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1.
Elimination of cervical cancer in Latin America (Project ECHO-ELA): lessons from phase one of implementation
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Batman, Samantha
; Varon, Melissa Lopez
; San Miguel-Majors, Sandra L.
; Benitez Majano, Sara
; Pontremoli Salcedo, Mila
; Montealegre, Jane
; Arrossi, Silvina
; Oliveira, Maria Tereza da Costa
; Oliveira, Lucia H. De
; Luciani, Silvana
; Milan, Jessica
; Trimble, Edward L.
; Schmeler, Kathleen M.
; Maza, Mauricio
.
RESUMO Este trabalho descreve os resultados do programa Extension for Community Healthcare Outcomes para eliminação do câncer do colo do útero nas Américas (ECHO ELA), desenvolvido na forma de cooperação trilateral entre a Organização Pan-Americana da Saúde (OPAS), o Instituto Nacional do Câncer dos Estados Unidos (NCI) e o MD Anderson Cancer Center da Universidade do Texas (MD Anderson). O programa visa a disseminar estratégias para a prevenção do câncer do colo do útero e está estruturado em torno dos três pilares da estratégia de eliminação do câncer do colo do útero da Organização Mundial da Saúde (OMS) e das Metas 90-70-90 associadas. O público-alvo inclui autoridades sanitárias de países da América Latina e do Caribe, bem como os pontos focais de doenças não transmissíveis nas representações da OPAS nos países, além de colaboradores clínicos e de saúde pública. Todos os meses, são realizadas sessões virtuais de uma hora e meia em espanhol usando o formato ECHO®. No período de maio de 2020 a junho de 2021, foram realizadas 14 sessões do ECHO, com uma média de 74 participantes por sessão (variação: 46 a 142). Foram realizadas duas enquetes anônimas (linha de base e acompanhamento) e dois grupos focais. Os entrevistados afirmaram que os tópicos sobre os quais mais aprenderam foram a situação da vacinação contra o HPV na região e as estratégias para implementar a vacinação contra o HPV. As necessidades identificadas incluíam apoio entre as sessões do ECHO e assistência técnica específica para o país. O programa ECHO ELA oferece um fórum para aumentar a colaboração entre os países da América Latina e do Caribe e difundir melhores práticas para atingir as metas de eliminação do câncer do colo do útero da OMS.
RESUMEN Se describen los resultados del programa ECHO® (Extension for Community Healthcare Outcomes) para la eliminación del cáncer cervicouterino en las Américas (ECHO-ELA), que se concibió como una cooperación trilateral entre la Organización Panamericana de la Salud (OPS), el Instituto Nacional del Cáncer de los Estados Unidos (NCI) y el centro contra el cáncer MD Anderson (MD Anderson) de la Universidad de Texas. La finalidad del programa es difundir las estrategias para la prevención del cáncer cervicouterino, y está estructurado en torno a los tres pilares de la estrategia para la eliminación del cáncer cervicouterino de la Organización Mundial de la Salud (OMS) y los objetivos 90-70-90 conexos. El público destinatario comprende autoridades de salud de países de América Latina y el Caribe, así como los puntos focales de la OPS para las enfermedades no transmisibles en las Representaciones en los países, además de colaboradores en el ámbito clínico y de la salud pública. Las sesiones virtuales se llevan a cabo en español, durante 1,5 horas cada mes, utilizando el formato ECHO®. De mayo del 2020 a junio del 2021 se celebraron 14 sesiones de ECHO, con un promedio de 74 participantes por sesión (límites: 46-142). Se realizaron dos encuestas anónimas (al inicio y de seguimiento) y dos grupos de opinión. Los encuestados declararon que los temas sobre los que más aprendieron fueron la situación de la vacunación contra el VPH en la región y las estrategias para poner en marcha la vacunación contra el VPH. Entre las necesidades mencionadas figuraban el apoyo entre las sesiones de ECHO y la asistencia técnica específica para cada país. El programa ECHO-ELA brinda un foro para una mayor colaboración entre los países de América Latina y el Caribe y para difundir las estrategias sobre las mejores prácticas, a fin de alcanzar los objetivos de la OMS de eliminación del cáncer cervicouterino.
