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Asociación entre niveles de empatía en médicos y satisfacción del paciente
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Baro Vila, Rocio C.

; Sigal, Alan R.

; Massa, Maximiliamo

; Benzadon, Mariano

; Gelpi, Ricardo J.

; Alves de Lima, Alberto

Medicina (Buenos Aires)

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Jun 2023, Volumen 83 Nº 2 Paginas 212 - 218

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

Resumen Introducción: Una buena relación médico-paciente es crucial para la práctica médica. Un elemento fundamen tal de la misma es la empatía del médico tratante, y esta puede ser cuantificada mediante una escala validada llamada Escala de Empatía de Jefferson. Métodos: En este estudio buscamos correlacionar los valores de empatía de los médicos del servicio con los resultados de las encuestas de satisfacción del pa ciente ambulatorio, medido mediante una herramienta llamada HCAPS. Resultados: Encontramos que los pacientes percibían un mayor trato respetuoso y que se les explicaba mejor sus opciones de tratamiento por parte de los médicos con mayores niveles de empatía. No hubo diferencias en los niveles de empatía de los médicos según su edad, sexo, o tiempo desde la obtención del título de especialista. Discusión: Los resultados validan a la empatía como una habilidad clave dentro de la relación médico-paciente.

Abstract Introduction: A good doctor-patient relationship is crucial to medical practice. A fundamental element of it is the empathy of the treating physician, and it can be quantified by means of a validated scale called the Jefferson Empathy Scale. Methods: In this study we sought to correlate the empathy values of our physicians with the results of outpatient satisfaction surveys, measured using a tool called HCAPS. Results: We found that patients perceived greater respectful treatment and had their treatment options better explained to them by physicians with higher lev els of empathy. There were no differences in physicians’ empathy levels according to their age, gender, or time since qualifying as a specialist. Discussion: These results validate empathy as a key skill in the doctor-patient relationship.

Pulmonary Cement Embolism
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Morgado, Margarida

; Vilares, Ana Teresa

; Alves, Filipe Barros

; Castro, Ricardo

; Madureira, António J.

Acta Radiológica Portuguesa

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Abr 2023, Volumen 35 Nº 1 Paginas 48 - 49

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

Abstract Vertebroplasty and kyphoplasty are widely used procedures for patients with symptomatic spinal compression fractures. Cement leakage into the paravertebral veins leading to pulmonary embolism is not an uncommon complication and the risk is increased when treating bone metastases. We present a case and images of a patient with previous vertebral compression fractures from metastatic breast cancer treated with vertebroplasty and kyphoplasty which presented imaging findings consistent with pulmonary cement embolism.

Resumo A vertebroplastia e a cifoplastia são procedimentos amplamente utilizados em doentes sintomáticos com fraturas vertebrais compressivas. O extravasamento de cimento ósseo para as veias paravertebrais com consequente embolia pulmonar não é uma complicação incomum e o risco é superior no tratamento de metástases ósseas. Apresentamos um caso clínico com imagens de uma doente com antecedentes de fraturas vertebrais compressivas por metastização óssea de cancro da mama, tratadas com vertebroplastia e cifoplastia, que evidenciou achados imagiológicos compatíveis com embolia pulmonar por cimento ósseo.

https://doi.org/10.25748/arp.28000

Nutritional evaluation and palatability of pet biscuits for dogs
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Poppi, Amanda Camila de Oliveira

; Oliveira, Gislaine Gonçalves

; Casetta, Jaisa

; Goes, Elenice Souza dos Reis

; Gasparino, Eliane

; Marques, Diogo de Oliveira

; Nogueira, Carla Cristina Alves

; Sbaraini, Sabrina Campos

; Santos, Sabrina Martins dos

; Khatlab, Angelica

; Vasconcellos, Ricardo Souza

; Cavali, Jucilene

; Dantas Filho, Jerônimo Vieira

; Souza, Maria Luiza Rodrigues de

Brazilian Journal of Food Technology

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2023, Volumen 26 elocation e2022132

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

Abstract The study's aim was to evaluate the microbiological, nutritional, textural quality and palatability of pet biscuits made with the inclusion of three flours. The treatments were chicken viscera flour (CVF), commercial Nile tilapia flour (FF) and mixed fish flours of several species (FVF). For the FVF, only the carcasses (backbones) of Nile tilapia, salmon, tuna and sardines were used, and they were washed, whereas FVF as well as the others were cooked for 60 minutes, then pressed, ground and dehydrated for 24 hours at 60° C. After this period, they were crushed and ground for inclusion in the biscuits. The CVF, FF and FVF flours showed 43.82%, 50.48% and 56.70% of crude protein, respectively. CVF had the highest lipid content (10.01%) and FVF had the highest ash content (23.94%) and FVF had the highest caloric value (338.63 kcal 100 g-1). The inclusion of flours in biscuits did not influence the protein and carbohydrate contents, whose average values were 18.48% and 50.23%. However, they influenced the moisture content, lipids, ash and caloric value. Biscuits with the inclusion of viscera (CVF) had the highest lipid content (5.91%) and those with fish had the highest ash content (5.66% and 5.81%) for FF and FVF. Biscuits with FVF had a lower caloric value (318.47 kcal 100 g-1). The microbiological analysis indicated that the biscuits were considered of good quality to feed dogs. Regarding texture and palatability, there was no significant difference between treatments. The inclusion of fish flour, both FF and FVF, is a viable alternative.

