Renal deficit and associated factors in children born with low birth weight / Déficit renal e fatores associados em crianças nascidas com baixo peso

ABSTRACT Introduction: Kidney problems may be due to low birth weight alone or may occur in association with other conditions. The objective this study was to evaluate the association between maternal and birth characteristics, anthropometric measurements, and kidney function deficit in low birth weight infants. Methods: Cross-sectional study with children who were born weighing < 2500 grams and were under outpatient follow-up. Maternal factors investigated were prenatal care and presence of hypertension, diabetes, and infection during pregnancy. The children's variables were sex, gestational age, birth weight, Apgar score, use of nephrotoxic medications, age, body weight at the time of evaluation, height, and serum creatinine and cystatin C dosages. The glomerular filtration rate (GFR) was estimated with the combined Zapittelli equation. Multivariate logistic regression model was used for identification of associated factors, with renal function deficit (GFR < 60 mL/min/1.73 m2) as the dependent variable. Results: Of the 154 children evaluated, 34.42% had kidney function deficit. Most of them had a gestational age > 32 weeks (56.6%), a mean birth weight of 1439.7 grams, and mean estimated GFR of 46.9 ± 9.3 mL/min/1.73 m2. There was a significant association of GFR < 60 mL/min/1.73 m2 with children's current weight and use of nephrotoxic drugs. Discussion: Children born with low birth weight had a high prevalence of kidney function deficit and current normal weight was a protective factor while the use of nephrotoxic drugs during perinatal period increased the chance of kidney deficit. These findings reinforce the need to evaluate the kidney function in these children, especially those who use nephrotoxic drugs.

RESUMO Introdução: Problemas renais podem ser devido apenas ao baixo peso ao nascer ou podem ocorrer em associação com outras condições. O objetivo deste estudo foi avaliar a associação entre características maternas e de nascimento, medidas antropométricas e déficit da função renal em bebês de baixo peso ao nascer. Métodos: Estudo transversal com crianças que nasceram com peso < 2500 gramas e estavam sob acompanhamento ambulatorial. Os fatores maternos investigados foram cuidados pré-natal e presença de hipertensão, diabetes e infecção durante a gravidez. As variáveis das crianças foram sexo, idade gestacional, peso ao nascer, índice Apgar, uso de medicamentos nefrotóxicos, idade, peso corporal no momento da avaliação, altura e dosagens séricas de creatinina e cistatina C. A taxa de filtração glomerular (TFG) foi estimada com a equação combinada de Zapittelli. Utilizou-se um modelo de regressão logística multivariada para identificação de fatores associados, com déficit da função renal (TFG < 60 mL/min/1,73 m2) como variável dependente. Resultados: Das 154 crianças avaliadas, 34,42% apresentaram déficit da função renal. A maioria tinha idade gestacional > 32 semanas (56,6%), peso médio ao nascer de 1439,7 gramas, e TFG média estimada de 46,9 ± 9,3 mL/min/1,73 m2. Houve uma associação significativa da TFG < 60 mL/min/1,73 m2 com o peso atual das crianças e o uso de medicamentos nefrotóxicos. Discussão: Crianças nascidas com baixo peso apresentaram alta prevalência de déficit da função renal e o peso atual normal foi um fator de proteção, enquanto o uso de medicamentos nefrotóxicos durante o período perinatal aumentou a chance de déficit renal. Estes achados reforçam a necessidade de avaliar a função renal destas crianças, especialmente aquelas que usam medicamentos nefrotóxicos.

Caracterización de pacientes no adherentes al tratamiento de hipertensión arterial / Characterization of patients not adherent to high blood pressure treatment

Introducción. La falta del cumplimiento terapéutico es un problema en el control de la hipertensión arterial. Objetivo. Caracterizar los pacientes no adherentes al tratamiento de hipertensión arterial en pobladores de la V Región Sanitaria del Paraguay. Material y Métodos: Estudio transversal que incluyó pacientes hipertensos conocidos que se encontraban en tratamiento para la hipertensión arterial. Se utilizó la Escala de adherencia a la medicación de Morisky 8 ítems que mide comportamientos de adherencia específicos asociados a la ingesta de medicamentos. Resultados. Se incluyeron163 pacientes, todos considerados no adherentes al tratamiento según la Escala Morinsky MMAS-8. El 52,2% tenía más de 40 años, 66,3% del sexo femenino, 40,5% de nivel universitario, 57,1% casado y el 87,7% vive con la familia. El 66,9% informó trabajar hasta 8 horas por día y el 58,3% con ingresos mayores a 2 salarios mínimos. En cuanto al conocimiento el 53,9% fue alto. El 50% de los pacientes declaró utilizar plantas medicinales para su tratamiento, el 7,4% con depresión frecuentemente o casi siempre y el 22,1% ansiedad frecuentemente o casi siempre. En cuanto a las preguntas de no adherencia, el 53,4% olvidó tomar alguna vez su medicación o dejar de tomarla cuando siente que está bajo control (53,3%),el 44,2% deja de tomar su medicación porque se siente peor con ella y el 46,5% la olvida cuando viaja. Conclusión. La no adherencia en los pacientes de la V Región fue alarmante, por tanto, se deben de realizar medidas de acción respecto a las mismas. Palabras Clave: hipertensión; presión arterial; cumplimiento y adherencia al tratamiento; epidemiologia

Introduction. The lack of therapeutic compliance is a problemto control high blood pressure.Objective. To characterize patients who do not adhere to the treatment of arterial hypertension in the Vsanitary region of Paraguay. Material and Methods: A cross-sectional study was carried out in known hypertensive patients who were undergoing treatment for high blood pressure. The 8-item Morisky Medication Adherence Scale was used, which measures specific adherence behaviors associated with medication intake. Results.163 patients were included, all considered non-adherent to treatment according to the Morinsky MMAS-8 Scale. 52.2% were over 40 years old, 66.3% female, 40.5% with university level, 57.1% married, and 87.7% lived with their family. 66.9% reported working up to 8 hours per day and 58.3% with income greater than 2 minimum wages. Regarding knowledge, 53.9% was high. 50% of the patients declared using medicinal plants for their treatment, 7.4% with depression frequently or almost always and 22.1% with anxiety frequently or almost always. Regarding the non-adherence questions, 53.4% ever forgot to take their medication or stopped taking it when they feel they are under control (53.3%), 44.2% stop taking their medication because they feel worse with it and 46.5% forget it when traveling. Conclusion. The non-adherence in patients from Region V was alarming, therefore, action measures must be taken regarding them. Key words:hypertension; blood pressure; treatment adherence and compliance; epidemiology

Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92-2.31)/1.60 (1.27-2.02) for SGA; 0.90 (0.55-1.47)/1.05 (0.55-1.99) for LGA; 1.65 (1.08-2.51)/1.58 (1.28-1.96) for stunting; and 1.48 (1.02-2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.