ABSTRACT We describe the outcomes of The Extension for Community Healthcare Outcomes-Elimination of Cervical Cancer in The Americas (ECHO-ELA) program, which was developed as a tri-lateral cooperation between Pan American Health Organization (PAHO), the U.S. National Cancer Institute (NCI) and The University of Texas MD Anderson Cancer Center (MD Anderson). The program’s purpose is to disseminate strategies for cervical cancer prevention and is structured around the three pillars of the World Health Organization’s (WHO) Cervical Cancer Elimination Strategy and the associated 90-70-90 target goals. The target audience includes health authorities from Latin American and Caribbean countries, as well as PAHO’s non-communicable disease Focal Points in country offices as well as clinical and public health collaborators. The virtual sessions are held in Spanish for 1.5 hours every month using the ECHO® format. From May 2020 to June 2021, 14 ECHO sessions were held with an average of 74 participants per session (range: 46 – 142). We conducted two anonymous surveys (baseline and follow up) and two focus groups. Respondents stated that the topics they learned the most about included the state of HPV vaccination in the region and strategies for implementing HPV vaccination. Identified needs included support between ECHO sessions and country-specific technical assistance. The ECHO-ELA program provides a forum for increased collaboration between countries in Latin America/Caribbean and the dissemination of best-practice strategies to reach the WHO Cervical Cancer Elimination target goals.
2.
Recomendaciones de manejo de los anticoagulantes orales directos (DOACs) anti Xa y anti IIa
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Ceresetto, José M.
; Tajer, Carlos
; Duboscq, Cristina
; Bottaro, Federico
; Casais, Patricia
; Korin, Jorge
; Fondevila, Carlos
; Giumelli, Carla
; Scazziota, Alejandra
; Rossi, Andrea
; Botto, Fernando
; Ariscancela, Maria Ester
; Martinuzzo, Marta
; Zaidel, Ezequiel
; Fitz Maurice, Mario
; Bahit, Cecilia
; Vazquez, Fernando
; Molnar, Soledad
; Saizberg, Simón
; Negri Aranguren, Pedro
; Rosa, Claudio
; Fedele, José Luis
; Comignani, Pablo
; Pombo, Gonzalo
; Raña, Pablo
; Adamczuk, Yolanda
; Martí, Alejandra
; Charask, Adrián
; Penchasky, Diana
; Riveros, Dardo
; Mariani, Javier
; Puente, Dolores
; Celebrin, Lucia
; Bosio, Martín
; Brodsky, Andrés
; Sanchez Lucero, Analía
; Castillo Costa, Yanina
; Hirschson, Alfredo
; Arbesú, Guillermo
; Viñuales, Susana
; Kazelian, Lucía
; Maneyro, Alberto
; Gutierrez, Victoria
; Castro Rios, Miguel
; Gagliardi, Juan
; Lescano, Adrián
; Repetto, Fernanda
.
Abstract Direct oral anticoagulants have emerged as the drugs that have changed the man agement of the antithrombotic treatment in the last 15 years. Their advantages, like a more friendly way of anticoagulation and their lower risk of bleeding, especially in the brain, have positioned these new anticoagu lants as the first drug of choice in the two most frequent indications of anticoagulation, atrial fibrillation, and the venous thromboembolic disease. However, not all the patients can receive these agents, not all the direct oral anticoagulants have the same characteristics, and most importantly, not all the diseases with an indication of an anticoagulant drug can be treated with them. Therefore, it is mandatory that all the faculties involved in the management of these drugs must know them in depth, to decide the best treatment for the patient. This position paper, from a group of experts in anticoagulation in Argentina, can help the general practitioner in the daily use of direct oral anticoagulants based on the new evidence and the experience of a wide group of professionals. The way we relate to the anticoagulant treatment has changed in the last years. The doctors who work with them must also do so.
