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AIM: The VACTERL association or Syndrome consists of Vertebral, Anorectal, Cardiac, Tracheo-Esophageal, Renal, and Limb defects. The diagnosis relies on the presence of at least three of these structural abnormalities. This study reports a single case of a patient with VACTERL Syndrome (VS), aiming to assist dentists in recognizing the general aspects, systemic changes, and oral care related to this condition. CASE REPORT: A 14-year-old female patient medically diagnosed with VS. The study evaluated the presence of systemic alterations, medication use, behavioral deviations, cognitive development, and oral aspects. The patient exhibited cardiovascular alterations including a ventricular septal defect (C), anal atresia (A), polydactyly (considered limb alteration-L), and scoliosis (a possible indication of vertebral anomalies-V). In the intraoral examination, findings included tooth crowding, enamel hypomineralization in several teeth, a deep and atretic palate, generalized gingivitis, bleeding, gingival hyperplasia, Class III malocclusion, and a right unilateral crossbite. CONCLUSION: Patients diagnosed with VACTERL syndrome experience significant systemic impairments. The research subject presented compromised oral health, challenges in dental management, delays in neuropsychomotor development, though these are not inherent to the syndrome. It is crucial to prevent oral diseases and provide early dental care for these patients to avoid the need for complex and invasive dental treatments due to systemic impairments.

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Lactic acid (LA) production has seen significant progress over the past ten years. LA has seen increased economic importance due to its broadening use in different sectors such as the food, medicine, polymer, cosmetic, and pharmaceutical industries. LA production bioprocesses using microorganisms are economically viable compared to chemical synthesis and can benefit from metabolic engineering for improved productivity, purity, and yield. Strategies to optimize LA productivity in microorganisms on the strain improvement end include modifying metabolic routes, adding gene coding for lactate transporters, inducing tolerance to organic acids, and choosing cheaper carbon sources as fuel. Many of the recent advances in this regard have involved the metabolic engineering of yeasts and filamentous fungi to produce LA due to their versatility in fuel choice and tolerance of industrial-scale culture conditions such as pH and temperature. This review aims to compile and discuss metabolic engineering innovations in LA production in yeasts and filamentous fungi over the 2013-2023 period, and present future directions of research in this area, thus bringing researchers in the field up to date with recent advances.

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Some of the vernacular or scientific names are related to possible medicinal and/or toxic properties that can reveal the presence of potential bioactive agents, contributing to the discovery of new drugs and/or knowledge of the risks associated with their use. This study sought to list the scientific and vernacular names of plants whose lexicons are related to those possible properties of plants and to compare them with the "ethno" (ethnobotanical and ethnopharmacological) and pharmacological data available in the scientific literature. A floating reading of the two classical and reference works on Brazilian medicinal plants was performed, and plants with vernacular and/or scientific names related to the possible medicinal and/or toxic properties were listed. Correlations between the meanings of the species' names (lexicon) and their possible biological properties were made from their translation from Latin by consulting dictionaries. A bibliographic survey was conducted on the "ethno" and pharmacological data for each species. Finally, data from these three dimensions (lexicon, "ethno," and pharmacology) were classified and compared using a bioprospection classification. It resulted in a list of 90 plant species belonging to 47 families. 66 of the 90 species presented "ethno" data from the scientific literature, while 46 species presented pharmacological data. Of these, 46 (69.7%) and 27 (58.7%), respectively, showed equivalence with the possible medicinal and/or toxic properties of plants according to their lexicons. According to this study, half of the plants investigated demonstrate equivalence in the three dimensions analyzed (lexicons, "ethno," and pharmacological data from the scientific literature). Gastrointestinal and nervous system categories are among the most common in all three dimensions. Plant lexicons may be closely linked to the possible medicinal and/or toxic properties and the study of plant lexicons may represent one more approach for the search for new drugs, mainly considering the gastrointestinal, nervous, and parasites categories.

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INTRODUCTION: Clinical trials on tyrosine kinase inhibitors (TKI) treatment have shown an improvement in overall and progression-free survival in patients with advanced differentiated thyroid cancer. However, it is necessary to evaluate these studies to assess methodological biases and inconsistencies that may impact the effects. OBJECTIVE: To map and assess the methodological quality of randomized clinical trials (RCTs) regarding randomization, allocation concealment, blinding, and selective reporting bias. METHODS: RCTs assessing the efficacy and safety of TKI for the treatment of advanced differentiated thyroid cancer were included. The search was performed in the MEDLINE database. The included RCTs were assessed for the adequacy of the methodological steps, as recommended by the Cochrane Risk of Bias tool. RESULTS: Nine studies were analyzed, of which 77.7% were classified as low risk of bias regarding selective reporting and 33.3% as high risk of reporting bias. The mean time between protocol registration and study publication was approximately 5.11 years. Moreover, 66.7% were classified as low risk of bias for randomization and allocation concealment, and 33.3% did not specify the randomization process and allocation concealment in a way that would allow the identification of occurrences of bias. Concerning blinding of participants and outcome assessors, 77.8% of the RCTs reported adequate blinding and were classified as having a low risk of bias, 11.1% had a high risk of bias, and 11.1% had insufficient information and were classified as having unclear risk of bias. Regarding the blinding of the outcome assessors, 33.3% did the blinding correctly, 11.1% did not blind, and 55.6% did not provide enough information. CONCLUSION: Overall, the assessed RCTs were predominantly at low risk of bias. The critical evaluation of these studies is essential to have confidence in the treatment estimated effect that will support clinical decision-making and provide information to preclude future clinical study flaws.

