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Resumo Introdução Idosos institucionalizados possuem maiores riscos para a prescrição de cinco ou mais medicamentos, ou polifarmácia, e, por consequência, de eventos adversos, por apresentarem problemas de saúde limitantes, fragilidade e baixa funcionalidade. Esse risco é ainda maior quanto maior o declínio cognitivo. Objetivo Determinar a prevalência de declínio cognitivo (DC) e a relação com o uso de medicamentos em idosos institucionalizados. Método Estudo transversal descritivo realizado por análise de prontuários dos idosos institucionalizados portadores ou não de DC, conforme resultados de testes validados. Foram levantados os medicamentos utilizados e os medicamentos potencialmente inadequados (MPI) por meio dos Critérios de Beers (2015). Resultados Foram avaliados 88 idosos, com idade média de 77,6 (9,2) anos. A prevalência de DC foi de 75%, sendo maior no sexo feminino (82,5%, p = 0,01) e em idosos acima de 80 anos (85%, p = 0,04). Antieméticos e inibidores de bomba de prótons foram significativamente mais utilizados nos idosos com DC. A prevalência de polifarmácia foi de 69,3%, e 71 idosos (80,68%) utilizavam pelo menos um MPI, com maior prevalência do uso de MPI na faixa etária de 60 a 79 anos (p = 0,004). Os idosos que utilizavam pelo menos um MPI também usavam maior número de medicamentos (p = 0,014). Conclusão A presença de DC teve relação com a maior utilização de antieméticos e inibidores de bomba de prótons, mas não com o maior uso de MPI. Além disso, foi observada elevada prevalência de polifarmácia e MPI em prescrições dos idosos institucionalizados. Abstract Background Institutionalized elderly are at greater risk of prescribing five or more medications and consequently of higher occurence of adverse events, as they have limiting health problems, frailty and low functionality. This risk is even greater if they also have cognitive decline. Objective To determine the prevalence of cognitive disorders (CDs) and its association with the medication used by the institutionalized elderly population of the interior of Minas Gerais, Brazil. Method Descriptive cross-sectional study for analysis of medical records of institutionalized elderly with or without CDs, according to validated tests. The medicine used and the potentially inappropriate medications (PIMs) were determined as per the Beers criteria (2015). Results Eighty eight elderly people, with mean age of 77.6 (9.2) years, were included. CD prevalence was 75% higher in females (82.5%, p = 0.01) and in older age groups, with 80 years and above (85%, p = 0.04). Antiemetics and proton pump inhibitors were significantly more used by the elderly with CDs. The prevalence of polypharmacy was 69.3%, 71 elderlies (80.7%) used at least one PIM, and a higher prevalence of PIM use was observed in elderly people of 60 to 79 years old (p = 0.004). The elderly who used at least one PIM was also observed to use a higher number of medications (p = 0.014). Conclusion CDs was found to be related to the higher use of antiemetics and proton pump inhibitors, but not to the use of PIMs in regards to the institutionalized elderlies. Furthermore, a high prevalence of polypharmacy and PIMs were detected in the prescriptions of the institutionalized elderly subjects.