Resumen Los anticoagulantes orales directos han surgido como una de las herramientas que ha cambiado el manejo de la enfermedad trombótica en los últimos 15 años. Sus ventajas, desde el punto de vista de la facilidad de uso y menor riesgo de sangrado, especialmente de sangrado cerebral, han posicionado a estos nuevos anticoagulantes como la primera alternativa de tratamiento en las dos indicaciones más frecuentes en que necesitamos estas drogas, la fibrilación auricular y la enfermedad tromboembólica venosa. Sin embargo, no todos los pacientes pueden recibir estos agentes, no todos los anticoagulantes directos tienen las mismas pro piedades y fundamentalmente, no todas las enfermedades con indicación de un anticoagulante pueden tratarse con ellos;con lo cual es necesario que todos los profesionales que están involucrados en el manejo de estos medicamentos estén obligados a conocerlos en profundidad, para poder decidir el mejor tratamiento en cada caso particular. Este documento de posición de expertos de diferentes especialidades de Argentina, presenta lineamientos para el uso correcto de los anticoagulantes directos en base a nueva evidencia y a la experiencia de uso de un amplio grupo de profesionales. La forma de relacionarnos con el tratamiento anticoagulante ha cambiado. Los médicos que trabajamos con ellos también debemos hacerlo.
810 downloads
3.
Guía de práctica clínica de la Sociedad Interamericana de Cardiología sobre prevención primaria de enfermedad cardiovascular en la mujer
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Sueldo, Mildren A. del
; Rivera, María A. Mendonça
; Sánchez-Zambrano, Martha B.
; Zilberman, Judith
; Múnera-Echeverri, Ana G.
; Paniagua, María
; Campos-Alcántara, Lourdes
; Almonte, Claudia
; Paix-Gonzales, Amalia
; Anchique-Santos, Claudia V.
; Coronel, Claudine J.
; Castillo, Gabriela
; Parra-Machuca, María G.
; Duro, Ivanna
; Varletta, Paola
; Delgado, Patricia
; Volberg, Verónica I.
; Puente-Barragán, Adriana C.
; Rodríguez, Adriana
; Rotta-Rotta, Aida
; Fernández, Anabela
; Izeta-Gutiérrez, Ana C.
; Ancona-Vadillo, Ana E.
; Aquieri, Analía
; Corrales, Andrea
; Simeone, Andrea
; Rubilar, Bibiana
; Artucio, Carolina
; Pimentel-Fernández, Carolina
; Marques-Santos, Celi
; Saldarriaga, Clara
; Chávez, Christian
; Cáceres, Cristina
; Ibarrola, Dahiana
; Barranco, Daniela
; Muñoz-Ortiz, Edison
; Ruiz-Gastelum, Edith D.
; Bianco, Eduardo
; Murguía, Elena
; Soto, Enrique
; Rodríguez-Caballero, Fabiola
; Otiniano-Costa, Fanny
; Valentino, Giovanna
; Rodríguez-Cermeño, Iris B.
; Rivera, Ivan R.
; Gándara-Ricardo, Jairo A.
; Velásquez-Penagos, Jesús A.
; Torales, Judith
; Scavenius, Karina
; Dueñas-Criado, Karen
; García, Laura
; Roballo, Laura
; Kazelian, Lucía R.
; Coussirat-Liendo, Macarena
; Costa-Almeida, María C.
; Drever, Mariana
; Lujambio, Mariela
; Castro, Marildes L.
; Rodríguez-Sifuentes, Maritza
; Acevedo, Mónica
; Giambruno, Mónica
; Ramírez, Mónica
; Gómez, Nancy
; Gutiérrez-Castillo, Narcisa
; Greatty, Onelia
; Harwicz, Paola
; Notaro, Patricia
; Falcón, Rocío
; López, Rosario
; Montefilpo, Sady
; Ramírez-Flores, Sara
; Verdugo, Silvina
; Murguía, Soledad
; Constantini, Sonia
; Vieira, Thais C.
; Michelis, Virginia
; Serra, César M.
.
https://doi.org/10.24875/acm.22000071
450 downloads
4.
