Comparison Between Surgical Techniques for Correction of Congenital Syndactyly: A Systematic Review and Meta Analysis.

This review aimed to assess which surgical technique has better outcomes to correct one of the most common congenital anomalies of the upper limb: syndactyly. The following databases were used in the search: PubMed, Embase, Cochrane (CENTRAL), LILACS, SciELO, Scopus and Web of Science, on October 27, 2022. Studies that described a surgical technique for correcting syndactyly and evaluated surgical complications were included. Studies about noncongenital or foot syndactyly were excluded. The risk of bias was assessed using a specific method for case reports. For synthesis of results, the characteristics of the studies and techniques were demonstrated by a qualitative analysis. Meta-analysis models were applied for complications, functionality, and aesthetic. 73 studies were included, of which 70 were series or case reports, 27 studies did not use skin grafts and 7 studies used external fixators. To evaluate functional results, 42 studies used only the surgeon's opinion. Meta-analyses showed a higher incidence of scar defects when using skin grafts and of infection when using external fixators. There was no difference for web creep and readmission. Few studies evaluated results using the VSS scale, showing worse scar pigmentation when skin grafts were used, but there was no difference in other parameters (PROSPERO CRD42022368930).

The effects of dissolved organic carbon and model compounds (DOC analogues) on diffusive water flux, oxygen consumption, nitrogenous waste excretion rates and gill transepithelial potential in Pacific sanddab (Citharichthys sordidus) at two salinities.

Many flatfish species are partially euryhaline, such as the Pacific sanddab which spawn and feed in highly dynamic estuaries ranging from seawater to near freshwater. With the rapid increase in saltwater invasion of freshwater habitats, it is very likely that in these estuaries, flatfish will be exposed to increasing levels of dissolved organic carbon (DOC) of freshwater origin at a range of salinities. As salinity fluctuations often coincide with changes in DOC concentration, two natural freshwater DOCs [Luther Marsh (LM, allochthonous) and Lake Ontario (LO, autochthonous) were investigated at salinities of 30 and 7.5 ppt. Optical characterization of the two natural DOC sources indicate salinity-dependent differences in their physicochemistry. LO and LM DOCs, as well as three model compounds [tannic acid (TA), sodium dodecyl sulfate (SDS) and bovine serum albumin (BSA)] representing key chemical moieties of DOC, were used to evaluate physiological effects on sanddabs. In the absence of added DOC, an acute decrease in salinity resulted in an increase in diffusive water flux (a proxy for transcellular water permeability), ammonia excretion and a change in TEP from positive (inside) to negative (inside). The effects of DOC (10 mg C L-1) were salinity and source-dependent, with generally more pronounced effects at 30 than 7.5 ppt, and greater potency of LM relative to LO. Both LM DOC and SDS increased diffusive water flux at 30 ppt but only SDS had an effect at 7.5 ppt. TA decreased ammonia excretion at 7.5 ppt. LO DOC decreased urea-N excretion at both salinities whereas the stimulatory effect of BSA occurred only at 30 ppt. Likewise, the effects of LM DOC and BSA to reduce TEP were present at 30 ppt but not 7.5 ppt. None of the treatments affected oxygen consumption rates. Our results demonstrate that DOCs and salinity interact to alter key physiological processes in marine flatfish, reflecting changes in both gill function and the physicochemistry of DOCs between 30 and 7.5 ppt.

Derivation and external validation of predictive models for invasive mechanical ventilation in intensive care unit patients with COVID-19.

BACKGROUND: This study aimed to develop prognostic models for predicting the need for invasive mechanical ventilation (IMV) in intensive care unit (ICU) patients with COVID-19 and compare their performance with the Respiratory rate-OXygenation (ROX) index. METHODS: A retrospective cohort study was conducted using data collected between March 2020 and August 2021 at three hospitals in Rio de Janeiro, Brazil. ICU patients aged 18 years and older with a diagnosis of COVID-19 were screened. The exclusion criteria were patients who received IMV within the first 24 h of ICU admission, pregnancy, clinical decision for minimal end-of-life care and missing primary outcome data. Clinical and laboratory variables were collected. Multiple logistic regression analysis was performed to select predictor variables. Models were based on the lowest Akaike Information Criteria (AIC) and lowest AIC with significant p values. Assessment of predictive performance was done for discrimination and calibration. Areas under the curves (AUC)s were compared using DeLong's algorithm. Models were validated externally using an international database. RESULTS: Of 656 patients screened, 346 patients were included; 155 required IMV (44.8%), 191 did not (55.2%), and 207 patients were male (59.8%). According to the lowest AIC, arterial hypertension, diabetes mellitus, obesity, Sequential Organ Failure Assessment (SOFA) score, heart rate, respiratory rate, peripheral oxygen saturation (SpO2), temperature, respiratory effort signals, and leukocytes were identified as predictors of IMV at hospital admission. According to AIC with significant p values, SOFA score, SpO2, and respiratory effort signals were the best predictors of IMV; odds ratios (95% confidence interval): 1.46 (1.07-2.05), 0.81 (0.72-0.90), 9.13 (3.29-28.67), respectively. The ROX index at admission was lower in the IMV group than in the non-IMV group (7.3 [5.2-9.8] versus 9.6 [6.8-12.9], p < 0.001, respectively). In the external validation population, the area under the curve (AUC) of the ROX index was 0.683 (accuracy 63%), the AIC model showed an AUC of 0.703 (accuracy 69%), and the lowest AIC model with significant p values had an AUC of 0.725 (accuracy 79%). CONCLUSIONS: In the development population of ICU patients with COVID-19, SOFA score, SpO2, and respiratory effort signals predicted the need for IMV better than the ROX index. In the external validation population, although the AUCs did not differ significantly, the accuracy was higher when using SOFA score, SpO2, and respiratory effort signals compared to the ROX index. This suggests that these variables may be more useful in predicting the need for IMV in ICU patients with COVID-19. GOV IDENTIFIER: NCT05663528.

Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure.

BACKGROUND: 123Iodine-meta-iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate the cardiac sympathetic function of patients with HF and its relation with myocardial remodeling and exercise capacity. METHODS AND RESULTS: Prospectively enrolled patients with HF (New York Heart Association class II-III) were stratified into HF with preserved left ventricular ejection fraction [LVEF] ≥45%) and reduced LVEF. Ventricular morphology/function and myocardial extracellular volume (ECV) fraction were quantified by cardiovascular magnetic resonance, global longitudinal strain by echocardiography, cardiac sympathetic function by heart-to-mediastinum ratio from 123iodine-meta-iodobenzylguanidine scintigraphy. All participants underwent cardiopulmonary exercise testing. The cohort included 33 patients with HF with preserved LVEF (LVEF, 60±10%; NT-proBNP [N-terminal pro-B-type natriuretic peptide], 248 [interquartile range, 79-574] pg/dL), 28 with HF with reduced LVEF (LVEF, 30±9%; NT-proBNP, 743 [interquartile range, 250-2054] pg/dL) and 20 controls (LVEF, 65±5%; NT-proBNP, 40 [interquartile range, 19-50] pg/dL). Delayed (4 hours) 123iodine-meta-iodobenzylguanidine heart-to-mediastinum ratio was lower in HF with preserved LVEF (1.59±0.25) and HF with reduced LVEF (1.45±0.16) versus controls (1.92±0.24; P<0.001), and correlated negatively with diffuse fibrosis assessed by ECV (R=-0.34, P<0.01). ECV in segments without LGE was increased in HF with preserved ejection fraction (0.32±0.05%) and HF with reduced left ventricular ejection fraction (0.31±0.04%) versus controls (0.28±0.04, P<0.05) and was associated with the age- and sex-adjusted maximum oxygen consumption (peak oxygen consumption); (R=-0.41, P<0.01). Preliminary analysis indicates that cardiac sympathetic function might potentially act as a mediator in the association between ECV and NT-proBNP levels. CONCLUSIONS: Abnormally low cardiac sympathetic function in patients with HF with reduced and preserved LVEF is associated with extracellular volume expansion and decreased cardiopulmonary functional capacity.

Glyphosate and its formulated product Roundup Transorb R® affect locomotor activity and reproductive and developmental parameters in Jenynsia lineata fish: An intergenerational study.

Glyphosate is the most widely utilized herbicide worldwide due to its effectiveness in controlling agricultural weeds. However, its persistence in aquatic ecosystems has raised concerns about the well-being of non-target organisms such as fish. This study aimed to evaluate the effects of chronic exposure (21 days) to glyphosate or its formulated product Roundup Transorb R®, at an environmentally relevant concentration permitted by regulations in certain countries (65 µg/L of glyphosate), on the locomotor activity and reproductive success of the fish Jenynsia lineata, as well as on the morphology/development and locomotor activity of its offspring, as intergenerational effects. Neither the pure nor formulated herbicide altered the distance traveled and velocity of adult fish exposed to the herbicide (F0), but they negatively affected reproductive success, decreasing the percentage of positive response to the presence of the female, reducing the number of gravid females, causing abortions, and lowering offspring survival (F1). In the F1 generation, a decrease in weight and length was noted along with developmental abnormalities in both treatment groups (pure or formulated glyphosate), with the formulation causing more harm. Observed developmental abnormalities included muscle atrophy, ascites, pigmentary disorders, vertebral agenesis, spinal deviation, and exophthalmia. Furthermore, parental exposure to pure glyphosate led to an increase in the distance traveled and velocity of F1 (hyperlocomotion), whereas exposure to the formulated product resulted in a decrease in these behaviors (hypolocomotion) of F1. These findings highlight the toxic effects of glyphosate at very low concentrations, although varying between pure and formulated, and demonstrate the intergenerational consequences of herbicide exposure, underscoring the risk to the survival of fish offspring in glyphosate-contaminated environments.

