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Abstract This study evaluated color stability (CS), anti-adherence effect (AAE), and cell viability of microorganisms on acrylic resin (AR) surface, treated associated or not with sodium percarbonate (SP). AR specimens were prepared, and color analysis was performed before and after the treatments and the CS was calculated. For analysis of AAE, the samples were sterilized by radiation in a microwave oven. Then samples were randomly distributed: phosphate-buffered saline (PBS - control), 0.5% sodium hypochlorite (SH), phytosphingosine (PHS), and phytosphingosine + SP (PHS+Na2CO3). The specimens remained in contact with solutions for 30 minutes and were later contaminated by Candida albicans. Aliquots were seeded in Petri dishes with Sabouraud Dextrose agar and incubated at 37°C for 24 hours. After the incubation, the number of colonies was counted. The cell viability of adhered microorganisms on the AR was evaluated and 20 fields were observed under an epifluorescence microscope, and the percentage of adhered viable cells was calculated. Data were compared (One-way ANOVA, Tukey, p<.05). As for CS, PHS+ Na2CO3 (0.4±0.1) resulted in less change than PBS (0.9±0.2), similar to the other groups (SH [1.0±0.3)]; PHS [0.9±0.2)]). There was no difference for all tested solutions regarding the ability to avoid microorganism adherence (p>0.05), but PHS (11.2±4.1) resulted in a smaller area of adhered viable cells, statistically different from SH (18.2±7.6) and PBS (26.4±10.8). It was concluded that PHS resulted in lower adhered viable cells and when associated with Na2CO3, also shows a lower effect on the CS of AR.

Resumo Este estudo avaliou estabilidade de cor (EC), efeito antiaderente (EAA) e viabilidade celular de microrganismos em superfície de resina acrílica (RA), tratada com solução de fitoesfingosina, associada ou não ao percarbonato de sódio (PS). Espécimes RA foram preparados e análise de cor foi realizada antes e após os tratamentos e EC foi calculada. Para análise de EAA, as amostras foram esterilizadas por radiação em forno de micro-ondas. Então foram distribuídas aleatoriamente: solução salina tamponada com fosfato (PBS - controle), hipoclorito de sódio 0,5% (SH), fitoesfingosina (PHS) e fitoesfingosina + SP (PHS+Na2CO3). Os espécimes permaneceram em contato com as soluções por 30 minutos e posteriormente foram contaminados por Candida albicans. Alíquotas foram semeadas em placas de Petri com ágar Sabouraud Dextrose e incubadas a 37°C por 24 horas. Após a incubação, o número de colônias foi contado. A viabilidade celular dos microorganismos aderidos na RA foi avaliada e 20 campos foram observados em microscópio de epifluorescência, e a porcentagem de células viáveis aderidas foi calculada. Os dados foram comparados (One-way ANOVA, Tukey, p<0,05). Quanto a EC, o PHS+ Na2CO3 [0,4 (0,1)] resultou em menor alteração que o PBS [0,9 (0,2)], semelhante aos demais grupos (SH [1,0 (0,3)]; PHS [0,9 (0,2)]). Não houve diferença para todas as soluções testadas quanto à capacidade de evitar a aderência de microorganismos (p>0,05), mas o PHS [11,2 (4,1)] resultou em uma área menor de células viáveis aderidas, estatisticamente diferente do SH [18,2 (7,6)] e PBS [26,4 (10,8)]. Concluiu-se que o PHS resultou em menor número de células viáveis aderidas e, quando associado ao Na2CO3, também apresenta menor efeito sobre o EC da RA.

https://doi.org/10.1590/0103-6440202305357

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion
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Araujo, Leticia Campos de

; Amorim, Ayodele Alves

; Vivanco, Rocio Geng

; Arruda, Carolina Noronha Ferraz de

; Bikker, Floris J

; Pires-de-Souza, Fernanda de Carvalho Panzeri

Brazilian Dental Journal

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mar 2023, Volume 34 N. 2 Pages 88 - 96