Caro(a) Leitor(a), O II Congresso Médico de Fernandópolis (II COMFER) da Universidade Brasil - Campus Fernandópolis, realizado nos dias 28 a 30 de outubro de 2021, mostrou-se um sucesso. Contamos com a participação de 9 profissionais médicos, que transmitiram através de palestras, um conhecimento de alta qualidade para os participantes. Neste ano, com o intuito de continuar levando conhecimento técnico e científico para acadêmicos e profissionais de diversas áreas da saúde, o evento propôs uma experiência diferente, de forma online, prezando a segurança de todos devido a pandemia da COVID19. Contamos com palestrantes egressos do Curso de Medicina de Fernandópolis, convidados de várias especialidades médicas, oriundos de outras instituições tais como: Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP); Universidade Camilo Castelo Branco (UNICASTELO); Faculdade de Medicina de São José do Rio Preto (FAMERP); Faculdade de Medicina da Universidade de São Paulo (FMUSP); Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP); Pontifícia Universidade Católica de Goiás (PUC-GO); Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP-EPM) e Faculdade de Medicina de Catanduva (FAMECA). O evento contou com a presença de 240 congressistas, entre eles, alunos do Curso de Medicina da Universidade Brasil em Fernandópolis e outras instituições de ensino do Brasil; médicos residentes na cidade de Fernandópolis e médicos residentes na região. Com inovação e tecnologia, neste ano abrimos a oportunidade à vários profissionais da saúde do Brasil e de outras áreas como o Direito Médico, a fim de acompanhar o congresso e submeter trabalhos científicos que tivessem uma temática em consonância à medicina. Contamos com 65 painéis submetidos nas modalidades: Pesquisa Científica, Caso Clínico, Revisão de Literatura e Projeto de Extensão Universitária. Dentre as submissões, foram escolhidos os 10 melhores para apresentação oral, realizada no dia 30 de outubro. Diante do sucesso alcançado, gostaríamos de agradecer a todos os envolvidos na realização deste evento. Nossos sinceros agradecimentos aos 18 membros da Comissão Organizadora, dentre discentes e docentes que com muito empenho puderam realizar este evento que só tende a abrilhantar o Curso de Medicina da Universidade Brasil (UB), sempre com o intuito de levar conhecimento e vivência na área da saúde. Muito obrigado a UB e a IFMSA BRAZIL – UB pelo apoio para realização do II COMFER. Em 2022 estaremos de volta! Vinicius Paiva Gontijo / Presidente Discente do II COMFER - II Congresso Médico de Fernandópolis - 2021 Curso de Medicina da Universidade Brasil – Campus Fernandópolis

Introduction: The use of social media is an extremely popular activity, with an average time spent of two and a half hours daily. The number of users continues to rise, with 4.65 billion around the world in 2022, approximately 58.7% of the world population. A rising number of studies show that a minority of these persons will develop a behavioral addiction on social media. The aim of this study was to understand if the use of a specific social media platform predicts increased addictive potential.Material and Methods: A cross-sectional sample of 300 persons (aged 18 years-old or older, 60.33% female), completed an online survey including sociodemographic questions, data regarding the use of social media and the Bergen Social Media Addiction Scale (BSMAS). Linear and logistic regression models were performed to determine the risk for each media platform.Results: Instagram® use was a significant predictor of higher scores on the BSMAS (B 2.51; p < 0.0001; CI 1.33 - 3.69). The use of other platforms including Facebook® (B -0.31), Twitter® (B 1.38) and Pinterest® (B -0.15) was not found to predict a higher risk of social media addiction.Conclusion: Instagram® scored a higher grade in BSMAS scale, with statistical significance, which could suggest a higher addictive potential. More research is needed to establish the direction of this relationship, since the cross-sectional study design does not allow inferences about directionality.

In this research the relationship between hair cortisol and burnout was evaluated through the study of third-variables effect. Hair cortisol concentration was measured in 234 health workers. All participants completed perceived stress survey and Maslach Burnout Inventory. Our results showed that 40% of volunteers presented altered hair cortisol values, 12% burnout, 33% showed high depersonalization, 38% high emotional fatigue, 36% low personal fulfillment and 22% presented 2 of the 3 burnout components. A moderated mediation was found between psychological and biological variables. This research highlights the importance of including a biological variable such as hair cortisol in burnout assessment.

