanistic insight toward understanding how SF3B4 mutations lead to the skeletal abnormalities observed in the acrofacial dysostoses.

Correction: Altered mRNA Splicing, Chondrocyte Gene Expression and Abnormal Skeletal Development due to SF3B4 Mutations in Rodriguez Acrofacial Dysostosis.

[This corrects the article DOI: 10.1371/journal.pgen.1006307.].

Computational Investigation of Growth Hormone Receptor Trp169Arg Heterozygous Mutation in a Child With Short Stature.

Mutations in the growth hormone receptor (GHR) gene can cause disruption of the growth hormone signaling pathway, resulting in growth deficiency due to growth hormone (GH) resistance. Both recessive and apparently dominant mutations have been described in the literature. In order to shed some light on the molecular mechanism of partial growth hormone resistance caused by heterozygous mutations, we performed an in-depth in silico analysis of a mutation found in a girl with a previous diagnosis of idiopathic short stature. An array of algorithms was used to predict pathogenicity and potential impact on the protein, and molecular modeling, docking and dynamics were used to determine structural consequences. The results suggest that both of the possible single mutation-containing heteromeric GH-GHR complexes, as well as the double GHR mutant complex result in perturbation of complex structures, with altered ability of the GHR dimers to interact with the GH peptide. J. Cell. Biochem. 118: 4762-4771, 2017. © 2017 Wiley Periodicals, Inc.

Short stature, unusual face, delta phalanx, and abnormal vertebrae and ribs in a girl born to half-siblings.

Delta phalanx is a rare abnormality typically associated with additional features. We describe a patient with a phenotype resembling Catel-Manzke syndrome, but with delta phalanx and abnormal vertebrae and ribs. The patient was the only child of half siblings born with a marked prenatal growth deficiency. At 10 years of age, she had a short stature, long face, long and tubular nose with small alae nasi, high palate, short and broad thorax, and short index fingers with radial deviation. There were hyperpigmentations following Blaschko's lines. Radiology showed a proximal delta phalanx in the index finger of hands, abnormal vertebrae, and fused and small ribs. GTG-Banding karyotype and microarray analysis yielded normal results. Exome sequencing identified 25 genes that harbored homozygous variants, but none of these is assumed to be a good candidate to explain (part of) the phenotype. The here described patient may have a new condition, possibly following an autosomal recessive pattern of inheritance, although due to the high degree of consanguinity a compound etiology of the phenotype by variants in various genes may be present as well.

Partial trisomy 17q and partial monosomy 20q in a boy with craniosynostosis.

Craniosynostosis is defined as a premature fusion of at least one cranial suture, which can be accompanied by other findings. Of syndromic cases, 14-22% have been associated with chromosomal rearrangements. This report describes a Brazilian boy with syndromic craniosynostosis who also presented with intellectual disability, microcephaly, frontal bossing, bitemporal narrowing, short neck, syndactyly, and cardiac defects. Chromosome banding showed an apparently normal male karyotype. Subsequent chromosomal microarray analysis (CMA) using the Affymetrix CytoScan 750 K Array showed a duplication of 2.1 Mb on chromosome 17q and a deletion of 1.4 Mb on chromosome 20q. The data suggested an unbalanced translocation, which was confirmed by fluorescence in-situ hybridization analysis (FISH). While there are several reports in the literature of chromosome 17q duplication syndrome accompanied by partial monosomies of other chromosomes, this is the first case featuring partial monosomy of 20q. The patient́s phenotype is generally consistent with 17q duplication syndrome, however craniosynostosis has rarely been associated with this chromosomal anomaly.

Recommendations from the Brazilian Society of Anesthesiology (SBA) for difficult airway management in pediatric care.

Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics.

Dual diaminopimelate biosynthesis pathways in Bacteroides fragilis and Clostridium thermocellum.

Bacteroides fragilis and Clostridium thermocellum were recently found to synthesize diaminopimelate (DAP) by way of LL-DAP aminotransferase. Both species also contain an ortholog of meso-diaminopimelate dehydrogenase (Ddh), suggesting that they may have redundant pathways for DAP biosynthesis. The B. fragilis Ddh ortholog shows low homology with other examples of Ddh and this species belongs to a phylum, the Bacteriodetes, not previously known to contain this enzyme. By contrast, the C. thermocellum ortholog is well conserved with known examples of Ddh. Using in vitro and in vivo assays both the B. fragilis and C. thermocellum enzymes were found to be authentic examples of Ddh, displaying kinetic properties typical of this enzyme. The result indicates that B. fragilis contains a sequence diverged form of Ddh. Phylogenomic analysis of the microbial genome database revealed that 77% of species with a Ddh ortholog also contain a second pathway for DAP biosynthesis suggesting that Ddh evolved as an ancillary mechanism for DAP biosynthesis.

