Abstract Introduction: Seat belt aorta is a rare but often severe complication arising from blunt trauma with compression of the abdominal aorta against vertebrae. Seat belt sign is often present as an ecchymosis across the abdomen. The association with abdominal wall disruption and hollow viscus injury has been named seat belt triad; the presence of Chance fracture is sometimes considered a fourth component. Methods: Using Pubmed and Embase databases we reviewed all articles regarding abdominal seat belt aortic injuries and analysed presentation at admission, concomitant lesions, including presence of seat belt triad, treatment and outcomes. Results: Fifty-two cases were reported, from 1968 to 2019. Twenty-nine males (56%), mean age 43 ± 19 years. Most patients were stable at admission, with 29 (55.8%) presenting acute abdomen, 26 (50%) limb ischemia, 9 (17.3%) hypovolemic shock and 2 (3.8%) late-onset claudication. Seat belt sign was identified in 40 patients (76.9%), seat belt triad in 38 (73.1%) and 22 (42.3%) had Chance fractures, of which only 2 were not associated with seat belt triad. Most patients presented with aortic dissection (90.4%), complicated with pseudoaneurysm (11.5%), contained rupture (7.7%) or uncontained rupture (3.8%); 2 patients presented isolated iliac thrombosis and 3 limb ischemia. All patients required immediate surgical intervention, of which 40 (76.9%) required urgent vascular surgery. Forty-eight patients (92.3%) underwent vascular surgery: 39 open revascularizations and 9 endovascular procedures; three were managed conservatively. Ten patients (19.2%) passed away or died, of which 7 had seat belt triad. No patients needed reinterventions for vascular lesions except one, yet 3 required limb amputation. Most patients with seat belt triad required further visceral and abdominal wall repair. Conclusions: Seat belt aorta and especially seat belt triad are severe complications associated with high morbimortality often requiring surgery and multiple interventions. As patients are usually conscious and stable upon admission, this condition should not be disregarded.

Abstract Introduction: The use of statins in hemodialysis patients is a topic of ongoing research and debate. Patients with chronic kidney disease on hemodialysis constitute a large proportion of patients treated in the vascular surgery field. Clinical data of the protective statin effect on this group is scarce and conflicting results exist regarding cardiovascular, cerebrovascular and limb outcomes. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases to understand the relationship between statin effect and cardiovascular, limb outcomes and cerebrovascular outcomes. A narrative review was constructed, based on the obtained literature. Results: Although the use of statins in hemodialysis patients may provide cardiovascular benefits, the optimal dosage and safety profile of these medications in this population remain uncertain. A carefully evaluation of the risks and benefits of statins should be made based on each patient's specific requirements and circumstances. Conclusion: The role of statins for patients with peripheral arterial disease who are on hemodialysis remains unclear. Further analyses should focus on this subgroup of dialysis patients, who are becoming more prevalent on the vascular surgery departments, allowing for an optimized treatment with better patient outcomes.

Abstract Objective: to analyze the prevalence of tuberculosis, coronavirus, chronic conditions and vulnerabilities among migrants and refugees in Brazil. Method: this is a cross-sectional study of the electronic survey type conducted with international migrants during the COVID-19 pandemic. Descriptive statistics was applied for the analysis, with calculation of position and dispersion measures. Regarding the categorical variables, relative and absolute frequencies were estimated. Results: the study participants were 553 migrants and refugees, verifying 3.07%, 7.2% and 27.3% prevalence of tuberculosis, COVID-19 and chronic conditions, respectively. Among the vulnerabilities, 32% reported unemployment, 37.6% moved to Brazil as a result of the social situation in their countries and 33.6% were living as refugees or sheltered people. Conclusion: tuberculosis, chronic diseases and COVID-19 presented higher prevalence values in migrants and refugees than in the general population. As this is a population group that still has significant difficulty accessing health services and social protection systems, based on diverse evidence, the study will subsidize public policies, Nursing care and the incorporation of new routines in the service.

