Partial extraction therapies (PET): a review of the literature / Terapias de extração parcial (TEP): uma revisão da literatura

ABSTRACT One of the most common dental procedures is tooth extraction; however, the bone defect resulting from the process is only partially restored, leading to considerable bone loss. To rehabilitate a fully or partially edentulous patient, we must handle these sites with delicate surgical procedures. There is a large literature presenting attempts to overcome the negative effects of a dental extraction, with the aim of reducing tissue volume loss or restoring the alveolar architecture. In this context, Partial Extraction Therapy (PET) represents a subgroup of interventions to prevent bone loss after extraction using the tooth itself to prevent alveolar bone loss. This literature review aims to make a survey of the published articles on PET, with an emphasis on socket shield technique, and to explain the other techniques such as root burial, pontic-shield and proximal socket-shield, their indications and counter indications in order to deepen the knowledge of these techniques. To identify the included or considered studies, we adopted a detailed search strategy for MEDLINE and Cochrane Library focused in the last 31 years, whose language was English, Spanish or Portuguese. This text presents an analysis of current data regarding the alternatives for alveolar preservation and the installation of immediate implants in these areas, presenting the possibility of a different surgical technique. However, due to the immaturity and lack of conclusive scientific evidence regarding the predictability of the procedures, it is considered that the use of the socket shield technique must be done in an extremely cautious way.

RESUMO Um dos procedimentos odontológicos mais comuns é a extração dentária, contudo, , o defeito ósseo decorrente do processo é apenas parcialmente restaurado, levando a uma perda ossea volumétrica consideravel. Para reabilitar um paciente totalmente ou parcialmente desdentado, devemos manusear estes sitios com intervenções cirúrgicas delicadas. Há uma vasta literatura apresentando tentativas de transpor os efeitos negativos de uma extração dentária, com o objetivo de diminuir a perda volumétrica tecidual ou restaurar a arquitetura alveolar. Neste contexto, a Terapia de Extração Parcial (TEP) representa um subgrupo de intervenções para prevenir a perda óssea após exodontia, usando o próprio dente para prevenir a perda óssea alveolar. Essa revisão de literatura tem por objetivo fazer um levantamento dos artigos publicados sobre as TEP, com ênfase na técnica de socket shield, e explanar a cerca das demais técnicas como sepultamento radicular, pontic-shield e proximal socket-shield, suas indicações e contra-indicações, a fim de aprofundar o conhecimento dessas técnicas. Para a identificação dos estudos inclui?dos ou considerados, adotamos a estrate?gia de busca detalhada para os bancos MEDLINE e Biblioteca Cochrane nos u?ltimos 31 anos, cujo idioma fosse o ingle?s, espanhol ou o portugue?s. Este texto, apresenta uma análise de dados atuais a respeito das alternativas para a preservação alveolar e instalação de implantes imediatos nestas áreas, apresentando a possibilidade de uma técnica cirúrgica diferenciada. No entanto, devido a imaturidade e falta de comprovação cientifica contundente a respeito da previsibilidade dos procedimentos, considera-se que o emprego da técnica de socket shield deve ser feito de forma cautelosa.

Estado da arte sobre a produção científica nacional da medicalização do comportamento / State of the art research on the brazilian national scientific production of medicalization of behavior / Estado del arte sobre la producción científica de la medicalización del comportamiento

O presente trabalho apresenta uma pesquisa de estado da arte, de caráter quantitativo, que objetivou realizar o mapeamento das publicações científicas nacionais sobre o tema da medicalização do comportamento entre os anos 2000 e 2018. Neste levantamento, foram identificados os autores, seus respectivos estados, regiões e instituições de origem, número de publicações por ano, periódicos nos quais os artigos foram publicados e áreas de conhecimento desses periódicos, sujeitos-alvo das pesquisas, tipo de pesquisa e a ênfase da medicalização envolvida. Para isso, a base Periódico-CAPES ofereceu o material analítico, a partir da seguinte estratégia de busca: medicalização AND (comportament* OR desvio OR conduta OR transtorno OR sofrimento). A partir dos dados coletados, foram construídos gráficos com o fim de obter um panorama das investigações sobre o tema em questão. Os dados encontrados sinalizam, dentre outras coisas: o aumento do número de publicações a partir do ano de 2009; a concentração de autores nos estados das regiões Sudeste e Sul; a maior prevalência de publicações em revistas de Saúde Coletiva e Interdisciplinar; a predominância de pesquisa teórica relativamente aos estudos empíricos; a prevalência das mulheres como sujeito-alvo de quantidade importante de pesquisas sobre medicalização do comportamento. (AU)