Study of the potential toxicity of adrenaline to neurons, using the SH-SY5Y human cellular model

Abstract Prolonged overexposure to catecholamines causes toxicity, usually credited to continuous adrenoceptor stimulation, autoxidation, and the formation of reactive pro-oxidant species. Non-differentiated SH-SY5Y cells were used to study the possible contribution of oxidative stress in adrenaline (ADR)-induced neurotoxicity, as a model to predict the toxicity of this catecholamine to peripheral nerves. Cells were exposed to several concentrations of ADR (0.1, 0.25, 0.5 and 1mM) and two cytotoxicity assays [lactate dehydrogenase (LDH) release and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazolium bromide (MTT) reduction] were performed at several time-points (24, 48, and 96h). The cytotoxicity of ADR was concentration- and time-dependent in both assays, since the lowest concentration tested (0.1mM) also caused significant cytotoxicity at 96h. N-acetyl-cysteine (1mM), a precursor of glutathione synthesis, prevented ADR-induced toxicity elicited by 0.5mM and 0.25mM ADR following a 96-h exposure, while the antioxidant Tiron (100µM) was non-protective. In conclusion, ADR led to mitochondrial distress and ultimately cell death in non-differentiated SH-SY5Y cells, possibly because of ADR oxidation products. The involvement of such processes in the catecholamine-induced peripheral neuropathy requires further analysis.

Diagnostic performance of anthropometric indicators used to assess excess body fat in adolescence / Desempenho diagnóstico dos indicadores antropométricos na avaliação do excesso de gordura corporal na adolescência

Abstract Objective: To compare the performance of anthropometric indicators that identify excess body fat (BF) in adolescents. Methods: This is a methodological study that used probability cluster sampling through school and class draws. Data collection included sociodemographic characteristics and anthropometric measures. Body mass index (BMI), waist-to-height ratio (WtHR), conicity index (C index), and waist circumference (WC) were calculated. Body fat percentage (BF%) was calculated from skinfold thickness and used as the gold standard. To analyze the data, descriptive statistics, Student's t-test, Receiver Operating Characteristic (ROC) curve, and Youden's index were used, in addition to correlation coefficient calculation between the indicators and BF%. Results: A total of 997 adolescents enrolled in municipal secondary schools participated in the study. By calculating the BMI, we found that 10.6% of adolescents were overweight, and 4.7% were obese. BMI, WC, and WtHR had the highest accuracy to predict body fatness. All the anthropometric indicators had higher specificity than sensitivity to diagnose excess BF in males. WC had the highest sensitivity in both genders. C index had the smallest area under the ROC curve and the lowest sensitivity in both genders, but its specificity was equivalent to that of the other indicators. Conclusions: BMI, WtHR, and WC were the best anthropometric indicators to predict excess BF in adolescents and had the best correlation coefficients. These tools can be considered in the screening to detect excess BF in adolescents.

RESUMO Objetivo: Comparar o desempenho de indicadores antropométricos para identificar o excesso de gordura corporal (GC) em adolescentes. Métodos: Estudo metodológico com amostragem probabilística por conglomerados, por sorteio das escolas e turmas. A coleta de dados incluiu características sociodemográficas e medidas antropométricas. O índice de massa corporal (IMC), a relação cintura-estatura (RCE), o índice de conicidade (IC) e a circunferência da cintura (CC) foram calculados. O percentual de gordura corporal (%GC) foi calculado com base na espessura das dobras cutâneas e utilizado como padrão-ouro. Para analisar os dados, foram utilizadas estatísticas descritivas, teste t de Student, curva Receiver Operating Characteristic (ROC) e índice de Youden. Foi calculado o coeficiente de correlação entre os indicadores e o %GC. Resultados: Participaram do estudo 997 adolescentes de escolas municipais. Identificou-se, pelo IMC, que 10,6% dos adolescentes apresentavam sobrepeso e 4,7%, obesidade. O IMC, a CC e a RCE apresentaram a maior acurácia para predizer a gordura corporal. Todos os indicadores antropométricos apresentaram especificidade superior à sensibilidade para diagnosticar excesso de GC no sexo masculino. A CC apresentou a maior sensibilidade em ambos os sexos. O IC apresentou a menor área sob a curva ROC e a menor sensibilidade em ambos os sexos, mas especificidade equivalente aos demais indicadores. Conclusões: IMC, RCE e CC apresentaram a melhor capacidade de predizer excesso de GC em adolescentes e os melhores coeficientes de correlação. Essas ferramentas podem ser consideradas formas de rastreamento na identificação do excesso de GC em adolescentes.