Resumen Objetivo: analizar la prevalencia de tuberculosis, coronavirus, condiciones crónicas y vulnerabilidades en inmigrantes y refugiados en Brasil. Método: se trata de un estudio transversal, del tipo encuesta electrónica, realizado con migrantes internacionales durante la pandemia de COVID-19. Para el análisis se aplicó estadística descriptiva, con cálculo de medidas de posición y dispersión. En cuanto a las variables categóricas, se estimaron las frecuencias relativas y absolutas. Resultados: participaron del estudio 553 inmigrantes y refugiados, la prevalencia de tuberculosis era del 3,07%, de COVID-19 del 7,2% y de condiciones crónicas del 27,3%. Entre las vulnerabilidades, el 32% reportó desempleo, el 37,6% emigró a Brasil por la situación social de su país y el 33,6% vivía en un asilo o albergue. Conclusión: la tuberculosis, las enfermedades crónicas y el COVID-19 fueron más prevalentes en inmigrantes y refugiados que en la población general. Por tratarse de una población que aún tiene grandes dificultades para acceder a los servicios de salud y sistemas de protección social, el estudio contribuirá, con base en la evidencia, a las políticas públicas, la atención de enfermería y la incorporación de nuevas rutinas en el servicio.

Resumo Objetivo: analisar a prevalência de tuberculose, coronavírus, condições crônicas e vulnerabilidades entre migrantes e refugiados no Brasil. Método: trata-se de estudo transversal, do tipo inquérito eletrônico, realizado com migrantes internacionais durante a pandemia de COVID-19. Para a análise, aplicou-se estatística descritiva, com cálculo de medidas de posição e de dispersão. Quanto às variáveis categóricas, estimaram-se as frequências relativas e absolutas. Resultados: participaram do estudo 553 migrantes e refugiados, verificando-se prevalência de 3,07% de tuberculose, 7,2% de COVID-19 e 27,3% de condições crônicas. Entre as vulnerabilidades, 32% referiram desemprego, 37,6% mudaram para o Brasil em decorrência da situação social do seu país e 33,6% residiam em asilo e ou abrigo. Conclusão: a tuberculose, as doenças crônicas e a COVID-19 apresentaram maior prevalência em migrantes e refugiados que na população em geral. Por tratar-se de uma população ainda com grande dificuldade de acesso aos serviços de saúde e aos sistemas de proteção social, o estudo subsidiará, com base em evidências, as políticas públicas, o atendimento do enfermeiro e a incorporação de novas rotinas no serviço.

Abstract Objective: to assess the occurrence of overweight/obesity in patient with epilepsy (PWEs) and to relate it to cognitive aspects and clinical variables. Methodology: the measurements of waist circumference, calf circumference, arm circumference, and the body mass index were related to the scores of the Mini-Mental State Examination and the Brief Cognitive Battery-Edu, as well as to the clinical variables of 164 PWEs, with a significance level of p < 0.05. Data were compared to a similar control group (CG) comprising 71 cases. Linear and multiple logistic regression models were used to assess factors related to cognitive aspects. Results: the mean age of the PWEs was 49.8 ± 16.6 years with a mean length of epilepsy of 22 ± 15.9 years. Overweight/obesity occurred in 106 (64.6 %) PWEs and in 42 (59.1 %) CG subjects. The PWEs had a worse performance in several cognitive functions when compared to CG subjects. In the PWEs, overweight/obesity was associated with lower educational level, older age, and cognitive impairment. Greater waist circumference, overweight, age at the first seizure, and use of polytherapy with antiseizure medications were predictive factors of memory impairment in multiple linear regression. Greater arm and calf circumference values were associated with better performance in several cognitive areas. Conclusion: the occurrence of overweight/obesity in PWEs and CG subjects was high. Cognitive impairment occurred in a high number of PWEs and was associated with overweight, greater waist circumference values, and clinical aspects of epilepsy. Better cognitive performance was associated with greater arm and calf circumference.

Resumen Objetivo: evaluar la ocurrencia de sobrepeso/obesidad en pacientes con epilepsia y relacionarla con aspectos cognitivos y variables clínicas. Metodología: las medidas de circunferencia de cintura, circunferencia de pantorrilla, circunferencia de brazo e índice de masa corporal se relacionaron con los puntajes del Mini-Mental State Exam y de la Batería Cognitiva Breve-Edu, así como con las variables clínicas de 164 pacientes con epilepsia, con un nivel de significación de p < 0,05. Los datos se compararon con un grupo de control similar (GC) compuesto por 71 casos. Se utilizaron modelos de regresión logística lineal y múltiple para evaluar factores relacionados con aspectos cognitivos. Resultados: la edad media de las pacientes con epilepsia fue de 49,8 ± 16,6 años con una duración media de la epilepsia de 22 ± 15,9 años. Presentaron sobrepeso/obesidad 106 (64,6 %) pacientes con epilepsia y 42 (59,1 %) sujetos del GC. Los pacientes con epilepsia tuvieron un peor desempeño en varias funciones cognitivas en comparación con los sujetos del GC. En las pacientes con epilepsia, el sobrepeso/obesidad se asoció con menor nivel educativo, mayor edad y deterioro cognitivo. La mayor circunferencia de la cintura, el sobrepeso, la edad de la primera convulsión y el uso de politerapia con medicamentos anticonvulsivos fueron factores predictivos del deterioro de la memoria en la regresión lineal múltiple. Los valores mayores de circunferencia del brazo y la pantorrilla se asociaron con un mejor rendimiento en varias áreas cognitivas. Conclusión: la incidencia de sobrepeso/obesidad en sujetos pacientes con epilepsia y GC fue alta. El deterioro cognitivo ocurrió en un alto número de pacientes con epilepsia y se asoció con sobrepeso, mayores valores de circunferencia de la cintura y aspectos clínicos de la epilepsia. Un mejor rendimiento cognitivo se asoció con una mayor circunferencia del brazo y la pantorrilla.

