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RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.

ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

https://doi.org/10.1590/0004-282x-anp-2021-0162 1 downloads

Efeito do tratamento com antileucotrieno em contratura capsular: estudo experimental
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CAMARGO, CRISTINA PIRES

; CARVALHO, HELOISA ANDRADE

; KUBRUSLY, MARCIA SALDANHA

; MEDEIROS, SOFIA AMARAL

; BESTEIRO, JULIO MORAIS

; GEMPERLI, ROLF

Revista Brasileira de Cirurgia Plástica

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jul 2021, Volume 36 N. 3 Pages 281 - 286

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

RESUMO Introdução: 40% dos pacientes submetidos à radioterapia após reconstrução de mama por implante de prótese de silicone podem desenvolver encapsulamento da prótese. Diversas estratégias já foram testadas para prevenir a contratura da cápsula com resultados insatisfatórios. Este estudo analisou o efeito do antileucotrieno (AL) tópico na formação de contratura capsular em ratos com implantes de silicone associados à irradiação. Métodos: Foram implantados blocos de silicone na região dorsal em 20 ratas fêmeas, espécie Wistar com peso variando de 200-250g. Os animais foram divididos em dois grupos: controle (injeção de solução fisiológica 0,9% no tecido ao redor do implante) e grupo intervenção (injeção de 10mg de AL no tecido ao redor do implante). Imediatamente após a cirurgia os animais foram irradiados com dose única de 10Gy. Após dois meses, coletamos amostras de cápsulas para análise histológica e análise da expressão gênica dos seguintes biomarcadores: iNOS, VEGF-a e MMP-9. Resultados: A densidade vascular foi menor no grupo AL quando comparado ao grupo controle (55,4±30,0 vs. 81,8±26,7, p=0,05, respectivamente). Da mesma forma, o VEGF-a teve o mesmo comportamento (grupo controle - 0,34±0,1 vs. grupo Al - 0,02±0,001, p=0,04). Conclusão: Este estudo sugeriu que o tratamento com AL diminui a angiogênese em animais submetidos a implantes de silicone e submetidos à radioterapia

ABSTRACT Introduction: 40% of patients undergoing radiotherapy after breast reconstruction by silicone prosthesis implant may develop prosthesis encapsulation. Several strategies have already been tested to prevent capsule contracture with unsatisfactory results. This study analyzed the effect of topical antileukotriene (AL) on capsular contracture formation in rats with silicone implants associated with irradiation. Methods: Silicone blocks were implanted in the dorsal region in 20 female rats Wistar with weights ranging from 200-250g. The animals were divided into two groups: control (injection of 0.9% saline solution into the tissue around the implant) and intervention group (injection of 10mg of AL into the tissue around the implant). Immediately after surgery, the animals were irradiated with a single dose of 10Gy. After two months, we collected capsule samples for histological analysis and gene expression analysis of the following biomarkers: iNOS, VEGF-a and MMP-9. Results: Vascular density was lower in the AL group when compared to the control group (55.4±30.0 vs. 81.8±26.7, p=0.05, respectively). Similarly, VEGF-a had the same behavior (control group - 0.34±0.1 vs. group Al - 0.02±0.001, p=0.04). Conclusion: This study suggested that treatment with AL decreases angiogenesis in animals submitted to silicone implants and underwent radiotherapy.

https://doi.org/10.5935/2177-1235.2021rbcp0092

Light-emitting diode stimulates radiodermatitis recovery
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Camargo, Cristina Pires

; Carvalho, Heloisa Andrade

; Maluf, Feres Camargo

; Sousa, Alexandre Agostinho da Cruz

; Perin, Paulo Otavio Maluf

; Perin, Marcela Maluf

; Morais-Besteiro, Julio

; Gemperli, Rolf

Acta Cirúrgica Brasileira

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2021, Volume 36 N. 3 elocation e360301

