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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

Morbimortality and determinants of reperfusion in ischemic stroke
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Oliveira, Adriana Ribeiro

; Jesus, Pedro Antônio Pereira de

; Bulhões, Fábio Vieira de

; Martins Netto, Eduardo

; Oliveira Filho, Jamary

; Roever, Leonardo

; Improta-Caria, Alex Cleber

; Aras, Roque

Revista da Associação Médica Brasileira

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2024, Volume 70 N. 1 elocation e20230472

Abstract: En | Text: En | PDF: En

SUMMARY BACKGROUND: Cerebrovascular accident (or stroke) and ischemic heart disease are the the major causes of death in the world. It is estimated that about 85% of strokes are ischemic in origin. Reperfusion therapy in the acute phase of ischemic stroke with a recombinant human tissue plasminogen activator is effective, but some factors influence the success of this treatment. OBJECTIVE: The aim of this study was to evaluate clinical aspects and possible determinants for reperfusion after venous thrombolysis. METHODS: This is a retrospective, cross-sectional, observational study based on a review of hospital records of inpatients diagnosed with ischemic stroke treated with intravenous thrombolysis, the main outcome being reperfusion or not. RESULTS: Data from this study revealed a predominance of females in the group of reperfused patients and males in the non-reperfused group, both maintaining moderate severity on the National Institutes of Health Stroke Scale and admission without statistical significance (p>0.18). In addition, the mean admission severity score was 13.2 for the group of reperfused patients and 14.2 for those not reperfused, and the mean ejection fraction of both groups was within normal functionality, with a mean of 0.50 for reperfused patients and 0.62 for non-reperfused patients. CONCLUSION: We found an association between successful venous chemical thrombolysis reperfusion and lower mortality in patients with acute stroke.

https://doi.org/10.1590/1806-9282.20230472

Effect of glyphosate management, formulations and rates on the agronomic performance of maize with the cp4epsps gene
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Albrecht, Alfredo Junior Paiola

; Albrecht, Leandro Paiola

; Barroso, Arthur Arrobas Martins

; Silva, André Felipe Moreira

; Krenchinski, Fábio Henrique

; Larini, Willian Felipe

; Victoria Filho, Ricardo

Revista Ciência Agronômica

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2024, Volume 55 elocation e20228614

Abstract: En | Text: En | PDF: En

ABSTRACT Second-generation glyphosate-tolerant maize (Roundup Ready 2, RR2) is characterised by the expression of the cp4epsps gene. Despite some studies suggesting possible undesirable effects from the application of glyphosate in RR2 maize, other reports have demonstrated glyphosate selectivity for RR2 plants, with minor damage symptoms, if any, and with no negative effects on the chlorophyll indices. The aim of this study was to evaluate the effect of different types of glyphosate management, formulations and rates of application on chlorophyll indices and the agronomic performance of an RR2 maize genotype expressing the cp4epsps gene. Five experiments were conducted in a full factorial design (2 x 5 x 5) to evaluate two types of management, two formulations and five rates of glyphosate. Damage symptoms, chlorophyll indices and variables related to agronomic performance (plant height, stem diameter, yield and 100-grain weight) were evaluated. Similar crop responses were found for each of the glyphosate formulations (potassium salt and isopropylamine salt) and types of management (single application and sequential application) under test, indicating that the use of glyphosate-based commercial products affords flexibility in terms of formulation and frequency of application. Glyphosate formulated as potassium salt or isopropylamine salt and applied to RR2 maize either in a single application (full rate) or in two sequential applications (each at half rate) has a similar effect and may therefore be used without distinction. However, it is important to consider the rate of application since high rates of glyphosate (especially greater than 1,440 g ae ha-1) may affect the development and production of RR2 maize.

https://doi.org/10.5935/1806-6690.20240013

Impact of harvest delay on the physiological and sanitary quality of Sorghum sp. seeds
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Martins, Antonio Guimarães

; Zuffo, Alan Mario

; Barrozo, Leandra Matos

; Mezzomo, Ricardo

; Silva, Francisco Charles dos Santos

; Steiner, Fabio

; Santos, Raianara Andrade dos

; Alves, Charline Zaratin

Revista Ciência Agronômica

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2024, Volume 55 elocation e20238802