Abstract Introduction: The descending thoracic aorta (DTA) has been used as inflow mostly as a secondary option for revascularization after either graft failure/infection or other intra-abdominal pathologies contraindicating a standard abdominal aortic approach. The objective of this review is to summarize current evidence on the use of this inflow site for revascularization procedures. Methods: A comprehensive electronic literature search was performed, using PubMed and Embase databases. All literature published in English in the last 30 years was considered. The main goal was to assess the feasibility and practicality of implementing this approach in cases of severe and complex aortoiliac lesions. Results: Our review comprised 11 articles. DTA has been used predominately as a secondary option. The 30-day mortality rate was 4% (9/222). Secondary graft patency at 5-years was generally high across all studies. The use of DTA as inflow has been shown to be a safe and effective option for aorto-iliac reconstruction. Conclusion: DTA can be used safely as an inflow for lower-limb revascularization and it remains an important tool in the vascular surgeon's armamentarium.

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

RESUMO Esta pesquisa teve como objetivo identificar como a literatura aborda a paixão empreendedora, e quais teorias são utilizadas para relacioná-las ao comportamento empreendedor. Para mapear a literatura existente, adotou-se um projeto sistematizado de revisão de escopo, com busca nas bases de dados Web of Science e Scopus. O relatório da revisão foi elaborado seguindo o protocolo Prisma-SCR. Este estudo identificou algumas evidências, tais como: emoções são antecedentes para a motivação empreendedora, e empreendedores que são apaixonados por seus empreendimentos são mais propensos a perseverar e ter uma chance maior de sucesso. A paixão empreendedora desempenha um papel crucial no desenvolvimento de oportunidades, aquisição de recursos e engajamento dos funcionários, além de ser um fator irracional importante que afeta o processo empreendedor. A singularidade deste estudo reside na sua qualidade de ser a primeira revisão de escopo conduzida acerca da paixão empreendedora, constructo que merece uma análise aprofundada devido à sua influência positiva nos resultados no âmbito do empreendedorismo. A revisão de escopo sobre a paixão empreendedora pode contribuir para o desenvolvimento de teorias e práticas relacionadas ao empreendedorismo, suscitando a criação de políticas públicas e decisões empresariais. relacionálas relacioná las empreendedor existente adotouse adotou se Scopus PrismaSCR. PrismaSCR Prisma SCR. SCR Prisma-SCR evidências sucesso oportunidades funcionários empreendedorismo empresariais

RESUMEN Esta investigación tuvo como objetivo identificar cómo la literatura aborda la pasión emprendedora y qué teorías se utilizan para relacionarla con el comportamiento emprendedor. Para mapear la literatura existente, se adoptó un proyecto de revisión sistemática del alcance, con una búsqueda en las bases de datos Web of Science y Scopus. El informe de revisión siguió el protocolo Prisma-SCR. Este estudio identificó algunas evidencias, tales como: las emociones son antecedentes de la motivación emprendedora, y los emprendedores apasionados por sus emprendimientos tienen más probabilidades de perseverar y tener mayores posibilidades de éxito. La pasión emprendedora juega un papel crucial en el desarrollo de oportunidades, la adquisición de recursos y el compromiso de los empleados, además de ser un factor irracional importante que afecta el proceso emprendedor. La singularidad de este estudio radica en su calidad de ser la primera revisión de alcance realizada sobre la pasión emprendedora, un constructo que merece un análisis en profundidad debido a su influencia positiva en los resultados en el campo del emprendimiento. La revisión del alcance sobre la pasión emprendedora puede contribuir al desarrollo de teorías y prácticas relacionadas con el emprendimiento, impulsando la creación de políticas públicas y decisiones empresariales. emprendedor existente Scopus PrismaSCR. PrismaSCR Prisma SCR. SCR Prisma-SCR evidencias éxito oportunidades empleados emprendimiento empresariales