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose To evaluate the effect of light-emitting diode (LED) in an experimental model of radiodermatitis. Methods Ten male Wistar rats weighing 200–250 g were analyzed. Radiation was delivered in a single dose (20 Gy with Strontium-90 dermatological plaques), two areas per animal. After 15 days, they were divided into two groups: control group (n = 5) and LED group (n = 5), which was treated during 21 days later (LED 660 nm, 10 min in alternate days). The endpoints were radiodermatitis scale, histological analysis HE, Picrius Sirius and the gene expression of interleukin-10 (IL-10) and matrix metalloproteinase-9 (MMP-9). Results The LED group showed a higher number of dermal appendages (p = 0.04) and angiogenesis(p = 0.007), a tendency towards higher IL-10 (p = 0.06) and an increase in MMP-9 (p = 0.004) when compared to the control group. Conclusions This study suggested that the use of LED for radiodermatitis increased skin regeneration.

https://doi.org/10.1590/acb360301 694 downloads

Consequences of psychoactive substance use: a comparative study of two services in Brazil and Portugal
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Boska, Gabriella de Andrade

; Seabra, Paulo Rosário Carvalho

; Oliveira, Márcia Aparecida Ferreira de

; Fernandes, Ivan Filipe de Almeida Lopes

; Claro, Heloísa Garcia

; Sequeira, Rui Manuel Russo

Revista da Escola de Enfermagem da USP

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2021, Volume 55 elocation e20210138

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

RESUMO Objetivo: Comparar as consequências do consumo de substâncias psicoativas entre usuários de serviços de saúde mental no Brasil e em Portugal. Método: Estudo transversal, comparativo, de natureza quantitativa, realizado com 362 usuários de dois serviços especializados de tratamento nas cidades de São Paulo (n = 200) e Lisboa (n = 162). Dados coletados em 2019 por meio da aplicação da escala Consequências da Dependência de Substâncias. Realizou-se análise descritiva e regressões de mínimos quadrados ordinários e logística. Resultados: Todas as dimensões avaliadas pela escala foram mais graves para os usuários brasileiros, com diferença para o domínio físico e habilidades cognitivas (p < 0,01). Destaca-se maior probabilidade dos participantes brasileiros para consumir cocaína (p < 0,01) e ter psicose (p = 0,02) e dos portugueses ter hepatites (p < 0,01), transtorno de personalidade (p < 0,01), fazer uso de benzodiazepínicos (p < 0,01) e tabaco (p < 0,01) e receber suporte farmacológico (p < 0,01). Conclusão: Constatou-se que os usuários brasileiros apresentam consequências mais graves relacionadas ao consumo de substâncias e os portugueses, mais comorbidades e exposição a consumo de risco. Emerge que as respostas portuguesas minimizam a gravidade das consequências.

ABSTRACT Objective: To compare the consequences of psychoactive substance use among users of mental health services in Brazil and Portugal. Method: Cross-sectional, comparative, quantitative study, carried out with 362 users of two specialized treatment services in the cities of São Paulo (n = 200) and Lisbon (n = 162). Data collected in 2019 through the application of the Substance Addiction Consequences scale. A descriptive analysis and ordinary least squares and logistic regressions were performed. Results: All dimensions assessed by the scale were more severe for Brazilian users, with a difference for the physical domain and cognitive skills (p < 0.01). Brazilian participants were more likely to consume cocaine (p < 0.01) and have psychosis (p = 0.02) and Portuguese participants to have hepatitis (p < 0.01), personality disorders (p < 0.01), use benzodiazepines (p < 0.01) and tobacco (p < 0.01), and receive pharmacological support (p < 0.01). Conclusion: It was found that Brazilian users have more serious consequences related to substance use, and Portuguese users have more comorbidities and exposure to risky consumption. It emerges that Portuguese responses minimize the consequences severity.

RESUMEN Objetivo: Comparar las consecuencias del consumo de sustancias psicoactivas entre usuarios de servicios de salud mental en Brasil y Portugal. Método: Estudio transversal, comparativo de naturaleza cuantitativa, realizado con 362 usuarios de dos servicios especializados de tratamiento en las ciudades de Sao Paulo (n = 200) y Lisboa (n = 162). Datos recogidos en 2019 a través de la aplicación de la escala Consecuencias de la Dependencia de Sustancias. Se realizó análisis descriptivo y regresiones de mínimos cuadrados ordinarios y logística. Resultados: Todas las dimensiones calculadas por la escala fueron más graves para los usuarios brasileños, con diferencia para el dominio físico y habilidades cognitivas (p < 0,01). Se destaca mayor probabilidad de que los participantes brasileños consuman cocaína (p < 0,01) y tengan psicosis (p = 0,02) y de que los portugueses tengan hepatitis (p < 0,01), trastorno de personalidad (p < 0,01), utilicen benzodiacepinicos (p < 0,01) y tabaco (p < 0,01) y reciban soporte farmacológico (p < 0,01). Conclusión: Se pudo constatar que los usuarios brasileños presentan consecuencias más graves relacionadas al consumo de sustancias y los portugueses, más comorbidades y exposición al consumo de riesgo. Se notó que las respuestas portuguesas minimizan la gravedad de las consecuencias.