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Entre acadêmicos, a violência sexual acontece geralmente nos "trotes", eventos esportivos e confraternizações promovidas por associações estudantis. O objetivo deste estudo foi investigar como representantes de atléticas universitárias e centros acadêmicos compreendem, identificam e lidam com a violência sexual no ambiente universitário. Foram entrevistados 38 representantes dessas agremiações, que responderam a perguntas disparadoras a respeito de práticas de violência sexual na universidade. A importunação sexual física no contexto de festas foi a violência mais relatada, e o estupro, a menos mencionada. A maioria recorria aos coordenadores de curso para reportar casos de violência sexual, e poucos conheciam caminhos oficiais de denúncias e serviços especializados. Iniciativas pontuais para o enfrentamento da violência sexual foram tomadas por algumas associações estudantis. Contudo, tais estratégias poderiam ser mais efetivas se fossem amparadas e coordenadas institucionalmente por uma política universitária de combate à violência sexual e de gênero.

Sexual violence among students occurs generally during "pranks", sport events and social gatherings promoted by student associations. The aim of this study was to investigate how representatives of university athletics associations and academic centers understand, identify and deal with sexual violence at university. We interviewed 38 representatives, who answered trigger questions about sexual violence at university. Physical sexual harassment at parties was the most commonly reported form of violence, while rape was the least mentioned form. Most victims resorted to course coordinators to report cases of sexual violence, with few being aware of the official reporting channels and specialized services. While there are some ad-hoc initiatives, activities organized by student associations could help to curb sexual violence if supported and institutionally coordinated via a university policy to combat sexual and gender-based violence.

Entre académicos, la violencia sexual sucede por lo general en la "novatadas", eventos deportivos y confraternizaciones promovidas por asociaciones estudiantiles. El objetivo de este estudio fue investigar cómo representantes de asociaciones deportivas y centros académicos comprenden, identifican y enfrentan la violencia sexual en el ambiente universitario. Fueron entrevistados 38 representantes de esas agremiaciones que respondieron preguntas disparadoras sobre las prácticas de violencia sexual en la universidad. La importunación sexual física en el contexto de fiestas fue la violencia más relatada y la violación la menos mencionada. La mayoría recurriría a los coordinadores de cursos para informar casos de violencia sexual y pocos conocían caminos oficiales de denuncias y servicios especializados. A pesar de algunas iniciativas puntuales, las actividades organizadas por asociaciones estudiantiles podrían ayudar a cohibir la violencia sexual en la universidad, si fueran amparadas y coordinadas institucionalmente por una política universitaria de combate a la violencia sexual y de género.

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Resumo Objetivo: Analisar a relação entre o processo de ensino aprendizagem e a saúde mental de estudantes do ensino superior do estado do Ceará, Brasil, durante o isolamento social na pandemia Covid-19. Método: Estudo exploratório, descritivo e transversal, realizado com 3.691 estudantes universitários no ano de 2020. Analisaram-se as variáveis preocupação com a continuidade do curso de forma presencial, condições de acesso à internet e satisfação em relação à participação nas atividades pedagógicas durante o isolamento. Verificaram-se relações positivas (r>0) e estatisticamente significativas (p<0,001) entre a Escala Global MHI-38, as dimensões Bem-estar positivo e Distresse, as dimensões primárias e melhores condições de acesso à internet e satisfação quanto às atividades pedagógicas da instituição. Resultados: Constataram-se relações negativas (r<0) e estatisticamente significativas (p<0,001) entre as dimensões mensuradas e a preocupação com a continuidade do curso de forma presencial. As dimensões primárias apresentaram tendência para aumentar com o aumento da satisfação em relação às atividades pedagógicas e das condições de acesso à internet. Por outro lado, as dimensões primárias diminuíram com o aumento da preocupação com a continuidade do curso de forma presencial. Conclusão: Os resultados sugerem que a mudança no modelo de ensino aprendizagem impactou de forma significativa a saúde mental dos estudantes e que melhores condições de acesso às atividades tendem a otimizar o quadro, enquanto o intenso cenário de preocupação torna o adoecimento psíquico mais expressivo. Logo, cabe às instituições a criação e o fortalecimento das políticas de assistência aos discentes no âmbito da saúde mental.