Abstract: En | Text: En | PDF: En

ABSTRACT Harvest delay can alter the physiological and sanitary quality of sorghum seeds due to the longer exposure time of seeds to adverse environmental conditions in the field. In this study, we investigated the impact of delayed Sorghum sp. harvest on the physiological and sanitary quality of seeds in four hybrids grown in the tropical soil of the Brazilian Cerrado region. Plants from four Sorghum sp. hybrids (IPA SUDAN 4202, BRS 658, BRS 810, and BRS 373) were grown and submitted to four seed harvest periods (0, 7, 14, and 21 days after stage 9 - seed physiological maturity). The treatments were arranged in a completely randomized block design in a 4 × 4 factorial, with four replicates. At each harvest period, the thousand-seed weight, water content, first count of the germination test, germination, seedling emergence, emergence speed index, seedling dry matter, accelerated aging, electrical conductivity, and sanitary quality of seeds were determined. Seeds of higher physiological and sanitary quality of the IPA SUDAN 4202 and BRS 658 sorghum hybrids can be obtained when the harvest is carried out up to 7 days after the physiological maturity stage. However, the delay in seed harvesting at 14 and 21 days after physiological maturity results in a higher incidence of Colletotrichum sp., Curvularia sp., Rhizoctonia sp., and Alternaria sp. on the seeds of these hybrids. Delaying the harvest of sorghum seeds from 7 days after the physiological maturity stage compromises seed vigor and viability and increases the incidence of pathogens.

https://doi.org/10.5935/1806-6690.20230068

Orthodontics in the oral health care network of the Unified Health System (SUS)
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MARTINS, Fábio Carneiro

; SANTOS, Brunna Rodrigues Machado dos

; CROSATO, Edgard Michel

; TEIXEIRA, Maria Clara Lembro

; GABRIEL, Mariana

; ARAÚJO, Maria Ercília de

; GOES, Paulo Savio Angeiras de

; CARRER, Fernanda Campos de Almeida

Brazilian Oral Research

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2024, Volume 38 elocation e011

Abstract: En | Text: En | PDF: En

Abstract This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

https://doi.org/10.1590/1807-3107bor-2024.vol38.0011

“Epidemia” de violência nas escolas brasileiras e os efeitos na saúde dos sobreviventes: uma perspectiva a partir das experiências adversas na infância Epidemia “Epidemia sobreviventes
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Jural, Lucas Alves

; Risso, Patricia de Andrade

; Cunha, Antônio José Ledo Alves da

; Fagundes, Fábio Anevan

; Fonseca-Gonçalves, Andréa

; Paiva, Saul Martins

; Maia, Lucianne Cople

Cadernos de Saúde Pública

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2024, Volume 40 N. 3 elocation e00169723

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

https://doi.org/10.1590/0102-311xpt169723

Individual and contextual factors associated with the survival of patients with severe acute respiratory syndrome by COVID-19 in Brazil
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Martins Neto, Carlos

; Silva, Fábio Nogueira da

; Dias Júnior, José de Jesus

; Branco, Maria dos Remédios Freitas Carvalho

; Santos, Alcione Miranda dos

; Oliveira, Bruno Luciano Carneiro Alves de

Revista Brasileira de Epidemiologia

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2024, Volume 27 elocation e240019

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

RESUMO Objetivo: Analisar a influência dos fatores individuais e contextuais do hospital e do município de assistência sobre a sobrevida de pacientes com Síndrome Respiratória Aguda Grave por COVID-19. Métodos: Estudo de coorte hospitalar com dados de 159.948 adultos e idosos com Síndrome Respiratória Aguda Grave por COVID-19 internados de 01 de janeiro a 31 de dezembro de 2022 e notificados no Sistema de Informação de Vigilância Epidemiológica da Influenza. As variáveis contextuais foram relacionadas à estrutura, aos profissionais e equipamentos dos estabelecimentos hospitalares e indicadores socioeconômicos e de saúde dos municípios. O desfecho foi a sobrevida hospitalar em até 90 dias. Árvore de sobrevida e curvas de Kaplan-Meier foram utilizados para analisar a sobrevida. Resultados: A letalidade hospitalar foi de 30,4%. Idosos submetidos à ventilação mecânica invasiva e internados em cidades com baixo percentual de arrecadação de impostos apresentaram menor sobrevida quando comparados aos demais grupos identificados na árvore de sobrevida (p<0,001). Conclusão: O estudo indicou a interação de fatores contextuais com os individuais, e evidencia que características hospitalares e dos municípios aumentam o risco de óbito, destacando a atenção à organização, ao funcionamento e desempenho da rede hospitalar.

