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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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Fecha de publicación: 2024-04-08

Resumen: 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

Noteworthy records of the ticks Ornithodoros rostratus and Amblyomma sculptum parasitizing Pteronura brasiliensis in the central-western region of Brazil, with pathogen investigation notes
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Barros-Battesti, Darci Moraes

; André, Marcos Rogério

; Hoppe, Estevam Guilherme Lux

; Seron, Gustavo

; Bassini-Silva, Ricardo

; Calchi, Ana Claúdia

; Andrade, Lívia Oliveira

; Perin, Patrícia Parreira

; Martins, Thiago Fernandes

; Castro-Santiago, Ana Carolina

; Leuchtenberger, Caroline

; Almeida, Samara

; Foerster, Nathalie

; Furtado, Mariana

; de Castro Jacinavicius, Fernando

Revista Brasileira de Parasitologia Veterinária

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2024, Volumen 33 Nº 1 elocation e014523

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

Resumo Um macho de Pteronura brasiliensis (Carnivora: Mustelidae) foi encontrado morto às margens do Rio Negro, no Pantanal do estado de Mato Grosso do Sul, município de Aquidauana. Dois carrapatos encontrados aderidos à sua pele foram identificados, morfologicamente, como uma ninfa de segundo ínstar de Ornithodoros rostratus (Argasidae) e um macho de Amblyomma sculptum (Ixodidae). Para complementar a identificação morfológica, esses espécimes de carrapatos foram submetidos à extração de DNA e testados por meio de ensaios de PCR, para confirmar a identidade molecular dos espécimes. Além disso, os extraídos dos carrapatos foram testados e revelaram-se negativos nos ensaios de PCR para todos os patógenos testados. Também foram examinados 30 lotes, compostos por 174 indivíduos de O. rostratus, depositados na Coleção Acari do Instituto Butantan, e encontramos material de quatro estados brasileiros, incluindo-se um lote contendo 2 machos e 2 fêmeas de Aquidauana, estado de Mato Grosso do Sul (MS), coletado do solo. Este foi, portanto, o primeiro registro de O. rostratus parasitando P. brasiliensis e o primeiro registro de localidade (Aquidauana). Da mesma forma, A. sculptum é comumente encontrado no Pantanal e relatado aqui, pela segunda vez, parasitando a ariranha, hospedeiro pouco estudado em relação a ectoparasitas.

Abstract A male of Pteronura brasiliensis (Carnivora: Mustelidae) was found dead on the banks of the Rio Negro, in the Pantanal wetlands of Mato Grosso do Sul state, Aquidauana municipality. Two ticks found attached to its skin were morphologically identified as a second-instar nymph of Ornithodoros rostratus (Argasidae) and a male of Amblyomma sculptum (Ixodidae). In order to complement the morphological identification, these tick specimens were subjected to DNA extraction, and tested using PCR assays to confirm the molecular identity the specimens. Also, the tick DNA samples were tested and were negative in the PCR assays for all the pathogens tested. We also examined 30 batches, consisting of 174 individuals of O. rostratus deposited in the Acari Collection of the Butantan Institute, and we found material from four Brazilian states, including one batch containing 2 males and 2 females from Aquidauana, of Mato Grosso do Sul state, collected from the soil. This was therefore the first record of O. rostratus parasitizing P. brasiliensis and the first locality record (Aquidauana). Likewise, A. sculptum is commonly found in the Pantanal and is reported here for the second time parasitizing the giant otter, which is a host little studied regarding the ectoparasites.

https://doi.org/10.1590/s1984-29612024003

STRENGTH AND ENDURANCE TRAINING IN CYTOKINE AND BODY COMPOSITION OF PEOPLE WITH HIV/AIDS
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P. Barros, Gustavo Willames

; C. Carvalho, Paulo Roberto

; Santos, Heleodório Honorato Dos

; B. de Lorena, Virginia Maria

; A. de Oliveira, Bruna Fernanda

; Santos, José Cristiano Faustino dos

; Leandro, Magno Petrônio Galvão

; Araújo, Paulo Sergio R. de

Revista Brasileira de Medicina do Esporte

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2024, Volumen 30 elocation e2022_0123