Abstract Objective: Analyze the relationship between the teaching-learning process and the mental health of higher education students in Ceará State, Brazil, during social isolation caused by the Covid-19 pandemic. Method: An exploratory, descriptive, and cross-sectional study was conducted with 3,691 university students in 2020. The variables concerned with the continuity of the course in person, internet access conditions, and satisfaction regarding participation in pedagogical activities during isolation were analyzed. There were positive (r>0) and statistically significant (p<0.001) relationships between the MHI-38 Global Scale, the Positive well-being and Distress dimensions, the primary dimensions, and better internet access conditions and satisfaction with the pedagogical activities of the institution. Results: On the other hand, negative (r<0) and statistically significant (p<0.001) relationships were found between the assessed dimensions and the concern with continuing the course in person. The primary dimensions tended to increase with increasing satisfaction with pedagogical activities and internet access conditions. On the other hand, the primary dimensions decreased with the increase in the concern with the continuity of the in-person course. Conclusion: The results suggest that the change in the teaching-learning model significantly impacted the students' mental health and that better conditions of access to activities tend to optimize the picture, while the intense scenario of concern makes the psychic illness more expressive. Therefore, it is up to the institutions to create and strengthen mental health policies for students.

Resumen Objetivo: analizar la relación entre el proceso de enseñanza-aprendizaje y la salud mental de estudiantes de enseñanza superior del estado de Ceará, Brasil, durante el aislamiento social provocado por la pandemia de Covid-19. Método: Se realizó un estudio exploratorio, descriptivo y transversal con 3.691 estudiantes universitarios en 2020. Se analizaron las variables relacionadas con la continuidad del curso presencial, las condiciones de acceso a internet y la satisfacción con la participación en actividades pedagógicas durante el aislamiento. Hubo relaciones positivas (r>0) y estadísticamente significativas (p<0,001) entre la Escala Global MHI-38, las dimensiones Bienestar positivo y Angustia, las dimensiones primarias y mejores condiciones de acceso a internet y satisfacción con las actividades pedagógicas de la institución. Resultados: se encontraron relaciones negativas (r<0) y estadísticamente significativas (p<0,001) entre las dimensiones medidas y la preocupación por continuar el curso presencialmente. Las dimensiones primarias tendieron a aumentar con el aumento de la satisfacción con las actividades pedagógicas y las condiciones de acceso a Internet. Por otro lado, las dimensiones primarias disminuyeron con el aumento de la preocupación por la continuidad del curso presencial. Conclusión: Los resultados sugieren que el cambio en el modelo de enseñanza-aprendizaje impactó significativamente la salud mental de los estudiantes y que mejores condiciones de acceso a las actividades tienden a optimizar el cuadro, mientras que el escenario de intensa preocupación hace más expresiva la enfermedad psíquica. Por lo tanto, corresponde a las instituciones crear y fortalecer políticas de salud mental para los estudiantes.

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Insecticide resistance in Aedes aegypti poses a significant threat to disease control. One form of resistance, caused by kdr mutations in the NaV gene, hinders vector control efforts in Brazil. Despite genetic differences typically accumulating among isolated populations, this mosquito can actively and passively disperse through human transportation. Our study investigated the genetic structure and spread of kdr mutations in Ae. aegypti populations across six localities in Amapá State, Brazil, within the Amazonian Forest. Using 12 microsatellite loci and qPCR methods, we assessed genetic structure and identified three common kdr mutations (V410L, V1016I, and F1534C). High prevalence of kdr alleles was observed in all localities, indicating widespread distribution in Amapá State. Microsatellite analysis revealed differentiation among mosquito populations, dividing them into two distinct clusters supported by Bayesian and DAPC analyses. Oiapoque, located along the northern border with French Guiana, exhibited the highest kdr frequencies and genetic differentiation compared to other localities. Our findings suggest genetic structure in Ae. aegypti populations in Amapá State, with some passive gene flow between clusters. The study underscores the need for continuous surveillance of Ae. aegypti populations to monitor the spread of insecticide resistance and inform effective vector control strategies.

