Condição física e desenvolvimento radicular de gramíneas em solo construído após mineração de carvão

The objective of this work was to evaluate the root development of the physical condition and the potential of agricultural use of a constructed minesoil after coal mining, besides the root development of tropical grasses in this soil, considering different revegetation periods. The soil was constructed in early 2003, and the experiment was installed in November/December 2007. Soil physical condition was evaluated in plots vegetated with perennial grasses such as Urochloa humidicola, Panicum maximum, and U. brizantha. In July 2012, disturbed and undisturbed soil samples were taken for determining physical and chemical attributes in the 0.00–0.10, 0.10–0.20, and 0.20–0.30-m soil layers. Soil monoliths were collected for characterizing the root system. After 58 months of revegetation, the physical condition of the constructed minesoil is still inadequate to an agricultural use that requires intensive soil management. Among the evaluated layers, only the 0.00–0.10-m layer provides conditions for the soil to function properly in the ecosystem. Urochloa brizantha was more promising for the recovery of soil structure in the 0.00–0.10-m soil layer, and root density was the most sensitive attribute to distinguish the potential development of the different species in this layer.O objetivo deste trabalho foi avaliar a condição física e a potencialidade de uso agrícola de um solo construído após mineração com carvão, além do desenvolvimento radicular de gramíneas tropicais nesse solo, tendo‑se considerado diferentes períodos de revegetação. O solo foi construído no início de 2003, e o experimento instalado em novembro/dezembro de 2007. A condição física do solo construído foi avaliada nas parcelas ocupadas por gramíneas perenes, como Urochloa humidicola, Panicum maximum e U. brizantha. Em julho de 2012, foram coletadas amostras de solo com estrutura preservada e não preservada para a determinação dos atributos físico-químicos, nas camadas de 0,00–0,10, 0,10–0,20 e 0,20–0,30 m. Monólitos de solo foram coletados para caracterização do sistema radicular das diferentes gramíneas. Após 58 meses de revegetação, a condição física do solo construído ainda é inadequada ao uso agrícola que envolva práticas mais intensivas de manejo de solo. Entre as camadas avaliadas, somente a de 0,00–0,10 m fornece condições para que o solo cumpra suas funções no ecossistema. Urochloa brizantha mostra-se mais promissora para a recuperação da estrutura do solo na camada de 0,00–0,10 m, e a densidade radicular foi o atributo mais sensível para a diferenciação do desenvolvimento potencial das diferentes espécies nesta camada

Cirurgia de Whipple: Indicação e Técnicas.

We explore Whipple surgery, a complex surgical intervention used to treat pancreatic tumors and periampullary conditions. We discuss its history, surgical techniques, improvements and evolution over the years. We address the complications associated with Whipple surgery, including pancreatic fistulas, hemorrhages, anastomotic strictures and postoperative infections, highlighting the importance of prevention and adequate management of these complications. We explore adjuvant treatment, such as chemotherapy, which aims to reduce the risk of pancreatic cancer recurrence after surgery. We discuss palliative care as a fundamental part of treatment for patients with advanced or metastatic stages of pancreatic cancer, emphasizing the importance of relieving symptoms, improving quality of life, and providing emotional and social support. We address the need for a personalized approach to treating pancreatic cancer, taking into account the stage of the disease and the individual needs of the patient. We conclude that treating pancreatic cancer is a multifaceted challenge, and the combination of surgery, adjuvant treatment and palliative care plays a crucial role in improving quality of life and increasing the chances of therapeutic success for patients.Exploramos a cirurgia de Whipple, uma intervenção cirúrgica complexa utilizada no tratamento de tumores pancreáticos e condições periampulares. Discutimos sua história, técnicas cirúrgicas, aprimoramentos e evolução ao longo dos anos. Abordamos as complicações associadas à cirurgia de Whipple, incluindo fístulas pancreáticas, hemorragias, estenoses de anastomose e infecções pós-operatórias, destacando a importância da prevenção e manejo adequado dessas complicações. Exploramos o tratamento adjuvante, como a quimioterapia, que tem o objetivo de reduzir o risco de recorrência do câncer de pâncreas após a cirurgia. Discutimos os cuidados paliativos como parte fundamental do tratamento para pacientes em estágios avançados ou metastáticos do câncer de pâncreas, enfatizando a importância de aliviar sintomas, melhorar a qualidade de vida e fornecer apoio emocional e social. Abordamos a necessidade de uma abordagem personalizada no tratamento do câncer de pâncreas, levando em consideração o estágio da doença e as necessidades individuais do paciente. Concluímos que o tratamento do câncer de pâncreas é um desafio multifacetado, e a combinação de cirurgia, tratamento adjuvante e cuidados paliativos desempenha um papel crucial na melhoria da qualidade de vida e no aumento das chances de sucesso terapêutico para os pacientes.&nbsp

Análise de trilha de componentes de produção primários e secundários em tomateiro do grupo Salada

O objetivo deste trabalho foi avaliar as correlações genotípicas e seus desdobramentos em efeitos diretos e indiretos de componentes de produção primários e secundários sobre a produtividade de frutos em acessos de tomateiro, pela análise de trilha. Foram utilizados dados de 20 características, avaliadas em 132 acessos de tomateiro do grupo Salada, do Banco de Germoplasma de Hortaliças da Universidade Federal de Viçosa. Após o diagnóstico de multicolinearidade, oito características foram descartadas, e a análise de trilha foi realizada com: variável principal (produção total de frutos); variáveis primárias (peso médio e número total de frutos); e variáveis secundárias (frutos não comercializáveis, índice de precocidade, comprimento da folha, espessura do pecíolo principal, comprimento e diâmetro do entrenó, número de lóculos, acidez total e sólidos solúveis totais dos frutos). O comprimento da folha, o índice de precocidade e o diâmetro do entrenó apresentaram maior correlação genotípica com a produção total de frutos (0,69; -0,54 e 0,5, respectivamente). A análise de trilha com um único diagrama causal mostrou igual importância das variáveis primárias na determinação da produção. A análise de trilha com dois diagramas causais mostrou que a seleção simultânea do comprimento da folha e do diâmetro do entrenó pode ser uma boa alternativa para a obtenção de ganhos na produção total de frutos