This study presents quantitative state-of-the-art research aimed at mapping Brazilian scientific publications on the topic of medicalization of behaviors between the years 2000 and 2018. The research identified authors, their respec-tive states, regions, and institutions of origin, the number of publications per year, the journals in which the articles were published, the fields of knowledge of these journals, the target subjects of the research, the type of research, and the emphasis on the involved medicalization. Data from the Periodic Portal from CAPES provided the analytical material using the following search strategy: medicalization AND (behavior* OR deviation OR conduct OR disorder OR suffering). The collected data were used to create graphs in order to provide an overview of the research on the subject. The findings indicate, among other things: an increase in the number of publications since 2009; a concentration of authors in Brazilian states from the southeastern and southern regions; a higher prevalence of publications in journals related to Collective and Inter-disciplinary Health fields; a predominance of theoretical research compared to empirical studies; and a significant focus on women as the subject of research on medicalization of behaviors. (AU)

En el presente trabajo fue realizada una investigación cuantitativa del Estado del Arte que objetivó el mapeado de las publicaciones científicas sobre el tema de la medicalización del comportamiento, entre los años 2000 y 2018. En este levantamiento, fueron identificados los autores, sus respectivos estados, regiones e instituciones de origen, número de publicaciones por año, periódicos en los cuales los artículos fueron publicados y las áreas de conocimiento de estos periódicos, tema objetivo de las investigaciones, tipo de investigación y énfasis de la medicalización involucrada. Para ello, fue utilizado el Periódico-CAPES, aplicando los siguientes descriptores: medicalización AND (comportamient* OR desvío OR conducta OR trastorno OR sufrimiento). A partir de los datos colectados, fueron construidos gráficos con el fin de ofrecer un panorama de las investigaciones sobre el tema en cuestión. Los datos encontrados señalan, entre otras cosas: el aumento del número de publicaciones a partir del año de 2009; la concentración de los autores en los estados de las regiones del Sudeste y Sur; la mayor prevalencia de publicaciones en revistas de Salud Colectiva e Interdisciplinaria; la predominancia de la investigación teórica relativa a los estudios empíricos; la prevalencia de las mujeres como objeto de investi-gación de cantidad importante de investigaciones sobre la medicalización del comportamiento. (AU)

Eletrocardiograma padrão de 12 derivações para diagnóstico da oclusão coronariana aguda: nova abordagem eletrocardiográfica das síndromes coronarianas / Preservation of anatomical specimens in sodium chloride: a study with fertilization product / Conservación de especímenes anatómicos en cloruro sódico: un estudio con producto de fertilización

Introdução: As síndromes coronarianas agudas decorrem de ruptura de placa coronariana com formação de trombos, embolização e obstrução, dependendo do nível de obstrução, podemos ter infartos e anginas e a nível eletrocardiográfico podemos ter ou não o supra desnivelamento do segmento ST. Para o correto diagnóstico e melhor prognóstico é importante acompanhar suas manifestações clínicas e avaliar as alterações eletrocardiográficas. Objetivo: Estudar uso do eletrocardiograma padrão de 12 derivações, para diagnóstico da oclusão coronariana aguda: uma nova abordagem eletrocardiográfica das síndromes coronarianas. Método: Estudo de revisão integrativa, com dados secundários da Biblioteca Virtual em Saúde (BVS), base eletrônica de dados da Literatura Latino ­ Americana e do Caribe em Ciências da Saúde (Lilacs) e da biblioteca digital Scientific Electronic Library Online (Scielo). Resultados: Descreveu-se 7 achados eletrocardiográficos sugestivos de oclusão coronariana aguda: padrões como os De Winter, Wellens, IAM posterior, distorção final do QRS, Critérios de Sgarbossa- Smith para IAM associado a BRE ou ritmo de marca-passo ventricular, ondas T's hiperagudas e fórmulas matemáticas para diagnóstico da oclusão da descendente anterior. Conclusão: Embora a abordagem que se vale de tais achados no ECG seja mais acurada na detecção da oclusão coronariana aguda do que os critérios milimétricos do segmento ST, essa nova abordagem precisa de mais estudos para avaliação de seu real poder diagnóstico.

Introduction: As acute coronary syndromes due to coronary plaque rupture, with thrombus formation, embolization and obstruction, depending on the degree of obstruction, we may have infarction and angina at the electrocardiographic level, we may have an unevenness or overdevelopment of the ST interval. For a correct diagnosis and prognosis, it is important to monitor its clinical manifestations and assess electrocardiographic changes. Objective: To study the use of a standard 12- lead electrocardiogram for the diagnosis of acute coronary occlusion: a new electrocardiographic approach to coronary syndromes. Method: Integrative review study, secondary data from the Virtual Health Library (VHL), electronic database of the Latin American and Caribbean Literature on Health Sciences (Lilacs) and the Scientific Electronic Library Online (Scielo) digital library. Results: Seven electrocardiographic findings suggestive of acute coronary occlusion were described: patterns such as De Winter, Wellen, posterior AMI, terminal QRS distortion, Sgarbossa-Smith criteria for AMI associated with LBBB or ventricular paced rhythm, hyperacute T waves, and mathematical formulas for diagnosing anterior descending occlusion. Conclusion: Although the approach that makes use of such ECG findings is more accurate in detecting acute coronary occlusion than the millimeter ST-segment criteria, this new approach needs further studies to assess its real diagnostic power.

