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In the Brazilian Amazon, nitrogen input strategies are required to maintain forage-livestock systems productivity. However, greenhouse gases (GHG) emissions mitigation from tropical soils is also a global demand. This research aims to assess productivity and nitrous oxide (N2O) emissions from Oxisol cultivated with Marandu palisade grass (Brachiaria brizantha [Hochst. Ex A.Rich.] Stapf) submitted to nitrogen (N) input strategies (N fertilization and biological N fixation) in the Brazilian Amazon. The treatments were the following: control (unfertilized); U40 (fertilized with 40 kg N/ha as urea); U80 (fertilized with 80 kg N/ha as urea); AS40 (fertilized with 40 kg N/ha as ammonium sulfate); AS80 (fertilized with 80 kg N/ha as ammonium sulfate); and IAB (inoculated with Azospirillum brasilense ). From January to March 2016, soil N2O emission, forage accumulation (FA) and relative emission (RE) were assessed during two 28-day cycles. The FA was greater in the U80 and AS80 than in control and IAB. The highest peaks of soil N2O flux occurred from 4 to 7 days after N fertilization, primarily in the highest N rates treatments. Overall, 40 kg N/ha resulted in higher N2O flux than control and IAB, which were lower than 80 kg N/ha regardless of the N source. The lowest fluxes occurred in the control and IAB (below 20 ug N-N2O m-2 hr-1). All of the emission factors (EF) calculated for both fertilizers and rates were lower than 0.35%, which is below the 1% established by the IPCC. Our results indicate the need for discussion of the EF in the pasture intensification to contribute to avoid deforestation and mitigating emissions. The inputs of 40 kg N/ha per application with urea or ammonium sulfate, due to the low EF and RE, are recommended as a pasture N input strategy in the Brazilian Amazon. Made available in DSpace on 2022-01-29T02:06:21Z (GMT). No. of bitstreams: 1 2021-cpamt-bcp-nitroux-oxide-emissions-forage-accumulation-brazilian-amazon-forage-livestock-systems-input-strategies.pdf: 918233 bytes, checksum: cdb36c91edc2d8b49149523b66a85855 (MD5) Previous issue date: 2021

International audience; INTRODUCTION: Traumatic cardiac arrest (TCA) guidelines emphasize specific actions that aim to treat the potential reversible causes of the arrest. The aim of this study was to measure the impact of these recommendations on specific rescue measures carried out in the field, and their influence on short-term outcomes in the resuscitation of TCA patients. METHODS: We conducted a retrospective study of all TCA patients treated in two emergency medical units, which are part of the Northern Alps Emergency Network, from January 2004 to December 2017. We categorised cases into three periods: pre-guidelines (from January 2004 to December 2007), during guidelines (from January 2008 to December 2011), and post-guidelines (from January 2012 to December 2017). Local guidelines, a physician education programme, and specific training were set up during the post-guidelines period to increase adherence to recommendations. Utstein variables, and specific rescue measures were collected: advanced airway management, fluid administration, pelvic stabilisation or tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary endpoint was survival rate at day 30 with good neurological status (cerebral performance category scores 1 and 2) in each period, considering the pre-guidelines period as the reference. RESULTS: There were 287 resuscitation attempts in the TCA cases included, and 279 specific interventions were identified with a significant increase in the number of fluid expansions (+16%), bilateral thoracostomies (+75%), and pelvic stabilisations (+25%) from the pre- to post-guidelines periods. However, no improvement in survival over time was found. CONCLUSION: Reversible measures were applied but to a varying degree, and may not adequately capture pre-hospital performance on overall TCA survival.

Introdução: Mais da metade das admissões em unidades de terapia intensiva é de indivíduos com 65 anos ou mais. Uma das principais etiologias de hospitalização e de mortalidade entre as pessoas acima dos 60 anos são as infecções do trato respiratório e suas complicações. Objetivo: Traçar o perfil clínico, sociodemográfico de idosos internados em Unidades de Terapia Intensiva por doença respiratória aguda (DRA) num Hospital Regional do Sertão da Paraíba. Métodos: Estudo de campo descritivo, documental e retrospectivo com abordagem quantitativa. A pesquisa foi realizada na Unidade de Terapia Intensiva do Hospital Regional do Sertão da Paraíba. Foram analisados 24 prontuários de pacientes admitidos no período de janeiro de 2018 a Janeiro de 2019, a partir de fichas de avaliação de prontuário. Adotou-se uma amostra não probabilística intencional baseada nos critérios de inclusão: pacientes idosos acima de 60 anos atendidos no período de janeiro de 2018 a Janeiro de 2019 com diagnóstico de doença respiratória aguda. Resultados: Constatou-se que o perfil sociodemográfico dos idosos internados UTI por (DRA) HRSP foi de pacientes com idade média de 70,52 anos, do sexo masculino, casados, de raça parda, que não informaram as suas profissões, que ficaram internados em média por 10,041 dias na UTI, que tiveram como principal diagnóstico pneumonia e que apresentaram como desfecho em 75% dos casos o óbito. Conclusão: Pode-se concluir que o índice de mortalidade encontrado nesse grupo é mais alto que o encontrado em outros estudos.