ABSTRACT This research aimed to identify how literature approaches entrepreneurial passion and which theories are used to relate it to entrepreneurial behavior. To map the existing literature, a systematic scoping review project was adopted, with a search in the Web of Science and Scopus databases. The review report followed the protocol Prisma-SCR. This study identified some evidence, such as: emotions are antecedents to entrepreneurial motivation, and entrepreneurs who are passionate about their ventures are more likely to persevere and have a greater chance of success. Entrepreneurial passion plays a crucial role in the development of opportunities, resource acquisition, and employee engagement, as well as being an important irrational factor that affects the entrepreneurial process. The uniqueness of this study lies in its quality of being the first scoping review conducted on entrepreneurial passion, a construct that deserves an in-depth analysis due to its positive influence on outcomes in the field of entrepreneurship. The scoping review on entrepreneurial passion can contribute to the development of theories and practices related to entrepreneurship, prompting the creation of public policies and business decisions. behavior adopted databases PrismaSCR. PrismaSCR Prisma SCR. SCR Prisma-SCR evidence motivation success opportunities acquisition engagement process indepth depth entrepreneurship decisions

ABSTRACT This study aims to evaluate motor proficiency in the neighbourhood environment in children aged six to ten. The sample was constituted of 397 children. The Motor Proficiency Test from Bruininks-Oseretsky-BOT-2 was used to evaluate motor performance. In the neighbourhood environment, it was used a questionnaire elaborated by the researchers. The Criteria of Economic Classification Brazil (CCEB-ABEP) was used to classify the socioeconomic level. In the group comparisons, the Kruskall-Wallis and Mann-Whitney U tests were used, and the χ2 test was used for the association. The results demonstrated that 68,3% of the children are inside the average for their age in global motor development. When comparing motor proficiency with the socioeconomic classes, a significant statistical difference was found between fine motor coordination, body control, strength and agility and global motor coordination. A relation was found between using ATI and global motor coordination, Square/Playground with body control and global motor coordination, and clubs/private schools with CMA, FO-AGI and DMG. It was concluded that the neighbourhood environment of the area where the child lived in the city of Maringá is not associated with motor proficiency. On the other hand, the socioeconomic level is so much associated with motor proficiency that belonging to the lower socioeconomic class disfavoured the performance of the evaluated children. In relation to the characteristics of the neighbourhood, frequenting opened and public spaces such as sidewalks and streets did not result in higher motor proficiency, but spaces with equipment, such as the ATI, square/playgrounds, sports centres/sports courts and clubs/private schools.

RESUMO Este estudo teve como objetivo verificar a associação entre a proficiência motora e o ambiente da vizinhança de 397 crianças de seis a dez anos de idade. Para avaliar o desempenho motor foi utilizado o Teste de Proficiência Motora de Bruininks-Oseretsky - BOT-2. O ambiente da vizinhança foi avaliado por um questionário elaborado pelos pesquisadores e o nível socioeconômico das famílias foi avaliado pelo Critério de Classificação Econômica Brasil (CCEB-ABEP). Para comparação entre grupos foi utilizado o Teste Kruskall-Wallis e o Teste U Mann-Whitney e para associação foi utilizado o Teste de χ2. Os resultados demonstraram que 68,3% das crianças estão na média para a idade no desenvolvimento motor global. A classe social com nível socioeconômico maior mostrou melhor coordenação motora fina, controle corporal, força e agilidade e o desenvolvimento motor global. Foi encontrada associação entre utilizar Academia da terceira idade e o desenvolvimento motor global, a praça/parquinho com a coordenação corporal e desenvolvimento motor global, e clubes/escolinhas particulares com coordenação motora fina, força e agilidade e desenvolvimento motor global. Conclui-se que o ambiente da vizinhança em que a criança reside não influenciou o desempenho na proficiência motora, mas o nível socioeconômico sim, tanto que pertencer a classe socioeconômica mais baixa desfavoreceu o desempenho motor global das crianças. Frequentar espaços abertos e públicos como calçadas e ruas não resultou numa maior proficiência motora, o que ocorre em espaços construídos com equipamentos como as ATI, praças/parquinhos, centros esportivos/quadras de esportes e clubes/escolinhas esportivas.