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

Abstract This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey’s test; and Ra, by 2-way ANOVA, repeated measures, and Tukey’s test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Resumo Este estudo avaliou o efeito da Fitoesfingosina (PHS) e da vitrocerâmica bioativa (Biosilicato) sobre o esmalte dental em termos de alteração de cor (ΔE), microdureza (KHN) e rugosidade superficial, quando submetido a desafio erosivo (DE). Sessenta espécimes de dentes bovinos (6×6×2mm) foram obtidos. Foram realizadas leituras de cor inicial (Easyshade, VITA), microdureza (HMV-2, Shimadzu) e rugosidade superfícial (SJ-201P, Mitutoyo). Os espécimes foram separados em grupos de acordo com os tratamentos: PHS, Biosilicato a 10%, PHS+Biosilicato a 10%, e saliva artificial (controle). Em seguida, foram submetidos a DE com Coca-Cola por 2 min. Esse ciclo foi repetido 4 vezes/dia por 15 dias. Entre os ciclos, as amostras foram mantidas em saliva artificial (2 h/37°C). Após os ciclos diários, os espécimes também foram armazenados em saliva artificial a 37ºC. Foram realizadas leituras finais de cor, microdureza e rugosidade superficial. Os dados de cor e microdureza foram analisados por ANOVA de uma via, teste de Tukey; e dados de rugosidade superficial, por ANOVA de duas vias, teste de Tukey (p<.05). A maior ΔE ocorreu em Saliva+DE (p<.05). Grupos tratados com PHS apresentaram menor alteração de cor do que Saliva+DE (p<.05). Biosilicate+DE demonstrou valores intermediários, similar (p>.05) aos outros grupos, exceto Saliva+DE. Todos os grupos presentaram média acima dos limites 50:50% de perceptibilidade (50:50%LP) e aceitabilidade (50:50%LA) exceto o controle que demonstrou média acima do 50:50%LA mas abaixo do 50:50%LP. Biosilicate+DE mostrou maior microdureza realativa do que Saliva+DE (p<.05), mas similar a PHS+DE e PHS+Biosilicato+DE. A rugosidade de superfície do esmalte aumentou para todos os grupos, exceto para o controle que presentou a menor alteração (p<.05). O Biosilicato apode prevenir perda mineral do esmalte indizido pela erosão melhor que a saliva. O PHS associado ou não ao Biosilicato demonstrou melhor estabilidade de cor que a saliva.

https://doi.org/10.1590/0103-6440202304904

Análise comparativa de classificações de vulnerabilidade para municípios g100
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Carvalho, Carolina de Campos

; Martins, Mônica

; Viacava, Francisco

; Oliveira, Ricardo Antunes Dantas de

Revista Brasileira de Estudos de População

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2023, Volume 40 elocation e0246

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

Abstract In 2009, the Frente Nacional de Prefeitos (FNP) named a group of municipalities with more than 80,000 inhabitants, low levels of public revenue per capita and high socioeconomic vulnerability g100. This study sought to describe the g100 from the comparative position according to three measures of socioeconomic vulnerability applied to municipalities with more than 80,000 inhabitants, and to discuss the pertinence of using the FNP proposal as a suggestion for prioritization in social policies. Comparing the list of the first 100 g100 municipalities with the indices: Municipal Human Development Index (HDIM), Social Vulnerability Index (IVS) and Brazilian Deprivation Index (IBP), we identified 25 municipalities classified as g100 that were not classified among the top 100 in the other indices; but 46 g100 counties were among the most considered in all three measures. The need for broad debate and consensus on measures of socioeconomic vulnerability used in the planning and execution of public policies is discussed. This reflection is based on the belief that public actions and policies are intrinsically implemented to guarantee greater geographic and allocative equity in order to respond to the demands of the population.

Resumen En 2009, el Frente Nacional de Alcaldes (FNP) nombró como g100 a un grupo de municipios caracterizados por tener más de ochenta mil habitantes, bajos niveles de ingreso público per cápita y alta vulnerabilidad socioeconómica. Este estudio buscó describir el g100 a partir de la posición comparativa según tres medidas de vulnerabilidad socioeconómica aplicadas a municipios con más de ochenta mil, y a partir de ahí discutir la pertinencia de utilizar la propuesta del FNP como sugerencia de priorización en las políticas sociales. Para ello se comparó la lista de los primeros cien municipios del g100 con los índices de desarrollo humano municipal (HDIM), de vulnerabilidad social (IVS) y brasileño de privación (IBP). Se identificó que 25 municipios clasificados como g100 no estaban clasificados entre los 100 primeros en los demás índices, aunque 46 estuvieron entre los más considerados en las tres medidas. Se discute la necesidad de un amplio debate y consenso sobre las medidas de vulnerabilidad socioeconómica utilizadas en la planificación y ejecución de políticas públicas. Esta reflexión se ancla en la defensa de que las acciones y políticas públicas se inician intrínsecamente para garantizar una mayor equidad geográfica y distributiva frente a la obediencia para responder a las demandas de la población.

Resumo Em 2009, a Frente Nacional de Prefeitos (FNP) denominou g100 um grupo de municípios caracterizados por possuir mais de 80 mil habitantes, baixos níveis de receita pública per capita e alta vulnerabilidade socioeconômica. Este estudo buscou descrever o g100 a partir da posição comparativa segundo três medidas de vulnerabilidade socioeconômica aplicadas aos municípios com mais de 80 mil habitantes, discutindo a pertinência do uso da proposta da FNP como critério de priorização em políticas sociais. Comparou-se a listagem dos 100 primeiros municípios g100 com aquelas do Índice do Desenvolvimento Humano Municipal (IDHM), Índice de Vulnerabilidade Social (IVS) e Índice Brasileiro de Privação (IBP). Identificou-se que 25 municípios classificados como g100 não estavam entre os 100 primeiros nos demais índices; mas 46 municípios g100 encontravam-se entre os mais vulneráveis nas três medidas. Discute-se a necessidade de amplo debate e consenso sobre as medidas de vulnerabilidade socioeconômica empregadas no planejamento e execução de políticas públicas. Esta reflexão está ancorada na defesa de que as ações e políticas públicas sejam intrinsicamente planejadas para garantia de maior equidade geográfica e alocativa em face da efetividade de resposta às demandas da população.