Use of Cracker Residue in the Diet of Dairy Heifers: Impacts on Animal Health, Ruminal Fatty Acids Profile, Digestibility, Weight Gain, and Economic Viability.

This study determined whether the isomeric or isoenergetic/isoproteic substitution of corn in the diet of Jersey heifers in the rearing phase with cracker residue would impair growth and health, as well as reducing production costs. Fourteen Jersey females in the growth phase were used, separated into two treatments with seven animals in each lot in collective pens. The experiment used 7-month-old animals (169.8 ± 2.89 kg) and lasted for four months. In Experiment I, the animals were divided into two groups: treatment, with the partial replacement of 40% corn with cracker residue, and control, in which the animals consumed the same diet with 100% corn (isometric diet kg for kg). In Experiment II, the animals with a body weight of 200.2 ± 3.85 kg were divided into two groups: Treatment, replacing 100% of the corn with cracker residue, and control, in which the animals consumed an isoprotein and isoenergetic diet but with 100% of the corn in the formulation. The diet consisted of concentrate, Tifton 85 hay, and corn silage, supplied twice a day individually, with animals contained in their feeders by kennels. There was water ad libitum in the bay. Biweekly weighing and monthly blood analysis were performed, totaling four collections per part for hematologic evaluation, carbohydrate, lipid, and protein metabolism variables. At the end of each experiment, ruminal fluid was collected to measure the volatile fatty acid profile, and feces were collected to determine the apparent digestibility coefficient (ADC). Experiments I and II showed no effect of treatment on body weight, weight gain, average daily weight gain, feed intake, and feed efficiency. There was no effect of treatment on leukocyte, erythrocyte, lymphocyte, neutrophil, monocyte, and eosinophil counts, hematocrit, and hemoglobin concentration (p > 0.05). Experiment I showed a difference between groups for the variables albumin, globulin, total proteins, cholesterol, glucose, and urea, which did not happen in Experiment II. In both experiments, a higher ADC of nutrients was found in the treatment group which had cracker residue (p > 0.05). The concentration of volatile fatty acids in Experiment I was higher in the control group, unlike in Experiment II, where the highest concentration was in the treatment group (p > 0.05). Because experiment I had an isometric substitution, the diets had different bromatological composition, which is the probable cause of the difference between groups; this did not happen in experiment II, in which the diets consumed by the animals was isoproteic and isoenergetic. Based on these data we conclude that the substitution of cracker residue in an isomeric or isoenergetic/isoproteic form does not negatively affect weight gain and animal health, as well as reduces the cost of the concentrate, consequently reducing the cost of production of these animals.

Hematological and genotoxic biomarkers in a natural population of freshwater turtles Trachemys dorbigni (Duméril & Bibron, 1835) (Testudines: Emydidae) living in an urban area in Southern Brazil.

The present study aimed to report the morphometric and hematological indices and genotoxicity of a free-life population of D'Orbigny's slider turtles (Trachemys dorbigni) living in an urban area in Southern Brazil. For that, 16 specimens were randomly captured in an urban canal that receives irregular releases of wastewater. Biometrics and external visual changes were analyzed, such as turtle shell deformities, and the presence of parasites. Blood samples were collected to evaluate the hematological profile and the presence of micronuclei and other erythrocyte nuclear abnormalities as potential mutagenic and genotoxic effects. Water physicochemical parameters were also measured. Organisms with ectoparasites (31.25%) and small carapace deformations (56.25%) were observed, but maximum carapace length and weight were considered normal for the species according to the literature. The blood profile indicated low hemoglobin and hematocrit and a high number of total leukocytes, particularly eosinophils which characterize parasitic infections. A frequency of 0.12% for the micronucleus was considered basal, but the frequency of other erythrocyte abnormalities was evident, mainly of blebbed nuclei (63.79%), indicating chromosomal damage in the early stage. The results of this study suggest that natural populations of chelonian inhabiting urbanized areas are impacted by anthropogenic activities in the surrounding environment. Furthermore, it provides comprehensive data which can serve as a comparative model for environmental monitoring studies involving turtles.

Breastfeeding outpatient in primary care as an important action to promote breastfeeding: experience report. / Ambulatório de amamentação na atenção básica como uma importante ação de promoção ao aleitamento materno: relato de experiência.

