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Summary Background Treatment failure (TF) in leprosy following multidrug therapy (MDT) presents a significant challenge. The current World Health Organization (WHO) fixed-duration MDT regimen, based on lesion count, might not be adequate. Leprosy lacks clear-cut objective cure criteria, and the predictive value of post-MDT histopathological findings remains uncertain. This study aims to identify predictive factors for TF among leprosy patients who have completed the WHO-recommended MDT. Methods An analysis was conducted on 80 individuals from a national leprosy reference center, comprising 40 TF cases (with a mean relapse at 13.0 months) and 40 controls (with a mean of 113.1 months without disease signs). Various epidemiological and clinical-laboratory parameters were assessed post-MDT. Results In skin samples, the presence of foamy granuloma (OR = 7.36; 95%CI2.20-24.60; p = 0.0012) and histological bacillary index (hBI) ≥ 1+ (OR = 1.55; 95%CI1. 22-1.99; p = 0.0004) were significantly associated with TF, with odds ratios of 7.36 and 1.55, respectively. Individuals who experienced TF had a mean hBI of 3.02+ (SD ± 2.02), while the control group exhibited a mean hBI of 1.8+ (SD ± 1.88). An hBI ≥ 3 + showed a sensitivity of 73% and a specificity of 78% for TF detection (AUC: 0.75; p = 0.0001). Other histopathological features like epithelioid granulomas, and skin changes did not show significant associations (p > 0.05). Additionally, higher anti-phenolic glycolipid-I (anti-PGL-I) ELISA index (EI) levels were linked to a 1.4-fold increased likelihood for TF (OR = 1.4; 95%CI1.13-1.74; p = 0.0019). A mean EI of 4.48 (SD ± 2.80) was observed, with an EI ≥ 3.95 showing a sensitivity of 79% and a specificity of 59% for TF detection (AUC: 0.74; p = 0.0001). Moreover, the presence of Mycobacterium leprae (M. leprae) DNA in real-time polymerase chain reaction (qPCR) was associated with a 3.43-fold higher likelihood of TF. Multivariate regression analysis indicated that concurrent presentation of neural/perineural lymphocytic infiltrate, foamy granuloma, hBI ≥ 1+, and EI ≥ 1 markedly increased the likelihood of TF by up to 95.41%. Conclusion Persistence of nerve-selective lymphocytic infiltrate, foamy granulomas, and bacilli in skin biopsies, and elevated EI post-MDT, may serve as predictive factors for identifying individuals at higher probability of TF.

Objectives: Fungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU. Methods: This study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed. Results: Thirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %). Conclusion: These findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU.

ABSTRACT: Despite the progress achieved, the cashew cultivar (Anacardium occidentale L.) breeding program at Embrapa Agroindústria Tropical (CNPAT) has not yet peaked in terms of primary and secondary yield components, and the quality properties of the peduncles. Significant improvement is expected with the breeding program in obtaining new elite clones (cultivars). This this study investigated genotype x environment x attribute interaction in cashew trees using principal component analysis with multiple data matrices. The experimental design was completely randomized, in a factorial scheme with repeated measures over time, applying the confounding technique, with 3 treatments and 4 replications, totaling 48 plots. The total number of plants was represented by 30 plants of each clone in each environment. Around 30 ripe cashew peduncles of each genotype were harvested early in the morning and sent to the post-harvest laboratory of Embrapa Agroindústria Tropical (CNPAT). The factors considered for joint biplot graphical analysis were three genotypes (G1, G2, G3), four environments (combination of two locations, Alto Santo and Beberibe, municipalities in the state of Ceará, two agricultural years (2013 and 2014), and eight physicochemical peduncle properties. The study was implemented using principal component analysis (PCA), with a three-way data array (genotypes x environments x variables). The genotypes did not exhibit phenotypic stability for the variables assessed and environments studied because these cultivars are located far from the center of the graph, that is, away from the origin. The three genotypes showed positive and negative phenotypic adaptations for different variables and environments, qualifying them for consumption of pseudofruits as table fruits, industrially processed products, or even displaying dual purpose consumption suitability.

Background: Early detection of antimicrobial-resistant microorganisms is crucial to prevent subsequent invasive infections and contain their spread in the Neonatal Intensive Care Unit (NICU). This study aims to investigate the association between intestinal colonization (IC) by Gram-negative bacteria and the risk of bloodstream infection (BSI) in critically ill neonates. Methods: Data from the electronic medical records of 678 newborns admitted to a NICU Brazilian between 2018 and 2022 were retrospectively analyzed. Participants were monitored by the National Health Security Network. Results: Among neonates, 6.9 % had IC (56.9 % attributed to Acinetobacter baumannii); of these, 19.1 % developed BSI (66.7 % by Staphylococcus spp.). Within the A. baumannii colonization, 34.5 % occurred during an outbreak in September 2021. Colonized individuals had a longer mean length of stay (49.3 ± 26.4 days) and higher mortality rate (12.8 %) compared to non-colonized individuals (22.2 ± 16.9 days; 6.7 %, respectively). Previous use of antimicrobials and invasive devices significantly increased the risk of colonization. Colonization by drug-resistant microorganisms, along with the occurrence of BSI, was associated with increased mortality and reduced survival time. Conclusions: IC contributed to the incidence of BSI, leading to more extended hospital stays and higher mortality rates. Its early detection proved to be essential to identify an outbreak and control the spread of resistant microorganisms within the NICU.

