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ABSTRACT In Brazil, the COVID-19 burden was substantial, and risk factors associated with higher in-hospital mortality rates have been extensively studied. However, information on short-term all-cause mortality and the factors associated with death in patients who survived the hospitalization period of acute SARS-CoV-2 infection is limited. We analyzed the six-month post-hospitalization mortality rate and possible risk factors of COVID-19 patients in a single center in Brazil. This is a retrospective cohort study focused on a six-month follow-up. The exclusion criteria were death during hospitalization, transference to another hospital, and age under 18. We collected data from the charts of all hospitalized patients from March 2020 to December 2020 with a positive RT-PCR test for SARS-CoV-2, resulting in a sample size of 106 patients. The main outcome was death after hospitalization, whereas comorbidities and demographics were evaluated as risk factors. The crude post-hospitalization death rate was 16%. The first 30 days of follow-up had the highest mortality rate. In a Cox regression model for post-hospitalization mortality, previous chronic kidney disease (HR, 4.06, 95%CI 1.46 – 11.30) and longer hospital stay (HR 1.01, 95%CI 1.00 – 1.02) were the only factors statistically associated with death. In conclusion, a high six-month all-cause mortality was observed. Within the six-month follow-up, a higher risk of death was observed for patients who had prior CKD and longer hospital stay. These findings highlight the importance of more intensive medical surveillance during this period.

https://doi.org/10.1590/s1678-9946202466001

Evaluation of Different Heating Systems for the Hydrolysis of Residual Frying Oil Catalyzed by Free and Immobilized Lipase
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Correia, Thais Bazilli de Almeida

; Sousa, Grazielle Pereira Reis de

; Reis, Willian de Souza Matias

; Theodoro, Janaina Martins

; Hidalgo, Vitor Bertolassi

; Santos, Jorge Henrique Vieira

; Rós, Patrícia Caroline Molgero Da

; Pereira, Ernandes Benedito

Brazilian Archives of Biology and Technology

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2024, Volumen 67 elocation e24220625

Resumen: En | Texto: En | PDF: En

Abstract Large quantities of residual cooking oil are being increasingly generated in various sectors, as it is often improperly disposed of and causes serious environmental problems. A commonly used alternative is the use of lipases in enzymatic hydrolysis, since it is rather attractive to several sectors, in addition to allowing the use of products generated thereof, such as: free fatty acids, diacylglycerols, monoacylglycerols and free glycerol, moreover, it is capable of operating in mild temperature and pressure conditions. Therefore, the present study aimed to evaluate alternatives for the hydrolysis of residual frying oil by evaluating the efficiency of different types of supports and heating systems using free and immobilized forms of lipase from Burkholderia cepacia (BCL) and Porcine pancreas (PPL) as biocatalyst. Polyhydroxybutyrate (PHB), niobium oxide (Nb2O5) and chitosan (CHIT) were evaluated as support for immobilizing BCL and PPL lipases, and superior results were found regarding the hydrolytic activity of immobilization derivatives using PHB and Nb2O5. Among the heating systems under evaluation, the highest percentage of residual oil hydrolysis was found using the ultrasound system for both free and immobilized lipases, reaching 57.91% hydrolysis for lipases immobilized on Nb2O5 and 61.11% hydrolysis for the derivative immobilized on PHB. The operational stability of both biocatalysts was evaluated using similar half-life time values for both. Thus, it was observed that the ultrasound system was efficient in improving lipase performance in the hydrolysis of free fatty acids, once this unconventional heating system is quite promising for accelerating such enzymatic reactions.

https://doi.org/10.1590/1678-4324-2024220625

Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023
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Almeida, André Luiz Cerqueira