Resumo Objetivou-se avaliar a qualidade microbiológica e nutricional, a textura e a palatabilidade de biscoitos pet elaborados com a inclusão de três farinhas. Os tratamentos foram farinha de vísceras de frango (FVC), farinha de tilápia comercial (FF) e mix de farinhas de peixes de várias espécies (FVF). Para FVF, foram utilizadas apenas as carcaças (espinhaço) de tilápia, salmão, atum e sardinha, as quais foram lavadas. Em todos os tratamentos, as farinhas foram cozidas por 60 minutos, depois prensadas, moídas e desidratadas por 24 horas a 60 °C. Decorrido esse período, as farinhas foram trituradas e moídas para inclusão nos biscoitos. As farinhas FVC, FF e FVF apresentaram 43,82%, 50,48% e 56,70% de proteína bruta, respectivamente. A FVC apresentou maior teor lipídico (10,01%) e a FVF, maior teor de cinzas (23,94%) e o maior valor calórico (338,63 kcal 100 g-1). A inclusão das farinhas nos biscoitos não influenciou nos teores de proteína e carboidratos, cujos valores médios foram de 18,48% e 50,23%, respectivamente. Entretanto, influenciaram no teor de umidade, lipídios, cinzas e valor calórico. Os biscoitos com inclusão de vísceras (CVF) apresentaram os maiores teores de lipídeos (5,91%) e aqueles com inclusão pescado maiores teores de cinzas (5,66% e 5,81%) para FF e FVF. Os biscoitos com FVF apresentaram menor valor calórico (318,47 kcal 100 g-1). A análise microbiológica indicou que os biscoitos apresentaram qualidades apropriadas para serem fornecidos a cães. Em relação a textura e aceitabilidade, não houve diferença significativa entre os tratamentos. A inclusão de farinhas de peixe, tanto FF quanto FVF, é uma alternativa viável.

https://doi.org/10.1590/1981-6723.13222

Microbiological evaluation of feet-cutter disc for broiler with a self-washing system using heated and non-heated water
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Cavani, Ricardo

; Rubio, Marcela da Silva

; Alves, Lucas Bocchini Rodrigues

; Alves, Khauston Augusto Pereira

; Cardozo, Marita Vedovelli

Brazilian Journal of Food Technology

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2023, Volumen 26 elocation e2022046

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

Abstract The increased worldwide demand for chicken meat requires constant automation of operating systems and the proper implementation of self-control programs by slaughterhouses. Thus, this study aimed to evaluate the efficacy of a self-washing system using heated water on reducing the load of public health concern bacteria on a broiler feet-cutter disc. In a three-month period, 84 samples (n = 42 per group) were collected for microbiological analysis from the feet-cutter disc with an operational self-washing process with Non-Heated Water (NHW) and Heated Water (HW). The logarithmic counts of Mesophilic Aerobics, Sulphite-Reducing Clostridia (SRC), Escherichia coli and Staphylococcus aureus in the NHW group were 1.82, 0.56, 0.31 and 0.14 Log10 CFU/cm2, respectively, whereas in the HW group were 1.17, 0.04, 0.15 and 0.08 Log10 CFU/cm2. Salmonella spp. was absent in all evaluated samples in both groups. The heated-water system reduced bacterial count, but statistical differences were solely observed for Mesophilic Aerobics and SRC. Nevertheless, its usage could be an additive in the operational procedure to avoid microbiological violations of food safety, in addition to being easy-to-implement and affordable for the industry.

Resumo O aumento mundial da demanda por carne de frango exige constante automação de sistemas de operação e implementação adequada de programas de autocontrole pelos abatedouros. Assim, o objetivo do presente estudo foi avaliar a eficiência de sistema de autolavagem com água aquecida na redução da contagem de bactérias de interesse em saúde pública em disco corta-pés de frangos. Em um período de três meses, 84 amostras (n = 42, por grupo) foram colhidas para análises microbiológicas em disco corta-pés contando com um sistema operacional de autolavagem com água não aquecida (NHW) e água aquecida (HW). As contagens de Aeróbios Mesófilos, Clostridium Sulfito-redutor, Escherichia coli e Staphylococcus aureus, no grupo NHW, foram de 1,82, 0,56, 0,31 e 0,14 Log10 UFC/cm2, respectivamente, enquanto que, no grupo HW, foram de 1,17, 0,04, 0,15 e 0,08 Log10 UFC/cm2. Salmonella spp. foi ausente em todas amostras avaliadas, em ambos os grupos. O sistema com água aquecida reduziu as contagens bacterianas, mas diferenças estatísticas foram observadas somente em Aeróbios Mesófilos e Clostridium Sulfito-redutor. Apesar disso, seu uso pode ser um adicional ao procedimento operacional para evitar a violação dos limites microbiológicos de segurança alimentar, além de ser um sistema de fácil implementação e de baixo custo.

