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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

Psychological distress among South African healthcare workers during the COVID-19 pandemic
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Ramlagan, Shandir

; Sewpaul, Ronel

; Shean, Yolande

; Schmidt, Tenielle

; North, Alicia

; Reddy, Sasiragha P.

Curationis

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2024, Volume 47 N. 1 Pages 1 - 12

Abstract: En | Text: En | PDF: En

BACKGROUND: The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). OBJECTIVES: This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. METHOD: The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. RESULTS: A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. CONCLUSION: Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs CONTRIBUTION: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.

https://doi.org/10.4102/curationis.v47i1.2477

Opioid administration and rescue dose: exploring the effects of opioid combinations dose
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Kraychete, Durval C.

; Schmidt, André P.

; Souza, Anna Karla N.

; Barros, Guilherme A.M. de

Brazilian Journal of Anesthesiology

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dec 2023, Volume 73 N. 6 Pages 707 - 710

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.08.002

The impact of anesthesia on postoperative outcomes: the effect of regional anesthesia on the incidence of surgical site infections outcomes
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Schmidt, André P.

; Bevilacqua Filho, Clóvis T.

Brazilian Journal of Anesthesiology

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jan 2023, Volume 73 N. 1 Pages 1 - 2

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.12.001

Phytase in diets with different phytate concentrations for broilers
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Barrilli, Lucas Newton Ezaki

; Santos, Marley Conceição dos

; Bassi, Lucas Schmidt

; Kuritza, Leandro Nagae

; Oliveira, Simone Gisele de

; Maiorka, Alex

Ciência Rural

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2023, Volume 53 N. 4 elocation e20210831

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

RESUMO: Este estudo teve como objetivo avaliar o efeito da inclusão de diferentes doses de fitase em rações para frangos de corte com diferentes níveis de fitato e níveis reduzidos de cálcio (Ca) e fósforo disponível (Pd) sobre seu desempenho. Foram utilizados 1.404 frangos machos Cobb®500, distribuídos em delineamento inteiramente casualizado, em esquema fatorial 2x3, com dois níveis de fitato (4,25 kg / ton - MP e 6,0 kg / ton - HP) e três níveis de fitase (0, 750 e 1500 FTU / kg), com nove repetições por tratamento. Foram avaliados os parâmetros de desempenho, e aos 21 dias de idade, quatro frangos por repetição foram abatidos para coleta do conteúdo ileal para análise do coeficiente de digestibilidade ileal aparente (CDIA), e foram removidas a tíbia direita de um frango por repetição para quantificar seu peso e porcentagem de resíduo mineral (% RM), Ca e P. Aos 42 dias de idade, uma ave por repetição foi abatida para medir o rendimento de carcaça e cortes. Os animais que receberam fitase na dieta apresentaram maior consumo médio de ração e ganho de peso médio, e maior peso ósseo, % RM, % Ca e % P, quando comparados ao tratamento sem fitase (P < 0,01). Os animais que receberam dieta contendo HP com inclusão de 1500FTU / kg de fitase apresentaram os melhores CDIAs de nutrientes (P < 0,0001). Em relação ao fitato, os animais que receberam a dieta MP apresentaram maior CDIA de matéria seca e maior %P na tíbia quando comparados aos animais que receberam a dieta HP. A adição de fitase a dietas com níveis reduzidos de Ca e Pd pode melhorar os CDIAs e as características ósseas na presença de níveis elevados de fitato. No entanto, a redução dos níveis de Ca e Pd na dieta sem adição de fitase prejudica o desempenho dos frangos de corte e não afeta o rendimento de carcaças e cortes.

ABSTRACT: This study evaluated the effect of including different doses of phytase in broiler diets with different levels of phytate and reduced levels of calcium (Ca) and available phosphorus (aP), on broilers performance, digestibility (CAID), and bone characteristics. One thousand four hundred and four Cobb®500 broilers were used, distributed in a complete randomized design, and a 2x3 factorial arrangement, with two phytate levels (4.25 kg/ton - MP and 6.0 kg/ton - HP) and three phytase levels (0, 750, and 1500 FTU/kg) totalizing six treatments with nine replicates each. The animals that received phytase in their diet showed higher average feed intake and weight gain, and higher bone weight, % mineral residue, % Ca, and % P, when compared to the treatment without phytase (P < 0.01). Animals that received a diet containing HP with the inclusion of 1500FTU/kg phytase had the best CAID of nutrients (P < 0.0001). Regarding phytate, animals that received the MP diet showed a higher CAID of dry matter, and higher %P in the tibia when compared to animals that received the HP diet. The addition of phytase to diets with reduced Ca and aP levels can improve the CAIDs and bone characteristics in the presence of high phytate levels. However, reducing Ca and aP levels in the diet without adding phytase impairs the performance of broilers and has no effect on their carcass and cuts yield.