Posicionamento Brasileiro sobre o Uso da Multimodalidade de Imagens na Cardio-Oncologia – 2021
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Melo, Marcelo Dantas Tavares de
; Paiva, Marcelo Goulart
; Santos, Maria Verônica Câmara
; Rochitte, Carlos Eduardo
; Moreira, Valéria de Melo
; Saleh, Mohamed Hassan
; Brandão, Simone Cristina Soares
; Gallafrio, Claudia Cosentino
; Goldwasser, Daniel
; Gripp, Eliza de Almeida
; Piveta, Rafael Bonafim
; Silva, Tonnison Oliveira
; Santo, Thais Harada Campos Espirito
; Ferreira, Waldinai Pereira
; Salemi, Vera Maria Cury
; Cauduro, Sanderson A.
; Barberato, Silvio Henrique
; Lopes, Heloísa M. Christovam
; Pena, José Luiz Barros
; Rached, Heron Rhydan Saad
; Miglioranza, Marcelo Haertel
; Pinheiro, Aurélio Carvalho
; Vrandecic, Bárbara Athayde Linhares Martins
; Cruz, Cecilia Beatriz Bittencourt Viana
; Nomura, César Higa
; Cerbino, Fernanda Mello Erthal
; Costa, Isabela Bispo Santos da Silva
; Coelho Filho, Otavio Rizzi
; Carneiro, Adriano Camargo de Castro
; Burgos, Ursula Maria Moreira Costa
; Fernandes, Juliano Lara
; Uellendahl, Marly
; Calado, Eveline Barros
; Senra, Tiago
; Assunção, Bruna Leal
; Freire, Claudia Maria Vilas
; Martins, Cristiane Nunes
; Sawamura, Karen Saori Shiraishi
; Brito, Márcio Miranda
; Jardim, Maria Fernanda Silva
; Bernardes, Renata Junqueira Moll
; Diógenes, Tereza Cristina
; Vieira, Lucas de Oliveira
; Mesquita, Claudio Tinoco
; Lopes, Rafael Willain
; Segundo Neto, Elry Medeiros Vieira
; Rigo, Letícia
; Marin, Valeska Leite Siqueira
; Santos, Marcelo José
; Grossman, Gabriel Blacher
; Quagliato, Priscila Cestari
; Alcantara, Monica Luiza de
; Teodoro, José Aldo Ribeiro
; Albricker, Ana Cristina Lopes
; Barros, Fanilda Souto
; Amaral, Salomon Israel do
; Porto, Carmen Lúcia Lascasas
; Barros, Marcio Vinícius Lins
; Santos, Simone Nascimento dos
; Cantisano, Armando Luís
; Petisco, Ana Cláudia Gomes Pereira
; Barbosa, José Eduardo Martins
; Veloso, Orlando Carlos Glória
; Spina, Salvador
; Pignatelli, Ricardo
; Hajjar, Ludhmilla Abrahão
; Kalil Filho, Roberto
; Lopes, Marcelo Antônio Cartaxo Queiroga
; Vieira, Marcelo Luiz Campos
; Almeida, André Luiz Cerqueira
.
https://doi.org/10.36660/abc.20200266
103 downloads
5.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
6.
The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA
; BACCARO, FABRICIO
; CRONEMBERGER, CECILIA
; HIPÓLITO, JULIANA
; BARROS, CLAUDIA FRANCA
; RODRIGUES, DOMINGOS DE JESUS
; NECKEL-OLIVEIRA, SELVINO
; OVERBECK, GERHARD E.
; DRECHSLER-SANTOS, ELISANDRO RICARDO
; ANJOS, MARCELO RODRIGUES DOS
; FERREGUETTI, ÁTILLA C.
; AKAMA, ALBERTO
; MARTINS, MARLÚCIA BONIFÁCIO
; TOMAS, WALFRIDO MORAES
; SANTOS, SANDRA APARECIDA
; FERREIRA, VANDA LÚCIA
; CUNHA, CATIA NUNES DA
; PENHA, JERRY
; PINHO, JOÃO BATISTA DE
; SALIS, SUZANA MARIA
; DORIA, CAROLINA RODRIGUES DA COSTA
; PILLAR, VALÉRIO D.
; PODGAISKI, LUCIANA R.
