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Abstract The use of fungi and bacteria with pathogenic capacity towards insects is considered a sustainable agroecological alternative for efficient pest control, as they are microorganisms of easy production in industrial scale, formulation and use. Therefore, the objective was to evaluate four entomopathogenic formulations in the control of Brevicoryne brassicae L., a key pest of cabbage (Brassica oleracea L.), in a randomized complete block design with 4 treatments, plus an absolute control and 4 replicates. The variables evaluated were the number of dead and live aphids per plant and the number of infested plants. The commercial formulations Biosafe, BesT-K, Metarrizo and Yurak containing strains of Bacillus subtilis, Bacillus thuringiensis var kurstaki (Btk), Metarhizium anisopliae and Bauveria bassiana respectively, are the ones that were used by spray application to the crop in two seasons: planting, season August-December 2019 and August-December 2021. Among the results, M. anisopliae was recorded with up to 91.11 % efficiency, followed by B. bassiana with 89.50 % and Bs with 79.38 % in the reduction of populations under field conditions. In the laboratory, Btk and M. anisopliae reached 100 % mortality in a period of seven days, so it is concluded that in the medium term, entomopathogenic fungi in the field are more efficient in aphid control; however, in controlled conditions Btk is also efficient.

Resumen El uso de hongos y bacterias con capacidad patogénica hacia los insectos se considera una alternativa agroecológica sostenible de lucha eficiente contra las plagas por ser microorganismos de fácil producción en escala industrial, formulación y uso; entonces, el objetivo ha sido evaluar cuatro formulados entomopatógenos en el control de Brevicoryne brassicae L, plaga clave de la col (Brassica oleracea L.), en diseño de bloques completos al azar de 4 tratamientos, sumado un testigo absoluto y 4 réplicas, siendo las variables evaluadas la cantidad de pulgones muertos y vivos por planta y cantidad de plantas infestadas. Los formulados comerciales Biosafe, BesT-K, Metarrizo y Yurak que contenían cepas de Bacillus subtilis, Bacillus thuringiensis var kurstaki (Btk), Metarhizium anisopliae y Bauveria bassiana, respectivamente, son los que fueron utilizados mediante la aplicación por aspersión al cultivo en dos épocas de siembra, temporada agosto-diciembre 2019 y agosto-diciembre 2021. Entre los resultados se registró al M. anisopliae con hasta 91,11 % de eficiencia, seguida por B. bassiana con 89,50 % y Bs con 79,38 % en la reducción de las poblaciones en condiciones de campo; en laboratorio el Btk y M. anisopliae alcanzaron el 100 % de mortalidad en un lapso de siete días, por lo que se concluye que a mediano plazo los hongos entomopatógenos en campo resultan ser más eficientes en el control del pulgón, sin embargo, en condiciones controladas el Btk también es eficiente.

https://doi.org/10.29166/siembra.v11i1.4994

Razonamientos Legales de la Contratación Estatal en Colombia Contra la Corrupción
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Mendoza Rangel, Fabián Leonardo

; Piñerez Flórez, Miguel Antonio

; Montes Montealegre, Henry Ali

Revista Economía y Política

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Jun 2024, Nº 39 Paginas 58 - 74

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

ABSTRACT This research article focuses its efforts on understanding the adverse effect of corruption within state procurement. This situation is becoming a nuisance for civil society because it has a negative impact on the progress of the nation. Legal and documentary hermeneutics is used as a tool to interpret with a critical basis the norms that regulate the conduct of free competition and the defense of collective rights promulgated in the Political Constitution of 1991, when reviewing the foundations of Law 80 of 1993 and the other regulations that delimit state contraction, sanctions for corruption and the SECOP disclosure system necessary to monitor it. Concluding in the need to maintain an assertive criterion among public officials when selecting a contractor, since the State has great difficulties monitoring each contract's progress in the country.

RESUMEN El presente artículo de investigación centra sus esfuerzos en comprender el efecto adverso de la corrupción dentro de la contratación estatal, situación que se está convirtiendo en una molestia para sociedad civil puesto que, repercute negativamente en el progreso de la nación. Se emplea la hermenéutica jurídica y documental como herramienta para interpretar con un sustento crítico las normas que regulan el proceder de la libre competencia y la defensa de los derechos colectivos promulgado en la Constitución Política de 1991, al revisar los fundamentos de la ley 80 de 1993 y las demás normas que delimitan la contracción estatal, las sanciones al corrupto y el sistema de divulgación SECOP necesario para darle seguimiento. Concluyendo en la necesidad de mantener un criterio asertivo entre los funcionarios públicos al momento de seleccionar un contratista, ya que el Estado posee grandes dificultades para estar vigilando el progreso de cada contrato en el país.

https://doi.org/10.25097/rep.n39.2024.04

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution
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Montanha, Rafaela Marito