Among the primary beef producers globally, Brazil stands out due to livestock production based on pastures without massive grain dependence. Moreover, the adoption of integrated systems has increased in Brazilian farms in the past few years, reaching significant numbers such as 11.5 million hectares covered by some sort of integration, including silvopastoral systems (SPS). This study aimed to evaluate the diversity of Coleoptera species and dung pats decomposition in an open pasture (OP) of Urochloa brizantha cv. Marandu and in an SPS with Eucalyptus urograndis clone H13. There were no significant differences in dung beetle richness or abundance in OP and SPS, as well as similar rates of dung pats disintegration. Most insects were captured during the rainy season, and richness and diversity of species were similar between systems. The traps' distance to the Eucalyptus rows did not influence the number of dung beetles sampled; however, fewer individuals were captured under the tree rows. We suggest the importance of beetles for cattle dung decomposition and biological control of parasites, eventhough community structure was similar between systems with different habitat complexity.

Brazil is one of the few countries in the world that can produce animal products, grains, fibers, and bioenergy in the same area, either in a consortium, rotation, or succession. Our objective was to compare pasture productivity and animal performance in agroforestry systems with grass monoculture in the Brazilian Amazon Biome. The experiment was carried out in Sinop, MT, Brazil, with Nellore steers in a continuous stocking with variable stocking rate. The experimental design was a randomized complete block, with four systems and four replicates. The palisadegrass [Brachiaria brizantha (Hochst. ex A. Rich.) R. D. Webster cv. Marandu] was planted in the four systems: livestock (grass monoculture); livestock–forestry [eucalyptus trees (Eucalyptus urograndis; hybrid of Eucalyptus grandis W. Hill ex Maiden and Eucalyptus urophylla S. T. Blake) arranged in three-row groves spaced 30 m apart]; crop–livestock (palisadegrass after two years of crops); and crop–livestock–forestry (palisadegrass after two years of crops with single rows of eucalyptus trees spaced 37 m apart). The herbage accumulation was greater in the systems with the two previous cropping years (crop–livestock and crop–livestock–forestry) than in the livestock and livestock–forestry, in both seasons. In the crop–livestock–forestry, the greatest herbage accumulation associated with the modified microclimate supported the greatest average daily gain (0.750 kg BW day− 1), stocking rate in both seasons, resulting in the greatest gain per area (940 kg BW ha− 1). We conclude that agroforestry systems assure pasture productivity and animal performance similar or greater than livestock (grass monoculture). Furthermore, the combination of two previous crop years and the least tree density optimized the synergy between crop, livestock, and forestry components, improving beef cattle productivity in crop–livestock–forestry systems.

Compared to conventional cattle ranching that can be characterized by low biodiversity level and grass monoculture adoption, integrated systems have great potential to improve not only animal welfare but also livestock performance. Among several strategies combining crops, livestock and forestry, silvopastoral systems must be highlighted due to the microclimatic conditions, mainly in tropical countries such as Brazil, where cattle are frequently submitted to unfavorable thermal conditions. However, according to previous studies, shading can potentially worsen parasitism in herds raised in these systems due to more favorable microenvironmental conditions. This study aimed to evaluate daily weight gain in Nellore steers in open pasture and in silvopastoral system and its relationship with microclimatic conditions and faecal egg count. A negative correlation (− 0.42677) between nematode egg counts and daily weight gain was found in both systems. Besides, the mean egg counts were equal in the silvopastoral system and in the open pasture. Regarding the effect of seasons over the year, there was an environmental influence on the egg counts, with higher averages during the dry seasons. Haemonchus, Cooperia, and Oesophagostomum were the genera identified in both systems. Based on the results, it can be concluded that the silvopastoral system was not able to influence the nematode egg counts and daily weight gain in Nellore steers raised in Mato Grosso.

CONTEXT Limited land availability and an increasing global population are challenges faced by the agricultural sector in the coming decades. The silvopastoral system is an efficient alternative to full sun pastures that could be used to sustainably intensify animal and crop production. However, the adoption of this system is being held back by a lack of knowledge on how the trees in such a system should be arranged in order to avoid detrimental effects on pasture growth. OBJECTIVE The aim of this study was to test different arrangements of trees in the Eucalyptus-Marandu palisade grass silvopastoral system and to evaluate its performance in different regions of Brazil. METHODS A functional-structural plant model was developed to simulate radiation interception by trees and was then coupled to the CROPGRO-Perennial Forage model to simulate the production of forage biomass. Considering solar radiation as the main resource under competition, water interactions that occur under-ground between Eucalyptus and Maranu palisade grass were not considered. The models were calibrated with experimental data collected in silvopastoral systems in Brazil. The silvopastoral systems were selected according to a combination of tree row spacing (15, 30, and 45 m), two row orientations (north-south and east-west), and single or triple rows. Simulations were replicated for different tree ages (2, 4, 6, 8, 10 and 12 years) representing different levels of shading. RESULTS AND CONCLUSIONS Our simulations show that the tree arrangement has a significant effect on the incidence of radiation on the pasture, resulting in different levels of forage production. Row spacing of 30 and 45 m is suitable for providing forage for the animals for several years. In contrast, tree arrangements with a row spacing of 15 m or triple lines demand more careful planning and management, taking into account the soil and climatic characteristics of each region. Lower declines in the forage production were observed in arrangements of 45 m, varying from 1000 and 3000 kg ha−1 after 6 years of system establishment. In this period, the annual production level was lower than 14,000 kg ha−1 for arrangments with row spacing of 15 and 30 m, being recommend pruning and thinning practices aiming to increase the radiation incidence within the system. SIGNIFICANCE The approach used in this study can be extended to other combinations of species and environments to aid the planning and management of this kind of system.

