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Background Antiplatelet and anticoagulants are one of the mainstay treatment of acute coronary syndrome (ACS), however they are associated with a significant increase of bleeding risk. While anaemia is a recognized predictor of adverse outcomes, it is unknown if a variation of haemoglobin (HB) levels, even without associated anaemia, has the same impact. Purpose The aim of this study was to determine the prognostic impact of HB variation after percutaneous coronary intervention (PCI) in ACS patients. Methods Retrospective analysis of 822 consecutive patients admitted due to ACS and treated with PCI, in a single coronary intensive care unit. Delta HB – ΔHB – (HB at admission – HB 24 hours after PCI) was calculated. Clinical variables and therapeutic strategies were examined. The primary endpoint analysed during follow-up was all-cause mortality. Possible predictors for all-cause mortality were assessed by Cox regression models. When statistically significant values were found in univariate analysis, multivariate analysis was used to determine whether ΔHB was independent from other known factors in predicting the outcome. Results In the studied sample, 75.4% were male. Mean age was 66.4±13.1. ST-elevation myocardial infarction (STEMI) occurred in 45.5%, non-ST segment elevation myocardial infarction in 42.6% and unstable angina in 11 9% of the studied population. Moderate to severe systolic dysfunction was present in 23.5% of the cases. Regarding comorbidities and past medical history, 76% had hypertension (HTN), 30.3% diabetes, 16.4% chronic kidney disease (CKD), 62.2% dyslipidaemia and 10.5% heart failure (HF). Mean HB at admission was 13.8±1.8 g/dL, mean HB after PCI was 12.9±1.9 g/dL and mean ΔHB was 0.9±1.1 g/dL. The mean follow-up was 51.6±30.6 months. In univariate analysis, ΔHB was significantly associated with all-cause mortality (HR 1.15 per 1 g/dL loss, 95% CI 1.01–1.30, p=0.04), as was HB at admission, HB after PCI, age, sex, diabetes, HTN, dyslipidaemia, CKD and moderate to severe systolic dysfunction. In multivariate analysis, ΔHB remained significantly associated with the endpoint and gained even more statistical power (HR 1.25, 95% CI 1.10–1.43, p Conclusions In our study, irrespective of the admission and discharge HB, ΔHB was associated with more adverse outcomes in patients submitted to PCI. Hence, even patients with a normal HB after PCI have a worse long-term prognosis if a negative variation of HB occurs. This highlights the importance of identifying and optimising all the correctable factors that might lead to an increased bleeding risk. Funding Acknowledgement Type of funding sources: None.

O presente artigo objetiva analisar a importância do patrimônio arquitetônico para a compreensão da evolução histórico-geográfica dos lugares e dos grupos sociais que os habitam. O trabalho também apresenta como objetivos específicos: entender a função do conjunto patrimonial histórico arquitetônico para a construção da memória social sobre a cidade de Fortaleza; discutir a relevância das formas de proteção e salvaguarda do patrimônio histórico arquitetônico; apresentar o Palacete do Ceará, relevante patrimônio histórico arquitetônico e sua relação com a memória e a identidade socioespacial fortalezense e entender a visão da sociedade local, quanto aos patrimônios arquitetônicos. O percurso metodológico qualitativo, baseia-se em uma revisão de literatura especializada e a realização de questionário online via google formulário. Os resultados da pesquisa evidenciam que o patrimônio promove e fortalece a identidade de um povo assim como o senso de pertencimento ao lugar habitado. Percebe-se também, que a sociedade fortalezense reconhece a importância da preservação patrimonial e demonstra interesse em conhecer a história desses patrimônios.