; Melo, Marcelo Dantas Tavares de

; Bihan, David Costa de Souza Le

; Vieira, Marcelo Luiz Campos

; Pena, José Luiz Barros

; Del Castillo, José Maria

; Abensur, Henry

; Hortegal, Renato de Aguiar

; Otto, Maria Estefania Bosco

; Piveta, Rafael Bonafim

; Dantas, Maria Rosa

; Assef, Jorge Eduardo

; Beck, Adenalva Lima de Souza

; Santo, Thais Harada Campos Espirito

; Silva, Tonnison de Oliveira

; Salemi, Vera Maria Cury

; Rocon, Camila

; Lima, Márcio Silva Miguel

; Barberato, Silvio Henrique

; Rodrigues, Ana Clara

; Rabschkowisky, Arnaldo

; Frota, Daniela do Carmo Rassi

; Gripp, Eliza de Almeida

; Barretto, Rodrigo Bellio de Mattos

; Silva, Sandra Marques e

; Cauduro, Sanderson Antonio

; Pinheiro, Aurélio Carvalho

; Araujo, Salustiano Pereira de

; Tressino, Cintia Galhardo

; Silva, Carlos Eduardo Suaide

; Monaco, Claudia Gianini

; Paiva, Marcelo Goulart

; Fisher, Cláudio Henrique

; Alves, Marco Stephan Lofrano

; Grau, Cláudia R. Pinheiro de Castro

; Santos, Maria Veronica Camara dos

; Guimarães, Isabel Cristina Britto

; Morhy, Samira Saady

; Leal, Gabriela Nunes

; Soares, Andressa Mussi

; Cruz, Cecilia Beatriz Bittencourt Viana

; Guimarães Filho, Fabio Villaça

; Assunção, Bruna Morhy Borges Leal

; Fernandes, Rafael Modesto

; Saraiva, Roberto Magalhães

; Tsutsui, Jeane Mike

; Soares, Fábio Luis de Jesus

; Falcão, Sandra Nívea dos Reis Saraiva

; Hotta, Viviane Tiemi

; Armstrong, Anderson da Costa

; Hygidio, Daniel de Andrade

; Miglioranza, Marcelo Haertel

; Camarozano, Ana Cristina

; Lopes, Marly Maria Uellendahl

; Cerci, Rodrigo Julio

; Siqueira, Maria Eduarda Menezes de

; Torreão, Jorge Andion

; Rochitte, Carlos Eduardo

; Felix, Alex

Arquivos Brasileiros de Cardiologia

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Dic 2023, Volumen 120 Nº 12 elocation e20230646

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20230646

Hematological and coagulation parameters as predictors of death by Coronavirus disease in hospitalized patients: a Brazilian follow-up study
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Guimarães, Gabriel Macedo Costa

; Faustino, Renan

; Oliveira, Any Caroline

; Alves, Lilian Santos

; Carvalho, Fabiana Rabe

; Baptista, Katia Lino

; Yaginuma, Karina Yuriko

; Santos, Hugo Henrique Kegler dos

; Almeida, Jorge Reis

; Medeiros, Thalia

; Silva, Andrea Alice

Brazilian Journal of Pharmaceutical Sciences

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2023, Volumen 59 elocation e21798

Resumen: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the hematological and coagulation parameters according to the clinical outcomes of coronavirus disease (COVID-19). We analyzed the hematological and coagulation parameters of hospitalized patients with COVID-19 at admission, and two and three weeks during hospitalization. To assess the performance of these parameters in predicting poor outcomes, receiver operating characteristic (ROC) curves were created. We studied 128 patients with COVID-19 (59.2±17.7 years, 56% male). Non-survivors (n=54, 42%) presented significant alterations in hematological and coagulation parameters at admission, such as increased in white blood cells (WBC), neutrophil, and band cell counts, as well as elevated prothrombin time (PT), activated partial thromboplastin time, and D-dimer levels. During follow-up, the same group presented a gradual increase in D-dimer and PT levels, accompanied by a reduction in PT activity, hemoglobin, and red blood cell count (RBC). ROC curves showed that WBC, neutrophil, and band cell counts presented the best area under the curve (AUC) values with sensitivity and specificity of >70%; however, a logistic regression model combining all the parameters, except for RBC, presented an AUC of 0.89, sensitivity of 84.84%, and specificity of 77.41%. Our study shows that significant alterations in hematological and coagulation tests at admission could be useful predictors of disease severity and mortality in COVID-19.

https://doi.org/10.1590/s2175-97902023e21798

Factors associated with the lifestyle of state basic education teachers of state during the pandemic
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Vieira, Alexandre dos Reis

; Andrade Junior, Jorge Luiz Bento de

; Costa, Lucas Linhares

; Teixeira, Rafaela Borges

; Vieira, Vinicius de Paula Arruda

; Magalhães, Tatiana Almeida de

; Silva, Nayra Suze Souza e

; Haikal, Desirée Sant’Ana

; Silva, Rosângela Ramos Veloso

; Pinho, Lucinéia de

Revista Gaúcha de Enfermagem

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2023, Volumen 44 elocation e20230068

Resumen: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective: To analyze the prevalence and factors associated with the lifestyle profile of public basic education teachers in Minas Gerais during the COVID-19 pandemic. Method: Epidemiological websurvey carried out with public basic education teachers in Minas Gerais. Data collection took place from August to September2020 via digital form. Anthropometric, sociodemographic, work, and lifestyle characteristics were evaluated. Poisson Regression was used. Results: 15,641 teachers participated and 31.1% had inadequate health habits. There was a higher prevalence among men (PR=1.38; 95%CI:1.31;1.45), older age (PR=1.20; 95%CI: 1.07;1.34), greater weekly workload (RP=1.10; 95%CI:1.03;1.17) and those dissatisfied with work (RP=1.21; 95%CI:1.15;1.27). As a protective factor, professors with longer teaching experience (RP=0.92; 95%CI:0.87;0.98) and those hired or appointed (PR=0.89; 95%CI:0.85) ;0.94). Conclusion: Lifestyle inadequacy was found among older male teachers, with longer working hours and job dissatisfaction.