; MENIN, MARCELO
; BÍGIO, NARCÍSIO COSTA
; ARAGÓN, SUSAN
; MANZATTO, ANGELO GILBERTO
; VÉLEZ-MARTIN, EDUARDO
; SILVA, ANA CAROLINA BORGES LINS E
; IZZO, THIAGO JUNQUEIRA
; MORTATI, AMANDA FREDERICO
; GIACOMIN, LEANDRO LACERDA
; ALMEIDA, THAÍS ELIAS
; ANDRÉ, THIAGO
; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA
; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA
; MESSIAS, MARILUCE REZENDE
; MARQUES, MARCIA C.M.
; PADIAL, ANDRE ANDRIAN
; MARQUES, RENATO
; BITAR, YOUSZEF O.C.
; SILVEIRA, MARCOS
; MORATO, ELDER FERREIRA
; PAGOTTO, RUBIANI DE CÁSSIA
; STRUSSMANN, CHRISTINE
; MACHADO, RICARDO BOMFIM
; AGUIAR, LUDMILLA MOURA DE SOUZA
; FERNANDES, GERALDO WILSON
; OKI, YUMI
; NOVAIS, SAMUEL
; FERREIRA, GUILHERME BRAGA
; BARBOSA, FLÁVIA RODRIGUES
; OCHOA, ANA C.
; MANGIONE, ANTONIO M.
; GATICA, AILIN
; CARRIZO, MARÍA CELINA
; RETTA, LUCÍA MARTINEZ
; JOFRÉ, LAURA E.
; CASTILLO, LUCIANA L.
; NEME, ANDREA M.
; RUEDA, CARLA
; TOLEDO, JOSÉ JULIO DE
; GRELLE, CARLOS EDUARDO VIVEIROS
; VALE, MARIANA M.
; VIEIRA, MARCUS VINICIUS
; CERQUEIRA, RUI
; HIGASHIKAWA, EMÍLIO MANABU
; MENDONÇA, FERNANDO PEREIRA DE
; GUERREIRO, QUÊZIA LEANDRO DE MOURA
; BANHOS, AUREO
; HERO, JEAN-MARC
; KOBLITZ, RODRIGO
; COLLEVATTI, ROSANE GARCIA
; SILVEIRA, LUÍS FÁBIO
; VASCONCELOS, HERALDO L.
; VIEIRA, CECÍLIA RODRIGUES
; COLLI, GUARINO RINALDI
; CECHIN, SONIA ZANINI
; SANTOS, TIAGO GOMES DOS
; FONTANA, CARLA S.
; JARENKOW, JOÃO A.
; MALABARBA, LUIZ R.
; RUEDA, MARTA P.
; ARAUJO, PUBLIO A.
; PALOMO, LUCAS
; ITURRE, MARTA C.
; BERGALLO, HELENA GODOY
; MAGNUSSON, WILLIAM E.
.
Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.
https://doi.org/10.1590/0001-3765202120201604
1034 downloads
7.
Mycoplasma spp. in captive snakes (Boa constrictor and Bothrops atrox) from Brazil
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Magalhães, Barbara Souza Neil
; Machado, Leandro dos Santos
; Figueira, Arthur de Almeida
; Dias, Thomas Salles
; Feijó, Thiago de Almeida
; Barreto, Maria Lucia
; Tuffanelli, Giulia de Almeida
; Cunha, Nathalie Costa da
; Nascimento, Elmiro Rosendo do
; Pereira, Virginia Léo de Almeida
; Almosny, Nádia Regina Pereira
.
RESUMO: Embora raros, os micoplasmas estão incluídos entre as causas de doenças respiratórias em répteis e, na ordem Squamata, já foram realizados três relatos destes microrganismos causando doença em pítons. Este estudo teve como objetivo avaliar a ocorrência de espécies de Mycoplasma em serpentes em cativeiro. Foram avaliadas 26 serpentes das famílias Pythonidae (13), Boidae (7), Viperidae (5) e Colubridae (1) do RioZoo, Brasil. Os animais foram examinados para determinar sinais clínicos consistentes com qualquer doença infecciosa. Amostras de swab traqueal de cobras foram coletadas em meio Frey e analisadas por isolamento microbiológico e pela técnica da PCR para identificar Mycoplasma spp. As amostras positivas para o gênero Mycoplasma spp. foram submetidas ao sequenciamento genético para identificação das espécies. No isolamento, 19,23% (5/26) foram positivos, enquanto 65,38% (17/26) dos animais foram positivos por PCR. Com base nas análises das seis sequências obtidas, houve similaridade com o Mycoplasma spp. descrito anteriormente em um píton e M. agassizii e M. testudineum encontrados em quelônios. Este é o primeiro relato de Mycoplasma spp. em animais das famílias Boidae e Viperidae. Mycoplasma spp. foi detectado em serpentes com e sem sinais clínicos. Os micoplasmas encontrados apresentaram semelhança genética com outros já descritos em répteis. Não houve relação entre a presença de Mycoplasma spp. e sinais clínicos.