; Gioia, Thamy Barbara

; Ramos, Antônio Carlos Vieira

; Ferreira, Natalia Marciano de Araujo

; Torres, Miguel Angel Fuentealba

; Pimenta, Rosângela Aparecida

; Kerbauy, Gilselena

; Arcêncio, Ricardo Alexandre

; Pieri, Flávia Meneguetti

Revista Brasileira de Epidemiologia

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2024, Volumen 27 elocation e240015

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

RESUMO Objetivo: Este estudo teve como objetivo analisar a evolução espaçotemporal das taxas de incidência do vírus da imunodeficiência humana (HIV) e da síndrome da imunodeficiência adquirida (AIDS) no estado do Paraná, Brasil. Métodos: Foi realizado um estudo ecológico com componente analítico de séries temporais e análise espacial no estado do Paraná, de 2007 a 2022. A fonte de dados foi o Sistema de Informação de Agravos de Notificação. Para estudar a tendência, foi utilizado o modelo de regressão linear generalizada de Prais-Winsten por meio da decomposição de séries temporais e, para a análise espacial, foi aplicado o Índice de Moran. Resultados: A amostra total foi composta de 50.676 registros de HIV/AIDS. A taxa de incidência apresentou tendência crescente, com crescimento médio de 2,14% (intervalo de confiança de 95% — IC95% 1,16–3,13) ao mês. Nos períodos de 2007 a 2014 e 2015 a 2022, a média de casos no estado foi de 105,64 e 159,20 a cada 100 mil habitantes, respectivamente, com importantes variações entre os municípios. Agrupamentos espaciais de alto risco permaneceram na região metropolitana à capital e litoral e um novo agrupamento foi observado à região norte do estado. Conclusão: As taxas de incidência do HIV/AIDS apresentaram tendência temporal crescente. O número de casos variou substancialmente em alguns municípios, principalmente naqueles localizados na região litorânea. A análise espacial revelou padrões geoespaciais de alto risco nas principais regiões metropolitanas do Paraná: Curitiba (abrange o litoral), Londrina e Maringá, as quais compartilham características como elevado grau de urbanização e constante desenvolvimento econômico.

ABSTRACT Objective: The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. Methods: An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais–Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. Results: The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval – 95%CI 1.16–3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. Conclusion: The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

https://doi.org/10.1590/1980-549720240015

Riesgo cardiovascular en pacientes con esclerosis sistémica
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Chico Capote, Araceli

; Estévez del Toro, Miguel Hernán

; Cruz Cárcamo, Orlando Antonio

; Puente Carmona, Rolando

Revista Cubana de Medicina

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2024, Volumen 63 elocation e3408

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

RESUMEN Introducción: El riesgo cardiovascular es importante en la evaluación de los pacientes con esclerosis sistémica. Objetivo: Determinar el riesgo cardiovascular en pacientes con esclerosis sistémica. Métodos: Se realizó un estudio transversal y descriptivo en pacientes protocolizados del Servicio de Reumatología, en el período de enero 2020 a enero 2022. Se recogieron variables demográficas, clínicas, y se aplicó la calculadora de riesgo cardiovascular Framingham. Resultados: Se incluyeron 105 pacientes con edad media de 48,6 ± 15,3 años, el grupo más frecuente de 50 a 59 años (36,2 %), predominó el sexo femenino 92,2 % y el color de piel blanca (74,3 %), el tiempo de evolución fue mayor a 5 años (66,7 %) con una media de 10,5 ± 9,3. El valor promedio de la escala de gravedad modificada de Medsger fue 5,1 ± 2,7 y el 72,4 % con afectación leve. El fenómeno de Raynaud y la fibrosis pulmonar fueron más frecuentes con un 89,5 % y 55,2 %. El índice de Rodnan en promedio fue de 13,1 ± 8,0 y los reactantes de fase aguda normales en la mayoría. Los factores de riesgo cardiovascular más frecuentes fueron la HTA (30,2 %) y dislipidemia (19,9 %). El índice de masa corporal que predominó fue de peso adecuado (54,3 %). Predominó el riesgo cardiovascular bajo según score de Framingham (86 %). Existieron diferencias significativas entre las medias del tiempo de evolución y el riesgo cardiovascular (10 ± 6,9 frente a 9,6 ± 8,8 frente a 16,9 ± 10,8; p = 0,032). Conclusiones: El riesgo cardiovascular en los pacientes con esclerosis sistémica fue bajo.

ABSTRACT Introduction: Cardiovascular risk is important in the evaluation of patients with systemic sclerosis. Objective: To determine the cardiovascular risk in patients with systemic sclerosis. Methods: A cross-sectional and descriptive study was carried out in protocolized patients of Rheumatology Service, from January 2020 to January 2022. Demographic and clinical variables were collected, and Framingham cardiovascular risk calculator was used. Results: One hundred five patients were included with a mean age of 48.6 ± 15.3 years, the most frequent group was 50 to 59 years (36.2%), female sex (92.2%) predominated, as well as white skin color (74.3%). The evolution time was greater than 5 years (66.7%) with a mean of 10.5 ± 9.3. The average value of modified Medsger severity scale was 5.1 ± 2.7 and 72.4% had mild involvement. Raynaud's phenomenon and pulmonary fibrosis were more common at 89.5% and 55.2%. Rodnan index on average was 13.1 ± 8.0 and the acute phase reactants were normal in the majority. The most frequent cardiovascular risk factors were HBP (30.2%) and dyslipidemia (19.9%). The predominant body mass index was adequate weight (54.3%). Low cardiovascular risk according to Framingham score prevailed (86%). There were significant differences between the mean duration of evolution and cardiovascular risk (10 ± 6.9 vs. 9.6 ± 8.8 vs. 16.9 ± 10.8; p = 0.032). Conclusions: The cardiovascular risk in patients with systemic sclerosis was low.