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

ABSTRACT Introduction: HIV/AIDS is considered one of the great cases of public health, but it is seen that patients who use antiretroviral therapy (ART) and practice strength training promote a promotion of their health. Objectives: Assess the impact of strength and resistance training on cytokines and body composition in people living with HIV/AIDS. Methods: Randomized clinical trial, the sample consisted of 12 patients, 7 from the Strength Group (GF) and 5 from Group 2, Muscular Resistance (MGR). We compared the levels of IL-2, IL-4, IL-6, IL-10 and TNF-α cytokines and body composition in the first and last sessions. The patients completed 36 strength and resistance training sessions over 12 weeks. Results: After 36 sessions of GRM resistance training, there was a significant increase from 4,734 pg/mL to 5,050 pg/mL of IL-10 (p=0.002). Regarding the GFR, no significant results were found. For body composition, there were significant differences in GFR due to the increase in lean mass of the arms from 6,441g to 7,014g (p=0.04), legs from 16,379g to 17,281g (p=0.02) and whole body of 45,640g to 47,343g (p=0.01). In G2 there was a significant decrease in the percentage of fat in the arms from 23,160% to 20,750% (p = 0.04). To assess quality of life, the WHOQOL-HIV-Bref questionnaire was used, where significant improvement was found in all domains, except for the level of independence domain. Conclusion: We conclude that muscular resistance training is effective in increasing IL-10 and decreasing the percentage of fat in the arms, whereas strength training increases lean mass in arms, legs, and the whole body. Level of Evidence I; Randomized Clinical Trial.

RESUMEN Introducción: El VIH/SIDA es considerado uno de los grandes casos de salud pública, sin embargo, está comprobado que pacientes que hacen uso de la terapia antirretroviral (TARV) y practican entrenamiento de fuerza provoca una promoción de su salud. Objetivos: Evaluar el impacto del entrenamiento de fuerza en la resistencia a las citoquinas y en la composición corporal de las personas que viven con VIH/SIDA. Métodos: Ensayo clínico aleatorizado, la muestra estuvo compuesta por 12 pacientes, siete del Grupo de Fuerza (TFG) y cinco del Grupo de Resistencia Muscular (GRM). Se compararon los niveles de las citocinas IL-2, IL-4, IL-6, IL-10 y TNF-α y la composición corporal en la primera y la última sesión. Los pacientes completaron 36 sesiones de entrenamiento de fuerza y resistencia durante 12 semanas. Resultados: Tras 36 sesiones de entrenamiento de resistencia GRM, se produjo un aumento significativo de 4.734 pg/mL a 5.050 pg/mL de IL-10 (p=0,002). En cuanto a la TFG, no se encontraron resultados significativos. En cuanto a la composición corporal, hubo diferencias significativas en la TFG debido al aumento de la masa magra en brazos de 6.441g a 7.014g (p=0,04), piernas de 16.379g a 17.281g (p=0,02) y cuerpo entero de 45.640g a 47.343g (p=0,01). En el GRM hubo una disminución significativa del porcentaje de grasa en los brazos de 23.160% a 20.750% (p = 0,04). Para la evaluación de la calidad de vida se utilizó el cuestionario WHOQOL-HIV-Bref, donde se encontró una mejoría significativa en todos los dominios, excepto en el dominio nivel de independencia. Conclusión: Concluimos que el entrenamiento de resistencia muscular es eficaz para aumentar la IL-10 y disminuir el porcentaje de grasa en los brazos, mientras que el entrenamiento de fuerza aumenta la masa magra total. Nivel de Evidencia I; Ensayo clínico aleatorizado.

RESUMO Introdução: O HIV/AIDS é considerado um dos grandes casos de saúde pública, porém verifica-se que pacientes que fazem uso de terapia antirretroviral (TARV) e praticam treinamento de força provocam uma promoção de sua saúde. Objetivos: Avaliar o impacto do treinamento de força sobre a resistência nas citocinas e a composição corporal de pessoas vivendo com HIV/AIDS. Métodos: Ensaio clínico randomizado, a amostra foi composta por 12 pacientes, sendo sete do Grupo Força (TFG) e cinco do Grupo Resistência Muscular (GRM). Comparou-se os níveis das citocinas IL-2, IL-4, IL-6, IL-10 e TNF-α e a composição corporal na primeira e na última sessão. Os pacientes completaram 36 sessões de treinamento de força e resistência ao longo de 12 semanas. Resultados: Após 36 sessões de treinamento resistido GRM, houve um aumento significativo de 4.734 pg/mL para 5.050 pg/mL de IL-10 (p=0,002). Em relação à TFG, não foram encontrados resultados significativos. Para composição corporal, houve diferenças significativas na TFG devido ao aumento da massa magra dos braços de 6.441g para 7.014g (p=0,04), pernas de 16.379g para 17.281g (p=0,02) e corpo inteiro de 45.640g para 47.343g (p=0,01). No GRM houve diminuição significativa do percentual de gordura nos braços de 23.160% para 20.750% (p = 0,04). Para avaliação da qualidade de vida foi utilizado o questionário WHOQOL-HIV-Bref, onde foi encontrada uma melhora significativa em todos os domínios, exceto no domínio nível de independência. Conclusão: Conclui-se que o treinamento de resistência muscular é eficaz em aumentar a IL-10 e diminuir o percentual de gordura nos braços, enquanto o treinamento de força aumenta a massa magra geral. Nível de Evidência I; Ensaio Clínico Randomizado.