https://doi.org/10.1590/1981-6723.04622

Favorable Safety Experience of Local Dental Anesthesia in ICD Recipients with Cardiac Channelopathies
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Oliveira, Ana Carolina Guimarães

; Neves, Itamara Lucia Itagiba

; Sacilotto, Luciana

; Olivetti, Natália Quintella Sangiorgi

; Bueno, Savia Christina Pereira

; Pessente, Gabrielle D’Arezzo

; Santos-Paul, Marcela Alves dos

; Montano, Tânia Cristina Pedroso

; Carvalho, Cíntia Maria Alencar de

; Grupi, Cesar José

; Barbosa, Sílvio Alves

; Pastore, Carlos Alberto

; Samesima, Nelson

; Wu, Tan Chen

; Hachul, Denise Tessariol

; Scanavacca, Maurício Ibrahim

; Neves, Ricardo Simões

; Darrieux, Francisco Carlos da Costa

International Journal of Cardiovascular Sciences

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2023, Volumen 36 elocation e20200312

Resumen: En | Texto: En | PDF: En

Abstract Background Dental anesthetic management in implantable cardioverter defibrillator (ICD) recipients with cardiac channelopathies (CCh) can be challenging due to the potential risk of life-threatening arrhythmias and appropriate ICD therapies during procedural time. Objectives The present study assessed the hypothesis that the use of local dental anesthesia with 2% lidocaine with 1:100,000 epinephrine or without a vasoconstrictor can be safe in selected ICD and CCh patients, not resulting in life-threatening events (LTE). Methods Restorative dental treatment under local dental anesthesia was made in two sessions, with a wash-out period of 7 days (cross-over trial), conducting with a 28h - Holter monitoring, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments in 3 time periods. Statistical analysis carried out the paired Student’s t test and the Wilcoxon signed-rank test. In all cases, a significance level of 5% was adopted. All patients were in stable condition with no recent events before dental care. Results Twenty-four consecutive procedures were performed in 12 patients (9 women, 3 men) with CCh and ICD: 7 (58.3%) had long QT syndrome (LQTS), 4 (33.3%) Brugada syndrome (BrS), and 1 (8.3%) Catecholaminergic polymorphic ventricular tachycardia (CPVT). Holter analysis showed no increased heart rate (HR) or sustained arrhythmias. Blood pressure (BP), electrocardiographic changes and anxiety measurement showed no statistically significant differences. No LTE occurred during dental treatment, regardless of the type of anesthesia. Conclusion Lidocaine administration, with or without epinephrine, can be safely used in selected CCh-ICD patients without LTE. These preliminary findings need to be confirmed in a larger population with ICD and CCh.

https://doi.org/10.36660/ijcs.20200312

Deep sea ecosystem exploration and ‘health check’: sampling strategy and methods applied during the iAtlantic_BR10_Petrobras cruise in the Santos Basin, Southwest Atlantic
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Perez, Jose Angel A.

; Barros Neto, Halésio M.C. de

; Arantes, Renata C.M.

; Gaurisas, Daniela Y.

; Silva, Camila F.

; Alves, Fernanda Maria M.

; Costa, Júlia A.

; Eloi, Paula D.C.

; Fonseca, Thayse S.

; Gavazzoni, Lucas

; Lonskis, Isabella da S.

; Nardi, Ricardo U.

; Nascimento, Pedro O.

; Rodrigues, João Vitor M.

; Santos, Ana Lara F. dos

; Santos, Edson C. dos

; Schroeder, Rafael

; Silva, Luis Carlos da

; Souza, Fernanda dos S.S. de

; Bernardino, Ângelo F.

; Cavalcanti, Guarani H.

; Lindner, Alberto

; Mahiques, Michel M. de

; Millo, Christian

; Reis, Priscila

; Sweetman, Andrew K.

; Roberts, J. Murray

Ocean and Coastal Research

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2023, Volumen 71 elocation e23046

Resumen: En | Texto: En | PDF: En

Abstract The iAtlantic Project has established an international collaborative strategy to improve mapping and characterization of deep and open ocean ecosystems in understudied regions of the Atlantic and evaluate their health. In December 2022, the first iAtlantic expedition in the South Atlantic set off to map and explore seafloor ecosystems in the Santos Basin slope (200-1,000 m depths) in collaboration with the Petrobras ‘Santos Basin - Regional Characterization Project.’ The 17-day ‘iAtlantic_BR10-Petrobras’ cruise was conducted on board the research vessel NPqHOc Vital de Oliveira (Brazilian Navy) and performed (a) water column structure characterization, (b) seafloor morphology mapping, (c) description of benthic habitats and communities by seafloor imagery and biological/ geological sampling, and (d) ex-situ experiments to assess the functioning of sedimentary ecosystems and their responses to climate-related environmental changes. This study describes the rationale behind the iAtlantic_BR10-Petrobras cruise science plan, reports its sampling strategy and methods, and summarizes its collected data and preliminary results.

