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Abstract In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics.

Resumo Nas últimas décadas, houve progressos significativos no diagnóstico e no tratamento da distrofia muscular de Duchenne (DMD), considerada a distrofia muscular mais comum na infância. Diretrizes internacionais foram publicadas e revisadas recentemente. Um grupo de especialistas brasileiros desenvolveu um padrão de atendimento baseado em revisão de literatura, com recomendações graduadas pautadas em evidências compiladas em uma publicação dividida em duas partes. A implementação de melhores práticas de manejo ajudou a modificar a história natural desta doença crônica, progressiva, que, no passado, oferecia uma expectativa de vida muito limitada para crianças do sexo masculino. Desde a publicação desse consenso anterior, o diagnóstico, o tratamento com esteroides, a reabilitação e os cuidados sistêmicos ganharam novas possibilidades a partir da divulgação dos resultados de trabalhos originais em algumas dessas áreas. Além disso, as pesquisas e o desenvolvimento de novos fármacos estão em andamento, e algumas intervenções já foram aprovadas para uso em determinados países. Nesse contexto, identificamos a necessidade de rever as recomendações anteriores sobre o manejo dos pacientes brasileiros com DMD. Nosso objetivo principal foi elaborar uma atualização baseada em evidências sobre esses tópicos do consenso.

https://doi.org/10.1055/s-0043-1761466

Influence of nutritional management prior to adaptation to a feedlot diet on ruminal microbiota of Nellore cattle
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Pinto, Ana Carolina Janssen

; Bertoldi, Gustavo Perina

; Felizari, Luana Doretto

; Demartini, Breno Leite

; Dias, Evandro Fernando Ferreira

; Squizatti, Mariana Martins

; Silvestre, Antonio Marcos

; Perna Junior, Flavio

; Mesquita, Lígia Garcia

; Souza, Johnny Maciel

; Rodrigues, Paulo Henrique Mazza

; Cruz, Gustavo D.

; Millen, Danilo Domingues

Revista Brasileira de Zootecnia

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2023, Volume 52 elocation e20210229

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to evaluate the effect of either a limited forage intake or concentrate supplementation prior to the adaptation to high-concentrate diets on dry matter intake, ruminal pH, bacteria, and protozoa of Nellore cattle. The experiment was designed as a two 3×3 Latin square, and six cannulated Nellore steers were used. Each experimental period was composed by three feeding phases: pre-adaptation (14 days), adaptation (12 days), and finishing (seven days) diet, in a total of 33 days per period. The steers were assigned to one of three pre-adaptation dietary treatments: control (Tifton hay fed ad libitum + mineral supplement), restriction (Tifton hay fed at 1.4% of BW + mineral supplement), and concentrate (Tifton hay fed ad libitum + 0.5% of BW of a mix of concentrate feedstuffs and mineral supplement). The adaptation period consisted of two adaptation diets, which contained 72 and 79% concentrate for six days each. The finishing diet contained 86% concentrate. During the pre-adaptation phase, restricted cattle had higher pH than concentrate-fed cattle. There was a reduction in M. elsdenii relative population in cattle from either restriction or concentrate groups. During adaptation and finishing phases, cattle from concentrate group had smaller F. succinogenes populations compared with the control group. The previous nutritional backgrounds impact ruminal microbiota during adaptation and finishing phases without causing any negative effect on ruminal pH. Feeding concentrate prior to the adaptation positively impacted the transition to high-concentrate diets and promoted increased dry matter intake.

https://doi.org/10.37496/rbz5220210229

Response to the letter: Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Pioneers's Point of View
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Tincani, Alfio

