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O presente ensaio é dedicado à cláusula solve et repete, que se constitui em mecanismo legítimo de alocação positiva dos riscos contratuais, por meio do qual garante-se a exequibilidade imediata da prestação, ainda que existam razões jurídicas que justifiquem a possibilidade de não cumprimento ou o retardamento da prestação pelo devedor. Inserida no exercício legítimo da autonomia negocial dos contratantes, sujeita-se tal disposição a controle de legalidade e abusividade, do que se extrai a relevância de seu estudo, com base em seus contornos e limites no direito brasileiro, à luz da legalidade constitucional.

Abstract Background The sand fly Nyssomyia neivai is one of the most abundant species in Southern Brazil. It is frequently found in areas that are foci of visceral leishmaniasis in the state of Santa Catarina, caused by Leishmania infantum. In this region, the main vector of L. infantum, Lutzomyia longipalpis, has not been detected. In the absence of L. longipalpis, this study aimed to identify the sand fly fauna and diagnose any potential Leishmania spp. infection in sand flies and in dogs in a region of Southern Brazil that experienced a recent canine visceral leishmaniasis outbreak. Methods This report includes a survey of the sand fly fauna at the Zoonosis Control Center of the Municipality of Tubarão (Santa Catarina, Brazil). Molecular tests were conducted to investigate Leishmania spp. natural infection in sand flies using polymerase chain reaction (PCR). In positive females, in addition to morphological identification, molecular analysis through DNA barcoding was performed to determine the sand fly species. Additionally, the dogs were tested for the presence of Leishmania spp. using a non-invasive technique for the collection of biological material, to be assessed by PCR. Results A total of 3419 sand flies, belonging to five genera, were collected. Nyssomyia neivai was the most abundant species (85.8%), followed by Migonemyia migonei (13.3%), Pintomyia fischeri (0.8%), Evandromyia edwardsi (

Abstract: In Theobroma grandiflorum (cupuassu) orchards, efficient nutrient management is essential to achieve high yields and fruit quality. Thus, fertilization programs should be guided by the concentration of nutrients exported by fruits, as observed with other fruit species. The aim of this study was to quantify the export of macro and micronutrients by fruits of cupuassu genotypes, in order to guide nutrient replacement recommendations replacement. Six cupuassu genotypes (‘BRS Careca’, ‘BRS Fartura’, ‘BRS Duquesa’, ‘BRS Curinga’, ‘BRS Golias’ and ‘genotype 63’) were used, and 40 fruits per genotype were sampled, totaling 240 fruits, in the municipality of Tomé-Açu (Pará/Brazil). Fruits were broken and manually pulped and then separated into peel, seed and pulp. In each fruit part, the contents of macro and micronutrients were analyzed, and later extrapolated to ton of fresh fruits. Potassium was the macronutrient most exported by cupuassu fruits, and ‘genotype 63’ accounted for the largest exports per ton of fresh fruits of this nutrient. The export of nutrients per ton of fresh fruits followed this order for macronutrients (kg ton-1): K (4.34), N (2.73), P (0.54), Mg (0.40), S (0.29), Ca (0.26) and for micronutrients (g ton-1): Zn (6.24), Fe (4.97), Mn (3.49), Cu (2.45), Ni (0.18) and Mo (0.11). The average replacement per plant and per year, during the productive phase, for the five Cupuassu genotypes is 471 g of K2O, 326 g of N, 245 g of P2O5, 27 g of CaO, 56 g of MgO, 63 g of SO4-2 and 15 g of Fritted Trace Elements (FTE).