Introducción: Como síndromes coronarios agudos debidos a rotura de placa coronaria, con formación de trombo, embolización y obstrucción, dependiendo del grado de obstrucción, podemos tener infarto y angina a nivel electrocardiográfico, podemos tener un desnivel o sobredesarrollo del intervalo ST. Para un correcto diagnóstico y pronóstico es importante monitorizar sus manifestaciones clínicas y valorar los cambios electrocardiográficos. Objetivo: Estudiar el uso de un electrocardiograma estándar de 12 derivaciones para el diagnóstico de la oclusión coronaria aguda: una nueva aproximación electrocardiográfica a los síndromes coronarios. Método: Estudio de revisión integradora, datos secundarios de la Biblioteca Virtual en Salud (BVS), base de datos electrónica de la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs) y de la biblioteca digital Scientific Electronic Library Online (Scielo). Resultados: Se describieron siete hallazgos electrocardiográficos sugestivos de oclusión coronaria aguda: patrones como De Winter, Wellen, IAM posterior, distorsión terminal del QRS, criterios de Sgarbossa-Smith para IAM asociado a BRIHH o ritmo ventricular estimulado, ondas T hiperagudas y fórmulas matemáticas para el diagnóstico de oclusión de la descendente anterior. Conclusiones: Aunque el enfoque que hace uso de dichos hallazgos ECG es más preciso en la detección de la oclusión coronaria aguda que los criterios milimétricos del segmento ST, este nuevo enfoque necesita más estudios para evaluar su poder diagnóstico real.

Hiv/aids e sua principal coinfecção-tuberculose: panorama de uma década de um estado do nordeste brasileiro e suas semelhanças à sociodemografia subsaariana / Hiv/aids and its main coinfection-tuberculosis: a decade panorama of a northeastern brazilian state and its similarities to subsaharan sociodemographics / Vih/sida y su principal coinfección-tuberculosis: panorama decenal de un estado del nordeste brasileño y sus similitudes con la sociodemografía subsahariana

Introdução: Entre o início da epidemia do HIV na década de 1980 até 2018, houve cerca de 32 milhões de óbitos e no mundo existem aproximadamente 37,9 milhões de pessoas viviam com HIV e AIDS. Assim, mesmo com advento da TARV, as pessoas vivendo com HIV/AIDS permanecem sujeitas a redução na qualidade de vida, sendo que dentre esses fatores a coinfecção por Tuberculose se demonstra a principal responsável pela alteração de prognóstico. Desta forma o presente estudo busca estabelecer um panorama epidemiológico das pessoas vivendo com HIV/ AIDS e a sua principal coinfecção no Estado do Maranhão. Metodologia: Trata-se de um estudo epidemiológico descritivo retrospectivo, de abordagem quantitativa que apresenta o perfil das pessoas que vivem com HIV/AIDS, bem como, a principal coinfecção, no período de 2009 a 2018 no Maranhão. Resultados: No período de 2009 a 2018 foram notificados 7691 casos de AIDS no Maranhão, sendo a maioria composta por indivíduos de 20 a 49 anos, do sexo masculino, cor parda e com escolaridade entre a 1ª serie e o ensino fundamental completo, via de transmissão heterossexual e com maior tendência a coinfecção por Tuberculose nos últimos anos da amostra e nos casos de uso de TARV. Conclusão: O Panorama obtido propõe uma maior necessidade de intervenção e conscientização da necessidade de códons, além de maior rastreio de indivíduos no uso da TARV. Embora observada forte redução nas notificações em 2018, há a necessidade de cautela, principalmente pelo retrato da epidemia em regiões com similaridade sócio demográfica.

Introduction: Between the beginning of the HIV epidemic in the 1980s until 2018, there were about 32 million deaths and in the world there are approximately 37.9 million people living with HIV and AIDS. Thus, even with the advent of ART, people living with HIV/AIDS remain subject to reduced quality of life, and among these factors, co-infection with tuberculosis proves to be the main responsible for the change in prognosis. Thus, the present study seeks to establish an epidemiological panorama of people living with HIV/AIDS and their main co-infection in the state of Maranhão. Methodology: This is a retrospective descriptive epidemiological study, of quantitative approach that presents the profile of people living with HIV/AIDS, as well as, the main coinfection, in the period from 2009 to 2018 in Maranhão. Results: In the period from 2009 to 2018, 7691 cases of AIDS were notified in Maranhão, being the majority composed of individuals aged 20 to 49 years, male, brown color and with education between 1st grade and complete elementary school, heterosexual transmission route and with a greater tendency to coinfection by Tuberculosis in the last years of the sample and in cases of ART use. Conclusion: The Panorama obtained proposes a greater need for intervention and awareness of the need for codons, in addition to greater screening of individuals on ART use. Although observed a strong reduction in notifications in 2018, there is a need for caution, mainly because of the epidemic's portrayal in regions with socio demographic similarity.

