Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters

ABSTRACT Objective: The risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy (FNAB) of thyroid nodules (TN) with diameters ≥ 3-4 cm remains controversial. However, some groups have indicated surgical treatment in these patients regardless of the FNAB results. We aimed to evaluate the diagnostic accuracy of the FNAB in systematically resected ≥4 cm TN and if the risk of malignancy is higher in these patients. Subjects and methods: We retrospectively evaluated 138 patients (142 nodules) with TN with diameters ≥4 cm who underwent thyroidectomy. Results: The FNAB results were nondiagnostic/unsatisfactory (ND/UNS) in 2.1% of the cases and benign in 51.4%. They indicated atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) in 23.9% of cases, follicular neoplasia/suspicious for a follicular neoplasm (FN/SFN) in 9.2%, suspicion of malignancy (SUS) in 8.5%, and malignant in 4.9%. The histopathological analysis after thyroidectomy revealed a thyroid cancer rate of 100% in the FNABs classified as malignant, 33.3% in SUS cases, 7.7% in FN/SFN, 17.6% in AUS/FLUS, and 4.1% in benign FNABs. None of the ND/UNS FNABs were malignant. The global malignancy diagnosis was 14.8% (n = 21). However, the rate of false negatives for FNAB was low (4.1%). Conclusion: We showed that the risk of malignancy in nodules with diameters ≥4 cm was higher compared to the risk of thyroid cancer in TN in general. However, we found a low rate of false-negative cytological results; therefore, our data do not justify the orientation of routine resection for these larger nodules.

Comparative study of the levonorgestrel intrauterine system and laparoscopic hysterectomy for the treatment of heavy menstrual bleeding in enlarged uteri

ABSTRACT Objective To evaluate the effectiveness of the levonorgestrel intrauterine system in the treatment of patients with heavy menstrual bleeding and an enlarged uterus and to compare satisfaction and its complications with hysterectomy. Methods This was a comparative cross-sectional observational study of women with heavy menstrual bleeding and an enlarged uterus. Sixty-two women were treated and followed up for four years. Insertion of the levonorgestrel intrauterine system was performed in Group 1, and laparoscopic hysterectomy was performed in Group 2. Results In Group 1 (n=31), 21 patients (67.7%) showed improvement in the bleeding pattern, and 11 patients (35.5%) had amenorrhea. Five patients (16.1%) remained with heavy bleeding and were considered to have experienced treatment failure. There were seven expulsions (22.6%); in five patients, bleeding remained heavy, but in two patients the bleeding returned to that of normal menstruation. No relationship was found between treatment failure and greater hysterometries (p=0.40) or greater uterine volumes (p=0.50), whereas expulsion was greater in uteri with smaller hysterometries (p=0.04). There were 13 (21%) complications, seven (53.8%) in the group that underwent insertion of the levonorgestrel intrauterine system (all were device expulsions), and six (46.2%) in the surgical group, which were the most severe ones (p=0.76). Regarding satisfaction, 12 patients (38.7%) were dissatisfied with the levonorgestrel intrauterine system and one (3.23%) was dissatisfied with the surgical treatment (p=0.00). Conclusion Treatment with the levonorgestrel intrauterine system in patients with heavy menstrual bleeding and an enlarged uterus was effective, and when compared with laparoscopic hysterectomy, it had a lower rate of satisfaction and the same rate of complications, although less severe.

Ventilador mecânico invasivo de emergência resistente e de fácil manutenção / Robust, maintainable, emergency invasive mechanical ventilator

RESUMO Objetivo: Desenvolver um ventilador mecânico invasivo simples, resistente, seguro e eficiente que possa ser utilizado em áreas remotas do mundo ou zonas de guerra, em que a utilidade prática de equipamentos mais sofisticados é limitada por questões de manutenção, disponibilidade de peças, transporte e/ou custo. Métodos: O dispositivo implementa o modo de ventilação mandatória contínua com pressão controlada, complementado por um simples modo assisto-controlado. Pode-se também utilizar a pressão positiva contínua nas vias aéreas. Ao se evitar o fluxo contínuo de oxigênio ou ar, minimiza-se o consumo de gases comprimidos. As taxas respiratórias e as relações de tempo de inspiração e expiração são determinadas eletronicamente. Além disso, conta com um alarme de apneia/falta de energia. Resultados: Os perfis de pressão foram medidos para uma série de condições, sendo considerados ajustáveis dentro de uma margem de erro de ± 2,5cmH2O, e foram considerados bem estáveis dentro dessa variação durante um período de 41 horas. Os parâmetros de tempo do ciclo respiratório foram precisos dentro de alguns pontos percentuais durante o mesmo período. O dispositivo foi testado quanto à durabilidade por um período equivalente a 4 meses. Os testes químicos e biológicos não conseguiram identificar qualquer contaminação do gás por compostos orgânicos voláteis ou micro-organismos. Em comparação com um ventilador bem estabelecido, o teste de ventilação em um animal de grande porte mostrou que este poderia ser ventilado adequadamente durante um período de 60 minutos, sem quaisquer efeitos negativos perceptíveis durante o período subsequente de 24 horas. Conclusão: Este projeto de ventilador pode ser viável após novos testes em animais e aprovação formal pelas autoridades competentes, para aplicação clínica nas circunstâncias atípicas anteriormente mencionadas.