Introdução: Nocardia spp. são bactérias filamentosas Gram-positivas, fracamente ácido-álcool resistentes, presentes no solo. A infecção ocorre por inalação, inoculação direta ou ingestão, sendo a via respiratória o principal mecanismo. Considerada uma bactéria oportunista, acomete principalmente imunossuprimidos, entretanto, pode afetar indivíduos saudáveis. Suas manifestações podem ser resumidas em: pulmonar, cutânea (micetoma) e doença disseminada. Objetivo: Relatar um caso de infecção disseminada por N. brasiliensis com longo tempo de evolução em paciente sem história prévia de imunossupressão. Método: Homem, 44 anos, natural de Caxias-MA, procedente de Goiás, trabalhador rural com exposição a lavouras de milho e cana, diagnóstico recente de diabetes tipo 2, inicia quadro de lesões cutâneas nodulares em dorso há 4 anos, sem história de trauma local. Foi submetido a drenagem de lesões, biópsia e tratamento com antibacteriano e antifúngico empíricos. Entretanto, evoluiu com perda ponderal importante e surgimento de lesões fistulizantes em região inguinal. Nos exames complementares, apresentava anemia, elevação de creatinina, hipercalcemia e lesões líticas em coluna lombossacra e quadril, sendo feita a hipótese de mieloma múltiplo, no entanto a eletroforese de proteínas não evidenciou pico monoclonal. A TC de tórax evidenciou micronódulos randômicos. A sorologia anti-HIV foi não reagente, imunoglobulinas dentro da normalidade e rastreio oncológico para idade negativo. Foram visualizadas estruturas sugestivas de Nocardia spp. em cultura de biópsia cutânea e músculo paravertebral. A confirmação de espécie como N. brasiliensis foi realizada por técnica de MALDI-TOF, sendo iniciado tratamento com cotrimoxazol, meropenem e linezolida. A biópsia de coluna vertebral apresentou cultura negativa e o anatomopatológico evidenciou osteólise, fibrose e ausência de clonalidade plasmocitária. Conclusão: Relatamos uma apresentação atípica de nocardiose disseminada com importante acometimento ósseo em paciente com história ocupacional relevante e sem histórico prévio de imunossupressão. A nocardiose cutânea em nosso meio tem como principal agente a N. brasiliensis e pode mimetizar outras infecções como a tuberculose e as micoses endêmicas ou de implantação, dificultando o diagnóstico. Há poucos relatos na literatura de osteomielite por Nocardia spp. e, ao nosso conhecimento, este é o primeiro relato de lesões osteolíticas relacionadas à doença.

Como práticas de dança se configuram enquanto pesquisa? Que conhecimentos podem surgir de tais práticas? Que ferramentas ou métodos podem ajudar a dar suporte à prática como pesquisa em dança? Estas e outras perguntas atravessam o texto, que se baseia nas descobertas metodológicas que fiz no processo de doutoramento que resultou na tese intitulada “xxxxxxxxxxxxxx” (AUTOR, ANO). Aqui se encontram reflexões que auxiliam em uma breve delimitação do campo da Prática como Pesquisa (PcP) enquanto possibilidade de horizonte metodológico para investigações em dança. Além disso, apresenta-se uma síntese do Processo de Articulações Criativas (PAC), de Jane Bacon e Vida Midgelow (2014), enquanto um método que é receptivo à autonomia de pesquisadores em seu uso, incentivando, justamente, as descobertas de caminhos à medida em que se caminha com a pesquisa.