https://doi.org/10.20947/s0102-3098a0246

Pandemia da Covid-19: variação no uso de internações hospitalares nos municípios g100
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Carvalho, Carolina de Campos

; Martins, Mônica

; Viacava, Francisco

; Peixoto, Caio de Paula

; Romão, Anselmo Rocha

; Oliveira, Ricardo Antunes Dantas de

Saúde em Debate

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dec 2022, Volume 46 N. spe8 Pages 89 - 105

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

ABSTRACT This study aims to comparatively analyze the volume and flows for hospital admissions before and during the first year of the COVID-19 pandemic in 112 g100 municipalities, which are characterized by having more than 80,000 inhabitants, low income, and high socioeconomic vulnerability. Data from the SUS Hospital Information System regarding hospitalizations of adults (age ≥ 18 years) in the period 2017-2020. Hospitalizations were classified according to type of admission or specialty of treatment in the following categories: elective, urgency/emergency, clinical, surgical, obstetric, and oncological treatment. Elective hospitalizations showed a greater reduction in volume in 2020 compared to the previous year, probably due to the measures adopted to minimize the risks of contagion and prioritization of care to severe patients by COVID-19. Considering the place of hospitalization, no significant changes were observed in relation to the referral of residents of g100 municipalities to other municipalities. However, there was differentiation between localities in which regionalization in health works in a more appropriate way, and others where there is a scarcity of resources or need for more effective planning and management.

RESUMO Este estudo objetivou analisar comparativamente o volume e os fluxos para internações hospitalares antes e durante o primeiro ano da pandemia da Covid-19 nos 112 municípios g100. Esses municípios caracterizam-se por ter mais de 80 mil habitantes, baixa renda e alta vulnerabilidade socioeconômica. Foram utilizados dados do Sistema de Informações Hospitalares do Sistema Único de Saúde referentes ao período 2017-2020. Selecionaram-se as internações de adultos (idade ≥ 18 anos), que foram classificadas segundo tipo de admissão ou especialidade do tratamento nas seguintes categorias: eletivas ou urgência/ emergência; tratamento clínico, cirúrgico, obstétrico e oncológico. As internações eletivas apresentaram maior redução no volume em 2020 em relação ao ano anterior devido às medidas adotadas para minimizar os riscos de contágio e priorização do cuidado aos pacientes grave por Covid-19. Não foram observadas alterações significativas em relação ao local de realização das internações de residentes de municípios g100. Contudo, no g100, observou-se diferenciação entre localidades nas quais a regionalização em saúde funciona de forma mais adequada, e em outras onde há escassez de recursos ou necessidade de planejamento e gestão mais efetivos.

https://doi.org/10.1590/0103-11042022e807

Pandemia da Covid-19: variação no uso de internações hospitalares nos municípios g100
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Carvalho, Carolina de Campos

; Martins, Mônica

; Viacava, Francisco

; Peixoto, Caio de Paula

; Romão, Anselmo Rocha

; Oliveira, Ricardo Antunes Dantas de

Saúde em Debate

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2022, Volume 46 N. spe8 Pages 89 - 105

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

https://doi.org/10.1590/0103-11042022e807

Knowledge, attitudes, and psychosocial impacts among Brazilian Pediatric Dentists during COVID-19 pandemic
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Torres, Carolina Paes

; Lizzi, Elisangela Aparecida da Silva

; Borsatto, Maria Cristina

; Nelson Filho, Paulo

; De Rossi, Andiara

; Díaz-Serrano, Kranya Victoria

; Barros, Aldevina Campos Freitas de

; Paula-Silva, Francisco Wanderley Garcia

; Carvalho, Fabrício Kitazono de

; Silva, Raquel Assed Bezerra

; Silva, Lea Assed Bezerra

; Lucisano, Marília Pacífico

; Queiroz, Alexandra Mussolino

Brazilian Oral Research

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2022, Volume 36 elocation e028