BackgroundThe aim was to describe the organisational changes in French EDs in response to the COVID-19 pandemic with regard to architectural constraints and compare with the recommendations of the various bodies concerning the structural adjustments to be made in this context.MethodsAs part of this cross-sectional study, all heads of emergency services or their deputies were contacted to complete an electronic survey. This was a standardised online questionnaire consisting of four parts: characteristics of the responding centre, creation of the COVID-19 zone and activation of the hospital’s emergency operations plan, flow and circulation of patients and, finally, staff management. Each centre was classified according to its workload related to COVID-19 and its size (university hospital centre, high-capacity hospital centre and low-capacity hospital centre). The main endpoint was the frequency of implementation of international guidelines for ED organisation.ResultsBetween 11 May and 20 June 2020, 57 French EDs completed the online questionnaire and were included in the analysis. Twenty-eight EDs were able to separate patient flows into two zones: high and low viral density (n=28/57, 49.1%). Of the centres included, 52.6% set up a specific triage area for patients with suspected COVID-19 (n=30/57). Whereas, in 15 of the EDs (26.3%), the architecture made it impossible to increase the surface area of the ED.ConclusionAll EDs have adapted, but many of the changes recommended for the organisation of ED could not be implemented. ED architecture constrains adaptive capacities in the context of COVID-19.

The management of Out of hospital Traumatic Cardiac Arrest (TCA) for professional rescuers combines advanced life support with specifics actions to treat potential reversible causes of the arrest: hypovolemia, hypoxemia, Tension Pneumothorax (TPx) and tamponade. The aim of this study was to assess the impact of specific rescue gestures on short-term outcomes in the context of resuscitation of patients with a pre-hospital TCA.Methods: We conducted a retrospective study of all TCA treated in two emergency medical units (EM unit), which are part of the Northern Alps emergency network, from January 2004 to December 2017. Utstein variables and specific rescue actions in TCA were compiled: advanced airway management, fluid administration, pelvic stabilization or tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary end point was the survival rate at day 30 with good neurologic outcome (cerebral performance category [CPC] score 1 & 2).Results: 287 resuscitations attempt in TCA were included and 279 specific interventions were Identified: 262 Fluid expansion, 41 External Pelvic stabilizations, 5 tourniquets, 175 bilateral thoracostomies, (including 44 with TPx).Conclusion: Among standard resuscitation measures to treat reversible causes of cardiac arrest, we were able to show that bilateral thoracostomy and tourniquet application on a limb hemorrhage improves survival of TCA. A larger sample for pelvic stabilization is necessary.

Congenital Generalized Lipodystrophy (CGL) was recently associated with Respiratory Muscle Dysfunction (RMD), as well as changes in redox homeostasis and endoplasmic reticulum stress (ERS). Although ERS has been related to RMD in many diseases, there is no data concerning its role in CGL physiopathology. We hypothesized that CGL-associated RMD may be related to oxidative stress (OS) and ERS. To evaluate the mRNA expression levels of OS and ERS factors, correlating with Maximal Respiratory Pressures in subjects with CGL. A cross-sectional study with 11 CGL subjects was conducted in Northeastern Brazil. NFE2L2, APEX1, OGG1, XBP1 splicing, DDIT3, and HSPA5 RNAm levels from CGL leukocytes were analyzed by qPCR. Gaussian distribution was evaluated by Shapiro Wilk and correlation tests were performed. The significance level was set at 5%. We found that the mean of NFE2L2, APEX1, and OGG1 RNAm levels was higher in CGL subjects compared to the healthy controls. Regarding ERS markers, we found that the mean of XBP1 RNAm levels was increased, while a significant reduction of DDIT3 RNAm was detected. Although no correlation was established between MIP and NFE2L2, APEX1, and OGG1 RNAm, a strong negative correlation was found between MIP and XBP1 RNAm splicing. Further, this ERS marker positively correlated with MEP. The upregulation of OS and ERS markers was observed in CGL subjects compared to the healthy controls. A strong negative correlation was only found between MIP and XBP1 splicing RNAm. These data suggest that CGL is an ERS-related metabolic disease and therapeutic strategies targeted to treat RMD in CGL should include ERS modulators.

Integrated crop–livestock–forestry systems are a sustainable agriculture system based on the intensification of land use to produce food, fiber and energy and are a priority theme in the public policy of the Brazilian government. The lack of technical and scientific knowledge may be one of the most challenging factors contributing to the low adoption of these complex, integrated systems. The objective of this study was to evaluate the crop, livestock and forestry performance assessment under different production systems in the north of Mato Grosso. Ten production systems were evaluated from 2011 to 2015, including crop production (soybean/corn), livestock (palisade grass pastures with Nellore steers) and forestry (Eucalyptus urograndis H13), in both single and integrated systems. Annual evaluations of production components in the crops, forage, cattle and trees were carried out. A negative influence on the grain yields in the fourth and fifth years for soybean and the third year onward for maize was observed as a result of the presence of the tree in the production systems. Forage availability and animal weight gain were increased by the rotation of crop–livestock, while no differences were found for wood individual volume yield among the production systems.