Mielomeningocele e anomalias associadas: uma série de casos e revisão sistemática

A mielomeningocele é uma malformação congênita grave do sistema nervoso central, representando um dos tipos mais complexos de defeitos do tubo neural. A condição é marcada pela exposição das meninges e, em alguns casos, da medula espinhal, através de uma abertura na coluna vertebral, desafiando tanto o prognóstico do paciente quanto as estratégias de tratamento. O presente estudo visa explorar os avanços recentes no diagnóstico, intervenções cirúrgicas e desfechos neurológicos associados à mielomeningocele, com foco particular na eficácia e segurança das abordagens atuais. Para isso, foi realizada uma revisão sistemática da literatura de 2016 a 2024 nas bases de dados PubMed (Medline), Cochrane Library e SciELO, aplicando critérios de inclusão e exclusão rigorosos para selecionar estudos que abordassem esses aspectos. Três estudos chave foram analisados, destacando-se pelas técnicas de diagnóstico antenatal, pela utilização de intervenções cirúrgicas inovadoras, como o fechamento fetal, e pelos cuidados pós-operatórios visando melhorias nos desfechos neurológicos. Os resultados indicam uma tendência positiva na melhoria da qualidade de vida dos pacientes, com avanços significativos no controle e na prevenção de complicações a longo prazo. No entanto, foi observada a necessidade de uma abordagem multidisciplinar no tratamento, integrando cuidados neurocirúrgicos, ortopédicos e reabilitativos. A mielomeningocele, apesar dos desafios, tem testemunhado progressos notáveis nas últimas décadas, sugerindo um futuro mais promissor para os pacientes afetados. Ainda assim, são necessários mais estudos para consolidar essas abordagens e otimizar as estratégias de tratamento na prática clínica

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. METHODS: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries-Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Chemical attributes and plant growth in soils with urban wastes application

O uso de composto de lixo (CL) e de lodo de esgoto (LE) na agricultura é uma alternativa viável para a melhor disposição destes resíduos urbanos em solos. Estudos de longo prazo podem melhorar o entendimento da dinâmica e as modificações que estes materiais ocasionam no solo e na resposta de plantas. O objetivo desse estudo foi avaliar os efeitos residuais (aplicações entre 2002 e 2006) e imediatos (reaplicação em 2015, após pousio) dos resíduos CL e LE, em dois solos [Latossolo Vermelho distroférrico (LVd) e um Argissolo Vermelho distrófico (PVd)], quanto às modificações em atributos químicos do solo, elementos-traços (ET) e resposta de plantas de aveia (Avena sativa) e milho (Zea mays). O experimento consta de colunas de solo, com aplicação de duas doses dos resíduos, CL e LE, com base no suprimento de nitrogênio, sendo a maior repetida e enriquecida com ET (Cd, Cu, Ni, Pb e Zn), além de tratamentos com adubação mineral e testemunha. Quanto aos efeitos residuais, na camada de 0-20 cm de ambos os solos, os resíduos promoveram maiores teores de C orgânico e P disponível e valores de CTC, porém o CL resultou em maiores valores de pH do solo. Com exceção do Cu, os teores de ET no solo diminuíram com o tempo. A produção de matéria seca de aveia diminuiu expressivamente após o longo período de pousio, possivelmente pela limitação em N. Os tratamentos com LE enriquecido com ET resultaram em maior acúmulo destes elementos na parte aérea da aveia. Após a reaplicação dos resíduos, o LE resultou em maior produção de matéria seca e maior acúmulo de macronutrientes (N, P, Ca e Mg) pelas plantas de milho em comparação ao CL. Os tratamentos com CL e LE enriquecidos determinaram nas plantas teores de ETS não essenciais considerados fitotóxicos.The use of urban solid waste compost (SWC) and sewage sludge (SS) in agriculture is a viable alternative for better disposal of these urban residues in soils. Long-term studies may improve the understanding of the dynamic and changes caused by these materials in soils and plant responses. The aim of this study was to evaluate residual effects (applications from 2002 to 2006) and immediate effects (application in 2015, after a fallow time) of SWC and SS residues in two soils [Typic Haplorthox (LVd) and Arenic Paleudult (PVd)], regarding soil chemical attributes and trace elements (ET) and oat (Avena sativa) and corn (Zea mays) plant responses. The experiment is carried out in soil columns with application of two doses of both SWC and SS and also with the major dose enriched with ET (Cd, Cu, Ni, Pb and Zn), besides mineral fertilization and control treatments. Residue doses were established according N supply. Regarding residual effects in the 0-20 cm layer of both soils SWC and SS materials improved organic C and available P contents and CEC values, but soil pH was higher for SWC treatments. Except for Cu, soil ET contents decreases with time. Oat dry matter production was very small after the fallow time possibly due to low residual N supply. Treatments enriched with ET resulted in higher contents of these elements in oat shoots. After residue reapplication SS caused higher corn dry matter production and macronutrient (N, P, Ca and Mg) contents than SWC. Non-essential metal in levels possibly toxic for corn plants resulted from treatments with SWC and SS enriched with ET