Introducción: Entre el inicio de la epidemia del VIH en la década de 1980 hasta 2018, hubo cerca de 32 millones de muertes y en el mundo hay aproximadamente 37,9 millones de personas que viven con el VIH y el SIDA. Así, incluso con el advenimiento de la terapia antirretroviral, las personas que viven con VIH/SIDA siguen estando sujetas a la reducción de la calidad de vida, y entre estos factores, la coinfección con tuberculosis resulta ser el principal responsable del cambio en el pronóstico. Así, el presente estudio busca establecer un panorama epidemiológico de las personas que viven con VIH/SIDA y sus principales coinfecciones en el estado de Maranhão. Metodología: Se trata de un estudio epidemiológico descriptivo retrospectivo, de abordaje cuantitativo que presenta el perfil de las personas que viven con VIH/SIDA, así como, la principal coinfección, en el período de 2009 a 2018 en Maranhão. Resultados: En el período de 2009 a 2018, fueron notificados 7691 casos de SIDA en Maranhão, siendo la mayoría compuesta por individuos de 20 a 49 años, de sexo masculino, color castaño y con escolaridad entre 1º grado y primaria completa, vía de transmisión heterosexual y con mayor tendencia a la coinfección por Tuberculosis en los últimos años de la muestra y en los casos de uso de TAR. Conclusiones: El Panorama obtenido propone una mayor necesidad de intervención y concienciación de la necesidad de codones, además de un mayor cribado de los individuos en uso de TAR. A pesar de observarse una fuerte reducción de notificaciones en 2018, es necesario ser cautelosos, principalmente por el retrato de la epidemia en regiones con similitud socio demográfica.

Corifollitropin Alfa for Controlled Ovarian Stimulation in Assisted Reproductive Technologies: State of the Art / Alfacorifolitropina para estimulação ovariana controlada em tecnologias de reprodução assistida: Estado da arte

Abstract Physical and emotional burdens during the journey of infertile people through assisted reproductive technologies are sufficient to justify the efforts in developing patient-friendly treatment strategies. Thus, shorter duration of ovarian stimulation protocols and the need for less injections may improve adherence, prevent mistakes, and reduce financial costs. Therefore, the sustained follicle-stimulating action of corifollitropin alfa may be the most differentiating pharmacokinetic characteristic among available gonadotropins. In this paper, we gather the evidence on its use, aiming to provide the information needed for considering it as a first choice when a patient-friendly strategy is desired.

Resumo O desgaste físico e emocional durante a jornada de pessoas inférteis pelas tecnologias de reprodução assistida é suficiente para justificar esforços no desenvolvimento de estratégias de tratamento compassivas. Desta forma, a menor duração dos protocolos de estimulação ovariana e a necessidade de menos injeções podem melhorar a adesão, prevenir erros e reduzir custos financeiros. Portanto, a estimulação folicular sustentada da alfacorifolitropina parece ser a característica farmacocinética que melhor a diferencia das gonadotrofinas atualmente disponíveis no mercado. No presente artigo, reunimos evidências sobre seu uso, com o objetivo de fornecer as informações necessárias para considerá-la como primeira escolha quando se deseja uma estratégia amigável ao paciente.

The use of light-transparent acetate sheet to measure canopy height of marandu palisadegrass: the influence of development stage and sward height

The use of light-transparent acetate sheet (LAS) may generate variations in the height measured in the sward. However, we compared the use or non-use of LAS to measure the average sward height of marandu palisadegrass (Urochloa brizantha syn. Brachiaria brizantha cv. Marandu) pastures. In the first experiment, the methods were applied in pastures with different average heights (15, 25, 35, and 45 cm), managed under continuous stocking with sheep, and with predominance of vegetative tillers. The shorter pastures (15 and 25 cm) had similar heights with or without the use of the LAS. However, in the taller pastures (35 and 45 cm), the use of LAS resulted in lower height values, compared with its absence. In the second experiment, we compared both methods for measuring the height of deferred marandu palisadegrass and fertilized with two nitrogen levels (50 and 200 kg ha-1) and with high presence of reproductive tillers. A completely randomized design with four replicates was adopted. With 200 kg ha-1 of N, the canopy height was greater than when it was fertilized with 50 kg ha-1 of N. With the use of LAS, the height of deferred and reproductive canopy was greater than without it. In a taller marandu palisadegrass pasture with predominance of vegetative tillers, the use of LAS results in smaller height, contrary to what occurs in deferred swards with reproductive tillers.