Abstract Introduction: Blunt thoracic aortic injuries (BTAI) are defined as a tear in the thoracic aorta caused by a high energy blunt trauma. The most common reported mechanism of injury is motor vehicle accidents, and it can be potentially lethal. The Society for Vascular Surgery (SVS) and the European Society for Vascular Surgery (ESVS) guidelines recommend thoracic endovascular aortic repair (TEVAR) as the first line treatment for BTAI. Other controversies regarding BTAI management were reported in the literature, such as the best treatment for minimal aortic injuries with intimal tear, ideal stent graft oversizing, best timing for treatment and necessity to cover the left subclavian artery (LSA). The purpose of this review is to identify and analyze appropriate studies published so far about the management of BTAI. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases. We used the following combination of key words in our search strategy ((aortic injury) AND (blunt thoracic trauma)) AND (vascular surgery* OR treatment* OR TEVAR*). Articles not in English were excluded. The primary subject was results of endovascular treatment. Secondary subjects were indications and results of OSR, best timing for intervention, ideal graft oversizing, need for left subclavian artery (LSA) coverage, and management of BTAI grade I (intimal tear). Results: Data related to our primary and secondary subjects were extracted from the selected articles. TEVAR is considered the primary treatment for BTAI, if the patient has suitable anatomy, with good short and mid-term outcomes, with lower mortality and paraplegia rates at short and mid-term follow-up, compared to OSR. Despite good term results at short-term follow-up after TEVAR, long-term outcomes are still a concern. OSR is still a valid option in selected cases, and it should be considered for patients whose injury location is unsuitable for the endovascular approach. In most patients with BTAI, it is recommended around 10% of graft oversizing. However, a more aggressive approach with oversizing between 10-20% should be considered for patients with considerable hypotension and even >20% for patients presenting with severe hypotensive hemorrhagic shock. A necessity of LSA coverage has been reported in 30% of TEVAR for urgent treatment of BTAI, and it seems to be well tolerated. We should considered expectant approach with serial follow-up CT scans in patients with BTAI grade I injuries with asymptomatic intimal aortic tear. Conclusions: This literature review reports and synthetizes published data about the management strategies for BTAI. TEVAR seems to be effective in the treatment of BTAI, with few complications and good outcomes at short and mid-term follow-up, and it should be the first-line treatment for these patients. OSR should be an option when a patient’s injury is not suitable for endovascular approach.

Abstract Introduction: Blunt thoracic aortic injuries (BTAI) are defined as a tear in the thoracic aorta caused by a high energy blunt trauma. The most common reported mechanism of injury is motor vehicle accidents, and it can be potentially lethal. The Society for Vascular Surgery (SVS) and the European Society for Vascular Surgery (ESVS) guidelines recommend thoracic endovascular aortic repair (TEVAR) as the first line treatment for BTAI. Other controversies regarding BTAI management were reported in the literature, such as the best treatment for minimal aortic injuries with intimal tear, ideal stent graft oversizing, best timing for treatment and necessity to cover the left subclavian artery (LSA). The purpose of this review is to identify and analyze appropriate studies published so far about the management of BTAI. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases. We used the following combination of key words in our search strategy ((aortic injury) AND (blunt thoracic trauma)) AND (vascular surgery* OR treatment* OR TEVAR*). Articles not in English were excluded. The primary subject was results of endovascular treatment. Secondary subjects were indications and results of OSR, best timing for intervention, ideal graft oversizing, need for left subclavian artery (LSA) coverage, and management of BTAI grade I (intimal tear). Results: Data related to our primary and secondary subjects were extracted from the selected articles. TEVAR is considered the primary treatment for BTAI, if the patient has suitable anatomy, with good short and mid-term outcomes, with lower mortality and paraplegia rates at short and mid-term follow-up, compared to OSR. Despite good term results at short-term follow-up after TEVAR, long-term outcomes are still a concern. OSR is still a valid option in selected cases, and it should be considered for patients whose injury location is unsuitable for the endovascular approach. In most patients with BTAI, it is recommended around 10% of graft oversizing. However, a more aggressive approach with oversizing between 10-20% should be considered for patients with considerable hypotension and even >20% for patients presenting with severe hypotensive hemorrhagic shock. A necessity of LSA coverage has been reported in 30% of TEVAR for urgent treatment of BTAI, and it seems to be well tolerated. We should considered expectant approach with serial follow-up CT scans in patients with BTAI grade I injuries with asymptomatic intimal aortic tear. Conclusions: This literature review reports and synthetizes published data about the management strategies for BTAI. TEVAR seems to be effective in the treatment of BTAI, with few complications and good outcomes at short and mid-term follow-up, and it should be the first-line treatment for these patients. OSR should be an option when a patient’s injury is not suitable for endovascular approach.