https://doi.org/10.1590/1980-220x-reeusp-2021-0138 158 downloads

Impact of COVID-19 pandemic on a daily-based outpatient treatment routine: experience of a radiotherapy department of a tertiary public/university hospital in Brazil
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Carvalho, Heloisa de Andrade

; Vasconcelos, Karina Gondim Moutinho C.

; Gomes, Herbeni Cardoso

; Salvajoli, João Víctor

Clinics

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2020, Volume 75 elocation e2298

Abstract: En | Text: En | PDF: En

OBJECTIVES: To report the impact of the COVID-19 pandemic on patient attendance at a radiotherapy department two months after the implementation of specific policies regarding the pandemic. METHODS: The proposed treatment schemes, favoring hypofractionated schedules, and COVID-19 management strategies regarding irradiation are presented. Attendance after two months of implementation of these policies was measured and compared with that during the same period in 2019. RESULTS: A 10% reduction in the number of treated patients and a 26% reduction in the number of sessions was observed. The main impact was a decrease in the treatment of benign diseases and gastrointestinal tumors, with a general increase in breast cancer treatments. Eighteen (1.7%) patients were confirmed as having COVID-19 during radiotherapy in April and May 2020, three of whom were hospitalized, and one patient died because of COVID-19. Among the 18 patients, 12 had their treatments interrupted for at least 15 days from symptom appearance. CONCLUSION: There was a decrease in the number of treated patients in our radiotherapy department, with a greater decrease in the total number of sessions. This indicated, overall, a smaller number of fractions/patients treated, despite our efforts to maintain the treatment routine. We had several patients who were infected with COVID-19 and one related death during treatment in the first few months of the pandemic in São Paulo Brazil.

https://doi.org/10.6061/clinics/2020/e2298 350 downloads

Mammary adenectomy followed by immediate reconstruction for treatment of patients with early-infiltrating breast carcinoma: a cohort study
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Barros, Alfredo Carlos Simões Dornellas de

; Carvalho, Heloísa Andrade

; Andrade, Felipe Eduardo Martins

; Nimir, Cristiane da Costa Bandeira Abrahão

; Sampaio, Marcelo Moura Costa

; Makdissi, Fabiana Baroni

; Mano, Max Senna

Sao Paulo Medical Journal

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jul 2019, Volume 137 N. 4 Pages 336 - 342

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Use of mammary adenectomy for breast carcinoma treatment remains controversial. OBJECTIVE: This study aimed to verify the oncological safety of mammary adenectomy and immediate breast reconstruction for treating selected patients with infiltrating breast carcinoma and to evaluate patients’ satisfaction with the reconstructed breasts. DESIGN AND SETTING: Cohort study conducted among patients treated at Hospital Sírio-Libanês, São Paulo, Brazil. METHODS: This study was based on 152 selected patients (161 operated breasts) with infiltrating breast carcinoma who underwent mammary adenectomy and immediate breast reconstruction. In all patients, the diameter of the largest focus of the tumor was less than 3.0 cm, the imaging tumor-nipple distance was greater than 2.0 cm and the pathological assessment showed clear margins. The cumulative incidence of local recurrence (LR), recurrence-free survival (RFS) and overall survival (OS) curves were estimated using the Kaplan-Meier method. After at least one year of follow-up, 64 patients were asked about their satisfaction with the reconstructed breast(s). RESULTS: At a mean follow-up time of 43.5 months, seven cases of LR (4.4%), four distant metastases (2.6%) and five deaths (3.3%) were recorded. The five-year actuarial LR-free survival, RFS and OS were 97.6%, 98.3% and 98.3%, respectively. No cases of nipple-areolar complex recurrence were reported. Forty-one patients (64%) indicated a high level of satisfaction with the reconstructed breasts. CONCLUSIONS: Mammary adenectomy is a safe and efficacious procedure for selected patients with early-infiltrating breast carcinoma and results in a high rate of patient satisfaction with the reconstructed breasts.