Effect of temperature and drought stress on germination of Magnolia pugana, an endangered species from western Mexico
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Jacobo-Pereira, César

; Muñiz-Castro, Miguel Ángel

; Muñoz-Urias, Alejandro

; Huerta-Martínez, Francisco Martín

; Vázquez-García, J. Antonio

; Flores, Joel

Botanical Sciences

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Dic 2023, Volumen 101 Nº 4 Paginas 1115 - 1127

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

Resumen Antecedentes: Las poblaciones de Magnolia pugana están disminuyendo, asimismo la precipitación disminuirá 10 % y la temperatura aumentará (2-4 °C) en su área de distribución, de acuerdo al escenario de cambio climático más severo, lo que puede comprometer su germinación. Hipótesis: La interacción del aumento de temperatura y disminución del potencial hídrico reduce y retrasa la germinación de Magnolia pugana. Especie de estudio: Magnolia pugana, endémica del occidente de México, en peligro de extinción. Sitio y año de estudio: Sur de Zacatecas y centro de Jalisco, México. Abril, 2019. Materiales y métodos: Se evaluó la viabilidad de semillas con la prueba de tetrazolio. Se analizó el efecto de temperatura (24, 28 y 37 °C), potencial hídrico (con PEG 8000) (0, -0.3, -0.6, -0.9, -1.2 MPa) y su interacción sobre porcentaje y tiempo medio de germinación, con ANOVA factoriales. Resultados: La viabilidad fue 80 %. Las interacciones entre temperatura y potencial hídrico sobre porcentaje y tiempo medio de germinación fueron significativas. No hubo germinación a 37 °C. El porcentaje de germinación más alto (78 %) se produjo a 24 °C y -0.3 MPa, el menor (3 %) a 28 °C y -0.6 MPa. A 24 °C y 0 MPa germinaron en menor tiempo (23.9 ± 1.5 días), a 28 °C y -0.9 MPa se retrasó 1.5 veces. Conclusiones: La interacción entre bajo potencial hídrico y aumento de temperatura redujo la germinabilidad de Magnolia pugana, condiciones previstas por futuros escenarios de cambio climático, con esto su vulnerabilidad a la extinción podría aumentar.

Abstract Background: Magnolia pugana populations are declining, in addition, it is estimated that precipitation will decrease by up to 10 % and temperatures will increase (2-4 °C) under the most severe climate change scenario, which may affect germination. Hypotheses: The interaction of increased temperature and decreased water potential reduces and delays the germination of Magnolia pugana seeds. Studied species: Magnolia pugana, an endangered species endemic to western Mexico. Study site and dates: Southern Zacatecas and central Jalisco, Mexico. April 2019. Materials and methods: Seed viability was evaluated with tetrazolium test. In addition, the effects of temperature (24, 28, and 37 °C), water potential with PEG 8000 (0, -0.3, -0.6, -0.9, -1.2 MPa) and its interaction on the percentage and mean germination time were analyzed with factorial ANOVA tests. Results: Viability was 80 %. The interactions between temperature and water potential on germination percentage and mean germination time were significant. There was no germination at 37 °C. The highest germination (78 %) was at 24 °C and -0.3 MPa, while the lowest (3 %) was at 28 °C and -0.6 MPa. The control treatment (24 °C and 0 MPa) facilitated germination in a shorter time (23.9 ± 1.5 days). At 28 °C and -0.9 MPa, the mean germination time was slowed by 1.5 times. Conclusions: Magnolia pugana germinability was reduced by the interaction between low water potentials and increased temperature, conditions predicted by future climate change scenarios, therefore its vulnerability to extinction could increase.

https://doi.org/10.17129/botsci.3337

Narrativas transnacionales de la violencia. El caso de Somos
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Carranza Ríos, Marco Antonio

; Mino Gracia, Fernando

; Gachuz Fuentes, Fernando

; Carrasco Rivera, Miguel Ángel

Historia y grafía

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Dic 2023, Nº 61 Paginas 207 - 250

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

Resumen Este trabajo es una mirada a las nociones de memoria que están inmersas en los productos mediales de factura transnacional. A través de las modalidades conceptuales propuestas por Astrid Erll se describen y analizan los procesos del trazo intermedial, la remediación transmedial y las implicaciones intramediales de Somos., relato en formato serie, producido por Netflix, que adapta a la ficción la “masacre de Allende” sucedida en Coahuila en 2011. Proponemos que Somos., si bien enuncia la intención de sustituir el discurso frívolo de la violencia por un relato “realista” centrado en las víctimas de esta, de hecho complementa un discurso audiovisual -y contribuye a una memoria colectiva- que alimenta una narrativa hegemónica transnacional de la “violencia latinoamericana”.