A insuficiência cardíaca (IC) consiste em uma síndrome em que o coração apresenta sua capacidade de enchimento ou ejeção dos ventrículos diminuída. A deficiência de ferro está comumente associada a IC e vem sendo evidenciada como um fator de pior prognóstico. O objetivo desse estudo consiste em avaliar os pacientes acometidos por insuficiência cardíaca quanto à suplementação de ferro endovenoso em comparação com a não suplementação (ou placebo). Nesta revisão sistemática, realizou-se uma busca bibliográfica nas bases de dados eletrônicas Biblioteca Virtual em Saúde, Portal de Periódicos Capes e SciSearch. Foram utilizados os Descritores em Ciências da Saúde (DeCS) Insuficiência Cardíaca, Anemia ferropriva e Deficiência de Ferro. O Sistema GRADE foi utilizado para avaliar a qualidade de evidência dos artigos analisados, tendo sido incluído 11 Estudos Clínicos Randomizados que abrangem 5 nacionalidades. Os pacientes sintomáticos e diagnosticados com IC associada à Anemia Ferropriva apresentaram melhoras nos desfechos primários na escala da auto avaliação global e na classe funcional da New York Heart Association (NYHA) ao receberem reposição de ferro endovenoso quando comparado aos que receberam placebo. Além disso, não houve melhoras significativas nos pacientes quanto ao tratamento por ferro oral. Assim, conclui-se que a anemia tem repercussões importantes aos pacientes acometidos a IC, estando relacionada a um pior prognóstico. Logo, faz-se necessária a suplementação de ferro endovenoso para melhoria dos sintomas e da qualidade de vida, devendo ser acompanhada por especialistas devido às possíveis reações adversas que podem vir a aparecer.

A oxigenação por membrana extracorpórea (ECMO) tem sido amplamente utilizada em pacientes com insuficiência respiratória grave causada pelo novo coronavírus (COVID-19). Nessas pessoas, o interstício pulmonar é ocupado por células e substâncias inflamatórias, o que prejudica as trocas gasosas e causa hipoxemia. O tratamento com ECMO consiste em impulsionar o sangue do enfermo através de uma cânula para uma membrana artificial capaz de oxigená-lo, que então está apto a retornar para o organismo. Objetivou-se identificar, em pacientes com insuficiência respiratória por COVID-19, se o tratamento ECMO comparado à terapêutica padrão proporciona melhoras no quadro clínico. Foi realizada, no mês de maio de 2021, uma revisão sistemática da literatura. A pesquisa foi realizada inicialmente em duas bases de dados: PubMed e BVS. Dos artigos resultantes, 7 foram selecionados por se encaixarem nos critérios de pesquisa. A partir da análise dos resultados, verificou-se que o tratamento com ECMO é capaz de reduzir a mortalidade dos pacientes que se encontram com insuficiência respiratória grave quando comparado aos outros tratamentos utilizados. Quando utilizado, esse recurso mostrou-se capaz de diminuir a quantidade de substâncias inflamatórias e a tempestade de citocinas, possibilitando, assim, a melhora no suprimento de oxigênio para os órgãos vitais e evitando lesões pulmonares decorrentes de danos mecânicos. Além disso, quando utilizada em conjunto com as medicações, mostrou redução da inflamação. Portanto, percebe-se que o ECMO é uma boa alternativa aos pacientes, porém não quando usado isoladamente. É necessário complementar o tratamento com medicações que aliviem os sintomas.

This study assessed the fermentation profile, losses and the chemical composition of Piata palisadegrass (Brachiaria brizantha cv. Piata) ensiled with different additives. The experimental design was completely randomized, with four replicates per treatment, and five treatments with different additives, as follows: T1 control without additives; T2 - microbial inoculant SiloMax Centurium (Matsuda); T3 - enzyme-bacterial inoculant Sil All C4 (Alltech do Brasil); T4 - corn meal (100 g kg-1 in the fresh matter); and T5 - crude glycerin (100 g kg-1 in the fresh matter), totaling 20 experimental silos. Addition of cornmeal caused an increase in the dry matter (DM) and non-fiber carbohydrates (NFC) contents and a decrease in the neutral detergent neutral (NDF) content of the silage. The highest loss of total DM (124.7 g kg-1) was observed for the silage without additives, whereas addition of cornmeal provided the lowest loss of total DM (32.2 g kg-1). Lower pH values and higher titratable acidity values were observed in the silages containing cornmeal and crude glycerin, respectively, as well as greater production of lactic acid. It is recommended to include corn meal at 100 g kg-1 in the fresh matter, as it provides a better fermentative profile and nutritive value, in addition to lower losses of DM. In addition, the inclusion of glycerin at 100 g kg-1 of the fresh matter suggested it as a potential additive.