This paper describe a successful experience of promotion, prevention and support for breastfeeding developed by professionals from a basic health unit. This is a Breastfeeding Outpatient Clinic, implemented in a health center in Belo Horizonte, in August 2019. The Outpatient Clinic was established based on the perception of the unit's team that many mothers had difficulty breastfeeding, however, due to the work overload of this team, this assistance did not occur in a timely manner, resulting in early weaning. Initially, a meeting was held to sensitize the team on the breastfeeding indicators of the unit. Based on this knowledge, the implementation of a breastfeeding Outpatient clinic was proposed, aimed not only at dyad with difficulties in managing breastfeeding, but at all postpartum women in the area covered by that health center. A flow was created, through which it was established that all postpartum women who brought their children to carry out the heel prick test at the unit would be referred to the Breastfeeding Outpatient Clinic to perform this service. With the improvement of care, the users of the health center started to breastfeed for longer, which reflected in the improvement of the unit's indicators.

O presente estudo tem por objetivo descrever uma experiência de promoção, prevenção e apoio ao aleitamento materno desenvolvida por profissionais de uma unidade básica de saúde. Trata-se de um ambulatório de amamentação, implementado em um centro de saúde, em Belo Horizonte, em agosto de 2019. O ambulatório foi instituído a partir da percepção da equipe da unidade de que muitas mães tinham dificuldade com o processo de amamentação, no entanto, em função da sobrecarga de trabalho desta equipe, esta assistência não ocorria em tempo hábil, resultando no desmame precoce. Inicialmente realizou-se uma reunião para sensibilização da equipe sobre os indicadores de aleitamento materno da unidade. A partir desse conhecimento foi proposta a implementação de um ambulatório de amamentação, destinado não apenas às puérperas com dificuldade no manejo do aleitamento materno, mas à todas da área de abrangência daquela Unidade Básica de Saúde (UBS). Para captação das puérperas, foi estabelecido um fluxo, por meio do qual ficou estabelecido que todas as puérperas que trouxessem seus filhos para realização do teste do pezinho na unidade, seriam encaminhadas ao ambulatório para a realização deste atendimento. Com a melhora da assistência, as usuárias da unidade básica de saúde passaram a amamentar por mais tempo, o que refletiu na melhora dos indicadores da unidade.

Comparison between high-flow nasal oxygen (HFNO) alternated with non-invasive ventilation (NIV) and HFNO and NIV alone in patients with COVID-19: a retrospective cohort study.

BACKGROUND: Non-invasive respiratory support (conventional oxygen therapy [COT], non-invasive ventilation [NIV], high-flow nasal oxygen [HFNO], and NIV alternated with HFNO [NIV + HFNO] may reduce the need for invasive mechanical ventilation (IMV) in patients with COVID-19. The outcome of patients treated non-invasively depends on clinical severity at admission. We assessed the need for IMV according to NIV, HFNO, and NIV + HFNO in patients with COVID-19 according to disease severity and evaluated in-hospital survival rates and hospital and intensive care unit (ICU) lengths of stay. METHODS: This cohort study was conducted using data collected between March 2020 and July 2021. Patients ≥ 18 years admitted to the ICU with a diagnosis of COVID-19 were included. Patients hospitalized for < 3 days, receiving therapy (COT, NIV, HFNO, or NIV + HFNO) for < 48 h, pregnant, and with no primary outcome data were excluded. The COT group was used as reference for multivariate Cox regression model adjustment. RESULTS: Of 1371 patients screened, 958 were eligible: 692 (72.2%) on COT, 92 (9.6%) on NIV, 31 (3.2%) on HFNO, and 143 (14.9%) on NIV + HFNO. The results for the patients in each group were as follows: median age (interquartile range): NIV (64 [49-79] years), HFNO (62 [55-70] years), NIV + HFNO (62 [48-72] years) (p = 0.615); heart failure: NIV (54.5%), HFNO (36.3%), NIV + HFNO (9%) (p = 0.003); diabetes mellitus: HFNO (17.6%), NIV + HFNO (44.7%) (p = 0.048). > 50% lung damage on chest computed tomography (CT): NIV (13.3%), HFNO (15%), NIV + HFNO (71.6%) (p = 0.038); SpO2/FiO2: NIV (271 [118-365] mmHg), HFNO (317 [254-420] mmHg), NIV + HFNO (229 [102-317] mmHg) (p = 0.001); rate of IMV: NIV (26.1%, p = 0.002), HFNO (22.6%, p = 0.023), NIV + HFNO (46.8%); survival rate: HFNO (83.9%), NIV + HFNO (63.6%) (p = 0.027); ICU length of stay: NIV (8.5 [5-14] days), NIV + HFNO (15 [10-25] days (p < 0.001); hospital length of stay: NIV (13 [10-21] days), NIV + HFNO (20 [15-30] days) (p < 0.001). After adjusting for comorbidities, chest CT score and SpO2/FiO2, the risk of IMV in patients on NIV + HFNO remained high (hazard ratio, 1.88; 95% confidence interval, 1.17-3.04). CONCLUSIONS: In patients with COVID-19, NIV alternating with HFNO was associated with a higher rate of IMV independent of the presence of comorbidities, chest CT score and SpO2/FiO2. Trial registration ClinicalTrials.gov identifier: NCT05579080.