The sward height at the early stockpiling period modifies the structural characteristics of marandu palisadegrass under continuous stocking

The control of sward height at the early stockpiling period influences the structural characteristics of stockpiled sward in winter. So, we conducted this work on the Cerrado region of Brazil based on the hypothesis that the reduction of pasture height at the beginning of stockpiling period results in: (i) lower stock of forage mass; and (ii) higher live leaf mass, but lower stem mass in stockpiled pasture during the winter. The treatments were four sward heights (15, 25, 35, and 45 cm) at early stockpiling period of marandu palisadegrass (Brachiaria brizantha syn. Urochloa brizantha cv. Marandu). The experiment was conducted in a completely randomized design, with three replications (paddocks with 800 m²). The stockpiled swards were evaluated during the grazing period in winter on days 7 (beginning), 45 (middle) and 90 (end). The vegetative tiller number (VEGT), live leaf mass (LLM) and leaf area index (LAI) were greater in the 15 cm stockpiled pasture than the other treatments. Greater heights (35 and 45 cm) at stockpiling resulted in greater forage mass than lower heights (15 and 25 cm). The VEGT, LLM, number of reproductive tillers, live stem mass, forage mass and LAI values were higher at the beginning than at the end of the grazing period. Our hypothesis has been proven, so that the reduction of sward height of the marandu palisadegrass at the beginning of the stockpiling period results in lesser forage mass, but with better structural characteristics.

How does the initial sward height and the grazing period influence the spatial variability of vegetation in deferred signal grass pastures?

The objective of this study was to evaluate the spatial variability of structural characteristics of deferred pastures of Brachiaria decumbens cv. Basilisk (signal grass) subjected to associations of sward heights (10, 20, 30, and 40 cm) at the beginning of deferment and grazing periods (1, 28, 56, 85, and 113 days). The experiment was arranged in a split-plot and completely randomized-block design with two replicates. Pastures remained deferred from March to June 2010. From June to the beginning of October 2010, deferred pastures were utilized by steers under continuous grazing and at a fixed initial stocking rate of 3.5 AU ha-1. At the beginning of the deferment, the coefficient of variation (CV) for pasture height was reduced linearly with the pasture height. During the grazing period, in the winter, the CV for pasture height was not influenced by initial pasture height; however, it responded quadratically to the grazing period, with a maximum value of 36.4% at 71 days of the period of utilization. The CV for tiller height was reduced linearly with pasture height at the beginning of deferment but increased linearly along with the grazing period. The initial pasture height did not change the CV of the falling index. However, the latter was quadratically influenced by the grazing period, with a maximum value of 59.5% at 67 days of the utilization period. Signal grass pastures deferred at a lower height have a higher spatial variability of the vegetation. In the grazing period, there are changes in the spatial variability of the vegetation of the deferred signal grass.

How does the condition of the pasture in late winter influence the plant and animal responses in the subsequent seasons?

This study aimed to test the hypotheses: (i) the deferred pasture with lower height in late winter has greater herbage accumulation rate (HAR) and better structure, which facilitates the animal selective grazing during the subsequent spring and summer; (ii) the mowed of high pasture in late winter improves the sward structure but decreases its HAR from the spring. Four pasture condition in late winter of Urochloa brizantha cv. Marandu were evaluated: low (24.1 cm and 2,420 kg.ha-1 of DM); low/mowed (25.2 cm and 2,198 kg.ha-1 of DM, mowed at 8.0 cm); high (49.0 cm and 3,837 kg.ha-1 of DM); and high/mowed (50.0 cm and 4,211 kg.ha-1 DM, mowed at 8.0 cm). The highest live leaf blade percentage (LLBP) and the lowest dead stem percentage (DSP) occurred in the mowed pastures. The live stem (LSP) and dead leaf blade percentages of the grazing simulation sample were higher in the high pasture. This same pattern of response occurred for apparent selectivity indices (ASI) of the live leaf blade and live stem. The ASI of the dead leaf blade was greater in the high pasture, intermediate in the mowed pastures, and lower in the low pasture. The ASI of the dead stem was lower in the low pasture. The HAR was higher in low pasture. Our results support the first hypothesis. The mowing of high pasture in late winter improves the sward structure and the animal selective grazing but does not decrease the HAR during spring and summer.

Does amount of cut vegetal residue on the canopy influence growth and the structural characteristics of marandu palisadegrass?