ABSTRACT Objective: To analyze the influence of individual and contextual factors of the hospital and the municipality of care on the survival of patients with Severe Acute Respiratory Syndrome due to COVID-19. Methods: Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis. Results: Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001). Conclusion: The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.

https://doi.org/10.1590/1980-549720240019

[SciELO Preprints] - Cardiovascular Statistics – Brazil 2023
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Oliveira, Gláucia Maria Moraes de Brant, Luisa Campos Caldeira Polanczyk, Carisi Anne Malta, Deborah Carvalho Biolo, Andreia Nascimento, Bruno Ramos Souza, Maria de Fatima Marinho de Lorenzo, Andrea Rocha De Fagundes Júnior, Antonio Aurélio de Paiva Schaan, Beatriz D. Silva, Christina Grüne de Souza e Castilho, Fábio Morato de Cesena, Fernando Henpin Yue Soares, Gabriel Porto Xavier Junior, Gesner Francisco Barreto-Filho, Jose Augusto Soares Passaglia, Luiz Guilherme Pinto-Filho, Marcelo Martins Machline-Carrion, M. Julia Bittencourt, Marcio Sommer Pontes Neto, Octavio M. Villela, Paolo Blanco Teixeira, Renato Azeredo Stein, Ricardo Sampaio, Roney Orismar Gaziano, Thomaz A. Perel, Pablo Roth, Gregory A. Ribeiro, Antonio Luiz Pinho

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Publication date: 2023-12-14

Abstract: En Pt

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.  The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.  Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG). 

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.  Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG). 

https://doi.org/10.1590/SciELOPreprints.7707

Oral cancer over six decades: a multivariable analysis of a clinicopathologic retrospective study
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Daroit, Natália Batista

; Martins, Lucas Nunes

; Garcia, Alan Ballardin

; Haas, Alex Nogueira

; Maito, Fábio Luiz Dal Moro

; Rados, Pantelis Varvaki

Brazilian Dental Journal

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oct 2023, Volume 34 N. 5 Pages 115 - 124

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

Abstract Studies have reported changes in the epidemiological profile of patients with oral cancer in recent decades, especially regarding gender and age. This study aimed to evaluate a historical series of oral malignant lesions prevalence over six decades and define characteristics associated with the occurrence, mainly, of oral squamous cell carcinoma (OSCC). A retrospective review of histopathological records from 1953 to 2019 was conducted in three oral pathology laboratories in South Brazil about age, sex, anatomical site, clinical aspect, and histopathological diagnosis. Descriptive and analytical analyses were performed comparing the histopathological diagnoses with other variables. Multivariable logistic regression was applied to determine the associated predictors of OSCC. Of the 53,065 records available in the institutions, 986 were oral malignant tumors (including all malignant neoplasms), representing 1.86% of all diagnoses. The occurrence of OSCC in the 1960's was 80.0%, decreasing over time reaching the lowest percentage of cases in the 1990's (75.8%) and significantly increasing to 88.7% in the 2010s. Females had a lower chance than males of having OSCC independently of the decade (odds ratio=0.30, p<0.001). This was the same for older individuals compared to those younger than 40 years. No interactions between sex, age, and decade were observed. The number of diagnoses of oral malignant lesions increased over time, and the occurrence of OSCC varied. Older individuals and males had higher chances of having OSCC independently of the decade. Therefore, in this study sample, no changes were observed in the epidemiological profile over the years concerning these predictors.