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OBJECTIVES: The coronavirus disease pandemic has become a major global health crisis since 2019. Recent data show the association of diabetes, hypertension, and obesity with poor related outcomes in coronavirus disease infection. This descriptive study aimed to identify the clinical and laboratory parameters in patients with acute respiratory syndrome and confirmed severe acute respiratory syndrome coronavirus 2 infection. METHODS: In this cross-sectional study, we analyzed data of 409 patients admitted to a referral hospital in Rio Grande do Sul, Brazil, with coronavirus disease infection confirmed by reverse transcription polymerase chain reaction. Clinical, laboratory, and imaging data were collected retrospectively from electronic medical records using a template with the variables of interest. RESULTS: The average age was 64 years (52-73), and the body mass index was 27 kg/m² (22.1-31.2). Hypertension, diabetes, and obesity were observed in 58, 33, and 32% of the patients, respectively. Patients admitted to an intensive care unit were older [66 years (53-74) vs. 59 years (42.2-71.7)], with significantly higher impairment on chest computed tomography [75% (50-75) vs. 50% (25-60)] and received higher doses of corticosteroid therapy [39.4 mg (14.3-70.3) vs. 6 mg (6-14.7)]. Hematological parameters were lower in critically ill patients, with greater differences observed on the fifth day of hospitalization [hemoglobin 11.5 g/dL (9.5-13.1) vs. 12.8 g/dL (11.5-14.2), platelets 235,000 µL (143,000-357,000) vs. 270,000 µL (192,000-377,000), and lymphocytes 900 µL (555-1,500) vs. 1,629 µL (1,141-2,329)]. C-reactive protein levels and kidney function were also worse in intensive care unit patients. The mortality rate was significantly higher in the intensive care unit compared to the basic care unit (62.8 vs. 12.2%). CONCLUSION: Our findings suggest that metabolic and cardiovascular comorbidities, as well as abnormal hematological parameters, are common findings among patients with severe respiratory syndrome related to coronavirus disease.

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BACKGROUND: Maternal vaccination is safe and provides protection against COVID-19 in mothers and neonates, and it is necessary to evaluate its effect on the induction of immune responses through the levels of neutralizing antibodies present in maternal and neonatal blood. METHODS: An observational study with transversal analysis was carried out. Included in the research were neonates (<1 month) whose mothers had been immunized whilst pregnant with at least one dose of the vaccine BNT16b and had not shown any symptoms of COVID-19. The blood of the mothers and newborns was collected during the Guthrie test and sent to the laboratory for the detection of neutralizing antibodies against SARS-CoV-2. RESULTS: A total of 162 pairs of mothers and neonates were analyzed with an average age of 26.3 ± 5.97 years and 13.4 ± 6.90 days, respectively. All samples collected present neutralizing antibodies with an average percentage of 91% in the mothers and 92% in the neonates. The most satisfactory immune response was observed in neonates and mothers vaccinated during the second trimester of gestation. CONCLUSIONS: The vaccination of expectant mothers with the immunizer BNT162b2 has promoted a robust immunological response in both the mothers and the neonates.

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SUMMARY OBJECTIVES: The coronavirus disease pandemic has become a major global health crisis since 2019. Recent data show the association of diabetes, hypertension, and obesity with poor related outcomes in coronavirus disease infection. This descriptive study aimed to identify the clinical and laboratory parameters in patients with acute respiratory syndrome and confirmed severe acute respiratory syndrome coronavirus 2 infection. METHODS: In this cross-sectional study, we analyzed data of 409 patients admitted to a referral hospital in Rio Grande do Sul, Brazil, with coronavirus disease infection confirmed by reverse transcription polymerase chain reaction. Clinical, laboratory, and imaging data were collected retrospectively from electronic medical records using a template with the variables of interest. RESULTS: The average age was 64 years (52-73), and the body mass index was 27 kg/m² (22.1-31.2). Hypertension, diabetes, and obesity were observed in 58, 33, and 32% of the patients, respectively. Patients admitted to an intensive care unit were older [66 years (53-74) vs. 59 years (42.2-71.7)], with significantly higher impairment on chest computed tomography [75% (50-75) vs. 50% (25-60)] and received higher doses of corticosteroid therapy [39.4 mg (14.3-70.3) vs. 6 mg (6-14.7)]. Hematological parameters were lower in critically ill patients, with greater differences observed on the fifth day of hospitalization [hemoglobin 11.5 g/dL (9.5-13.1) vs. 12.8 g/dL (11.5-14.2), platelets 235,000 μL (143,000-357,000) vs. 270,000 μL (192,000-377,000), and lymphocytes 900 μL (555-1,500) vs. 1,629 μL (1,141-2,329)]. C-reactive protein levels and kidney function were also worse in intensive care unit patients. The mortality rate was significantly higher in the intensive care unit compared to the basic care unit (62.8 vs. 12.2%). CONCLUSION: Our findings suggest that metabolic and cardiovascular comorbidities, as well as abnormal hematological parameters, are common findings among patients with severe respiratory syndrome related to coronavirus disease.

