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ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

https://doi.org/10.1590/s1677-5538.ibju.2023.0065

Multivariate analysis as a tool in the selection of sustainable melon agroecosystems in the semi-arid region
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Salviano, Alessandra M.

; Castro, José M. da C.

; Melo, Stefeson B. de

; Macedo, Márcia V. de

; Oliveira, Vitória R.

; Giongo, Vanderlise

Revista Caatinga

Journal Metrics
- Sobre o periódico
- SciELO Analytics

sep 2023, Volume 36 N. 3 Pages 543 - 552

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

ABSTRACT Soil management systems, including tillage and green manuring, are important for the control of nematodes and for the sustainable production. The objective was to select, through multivariate analysis, sustainable agroecosystems for yellow melon cultivated under irrigated conditions in the Brazilian semi-arid region. The long-term experiment is set up in Argissolo Vermelho- Amarelo (Ultisol) with six multifunctional agroecosystems, composed of the combination of three mixtures of cover crops (1 - 75% legumes + 25% grasses and oilseeds; 2 - 25% legumes + 75% grasses and oilseeds and 3 - spontaneous vegetation) and two types of soil management (no tillage-NT and tillage-T). The purpose was to evaluate the nutritional status of plants, soil fertility, nematode population in roots and soil, and the yield. Data were analyzed with multivariate techniques, allowing the grouping of the agroecosystems based on their similarities and complexity of functions. The incorporation of plant residues to the soil reduces nematode population, but their maintenance on the surface allows the improvement of fertility and yield, even under larger nematode populations. The agroecosystems that associate the nonincorporation of residues from cover crops with larger species diversity in composition constitute the most complex model, allowing different environmental functionalities. Thus, it is recommended not to incorporate the plant residues, planting the melon seedlings directly in the straw. However, considering that the results obtained with the non-incorporation of spontaneous vegetation were similar to those obtained with the incorporation of commercial cover crops, it is concluded that this practice is also viable and adapted to the semi-arid conditions.

RESUMO Sistemas de manejo de solos, incluindo revolvimento e adubação verde, são importantes para o controle de nematoides e para a produção sustentável. Objetivou-se selecionar, por meio da análise multivariada, agroecossistemas sustentáveis para cultivo irrigado de melão amarelo no Semiárido brasileiro. As avaliações ocorreram num experimento de longa duração, com seis agroecossistemas multifuncionais, compostos pela combinação de três misturas de plantas de cobertura (1 - 75% leguminosas + 25% gramíneas e oleaginosas; 2 - 25% leguminosas + 75% gramíneas e oleaginosas e 3 - vegetação espontânea) e dois tipos de manejo do solo (sem e com revolvimento). Avaliaram-se o estado nutricional das plantas, a fertilidade do solo, as populações de nematoides nas raízes e no solo e a produtividade da cultura. Os dados foram submetidos às técnicas de análises multivariadas, permitindo agrupar os agroecossistemas por semelhanças e complexidade das suas funções. A incorporação dos resíduos vegetais ao solo reduz a população de nematoides, mas sua manutenção na superfície permite melhorar a fertilidade e alcançar boas produtividades, mesmo sob maior população de nematoides. Os agroecossistemas que associam o não revolvimento dos resíduos vegetais das plantas de cobertura com maior diversidade de espécies na composição é o modelo considerado mais complexo, permitindo diferentes funcionalidades ambientais. Assim, recomenda-se não incorporar os resíduos vegetais, transplantando as mudas de meloeiro diretamente sobre a palhada. No entanto, considerando que os resultados obtidos com a não incorporação da vegetação espontânea foram semelhantes à incorporação das plantas de cobertura comerciais, conclui-se que esta prática também é viável e adaptada às condições semiáridas.

https://doi.org/10.1590/1983-21252023v36n307rc

Rituximab en el tratamiento de esclerosis múltiple. Experiencia de un hospital de tercer nivel en México
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Castro-Macías, Jaime I.

; Rodríguez-Jiménez, José C.