ABSTRACT Objective: To develop a simple, robust, safe and efficient invasive mechanical ventilator that can be used in remote areas of the world or war zones where the practical utility of more sophisticated equipment is limited by considerations of maintainability, availability of parts, transportation and/or cost. Methods: The device implements the pressure-controlled continuous mandatory ventilation mode, complemented by a simple assist-control mode. Continuous positive airway pressure is also possible. The consumption of compressed gases is minimized by avoiding a continuous flow of oxygen or air. Respiratory rates and inspiration/expiration time ratios are electronically determined, and an apnea/power loss alarm is provided. Results: The pressure profiles were measured for a range of conditions and found to be adjustable within a ± 2.5cmH2O error margin and stable well within this range over a 41-hour period. Respiratory cycle timing parameters were precise within a few percentage points over the same period. The device was tested for durability for an equivalent period of four months. Chemical and biological tests failed to identify any contamination of the gas by volatile organic compounds or microorganisms. A ventilation test on a large animal, in comparison with a well established ventilator, showed that the animal could be adequately ventilated over a period of 60 minutes, without any noticeable negative aftereffects during the subsequent 24-hour period. Conclusion: This ventilator design may be viable, after further animal tests and formal approval by the competent authorities, for clinical application in the abovementioned atypical circumstances.

Fantastic Lifestyle Questionnaire applied to undergraduate medical students during the COVID-19 pandemic: a factor analysis

SUMMARY OBJECTIVE: To identify what structure represents life style in medical students, in a public university, with the application of the Fantastic Lifestyle Questionnaire. METHODS: This is a cross-sectional exploratory study. The Fantastic Lifestyle Questionnaire was applied online to medical students. Factorial analysis was realized and factors were extracted by principal components method. Rotation was conducted by Varimax method. RESULTS: Sixty-one questionnaires were analyzed. Students were male in 45.9%, single in 88.5%. The model was composed of three factors that explained 63.5% of all observed variance. The factors related to sleep perception, nutrition and stress, followed by relationships and entertainment and then, activity. Cronbach's alpha was 0.81, which was considered good. CONCLUSION: The model composed by the three factors observed in this group of students represented the construct quality of life, evaluated by the Fantastic Lifestyle Questionnaire. This result may provide substrate to actions that aim to improve quality of life and well-being in medical students from this university.

The impact of the genetic background in a patient with papillary thyroid cancer and familial adenomatous polyposis

SUMMARY Thyroid cancer is the most common endocrine malignancy, and papillary thyroid carcinoma (PTC) is the main subtype. The cribriform morular variant is a histological phenotype of PTC characterized by its relationship with familial adenomatous polyposis (FAP). Description of the case: We report the genetic assessment of a 20-year-old female patient diagnosed with a cribriform-morular variant of PTC and FAP. We aimed to assess the genetic background of the reported patient, looking for variants that would help us explain the predisposition to tumorigenesis. Genomic DNA was extracted from peripheral blood lymphocytes, and whole exome sequencing was performed. We applied an overrepresentation and gene-set enrichment analysis to look for an accumulation of effects of variants in multiple genes at the genome. We found an overrepresentation of single nucleotide variants (SNVs) in extracellular matrix interactions and cell adhesion genes. Underrepresentation of SNVs in genes related to the regulation of autophagy and cell cycle control was also observed. We hypothesize that the package of alterations of our patient may help to explain why she presented colonic manifestations and thyroid cancer. Our findings suggest that multiple variants with minor impact, when considered together, may be helpful to characterize one particular clinical condition.

Abdominal obesity-related risk factors in children from public schools of Barbacena, Minas Gerais, Brazil / Fatores associados à obesidade abdominal em crianças matriculadas na rede pública de ensino, Barbacena, Minas Gerais

ABSTRACT Objective: To evaluate the sociodemographic and lifestyle factors associated with abdominal obesity in children from public schools in Barbacena, state of Minas Gerais, Brazil. Methods: This is a cross-sectional study conducted on 326 students aged 7 to 9 years from public schools in the urban area of the city. Anthropometric data included body weight, height, body mass index according to age, waist circumference, and waist-to-height ratio. Food consumption was evaluated using the Previous Day Food Questionnaire. Abdominal obesity was assessed based on waist circumference and waist-to-height ratio. The bivariate and multivariate analyses were performed by logistic regression, estimating the crude and adjusted odds ratio (OR), with 95% confidence interval. Results: The prevalence of overweight was 30.7%; whereas the prevalence of abdominal obesity was 9.2 and 12.6% according to waist circumference and waist-to-height ratio, respectively. Boys (OR 2.76; 95%CI 1.22-6.25) and children from central schools (OR 2.73; 95%CI 1.08-6.80) presented an increased chance of abdominal obesity according to waist circumference. Abdominal obesity according to waist-to-height ratio was associated with the central location of the schools (OR 2.18; 95%CI 1.02-4.63) and the habit of skipping supper (OR 2.01; 95%CI 1.00-4.09). Conclusions: The findings showed that being a boy, studying in a central school, and skipping supper were the main risk factors associated with abdominal obesity.