https://doi.org/10.1590/2675-2824071.23069jaap

Physiological Adaptations to Life in Space: An Update
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Silva, Isadora de Carvalho e

; Russomano, Thais

; Ferreira, Ricardo Alves

; Cupertino, Marli do Carmo

; Alcântara, Fabíola Alves

; Geller, Mauro

; Cima, Oswaldo Monteiro Del

; Siqueira-Batista, Rodrigo

Journal of Aerospace Technology and Management

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2023, Volumen 15 elocation e2823

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ABSTRACT The historic flight of cosmonaut Yuri Alekeseyevich Gagarin, in 1961, established the need for research regarding the physiological adaptations of the human body when exposed to the space environment. Since then, several morpho-functional transformations – varying between normal and pathological – have been identified within the organisms of astronauts subjected to the extremely disparate environments of the cosmos, consequently, comprehension and preparation of these transformations becomes essential, considering the possibilities (1) of returning to the Moon and (2) of initiating the trip to Mars. Accordingly, the purpose of this article – conceived as a narrative literature review – is to present the main aspects of the physiological modifications within the human body due to the extraterrestrial environment, with emphasis on cardiovascular, renal, hydroelectrolytic, hematological, immunological, respiratory, neurological, psychological, sensory, gastrointestinal, endocrine, musculoskeletal, integumentary, and genetic adaptations.

https://doi.org/10.1590/jatm.v15.1319

TIME IN SEDENTARY BEHAVIOR AND PHYSICAL ACTIVITY AS DISCRIMINATORS OF DIABESITY IN QUILOMBOLAS
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Santana, Poliana Pereira

; Santos, Clarice Alves dos

; Mussi, Ricardo Franklin de Freitas

; Rocha, Saulo Vasconcelos

Journal of Physical Education

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2023, Volumen 34 elocation e3432

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

ABSTRACT Introduction: Diabesity is characterized as a simultaneous condition of type 02 diabetes and obesity. Among the aspects that influence the development of diabetes, the time in sedentary behavior and the time of physical activity are important risk factors. Objectives: To estimate cut-off points for time spent in sedentary behavior and physical activity as a discriminator of the presence of diabesity and to evaluate the predictive ability of WC and PA to identify this condition in quilombola adults. Methodology: this is a cross-sectional study with a sample composed of 332 adults (age ≥ 50 years), participants in the study of the Epidemiological Profile of Quilombolas from Bahia living in the micro-region of Guanambi, Brazil. The data were obtained by means of interviews and anthropometric evaluation. Sociodemographic and lifestyle information (physical activity and sedentary behavior) were included. To analyze the cut-off point of Sedentary Behavior as a predictor of diabesity, the Receiver Operating Characteristic (ROC) curve was used. Results: Time in sedentary behavior >120 min/day and time in physical activity <240 min/week were the best cut-off points for discriminating diabesity in quilombola, with area under the ROC curve of 0.62, 95% CI (0.56-0.67) and 0.62 (95% CI: 0.55-0.67), respectively. Conclusions: The results showed that time in sedentary behavior and time in physical activity showed a good ability to discriminate the presence of diabesity among quilombola adults.

RESUMO Introdução: A Diabesidade caracteriza-se como uma condição simultânea de diabetes tipo 02 e obesidade. Dentre os aspectos que influenciam o desenvolvimento da diabesidade, o tempo em comportamento sedentário e o tempo de atividade física apresentam-se como importantes fatores de risco. Objetivos: estimar pontos de corte para o tempo em comportamento sedentário e atividade física como discriminador de presença de diabesidade e avaliar a capacidade preditiva do CS e AF para identificar essa condição em adultos quilombolas. Metodologia: trata-se de estudo transversal com amostra composta por 332 adultos (idade ≥ 50 anos), participantes do estudo de Perfil Epidemiológico dos Quilombolas baianos residentes na microrregião de Guanambi, Brasil. Os dados foram obtidos por meio de entrevistas e avaliação antropométrica. Foram incluídas informações sociodemográficas e estilo de vida (atividade física e comportamento sedentário). Para a análise do ponto de corte do Comportamento Sedentário e o tempo de atividade física como preditores de diabesidade, foi utilizada a curva Receiver Opereting Characteristic (ROC). Resultados: Tempo em comportamento sedentário >120 min/dia e tempo de atividade física >240 min/semana foram os melhores pontos de corte para discriminar a diabesidade em quilombola, com área sob a curva ROC de 0,62, IC 95% (0,56-0,67) e 0,62 (IC 95%: 0,55-0,67), respectivamente. Conclusões: Os resultados mostraram que o tempo em comportamento sedentário e atividade física apresentaram uma boa capacidade para discriminar a presença de diabesidade entre adultos quilombolas.

https://doi.org/10.4025/jphyseduc.v34i1.3232

Calcareous nannofossils, biostratigraphy, and paleobiogeography of the Aptian/Albian Romualdo Formation in the Araripe Basin, North-Eastern Brazil
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Lemos, Flávia Azevedo Pedrosa