https://doi.org/10.1590/0103-8478cr20210831

Videolaryngoscopy in anesthesia and perioperative medicine: innovations, challenges, and best practices medicine innovations challenges
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Quintao, Vinícius Caldeira

; Carvalho, Vanessa Henriques

; Costa, Luiz Guilherme Villares da

; Germano-Filho, Paulo Alipio

; Nascimento, José Carlos R.

; Lima, Rodrigo Moreira e

; Nunes, Rogean Rodrigues

; Brandão, Antônio Carlos

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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2023, Volume 73 N. 5 Pages 525 - 528

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.08.003

Hydroxyethyl starch for perioperative fluid management: a critical appraisal management
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Schmidt, Andre P.

; Bilotta, Federico

Brazilian Journal of Anesthesiology

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2023, Volume 73 N. 5 Pages 529 - 531

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.07.004

Registration of clinical trials in anesthesiology: promoting transparency in clinical research
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Schmidt, André P.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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dec 2022, Volume 72 N. 6 Pages 685 - 687

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.09.002

Participation and Learning Through the Lens of Transnational Comparative Studies: Gender Facets and Temporal Constraints
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Schmidt-Lauff, Sabine

; Berendi, Carmel

; Brečić-Ločičnik, Meta

Sisyphus - Journal of Education

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oct 2022, Volume 10 N. 2 Pages 9 - 36

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

Abstract Participation in adult learning is shaped by “heterogeneous, complementary, antagonistic and contradictory temporalities” (Alhadeff-Jones, 2017, p. 3). Time is an essential, sociocultural factor, and learning needs and takes time (cf. Schmidt-Lauff, 2019). “Too busy at work” and “childcare or family responsibilities” (OECD, 2017) are the main reasons for non-participation in adult education. Time is a significant element in gender inequalities on the international level (European Institute for Gender Equality, 2020a, 2020c). This paper comparatively investigates how time, gender and learning are interwoven in adult education in Slovenia and Hungary. The analysis includes a first comparison of quantitative data and time-related policies. However, to do justice to the complex character of time, a triangular approach, using qualitative data collected in interviews with (non-)participants, goes beyond statistical description. The study aims to better understand the subjective experience of temporalities, while learning (considering stress and maturation, etc.). The paper seeks to raise awareness on the time sensitivity, for example, of struggling with temporal constraints when both caring for children and being a successful businessperson.

Resumo A participação na aprendizagem de adultos é moldada por “temporalidades heterogéneas, complementares, antagónicas e contraditórias” (Alhadeff-Jones, 2017, p. 3). O tempo é um fator essencial, sociocultural, e a aprendizagem precisa de tempo e leva tempo (cf. Schmidt-Lauff, 2019). “Demasiado ocupado no trabalho” e “responsabilidades com os filhos ou família” (OECD, 2017) são as principais razões para a não-participação na educação de adultos. O tempo é um elemento importante nas desigualdades de género a nível internacional (European Institute for Gender Equality, 2020a, 2020c). Este artigo faz uma análise comparativa de como o tempo, o género e a aprendizagem estão interligados na educação de adultos na Eslovénia e na Hungria. A análise inclui uma comparação inicial de dados quantitativos e políticas relacionadas com o tempo. No entanto, para fazer jus ao caráter complexo do tempo, uma abordagem triangular, utilizando dados qualitativos recolhidos em entrevistas com (não-)participantes em atividades de educação de adultos, vai mais longe que a descrição estatística. O estudo pretende uma melhor compreensão da experiência subjetiva de temporalidades, enquanto aprendizagem (considerando o stress e a maturação, etc.). Este artigo procura chamar a atenção para a sensibilidade temporal, por exemplo, na luta contra restrições temporais quando se cuida de filhos e se é um empresário bem-sucedido ao mesmo tempo.