https://doi.org/10.1590/1517-8692202430012022_0123i

Hierarchical pedotransfer functions for predicting bulk density in Brazilian soils
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Reis, Aline Mari Huf dos

; Teixeira, Wenceslau Geraldes

; Fontana, Ademir

; Barros, Alexandre Hugo Cezar

; Victoria, Daniel de Castro

; Vasques, Gustavo Mattos

; Samuel-Rosa, Alessandro

; Ottoni, Marta Vasconcelos

; Monteiro, José Eduardo Boffino de Almeida

Scientia Agricola

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2024, Volumen 81 elocation e20220255

Resumen: En | Texto: En | PDF: En

ABSTRACT Bulk density (BD) is a soil physical property used as a soil quality indicator and variations in this measurement influence soil water content and carbon stock estimates. This study aims to compile a database of samples of bulk density, textural fractions, and organic carbon values, as well as evaluate the accuracy of published pedotransfer functions (PTF) that predict bulk density, and propose a hierarchical PTF to predict the bulk density of Brazilian Soils. The performance of eleven PTFs and the newly proposed PTFs were evaluated and compared using the root mean square error (RMSE) and coefficient of determination (R2) based on a testing soil database collected from the literature. We noticed a slight improvement in accuracy when organic carbon and coarse and fine sand fractions were included as predictors alongside silt and clay. The best results with existing PTFs were obtained by PTF-A in Tomasella and Hodnett (1998) (RMSE = 0.20 g cm–3) and PTF-F in Benites et al. (2007) (RMSE = 0.17 g cm–3). Our proposed PTFs use textural fractions and organic carbon as predictors in a hierarchical form. The proposed PTF-4, which uses fine sand, coarse sand, clay, and organic carbon, presented the lowest value for RMSE (0.14 g cm–3) for BD prediction.

https://doi.org/10.1590/1678-992x-2022-0255

Use of intravenous lidocaine in a patient with refractory chest pain secondary to Takayasu arteritis. Case report
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Silva, Leandro Barros da

; Siqueira, Barbara Caroline Silva de

; Pinto, Gustavo Luiz Behrens

; Sampaio Filho, Antonio Argolo de

; Valente, Julie Azevedo Araújo

BrJP

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Dic 2023, Volumen 6 Nº 4 Paginas 465 - 468

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

ABSTRACT BACKGROUND AND OBJECTIVES: Takayasu’s arteritis (TA) is a rare form of chronic inflammatory disease involving large vessels, with uncertain etiology, with chest pain as a common and challenging symptom, resulting from inflammation in the aortic root or arch, pulmonary artery or coronary arteries. The objective of this study was to describe the use of intravenous lidocaine to treat severe and refractory chest pain secondary to TA. CASE REPORT: A 33-year-old female patient diagnosed with TA, with severe chest pain that was difficult to manage, was admitted after consulting an emergency department. The pain was unresponsive to traditional treatment after a week of drug adjustments. As a therapeutic option, a Sympathetic Venous Blockade (SVB) with lidocaine was chosen, achieving a reduction in pain from 10 to 3 on the Visual Analog Scale. Infliximab was administered before discharge. The patient was re-evaluated at an outpatient appointment after 30 days. CONCLUSION: This strategy for the treatment of severe chest pain allowed for pain reduction and relief.

RESUMO JUSTIFICATIVA E OBJETIVOS: A arterite de Takayasu (AT) é uma forma rara de doença inflamatória crônica envolvendo grandes vasos, com etiologia incerta, tendo a dor torácica como um sintoma comum e desafiador, consequente à inflamação na raiz ou arco aórtico, artéria pulmonar ou coronárias. O objetivo deste estudo foi relatar a utilização da lidocaína por via endovenosa na abordagem da dor torácica intensa e refratária secundária à AT. RELATO DO CASO: Paciente do sexo feminino, 33 anos, com diagnóstico de AT, dor torácica intensa de difícil manejo, internada após consulta em serviço de emergência. Dor não responsiva ao tratamento tradicional após uma semana de ajustes em fármacos. Como opção terapêutica, foi escolhido o Bloqueio Simpático Venoso (BSV) com lidocaína, obtendo redução da dor de 10 para 3 na Escala Analógica Visual. Antes da alta hospitalar foi administrado infliximabe. Paciente foi reavaliada em consulta ambulatorial após 30 dias. CONCLUSÃO: Esta estratégia fora tratamento da dor torácica intensa permitiu redução e alívio da dor.

https://doi.org/10.5935/2595-0118.20230086-en

[SciELO Preprints] - OTÁVIO DE FARIA: A BRAZILIAN FASCISM IN THREE ACTS (1931-1937)
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Silva, Gustavo Gabaldo Grama de Barros