; Mena-Novoa, Andrés

Gaceta médica de México

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jun 2023, Volume 159 N. 3 Pages 184 - 189

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

Resumen Antecedentes: La esclerosis múltiple es una enfermedad crónica, autoinmune y degenerativa. Las terapias blanco contra los linfocitos B han probado ser efectivas en su tratamiento; sin embargo, existen pocos estudios que evalúen su eficacia en población mexicana. Objetivo: Evaluar el impacto clínico del rituximab en pacientes con esclerosis múltiple remitente recurrente (EMRR) de reciente diagnóstico. Material y métodos: Estudio de vida real, descriptivo, en el que se evalúa rituximab como tratamiento de EMRR durante un periodo de 24 meses. Se analizaron variables clínicas pre y postratamiento; se realizó la comparación entre pacientes naïve y no naïve. Resultados: Se incluyeron 28 pacientes con EMRR. La edad media al diagnóstico fue de 30.7 años y 22 pacientes fueron naïve (78.5 %). Después de 24 meses, se observó una reducción media de 1.8 puntos en EDSS y en el número de lesiones activas por resonancia magnética. Aunque se logró establecer una diferencia significativa en ambas variables con p < 0.05, el modelo de regresión logística no mostró una relación entre las variables para alcanzar un NEDA-3. No se observaron eventos adversos graves. Conclusiones: El tratamiento con rituximab resultó en mejoría significativa clínica y radiológica en pacientes mexicanos con EMRR naïve y no-naïve.

Abstract Background: Multiple sclerosis is a chronic, autoimmune, degenerative disease. Therapies targeting B-cells have been shown to be effective in its treatment; however, there are few studies evaluating their efficacy in the Mexican population. Objective: To evaluate the clinical impact of rituximab in patients with newly-diagnosed relapsing-remitting multiple sclerosis (RRMS). Material and methods: Real life, descriptive study, in which rituximab was evaluated as treatment for RRMS over a 24-month period. Pre- and post-treatment clinical variables were analyzed; a comparison was made between treatment-naïve and non-treatment-naïve patients. Results: Twenty-eight patients with RRMS were included. Mean age at diagnosis was 30.7 years, and 22 patients were treatment-naïve (78.5 %). After 24 months, there was a mean reduction of 1.8 points in the EDSS scale and a decrease in the number of active lesions on magnetic resonance imaging; a significant difference in both variables could be established (p < 0.05). However, the logistic regression model did not show a relationship between the variables for achieving NEDA-3 criteria. No serious adverse events were observed. Conclusions: Treatment with rituximab resulted in significant clinical and radiological improvement in treatment-naïve and non-treatment-naïve Mexican patients with RRMS.

https://doi.org/10.24875/gmm.23000014

Complete revascularization with PCI in STEMI patients with multivessel disease, when is the appropriate time?
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Aquino-Bruno, Heberto

; García-García, Juan F.

; Muratalla-González, Roberto

; Alcántara-Meléndez, Marco A.

; Morales-Portano, Julieta D.

; Gómez-Álvarez, Enrique B.

; Merino-Rajme, José A.

; Castro-Rubio, José A.

; Plata Corona, Juan C.

Archivos de cardiología de México

Journal Metrics
- Sobre o periódico
- SciELO Analytics

mar 2023, Volume 93 N. 1 Pages 53 - 61

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

Abstract Objective: The purpose was to compare the outcomes of patients with ST-elevation myocardial infarction and multivessel coronary artery disease undergoing one-time multivessel revascularization (OTMVR) versus in-hospital staged complete revascularization with percutaneous coronary intervention. Methods: This was a single-center, retrospective, observational, and cohort study, including data from January 2013 to April 2019. A total of 634 patients were included in the study. Comparisons were made between patients who underwent in-hospital staged complete revascularization versus OTMVR. The primary endpoint was all-cause in-hospital mortality, secondary endpoints included cardiovascular complications, all-cause new hospitalization, and mortality evaluated at 30 days and 1 year. In addition, we constructed a logistic regression model for determining the risk factors that predicted mortality. Results: Of the 634 patients, 328 were treated with staged revascularization and 306 with OTMVR. About 76.7% were men, with a mean age of 63.3 years. Less complex coronary lesions and a higher proportion of the left anterior descending artery as the culprit vessel were found in the OTMVR group. Compared with staged revascularization, the primary and secondary endpoints occurred less frequently with OTMVR strategy. Conclusions: OTMVR did not generate more complications and demonstrate better clinical outcomes than in-hospital staged revascularization.