RESUMO Objetivo: Avaliar os fatores sociodemográficos e de estilo de vida associados à obesidade abdominal em crianças de escolas públicas de Barbacena, Minas Gerais. Métodos: Trata-se de estudo transversal realizado com 326 escolares de sete a nove anos, matriculados em escolas da zona urbana da cidade. As variáveis antropométricas avaliadas foram peso, estatura, índice de massa corpórea por idade, circunferência da cintura e relação cintura-estatura. O consumo alimentar foi registrado pelo Questionário Alimentar do Dia Anterior. A obesidade abdominal foi avaliada com base na circunferência da cintura e relação cintura-estatura. As análises bivariada e multivariada foram realizadas por meio de regressão logística, estimando-se a Odds Ratio (OR) bruta e ajustada, com os intervalos de confiança de 95% (IC95%). Resultados: A prevalência de excesso de peso foi de 30,7%, enquanto a prevalência de obesidade abdominal foi de 9,2 e 12,6%, de acordo com circunferência da cintura e relação cintura-estatura, respectivamente. Crianças do sexo masculino (OR 2,76; IC95% 1,22-6,25) e de escolas centrais (OR 2,73; IC95% 1,08-6,80) tiveram maior chance de apresentar obesidade abdominal segundo a circunferência da cintura. A obesidade abdominal, de acordo com a relação cintura-estatura, associou-se à localização central das escolas (OR 2,18; IC95% 1,02-4,63) e à omissão da ceia (OR 2,01; IC95% 1,00-4,09). Conclusões: Os achados mostraram que ser do sexo masculino, estudar em escola central e omitir a ceia foram os principais fatores de risco associados à obesidade abdominal.

Estilo de vida e qualidade do sono de estudantes de medicina em uma universidade pública, durante a pandemia da COVID-19: um estudo transversal / Life style and quality of sleep in medical students of a public university, during the COVID-19 pandemic: a cross-sectional study

Introdução: A graduação em medicina pode comprometer a qualidade do sono e a qualidade de vida. Objetivo: Avaliar o estilo de vida e a qualidade do sono entre estudantes de medicina. Métodos: Trata-se de estudo do tipo survey online transversal. Foram convidados os 200 estudantes de medicina de uma universidade pública de São Paulo, que cursavam regularmente, dos quais 61 (30,5%) responderam ao questionário. A coleta foi realizada durante a pandemia da COVID-19, no período de novembro de 2020 a março de 2021. O critério de exclusão foi o preenchimento incorreto do questionário. Foram aplicados o Índice de Qualidade do Sono de Pittsburg (PSQI) e a Fantastic Life Questionnaire (FLQ). Diferenças entre mais de duas medianas foram calculadas pela ANOVA de Kruskal-Wallis. A associação entre o estilo de vida e a qualidade do sono foi calculada pela correlação de Spearman. Foi considerado o valor de p<0,05. Resultados: A mediana do PSQI foi 6 (ruim) e do FLQ foi 55 (bom). A medida em que o estilo de vida piorou, a qualidade do sono piorou (p=0,005). Foi observada correlação entre a piora do estilo de vida e a piora da qualidade do sono (p<0.001). Conclusão: Foi observado que a maioria dos estudantes desta universidade apresentavam estilo de vida bom ou regular, qualidade do sono ruim e à medida que a qualidade do sono piorou a qualidade de vida também piorou. Este estudo foi conduzido durante a pandemia da COVID-19 e seus resultados podem ter sido influenciados por isto. [au]

Introduction: The academic life of medical students may compromise sleep quality and quality of life. Objective:To evaluate lifestyle and sleep quality in medical students. Methods: This is an online cross-sectional survey study. Two-hundred attending medical students of a public university in São Paulo were invited to participate and 61(30.5%) answered the questionnaire. Sampling occured during the COVID-19, between november 2020 and march 2021. Exclusion criteria was incorrect filling of the questionnaire. The Pittsburg Sleep Quality Index (PSQI) and the Fantastic Life Questionnaire (FLQ) were applied. Differences between more than two medians were calculated by Kruskal-Wallis ANOVA. The association between life style and sleep quality was calculated by Spearman correlation. A p value <0.05 was considered. Results: PSQI median was 6 (poor) and FLQ was 55 (good). As life style worsened, sleep quality also worsened (p=0.005). A correlation between a worse life style and a worse sleep quality was observed (p<0.001). Conclusion:It was observed that most medical students had a good or regular life style and a poor sleep quality. As long as sleep quality worsened, life style worsened. This study was conducted during the COVID-19 pandemic and its results may have been influenced by this. [au]