Mammals in São Paulo State: diversity, distribution, ecology, and conservation / Mamíferos do Estado de São Paulo: diversidade, distribuição, ecologia e conservação

Abstract Mammals are charismatic organisms that play a fundamental role in ecological functions and ecosystem services, such as pollination, seed dispersal, nutrient cycling, and pest control. The state of São Paulo represents only 3% of the Brazilian territory but holds 33% of its mammalian diversity. Most of its territory is dominated by agriculture, pastures, and urban areas which directly affect the diversity and persistence of mammals in the landscape. In addition, São Paulo has the largest port in Latin America and the largest offshore oil reservoir in Brazil, with a 600 km stretch of coastline with several marine mammal species. These human-made infrastructures affect the diversity, distribution, ecology, and the future of mammals in the state. Here, we answer five main questions: 1) What is the diversity of wild mammals in São Paulo state? 2) Where are they? 3) What is their positive and negative impact on human well-being? 4) How do mammals thrive in human-modified landscapes? 5) What is the future of mammals in the state? The state of São Paulo holds 255 species of native mammals, with four endemic species, two of them globally endangered. At least six species (two marsupials, Giant otter, Pampas deer, Brazilian dwarf brocket deer, and Giant armadillo) were extirpated from the state due to hunting and habitat loss. The intense human land use in the state forced many mammalian species to change their diet to cope with the intense fragmentation and agriculture. Large-scale monoculture has facilitated the invasion of exotic species such as wild boars (javali) and the European hare. Several "savanna-dwelling" species are expanding their ranges (Maned wolf, Brocket deer) over deforested areas and probably reflect changes towards a drier climate. Because the state has the largest road system, about 40,000 mammals from 33 species are killed per year in collisions causing an economic loss of 12 million dollars/year. The diversity of mammals is concentrated in the largest forest remnants of Serra do Mar and in the interior of the State, mainly in the regions of Ribeirão Preto and Jundiaí. Sampling gaps are concentrated throughout the interior of the state, particularly in the northwest region. Wild mammals play a fundamental role in many ecosystem services, but they can also be a concern in bringing new emergent diseases to humans. Although the taxonomy of mammals seems to be well known, we show that new species are continuously being discovered in the state. Therefore, continuous surveys using traditional and new technologies (eDNA, iDNA, drones), long-term population monitoring, investigation of the interface of human-wildlife conflict, and understanding of the unique ecosystem role played by mammals are future avenues for promoting sustainable green landscapes allied to human well-being in the state. The planting of forest or savanna corridors, particularly along with major river systems, in the plateau, controlling illegal hunting in the coastal areas, managing fire regimes in the Cerrado, and mitigating roadkill must be prioritized to protect this outstanding mammal diversity.

Resumo Os mamíferos são organismos carismáticos que desempenham um papel fundamental na função ecológica e nos serviços ecossistêmicos, como polinização, dispersão de sementes, ciclagem de nutrientes e controle de pragas. O Estado de São Paulo representa apenas 3% do território brasileiro, mas detém 33% da diversidade de mamíferos. A maior parte de seu território é dominado pela agricultura, pastagens e áreas urbanas que afetam diretamente a diversidade e a persistência dos mamíferos na paisagem. Além disso, São Paulo possui o maior porto da América Latina e o maior reservatório de petróleo costeiro do Brasil, com 600 km de extensão de litoral com diversas espécies de mamíferos marinhos. Essas infraestruturas afetam a diversidade, distribuição, ecologia e o futuro dos mamíferos no estado. Aqui, respondemos cinco perguntas principais: 1) Qual é a diversidade de mamíferos silvestres no Estado de São Paulo? 2) Onde eles ocorrem? 3) Qual é o seu impacto positivo e negativo no bem-estar humano? 4) Como os mamíferos persistem em paisagens modificadas pelo homem? 5) Qual é o futuro dos mamíferos no estado? O estado de São Paulo possui 255 espécies de mamíferos nativos, com quatro espécies endêmicas, duas delas globalmente ameaçadas de extinção. Pelo menos seis espécies (dois marsupiais, ariranha, veado-campeiro, veado-cambuta e tatu-canastra) foram extirpadas do estado devido à caça e perda de habitat. O intenso uso humano da terra no estado forçou muitas espécies de mamíferos a mudar sua dieta para lidar com a intensa fragmentação e agricultura. A monocultura em larga escala facilitou a invasão de espécies exóticas, como porcos selvagens (javaporco) e a lebre europeia. Várias espécies de áreas abertas estão expandindo suas áreas de distribuição (lobo-guará, veado-catingueiro) sobre áreas desmatadas e provavelmente refletem mudanças em direção a um clima mais seco. Como o estado possui o maior sistema rodoviário do Brasil, cerca de 40 mil mamíferos de 33 espécies são mortos por ano em colisões, causando um prejuízo econômico de 12 milhões de dólares/ano. A diversidade de mamíferos está concentrada nos maiores remanescentes florestais da Serra do Mar e no interior do Estado, principalmente nas regiões de Ribeirão Preto e Jundiaí. As lacunas amostrais estão concentradas em todo o interior do estado, principalmente na região noroeste. Os mamíferos silvestres desempenham um papel fundamental em muitos serviços ecossistêmicos, mas também podem ser uma preocupação em trazer novas doenças emergentes para as populações humanas. Embora a taxonomia de mamíferos pareça ser bem conhecida, mostramos que novas espécies estão sendo continuamente descobertas no estado. Portanto, pesquisas usando tecnologias tradicionais e novas (eDNA, iDNA, drones), monitoramento populacional de longo prazo, a investigação da interface do conflito homem-vida selvagem e a compreensão do papel único no ecossistema desempenhado pelos mamíferos são um caminho futuro para promover uma paisagem verde sustentável aliada ao bem-estar humano no estado. O plantio de corredores florestais ou de cerrado, principalmente junto aos principais sistemas fluviais, no planalto, o controle da caça ilegal nas áreas costeiras, o manejo dos regimes de fogo no Cerrado e a mitigação dos atropelamentos devem ser uma prioridade para proteger essa notável diversidade de mamíferos.