Abstract This work looks at the notions of memory immersed in transnational media products. Through the conceptual modalities proposed by Astrid Erll, the processes of the intermedial trace, the transmedial remediation, and the intramedial implications of Somos., a serialized story produced by Netflix which adapts the “Allende massacre” to fiction, are described and analyzed. We propose that although Somos. states the intention of replacing the frivolous discourse of violence with a “realistic” account focused on its victims, in fact, it complements an audiovisual discourse-and contributes to a collective memory-that feeds a transnational hegemonic narrative of “Latin American violence”.

https://doi.org/10.48102/hyg.vi61.483

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

; Melo, Marcelo Dantas Tavares de

; Bihan, David Costa de Souza Le

; Vieira, Marcelo Luiz Campos

; Pena, José Luiz Barros

; Del Castillo, José Maria

; Abensur, Henry

; Hortegal, Renato de Aguiar

; Otto, Maria Estefania Bosco

; Piveta, Rafael Bonafim

; Dantas, Maria Rosa

; Assef, Jorge Eduardo

; Beck, Adenalva Lima de Souza

; Santo, Thais Harada Campos Espirito

; Silva, Tonnison de Oliveira

; Salemi, Vera Maria Cury

; Rocon, Camila

; Lima, Márcio Silva Miguel

; Barberato, Silvio Henrique

; Rodrigues, Ana Clara

; Rabschkowisky, Arnaldo

; Frota, Daniela do Carmo Rassi

; Gripp, Eliza de Almeida

; Barretto, Rodrigo Bellio de Mattos

; Silva, Sandra Marques e

; Cauduro, Sanderson Antonio

; Pinheiro, Aurélio Carvalho

; Araujo, Salustiano Pereira de

; Tressino, Cintia Galhardo

; Silva, Carlos Eduardo Suaide

; Monaco, Claudia Gianini

; Paiva, Marcelo Goulart

; Fisher, Cláudio Henrique

; Alves, Marco Stephan Lofrano

; Grau, Cláudia R. Pinheiro de Castro

; Santos, Maria Veronica Camara dos

; Guimarães, Isabel Cristina Britto

; Morhy, Samira Saady

; Leal, Gabriela Nunes

; Soares, Andressa Mussi

; Cruz, Cecilia Beatriz Bittencourt Viana

; Guimarães Filho, Fabio Villaça

; Assunção, Bruna Morhy Borges Leal

; Fernandes, Rafael Modesto

; Saraiva, Roberto Magalhães

; Tsutsui, Jeane Mike

; Soares, Fábio Luis de Jesus

; Falcão, Sandra Nívea dos Reis Saraiva

; Hotta, Viviane Tiemi

; Armstrong, Anderson da Costa

; Hygidio, Daniel de Andrade

; Miglioranza, Marcelo Haertel

; Camarozano, Ana Cristina

; Lopes, Marly Maria Uellendahl

; Cerci, Rodrigo Julio

; Siqueira, Maria Eduarda Menezes de

; Torreão, Jorge Andion

; Rochitte, Carlos Eduardo

; Felix, Alex

Arquivos Brasileiros de Cardiologia

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Dic 2023, Volumen 120 Nº 12 elocation e20230646

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

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

A web-based survey to map the electromyography practice in Brazil
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Tabatinga Neto, José Lopes

; Basso, Gabriela Ejima Mie

; Lima Junior, David Nunes de

; Ferreira, Eduardo Soares

; Paula, Denisse Sales

; Leitão, Antônio Miguel Furtado

; Viana Júnior, Antonio Brazil

; Thomas, Florian Patrick

; Gondim, Francisco de Assis Aquino

Arquivos de Neuro-Psiquiatria

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Nov 2023, Volumen 81 Nº 11 Paginas 949 - 955

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

Abstract Background Detailed information about the electromyography practice in Brazil is largely unavailable. Objective To evaluate where and how electromyography is performed in Brazil, as well as regional disparities and the professional and academic credentials of electromyographers. Methods We conducted an internet-based survey of active Brazilian electromyographers. The websites of health insurance companies, professional academies, medical cooperatives, online search engines, and social networks in each Brazilian state were screened and we evaluated the credentials of each electromyographer listed in the Brazilian Federal Medical Board (BFMB) registration website and their online curricula vitae in the Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq, in Portuguese). We also evaluated the same parameters in a control group of non-electromyographer neurologists randomly matched by geographical distribution and gender. Results We found 469 electromyographers (384 neurologists and 85 non-neurologists), with a male predominance. In total, 81.9% were BFMB-certified neurologists, 49.9%, BFMB-certified clinical neurophysiologists, and 10.4%, BFMB-certified physiatrists. Among the non-neurologists, 48.2% were physiatrists. Most electromyographers practiced in states on the Southern and Southeastern regions of Brazil. When adjusted by population, the Federal District and the states of Mato Grosso do Sul and Goiás presented the highest of eletromyographers density. Electromyographers were not more likely to have current/past academic affiliations. Conclusion In Brazil, electromyography is performed predominantly by neurologists, and half of them are BFMB-certified clinical neurophysiologists. The present study highlights regional disparities and may guide government-based initiatives, for instance, to improve the diagnosis of leprosy and the management of neuromuscular disorders within the Brazilian territory.