Background and Objectives: Invasive fungal infections are associated with high morbidity and mortality in patients admitted to hospital, including those receiving appropriate therapy. The aim of this study was to evaluate the use of prophylactic and preemptive antifungal therapy; clinical and epidemiological features; and mortality of patients admitted to an infectious disease ward of a public high complexity hospital in Uberlandia, Minas Gerais, Brazil. Methods: This is a retrospective study carried out in the infectious diseases ward of a public university hospital in Brazil. Data from patients hospitalized in 2019 and 2020 who received azole antifungals (fluconazole, itraconazole, or voriconazole), echinocandin (anidulafungin), and polyene (amphotericin B) were collected from medical records. Results: During the study period, 111 patients received one or more antifungal agent. The length of hospital stays of patients (29.35 days; p=0.0252), mean number of days of antibacterial drug use (23.5 days; p=0.0164), a diagnosis of AIDS (p=0.0397), mechanical ventilation (MV) (p

Abstract It is known that the chronotype potentially mediates the performance and tolerance to work in shifts and that shift rotation is associated with negative effects on psychomotor performance. This study aimed to evaluate the effect of chronotype on psychomotor performance throughout a complete shift rotation schedule. Thirty males working in clockwise rotating shifts from a mining company were evaluated under a real-life condition over the following shift schedule: 2 days of day work, 2 days of evening work and 2 days of night work. The chronotype was determined using the Munich Chronotype Questionnaire adapted for shift workers and the obtained scores were categorized by tertiles (early-type, intermediate-type and late-type). Work performance was evaluated by Psychomotor Vigilance Test (PVT) daily just before shift starts and after shift ends. Sleep duration was evaluated by actigraphy over the whole shift. No isolated effect of the shift or interaction between shift and chronotype was found in the performance variables evaluated. A significant isolated effect of the chronotype showed that the early-type individuals had higher values of pre- and post-work Mean of Reaction Time (MRT) (308.77 ± 10.03 ms and 306.37 ± 8.53 ms, respectively) than the intermediate-type (257.61 ± 6.63 ms and 252.91 ± 5.97 ms, respectively, p

Objetivo: analisar a associação entre doenças cardiometabólicas, violência sofrida e uso de drogas em caminhoneiros. Método: estudo transversal que envolveu 235 motoristas que estiveram em um posto de combustível no município de Uberlândia (MG), Brasil. Os dados foram coletados por meio de entrevistas autorrelatadas e aplicados os Testes de Qui Quadrado e Regressão Logística, adotando-se um nível de significância de 0,05 para todas as variáveis. Resultados: observou-se uma relação entre os eventos violentos no trânsito e algumas doenças cardiometabólicas, especialmente a doença vascular periférica (OR=6,00 (IC 95% 2,47-14,56) e a obesidade (OR=2,56 (IC 95% 1,42-4,62); sendo que também o abuso de álcool (OR=4,16 (IC 95% 1,53-11,29) e tabaco (OR=2,68 (IC 95% 1,10-6,51) se relacionaram com essas patologias. Conclusão: exposição a assaltos e acidentes de trânsito, e uso de álcool e tabaco foram associados a uma maior chance de prevalência das doenças cardiometabólicas entre caminhoneiros.

Cancer is the second leading cause of death in Brazil, and head, neck, and lung cancer are among the five most common types in the male Brazilian population. It is reported that tobacco, alcohol and occupational agents are important risk factors for the disease. This study aims to describe the work profile and the use of alcohol and tobacco among patients diagnosed with these types of cancers. It is a quantitative, descriptive, exploratory, transversal study. The sample consisted of 118 patients seen and registered at a public hospital, who answered a questionnaire that contained sociodemographic and professional information, in addition to the Fagerstrom Test and the AUDIT. Most participants were men, white, married, with an average age of 60, an incomplete primary education, income below one minimum wage, with the main occupational activities related to rural work, civil construction, and cleaning and maintenance. The history of alcohol and tobacco abuse, which also occurred after the diagnosis of cancer, was raised, as well as living with family members and co-workers who also used these substances. It is concluded that there is a need for assistance aimed at changing lifestyles during cancer treatment, expanding the vision of studies related to cancer for specific sociodemographic groups, concerning lifestyle and consumption habits, work profile, as well as work environment.

RESUMO As cardiopatias congênitas (CC) estão entre as principais causas de morbimortalidade na primeira infância e os lactentes com essa condição podem apresentar atrasos no desenvolvimento neuropsicomotor (DNPM). O objetivo deste estudo foi avaliar a influência da CC no DNPM de lactentes. Trata-se de um estudo observacional com avaliação do desenvolvimento neuropsicomotor realizada pela Bayley Scales of Infant and Toddler Development (BSID-III). As condições maternas e clínicas dos lactentes foram verificadas no relatório de alta médica e na caderneta de saúde da criança, e a condição socioeconômica das famílias pelo Critério da Classificação Econômica Brasil. Para associar as variáveis clínicas e o DNPM foram utilizados o coeficiente de correlação de Spearman e o teste de razão de verossimilhança. Foram avaliados 18 lactentes, com predomínio do sexo feminino (72,2%). A maioria das mães (47,1%) possuía ensino médio completo ou superior incompleto, com média da idade de 27,2±5,5 anos. Houve correlação das escalas do BSID-III com as variáveis quantitativas analisadas: escala motora com o peso (p=0,02 e r=0,54) e com uso de oxigenoterapia (p=0,009 e r=−0,591); já para as variáveis qualitativas as associações foram entre: escala motora e condição socioeconômica (p=0,015), escala motora e comunicação interatrial - (CIA) (p=0,023) e escala da linguagem e CIA (p=0,038). A CC influenciou o DNPM, principalmente no aspecto motor. Além disso peso, diagnóstico de CIA, uso de oxigenoterapia e condição socioeconômica foram considerados como principais fatores de risco para o atraso no DNPM.

Abstract INTRODUCTION: Bloodstream infection due to Candida spp. is a primary cause of morbidity and mortality in tertiary hospitals. METHODS: In this retrospective study, we included patients with a positive blood culture for Candida spp. after 48 h of hospitalization. RESULTS A total of 335 patients who had candidemia were included in this study. Risk factors associated with mortality were hospitalization in internal medicine units and surgical clinics, age >60 years, mechanical ventilation, orotracheal intubation, hemodialysis, corticosteroids use, and C. parapsilosis infection. CONCLUSIONS: This study highlights the importance of health care related to invasive procedures and actions to improve patient immunity.