Resumen Objetivo: El propósito fue comparar resultados de pacientes con infarto agudo de miocardio con elevación del segmento ST y enfermedad coronaria multivaso sometidos a revascularización completa de un solo momento frente a revascularización completa por etapas mediante intervención coronaria percutánea. Métodos: Estudio cohorte observacional, retrospectivo, unicéntrico, con datos de enero de 2013 a abril de 2019, incluyendo 634 pacientes. Se compararon resultados entre pacientes sometidos a revascularización completa por etapas frente a revascularización completa en un solo momento. El objetivo primario fue valorar mortalidad intrahospitalaria por cualquier causa y como objetivos secundarios se evaluaron a 30 días y 1 año las complicaciones cardiovasculares, hospitalizaciones y mortalidad. Se construyó un modelo de regresión logística para determinar los factores de riesgo que predijeron mortalidad. Resultados: De 634 pacientes, 328 fueron tratados con revascularización por etapas y 306 con revascularización en una intervención. El 76.7% fueron hombres, con una media de edad de 63.3 años. En el grupo de revascularización de un solo tiempo se encontraron lesiones coronarias menos complejas y una mayor proporción de la arteria descendente anterior como vaso culpable. Comparado con el grupo de revascularización por etapas, los objetivos primarios y secundarios ocurrieron con menos frecuencia en el grupo de revascularización en un solo tiempo. Conclusiones: Comparada con la revascularización intrahospitalaria por etapas, la revascularización en una intervención lleva a mejores desenlaces clínicos sin generar más complicaciones.

https://doi.org/10.24875/acm.21000375

Saúde mental de agentes comunitários de saúde no contexto da COVID-19
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Farias, Sidney Feitoza

; Forte, Franklin Delano Soares

; Costa, Milena Silva

; Guimarães, José Maria Ximenes

; Morais, Ana Patrícia Pereira

; Oliveira, André Luiz Sá de

; Silva Júnior, Fernando José Guedes da

; Nascimento, Elaine Ferreira do

; Vasconcelos, Maristela Inês Osawa

; Dias, Maria Socorro de Araújo

; Oliveira, Felipe Proenço de

; Machado, Maria de Fátima Antero Sousa

; Castro, Marcia C.

; Yousafzai, Aisha Khizar

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 28 N. 8 Pages 2363 - 2376

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

Resumo O objetivo deste estudo foi analisar os fatores relacionados à saúde mental dos agentes comunitários de saúde (ACS) no contexto da COVID-19. Participaram 1.935 ACS de quatro capitais nordestinas e de quatro cidades do interior do Ceará. Foram coletados dados sociodemográficos e profissiográficos; SRQ-20; WHOQOL-Bref; exposição à violência; Escala de Autoeficácia Geral (EAEG); Escala Multidimensional de Suporte Social Percebido (MSPSS); informações relacionadas à COVID-19 e Escala de Ansiedade para Coronavírus (EAC). 40,5% exibiram SRQ > 7, sinalizando altos níveis de transtornos mentais comuns (TMC)/problemas de saúde mental. Utilizou-se a regressão linear múltiplas (backward). Observou-se que o aumento de risco de TCM foi influenciado pelos seguintes fatores: exposição à violência; EAC; não saber se teve COVID-19; desconhecer as variáveis que diminuíam o risco; os domínios físico e psicológico do WHOQOL-Bref; não ter aumento da jornada de trabalho; e não ter tido COVID-19. Os dados revelam a dinâmica multidimensional da saúde mental e ajudam a compreender a relação entre violência comunitária, COVID-19, qualidade de vida, idade e tempo de atuação na ESF com a saúde mental dos ACS.

Abstract This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC). Approximately 40.5% had SRQ > 7, signaling high levels of Common Mental Disorders (CMD)/mental health issues. We adopted the Multiple linear (backward) regression. We observed that the increased risk of CMD was influenced by exposure to violence, EAC, not knowing they had COVID-19, not knowing the variables that reduced the risk, the physical and psychological domains of the WHOQOL-Bref, not having increased working hours, and not having had COVID-19. The data reveal the multidimensional dynamics of mental health and help understand the relationship between community violence, COVID-19, quality of life, age, and ESF working time with the mental health of ACS.

https://doi.org/10.1590/1413-81232023288.06462023

Community health workers perspective on the COVID-19 impact on primary health care in Northeastern Brazil
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Forte, Franklin Delano Soares

; Guimarães, José Maria Ximenes

; Farias, Sidney Feitoza

; Oliveira, André Luiz Sá de

; Dias, Maria Socorro de Araújo

; Monteiro, Claudete Ferreira de Souza

; Guedes da Silva Júnior, Fernando José

; Morais, Ana Patrícia Pereira

; Moreira, Maria Rosilene Candido

; Castro, Márcia C.