The pasture mowing in late winter removes the old forage, improving the pasture structure in spring and summer. However, the residue after mowing can affect tillering, thus limiting forage production and the structural characteristics of pasture. We hypothesized that the high amount of cut vegetal residues on the plants in late winter causes a decrease in forage production and modifies the structural characteristics of the forage canopy during the spring and summer. The treatments were four cut vegetal residues (0; 2,000; 4,000 and 8,000 t ha-1 of natural material) deposited on Urochloa brizantha cv. Marandu canopy in late winter. After that, the forage production and structure characteristics were evaluated during the spring and summer for two years. The complete randomized block design, with four replications, was used. The defoliation management was characterized by the adoption of pre- and post-cut heights of 25 and 15 cm, respectively. For both years, there was no effect of cut vegetal residue on all the characteristics evaluated. No variable was affected by the interaction cut vegetal residue amount × year of evaluation. The dead leaf blade percentage was greater in year 2 (6.9%) than in year 1 (3.5%). The average values of variables were live leaf blade percentage = 84.2%; live stem percentage = 8.7%; dead stem percentage = 1.9%; number of vegetative tiller = 653 tiller/m2; number of reproductive tiller = 5 tiller m-2. The forage production rate presented an average value of 46 kg/ha/day of dry matter. The cut vegetal residue amount of up to 8,000 t/ha of natural material on the plants in late winter does not affect the forage production or modifies the structural characteristics of marandu palisadegrass during the subsequent spring and summer.

Spatial distribution and effects of land use and cover on cutaneous leishmaniasis vectors in the municipality of Paracambi, Rio de Janeiro, Brazil

ABSTRACT The municipality of Paracambi (Rio de Janeiro, Brazil) reports sporadic cases of American cutaneous leishmaniasis (ACL). Previous studies detected Nyssomyia intermedia (Diptera: Psychodidae) as the main vector in the region, but its spatial distribution and the presence of other vector species have not been evaluated. This study aims at filling this knowledge gap, by studying the ecology of sand flies, their spatiotemporal distribution, and correlation with land use/cover. Two campaigns of monthly sand fly collections using light traps and manual captures were conducted in 1992-1994 and 2001-2003. Females were dissected to detect natural Leishmania infections. The spatial distribution of sand flies was assessed using kernel density maps. Correlations with land use/cover were evaluated by extracting satellite imagery data around the capture points. A total of 17,232 sand flies from 13 species were captured. Medically important species included Ny. intermedia, Migonemyia migonei, Pintomyia fischeri and Ny. whitmani. No Leishmania-infected females were detected. Highest densities were detected in the peri-urban areas Cascata and Sabugo, and in rural areas São José and Mutirão. Ny. intermedia had statistically significant correlations with pasture and agricultural areas. Present results strengthened that Ny. intermedia and Mg. migonei are the main local ACL vectors. Correlations with land use evidence the association between ACL and anthropic environmental change.

Infecção por COVID-19 na gestação / COVID-19 infection in pregnancy

SARS-CoV-2 é um novo agente infeccioso e pouco se sabe acerca do risco de sua infecção para o desenvolvimento embrionário e fetal humano, por isso é de extrema importância identificar o quadro clínico da infecção em gestantes, bem como registrar as complicações perinatais associadas à COVID-19. O quadro clínico em gestantes é semelhante ao do restante da população, contudo foi observado um aumento potencial de desfechos adversos em gestantes ­ como admissão em unidade de terapia intensiva, necessidade de ventilação mecânica e maior risco de parto prematuro e de cesáreas ­ e as taxas de mortalidade são semelhantes às da população em geral. Uma questão recorrente e ainda não elucidada seria a possibilidade de transmissão vertical do SARS-CoV-2.(AU)

SARS-CoV-2 is a new infectious agent, which little is known about the risk of its infection for human embryonic and fetal development, it is extremely important to identify the clinical symptoms of the infection in pregnant women, as well as to record the perinatal complications associated with COVID-19. The clinical symptoms in pregnant women is similar to the rest of the population, an increase in the risk of adverse outcomes in pregnant women was observed, such as: intensive care unit admission, need for mechanical ventilation, a higher risk of prematurity and cesarean, however mortality rates are similar to the general population. A recurring and unexplained issue would be the possibility of vertical transmission of SARS-CoV-2.(AU)

Ex vivo retrieval of mature oocytes for fertility preservation in a patient with bilateral borderline ovarian tumor / Recuperação ex vivo de oócitos maduros para preservação da fertilidade em paciente com tumor ovariano borderline bilateral

Abstract We report a case of ultrasound-guided ex vivo oocyte retrieval for fertility preservation in a woman with bilateral borderline ovarian tumor, for whom conventional transvaginal oocyte retrieval was deemed unsafe because of the increased risk of malignant cell spillage. Ovarian stimulation with gonadotropins was performed. Surgery was scheduled according to the ovarian response to exogenous gonadotropic stimulation; oophorectomized specimens were obtained by laparoscopy, and oocyte retrieval was performed ~ 37 hours after the ovulatory trigger. The sum of 20 ovarian follicles were aspirated, and 16 oocytes were obtained.We performed vitrification of 12 metaphase II oocytes and 3 oocytes matured in vitro. Our result emphasizes the viability of ex vivo mature oocyte retrieval after controlled ovarian stimulation for those with high risk of malignant dissemination by conventional approach.