Síndrome da encefalopatia posterior reversível em paciente com COVID-19 submetida à oxigenação por membrana extracorpórea / Posterior reversible encephalopathy syndrome in a patient submitted to extracorporeal membrane oxygenation for COVID-19

RESUMO Uma mulher com 63 anos de idade compareceu ao pronto-socorro com história aguda de febre, prostração e dispneia. Recebeu diagnóstico de quadro grave da COVID-19 e síndrome do desconforto respiratório agudo. Apesar de suporte clínico intensivo, cumpriu os critérios para ser submetida à oxigenação venovenosa por membrana extracorpórea. No dia 34, após 7 dias de desmame da sedação com evolução positiva de seu quadro neurológico, apresentou uma crise tônico-clônica generalizada limitada, não relacionada com desequilíbrio hidroeletrolítico ou metabólico, que levou à necessidade de investigação diagnóstica. Seus exames de imagem cerebral revelaram síndrome da encefalopatia posterior reversível. Este caso enfatiza a questão das complicações neurológicas em pacientes com COVID-19 grave e a importância do diagnóstico e suporte precoces.

ABSTRACT A 63-year-old woman presented to the emergency department with an acute history of fever, prostration and dyspnea. She was diagnosed with severe COVID-19 acute respiratory distress syndrome and, despite optimized critical care support, met the indications for veno-venous extracorporeal membrane oxygenation. On day 34, after 7 days of wean sedation with a positive evolution of neurologic status, she presented a limited generalized tonic-clonic seizure not related to hydroelectrolytic or metabolic imbalance, which led to a diagnostic investigation; her brain imaging tests showed a posterior reversible encephalopathy syndrome. This case emphasizes the issue of neurological complications in patients with severe COVID-19 infection and the importance of early diagnosis and support.

Nanofat injector: dispositivo descartável de baixo custo para padronização e otimização do tempo de enxertia / Nanofat injector: a low-cost disposable device for standardization and optimization of grafting time

Introdução: O enxerto de gordura nano melhora a qualidade da pele nos danos secundários ao envelhecimento e nas sequelas cicatriciais. Apresentamos resultados iniciais do enxerto de gordura nano com o uso de um dispositivo descartável de baixo custo propondo uma padronização da sua utilização conforme a área a ser tratada. Métodos: Foi realizada uma coorte prospectiva de julho de 2019 a março de 2020. O critério de inclusão foi pacientes que realizaram enxerto de gordura nano para tratamento da pele. Já o critério de exclusão foi a realização prévia de algum tratamento invasivo da pele. Foram analisadas 20 pacientes consecutivas que preencheram os pré-requisitos. Os resultados foram avaliados no 6º mês de pós-operatório. As pacientes responderam um questionário, classificando de 1 - muito ruim a 10 - excelente, as alterações na qualidade da pele. Resultados: As vinte pacientes acompanhadas não apresentaram nenhuma complicação pós-operatória. O edema após aplicação reduziu entre três e sete dias. Não houve hematoma nem infecção. As pacientes que realizaram somente enxerto de gordura nano, sem outra cirurgia associada, conseguiram voltar às suas atividades após 24 horas. Os escores relatados pelas pacientes com 6 meses foram entre 7 e 10, com média de 8. Conclusão: A utilização do sistema Smartneedle™ para a enxertia de gordura nano apresenta resultados na satisfação das pacientes semelhante aos outros métodos de aplicação e permite uma distribuição uniforme e padronizada do enxerto conforme a região anatômica, além de otimizar o tempo cirúrgico.

Introduction: Nanofat graft improves skin quality in damage secondary to aging and scar sequelae. We present the initial results of the nanofat graft using a low-cost disposable device, proposing a standardization of its use according to the area to be treated. Methods: A prospective cohort was conducted from July 2019 to March 2020. The inclusion criterion was patients who underwent nanofat grafting for skin treatment. The exclusion criterion was the previous performance of some invasive treatment of the skin. Twenty consecutive patients who met the prerequisites were analyzed. The results were evaluated in the 6th postoperative month. The patients answered a questionnaire, classifying from 1 - very bad to 10 - excellent, changes in skin quality. Results: The twenty patients followed did not present any postoperative complications. Edema after the application was reduced between three and seven days. There was no hematoma or infection. Patients who underwent only nanofat grafting without another associated surgery could return to their activities after 24 hours. The scores reported by patients at 6 months were between 7 and 10, with a mean of 8. Conclusion: The use of the Smartneedle™ system for nanofat grafting presents patient satisfaction similar to other application methods and allows a uniform and standardized distribution of the graft according to the anatomical region and optimizing surgical time

Management of thyroid disorders during the COVID-19 outbreak: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)