; Yousafzai, Aisha Khizar

Cadernos de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 39 N. 7 elocation e00007223

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

Resumo: Este artigo avalia as repercussões da pandemia da COVID-19 no cotidiano de trabalho da equipe da Estratégia Saúde da Família (ESF) em diversos municípios do Nordeste brasileiro, na perspectiva dos agentes comunitários de saúde (ACS). Um questionário estruturado foi utilizado para coletar informações sobre a COVID-19, atividades dos ACS e equipes da ESF em 2021. Participaram 1.935 ACS de quatro capitais (Fortaleza - Ceará, João Pessoa - Paraíba, Recife - Pernambuco e Teresina - Piauí) e quatro cidades do interior (Crato, Juazeiro do Norte, Barbalha e Sobral, Ceará). A idade média dos ACS era de 46,25±8,54 anos, sendo a maioria mulheres (82,42%). Muitos (39,92%) estavam infectados com COVID-19, dos quais 70,78% acreditavam ter sido infectados no ambiente de trabalho. Ao todo, 77,82% definiam seu papel como linha de frente no combate à COVID-19, 16,07% relataram receber treinamento para a COVID-19 e 13,74% tinham acesso a equipamentos de proteção suficientes contra a COVID-19. A maioria (90,27%) acredita que suas rotinas de trabalho foram modificadas pela pandemia, fortalecendo o espírito de equipe (41,46%) ou enfraquecendo-o (44,41%). Houve uma redução na promoção da saúde nas escolas (75,66%) e na frequência de visitas domiciliares (60,55%), de grupos específicos na comunidade (93,96%) e outros serviços comunitários locais (66,01%). Nos municípios avaliados, observou-se uma heterogeneidade significativa em relação à resposta à pandemia de COVID-19, possivelmente associada à falta de coordenação do Governo Federal. A pandemia levou a uma reconfiguração dos sistemas locais de saúde, fluxos de trabalho e protocolos de atenção primária para as equipes da ESF. A importância do Sistema Único de Saúde (SUS) e seu potencial de reorganização durante as crises devem ser reconhecidos, preservando-se os avanços alcançados até o momento.

Resumen: Este artículo evalúa las repercusiones de la pandemia de COVID-19 en el trabajo cotidiano del equipo de la Estrategia Salud de la Familia (ESF) en diversos municipios del Nordeste brasileño, desde la perspectiva de los agentes comunitarios de salud (ACS). Se utilizó un cuestionario estructurado para recopilar información sobre COVID-19, actividades de los ACS y equipos de la ESF en el 2021. Participaron 1.935 ACS de cuatro capitales (Fortaleza - Ceará, João Pessoa - Paraíba, Recife - Pernambuco y Teresina - Piauí) y cuatro ciudades del interior (Crato, Juazeiro do Norte, Barbalha y Sobral - Ceará). La edad media de los ACS era de 46,25±8,54 años, y la mayoría eran mujeres (82,42%). Muchos (39,92%) estaban infectados con COVID-19, de los cuales el 70,78% creía haberse contagiado en el entorno laboral. En total, el 77,82% definió su papel como línea de frente en el combate a la COVID-19, el 16,07% informó haber recibido capacitación para la COVID-19 y el 13,74% tuvo acceso a equipos de protección suficiente contra la COVID-19. La mayoría (90,27%) cree que sus rutinas de trabajo se vieron modificadas por la pandemia, fortaleciendo el espíritu de equipo (41,46%) o debilitándolo (44,41%). Hubo una reducción en la promoción de la salud en las escuelas (75,66%) y en la frecuencia de las visitas domiciliarias (60,55%), de grupos específicos en la comunidad (93,96%) y otros servicios comunitarios locales (66,01%). En los municipios analizados, se observó una heterogeneidad significativa con relación a la respuesta a la pandemia de COVID-19, posiblemente asociada a la falta de coordinación del Gobierno Federal. La pandemia condujo a una reconfiguración de los sistemas locales de salud, los flujos de trabajo y los protocolos de atención primaria para los equipos de la ESF. Se debe reconocer la importancia del Sistema Único de Salud y (SUS) su capacidad de reorganización durante las crisis, preservando los avances logrados hasta el momento.