ABSTRACT: Although rare, mycoplasmas are included among the causes of respiratory diseases in reptiles and, in the order Squamata, three reports of these microorganisms causing diseases in pythons have already been reported. This study aimed to evaluate the occurrence of Mycoplasma species in captive snakes. A total of 26 snakes of the families Pythonidae (13), Boidae (7), Viperidae (5) and Colubridae (1) from RioZoo, Brazil, were evaluated. Animals were examined to determine clinical signs consistent with any infectious disease. Tracheal swab samples from snakes were collected in Frey medium and analyzed for the presence of Mycoplasma spp.by isolation and a genus-specific PCR. DNA sequencing analyses of six positive samples by PCR were carried out to identify the species. Using isolation 19.23% (5/26) was positive, while 65.38% (17/26) of the animals were positive by PCR. Based on the analyses of the six sequences obtained, there was similarity with a Mycoplasma spp. previously described in a phyton and, M. agassizii and M. testudineum reported in chelonians. This is the first report of Mycoplasma spp. in animals of the families Boidae and Viperidae. Mycoplasma spp. were detected in snakes with and without clinical signs. The mycoplasmas reported resented identity (range, 95% to 100%) to others already described in reptiles. There was no relationship between the presence of Mycoplasma spp. and clinical signs.
https://doi.org/10.1590/0103-8478cr20200583
664 downloads
8.
Purification and characterization of fibrinolytic protease from Streptomyces parvulus by polyethylene glycol-phosphate aqueous two-phase system
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ALENCAR, VIVIANE N.S.
; NASCIMENTO, MARIA CLARA DO
; FERREIRA, JULYANNE V. DOS SANTOS
; BATISTA, JUANIZE M. DA SILVA
; CUNHA, MARCIA N.C. DA
; NASCIMENTO, JÉSSICA M. DO
; SOBRAL, RENATA V. DA SILVA
; COUTO, MILENA T.T. DO
; NASCIMENTO, THIAGO P.
; COSTA, ROMERO M.P.B.
; PORTO, ANA LÚCIA F.
; LEITE, ANA CRISTINA L.
.
Abstract Fibrinolytic proteases are a promising alternative in the pharmaceutical industry, they are used in the treatment of cardiovascular diseases, especially thrombosis. Microorganisms are the most interesting source of fibrinolytic proteases. The aim of this study was the production of fibrinolytic protease from Streptomyces parvulus DPUA 1573, the recovery of the protease by aqueous two-phase system and partial biochemical characterization of the enzyme. The aqueous two-phase system was performed according to a 24-full factorial design using polyethylene glycol molar mass, polyethylene glycol concentration, citrate concentration and pH as independent variables. It was analyzed the effect of different ions, surfactants, inhibitors, pH and temperature on enzyme activity. The best conditions for purifying the enzyme were 17.5% polyethylene glycol 8,000, 15% Phosphate and pH 8.0, it was obtained a partition coefficient of 7.33, a yield of 57.49% and a purification factor of 2.10-fold. There was an increase in enzyme activity in the presence of Fe2+ and a decrease in the presence of $\beta$-Mercaptoethanol, phenylmethylsulfonyl fluoride and Iodoacetic acid. The optimum pH was 7.0 and the optimum temperature was 40 ºC. The purified protease exhibited a molecular mass of 41 kDa. The fibrinolytic protease from Streptomyces parvulus proved to be a viable option for the development of a possible drug with fibrinolytic action.
https://doi.org/10.1590/0001-3765202120210335
1 downloads
9.
