Prune-Belly Syndrome: An Update.

The Prune-Belly (Eagle-Barrett) syndrome (PBS) is a congenital and genetically heterogeneous disease, more prevalent in males, defined by the clinical triad (1) deficiency of abdominal muscles, (2) bilateral cryptorchidism, and (3) urinary tract abnormalities. The abdomen of an infant with PBS has a typical appearance, similar to the aspect of a prune, which gives it its name. Although the etiology of this disorder is still unknown, numerous theories, mutations, and genetic disturbances have been proposed to explain the origin of PBS. Prognosis can differ a lot from one patient to another, since this condition has a wide spectrum of clinical presentation. Despite being a rare condition, the importance of PBS should not be underestimated, in the light of the potential of the disorder to lead to chronic kidney disease and other severe complications. In that regard, this review gathers the most up-to-date knowledge about the etiopathogenesis, clinical features, diagnosis, management and prognosis of PBS.

Revisión histórica, distribución potencial y estado de conservación de la rata endémica de México Xenomys nelsoni (Rodentia: Cricetidae) / Historical review, potential distribution, and conservation of the Mexican endemic rat Xenomys nelsoni (Rodentia: Cricetidae)

Resumen Introducción: La Rata de Magdalena, Xenomys nelsoni, es un roedor endémico de México, de distribución restringida a las selvas bajas caducifolias densas, en una pequeña región de la costa del Pacífico mexicano. Es una especie poco conocida, catalogada como "En Peligro" de acuerdo con la Unión Internacional para la Conservación de la Naturaleza (IUCN). Este desconocimiento unido a la alta tasa de deforestación de su hábitat hace que su conservación sea prioritaria. Objetivo: Realizar un recuento histórico de los registros depositados en las colecciones científicas, generar mapas de distribución potencial y analizar el estado de conservación de la especie. Método: Los datos de ocurrencia de las especies se obtuvieron de la literatura y bases de datos digitales y se analizaron por décadas. Se utilizaron los programas GARP y MaxEnt para generar los modelos de nicho ecológico. La importancia de las variables en el modelo se estimó mediante un análisis Jackknife. Resultados: A lo largo de 129 años 19 recolectores registraron 69 ejemplares, de los cuales 65 están depositados en siete colecciones internacionales y una nacional. Aunque la especie sólo se ha recolectado en Jalisco y Colima, la distribución potencial de X. nelsoni incluye también el estado de Michoacán. De esta área estimada, sólo el 1.5 % se encuentra dentro de un Área Natural Protegida. Conclusiones: Los resultados de la distribución potencial podrían ser utilizados para verificar la presencia de la especie en lugares donde no ha sido recolectada como el norte de la Reserva de la Biosfera Chamela-Cuixmala y en algunas zonas de la provincia fisiográfica Costas del Sur en el estado de Michoacán. Es necesario incrementar los muestreos en regiones poco estudiadas predichas por el modelo y aumentar el área de protección.

Abstract Introduction: The Magdalena Rat, Xenomys nelsoni, is a rodent endemic to Mexico, whose distribution is restricted to dense tropical dry forests in a small region on the Pacific coast of Mexico. It is a poorly known species categorized as "Endangered" by the International Union for Conservation of Nature (IUCN). This lack of knowledge and the high rates of deforestation of its habitat makes its conservation a priority. Objective: To summarize the historical records deposited in scientific collections, to create potential distribution maps, and to analyze the conservation status of the species. Methods: We obtained species occurrence data from literature and digital databases, analyzing them by the decade. We used GARP and MaxEnt software to generate the ecological niche models. The importance of the variables in the model was estimated using the Jackknife technique. Results: Over 129 years, 19 collectors registered 69 specimens, of which 65 are deposited in one national and seven international collections. Although the species has only been collected in Jalisco and Colima, the potential distribution for X. nelsoni also includes the state of Michoacán. Of this estimated area, only 1.5 % is in a Protected Natural Area. Conclusions: The results of the potential distribution could be used to verify the presence of the species in places where it has not been collected, such as the northern part of the Chamela-Cuixmala Biosphere Reserve and in some areas of the physiographic province Costas del Sur in the state of Michoacán. It is needed to increase samplings in the least studied regions predicted by the model and expand the area of protection.

Cardiac manifestations in children with the multisystem inflammatory syndrome (MIS-C) associated with SARS-CoV-2 infection: Systematic review and meta-analysis.