; Lehn, Carlos

; Cernea, Cláudio

; Queiroz, Emilson

; Dias, Fernando

; Walder, Fernando

; Hojaij, Flávio

; Monteiro, Francisco

; Kligerman, Jacob

; Podesta, José

; Brandão, Lenine

; Mello, Luiz Eduardo Barbalho de

; Medina, Luiz

; Abrahao, Márcio

; Tavares, Marcos

; Barbosa, Mauro

; Cervantes, Onivaldo

; Demétrio, Paula

; Curioso, Ricardo

; Lima, Roberto

; Arap, Sérgio

; Vasconcellos, Sylvio

Archives of Endocrinology and Metabolism

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dec 2021, Volume 65 N. 6 Pages 860 - 861

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000425 1 downloads

Transoral thyroidectomy: A reflexive opinion on the technique
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Tincani, Alfio

; Lehn, Carlos

; Cernea, Cláudio

; Queiroz, Emilson

; Dias, Fernando

; Walder, Fernando

; Hojaij, Flávio

; Monteiro, Francisco

; Kligerman, Jacob

; Podesta, José

; Brandão, Lenine

; Mello, Luiz Eduardo Barbalho de

; Medina, Luiz

; Abrahao, Márcio

; Tavares, Marcos

; Barbosa, Mauro

; Cervantes, Onivaldo

; Demétrio, Paula

; Curioso, Ricardo

; Lima, Roberto

; Arap, Sérgio

; Vasconcellos, Sylvio

Archives of Endocrinology and Metabolism

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jun 2021, Volume 65 N. 3 Pages 396 - 399

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000383 128 downloads

Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil
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Silva Júnior, João Manoel

; Chaves, Renato Carneiro de Freitas

; Corrêa, Thiago Domingos

; Assunção, Murillo Santucci Cesar de

; Katayama, Henrique Tadashi

; Bosso, Fabio Eduardo

; Amendola, Cristina Prata

; Serpa Neto, Ary

; Malbouisson, Luiz Marcelo Sá

; Oliveira, Neymar Elias de

; Veiga, Viviane Cordeiro

; Rojas, Salomón Soriano Ordinola

; Postalli, Natalia Fioravante

; Alvarisa, Thais Kawagoe

; Lucena, Bruno Melo Nobrega de

; Oliveira, Raphael Augusto Gomes de

; Sanches, Luciana Coelho

; Silva, Ulysses Vasconcellos de Andrade e

; Nassar Junior, Antonio Paulo

; Réa-Neto, Álvaro

; Amaral, Alexandre

; Teles, José Mário

; Freitas, Flávio Geraldo Rezende de

; Bafi, Antônio Tonete

; Pacheco, Eduardo Souza

; Ramos, Fernando José

; Vieira Júnior, José Mauro

; Pereira, Maria Augusta Santos Rahe

; Schwerz, Fábio Sartori

; Menezes, Giovanna Padoa de

; Magalhães, Danielle Dourado

; Castro, Cristine Pilati Pileggi

; Henrich, Sabrina Frighetto

; Toledo, Diogo Oliveira

; Parra, Bruna Fernanda Camargo Silva

; Dias, Fernando Suparregui

; Zerman, Luiza

; Formolo, Fernanda

; Nobrega, Marciano de Sousa

; Piras, Claudio

; Piras, Stéphanie de Barros

; Conti, Rodrigo

; Bittencourt, Paulo Lisboa

; D’Oliveira, Ricardo Azevedo Cruz

; Estrela, André Ricardo de Oliveira

; Oliveira, Mirella Cristine de

; Reese, Fernanda Baeumle

; Motta Júnior, Jarbas da Silva

; Câmara, Bruna Martins Dzivielevski da

; David-João, Paula Geraldes

; Tannous, Luana Alves

; Chaiben, Viviane Bernardes de Oliveira

; Miranda, Lorena Macedo Araújo

; Brasil, José Arthur dos Santos

; Deucher, Rafael Alexandre de Oliveira

; Ferreira, Marcos Henrique Borges

; Vilela, Denner Luiz

; Almeida, Guilherme Cincinato de

; Nedel, Wagner Luis

; Passos, Matheus Golenia dos

; Marin, Luiz Gustavo

; Oliveira Filho, Wilson de

; Coutinho, Raoni Machado

; Oliveira, Michele Cristina Lima de

; Friedman, Gilberto

; Meregalli, André

; Höher, Jorge Amilton

; Soares, Afonso José Celente

; Lobo, Suzana Margareth Ajeje

Revista Brasileira de Terapia Intensiva

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mar 2020, Volume 32 N. 1 Pages 17 - 27

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.

ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.

https://doi.org/10.5935/0103-507x.20200005 1048 downloads

Brazilian consensus on Duchenne muscular dystrophy. Part 2: rehabilitation and systemic care
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Araujo, Alexandra P. Q. C.

; Nardes, Flavia

; Fortes, Clarisse P. D. D.

; Pereira, Jaqueline A.

; Rebel, Marcos F.

; Dias, Cristina M.

; Barbosa, Rita de Cassia G. A.

; Lopes, Mauro V. R.

; Langer, Ana Lucia

; Neves, Flavio R.

; Reis, Edna Fátima

Arquivos de Neuro-Psiquiatria

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jul 2018, Volume 76 N. 7 Pages 481 - 489

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Avanços significativos na compreensão e no manejo da Distrofia Muscular de Duchenne (DMD) ocorreram desde a publicação de diretrizes internacionais para o cuidado destes pacientes em 2010. Nosso objetivo foi elaborar um consenso nacional baseado em evidências para o cuidado multidisciplinar dos pacientes com DMD no Brasil. Utilizamos uma combinação da técnica de Delphi com uma revisão sistemática da literatura de 2010 a 2016 para classificarmos os níveis de evidência e graus de recomendação para o consenso. Nossas recomendações foram divididas em duas partes. A metodologia utilizada na elaboração do consenso e conceitos gerais da doença encontram-se na parte 1. Neste artigo fornecemos os resultados e recomendações sobre reabilitação e cuidados sistêmicos para DMD.

ABSTRACT Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) have occurred since the publication of international guidelines for DMD care in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations for the guideline. Our recommendations were divided in two parts. Guideline methodology and overall disease concept descriptions are found in Part 1. Here we present Part 2, where we provide the results and recommendations on rehabilitation and systemic care for DMD.

https://doi.org/10.1590/0004-282x20180062 15068 downloads

Communication in health: a new time
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FERREIRA, Carolina Menezes

; GIARDELLI, Gil

; LIMA, Mike Lopes

; KAPIM, Gabriela

; GARBIN, Daiana

; FISBERG, Mauro

; ZAMBRONE, Flávio

; CORRÊA, Tadeu

; BOULOS, Marcos

; POLTRONIERI, Fabiana

; PAULON, Clarice Pimentel

; SILVA, Gumercindo

; ESCOBAR, Ana

; MALZYNER, Gabriela

; ATALLA, Marcio

; NEVES, Bianca

; ANTONACCIO, Cynthia

; SILVESTRE, Paulo

; REIS, Ciro Dias

; GRISOLIA, Daisy

; CRESCIA, Elena

; OTTO, Gustavo

Food Science and Technology

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jul 2017, Volume 37 N. 3 Pages 345 - 348

Abstract: En | Text: En | PDF: En

Abstract The interface between the fields of health and communication brings together a wide diversity of topics, perspectives and articulations between academic production (scientific content) and its dissemination to the public (health journalism). The development and convergence of communication technologies, the progressive mediatization of society and institutions, the new generation of readers and their ways of consuming health content are some of the examples of the various issues addressed in health communication. The aim of this article is to reflect on the relationship between media and health and its current importance in the production and dissemination of contents, in light of the new information and communication technologies, producing efficient and credible information, directed to different audiences.

https://doi.org/10.1590/1678-457x.19517 1285 downloads

Germination test as a fast method to detect glyphosate-resistant sourgrass
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Dias, Marcos Altomani Neves