Safety and feasibility of upper limb vascular access for cardiac catheterization in anticoagulated and non-anticoagulated patients.

BACKGROUND: The upper limb approach utilizing transradial access for combined left and right heart catheterization (CLRHC) and ultrasound-guided antecubital venous access for isolated right heart catheterization (IRHC) are strategies that may reduce risks, especially in anticoagulated patients. combined left and right heart catheterization. OBJECTIVES: To assess safety and feasibility of upper limb approach for IRHC or CLRHC in anticoagulated versus non-anticoagulated patients. METHODS: Ninety-three patients who underwent IRHC or CLRHC with ultrasound-guided antecubital venous access and transradial arterial access were prospectively enrolled. The primary outcome was a composite of procedure failure and incidence of immediate vascular complications. RESULTS: Of the 93 patients, 44 (47%) were on anticoagulation and 49 (53%) were not. Mean age was 54 ± 17 and 53 ± 15 years, respectively. Atrial fibrillation (39% vs 15%) and chronic kidney disease (21% vs 6%) were more common in anticoagulated patients. The main indication for anticoagulation was deep vein thrombosis/pulmonary thromboembolism in 22 patients (50%). The primary outcome occurred in 4 (8%) patients in the non-anticoagulated group as compared with 0 in the anticoagulated group (p = 0.12). Procedure failure occurred in two patients (4%) and immediate vascular complications in two patients (4%) in the non-anticoagulated group (p = 0.3 for all). There was no difference between groups regarding duration of the procedure, radiation dose, fluoroscopy time, post-procedure recovery room time and median time to venous or arterial hemostasis. CONCLUSIONS: The upper limb approach for heart catheterization had similar rates of procedure failure and immediate vascular complications in anticoagulated patients when compared to non-anticoagulated patients.

Comparison of Admission Lung Ultrasound and Left Ventricular End-Diastolic Pressure in Patients Undergoing Primary Percutaneous Coronary Intervention.

[Figure: see text].

Network Analysis Combining Proteomics and Metabolomics Reveals New Insights Into Early Responses of Eucalyptus grandis During Rust Infection.

Eucalyptus rust is caused by the biotrophic fungus, Austropuccinia psidii, which affects commercial plantations of Eucalyptus, a major raw material for the pulp and paper industry in Brazil. In this manuscript we aimed to uncover the molecular mechanisms involved in rust resistance and susceptibility in Eucalyptus grandis. Epifluorescence microscopy was used to follow the fungus development inside the leaves of two contrasting half-sibling genotypes (rust-resistance and rust-susceptible), and also determine the comparative time-course of changes in metabolites and proteins in plants inoculated with rust. Within 24 h of complete fungal invasion, the analysis of 709 metabolomic features showed the suppression of many metabolites 6 h after inoculation (hai) in the rust-resistant genotype, with responses being induced after 12 hai. In contrast, the rust-susceptible genotype displayed more induced metabolites from 0 to 18 hai time-points, but a strong suppression occurred at 24 hai. Multivariate analyses of genotypes and time points were used to select 16 differential metabolites mostly classified as phenylpropanoid-related compounds. Applying the Weighted Gene Co-Expression Network Analysis (WGCNA), rust-resistant and rust-susceptible genotypes had, respectively, 871 and 852 proteins grouped into 5 and 6 modules, of which 5 and 4 of them were significantly correlated to the selected metabolites. Functional analyses revealed roles for photosynthesis and oxidative-dependent responses leading to temporal activity of metabolites and related enzymes after 12 hai in rust-resistance; while the initial over-accumulation of those molecules and suppression of supporting mechanisms at 12 hai caused a lack of progressive metabolite-enzyme responses after 12 hai in rust-susceptible genotype. This study provides some insights on how E. grandis plants are functionally modulated to integrate secondary metabolites and related enzymes from phenylpropanoid pathway and lead to temporal divergences of resistance and susceptibility responses to rust.