Resumo Antecedentes Informações detalhadas sobre a prática de eletromiografia no Brasil são em grande parte indisponíveis. Objetivo Avaliar onde e como a eletromiografia é realizada no Brasil, as disparidades regionais, e as credenciais profissionais e acadêmicas dos eletromiografistas. Métodos Realizamos uma enquete via internet de eletromiografistas brasileiros ativos. Foram rastreados sites de operadoras de planos de saúde, academias profissionais médicas, cooperativas médicas, ferramentas de busca online e redes sociais em cada estado brasileiro. Em seguida, avaliamos as credenciais de cada eletromiografista listado no site de registro do Conselho Federal de Medicina (CFM) e seus curricula vitae online no Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Também avaliamos os mesmos parâmetros em um grupo controle de neurologistas não eletromiografistas pareados aleatoriamente por distribuição geográfica e gênero. Resultados Encontramos 469 eletromiografistas (384 neurologistas e 85 não neurologistas), com predominância do sexo masculino. Ao todo, 81,9% eram neurologistas com certificação confirmada pelo site do CFM, 49,9%, neurofisiologistas clínicos com certificação confirmada pelo site do CFM, e 10,4%, fisiatras com certificação confirmada pelo mesmo site. Entre os não neurologistas, 48,2% eram fisiatras. A maioria dos eletromiografistas atuava nos estados do Sul e do Sudeste. Quando ajustados pela população, o Distrito Federal e os estados de Mato Grosso do Sul e Goiás apresentaram a maior densidade de eletromiografistas. Os eletromiografistas não eram mais propensos a ter vínculos acadêmicos atuais/passados. Conclusão No Brasil, a eletromiografia é realizada predominantemente por neurologistas, e metade deles são neurofisiologistas clínicos com certificação confirmada pelo site do CFM. Este estudo destacou as disparidades regionais, e pode orientar ações governamentais para, por exemplo, melhorar o diagnóstico da hanseníase e o manejo das doenças neuromusculares no território brasileiro.

https://doi.org/10.1055/s-0043-1777007

10.

Impact of Percutaneous Endoscopic Gastrostomy Tube Feeding on Nutritional Status in Patients Undergoing Chemoradiotherapy for Oesophageal Cancer
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Garcia, Joana Lemos

; Rodrigues, Rita Vale

; Mão-de-Ferro, Susana

; Ferreira, Sara

; Serrano, Miguel

; Castela, Joana

; Sacarrão, Raquel

; Francisco, Fátima

; Sousa, Liliana

; Pereira, António Dias

GE-Portuguese Journal of Gastroenterology

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Oct 2023, Volumen 30 Nº 5 Paginas 24 - 32

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

Resumo Introdução: A neoplasia do esófago associa-se a disfagia e perda ponderal, sendo a desnutrição agravada pelo tratamento multimodal. Objetivo: Avaliar o impacto da colocação de gastrostomia percutânea endoscópica (PEG) no estado nutricional de doentes com neoplasia do esófago propostos para quimiorradioterapia (QRT). Métodos: Estudo comparativo com braço prospetivo e contro-lo retrospetivo. Incluídos doentes com neoplasia do esófago propostos para QRT definitiva ou neoadjuvante, com disfagia grau >2 e/ou perda de peso >10%. Colocada PEG (método pull) antes do início de QRT. Avaliada se-menteira tumoral por zaragatoa e histologia. Como controlo, utilizada coorte histórica de doentes sem PEG. Registo ACTRN12616000697482. Resultados: 29 doentes (grupo intervenção, GI) foram comparados com 30 controlos (GC). Sem diferença significativa nos principais outcomes: perda de peso durante a QRT 8.1 ± 5.5 kg versus 9.1 ± 4.2 kg (p = 0.503); mortalidade aos 6 meses após QRT ou cirurgia 17.2% versus 26.7% (p = 0.383); taxa de complicações perioperatórias 54.5% versus 55.6% (p = 1.000); admissões hospitalares não planeadas 34.5% versus 40.0% (p = 0.661). No GC, durante a QRT, 14 (46.7%) apresentaram disfagia graus 3-4, dos quais 12 necessitaram de nutrição por sonda nasogástrica (n = 10), gastrostomia cirúrgica (n = 1) ou dilatação esofágica (n = 1). No GI, 89.7% utilizaram a PEG durante QRT, em algum momento de forma exclusiva em 51.7%. Os eventos adversos foram sobretudo minor (n = 12; 41.4%), sobretudo infeções tardias periestoma; 1 complicação major (laparotomia exploradora por suspeita de interposição de cólon, não confirmada). Sem evidência citológica ou histológica de sementeira tumoral no estoma. Conclusão: Embora não se tenham observado diferenças na perda de peso, complicações cirúrgicas e mortalidade entre grupos, metade dos utentes necessitou de nutrição entérica exclusiva, tornando a colocação de PEG uma alternativa a considerar.