Luchas de género en internet, una mirada desde la etnografía virtual / Gender Struggles on the Internet, a Look from Virtual Ethnography / Lutas de gênero na internet, uma perspectiva a partir da etnografia virtual

Resumen: Este texto presenta los resultados de la investigación Cibercultura y Resistencia: luchas de género en internet, que tuvo por objeto de estudio las prácticas digitales como acciones contemporáneas de los movimientos sociales, en particular las prácticas de quienes trabajan por los derechos sexuales y reproductivos en América Latina y su vínculo con la Bioética social como dimensión comprensiva de las tensiones culturales. La fundamentación teórica presenta el ciberespacio como escenario sociopolítico, cultural y económico. El diseño metodológico propuso la etnografía virtual para caracterizar la emergencia de formas de ciudadanía digital a través del ciberactivismo de género. Se analizaron las prácticas de veinticinco organizaciones sociales en total, con tres perfiles específicos: feminista, nuevas masculinidades y diversidad sexual, en cinco países de Latinoamérica. Se observaron las redes sociales Facebook, Twitter y páginas web, a través de un kit de etnografía virtual diseñado por el proyecto que incluyó fichas de registro, un banco de imágenes y diverso material multimedia. Los resultados presentan el análisis de narrativas textuales y visuales de estas prácticas, tanto en su dimensión Bioética como política. Se demostró cómo el activismo digital ha facilitado la ocupación del espacio público en la sociedad de la información y genera procesos de participación política con actores y acciones emergentes por fuera de las prácticas convencionales.

Summary: This text presents the results of a research on Cyberculture and Resistance: gender struggles on the internet, which aimed to study digital practices as contemporary actions of social movements, particularly the practices of those who work for sexual and reproductive rights in Latin America and its link with social bioethics as a comprehensive dimension of cultural tensions. The theoretical foundation presents cyberspace as a socio-political, cultural, and economic scenario. The methodological design proposed virtual ethnography to characterize the emergence of digital citizenship forms through gender cyberactivism. Practices of twenty-five social organizations in total were analyzed, with three specific profiles: feminist, new masculinities, and sexual diversity, in five Latin American countries. Facebook, Twitter, and webpages are observed through a virtual ethnography kit designed by the project, which included registration sheets, an image bank and different multimedia material. The results present the analysis of textual and visual narratives of these practices, both in their bioethical and political dimension. It demonstrated how digital activism facilitated the occupation of public space in the information society and the generation of processes for political participation with emerging stakeholders and actions outside conventional practices.

Resumo: Este texto apresenta os resultados da pesquisa Cibercultura e Resistência: Lutas de Gênero na Internet, que teve como objetivo estudar as práticas digitais como ações contemporâneas dos movimentos sociais, em particular as práticas daqueles que trabalham pelos direitos sexuais e reprodutivos na América Latina e sua ligação com a Bioética social como dimensão abrangente das tensões culturais. Os fundamentos teóricos apresentam o ciberespaço como um cenário sociopolítico, cultural e económico. O desenho metodológico propôs a etnografia virtual para caracterizar o surgimento de formas de cidadania digital por meio do ciberativismo de gênero. Analisamos as práticas de vinte e cinco organizações sociais no total, com três perfis específicos: feminista, novas masculinidades e diversidade sexual, em cinco paises latino-americanos. As redes sociais Facebook, Twitter e sites foram observados por meio de um kit de etnografia virtual desenhado pelo projeto e que incluía fichas de registro, um banco de imagens e vários materiais multimidia. Os resultados apresentam a análise das narrativas textuais e visuais dessas práticas, tanto em suas dimensões Bioéticas quanto politicas. Foi demonstrado como o ativismo digital tem facilitado a ocupação do espaço público na sociedade da informação e gera processos de participação politica com atores e ações emergentes que se encontram fora das práticas convencionais.

Canal y carne de corderos Santa Inés y cruces con Dorper o Texel: Un meta-análisis / Carcass and meat of Santa Inês lambs and crosses with Dorper or Texel: A meta-analysis

RESUMEN Objetivo. Evaluar las características cuantitativas de la canal y composición química de la carne de corderos puros Santa Inés (SI) y cruces con Dorper (DO-SI) o Texel (TX-SI), terminados en confinamiento o semiconfinamiento, mediante un meta-análisis. Materiales y métodos. Bases de datos virtuales como Google Scholar, Science Direct y Scielo fueron utilizados para seleccionar los artículos científicos publicados desde el año 2000 a 2019. Palabras clave como genotipo, corderos, características de la canal y calidad de la carne, tanto en idioma español, portugués e inglés fueron utilizadas como criterios de inclusión de los artículos. De cada grupo genético, fueron evaluados: desempeño animal, características cuantitativas de la canal, cortes de la canal y composición química de la carne. Todos fueron incluidos en el análisis proveniente de 37 artículos científicos. Resultados. Peso corporal final, peso de la canal caliente, rendimiento de la canal fría y porcentaje de músculo no difieren entre los diferentes genotipos evaluados. Corderos DO-SI presentaron mayor consumo de materia seca, ganancia diaria de peso, área de ojo de lomo y porcentaje de lomo. Composición química no fue influenciada por los genotipos. Conclusiones. En ambiente tropical y subtropical, corderos puros SI terminados en confinamiento o semiconfinamiento presentan características cuantitativas de la canal y composición química similar a los corderos de cruces DO-SI y TX-SI.

ABSTRACT Objective. To evaluate the quantitative characteristics of the carcass and chemical composition of the meat of purebred Santa Inês (SI) lambs and crosses with Dorper (DO-SI) or Texel (TX-SI), finished in feedlot or semi-feedlot, through a meta-analysis. Materials and methods. Virtual databases such as Google Scholar, Science Direct and Scielo were used to select scientific articles published from 2000 to 2019. Keywords such as genotype, lambs, carcass characteristics and meat quality, both in Spanish, Portuguese and English were used as criteria for the inclusion of articles. From each genetic group were evaluated: animal performance, quantitative characteristics of the carcass, carcass cuts and chemical composition of the meat. These variables were included in the analysis from 37 scientific articles. Results. Final body weight, hot carcass weight, cold carcass yield and muscle percentage do not differ between the different genetic groups evaluated. DO-SI lambs showed higher dry matter intake, daily weight gain, loin eye area and loin percentage. Chemical composition was not influenced by the genetic groups. Conclusions. In a tropical and subtropical environment, purebred lambs SI finished in feedlot or semi-feedlot have quantitative characteristics of the carcass and chemical composition similar to DO-SI and TX-SI lambs.