Long-term Pattern of Red Cell Distribution Width in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

Red cell distribution width (RDW) is an indirect marker of inflammation and an independent predictor of long-term mortality. The aim of this study was to determine RDW values in patients with ST-elevation acute myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI) and evaluate its association with adverse outcomes. We measured RDW in STEMI patients before undergoing primary PCI and divided into low and high RDW. Patients were followed up to 3 years after their discharge for the occurrence of in-hospital, 30-days, and long-term major adverse cardiovascular events (MACEs) and mortality. We included 485 patients with a mean age of 61.1(±12.5) years, 62.9% were male. In multivariate analysis, RDW remained independent predictor of long-term mortality and MACE [relative risk (RR) 1.51; 95% confidence interval (95% CI) = 1.11-2.05; P = 0.007 and RR = 1.42; 95% CI = 1.30-1.82; P = 0.004. Area under the curve for long-term mortality was 0.65 (95% CI = 0.61-0.69; P < 0.0001). RDW < 13.4 had a negative predictive value of 87.4% for all-cause mortality. Patients who had worse outcomes remained with higher values of RDW during the follow-up. In conclusion, high RDW is an independent predictor of long-term mortality and MACE in patients with STEMI undergoing primary PCI. A low RDW has an excellent negative predictive value for long-term mortality. Patients with sustained elevated levels of RDW have worse outcomes at long-term follow-up.

Admission Bedside Lung Ultrasound Reclassifies Mortality Prediction in Patients With ST-Segment-Elevation Myocardial Infarction.

BACKGROUND: Early risk stratification is essential for in-hospital management of ST-segment-elevation myocardial infarction. Acute heart failure confers a worse prognosis, and although lung ultrasound (LUS) is recommended as a first-line test to assess pulmonary congestion, it has never been tested in this setting. Our aim was to evaluate the prognostic ability of admission LUS in patients with ST-segment-elevation myocardial infarction. METHODS: LUS protocol consisted of 8 scanning zones and was performed before primary percutaneous coronary intervention by an operator blinded to Killip classification. A LUS combined with Killip (LUCK) classification was developed. Receiver operating characteristic and net reclassification improvement analyses were performed to compare LUCK and Killip classifications. RESULTS: We prospectively investigated 215 patients admitted with ST-segment-elevation myocardial infarction between April 2018 and June 2019. Absence of pulmonary congestion detected by LUS implied a negative predictive value for in-hospital mortality of 98.1% (93.1-99.5%). The area under the receiver operating characteristic curve of the LUCK classification for in-hospital mortality was 0.89 (P=0.001), and of the Killip classification was 0.86 (P<0.001; P=0.05 for the difference between curves). LUCK classification improved Killip ability to predict in-hospital mortality with a net reclassification improvement of 0.18. CONCLUSIONS: In a cohort of patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention, admission LUS added to Killip classification was more sensitive than physical examination to identify patients at risk for in-hospital mortality. LUCK classification had a greater area under the receiver operating characteristic curve and reclassified Killip classification in 18% of cases. Moreover, absence of pulmonary congestion on LUS provided an excellent negative predictive value for in-hospital mortality.

Randomized clinical trial comparing the efficacy and safety of ketamine and fentanyl for analgesia in pediatric orthopedic procedures / Ensaio clínico randomizado comparando a eficácia e a segurança da cetamina e do fentanil para analgesia em procedimentos ortopédicos pediátricos

ABSTRACT BACKGROUND AND OBJECTIVES: Bone fractures constitute a frequent cause of emergency care in the pediatric population. Opioid drugs are routinely used for analgesia during the hospitalization of children victims of trauma. Few studies have evaluated the importance of a multimodal approach to analgesia in this context. The aim of this study was to compare the analgesic effect and possible side effects of fentanyl compared to those of ketamine. METHODS: The study analyzed 50 children and adolescents, aged between 24 and 192 months, submitted to surgical treatment of upper limb fractures in a tertiary trauma care hospital. The participants were randomized into two groups: one that received Ketamine and the other Fentanyl. In the post-anesthetic recovery room (PARR), pain intensity and the occurrence of delirium were measured for a period of 30 minutes. The incidence of respiratory depression, nausea, vomiting and other side effects during the surgical procedure were assessed. RESULTS: The sample consisted mostly of male individuals (76.0%). The mean age of the participants was 90.1 months. The use of a low-flow oxygen cannula was necessary in 30.0% of the participants. The incidence of vomiting and laryngospasm was 2.0% among the participants, and 6.0% presented increased salivary secretion. The occurrence of pain, delirium and respiratory depression was not different between the two assessed groups, as well as the occurrence of nausea and laryngospasm. CONCLUSION: Ketamine is not an effective and safe option to opioids for analgesia in children undergoing surgical procedures to treat upper limb fractures.