https://doi.org/10.1590/1516-3180.2018.0356220719 957 downloads

Short Message Service (SMS) e promoção do autocuidado em DM2: revisão integrativa
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Hovadick, Ana Carolina de Andrade

; Reis, Ilka Afonso

; Torres, Heloísa Carvalho

Acta Paulista de Enfermagem

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apr 2019, Volume 32 N. 2 Pages 210 - 219

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

Abstract Objective: To synthesize and analyze the available evidence in the scientific literature on use effects of Short Message Service (SMS) in self-care promotion in type 2 diabetes mellitus. Methods: An integrative review of the literature was developed between 2007 and 2017, using the following databases to search for the studies: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Nursing database, Virtual Campus of Public Health, Coleção Nacional das Fontes de Informação do Sistema Único de Saúde (freely translated as Collection of Information Sources of the Brazilian Unified Health System), Regional Health Coordination South, Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Latin American & Caribbean Literature in Health Sciences and PubMed. Descriptors such as text message, self-care, health education, health promotion and diabetes mellitus, as well as their descriptors in English and Spanish, and the associated Medical Subject Headings, were used. An initial sample of 739 articles was identified, of which 23 were classified as eligible to compose the final sample. Results: In general, the work reported positive results. Among these, the following stand out: significant improvement in glycosylated hemoglobin levels, greater compliance with medications, improved self-care practices, increased knowledge about DM and better foot care. Conclusion: Scientific evidence in the literature shows that the use of SMS as a methodological strategy may favor the improvement of self-care practices in type 2 DM.

Resumen Objetivo: Sintetizar y analizar las pruebas disponibles en la literatura científica sobre los efectos del uso de Short Message Service (SMS) para la promoción del autocuidado en diabetes mellitus tipo 2. Métodos: Se realizó una revisión integradora de la literatura del período de 2007 a 2017 y se utilizaron las siguientes bases de datos para la búsqueda de los estudios: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Scopus, Web of Science, Base de datos de enfermería, Campus Virtual de Saúde Pública, Coleção Nacional das Fontes de Informação do Sistema Único de Saúde, Coordenadoria Regional de Saúde Sui, Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Literatura latinoamericana y del Caribe en Ciencias de la Salud y PubMed. Para ello, se utilizaron descriptores como: mensaje de texto, autocuidado, educación en salud, promoción de la salud y diabetes mellitus, así como los respectivos descriptores en inglés y español, y los Medical Subject Headings asociados. Fue identificada una muestra inicial de 739 artículos, de los cuales 23 fueron clasificados como elegibles para formar parte de la muestra final. Resultados: En general, los trabajaos aportaron resultados positivos. Entre ellos pueden destacarse: mejora significativa de los niveles de hemoglobina glicosilada, mayor adhesión a los medicamentos, mejora de las prácticas de autocuidado, aumento del conocimiento sobre la diabetes y mejor cuidado de los pies. Conclusión: Evidencias científicas en la literatura demuestran que el uso de SMS como estrategia metodológica puede favorecer la mejora de las prácticas de autocuidado en diabetes tipo 2.

Resumo Objetivo: Sintetizar e analisar as evidências disponíveis na literatura científica sobre os efeitos do uso de Short Message Service (SMS) na promoção do autocuidado em diabetes mellitus tipo 2. Métodos: Foi desenvolvida uma revisão integrativa da literatura, no período de 2007 a 2017, utilizando para a busca dos estudos as seguintes bases de dados: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Base de dados de enfermagem, Campus Virtual de Saúde Pública, Coleção Nacional das Fontes de Informação do Sistema Único de Saúde, Coordenadoria Regional de Saúde Sul, Índice Bibliográfico Español en Ciencias de la Salud (iBECS), Literatura Latino-Americana e do Caribe em Ciências da Saúde e PubMed. Para isso, utilizou-se descritores como: mensagem de texto, autocuidado, educação em saúde, promoção em saúde e diabetes mellitus, bem como os respectivos descritores em inglês e espanhol, e os Medical Subject Headings associados. Foi identificada uma amostra inicial de 739 artigos, dos quais 23 foram classificados como elegíveis para compor a amostra final. Resultados: Em geral, os trabalhos reportaram resultados positivos. Dentre estes, destacam-se: melhora significativa dos níveis de hemoglobina glicada, maior adesão aos medicamentos, melhora das práticas de autocuidado, aumento do conhecimento acerca do diabetes e melhor cuidado com os pés. Conclusão: Evidências científicas na literatura mostram que o uso de SMS como estratégia metodológica pode favorecer a melhora das práticas de autocuidado em diabetes tipo 2.