RESUMEN Objetivo: Analizar la prevalencia y los factores asociados al perfil de estilo de vida de los docentes de educación básica pública de Minas Gerais durante la pandemia de COVID-19. Método: Encuesta epidemiológica de tipo websurvey realizada con profesores de educación básica pública en Minas Gerais. La recolección de datos ocurrió de agosto a septiembre2020 a través de formulario digital. Se evaluaron características antropométricas, sociodemográficas, laborales y de estilo de vida. Se utilizó la Regresión de Poisson. Resultados: Participaron 15.641 docentes y el 31,1% presentaba hábitos de salud inadecuados. Hubo mayor prevalencia en hombres (RP=1,38; IC 95%: 1,31; 1,45), mayor edad (RP=1,20; IC 95%: 1,07; 1,34), mayor carga de trabajo semanal (RP=1,10; IC 95%: 1,03). ;1,17) y los insatisfechos con el trabajo (RP=1,21; IC95%:1,15;1,27). Como factor protector, profesores con mayor experiencia docente (RP=0,92; IC95%:0,87;0,98) y contratados o nombrados (RP=0,89; IC95%:0,85;0,94). Conclusión: Se encontró inadecuación en el estilo de vida entre los maestros hombres y mayores, con jornadas laborales más largas e insatisfacción laboral.

RESUMO Objetivo: Analisar a prevalência e fatores associados ao perfil do estilo de vida dos professores da educação básica pública de Minas Gerais na pandemia da COVID-19. Método: Inquérito epidemiológico websurvey realizado com professores da educação básica pública de Minas Gerais. A coleta de dados ocorreu de agosto a setembro/2020 via formulário digital. Foram avaliadas as características antropométricas, sociodemográficas, laborais e estilo de vida. Utilizou-se a Regressão de Poisson. Resultados: Participaram 15.641 professores e 31,1% apresentaram hábitos inadequados de saúde. Houve maior prevalência entre homens (RP=1,38; IC95%:1,31;1,45), maior idade (RP=1,20; IC95%: 1,07;1,34), maior carga semanal de trabalho (RP=1,10; IC95%:1,03;1,17) e os insatisfeitos com o trabalho (RP=1,21; IC95%:1,15;1,27). Como fator de proteção encontraram-se os professores com mais tempo de trabalho docente (RP=0,92; IC95%:0,87;0,98) e contratados ou designados (RP=0,89; IC95%:0,85;0,94). Conclusão: Verificou-se inadequação do estilo de vida entre os professores homens mais velhos, com maior jornada laboral e insatisfação com o trabalho.

https://doi.org/10.1590/1983-1447.2023.20230068.en

Reproductive development of dairy heifers in an integrated livestock-forest system during the summer
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Dias, Hugo Rocha Sabença

; Camargo, Agostinho Jorge dos Reis

; Oliveira, Gabriela Ferreira

; Mourão, Anderson Moreira

; Saraiva, Naiara Zoccal

; Camargo, Luiz Sérgio de Almeida

; Müller, Marcelo Dias

; Martins, Carlos Eugênio

; Nogueira, Luiz Altamiro Garcia

; Brandão, Felipe Zandonadi

; Oliveira, Clara Slade

Animal Reproduction

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2023, Volumen 20 Nº 3 elocation e20230100

Resumen: En | Texto: En | PDF: En

Abstract This study aimed to assess the cortisol, body and reproductive development of prepubertal Holstein and Holstein-Gir ¾ heifers at 27 months of age maintained in an integrated livestock-forest (ILF) system for 60 summer days compared to the monoculture system in full sun (FS). The ILF system promoted changes (P=0.02) in the cortisol levels of Holstein-Gir ¾ heifers and did not affect weight gain in any of the breed groups studied. Animals in ILF system presented a lower (P=0.006) vulvar development for the rima height parameter and similar for the vulva width parameter. The ovarian follicular population of Holstein-Gir ¾ heifers in the ILF system was lower (P=0.004); however, for the Holstein heifers, no statistical difference was found, and numbers were higher (P=0.08) in the ILF system. None of the other ovarian parameters studied had any changes, and we also found important racial differences. Weight gain (P=0.003), vulvar development (P<0.001), and mean follicular size (P=0.008) were higher in the Holstein-Gir ¾ animals. Based on such results, the effect of the ILF system at 27 months of age on stress and reproductive parameters in the Holstein breed is considered positive, although negative effects have been detected on reproductive parameters in the Holstein-Gir ¾ breed.

https://doi.org/10.1590/1984-3143-ar2023-0100

Evaluation of herpesvirus members on hospital admission in patients with systemic lupus erythematous shows higher frequency of Epstein-Barr virus and its associated renal dysfunction
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Lino, Katia