O acidente vascular encefálico (AVE) é uma das patologias de maior prevalência de óbitos no Brasil, destacando-se também como substancial causa de incapacidade no mundo. Nesse sentido, é fundamental o conhecimento clínico epidemiológico do AVE, além de suas implicações nos cenários científico e de saúde pública. Este trabalho tem por objetivo analisar o perfil clínico e epidemiológico dos casos de acidente vascular encefálico no Estado do Piauí, no período de 2011 a 2021. Trata-se de uma pesquisa do tipo epidemiológica, documental e quantitativa de natureza descritiva e retrospectiva, onde o cenário de coleta de dados foi o banco de dados do DATASUS. Foram selecionadas as seguintes varáveis: sociodemográficas (sexo, idade, raça), caráter do atendimento e taxa de mortalidade. No período avaliado o número de internações por AVE no estado do Piauí foi de 29.979 casos. Com maior ocorrência na faixa etária de 70 a 79 anos com 7.982 casos (26,62%), e maior prevalência em indivíduos do sexo masculino, 15.485 (51,65%) homens acometidos. A maioria dos atendimentos foram de caráter de urgência, com 29.863 casos (99,62%), e com indivíduos de raça não informada (49,19%). A capital de Teresina apresentou o maior número de internações por AVE, cerca de 12.339 casos. A taxa de mortalidade por AVE foi maior no ano de 2015, cerca de 17,81%. No presente estudo foi possível analisar que as taxas de internação hospitalar por AVE vêm diminuindo ao longo dos anos no estado do Piauí, bem como, a taxa de mortalidade, no entanto, existe a necessidade da implementação de mais estratégias para promover à saúde e prevenir a ocorrência de AVE.

Considering the potential impact on health and the scarce data available regarding early-life exposure to mycotoxins, earlyMYCO project (early-life exposure to MYCOtoxins and its impact on health) proposed to answer key questions: are pregnant women and infants until six months exposed to mycotoxins? Is this exposure a health threat? Does this early-life exposure influence the intestinal immune system development? Which is the burden derived from the exposure to mycotoxins? The earlyMYCO pilot study enrolled 19 pairs of mother and children, with a loss to follow-up ranging between 11% and 47% for different moments of observation. The mycotoxins’ biomarkers detected were AFB1, OTA, DON and bZEL in urine samples (mother and children), and AFB1, aZEL, FB1, FB2 and FB3 in breast milk samples. Food consumption data revealed that foods consumed more frequently during the week were bread, dairy products, non-alcoholic drinks (tea and coffee), animal products (meat and fish) and pasta. Regarding infants, 22% were fed with infant formula and 78% were exclusively breastfed. Considering the exposure levels, a low risk of mothers’ exposure to the main mycotoxins analyzed is expected, since urine samples did not reveal detectable levels of these compounds; however, infants’ urine samples presented a DON mean value of 14.8 ng/mL (corresponding to 148.0 μg/kg bw/day through reverse dosimetry), which could represent a risk for this population group. Notably, maternal exposure to AFB1 promoted an increase of overall T cell population, while it also resulted in a selective reduction of cytokine-producing innate lymphoid cells group 2 (ILC2) population in intestine of the progeny. These alterations were associated with decreased expression of Reg3b and Reg3g by the intestinal mucosa of progeny. Thus, these results indicate that maternal exposure to mycotoxins impacts the development of offspring intestinal immune system. An in vitro approach using intestinal cell lines Caco-2 and Caco-2/HT29-MTX models exposed to AFB1 during 24h, confirmed the deleterious effects of AFB1 on intestinal membrane integrity and its effect on mucus layer. To assess the impact of AFB1 on early-life microbiota, faeces from litters of AFB1 treated female mice and controls were assessed by metagenomics. Although the overall diversity (Shannon diversity index) of the microbiome wasn’t affected between groups, the microbiome composition varied between AFB1 and control faecal samples (Bray–Curtis dissimilarity index). In particular, some beneficial species were diminished in the litters from AFB1 treated females. Results emphasized the need for assessing the prenatal and lactation exposure to mycotoxins. This work was funded by FCT/MCTES through national funds, to earlyMYCO (PTDC/MED-TOX/28762/2017), and CESAM (UIDP/50017/2020+UIDB/50017/2020). N/A