Prevention of UVB radiation-induced oxidative stress in mice by topical administration of Azadirachta indica(neem) extract

Neem tree (Azadirachta indica A. Juss. fam. Meliaceae) has been extensively employed to combat diverse pathologies. Moreover, it has been described that its leaf extract present anticarcinogenic action. Thus, the neem extract (NE) chemical and antioxidant properties was evaluated, and also, the capacity of two dermatological formulations incorporated with neem extract (F1 and F2) to avoid oxidative UVB-induced skin injury in hairless mice. NE constituents were investigated and free radical scavenging ability were determined by different methods in vitro. Skin from mice treated with F1 and F2 and submitted to UVB radiation were tested for different parameters of inflammation and oxidative injury. Results show that the NE polyphenol and flavonoid content were 135.30 and 37.12mg/g, respectively. High performance liquid chromatography (HPLC) results demonstrated the existence of azarachtin, rutin, ursolic acid and tannic acid. NE presented scavenging ability by ABTS radical, ferric-reducing antioxidant power (FRAP), inhibition of lipid peroxidation and iron chelation. In vivo, it was observed that mice treated with F1 and F2 showed amelioration of the inflammation by reducing UVB induced skin edema. However, only samples from animals treated with F1 had lower neutrophil recruitment (measured by myeloperoxidase activity), and returning the oxidative status to baseline levels in parameters such as reduced glutathione level, ferric reducing ability (FRAP), and scavenging of free radical (ABTS). Concluding, NE demonstrated a good antioxidant property in vitro, and the data suggest the use of NE added F1 to prevent skin damage caused by UVB irradiation.(AU)

Evaluation of usability of a neonatal health information system according to the user's perception / Avaliação da usabilidade de um sistema de informação em saúde neonatal segundo a percepção do usuário

ABSTRACT Objective: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. Methods: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. Results: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as "good", "excellent" or "better than imaginable". The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. Conclusion: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.

RESUMO Objetivo: Mensurar o grau de satisfação de profissionais de saúde quanto à usabilidade de um sistema de informação em saúde neonatal e identificar os fatores que podem influenciar na satisfação do usuário frente à usabilidade. Métodos: Estudo transversal e exploratório realizado com 50 profissionais de saúde integrantes dos centros da Rede Brasileira de Pesquisas Neonatais. Para avaliação da usabilidade foi utilizado o instrumento System Usability Scale entre fevereiro e março de 2017. Realizou-se a análise estatística descritiva e inferencial das variáveis coletadas, com a finalidade de descrever a amostra, quantificar o grau de satisfação dos usuários e identificar as variáveis associadas ao grau de satisfação do usuário em relação à usabilidade. Resultados: Da população avaliada, 75% era do sexo feminino, com idade média 52,8 anos, 58% com pós-graduação (doutorado); tempo médio da última formação de 17 anos; área de atuação em medicina (neonatologia), grau intermediário de conhecimento em informática e tempo de utilização média do sistema de 52 meses. Quanto à usabilidade, 94% avaliaram o sistema como "bom", "excelente" ou "melhor impossível". A usabilidade do sistema não foi associada a idade, sexo, escolaridade, profissão, área de atuação, nível de conhecimento em informática e tempo de uso do sistema. Conclusões: O grau de satisfação do usuário do sistema informatizado de saúde foi considerado bom. Não foram identificados fatores demográficos que influenciassem sua avaliação.

Detection of bluetongue virus in Brazilian cervids in São Paulo state / Detecção de vírus da língua azul em cervídeos brasileiros no estado de São Paulo

Viral hemorrhagic diseases in cervids occur worldwide and include epizootic hemorrhagic disease (EHD), bluetongue (BT), and adenoviral hemorrhagic disease (AHD). Since gross lesions in all three hemorrhagic diseases are identical (hemorrhagic enteropathy, pulmonary edema, systemic petechial and suffusion hemorrhages), it is necessary to use accurate techniques for a definitive etiologic diagnosis. Archival material (paraffin blocks) at the Department of Veterinary Pathology of FCAV - Unesp was reviewed for lesions of hemorrhagic disease and 42 captive and free-living Brazilian deer were selected to include in this study. Paraffin-embedded tissues were evaluated using immunohistochemistry and tested negative for adenovirus. Using real time RT-PCR, EHD virus was not detected in paraffin-embedded tissues in any of the cases evaluated. The same technique was used for detection of BT virus and seven positive animals (16,66%) were confirmed after agarose 4% gel electrophoresis and gene sequencing. The main macroscopic changes observed in the positive animals were hemorrhagic intestinal contents, reddish mucous membrane of the gastrointestinal tract, ulcers on tongue and petechiae in various organs. Microscopic changes observed were lymphocytic inflammatory infiltrate in liver, kidney and lungs, hemorrhage, and congestion in various organs. All positive cases were from captive animals, three females (two young and one adult), and four young males. This study demonstrates that the bluetongue virus is involved in hemorrhagic disease outbreaks of deer in Brazil.(AU)

Doenças hemorrágicas virais em cervídeos ocorrem no mundo todo e incluem a doença epizoótica hemorrágica (DEH), língua azul (LA), e doença hemorrágica por adenovírus (DHA). Uma vez que as lesões nas três doenças hemorrágicas são idênticas (enteropatia hemorrágica, edema pulmonar, petéquias sistêmicas e sufusões hemorrágicas), é necessário utilizar técnicas precisas para um diagnóstico etiológico definitivo. Material de arquivo (blocos de parafina) do Departamento de Patologia Veterinária da FCAV - Unesp foi revisado para lesões de doenças hemorrágicas e 42 cervídeos brasileiros de cativeiro e de vida livre foram selecionados e incluídos neste estudo. Tecidos embebidos em parafina foram avaliados usando imunohistoquímica e foram negativos para adenovírus. Usando o RT-PCR em tempo real, o vírus da DEH não foi detectado nos tecidos de nenhum dos casos avaliados. A mesma técnica foi utilizada para detecção do vírus da LA e sete animais positivos (16,66%) foram confirmados após eletroforese em gel de agarose a 4% e sequenciamento genético. As principais alterações macroscópicas observadas nos animais positivos foram conteúdo intestinal hemorrágico, mucosa do trato gastrointestinal avermelhada, úlceras na língua e petéquias em vários órgãos. As alterações microscópicas observadas foram infiltrado inflamatório linfocítico em fígado, rins e pulmões, e hemorragia e congestão em vários órgãos. Todos os casos positivos foram de animais de cativeiro, três fêmeas (dois jovens e um adulto), e quatro jovens do sexo masculino. Este estudo demonstra que o vírus da lingual azul está envolvido nos surtos de doença hemorrágica em veados no Brasil.(AU)