Objetivos: Estudo observacional e transversal de uma população de indivíduos com anemia falciforme (AF) para investigar associações entre genótipos de genes PPAR s (receptores ativados por proliferação de peroxissomos) e condições clínicas. Metodologia: Os dados demográficos de indivíduos acompanhados no Hemocentro de Governador Valadares, MG, foram extraídos de registros médicos e avaliações clínicas aplicadas. As variáveis clínicas consideradas incluíram osteonecrose, esplenectomia, colelitíase, úlcera, complicações renais, dor crônica, crises de dor aguda e aplásticas relatadas no período de um ano. As genotipagens de variantes de PPARA rs4253747 (T>A), PPARG rs10865710 (C>G) e PPARG rs709158 (A>G) foram realizadas por qPCR com ensaios TaqMan® (ThermoFisher). Análises de associação entre os genótipos e desfechos clínicos foram feitas por testes de contingência ajustados para idade, calculada a razão de chances (RC) e o intervalo de confiança (IC), considerando nível de confiança de 95% e p-valor < 0,05. Resultados: 82 participantes com idade mínima de 6,47 anos, idade máxima de 24,35 anos com média de 16,8 anos; 56,10% do sexo feminino e 12,20% em regime de transfusões frequentes. Em regime de terapia com hidroxiureia (HU) estavam 68,3%, (90,91% > 2 anos, 3,64% entre em 1-2 anos e 5,45% < 1 ano). Os 5 desfechos clínicos com maior frequência no período foram: colelitíase 59,76%; crises álgicas 23,17%; osteonecrose 15,85%, comprometimento pulmonar 8,54% e doença renal crônica 8,54%. No modelo genético de dominância (AT+AA vs TT), os genótipos AT+AA de PPARA _rs4253747 foram associados a risco (OR = 1,36, IC 95% 1,01-1,83, p = 0,041) e os genótipos AT+TT, no modelo de recessividade (AT+TT vs AA), associados à proteção de osteonecrose (OR = 0,428, IC 95% 0,256-0,716, p < 0,001); à risco de crises álgicas (OR = 2,11, IC 95%1,53-2,89, p < 0,001) e colelitíase (OR = 1,55, IC 95% 1,12-2,14, p = 0,008). Os genótipos GG+CG de PPARG_ rs10865710, no modelo de dominância (GG+CG vs CC), foram associados a risco para osteonecrose (OR = 2,63, IC 95% 1,95-3,54, p < 0,001) e os genótipos CC+CG, em modelo de recessividade, associados à proteção de osteonecrose (OR = 0,466, IC 95% 0,260-0,837, p = 0,009) e colelitíase (OR = 0,446, IC 95% 0,315-0,63, p < 0,001). Discussão: Os resultados indicam que certos genótipos de PPARs, codificadores de fatores de transcrição alvo de genes que controlam diversos processos homeostáticos envolvendo inflamação, adipogênese, metabolismo lipídico e de glicose, estão associados com osteonecrose, colelitíase e crises álgicas em indivíduos com AF. A presença do alelo A-rs4253747 (PPARA) ou G-rs10865710 (PPARG) apresenta risco aumentado de osteonecrose, enquanto a presença dos alelos alternativos são protetores para esse desfecho. A necrose avascular, que mais comumente acomete as cabeça do fêmur e do úmero, representa um importante evento na AF, com forte repercussão em limitação física e/ou incapacidade e dor. Conclusão: Nossas análises sugerem que variantes genéticas de PPAR s podem ser moduladores de complicações clínicas em indivíduos com AF. Para confirmar nossos resultados e propor um mecanismo de como PPARs estão envolvidos na gravidade clínica, será necessário aumentar a amostra e realizar novos estudos, como os de expressão gênica incluindo fatores modificadores da AF nas análises.

Abstract Ranacephala hogei is a South American freshwater turtle considered one of the 25 most endangered chelonian species in the world. Endemic to the Atlantic Forest hotspot of southeastern Brazil, the conservation status of R. hogei is subject to continuous assessment at various levels. However, the scarcity of data regarding this species, particularly its geographic range, challenges these evaluations. In an effort to address these gaps, we conducted a comprehensive long-term inventory using different methods to study this species. Our efforts resulted in a 144% increase in documented occurrence points, including a new hydrographic basin and protected areas. By combining historical and current records, we have observed the persistence of R. hogei in rural areas, even in locations where its extinction was previously predicted. Consequently, our data significantly contribute to supporting future conservation assessments.