RESUMO JUSTIFICATIVA E OBJETIVOS: As fraturas ósseas constituem causa frequente de atendimento de emergência na população pediátrica. Fármacos opioides são rotineiramente utilizados para analgesia durante a hospitalização de crianças vítimas de trauma. Poucos estudos avaliaram a importância de uma abordagem multimodal para analgesia nesse contexto. O objetivo deste estudo foi comparar o efeito analgésico e possíveis efeitos adversos do fentanil em relação aos da cetamina. MÉTODOS: Foram analisados 50 crianças e adolescentes, com idade entre 24 e 192 meses, submetidos ao tratamento cirúrgico das fraturas de membros superiores em um hospital terciário de atendimento ao trauma. Os participantes foram aleatorizados em dois grupos: um recebeu cetamina e outro fentanil. Na sala de recuperação pós-anestésica (SRPA), a intensidade da dor e a ocorrência de delirium foram mensuradas por um período de 30 minutos. A incidência de depressão respiratória, náuseas, vômitos e outros efeitos adversos durante o procedimento cirúrgico foram avaliados. RESULTADOS: A amostra foi composta, em sua maioria, por indivíduos do sexo masculino (76,0%). A média de idade dos participantes foi de 90,1 meses. O uso de cânula de oxigênio de baixo fluxo foi necessário em 30,0% dos participantes. A incidência de vômitos e laringoespasmo foi de 2,0% entre os participantes, sendo que 6,0% apresentaram aumento da secreção salivar. A ocorrência de dor, delirium e depressão respiratória não foi diferente entre os dois grupos avaliados, assim como a ocorrência de náuseas e laringoespasmo. CONCLUSAO: Acetamina não se mostrou uma opção eficaz e segura aos opioides para analgesia em crianças submetidas a procedimentos cirúrgicos para tratamento de fraturas de membros superiores.

Superdominant Circumflex Thrombosis With Occluded LAD and Absent RCA Ostium.

To our knowledge, this is the first report of primary percutaneous coronary intervention in a patient with a superdominant left circumflex artery, in which the entire right coronary artery myocardium territory is provided by the left circumflex. Coronary angiographic images of our 80-year-old male patient illustrate this anomaly. Single coronary arteries are among the most rare anatomic coronary anomalies, and the absence of right coronary artery ostium has been described as the rarest of these anomalies. Coronary events in such cases can be catastrophic due to the large amount of myocardium at risk.

Recommendations from the Brazilian Society of Anesthesiology (SBA) for difficult airway management in pediatric care

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics.

Valor prognóstico da amplitude de distribuição das hemácias em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronariana percutânea / Prognostic value of red cell distribution width in ST-segment elevation myocardium infarction patients undergoing percutaneous coronary intervention

Objetivo: Determinar os valores da amplitude de distribuição das hemácias em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronária percutânea primária e avaliar sua associação com resultados adversos. Métodos: Os níveis de amplitude de distribuição das hemácias foram medidos em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST antes da intervenção coronária percutânea primária e divididos conforme valor das amplitudes de distribuição das hemácias. Após a alta hospitalar, os pacientes foram acompanhados por até 3 anos para a ocorrência de eventos cardiovasculares adversos maiores e mortalidade a longo prazo. Resultados: Foram incluídos 893 pacientes com idade média de 60,7 (±12,5) anos, e 66,3% eram do sexo masculino. Na análise multivariada, a hemácia permaneceu como preditor independente de mortalidade a longo prazo. A área sob a curva para mortalidade a longo prazo foi de 0,64 (IC95% 0,61-0,67; p<0,0001). Amplitudes de distribuição das hemácias <13,3 tiveram valor preditivo negativo de 87,1% para mortalidade por todas as causas. Conclusão: Um valor elevado de amplitude de distribuição das hemácias é um preditor independente de mortalidade a longo prazo e eventos cardiovasculares adversos maiores em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronária percutânea primária. Amplitudes de distribuição das hemácias baixas têm baixo tem um excelente valor preditivo negativo para mortalidade a longo prazo. (AU)

Objective: To determine red cell distribution width values in ST-elevation acute myocardial infarction patients undergoing primary percutaneous coronary intervention and to evaluate its association with adverse outcomes. Methods: Red cell distribution width levels were measured in ST-segment elevation myocardial infarction patients before primary percutaneous coronary intervention and divided into low and high red cell distribution width. After discharge, patients were followed for up to 3 years for the occurrence of long-term major adverse cardiovascular events and mortality. Results: A total of 893 patientes were with a mean age of 60.7 (±12.5) years, 66.3% were male. In multivariate analysis, the red cell distribution width remained as an independent predictor of long-term mortality. The area under the curve for long-term mortality was 0.64 (95%CI0.61-0.67; p<0.0001). Red cell distribution width<13.3 had a negative predictive value of 87.1% for all-cause mortality. Conclusion: High number of red cell distribution width is an independent predictor of long-term mortality and major adverse cardiovascular events in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. A low number of red cell distribution width has an excellent negative predictive value for long-term mortality. Patients with sustained elevated levels of red cell distribution width have worse outcomes at long-term follow-up. (AU)

Label-Free Quantitative Proteomic Analysis of Puccinia psidii Uredospores Reveals Differences of Fungal Populations Infecting Eucalyptus and Guava.