Abstract: En | Text: En | PDF: En

Abstract: In this study, we evaluated the knowledge, attitudes, and psychosocial impacts among Brazilian pediatric dentists during the COVID-19 pandemic. A cross-sectional study with primary data collection was carried out using an online structured questionnaire. Data were submitted to descriptive analysis by using absolute and relative frequencies. A chi-square test was used for association analysis and log-linear regression models to estimate the prevalence ratio (5%). The population comprised mostly women and knowledge regarding COVID-19 was satisfactory (above 80% in most items). N95 masks and faceshields were used, albeit 64.22% reported difficulty in providing dental care to children due to the need for extra Personal Protective Equipment. Thirty eight percent provided urgency/emergency dental care, 59.78% performed invasive procedures, 59.56% used high speed handpieces, 8.44% started using cariostatics, and 6.22% introduced the use of chemomechanical caries removal agents. Fear for the future (PR = 1.21) and use of medications (for anxiety, depression, or insomnia) increased (PR = 1.16) among the ones who had wage losses. Brazilian pediatric dentists have knowledge about COVID-19, and attitudes in their clinical routines changed due the pandemic. Financial life was harmed and a negative impact of the pandemic in psychosocial aspects of workers was found.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0028

Risk factors of transplant renal artery stenosis in kidney transplant recipients
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Kanhouche, Gabriel

; Santos, Gustavo Rocha Feitosa

; Orellana, Henry Campos

; Galhardo, Attilio

; Faccinetto, Ana Carolina Buso

; Barteczko, Manoela Linhares Machado

; Carvalho, Luiz Sérgio F. de

; Taddeo, Julia Bernardi

; Foresto, Renato Demarchi

; Moises, Valdir Ambrósio

; Tedesco-Silva, Helio

; Pestana, José Medina

; Barbosa, Adriano Henrique Pereira

Clinics

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2022, Volume 77 elocation 100087

Abstract: En | Text: En | PDF: En

Abstract Background: Transplant Renal Artery Stenosis (TRAS) is a recognized vascular complication after kidney transplantation. The overall risk predictors of TRAS are poorly understood. Methods: Retrospective analysis of patients with suspected TRAS (Doppler ultrasound PSV > 200 cm/s) who underwent angiographic study in a single center between 2007 and 2014. All patients with stenosis > 50% were considered with TRAS. Stenosis restricted in the body of the artery was also analyzed in a subgroup. Results: 274 patients were submitted to a renal angiography and 166 confirmed TRAS. TRAS group featured an older population (46.3 ± 11.0 vs. 40.9 ±14.2 years; p = 0.001), more frequent hypertensive nephropathy (30.1% vs. 15.7%; p = 0.01), higher incidence of Delayed Graft Function (DGF) (52.0% vs. 25.6%; p < 0.001) and longer Cold Ischemia Time (CIT) (21.5 ± 10.6 vs. 15.7 ± 12.9h; p < 0.001). In multivariable analyses, DGF (OR = 3.31; 95% CI 1.78-6.30; p < 0.0001) was independent risk factors for TRAS. DM and CIT showed a tendency towards TRAS. The compound discriminatory capacity of the multivariable model (AUC = 0.775; 95% CI 0.718-0.831) is significantly higher than systolic blood pressure and creatinine alone (AUC = 0.62; 95% CI 0.558-0.661). In body artery stenosis subgroup, DGF (OR = 1.86; 95% CI 1.04-3.36; p = 0.03) and Diabetes Mellitus (DM) (OR = 2.44; 95% CI 1.31-4.60; p = 0.005) were independent risk factors for TRAS. Conclusion: In our transplant population, DGF increased more than 3-fold the risk of TRAS. In the subgroup analysis, both DGF and DM increases the risk of body artery stenosis. The addition of other factors to hypertension and renal dysfunction may increase diagnostic accuracy.

https://doi.org/10.1016/j.clinsp.2022.100087

Gonadal Differentiation During Embryonic and Fetal Development of Male New Zealand Rabbits (Oryctolagus cuniculus)
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Miranda, Carla Maria Figueiredo de Carvalho

; Leonel, Luciano César Pereira Campos

; Koga, Bruna Andrade Aguiar

; Anunciação, Adriana Raquel de Almeida da

; Mario, Lara Carolina

; Favaron, Phelipe Oliveira

; Martins, Daniele dos Santos

; Vásquez, Bélgica

; Conei, Daniel

; Miglino, Maria Angélica

; del Sol, Mariano

International Journal of Morphology

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oct 2021, Volume 39 N. 5 Pages 1253 - 1263

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

SUMMARY: The rabbit is considered an ideal animal model for studies that describe abnormalities in the testicles due to the similar morphogenetic mechanisms of sexual development and diseases commonly found in humans. The aim of this study was to determine the male sexual differentiation of the New Zealand rabbit (Oryctolagus cuniculus) through development. The gestational age was estimated and classified as 9, 12, 14, 16, 18, 20, 23 and 28 gestational days. The morphological and sexual determination were performed by histological analysis of the reproductive tract in the embryos and fetuses (9-28 days) as well as by immunohistochemistry- Desert hedgehog-Dhh- (testis-specific protein on Y chromosome- 16, 20, 23 days and adult rabbits). Gonads were observed from the 14th day in an undifferentiated stage and with homogeneous aspect. Sexual differentiation was observed from the 16th day with presence of cells forming gonadal cords and Dhh+ cells in the gonadal parenchyma. From the 18th gestational day testicular cords were observed, which evolved into organized seminiferous tubules. The formation of the efferent ducts and ductus deferens and epididymis was observed on the 20th and 23rd days, respectively. The differentiation of the external genitalia occurred from the 23rd days from the anogenital distance and was identified to identify the penile structures. In summary, the features of the sexual differentiation were determined by observation of the Dhh+ protein in embryos from the 16th day to adulthood, and the morphological particularities observed from the 18th gestational day, determined by differentiation of the external genitalia from the 23rd day.