Energy drinks are nonalcoholic beverages whose main ingredients are sugar, taurine, and caffeine. The consumption of energy drinks is increasing worldwide, but only a few conflicting studies have investigated the vascular effects of energy drinks in young adults. The aim of this study was to evaluate microvascular reactivity before and after energy drinks consumption in young healthy male volunteers. This was a cross-sectional prospective study. Microvascular reactivity signals were evaluated in the skin of the forearm using laser speckle contrast imaging with acetylcholine (ACh) iontophoresis before and 90 and 180 min after the randomized consumption of one ED or the same volume of water (control), followed by a postocclusive reactive hyperemia (PORH) test. Thirty-two volunteers were evaluated (age: 25.4±4.3 years). Energy drink consumption prevented the rest-induced reduction in cutaneous vascular conductance over time that was observed in the control group. In the control group, there were significant reductions in microvascular vasodilation at 90 and 180 min compared to baseline (P=0.004), but this was not the case in the energy drink group (P=0.76). Our results demonstrated that the reduction in microvascular conductance associated with prolonged immobility can be prevented by the consumption of one energy drink, highlighting the vasodilator effects of this beverage in young individuals at rest. The between-study variability in terms of the brand of energy drinks and the ingested volume, as well as the method of vascular evaluation and the inclusion criteria, may explain the discrepancies among previous studies on the vascular effects of energy drinks.

Abstract Objective Adolescence is a crucial phase in human development, encompassing biological, psychological, and social aspects, representing a period of change and preparation for adulthood. The objective of this study was to develop and validate an instrument to assess the lifestyle of adolescents, based on biopsychosocial indicators. Method After theoretical development, the instrument was administered to 1,289 adolescents aged 12 to 17. Reliability and validity analyses were conducted using Cronbach’s alpha coefficient and factor analysis. Results The instrument consisted of 51 items across the following dimensions: Eating Habits, Physical Activity, Sleep and Rest, Personal Well-being, Leisure and Entertainment, Stress Management, Preventive Behavior, and Social Relationships. The factor analysis, using loadings above 0.50, suggested the exclusion of 18 items, and the Cronbach’s alpha value was 0.802, indicating good internal consistency. Conclusion The final instrument comprised eight domains and 33 items, demonstrating satisfactory psychometric properties of reliability and validity, thus serving as an important research tool.

Identifying the mechanisms behind the β-cell adaptation to failure is important to develop strategies to manage type 2 diabetes (T2D). Using db/db mice at early stages of the disease process, we took advantage of unbiased RNA sequencing to identify genes/pathways regulated by insulin resistance in β-cells. We demonstrate herein that islets from 4-week-old nonobese and nondiabetic leptin receptor-deficient db/db mice exhibited downregulation of several genes involved in cell cycle regulation and DNA repair. We identified the transcription factor Yin Yang 1 (YY1) as a common gene between both pathways. The expression of YY1 and its targeted genes was decreased in the db/db islets. We confirmed the reduction in YY1 expression in β-cells from diabetic db/db mice, mice fed a high-fat diet (HFD), and individuals with T2D. Chromatin immunoprecipitation sequencing profiling in EndoC-βH1 cells, a human pancreatic β-cell line, indicated that YY1 binding regions regulate cell cycle control and DNA damage recognition and repair. We then generated mouse models with constitutive and inducible YY1 deficiency in β-cells. YY1-deficient mice developed diabetes early in life due to β-cell loss. β-Cells from these mice exhibited higher DNA damage, cell cycle arrest, and cell death as well as decreased maturation markers. Tamoxifen-induced YY1 deficiency in mature β-cells impaired β-cell function and induced DNA damage. In summary, we identified YY1 as a critical factor for β-cell DNA repair and cell cycle progression.

Introduction: The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. Methods: Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents’ clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. Results: There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents’ coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. Conclusion: The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.

This case report presents a rare manifestation of a pigmented cutaneous metastasis of breast carcinoma with a zosteriform distribution. A 77-year-old woman, previously diagnosed with invasive ductal carcinoma of the breast, exhibited pigmented lesions resembling shingles on the left thoracodorsal region. Dermoscopic and histopathological examinations confirmed invasive carcinoma of mammary origin associated with melanocytic colonization. The zosteriform pattern, though rare, has been reported in cases of cutaneous metastasis from breast cancer. Treatment options include addressing the primary tumor and direct approaches such as surgery or radiotherapy for skin lesions. This report highlights the importance of clinical suspicion, histopathological evaluation, and immunohistochemical examinations for accurate diagnosis, enabling timely and appropriate treatment for improved patient outcomes.