Made available in DSpace on 2022-04-28T17:21:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-08-01 In this paper, it is aimed to investigate the ambivalently psychological construction of the protagonist Jose Celio in the novel De mim ja nem se lembra, by Luiz Ruffato. Jose Celio's perception, regarding his migration to Greater Sao Paulo and his relation there, is inscribed on an instinct duality sense, denying, therefore, a manichean point of view of the world. In his letters sent to his mother, which are the core of the narrative, the protagonist's affective ambiguities, and the conflicted association of what is around him, are manifested: for example, at the same time that he misses his family, he edifies other bonds; at the same time that his work retracts his hours of joy, the labor itself provides him his political education in the middle of a dictatorship. The feeling of helplessness, the loss of a stable place, provokes, as well, through Jose Celio's partial porosity, his individual autonomy. Based on the ideas of Sigmund Freud (1986) about the feeling of helplessness, of Enrico Testa (2019) on the permeability of the literary characters, of Franco Moretti regarding the Bildungsroman and the texts of the novels critical fortune, it is shown how the nostalgia and the potent will of building the future, which is ambiguously ruptured by his early death, coexist in the registration of the protagonist's psychology through the letters to his mother. Univ Estadual Paulista, Estudos Literarios, Sao Paulo, SP, Brazil Univ Estadual Paulista, Estudos Literarios, Sao Paulo, SP, Brazil

Purpose Platinum-derived chemotherapy is one of the cornerstones in the treatment of central nervous system tumors in children. We aimed to assess the incidence of hearing loss in children after the exposure to platinum drugs. Material and methods Retrospective study of prospectively collected data on children consecutively diagnosed with brain tumors and treated with platinum derivatives at a tertiary referral hospital between January 2006 and December 2015. We analyzed multiples variables, such as: age at diagnosis, tumor location, hydrocephalus, platinum drug type, radiotherapy, and follow-up time. The final sample size was 51 patients. Results The median age at diagnosis was 6 years. The median overall follow-up time was 75 months. The incidence of ototoxicity was 23.5%. Rates of hearing loss with carboplatinum were lower than with cisplatinum. A statistically significant association occurred between the presence of hydrocephalus, radiotherapy exposure, infratentorial tumor location, and ototoxicity after treatment with platinum derivatives. Conclusions Childhood central nervous system tumors nowadays exhibit improved cure and survival rates. However, the ototoxicity resulting from the chemotherapy treatment may accompany patients for the rest of their lives. This study reveals that this occurrence is not negligible, and the association of radiotherapy and the presence of hydrocephalus can be potentiating factors.

This paper presents a detailed and up-to-date security analysis of the voting software used in Brazilian elections based on results obtained by the authors in a recent hacking challenge organized by the national electoral authority. During the event, multiple serious vulnerabilities were detected in the voting software, which when combined compromised the main security properties of the equipment, namely ballot secrecy and software integrity. The insecure storage of cryptographic keys, hard-coded directly in source code and shared among all machines, allowed full content inspection of the software installation memory cards, after which two shared libraries missing authentication signatures were detected. Injecting code in the libraries allowed the execution of arbitrary code in the machine, violating the integrity of the voting software. Our progress is richly described, to illustrate difficulties and limitations in the testing methodology chosen by the electoral authority, and to inform how teams participating in future challenges can optimize their performance. We trace the history of the vulnerabilities to a previous security analysis, providing some perspective about how the system evolved in the past 6 years. As far as we know, this was the most in-depth compromise of an official large-scale voting system ever performed under such severely restricted conditions.

Intencionamos, nessa resenha, analisar como o fim da crença no futuro, acontecido no ano de 1968, de acordo com a visão de Franco Berardi, foi percebido anteriormente por muitos literatos. Cotejando a argumentação de Berardi com a de Antonio Candido (1989), principalmente, no ensaio "Literatura e subdesenvolvimento", avaliamos que a dissolução do porvir já se encontrava no imaginário de nossos escritores e de outros, mundialmente. Assim, havia um descompasso entre a revolução estética ocorrida na prosa do século XX - na esteira das vanguardas, que pensavam o futuro - e o assunto dessas narrativas - que pareciam não vislumbrar o amanhã.