ABSTRACT This position statement was prepared to guide endocrinologists on the best approach to managing thyroid disorders during the coronavirus disease (COVID-19) pandemic. The most frequent thyroid hormonal findings in patients with COVID-19, particularly in individuals with severe disease, are similar to those present in the non-thyroidal illness syndrome and require no intervention. Subacute thyroiditis has also been reported during COVID-19 infection. Diagnosis and treatment of hypothyroidism during the COVID-19 pandemic may follow usual practice; however, should avoid frequent laboratory tests in patients with previous controlled disease. Well-controlled hypo and hyperthyroidism are not associated with an increased risk of COVID-19 infection or severity. Newly diagnosed hyperthyroidism during the pandemic should be preferably treated with antithyroid drugs (ATDs), bearing in mind the possibility of rare side effects with these medications, particularly agranulocytosis, which requires immediate intervention. Definitive treatment of hyperthyroidism (radioiodine therapy or surgery) may be considered in those cases that protective protocols can be followed to avoid COVID-19 contamination or once the pandemic is over. In patients with moderate Graves' ophthalmopathy (GO) not at risk of visual loss, glucocorticoids at immunosuppressive doses should be avoided, while in those with severe GO without COVID-19 and at risk of vision loss, intravenous glucocorticoid is the therapeutic choice. Considering that most of the thyroid cancer cases are low risk and associated with an excellent prognosis, surgical procedures could and should be postponed safely during the pandemic period. Additionally, when indicated, radioiodine therapy could also be safely postponed as long as it is possible.

Anatomia e etiologia do ombro doloroso / Painful shoulder anatomy and etiology

O ombro doloroso tem etiologia multifatorial, e suas causas são traumas, instabilidades ou lesões degenerativas. Podem ser classificadas como intra-articulares, extra-articulares ou à distância. O objetivo deste estudo foi descrever a anatomia do ombro nas principais doenças, baseado em revisão bibliográfica da literatura recente e de livros-texto de anatomia. Em conclusão, o conhecimento da anatomia é fundamental para compreensão das várias doenças que afetam o ombro doloroso para seu correto diagnóstico e tratamento.

The painful shoulder has a multifactorial etiology, and its causes are trauma, instability or degenerative lesions. They can be classified as intra-articular, extraarticular or at a distance. The aim of this study was to describe the anatomy of the shoulder in major diseases, based on review of recent literature and anatomy textbooks. In conclusion, knowledge of anatomy is essential for understanding the various diseases that affect the painful shoulder for its correct diagnosis and treatment.

Avaliação da contaminação de nitrato e Escherichia coli em água subterrânea no município de Carapicuiba (SP) / Evaluation of nitrate and Escherichia coli contamination on groundwater in the city of Carapicuiba (SP)

Objetivo ­ Verificar a concentração de nitrato e a presença ou ausência de bactérias da espécie Escherichia coli em amostras de água subterrânea (poços) destinadas ao consumo humano e comparar os resultados aos Valores Máximos Permitidos (VMP) pela Portaria 2.914 do Ministério da Saúde. Métodos ­ Durante um ano (2017-2018), semestralmente, foram coletadas amostras de águasconsumidas por moradores em diferentes pontos: poços 1 e 2, ambos sem tratamento e com o auxílio de amostradores descartáveis do tipo bailer e; torneiras, denominados S1 e S2, água tratada pela Companhia de Saneamento Básico do Estado de São Paulo (SABESP) e destinadas ao abastecimento público. Esses últimos como grupo controle, pois não foram identificados poços de monitoramento ou nascentes próximas sem contaminação. As amostras em frascos apropriados foram preservadas em caixas térmicas (± 4°C) e encaminhadas para análise química e microbiológica, seguindo os protocolos de coletas da CETESB e USEPA e os métodos 4500-NO3-B e 9215c da APHA. As análises físico-químicas, tais como pH, OD, temperatura, cloro livre, condutividade elétrica e profundidade foram realizadas em campo com equipamentos, tais como multiparâmetro da marca Hanna Hi 9828 e outros. Resultados ­ Verificou-se que as águas subterrâneas são de natureza rasas (poços com profundidade < 20 m) e suas águas ligeiramente ácida (pH=5,0). Em ambos os poços houve a presença de bactérias E. coli e elevada concentração do íon nitrato (>18 mg/L) no período seco e chuvoso, estando em não conformidade ao VMP dado pela Portaria 2.914. As amostras S1 e S2 apresentaram ausência de E.coli e valores abaixo de 0,5 mg/L de N-NO-3. informação dos parâmetros de qualidade nos rótulos. O levantamento de alguns rótulos, mostrou que em cinco marcas de água envasadas, três delas estão não conforme a VMP ora citada (NO-3-N > 10 mg/L). Conclusão ­ O presente estudo demonstrou que para fins de potabilidade a água dos poços está imprópria para o consumo humano