Supplemental vibrissal extensions as an alternative to improve the tactile sensitivity of blind dogs - a preliminary approach investigation.

OBJECTIVE: This preliminary study suggests a way to artificially extend vibrissae of blind dogs to assist ambulation and avoiding facial contact with obstacles. PROCEDURES: Fourteen irreversibly blind dogs had 5-6 mystacial vibrissae on each side of the face supplementally extended by attaching carefully chosen adult pig hairs to them and were subjected to a maze test before and after the procedure. In three of these dogs the test was repeated one more time after all the extensions had fallen off. Collision counts and course times with and without extensions were analyzed and compared. A p-value > 0.05 was considered significant. RESULTS: Median number of collisions was significantly higher post-extensions (5 IQR 2.25) and after extensions had fallen off (4 IQR 7.50) compared to pre-extensions (1 IQR 1), p = 0.021. Median times were significantly higher pre-extension (25.6 IQR 8.98) and after the extensions had fallen off, compared to the post-extension performance (22.8 IQR 8.55), p = 0.04. CONCLUSION: Vibrissae play an important role in the tactile perception of blind dogs, and our preliminary results suggest that extending this sensory organ possibly improves obstacle location and their quality of life.

Comparativo da especificidade das escalas de Tinetti e SPPB na avaliação de idosos saudáveis e com disfunções neuromotoras no sul de Goiás / Comparison of the specificity of the tinetti and sppb scales in the assessment of healthy elderly people and those with neuromotor dysfunctions in southern Goiás

Introdução: o aumento da população idosa no mundo e as alterações fisiológicas decorrentes desse processo refletem a necessidade de boas ferramentas de avaliação para a identificação precoce de possíveis declínios. Objetivo: comparar os achados da avaliação pelas escalas Short Physical Performance Battery (SPPB) e Índice de Equilíbrio e Marcha de Tinetti validadas no Brasil, verificando a especificidade de cada escala na avaliação de idosos saudáveis e com disfunções neuromotoras. Métodos: 76 indivíduos, 43 saudáveis e 33 com disfunção neuromotora, de ambos os sexos, com idade mínima de 60 anos, residentes nos municípios de Caldas Novas-GO, Itumbiara-GO e Goiatuba-GO, foram avaliados em dias alternados pelas escalas SPPB e Tinetti. Resultados: os grupos apresentaram pontuações maiores nas avaliações pelo Índice Tinetti, o que sugere maior sensibilidade da SPPB na avaliação da marcha e do equilíbrio desses indivíduos. Conclusão: SPPB mostrou-se mais específica que o Índice de Tinetti, sendo capaz de detectar alterações que o Índice Tinetti não foi capaz de encontrar.

Introduction: the increase in the elderly population in the world and the physiological changes resulting from this process reflect the need for good assessment tools for the early identification of possible declines. Objective: to compare the assessment findings by the Short Physical Performance Battery (SPPB) and Tinetti's Balance and Gait Index validated in Brazil, verifying the specificity of each scale in the assessment of healthy elderly people and those with neuromotor dysfunctions. Methods: 76 individuals, 43 healthy and 33 with neuromotor dysfunction, of both sexes, aged at least 60 years, living in the cities of Caldas Novas-GO, Itumbiara-GO and Goiatuba-GO, were evaluated on alternate days by the SPPB and Tinetti scales. Results: the groups presented higher scores in the evaluations by Tinetti, which suggests greater sensitivity of the SPPB in the evaluation of gait and balance of these individuals. Conclusion: SPPB was more specific than Tinetti, being able to detect changes that the Tinetti Index was not able to find.

Proteomics of serum-derived extracellular vesicles are associated with the severity and different clinical profiles of patients with COVID-19: An exploratory secondary analysis.