; Obara, Flavio Eduardo Botelhos

; Arruda, Natalia

; Cursi, Patricia Ribeiro

; Gonçalves, Navara Roberto

; Christoffoleti, Pedro Jacob

Bragantia

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sep 2015, Volume 74 N. 3 Pages 307 - 310

Abstract: En | Text: En | PDF: En

The occurrence of weed species with different levels of resistance to glyphosate has increasingly spread in agricultural areas. In Brazil, sourgrass is among the main species presenting issues in this regard. Thus, fast and reliable methods to detect glyphosate resistance are of special interest for this specie, either for research or rational management purposes. This study was carried out to verify the feasibility of using the germination test to detect glyphosate resistance in sourgrass. The experiment was conducted with two sourgrass biotypes, with different levels of susceptibility to glyphosate. The seeds were previously imbibed in solutions composed of 0, 0.1875%, 0.25%, 0.75%, 1.5%, 3% and 6% of glyphosate during two periods, five and ten minutes, and submitted to germination tests. The results indicate the germination test as a feasible and time-saving approach to evaluate glyphosate-resistant sourgrass, with results available in seven days.

https://doi.org/10.1590/1678-4499.0089 1458 downloads

Recombinant hepatitis C virus-envelope protein 2 interactions with low-density lipoprotein/CD81 receptors
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Urbaczek, Ana Carolina

; Ximenes, Valdecir Farias

; Afonso, Ana

; Generoso, Wesley Cardoso

; Nogueira, Camila Tita

; Tansini, Aline

; Cappelini, Luciana Teresa Dias

; Malagó Júnior, Wilson

; Silva, Flávio Henrique da

; Fonseca, Luiz Marcos da

; Costa, Paulo Inácio da

Memórias do Instituto Oswaldo Cruz

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jun 2015, Volume 110 N. 4 Pages 534 - 542

Abstract: En | Text: En | PDF: En

Hepatitis C virus (HCV) envelope protein 2 (E2) is involved in viral binding to host cells. The aim of this work was to produce recombinant E2B and E2Y HCV proteins in Escherichia coli and Pichia pastoris, respectively, and to study their interactions with low-density lipoprotein receptor (LDLr) and CD81 in human umbilical vein endothelial cells (HUVEC) and the ECV304 bladder carcinoma cell line. To investigate the effects of human LDL and differences in protein structure (glycosylated or not) on binding efficiency, the recombinant proteins were either associated or not associated with lipoproteins before being assayed. The immunoreactivity of the recombinant proteins was analysed using pooled serum samples that were either positive or negative for hepatitis C. The cells were immunophenotyped by LDLr and CD81 using flow cytometry. Binding and binding inhibition assays were performed in the presence of LDL, foetal bovine serum (FCS) and specific antibodies. The results revealed that binding was reduced in the absence of FCS, but that the addition of human LDL rescued and increased binding capacity. In HUVEC cells, the use of antibodies to block LDLr led to a significant reduction in the binding of E2B and E2Y. CD81 antibodies did not affect E2B and E2Y binding. In ECV304 cells, blocking LDLr and CD81 produced similar effects, but they were not as marked as those that were observed in HUVEC cells. In conclusion, recombinant HCV E2 is dependent on LDL for its ability to bind to LDLr in HUVEC and ECV304 cells. These findings are relevant because E2 acts to anchor HCV to host cells; therefore, high blood levels of LDL could enhance viral infectivity in chronic hepatitis C patients.

https://doi.org/10.1590/0074-02760140441 16764 downloads

10.