Al–Si A413 treated and untreated alloys were cast and poured at approximately 720 oC, 700 oC, and 680 oC in a cooling slope to obtain the semisolid material feeding the ceramic nozzle (150 cm3) at the lower roll (single-roll melt-dragged processing)—this drags the metallic slurry via the chill/columnar layers at a rate of 0.2 m/s, forming a molten-metal strip with a thickness of 2 mm and width 45 mm, approximately. The untreated alloy poured at 720 oC formed coarse structures of α-Al dendrites, as well as a coarse eutectic of Al–Si and microshrinking on the surface of the casting strip facing the atmosphere. The Al–Si 413 alloy poured at 680 oC and treated with Al5Ti1B (0.1%) led to microstructural refinement, resulting in α-Al globular structures, the absence of microporosities on the surface facing the atmosphere, and a finer and more homogeneous distribution of the eutectic grains with smaller Si particles. The AlTiB master alloys are not used as a grain refiner in Al–Si alloys because of Si poisoning. This subject is discussed in this paper. The addition of the inoculant and 0.2% of the Al–Si eutectic morphology modifying agent (Al–10%Sr) refined both the α-Al and eutectic phases more efficiently in the cast strip poured at 700 oC and 680 oC. This suggests that the inoculant did not interfere with the action of the modifying agent. As a result, molten metal strips of higher mechanical strengths and ductilities were obtained.

Pagano and collaborators have recently reported lower ventral striatum D3 receptor availability in Parkinson's disease using PET scan. Our group conducted the first postmortem study of individuals with PD who had ICD and related behaviours in life and reported lower alpha-synuclein pathology and D3R levels in the nucleus accumbens of such individuals. The findings by Pagano and co-authors of low D3R binding in PD patients at baseline, when taken together with our findings of lower Lewy pathology and D3R in the nucleus accumbens, favour the hypothesis that D3R levels are downregulated because of excessive synaptic dopamine.

O objetivo do presente artigo é assinalar o surgimento, mesmo que embrionário, da introspecção em Caetés, característica marcante em obras posteriores de Graciliano Ramos. Trata-se de ampliar o modo como a crítica tem avaliado essa narrativa e a produção do autor, considerando a primeira, muitas vezes, apenas como romance de costumes, analisando o início da presença do mergulho introspectivo somente em livros que vieram depois. Fazendo uso de alguns textos da fortuna crítica do livro e estudos sobre o nosso romance, mostramos como Caetés movimenta-se entre a tensão mínima e a interiorizada, alterando a sua forma/conteúdo dependendo do momento narrativo.

Iberdrola developed the 350 MW Wikinger offshore windfarm (OWF) in the German Baltic Sea where ground conditions are mainly dominated by deposits of the Upper Quaternary series and post-glacial deposits overlying Cretaceous Upper Chalk (low-density, grade A1/A2) of Maastrichtian age and at some locations with Paleogene Limestone (high-density to very high density, grade A1/A2). Current pile design methods for open tubular steel piles in Chalk highlighted significant design uncertainties for open tubular piles that would lead to unnecessarily conservative pile dimensions of 70 m embedded length or longer for the 70 four-legged jacket wind turbine support structures and the six-legged offshore substation. For mainly axially loaded piles, German legislation requires the execution of dynamic pile load tests on production piles at a minimum of 10% of wind turbine generator locations immediately following pile installation. This practice offers no opportunity for pile design optimisation. If positive, the pile tests can confirm design assumptions, but risk costly delays in OWF commissioning if the dynamically ‘measured’ capacities fall below design requirements. After careful consideration of costs and benefits, and with the clear advantages of eliminating ambiguity of test results, it was decided that offshore tests at the Wikinger OWF offered the best return on investment regarding foundation design optimisation, assurance and certification. To address these concerns, in advance of final design, offshore dynamic and fully autonomous static pile load tests were commissioned. These were completed 10 weeks after pile driving on 50%-downscaled piles with penetrations of up to 31 m in water depths of around 40 m. This paper provides an overview of the test results and how they were applied in detailed design and validated during construction through dynamic pile tests. Lessons learned are shared and conclusions are drawn regarding on-site offshore pile test results and their transfer into the foundation design and planning process.