Abstract: This article evaluates the COVID-19 pandemic impacts on the Family Health Strategy (FHS) team’s work routines across a range of northeast Brazilian cities as perceived by community health workers (CHW). Data on COVID-19, CHW activities, and FHS teams were collected in 2021 by a structured questionnaire. A total of 1,935 CHWs from four state capitals (Fortaleza - Ceará State, João Pessoa - Paraíba State, Recife - Pernambuco State, Teresina - Piauí State) and four hinterland cities (Crato, Juazeiro do Norte, Barbalha, Sobral - Ceará State) participated in the study. Most CHWs were women (82.42%), with mean age 46.25±8.54 years. Many (39.92%) were infected with COVID-19, of which 70.78% believed they were infected in the workplace. A total of 77.82% defined their role as frontline in the fight against COVID-19, 16.07% reported receiving training for COVID-19, and 13.74% had access to sufficient protective equipment. Most (90.27%) believed their work routines were modified by the pandemic, either strengthening (41.46%) or weakening (44.41%) the team spirit. Home visits (60.55%), health promotion actions in schools (75.66%) and in specific community groups (93.96%), and other on-site community services (66.01%) showed a reduction in frequency. The sampled cities revealed a significant heterogeneity regarding responses to the COVID-19 pandemic, possibly associated with a lack of coordination by the Federal Government. Regardless of context, the pandemic led to a reconfiguration of local health systems, workflows, and primary care protocols for FHS teams. The importance of the Brazilian Unified National Health System (SUS) and its potential for reorganization during crisis should be acknowledged while preserving the headway made thus far.

https://doi.org/10.1590/0102-311xen007223

Saúde mental de agentes comunitários de saúde no contexto da COVID-19
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Farias, Sidney Feitoza

; Forte, Franklin Delano Soares

; Costa, Milena Silva

; Guimarães, José Maria Ximenes

; Morais, Ana Patrícia Pereira

; Oliveira, André Luiz Sá de

; Silva Júnior, Fernando José Guedes da

; Nascimento, Elaine Ferreira do

; Vasconcelos, Maristela Inês Osawa

; Dias, Maria Socorro de Araújo

; Oliveira, Felipe Proenço de

; Machado, Maria de Fátima Antero Sousa

; Castro, Marcia C.

; Yousafzai, Aisha Khizar

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 28 N. 8 Pages 2363 - 2376

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

https://doi.org/10.1590/1413-81232023288.06462023

An analysis of spatial dispersal in Ceratitis capitata in an orchard of the ‘Palmer’ mango using McPhail traps1
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Castro, Ingrid Thalia Prado de

; Lemos, Odair Lacerda

; Leite, Suzany Aguiar

; Souza, José Rafael de

; Ladeia, Crislaine Alves

; Freire, Daniel Santos

; Santos, Hosnerson Renan de Oliveira

; Silva, Gabriela Leite

Revista Ciência Agronômica

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2023, Volume 54 elocation e20228420

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to analyse patterns of spatial dispersal in Ceratitis capitata using two types of attractive traps and propose a predictive model of pest dispersal with the aim of determining management zones for decision-making. The experiment was conducted in an orchard of the ‘Palmer’ mango in the district of Belo Campo, Bahia. Sampling was carried out using McPhail and Jackson traps. The pattern of spatial dispersal in C. capitata was determined using the Perry and Mead Index of Dispersion, the Morisita Index, and the Local Moran index (LISA). The spatial variability of the abundance of C. capitata was obtained by geostatistical analysis, with the indicator kriging method used to prepare the location and spatial distribution maps. The Perry and Mead Index of Dispersion and the Morisita Index showed an aggregated pattern of spatial dispersal, whereas the Moran Local index showed a random pattern from 7 DFSH (days from the start of the harvest) to 35 DFSH, and an aggregated pattern at 42 DFSH. The SDI was strong at 7 and 35 DFSH and moderate at 14, 28 and 42 DFSH. The dispersal patterns of C. capitata allow an exponential predictive model to be produced, outlining strategies for exponential management zones of C. capitata, and detecting which places have the highest risk of the pest occurring.

https://doi.org/10.5935/1806-6690.20230056

Community health workers perspective on the COVID-19 impact on primary health care in Northeastern Brazil
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Forte, Franklin Delano Soares

; Guimarães, José Maria Ximenes

; Farias, Sidney Feitoza

; Oliveira, André Luiz Sá de

; Dias, Maria Socorro de Araújo

; Monteiro, Claudete Ferreira de Souza

; Guedes da Silva Júnior, Fernando José

; Morais, Ana Patrícia Pereira

; Moreira, Maria Rosilene Candido

; Castro, Márcia C.