RESUMEN: El conejo se considera un modelo animal ideal para estudios que describen anomalías a nivel testícular debido a que presenta mecanismos morfogenéticos similares al desa- rrollo sexual y enfermedades que se encuentran comúnmente en los seres humanos. El objetivo de este estudio fue determinar la diferenciación sexual masculina del conejo de Nueva Zelanda (Oryctolagus cuniculus) a través del desarrollo. La edad gestacional se estimó y clasificó en 9, 12, 14, 16, 18, 20, 23 y 28 días gestacionales. La determinación morfológica y sexual se realizó mediante análisis histológico del tracto reproductivo en los embriones y fetos (9 - 28 días) así como mediante inmunohistoquímica -Desert hedgehog-Dhh- (proteína testicular específica en el cromosoma Y- 16, 20, 23 días y conejos adultos). Las gónadas se observaron a partir del día 14 en un estadio indiferenciado y con aspecto homogéneo. Se observó diferenciación sexual a partir del día 16 con presencia de células formadoras de cordones gonadales y células Dhh+ en el parénquima gonadal. A partir del día 18 de gestación se observaron cordones testiculares, que evolucionaron a túbulos seminíferos organizados. La formación de los conductos eferentes, deferentes y del epidídimo se observó a los 20 y 23 días, respectivamente. La diferenciación de los genitales externos ocurrió a partir del día 23 desde la distancia anogenital y se utilizó para identificar las estructuras del pene. En conclusión, las características de la diferenciación sexual se determinaron mediante la observación de la proteína Dhh en embriones desde el día 16 hasta la edad adulta, y las particularidades morfológicas observadas a partir del día 18 de gestación, determinadas por diferenciación de los genitales externos a partir del día 23.

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Registro Multicêntrico de Takotsubo (REMUTA) – Aspectos Clínicos, Desfechos Intra-Hospitalares e Mortalidade a Longo Prazo
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Almeida Junior, Gustavo Luiz Gouvêa de

; Mansur Filho, João

; Albuquerque, Denilson Campos de

; Xavier, Sergio Salles

; Pontes, Álvaro

; Gouvêa, Elias Pimentel

; Martins, Alexandre Bahia Barreiras

; Nunes, Nágela S. V.

; Carestiato, Lilian Vieira

; Petriz, João Luiz Fernandes

; Santos, Armando Márcio Gonçalves

; Bandeira, Bruno Santana

; Abufaiad, Bárbara Elaine de Jesus

; Pacheco, Luciana da Camara

; Oliveira, Maurício Sales de

; Ribeiro Filho, Paulo Eduardo Campana

; Sampaio, Pedro Paulo Nogueres

; Duque, Gustavo Salgado

; Camillis, Luiz Felipe

; Marques, André Casarsa

; Lourenço Jr, Francisco Carlos

; Palazzo, José Ricardo

; Costa, Cláudio Ramos da

; Silva, Bibiana Almeida da

; Zukowski, Cleverson Neves

; Garcia, Romulo Ribeiro

; Zonis, Fernanda de Carvalho

; Paula, Suzana Andressa Morais de

; Ferrari, Carolina Gravano Ferraz

; Rangel, Bruno Soares da Silva

; Ferreira, Roberto Muniz

; Mendes, Bárbara Ferreira da Silva

; Castro, Isabela Ribeiro Carvalho de

; Souza, Leonardo Giglio Gonçalves de

; Araújo, Luiz Henrique dos Santos

; Giani, Alexandre

Arquivos Brasileiros de Cardiologia

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aug 2020, Volume 115 N. 2 Pages 207 - 216