A two-stage desulfurization process including an abiotic filtration using cellular concrete waste (first stage) and an anoxic biotrickling filter filling with an inoculated expanded schist material (second stage) was investigated to remove H2S in mimic biogas with limited O2 amount (ranged from 0.5 to 0.8%). The two-stage process was able to satisfactorily remove H2S for all experimental conditions (RE > 97%; H2S concentration = 1500 mg m−3; total Empty Bed Residence Time (EBRT) = 200 s; removal capacity (RC) = 26 g m−3 h−1). Moreover, at a total EBRT = 360 s (i.e., 180 s for each stage), the H2S loading rate (LR) was almost treated by the bed of cellular concrete alone, indicating that abiotic filtration could be applied to satisfactorily remove H2S contained in the gas. According to the H2S concentration entering the biotrickling filter, the majority end-product was either elemental sulfur (S0) or sulfate (SO42−). Thus, the ability of the abiotic filter to remove a significant part of H2S would avoid the clogging of the biotrickling filter due to the deposit of S0. Consequently, this two-stage desulfurization process is a promising technology for efficient and economical biogas cleaning adapted to biogas containing limited O2 amounts, such as landfill biogas.

No contexto atual as Parcerias Público-Privadas (PPP) têm se expandido como modelo de gestão na educação básica brasileira, conformando um projeto específico de educação. Com a maior inserção destas PPP tem sido possível observar mudanças qualitativas no sentido da prática educacional, bem como nos conteúdos trabalhados com os estudantes. Buscando desvelar o sentido político assumido por essas instituições esse artigo tem como objetivo apreender as concepções de liberdade de escolha e escolha profissional presentes na apostila de uma dessas PPP – o Instituto de Co-responsabilidade pela Educação (ICE). A partir do materialismo histórico dialético, buscou-se analisar a apostila produzida pelo Instituto, que tem como foco a elaboração de um “Projeto de Vida” para os estudantes do ensino médio. Com tal análise, foi possível perceber que as noções de “liberdade de escolha” e “escolha profissional” sustentam a reprodução da ideologia dominante, sobretudo em relação ao individualismo burguês. Discute-se como o material traz uma concepção de liberdade calcada na meritocracia, ignorando as determinações sociais e históricas do processo de escolha, aproximando-se, assim, da não-liberdade. Por fim, discute-se como tal concepção contribui para uma formação para o trabalho alienado e não para uma formação integral dos estudantes.

Supplementation with a β- adrenergic agonist (β-AA) for 21 days in Brahman steers under heat stress conditions (HS) was evaluated with respect to feedlot performance and carcass merit. Twenty-four Brahman steers (kg = 338 ± 39) were housed in two controlled environment chambers with one of two environmental (ENV) conditions 1) heat stress (HS; THI = 73 to 85) and 2) thermoneutral (TN; THI = 68) with either Zilpaterol hydrochloride (ZL) or soymeal supplementation (CN) using a randomly assigned in a 2 x 2 factorial design (n=6/group). Daily data were collected for dry matter intake, water intake, respiratory rate (RR), and rectal temperature (RT). At the end of 21 d period, total weight gain was used to calculate average daily gain (ADG) and gain to feed. Blood samples were collected from the jugular vein on days -7, 3, 10, and 21 for cortisol analysis, and biological impedance analysis (BIA) was determined on days 3, 10, and 21 on each animal. Steers were harvested at 544 kg on average post supplementation/environment conditions, and carcass merit was determined. There were no differences (P > 0.05) in feedlot performance. Brahmans exposed to heat stress had greater RR during the heat stress periods of the experiment, regardless of supplementation. Environment and day interactions (P < 0.04) were observed for RT, HS steers had a greater RT on d 8 but similar RT on d 15 and 19. Stressed steers with ZL had higher RT (P < 0.05) than TN/CN steers on d 11. There was no interaction (P > 0.05) between environmental conditions and CN and ZH supplementation for cortisol concentrations. Regardless of environmental treatment or supplementation, no difference (P > 0.05) was associated with BIA characteristics. There were no differences (P > 0.05) for hot carcass weight, cold carcass weight, USDA yield grade, 12th rib loin eye area, marbling score, KPH percentage, and 12th rib fat thickness between groups. Twelfth-rib loin eye area lean color from HS/CN had higher lightness (L*) (P < 0.05) than TN/CN steers. HS/CN steers present a similar (L*) to ZL in TN and HS conditions. Redness-greenness (a*) was greater (P = 0.01) in carcasses from HS steers with or without ZL than TN/ZL but similar to TN/CN. Steers exposed to HS and CN had a higher (P = 0.02) change of 12th rib lean color from yellow to blue (b*) than TN steers with CN and ZL. Supplementation with β-AA did not negatively impact growth, carcass performance, or carcass merit in heat-stressed steers.