Introduction: Congenital Generalized Lipodystrophy (CGL) is a disease characterized by metabolic, cardiovascular and respiratory disturbances. Although oxidative stress (OS) have been related to decreased Respiratory Muscle Strength (RMS), their contribution in RMS of CGL subjects needs to be investigated. Objective: To evaluate the levels of metabolic parameters and OS markers, correlating with Maximal Respiratory Pressures in CGL subjects. Methods: Eleven CGL subjects participated in this cross-sectional study. Peripheral blood was collected for biochemical dosages of glucose, triglycerides, total cholesterol, HDL, oxidized glutathione:total glutathione (GSSG:GSH) ratio and malondialdehyde (MDA). MIP and MEP were measured by manovacuometry according to the ATS/ERS guidelines. Data normality was assessed by Shapiro Wilk test. Correlations were performed according to data distribution. Significance level was set at 5%. Results: The majority of CGL subjects were genetically diagnosed with type 2 (BSCL2 mutation) and 67% were females. Mean age was 31.45±8.0 years. GSSG:GSH ratio correlation between MIP and MEP were r= -0.70 (p=0.0358) and r= 0.61 (p=0.076), respectively. MDA correlation between MIP and MEP were r= -0.34 (p=0.3) and r= 0.38 (p=0.3), respectively. No correlation was found between metabolic parameters and MIP and MEP. Conclusions: A strong significant correlation was found between MIP and GSSG:GSH ratio. These data suggest that CGL is an oxidative stress-related metabolic disease and the assessment of OS markers, in addition to metabolic parameters, may be essential to reduce pulmonary comorbidities associated with CGL subjects.

Introdução: A diabetes mellitus é uma doença cada vez mais prevalente no mundo moderno, sendo altamente relacionada a fatores genéticos e comportamentais e que acarreta em inúmeros problemas de saúde pública. Objetivo: analisar a utilização da vitamina D com o intuito de diminuir o risco cardiovascular em pacientes portadores de diabetes mellitus tipo 2. Métodos: Foi feita uma revisão sistemática da literatura. Para elaboração do estudo, realizou-se busca de dados nacionais e internacionais e sucedeu-se a eleição de critérios de elegibilidade considerando idioma do artigo (inglês e português), textos completos e publicados nos últimos 10 anos. Em sequência, a partir da leitura dos títulos e posterior análise dos resumos, a amostra final constituiu-se de 13 publicações. Resultados: Foi detectado um baixo número de publicações, contudo, constatou-se que a vitamina D e seus análogos têm uma eficácia direta sobre os marcadores utilizados para predizer o risco cardiovascular dos pacientes mesmo possuindo ainda dúvidas sobre seus mecanismos de ação. Conclusões: A intervenção com vitamina D apresenta bons resultados no tocante à diminuição dos marcadores de risco cardiovascular em pacientes diabéticos. Contudo, devem ser realizadas mais pesquisas para melhor esclarecer a correlação dos níveis de vitamina D e a diminuição de eventos cardiovasculares, além de melhor seus mecanismos fisiológicos, estratégias terapêuticas e seus efeitos nos mais diversos perfis populacionais para assim elaborar intervenções eficazes e conclusivas.

As doenças cardiovasculares são consideradas a principal causa de óbito nos países desenvolvidos e são responsáveis por deixar limitações em pacientes sobreviventes a ela, o que repercute de forma considerável na qualidade de vida (QV), no prognóstico e na saúde deles. Desse modo, objetiva-se analisar as limitações provocadas pelo Infarto Agudo do Miocárdio (IAM) e as repercussões na QV desses pacientes. Para isso, desenvolveu-se esta revisão sistemática, que reuniu evidências disponíveis em plataformas de busca como a Biblioteca Virtual em Saúde (BVS), Medical Publisher (PubMed) e a Semantic Scholar. Foram usados os Descritores em Ciências da Saúde (DeCS) “myocardial infarction”, “quality of life” e “limitation of activity, chronic” combinados com operador booleano “AND” para a busca, além do filtro para compreender resultados dos últimos 10 anos (2011-2021). Por fim, realizou-se longa triagem para incluir achados mais pertinentes que respondessem à pergunta PICO, resultando em 26 publicações. Dentre os achados principais dos artigos, destacam-se alterações principalmente nas dimensões de atividades habituais, funções físicas, mobilidade, dor e ansiedade/depressão, sendo reflexos da presença de limitações como a fadiga, angina, dispneia, sintomas de transtornos de estresse pós-traumático, disfunção erétil, limitações laboratoriais e financeiras. Os pacientes pós-IAM com mais limitações, apresentaram menor QV, podendo ser visto como um fator preditivo para aumento das chances de recidiva e da mortalidade. É importante que profissionais da saúde tenham conhecimento e atuem nesse ciclo patológico com intervenções individualizadas, visando a sobrevida e a qualidade de vida dos pacientes.

Objetivo: analisar, a partir de uma revisão sistemática da literatura, quais são os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca. Métodos: efetuou-se uma revisão sistemática da literatura a partir da questão de pesquisa “Quais os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca?”. Para a seleção dos artigos que compõem este estudo, realizou-se uma busca nas seguintes bases de dados: Medical Publisher (PUBMED), Biblioteca Virtual em Saúde (BVS), Science Direct (SD) e Semantic Scholar utilizando-se como critérios de elegibilidade apenas estudos observacionais ou ensaios clínicos randomizados, que contemplassem a questão de pesquisa, que fossem relevantes e atuais para abordar o tema. A amostra final é composta por 25 publicações. Resultados: os principais fatores preditivos para o desenvolvimento da síndrome cardiorrenal se associam com os fatores de risco cardiovasculares e às manifestações geradas a partir do comprometimento renal. Conclusão: a junção de comorbidades do paciente, com fatores de risco para desenvolvimento de doença cardiovascular, de injúria renal aguda associado com marcadores laboratoriais de injúria miocárdica e de lesão renal podem atuar como fatores preditivos confiáveis para o desenvolvimento da síndrome cardiorrenal.