Abstract Pediatric trichotillomania is characterized by the persistent pulling of one’s own hair, resulting in areas of hair loss and affecting the child and family’s daily functioning. Studies investigating the etiology, evolution, and treatment of pediatric trichotillomania are scarce. Scientific data suggests that pediatric trichotillomania can persist into adulthood and indicate the role of external stressors in its etiology. This article describes five clinical cases of children aged between 21 months and four years diagnosed with pediatric trichotillomania, with several external stressors as possible etiology. Psychoeducation and caregiver-child psychotherapy or child-centered play therapy were proposed as treatments. The authors highlight the importance of external stressors in the etiology of pediatric trichotillomania and suggest the beneficial effect of psychoeducation and psychotherapy in its course. Further research is critical to improve the screening and treatment of pediatric trichotillomania.

Resumo A tricotilomania infantil caracteriza-se pela necessidade recorrente de arrancar o cabelo/pêlo, resultando em áreas de rarefação capilar/pilosa e com impacto funcional na vida da criança e família. Os estudos acerca da etiologia, evolução e tratamento da condição são escassos. A evidência científica sugere que pode persistir até à idade adulta e ressalva a importância dos fatores psicossociais na sua etiologia. Neste artigo, são apresentados cinco casos clínicos de crianças com idades compreendidas entre 21 meses e quatro anos com diagnóstico de tricotilomania infantil com vários stressores como possível etiologia. O tratamento proposto consistiu em psicoeducação e psicoterapia cuidador-criança ou terapia de jogo centrada na criança. O presente estudo reforça a importância dos fatores psicossociais no desenvolvimento desta perturbação e o benefício da psicoeducação e da psicoterapia. São necessários mais estudos para otimizar o diagnóstico e tratamento da tricotilomania infantil.

Abstract Introduction: Recently published studies on peripheral arterial occlusive disease (PAOD) have revealed marked sex disparities in patient selection and treatment outcomes. In a recent retrospective study with data from 11 different countries, Portugal was highlighted as one of the countries with greater sex discrepancies related to PAOD treatment. We aimed to analyze sex specific differences in the treatment of symptomatic PAOD, concerning different variables, in a single hospital center, in Portugal. Methods: Data on treatment of symptomatic PAOD patients from October 1st, 2020, to December 31st, 2021, were retrospectively collected from clinical registries from a single hospital center in Portugal. Different variables and post-operative outcomes were analyzed dichotomized by sex, with descriptive statistics. Statistical analyses were conducted using the IBM Statistical Package for Social Sciences (SPSS) software v28. Results: A total of 220 patients, 15,9% female and 84,1% male, were treated for PAOD, in the selected period, in a hospital center from Portugal. Female patients were older (mean age of 73.8 years versus 69.5 years in male); were less likely to be treated for intermittent claudication (3% versus 6% of men); more often treated at a more advanced stage of the disease with trophic lesions (91% versus 74% of men); more likely to be offered primary major amputation (14% versus 3% of male patients); less likely to be taking statins as part of PAOD medical management (65.7% versus 77.8% of male); and had a higher 90-day mortality rate (17.1% versus 6.5% in men). They were also more frequently treated with endovascular procedures (40%) than with OSR (26%). Conclusion: Remarkable sex discrepancies in the treatment of PAOD were found in our hospital center. This study brings awareness to the scientific medical community for sex disparities in the management of patients with PAOD.

ABSTRACT The insertion of the tree component in coffee production is a strategy from an economic and environmental perspective. Thus, the objective of this study was to evaluate the temporal influence on the agronomic and productive performance of the coffee crop under the interference of different tree species as a function of spacing. The experiment was set in the municipality of Santo Antônio de Amparo-MG, in 2012, and conducted in a randomized block design with four replications. The treatments were: cultivar ‘Catuai Vermelho IAC 99’ in monoculture (3.40 m x 0.65 m) and intercropped with African mahogany, teak and pink cedar, in two spacings (9 x 13.6 m and 18 x 13.6 m), in coffee rows. Three coffee rows were fixed between rows, totaling 13.6 m. The following variables were evaluated: height (m), stem diameter (cm), crown diameter (m), productivity (bags ha-1) and yield (l/sc) for coffee. From the evaluations, there is a significant effect of height, productivity and yield for the coffee crop. The system intercropped with tree species did not influence coffee productivity and yield until the 3rd harvest and, for the 5th harvest, intercropping with mahogany favored productivity, although the accumulated productivity did not show any treatment effect.