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Fecha de publicación: 2023-09-18

Resumen: En Pt

The Brazilian political-social thought of the 1930s often reflects the climate of radicalism – ideological and cultural – from that time. Those were years when liberalism, socialism, integralism and fascism clashed in the public and intellectual arenas, in search of the roots of national identity and the possible paths to its destiny. In this context, the young Otávio de Faria appears, a member of the Catholic reaction, theorist of Brazilian fascism and acclaimed at the time as one of the most eloquent voices of the “new generation”. Thus, the main issue of the present work is to conceive how Faria understands the promises and limits of fascism as a possible way out of the aporias of modern Brazil. To this end, three works from his bibliography are analyzed: “Machiavel e o Brasil” [1931] (1933), “Destino do socialismo” (1933) e “Cristo e César” (1937). In his debut book, the fascist revolution is ambiguously combined with the theme of the spiritual revolution and the formation of a elite capable of civilizing the nation “from above”. In the second and third, a fascito-Catholic synthesis offers an unequivocal way out of the crisis, suggests an alternative capable of recovering the harmony between the spiritual and temporal order, as well as announces a “new world” beyond modernity.

O pensamento político-social brasileiro da década de 1930 muitas vezes reflete o clima de radicalismo – ideológico e cultural – da época. Eram anos em que liberalismo, socialismo, integralismo e fascismo se defrontavam nas arenas pública e intelectual, em busca tanto das raízes da identidade nacional quanto dos possíveis caminhos para seu destino. Neste contexto surge o jovem Otávio de Faria, integrante da reação católica, teórico do fascismo brasileiro e conclamado no período como uma das vozes mais eloquentes da “nova geração”. Assim, a grande questão do presente trabalho é conceber de que maneira Faria compreende as promessas e limites do fascismo como uma saída possível para as aporias do Brasil moderno. Para tal, são analisadas três obras da fase político-teológica de sua bibliografia: “Machiavel e o Brasil” [1931] (1933), “Destino do socialismo” (1933) e “Cristo e César” (1937). Em seu livro de estréia, a revolução fascista combina-se de maneira ambígua com o tema da revolução espiritual e da formação de uma nova elite capaz de civilizar a nação “por cima”. No segundo e no terceiro, uma síntese fascito-católica oferece uma saída inequívoca para a crise, sugere uma alternativa passível de recuperar a harmonia entre a ordem espiritual e temporal, bem como anuncia um “novo mundo” para além da modernidade.

https://doi.org/10.1590/SciELOPreprints.6795

Comparación de sistemas de evaluación diagnóstica de la severidad de la osteoartrosis en imágenes de TAC de las ATM
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Moncada, Gustavo

; Barros, Javiera Paz

International journal of interdisciplinary dentistry

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Ago 2023, Volumen 16 Nº 2 Paginas 146 - 151

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

ABSTRACT: Objective: To compare and validate diagnostic systems for the severity of Osteoarthrosis (OA) of the temporomandibular joints (TMJ) in computed tomography (CT) images. Method: An observational, retrospective, analytical, blinded, retrospective study was performed. Ninety-nine patients (198MSCT-ATM) were evaluated, applying the criteria of seven different diagnostic systems. A calibrated clinician (K=0.7) performed the evaluations. Content validity was performed under the Ahmad criteria. Internal consistency was determined with Cronbach’s Alpha. Data were correlated with Spearman’s Rho. Results: For condylar erosion severity, there was a high positive correlation between Alexiou/Arayasantiparb (rho=0.986) and a low one between Cömert/Alexiou (rho=0.421) and Cömert/Arayasantiparb (rho=0.422) classifications. For condylar sclerosis, we found a strong correlation between Cömert/Alexiou, Masilla/Alexiou and Cömert/Masilla classifications (rho=857; rho=0.853; rho=0.998). The data presented high internal consistency (Cronbach’s alpha=0.897) and low content validation (36.2%). Conclusions: The measurements of the 7 systems have a high reliability. Bone erosion, sclerosis and osteophytes are measured at four levels of severity and with a similar scale in three diagnostic systems (Alexiou, Arayasantiparb and Cömert). We suggest to complement it with the determination of joint space and condylar mobility, as proposed by RDC/TMD. Content validity was low, only the Cömert and Alexiou diagnostic systems were higher than 50%.