Resumo Relatamos um caso de obtenção ex vivo de óvulos, guiada por ultrassonografia, para preservação da fertilidade em uma mulher com tumor ovariano borderline bilateral, para quem a recuperação transvaginal convencional foi considerada insegura, devido ao aumento do risco de disseminação de célulasmalignas. Foi realizada estimulação ovariana com gonadotrofinas. A cirurgia foi agendada de acordo com a resposta ovariana à estimulação gonadotrófica exógena; após ooforectomia por laparoscopia, ~ 37 horas após a maturação folicular, procedeu-se à recuperação extracorpórea de oócitos. Umtotal de 20 folículos ovarianos foi aspirado e 16 complexos cumulus foramobtidos, resultando na vitrificação de 12 oócitos maduros e de 3 oócitos imaturos amadurecidos in vitro. Nosso resultado enfatiza a viabilidade da recuperação ex vivo de oócitos maduros após estimulação ovariana controlada para mulheres com alto risco de disseminação maligna pela captação oocitária realizada convencionalmente pela via transvaginal.

Covid-19: Uncertainties from conception to birth / Covid-19: incertezas desde a concepção até o nascimento

Abstract Scientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.

Resumo As informações científicas sobre o impacto do novo coronavírus, SARS-CoV-2, na saúde de gestantes, fetos e recém-nascidos são consideradas de confiabilidade limitada, sem evidências de boa qualidade, e levam a conclusões enviesadas. De fato, as impressões iniciais de que a evolução da Covid-19 não era diferente entre mulheres grávidas e não grávidas, e de que o SARS-CoV-2 não era transmitido verticalmente, são confrontadas pela documentação de agravamentos da doença durante a gravidez, resultados obstétricos negativos, e a possibilidade de transmissão vertical. Este artigo tem como objetivo compilar os dados disponíveis sobre a associação entre a Covid-19 e os eventos reprodutivos, desde a concepção até o nascimento.

Visão dos docentes de uma universidade aberta à terceira idade quanto ao processo de ensino e aprendizagem de idosos / An open university of the third age professors view about the teaching and learning process of the elderly

Esta pesquisa tem por objetivo compreender a visão dos docentes em um projeto de educação para adultos e idosos, oferecido no formato de Universidade Aberta à Terceira Idade (UATI), quanto ao processo ensino-aprendizagem de idosos. Trata-se de pesquisa qualitativa, na qual participaram de uma entrevista semiestruturada treze professores que ministraram aulas entre 2013 e 2016. O procedimento de análise de conteúdo permitiu conhecer a forma de ingresso, os aspectos didáticos empregados e a percepção dos docentes quanto aos alcances e às limitações da proposta. Os dados indicaram que a maioria dos docentes são provenientes da própria instituição de ensino, privilegiam aulas expositivas e dialogadas e centralidade na relação professor/aluno e menos na relação entre idosos. Conclui-se que há necessidade de preparação do docente para atuar com idosos e o conteúdo ministrado deve estar relacionado às necessidades e às motivações de aprendizagem dos alunos, a fim de favorecer o processo de aprendizagens cognitivas e emocionais.(AU)

This research aims to understand the professors' view in an adult and elderly education project, offered in the format of Open University of the Third Age (OUTA), about the learning and teaching process of the elderly. This qualitative research was carried out with thirteen professors who taught between 2013 and 2016 and participated in a semi-structured interview. The content analysis procedure allowed us to know the form of entry, didactic aspects employed, and the professors' perception of the scope and limitations of the proposal. The data indicated that the professors' majority came from the institution itself, they favor dialogic lectures classes, the centrality in the professor/student relationship, and less in the relationship between the elders. It is concluded that there is a need to prepare professors to work with elderlies and the content taught must be related to students' learning needs and motivations to favor the process of cognitive and emotional learning.(AU)

Influência da progesterona injetável na taxa de prenhez e perda gestacional de fêmeas nelore de distintas categorias reprodutivas submetidas a inseminação artificial em tempo fixo / Influence of injectable progesterone on the pregnancy rate and gestational loss of Nellore females of different reproductive categories undergoing fixed-time artificial insemination