Objective ­ To verify nitrate concentration, the presence or absence of Escherichia coli bacterium in groundwater samples (wells) intended for human consumption, and to compare the results to Maximum Permitted Values (MPV) by Portaria 2.914 of the Ministry of Health. Methods ­ During one year (2017-2018), samples of water consumed by residents at different points were taken every semester: wells 1 and 2, both without treatment and with the aid of disposable samplers of the bailer type; taps, called S1 and S2, water treated by the Basic Sanitation Company of the State of São Paulo (SABESP) and intended for public supply. The latter as a control group because no monitoring wells or nearby springs were identified without contamination. The samples in appropriate flasks were preserved in thermal boxes (± 4°C) and sent for chemical and microbiological analysis, following CETESB and USEPA collection protocols and APHA methods 4500-NO3-B and 9215c. Physical-chemical analyzes, such as pH, OD, temperature, free chlorine, electrical conductivity and depth were performed in the field with equipment such as multi-parameter, Hanna brand and others. Results ­ Groundwaters were found to be shallow (wells with depth <20 m) and their waters slightly acidic (pH = 5.0). In both wells, the presence of E. coli bacteria and high concentration of nitrate ion (> 18 mg / L) in the dry and rainy season were observed, being in non-compliance with the MPV given by Portaria 2.914. Samples S1 and S2 showed absence of E.coli and values below 0.5 mg / L of N-NO-3. Information on the quality parameters on the labels. The survey of some labels showed that in five bottled watermarks, three of them are contaminated by nitrate according to the MPV (NO-3-N> 10 mg / L). Conclusion ­ The present study demonstrates that drinking water from wells is unfit for human consumption.

Restless Legs Syndrome, and symptoms of Restless Syndrome in patients with Graves disease: a cross-sectional survey

OBJECTIVES: Restless legs syndrome (RLS) is a frequent comorbid condition associated with distinct unrelated diseases. While the incidence of RLS has not been definitively confirmed, RLS-like symptoms have been reported in a section of Asian population who also had hyperthyroidism. The prevalence of RLS is generally low in Asian populations. Under these circumstances, we hypothesized that in a population where RLS is common, such as in Brazil, RLS could manifest as a comorbid ailment alongside Graves' disease, a common hyperthyroid condition. METHODS: In a cross-sectional survey, 108 patients who presented with Graves' disease were analyzed for restless legs or associated symptoms. RESULTS: Twelve patients (11.1%) displayed symptoms of RLS prior to the incidence of Graves' disease. These patients experienced worsening of the symptoms during their hyperthyroid state. Six patients (5.6%) developed RLS, consequent upon the incidence of Graves' disease as per the consensus of the panel of the experts. Fifteen patients (13.9%) also presented with RLS-like symptoms without any discernible circadian feature of the syndrome. CONCLUSION: Our findings confirm that Graves' disease might trigger restless legs-like symptoms, while the condition of hyperthyroidism could also be complicated by definite RLS.

Envelhecimento Ativo em Questão - Reflexões a partir de uma Oficina de Teatro com Pessoas Idosas / Active Aging in Question - Reflections from a Theater Workshop with Older People / Envejecimiento Activo en Questión: Reflexiones de un Taller de Teatro con Personas Mayores

O conceito de Envelhecimento Ativo, preconizado pela Organização Mundial de Saúde e propagado pelos discursos midiáticos e acadêmicos, carrega certa subjetividade sobre o envelhecer que, a nosso ver, precisa ser reavaliado. Com prescrições sobre o que seria um envelhecimento bem-sucedido, idealiza-se a pessoa idosa-modelo e descarta-se o dissenso e as singularidades. Neste trabalho, apresentamos uma vivência de teatro voltada a pessoas de mais idade, que pretende contribuir com reflexões acerca deste conceito e sugerir formas originais de pensar e viver a velhice.

The concept of Active Aging, advocated by the World Health Organization and propagated by media and academic discourses, carries a certain subjectivity about aging that, in our view, needs to be reevaluated. With prescriptions on what would be a successful aging, idealize the elderly model and discard dissent and singularities. In this paper, we present a theater experience aimed at older people who want to contribute reflections on this concept and suggest original ways of thinking and living old age.

El concepto de Envejecimiento Activo, defendido por la Organización Mundial de la Salud y propagado por los medios de comunicación y los discursos académicos, conlleva una cierta subjetividad sobre el envejecimiento que, en nuestra opinión, debe ser reevaluada. Con recetas sobre lo que sería un envejecimiento exitoso, idealice el modelo de ancianos y descarte la disidencia y las singularidades. En este artículo, presentamos una experiencia teatral dirigida a personas mayores que desean aportar reflexiones sobre este concepto y sugerir formas originales de pensar y vivir la vejez.