; Alves, Lilian Santos

; Trizzotti, Natalia

; Raposo, Jessica Vasques

; Souza, Cintia Fernandes

; Silva, Andrea Alice da

; Paula, Vanessa Salete de

; Almeida, Jorge Reis

Brazilian Journal of Nephrology

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Dic 2022, Volumen 44 Nº 4 Paginas 490 - 497

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Introduction: Members of the Herpesviridae family have been described in patients with systemic lupus erythematous (SLE), but the clinical impact on renal function is not well known. Methods: HSV1, HSV2, VZV, EBV, CMV, HHV-6, HHV-7, and HHV-8 were evaluated by molecular biology on admission in blood samples from 40 consecutive SLE patients hospitalized for lupus activity. Results: Patients were 90.0% female, 77.5% non-white, with average age of 32.7 ± 13.6 years. We found positivity for EBV (65.0%), CMV (30.0%), HSV-1 (30.0%), HHV-6 (12.5%), and HHV-7 (7.5%). For all viruses, age, SLEDAI, hematological tests, ferritin, LDH, C-reactive protein, and erythrocyte sedimentation rate (ESR) were not significant. However, EBV positivity was a significant factor for higher serum creatinine (3.0 ± 2.8 vs. 0.9 ± 0.8; P = 0.001) and urea (86 ± 51 vs. 50 ± 46; P = 0.03). Moreover, positive cases for EBV only or with combined co-infections (66.7%-CMV; 58.3%-HSV-1) or negative for EBV only were evaluated by Kruskal-Wallis test again showed statistical significance for serum creatinine and urea (both P ≤ 0.01), with posttest also showing statistical differences for renal dysfunction and EBV presence (alone or in combined co-infections). The presence of EBV viral load was also significant for nephrotic-range proteinuria, renal flare, and the need for hemodialysis. Conclusion: Members of the Herpeviridae family (mainly EBV, HSV-1 and CMV) are common on hospital admission of SLE patients, reaching 65% for EBV, which seems to be associated with renal dysfunction and could reflect a previous association or overlapping disease, which is not well understood.

Resumo Introdução: Membros da família Herpesviridae tem sido descritos em pacientes com lúpus eritematoso sistêmico (LES), mas o impacto clínico na função renal não é bem conhecido. Métodos: Avaliou-se HSV1, HSV2, VZV, EBV, CMV, HHV-6, HHV-7, HHV-8 por biologia molecular na admissão em amostras sanguíneas de 40 pacientes com LES consecutivos hospitalizados por atividade lúpica. Resultados: Pacientes 90,0% mulheres, 77,5% não brancos, idade média 32,7 ± 13,6 anos. Encontramos positividade para EBV (65,0%), CMV (30,0%), HSV-1 (30,0%), HHV-6 (12,5%), HHV-7 (7,5%). Para todos os vírus, idade, SLEDAI, exames hematológicos, ferritina, LDH, proteína C reativa, velocidade de hemossedimentação não foram significativos. Entretanto, positividade para EBV foi estatisticamente significativo para creatinina (3,0 ± 2,8 vs. 0,9 ± 0,8; P = 0,001) e ureia (86 ± 51 vs. 50 ± 46; P = 0,03) séricas mais elevadas. Ademais, casos positivos para EBV isolado ou com coinfecções combinadas (66,7%-CMV; 58,3%-HSV-1) ou negativos apenas para EBV foram avaliados pelo teste Kruskal-Wallis e novamente mostraram significância estatística para creatinina e ureia séricas (ambas P ≤ 0,01), com pós-teste mostrando também diferenças estatísticas para disfunção renal e presença de EBV (sozinho ou em coinfecções combinadas). A presença de carga viral do EBV também foi significativa para proteinúria de faixa nefrótica, inflamação aguda, necessidade de hemodiálise. Conclusão: Membros da família Herpeviridae (principalmente EBV, HSV-1, CMV) são comuns na admissão de pacientes com LES, chegando a 65% para EBV, que parece associar-se à disfunção renal podendo refletir associação prévia ou doença sobreposta, o que não é bem compreendido.

https://doi.org/10.1590/2175-8239-jbn-2021-0184

“Flattening the curve”: effective measures from Niterói city (Rio de Janeiro, Brazil) for COVID-19 control
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Carvalho, Fabiana Rabe

; Medeiros, Thalia

; Guimarães, Gabriel Macedo Costa

; Aguiar-Alves, Fábio

; Silva, Andrea Alice

; Almeida, Jorge Reis

Cadernos Saúde Coletiva

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Sep 2022, Volumen 30 Nº 3 Paginas 439 - 445