Resumo Alguns estudos relataram mudanças no perfil epidemiológico dos pacientes com câncer bucal nas últimas décadas, principalmente quanto ao gênero e a idade. Este estudo teve como objetivo avaliar, em uma série histórica, a prevalência de todas as lesões malignas bucais ao longo de seis décadas e definir características associadas na ocorrência, principalmente, de carcinoma espinocelular (CEC). Um levantamento retrospectivo dos registros histopatológicos de 1953 a 2019 foi realizado em três laboratórios de Patologia Bucal no Sul do Brasil em relação à idade, gênero, sítio anatômico, aspecto clínico e diagnóstico histopatológico. Análises descritivas e analíticas foram realizadas comparando-se os diagnósticos histopatológicos com as outras variáveis. A regressão logística multivariada foi aplicada para determinar os possíveis preditores associados ao CEC. Dos 53.065 prontuários disponíveis nas instituições, 986 eram tumores malignos bucais (incluindo todas as neoplasias malignas), representando 1,86% de todos os diagnósticos. A ocorrência de CEC na década de 1960 foi de 80,0%, diminuindo ao longo do tempo, atingindo o menor percentual de casos na década de 1990 (75,8%) e aumentando significativamente para 88,7% na década de 2010. As mulheres tiveram menor risco de desenvolver CEC do que os homens, independentemente da década (OR=0,30, p<0,001). Este foi o mesmo para indivíduos com idade mais avançada em comparação com aqueles com menos de 40 anos de idade. Não foram observadas interações entre gênero, idade e década. O número de diagnósticos de lesões malignas bucais aumentou ao longo das décadas e a ocorrência de CEC variou. Indivíduos com mais de 40 anos e do sexo masculino tiveram maiores chances de ter CEC, independentemente da década analisada. Portanto, nessa amostra estudada, não foram observadas mudanças no perfil epidemiológico ao longo dos anos com relação a esses preditores.

https://doi.org/10.1590/0103-6440202305264

10.

A Systematic Literature Review to Identify Patient Registries in Portugal
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Pedrosa, Hugo

; Pereira, Fábio

; Carrilho, Magda

; Martins, Catarina

; Martins, Ricardo

; Cruz, Pedro

Portuguese Journal of Public Health

Journal Metrics
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sep 2023, Volume 41 N. 2 Pages 132 - 139

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

Abstract Introduction: Patient registries are one of the main sources of real-world data (RWD), which enables different healthcare stakeholders to analyse and benchmark clinical practice and foster better care. Despite the growing need for RWD, the current use of patient registries in Portugal is not fully understood. This study aimed to identify and provide an overview of patient registries in Portugal. Methods: Registries identification included a systematic literature review (SLR) using PRISMA© methodology. An electronic search was conducted in Embase®, MEDLINE©, and Cochrane Ovid® software, considering a set of rules and relevant search terms. Patient registries and databases, hospital, primary healthcare, and population-based studies between January 1955 and March 2021 were considered while randomized controlled trials and transversal observational studies were excluded. A manual review for validation was performed to identify unique registries. To complement SLR, an additional hand search was conducted using the Google® search engine. A literature and website search was conducted to provide an overview of the registries identified. Results: From the 108 unique registries, 76 (70%) were classified as national and 32 (30%) as international (with data collected from the Portuguese population). Most national registries were found to be owned by medical societies and health authorities (88%) and are predominantly implemented in hospitals (82%). National registries cover 18 different medical specialities, mostly Cardiology and Oncology. Discussion: This study identified and provided an overview of the registries collecting data from the Portuguese population. The study results aim to improve the information available to promote the increased utility of RWD at both national and international levels. In the future, an easy-access and centralized repository, aggregating all patient registries, should be created in Portugal to disseminate information. Additionally, an in-depth characterization of the 76 national registries must be performed to better understand and clarify their potential and usefulness.