; Yousafzai, Aisha Khizar

Cadernos de Saúde Pública

Journal Metrics
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- SciELO Analytics

2023, Volume 39 N. 7 elocation e00007223

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

https://doi.org/10.1590/0102-311xen007223

10.

Condiciones de salud de los indígenas hitnü potencialmente expuestos a petróleo crudo (Arauca, Colombia)
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Rivero-Rubio, Carolina

; Navarro-Rodríguez, Angélica I.

; Castro-Reyes, María C.

; Araújo-Quintana, Óscar

; Moreno-Montoya, José

; Estévez-García, Jesús A.

; Martínez-Silva, Pablo A.

; Idrovo, Álvaro J.

; Amaya-Castellanos, Claudia

Biomédica

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dec 2022, Volume 42 N. 4 Pages 679 - 696

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

Resumen Introducción. El pueblo hitnü vive en condiciones sanitarias precarias, con inseguridad alimentaria y víctima de la violencia sociopolítica en Arauca (Colombia). Además, se sospecha que pueden estar afectados por la exposición a los hidrocarburos del petróleo. Objetivo. Identificar los eventos de salud del perfil de morbilidad y mortalidad de los indígenas hitnü que podrían asociarse con la exposición a petróleo crudo. Materiales y métodos. Se realizó un estudio transversal con indígenas hitnü, durante febrero y marzo de 2021, época de sequía. Se aplicó un cuestionario de hogares y uno individual para recolectar datos del ambiente peridomiciliario, ocupaciones y otras actividades, así como datos sociodemográficos, signos, síntomas y hallazgos de un examen médico. La potencial asociación con los hidrocarburos se exploró considerando tres grupos, según su localización: cabecera de Arauca, resguardo Aspejená (no expuestos) y resguardos de San José del Lipa y La Vorágine (expuestos por su cercanía al río Ele y afluentes). Con listados libres, se exploraron las causas de muerte. El estudio incorporó un riguroso manejo intercultural en todos sus componentes. Resultados. Participaron 576 indígenas de 16 asentamientos. El agua consumida pudo servir como medio de exposición a los hidrocarburos. Los problemas de salud fueron muy variados e incluían enfermedades infecciosas y crónicas, malnutrición y trauma. Las masas en el cuello se asociaron con residir en los resguardos ancestrales (RP=3,86; IC95% 1,77-8,39), territorios potencialmente expuestos al petróleo. Las causas de muerte más relevantes fueron el homicidio, los tumores y la tuberculosis. Conclusión: Por su posible asociación con los hidrocarburos, es prioritario el estudio intercultural de linfoadenopatías entre indígenas potencialmente expuestos al petróleo.

Abstract Introduction: The Hitnü indigenous people live in precarious sanitary conditions, with food insecurity and being victims of sociopolitical violence in Arauca, Colombia. In addition, it is possible that they may be affected by exposure to hydrocarbons found in oil. Objective: To identify the health outcomes of morbidity and mortality profiles of the Hitnü people that could be associated with the exposure to crude oil. Materials and methods: A cross-sectional study was carried out with Hitnü indigenous people, during February and March, 2021, time of drought. A household questionnaire was applied, and one individual to collect data from the environment around the house, occupations and other activities, as well as data from sociodemographic, signs, symptoms, and findings of a medical examination. The potential association with hydrocarbons was explored considering three groups: inhabitants in Arauca city, Aspejaná reserve (not exposed), and San José del Lipa and La Vorágine reserves (exposed by the Ele river and tributaries). With free listings, causes of death were explored. The study incorporated a rigorous intercultural management in all its components. Results: A total of 576 indigenous people from 16 settlements participated. The water consumed could serve as means of exposure to hydrocarbons. Health problems were very varied, including infectious and chronic diseases, malnutrition, and trauma. The masses on the neck were associated with residing in the ancestral reserves (PR = 3.86; CI95% 1.77-8.39), territories with potential exposure to crude-oil. The most relevant causes of death were homicide, tumors, and tuberculosis. Conclusion: For its possible association with exposure to hydrocarbons, it is a priority to start the intercultural study of lymphadenopathies in indigenous communities potentially exposed to crude oil.

https://doi.org/10.7705/biomedica.6591

11.

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

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Publication date: 2022-10-11

Abstract: En Pt

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

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

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

12.