BACKGROUND AIMS: Coronavirus disease 2019 (COVID-19) is characterized by a broad spectrum of clinical manifestations with the potential to progress to multiple organ dysfunction in severe cases. Extracellular vesicles (EVs) carry a range of biological cargoes, which may be used as biomarkers of disease state. METHODS: An exploratory secondary analysis of the SARITA-2 and SARITA-1 datasets (randomized clinical trials on patients with mild and moderate/severe COVID-19) was performed. Serum-derived EVs were used for proteomic analysis to identify enriched biological processes and key proteins, thus providing insights into differences in disease severity. Serum-derived EVs were separated from patients with COVID-19 by size exclusion chromatography and nanoparticle tracking analysis was used to determine particle concentration and diameter. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was performed to identify and quantify protein signatures. Bioinformatics and multivariate statistical analysis were applied to distinguish candidate proteins associated with disease severity (mild versus moderate/severe COVID-19). RESULTS: No differences were observed in terms of the concentration and diameter of enriched EVs between mild (n = 14) and moderate/severe (n = 30) COVID-19. A total of 414 proteins were found to be present in EVs, of which 360 were shared while 48 were uniquely present in severe/moderate compared to mild COVID-19. The main biological signatures in moderate/severe COVID-19 were associated with platelet degranulation, exocytosis, complement activation, immune effector activation, and humoral immune response. Von Willebrand factor, serum amyloid A-2 protein, histone H4 and H2A type 2-C, and fibrinogen ß-chain were the most differentially expressed proteins between severity groups. CONCLUSION: Exploratory proteomic analysis of serum-derived EVs from patients with COVID-19 detected key proteins related to immune response and activation of coagulation and complement pathways, which are associated with disease severity. Our data suggest that EV proteins may be relevant biomarkers of disease state and prognosis.

Neurological and neuropsychiatric manifestations of post-COVID-19 condition in South America: a systematic review of the literature.

BACKGROUND: The post-COVID-19 condition is a major modern challenge in medicine and has a high global impact on the health of the population. OBJECTIVE: To determine the main neurological and neuropsychiatric manifestations after acute COVID-19 infection in South American countries. METHODS: This is a systematic review study, registered on the PROSPERO platform following the PRISMA model. 4131 articles were found with the search strategies used. Neurological and neuropsychiatric manifestations were investigated in individuals three months or more after acute COVID-19 infection, and older than 18 years, including studies conducted in South American countries published between 2020 and 2022. RESULTS: Six studies (four from Brazil and two from Ecuador) were analyzed. Regarding the type of study: three were cohorts, two were case reports, and one was cross-sectional. The main outcomes found were new pain (65.5%) and new chronic pain (19.6%), new headache (39.1%), daily chronic headache (13%), paresthesia (62%), in addition to neuropsychiatric diseases, such as generalized anxiety disorder (15.1%), post-traumatic stress syndrome (13.4%), depression and anxiety (13.5%), suicidal ideation (10.1%), and several cognitive disorders. CONCLUSION: Neurological and neuropsychiatric manifestations related to depression and anxiety, and cognition disorders are reported during the post-COVID-19 condition in South America. Symptoms associated with chronic pain appear to be associated with the condition. More studies on post-COVID-19 conditions are needed in the South America region.

ANTECEDENTES: A condição pós-COVID-19 é um grande desafio moderno na medicina e tem alto impacto global na saúde da população. OBJETIVO: Determinar as principais manifestações neurológicas e neuropsiquiátricas após a infecção aguda da COVID-19 nos países da América do Sul. MéTODOS: Trata-se de um estudo de revisão sistemática, registrado na plataforma PROSPERO seguindo o modelo PRISMA. Foram encontrados 4131 artigos com as estratégias de buscas empregadas. Investigaram-se manifestações neurológicas e neuropsiquiátricas em indivíduos com três meses ou mais desde a infecção aguda por COVID-19, maiores de 18 anos, incluindo estudos realizados em países da América do Sul publicados entre 2020 e 2022. RESULTADOS: Foram analisados seis estudos (quatro do Brasil e dois do Equador). Em relação ao tipo de estudo: três eram coortes, dois relatos de casos e um transversal. Os principais desfechos encontrados foram em relação à dor nova (65,5%) e dor crônica nova (19,6%), cefaleia nova (39,1%), cefaleia crônica diária (13%), parestesia (62%), além de doenças neuropsiquiátricas como transtorno de ansiedade generalizada (15,1%), síndrome do estresse pós-traumático (13,4%), depressão e ansiedade (13,5%), ideação suicida (10,1%) e diversos distúrbios cognitivos. CONCLUSãO: Manifestações neurológicas e neuropsiquiátricas relacionadas à depressão e ansiedade e distúrbios de cognição são relatados durante a condição pós-COVID-19 na América do Sul. Os sintomas associados a quadros de dor crônica parecem estar associados à condição. Mais estudos sobre condições pós COVID-19 são necessários na região da América do Sul.

The use of integrative tools and multiple models for aquatic environmental quality assessment: a case study of the Mirim Lagoon, Southern Brazil.