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução No Brasil, algumas cidades adotaram várias medidas que provavelmente tiveram um impacto positivo no controle da Covid-19. Objetivo Relatar a distribuição dos casos de Covid-19 no Brasil, no estado do Rio de Janeiro e na cidade de Niterói. Paralelamente, buscamos demonstrar as estratégias preventivas adotadas pela cidade de Niterói para o controle da Covid-19. Método Dados fornecidos pelo Ministério da Saúde e Fundação Municipal de Saúde de Niterói foram usados para relatar o número de casos e óbitos causados pela Covid-19. Para algumas análises, os dados foram agrupados por semana e normalizados para 100.000 habitantes. Resultados Até 18 de julho de 2020, o Brasil registrou 2.074.860 casos e 78.772 mortes e o estado do Rio de Janeiro registrou 135.230 casos e 11.919 mortes; ambos ainda apresentando curvas ascendentes para mortes por Covid-19. Em contrapartida, a taxa de novos óbitos/100.000 habitantes é consistentemente menor na cidade de Niterói. Estimamos que 712 mortes foram evitadas pelas medidas adotadas pela cidade de Niterói, em comparação com o que foi observado no Rio de Janeiro. Conclusão As medidas preventivas adotadas pela cidade de Niterói foram eficazes na redução tanto da disseminação do vírus quanto da taxa de óbitos. Portanto, esta discussão se mostra relevante para a tomada de decisões futuras durante o surto de Covid-19 no Brasil.

Abstract Background In Brazil, some local city government’s adopted several measures, which probably had a positive impact on COVID-19 control. Objective To report the distribution of COVID-19 cases in Brazil, Rio de Janeiro state and Niterói city. In parallel, we aimed to demonstrate the preventive strategies adopted by Niterói city. Method Data provided by the Brazilian Ministry of Health and Municipal Health Foundation of Niterói were used to report COVID-19 cases and deaths. For some analysis, data were grouped by week and normalized for 100,000 inhabitants. Results By July 18th, 2020, Brazil reported 2,074,860 cases and 78,772 deaths and Rio de Janeiro state registered 135,230 cases and 11,919 deaths; both still presenting ascendant curves for COVID-19 deaths. In contrast, the rate of new deaths per 100,000 inhabitants is consistently lower in Niterói city. Importantly, we estimated that 712 deaths were prevented by the measures adopted by Niterói city, in comparison to which was observed in Rio de Janeiro. Conclusion The early preventive measures adopted in Niterói city were effective in reducing both the viral spread and rate of deaths. In this regard, this discussion could be relevant for making future decisions during the COVID-19 outbreak in Brazil.

https://doi.org/10.1590/1414-462x202230030404

Para Não Esquecer: Memória, Poder e Arquivo Malê em Narrativa Amadiana
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Ferreira, Tatiane Almeida

Comunicação e Sociedade

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Jun 2022, Volumen 41 Paginas 131 - 147

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract: This article discusses the relations between power, memory, and the archive that surround the Malês revolt, a historical event narrated in Bahia de Todos os Santos: Guia de Ruas e Mistérios (Bahia de Todos os Santos: A Guide to the Streets and Mysteries) by the writer Jorge Amado (1977). It seeks to share reflections, tensions, and intentions that the contact with post-structuralist and decolonial studies can trigger before history, as a movement of insubmission able to potentiate a critique of official thought and the elected narratives. The Malê resistance and endeavor to protect their identity is a power expressed in Amado’s book, which denounces the physical, linguistic, religious, social, and historical violence experienced by the dehumanization of Black bodies and the erasure of the national history of these popular figures who had participation in struggles for freedom and were silenced in the nation’s official narratives. The work developed also aims to understand how the Brazilian novelist approaches these structures forged in the relations of power and control of history and memory used as mechanisms to erase the identities of ethnic minorities on Brazilian soil. The development of this study relied on the theoretical concepts of Derrida (1995/2001), Deleuze (1969/2009), Foucault (1969/2008), Mignolo (2003), Grosfoguel (1996), Quijano (2005), and Reis (1986).

Resumo: Neste artigo, se problematiza as relações entre o poder, a memória e o arquivo que circundam a revolta dos malês, acontecimento histórico narrado em Bahia de Todos os Santos: Guia de Ruas e Mistérios, do escritor Jorge Amado (1977), buscando compartilhar reflexões, tensionamentos e intenções que o contato com os estudos pós-estruturalistas e decoloniais podem provocar ante a história, significando um movimento de insubmissão capaz de potencializar uma crítica ao pensamento oficial e às narrativas eleitas. A resistência e a busca malê para resguardar sua identidade é uma potência expressa no livro amadiano, que denuncia a violência física, linguística, religiosa, social e histórica vivenciada pela desumanização dos corpos negros e o apagamento da história nacional dessas figuras populares que tiveram uma participação em lutas em prol da liberdade e foram silenciadas nas narrativas oficias da nação. O trabalho desenvolvido tem por intuito ainda compreender como o romancista brasileiro aborda essas estruturas forjadas nas relações de poder e de controle da história e da memória utilizadas como mecanismos para apagar identidades das minorias étnicas em solos brasileiros. Para o desenvolvimento deste estudo, foram utilizadas as concepções teóricas de Derrida (1995/2001), Deleuze (1969/2009), Foucault (1969/2008), Mignolo (2003), Grosfoguel (1996), Quijano (2005) e Reis (1986).

https://doi.org/10.17231/comsoc.41(2022).3727 25 descargas

10.