According to the World Health Organisation, as of October 2022, there have been 55,560,329 reported cases of SARS-COV-2 in patients under 19 years old. It is estimated that about 0.06% of these patients may develop MIS-C, representing more than 2 million children worldwide. This systematic review and meta-analysis examined the pooled prevalence of cardiovascular manifestation and cardiac complications in children hospitalised with MIS-C. The PROSPERO register number is CRD42022327212. We included case-report studies, case-control studies, cohort studies, and cross-sectional studies, as well as clinical trials or studies describing cardiac manifestations of MIS-C and its sequelae in a paediatric population. Initially, 285 studies were selected, but there were 154 duplicates, and 81 were excluded because they did not fit the eligibility criteria. Thus, 50 studies were selected for review, and 30 were included in the meta-analysis. A total sample size of 1445 children was included. The combined prevalence of myocarditis or pericarditis was 34.3% (95% CI: 25.0%-44.2%). The combined prevalence for echocardiogram anomalies was 40.8% (95% CI: 30.5%-51.5%), that of Kawasaki disease presentation was 14.8% (95% CI: 7.5%-23.7%), and that of coronary dilation was 15.2% (95% CI: 11.0%-19.8%). The rate of electrocardiogram anomalies was 5.3% (95% CI: 0.8%-12.3%), and the mortality rate was 0.5% (CI 95%: 0%-1.2%). Furthermore, 186 children still had complications at discharge, with a combined prevalence of such long-lasting manifestations of 9.3% (95% CI: 5.6%-13.7%). Studies that assess whether these children will have an increased cardiovascular risk with a greater chance of acute myocardial infarction, arrhythmias, or thrombosis will be essential for healthcare planning.

Beneficios del ejercicio físico prenatal como facilitador en el trabajo de parto y prevención de complicaciones postparto / Benefits of Prenatal Physical Exercise as a Facilitator in Labor and Prevention of Postpartum Complications

Introducción. Introducción. Durante la etapa de embarazo es de vital importancia realizar ejercicio físico por ser un período que conlleva modificaciones y adaptaciones tanto anatómicas como fisiológicas en la mujer generando beneficios tanto para ella como para el bebé en gestación. Objetivo. Describir beneficios del ejercicio físico prenatal en embarazadas como facilitador del periodo de parto y prevención de complicaciones postparto. Métodos. Se incluyeron revisiones de fuente primaria en las bases de datos EBSCO, SCIENCE DIRECT, Pubmed y se aplica evaluación de los artículos con escala PEDro. Resultados. El ejercicio físico en embarazo disminuye los partos instrumentales y por cesárea, uso de analgesia epidural, duración del trabajo de parto, dolor perineal reduce las episiotomía, y contribuye a un perineo intacto. Conclusiones. Existe escasa evidencia de que el ejercicio físico en embarazadas es beneficioso durante el parto y postparto.

Introduction. During the pregnancy stage it is vital to perform physical exercise because it is a period that involves modifications and adaptations both anatomical and physiological in women, generating benefits for the mother and the unborn child. Objective. Describe benefits of prenatal physical exercise in pregnant women as a facilitator of the period of childbirth and prevention of postpartum. Methods. Primary source reviews were included in the EBSCO, SCIENCE DIRECT, Pubmed databases and article evaluation with the PEDro scale was applied. Results. Physical exercise in pregnancy decreases instrumental and cesarean deliveries, use of epidural analgesia, duration of labor, perineal pain reduces episiotomy, and contributes to an intact perineum. Conclusions. There is little evidence that physical exercise in pregnant women is beneficial during childbirth and postpartum.

OBESITY AND SEVERE STEATOSIS: THE IMPORTANCE OF BIOCHEMICAL EXAMS AND SCORES. / OBESIDADE E ESTEATOSE GRAVE: A IMPORTÂNCIA DA AVALIAÇÃO BIOQUÍMICA E ESCORES.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is considered a public health problem, mainly in severely obese patients. The aim of the present study was to investigate different biochemical-based scores available and determine which one could best serve as an NAFLD predicting tool in a severely obese population. METHODS: This was a cross-sectional study involving severely obese patients. All patients were evaluated with serum laboratory parameters for 1 week before biopsy, and all patients were treated with intraoperative liver biopsy, during bariatric surgery. RESULTS: A total of 143 severely obese patients were included. The median body mass index (BMI) was 48 kg/m2 (35-65). Diabetes mellitus was present in 36%, and steatosis was present in 93% (severe steatosis in 20%). Only aspartate transaminase (AST) to platelet ratio index (APRI=0.65 (95% CI: 0.55-0.8) and homeostatic model assessment for insulin resistance (HOMA-IR=0.7 (95% CI: 0.58-0.82) showed significant capacity for the prediction of severe steatosis. Hepatic steatosis index (HSI), NAFLD fibrosis score (NAFLDS), alanine aminotransferase (ALT)/AST, and fibrosis-4 (FIB-4) were not able to correctly predict severe steatosis on liver biopsy. APRI showed high specificity of 82% and low sensitivity of 54%. In contrast, HOMA-IR showed high sensitivity of 84% and low specificity of 48%. CONCLUSIONS: NAFLDS, FIB-4, AST/ALT, and HSI have no utility for the evaluation of severe steatosis in severely obese patients. Diabetes and insulin-resistance-related biochemical assessments, such as HOMA-IR, can be used as good screening tools for severe steatosis in these patients. APRI score is the most specific biochemical diagnostic tool for steatosis in severely obese patients and can help clinicians to decide the need for bariatric or metabolic surgery.