Brazilian practice guidelines for stroke rehabilitation: part II
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Minelli, Cesar

; Luvizutto, Gustavo José

; Cacho, Roberta de Oliveira

; Neves, Luciana de Oliveira

; Magalhães, Sheila Cristina Sayuri Abe

; Pedatella, Marco Túlio Araújo

; Mendonça, Lucia Iracema Zanotto de

; Ortiz, Karin Zazo

; Lange, Marcos Christiano

; Ribeiro, Priscila Watson

; Souza, Luciane Aparecida Pascucci Sande de

; Milani, Cristiano

; Cruz, Daniel Marinho Cezar da

; Costa, Rafael Dalle Molle da

; Conforto, Adriana Bastos

; Carvalho, Fernanda Martins Maia

; Ciarlini, Bruna Silva

; Frota, Norberto Anizio Ferreira

; Almeida, Kelson James

; Schochat, Eliane

; Oliveira, Tatiana de Paula

; Miranda, Camila

; Piemonte, Maria Elisa Pimentel

; Lopes, Laura Cardia Gomes

; Lopes, Camila Galvão

; Tosin, Michelle Hyczy de Siqueira

; Oliveira, Bianca Campos

; Oliveira, Beatriz Guitton Renaud Baptista de

; Castro, Shamyr Sulyvan de

; Andrade, João Brainier Clares de

; Silva, Gisele Sampaio

; Pontes-Neto, Octávio Marques

; Carvalho, João José Freitas de

; Martins, Sheila C. Ouriques

; Bazan, Rodrigo

Arquivos de Neuro-Psiquiatria

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jul 2022, Volume 80 N. 7 Pages 741 - 758

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

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

https://doi.org/10.1055/s-0042-1757692

13.

A Structural Design Comparison Between Two Reinforced Concrete Regular 6-Level Buildings using Soil-Structure Interaction in Linear Range
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López M., Nelson A.

; Pérez M., Gabriela E.

; Castro P., Christian F.

; Vielma P., Juan C.

; López M., Leonardo J.

; Alviar M., José D.

; Romero R., Carlos A.

; Guerrero C., David P.

; Montesinos M., Vanessa V.

Ingeniería e Investigación

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apr 2022, Volume 42 N. 1 elocation e101

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

RESUMEN Comúnmente, los ingenieros estructurales diseñan superestructuras como empotradas en la base y transmiten las reacciones a la infraestructura para diseñar el sistema de cimientos y estimar los desplazamientos del suelo, obviando el cambio en la respuesta sísmica que esto induce. En este artículo se transformó el sistema de cimientos en resortes equivalentes y se comparó y cuantificó la respuesta sísmica en el rango lineal, obteniendo resultados como aumento de los períodos, aumento de las cuantías de acero de refuerzo en vigas (entre 7% y 25 %) y columnas (entre 29% y 39%) un aumento de la cantidad de estribos por metro lineal (entre 3 % y 11 % en columnas y entre 5 % y 45 % en vigas) y las derivas (entre 1 % y 14 %), y una disminución de cortantes basales (hasta 20 %), lo que afecta de forma directa el diseño de la estructura. Este estudio concluye que es necesaria la inclusión de la interacción suelo estructura en el diseño estructural en el rango lineal.

ABSTRACT Structural engineers commonly design superstructures as fixed at the base and transmit the reactions to the infrastructure in order to design the foundation system and estimate the displacement of the soil while disregarding the change in seismic response that this induces. In this article, the foundation system was transformed into equivalent springs, and the seismic response in the linear range was compared and quantified, obtaining results such as increased periods, increased amounts of steel reinforcement in beams (between 7% and 25%) and columns (between 29% and 39%), an increase in the number of stirrups per linear meter (between 3% and 11% in columns and between 5% and 45% in beams) and drifts (between 1% and 14%), and a decrease in basal shear (up to 20%), which directly affects the design of the structure. This study concludes that the inclusion of the soil-structure interaction is necessary for structural design in the linear range.

https://doi.org/10.15446/ing.investig.v42n1.86819 49 downloads

14.

Cushing’s syndrome due to ectopic adrenocorticotropin secretion by a parotid carcinoma
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Antonacio, Fernanda F.

; Harada, Guilherme

; Vilela, Rafael S.

; Freitas, Thais C.

; Lima Jr., Jose V.

; Kowalski, Luiz Paulo

; Almeida, Madson Q.