Abstract Introduction: Oesophageal cancer causes dysphagia and weight loss. Malnutrition further worsens with multimodal treatment. Aim: The aim of the study was to evaluate the impact of percutaneous endoscopic gastrostomy (PEG) placement in the nutritional status of patients with oesophageal cancer requiring chemoradiotherapy (CRT). Methods: A comparative study with a prospective arm and a historical cohort was conducted. Oesophageal cancer patients undergoing CRT with dysphagia grade >2 and/or weight loss <10% were submitted to PEG-tube placement (pull method) before CRT. Stoma seeding was evaluated through a swab obtained after placement and, in surgical patients, the resected stoma. A matched historical cohort without PEG placement was used as control (trial ACTRN12616000697482). Results: Twenty-nine patients (intervention group, IG) were compared to 30 patients (control group, CG). Main outcomes did not differ in the IG and CG: weight loss during CRT 8.1 ± 5.5 kg versus 9.1 ± 4.2 kg (p = 0.503); 6-month mortality after CRT or surgery 17.2% versus 26.7% (p = 0.383); perioperative complication rate 54.5% versus 55.6% (p = 1.000); unplanned hospital admissions 34.5% versus 40.0% (p = 0.661). In the CG, during CRT, 14 (46.7%) patients presented with dysphagia grade 3-4, of whom 12 required nasogastric tube feeding (n = 10), surgical gastrostomy (n = 1), and oesophageal dilation (n = 1). In the IG, 89.7% used the PEG tube during CRT, sometimes exclusively in 51.7%. Adverse events were mainly minor (n = 12, 41.4%), mostly late peristomal infections, 1 major complication (exploratory laparotomy due to suspected colonic interposition, not confirmed). There was no cytological or histological evidence of stomal tumour seeding. Conclusion: Weight loss, hospital admissions, surgical complications, and mortality were identical in oesophageal cancer patients referred for CRT, regardless of prophylactic PEG. However, half of the patients required exclusive enteral nutritional support, making PEG-tube placement an alternative to consider.

https://doi.org/10.1159/000525853

11.

Transformações no mundo do trabalho em saúde: os(as) trabalhadores(as) e desafios futuros
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Machado, Maria Helena

; Campos, Francisco

; Haddad, Ana Estela

; Santos Neto, Pedro Miguel dos

; Machado, Antônio Vieira

; Santana, Vanessa Gabrielle Diniz

; Marengue, Helena da Conceição Ouana

; Santos, Renato Penha de Oliveira

; Mauaie, Clara Cacilda

; Freire, Neyson Pinheiro

Ciência & Saúde Coletiva

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Oct 2023, Volumen 28 Nº 10 Paginas 2773 - 2784

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

Resumo O artigo versa sobre o mundo do trabalho da saúde, especialmente no SUS no contexto da pandemia no Brasil. O artigo utilizou dados das pesquisas “Condições de trabalho dos profissionais de saúde no contexto da COVID-19 no Brasil” e “Os trabalhadores invisíveis da saúde: condições de trabalho e saúde mental no contexto da COVID-19 no Brasil”. A análise dos dados comprova que a pandemia evidenciou problemas estruturais existentes no âmbito do Sistema Único de Saúde, envolvendo a gestão da FTS o que pode ser interpretado como mais um dos reflexos das desigualdades socioeconômicas já existentes no país. Destacam-se: a reduzida oferta de educação permanente, a regulação do cuidado híbrido, precarização, desproteção no ambiente de trabalho, frágil biossegurança levando a trágicas taxas de adoecimento e mortes de trabalhadores da saúde. Conclui mostrando a importância de formulação de políticas públicas no âmbito da gestão da educação e do trabalho no SUS que assegurem a discussão sobre cuidado híbrido como nova forma de atuar sem perder qualidade, a necessidade de se rever questões referentes a: educação permanente, proteção, valorização e redução das desigualdades apontadas entre os contingentes profissionais analisados nesse artigo.

Abstract This article addresses the world of healthcare work, especially in the Brazilian Unified Healthcare System (SUS) in the context of the COVID-19 pandemic in Brazil. This study used data from the following surveys: “Working conditions of health professionals in the context of COVID-19 in Brazil” and “The Invisible health workers: working conditions and mental health in the context of COVID-19 in Brazil”. Data analysis proves that the pandemic highlighted existing structural problems within SUS, involving the issue of healthcare workforce (HWF) management, which can be interpreted as another reflection of the socioeconomic inequalities that already exist in the country. This article highlights: the reduced provision of permanent education, the regulation of hybrid care, precariousness, a lack of protection in the work environment, as well as fragile biosecurity leading to tragic rates of illness and death of health workers. Our study concludes by showing the importance of formulating public policies in the scope of education and work management in SUS that ensure the discussion on hybrid care as a new way of acting without losing quality, together with the need to review issues related to permanent education, protection, valuation, and reduction of inequalities pointed out among the professional contingents analyzed in this article.

https://doi.org/10.1590/1413-812320232810.10702023

12.