Genetic diversity of the pampas deer (Ozotoceros bezoarticus) population in the Brazilian Pantanal assessed by combining fresh fecal DNA analysis and a set of heterologous microsatellite loci

Abstract The pampas deer (Ozotoceros bezoarticus) is close to being classified as 'globally threatened', with the largest population occurring in the Brazilian Pantanal. Since capture is stressful to these animals, non-invasive sampling methods such as the use of feces can provide reliable sources of DNA. The aim of this study was to use fecal samples to evaluate the genetic variability of the Brazilian Pantanal population of pampas deer. Six heterologous microsatellite markers were used to screen 142 stool specimens. Seventy-four deer were identified, of which 50 adults were used to determine the genetic characteristics of the population. The Pantanal population showed high genetic diversity (mean number of alleles per locus = 11.5, expected heterozygosity = 0.75). This is the first investigation to characterize a South American deer species using fecal DNA and demonstrates the usefulness and efficiency of this approach, as well as the feasibility of obtaining information that could not have been easily obtained by traditional DNA sampling. Our findings suggest that management strategies for this species may be much more effective if applied now when the population still shows high genetic variability.

Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis / Avaliação da eficácia do plasma rico em plaquetas na consolidação óssea de pacientes submetidos a artrodese lombar

ABSTRACT OBJECTIVE: To determine whether the use of autograft associated with platelet-rich plasma (PRP) increases bone healing in patients undergoing lumbar fusion. METHOD: This was a prospective, descriptive, and comparative study, which included 40 patients undergoing lumbar fusion, who were divided into two groups: group I, autograft only, and group II, autograft associated with PRP. After surgery, patients were followed-up on the first, third, and sixth month. The Molinari radiographic classification and Glassman tomographic classification were used as criteria to analyze the bone consolidation. RESULT: Comparing the group I with group II, according to the criteria of Molinari, bilateral fusion was observed in 27.5% of the patients in group I in the first month after surgery. In group II, the rate of bilateral fusion was 25.0% and 20% in the third and sixth months, respectively. The results of computed tomography scans performed at six months after surgery indicated, according to the criteria of Glassman, a rate of bilateral solid fusion of 15.0% and 10.0% in groups I and II, respectively. CONCLUSION: The use of PRP showed no significant difference in bone healing in cases of lumbar arthrodesis.

RESUMO OBJETIVO: Analisar se o uso de enxerto autólogo associado a plasma rico em plaqueta (PRP) aumenta a consolidação óssea em pacientes submetidos à artrodese lombar. MÉTODO: Estudo prospectivo, de caráter descritivo e comparativo, com 40 pacientes submetidos à artrodese lombar, que foram divididos em dois grupos: grupo I, somente enxerto autólogo, e grupo II, enxerto autólogo associado a PRP. Após o procedimento cirúrgico, o acompanhamento foi feito no primeiro, terceiro e sexto mês. Os critérios de classificação radiográfica de Molinari e tomográfica de Glassman foram usados como padrão para analisar a consolidação. RESULTADO: Na comparação do grupo I com o grupo II no primeiro mês de pós-operatório, de acordo com os critérios de Molinari, 27,5% dos pacientes apresentaram fusão bilateral no grupo I. No terceiro e sexto mês, observou-se uma taxa de fusão bilateral de 25% e 20% para o grupo II. O resultado das tomografias feitas no sexto mês de pós-operatório indicou, de acordo com os critérios de Glassman, uma taxa de fusão sólida bilateral de 15% e 10% nos grupos I e II, respectivamente. CONCLUSÃO: Observou-se que o uso do PRP não apresentou diferença significativa na consolidação óssea nas artrodeses lombares.

Identifying Mazama gouazoubira (Artiodactyla; Cervidae) chromosomes involved in rearrangements induced by doxorubicin

Abstract The process of karyotype evolution in Cervidae from a common ancestor (2n = 70, FN = 70) has been marked by complex chromosomal rearrangements. This ancestral karyotype has been retained by the current species Mazama gouazoubira (Fischer 1814), for which a chromosomal polymorphism (Robertsonian translocations and the presence of B chromosomes) has been described, presumably caused by a chromosome fragility. Thus, this study has identified doxorubicin-induced chromosome aberrations and mapped the regions involved in breaks, which may be related to the chromosome evolution process. G-banding pattern showed that 21 pairs of chromosomes presented chromosomal aberrations, 60% of the total chromosome number of the species M. gouazoubira. Among chromosomes that carry aberrations, the region where they were most frequently concentrated was distal relative to the centromere. These data suggest that certain chromosomal regions may be more susceptible to chromosome fragility and consequently could be involved in karyotype differentiation in species of the family Cervidae.

Relevância dos indicadores de estratégias de supervisão clínica em enfermagem / Relevance of indicators of clinical supervision strategies in nursing

Identificar os indicadores de estratégias de supervisão clínica em enfermagem que os enfermeiros consideram mais relevantes. Métodos: investigação quantitativa, de caráter descritivo e exploratório.Para a coleta de dados foi construído um questionário, que foi aplicado a uma amostra de 316 enfermeiros que exerciam funções em contexto hospitalar e em cuidados de saúde primários. Resultados: destaca-se a relevância atribuída pelos enfermeiros aos indicadores das estratégias de supervisão clínica, em particular no que concerne aos processos reflexivos, bem como aos métodos direcionados para a ação e demonstração.Conclusão: os indicadores identificados no estudo constituem um importante passo para a estruturação e avaliação dos processos de supervisão, concorrendo para a melhoria da qualidade e segurança dos cuidados.