Introduction: Patients with Berardinelli-Seip Congenital Lipodystrophy Syndrome (BSCL) show metabolic and cardiovascular disturbs. Previous data from our research group revealed a decrease of respiratory function of BSCL individuals. However, there is a lack of data in the literature showing if there is a correlation between respiratory muscle strength and balance in these subjects. Objective: To correlate Maximum Static Respiratory Pressures (Inspiratory Pressure - MIP and Expiratory Pressure - MEP) to the balance in BSCL subjects. Methods: This was a cross-sectional study conducted at the “Associacao dos Pais e Pessoas com a Sindrome de Berardinelli do Rio Grande do Norte (ASPOSBERN)”. Eleven people with BSCL participated in this study. Maximal respiratory pressures were assessed by manovacuometry according to the ATS/ERS guidelines. Balance was evaluated by the Short Physical Performance Battery (SPPB). Data normality was assessed by Shapiro Wilk test; correlation was performed according to data distribution. Significance level was set at 5%. Results: Mean age was 31.45 ± 8.0 years. Mean absolute values of MIP and MEP were: -75.4 ± 19 cmH2O (70.2 ± 14.9% of predicted values) and 57.7 ± 32 cmH2O (49.8 ± 23.8% of predicted values), respectively. Mean static balance was 3.6 ± 0.67 points. Correlation values were r= 0.64 (p=0.85) for MIP and r= -0.10 (p=0.76) for MEP. Conclusions: Subjects with BSCL showed decreased respiratory muscle strength while no dysfunction was found when we assessed balance. No significant correlation was found when we correlated maximal respiratory pressures to balance.

Background Berardinelli-Seip Congenital Generalized Lipodystrophy (BSCL) is an ultra-rare metabolic disease characterized by hypertriglyceridemia, hyperinsulinemia, hyperglycemia, hypoleptinemia, and diabetes mellitus. Although cardiovascular disturbances have been observed in BSCL patients, there are no studies regarding the Respiratory Muscle Strength (RMS) in this type of lipodystrophy. This study aimed to evaluate RMS in BSCL subjects compared with healthy subjects. Methods Eleven individuals with BSCL and 11 healthy subjects matched for age and gender were included in this study. The Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), and Peripheral Muscle Strength (PMS) were measured for three consecutive years. BSCL subjects were compared to healthy individuals for MIP, MEP, and PMS. Correlations between PMS and MIP were also analyzed. The genetic diagnosis was performed, and sociodemographic and anthropometric data were also collected. Results BSCL subjects showed significantly lower values for MIP and MEP (p

Objetivou-se caracterizar o potencial produtivo, a distribuição mensal, a composição morfológica e botânica da forragem de aveia preta e de azevém anual submetidos a estratégias de manejo de corte no estado de São Paulo. O delineamento experimental foi inteiramente casualizado, com tratamentos correspondendo a combinações entre formas de cultivo (aveia e azevém exclusivos ou combinados) e estratégias de colheita (cortes com 95% de interceptação de luz (IL) ou intervalo FIXO de 30 dias de rebrotação), em arranjo fatorial com três repetições. Os estandes colhidos por IL acumularam 1580kg MS ha-1 corte-1, e os por FIXO 2020kg de MS ha-1 corte-1. A proporção de folhas foi maior no azevém (70%), seguido do cultivo combinado (64%) e depois pela aveia (52%). Entre os manejos, a IL resultou em maiores proporções de folha e menor proporção de colmos que o FIXO. A proporção de azevém foi de 64%, sob o manejo por IL, e 70% no manejo por descanso FIXO. Ao longo do tempo, ocorreu a substituição da aveia pelo azevém na composição do dossel combinado. Ambas as estratégias de manejo podem ser adotadas para essas forrageiras de inverno em sistemas de integração agricultura e pecuária, com vantagem para o azevém. The objective in this study was to characterize the productive potential, monthly yield distribution, and forage plant-part and botanical composition of black oats and annual ryegrass under harvest strategies in São Paulo. The experimental design was completely randomized with treatments corresponding to the combination among stand composition (exclusive oats, exclusive annual ryegrass, or oats + ryegrass, O+R) and harvest strategies (at 95% LI or every 30 days of regrowth, FIXED), in a factorial arrangement with three replications. Stands managed by LI accumulated 1580kg DM ha-1 harvest-1, and those managed by FIXED 2020kg DM ha-1 harvest-1. Leaf proportion was higher in ryegrass (70%), followed by O+R (64%) and oat (52%). Swards managed by LI had higher proportion of leaves and less stem than those harvested at FIXED intervals. The proportion of ryegrass was higher under the LI management (64%), than under the FIXED (70%). Over time there was the replacement of oats by ryegrass in the mixed canopy composition. Exclusive ryegrass stands are recommended. Both harvest strategies can be adopted for these winter forages in integrated systems of agriculture and livestock.