Associação entre práticas de atividade física e desempenho acadêmico de estudantes chilenos do ensino fundamental e médio / Association between physical activity practices and academic performance of Chilean elementary and middle school students / Asociación entre prácticas de actividades físicas y rendimiento académico de estudiantes chilenos de educación primaria y secundaria

Resumo O objetivo do estudo foi analisar a associação entre a prática de atividade física e o desempenho acadêmico (DA) de estudantes do ensino fundamental e médio da cidade de Talca, Chile. Foram avaliados 2.094 (52,1% sexo feminino) crianças e adolescentes de ambos os sexos, de 12 a 19 anos (média de 16,1 ±1,7 anos). A prática de atividade física foi mensurada por questionário e o DA por meios das notas finais do 7° ano do ensino fundamental ao 4° ano do ensino médio nas disciplinas de matemática, biologia, educação física, inglês e castelhano. A regressão linear foi feita para avaliar a relação entre a prática de atividade física e o desempenho acadêmico. Os resultados mostram que a frequência nas disciplinas foi de 90%. A média das notas nas disciplinas foi acima de 4 (suficiente para passar de ano). Os escolares do sexo feminino apresentaram notas mais altas em biologia 5,80 ± 0,61, p = 0,001, inglês 5,88 ± 0,65, p = 0,01 e castelhano 5,91 ± 0,57, p < 0,001. Mais de 75% da amostra relataram fazer atividade física pelo menos três vezes na semana. Quando visualizamos o escore total de prática de atividade física, os estudantes eram estatisticamente mais ativos, 26,40 ± 6,12 p = 0,001, do que as estudantes, 25,54 ± 5,97, e quando associamos com desempenho acadêmico nas disciplinas citadas anteriormente, encontramos associação positiva com a disciplina de matemática no sexo masculino. [F(6; 857) = 8,180, p = 0,039; t(857) = 2,068, p = 0,039]. Os resultados da regressão linear revelaram associação entre o score total de atividade física (25,96 ± 6,06) e desempenho acadêmico na disciplina de matemática apenas no sexo masculino β= 0,07, estatisticamente significante p = 0,039. Conclui‐se que estudantes do sexo masculinos com maior score de atividade física têm melhor desempenho acadêmico na disciplina de matemática, mas não em biologia, educação física, inglês e castelhano.

Abstract The present study sought to analyze the associations of physical activity and academic achievement of middle school students from the city of Talca, Chile. A total of 2,094 (52,1% female) children and adolescents, boys and girls from 12 to 19 years old, participated in the study. The physical activity was measured by questionnaire. Data on students' academic achievement was obtained through consulting the school official documents about the final year grades in Mathematics, Biology, Physical Education, English and Spanish. A linear regression analysis was performed to evaluate the associations of physical activity and academic achievement. The results show that the students' attendance across subjects was 90%. The mean of all subjects was above 4 (enough to have success and to move on for the next school year). Girls had the higher grades in biology 5,80 ± 0,61, p = 0.001, English 5,88 ± 0,65, p = 0.01 e Spanish 5,91 ± 0,57, p < 0.001. More that 75% of the sample mentioned to practice physical activity at least three times per week. Boys were significantly more active than girls (26,40 ± 6,12 and 25,54 ± 5,97 p = 0.001). Among boys, physical activity was positively associated with their mathematics grades [F(6; 857) = 8,180, p = 0.039; t(857) = 2,068, p = 0.039]. The linear regression results only revealed a significant association between the physical activity score (25,96 ± 6,06) and mathematics grades for boys (β= 0,07; p = 0,039). These study results lead to the conclusion that boys with a higher physical activity score had a better academic achievement in mathematics, but not in biology, physical education, English and Spanish.

Resumen El objetivo de este estudio fue analizar la asociación entre la práctica de actividad física y el rendimiento académico (RA) de estudiantes de enseñanza básica y media de la ciudad de Talca, Chile. Se evaluó a 2.094 niños y adolescentes de ambos sexos (el 52,1% de sexo femenino), de 12 a 19 años (media de edad de 16,1 ± 1,7). La práctica de actividad física fue medida por un cuestionario y el RA por medio de las notas finales desde el 7.° año de enseñanza básica hasta el 4.° año de enseñanza media en las asignaturas de matemáticas, biología, educación física, inglés y castellano. Se llevó a cabo la regresión lineal para evaluar la relación entre la práctica de actividad física y el rendimiento académico. Los resultados muestran que la frecuencia en las asignaturas fue del 90%. El promedio de las notas en las asignaturas fue sobre 4 (suficiente para ser promovido). Los escolares del sexo femenino presentaron notas más altas en biología (5,80 ± 0,61; p = 0,001), inglés (5,88 ± 0,65; p = 0,001) y castellano (5,91 ± 0,57; p < 0,001). Más del 75% de la muestra realizaba alguna actividad física, por lo menos, 3 veces a la semana. Cuando visualizamos la puntuación total de la práctica de actividad física, los estudiantes del sexo masculino eran estadísticamente más activos (26,40 ± 6,12; p = 0,001) que las estudiantes del sexo femenino (25,54 ± 5,97) y, cuando asociamos el rendimiento académico con las asignaturas citadas anteriormente, encontramos asociación positiva con la asignatura de matemáticas en el sexo masculino [F(6; 857) = 8,180; p = 0,039; t(857) = 2,068; p = 0,039]. Los resultados de la regresión lineal revelaron asociación entre la puntuación total de actividad física (25,96 ± 6,06) y rendimiento académico en la asignatura de matemáticas apenas en el sexo masculino (β = 0,07), estadísticamente significativo (p = 0,039). La conclusión es que los estudiantes del sexo masculino con mayor puntuación de actividad física poseen mejor rendimiento académico en la asignatura de matemáticas pero no en biología, educación física, inglés y castellano.