Objective: to identifying the indicators of strategies of clinical supervision in nursing that nurses consider morerelevant. Methods: it is a descriptive and exploratory research with a quantitative approach. A questionnairewas constructed to collect data, applied to a sample of 316 nurses who performed functions in a hospital contextand primary health care. Results: the relevance attributed by the nurses to the indicators of clinical supervisionstrategies, especially the reflexive processes, as well as to methods directed to action and demonstration, arehighlighted. Conclusion: the indicators identified in the study constitute an important step in the structuringand evaluation of supervision processes, contributing to the improvement of quality and safety of care.

Morfologia da língua do cervo do pantanal (Blastocerus dichotomus) / Morphology of the tongue of the Marsh deer (Blastocerus dichotomus)

Objetivou-se descrever a morfologia da língua do cervo do pantanal (Blastocerus dichotomus), o maior cervídeo da fauna brasileira, pois poucas são as informações detalhadas sobre sua morfologia. Línguas e fragmentos linguais de oito cervos do pantanal, adultos, provenientes do Projeto Cervo-do-Pantanal de Porto Primavera foram analisados quanto aos seus aspectos macroscópicos e à microscopia de luz. A língua do cervo do pantanal ocupa grande parte da cavidade oral, onde a raiz e o corpo estão fixados caudalmente pelo osso hióide e, em sua porção média, pelo frênulo lingual; seu ápice, achatado e plano é livre; apresenta torus lingual pouco proeminente, não havendo delimitação da fossa lingual. Na superfície dorsal encontram-se as seguintes papilas: filiformes, cônicas, lenticulares, fungiformes e valadas. Histologicamente verificou-se que a mucosa reveste-se de epitélio estratificado pavimentoso queratinizado, a lâmina própria constitui-se de tecido conjuntivo, rico em fibras colágenas dispostas em várias direções, onde se verifica abundante vascularização, além de acúmulo de tecido linfático.

The aim was to describe the morphology of the tongue of the Marsh deer (Blastocerus dichotomus), the largest deer of the Brazilian fauna, since there is little detailed information on their morphology. Tongues of eight adult Marsh deers, belonging to Projeto cervo-do-pantanal de Porto Primavera were analyzed for their macroscopic aspects and by light microscopy. The Marsh deer tongue occupies most of the oral cavity, where the root and body are fixed caudally by the hyoid bone, and in its middle portion by the frenulum linguae; its free apex is flat and plane, has little prominent torus lingae and there is no demarcation of fossa linguae. The lateral and ventral surfaces are covered by a thin mucosa; however the dorsal surface is covered by thick mucosa, although soft. On the dorsal surface are the papillae: filiform, conical, lenticular, fungiform and vallate. Histologically was found that the mucosa has a stratified squamous epithelium, the lamina propria consists of connective tissue rich in collagen fibers arranged in several directions, where there is abundant vascularization and accumulation of lymphoid tissue.

Tumores filoides de la mama. Experiencia de 2 años / Phyllodes of breast tumors. 2 years of experience

Introducción: Los tumores filoides constituyen un grupo de raros tumores fibroepiteliales de la mama, representan el 0,3-1,0%. El diagnóstico preoperatorio inadecuado conduce con frecuencia a la escisión local con márgenes positivos, lo cual precisara una cirugía de ampliación de márgenes por la alta probabilidad de recidiva. Objetivo: Describir las características demográficas, diagnóstico, tratamiento y evolución de pacientes portadores de tumores filoides en el período de marzo del 2012 a marzo del 2014 en el Servicio de Mastología del Hospital Central del Instituto de Previsión Social. Pacientes y método: Estudio retrospectivo, observacional, descriptivo de casos consecutivos. Resultados: En 2 años se identificaron 11 casos de tumores filoides, el rango de edades fue de 33-66 años, promedio de 45.9. Las tumoraciones presentaron tamaños entre 4 a 16 cm, promedio de 8.3 cm. Todos fueron sometidos a biopsia con aguja gruesa que informo sospecha de filoides en 8 de 11, en 2 casos informo un fibroadenoma. Todos fueron sometidos a exceresis de la tumoración en donde 2 casos los márgenes estuvieron comprometidos y precisaron ampliación de márgenes, los 2 casos que fueron informados como fibroadenoma. Todas las pacientes presentan un periodo de controles mayores a 6 meses libres de enfermedad. Conclusión: La edad promedio fue de 45.9 años, el diagnóstico se realizó por biopsia con aguja gruesa, donde el informe anatomopatológico reveló tumor filoides en el 72% de los casos, la excéresis tumoral fue el tratamiento, sin complicaciones.

Introduction: These neoplasms are a group of rare fibroepithelial tumors of the breast, accounting for 0.3-1.0% of breast tumors. Phyllodes tumors are generally classified into benign, borderline, and malignant tumors. Inadequate preoperative diagnosis often leads to local excision with positive margins, which will require surgery to expand margins because of the high probability of recurrence. Objective: Describe the demographic characteristics, diagnosis, treatment, and evolution of patients with tumor phyllodes in the period of March 2012 to March of 2014 in the service of Mastology of the Hospital Central of the Institute of Social Welfare. Patients an methods: Retrospective, observational, descriptive study of consecutive cases. Results: In two years 11 cases of phyllodes tumors were identified, the age range was between 33 to 66 years old, mean 45.9. The tumors had sizes gobetween 4-16 cm, mean 8.3 cm. All underwent core needle biopsy that inform suspected phyllodes in 8 of 11 cases, in 2 cases they reported a fibroadenoma. All underwent exeresis of the tumor where 2 cases were committed and required margins expanding margins, both were the reported as fibroadenoma. All patients have a greater control period to 6 months free of disease. Conclusion: Phyllodes tumors are a group of rare fibroepithelial tumors of the breast, accounting for 0.3-1.0% of all breast tumors (5, 6). To distinguish a phyllodes tumor of a fibroadenoma through physical examination is extremely difficult, a core biopsy can accurately diagnose most diseases of the breast (16, 17), but may be inconclusive to differentiate a benign fibroadenoma of a phyllodes tumor.