Puccinia psidii sensu lato (s.l.) is the causal agent of eucalyptus and guava rust, but it also attacks a wide range of plant species from the myrtle family, resulting in a significant genetic and physiological variability among populations accessed from different hosts. The uredospores are crucial to P. psidii dissemination in the field. Although they are important for the fungal pathogenesis, their molecular characterization has been poorly studied. In this work, we report the first in-depth proteomic analysis of P. psidii s.l. uredospores from two contrasting populations: guava fruits (PpGuava) and eucalyptus leaves (PpEucalyptus). NanoUPLC-MSE was used to generate peptide spectra that were matched to the UniProt Puccinia genera sequences (UniProt database) resulting in the first proteomic analysis of the phytopathogenic fungus P. psidii. Three hundred and fourty proteins were detected and quantified using Label free proteomics. A significant number of unique proteins were found for each sample, others were significantly more or less abundant, according to the fungal populations. In PpGuava population, many proteins correlated with fungal virulence, such as malate dehydrogenase, proteossomes subunits, enolases and others were increased. On the other hand, PpEucalyptus proteins involved in biogenesis, protein folding and translocation were increased, supporting the physiological variability of the fungal populations according to their protein reservoirs and specific host interaction strategies.

A volta aos estudos dos alunos evadidos do ensino superior brasileiro / Regreso a los estudios de los alumnos evadidos de la educación superior brasileña / La reprise des cours des étudiants brésiliens decroches de l'université / The return to higher education of dropout students in brazil

Resumo O número de alunos no ensino superior brasileiro aumentou muito recentemente. Mas a evasão tem sido alta e objeto de estudo de diversos pesquisadores. Este trabalho analisa microdados do Censo da Educação Superior de 2009 a 2017 sobre a volta aos estudos dos alunos que se evadiram do ensino superior. Os resultados mostram que grande parte dos alunos que se desvincularam voltou para o ensino superior posteriormente, e, apesar de não voltarem para cursos da mesma instituição, a maior parte volta para cursos na mesma área do curso originalmente evadido. Além disso, os cursos da área de Comércio e Administração são um destino importante dos alunos que se desvincularam de cursos superiores, independentemente da área de origem.

Resumen El número de alumnos en la educación superior brasileña aumentó muy recientemente. Sin embargo, la evasión viene siendo elevada y es objeto de estudio de diversos investigadores. Este trabajo analiza microdatos del Censo de la Educación Superior de 2009 a 2017 sobre el regreso a los estudios de los alumnos que se evadieron de la educación superior. Los resultados muestran que una gran parte de los alumnos que se desvincularon volvió posteriormente a la educación superior y, a pesar de que no regresaron a cursos de la misma institución, la mayor parte volvió a cursos de la misma área del curso originalmente evadido. Por otra parte, los cursos del área de Comercio y Administración son un destino importante de los alumnos que se desvincularon de cursos superiores, independientemente del área de origen.

Résumé Le nombre d'étudiants dans l'enseignement supérieur a beaucoup augumenté ces derniers temps. Pourtant l'abandon est élevé et l'objet d'étude de différents chercheurs. Ce travail analyse des microdonnées du Recensement de l'Enseignement Supérieur (Censo da Educação Superior) de 2009 à 2017 sur la reprise des cours par des étudiants ayant abandonné l'enseignement supérieur. Les résultats montrent qu'une grande partie des étudiants qui avait décroché est retournée ultérieurement á l'université, et bien qu'ils n'aient pas repris les cours dans la même institution, la plupart reprend leurs études dans le même domaine. Par ailleurs, les cours supérieurs de commerce et administration sont une destination importante des étudiants décrochés de l'université indépendamment du domaine d'origine.

Abstract The number of students in Brazilian higher education has increased dramatically in the recent period. However, evasion has been high and object of study by several researchers. This work brings a new look at the problem, analyzing the return of students who have dropped out from higher education with the microdata of the Higher Education Census from 2009 to 2017. The results show that a large part of the students who dropped out of higher education later returned to higher education and, although they did not return to programs from the same higher education institution, most of them returned to the same area of the originally dropped out program. In addition, programs in the area of Business and Administration are an important destination when students who have dropped out from higher education return, regardless of their area of origin.