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

Resumo Fundamento A síndrome de takotsubo (takotsubo) é uma forma de cardiomiopatia adquirida. Dados nacionais sobre essa condição são escassos. O Registro REMUTA é o primeiro a incluir dados multicêntricos dessa condição no nosso país. Objetivo Descrever as características clínicas, prognóstico, tratamento intra-hospitalar e mortalidade hospitalar e em 1 ano de seguimento. Métodos Estudo observacional, retrospectivo, tipo registro. Incluídos pacientes internados com diagnóstico de takotsubo ou que desenvolveram esta condição durante internação por outra causa. Os desfechos avaliados incluíram fator desencadeador, análise dos exames, uso de medicações, complicações e óbito intra-hospitalar e em 1 ano de seguimento. O nível de significância adotado foi de 5%. Resultados Foram incluídos 169 pacientes, em 12 centros no Estado do Rio de Janeiro. A idade média foi de 70,9 ± 14,1 anos e 90,5% eram do sexo feminino; 63% dos casos foram de takotsubo primário e 37% secundário. Troponina I foi positiva em 92,5% dos pacientes e a mediana de BNP foi de 395 (176,5; 1725). Supradesnivelamento do segmento ST esteve presente em 28% dos pacientes. A fração de ejeção do ventrículo esquerdo teve mediana de 40 (35; 48)%. Observamos taxa de 25,7% de ventilação mecânica invasiva e 17,4% de choque. Suporte circulatório mecânico foi utilizado em 7,7%. A mortalidade intra-hospitalar foi de 10,6% e a mortalidade ao final de 1 ano foi de 16,5%. Takotsubo secundário e choque cardiogênico foram preditores independentes de mortalidade. Conclusão Os resultados do REMUTA mostram que takotsubo não se trata de patologia benigna como se pensava, especialmente no grupo de takotsubo secundário que acarreta elevada taxa de complicações e de mortalidade. (Arq Bras Cardiol. 2020; 115(2):207-216)

Abstract Background Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil. Objective To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up. Methods This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted. Results The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality. Conclusion The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216)

https://doi.org/10.36660/abc.20190166 1217 downloads

10.

[SciELO Preprints] - The Novel Coronavirus: An Alert for Pacifiers’ Disinfection
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Souza, Vívian Gonçalves Carvalho Lopes, Danielle Fernandes Machado, Fernanda Campos Fabri, Rodrigo Luiz Apolônio, Ana Carolina Morais

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Publication date: 2020-04-24

Abstract: En

Objective: To evaluate the best strategy for pacifier disinfection methods. Material and Methods: The literature search was conducted on MEDLINE/PubMed, Scielo, Lilacs, Web of Science, and Scopus databases to find all relevant articles published over the past 20 years, based on PRISMA guidelines. Two reviewers extracted data independently by using a standardized form. The following factors were recorded: country of study, type of study, pacifier material, sample number, microorganisms analyzed, decontamination methods used, method accessibility and results found. Results: A total of 121 articles were obtained from all databases. The selected documents underwent a final screening, resulting in 8 articles. The method of disinfection analyzed by the literature were: 3.5% neutral detergent, apple cider vinegar 70% spray, boiling water during 15 minutes, sodium hypochlorite 2.5, hydrogen peroxide 70% spray, chlorhexidine 0.12%, Brushtox®, sterile water and microwave. Conclusion: Because of the broad methods for pacifier disinfection and different levels of accessibility to disinfectant agents, the pacifier consensus for decontamination remains unclear. Although the disinfection methods are diverse, the methods suggested to its disinfection were identified and described in this article.

https://doi.org/10.1590/pboci.2020.070

11.

MODY probability calculator for GCK and HNF1A screening in a multiethnic background population
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Tarantino, Roberta Magalhães

; Abreu, Gabriella de Medeiros

; Fonseca, Ana Carolina Proença de

; Kupfer, Rosane

; Pereira, Maria de Fátima Carvalho

; Campos Júnior, Mario

; Zajdenverg, Lenita

; Rodacki, Melanie

Archives of Endocrinology and Metabolism

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feb 2020, Volume 64 N. 1 Pages 17 - 23

Abstract: En | Text: En | PDF: En

ABSTRACT Objective We aimed to identify the frequency of monogenic diabetes, which is poorly studied in multiethnic populations, due to GCK or HNF1A mutations in patients with suggestive clinical characteristics from the Brazilian population, as well as investigate if the MODY probability calculator (MPC) could help patients with their selection. Subjects and methods Inclusion criteria were patients with DM diagnosed before 35 years; body mass index < 30 kg/m2; negative autoantibodies; and family history of DM in two or more generations. We sequenced HNF1A in 27 patients and GCK in seven subjects with asymptomatic mild fasting hyperglycemia. In addition, we calculated MODY probability with MPC. Results We identified 11 mutations in 34 patients (32.3%). We found three novel mutations. In the GCK group, six cases had mutations (85.7%), and their MODY probability on MPC was higher than 50%. In the HNF1A group, five of 27 individuals had mutations (18.5%). The MPC was higher than 75% in 11 subjects (including all five cases with HNF1A mutations). Conclusion Approximately one third of the studied patients have GCK or HNF1A mutations. Inclusion criteria included efficiency in detecting patients with GCK mutations but not for HNF1A mutations (< 20%). MPC was helpful in narrowing the number of candidates for HNF1A screening.

https://doi.org/10.20945/2359-3997000000173 1221 downloads

12.