https://doi.org/10.1590/1982-0194201900029 89 downloads

Short Message Service (SMS) e promoção do autocuidado em DM2: revisão integrativa
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Hovadick, Ana Carolina de Andrade

; Reis, Ilka Afonso

; Torres, Heloísa Carvalho

Acta Paulista de Enfermagem

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mar 2019, Volume 32 N. 2 Pages 210 - 219

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

https://doi.org/10.1590/1982-0194201900029 3139 downloads

10.

Urinary infection or radiation cystitis? A prospective evaluation of urinary symptoms in patients submitted to pelvic radiotherapy
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Xavier, Vítor Fonseca

; Gabrielli, Flávia Carolina Grosso

; Ibrahim, Karim Yaqub

; Gomes, Mariana Vilela Soares

; Guimarães, Roger Guilherme Rodrigues

; Abdala, Edson

; Carvalho, Heloisa de Andrade

Clinics

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2019, Volume 74 elocation e1388

Abstract: En | Text: En | PDF: En

OBJECTIVES: The purpose of this study was to evaluate the incidence of urinary tract infection (UTI) in patients with cystitis symptoms who underwent pelvic radiation therapy and identify correlated predictive factors. METHODS: A prospective cohort study was conducted of patients who met the following: primary pelvic cancer treated with curative intent, older than 18 years old, and good performance status. The exclusion criteria were patients being treated for a UTI, using a urinary catheter, in dialysis or with cystostomy or nephrostomy, and using antibiotics during treatment. Urinalysis and urine culture were collected before the beginning of radiation therapy. Weekly evaluations of urinary symptoms were subsequently performed. In cases of new or worsening symptoms, a questionnaire was applied, and new urine exams were collected. The UTI diagnosis was defined by uroculture as bacterial growth greater than 104 CFU/mL. RESULTS: From September 2014 to November 2015, 112 patients were sequentially recruited, and 72 (64%) fulfilled the inclusion criteria. During follow-up, 24 (33%) patients had new urinary symptoms or worse preexisting symptoms. A UTI was confirmed in the second urinary culture in only one (1.4%) patient. CONCLUSIONS: The incidence of UTI was much lower than expected, suggesting that asymptomatic bacteriuria develops symptoms due to radiotherapy. Due to the low rate of UTI, no predictive factor was identified.

https://doi.org/10.6061/clinics/2019/1388 1240 downloads

11.

USE OF NEEM (Azadirachta indica) AS A SUBSTITUTE FOR ANTIMICROBIAL DRUGS IN BROILER CHICKENS’ FEED
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Assunção, Patricia da Silva

; Mello, Heloisa Helena de Carvalho

; Mascarenhas, Alessandra Gimenez

; Andrade, Maria Auxiliadora

; Teixeira, Karla Andrade

; Oliveira, Helder Freitas de

; Carvalho, Deborah Pereira

Ciência Animal Brasileira

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2019, Volume 20 elocation e-52588

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

Resumo Realizou-se um experimento objetivando avaliar a utilização de Neem como antimicrobiano em rações de frangos de corte. Foram utilizados 240 pintos de corte, Cobb, com 1 dia de idade, distribuídos em delineamento inteiramente casualizado, 4 tratamentos, 6 repetições, 10 aves por unidade experimental, o período experimental foi de 21 dias. Os tratamentos consistiram: dieta basal sem inclusão de antimicrobiano; dieta com 0,05% de tilosina; dieta com 0,05% e 0,1% de Neem. Avaliou-se: o desempenho zootécnico, a digestibilidade da ração, contagem intestinal de Salmonella sp. e Escherichia coli, e o desenvolvimento dos órgãos linfoides. Dados de desempenho e metabolização dos nutrientes da ração foram submetidos à ANOVA, médias comparadas pelo teste Tukey, adotou-se α=0,05. Dados de contagem de E. coli foram analisados pelo teste de Kruskal-Wallis. O Neem não influenciou as variáveis de desempenho. O coeficiente de metabolizabilidade da matéria seca e extrato etéreo da ração foi melhor com utilização de tilosina (P<0,05). Não se observou crescimento de Salmonella durante o período experimental. A utilização de Neem não reduziu a população de E. coli, e não influenciou no peso dos órgãos linfoides. A utilização do Neem não afetou o desempenho, digestibilidade e microbiota intestinal das aves até 21 dias.