OBJETIVOS: A doença hepática gordurosa não-alcoólica já é considerada um problema de saúde pública, principalmente em pacientes com obesidade severa. O objetivo do presente estudo foi investigar os diferentes escores de bioquímiosa disponíveis e determinar qual deles poderia servir melhor como uma ferramenta de avaliação da NAFLD em uma população de obesos. MÉTODOS: Este é um estudo transversal de pacientes obesos. Todos os pacientes foram avaliados com parâmetros laboratoriais séricos 1 semana antes da biópsia e todos os pacientes foram submetidos a biópsia hepática intra-operatória, durante a cirurgia bariátrica. RESULTADOS: Cento e quarenta e três pacientes obesos foram incluídos. Apenas APRI (0,65; IC 95%: 0,55 a 0,8) e HOMA-IR (0,7; IC 95%: 0,58 a 0,82) mostraram capacidade significativa de predição de esteatose grave. HSI, NALFDS, ALS / AST e FIB-4 não foram capazes de prever corretamente esteatose grave na biópsia hepática. APRI mostrou alta especificidade (82%) e baixa sensibilidade (54%). Em contraste, o HOMA-IR apresentou alta sensibilidade (84%) e baixa especificidade (48%). CONCLUSÃO: O NALFDS, FIB-4, AST / ALT e HSI não têm utilidade para avaliação de esteatose grave em pacientes com obesidade severa. Diabetes e avaliação bioquímica relacionada à resistência à insulina, como o HOMA-IR, podem ser empregados como boas ferramentas de rastreamento para esteatose grave em tais pacientes. O escore APRI é a ferramenta diagnóstica bioquímica mais específica para esteatose em pacientes com obesidade severa e pode ser empregado, por equipes médicas, para auxiliar na indicação de cirurgia bariátrica ou metabólica.

Randomized, phase 1/2, double-blind pioglitazone repositioning trial combined with antifungals for the treatment of cryptococcal meningitis - PIO study.

BACKGROUND: Cryptococcosis affects more than 220,000 patients/year, with high mortality even when the standard treatment [amphotericin B (AMB), 5-flucytosin (5-FC) and fluconazole] is used. AMB presents high toxicity and 5-FC is not currently available in Brazil. In a pre-clinical study, pioglitazone (PIO - an antidiabetic drug) decreased AMB toxicity and lead to an increased mice survival, reduced morbidity and fungal burden in brain and lungs. The aim of this trial is to evaluate the efficacy and safety of PIO combined with standard antifungal treatment for human cryptococcosis. METHODS: A phase 1/2, randomized, double blind, placebo-controlled trial will be performed with patients from Belo Horizonte, Brazil. They will be divided into three groups (placebo, PIO 15 mg/day or PIO 45 mg/day) and will receive an additional pill during the induction phase of cryptococcosis' treatment. Our hypothesis is that treated patients will have increased survival, so the primary outcome will be the mortality rate. Patients will be monitored for survival, side effects, fungal burden and inflammatory mediators in blood and cerebrospinal fluid. The follow up will occur for up 60 days. CONCLUSIONS: We expect that PIO will be an adequate adjuvant to the standard cryptococcosis' treatment. TRIAL REGISTRATION: ICTRP/WHO (and International Clinical Trial Registry Plataform (ICTRP/WHO) (http://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-9fv3f4), RBR-9fv3f4 (http://www.ensaiosclinicos.gov.br/rg/RBR-9fv3f4). UTN Number: U1111-1226-1535. Ethical approvement number: CAAE 17377019.0.0000.5149.