Bioregulatory substances, such as acetylcholine (ACh) and γ-aminobutyric acid (GABA), have shown promise in mitigating water deficit effects on plants. Their action on plant physiology, particularly in stomatal regulation and osmoprotection, contributes to enhanced agricultural productivity. Regarding soybean plants, changes in the metabolic profile that could justify the improvement in physiological performance and growth are still unknown. This study investigated the impact of combined ACh:GABA application during soybean V4 and R2 stages using physiological assessments and NMR-based metabolomics. Two equimolar doses (2 and 8 mM) of ACh:GABA were applied to soybean plants subjected to two water regimes: 100 % of field capacity (continuously irrigated) and water deficit (water suspension). Results demonstrated enhanced gas exchange, biomass, and chlorophyll content, alongside favorable enzymatic activity. NMR analysis revealed metabolites countering oxidative stress, supporting osmoprotection, and contributing to soybean development and energy supply. The 8 mM ACh:GABA application notably improved plant performance, showcasing potential for water deficit mitigation in soybeans.

Leishmaniasis is a group of diseases caused by protozoa of the genus Leishmania and is transmitted by the bite female sand fly. The present work is characterized as a descriptive study in two areas: a forest area located in the Parque Estadual do Rio Doce, and another urban area located in the municipality of Timóteo-MG, with the objective of identifying the presence of Leishmania spp. and the blood source of the collected female sand flies. Part of the females were obtained from the Parque Estadual do Rio Doce, and part was collected using 19 ligth traps distributed in residences of Timóteo. For molecular studies of Leishmania spp. DNA, the ITS1 gene was used, and in the search for blood source, the CytB gene was used and positive samples were sequenced. The study demonstrated that there are at least three species of Leishmania circulating in the study areas: Leishmania (Viannia) braziliensis, Leishmania (Leishmania) amazonensis, and Leishmania (V.) guyanensis. Nyssomyia whitmani was the predominant sand fly species in the urban area of Timóteo with a positive diagnosis for the presence of Leishmania braziliensis DNA. We found the presence of blood from Gallus gallus (Chicken) and Sus scrofa (Pig) in sand flies. The present study demonstrates that Leishmania braziliensis is the main agent of cutaneous leishmaniasis in the study area, with the effective participation of Nyssomyia whitmani as the vector and both Gallus gallus and Sus scrofa acting as a food source for female sand flies, and helping maintaining the sand fly life.

Abstract The ability to manipulate objects with limbs has evolved repeatedly among land tetrapods. Several selective forces have been proposed to explain the emergence of forelimb manipulation, however, work has been largely restricted to mammals, which prevents the testing of evolutionary hypotheses in a comprehensive evolutionary framework. In birds, forelimbs have gained the exclusive function of flight, with grasping transferred predominantly to the beak. In some birds, the feet are also used in manipulative tasks and appear to share some features with manual grasping and prehension in mammals, but this has not been systematically investigated. Here we use large online repositories of photographs and videos to quantify foot manipulative skills across a large sample of bird species (>1000 species). Our results show that a complex interaction between niche, diet and phylogeny drive the evolution of manipulative skills with the feet in birds. Furthermore, we provide strong support for the proposition that an arboreal niche is a key element in the evolution of manipulation in land vertebrates. Our systematic comparison of foot use in birds provides a solid base for understanding morphological and neural adaptations for foot use in birds, and for studying the convergent evolution of manipulative skills in birds and mammals.