The mangaba is a fruit tree with great potential for the northeast of Brazil. Due to the scarcity of improved cultivars, and as it is a species that is still in the process of domestication, exploitation has been based on rational and sustainable extractivism by farmer-gatherers. The aim of this study was to analyse the correlations between technological variables of the mangaba, and to carry out an early selection of the genotypes that make up the base population of the mangaba improvement program of Embrapa Meio-Norte. The variables fruit weight, pulp weight and percentage pulp show significant correlation with fruit length and fruit diameter, allowing indirect selection for the first set of variables by means of the latter, which are easily measured. Genotypes 4, 13, 16, 21, 25, 32, 35 and 49 show a positive association with fruit weight, fruit length, fruit diameter, pulp weight and percentage weight, and are therefore candidates for selection. Principal component 1 is associated with fruit weight, fruit length, fruit diameter, skin weight, number of seeds per fruit, seed weight, TTA and pulp weight. These variables can be selected with greater mathematical certainty, since this component concentrates more information regarding variability and is therefore more important.

Background: Contamination of the hospital environment with multi-resistant (MDR) Staphylococcus increases the risk of infection. The aim of this study is to identify the MDR species of Staphylococcus on inanimate surfaces, in air, and in clinical samples, and analyze the risk factors that correlate with the occurrence of infections in a Neonatal Intensive Care Unit. Methods: Samples of inanimate surfaces and air were taken using a premoistened swab (0.9% sodium chloride) and spontaneous air sedimentation, respectively. The clinical isolates were recovered from infected neonates. The isolates (environmental and clinical) were identified by matrix-assisted laser desorption ionization-time of flight and the resistance profile was calculated using the disk diffusion agar technique. Results: In total, 181 isolates were obtained, 93 from (surfaces), 18 from the air, and 70 clinical samples. S. epidermidis was the most frequent species (66.8%), and the failure rate in air cleaning was 100%. More than 60% of the isolates were MDR, and the majority of clinical isolates (60.4%) had a resistance profile identical to that of the environmental isolates. Conclusion: Staphylococcus spp. were found in most of the analyzed samples, with a high frequency of MDR isolates, demonstrating the importance of the hospital environment as a reservoir, and the need for infection control measures, and rational use of antimicrobials.

RESUMO Crianças com síndrome de Down apresentam atrasos no desenvolvimento neuropsicomotor relacionados a tônus muscular, controle postural e equilíbrio. O desenvolvimento motor sofre interferência multifatorial, que envolve características biológicas, psicológicas, sociais e ambientais. Assim, o ambiente em que o lactente está incluído pode atuar como facilitador do desenvolvimento neuropsicomotor. O objetivo deste estudo foi avaliar a influência do ambiente domiciliar no desenvolvimento motor de lactentes com síndrome de Down. Participaram do estudo 16 lactentes com a síndrome, divididos em grupo I (3 a 11 meses) e grupo II (12 a 18 meses), avaliados pela Alberta Infant Motor Scale (AIMS) e pelo questionário Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS). A análise de dados foi feita por meio do teste de Kruskal-Wallis, coeficiente de correlação de Spearman e teste de razão de verossimilhança. Os resultados evidenciaram uma correlação positiva significativa entre o escore bruto da AIMS e a variedade de estímulos (p=0,01, r=0,78) e com o escore total do questionário AHEMD-IS (p=0,02, r=0,74) no grupo II. Verificou-se, ainda, correlação entre a renda familiar e as oportunidades com brinquedos de função motora grossa (p=0,05, r=0,49), porém com correlação fraca. Conclui-se que o ambiente domiciliar tem importante papel no desenvolvimento motor de crianças com síndrome de Down entre 12 e 18 meses, por proporcionar oportunidades de vivências e experimentações. Assim, pode-se afirmar que ambientes mais adequados proporcionam melhor desempenho motor.

The mango (Mangífera indica L.) is one of the main exotic fruits grown in Brazil, and is used as a component in various arrangements within production systems, where genetically improved cultivars are continually sought by producers to establish commercial plantations. The aim of this research therefore, was to describe the structure of variance (estimation) and mean values (prediction) in the classification and progressive selection of elite genotypes of the pink mango using the REML/BLUP procedure with a focus on mixed models. Twelve agro-technological variables were evaluated in twelve elite genotypes from three crops: 2010-2011, 2011-2012 and 2012-2013, in a completely randomised block design with six replications. Estimates of the repeatability coefficient were medium and high for most of the key attributes in the mango genetic breeding program: 0.83 for fruit weight, 0.91 for total soluble solids (SST), 0.51 for firmness, 0.93 for total titratable acidity (ATT), 0.92 for the SST/ATT ratio, and 0.767 pulp weight, and low (0.05) for percentage pulp. High genetic control was seen in the expression of the variables, and high mean stability in the repetition of the variable in successive cycles, with the exception of percentage pulp. As for percentage pulp, the most promising materials were the following, in decreasing order of future mean values: ‘CPAC 165’ (73.05), CPAC 329 (73.03), ‘Rosa 2’ (73.00), ‘Espada vermelha’ (72.98), ‘Rosa 36’ (72.97) and ‘P5Rosa’ (72.96), surpassing the control. This is a desirable attribute in the mango for both in natura consumption and industry. = A mangueira (Mangífera indica L.) é uma das principais fruteiras exóticas cultivadas no Brasil, sendo utilizada como um componente em vários arranjos dentro de sistemas produtivos, onde as cultivares geneticamente melhoradas são continuamente procuradas por parte dos produtores para a formação de plantios comerciais. Assim, objetivou-se com esta pesquisa descrever a estrutura de variâncias (estimação) e de médias (predição) na classificação e seleção progressiva de genótipos elites de manga rosa, empregando o procedimento REML/BLUP com enfoque em modelos mistos. Doze variáveis agrotecnológicas foram avaliadas em doze genótipos elites, em três safras: 2010-2011, 2011-2012 e 2012-2013, em delineamento experimental de blocos completamente casualizados, com seis repetições. As estimativas do coeficiente de repetibilidade foram medianos e altos para a maioria dos atributos chave do programa de melhoramento genético da mangueira: 0,83 para peso do fruto, 0,91 para sólidos solúveis totais (SST), 0,51 para firmeza, 0,93 para acidez total titulável (ATT), 0,92 para a relação SST/ATT, 0,767 peso da polpa e baixo (0,05) para porcentagem de polpa. Mostrando para essas variáveis alto controle genético na expressão das variáveis e grande estabilidade média na repetição do caráter em ciclos sucessivos, exceção feita para porcentagem de polpa. Quanto à porcentagem de polpa, os materiais mais promissores foram os seguintes, em ordem decrescente de médias futuras: CPAC 165 (73,05), CPAC 329 (73,03), Rosa 2 (73,00), Espada vermelha (72,98), Rosa 36 (72,97) e P5Rosa (72,96), superando a testemunha. Esse é um atributo desejável em manga tanto para o consumo in natura, quanto para a indústria.