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Objetivo: avaliar a contrarreferência como estratégia para a continuidade do cuidado às mulheres e recém-nascidos de uma maternidade de risco habitual para a atenção primária de saúde. Métodos: estudo qualitativo realizado em maternidade de risco habitual e em unidades de saúde em Curitiba, Paraná, Brasil. Os dados foram coletados entre setembro e novembro de 2020, com enfermeiros das unidades de saúde e mulheres que tiveram a alta contrarrefenciada da maternidade. Mediante análise de conteúdo, as falas foram estratificadas em temas e subtemas pré-definidos pelo referencial teórico adotado, que prevê três categorias de continuidade do cuidado e suas respectivas dimensões. Resultados: participaram oito enfermeiros e seis puérperas. Emergiram das entrevistas 26 estratos. Destacaram-se, na Categoria informacional, a dimensão "o uso das informações obtidas pela contrarreferência para continuidade do cuidado"; na Categoria relacional a dimensão "a importância de vínculo entre profissionais e pacientes", e na Categoria gerencial "a utilização de mecanismos de rede para um cuidado efetivo". Conclusão: a contrarreferência foi evidenciada como estratégia para continuidade de cuidado pelos dois grupos investigados, capaz de proporcionar subsídios para promover um cuidado eficiente para as puérperas. Entretanto, há necessidade de otimizar instrumentos de contrarreferência padronizados, efetivando o processo na rede de saúde.

Objective: to evaluate counter-referral as a strategy for the continuity of care of women and newborns from a usual-risk maternity hospital to primary health care. Methods: qualitative study developed in a usual-risk maternity and in health units in Curitiba, Paraná, Brazil. Data collection period was between September and November 2020 with nurses from the health units and women who had counter-referral discharge from the maternity hospital. After content analysis, the speeches were divided into themes and subthemes predefined by the theoretical framework adopted, which provides for three categories of continuity of care and their respective dimensions. Results: eight nurses and six puerperal women participated. Twenty-six strata emerged from the interviews. Highlights, in the Informational category, the dimension "the use of information obtained by counter-referral for continuity of care"; in the Relational category, the dimension "the importance of professional-patient bonding", and in the Managerial category, "the use of network mechanisms for effective care". Conclusion:the counter-referral was evidenced as a strategy for continuity of care by the two groups investigated, capable of providing support to promote efficient care for puerperal women. However, there is a need to optimize standardized counter-referral instruments, making the process effective in the health network.

Objetivo: evaluar la contrarreferencia como estrategia para la continuidad de la atención a mujeres y recién nacidos en una maternidad de riesgo habitual para la atención primaria de salud. Métodos: estudio cualitativo desarrollado en maternidades de riesgo habitual y en unidades de salud de Curitiba, Paraná, Brasil. El período de recolección de datos fue entre septiembre y noviembre de 2020 con enfermeros de las unidades de salud y mujeres que tuvieron alta por contrarreferencia de la maternidad. A través del análisis de contenido, los discursos fueron divididos en temas y subtemas predefinidos por el referencial teórico adoptado, que prevé tres categorías de continuidad del cuidado y sus respectivas dimensiones. Results: eight nurses and six puerperal women participated. Twenty-six strata emerged from the interviews. Highlights, in the Informational category, the dimension "the use of information obtained by counter-referral for continuity of care"; in the Relational category, the dimension "the importance of professional-patient bonding", and in the Managerial category, "the use of network mechanisms for effective care". Conclusión: la contrarreferencia se evidenció como una estrategia de continuidad del cuidado por parte de los dos grupos investigados, capaz de brindar apoyo para promover el cuidado eficiente de la puérpera. Sin embargo, existe la necesidad de optimizar los instrumentos estandarizados de contrarreferencia, haciendo efectivo el proceso en la red de salud.

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Diabetic foot ulcers (DFUs) are considered one of the most severe chronic complications of diabetes and can lead to amputation in severe cases. In addition, bacterial infections in diabetic chronic wounds aggravate this scenario by threatening human health. Wound dressings made of polymer matrices with embedded metal nanoparticles can inhibit microorganism growth and promote wound healing, although the current clinical treatments for diabetic chronic wounds remain unsatisfactory. In this view, this research reports the synthesis and characterization of innovative hybrid hydrogels made of carboxymethyl cellulose (CMC) and poly(vinyl alcohol) (PVA) chemically crosslinked by citric acid (CA) functionalized with silver nanoparticles (AgNPs) generated in situ using an eco-friendly aqueous process. The results assessed through comprehensive in vitro and in vivo assays demonstrated that these hybrid polymer hydrogels functionalized with AgNPs possess physicochemical properties, cytocompatibility, hemocompatibility, bioadhesion, antibacterial activity, and biocompatibility suitable for wound dressings to support chronic wound healing process as well as preventing and treating bacterial infections. Hence, it can be envisioned that, with further research and development, these polymer-based hybrid nanoplatforms hold great potential as an important tool for creating a new generation of smart dressings for treating chronic diabetic wounds and opportunistic bacterial infections.