Introdução: A terapia direcionada para o receptor tipo 2 do fator de crescimento epidérmico humano (HER-2), introduzida pelo trastuzumabe, representou grande avanço no tratamento do câncer de mama, impactando na sobrevida de pacientes que com alta expressão dessa proteína. A sobrevida a longo prazo (maior que cinco anos) ainda é rara (em torno de 25%), segundo a literatura. Há evidências de que a manutenção da terapia-alvo após progressão de doença resulta em benefício clínico, todavia, não há consenso sobre a duração do tratamento. Relato Do Caso: Trata-se de relato de observação única de paciente com sobrevida prolongada em tratamento de câncer de mama HER-2+ com trastuzumabe associado a outros medicamentos. Dados clínicos, patológicos, histórico de tratamento e de sobrevida foram coletados do prontuário, de forma retrospectiva. Paciente, sexo feminino, 37 anos, pré-menopausa, sem comorbidades associadas, praticante de exercícios físicos, sem histórico de tabagismo ou etilismo, diagnosticada em março de 2015. Realizou tratamento quimioterápico venoso (Docetaxel) com finalidade paliativa, obtendo resposta máxima. O trastuzumabe foi mantido, associado ao anastrozol, apresentando atualmente doença estável e sobrevida prolongada (superior a oito anos). Estudos recentes demostram que resultados clínicos encontrados são melhores para pacientes triplo positivo (RH e HER-2 positivos), sugerindo que essa terapia pode modificar o curso natural da doença. Conclusão: Este relato de paciente jovem com diagnóstico de câncer de mama HER2+, metastático ao diagnóstico e prognóstico desfavorável descreveu o uso de terapia-alvo prolongada com trastuzumabe, em associação a diferentes esquemas quimio e hormônioterápicos no qual se observou sobrevida em longo prazo, acima da descrita em literatura, e aumento da qualidade de vida. Sugere-se a realização de estudos de coorte com um grupo maior de pacientes para análise de dados de vida real que apoiem a tomada de decisão da equipe sobre o uso de terapia-alvo após progressão de doença.

ABSTRACT Objective To describe the clinical, bronchoscopic, diagnostic, and therapeutic aspects between children and adults. Methods This retrospective study compared the clinical and bronchoscopic characteristics of adults and children who underwent bronchoscopy for suspected foreign body aspiration. Data on sex, outpatient or emergency origin, bronchoscopy results, characteristics of the aspirated foreign body, and complications were analyzed. Results In total, 108 patients were included in the analysis, with foreign body aspiration diagnosed in 69% of patients (30 children and 44 adults). In 91% of patients, there was a clinical history suggestive of aspiration. The mean age of the adults was 65.89 (±19.75) years, and that of the children was 2.28 (±1.78) years. Most of the children were under 3 years of age (80%), while adults were mostly 70 years of age or older (54.5%). Emergency care was more common among children than adults. The most common foreign bodies found in both age groups were organic bodies, primarily seeds. The most frequent locations of foreign bodies were the lobar bronchi in adults and the main bronchi in children. Flexible bronchoscopy is the primary method for diagnosis and treatment. Transient hypoxemia occurred particularly frequently in children (5%). Conclusion Foreign body aspiration, particularly that involving seeds, is more common in the extremes of age. A clinical history suggestive of aspiration is crucial in determining the need for bronchoscopy, which should be performed as early as possible. Flexible bronchoscopy is an effective and safe diagnostic technique.

A bulimia nervosa (BN) é um transtorno alimentar de causas multifatoriais e que possui raízes mais profundas do que apenas a relação do indivíduo com a nutrição. O presente estudo objetivou revisar a produção científica, a fim de responder à seguinte pergunta: “Quais as repercussões psíquicas e clínicas no paciente com bulimia nervosa e quais tipos de intervenções podem ser propostas?". Para tal, foi realizada uma busca, no período de outubro e novembro de 2022, nas bases de dados: Medline/PubMed e The Cochrane Library, com rastreamento de estudos publicados no período de 2012 a 2022. Foram identificados 454 estudos, dos quais, após serem aplicados os critérios de inclusão e exclusão, apenas 14 artigos foram inseridos nesta revisão. A partir desse resultado foi possível entender que indivíduos com BN estão em sofrimento psíquico e necessitam não só de intervenção psiquiátrica, como também nutricional, psicológica e farmacológica para gradual remissão da doença.