Resumo Introdução: Os registos de doentes são uma das principais fontes de dados do mundo real (RWD). Estes permitem que os diferentes intervenientes da área da saúde analisem e avaliem a prática clínica existente, e promovam melhores cuidados. Apesar da crescente necessidade de RWD, o atual contexto dos registos de doentes em Portugal não é totalmente conhecido. Este estudo visa identificar e providenciar uma visão geral dos diferentes registos de doentes em Portugal. Métodos: A identificação dos registos incluiu uma revisão sistemática da literatura (SLR) utilizando a metodologia PRISMA©. Realizou-se uma pesquisa eletrónica no Embase®, Medline©, e Cochrane©, utilizando o software Ovid® e considerando um conjunto de regras e termos de pesquisa relevantes. Registos de doentes, estudos de bases de dados, estudos hospitalares, estudos implementados nos cuidados de saúde primários e estudos de base populacional entre janeiro de 1955 e março de 2021 foram considerados, tendo sido excluídos os ensaios clínicos e os estudos observacionais transversais. Procedeu-se a uma revisão manual de validação com o intuito de compilar e identificar registos únicos. Para complementar o SLR, foi realizada uma pesquisa adicional de outras fontes usando o motor de pesquisa Google®. Foi realizada uma pesquisa adicional na literatura e em websites para permitir uma classificação geral de cada registo identificado. Resultados: Dos 108 registos únicos identificados, 76 (70%) foram classificados como nacionais e 32 (30%) como internacionais (com dados recolhidos da população portuguesa). Os resultados revelaram que a maioria dos registos nacionais pertence a sociedades médicas e autoridades de saúde (88%) e são predominantemente implementados em hospitais (82%). Os registos nacionais abrangem 18 especialidades médicas diferentes, sendo a Cardiologia e a Oncologia as que têm maior número de registos. Discussão: Este estudo permitiu identificar e ter uma visão geral dos registos que recolhem dados sobre a população portuguesa. Os resultados deste estudo visam melhorar a informação disponível e promover uma maior utilidade do RWD a nível nacional e internacional. No futuro, deverá ser criado em Portugal um repositório centralizado e de fácil acesso para disseminar a informação. Adicionalmente, deverá ser feita uma caracterização aprofundada dos 76 registos nacionais para melhor compreender e clarificar o seu potencial, a sua utilidade e determinar quais os fatores que irão emergir como essenciais.

https://doi.org/10.1159/000531447

11.

Core Competencies Self-Assessment and Patient-Practitioner Orientation during the First Year of a Brazilian Orthopedic Residency
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Barbato, Kelly Biancardini Gomes

; Carvalho, Luciana Santos de

; Marangoni, Viviani Barreira

; Souza, Fábio de

; Vaena, Marcella Martins de Vasconcelos

Revista Brasileira de Ortopedia

Journal Metrics
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sep 2023, Volume 58 N. 5 Pages 742 - 749

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

Abstract Objective Training a competent physician requires to direct the resident profile of graduate students for practice activities. We sought to identify the doctor-patient relationship orientation and the self-assessment of the core competencies, which they pointed out needed to be developed. Methods All 56 orthopedic residents admitted between 2016 and 2019 participated in the present prospective observational study. The Patient Practitioner Orientation Scale (PPOS) and a self-assessment questionnaire were answered at the beginning and end of the first year of residency (R1) in Orthopedics and Traumatology. We calculated mean and standard deviation for PPOS items and scores and analyzed them through the paired t-test. Self-Assessment Questionnaire answer options were “yes” or “I need to improve it” and skills were classified in decreasing order of the frequency of “I need to improve it” responses with description of absolute number and percentage. We compared frequencies using Fisher Test. P-values < 0.05 were considered statistically significant. GraphPad Prism 8.4.3 (GraphPad Software, San Diego, CA, USA) and Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) were used for statistical analysis. Results In the period between the beginning and the end of R1, the total PPOS mean score significantly decreased from 4.63 to 4.50 (p= 0.024), more biomedical-focused. Around one-third of the residents identified competencies of patient care, practice-based learning and improvement, and interpersonal and communication skills as needed to improve. Conclusions The PPOS and self-assessment activities could promote reflection practices and are possible tools for learner-centered competency assessment. Biomedical guidance tends to prevail as the training of physicians progresses, and periodic self-assessments can be worked on to build a growth mindset.