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Introdução: A síndrome de Meigs é uma condição clínica rara, definida como a associação de derrame pleural, ascite e fibroma ovariano, com resolução dos sintomas após a ressecção do tumor. Relato do caso: Paciente, sexo feminino, 56 anos, com tosse seca, associada à hiporexia, à perda de peso e à dispneia progressiva durante um mês. Radiografia de tórax e posteriormente tomografia de tórax mostraram derrame pleural volumoso à direita, sendo realizada toracocentese com drenagem de 2.500 ml de líquido seroso, sugestivo de exsudato. Ao exame, observou-se massa palpável em hipogástrio, com limite superior em cicatriz umbilical. Exames de imagem mostram formação expansiva sólida de possível origem ovariana esquerda e presença de líquido ascítico. A paciente foi submetida à histerectomia total com salpingo-ooforectomia bilateral e ressecção da massa pélvica. No intraoperatório, o exame por congelação foi sugestivo de fibroma ovariano. O histopatológico da peça cirúrgica confirmou fibroma ovariano medindo 13,0 x 12,5 x 7,5 cm e o exame citopatológico do líquido ascítico foi negativo para células neoplásicas. A paciente evoluiu em bom estado geral com resolução do derrame pleural e da ascite e segue sem recorrência dos sintomas. Conclusão: O diagnóstico definitivo é feito pela confirmação histológica de fibroma ovariano e resolução dos sintomas após a remoção da tumoração. A dispneia pode ser o sintoma inicial e o marcador tumoral CA-125 pode estar elevado. O prognóstico costuma ser bom e as chances de recidiva são mínimas.

ntroduction: Meigs syndrome is a rare clinical condition, defined as the association of pleural effusion, ascites and ovarian fibroma, with resolution of symptoms after tumor resection. Case report: Female patient, 56 years old, with dry cough associated with hyporexia, weight loss and progressive dyspnea for one month. Chest X-ray and later chest tomography showed massive pleural effusion on the right. Thoracocentesis was performed with drainage of 2,500 ml of serous fluid, suggestive of exudate. On examination, a palpable mass was observed in the hypogastrium, with an upper limit in the umbilicus. Imaging exams show solid expansive formation of possible left ovarian origin and presence of ascitic fluid. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy and resection of the pelvic mass. Intraoperatively, frozen section was suggestive of ovarian fibroma. Histopathological of the surgical specimen confirmed ovarian fibroma measuring 13.0 x 12.5 x 7.5 cm and cytopathological examination of the ascitic fluid was negative for neoplastic cells. The patient evolved in good general condition with resolution of the pleural effusion and ascites and continues without recurrence of symptoms. Conclusion: The definitive diagnosis is made by histological confirmation of ovarian fibroma and resolution of symptoms after removal of the tumor. Dyspnea may be the initial symptom and the CA-125 may be elevated. The prognosis is usually good and the chances of recurrence are minimal.

Introducción: El síndrome de Meigs es una condición clínica rara, definida como la asociación de derrame pleural, ascitis y fibroma de ovario, con resolución de los síntomas después de la resección del tumor. Informe del caso: Paciente femenino de 56 años con tos seca asociada a hiporexia, pérdida de peso y disnea progresiva durante 1 mes de evolución. La radiografía de tórax y posterior tomografía de tórax mostró derrame pleural masivo en el lado derecho, se realizó toracocentesis con drenaje de 2.500 ml de líquido seroso, sugestivo de exudado. A la exploración se observa una masa palpable en hipogastrio, con límite superior en ombligo. Los exámenes de imagen muestran formación sólida expansiva de posible origen ovárico izquierdo y presencia de líquido ascítico. La paciente fue sometida a histerectomía total con salpingooforectomía bilateral y resección de la masa pélvica. Intraoperatoriamente, sección congelada sugestiva de fibroma de ovario. El histopatológico de la pieza quirúrgica confirmó fibroma de ovario de 13,0 x 12,5 x 7,5 cm y el examen citopatológico del líquido ascítico fue negativo para células neoplásicas. El paciente evolucionó en buen estado general con resolución del derrame pleural y ascitis y continúa sin recidiva de los síntomas. Conclusión: El diagnóstico definitivo se realiza mediante la confirmación histológica del fibroma de ovario y la resolución de los síntomas tras la extirpación del tumor. La disnea puede ser el síntoma inicial y el CA-125 puede estar elevado. El pronóstico suele ser bueno y las posibilidades de recurrencia son mínimas.