The main purpose of this work is the generation of new intelligent functionalities at the optical network physical layer in Gigabit Ethernet interfaces and nodes. These new tools are achieved by the use of a field programmable gated array (FPGA) integrated circuit associated with microwave RF subcarriers. With such intelligence, a new IP/Ethernet network element is introduced and described, and special attention is dedicated to its structure, to its implementation and to the aspects of its use in networks. An experimental setup using the developed element is shown as a proof-of-concept, demonstrating the characteristics of the system and the transparency of the optical intelligence with respect to the Ethernet standard. © 2006 Wiley Periodicals, Inc. Microwave Opt Technol Lett 48: 1330–1334, 2006; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.21626

The induced colorectal carcinogenesis in rodents has a long history and currently uses the substances 1,2-dimethylhydrazine and azoxymethane. Objective: The aim of this study was to compare the inductive effect of the substances azoxymethane and 1,2-dimethylhydrazine in colorectal carcinogenesis. Method: 30 randomly chosen male Wistar rats were divided into four groups. G1 group was treated with 1,2-dimethylhydrazine and C1 was its control group; G2 group was treated azoxymethane and C2 was its control group. The animals were weekly weighed until euthanasia, when their intestines were removed, processed and analyzed by an experienced pathologist. Results: Among the control groups (C1 and C2) no histologic changes were observed; moderate dysplasia was detected in G2 group; hyperplasia, mild dysplasia, severe dysplasia and carcinoma were observed in G1 group. When this study compared the cost of the substances, 1,2-dimethylhydrazine was more than 50 times less expensive than azoxymethane. Conclusion: Azoxymethane is able to promote histological changes consistent with colorectal carcinogenesis. 1,2-Dimethylhydrazine produced neoplasia and dysplasia, and, compared to the azoxymethane, was more efficient in the induction of colorectal cancer. Resumo: A carcinogênese colorretal induzida em roedores tem longa história e utiliza, atualmente, as substâncias 1,2 dimetil-hidrazina (DMH) e azoximetano (AOM). Objetivo: Comparar o efeito indutivo das substâncias AOM e DMH para o câncer colorretal (CCR). Método: 30 ratos Wistar machos foram randomizados em quatro grupos. O grupo G1 foi inoculado com DMH, o grupo C1 foi seu controle; G2 recebeu o AOM e C2 foi seu controle. Os animais foram pesados semanalmente até a eutanásia, quando tiveram seus intestinos retirados, processados e analisados por um patologista experiente. Resultados: Os animais dos grupos de controle apresentaram tecido colorretal normal e os animais do grupo G2 apresentaram um padrão de displasia moderada. Nas lâminas do grupo G1, foram encontradas regiões de hiperplasia, displasia leve, displasia grave, e carcinoma. Comparado o custo das substâncias AOM e DMH, este último teve um preço mais de 50 vezes menor ao do AOM. Conclusão: AOM é capaz de promover alterações histológicas compatíveis com a carcinogênese colorretal. DMH produziu neoplasia e displasia grave e, comparada ao AOM, foi mais eficiente na indução do câncer colorretal. Keywords: Colorectal cancer, Experimental model, Carcinogenesis, Azoxymethane, 1,2-Dimethylhydrazine, Palavras-chave: Câncer colorretal, Modelo experimental, Carcinogênese, Azoximetano, 1,2-Dimetil-hidrazina

Invasive zygomycosis is a devastating fungal infection occurring as an opportunistic infection after bone marrow transplantation (BMT). Sinusitis can lead to fungal infection in immunosuppressed patients, and cavernous sinus thrombosis, an uncommon condition in immunocompetent patients, typically follows an infection involving the medial third of the face, nose, or paranasal sinuses. Patients undergoing unrelated-donor BMT (UD-BMT) are prone to develop life-threatening infections because of poor recovery of cellular immunity. Despite adequate clinical evaluation and treatment, the prognosis of patients with invasive fungal infections is dismal, especially when intracerebral structures are affected. We describe a case of a patient who underwent an UD-BMT and developed cavernous sinus thrombosis after sinusitis due to zygomycosis. Moreover, he also had disseminated fungal (Zygomycetes and Aspergillus) and viral (cytomegalovirus and adenovirus) infections.

A procedure for the analysis, modeling, and a practical trial of a Free-Space Optics (FSO) system is presented. The procedure has been conducted in the urban area of Rio de Janeiro, in 2002. Firstly, the transmitter and receiver characteristics are considered. Next, three additional parameters are introduced: they are: the atmospheric loss, the geometric loss and the scintillation. In this last parameter, a few ways how scintillation might be expressed in dB and translated into a power balance equation, is presented. Other fixed parameters, dealing with additional losses, are subsequently inserted. The FSO system availability is exhibited, using airports visibility data, leading to a prediction of the systemic availability. Attention is then focused on the Bit Error Rate, BER, which relates with the Recommendation ITU-T G.826. Within this last Recommendation, it is possible to perform a FSO analysis with respect to the climatic variation. The experiment has encompassed some short periods in which this city presents a strong morning fog. It is finally shown that FSO is a competitive and reliable transmission technology, provided proper and correct use.