Resumen La participación en el aprendizaje de adultos está determinada por “temporalidades heterogéneas, complementarias, antagónicas y contradictorias” (Alhadeff-Jones, 2017, p. 3). El tiempo es un factor sociocultural esencial, y el aprendizaje necesita tiempo y lleva tiempo (cf. Schmidt-Lauff, 2019). “Demasiado ocupado en el trabajo” y “responsabilidades con los niños o la familia” (OCDE, 2017) son las principales razones para no participar en la educación de adultos. El tiempo es un elemento importante en las desigualdades de género internacionales (European Institute for Gender Equality, 2020a, 2020c). Este artículo hace un análisis comparativo de cómo el tiempo, el género y el aprendizaje se entrelazan en la educación de adultos en Eslovenia y Hungría. El análisis incluye una comparación inicial de datos cuantitativos y políticas relacionadas con el tiempo. Sin embargo, para hacer justicia al carácter complejo del tiempo, un enfoque triangular, utilizando datos cualitativos recopilados en entrevistas con (no) participantes en atividades de educación de adultos, va más allá de la descripción estadística. El estudio tiene como objetivo una mejor comprensión de la experiencia subjetiva de las temporalidades, mientras se aprende (considerando el estrés y la maduración, etc.). Este artículo busca llamar la atención sobre la sensibilidad del tiempo, por ejemplo, en la lucha con las limitaciones de tiempo al cuidar a los niños y ser un empresario exitoso al mismo tiempo.

https://doi.org/10.25749/sis.25637

10.

Obstetric anesthesia: pearls and pitfalls in anesthesia for cesarean delivery
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Carvalho, Vanessa H.

; Azi, Liana M.T.A.

; Carvalho, Lorena I.M. de

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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jul 2022, Volume 72 N. 4 Pages 441 - 443

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.05.006

11.

How to identify a high-risk surgical patient?
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Schmidt, Andre P.

; Stefani, Luciana C.

Brazilian Journal of Anesthesiology

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jun 2022, Volume 72 N. 3 Pages 313 - 315

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.04.002

12.

Two years of the COVID-19 pandemic: an anesthesiology perspective
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Schmidt, André P.

; Módolo, Norma S.P.

; de Amorim, Célio G.

; Simões, Cláudia M.

; Kraychete, Durval C.

; Joaquim, Eduardo H.G.

; Lineburger, Eric B.

; Papa, Fábio V.

; Fernandes, Fátima C.

; Mendes, Florentino F.

; Guimarães, Gabriel M.N.

; Barros, Guilherme A.M.

; Silva-Jr, João M.

; Lima, Laís H. Navarro e

; Azi, Liana M.T.A.

; Carvalho, Lorena I.M.

; Stefani, Luciana C.

; Garcia, Luis V.

; Carmona, Maria José C.

; Salgado Filho, Marcello F.

; Nascimento Junior, Paulo do

; Alves, Rodrigo L.

; Carvalho, Vanessa H.

; Quintão, Vinicius C.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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apr 2022, Volume 72 N. 2 Pages 165 - 168

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.02.004

13.

Perioperative cognitive evaluation and training: the use of digital games for assessment and prevention of cognitive decline after major non-cardiac surgery
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Schmidt, André P.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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feb 2022, Volume 72 N. 1 Pages 4 - 6

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.11.001

14.

The effects of season and ontogeny in the diet of Piabarchus stramineus (Eigenmann 1908) (Characidae: Stevardiinae) from southern Brazil
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Lampert, Vinicius Renner

; Dias, Tatiana Schmidt

; Tondato-Carvalho, Karina Keyla

; Fialho, Clarice Bernhardt

Acta Limnologica Brasiliensia

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2022, Volume 34 elocation e31