O objetivo deste trabalho foi apresentar os resultados clínicos de 76 doentes azoospérmicos com síndrome de Klinefelter, sem mosaicismo cromossómico, tratados com microinjeção intracitoplasmática de espermatozoides (ICSI), "frescos" ou criopreservados, após biópsia testicular (TESE - testicular sperm extraction). Os espermatozoides foram obtidos em 31/77 (40,3%) das TESE realizadas. A idade média dos homens foi de 34,1 anos. Na maioria dos casos, observou-se um volume testicular reduzido (96,1%), níveis de FSH (98,3%) e LH (94,1%) aumentados e níveis de testosterona normais (77,6%). Em 25 ciclos de ICSI foram usados espermatozoides testiculares "frescos" e, em 22 ciclos, espermatozoides testiculares criopreservados. As taxas de fertilização (63,5% vs 41,6%), implantação (37% vs 13,2%), gravidez clínica (60,9% vs 19%), nados-vivos (52,2% vs 19%) e recém-nascidos (65,2% vs 23,8%) foram maiores no grupo em que a microinjeção foi realizada com espermatozoides testiculares "frescos". A análise cromossómica dos 21 recém-nascidos foi normal. Em conclusão, este trabalho acrescenta mais informações sobre a taxa de obtenção de espermatozoides após biópsia testicular de doentes com síndrome de Klinefelter e os consequentes resultados embriológicos e clínicos, para além de confirmar a transmissão cromossómica normal aos seus descendentes. The aim of the present work was to present the clinical outcomes of 76 azoospermic patients with non-mosaic Klinefelter syndrome, treated by testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (ICSI), using either fresh or cryopreserved testicular spermatozoa. Spermatozoa were recovered in 31/77 (40.3%) of the TESE attempts. The mean male age was 34.1 years old. In most of the cases, the testicular volume was reduced (96.1%), the levels of FSH (98.3%) and LH (94.1%) were increased, and the levels of testosterone were normal (77.6%). There were 25 ICSI treatment cycles using fresh testicular spermatozoa and 22 ICSI treatment cycles using frozen testicular spermatozoa. The rates of fertilization (63.5% vs 41.6%), implantation (37% vs 13.2%), clinical pregnancy (60.9% vs 19%), live birth delivery (52.2% vs 19%) and newborn (65.2% vs 23.8%) were higher in the group using fresh testicular spermatozoa. Chromosome analysis of the 21 newborns was normal. In conclusion, the present data adds further information regarding the recovery rate of spermatozoa after TESE and the embryological and clinical outcomes, besides reassuring the safety concerning to abnormal chromosomal transmission to the children of Klinefelter fathers.

Neste artigo analisamos parte de um estudo realizado em torno do Teorema da Equival��ncia da Intera����o (TEI), procurando assim contribuir para a investiga����o sobre esta tem��tica. O estudo em causa ocorreu num contexto universit��rio online e teve como participantes 207 estudantes de uma unidade curricular. Utilizando uma metodologia mista de investiga����o, aplicou-se um question��rio que visava posicionar os estudantes face ao tipo de intera����o mais valorizada dentro daquela unidade curricular, sendo que, posteriormente, se complementou essa an��lise atrav��s da an��lise de conte��do ��s respostas dos participantes. Os resultados evidenciaram que os estudantes t��m prefer��ncias semelhantes ��s j�� analisadas noutros estudos, embora se tenha verificado que na prefer��ncia pela intera����o estudante-professor h�� motiva����es que provavelmente est��o associadas �� import��ncia cultural que �� dada ao professor na sociedade. Verificamos assim que h�� um conjunto de avan��os significativos j�� feitos em torno do TEI, apesar de ainda haver desafios que necessitam de respostas para refinar as suas teses., RE@D - Revista de Educa����o a Dist��ncia e Elearning, Vol. 1 N.�� 1 (2018)