Prevalência de alterações ósseas no tarso de potros Crioulos de até vinte e seis meses de idade
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Gallio, Miguel

; Azevedo, Marcos da Silva

; Brass, Karin Erica

; Corte, Flávio Desessards De La

; Lopes, Luís Felipe Dias

Ciência Rural

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2014, Volume 44 N. 8 Pages 1442 - 1447

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Com o objetivo de definir a prevalência de alterações ósseas no tarso, foram examinados radiograficamente 77 potros da raça Crioula, com até 26 meses de idade e a relação das lesões com parâmetros biométricos e de manejo. Os animais foram divididos em dois grupos por idade: G1, incluindo potros de nove a 18 meses (34/77); e G2, com animais de 19 a 26 meses (43/77). Os animais também foram divididos pelo tempo de preparo para exposição morfológica em GC, grupo controle (29/77), os animais sem preparo para exposição; e GI, grupo incentivo (48/77), animais com preparo médio de 4,55 meses, e foram separados por sexo em machos (46/77) e fêmeas (31/77). Os dados foram coletados em 24 propriedades de criação ou centros de treinamento/preparo do estado do Rio Grande do Sul. Lesões radiograficamente visíveis foram observadas em 79,2% (61/77) dos animais, 80,4% dos machos, 77,4% das fêmeas, 77,3% dos animais do GC, 79,2% dos animais do GI, 86,7% dos animais do G1 e 76,7% dos animais do G2. O peso médio dos potros de 10 a 12 meses de idade foi 293,2kg, representando 71,3% do peso adulto; o peso médio dos animais com idade de 19 a 26 meses foi de 360,5kg (87,6% do peso adulto); do GC foi de 288,9kg (70,2% do peso adulto); e do GI 341,9kg (83,1% do peso adulto), apesar da idade média dos dois últimos grupos ter sido de apenas 16,8 e 19,0 meses, respectivamente. Observou-se relação positiva entre o aumento do escore corporal dos animais (P=0,01; r=0,3), do tempo de preparo dos animais para exposição morfológica (P=0,0001; r=0,7) e do escore de deposição de gordura na crista do pescoço (P=0,02; r=0,3) com as lesões radiográficas observadas no tarso dos potros. Vários fatores podem estar envolvidos na osteoartrite társica distal, entretanto, em cavalos Crioulos, o fator mais importante presente nas criações foi o sobrepeso.

Aiming to evaluate the prevalence of bone changes, radiographs were taken from both tarsal joints of 77 Crioulo yearlings, up to 26 months of age. The degree of changes was correlated with biometric parameters and management practices. The animals were separated into six groups, according to age: G1, including nine to 18 months old foals (34/77) and G2, with animals between 19 to 26 months of age (43/77); preparation time to halter class shows: GC, including animals who were not submitted to any preparation (29/77), and GI, consisting of young horses prepared to participate (average of 4.55 months of preparation time) in halter shows (48/77); and gender: colts (46/77) and fillies (31/77). Data were obtained from 24 breeding farms or training centers in Rio Grande do Sul state. Results showed that 79.22% (61/77) of the animals presented some degree of radiographically visible lesions, being 80.4% of males, 77.4% of females, 77.3% in GC, 79.2% in GI, 86.7% in G1 and 76.7% in G2. The mean body weight of the 10 to 12 month old yearlings (G1) was 293.2kg, representing 71.3% of the breed's mature weight and that of the 19 to 26 month old (G2) animals was 360.5kg (87.6% of the mature weight). The mean body weight of the GC was 288.9kg (70.2% of the mature weight) and of GI was 341.9kg (83.1% of the mature weight), although the average age of both groups was 16.8 and 19.0 months, respectively. A significant relationship was found between the animal's body condition score (P=0.01; r=0.3), time of preparation to halter class shows (P=0.0001; r=0.7), and neck crest score (P=0.02; r=0.3), and degree of the radiographic lesions found in the tarsi. Several factors can be involved in the development of distal tarsal juvenile osteoarthritis; however, in Crioulo breeding farms, the most important factor present was the horse's overweight.

https://doi.org/10.1590/0103-8478cr20131171 2462 downloads

11.