ABSTRACT Swamp palm (Mauritia flexuosa L.f.) is a typical palm tree from the Amazon and Cerrado of Brazil, whose fruits are used in cooking and the pharmaceutical industry. Seed germination of this palm is slow, irregular and often low, which makes its cultivation limited, being exploited in extractive systems. Also, little is known about seedling development, and this knowledge is important to define a protocol for the production of seedlings of this species. This research aimed to develop a protocol for the seed germination of swamp palm under semi-aseptic conditions and to evaluate the seedling development of swamp palm under different production systems. There was no germination in treatments without scarification. The best germination protocol for swamp palm was scarification with operculum removal in seeds recently extracted from the fruit with application of gibberellic acid (plant growth regulator) because it increased the rate and accelerated germination. However, imbibition in aerated water (with H2O2) proved to be suitable up to two days. The best method for seedlings production of swamp palm is the use of conventional bag (20×30 cm) with soil and manure or for producers with greater investment capacity, the use of tubes (180 cm3) for two months and subsequent transplanting to a conventional bag with soil and manure until completing six months.

Inflammatory bowel disease (IBD) is a problem that directly affects the quality of life of patients suffering from this condition. Monitoring the serum level of infliximab (IFX) (TDM) is an important tool for guiding therapeutic decisions in IBD patients. The purpose of this study was to determine the significance of quantitatively measuring the serum level of IFX (TDM) and antibody to IFX (ATI). Methods and materials: Prospective observational study involving 40 IBD patients on IFX therapy, including 14 Proactive (week 06 of the induction phase) and 26 Reactive (maintenance phase). Immediately prior to the infusion, blood samples were drawn and measured using a Bulhlmann rapid test instrument. Serum concentrations of IFX were categorized as supratherapeutic (>7.0 micrograms/ml), therapeutic (between 3.0 and 7.0 micrograms/ml), and subtherapeutic (3.0 micrograms/ml). When the serum concentration of IFX was 3 mcg/ml (subtherapeutic), the ATI was measured. 25 patients with CD and 15 patients with UC were evaluated. Only three of the twenty patients with subtherapeutic serum levels had a positive ATI, and both were reactive; two had CD and one had UC. There was a statistically significant difference between reactive and proactive patients with respect to levels of CRP (p = 0.042), with proactive DNS patients suffering greater alterations in CRP and albumin.

AbstractBackground and objective Thiazide diuretics are first-line drugs for the treatment of hypertension, but hypertension treatment guidelines have systematically discouraged their use in patients with advanced chronic kidney disease (CKD). For the first time, a systematic review and random-effects meta-analysis were performed to assess the effectiveness of thiazides and thiazide-like diuretics to treat hypertension in patients with stages 3b, 4, and 5 CKD.Design, setting, participants, & measurements A systematic review and random-effects meta-analysis that included a literature search using the following databases were performed: MEDLINE through PubMed, Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) through the Cochrane Library, Embase, and ISI – Web of Science (all databases). Prospective studies that evaluated the effectiveness of thiazide and thiazide-like diuretics in individuals with a GFR < 45 mL/min/1.73 m2 were included.Results Five clinical trials, totaling 214 participants, were included, and the mean GFR ranged from 13.0 ± 5.9 mL/min/1.73 m2 to 26.8 ± 8.8 mL/min/1.73 m2. There was evidence of a reduction in mean blood pressure and in GFR, as well as in fractional sodium excretion and fractional chloride excretion.Conclusion Thiazide and thiazide-like diuretics seem to maintain their effectiveness in lowering blood pressure in patients with advanced chronic kidney disease. These findings should spur new prospective randomized trials and spark discussions, particularly about upcoming hypertension guidelines.