Cáncer en la Unidad de Cáncer del Hospital Departamental de Villavicencio, Colombia, 2006-2008 / Cancer in the Departmental Hospital Unit, Villavicencio, Colombia, 2006-2008 Abstract

Objetivo: Caracterizar los casos de cáncer atendidos en la Unidad de Cáncer del Hospital Departamental de Villavicencio (Colombia). Métodos: Estudio de cohorte retrospectivo basado en datos rutinarios de las características demográficas y clínicas de los casos de cáncer infiltrantes y casos in situ para el periodo 20062008. Se realizó un análisis general y uno específico para cuatro localizaciones principales (cuello del útero, mama, estómago y próstata) y cáncer en niños. Se hicieron comparaciones entre grupos mediante Chi cuadrado y se usaron frecuencias y medidas de tendencia central para las variables categóricas y numéricas. Resultados: Se analizaron 1.617 casos de cáncer, 95,7% fueron infiltrantes. La media de edad fue de 57 años (DE±18 años). El 68,7% residía en Villavicencio. Las primeras localizaciones fueron en orden descendente: piel (19,2%), cuello del útero (14,5%), mama (10,5%), estómago (8%), y próstata (5,3%); los grupos diagnósticos más frecuentes en niños: leucemias, linfomas y otras neoplasias epiteliales malignas. El 8,2% de los pacientes habían muerto al momento de la recolección de información, 20,5% por cáncer de estómago. Conclusiones: Se evidenció mayor proporción de casos en mujeres y una tercera parte sin aseguramiento en salud. Los cánceres más frecuentes en hombres fueron piel y próstata; en mujeres, cáncer de cuello uterino y mama, con mayor proporción en los estadios clínicos localmente avanzados. En ninños el principal diagnóstico fue la leucemia. Esta información institucional constituye una base importante para acercarse a describir el comportamiento del cáncer en el orden local.

Objective: To characterise the cases of cancer treated at the Cancer Unit of the Villavicencio Departmental Hospital (Colombia). Methods: A retrospective cohort study was conducted based on routine data to describe the demographic characteristics of all newly diagnosed cancer cases (both in situ and invasive) collected in the hospital-based registry through active search for the period 2006-2008. In-depth analyses were performed for four major cancer sites (cervix uteri, breast, stomach, prostate), and childhood cancers. Comparisons between groups were made using frequencies and measurements of central tendency to summarise the numerical and categorical variables, as well as Chi-squared tests. Results: Of a total of 1,617 new cancer cases were analysed, 95.7% of which were invasive. The mean age was 57 years (SD 18 years), 68.7% were residents of Villavicencio. The most common locations were, in descending order: skin (19.2%), cervix uteri (14.5%), breast (10.5%), stomach (8%), and prostate (5.3%). The most common diagnostic groups in children were: leukaemia, lymphoma, and other malignant epithelial neoplasms. Of the 8.2% of patients who died at the time of data collection, 20.5% were due to stomach cancer. Conclusions: Most cancer cases were in women, and one-third were in individuals with no health insurance cover. The most frequently occurring cancers were skin and prostate for males, and cervical and breast cancer for females, with most cancers being diagnosed in locally advanced stages. Leukaemia was the most common childhood cancer. This hospital-based cancer registry provides important information for the description of the behaviour of cancer in the local setting.

Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus / Efeitos da abordagem terapêutica da persistência de canal arterial sobre a evolução neonatal de recém-nascidos de extremo baixo peso

OBJECTIVE: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. METHODS: This was a multicentric cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. Outcomes: death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. RESULTS: 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 - 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) ...

OBJETIVO: Analisar os efeitos da terapêutica adotada para o canal arterial (CA) em recém-nascidos (RN) < 1.000gadmitidos em unidades neonatais (UN) da Rede Brasileira de Pesquisas Neonatais (RBPN), sobre os desfechos: óbito, displasia broncopulmonar (DBP), hemorragia intraventricular grave (HIVIII/IV), retinopatia da prematuridade cirúrgica (ROPcir), enterocolite necrosante cirúrgica (ECNcir) e o desfecho combinado óbito e DBP. MÉTODOS: Estudo multicêntrico, de coorte, coleta de dados retrospectiva, incluindo RN de 16 UN da RBPN de 01/01/2010 a 31/12/2011, PN < 1.000 g, idade gestacional (IG) < 33 semanas e diagnóstico ecocardiográfico de PCA. Excluídos: óbitos ou transferências até o terceiro dia de vida, infecções congênitas ou malformações. Grupos:G1 - conservadora (sem intervenção medicamentosa ou cirúrgica), G2 - farmacológica (indometacina ou ibuprofeno) e G3 - cirúrgico (com ou sem tratamento farmacológico anterior). Analisou-se: uso de esteroide antenatal, parto cesárea, PN, IG, Apgar5' < 4, sexo masculino, SNAPPE II, síndrome do dDesconforto respiratório (SDR), sepse tardia, ventilação mecânica (VM), surfactante < 2 horas de vida, tempo de VM e os desfechos: óbito, dependência de oxigênio com 36 semanas (DBP36s), HIV III/IV, ROPcir, ECNcir e óbito/DBP36s. Estatística: Teste t-Student, Qui-Quadrado ou teste Exato de Fisher. Testes de Regressão Binária Logística e Regressão Múltipla Stepwise Backward. MedCalc (Medical Calculator) software, versão 12.1.4.0.p < 0,05. RESULTADOS: Foram selecionados 1.097 RN e 494 foram incluídos: G1-187 (37,8%), G2-205 (41,5%) e G3-102 (20,6%). Verificou-se: maior mortalidade (51,3%) no G1 e menor no G3(14,7%); maior frequência DBP36s (70,6%) e ROPcir (23,5%) ...