Iniquidades em saúde bucal: escolares beneficiários do Bolsa Família são mais vulneráveis?
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Oliveira, Luísa Jardim Corrêa de

; Correa, Marcos Britto

; Nascimento, Gustavo Giacomelli

; Goettems, Marília Leão

; Tarquínio, Sandra Beatriz Chaves

; Torriani, Dione Dias

; Demarco, Flávio Fernando

Revista de Saúde Pública

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dec 2013, Volume 47 N. 6 Pages 1039 - 1047

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

OBJETIVO : Analisar a associação entre ser beneficiário do Programa Bolsa Família e condições de saúde bucal entre escolares. MÉTODOS : Estudo transversal com 1.107 escolares entre oito e 12 anos de idade, provenientes de 20 escolas públicas e particulares da cidade de Pelotas, RS, em 2010. Os beneficiários do Programa Bolsa Família foram verificados por meio de lista fornecida pelas escolas participantes do estudo. Informações demográficas, socioeconômicas, de uso de serviço odontológico e de higiene bucal foram obtidas por meio de questionários respondidos pelos escolares e por seus pais. O exame clínico avaliou a presença de placa dental e experiência de cárie. Os dados foram analisados por meio dos testes do Qui-quadrado e Qui-quadrado de tendência linear e por regressão de Poisson (razão de prevalência; intervalo de confiança de 95%). RESULTADOS : Crianças de família não nuclear, que apresentavam CPOD ≥ 1 e que nunca haviam feito uso de serviço odontológico na vida estiveram associadas ao recebimento do Programa Bolsa Família. O modelo final mostrou que a prevalência de cárie foi duas vezes maior (RP 2,00; IC95% 1,47;2,69) em alunos beneficiários do Programa que também apresentaram maior severidade da doença, quando comparados aos alunos de escolas particulares (RM 1,53; IC95% 1,18;2,00). A prevalência de escolares que nunca haviam ido ao dentista foi mais de seis vezes maior em beneficiários do Programa Bolsa Família (RP 6,18; IC95% 3,07;12,45), em comparação com aqueles das escolas privadas, após ajustes. CONCLUSÕES : Escolares beneficiários do Programa Bolsa Família possuem maior carga de cárie e são os que menos acessam os serviços odontológicos. Esses achados sugerem a necessidade de incorporação da saúde bucal nas condicionalidades do Programa Bolsa Família.

OBJECTIVE : To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren. METHODS : A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS : Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS : Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

OBJETIVO : Analizar la asociación entre ser beneficiario del Programa Beca Familia y condiciones de salud bucal entre escolares. MÉTODOS : Estudio transversal con 1.107 escolares entre ocho y 12 años de edad, provenientes de 20 escuelas públicas y privadas de la ciudad de Pelotas, RS, Brasil, en 2010. El beneficiario del Programa Beca Familia fue verificado por medio de lista suministrada por las escuelas participantes del estudio. Informaciones demográficas, socioeconómicas, de uso de servicio odontológico y de higiene bucal fueron obtenidas por medio de cuestionarios respondidos por los escolares y por sus padres. El examen clínico evaluó la presencia de placa dental y experiencia de caries. Los datos fueron analizados por medio de las pruebas de Chi-cuadrado y Chi-cuadrado de tendencia linear y por regresión de Poisson (cociente de prevalencia; intervalo de confianza de 95%). RESULTADOS : Niños de familia no nuclear, que presentaban COPD ≥1 y que nunca habían hecho uso de servicio odontológico en la vida estuvieron asociados al recibimiento en el Programa Beca Familia. El modelo final mostró que la prevalencia de caries fue dos veces mayor (RP 2,00; IC95% 1,47;2,69) en alumnos beneficiarios del Programa que también presentaron mayor severidad de la enfermedad, al ser comparados con los alumnos de escuelas privadas (RR 1,53; IC95% 1,18;2,00). La prevalencia de escolares que nunca habían ido al dentista fue más de seis veces mayor en beneficiarios del Programa Beca Familia (RP 6,18; IC95% 3,07;12,45), en comparación con aquellos de escuelas privadas, posterior a los ajustes. CONCLUSIONES : Escolares beneficiarios del Programa Beca Familia poseen mayor carga de caries y son los que menos tienen hacen uso de los servicios odontológicos. Estos resultados sugieren la necesidad de incorporar salud bucal en las condiciones del Programa Beca Familia.

https://doi.org/10.1590/S0034-8910.2013047004688 4416 downloads

12.