RESUMEN: Objetivo: Comparar y validar sistemas diagnósticos de severidad de Osteoartrosis (OA) de las articulaciones temporomandibulares (ATM) en imágenes de tomografía computada (TAC). Método: Se efectuó un estudio observacional, retrospectivo, analítico y ciego. Se evaluaron 99 pacientes (198TAC-ATM), aplicando los criterios de siete diferentes sistemas diagnósticos. Un clínico calibrado (K=0,7) efectuó las evaluaciones. La validez de contenido se efectuó bajo los criterios Ahmad. La consistencia interna se determinó con Alpha de Cronbach. Se correlacionaron los datos con Rho de Spearman. Resultados: La severidad de la erosión condilar presenta alta correlación positiva entre las clasificaciones Alexiou/Arayasantiparb (rho=0,986) y baja entre Cömert/Alexiou (rho=0,421) y Cömert/Arayasantiparb (rho=0,422). La esclerosis condilar presentó fuerte correlación entre las clasificaciones de Cömert/Alexiou, Masilla/Alexiou y Cömert/Masilla (rho=857;rho=0,853;rho=0,998). Los datos presentaron alta consistencia interna (Alfa Cronbach=0,897) y baja validación de contenido (36,2%). Conclusiones: Las mediciones de los 7 sistemas presentan alta fiabilidad. La erosión ósea, esclerosis y osteofitos son medidos en cuatro niveles de severidad y con similar escala en tres sistemas de diagnóstico (Alexiou, Arayasantiparb y Cömert), sugiriendose complementar con determinación del espacio articular y movilidad condilar, como propone RDC/TMD para TTM. La validación de contenido fue baja, solo los sistemas diagnósticos de Cömert y Alexiou superaron el 50%.

https://doi.org/10.4067/s2452-55882023000200146

Fluid overload: clinical outcomes in pediatric intensive care unit
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Gomes, Romina Aparecida dos Santos

; Azevedo, Lorena Ferreira

; Simões, Bruna Pessanha Cerqueira

; Detomi, Letícia Silva

; Rodrigues, Karla Emília de Sá

; Rodrigues, Adriana Teixeira

; Melo, Maria do Carmo Barros de

; Fonseca, Jaisson Gustavo da

Jornal de Pediatria

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Jun 2023, Volumen 99 Nº 3 Paginas 241 - 246

Resumen: En | Texto: En | PDF: En

Abstract Objective The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. Methods A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. Results 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p = 0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p = 0.049) and between renal replacement therapy and death (p = 0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p = 0.064). There was no statistically significant association between death and the variables sex or age. Conclusions The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children.

https://doi.org/10.1016/j.jped.2022.10.002

Larvicidal activity of the crude methanolic extract from leaves of Clibadium surinamense against Aedes aegypti
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Cruz, Andrely de Jesus Soares da

; Silva, Wanessa Rendeiro da Silva e

; Cruz, Juliana dos Santos

; Dantas Sampaio-Júnior, Francisco

; Monteiro, Maria Vivina Barros

; Hamoy, Moises

; Scofield, Alessandra

; Góes-Cavalcante, Gustavo

Ciência Rural

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2023, Volumen 53 Nº 5 elocation e20210786

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

RESUMO: O uso contínuo de inseticidas sintéticos para o controle do mosquito vetor de arbovírus, Aedes aegypti, tem levado à seleção natural de populações resistentes a diferentes grupos químicos. Assim, compostos derivados de plantas surgiram como uma alternativa viável para o controle desses vetores. Desse modo, este estudo foi realizado para determinar se o extrato metanólico bruto (CME) das folhas de Clibadium surinamense possui atividade larvicida contra Ae. aegypti. Para isso, Larvas de terceiro e quarto instar de Ae. aegypti foram mantidas em recipientes contendo 99 mL de água e 1 mL de CME diluído em etanol nas concentrações de 250, 500, 750 e 1000 ppm. O grupo controle continha 99 mL de água e 1 mL de etanol. Três ensaios foram realizados em triplicata para cada grupo. Após 24 horas de observação, de acordo com a análise de variância de uma via,os valores de CL50 e CL90 foram de 283 e 430 ppm, respectivamente. Em conclusão, demonstramos pela primeira vez que o CME das folhas de C. surinamense apresenta atividade larvicida contra Ae. aegypti em condições de laboratório.

ABSTRACT: The continuous use of synthetic insecticides for controlling the arboviral vector Aedes aegypti has led to the natural selection of mosquito populations resistant to different chemical groups. Thus, plant-derived compounds have emerged as a viable alternative for vectorcontrol. This study determined whether the crude methanolic extract (CME) from leaves of Clibadium surinamense has larvicidal activity against Ae. aegypti. Third- and fourth-instar Ae. Aegyptilarvae were kept in recipients containing 99 mL of water and 1mL of ethanol-diluted CMEat concentrations of 250, 500, 750, and 1000 ppm. The control group contained 99 mL of water and 1 mL of ethanol. Three trials were performed in triplicate for each group.After 24 hours of treatment, the LC50 and LC90 values were determined to be 283 and 430 ppm, respectively, according to one-way analysis of variance. In conclusion, we have demonstrated for the first time that the CME from leaves of C. surinamense show larvicidal activity against Ae. aegypti under laboratory conditions.

https://doi.org/10.1590/0103-8478cr20210786

10.