PurposeQuality of life in colorectal cancer patients may be affected by colostomy and treatment, but relevant studies are still scarce and contradictory. The present study aimed to evaluate the association between colostomy time and treatment type with quality of life in colorectal cancer patients.MethodsA prospective observational study of 41 patients with colorectal cancer was conducted on three occasions T0, T1 and T2 (0-2; 3-5 and 6-8 months after ostomy surgery, respectively). The treatments prescribed were: surgery alone, chemotherapy or radiotherapy, or chemoradiotherapy. European Organization for Research and Treatment of Cancer questionnaires were used to evaluate quality of life. Worsening clinical changes were evaluated considering difference in scores between times of surgery ≥±9 points.ResultsRegarding ostomy surgery, scores in physical function improved between T0 and T1 and these better scores were maintained at T1 to T2. The same was observed for urinary frequency, appetite loss and dry mouth. Chemoradiotherapy was associated with worse scores for global health status, nausea and vomiting, bloating and dry mouth. Although significant differences were not observed in some domains in the Generalized Estimating Equations analysis, patients showed noticeable changes for the worse in the pain, anxiety, weight concern, flatulence and embarrassment domains during these periods.ConclusionsColostomy improved quality of life at 3-5 months in most domains of quality of life and remained better at 6-8 months after surgery. Chemoradiotherapy had a late negative influence on quality of life. Health teams could use these results to reassure patients that this procedure will improve their quality of life in many functional and symptomatic aspects.

Psoriasis and psoriatic arthritis are chronic, relapsing, immune-based diseases. Psoriatic patients may have nail involvement in 50 to 80% of cases, and this may reach 85% in patients with joint disease, in spite of the fact that the relationship between psoriasis and onychomycosis is not well established. The aim of this study was to investigate the occurrence of onychomycosis in patients with nail disorders and diagnosis of psoriasis and psoriatic arthritis. This was a cross-sectional study in which 38 patients diagnosed with psoriasis and/or psoriatic arthritis were interviewed and had altered nail samples analysed by mycological and histopathological exams. Twenty-two (57.89%) patients had a confirmed diagnosis for onychomycosis. Seventeen (44.8%) had a positive direct mycological examination, 16 (42.1%) had positive cultures, and 12 (31.6%) were positive for fungi by histopathological examination. Dermatophytes were identified in nine (56.3%) cultures, and of these, eight were Trichophyton rubrum and one T. tonsurans. Yeasts were isolated in seven patients (43.75%), which included four Candida parapsilosis and three C. albicans. Six patients (15.78%) were not using immunosuppressive therapy, and the others were using methotrexate, etanercept, adalimumab, infliximab, secukinumab, or golimumab, in monotherapy or in combination with other drugs. The confirmed onychomycosis rate in patients using methotrexate alone was 92.8% (n = 13). We concluded that it is possible that there is a positive relationship between psoriatic disease and onychomycosis. And we highlight that it is also worth investigating in the future the possible role of immunosuppressive therapy (mainly methotrexate) as a predisposing factor for the development of fungal infections in psoriatic patients.

Abstract Objectives: To evaluate possible relationships between drug abuse, symptoms suggestive of depression and gender in nursing team professionals. Method: A cross-sectional study conducted in a general hospital with 416 participants. Used questionnaire with sociodemographic information, ASSIST, AUDIT-C and PHQ-2 tests. Used Fisher's Exact Tests, Chi-Square Test, and Multivariate Logistic Regression Analysis. Results: The female gender presented decreased odds ratios for alcohol consumption in the binge pattern and use of marijuana; and double odds ratios for feelings of lack of interest and pleasure. Symptoms suggestive of depression presented potential risks for the use of sedatives. Conclusion: Drug abuse and symptoms of depression are associated and manifest differently, according to gender among nursing staff professionals. Implications for practice: Social and gender roles influence the mental health conditions of these professionals.

BACKGROUND AND OBJECTIVE: The increased use of epidural analgesia with catheter leads to the need to demonstrate the safety of this method and know the incidence of catheter colonization, inserted postoperatively for epidural analgesia, and the bacteria responsible for this colonization. METHODS: From November 2011 to April 2012, patients electively operated and maintained under epidural catheter for postoperative analgesia were evaluated. The catheter tip was collected for semiquantitative and qualitative microbiological analysis. RESULTS: Of 68 cultured catheters, six tips (8.8%) had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45 h (18-118) (p = 0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients, and surgical time showed no relation with the colonization of catheters. Microorganisms isolated from the catheter tip were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. CONCLUSION: Postoperative epidural catheter analgesia, under these study conditions, was found to be low risk for bacterial colonization in patients at surgical wards.