O Núcleo Ampliado de Saúde da Família segundo Agentes Comunitárias de Saúde / Extended Family Health Center from the perspective of Community Health Agents

A complexidade do cuidado na atenção primária à saúde em contexto de funcionamento de equipes de saúde da família levou à implementação de Núcleos Ampliados de Saúde da Família, formados por profissionais especialistas, que devem garantir o apoio clínico, sanitário e pedagógico à equipe de referência. Este artigo investigou a compreensão de agentes comunitárias de saúde sobre o Núcleo Ampliado de Saúde da Família (NASF-AB) junto a 13 mulheres que atuavam nessa função em duas equipes de saúde da família no Estado de Minas Gerais, a partir de questionário sociodemográfico e um roteiro de entrevista semiestruturado sobre a sua prática e relação com o NASF-AB. Os eixos temáticos que emergiram mediante análise de conteúdo foram: (1) informar e encaminhar o caso para um profissional do NASF ou mais; (2) discussão de caso e orientações do NASF-AB ao agente comunitário de saúde; (3) visita domiciliar conjunta; (4) função do NASF-AB. As participantes percebem o NASF-AB como uma equipe de especialistas que recebe encaminhamentos e realiza atendimentos grupais. O apoio matricial encontra-se em processo de construção, e não são todos são os profissionais que são reconhecidos como componentes do NASF-AB. Concluímos que há necessidade de valorizar o trabalho das agentes comunitárias de saúde e implementar ações de educação permanente.

The complexity of primary health care provided in the context of family health units led to the implementation of Núcleos Ampliados de Saúde da Família [Extended Family Health Centers], composed of medical specialists, responsible for providing clinical, sanitary and teaching support to the reference team. This paper presents the perceptions of community health agents regarding the Extended Family Health Center (NASF-AB). Thirteen female agents working in two family health teams in the state of Minas Gerais, Brazil responded to a sociodemographic questionnaire and a semi-structured interview addressing their experience and relationship with the NASF-AB. The following thematic axes emerged: (1) Report and refer cases to one or more NASF professional; (2) Community health agents discuss cases with the NASF-AB staff and receive guidance; (3) Joint home visits; (4) the role of the NASF-PHC. The participants perceive the NASF-PHC as a team of specialists who receive referrals and provide group care. Matrix support is under development and not all professionals are recognized as being members of NASF-AB staff. We conclude that there is a need to value the work of community health agents and implement permanent education actions.

Obesidade e esteatose grave: a importância da avaliação bioquímica e escores / Obesity and severe steatosis: the importance of biochemical exams and scores

RESUMO - RACIONAL: A doença hepática gordurosa não-alcoólica já é considerada um problema de saúde pública, principalmente em pacientes com obesidade severa. OBJETIVOS: O objetivo do presente estudo foi investigar os diferentes escores de bioquímiosa disponíveis e determinar qual deles poderia servir melhor como uma ferramenta de avaliação da NAFLD em uma população de obesos. MÉTODOS: Este é um estudo transversal de pacientes obesos. Todos os pacientes foram avaliados com parâmetros laboratoriais séricos 1 semana antes da biópsia e todos os pacientes foram submetidos a biópsia hepática intra-operatória, durante a cirurgia bariátrica. RESULTADOS: Cento e quarenta e três pacientes obesos foram incluídos. Apenas APRI (0,65; IC 95%: 0,55 a 0,8) e HOMA-IR (0,7; IC 95%: 0,58 a 0,82) mostraram capacidade significativa de predição de esteatose grave. HSI, NALFDS, ALS / AST e FIB-4 não foram capazes de prever corretamente esteatose grave na biópsia hepática. APRI mostrou alta especificidade (82%) e baixa sensibilidade (54%). Em contraste, o HOMA-IR apresentou alta sensibilidade (84%) e baixa especificidade (48%). CONCLUSÃO: O NALFDS, FIB-4, AST / ALT e HSI não têm utilidade para avaliação de esteatose grave em pacientes com obesidade severa. Diabetes e avaliação bioquímica relacionada à resistência à insulina, como o HOMA-IR, podem ser empregados como boas ferramentas de rastreamento para esteatose grave em tais pacientes. O escore APRI é a ferramenta diagnóstica bioquímica mais específica para esteatose em pacientes com obesidade severa e pode ser empregado, por equipes médicas, para auxiliar na indicação de cirurgia bariátrica ou metabólica.