Resumo Objetivo A formação de um médico competente requer direcionar o perfil de pós-graduação residente para atividades práticas. Buscou-se identificar a orientação de relacionamento médico-paciente e a autoavaliação das competências fundamentais que eles apontaram que precisavam ser desenvolvidas. Métodos Todos os 56 residentes em ortopedia admitidos entre 2016 e 2019 participaram do presente estudo observacional prospectivo. A Escala de Orientação Médico-Paciente (Patient Practitioner Orientation Scale [PPOS, na sigla em inglês]) e um questionário de autoavaliação foram respondidos no início e no final do primeiro ano de residência (R1) em Ortopedia e Traumatologia. Calculamos o desvio médio e padrão para itens e pontuações de PPOS e os analisamos através do teste t emparelhado. As opções de resposta do Questionário de Autoavaliação foram "sim" ou "preciso melhorar" e as habilidades foram classificadas na ordem decrescente da frequência das respostas "preciso melhorar" com descrição de número absoluto e percentual. Comparamos frequências usando o teste de Fisher. Consideramos significativos valores-p < 0,05. Os programas GraphPad Prism 8.4.3 (GraphPad Software, San Diego, CA, EUA) e Microsoft Excel (Microsoft Corporation, Redmond, WA, EUA) foram utilizados para análise estatística. Resultados No período entre o início e o final do R1, a média total de PPOS diminuiu significativamente, de 4,63 para 4,50 (p= 0,024), mais focada em biomédica. Cerca de um terço dos residentes identificou competências do cuidado ao paciente, aprendizagem e melhoria baseadas na prática e habilidades interpessoais e de comunicação, como necessitando melhorar. Conclusões As atividades de PPOS e autoavaliação podem promover práticas de reflexão e são possíveis ferramentas para avaliação de competência centrada no aluno. A orientação biomédica tende a prevalecer à medida que a formação dos médicos progride e as autoavaliações periódicas podem ser trabalhadas para construir uma mentalidade de crescimento.

https://doi.org/10.1055/s-0043-1768621

12.

Multispectral images for discrimination of sources and doses of fertilizer in coffee plants
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Rezende, Camila Isabel Pereira

; Assis, Gleice Aparecida de

; Martins, George Deroco

; Carvalho, Fábio Janoni

; Franco, Miguel Henrique Rosa

; Araújo, Nathalia Oliveira de

Revista Ceres

Journal Metrics
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jun 2023, Volume 70 N. 3 Pages 54 - 63

Abstract: En | Text: En | PDF: En

ABSTRACT Remote monitoring of the management of coffee crops is necessary as the demand in decision-making, where the aim is to rise production based on sustainable management is in a constant growth. In this work, it was evaluated the potential of images obtained by low-cost sensors in the discrimination of sources and doses of mineral and organomineral fertilizers in coffee. The experimental design was in randomized blocks, with five blocks and six treatments, as follows: (T1) - 100% of the organomineral treatment; (T2) - 70% of the organomineral treatment; (T3) - 50% of the organomineral treatment; (T4) - 100% of mineral fertilization; (T5) - standard treatment of the farm and (T6) - 70% of mineral fertilization. After management, we used the Mapir 3 Survey3W camera coupled to an ARP drone – Phantom4 to take images of the experiment over a 12-month vegetative period. Combined with image taking, it was collected agronomic parameters of coffee growth and productivity for two crops and concluded that different fertilization doses did not significantly affect the analyzed parameters. Based on the supervised classification of multispectral images, it was possible to discriminate treatments with a higher degree of accuracy (86.66% accuracy) than when analyzing coffee growth parameters.

https://doi.org/10.1590/0034-737x202370030006

13.