Background and objective: The increased use of epidural analgesia with catheter leads to the need to demonstrate the safety of this method and know the incidence of catheter colonization, inserted postoperatively for epidural analgesia, and the bacteria responsible for this colonization. Methods: From November 2011 to April 2012, patients electively operated and maintained under epidural catheter for postoperative analgesia were evaluated. The catheter tip was collected for semiquantitative and qualitative microbiological analysis. Results: Of 68 cultured catheters, six tips (8.8%) had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45 h (18–118) (p = 0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients, and surgical time showed no relation with the colonization of catheters. Microorganisms isolated from the catheter tip were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. Conclusion: Postoperative epidural catheter analgesia, under these study conditions, was found to be low risk for bacterial colonization in patients at surgical wards. Resumo: Objetivos: O aumento do uso de analgesia pela via peridural com uso de cateteres leva à necessidade de se demonstrar a segurança do método. O presente estudo teve como objetivo conhecer a incidência de colonização de cateteres inseridos para analgesia peridural no pós-operatório e as bactérias responsáveis por estas colonizações. Métodos: No período de novembro de 2011 a abril de 2012 foram avaliados pacientes operados eletivamente mantidos sob analgesia por cateter peridural no pós-operatório. A ponta do cateter foi coletada para análise microbiológica semi-quantitativa e qualitativa. Resultados: Seis (8,8%) pontas dos 68 cateteres cultivados apresentaram culturas positivas. Nenhum paciente apresentou infecção superficial ou profunda. O tempo médio de permanência do cateter foi de 43,45 horas (18-118 horas) (p = 0,0894). O tipo de cirurgia (contaminada ou não contaminada), estado físico dos pacientes e tempo cirúrgico não mostraram relação com a colonização dos cateteres. Os micro-organismos isolados da ponta de cateter foram Staphylococcus aureus, Pseudomonas aeruginosa e Sphingomonas paucimobilis. Conclusão: Conclui-se que, a analgesia por cateter peridural no pós-operatório, nas condições do presente estudo, revelou-se procedimento com baixo risco de colonização bacteriana em pacientes de enfermarias cirúrgicas. Keywords: Epidural anesthesia, Infection, Bacteria, Palavras-chave: Anestesia epidural, Infecção, Bactérias

Aim: The aim of this study was to evaluate the presence of filling material in oval root canals after endodontic retreatment performed by different techniques, considering the area (mm2), location and root third using computed microtomography (µ-CT). Methods: Thirty human lower central incisor underwent biomechanical preparation, root filling and filling removal using two techniques (n=15): MN- manual retreatment technique (Gates Glidden burs and stainless steel manual files); and RT- rotary retreatment technique (ProTaper Universal and ProTaper Retreatment Systems). Cross-sectional images of the teeth were made using µ-CT to identify the presence of remaining filling in all root thirds of the canal walls. The remaining material detected in 150 µ-CT sections was identified and its area quantified (mm2) for each root third individually. Results: Data analysis showed no difference in the remaining area of filling material (p=0.8611) for the both techniques. Higher frequency of remaining material was verified in the lingual wall of the root canals. Regardless of the retreatment technique, the apical third showed lager areas of remaining filling material. More areas of remaining material were detected in the cervical third of the RT group, whereas for the MN group, most areas were observed in the middle and apical thirds. Conclusion: According to our results, no significant differences were verified between the efficiency of the rotary and manual techniques for removing filling material due to the interferences caused by the root canal anatomy.

A mangueira (Mangífera indica L.) é uma das principais fruteiras exóticas cultivadas no Brasil, sendo utilizada como um componente em vários arranjos dentro de sistemas produtivos, onde as cultivares geneticamente melhoradas são continuamente procuradas por parte dos produtores para a formação de plantios comerciais. Assim, objetivou-se com esta pesquisa descrever a estrutura de variâncias (estimação) e de médias (predição) na classificação e seleção progressiva de genótipos elites de manga rosa, empregando o procedimento REML/BLUP com enfoque em modelos mistos. Doze variáveis agrotecnológicas foram avaliadas em doze genótipos elites, em três safras: 2010-2011, 2011-2012 e 2012-2013, em delineamento experimental de blocos completamente casualizados, com seis repetições. As estimativas do coeficiente de repetibilidade foram medianos e altos para a maioria dos atributos chave do programa de melhoramento genético da mangueira: 0,83 para peso do fruto, 0,91 para sólidos solúveis totais (SST), 0,51 para firmeza, 0,93 para acidez total titulável (ATT), 0,92 para a relação SST/ATT, 0,767 peso da polpa e baixo (0,05) para porcentagem de polpa. Mostrando para essas variáveis alto controle genético na expressão das variáveis e grande estabilidade média na repetição do caráter em ciclos sucessivos, exceção feita para porcentagem de polpa. Quanto à porcentagem de polpa, os materiais mais promissores foram os seguintes, em ordem decrescente de médias futuras: CPAC 165 (73,05), CPAC 329 (73,03), Rosa 2 (73,00), Espada vermelha (72,98), Rosa 36 (72,97) e P5Rosa (72,96), superando a testemunha. Esse é um atributo desejável em manga tanto para o consumo in natura, quanto para a indústria.

Este trabalho teve os seguintes objetivos: propor uma sistemática para o estudo e a interpretação da estabilidade e adaptabilidade fenotípica, por meio do modelo de Tucker3; avaliar o uso do gráfico joint plot; e comparar os resultados obtidos pela metodologia de três entradas com os resultados obtidos pelos modelos AMMI e pela análise biplot. Os dados utilizados são relativos a experimentos com 13 genótipos de feijão conduzidos em nove experimentos. Os resultados indicaram que o gráfico joint plot facilita o entendimento da interação tripla e traz ao pesquisador informações mais reais sobre a interação tripla do que a modelagem AMMI de duas entradas; o genótipo 6 foi o que menos contribuiu para a interação, e os genótipos 12, 9 e 5 foram os que mais contribuiram para a interação.The present research had the following objectives: to propose a systematics for the study and the interpretation of the phenotypic stability and adaptability, through Tucker3 models; assess the use of the joint plot; comparing the results obtained by tucker3 model with the results obtained by biplot analysis and AMMI models. The data used are related to the experiments with 13 genotypes of beans that had been lead in 9 distinct experiments. The results indicated that the joint plot graph facilitates the understanding of triple interaction and bring to the researcher more real information about triple interaction, than AMMI modeling of two entries. The genotype 6 was the one which least contributed for the triple interaction and genotypes 12, 9 and 5 were those e which had contributed more for the interaction.