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Objetivo: Explorar evidências disponíveis sobre formas de apresentação das problemáticas psíquicas que afetam a saúde mental de estudantes universitários, durante a pandemia da COVID-19. Fonte de dados: Revisão de escopo, subdivida em seis etapas: identificação do tema; questão de pesquisa; critérios de inclusão e exclusão de estudos; amostragem; categorização; avaliação, discussão dos resultados e apresentação da revisão. As bases de dados usadas foram: Web of Science, LILACS, MEDLINE e Scopus. Resumo das conclusões: Identificaram-se 1.543 artigos, 219 lidos na íntegra e 95 incluídos. Selecionaram-se estudos que descrevessem a saúde mental dos estudantes de ensino superior de todas as faixas etárias, sobre o conceito da saúde mental, no contexto da pandemia, sendo possível obter conhecimentos das sintomatologias apresentadas pelos estudantes no decorrer do isolamento social. A revisão de escopo mostrou que a saúde mental dos alunos foi afetada durante a pandemia de COVID-19 de diferentes maneiras e que a pandemia atuou como um intensificador dos sintomas.

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This study investigated the antimicrobial and antibiofilm activity of KWI18, a new synthetic peptide. KWI18 was tested against planktonic cells and Pseudomonas aeruginosa and Candida parapsilosis biofilms. Time-kill and synergism assays were performed. Sorbitol, ergosterol, lipid peroxidation, and protein oxidation assays were used to gain insight into the mechanism of action of the peptide. Toxicity was evaluated against erythrocytes and Galleria mellonella. KWI18 showed antimicrobial activity, with minimum inhibitory concentration (MIC) values ranging from 0.5 to 10 µM. KWI18 at 10 × MIC reduced P. aeruginosa and C. parapsilosis biofilm formation and cell viability. Time-kill assays revealed that KWI18 inhibited the growth of P. aeruginosa in 4 h and that of C. parapsilosis in 6 h. The mechanism of action was related to ergosterol as well as induction of oxidative damage in cells and biofilms. Furthermore, KWI18 demonstrated low toxicity to erythrocytes and G. mellonella. KWI18 proved to be an effective antibiofilm agent, opening opportunities for the development of new antimicrobials.

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Resumo Fundamento A prevalência de hipertensão arterial sistêmica (HAS) e de outros distúrbios metabólicos tem aumentado em indivíduos jovens. Entretanto, não há estudos representativos sobre esse assunto com a população do Distrito Federal (DF). Objetivo Estimar a prevalência de HAS e a sua associação com parâmetros lipídicos, glicídicos e de adiposidade em adolescentes do DF. Métodos Trata-se de um estudo observacional transversal com participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Foram avaliados pressão arterial, glicemia sanguínea, hemoglobina glicada, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), triglicerídeos, colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, índice de massa corporal (IMC) e perímetro da cintura, além de variáveis econômicas, demográficas e de maturação sexual. A análise de dados foi feita no software Stata e foi dividida nas seguintes etapas: análises descritiva, bruta e ajustada. Considerou-se p < 0,05. Resultados Foram incluídos 1.200 adolescentes com média de idade de 14,8 anos. A prevalência de HAS foi de 8% (intervalo de confiança de 95%: 6,3; 9,9). A maioria dos parâmetros se associou com a PA na análise bruta; na ajustada, os parâmetros glicídicos, lipídicos e de adiposidade mantiveram a associação, tendo IMC e HOMA-IR a maior magnitude na relação. Conclusão O estudo revelou elevada prevalência de HAS em adolescentes do DF, e os níveis pressóricos apresentaram-se associados a outros marcadores de perfil lipídico, glicídico e de adiposidade, evidenciando a relevância da vigilância em saúde para o planejamento de ações efetivas para a reversão do quadro e prevenção de novos casos.

Abstract Background The prevalence of hypertension and other metabolic disorders has increased in young individuals. However, no representative studies have been conducted in the population of the Federal District, Brazil. Objective To estimate the prevalence of hypertension and its association with lipid, glucose, and adiposity markers in school-aged adolescents living in the Federal District. Methods This cross-sectional study included participants of the Study of Cardiovascular Risks in Adolescents (Portuguese acronym, ERICA). Blood pressure, blood glucose, glycated hemoglobin, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, body mass index (BMI), waist circumference, and economic, demographic, and sexual maturity variables were assessed. The data were analyzed in Stata, and the analysis was divided into different stages: descriptive, crude, and adjusted. Significant results were set at p < 0.05. Results In total, 1,200 adolescents were included, and their mean age was 14.8 years. The prevalence of hypertension was 8% (95% confidence interval: 6.3; 9.9). Most parameters were associated with blood pressure in crude analysis. In adjusted analysis, glucose, lipid, and adiposity markers maintained the associations, and the highest magnitudes were those of BMI and HOMA-IR. Conclusion The study revealed a high prevalence of hypertension in adolescents living in the Federal District, and blood pressure levels were associated with other markers of lipid, glucose, and adiposity profile. The findings indicate the relevance of health surveillance for planning effective actions aimed at reversing this situation and preventing new cases.