RESUMO OBJETIVO Investigar os fatores associados ao diagnóstico precoce do autismo e de outros tipos de transtorno global do desenvolvimento (TGD) de crianças atendidas no Centro de Atenção Psicossocial Infantojuvenil do Sistema Único de Saúde, no período de 2013 a 2019, no Brasil. MÉTODOS Estudo transversal exploratório, com base nos dados do Registro das Ações Ambulatoriais de Saúde (RAAS) do primeiro atendimento de crianças de 1 a 12 anos. Foram estimados o risco relativo bruto (RRb) e ajustado (RRa), e respectivo intervalo de confiança de 95% (IC95%), utilizando o modelo de regressão de Poisson com estimativa de variância robusta. RESULTADOS Das 22.483 crianças incluídas no estudo, a maioria era do sexo masculino (81,9%), residia no mesmo município em que foi diagnosticada (96,8%) e na região Sudeste (57,7%). O diagnóstico precoce foi maior para autismo infantil (RRb= 1,48; IC95% 1,27–1,71), TGD sem designação de subtipo (RRb= 1,55; IC95% 1,34–1,80), outros TGD (RRb= 1,48; IC95% 1,21–1,81) e TGD não especificado (RRb= 1,44; IC95% 1,22–1,69) do que para autismo atípico. As crianças que residiam no mesmo município onde foi realizado o diagnóstico tiveram maior índice de diagnóstico precoce (RRb= 1,31; IC95% 1,10–1,55) do que as demais; bem como aquelas encaminhadas pela atenção básica (RRb= 1,51; IC95% 1,37–1,68) e por demanda espontânea (RRb= 1,45; IC95% 1,31–1,61) do que as oriundas de outros tipos de encaminhamento. O diagnóstico precoce foi maior a partir de 2014 e menor na região Norte quando comparada às demais. Na análise múltipla, a magnitude do RRafoi similar ao do RRb. CONCLUSÕES A identificação precoce de autismo e outros TGD tem melhorado no país, mas ainda representa cerca de 30% dos diagnósticos realizados. As variáveis incluídas no modelo foram significativas, mas ainda explicam pouco do diagnóstico precoce de crianças com autismo e outros TGD.

ABSTRACT OBJECTIVE To investigate the factors associated with the early diagnosis of autism and other types of pervasive developmental disorder (PDD) in children treated at the Psychosocial Care Center for Children and Adolescents of the Unified Health System, from 2013 to 2019,in Brazil. METHODS An exploratory cross-sectional study, based on data from the Record of Outpatient Health Actions (RAAS) of the first appointment of children aged 1 to 12 years. The gross (RRg) and adjusted (RRa) relative risks and respective 95% confidence intervals (95%CI) were estimated using the Poisson regression model with robust variance estimation. RESULTS Of the 22,483 children included in the study, the majority were male (81.9%), lived in the same municipality where they were diagnosed (96.8%) and in the Southeast region (57.7%). Early diagnosis was higher for childhood autism (RRg = 1.48; 95%CI 1.27–1.71) , PDD without subtype designation (RRg = 1.55; 95%CI 1.34–1.80), other PDD (RRg = 1.48; 95%CI 1.21–1.81) and PDD not otherwise specified (RRg = 1.44; 95%CI 1.22–1.69) than for atypical autism. Children residing in the same municipality where the diagnosis was made had a higher rate of early diagnosis (RRg = 1.31; 95%CI 1.10–1.55) than the others; as well as those referred by primary care (RRg = 1.51; 95%CI 1.37–1.68) and by spontaneous demand (RRg = 1.45; 95%CI 1.31–1.61) than those from other types of referral. Early diagnosis was higher from 2014 and lower in the North region than in the other regions. In the multiple analysis, the magnitude of RRa was similar to that of RRg. CONCLUSIONS Early identification of autism and other PDD has improved in Brazil, but it still represents about 30% of the diagnoses made. The variables included in the model were significant, but still explain little of the early diagnosis of children with autism and other PDD.