Inhibition of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase is associated with an increased risk of new-onset type 2 diabetes. We studied the association of genetic or pharmacological HMG-CoA reductase inhibition with plasma and adipose tissue (AT) metabolome and AT metabolic pathways. We also investigated the effects of statin-mediated pharmacological inhibition of HMG-CoA reductase on systemic insulin sensitivity by measuring the HOMA-IR index in subjects with or without statin therapy. The direct effects of simvastatin (20–250 nM) or its active metabolite simvastatin hydroxy acid (SA) (8–30 nM) were investigated on human adipocyte glucose uptake, lipolysis, and differentiation and pancreatic insulin secretion. We observed that the LDL-lowering HMGCR rs12916-T allele was negatively associated with plasma phosphatidylcholines and sphingomyelins, and HMGCR expression in AT was correlated with various metabolic and mitochondrial pathways. Clinical data showed that statin treatment was associated with HOMA-IR index after adjustment for age, sex, BMI, HbA1c, LDL-c levels, and diabetes status in the subjects. Supra-therapeutic concentrations of simvastatin reduced glucose uptake in adipocytes and normalized fatty acid-induced insulin hypersecretion from β-cells. Our data suggest that inhibition of HMG-CoA reductase is associated with insulin resistance. However, statins have a very mild direct effect on AT and pancreas, hence, other tissues as the liver or muscle appear to be of greater importance. Title in Web of Science: Impaired HMG-CoA Reductase Activity Caused by Genetic Variants or Statin Exposure: Impact on Human Adipose Tissue, beta-Cells and Metabolome

Obesity is increasing worldwide in prepubertal children, reducing the age of onset of associated comorbidities, including type 2 diabetes. Sulfur-containing amino acids, methionine, cysteine, and their derivatives play important roles in the transmethylation and transsulfuration pathways. Dysregulation of these pathways leads to alterations in the cellular methylation patterns and an imbalanced redox state. Therefore, we tested the hypothesis that one-carbon metabolism is already dysregulated in prepubertal children with obesity. Peripheral blood was collected from 64 children, and the plasma metabolites from transmethylation and transsulfuration pathways were quantified by HPLC. The cohort was stratified by BMI z-scores and HOMA-IR indices into healthy lean (HL), healthy obese (HO), and unhealthy obese (UHO). Fasting insulin levels were higher in the HO group compared to the HL, while the UHO had the highest. All groups presented normal fasting glycemia. Furthermore, high-density lipoprotein (HDL) was lower while triglycerides and lactate levels were higher in the UHO compared to HO subjects. S-adenosylhomocysteine (SAH) and total homocysteine levels were increased in the HO group compared to HL. Additionally, glutathione metabolism was also altered. Free cystine and oxidized glutathione (GSSG) were increased in the HO as compared to HL subjects. Importantly, the adipocyte secretory function was already compromised at this young age. Elevated circulating leptin and decreased adiponectin levels were observed in the UHO as compared to the HO subjects. Some of these alterations were concomitant with alterations in the DNA methylation patterns in the obese group, independent of the impaired insulin levels. In conclusion, our study informs on novel and important metabolic alterations in the transmethylation and the transsulfuration pathways in the early stages of obesity. Moreover, the altered secretory function of the adipocyte very early in life may be relevant in identifying early metabolic markers of disease that may inform on the increased risk for specific future comorbidities in this population.

Objetivamos, neste texto, examinar a dinâmica pulsional - entre o Eros e o Tânatos - irradiada pela e forma e pela mensagem do romanceControle, de Natalia Borges Polesso. A partir das noções de pulsão de morte e de vida, relacionadas conflitivamente e sintetizadas pelo filósofo Rogério M. de Almeida (2007), buscamos compreender como a figuração da doença, de larga tradição na literatura, insula Maria Fernanda, personagem principal da narrativa. Com o desaparecimento do transtorno epiléptico da protagonista, no entanto, a narradora expõe-se ao contato vigoroso com a alteridade, vislumbrando o futuro que outrora, quando doente, podia ser imaginado via alucinação. Por meio de ideias Susan Sontag (1984), Paul Ricouer (2007), Sidarta Ribeiro (2019) e do mencionado Rogério M. de Almeida (2007), analisamos a complexa rede afetiva que leva a protagonista a estruturar o porvir mediante a pulsão de vida.