Iniquidades em saude bucal: escolares beneficiarios do Bolsa Familia sao mais vulneraveis?
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Oliveira, Luisa Jardim Correa de

; Correa, Marcos Britto

; Nascimento, Gustavo Giacomelli

; Goettems, Marilia Leao

; Tarquinio, Sandra Beatriz Chaves

; Torriani, Dione Dias

; Demarco, Flavio Fernando

Revista de Saúde Pública

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dec 2013, Volume 47 N. 6 Pages 1039 - 1047

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/S0034-8910.2013047004688 2162 downloads

13.

Methods and logistics of a multidisciplinary survey of schoolchildren from Pelotas, in the Southern Region of Brazil
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Goettems, Marília Leão

; Correa, Marcos Britto

; Vargas-Ferreira, Fabiana

; Torriani, Dione Dias

; Marques, Margarete

; Domingues, Marlos Rodrigues

; Hallal, Pedro Curi

; Demarco, Flávio Fernando

Cadernos de Saúde Pública

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may 2013, Volume 29 N. 5 Pages 867 - 878

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

O artigo detalha os métodos de um estudo epidemiológico multidisciplinar conduzido em escolas em Pelotas, Sul do Brasil. O estudo transversal incluiu uma amostra representativa (n = 1.211) de crianças de 8 a 12 anos, em escolas públicas (15) e privadas (5). Questionários foram aplicados aos pais para obter informações socioeconômicas e culturais. As crianças foram entrevistadas, fornecendo informações demográficas, comportamentos de saúde bucal e prática de atividade física. Exame de saúde bucal foi realizado e medidas antropométricas aferidas para avaliação da condição nutricional. Diretores das escolas forneceram informações sobre o ambiente físico e social das escolas. Das 1.744 crianças elegíveis, a taxa de resposta foi 69,4% sem diferenças entre escolas. A metodologia proposta permitiu a obtenção de dados sobre diversos desfechos de saúde bem como sobre possíveis fatores de risco. Esta estratégia otimiza recursos financeiros de pesquisa e favorece a colaboração interprofissional.

This paper describes the methods of a multidisciplinary epidemiological survey conducted in schools in Pelotas, in the Southern Region of Brazil. This cross-sectional study evaluated a representative sample (n = 1,211) of eight to 12-year-old children attending public (15) and private (5) schools. Questionnaires were applied to parents to obtain information about socioeconomic and sociocultural characteristics. Children were interviewed to provide information on demographic characteristics, oral health behavior and physical activity habits. Oral health examinations were performed on the children and anthropometric data was collected to assess nutritional status. School principals responded a questionnaire about the social and physical environment of the school. A total of 1,744 children were eligible for the study; a response rate of 69.4% was achieved, with no significant differences between schools. The method used allowed investigators to obtain data on several health outcomes as well as on possible risk factors. This strategy optimizes the use of financial resources for research and promotes interprofessional collaboration.

El artículo detalla los métodos de un estudio epidemiológico multidisciplinar llevado a cabo en escuelas en Pelotas, sur de Brasil. El estudio transversal incluyó una muestra representativa (n = 1.211) de niños de 8 a 12 años, en escuelas públicas (15) y privadas (5). Los cuestionarios fueron administrados a los padres para obtener información socioeconómica y cultural. Los niños fueron entrevistados, proporcionando información demográfica, comportamientos de salud bucal y práctica de actividad física. Se realizaron un examen de salud bucal y medidas antropométricas para la evaluación de la condición nutricional. Directores de escuelas proporcionaron información sobre el ambiente físico y social de las escuelas. De los 1.744 niños elegibles, la tasa de respuesta fue de un 69,4% sin diferencias entre escuelas. La metodología propuesta permitió la obtención de datos sobre diversas soluciones de salud, así como sobre posibles factores de riesgo. Esta estrategia optimiza recursos financieros de investigación y favorece la colaboración interprofesional.