ABSTRACT - INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is considered a public health problem, mainly in severely obese patients. OBJECTIVE: The aim of the present study was to investigate different biochemical-based scores available and determine which one could best serve as an NAFLD predicting tool in a severely obese population. METHODS: This was a cross-sectional study involving severely obese patients. All patients were evaluated with serum laboratory parameters for 1 week before biopsy, and all patients were treated with intraoperative liver biopsy, during bariatric surgery. RESULTS: A total of 143 severely obese patients were included. The median body mass index (BMI) was 48 kg/m2 (35-65). Diabetes mellitus was present in 36%, and steatosis was present in 93% (severe steatosis in 20%). Only aspartate transaminase (AST) to platelet ratio index (APRI=0.65 (95% CI: 0.55-0.8) and homeostatic model assessment for insulin resistance (HOMA-IR=0.7 (95% CI: 0.58-0.82) showed significant capacity for the prediction of severe steatosis. Hepatic steatosis index (HSI), NAFLD fibrosis score (NAFLDS), alanine aminotransferase (ALT)/AST, and fibrosis-4 (FIB-4) were not able to correctly predict severe steatosis on liver biopsy. APRI showed high specificity of 82% and low sensitivity of 54%. In contrast, HOMA-IR showed high sensitivity of 84% and low specificity of 48%. CONCLUSIONS: NAFLDS, FIB-4, AST/ALT, and HSI have no utility for the evaluation of severe steatosis in severely obese patients. Diabetes and insulin-resistance-related biochemical assessments, such as HOMA-IR, can be used as good screening tools for severe steatosis in these patients. APRI score is the most specific biochemical diagnostic tool for steatosis in severely obese patients and can help clinicians to decide the need for bariatric or metabolic surgery.

Estimation of the commercial height of trees with laser meter: a viable alternative for forest management in the Brazilian Amazon.

Commercial height of the tree is a key variable for estimating the wood stock in tropical forests managed for timber production purposes. Most available measurement devices suffer limitations in this type of forest, promoting low precision measurements with high variation errors. The laser meter device appears as a viable alternative, as in addition to using trigonometric principles, it is not necessary that the device is close to the eyes of the meter to carry out the measurement. The device can be used to measure commercial height of trees on flat or sloping terrain, at different distances from the tree. However, there are no studies evaluating the precision of this device. The objective of this study was to determine the precision of the laser meter method for estimating the commercial height of trees, as compared to the actual measurement in a tropical forest in the Brazilian Amazon. Measurements were made on 300 trees with commercial height between 7 and 14 m. Actual commercial heights were measured with graduated ruler. Applied tests were paired t test, graphical analysis of residuals and calculations of bias statistics, mean absolute deviation, standard deviation of differences, and coefficient of determination (R 2). Paired t test indicated that the mean of the heights measured by the laser meter is statistically equal to that of the graduated ruler. Measurements with laser meter did not show bias and had mean error of 0.0745. The standard deviation of the differences indicated dispersion of errors of 0.97, equal to that shown in the graduated rule. Laser meter presents an alternative method for estimating the commercial height of trees in tropical forest in the Brazilian Amazon. There was no tendency to underestimate or overestimate the commercial heights of trees. Use of the laser meter is potentially of use for measuring the commercial height of trees in tropical forests.

Life Expectancy of Brazilian Neurosurgeons.

BACKGROUND: Life expectancy (LE) refers to the number of years that an individual is expected to survive. Emphasis is frequently placed on the relationship between LE and the conditions under which a population lives, but fewer studies have investigated the relationship between stress factors associated with specific professions and their effects on LE. The aim of this study is to evaluate Brazilian neurosurgeons' life expectancies (BNLEs) and compare them with those of physicians (both Brazilian and foreign) from other fields, as well as with Brazilian nondoctors. METHODS: The Brazilian Society of Neurosurgery death registry was used to obtain data that compared LEs from non-neurosurgeon physicians, as described in the national and international literature. BNLEs were also compared with the LEs of Brazilian citizens. RESULTS: Fifty-one neurosurgeons died between 2009 and 2016. All were males. The mean age at death was 68.31 ± 17.71 years. Among all-cause mortality, the breakdown was 20% cardiovascular diseases, 39% malignancies, 10% external factors, 6% gastrointestinal disorders, 12% neurologic illnesses, and 14% unknown causes. BNLE was shorter than LE of male Brazilian citizens. CONCLUSIONS: LE was similar among neurosurgeons and other doctors but shorter compared with Brazilian citizens. Further research is needed to provide data that can add to and confirm these results.

Carbono orgânico e atributos físicos do solo sob manejo agropecuário sustentável na Amazônia Legal / Organic carbon and physical attributes of soil under management sustainable agricultural in the Legal Amazon