Progesterone (P4) is essential for embryonic development and maintenance of pregnancy when deficiency causes early embryonic loss. In this study, we investigated the ability of hormonal supplementation to improve the fertility of Nellore females subjected to fixed-time artificial insemination (IATF) protocols. Here, we evaluated the effect of long-acting injectable progesterone (iP4) supplementation in the D4 after IATF on pregnancy rate and pregnancy loss in Nellore females (Bos taurus indicus) from different reproductive categories in Western Amazonia. Eight hundred thirteen Nellore females from 5 farms were selected and distributed into 2 groups: control [GC; administration of 0.5 mL of 0.9% saline solution, intramuscularly - IM] (n = 407) and a group that received injectable progesterone (iP4) that was long-acting [GiP4; administration of 0.5 mL of iP4, 300 mg, via IM four days after IATF] (n = 406). Each group contained 3 subgroups: heifers, primiparous cows, and multiparous cows. Of the 407 animals in the CG, 103 were heifers, 107 primiparous, and 197 multiparous. Of the 406 animals in the GiP4 group, there were 101 heifers, 107 primiparous, and 198 multiparous. On a random day of the estrous cycle (D0), an intravaginal device containing 1 g of P4 and 2 mg of estradiol benzoate (BE) was inserted by intramuscular injection. On D8, the P4 device was removed and 150 µg of D-cloprostenol (PGF2α), 300 IU eCG, and 1 mg BE were administered IM. Cows were inseminated at D10, 48-52 h after procedure on D8. Pregnancy diagnosis was made between 35 and 40 days after insemination through ultrasound examination. Between 80 and 90 days after insemination, a new ultrasound examination was performed to assess early pregnancy loss. The data were processed using the SAS 9.2. The conception rate, pregnancy loss, and final conception rate were analyzed using PROC GLIMMIX according to groups (CG and GiP4), categories (heifers, primiparous and multiparous), and their interactions as variables. The differences in the means of least squares were adjusted using the Tukey­Kramer method. Statistical significance was defined as P < 0.05. The general conception rate was 46% (375/816). Regardless of the animal class, GiP4 animals (51.97%) had higher conception rates (P < 0.05) than CG (40.29%). In the subgroups (heifers, primiparous and multiparous cows), there was a difference (P < 0.05) between animals treated with iP4 (52.48%, 57.94%, and 48.48%, respectively) and those who were not (39.81%, 41.12%, and 40.10%, respectively). Gestational losses, regardless of the animal class, were higher in females in the CG (7.93%) [P < 0.05] compared to those in the GiP4 group (2.84%). Regardless of treatment with iP4, the percentage of gestational loss in heifers was significantly higher (10.64%) than that in primiparous and multiparous cows (3.77% and 2.86%, respectively). The final conception rates were higher in animals that received long-acting iP4, which increased the final pregnancy in all parity categories. In the present study, the use of iP4 increased the pregnancy rate in Nellore females, regardless of the category. Although there has been no consensus on the use of iP4, there is an agreement that increases in the pregnancy rate are related to the moment of exogenous P4 application. In addition to influencing the pregnancy rate, reduction in pregnancy losses is also attributed to iP4 treatment, a fact demonstrated in the present study, where animals treated with iP4 had a lower pregnancy loss rate than normally occurs in beef cattle. Supplementation with long-acting iP4 increased the pregnancy rate at D35-40, reduced pregnancy losses, and increased the conception rate on D80-90 days in Nellore females reared in the Western Amazon, regardless of the animal category.(AU)

O que é a Psicologia Concreta? Reflexões politzerianas em torno do problema da crise da psicologia / What is Concrete Psychology? Politzerian reflections on the psychology crisis issues

Este artigo dedica-se a ­ a partir da análise da Crítica dos fundamentos da Psicologia, de Georges Politzer ­ caracterizar a psicologia concreta. O texto em tela resulta de pesquisa que objetiva identificar as semelhanças e diferenças nas análises da crise da psicologia da década de 1920 feitas por Vigotski e Politzer. O material apresentado dedica-se, em particular, a esse último autor. A análise aqui apresentada organiza-se em torno dos fundamentos da psicologia clássica, tal qual caracterizados por Politzer: a) a elementaridade do psíquico e a abstração do sentido; b) a análise da vida interior e dos processos internos; c) a apreensão imediata do fenômeno psicológico e o problema do método direto; e d) o postulado da convencionalidade da significação. A análise aqui empreendida ainda faz remissão à psicologia histórico-cultural, na medida em que ela se encontra com as apreciações politzerianas, e a outras escolas de psicologia não tratadas diretamente por Politzer. Por fim, apresenta-se um conjunto de questões em torno da psicologia concreta que configuram um interessante programa de pesquisa, a saber: a necessidade de um inventário crítico da crise da psicologia contemporaneamente; a identificação da psicologia histórico-cultural com a psicologia concreta; uma definição provisória da psicologia concreta.

This article aims to feature ­ from Georges Politzer's Critique of the Foundations of Psychology analysis ­ Concrete Psychology. This text is an outcome of a research ensued to identify similarities and differences in 1920's psychology crisis analysis carried out both by Vigotski and Politzer. The material here presented is dedicated, notably, to the latter author. The analysis is organized around the fundamentals of classical psychology as Politzer displays: a) elementary nature of psychic and the abstraction of meaning; b) inner life analysis and the internal processes; c) immediate apprehension of a psychological phenomenon and the problem of direct method; d) postulate of meaning conventionality. This is still an ongoing analysis reference to historical-cultural psychology insofar it meets Politzerian appraisals and other psychology schools not directly handled by Politzer. Finally, a set of issues is presented on Concrete Psychology setting up an interesting research program, namely: an uptodate critical inventory demand for psychology crisis; matching Historical-Cultural Psychology to Concrete Psychology; a provisional definition of Concrete Psychology.