Objective To identify the outcomes of physical function, physical fitness, training, and cuff parameters, used in BFRT in ACL rehabilitation. Methods This scoping review was initiated on April 25th, 2020, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Relevant literature was identified searching three main concepts: BFRT, rehabilitation and ACL injury on MEDLINE (PubMed), CENTRAL of Cochrane Library, Web of Science and PEDro. Studies looking at adults with a primary ACL injury undergoing conservative or pre/post-surgery rehabilitation with BFR or BFRT, with physical fitness and physical function as outcomes or other physical outcomes were included. Results Sixty-eight articles were identified and six were included. One article was added through backward tracking. All studies used BFRT in the ACL injury surgical rehabilitation. Most studies evaluated physical fitness (muscular strength and volume) however, physical function was not considered a primary outcome. Training and cuff parameters were heterogeneously prescribed. Conclusion The existing evidence is not enough to draw definitive conclusions due to the heterogenous reported outcomes and parameters. Future investigation with standardized outcome measures and specific protocols are needed to draw conclusions on patients’ physical function, so BFRT can be used more effectively in clinical rehabilitation practice.

The synaptonemal complex promotes faithful exchanges between homologous chromosomes during meiosis. Barbosa et al show that SCF-FBxo42 is important for assembly and maintenance of the synaptonemal complex by restricting the phosphatase PP2A-B56 level., Meiosis creates genetic diversity by recombination and segregation of chromosomes. The synaptonemal complex assembles during meiotic prophase I and assists faithful exchanges between homologous chromosomes, but how its assembly/disassembly is regulated remains to be understood. Here, we report how two major posttranslational modifications, phosphorylation and ubiquitination, cooperate to promote synaptonemal complex assembly. We found that the ubiquitin ligase complex SCF is important for assembly and maintenance of the synaptonemal complex in Drosophila female meiosis. This function of SCF is mediated by two substrate-recognizing F-box proteins, Slmb/βTrcp and Fbxo42. SCF-Fbxo42 down-regulates the phosphatase subunit PP2A-B56, which is important for synaptonemal complex assembly and maintenance.

Objectives: Evaluate the quality of life (QoL) in patients diagnosed with achalasia who performed Heller's myotomy. Methods: Between January 1, 2000 and March 27, 2019, 99 patients were submitted t...

Made available in DSpace on 2020-12-10T17:36:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 We aim, in this article, to demonstrate that the nostalgic affect is fundamental on the form/content construction of Graciliano Ramos' novel called Anguish. In order to examine the edification of this feeling on this book, we have investigated how the form/content of Anguish constructs ontological tensions originated from the affects of deep sadness. In order to achieve this objective, we have used critical essays about this narrative, such as the ones written by Luis Bueno (2015), Rui Mourao (1971), Liicia Helena Carvalho (1983) etc, and studies that lay the historical foundation on the nostalgic affect, and its relations with the melancholy, via, especially, A tinta da melancholia (2015), by Jean Starobinski, A politica da nostalgia, by Marcos Piason Natali (2006) and A potencia estetica da nostalgia, by Andre Antonio Barbosa (2019). Our exegesis has showed that the figuration Luis da Silva's sense of unbelonging, constructed through an incessant temporal movement of the speech, is not only the outcome of historical conflicts; it also derives from the representation of psychological conflicts, highly subjectives, powered by a major nostalgic feeling, building the tragical malaise of the protagonist. Univ Estadual Paulista Julio de Mesquita Filho UN, Sao Paulo, SP, Brazil Univ Estadual Paulista Julio de Mesquita Filho UN, Sao Paulo, SP, Brazil

During cell division, the guanine nucleotide exchange factor (GEF) ECT2 activates RhoA in a narrow zone at the cell equator in anaphase. ECT2 consists of three BRCT domains (BRCT0, 1, and 2), a catalytic GEF, and a pleckstrin homology (PH) domain. How the conserved BRCT domains spatially and temporally control ECT2 activity remains unclear. We reveal that each BRCT domain makes distinct contributions to the ECT2 function. We find that BRCT0 contributes to, and BRCT1 is essential for, ECT2 activation in anaphase. BRCT2 integrates two functions: GEF inhibition and RACGAP1 binding, which together limit ECT2 activity to a narrow zone at the cell equator. BRCT2-dependent control of active RhoA zone dimension functions in addition to the inhibitory signal of the astral microtubules. Our analysis provides detailed mechanistic insights into how ECT2 activity is regulated and how that regulation ensures, together with other signaling pathways, successful cell division.