O melhoramento da soja (Glycine max) está avançado, porém, não se obteve atingir o seu limiar produtivo, a despeito de sua base genética restrita é esperado avanço significativo com o melhoramento genético na obtenção de novos cultivares com altos níveis produtivos. Objetivou-se com este trabalho investigar a interação genótipo x ambiente em soja por meio da análise de componentes principais com múltiplas matrizes de dados. Foram avaliados 44 e 23 genótipos, nos anos agrícolas 2000 e 2001, respectivamente. Utilizou-se o delineamento de blocos aos acaso, com duas repetições estratificadas em três conjuntos experimentais com testemunhas comuns (IAC 100, Ocepar 4, IAS 5 e Primavera). Os fatores considerados para a análise foram: genótipos (G1, G2, G3..., G44), ambientes (combinação dos locais Anhembi-AN e Areão-AR com o controle intensivo-COM e ecológico-SEM de insetos) e atributos (produção e componentes). O estudo foi implementado por meio de análise de componentes principais com arranjo de três entradas (genótipo x ambiente x variáveis). Os genótipos 2, 3, 23, 28, 36, 38 e 44 apresentam tolerância a percevejos e boa produtividade no ambiente AN_COM. Os genótipos 7, 17, 21, 29, 35, 37 e 40 interagem positivamente com o ambiente AR_SEM com adaptabilidades e estabilidades específicas redundando em produtividades elevadas.

This work applies the three mode principal components analysis to analyze simultaneously the multiple attributes; to fit of models with additive main effects and multiplicative interaction effects (AMMI models) and the regressions models on sites (SREG models); to evaluate, respectively, the multivariate response of the genotype × environment interaction and the mean response of 36 genotypes of corn tested in 4 locations in Brazil. The results were presented by joint plots to identify the best genotypes for their adaptability and performance in the set of attributes.

O presente trabalho foi dirigido no sentido de realizar uma análise descritiva da precipitação pluviométrica mensal de estações climatológicas do Estado do Rio de Janeiro, utilizando medidas de posição e de dispersão e análises gráficas, e, através de um estudo sobre a aplicação de modelos de séries temporais, verificar a presença das componentes de sazonalidade e de tendência nestes dados. Os dados experimentais utilizados fazem parte do Banco de Dados Climatológicos do Estado do Rio de Janeiro. Selecionou-se três estações por apresentarem séries históricas consistentes. A estatística descritiva foi utilizada para caracterizar o comportamento geral da série. A metodologia de análise de variância em blocos casualizados e determinação de modelos de regressão linear múltipla, considerando anos e meses como variáveis preditoras, revelaram a presença de sazonalidade, que permitiu inferir sobre a ocorrência de fenômenos naturais repetitivos ao longo do tempo, e ausência de tendência. Aplicou-se a metodologia de regressão linear múltipla para a remoção da sazonalidade dessas séries temporais. Os dados originais foram subtraídos das estimativas feitas pelo modelo ajustado e procedeu-se novamente a análise de variância em blocos casualizados para os resíduos da regressão. Verificou-se que a regressão múltipla foi eficiente na remoção da sazonalidade da série.

ABSTRACT This study aimed to propose a clustering methodology with bootstrap resampling using the Additive Main Effects and Multiplicative Interaction Analysis (AMMI) to contribute to better prediction of phenotypic stability of genotypes and environments. It also aims to analyze the genetic divergence in the assessment of soybean lines, identify genotypes with high-yielding characteristics, with control of chewing and sucking insect pests, and cluster similar genotypes for the traits evaluated. A total of 24 experiments were conducted in randomized blocks, with two replications subdivided in experimental groups with common controls. AMMI with principal component analysis indicated that PC1 and PC2 were significant, explaining 83.9% of the sum of squares of the interaction. The first singular axis of AMMI analysis captured the highest percentage of "pattern" and, with subsequent accumulation of the dimensions of the axes, there was a decrease in the percentage of "pattern" and an increase in "noise". The Euclidean distance between genotype scores was used as the dissimilarity measure and clusters were obtained by the hierarchical method of Ward. Genotypes 97-8011, 97-8029, 97-8050 and IAS-5 had the best performance and are promising for recommendation purposes, with the greatest stability and best performance on grain yield.

RESUMO Objetivo: Comparar o desenvolvimento neuropsicomotor de lactentes nascidos prematuramente, com e sem displasia broncopulmonar, no primeiro ano de vida. Métodos: Estudo retrospectivo, do tipo transversal, realizado no período de 1º de janeiro de 2014 a 30 de dezembro de 2015, com lactentes prematuros, com peso < 1.500g ao nascer e diagnóstico de displasia broncopulmonar, na idade corrigida de 6 e 9 meses, avaliados pelo Teste de Triagem do Desenvolvimento DENVER II. As variáveis quantitativas foram descritas em médias, medianas e desvio padrão. Para as variáveis que apresentaram distribuição normal, aplicou-se o teste t de Student; do contrário, foi aplicado o teste de Mann-Whitney, considerando significância o valor de p < 0,05. As variáveis qualitativas foram descritas em frequências e porcentagens. Utilizou-se a regressão logística com análise da razão de chances para avaliar os efeitos das outras variáveis, como fatores de risco para alterações no desenvolvimento neuropsicomotor. Resultados: Os lactentes com displasia broncopulmonar apresentaram maior atraso no desenvolvimento neuropsicomotor quando comparados àqueles sem displasia broncopulmonar (p = 0,001). Os fatores associados com maior incidência para alterações no desenvolvimento neuropsicomotor, além da displasia broncopulmonar, foram: esteroide antenatal, sexo, peso ao nascimento, escore de Apgar no quinto minuto, Score for Neonatal Acute Physiology with Perinatal Extension, tempo de oxigenoterapia, ventilação mecânica e internação. Outras variáveis também podem ter influenciado o resultado, como uso de drogas pelas mães dos lactentes com displasia broncopulmonar. Conclusão: A displasia broncopulmonar associada a outros fatores pré e pós-natais pode ser considerada fator de risco para o atraso do desenvolvimento neuropsicomotor em lactentes nascidos prematuramente e com peso inferior a 1.500g, no primeiro ano de vida.