One-year impact of COVID-19 pandemic on renal replacement therapy and kidney transplantation in a tertiary center in Southern Brazil
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Teichmann, Pedro do Valle

; Moschetta, Marina Oliboni

; Franco, Rodrigo Fontanive

; Vicari, Alessandra Rosa

; Nunes, Gérson Luiz da Silva

; Lazzaretti, Maria Angela Kalil Nader

; Gomes, Miriam Gressler

; Dorigoni, Silvia Maria

; Dall’Agnol, Paulo Roberto

; Klafke, Adriana

; Thomé, Fernando Saldanha

; Spuldaro, Fabio

; Agra, Homero

; Almeida, Rafael de

; Lara, Darlan Martins

; Bauer, Andrea Carla

; Karhol, Cristina

; Manfro, Roberto Ceratti

Brazilian Journal of Nephrology

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jun 2023, Volume 45 N. 2 Pages 210 - 217

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

ABSTRACT Introduction: Patients on renal replacement therapy (RRT) and kidney transplant recipients (KTR) present multiple factors that may increase the risk of death from coronavirus disease 2019 (COVID-19). This study aimed to evaluate the incidence and impact of COVID-19 in RRT patients and KTRs. Methods: Between March 2020 and February 2021, we monitored the RRT population of thirteen dialysis facilities that refer patients for transplantation to our center, a tertiary hospital in Southern Brazil. In the same period, we also monitor COVID-19 incidence and mortality in our KTR population. Demographical, clinical, and COVID-19-related information were analyzed. Results: We evaluated 1545 patients in the dialysis centers, of which 267 (17.4%) were infected by COVID-19 and 53 (19.9%) died. Among 275 patients on the kidney transplant waiting list, 63 patients (22.9%) were infected and seven (11.1%) died. COVID-19 was the leading cause of death (29.2%) among patients on the waiting list. Within the population of 1360 KTR, 134 (9.85%) were diagnosed with COVID-19 and 20 (14.9%) died. The number of kidney transplants decreased by 56.7% compared with the same period in the previous twelve months. Conclusion: In the study period, patients on RRT and KTRs presented a high incidence of COVID-19 and high COVID-19-related lethality. The impact on the patients on the transplant waiting list was less pronounced. The lethality rate observed in both cohorts seems to be related to age, comorbidities, and disease severity.

Resumo Introdução: Pacientes em terapia renal substitutiva (TRS) e receptores de transplante renal (RTR) apresentam múltiplos fatores que podem aumentar o risco de óbito por doença do coronavírus 2019 (COVID-19). Este estudo teve como objetivo avaliar incidência e impacto da COVID-19 em pacientes em TRS e RTR. Métodos: Entre Março de 2020 e Fevereiro de 2021, monitoramos a população em TRS de treze unidades de diálise que encaminham pacientes para transplante ao nosso centro, um hospital terciário no Sul do Brasil. No mesmo período, também monitoramos a incidência e mortalidade da COVID-19 em nossa população de RTR. Foram analisadas informações demográficas, clínicas e relacionadas à COVID-19. Resultados: Avaliamos 1545 pacientes nos centros de diálise, dos quais 267 (17,4%) foram infectados pela COVID-19 e 53 (19,9%) foram a óbito. Entre 275 pacientes na lista de espera para transplante renal, 63 (22,9%) foram infectados e sete (11,1%) foram a óbito. COVID-19 foi a principal causa de óbito (29,2%) entre pacientes na lista de espera. Dentre a população de 1360 RTR, 134 (9,85%) foram diagnosticados com COVID-19 e 20 (14,9%) foram a óbito. O número de transplantes renais diminuiu em 56,7% comparado ao mesmo período nos doze meses anteriores. Conclusão: No período do estudo, pacientes em TRS e RTR apresentaram alta incidência de COVID-19 e alta letalidade relacionada à COVID-19. O impacto nos pacientes na lista de espera para transplante foi menos pronunciado. A taxa de letalidade observada em ambas as coortes parece estar relacionada à idade, comorbidades e gravidade da doença.

https://doi.org/10.1590/2175-8239-jbn-2022-0034en

14.

PENSAMENTO COMPUTACIONAL PARA CRIANÇAS POR MEIO DO PROJETO DE EXTENSÃO ACADEMIA HACKTOWN
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Martins, Danielle Juliana Silva

; Oliveira, Fábio Cristiano Souza

Cadernos CEDES

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may 2023, Volume 43 N. 120 Pages 33 - 44

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

ABSTRACT This paper presents the report of an experience carried out in the hinterland of Pernambuco, through the HackTown Academy Project, which promotes teaching activities that enhance computational thinking in children aged 7 to 10 years old, through programming courses in games and robotics. The courses offered make use of methodologies such as gamification, unplugged computing, game learning, storytelling, reading club, educational robotics, and programming, and they adopt the ludicity in the proposed activities and understand that methodological diversity promotes meaningful learning.