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

Resumo Objetivo No presente estudo, descrevemos e analisamos a dieta de Piabarchus stramineus, um pequeno lambari do rio Ibicuí, bacia do rio Uruguai, no sul do Brasil. Métodos Amostragens foram feitas mensalmente de abril de 2001 a março de 2002 com rede de arrasto de praia. Todos os exemplares foram medidos, pesados e tiveram o estômago retirado para análise de seu conteúdo. Os meses foram agrupados em estações e os peixes classificados em três classes de comprimento padrão (CCP). Foram testadas possíveis diferenças entre as diferentes estações do ano e as diferentes classes de comprimento padrão. Resultados O conteúdo de 301 estômagos foi analisado e identificou 27 itens alimentares e uma amplitude de nicho baixa a intermediária. O principal item/categoria alimentar foi insetos alóctones independentemente das estações do ano e P. stramineus pode ser classificada como uma espécie insetívora. Nós não observamos sobreposição alimentar entre os exemplares menores e maiores (CCP1 e CCP3). Por outro lado, observamos sobreposição alimentar entre exemplares pequenos e intermediários (CCP1 e CCP2) e entre exemplares intermediários e maiores (CCP2 e CCP3), evidenciando uma transição no consumo de alimento entre as classes de tamanho. Também foi evidenciado uma variação temporal na composição da dieta com interação entre as classes de comprimento. Desta forma, peixes de diferentes tamanhos tiveram dietas diferentes, com peixes menores se alimentando principalmente de cladóceros (CCP 1 e CCP2) enquanto peixes maiores (CCP3) se alimentaram principalmente de dípteros e himenópteros alóctones. Conclusões Ocorre variação temporal na dieta, mas essa variação é diferente em cada classe de comprimento. Itens alóctones tiveram grande importância na dieta da espécie nas diferentes fases de desenvolvimento, especialmente para exemplares maiores, com itens autóctones importantes especialmente para peixes menores. Os itens alóctones são fortemente relacionados à mata ciliar, motivo pelo qual enfatizamos a importância da conservação destes ambientes.

Abstract Aim In the present work we describe and analyze the diet of a small characin species, Piabarchus stramineus, from the Ibicuí River, Uruguay River Basin, southern Brazil. Methods Samples were collected monthly from April 2001 to March 2002 with seine net. All fish were measured, weighed, and had its stomach extruded for gut content analysis. Months were grouped in seasons and fish were classified within three standard length classes (SLC). We tested for possible alimentary differences between the different seasons of the year and standard length classes. Results The analysis of the content in 301 stomachs identified 27 food items and low to intermediary niche breadth. The main food item/category was allochthonous insects, regardless of the seasons, and P. stramineus can be classified as an insectivorous species. We observed no food overlap between smaller and larger fish (SLC1 and SLC3). On the other hand, we observed food overlap between small and intermediary fish (SLC1 and SLC2) and between intermediary and large fish (SLC2 and SLC3), evidencing a transition in food consumption along size classes. A temporal variation in diet composition was also observed among size classes. Thus, different sized fish differed in their diets, with smaller fish feeding mainly on cladocerans (SLC1 and SLC2) and larger fish (SLC3) feeding mainly on allochthonous Diptera and Hymenoptera. Conclusions The species diet varies in time (seasons) and such variation is different in each size class. Allochthonous food items were important in the diet of the species in the different developmental phases, especially for larger fish, with autochthonous items also important, especially for smaller fish. The allochthonous food items are strongly related to the ciliary forest; thus, we emphasize the importance of the conservation of such environments.

https://doi.org/10.1590/s2179-975x5621

15.

Effects of allopurinol on pain and anxiety in fibromyalgia patients: a pilot study
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Fagundes, Aécio C.

; Souza, Diogo O.

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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dec 2021, Volume 71 N. 6 Pages 660 - 663

Abstract: En | Text: En | PDF: En

Abstract Allopurinol is a potent inhibitor of the enzyme xanthine oxidase used in the treatment of hyperuricemia and gout. The aim of this pilot study was to investigate the effects of allopurinol on pain and anxiety in women displaying fibromyalgia refractory to conventional therapy. This prospective case series enrolled 12 women with previous diagnosis of fibromyalgia refractory to conventional therapy. Patients received an add-on therapy with oral allopurinol 300 mg twice daily for 30 days. Patients were submitted to evaluation for pain and anxiety scores before treatment, 15 and 30 days thereafter. This pilot study has demonstrated that oral administration of allopurinol 300 mg twice daily caused a significant reduction on pain scores up to 30 days of treatment in women with fibromyalgia. No effect was observed regarding anxiety scores. Randomized clinical trials are warranted and should further investigate allopurinol and more selective purine derivatives in the management of acute or chronic pain conditions.

https://doi.org/10.1016/j.bjane.2020.12.016

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