2730 downloads Cited 4 times in SciELO

14.

Methods and logistics of a multidisciplinary survey of schoolchildren from Pelotas, in the Southern Region of Brazil
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Goettems, Marília Leão

; Correa, Marcos Britto

; Vargas-Ferreira, Fabiana

; Torriani, Dione Dias

; Marques, Margarete

; Domingues, Marlos Rodrigues

; Hallal, Pedro Curi

; Demarco, Flávio Fernando

Cadernos de Saúde Pública

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may 2013, Volume 29 N. 5 Pages 867 - 878

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

1591 downloads Cited 7 times in SciELO

15.

Diretrizes para o ensino na atenção primária à saúde na graduação em medicina
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Demarzo, Marcelo Marcos Piva

; Almeida, Rodrigo Cariri Chalegre de

; Marins, João José Neves

; Trindade, Thiago Gomes da

; Anderson, Maria Inez Padula

; Stein, Airton Tetelbom

; Guimarães, Fabiano Gonçalves

; Oliveira, Felipe Proenço de

; Carvalho, Fernanda Plesmann de

; Silva, Flavio Dias

; Oliveira, Francisco Arsego de

; Carlos, Gustavo Tenório

; Marques, Jaciara Bezerra

; Geniole, Leika Aparecida Ishigama

; Silveira, Lia Márcia Cruz da

; Pinto, Maria Eugênia Bresolin

; Silva, Nayra Almeida da

; Bagatelli, Rodrigo Cechelero

; Batista, Sandro Rogério Rodrigues

; Barboza, Tânia de Araújo

; Sarti, Thiago Dias

; Barreto, Vitor

; Gusso, Gustavo Diniz Ferreira

; Belaciano, Mourad Ibrahim

Revista Brasileira de Educação Médica

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mar 2012, Volume 36 N. 1 Pages 143 - 148

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O presente documento traz diretrizes construídas conjuntamente pela Associação Brasileira de Educação Médica (ABEM) e a Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC) com a intenção de apoiar as escolas médicas de forma objetiva e prática, na elaboração de projetos político-pedagógicos no contexto da Atenção Primária à Saúde. Um marco reconhecido na política educacional brasileira é a publicação das Diretrizes Curriculares Nacionais, as quais flexibilizam as organizações curriculares, possibilitando a construção de projetos político-pedagógicos contemporâneos e consonantes com o Sistema Único de Saúde brasileiro. A Atenção Primária à Saúde é o ponto de convergência entre estas duas políticas, descentralizando o ensino da Medicina dos hospitais para toda a rede de saúde no Brasil. Destaca-se a imperiosidade de que o ensino na Atenção Primária à Saúde esteja presente longitudinalmente, ao longo de todo o curso, de preferência com inserções significativas (de aprendizado real e a partir do trabalho), mas que, sobretudo, deva fazer parte do núcleo de ensino da prática clínica do futuro médico.

These are a set of guidelines built by the Brazilian Association of Medical Education (ABEM) and the Brazilian Society of Family and Community Medicine (SBMFC) with the aim of supporting medical schools in a practical and objective manner, when elaborating pedagogical-political projects on Primary Health Care (PHC). The advent of the Brazilian National Curricular Guidelines for Medical Education, which are approved by the Ministry of Education in 2001 have since improved the teaching of undergraduate medical students on PHC, but there are still wide variations in implementation and quality of it in medical curricula. These guidelines by ABEM/SBMFC partnership can exert considerable influence on medical curricula by establishing minimum requirements and core competencies for PHC in Brazil.

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