; Castro Junior, Gilberto de

Archives of Endocrinology and Metabolism

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feb 2022, Volume 66 N. 1 Pages 92 - 96

Abstract: En | Text: En | PDF: En

SUMMARY We report a rare case of Cushing’s syndrome in a 37-year-old female who initially presented with localized acinic cell carcinoma of the parotid gland. In January 2014, she underwent a right parotidectomy with facial nerve preservation and adjuvant radiotherapy. In August 2018, she presented a histologically-proven local regional relapse. The patient was considered for salvage surgery with facial nerve sacrifice and remained with no evidence of disease. One year later the patient developed pulmonary dissemination and started to gain weight and developed facial plethora and acne on the face and upper trunk. In a physical examination, the patient presented moon face, buffalo hump, acne and stage 2 hypertension. Biochemical evaluation confirmed ACTH-dependent Cushing’s syndrome. IHC for ACTH in the lung biopsy revealed strong positive staining for ACTH confirming a diagnosis of ectopic ACTH secretion by a metastatic parotid acinic cell carcinoma. Ketoconazole (600 mg/d) was started to treat the CS. In addition, as chemotherapy was initiated to treat the metastatic disease. After the fifth cycle of chemotherapy, ketoconazole was suspended and the patient remained in remission of CS for four months, when CS recurred. A unique feature of this case is related to the clinical CS relapse associated with disease progression, which needed prompt treatment with ketoconazole, resulting in a significant improvement in the patient’s condition. Although rare, should be attentive for possible CS features in patients with high-grade salivary gland carcinomas, since the diagnosis of ectopic secretion of ACTH may significantly impact their management and outcomes.

https://doi.org/10.20945/2359-3997000000426

15.

Fishes of the Mitú Region: middle basin of the río Vaupés, Colombian Amazon
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Bogotá-Gregory, Juan D

; Lima, Flávio C. T.

; Donascimiento, Carlos

; Acosta-Santos, Astrid

; Villa-Navarro, Francisco A.

; Usma-Oviedo, José S.

; Ortega-Lara, Armando

; Castro-Pulido, William

; Córdoba, Edwin Agudelo

Biota Neotropica

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2022, Volume 22 N. 1 elocation e20211244

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

Resumo: La cuenca del río Amazonas alberga la ictiofauna dulceacuícola más diversa del mundo, sin embargo, grandes áreas de la cuenca permanecen inexploradas. Este es el caso de los afluentes de la parte alta del río Negro, especialmente los sistemas que drenan el territorio colombiano. A continuación, presentamos un listado de 224 especies derivadas del análisis de especímenes recolectados en la región de Mitú, cuenca media del río Vaupés (Departamento de Vaupés, Colombia). De las especies identificadas, 10 especies se registran en Colombia por primera vez y 26 especies para la Amazonía colombiana. El número de especies que presentamos aquí comprende casi un tercio de las especies conocidas para la Amazonía colombiana y casi una décima parte del total de las conocidas para la gran cuenca del Amazonas. Los órdenes más diversos fueron Characiformes (120 especies) y Siluriformes (65 especies), y los seis órdenes restantes comprendieron menos del 20% del total de especies. El área de estudio comprende sistemas de aguas negras que se consideran ambientes poco productivos por sus bajos contenidos de nutrientes. Discutimos aquí algunos aspectos ecológicos que podrían explicar cómo esta ictiofauna tan diversa tiene su origen y es mantenida en estos sistemas poco productivos. La información derivada del presente estudio adiciona nuevos registros de especies de peces para Colombia, y complementa la información derivada de los estudios realizados a la fecha en la Amazonía colombiana.

Abstract: The Amazon River basin hosts the most diverse freshwater ichthyofauna in the world, and yet huge areas of the basin remain unexplored. This is the case for the upper tributaries of the rio Negro, especially those draining the Colombian territory. Here we present a list of 224 species derived from the examination of specimens collected in the Mitú region (Vaupés Department, Colombia), the middle basin of the río Vaupés. Of the species identified in our study, 10 species are recorded from Colombia for the first time, and 26 species are newly recorded from the Colombian Amazon. The number of species we present here comprise almost one-third of the known species diversity of the Colombian Amazon and nearly a tenth of the total number of those known across the entirety of the Amazon basin. The most diverse orders were Characiformes (120 species) and Siluriformes (65 species), and the remaining six orders comprised less than 20% of total species. The study area comprised blackwater systems, which are considered to be nutrient-poor environments. We discuss some ecological aspects that might explain how this highly diverse ichthyofauna originates and is maintain in less productive systems. The list presented here adds an important number of new records and complements the information derived from previous studies, carried out thus far with regards to the fish fauna of the Colombian Amazon.

https://doi.org/10.1590/1676-0611-bn-2021-1244

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