No presente estudo, foram pesquisados os tumores do sistema nervoso central (SNC) diagnosticados na cidade de Curitiba entre 1990 e 1994. Realizaram-se 2371 biópsias de SNC das quais 1340 casos eram neoplasias primárias. Dentre as neoplasias primárias de SNC 304 (22,6%) eram meningiomas. Duzentos e nove meningiomas ocorreram em mulheres (68,7%) e 95 ocorreram em homens (31,3%). As idades variaram de 3 a 90 anos, com média de 45,8 anos. Duzentos e oitenta meningiomas localizavam-se no cérebro, 10 na medula espinhal, 9 no cerebelo e 5 na emergência de nervos cranianos. Na classificação histológica verificou-se que 294 (96,7%) eram do tipo clássico, 6 malignos (ou anaplásicos), 3 atípicos e 1 papilar. No grupo dos meningiomas clássicos 267 eram meningoteliais, 10 psamomatosos, 5 fibroblásticos, 5 microcísticos, 5 transicionais e 2 angiomatoses. Os autores concluem que as neoplasias meníngeas representaram o grupo mais freqüente de tumores primários do SNC e apresentaram características epidemiológicas e anátomo-patológicas similares às da literatura mundial, na qual é dada ênfase à dificuldade de estabelecer critérios biológicos e histológicos de malignidade neste grupo de tumores. The authors have retrospectively reviewed all tumors of central nervous system (CNS) operated at the most important neurosurgery hospitals of Curitiba in a 5-year period (1990-1994) and found 304 (22.4%) cases of meningioma. Age mean of the patients was 48.5 years, with a range of 3 to 90 years. A marked female preponderance (68.7%) was noted. The most common tumor location was brain (n=280) and the remaining cases occurred in spinal cord (n=10), cerebellum (n=9) and cranial nerves (n=5). Histologically, there were 294 (96.7%) meningiomas of the classical type, six malignant or anaplastic, three atypical and one papillary. Two hundred and sixty seven classical meningiomas were from the meningotelial subtype, ten psamomatousos, five fibroblastic, five microcystic, five transicional and two angiomatous. The authors conclude that meningiomas are one of the most common group of primary neoplasias of CNS and the definition of malignancy in those tumors is beset by frequent discordance between histologic and biologic features.

Os gliomas do nervo óptico podem apresentar-se esporadicamente ou como componentes da neurofibromatose. São neoplasias raras, correspondendo a 2 a 5% dos tumores intracranianos e cerca de 6% dos tumores intra-orbitários. No presente estudo, analisamos 11 casos de glioma de nervo óptico diagnosticados em Curitiba num período de 25 anos, sendo 10 pacientes do sexo feminino e 1 do sexo masculino. As idades variaram de 3 a 25 anos; 6 pacientes apresentavam idades inferiores a 15 anos. Dos casos desta série, 27,3% (n=3) apresentavam associação com neurofibromatose. Quanto à localização dos tumores, em 5 pacientes a lesão estava restrita ao nervo óptico e no restante havia extensão para o quiasma óptico, região supra-selar, lobo frontal ou temporal. Todos os pacientes tinham astrocitoma pilocítico. Optic nerve gliomas may occur alone or as components of neurofibromatosis. They are rare tumors accounting for 2 to 5% of all intracranial tumors and 6% of the intra-orbitary neoplasms. The authors present 11 cases of optic nerve glioma diagnosed in Curitiba in the last 25 years. Out of these 11 patients there were 10 women and only 1 man. The ages ranged from 3 to 25 years old, and 6 patients were under 15 years. In this series, 27,3% (n=3) of the cases were associated with neurofibromatosis. Five patients had their tumors restricted to the optic nerve while the others had either extension to the optic chiasm, supra-selar region, frontal or temporal lobe. All the patients had pilocytic astrocytomas.

An international task force recently redefined the concept of sepsis. This task force recommended the use of the quick Sequential Organ Failure Assessment (qSOFA) score instead of systemic inflammatory response syndrome (SIRS) criteria to identify patients at high risk of mortality. However, these new criteria have not been prospectively validated in some settings, and their added value in the emergency department remains unknown. To prospectively validate qSOFA as a mortality predictor and compare the performances of the new sepsis criteria to the previous ones. International prospective cohort study, conducted in France, Spain, Belgium, and Switzerland between May and June 2016. In the 30 participating emergency departments, for a 4-week period, consecutive patients who visited the emergency departments with suspected infection were included. All variables from previous and new definitions of sepsis were collected. Patients were followed up until hospital discharge or death. Measurement of qSOFA, SOFA, and SIRS. In-hospital mortality. Of 1088 patients screened, 879 were included in the analysis. Median age was 67 years (interquartile range, 47-81 years), 414 (47%) were women, and 379 (43%) had respiratory tract infection. Overall in-hospital mortality was 8%: 3% for patients with a qSOFA score lower than 2 vs 24% for those with qSOFA score of 2 or higher (absolute difference, 21%; 95% CI, 15%-26%). The qSOFA performed better than both SIRS and severe sepsis in predicting in-hospital mortality, with an area under the receiver operating curve (AUROC) of 0.80 (95% CI, 0.74-0.85) vs 0.65 (95% CI, 0.59-0.70) for both SIRS and severe sepsis (P