In the original article, there was an error. We used the phrase “non-regulated” for cattle diseases that are in fact listed in the New Animal Health Law that went into force in 2021. A correction has beenmade toAbstract. The corrected section is shown below. Copyright © 2022, Hodnik, Acinger-Rogić, Alishani, Autio, Balseiro, Berezowski, Carmo, Chaligiannis, Conrady, Costa, Cvetkovikj, Davidov, Dispas, Djadjovski, Duarte, Faverjon, Fourichon, Frössling, Gerilovych, Gethmann, Gomes, Graham, Guelbenzu, Gunn, Henry, Hopp, Houe, Irimia, Ježek, Juste, Kalaitzakis, Kaler, Kaplan, Kostoulas, Kovalenko, Kneževič, Knific, Koleci, Madouasse, Malakauskas, Mandelik, Meletis, Mincu, Mõtus, Muñoz-Gómez, Niculae, Nikitović, Ocepek, Tangen-Opsal, Ózsvári, Papadopoulos, Papadopoulos, Pelkonen, Polak, Pozzato, Rapaliuté, Ribbens, Niza-Ribeiro, Roch, Rosenbaum Nielsen, Saez, Nielsen, van Schaik, Schwan, Sekovska, Starič, Strain, Šatran, Šerić-Haračić, Tamminen, Thulke, Toplak, Tuunainen, Verner, Vilček, Yildiz and Santman-Berends

In this research the relationship between hair cortisol and burnout was evaluated through the study of third-variables effect. Hair cortisol concentration was measured in 234 health workers. All participants completed perceived stress survey and Maslach Burnout Inventory. Our results showed that 40% of volunteers presented altered hair cortisol values, 12% burnout, 33% showed high depersonalization, 38% high emotional fatigue, 36% low personal fulfillment and 22% presented 2 of the 3 burnout components. A moderated mediation was found between psychological and biological variables. This research highlights the importance of including a biological variable such as hair cortisol in burnout assessment.

INTRODUCTION Craniofacial microsomia (CFM) is caused by abnormalities in the development of the first and second pharyngeal arches. One-third to half of the patients with CFM also present with extra craniofacial (ECF) malformations. The knowledge of the visceral alteration related to CFM is vital for optimized care and a better prognosis. AIM To describe the incidence of ECF malformations in patients with CFM and to infer if there was a correlation between CFM and ECF malformations. MATERIALS AND METHODS The authors analyzed medical records of patients diagnosed with CFM from 1996 to 2006. The data collected included age, gender, category of craniofacial alteration, and the type of ECF malformation when present. The sample was inspected to find possible correlations between craniofacial abnormalities and ECF malformations. RESULTS The sample included 102 patients, with a mean age of 7 years and a predominance of males (61.8%). Ear malformations (93.1%) followed by mandible (59.8%) and facial nerve (10.8%) abnormalities were the most common CFM. Among patients with CFM, 37.2% had ECF involvement, mainly in vertebrae (20%), heart (11%), and limbs (9.8%). Multivariate analysis revealed that the presence of ear malformations was related to a higher incidence of nonspecific visceral malformations (P = 0.034) and that mandible malformation was related to an increased incidence of vertebral malformations (P = 0.008). CONCLUSION A significant percentage of patients with CFM presented associated ECF impairment. Ear and mandible involvement may be predictors of nonspecific visceral malformation and vertebral malformations, respectively.