Dissertação de mestrado em Ciências do Desporto –Especialização em Avaliação e Prescrição na Atividade Física

Drug prescribing in older adults presents a serious challenge in medical clinical practice as this group of patients is particularly susceptible to drug-related side effects. American Geriatrics Society Beers Criteria serve as guidelines for clinicians to prevent potentially inappropriate prescribing in adults aged 65 years and older. Along with other tools and clinical judgment, these criteria can be used as a prescribing quality indicator. The purpose of this study was to determine the prevalence of potentially inappropriate prescription and the most common potentially inappropriate medications prescribed among older patients at admission in an internal medicine ward, as well as its rate of discontinuation by clinicians by the time of discharge. This assessment was made in light of the American Geriatrics Society 2019 Updated AGS Beers Criteria. Data from three internal medicine wards of the University of Coimbra Hospital Center were analyzed during July 2019, resulting in a total of 153 selected patients. The mean age was 85 (SD 7.32) years and most of the patients were female (58%). On admission, 75% of patients had at least one potentially inappropriate drug prescribed. At discharge, the drug was discontinued in 21% of these patients. One potentially inappropriate drug was introduced in 16% of patients. More than ever, we must acknowledge deprescribing as an important component of a good prescribing continuum. Our results highlight clinicians’ poor recognition of potentially harmful drugs in the elderly and the urge to define a strategy that allows appropriate therapeutic adjustments in this age group.

The present work has the objective of analyzing the productivity, the height and the bromatological composition of the pigeon pea crop with chemical and organic fertilization. The experiment was performed at ETEC Prof. Dr. Antonio Eufrásio de Toledo and installed with three treatments: T1: Chemical fertilization with Simple Super Phosphate; T2: Organic fertilization with cattle manure; and T3: Witness, with four repetitions in randomized blocks. The parcels were demarcated with 2 m² each. At 120 days, 0.50 m of each plot was collected to analyze the productivity, height and sample formation for bromatological analysis. It was verified by means of statistics that there was no significant influence on the different treatments.

INTRODUCTION: We have performed a retrospective analysis of the frequency and relation to treatment of dopamine dysregulation syndrome (DDS) using the Queen Square Brain Bank (QSBB) database. METHODS: A search of the QSBB database for consecutive cases donated between 2005 to 2016 with a pathological diagnosis of Parkinson's disease was performed. RESULTS: DDS was present in 8.8% of cases, was more prevalent in males and associated with younger age of onset, longer disease duration and more dopa‐induced dyskinesias. Treatment approaches for DDS included: reduction of levodopa, reduction/cessation of DA and initiation of infusion therapies. DDS had completely resolved in just over half the patients. DA peak levodopa equivalent daily dose (LEDD) was higher in patients who failed to achieve remission. CONCLUSION: This is the first study to provide data on the course of DDS until death. Treatment strategies consisted mainly of reduction of dopaminergic treatment and despite the majority of patients showing some improvement, half remained symptomatic. Successful treatment was associated with a lower l‐dopa dosage at death.

Há diversos termos valorativos no embate entre o pensamento clássico e o mo- derno sobre a literatura, confrontados por Antoine Compagnon (2010) no seu seminal O demônio da teoria. Destacam-se dois índices de apreciação da obra literária que nor- teiam o nosso texto acerca d’A invenção dos subúrbios, de Daniel Francoy. O primeiro deles, e o mais relevante para nós, é a multivalência, entendida aqui como o número de camadas interpretativas que o romance oferece; o segundo é a desmoralizada origina- lidade, vista como pequenas fissuras formais que expandem o eixo semântico da obra...