Dengue diagnostics: serious inaccuracies are likely to occur if pre-analytical conditions are not strictly followed
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Iani, Felipe Campos de Melo

; Caetano, Ana Carolina Barbosa

; Cocovich, Jéssica Caroline Wenceslau

; Amâncio, Frederico Figueiredo

; Pereira, Maira Alves

; Adelino, Talita Émile Ribeiro

; Caldas, Sérgio

; Silva, Marcos Vinícius Ferreira

; Pereira, Glauco de Carvalho

; Duarte, Myrian Morato

Memórias do Instituto Oswaldo Cruz

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2020, Volume 115 elocation e200287

Abstract: En | Text: En | PDF: En

BACKGROUND The heat-labile nature of Dengue virus (DENV) in serum samples must be considered when applying routine diagnostic tests to avoid issues that could impact the accuracy of test results with direct implications for case management and disease reporting. OBJECTIVES To check if pre-analytical variables, such as storage time and temperature, have an impact on the accuracy of the main routine diagnostic tests for dengue. METHODS Virus isolation, reverse transcription real-time polymerase chain reaction (RT-PCR) and NS1 enzyme-linked immunosorbent assay (ELISA) were evaluated using 84 samples submitted to different pre-analytical conditions. FINDINGS Sensitivity and negative predictive value were directly affected by sample storage conditions. RT-PCR and virus isolation showed greater dependence on well-conserved samples for an accurate diagnosis. Interestingly, even storage at -30ºC for a relatively short time (15 days) was not adequate for accurate results using virus isolation and RT-PCR tests. On the other hand, NS1 ELISA showed no significant reduction in positivity for aliquots tested under the same conditions as in the previous tests. MAIN CONCLUSIONS Our results support the stability of the NS1 marker in ELISA diagnosis and indicate that the accuracy of routine tests such as virus isolation and RT-PCR is significantly affected by inadequate transport and storage conditions of serum samples.

https://doi.org/10.1590/0074-02760200287 354 downloads

13.

Curativo gel de clorexidina no transplante de células-tronco hematopoéticas
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Castanho, Lais Esparrachiari Carvalho

; Santos, Bruna Nogueira dos

; Margatho, Amanda Salles

; Braga, Fernanda Titareli Merizio Martins

; Reis, Paula Elaine Diniz dos

; Oliveira, Maria Carolina de

; Silveira, Renata Cristina de Campos Pereira

Acta Paulista de Enfermagem

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2020, Volume 33 elocation eAPE20180307

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

Abstract Objective Monitor the use of chlorhexidine gel dressing in the central venous catheter of children and adults submitted to hematopoietic stem cell transplantation (HSCT) to check for catheter-related bloodstream infection and skin irritation while using this dressing. Methods This is a prospective observational study with 25 patients with central venous catheters (CVC) inserted for hematopoietic stem cell transplantation. Dressing characteristics, skin characteristics, clinical conditions of patients and infection-related characteristics were evaluated daily. Patients were monitored from the first day of CVC insertion until removal, up to 45 days from the CVC insertion date. Results Catheter-related bloodstream infection (CRBSI) occurred in 28% of all patients, with an association between febrile neutropenia and infection (p<0.01). Skin irritation was identified in 24% of patients. No association was found between catheter-related bloodstream infection and skin irritation (p=0.51). A significant association was observed between skin irritation and dressing removal (p=0.03). Unscheduled dressing changes corresponded to 50% of all dressing changes identified during the study, and the main reason was presence of blood in the dressing (57.8%). Conclusion Using chlorhexidine gel dressing in patients submitted to HSCT proved to be an effective measure to reduce the occurrence of catheter-related infections, when compared to literature data. The cases of CRBSI found in this study were mainly associated with the condition of neutropenia, which is very common in this population. The cases of dressing-related skin irritation and presence of blood as the main reason for unscheduled change highlight the importance of nurses having proper knowledge about how to use this dressing in order to create protocols for safe dressing use and handling.

Resumen Objetivo Hacer un seguimiento del uso del vendaje gel de clorhexidina en catéter venoso central (CVC) en niños y adultos sometidos al trasplante de células madre hematopoyéticas (TCMH) para verificar los casos de infección del flujo sanguíneo relacionados con el catéter (IFSRC) y la irritación cutánea durante la validez de este vendaje. Métodos Estudio observacional y prospectivo, con 25 pacientes con catéter venoso central insertado para realizar el trasplante de células madre hematopoyéticas. Diariamente se evaluaron las características del vendaje y de la piel, las características clínicas del paciente y las relacionadas con la infección. Los pacientes recibieron un seguimiento a partir del primer día de la inserción del CVC hasta su retirada, con un límite de 45 días a partir de la fecha de inserción del CVC. Resultados La infección del flujo sanguíneo relacionada con el catéter se presentó en el 28% de los pacientes, hubo relación entre neutropenia febril e infección (p<0,01). Se identificó irritación cutánea en el 24% de los pacientes. No se identificó relación entre la infección del flujo sanguíneo relacionada con el catéter y la irritación cutánea (p=0,51). Hubo relación significativa entre la irritación cutánea y la suspensión del uso del vendaje (p=0,03). Los cambios no programados sucedieron en el 50% de los cambios registrados, y el motivo principal fue la presencia de sangre en el vendaje (57,8%). Conclusión El uso del vendaje gel de clorhexidina en pacientes sometidos al TCMH demostró ser una medida eficaz para la reducción de casos de infecciones relacionadas con el catéter, en comparación con los datos de la literatura. Los casos de IFSRC encontrados se relacionaron principalmente con la condición de neutropenia, muy común en esta población. Los casos identificados de irritación cutánea relacionados con el vendaje y la presencia de sangre como principal motivo de cambio no programado resaltan la importancia del conocimiento del uso del vendaje por parte de los enfermeros asistenciales, a fin de crear protocolos que indiquen el uso y manejo seguro del vendaje.