Estudos visando elevar a qualidade dos solos da Amazônia têm crescido na última década em virtude de seu uso inadequado poder limitar a capacidade de sua produção. Na Região Amazônica, pesquisas demonstram que a agropecuária contribui com o aumento de áreas degradadas correlacionadas ao desflorestamento, no entanto, essa prática possui considerável importância na economia. Dessa forma, o objetivo deste trabalho foi avaliar os níveis de densidade, porosidade total, macro e microporosidade, teores de carbono orgânico e quantificar o estoque de carbono nas camadas no perfil do solo em um sistema de ILPF e em sistemas convencionais no município de Paragominas, Pará. Foi utilizado um delineamento inteiramente casualizado, com três repetições, em esquema de parcela subdividida com quatro parcelas (sistemas de manejo do solo) e sete subparcelas (camadas do solo). As parcelas foram compostas por: sistema ILPF-Paricá, lavoura com plantio convencional de milho (PM), pastagem manejada com criação de gado de corte em sistema extensivo (PE) e como testemunha uma floresta secundária (FS). As subparcelas foram as profundidades de amostragem: 0-10, 10-20, 20-30, 30-40, 40-60, 60-80 e 80-100 cm. O sistema de integração ILPF-Paricá, aos cinco anos de cultivo, melhorou as condições físicas de densidade e porosidade do solo, além dos teores e estoques de carbono orgânico nas camadas subsuperficiais. O PM promoveu aumento da densidade do solo e perda de porosidade total e microporosidade em profundidade, mas apresentou teores e estoques de carbono orgânico similar ao sistema de integração Lavoura-Pecuária-Floresta. A pastagem demonstrou teores e estoques de carbono orgânico semelhante à floresta secundária, porém, indicou redução de macroporosidade.(AU)

Studies aimed at raising the quality of Amazonian soils have grown in the last decade because their inadequate use may limit the capacity of their production. In the Amazon Region, research shows that agriculture contributes to the increase of degraded areas correlated to deforestation, however, this practice has considerable importance in the economy. Thus, the objective of this work was to evaluate the levels of density, total porosity, macro and microporosity, organic carbon contents and to quantify the carbon stock in the soil profile layers in an ICLF system and in conventional systems in the municipality of Paragominas, Pará. A completely randomized design was used, with three replications, in a plot scheme subdivided with four plots (soil management systems) and seven subplots (soil layers). The plots were composed of: ICLF-Paricá system, conventional tillage maize (TM), pasture managed with cattle breeding in extensive system (PE) and as a secondary forest (FS). The subplots were the sampling depths: 0-10, 10-20, 20-30, 30-40, 40-60, 60-80 and 80-100 cm. The ICLF-Paricá integration system, at five years of cultivation, improved the physical conditions of soil density and porosity, as well as the levels and stocks of organic carbon in the subsurface layers. PM promoted increased soil density and loss of total porosity and microporosity in depth, but presented levels and stocks of organic carbon similar to the integrated crop- livestock-forest (ICLF) system. The pasture showed levels and stocks of organic carbon similar to the secondary forest, but indicated a reduction of macroporosity.(AU)

Carbono orgânico e atributos físicos do solo sob manejo agropecuário sustentável na Amazônia Legal / Organic carbon and physical attributes of soil under management sustainable agricultural in the Legal Amazon

Estudos visando elevar a qualidade dos solos da Amazônia têm crescido na última década em virtude de seu uso inadequado poder limitar a capacidade de sua produção. Na Região Amazônica, pesquisas demonstram que a agropecuária contribui com o aumento de áreas degradadas correlacionadas ao desflorestamento, no entanto, essa prática possui considerável importância na economia. Dessa forma, o objetivo deste trabalho foi avaliar os níveis de densidade, porosidade total, macro e microporosidade, teores de carbono orgânico e quantificar o estoque de carbono nas camadas no perfil do solo em um sistema de ILPF e em sistemas convencionais no município de Paragominas, Pará. Foi utilizado um delineamento inteiramente casualizado, com três repetições, em esquema de parcela subdividida com quatro parcelas (sistemas de manejo do solo) e sete subparcelas (camadas do solo). As parcelas foram compostas por: sistema ILPF-Paricá, lavoura com plantio convencional de milho (PM), pastagem manejada com criação de gado de corte em sistema extensivo (PE) e como testemunha uma floresta secundária (FS). As subparcelas foram as profundidades de amostragem: 0-10, 10-20, 20-30, 30-40, 40-60, 60-80 e 80-100 cm. O sistema de integração ILPF-Paricá, aos cinco anos de cultivo, melhorou as condições físicas de densidade e porosidade do solo, além dos teores e estoques de carbono orgânico nas camadas subsuperficiais. O PM promoveu aumento da densidade do solo e perda de porosidade total e microporosidade em profundidade, mas apresentou teores e estoques de carbono orgânico similar ao sistema de integração Lavoura-Pecuária-Floresta. A pastagem demonstrou teores e estoques de carbono orgânico semelhante à floresta secundária, porém, indicou redução de macroporosidade.