Deposition of Ti-Based Thin Films on AISI 1020 Steel Substrates Using the Cathodic Cage Plasma Deposition Technique
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Silva, Raul Felipe Barros da

; Cardoso, Wandercleiton

; Gontijo, Leonardo Cabral

; Pimentel, Bruno Poubel

; Viana, Pedro Rupf Pereira

; Galdino, André Gustavo de Sousa

Materials Research

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2023, Volumen 26 elocation e20230291

Resumen: En | Texto: En | PDF: En

The automotive industry is one of the largest industrial segments in the world market. The exhaust system of motor vehicles is responsible for the emission and treatment of toxic gasses released by the engine. In this sense, the application of titanium on an AISI 1020 steel substrate was carried out by plasma deposition using a cathode cage. The aim of this research was to evaluate the application of this material in the exhaust system of motor vehicles. The samples were characterized by scanning electron microscopy (SEM), confocal microscopy (CM), microhardness tests and corrosion resistance tests. The samples exhibited a thin film with higher titanium content and hardness than the uncoated sample. The corrosion potential also increased and the current density was lower than the uncoated sample. The conclusion is that the deposition of thin titanium films on AISI 1020 steel with CCPD has the potential to produce thin films.

https://doi.org/10.1590/1980-5373-mr-2022-0291

11.

Veno-venous extracorporeal membrane oxygenation in patients with SARS-CoV-2 pneumonia in Brazil: a case series
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Brasil, Lucas Mendes Cunha de Resende

; Arruda, Gabriel Nóbrega de

; Diniz, Gabriela Bezerra de Freitas

; Ikeoka, Dimas Tadahiro

; Saliba, Gustavo Niankowski

; Camargo, Camila Riberto

; Machado, David José de Barros

; Duarte, Felipe Aires

; Fernandes, Felipe Lourenço

Jornal Brasileiro de Pneumologia

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2023, Volumen 49 Nº 4 elocation e20230046

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

ABSTRACT Objective: The world has been suffering from the COVID-19 pandemic. Some COVID-19 patients develop severe viral pneumonia, requiring mechanical ventilation and measures to treat refractory hypoxemia, such as a protective ventilation strategy, prone positioning, and the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO). We describe a case series of 30 COVID-19 patients who needed VV-ECMO at the Hospital Alemão Oswaldo Cruz, located in the city of São Paulo, Brazil. Methods: We included all patients who required VV-ECMO due to COVID-19 pneumonia between March of 2020 and June of 2021. Results: Prior to VV-ECMO, patients presented with the following median scores: SOFA score, 11; APPS score, 7; Respiratory ECMO Survival Prediction score, 2; and Murray score, 3.3. The 60-day-in-hospital mortality was 33.3% (n = 10). Conclusions: Although our patients had a highly severe profile, our results were similar to those of other cohort studies in the literature. This demonstrates that VV-ECMO can be a good tool even in a pandemic situation when it is managed in an experienced center.

RESUMO Objetivo: O mundo vem sofrendo com a pandemia de COVID-19. Alguns pacientes com COVID-19 desenvolvem pneumonia viral grave, necessitando ventilação mecânica e medidas para tratar a hipoxemia refratária, como estratégias de ventilação protetora, posição prona e uso de oxigenação por membrana extracorpórea venovenosa (ECMO-VV). Descrevemos uma série de casos de 30 pacientes com COVID-19 que necessitaram de ECMO-VV no Hospital Alemão Oswaldo Cruz, localizado na cidade de São Paulo, Brasil. Métodos: Foram incluídos todos os pacientes que necessitaram de ECMO-VV devido à pneumonia por COVID-19 entre março de 2020 e junho de 2021. Resultados: Antes da ECMO-VV, os pacientes apresentavam as seguintes medianas: escore SOFA de 11; escore APPS de 7; escore Respiratory ECMO Survival Prediction de 2; e escore de Murray de 3,3. A mortalidade hospitalar em 60 dias foi de 33,3% (n = 10). Conclusões: Apesar de nossos pacientes apresentarem um perfil de alta gravidade, nossos resultados foram semelhantes aos de outros estudos de coorte na literatura. Isso demonstra que a ECMO-VV pode ser uma boa ferramenta mesmo em uma situação de pandemia quando administrada em um centro experiente.

https://doi.org/10.36416/1806-3756/e20230046

12.