Abstract In the present work, we carried out an experiment aiming at evaluating the use of Neem as an antimicrobial substance in the feeds of broiler chickens. We used 240 one-day-old Cobb broiler chicks distributed in an entirely casual design, with 4 treatments, 6 repetitions and 10 birds per experimental unit, during a 21-day experimental period. Treatments consisted of a basal diet with no antimicrobial inclusion, a diet with 0.05% of tylosin, and a diet with 0.05% and 0.1% of Neem. Parameters evaluated were zootechnical performance, feed digestibility, intestinal count of Salmonella sp. and Escherichia coli, and the development of lymphoid organs. Data on the performance and metabolization of nutrients were subjected to an ANOVA and averages were compared with a post-hoc Tukey test considering α=0.05. Data on E. coli counts were analyzed with a Kruskal-Wallis test. Neem did not influence performance variables. The metabolization coefficient of dry matter and feed ethereal extract was better with tylosin (P<0.05). No growth of Salmonella was observed during the experiment. The use of Neem did not reduce E. coli population and had no influence on lymphoid organs' weight. Therefore, Neem had no effect on the performance, digestibility and intestinal microbiota of birds up to 21 days old.

https://doi.org/10.1590/1089-6891v20e-52588 2064 downloads

12.

Impact of thoracic radiotherapy on respiratory function and exercise capacity in patients with breast cancer
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Suesada, Milena Mako

; Carvalho, Heloisa de Andrade

; Albuquerque, André Luis Pereira de

; Salge, João Marcos

; Stuart, Silvia Radwanski

; Takagaki, Teresa Yae

Jornal Brasileiro de Pneumologia

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dec 2018, Volume 44 N. 6 Pages 469 - 476

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

RESUMO Objetivo: Avaliar o impacto da radioterapia torácica na função respiratória e capacidade de exercício em pacientes com câncer de mama. Métodos: Pacientes com câncer de mama com indicação de radioterapia torácica após tratamento cirúrgico e quimioterápico foram submetidas a TCAR, avaliação respiratória e avaliação da capacidade de exercício antes da radioterapia torácica e três meses após o término do tratamento. Foram realizados teste de força muscular respiratória, medição da mobilidade torácica e prova de função pulmonar completa para a avaliação respiratória; realizou-se teste de exercício cardiopulmonar para avaliar a capacidade de exercício. A dose total de radioterapia foi de 50,4 Gy (1,8 Gy/fração) na mama ou na parede torácica, incluindo ou não a fossa supraclavicular (FSC). Histogramas dose-volume foram calculados para cada paciente com especial atenção para o volume pulmonar ipsilateral que recebeu 25 Gy (V25), em números absolutos e relativos, e a dose pulmonar média. Resultados: O estudo incluiu 37 pacientes. Após a radioterapia, observou-se diminuição significativa da força muscular respiratória, mobilidade torácica, capacidade de exercício e resultados da prova de função pulmonar (p < 0,05). A DLCO permaneceu inalterada. A TCAR mostrou alterações relacionadas à radioterapia em 87% das pacientes, o que foi mais evidente nas pacientes submetidas à irradiação da FSC. O V25% correlacionou-se significativamente com a pneumonite por radiação. Conclusões: Em nossa amostra de pacientes com câncer de mama, a radioterapia torácica parece ter causado perdas significativas na capacidade respiratória e de exercício, provavelmente por causa da restrição torácica; a irradiação da FSC representou um fator de risco adicional para o desenvolvimento de pneumonite por radiação.