Studies aimed at raising the quality of Amazonian soils have grown in the last decade because their inadequate use may limit the capacity of their production. In the Amazon Region, research shows that agriculture contributes to the increase of degraded areas correlated to deforestation, however, this practice has considerable importance in the economy. Thus, the objective of this work was to evaluate the levels of density, total porosity, macro and microporosity, organic carbon contents and to quantify the carbon stock in the soil profile layers in an ICLF system and in conventional systems in the municipality of Paragominas, Pará. A completely randomized design was used, with three replications, in a plot scheme subdivided with four plots (soil management systems) and seven subplots (soil layers). The plots were composed of: ICLF-Paricá system, conventional tillage maize (TM), pasture managed with cattle breeding in extensive system (PE) and as a secondary forest (FS). The subplots were the sampling depths: 0-10, 10-20, 20-30, 30-40, 40-60, 60-80 and 80-100 cm. The ICLF-Paricá integration system, at five years of cultivation, improved the physical conditions of soil density and porosity, as well as the levels and stocks of organic carbon in the subsurface layers. PM promoted increased soil density and loss of total porosity and microporosity in depth, but presented levels and stocks of organic carbon similar to the integrated crop- livestock-forest (ICLF) system. The pasture showed levels and stocks of organic carbon similar to the secondary forest, but indicated a reduction of macroporosity.

GBV-C/HIV-1 coinfection is associated with low HIV-1 viral load and high CD4+ T lymphocyte count.

GB virus C (GBV-C) is a lymphotropic virus with a low level or non-existent replication in the liver. The interaction between HIV-1 and GBV-C apparently reduces the progression of HIV-1 infection to AIDS and improves the quality of life of HIV-1 infected individuals. A cross-sectional study was established to determine the possible effect of HIV-1/GBV-C coinfection on HIV-1 viral load and CD4+ T lymphocyte counts. Samples from 313 HIV-1 infected persons from the Virus Laboratory of the Federal University of Pará as well as demographic and clinical information were obtained from medical records. This study used a nested PCR method to determine GBV-C viremia. The prevalence of HIV-1/GBV-C coinfection was 17%. There were no significant differences in the distribution according to age, sex or ethnicity between the groups. The differences in HIV-1 viral load and CD4+ T lymphocyte count between the HIV-1 and HIV-1/GBV-C groups were highly significant, indicating that coinfection results in lower viral loads and higher CD4+ T lymphocyte counts compared to HIV-1 mono-infection. The results indicate a protective effect among coinfected individuals.

O impacto da padronização de vitamina K em dietas hospitalares / The impact of vitamin K standardization in hospital diets

Estudo prospectivo controlado que avaliou o impacto de modificações dietéticas padronizadas dos teores de vitaminaK em dietas hospitalares sobre o controle da anticoagulação oral crônica em pacientes internados, em uso de varfarina.O grupo intervenção recebeu dieta com teor padronizado de vitamina K e o grupo controle recebeu dieta sem essapadronização. Em ambos, o monitoramento da Razão Normalizada Internacional (RNI) foi realizado de acordo comprotocolo da equipe médica, sem interferência dos membros da pesquisa. Foram coletados dados sobre o consumoalimentar de vitamina K, o RNI, a dosagem de varfarina utilizada, e o tempo dispendido para normalização do RNI.O consumo alimentar foi avaliado por meio de recordatório alimentar 24 horas a partir do início do uso de varfarinaaté a normalização do RNI. A amostra foi composta por 55 pacientes, sendo 29 no grupo controle e 26 no grupointervenção. A média de idade foi 55,47±17,52 anos, sendo 56,3% do sexo feminino e 49,1% idosos. O coeficiente devariação do consumo de vitamina K foi significativamente maior no grupo controle (0,45±0,22) quando comparado aogrupo intervenção (0,31±0,19), p=0,018. A dosagem média de varfarina utilizada foi significativamente menor no grupointervenção (5,30±1,42 mg/dia) quando comparado ao grupo controle (6,21±1,84mg/dia), p=0,044. Os dados obtidosmostraram que uma dieta hospitalar com quantidades padronizadas de vitamina K reduziu a dosagem de varfarinautilizada na normalização do RNI em pacientes anticoagulados orais. Por conseguinte, a dosagem menor de varfarinainduzida pela dieta pode reduzir o risco de eventos hemorrágicos, sobretudo em idosos

A prospective controlled study evaluating the impact of standardized dietary modifications on vitamin K levels in hospitaldiets of chronic oral, anticoagulated patients, using warfarin. The intervention group received a diet with a standardizedcontent of vitamin K and the control group received a diet without this standardization. In both, the InternationalNormalized Ratio (INR) was performed according to the medical staff's protocol, without interference from the researchgroup members. Data on dietary intake of vitamin K, INR, warfarin dosage, and the time taken for normalization ofINR were collected. Food intake was evaluated by a 24-hour food recall, starting from the beginning of warfarin useuntil the normalization of INR. The sample consisted of 55 patients, 29 patients in the control group and 26 patientsin the intervention group. The average age was 55.47 ± 17.52 years old, 56.3% were female, and 49.1% were elderly.The coefficient of variation in the consumption of vitamin K was significantly higher in the control group (0.45 ± 0.22)compared to the intervention group (0.31 ± 0.19); p = 0.018. The average dosage of warfarin use was significantly lowerin the intervention group (5.30 ± 1.42 mg / day) compared to the control group (6.21 ± 1,84mg / day); p = 0.044. Thedata showed that a hospital diet with standard amounts of vitamin K reduces the warfarin dosage to normalization of INRin oral anticoagulated patients. This result can reduce the risk of bleeding events, especially in the elderly