; Asakura, Yumi

; Antunes, Rogério Loureiro

; Araripe, Rilda Verônica Cardoso de

; Prado, Ludmila Alves Cadeira do

; Tomé, Maria Emilia Travassos Rio

; Oliveira, David Holanda de

; Nascimento, Luiz Ricardo Silva Lobo do

; Ng, Christiano

; Barreto, Alcina Magnólia Franca

Brazilian Journal of Geology

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2023, Volumen 53 Nº 2 elocation e20220054

Resumen: En | Texto: En | PDF: En

Abstract The objectives of this study were the biostratigraphic and paleobiogeographic interpretations of the calcareous nannofossil records of the Romualdo Formation (Aptian-Albian) in the south-central portion of the Araripe Basin. The methods used to process the samples were decanting, smear slide, centrifugation, and ultra-thin section confection. The taxonomic and biostratigraphic interpretations were carried out through qualitative and quantitative investigations. A total of 11 genera and 17 species of calcareous nannofossils, namely, Biscutum constans, Biscutum sp., Braarudosphaera africana, Braarudosphaera sp., Calculites sp., Discorhabdus ignotus, Hayesites albiensis, Hayesites sp., Nannoconus bucheri, Nannoconus sp., Retecapsa surirella, Rhagodiscus sp., Thoracosphaera sp., Watznaueria barnesiae, Watznaueria sp., Zeughrabdotus erectus, and Zeughrabdotus noeliae were identified. The integrated analysis of three outcrops suggests two distinct marine phases: the first in the Aptian, recognized in two outcrops, and during the Albian age. The genera Hayesites and Nannoconus suggest a strong Tethyan affinity. Differently, other calcareous nannofossils such as Watznaueria, Thoracosphaera, and Braarudosphaera recorded here are considered more resistant, cosmopolitan, and/or opportunistic species. Biscutum and Zeughrabdotus are sensitive calcareous nannofossils because they are more susceptible to dissolution and cannot be surely used to define this paleobiogeography and biostratigraphic range.

https://doi.org/10.1590/2317-4889202320220054

10.

BALB/c and C57BL/6 mouse strains influence gastric function outcomes with administration of cisplatin and dexamethasone
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Gama, Loyane Almeida

; Machado, Mariana Pirani Rocha

; Corá, Luciana Aparecida

; Beckmann, Ana Paula Simões

; Alves, Wellington David Luz

; Miranda, José Ricardo de Arruda

; Américo, Madileine Francely

Brazilian Journal of Pharmaceutical Sciences

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2023, Volumen 59 elocation e22718

Resumen: En | Texto: En | PDF: En

Abstract Our aim was to evaluate the effects of cisplatin and dexamethasone alone and combined on gastric contractility and histomorphometry of BALB/c and C57BL/6 mice. BALB/c and C57BL/6 male mice (8-week-old) were randomly separated into: Control; Cisplatin (7.5 mg/Kg); Dexamethasone (2.0 mg/Kg); and Dexamethasone plus Cisplatin (2.0 mg/Kg of dexamethasone 1-hour prior to 7.5 mg/Kg of cisplatin). Drugs were administered intraperitoneally for three days. Body weight and food intake were evaluated on 2nd day. Alternating Current Biosusceptometry technique was employed to measure gastric contractions on 3rd day. Afterward, mice were killed for gastric histomorphometric analysis. Cisplatin decreased food intake and caused bradygastria in BALB/c mice; however, the amplitude of gastric contractions decreased in both BALB/c and C57BL/6. Dexamethasone and cisplatin combined restored the gastric frequency and food intake only in BALB/c, but drug combination reduced the gastric amplitude of contractions in both strains. Dexamethasone alone increased gastric mucosa thickness in C57BL/6 and decreased muscular thickness in BALB/c. In conclusion, the mouse strains presented differences in acute effects of cisplatin and dexamethasone alone and combined on gastric function. This reinforces the importance of choosing the appropriate mouse strain for studying the acute effects of drugs on the gastrointestinal tract.

https://doi.org/10.1590/s2175-97902023e22718

11.

Obesity influences the development of bisphosphonate-induced osteonecrosis in Wistar rats
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LIMA, Wilson José de Miranda

; PONTES, Jannerson Cesar Xavier de

; FIGUEIREDO, Ludmila Silva de

; ARAÚJO, Rubens da Silva

; PAIVA SOUSA, Maria Carolina de

; AQUINO, Jailane de Souza

; CASTRO, Ricardo Dias de

; ALVES, Adriano Francisco

Journal of Applied Oral Science

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2023, Volumen 31 elocation e20230133