RESUMO Este trabalho apresenta o relato de experiência realizada no sertão de Pernambuco, por meio do Projeto Academia HackTown, que promove atividades de ensino que potencializam o pensamento computacional em crianças de 7 a 10 anos, em cursos de programação em jogos e robótica. Os cursos oferecidos fazem uso de metodologias como gamificação, computação desplugada, game learning, storytelling, clube de leitura, robótica educacional e programação, bem como adotam a ludicidade nas atividades propostas e compreendem que a diversidade metodológica promove a aprendizagem significativa.

https://doi.org/10.1590/cc271373

15.

Does Postpartum Hypopituitarism Influence the Craniofacial Pattern? A Case-Control Study with Sheehan’s Syndrome Patients
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Cavalcante, Davi de Sá

; Quidute, Ana Rosa Pinto

; Martins, Manoel Ricardo Alves

; Carvalho, Francisco Samuel Rodrigues

; Cid, Adília Mirela Pereira

; Silva, Paulo Goberlanio de Barros

; Aguiar, Andrea Silvia Walter de

; Ribeiro, Thyciana Rodrigues

; Costa, Fábio Wildson Gurgel

International journal of odontostomatology

Journal Metrics
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mar 2023, Volume 17 N. 1 Pages 38 - 45

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

RESUMEN: Este estudio tuvo como objetivo evaluar los aspectos morfológicos craneofaciales de los pacientes con síndrome de Sheehan (SHS). Se realizó un estudio observacional con 19 mujeres diagnosticadas con SHS y 19 controles asociados por edad y sexo. Se obtuvieron radiografías cefalométricas laterales y se analizaron 30 medidas lineales y angulares mediante el software Radiocef Studio 2. La edad media de los pacientes fue de 65,47 ± 10,19 años. Los principales hallazgos fueron proposición maxilar (52,63 %) y mandíbula (52,63 %) con respecto a la base del cráneo, prognatismo mandibular en 73,68 %, patrón de crecimiento profundo en 42,1 %, aumento del plano mandibular en 36,84 % y reducción de la altura facial anterior. El grupo SHS mostró diferencias estadísticamente significativas en SNB (p=0,026), N-Me (p=0,006), longitud del paladar blando (p=0,011) y Ena-Me (p<0,001) en comparación con los controles. El análisis de la puntuación de la desviación estándar reveló valores alterados en relación con las longitudes maxilares y mandibulares totales. El SHS mostró una morfología craneofacial alterada, caracterizada por prognatismo maxilomandibular, tipo braquifacial, aumento del plano mandibular y reducción de la longitud del velo del paladar. Este estudio informa hallazgos novedosos en SHS.

ABSTRACT: This study aimed to assess the craniofacial morphologic aspects of Sheehan’s syndrome (SHS) patients.An observational study was performed with 19 women diagnosed with SHS and 19 controls matched by age and sex. Lateral cephalometric radiographs were obtained, and 30 linear and angular measurements were analyzed using the Radiocef Studio 2 software. The mean age of patients was 65.47 ± 10.19 years. The main findings were propositioned maxilla (52.63 %) and mandible (52.63 %) relative to the cranial base, mandibular prognathism in 73.68 %, deep growth pattern in 42.1 %, increased mandibular plane in 36.84 %, and reduction in anterior facial height. The SHS group showed statistically significant differences in SNB (p=0.026), N-Me (p=0.006), soft palate length (p=0.011), and Ena-Me (p<0.001) in comparison with controls. The standard deviation score analysis revealed altered values in relation to total maxillary and mandibular lengths. SHS showed altered craniofacial morphology, characterized by maxillo- mandibular prognathism, brachyfacial type, increased mandibular plane, and reduction in soft palate length. This study reports novel findings in SHS.

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