Heat stress (HS) triggers oxidative stress, systemic inflammation, and disrupts growth efficiency of livestock. β-adrenergic agonists supplemented to ruminant livestock improve growth performance, increase skeletal muscle mass, and decrease carcass fat. The objective of this study was to understand the independent and interacting effects of HS and zilpaterol hydrochloride (ZH) supplementation on the transcriptome of subcutaneous white adipose tissue and the longissimus dorsi muscle in steers. Twenty-four Red Angus-based steers were assigned to thermoneutral (TN; Temperature Humidity Index [THI] = 68) or HS (THI = 73-85) conditions and were not supplemented or supplemented with ZH (8.33 mg/kg/d) for 21 d in a 2 × 2 factorial. Steers in the TN condition were pair-fed to the average daily feed intake of HS steers. RNA was isolated from adipose tissue and skeletal muscle samples collected via biopsy on 3, 10, and 21 d and sequenced using 3' Tag-Seq to an achieved average depth of 3.6 million reads/sample. Transcripts, mapped to ARS-UCD1.2, were quantified. Differential expression (DE) analyses were performed in DESeq2 with a significance threshold for false discovery rate of 0.05. In adipose, 4 loci (MISP3, APOL6, SLC25A4, and S100A12) were DE due to ZH on day 3, and 2 (RRAD, ALB) were DE due to the interaction of HS and ZH on day 10 (Padj0.05). In muscle, 40 loci (including TENM4 and OAZ1) were DE due to ZH on day 10, and 6 loci (HIF1A, LOC101903734, PDZD9, HNRNPU, MTUS1, and TMCO6) were DE due to environment on day 21 (Padj0.05). To explore biological pathways altered by environment, supplement, and their interaction, loci with DE (Praw0.05) were evaluated in Ingenuity Pathway Analysis. In adipose, 509 pathways were predicted to be altered (P0.01): 202 due to HS, 126 due to ZH, and 181 due to the interaction; these included inflammatory pathways predicted to be upregulated due to HS but downregulated due to the interaction of HS and ZH. In muscle, 113 pathways were predicted to be altered (P0.01): 23 due to HS, 66 due to ZH, and 24 due to the interaction of HS and ZH. Loci and pathway data in muscle suggest HS induced oxidative stress and that the stress response was moderated by ZH. Metabolic pathways were predicted to be altered due to HS, ZH, and their interaction in both tissues. These data provide evidence that HS and ZH interact to alter expression of genes in metabolic and immune function pathways and that ZH moderates some adverse effects of HS.Heat stress (HS) negatively impacts livestock health and carcass quality. Supplementation of livestock with β-adrenergic agonists (β-AA) increases muscle mass and decreases fat deposition. The purpose of this study was to understand how HS and zilpaterol hydrochloride (ZH), a β-AA, alter gene expression in muscle and in adipose of cattle. Twenty-four steers were assigned to thermoneutral (TN) or HS conditions and were not supplemented (NS) or supplemented with ZH for 21 d. RNA was isolated from muscle and adipose collected on days 3, 10, and 21 to identify changes in gene expression. Several individual loci were differentially expressed (DE) due to HS or ZH in both tissues while the interaction of HS and ZH altered expression in adipose. A less stringent definition of DE used to explore biological pathways predicted that both treatments alter metabolism. Pathway analyses also supported that HS increased inflammation in adipose, but that these inflammatory pathways were downregulated by ZH. HS also was predicted to induce oxidative stress in muscle although ZH moderated this response. This study provides information on how HS and β-AA act independently and interact to alter physiology, lending insight useful for the development of management and mitigation strategies for stress.