Risk factors associated with intramammary colonization with Mollicutes in dairy cattle from Southeast Brazil
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Morais, Ana Carolina Nunes de
; Pires, Danielle Regis
; Cunha, Nathalie Costa da
; Machado, Leandro dos Santos
; Helayel, Michel Abdalla
; Mendonça, Juliana França Monteiro de
; Souza, Guilherme Nunes de
; Barreto, Maria Lucia
; Nascimento, Elmiro Rosendo do
.
RESUMO: Bactérias da Classe Mollicutes estão associadas à infecção intramamária e diminuição da produção leiteira. O objetivo deste estudo foi investigar a ocorrência de Mollicutes e elucidar seus fatores de risco em rebanhos leiteiros do sudeste brasileiro. Para isso, amostras de leite de 387 vacas em lactação dos estados de Minas Gerais, Rio de Janeiro e São Paulo foram submetidas à reação em cadeia da polimerase (PCR) para detectar Mollicutes. Espécies de Mycoplasma foram investigadas nas amostras positivas por PCR, incluindo Mycoplasma bovis, M. alkalescens, M. bovigenitalium, M. bovirhinis, M. arginini e A. laidlawii. Foi aplicado um questionário epidemiológico para a coleta de dados sobre possíveis fatores de risco, que foram avaliados pelo teste de Qui-Quadrado de Pearson seguido de odds ratio (P≤0.05). Mollicutes foram detectados em 21% (4/19) dos rebanhos e 4% (16/387) dos animais, enquanto 1% (5/387) destes foram positivos para m. bovis, 3% (11/387) para m. arginini, sendo todas as amostras negativas para os demais agentes. Rebanhos com mais de 150 animais [OR=3,51 (95% IC 1,11-11,08)], ordenha manual [OR=9,97 (95% IC 2,80-35,49)] e ausência de linha de ordenha [OR=6,54 (95% IC 1,92-22,29)] foram considerados fatores de risco. A presença dessas condições pode favorecer a infecção intramamária por Mollicutes em rebanhos leiteiros no sudeste do Brasil. Este é o primeiro relato de M. bovis no Rio de Janeiro e M. arginini nos estados estudados.
ABSTRACT: Bacteria of Mollicutes Class are associated with intramammary infection and decrease in milk production. This study investigated the occurrence of Mollicutes and elucidated their risk factors in dairy herds from Southeast Brazil. For this, milk samples from 387 lactation cows from Minas Gerais, Rio de Janeiro and São Paulo States were subjected to the polymerase chain reaction (PCR) to detect Mollicutes. Species of Mycoplasma were investigated in Mollicutes positive samples by PCR, including Mycoplasma bovis, M. alkalescens, M. bovigenitalium, M. bovirhinis, M. arginini and A. laidlawii. An epidemiological questionnaire was applied to collect data on possible risk factors, which were assessed using Pearson’s Chi-square test followed by odds ratio (P≤0.05). Mollicutes were reported in 21% (4/19) of the herds and 4% (16/387) of the animals, while 1% (5/387) were positive for M. bovis and 3% (11/387) for M. arginini. All samples were negative to the other agents. Herds with more than 150 animals [OR=3.51 (95% CI 1.11-11.08)], manual milking [OR=9.97 (95% CI 2.80-35.49)] and not-milking animals with mastitis last [OR=6.54 (95% CI 1.92-22.29)] were risk factors. The presence of these conditions may favor intramammary infection by Mollicutes in dairy herds from Southeast Brazil. This is the first report of M. bovis in Rio de Janeiro and M. arginini in the studied states.
https://doi.org/10.1590/0103-8478cr20200694
115 downloads
10.
ASARONE-DERIVED PHENYLPROPANOIDS AND ISOQUINOLINE-DERIVED ALKALOIDS FROM THE BARK OF Duguetia pycnastera (Annonaceae) AND THEIR CYTOTOXICITIES
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Souza, César A. S. de
; Nardelli, Victória B.
; Paz, Weider H. P.
; Pinheiro, Maria Lúcia B.
; Rodrigues, Ana Carolina B. da C.
; Bomfim, Larissa M.
; Soares, Milena B. P.
; Bezerra, Daniel P.
; Chaar, Jamal da S.