ABSTRACT: Mango ( Mangifera indica L.) trees stand out among the main fruit trees cultivated in Brazil. The mango rosa fruit is a very popular local variety (landrace), especially because of their superior technological characteristics such as high contents of Vitamin C and soluble solids (SS), as well as attractive taste and color. The objective of this study was to select a breeding population of mango rosa (polyclonal variety; ≥5 individuals) that can simultaneously meet the fresh and processed fruit markets, using the multivariate method of principal components and the biplot graphic. The principal components, biplot graphic, and phenotype correlations were obtained using the R (2012) software. Pulp percentage and the pulp, skin, and seed mass variables can be indirectly selected using the smallest fruit diameter, which allowed an easier measurement. The P23R AREA3, P30R AREA3, and P32R AREA3 genotypes are selection candidates due to the presence of alleles, which are important agro-technological traits for mango breeding. This study showed that the biplot analysis is a valuable tool for decision making and visualization of interrelationships between variables and genotypes, facilitating the mango selection process.

Abstract: We compared the goodness of fit and efficiency of models for germination. Generalized Linear Models (GLMs) were performed with a randomized component corresponding to the percentage of germination for a normal distribution or to the number of germinated seeds for a binomial distribution. Lower levels of Akaikes’s Information Criterion (AIC) and Bayesian Information Criterion (BIC) combined, data adherence to simulated envelopes of normal plots and corrected confidence intervals for the means guaranteed the binomial model a better fit, justifying the importance of GLMs with binomial distribution. Some authors criticize the inappropriate use of analysis of variance (ANOVA) for discrete data such as copaiba oil, but we noted that all model assumptions were met, even though the species had dormant seeds with irregular germination.

ABSTRACT Cryptococcosis, a systemic disease caused by the fungus Cryptococcus neoformans/ Cryptococcus gattii is more severe in immunocompromised individuals. This study aimed to analyze the epidemiology of the disease, the molecular characteristics and the antifungal susceptibility of C. neoformans isolated from patients treated in a Brazilian university hospital. This retrospective study was conducted in the Clinical Hospital, Federal University of Uberlândia, and evaluated cases of cryptococcosis and strains of C. neoformans isolated from 2004 to 2013. We evaluated 41 patients, 85% of whom were diagnosed with AIDS. The fungus was isolated from the cerebrospinal fluid (CSF) of 21 patients (51%); 19.5% had fungemia and in 24% the agent was isolated from the CSF and blood, concurrently. Meningoencephalitis was the most frequent (75%) manifestation of infection. Despite adequate treatment, the mortality of the disease was 58.5%. Most isolates (97.5%) presented the VNI genotype (serotype A, var. grubii) and one isolate was genotyped as C. gattii (VGI); all the isolates were determined as mating type MATa and showed susceptibility to the tested antifungals (fluconazole, voriconazole, amphotericin B and 5-flucytosine). Although AIDS detection rates remain stable, opportunistic infections such as cryptococcosis remain as major causes of morbidity and mortality in these patients.

Introdução: A Infecção de Corrente Sanguínea associada a Cateter Venoso Central (ICS-CVC) é um grave evento adverso em unidades críticas.Objetivo: Avaliar a taxa de ICS-CVC de um Centro de Terapia Intensiva de Adultos (CTI) e suas Unidades de Terapia Intensiva (UTIs) especializadas, destacando os agentes etiológicos e perfil de resistência.Métodos: Foi realizado um estudo observacional, retrospectivo e descritivo, de análise documental com abordagem quantitativa dos prontuários de pacientes admitidos no período de 01 de março de 2016 a 31 de agosto de 2016 em um hospital na cidade de Uberlândia-MG, Brasil.Resultados: Foram identificados 30 casos de ICS-CVC num total de 4.265 pacientes-dia e 3.373 dispositivos-dia. A densidade de incidência de ICS-CVC no CTI de Adultos foi de 8,90 por 1.000 dispositivos-dia.A densidade de utilização do CVC foi de 0,79. Os indicadores de ICS-CVC foram calculados separadamente para as UTIs especializadas. Na UTI Cirúrgica, a densidade de incidência foi de 7,52 por 1.000 dispositivos-dia, na UTI Neurológica 14,88 por 1.000 dispositivos-dia e na UTI Clínica 5,85 por 1.000 dispositivos-dia. O Acinetobacter baumannii foi o agente mais frequente (15,2%) entre os micro-organismos identificados, seguido por Staphylococcus aureus (12,1%) e Staphylococcus epidermidis (12,1%). A resistência à oxacilina foi encontrada em 100% das cepas de Staphylococcus coagulase-negativa e em 25% de cepas de Staphylococcus aureus. Para as enterobactérias, a resistência às cefalosporinas de amplo espectro foi de 62,5% e aos carbapenêmicos foi de 25%. Para não fermentadores, a resistência aos carbapenêmicos foi de 75%.Conclusão: Os resultados demonstraram diferenças nas taxas de ICS-CVC entre as UTIs especializadas. Os patógenos gram-negativos destacaram-se como os agentes etiológicos mais frequentemente isolados. Os percentuais de bactérias gram-negativas resistentes aos carbapenêmicos e às cefalosporinas de amplo espectro foram maiores que o relatado por outros autores. Esses achados reforçam a importância da vigilância epidemiológica de acordo com o tipo de UTI.