Resumo: O objetivo deste estudo foi avaliar a associação das condições de nascimento, do estado nutricional e do crescimento infantil com fatores de risco cardiometabólicos aos 30 anos de idade. Também foi verificado se o índice de massa corporal (IMC) aos 30 anos mediava a associação entre o ganho de peso na infância e fatores de risco cardiometabólicos. Trata-se de um estudo de coorte prospectivo que incluiu todos os nascidos vivos em 1982 em hospitais da cidade de Pelotas, Rio Grande do Sul, Brasil, residentes da área urbana. As mães foram entrevistadas no parto e os participantes foram acompanhados em diferentes idades. Para as análises, foram utilizados os dados de peso e altura coletados no nascimento e aos 2 e 4 anos de idade e fatores de risco cardiovascular aos 30 anos. Regressões lineares múltiplas foram realizadas para a obtenção de coeficientes ajustados e G-fórmula para a análise de mediação. O ganho de peso relativo na infância, apesar da idade, está positivamente associado à pressão arterial média, enquanto o ganho de peso relativo tardio na infância está positivamente associado à espessura médio-intimal da artéria carótida, à velocidade da onda de pulso, aos triglicerídeos, ao colesterol não-HDL, à glicose plasmática e à proteína C reativa. O IMC na idade adulta capturou o efeito total do ganho de peso relativo entre 2 e 4 anos sobre a espessura médio-intimal da carótida, os triglicerídeos, o colesterol não-HDL e a proteína C reativa. Estes achados reforçam a evidência de que o rápido ganho de peso relativo após os 2 anos de idade pode ter consequências a longo prazo sobre o risco de distúrbios metabólicos e cardiovasculares.

Resumen: El objetivo de este estudio fue evaluar la asociación de las condiciones de nacimiento, estado nutricional y crecimiento infantil con factores de riesgo cardiometabólico a los 30 años de edad. También se verificó si el índice de masa corporal (IMC) a los 30 años mediaba la asociación entre el aumento de peso infantil y los factores de riesgo cardiometabólicos. Se trata de un estudio de cohorte prospectivo que incluyó todos los nacidos vivos en 1982 en hospitales de la ciudad de Pelotas, estado de Río Grande del Sur, Brasil, residentes del área urbana. Las madres fueron entrevistadas en el momento del parto y los participantes fueron seguidos a diferentes edades. Para los análisis, utilizamos los datos de peso y altura recopilados al nacer y a los 2 y 4 años de edad y los factores de riesgo cardiovascular a los 30 años. Se realizaron regresiones lineales múltiples para obtener coeficientes ajustados y la G-fórmula para el análisis de mediación. El aumento de peso relativo en la infancia, a pesar de la edad, se asocia positivamente con la presión arterial media, mientras que el aumento de peso relativo en la infancia tardía se asocia positivamente con el espesor de la íntima-media de la arteria carotídea, la velocidad de la onda del pulso, los triglicéridos, el colesterol no HDL, la glucosa plasmática y la proteína C reactiva. El IMC en adultos capturó el efecto completo del aumento de peso relativo a los 2 y 4 años sobre el espesor de la íntima-media carotídea, los triglicéridos, el colesterol no HDL y la proteína C reactiva. Estos hallazgos refuerzan la evidencia de que el rápido aumento de peso relativo después de los 2 años puede tener consecuencias a largo plazo sobre el riesgo de trastornos metabólicos y cardiovasculares.

Abstract: This study aimed to assess the association of birth conditions, nutritional status, and childhood growth with cardiometabolic risk factors at 30 years of age. We also evaluated whether body mass index (BMI) at 30 years mediated the association of weight gain in childhood with cardiometabolic risk factors. This is a prospective cohort study that included all live births in 1982 in hospitals in the city of Pelotas, Rio Grande do Sul State, Brazil, whose families lived in the urban area. Mothers were interviewed at birth, and participants were followed at different ages. For our analyses, we used data on weight and height collected at birth, 2 and 4 years and cardiovascular risk factors at 30 years. Multiple linear regressions were performed to obtain adjusted coefficients and G-formula for mediation analysis. Relative weight gain in childhood, despite the age, was positively related to mean arterial pressure, whereas relative weight gain in late childhood was positively associated with carotid intima-media thickness, pulse wave velocity, triglycerides, non-HDL cholesterol, plasma glucose, and C-reactive protein. BMI in adulthood captured the total effect of relative weight gain in the period between 2 and 4 years on carotid intima-media thickness, triglycerides, non-HDL cholesterol, and C-reactive protein. Our findings reinforce the evidence that rapid relative weight gain after 2 years of age may have long-term consequences on the risk of metabolic and cardiovascular disorders.