Work performance questionnaire after returning to work in ischemic stroke survivors: the WPQ-INNN survey
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Barboza, Miguel A.

; Becerra, Luis

; Serrano, Fabiola

; Soriano, Eduardo

; Uribe, Rodrigo

; Arauz, Antonio

Revista mexicana de neurociencia

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Oct 2023, Volumen 24 Nº 5 Paginas 157 - 164

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

Resumen Objetivo: la calidad de rendimiento laboral en sobrevivientes a un infarto cerebral ha sido poco estudiada. El objetivo de este estudio es analizar el rendimiento laboral posterior a un infarto cerebral no solo por la probabilidad de mantenerse activo en actividades laborales diarias, sino en la capacidad de recuperar habilidades cognitivas y motoras. Materiales y métodos: desarrollamos una encuesta de 15 ítems para sobrevivientes a un infarto cerebral que regresaron a trabajar. La encuesta evaluaba 11 dominios diferentes (lenguaje, memoria, atención, planeamiento, cálculo, escritura, habilidad motora, marcha, visión, afecto y auto-percepción). Consistencia interna, fiabilidad tes-retest, correlación de la escala de los ítems and análisis factorial se aplicó a la escala. Resultados: Un total de 100 sobrevivientes a un infarto cerebral se reclutaron (51 [51.0%] mujeres, mediana de edad 42 años [IIC 34.5-54.5 años]); mediana de tiempo para retorno laboral de 4 meses. El rendimiento laboral puntuó alto para 16% de los casos, bueno en 58%, moderado en 24% y bajo en 2%. El coeficiente alfa de Chronbach fue de 0.75 para la escala. La medición del Kaiser-Meyer-Olkin de adecuación de muestreo fue de 0.72 (p < 0.001). La fiabilidad test-retest, estimada por los coeficientes de correlación intraclase, fue buena. Memoria, lenguaje y atención explicaron el 59.7% de la varianza del cuestionario en el análisis de extracción. Conclusión: El WPQ-INNN es un instrument fiable y válido para la evaluación de la calidad de rendimiento laboral en sobrevivientes de un infarto cerebral que regresaron al trabajo.

Abstract Objective: Quality of performance after stroke in working-active survivors has been poorly studied. The aim of this study is to analyze work performance after stroke not only by the probability of being active in daily job activities but also by the survivor's ability to recover capability in different cognitive and motor areas. Material and methods: We developed a 15-item survey for stroke who had returned to their work activity. The survey evaluated 11 different domains (language, memory, attention, planning, calculating, writing, motor skills, gait, visual, mood, and self-perception). Internal consistency, test-retest reliability, item-scale correlation, and factor analysis were conducted. Results: A total of 100 ischemic stroke survivors were recruited (51 [51.0%] female patients, median age 42 years [interquartile range = 34.5-54.5 years]); median time to return to work was 4 months. Work performance after stroke was high in 16% of cases, good in 58% of cases, moderate in 24%, and low in 2%. Chronbach's alpha coefficient was 0.75 for the scale. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.72 (p < 0.001). The test-retest reliability, as estimated by the intraclass correlation coefficients, was good. Memory, language, and attention explained 59.7% of the variance of the questionnaire in the extraction analysis. Conclusion: The WPQ-INNN is a reliable and valid tool for the assessment of performance quality in stroke survivors who returned to work.

https://doi.org/10.24875/rmn.23000044

13.

Hacia los nuevos escenarios en la Educación. 2° Congreso internacional de la innovación y la tecnología en Educación
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Herrera-Pavo, Miguel Ángel

; Orellana-Navarrete, Verónica

; Jaramillo Baquerizo, Christian Paúl

; Balladares Burgos, Jorge Antonio

Revista Andina de Educación

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Oct 2023, Volumen 6 Nº 2 elocation e100

Resumen: Es | Texto: Es | PDF: Es

https://doi.org/10.32719/26312816.2022.6.2.0

14.