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volumen 76 elocation e1991

Resumen: En | Texto: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 descargas

11.

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality
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Lino, Katia

; Guimarães, Gabriel Macedo Costa

; Alves, Lilian Santos

; Oliveira, Any Caroline

; Faustino, Renan

; Fernandes, Cintia Souza

; Tupinambá, Gleiser

; Medeiros, Thalia

; Silva, Andrea Alice da

; Almeida, Jorge Reis

Brazilian Journal of Infectious Diseases

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2021, Volumen 25 Nº 2 elocation 101569

Resumen: En | Texto: En | PDF: En

ABSTRACT Introduction: Some COVID-19 patients have higher mortality and the responsible factors for this unfavorable outcome is still not well understood. Objective: To study the association between ferritin levels at admission, representing an inflammatory state, and hospital mortality in COVID-19 patients. Methods: From May through July 2020, SARS-CoV-2 positive patients with moderate to severe clinical symptoms were evaluated at admission, regarding clinical and laboratory data on renal and hepatic function, hematologic parameters, cytomegalovirus co-infection, and acute phase proteins. Results: A total of 97 patients were included; mean age = 59.9 ± 16.3 years, 58.8% male, 57.7% non-white, in-hospital mortality = 45.4%. Age, ferritin, C-reactive protein, serum albumin and creatinine were significantly associated with mortality. Ferritin showed area under the curve (AUC) of 0.79 (p < 0.001) for the cut-off of 1873.0 ng/mL, sensitivity of 68.4% and specificity of 79.3% in predicting in-hospital mortality. Age ≥60 years had an odds ratio (OR) of 10.5 (95% CI = 1.8–59.5; p = 0.008) and ferritin ≥1873.0 ng/mL had an OR of 6.0 (95% CI = 1.4–26.2; p = 0.016), both independently associated with mortality based on logistic regression analysis. Conclusion: The magnitude of inflammation present at admission of COVID-19 patients, represented by high ferritin levels, is independently predictive of in-hospital mortality.

https://doi.org/10.1016/j.bjid.2021.101569 133 descargas

12.

STOP-Bang and NoSAS questionnaires as a screening tool for OSA: which one is the best choice?
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Costa, José Coutinho

; Rebelo-Marques, Alexandre

; Machado, João Pedro Neiva

; Valentim, Bruno Miguel Figueiredo

; Ferreira, Cláudia Sofia de Almeida Vicente

; Gonçalves, Joana Daniela Oliveira

; Gama, Jorge Manuel dos Reis

; Teixeira, Maria de Fátima Lopes

; Moita, Joaquim Jorge Marques

Revista da Associação Médica Brasileira

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Sep 2020, Volumen 66 Nº 9 Paginas 1203 - 1209

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO INTRODUÇÃO: Na atualidade tem se verificado um crescimento significativo no número de doentes com suspeita de apneia obstrutiva do sono (AOS) referenciados para consulta do sono. Nesse sentido, instrumentos de rastreio e estratificação da gravidade dessa patologia têm se tornado cada vez mais relevantes. OBJETIVO: Avaliar e comparar o desempenho da escala NoSAS e Stop-Bang para o rastreio de AOS. MÉTODOS: Estudo prospectivo durante 12 meses. Avaliados todos os doentes encaminhados aos cuidados de saúde primários do centro de medicina do sono que completaram o questionário NoSAS (Neck circumference, Obesity, Snoring, Age, Sex), Stop-Bang (Snoring, Tiredness, Observed apnea, Pressure [high blood], BMI, Age, Neck circumference, Gender) e foram submetidos a polissonografia. Utilizou-se uma análise ROC (receiver operating characteristic) para encontrar as pontuações que maximizam simultaneamente a sensibilidade e especificidade para cada diagnóstico. RESULTADOS: Incluídos 294 indivíduos, 84% apresentavam AOS, sendo que em 28,8% a OAS era ligeira, 34,8% moderada e 36,4% grave. USANDO A ESCALA NOSAS PARA PREVISÃO DE AOS, AOS MODERADA A GRAVE E AOS GRAVE, A ÁREA ROC FOI: 0,770 (IC95%: 0,703-0,837), p<0,001, sensibilidade de 57,5% e especificidade de 83,0% para a pontuação 12); 0,746 (IC95%: 0,691- 0,802), p<0,001, sensibilidade de 68,2% e especificidade de 75,4% para a pontuação 13); 0,686 (IC95%: 0,622-0,749), p<0,001, sensibilidade de 71,1% e especificidade de 58,3% para a pontuação 13), respectivamente. USANDO A ESCALA STOP-BANG PARA A PREVISÃO DE AOS, AOS MODERADA A GRAVE E AOS GRAVE, A ÁREA ROC FOI: 0,862 (IC95%: 0,808-0,916), p<0,001, sensibilidade de 68,4% e especificidade de 85,1% para pontuação 5); 0,813 (IC95%: 0,756-0,861), p<0,001, sensibilidade de 77,3% e especificidade de 66,1% para a pontuação 5); 0,787 (IC95%: 0,732-0,841), p<0,001, sensibilidade de 70,0% e especificidade de 79,9% para a pontuação 6), respectivamente. CONCLUSÕES: A área ROC foi consistentemente alta para as duas escalas, confirmando a capacidade diagnóstica dos questionários NoSAS e Stop-Bang para todos os graus de gravidade de AOS. Assim, os nossos resultados sugerem que esses questionários podem ser um importante instrumento para rastreio e estratificação de doentes no diagnóstico de AOS. Globalmente, a capacidade de diagnóstico do Stop-Bang foi superior à do NoSAS.