Resumen: En | Texto: En | PDF: En

Abstract Medication-related osteonecrosis of the jaw (MRONJ) is characterized by bone exposure for more than eight weeks in patients who have used or been treated with antiresorptive or antiangiogenic drugs, without a history of radiation therapy or metastatic diseases in the jaws. Obesity is associated with changes in periodontal tissues and oral microbiota that are linked to bone alterations. This study aimed to analyze the influence of obesity on the development of bisphosphonate-induced osteonecrosis. The experiment randomly and simply divided 24 male Wistar rats (Rattus norvegicus) into four groups: healthy, with osteonecrosis, obese, and obese with osteonecrosis (n=6 per group). Osteonecrosis was induced through weekly intraperitoneal injection for eight weeks at a dose of 250 µg/kg of zoledronic acid in a 4 mg/5 mL solution, combined with trauma (exodontia). Obesity was induced through a high glycaemic index diet. Each group was qualitatively and quantitatively evaluated regarding the development of models and pathological anatomy of the lesions. The results were expressed in mean percentage and standard deviation and statistically analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test, with a significance level of 5% (p<0.05) to establish differences found between the groups. Animals in the osteonecrosis group and the obese with osteonecrosis group presented larger necrosis areas (averages: 172.83±18,19 µm2 and 290.33±15,77 µm2, respectively) (p<0,0001). Bone sequestration, hepatic steatosis, and increased adipocyte size were observed in the obese group (average: 97.75±1.91 µm2) and in the obese with osteonecrosis group (average: 98.41±1.56 µm2), indicating greater tissue damage in these groups (p<0,0001). All parameters analyzed (through histological, morphometric, and murinometric analyses) increased for the obese and obese with osteonecrosis groups, suggesting a possible influence of obesity on the results. However, further studies are needed to confirm the role of obesity in the possible exacerbation of osteonecrosis and understand the underlying mechanisms.

https://doi.org/10.1590/1678-7757-2023-0133

12.

[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio Rassi Jr., Anis Moraes Oliveira, Gláucia M. Lemos Correia, Luís Claudio Novaes Ramos Jr., Alberto Hasslocher-Moreno, Alejandro Marcel Luquetti Ostermayer, Alejandro Sousa, Andréa Silvestre de Amato Vincenzo de Paola, Angelo Sobral de Sousa, Antonio Carlos Pinho Ribeiro, Antonio Luiz Correia Filho, Dalmo Moraes de Souza, Dilma do Socorro Cunha-Neto, Edecio J. A. Ramires, Felix Bacal, Fernando Pereira Nunes, Maria do Carmo Martinelli Filho, Martino Ibrahim Scanavacca, Maurício Magalhães Saraiva, Roberto Alves de Oliveira Júnior, Wilson M. Lorga-Filho, Adalberto de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Adriana V. L. Sarabanda, Alvaro Yecê das Neves Pinto, Ana Assis Lopes do Carmo, André Schmidt, André Costa, Andréa Rodrigues da Ianni, Barbara Maria Markman Filho, Brivaldo Eduardo Rochitte, Carlos Thé Macedo, Carolina Mady, Charles Chevillard, Christophe Bittencourt das Virgens, Cláudio Marcelo Nery de Castro, Cleudson De Paoli de Carvalho Britto, Constança Felícia Pisani, Cristiano do Carmo Rassi, Daniela C. Sobral Filho, Dario Rodrigues Almeida, Dirceu A. Bocchi, Edimar T. Mesquita, Evandro de Souza Nogueira Sardinha Mendes, Fernanda Pereira, Francisca Tatiana Sperandio da Silva, Gilberto Marcelo de Lima Peixoto, Giselle Glotz de Lima, Gustavo H. Veloso, Henrique Turin Moreira, Henrique Bellotti Lopes, Hugo Masciarelli Francisco Pinto, Ibraim Pinto Dias, João Carlos Bemfica, João Marcos Silva-Nunes, João Paulo Soares Barreto-Filho, José Augusto Kerr Saraiva, José Francisco Lannes-Vieira, Joseli Menezes Oliveira, Joselina Luzia V. Armaganijan, Luciana Martins, Luiz Cláudio C. Sangenis, Luiz Henrique Barbosa, Marco Paulo Almeida-Santos, Marcos Antônio Simões, Marcos Vinicius Shikanai-Yasuda, Maria Aparecida Vieira Moreira, Maria da Consolação Higuchi, Maria de Lourdes Costa Monteiro, Maria Rita de Cássia Felix Mediano, Mauro Felippe Maia Lima, Mayara T. Oliveira, Maykon Moreira Dias Romano , Minna Nitz, Nadjar de Tarso Jorge Medeiros, Paulo Vieira Alves, Renato Alkmim Teixeira, Ricardo Coury Pedrosa, Roberto Aras, Roque Morais Torres, Rosália dos Santos Povoa, Rui Manoel Rassi, Sérgio Gabriel Salles Xavier, Sérgio Marinho Martins Alves , Silvia B. N. Tavares, Suelene Lima Palmeira, Swamy da Silva Junior, Telêmaco Luiz da Rocha Rodrigues, Thiago Madrini Junior, Vagner Maia da Costa , Veruska Dutra, Walderez

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Fecha de publicación: 2022-10-11

Resumen: En Pt

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.

Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;

https://doi.org/10.1590/SciELOPreprints.4820

13.