Evaluation of the effect of intrathecal GM1 in 24, 48, and 72 hours after acute spinal cord injury in rats
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Jorge, Daniel de Moraes Ferreira

; Marcon, Raphael Martus

; Cristante, Alexandre Fogaça

; Barros Filho, Tarcísio Eloy Pessoa

; Santos, Gustavo Bispo dos

Clinics

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2023, Volumen 78 elocation 100228

Resumen: En | Texto: En | PDF: En

Abstract Objective The aim of this study was to evaluate the best timing and feasibility of intrathecal application of sodium monosialoganglioside (GM1) after spinal cord contusion in Wistar rats as an experimental model. Methods Forty Wistar rats were submitted to contusion spinal cord injury after laminectomy. The animals were randomized and divided into four groups: Group 1 - Intrathecal application of GM1 24 hours after contusion; Group 2 - Intrathecal application of GM1 48 hours after contusion; Group 3 - intrathecal application of GM1 72 hours after contusion; Group 4 - Sham, with laminectomy and intrathecal application of 0.5 mL of 0.9% saline solution, without contusion. The recovery of locomotor function was evaluated at seven different moments by the Basso, Beattie, and Bresnahan (BBB) test. They were also assessed by the horizontal ladder, with sensory-motor behavioral assessment criteria, pre-and postoperatively. Results This experimental study showed better functional scores in the group submitted to the application of GM1, with statistically significant results, showing a mean increase when evaluated on known motor tests like the horizontal ladder and BBB, at all times of evaluation (p < 0.05), especially in group 2 (48 hours after spinal cord injury). Also, fewer mistakes and slips over the horizontal ladder were observed, and many points were achieved at the BBB scale analysis. Conclusion The study demonstrated that the intrathecal application of GM1 after spinal cord contusion in Wistar rats is feasible. The application 48 hours after the injury presented the best functional results.

https://doi.org/10.1016/j.clinsp.2023.100228

13.

Sistema da Gestão da Inovação e Transformação Digital: em busca de uma abordagem integrada
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Martins, Leonardo Duarte

; Athanazio, Raphaela Cristina Severiano

; Franco, Gustavo Pereira

; Paes, Ana Carolina dos Santos

; Bagno, Raoni Barros

Revista Brasileira de Inovação

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2023, Volumen 22 elocation e023007

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

ABSTRACT Innovation Management Systems (IMS) have been widely discussed in specialized literature and organizational practice for many years, given their importance for companies to innovate regularly. In parallel, the debate on Digital Transformation (DT) has rapidly emerged, albeit with a distributed nature across various domains (e.g., management, information systems, Industry 4.0), bringing a wealth of perspectives and complexity to understanding the phenomenon. Although both fields are closely related to the dynamics of innovation within companies, an integrated debate is still in its early stages, and the areas continue to follow independent paths. Thus, this study aims to identify points of intersection between IMS and DT and investigates how elements from these approaches can mutually support each other. To this end, we conducted a literature review in each knowledge area and selected the representative models of their constituent parts. After analysis and discussion, we propose a visual model to express potential mutual connections. The main conclusion is that an IMS can guide DT initiatives within the organization by designing structures and processes to deal with highly uncertain projects. On the other hand, one can associate DT with a set of technological tools and organizational trends that can foster enhanced IMSs.

RESUMO Sistemas de Gestão da Inovação (SGI) têm sido debatidos há muitos anos na literatura especializada e na prática das organizações, dada a importância para as empresas de inovar regularmente. Em paralelo, o debate da Transformação Digital (TD) tem emergido de forma acelerada, mas bastante distribuída entre várias vertentes (e.g., gestão, sistemas de informação, indústria 4.0) trazendo riqueza de perspectivas, mas também complexidade para compreensão do fenômeno. Embora ambos os campos se relacionem fortemente com a dinâmica da inovação nas empresas, um debate integrado ainda é incipiente e as áreas seguem trajetórias de estudo paralelas. Assim, este estudo busca identificar pontos de intercessão entre SGI e TD e investiga como elementos dessas abordagens podem se apoiar mutuamente. Para isso, é feita uma revisão de literatura em cada uma das áreas de conhecimento, selecionados modelos representativos de seus elementos constituintes e, em uma fase de análise e discussão, se propõe um modelo que expresse as conexões mútuas potenciais. Como principal conclusão, aponta-se que um SGI pode nortear iniciativas de TD na organização por meio do desenho de estrutura e processos para lidar com projetos de alta incerteza; por outro lado, a TD associa-se a um conjunto de ferramentas tecnológicas e tendências organizacionais que podem fomentar SGIs aprimorados.

https://doi.org/10.20396/rbi.v22i00.8669375

14.