Evaluating the elimination of Brazilian entomopathogenic Bacillus by non-target aquatic species: an experimental study.

Ecotoxicity tests are key to predict environmental hazards resulting from chemical and biological pesticides in non-target species. In order to assess the effects of microbial pesticides it is important to determine if they cause infection in test organisms. At present the microbial elimination rate or clearance is not included in ecotoxicological regulatory protocols. This study evaluated the elimination of Bacillus thuringiensis and Bacillus sphaericus from fish and snails, after 30 days' exposure to commercial formulations of such entomopathogens. Data obtained showed that in clean water the tendency to eliminate microbial agents from the body of the exposed organisms is gradual over time but after 7 days the fish and snails were free of the two tested Bacillus spp.

Patients' perceptions of benefits and risks of complete denture therapy.

PURPOSE: The aim of this study was to assess patients' perceptions of benefits and risks concerning complete denture therapy. A secondary objective was to assess the influence of clinical and sociodemographic variables on patients' perceptions. MATERIALS AND METHODS: The sample was composed of 104 volunteers who presented themselves for complete denture treatment at a dental school. The average age of the volunteers was 69.2 years (±) 9.3. Patient opinions concerning the benefits of complete denture therapy were recorded using a previously reported questionnaire. The answers were evaluated in three domains: (1) benefits (positive perceptions); (2) risks (negative perceptions); and (3) consequences of no treatment. RESULTS: The average time of use of the previous dentures was 20 years (SD ±12.9). Risk factors (negative perceptions) received lower scores by the patients, while the consequences of no treatment received higher scores. No association was found among evaluations of the previous dentures and educational level, marital status, and gender; however, patients' evaluation about their previous dentures was significantly different depending on age (p = 0.001) and previous dentures' time of use (p = 0.038). CONCLUSIONS: Patients presented a positive perception of complete denture therapy, and the risk factors (negative perceptions) received the lowest scores. Patient perception regarding complete denture therapy was not influenced by educational level, evaluation of the previous dentures, or marital status.

Development of a disposable and highly sensitive paper-based immunosensor for early diagnosis of Asian soybean rust.

Soybean is one of the most important crops and plays a key role in the whole food chain production. Soybean crops are very susceptible to the fungus Phakopsora Pachyrhizi, the agent responsible by the Asian soybean rust. The spore of the fungus is easily disseminated by wind with adequate environment, leaf wetness, high humidity and temperatures, the crop can be totally lost within few days. A high sensitive, specific and easy test is the key for early diagnosing the soybean rust and therefore save the crop. Here we present a paper-based immunosensor for early stage diagnosis of soybean rust that can be performed by unskilled operators on-site. Nitrocellulose membrane was chosen as the substrate to stick the antigen due to its high binding properties. Polyclonal antibodies labeled with fluorescent nanoparticles were employed as the recognizers. An analytical curve with spiked samples shows a linear response range from 0.0032 to 3.2 µg/mL. This immunosensor presents a very low detection limit of 2.2 ng/mL, which corresponds approximately to 8-12 spores/mL. The paper-based sensor reachs the detection range of ELISA and PCR based test systems, and outranges the available commercial test kits by two order of magnitude. We believe this immunosensor has a great potential as a point-of-care device for the early diagnosis of Asian soybean rust.

Adsorption and thermochemical data of divalent cations onto silica gel surface modified with humic acid at solid/liquid interface.

Humic acid immobilized onto silica gel surface was studied by the calorimetric titration of divalent cations in aqueous solution. The adsorption isotherms were obtained by the batchwise method and were fitted to a modified Langmuir equation. The maximum number of moles per gram of the material gave: 10.42+/-0.75, 13.16+/-0.58, 7.87+/-0.58 for copper, nickel and zinc, respectively. Gibbs free energies were negative for all systems and the adsorption interactions calorimetrically followed presented endothermic enthalpic values: 6.24+/-0.47, 6.75+/-0.74, 6.97+/-0.58 kJ mol-1 for the same sequence of divalent cations. All liquid/solid interface adsorptions were entropically driven.