Uso de conductos iliofemorales como medida para reducir la morbimortalidad neurológica y vascular en EVAR complejo
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Ferrer, Miguel

; Ferreira, Luis Mariano

; Aloy, Leonela

; Escordamaglia, Sergio

; Zambrano, Ángel

; La Mura, Antonio Ricardo

Angiología

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Oct 2023, Volumen 75 Nº 5 Paginas 290 - 297

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

Resumen Introducción y objetivo: la enfermedad oclusiva de las arterias ilíacas puede ser causa de complicaciones en EVAR. Su frecuencia no es muy alta, pero su mortalidad sí y hay evidencia escasa en cuanto a su repercusión en EVAR complejo. El uso de conductos iliofemorales es una herramienta que existe para combatir este problema. El objetivo de este trabajo es analizar el impacto del uso de conductos iliofemorales en la morbimortalidad neurológica y vascular en FEVAR y BEVAR. Materiales y métodos: recolección retrospectiva de pacientes con aneurismas yuxtarrenales, abdominotorácicos o endoleak IA tratados mediante FEVAR o BEVAR de forma electiva entre 2014 y 2020 en una sola institución (la Clínica La Sagrada Familia, Buenos Aires, Argentina). Se dividieron en dos grupos: uno, con conductos (grupo A), y otros, sin (grupo B). El grupo A se subdividió entre aquellos con conductos temporales y aquellos con permanentes. Resultados: analizamos 45 pacientes. 23 recibieron conductos (grupo A) y 22, no (grupo B). La edad media fue de 73 años y el diámetro promedio del saco fue de 69,89 mm. La estancia hospitalaria media fue de 4,7 días. El grupo A presentó más pacientes con enfermedad vascular periférica (56,5 % frente a 22,7 %, p = 0,045) y diámetros menores de arterias ilíacas externas. Hubo 8 complicaciones en el perioperatorio (17,8 %; grupo A, n = 1, 4,3 %, frente al grupo B, n = 7, 31,8 %; p = 0,043). Fallecieron 2 pacientes, lo que dejó una mortalidad perioperatoria del 4,4 % (grupo A, 0 %, frente al grupo B, 9,1 %; p = 0,45). Las complicaciones incluyeron isquemia medular, ruptura de la arteria ilíaca e isquemia de miembros inferiores. Dentro del grupo A, 12 pacientes (52,2 %) recibieron conductos permanentes y otros 11 (47,8 %), temporales. Conclusiones: los conductos iliofemorales en FEVAR y BEVAR son seguros cuando forman parte de la planificación preoperatoria. Las complicaciones neurológicas y vasculares no son infrecuentes y conllevan una alta mortalidad. El uso de conductos es efectivo para reducir su incidencia y la mortalidad asociada.

Abstract Introduction and objective: occlusive arterial disease involving the iliac arteries can be cause of complications in EVAR. Its frequency is not high, but its mortality is and there is scant evidence regarding its repercussion in complex EVAR. The use of iliofemoral conduits is a tool to overcome this problem. Our objective is to analyze the impact of the use of iliofemoral conduits in the neurological and vascular morbimortality associated with FEVAR and BEVAR. Materials and methods: retrospective recollection of patients who underwent elective FEVAR or BEVAR for juxtarrenal, thoracoabdominal aneurysms or type IA endoleak between 2014 and 2020 in one institution (Clínica La Sagrada Familia, Buenos Aires, Argentina). Patients were divided in two groups, one with conduits (group A) and one without (group B). Group A was subdivided between those who received temporary conduits and those with permanent conduits. Results: we analyzed 45 patients. 23 received conduits (group A) whereas 22 did not (group B). Mean age was 73 years and mean sac diameter was 69.89 mm. Mean hospital stay was 4.7 days. Group A presented more patients with peripheral vascular disease (56.5 % vs. 22.7 %, p = 0.045) and smaller iliac arteries. There were 8 complications in the perioperative period (17.8 %; group A, n = 1, 4.3 %; group B, n = 7, 31.8 %. p = 0.043). 2 patients died, leaving a perioperative mortality of 4.4 % (group A 0 % vs. group B 9.1 %, p = 0.45). Complications included spinal cord ischemia, iliac artery rupture and lower limb ischemia. In group A, 12 (52.2 %) patients received permanent conduits and 11 (47.8 %) temporary conduits. Conclusions: the use of iliofemoral conduits in FEVAR and BEVAR is safe when they are part of the preoperative planning. Neurological and vascular complications are not infrequent and carry a high mortality. The use of conduits is effective to reduce its incidence and associated mortality.

https://doi.org/10.20960/angiologia.00463

15.

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy
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Mathis, Maria Alice de

; Chacon, Priscila

; Boavista, Rodrigo

; de Oliveira, Marcos Vinícius Sousa

; de Barros, Pedro Macul Ferreira

; Echevarria, Marco Antonio Nocito

; Ferrão, Ygor Arzeno

; Vattimo, Edoardo Filippo de Queiroz

; Lopes, Antônio Carlos

; Torres, Albina Rodrigues

; Diniz, Juliana Belo

; Fontenelle, Leonardo

; do Rosário, Maria Conceição

; Shavitt, Roseli Gedanke

; da Silva, Renata de Melo Felipe

; Miguel, Eurípedes Constantino

; Costa, Daniel Lucas da Conceição

Brazilian Journal of Psychiatry

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Oct 2023, Volumen 45 Nº 5 Paginas 431 - 447

Resumen: En | Texto: En | PDF: En

Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.

https://doi.org/10.47626/1516-4446-2023-3081

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