Compared efficacy of rituximab, abatacept, and tocilizumab in patients with rheumatoid arthritis refractory to methotrexate or TNF inhibitors agents: a systematic review and network meta-analysis
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Pugliesi, Alisson

; Oliveira, Amanda Borges de

; Oliveira, Ana Beatrice

; Xavier, Ricardo

; Mota, Licia Maria Henrique da

; Bertolo, Manoel Barros

; Gonzalez-Gay, Miguel Angel

; Citera, Gustavo

; Carvalho, Luiz Sergio Fernandes de

Advances in Rheumatology

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2023, Volumen 63 elocation 30

Resumen: En | Texto: En | PDF: En

Abstract Background Our aim was to compare the efficacy of rituximab, tocilizumab, and abatacept in individuals with rheumatoid arthritis (RA) refractory to treatments with MTX or TNFi agents. Methods We searched 6 databases until January 2023 for phase 2–4 RCTs evaluating patients with RA refractory to MTX or TNFi therapy treated with rituximab, abatacept, and tocilizumab (intervention arm) compared to controls. Study data were independently assessed by two investigators. The primary outcome was considered as achieving ACR70 response. Results The meta-analysis included 19 RCTs, with 7,835 patients and a mean study duration of 1.2 years. Hazard ratios for achieving an ACR70 response at six months were not different among the bDMARDs, however, we found high heterogeneity. Three factors showing a critical imbalance among the bDMARD classes were identified: baseline HAQ score, study duration, and frequency of TNFi treatment in control arm. Multivariate meta-regression adjusted to these three factors were conducted for the relative risk (RR) for ACR70. Thus, heterogeneity was attenuated (I2 = 24%) and the explanatory power of the model increased (R2 = 85%). In this model, rituximab did not modify the chance of achieving an ACR70 response compared to abatacept (RR = 1.773, 95%CI 0.113–10.21, p = 0.765). In contrast, abatacept was associated with RR = 2.217 (95%CI 1.554–3.161, p < 0.001) for ACR70 compared to tocilizumab. Conclusion We found high heterogeneity among studies comparing rituximab, abatacept, and tocilizumab. On multivariate metaregressions, if the conditions of the RCTs were similar, we estimate that abatacept could increase the chance of reaching an ACR70 response by 2.2-fold compared to tocilizumab. Key messages Abatacept could increase the chance of reaching an ACR70 response by 2.2-fold compared to tocilizumab.

https://doi.org/10.1186/s42358-023-00298-z

15.

HLA-B27 positivity in a large miscegenated population of 5,389,143 healthy blood marrow donors in Brazil
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Resende, Gustavo Gomes

; Saad, Carla Gonçalves Schahin

; Oliveira, Danielli Cristina Muniz de

; Bueno Filho, Julio Silvio de Sousa

; Sampaio-Barros, Percival Degrava

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2023, Volumen 63 elocation 16

Resumen: En | Texto: En | PDF: En

Abstract Background The prevalence of HLA-B27 gene positivity in healthy Caucasian communities varies between 8 and 14%. However, there is a lack of information in countries with a high rate of miscegenation, such as Brazil. Aim To estimate the frequency of HLA-B27 in the Brazilian general population using a large national registry database. Methods This is a cross-sectional ecological study using the Brazilian Registry of Volunteer Bone Marrow Donors (REDOME) database on HLA-B27 allelic frequency and proportion of positives of healthy donors (18–60 years old). Data were analyzed according to sex, age, race (by self-reported skin color recommended by the Brazilian Institute of Geography and Statistics - IBGE), and geographic region of residence. Results From 1994 to 2022, a total of 5,389,143 healthy bone marrow donors were included. The overall positivity for HLA-B27 was 4.35% (CI 95% 4.32–4.37%), regardless of sex and age (57.2% were women, mean age was 41.7yo). However, there was a difference between races: 4.85% in Whites; 2.92% in Blacks; 3.76% in Pardos (Browns i.e. mixed races); 3.95% in Amarelos (Yellows i.e. Asian Brazilians); and 3.18% in Indigenous. There was also a difference regarding geographic region of residence (North: 3.62%; Northeast: 3.63%; Southeast: 4.29%; Midwest: 4.5% and 5.25% in South). The homozygosity rate for the HLA-B27 was 1.32% of all the positives and only 0.06% in the general population. Conclusions Our findings provide the first Brazilian national prevalence for HLA-B27 in 4.35%. There is a gradient gene positivity from North to South, suggesting that the genetic background related to the miscegenation due to colonization, slavery, and some later waves of immigration together with internal migratory flows, could explain our findings.

https://doi.org/10.1186/s42358-023-00302-6

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journal_title	título completo de la revista (ej. Cadernos de Saúde Pública)
la	código de idioma de publicación (ej. pt - Portugués, es - Español)
type	tipo de documento
pid	identificador de la publicación
publication_year	año de publicación del artículo
sponsor	financiador
aff_country	código del país de la afiliación del autor
aff_institution	institución de filiación del autor
volume	volumen del artículo
issue	número del artículo
elocation	elocation
doi	número DOI
issn	ISSN de la revista
in	código de la colección SciELO (ej. scl - Brasil, col - Colômbia)
use_license	código de licencia de uso del artículo

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