Resumo Objetivo Acompanhar o uso do curativo gel de clorexidina em cateter venoso central de crianças e adultos submetidos ao transplante de células-tronco hematopoéticas para verificar a ocorrência de infecção da corrente sanguínea relacionada ao cateter e irritação cutânea na vigência deste curativo. Métodos Estudo observacional e prospectivo, com 25 pacientes com cateter venoso central inserido para realização do transplante de células-tronco hematopoéticas. Diariamente avaliou-se as características do curativo, da pele, clínicas do paciente e relacionadas a infecção. Os pacientes foram acompanhados a partir do primeiro dia da inserção do CVC até a sua remoção, até o limite de 45 dias a partir da data de inserção do CVC. Resultados A infecção da corrente sanguínea relacionada ao cateter ocorreu em 28% dos pacientes, houve associação entre neutropenia febril e infecção (p<0,01). A irritação cutânea foi identificada em 24% dos pacientes. Não foi identificada associação entre infecção da corrente sanguínea relacionada ao cateter e a irritação cutânea (p=0,51). Houve associação significativa entre irritação cutânea e suspensão do uso do curativo (p=0,03). As trocas não programadas ocorreram em 50% das trocas identificadas e o principal motivo foi a presença de sangue no curativo (57,8%). Conclusão O uso do curativo gel de clorexidina em pacientes submetidos ao TCTH demonstrou ser uma medida eficaz na redução da ocorrência de infecções relacionadas ao cateter, quando comparado aos dados da literatura. Os casos de ICSRC encontrados foram associados, principalmente, à condição de neutropenia, muito comum nesta população. Os casos de irritação cutânea relacionados ao curativo identificados e a presença de sangue como principal motivo de troca não programada salientam a importância do conhecimento relacionado ao uso do curativo por parte dos enfermeiros assistenciais, a fim de criar protocolos que indiquem o uso e manejo do curativo com segurança.

https://doi.org/10.37689/acta-ape/2020ao0307 51 downloads

14.

Curativo gel de clorexidina no transplante de células-tronco hematopoéticas
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Castanho, Lais Esparrachiari Carvalho

; Santos, Bruna Nogueira dos

; Margatho, Amanda Salles

; Braga, Fernanda Titareli Merizio Martins

; Reis, Paula Elaine Diniz dos

; Oliveira, Maria Carolina de

; Silveira, Renata Cristina de Campos Pereira

Acta Paulista de Enfermagem

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2020, Volume 33 elocation eAPE20180307

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

https://doi.org/10.37689/acta-ape/2020ao0307 1234 downloads

15.

The Novel Coronavirus: An Alert for Pacifiers’ Disinfection
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Souza, Vívian Gonçalves Carvalho

; Lopes, Danielle Fernandes

; Machado, Fernanda Campos

; Fabri, Rodrigo Luiz

; Apolônio, Ana Carolina Morais

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2020, Volume 20 elocation e0071

Abstract: En | Text: En | PDF: En

Abstract Objective: To evaluate the best strategy for pacifier disinfection methods. Material and Methods: The literature search was conducted on MEDLINE/PubMed, Scielo, Lilacs, Web of Science, and Scopus databases to find all relevant articles published over the past 20 years, based on PRISMA guidelines. Two reviewers extracted data independently by using a standardized form. The following factors were recorded: country of study, type of study, pacifier material, sample number, microorganisms analyzed, decontamination methods used, method accessibility and results found. Results: A total of 121 articles were obtained from all databases. The selected documents underwent a final screening, resulting in 8 articles. The method of disinfection analyzed by the literature were: 3.5% neutral detergent, apple cider vinegar 70% spray, boiling water during 15 minutes, sodium hypochlorite 2.5, hydrogen peroxide 70% spray, chlorhexidine 0.12%, Brushtox®, sterile water and microwave. Conclusion: Because of the broad methods for pacifier disinfection and different levels of accessibility to disinfectant agents, the pacifier consensus for decontamination remains unclear. Although the disinfection methods are diverse, the methods suggested to its disinfection were identified and described in this article.

https://doi.org/10.1590/pboci.2020.070 797 downloads

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