SUMMARY INTRODUCTION: Currently there has been significant growth in the number of patients with suspected obstructive sleep apnea (OSA) referred to sleep clinics. In this sense, screening and stratification methods of the severity of this pathology have become increasingly relevant. OBJECTIVE: To evaluate the performance of the NoSAS and STOP-Bang scores in the screening of OSA in a sleep clinic. METHODS: Prospectively, for 12 months, all patients referred by primary care physicians to our sleep unit for clinical evaluation and who underwent in-lab polysomnography (PSG), also completed the NoSAS score (Neck circumference, Obesity, Snoring, Age, Sex) and STOP-Bang (Snoring, Tiredness, Observed apnea, Pressure (high blood), BMI, Age, Neck circumference, Gender). A ROC (receiver operating characteristic) analysis was used to find the scores that simultaneously maximize sensitivity and specificity for each diagnosis. RESULTS: Of the 294 individuals included, 84% had OSA, of which 28.8% were mild, 34.8% moderate, and 36.4% were severe. USING THE NOSAS SCORE FOR PREDICTING OSA, MODERATE TO SEVERE OSA, AND SEVERE OSA, THE ROC AREA WAS: 0.770 (95% CI: 0.703-0.837), p<0.001, sensitivity of 57.5%, and specificity of 83.0% for a score of 12; 0.746 (95% CI: 0.691-0.802), p<0.001, sensitivity of 68.2% and specificity of 75.4% for a score of 13; 0.686 (95% CI: 0.622-0.749), p<0.001, sensitivity of 71.1% and specificity of 58.3% for a score of 13, respectively. USING THE STOP-BANG SCORE FOR PREDICTING OSA, MODERATE TO SEVERE OSA, AND SEVERE OSA, THE ROC AREA WAS: 0.862 (95% CI: 0.808-0.916), p<0.001, sensitivity of 68.4% and specificity of 85.1% for a score of 5; 0.813 (95% CI: 0.756-0.861), p<0.001, sensitivity of 77.3% and specificity of 66.1% for a score of 5; 0.787 (95% CI: 0.732-0.841), p<0.001, sensitivity of 70.0% and specificity of 79.9% for a score of 6, respectively. CONCLUSIONS: The ROC area was consistently high for both scores confirming the diagnostic ability of the NoSAS and STOP-Bang questionnaires for all OSA severities. Thus, our results suggest that these questionnaires may be a powerful tool for the screening and stratification of patients in the diagnosis of OSA. Overall, the diagnostic ability of the STOP-Bang was higher than the NoSAS.

https://doi.org/10.1590/1806-9282.66.9.1203 780 descargas

13.

Effects of freezing and thawing cycles on the quality of Nile tilapia fillets
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ZUANAZZI, Jovana Silva Garbelini

; GOES, Elenice Souza dos Reis

; ALMEIDA, Fernanda Losi Alves de

; GOES, Marcio Douglas

; LARA, Jorge Antônio Ferreira de

; RIBEIRO, Ricardo Pereira

Food Science and Technology

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Jun 2020, Volumen 40 Paginas 300 - 304

Resumen: En | Texto: En | PDF: En

Abstract The aim of this investigation was to evaluate the impact of multiple freezing and thawing cycles on the physicochemical properties of Nile tilapia fillets. For this purpose, 72 fresh Nile tilapia fillets were packed and stored in a freezer at -18 °C. The frozen samples were submitted to five freeze-thaw cycles; in each cycle, the freezer was switched off during 14 hours. The consecutive freeze-thaw cycles resulted in a fillet’s total weight loss of 9.48%, with a quadratic regression (P < 0.0001) for thaw loss, with a greater loss percentage in cycle 3 (2.68%). pH values differed between the cycles (P < 0.0001), being observed an increment in this parameter only from cycle 4. The lipid oxidation remained constant in cycles 1, 2, 4 and 5, however in cycle 3 the lowest value (P < 0.0002) was observed. The luminosity, and intensity of the red and yellow colours increased linearly (P < 0.0001) as the cycles increased. Thereby, the tilapia fillets’ quality were adversely affected by the freezing cycles. The unfavourable alterations included weight loss, lipid oxidation and elevated pH, as well as the increasingly augmentation of brightness and red and yellow colorations of fillets as the progressive cycles occurred.

https://doi.org/10.1590/fst.11119 712 descargas

14.