ABSTRACT Objective: To evaluate the impact of thoracic radiotherapy on respiratory function and exercise capacity in patients with breast cancer. Methods: Breast cancer patients in whom thoracic radiotherapy was indicated after surgical treatment and chemotherapy were submitted to HRCT, respiratory evaluation, and exercise capacity evaluation before radiotherapy and at three months after treatment completion. Respiratory muscle strength testing, measurement of chest wall mobility, and complete pulmonary function testing were performed for respiratory evaluation; cardiopulmonary exercise testing was performed to evaluate exercise capacity. The total radiotherapy dose was 50.4 Gy (1.8 Gy/fraction) to the breast or chest wall, including supraclavicular lymph nodes (SCLN) or not. Dose-volume histograms were calculated for each patient with special attention to the ipsilateral lung volume receiving 25 Gy (V25), in absolute and relative values, and mean lung dose. Results: The study comprised 37 patients. After radiotherapy, significant decreases were observed in respiratory muscle strength, chest wall mobility, exercise capacity, and pulmonary function test results (p < 0.05). DLCO was unchanged. HRCT showed changes related to radiotherapy in 87% of the patients, which was more evident in the patients submitted to SCLN irradiation. V25% significantly correlated with radiation pneumonitis. Conclusions: In our sample of patients with breast cancer, thoracic radiotherapy seemed to have caused significant losses in respiratory and exercise capacity, probably due to chest wall restriction; SCLN irradiation represented an additional risk factor for the development of radiation pneumonitis.

https://doi.org/10.1590/s1806-37562017000000120 2615 downloads

13.

Cosmesis in patients with breast neoplasia submitted to the hypofractionated radiotherapy with of intensity-modulated beam
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Miranda, Fabiana Accioli

; Vieira, Marina Tamm Lannes

; Moraes, Fabio Ynoe de

; Marta, Gustavo Nader

; Carvalho, Heloísa de Andrade

; Hanna, Samir Abdallah

Revista da Associação Médica Brasileira

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nov 2018, Volume 64 N. 11 Pages 1023 - 1030

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

RESUMO OBJETIVO: Avaliar a satisfação cosmética de pacientes diagnosticadas com câncer de mama submetidas à radioterapia hipofracionada com técnica IMRT (hIMRT) e sua correlação com dados dosimétricos do planejamento radioterápico. MATERIAIS E MÉTODOS: Estudo de coorte retrospectivo que avaliou mulheres com diagnóstico de neoplasia maligna de mama submetidas a tratamento conservador ou mastectomia radical e tratadas com hIMRT. No período de agosto de 2007 a dezembro de 2014, em uma instituição filantrópica/particular, foram selecionados 170 prontuários. A avaliação cosmética foi feita por meio da escala de Harvard/RTOG/NSABP com um intervalo mínimo de um ano após o tratamento. Dados dosimétricos coletados foram: volume da mama/plastrão, volume que recebeu 95% (V95%) e 107% (V107%) da dose prescrita. RESULTADOS: O volume das mamas tratadas variou de 169 a 2.103 ml (mediana = 702; IQR: 535 a 914 ml). O V95% mediano foi 86,7% (54,6-96,6%; IQR: 80,0% a 90,6%); oito (5,7%) pacientes tiveram o V95% superior a 95%. O V107% mediano foi 0% (0%-16,3%; IQR: 0,0% a 0,3% e 13); 9,3% pacientes tiveram o V107% superior a 2%. Cento e trinta e três (78,2%) pacientes responderam à avaliação cosmética: 99 (74,4%) consideraram o resultado cosmético excelente. Não foram encontradas associações significativas entre a avaliação cosmética e o volume da mama (p=0,875), V95% (p=0,294) e V107% (p=0,301). CONCLUSÕES: Os resultados cosméticos mostraram-se favoráveis com o uso de hIMRT, e a ausência de correlação com os dados dosimétricos usuais ilustra a capacidade do hIMRT em minimizar a heterogeneidade da dose neste desfecho, mesmo em mamas volumosas.