Sanitary and physiological quality of 'purple' corn (Zea mays L. ) seeds submitted to thermotherapy / Qualidade sanitária e fisiológica de sementes de milho 'Roxo' (Zea mays L. ) submetidas à termoterapia

The use of seeds with good sanitary and physiological potential ensures the establishment of the crop, with a uniform, vigorous and disease-free seedling stand, which will result in good productivity levels. Seen that, the objective was to evaluate the sanitary and physiological quality of purple corn seeds (Zea mays L.) submitted to thermotherapy. They were subjected to heat treatment with immersion in sterile distilled water (SDW) heated at 50, 60 and 70 °C for 1, 2, and 3 minutes. The control (0 min) correspondens only to immersing the seeds in SDW, which were submitted to sanitary and germination tests in a completely randomized experimental design, in a factorial arrangement 3 × 3 + 1 (exposure time × temperature + additional control). Data were subjected to analysis of variance, and the means were compared with the Scott-Knott test up to 5% of probability, with the aid of the statistical program SISVAR®. Immersing Zea mays seeds in hot water at 50, 60 and 70 °C for 1, 2, and 3 minutes is efficient to prevent the increased incidence of Aspergillus sp., Penicillium sp., and Fusarium sp. The heat treatment at 60 °C for 1 and 2 minutes of immersion reduces the incidence of fungal mycoflora without impairing the physiological quality of seeds.(AU)

O uso de sementes com bom potencial sanitário e fisiológico garante o estabelecimento da cultura, com estande de plântulas uniformes, vigorosas e livres de doenças, que consequentemente resultará em bons níveis de produtividade. Diante do exposto, objetivou-se avaliar a qualidade sanitária e fisiológica de sementes de milho roxo (Zea mays L.) submetidas à termoterapia, por meio de tratamento térmico com imersão em água destilada esterilizada (ADE), aquecida à temperatura de 50, 60 e 70 °C por 1, 2 e 3 minutos. O controle (0 min) correspondeu apenas à imersão das sementes em ADE. As sementes foram submetidas aos testes de sanidade e germinação em delineamento experimental inteiramente randomizado em esquema fatorial 3 × 3 + 1 (tempo de exposição × temperatura + controle adicional). Os dados foram submetidos à análise de variância e as médias foram comparadas pelo teste de Scott-Knott até 5% de probabilidade, com o auxílio do programa estatístico SISVAR®. A imersão das sementes de Zea mays em água quente a 50, 60 e 70 °C durante 1, 2 e 3 minutos é eficiente para impedir o aumento da incidência de Aspergillus sp., Penicillium sp. e Fusarium sp. O tratamento térmico a 60 °C por 1 e 2 minutos de imersão reduz a incidência da micoflora fúngica, sem prejudicar a qualidade fisiológica das sementes.(AU)

Use of derived adipose stem cells to reduce complications of cutaneous scarring in smokers. An experimental model in rats

Abstract Purpose To evaluate the use of adipose-derived stem cells (ADSC) in reducing the necrosis area in an experimental model of cutaneous ischemic flap in rats submitted to subcutaneous nicotine injection to simulate a smoker patient. Methods In an experimental study, 30 rats were enrolled and divided into two experimental groups of 15 animals all submitted to a subcutaneous nicotine injection to create ischemic cutaneous flaps on their backs. Other 10 animals were used only to obtain adipose tissue derived stem cells (ADSC). The first group (n=15) received ADSC treatment at the end of surgery while the other group, the control (n=15), received no other interventions. After euthanasia, a decal was performed on the whole area of the flap, accurately defining the transition from necrosis to healthy region. Photos of all animals were collected and evaluated by scales standardized by Paint-Autocad- 2015 software to define the area of flap necrosis in each rat. Student T test was performed to compare the groups, considering a p< 0.05 significant. Data were analyzed using SPSS IBM® 18 version. Results Through the analysis of the images by the program Paint-Autocad-2015 and the area of decal obtained by the transparent sheet, we obtained a mean of 46% necrosis of the total area of the flap in the treatment group and 69.4% in the control group. In the descriptive analysis, a mean of 3.7 cm of necrosis CI 95% (3.2 - 4.2) was evident in the treatment group whereas a mean value of 5.56 CI 95% (5.2 - 5.9) was found in control group, with p value <0.001 for this comparison. Conclusion The application of adipose-derived stem cells reduces the percentage of necrosis in an experimental model of randomized cutaneous flap in rats submitted to subcutaneous nicotine injection.