Anoxia stress and effect on flesh quality and gene expression of tilapia
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ZUANAZZI, Jovana Silva Garbelini

; LARA, Jorge Antonio Ferreira de

; GOES, Elenice Souza dos Reis

; ALMEIDA, Fernanda Losi Alves de

; OLIVEIRA, Carlos Antonio Lopes de

; RIBEIRO, Ricardo Pereira

Food Science and Technology

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Mar 2019, Volumen 39 Nº 1 Paginas 195 - 202

Resumen: En | Texto: En | PDF: En

Abstract We evaluated the effect of the length of stay out of water on stress, gene expression, pH variation, blood parameters, histological analysis and water holding capacity (WHC) in fillets of the Nile tilapia (Oreochromis niloticus) cultivated in net-tanks. For this purpose, the fishes were maintained out of water under different periods of anoxia. Three and 6 min of anoxia in the pre-slaughter period increased the blood levels and mRNA expression of heat shock protein 70 the Nile tilapia and produced fillets with a less firm texture (greater sarcomere length). The evaluated periods of anoxia did not markedly affect pH and WHC. These results demonstrate that a pre-slaughter period of acute stress of up to 6 min does not considerably affect the quality of meat. The fillets of fish slaughtered in the early evening had a higher WHC and lower plasma glucose level than those slaughtered at the other time periods (morning and afternoon).

https://doi.org/10.1590/fst.00518 788 descargas

15.

Hemophagocytic lymphohistiocytosis, a rare condition in renal transplant - a case report
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Lima, Valentine de A. C. de Castro

; Gouvêa, Ana Luisa Figueira

; Menezes, Paulo

; Santos, Jacqueline da F.

; Rochael, Mayra Carrijo

; Carvalho, Fabiana Rabe

; Almeida, Jorge Reis

; Lugon, Jocemir Ronaldo

Brazilian Journal of Nephrology

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Dic 2018, Volumen 40 Nº 4 Paginas 423 - 427

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A linfohistiocitose hemofagocítica (LHH) é uma condição incomum e potencialmente fatal, caracterizada por importante ativação imunológica e produção maciça de citocinas por células mononucleares inflamatórias, devido a defeitos na função linfocitária citotóxica. É ainda mais incomum em receptores de transplante renal, nos quais está freqüentemente associada a infecções não controladas. A mortalidade da LHH é alta, e o diagnóstico diferencial com sepse é um desafio. A abordagem e o tratamento dependem do gatilho e das comorbidades subjacentes. Relatamos o caso de uma paciente transplantada renal com 50 anos de idade, admitida com febre e mal-estar 3 meses após o transplante, apresentando anemia, febre, hipertrigliceridemia, níveis elevados de ferritina sérica e antigenemia positiva para CMV. A urina mostrou positividade para células decoy e BKV-DNA. A biopsia do enxerto mostrou nefrite por CMV. Ambas as culturas de sangue e urina foram positivas para E. coli. A hemofagocitose foi confirmada pelo aspirado de medula óssea. A imunossupressão foi reduzida e a paciente recebeu altas doses de imunoglobulina intravenosa e dexametasona, com resposta completa após 3 semanas. Destaca-se a importância do diagnóstico precoce e do manejo adequado de uma condição rara e grave em um paciente transplantado renal, o que pode permitir um curso clínico favorável e melhorar a taxa de sobrevida.

Abstract Hemophagocytic lymphohistiocytosis (HLH) is an uncommon and life-threating condition characterized by major immune activation and massive cytokine production by mononuclear inflammatory cells, due to defects in cytotoxic lymphocyte function. It is even more unusual in renal transplant recipients, in which it is often associated with uncontrolled infection. The mortality is high in HLH and differential diagnosis with sepsis is a challenge. The approach and management depend on the underlying trigger and comorbidities. We report a case of a 50-year-old renal transplant female admitted with fever and malaise 3 months post-transplant and presenting anemia, fever, hypertriglyceridemia, high levels of serum ferritin, and positive CMV antigenemia. Urine was positive for decoy cells and BKV-DNA. Graft biopsy showed CMV nephritis. Both blood and urine cultures where positive for E. coli. Hemophagocytosis was confirmed by bone marrow aspiration. Immunosuppression was reduced, and the patient received high-dose intravenous immunoglobulin and dexamethasone, with complete response after 3 weeks. We highlight the importance of early diagnosis and proper management of a rare and serious condition in a renal transplant patient, which can allow a favorable clinical course and improve survival rate.

https://doi.org/10.1590/2175-8239-jbn-2018-0012 7217 descargas

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