SUMMARY OBJECTIVE: To assess the cosmetic satisfaction of patients diagnosed with breast cancer submitted to the hypofractionated radiotherapy with IMRT (hIMRT) technique and its correlation with dosimetric data of the radiotherapy planning. MATERIALS AND METHODS: The retrospective cohort study that assessed women with a diagnosis of malignant breast neoplasia submitted to the conservative treatment or radical mastectomy and treated with hIMRT. In the period between August 2007 to December 2014, in a philanthropic / private institution, 170 records were selected. The cosmetic assessment was carried out by means of the Harvard/RTOG/NSABP scale with one-year minimum range after treatment. The collected dosimetric data were: breast / chest wall volume, volume that received 95% (V95%) and 107% (V107%) of the prescribed dose. RESULTS: The volume of the treated breasts ranged from 169 to 2.103 ml (median = 702; IQR: 535 to 914 ml). Median V95% was 86.7% (54.6-96.6%; IQR: 80.0% to 90.6%); eight (5.7%) patients had V95% higher than 95%. Median V107% was 0% (0%-16.3%; IQR: 0.0% to 0.3% and 13); 9.3% patients had V107% higher than 2%. One hundred and thirty-three (78.2%) patients responded to the cosmetic assessment: 99 (74.4%) considered the cosmetic results excellent. Significant associations between cosmetic assessment and breast volume (p=0.875), V95% (p=0.294) e V107% (p=0.301) were not found. CONCLUSION: The cosmetic results showed favorable when using hIMRT, and the lack of correlation with usual the dosimetric data illustrates the capacity of hIMRT to minimize the heterogeneity of the dose in this endpoint, even in voluminous breasts.

https://doi.org/10.1590/1806-9282.64.11.1023 1276 downloads

14.

Radiotherapy and immune response: the systemic effects of a local treatment
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Carvalho, Heloisa de Andrade

; Villar, Rosangela Correa

Clinics

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2018, Volume 73 elocation e557s

Abstract: En | Text: En | PDF: En

Technological developments have allowed improvements in radiotherapy delivery, with higher precision and better sparing of normal tissue. For many years, it has been well known that ionizing radiation has not only local action but also systemic effects by triggering many molecular signaling pathways. There is still a lack of knowledge of this issue. This review focuses on the current literature about the effects of ionizing radiation on the immune system, either suppressing or stimulating the host reactions against the tumor, and the factors that interact with these responses, such as the radiation dose and dose / fraction effects in the tumor microenvironment and vasculature. In addition, some implications of these effects in cancer treatment, mainly in combined strategies, are addressed from the perspective of their interactions with the more advanced technology currently available, such as heavy ion therapy and nanotechnology.

https://doi.org/10.6061/clinics/2018/e557s 3046 downloads

15.

Substitution of blood plasma with soy protein concentrate in piglet diet
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Resende, Moisés Queiroz

; Mascarenhas, Alessandra Gimenez

; Mello, Heloisa Helena de Carvalho

; Arnhold, Emmanuel

; Teixeira, Karla Andrade

; Rufino, Luciana Moura

; Nunes, Romão da Cunha

Revista Brasileira de Zootecnia

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apr 2017, Volume 46 N. 4 Pages 324 - 330

Abstract: En | Text: En | PDF: En

ABSTRACT In this study, we evaluated the effects of substitution of partial and total spray-dried blood plasma (BP) with soy protein concentrate (SPC) in the diet of post-weaning piglets on their performance, intestinal histomorphometry, and blood parameters. Fifty-four castrated male piglets, weaned at an average age of 21 days and an initial average weight of 7.01±0.294 kg, were distributed in a completely randomized block design, with three diets (0%SPC-5%BP, 2.5%SPC-2.5%BP, and 5%SPC-0%BP), six replicates, and three piglets per experimental unit. The experimental feeds were formulated to meet the requirements of the piglets at 21-32 and 33-42 days of age (pre-starter diet) and 43-66 days of age (starter diet). From 21 to 32 and 21 to 42 days of age, daily feed intake, daily weight gain, and final weight of the animals were higher in the group fed 2.5%SPC-2.5%BP and 0%SPC-5%BP. From 21 to 66 days of age, daily weight gain and daily feed intake were higher in the animals fed 2.5%SPC-2.5%BP. No effect was observed on the histomorphometry variables. The total leukocyte count was higher in animals fed 2.5%SPC-2.5%BP and 5%SPC-0%BP and the lymphocyte count was lower in the piglets that received 0%SPC-5%BP. The combined use of soy protein concentrate and spray-dried blood plasma in the feeds of piglets between 21 and 42 days of age improves their productive performance.

https://doi.org/10.1590/s1806-92902017000400008 1327 downloads

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