Brazilian social housing is used to address the country’s housing deficit through government programs with the massive production of standardised affordable housing. This non-systemic approach is shown to neglect residents’ changing needs over time and results in inflexible housing in relation to environmental, constructive, and social issues. The use of inappropriate spatial patterns fails to account for residents’ current socioeconomic and spatial realities. Quantitative/qualitative methods involving residents ('n' = 162) and two case studies are used to assess resilience in social housing. The costs and implications arising from a lack of housing adaptability are identified. An ‘impact assessment’ tool is employed to document the shocks and tensions experienced by residents along with the negative effects on the house and its occupants. These impacts increase the vulnerability of families and hinder their adaptive capacity. The identification of major impacts and residents’ perceptions can be used to establish priorities for action. 'Policy relevance' Post-occupancy evaluation (POE) processes provide a more systemic approach to identifying and resolving the problems of creating housing fit for purpose. An impact evaluation tool was developed to help with a positive transformation. This indicates how architects, urban planners, and communities can act to mitigate and solve the problems experienced by users of social housing. The use of systemic POE in social housing can inform policies and planning practices that address the needs of residents. It is also intended to provide design information to agents involved in the production of social housing in Brazil, notably designers and users, in order to foster effective strategies to promote more resilient housing, especially in scenarios of intervention and renovations during use. These tools and processes contribute to fulfilling Habitat III’s New Urban Agenda and the United Nations’ Sustainable Development Goals (SDGs 1, 10, and 11).

The colonization of the oral cavity is a prerequisite to the development of oropharyngeal candidiasis. Aims: The aims of this study were: to evaluate colonization and quantify Candida spp. in the oral cavity; to determine the predisposing factors for colonization; and to correlate the levels of CD4+ cells and viral load with the yeast count of colony forming units per milliliter (CFU/mL) in HIV-positive individuals treated at a University Hospital. Saliva samples were collected from 147 HIV patients and were plated on Sabouraud Dextrose Agar (SDA) and chromogenic agar, and incubated at 30 ºC for 72 h. Colonies with similar morphology in both media were counted and the result expressed in CFU/mL. Results: Of the 147 HIV patients, 89 had positive cultures for Candida spp., with a total of 111 isolates, of which C. albicans was the most frequent species (67.6%), and the mean of colonies counted was 8.8 × 10³ CFU/mL. The main predisposing factors for oral colonization by Candida spp. were the use of antibiotics and oral prostheses. The use of reverse transcriptase inhibitors appears to have a greater protective effect for colonization. A low CD4+ T lymphocyte count is associated with a higher density of yeast in the saliva of HIV patients.

Infections by Candida species are a high-impact problem in public health due to their wide incidence in hospitalized patients. The goal of this study was to evaluate frequency, susceptibility to antifungals, and genetic polymorphism of Candida species isolated from clinical specimens of hospitalized patients. The Candida isolates included in this study were obtained from blood cultures, abdominal fluids, and central venous catheters (CVC) of hospitalized patients at the Clinical Hospital of the Federal University of Uberlândia during the period of July 2010 - June 2011. Susceptibility tests were conducted by the broth microdilution method. The RAPD-PCR tests used employed initiator oligonucleotides OPA09, OPB11, and OPE06. Of the 63 Candida isolates, 18 (28.5%) were C. albicans, 20 (31.7%) were C. parapsilosis complex species, 14 (22.2%) C. tropicalis, four (6.4%) C. glabrata, four (6.4%) C. krusei, two (3.3%) C. kefyr, and one (1.6%) C. lusitaniae. In vitro resistance to amphotericin B was observed in 12.7% of isolates. In vitro resistance to azoles was not detected, except for C. krusei. The two primers, OPA09 and OPB11, were able to distinguish different species. Isolates of C. albicans and C. parapsilosis complex species presented six and five clusters, respectively, with the OPA09 marker by RAPD-PCR, showing the genetic variability of the isolates of those species. It was concluded that members of the C. parapsilosis complex were the most frequent species found, and most isolates were susceptible to the antifungals amphotericin B, flucozanole, and itraconazole. High genetic polymorphisms were observed for isolates of C. albicans and C. parapsilosis complex species, mainly with the OPA09 marker.

Neste trabalho é apresentada a aplicação dos modelos AMMI com o propósito de analisar a interação entre genótipo e ambiente em experimentos agronômicos multiambientais com dados balanceados. São apresentados dois métodos de validação cruzada e o aperfeiçoamento desses métodos por meio da correção de autovalores, sendo estes ordenados por meio da regressão isotônica. É realizado um estudo comparativo entre esses métodos por meio de dados reais. Os resultados mostram para esse conjunto de dados que o método de EASTMENT & KRZANOWSKI (1982) seleciona um modelo mais parcimonioso. Além disso, quando esse método é aperfeiçoado com a correção dos autovalores, o número de componentes não se altera. O método de GABRIEL (2002) seleciona um maior número de termos no modelo, e, quando se aplica a correção de autovalores, o número de termos diminui. O aperfeiçoamento desses métodos por meio da correção de autovalores traz um grande benefício para o pesquisador do ponto de vista prático, uma vez que a seleção do número de termos multiplicativos representa um ganho do número de blocos (ou repetições), quando se utiliza o modelo AMMI em vez do modelo completo, sendo, portanto, melhor utilizar o modelo AMMI com correção dos autovalores e selecionar o número de componentes por meio do método de Eastment e Krzanowski.This paper presents an application of AMMI models - Additive Main effects and Multiplicative Interaction model - for a thorough study about the effect of the interaction between genotype and environment in multi-environments experiments with balanced data. Two methods of crossed validation are presented and the improvement of these methods through the correction of eigenvalues, being these rearranged by the isotonic regression. A comparative study between these methods is made, with real data. The results show that the EASTMENT & KRZANOWSKI (1982) method selects a more parsimonious model and when this method is improved with the correction of the eigenvalues, the number of components are not modified. GABRIEL (2002) method selects a huge number of terms to hold back in the model, and when this method is improved by the correction of eigenvalue, the number of terms diminishes. Therefore, the improvement of these methods through the correction of eigenvalues brings a great benefit from the practical point of view for the analyst of data proceeding from multi-ambient, since the selection of numbers of multiplicative terms represents a profit of the number of blocks (or repetitions), when the model AMMI is used, instead of the complete model.