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Every year, Brazil intensifies its activity in agriculture and, as a result, it has become one of the biggest consumers of pesticides in the world. The high rate of these substances raises environmental and human health concerns. Therefore, we collected papers from PubMed, Scopus, Scielo, and Web of Science databases, from 2015 to 2021. After a blind selection using the software Rayyan QCRI by two authors, 51 studies were included. Researchers from the South and the Southeast Brazilian regions contributed to most publications, from areas that concentrate agricultural commodity complexes. Among the pesticides described in the studies, insecticides, herbicides, and fungicides were the most frequent. The articles reported multiple toxic effects, particularly in rural workers. The results obtained can be used to direct policies to reduce the use of pesticides, and to protect the health of the population.

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BACKGROUND: The prevalence of hypertension and other metabolic disorders has increased in young individuals. However, no representative studies have been conducted in the population of the Federal District, Brazil. OBJECTIVE: To estimate the prevalence of hypertension and its association with lipid, glucose, and adiposity markers in school-aged adolescents living in the Federal District. METHODS: This cross-sectional study included participants of the Study of Cardiovascular Risks in Adolescents (Portuguese acronym, ERICA). Blood pressure, blood glucose, glycated hemoglobin, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, body mass index (BMI), waist circumference, and economic, demographic, and sexual maturity variables were assessed. The data were analyzed in Stata, and the analysis was divided into different stages: descriptive, crude, and adjusted. Significant results were set at p < 0.05. RESULTS: In total, 1,200 adolescents were included, and their mean age was 14.8 years. The prevalence of hypertension was 8% (95% confidence interval: 6.3; 9.9). Most parameters were associated with blood pressure in crude analysis. In adjusted analysis, glucose, lipid, and adiposity markers maintained the associations, and the highest magnitudes were those of BMI and HOMA-IR. CONCLUSION: The study revealed a high prevalence of hypertension in adolescents living in the Federal District, and blood pressure levels were associated with other markers of lipid, glucose, and adiposity profile. The findings indicate the relevance of health surveillance for planning effective actions aimed at reversing this situation and preventing new cases.

FUNDAMENTO: A prevalência de hipertensão arterial sistêmica (HAS) e de outros distúrbios metabólicos tem aumentado em indivíduos jovens. Entretanto, não há estudos representativos sobre esse assunto com a população do Distrito Federal (DF). OBJETIVO: Estimar a prevalência de HAS e a sua associação com parâmetros lipídicos, glicídicos e de adiposidade em adolescentes do DF. MÉTODOS: Trata-se de um estudo observacional transversal com participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Foram avaliados pressão arterial, glicemia sanguínea, hemoglobina glicada, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), triglicerídeos, colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, índice de massa corporal (IMC) e perímetro da cintura, além de variáveis econômicas, demográficas e de maturação sexual. A análise de dados foi feita no software Stata e foi dividida nas seguintes etapas: análises descritiva, bruta e ajustada. Considerou-se p < 0,05. RESULTADOS: Foram incluídos 1.200 adolescentes com média de idade de 14,8 anos. A prevalência de HAS foi de 8% (intervalo de confiança de 95%: 6,3; 9,9). A maioria dos parâmetros se associou com a PA na análise bruta; na ajustada, os parâmetros glicídicos, lipídicos e de adiposidade mantiveram a associação, tendo IMC e HOMA-IR a maior magnitude na relação. CONCLUSÃO: O estudo revelou elevada prevalência de HAS em adolescentes do DF, e os níveis pressóricos apresentaram-se associados a outros marcadores de perfil lipídico, glicídico e de adiposidade, evidenciando a relevância da vigilância em saúde para o planejamento de ações efetivas para a reversão do quadro e prevenção de novos casos.

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Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global coronavirus pandemic (COVID-19) in humans in 2019. Although SARS-CoV-2 infection is primarily asymptomatic and transitory in companion animals, the role of these animals in the life cycle of the virus remains unclear. This study aimed to survey the first SARS-CoV-2 infection cases in pets, including a dog and three cats in São Paulo, Brazil. Materials and Methods: We invited COVID-19-positive pet owners to participate in the survey and obtained nasal, oropharyngeal, and rectal swab samples from their pets. These samples were placed in vials and subjected to a real-time quantitative polymerase chain reaction. In addition, the owners answered an epidemiological questionnaire, and the pets underwent clinical examination and monitoring. Results: Out of 49 sampled pets, 3/19 (15.8%) cats and 1/30 (3.3%) dogs tested positive, with wide variations in viral loads. Despite the limitations of size and non-randomized sampling, our results showed that cats are more susceptible than dogs to SARS-CoV-2 infection, presenting a cat: dog ratio of 4.8: 1. Only one cat presented mild and transitory respiratory symptoms. Conclusion: Although SARS-CoV-2 infection was detected in pets in the largest South American city and the COVID-19 epicenter at the time, these first detected pet cases displayed either none or mild clinical signs.