Cardiac Arrhythmias and Covid-19
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Fagundes, Alexsandro Alves

; Melo, Sissy Lara de

; Armaganijan, Luciana

; Kuniyoshi, Ricardo

; Moraes, Luis Gustavo Belo de

; Borges, Vanessa Alves Guimarães

; Scanavacca, Mauricio

; Martinelli Filho, Martino

; Teixeira, Ricardo Alkmim

International Journal of Cardiovascular Sciences

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Dic 2021, Volumen 34 Nº 6 Paginas 717 - 727

Resumen: En | Texto: En | PDF: En

Abstract Cardiovascular manifestations of COVID-19 include cardiac rhythm disturbances, whose mechanisms, incidence, and most common types are not well established in this population. Intense inflammatory response and metabolic activity contribute to recurrence of pre-existing arrhythmias, and other arrhythmias can occur due to myocardial injury, acute coronary insufficiency, and electrolyte disturbances. Brady- and tachyarrhythmias, as well as conduction disorders have been described. QT interval prolongation and fatal ventricular arrhythmias ( Torsades de Pointes ) may result from the pathological process or adverse effect of drugs (antiarrhythmics, chloroquine / hydroxychloroquine, azithromycin and antivirals). Patients with congenital heart disease and hemodynamic repercussions, patients with signs of heart failure, pulmonary hypertension, cyanosis, hypoxemia, and those who underwent heart transplantation and immunosuppression are at greater risk. In patients with implantable cardioverter-defibrillators (ICDs), the risk depends on the presence of structural heart disease. In the course of COVID-19, in-person assessment of these patients should be limited to high-risk situations, including syncope, worsening of heart failure and shock delivery by ICDs. Likewise, cardiac implantable electronic device implantation or replacement surgery should be limited to emergency and urgent cases, including symptomatic high-degree atrioventricular block, ICD for secondary prevention and pulse generator replacement due to battery drain.

https://doi.org/10.36660/ijcs.20200123

14.

Saúde mental dos estudantes de Medicina do Brasil durante a pandemia da coronavirus disease 2019
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Teixeira, Larissa de Araújo Correia

; Costa, Ricardo Alves

; Mattos, Roberta Machado Pimentel Rebello de

; Pimentel, Déborah

Jornal Brasileiro de Psiquiatria

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Mar 2021, Volumen 70 Nº 1 Paginas 21 - 29

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

ABSTRACT Objective: The objective of the research is to verify the prevalence of psychological distress symptoms in medical students during the COVID-19 pandemic. Methods: This is a cross-sectional and exploratory study that evaluated 656 medical students in Brazil. Data were collected between May and June 2020, through two self-administered instruments. The first was a questionnaire prepared by the authors themselves to assess the social, demographic and cultural profile of the population. For the screening of signs of psychological distress, the Self-Report Questionnaire was used, a questionnaire with 20 items divided into four domains. During data analysis, associations between categorical variables were tested using Pearson's chi-square test. The significance level adopted was 5%. Results: The results show that the prevalence of individuals with signs of psychological distress was 62.8%. Risk factors for mental illness during the COVID-19 pandemic are being female, being in the first two years of the course, reporting poor adaptation to Distance Learning, having difficulty concentrating, worrying about the delay of graduation, have a previous diagnosis of mental disorder, live with someone who needs to work outside the home, inability to maintain healthy habits and fear being infected by the virus. Conclusion: We conclude that the signs of psychological distress are high among medical students during the COVID-19 pandemic. In addition, it was also possible to conclude that there are protective factors for mental illness.

RESUMO Objetivo: O objetivo desta pesquisa é verificar a prevalência de sintomas de sofrimento psíquico em estudantes do curso de Medicina durante a pandemia da COVID-19. Métodos: Trata-se de um estudo transversal e exploratório que avaliou 656 estudantes do curso de Medicina do Brasil. Os dados foram coletados, em maio e junho de 2020, por meio de dois instrumentos autoaplicáveis. O primeiro foi um questionário elaborado pelos próprios autores para avaliar o perfil social, demográfico e cultural da população. Para o rastreamento de indícios de sofrimento psíquico, utilizou-se o Self-Report Questionnaire, um questionário com 20 itens divididos em quatro domínios. Durante a análise de dados, as associações entre variáveis categóricas foram testadas por meio do teste qui-quadrado de Pearson. O nível de significância adotado foi de 5%. Resultados: A prevalência de indivíduos com indícios de sofrimento psíquico foi de 62,8%. São fatores de risco para o adoecimento mental durante a pandemia da COVID-19: ser do sexo feminino, estar nos dois primeiros anos do curso, relatar má adaptação ao ensino a distância, apresentar dificuldade de concentração, preocupar-se com o atraso da graduação, ter um diagnóstico prévio de transtorno mental, morar com alguém que precisa trabalhar fora de casa, ser incapaz de manter hábitos saudáveis e ter medo de ser infectado pelo vírus. Conclusão: Este estudo demonstrou que os indícios de sofrimento psíquico estão elevados entre estudantes de Medicina durante a pandemia da COVID-19. Além disso, também foi possível concluir que há fatores protetores para o adoecimento mental.

https://doi.org/10.1590/0047-2085000000315

15.

RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods
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Confortin, Susana Cararo

; Ribeiro, Marizélia Rodrigues Costa

; Barros, Aluísio J. D.

; Menezes, Ana Maria Baptista

; Horta, Bernardo L.

; Victora, Cesar Gomes

; Barros, Fernando C.

; Gonçalves, Helen

; Bettiol, Heloisa

; Santos, Iná Silva dos

; Barbieri, Marco Antonio

; Saraiva, Maria da Conceição Pereira

; Alves, Maria Teresa Seabra Soares de Britto e

; Silveira, Mariângela Freitas da

; Domingues, Marlos Rodrigues

; Lima, Natália Peixoto

; Rocha, Paulo Ricardo Higassiaraguti

; Cavalli, Ricardo Carvalho

; Batista, Rosângela Fernandes Lucena

; Cardoso, Viviane Cunha

; Simões, Vanda Maria Ferreira

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2021, Volumen 37 Nº 4 elocation e00093320

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

Resumo: O artigo descreve a história, objetivos e métodos utilizados pelas nove coortes do Consórcio RPS de Coortes de Nascimento. São identificados eixos temáticos comuns, com apresentação dos objetivos, anos de linha de base, fases de seguimento e representatividade das populações de estudo. O Consórcio inclui três coortes de nascimento de Ribeirão Preto, Estado de São Paulo (1978/1979, 1994 e 2010), quatro de Pelotas, Estado do Rio Grande do Sul (1982, 1993, 2004 e 2015) e duas de São Luís, Estado do Maranhão (1997 e 2010). As coortes provêm de três regiões do Brasil, de três estados diferentes, com importantes diferenças socioeconômicas, culturais e de infraestrutura. As coortes foram iniciadas ao nascer dos participantes, exceto a mais recente em cada município, onde as mães foram recrutadas durante a gestação. Os instrumentos para a coleta de dados foram refinados para aproximar diferentes exposições na primeira infância e a influência, a longo prazo, no processo saúde-doença. Os investigadores das nove coortes realizaram estudos perinatais e depois examinaram o capital humano, saúde mental, nutrição e sinais percursores de doenças crônicas. Um total de 17.636 nascidos vivos foram recrutados em Ribeirão Preto, 19.669 em Pelotas e 7.659 em São Luís. Nas coortes que foram iniciadas durante a gestação, foram entrevistadas 1.400 gestantes em Ribeirão Preto, 3.199 em Pelotas e 1.447 em São Luís. Foram utilizadas diferentes estratégias para reduzir as perdas de seguimento. A rede de pesquisa do Consórcio permite analisar a incidência de doenças e identificar possíveis relações causais que podem explicar os desfechos de saúde nessas populações e contribuir para o desenvolvimento de medidas públicas e políticas de saúde que estejam mais de acordo com as respectivas realidades.

Abstract: This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.

Resumen: El trabajo describe la historia, objetivos y métodos usados por nueve cohortes brasileñas del RPS Consorcio de Cohortes de Nacimiento. Se identificaron los ejes temáticos comunes y los objetivos, así como los periodos de referencia, la presentación del estadio de seguimiento y representatividad de la población estudiada. El consorcio incluye tres cohortes de nacimiento de Ribeirão Preto, Estado de São Paulo (1978/1979, 1994 y 2010), cuatro de Pelotas, Estado del Rio Grande do Sul (1982, 1993, 2004 y 2015), y dos de São Luís, Estado del Maranhão (1997 y 2010). Las cohortes cubren tres regiones de Brasil, de tres estados distintos, con marcadas diferencias socioeconómicas, culturales y de infraestructura. Las cohortes comenzaron con el nacimiento, excepto para la más reciente en cada municipio, donde las madres fueron reclutadas durante la gestación. Los instrumentos para la recogida de datos han sido depurados, con el fin de realizar una aproximación a diferentes exposiciones durante las fases tempranas de la vida y su influencia a largo plazo en el proceso de salud-enfermedad. Se incluyeron a los investigadores de las nueve cohortes, donde se llevaron a cabo estudios perinatales, así como los recursos humanos analizados posteriormente, al igual que la salud mental, nutrición y signos precursores de enfermedades no comunicables. Un total de 17.636 nacidos vivos fueron reclutados en Ribeirão Preto, 19.669 en Pelotas, y 7.659 en São Luís. En los estudios que comenzaron durante el embarazo, 1.400 mujeres embarazadas fueron entrevistadas en Ribeirão Preto, 3.199 en Pelotas, y 1.447 en São Luís. Se usaron diferentes estrategias para reducir pérdidas, con el fin de realizar el seguimiento. Esta red de investigación permite el análisis de la incidencia de enfermedades y el establecimiento de posibles relaciones causales que podrían explicar los resultados de salud de estas poblaciones, con el fin de contribuir al desarrollo de acciones gubernamentales y políticas de salud más consistentes con la realidad.

https://doi.org/10.1590/0102-311x00093320 419 descargas

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