This study performed toxicity assays with microalgae, microcrustaceans, and fish as well as evaluated biochemical and behavioral biomarkers in fish and microcrustaceans to assess the quality of the surface water of Mirim Lagoon, which belongs to one of the largest hydrographic basins in the world, located in southern Brazil. Three distinct sampling periods were chosen (January, March, and June 2022) based on the rice plantation dynamics which is the main activity surrounding the lagoon. In January, the plantation is irrigated; in March, the water is drained into the Mirim Lagoon, and July is the off-season. Concerning toxicity tests, there was significant inhibition in microalgae growth when exposed to water collected in March, but no mortality was observed for Ceriodaphia dubia, Daphnia magna, and Danio rerio. Regarding biomarkers, behavioral variables contributed more to the higher values of the Integrated Biomarker Response (IBR) index for both D. magna and D. rerio, in March. The Redundancy Analysis (RDA) indicated a correlation between the biomarkers for both organisms and abiotic parameters, mainly nutrients (total phosphorus and total nitrogen), thermotolerant coliforms, total solids, and turbidity. Spatially, there was no difference during monitoring, but the most significant ecotoxicological effects were observed in March. Multivariate analysis and the IBR index proved to be useful tools for monitoring of water bodies such as Mirim Lagoon.

Inclusion of exogenous enzymes in feedlot cattle diets: Impacts on physiology, rumen fermentation, digestibility and fatty acid profile in rumen and meat.

The objective of this study was to evaluate if the inclusion of a blend composed of exogenous enzymes (amylase, protease, cellulase, xylanase and beta glucanase) in the individual and combined form in the feedlot steers diet has benefits on the physiology, rumen fermentation, digestibility and fatty acid profile in rumen and meat. The experiment used 24 animals, divided into 4 treatments, described as: T1-CON, T2-BLEND (0.5 g mixture of enzyme), T3-AMIL (0.5 g alpha-amylase), T4-BLEND+AMIL (0.5 g enzyme blend+ 0.5 g amylase). The concentration of mineral matter was higher in the meat of cattle of T4-BLEND+AMIL. A higher proportion of monounsaturated fatty acids was observed in the T3-AMIL group when compared to the others. The percentage of polyunsaturated fatty acids was higher in the T2-BLEND and T4-BLEND+AMIL compared to the T1-CON. The combination of exogenous enzymes in the diet positively modulate nutritional biomarkers, in addition to benefits in the lipid and oxidative profile meat.

Neurological and neuropsychiatric manifestations of post-COVID-19 condition in South America: a systematic review of the literature / Manifestações neurológicas e neuropsiquiátricas da condição pós-COVID-19 na América do Sul: revisão sistemática da literatura

Abstract Background The post-COVID-19 condition is a major modern challenge in medicine and has a high global impact on the health of the population. Objective To determine the main neurological and neuropsychiatric manifestations after acute COVID-19 infection in South American countries. Methods This is a systematic review study, registered on the PROSPERO platform following the PRISMA model. 4131 articles were found with the search strategies used. Neurological and neuropsychiatric manifestations were investigated in individuals three months or more after acute COVID-19 infection, and older than 18 years, including studies conducted in South American countries published between 2020 and 2022. Results Six studies (four from Brazil and two from Ecuador) were analyzed. Regarding the type of study: three were cohorts, two were case reports, and one was cross-sectional. The main outcomes found were new pain (65.5%) and new chronic pain (19.6%), new headache (39.1%), daily chronic headache (13%), paresthesia (62%), in addition to neuropsychiatric diseases, such as generalized anxiety disorder (15.1%), post-traumatic stress syndrome (13.4%), depression and anxiety (13.5%), suicidal ideation (10.1%), and several cognitive disorders. Conclusion Neurological and neuropsychiatric manifestations related to depression and anxiety, and cognition disorders are reported during the post-COVID-19 condition in South America. Symptoms associated with chronic pain appear to be associated with the condition. More studies on post-COVID-19 conditions are needed in the South America region.

Resumo Antecedentes A condição pós-COVID-19 é um grande desafio moderno na medicina e tem alto impacto global na saúde da população. Objetivo Determinar as principais manifestações neurológicas e neuropsiquiátricas após a infecção aguda da COVID-19 nos países da América do Sul. Métodos Trata-se de um estudo de revisão sistemática, registrado na plataforma PROSPERO seguindo o modelo PRISMA. Foram encontrados 4131 artigos com as estratégias de buscas empregadas. Investigaram-se manifestações neurológicas e neuropsiquiátricas em indivíduos com três meses ou mais desde a infecção aguda por COVID-19, maiores de 18 anos, incluindo estudos realizados em países da América do Sul publicados entre 2020 e 2022. Resultados Foram analisados seis estudos (quatro do Brasil e dois do Equador). Em relação ao tipo de estudo: três eram coortes, dois relatos de casos e um transversal. Os principais desfechos encontrados foram em relação à dor nova (65,5%) e dor crônica nova (19,6%), cefaleia nova (39,1%), cefaleia crônica diária (13%), parestesia (62%), além de doenças neuropsiquiátricas como transtorno de ansiedade generalizada (15,1%), síndrome do estresse pós-traumático (13,4%), depressão e ansiedade (13,5%), ideação suicida (10,1%) e diversos distúrbios cognitivos. Conclusão Manifestações neurológicas e neuropsiquiátricas relacionadas à depressão e ansiedade e distúrbios de cognição são relatados durante a condição pós-COVID-19 na América do Sul. Os sintomas associados a quadros de dor crônica parecem estar associados à condição. Mais estudos sobre condições pós COVID-19 são necessários na região da América do Sul.

