AIM:Pneumothorax is the most common complication of computed tomography (CT)-guided lung biopsy, occurring in approximately 25% of cases, with 5-6% requiring chest tube placement. Tract-sealing techniques such as autologous blood, fibrin glue, and collagen plugs can reduce this risk but are costly or may cause local reactions. Saline tract sealing is an inexpensive and widely available alternative, but evidence of its effectiveness is limited. MATERIALS AND METHODS:We performed a systematic review and meta-analysis of randomised controlled trials and comparative cohort studies including adults undergoing CT-guided percutaneous lung biopsy, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The intervention was immediate instillation of sterile saline into the biopsy tract, compared with no sealing. The outcomes analysed were postbiopsy pneumothorax and chest tube placement. RESULTS:Seven studies (1455 patients; 680 received saline) were included. Saline tract sealing significantly reduced the risk of pneumothorax (risk ratios [RR]: 0.46; 95% confidence interval [CI]: 0.35-0.61; P < 0.00001) and the need for chest tube placement (RR: 0.22; 95% CI: 0.12-0.42; P < 0.0001). CONCLUSION:Saline tract sealing is associated with a significant reduction in pneumothorax and the need for chest tube placement after CT-guided lung biopsy and may be considered an adjunctive technique during the procedure.
A utilização de resíduos em materiais cimentícios constitui uma alternativa para reduzir o consumo de cimento Portland e os impactos ambientais associados à sua produção. Este estudo avaliou a substituição parcial do cimento por cinza de biomassa proveniente da indústria de papel e celulose, gerada predominantemente pela combustão de Pinus taeda, em argamassas de revestimento. Foram analisados teores de substituição de 0%, 2,5%, 5%, 7,5% e 10%, considerando a consistência, resistência à tração na flexão e resistência à compressão aos 28 dias. Os traços de referência e com 10% de substituição também foram avaliados quanto à resistência de aderência à tração. O aumento do teor de cinza reduziu a trabalhabilidade das argamassas, enquanto a resistência à flexão não apresentou diferenças estatisticamente significativas. A substituição de 10% proporcionou resistência à compressão de 3,78 MPa, correspondendo a um aumento de 37% em relação à referência. Na aderência à tração, o mesmo teor apresentou 0,30 MPa, redução de 14% em relação à referência, porém atendendo ao requisito normativo para revestimentos externos. Os resultados indicam a viabilidade técnica da substituição de até 10% do cimento por cinza de biomassa nas condições avaliadas, contribuindo para a valorização do resíduo e redução do consumo de cimento Portland.
This study examines Brazilian legal education through the lens of the patrimonialist structure of the State, as analyzed by Raymundo Faoro in Os Donos do Poder. The central objective is to critically reflect on legal education in Brazil, highlighting how the patrimonialism identified in Faoro's work contributes to the perpetuation of regional inequalities. The study adopts a theoretical and qualitative approach, using a critical lens and the deductive method, based exclusively on the analysis of Faoro’s text. The results indicate that legal education in Brazil remains historically tied to bureaucratic elites and disconnected from the social, economic, and cultural realities of the country's diverse regions. This contributes to the reproduction of structural inequalities and hinders the transformative role of law. The findings also point to the centralization of legal knowledge and the weakening of its public function, limiting access to justice and regional development. The study concludes by emphasizing the urgency of rethinking legal training considering territorial disparities and recognizing law's potential as a tool for regional transformation, while also acknowledging the limitations and future possibilities of Faoro’s legacy.
Introduction/Objective: Leprosy is a neglected disease that remains a major public health challenge in Brazil, with a substantial impact on socially vulnerable populations. Despite advances in diagnosis and treatment, advanced-stage cases still lead to hospitalizations and deaths. Understanding the regional distribution of these outcomes may reveal disparities in access to health services, contributing to the planning of more equitable interventions. This study aimed to analyze patterns of hospitalizations and in-hospital deaths due to leprosy in Brazil. Methodology: Observational, ecological, retrospective study based on secondary data from the SUS Hospital Information System (SIH/SUS), extracted from DATASUS. All individuals hospitalized for leprosy (ICD-10: A30) and its sequelae in Brazil between 2020 and 2024 were included. Variables analyzed included total number of hospitalizations, number of in-hospital deaths, and mortality rate, stratified by geographic macroregion (North, Northeast, Southeast, South, and Central-West). Data were organized into frequency tables, and mortality rate was calculated as the ratio between deaths and hospitalizations, expressed as a percentage. The Chi-Square test (χ²) was applied to evaluate the association between deaths and region, with a 5% significance level (p<0.05). Results: A total of 15,792 leprosy-related hospitalizations were analyzed between 2020 and 2024, with 321 deaths recorded, resulting in an overall mortality rate of 2.03%. The Northeast had the highest number of hospitalizations (6,036), followed by the Southeast (2,915), South (2,748), North (2,122), and Central-West (1,971). The highest mortality rates were observed in the South (2.84%) and Northeast (2.42%), while the lowest occurred in the Central-West (0.91%) and North (1.32%). The chi-square test indicated a statistically significant association between region and in-hospital deaths (χ²=31.27; p<0.001), suggesting regional inequality in leprosy-related outcomes. Conclusion: Findings reveal regional inequality in leprosy-related hospital outcomes in Brazil, with higher mortality in the South and Northeast. The statistical association between the distribution of deaths and macroregions points to potential differences in access to early diagnosis and quality of care.
Abstract Studies on paleophysiology and thermoregulation are central topics in fossil vertebrate paleobiology because they allow inferences about extinct organismal function beyond anatomical description. Pterosaur thermophysiology remains actively debated. Evidence such as relatively rapid growth and elevated metabolic rate estimates has been used to argue for endothermic-like physiologies consistent with the energetic demands of powered flight, whereas reproductive traits, including burial incubation and precocial development, have led some authors to propose ectothermic strategies more akin to those of extant non-avian diapsids. Here, we provide quantitative estimates of resting metabolic rate (RMR) for the tapejarid pterosaur Caiuajara dobruskii using phylogenetic eigenvector maps and osteocyte lacunar density as proxy. Analysis of six histological sections from three appendicular elements (femur, tibia, humerus) at different ontogenetic stages (adult and juvenile) yielded mass-independent RMR estimates of 0.24–0.76 ml O 2 h −1 g −0.86 , substantially higher than those of lepidosaurs but lower than typical mammalian and avian values. The retrodicted mass-independent maximum metabolic rate (MMR) of 5.68 ml O 2 h −1 g −0.87 falls between values for highly active reptiles and birds, suggesting sufficient aerobic capacity to sustain powered flight without fully matching the maximal performance of small endotherms. Together, these results suggest active-flighted pterosaurs fall among a metabolically intermediate continuum, limiting straightforward actualistic comparisons for inferring their thermoregulatory strategy.