Ambulatório de amamentação na atenção básica como uma importante ação de promoção ao aleitamento materno: relato de experiência / Breastfeeding outpatient in primary care as an important action to promote breastfeeding: experience report

RESUMO O presente estudo tem por objetivo descrever uma experiência de promoção, prevenção e apoio ao aleitamento materno desenvolvida por profissionais de uma unidade básica de saúde. Trata-se de um ambulatório de amamentação, implementado em um centro de saúde, em Belo Horizonte, em agosto de 2019. O ambulatório foi instituído a partir da percepção da equipe da unidade de que muitas mães tinham dificuldade com o processo de amamentação, no entanto, em função da sobrecarga de trabalho desta equipe, esta assistência não ocorria em tempo hábil, resultando no desmame precoce. Inicialmente realizou-se uma reunião para sensibilização da equipe sobre os indicadores de aleitamento materno da unidade. A partir desse conhecimento foi proposta a implementação de um ambulatório de amamentação, destinado não apenas às puérperas com dificuldade no manejo do aleitamento materno, mas à todas da área de abrangência daquela Unidade Básica de Saúde (UBS). Para captação das puérperas, foi estabelecido um fluxo, por meio do qual ficou estabelecido que todas as puérperas que trouxessem seus filhos para realização do teste do pezinho na unidade, seriam encaminhadas ao ambulatório para a realização deste atendimento. Com a melhora da assistência, as usuárias da unidade básica de saúde passaram a amamentar por mais tempo, o que refletiu na melhora dos indicadores da unidade.

ABSTRACT This paper describe a successful experience of promotion, prevention and support for breastfeeding developed by professionals from a basic health unit. This is a Breastfeeding Outpatient Clinic, implemented in a health center in Belo Horizonte, in August 2019. The Outpatient Clinic was established based on the perception of the unit's team that many mothers had difficulty breastfeeding, however, due to the work overload of this team, this assistance did not occur in a timely manner, resulting in early weaning. Initially, a meeting was held to sensitize the team on the breastfeeding indicators of the unit. Based on this knowledge, the implementation of a breastfeeding Outpatient clinic was proposed, aimed not only at dyad with difficulties in managing breastfeeding, but at all postpartum women in the area covered by that health center. A flow was created, through which it was established that all postpartum women who brought their children to carry out the heel prick test at the unit would be referred to the Breastfeeding Outpatient Clinic to perform this service. With the improvement of care, the users of the health center started to breastfeed for longer, which reflected in the improvement of the unit's indicators.

Effects of the Pesticide Carbofuran on Two Species of Chlorophyceae (Desmodesmus communis and Pseudopediastrum boryanum) and Their Pesticide Bioremediation Ability.

Carbofuran is one of the most toxic broad-spectrum pesticides. We evaluated the effects of carbofuran on two species of microalgae, Pseudopediastrum boryanum and Desmodesmus communis, through measurements of cell viability, biomass, chlorophyll content, and the production of reactive oxygen species (ROS). The ability of these algae to remove carbofuran dissolved in the media was also determined. For the evaluations, both microalgae species were exposed to carbofuran (FURADAN 350 SC®) at concentrations of 100, 1000, and 10,000 µg L-1 for 7 days. Algae cell viability and chlorophyll-a concentration were not affected by the presence of carbofuran. Both species grew when exposed to the pesticide; however, the microalgae D. communis grew less than its respective control when exposed to the highest concentration (10,000 µg L-1 of carbofuran), indicating an adverse effect of the pesticide on this species. A significant increase in ROS production was observed in D. communis and P. boryanum when exposed to the highest concentration tested. The microalgae P. boryanum completely removed carbofuran in the media within 2 days, regardless of the concentration, whereas D. communis achieved the same result only after 5 days of exposure. Growth inhibition was observed only until the disappearance of carbofuran from the media. The present study suggests the use of microalgae, mainly P. boryanum, as potential tools for the remediation of environments contaminated by carbofuran because of their resistance to the insecticide and their ability to remove it rapidly from water. Environ Toxicol Chem 2024;43:926-937. © 2023 SETAC.