; Koolen, Hector H. F.
; Silva, Felipe M. A. da
; Costa, Emmanoel Vilaça
.
The phytochemical investigation of the hexane and methanol extracts from the bark of Duguetia pycnastera Sandwith (Annonaceae) afforded seven known compounds, two asarone-derived phenylpropanoids and five isoquinoline-derived alkaloids. The asarones, γ-asarone (1-allyl-2,4,5-trimethoxybenzene) and 2,4,5-trimethoxy-styrene were isolated of the hexane extract while the aporphine alkaloids, O-methylmoschatoline, lysicamine, nornuciferidine, and guatterine N-oxide, and the benzyltetrahydroisoquinoline alkaloid, (S)-reticuline were isolated of the alkaloid fraction of the methanol extract. This is the first report of these compounds in D. pycnastera. γ-Asarone is being reported for the first time in the Annonaceae. Nornuciferidine is described for the second time in the Annonaceae while guatterine N-oxide is the third register. The structures of the isolated compounds were established by extensive analyses using 1D and 2D NMR spectroscopy in combination with MS. The cytotoxic activity of the isolated compounds (except for nornuciferidine) was evaluated against cancer and non-cancerous cell lines, in which lysicamine was the most active compound, mainly against HL-60, HepG2, and K562 with IC50 values of 24.40, 28.86 and 38.75 µmol L-1, respectively.
https://doi.org/10.21577/0100-4042.20170617
256 downloads
11.
Diversity of the diterpenes in the leaves of Xylopia laevigata (Annonaceae) and their cytotoxicities
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Costa, Emmanoel V.
; Sampaio, Marília F. C.
; Menezes, Leociley R. A.
; Dutra, Lívia M.
; Costa, Cinara O. S.
; Pinheiro, Maria Lúcia B.
; Silva, Felipe M. A. da
; Soares, Milena B. P.
; Bezerra, Daniel P.
; Barison, Andersson
; Koolen, Hector H. F.
.
The phytochemical investigation of the hexane extract which was obtained from the leaves of Xylopia laevigata (Annonaceae) produced six terpenes. Among these, five diterpenes named abieta-7,13-dien-3-one, ent-7β-acetoxy-16β-hydroxy-kaurane, 4-epi-cupressic acid, powerol, and labdorffianic acid B, and one oxygenated sesquiterpene, spathulenol. This is the first time these isolated diterpenes from X. laevigata have been described. The different structures belong to the abietane, kaurane, and labdane diterpenoids, and are indicative of the chemical diversity found in X. laevigata. Moreover, the diterpene ent-7β-acetoxy-16β-hydroxy-kaurane is reported herein for the first time as a natural product, and 4-epi-cupressic acid, powerol, and labdorffianic acid B are reported for the first time in the Annonaceae family. The structures of the isolated compounds were established by extensive analyses using 1D and 2D NMR spectroscopy in combination with MS. The cytotoxic activities of compounds abieta-7,13-dien-3-one, spathulenol, 4-epi-cupressic acid, and powerol were evaluated against tumor and non-tumor cell lines, in which spathulenol was found to be the most active, mainly against K562 with an IC50 value of 17.20 μmol L-1.
12.
Integrative Approach Based on Leaf Spray Mass Spectrometry, HPLC-DAD-MS/MS, and NMR for Comprehensive Characterization of Isoquinoline-Derived Alkaloids in Leaves of Onychopetalum amazonicum R. E. Fr.
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Lima, Bruna R. de
; Silva, Felipe M. A. da
; Soares, Elzalina R.
; Almeida, Richardson A. de
; Silva-Filho, Francinaldo A. da
; Barison, Andersson
; Costa, Emmanoel V.
; Koolen, Hector H. F.
; Souza, Afonso D. L. de
; Pinheiro, Maria Lúcia B.
.
Onychopetalum is an Amazonian botanical genus close-related with Bocageopsis and Unonopsis, whose species are used in traditional medicine. Although these genera are widely investigated from the phytochemical viewpoint, the knowledge about Onychopetalum remains almost unexplored. In order to perform a comprehensive characterization of isoquinoline-derived alkaloids from Onychopetalum amazonicum, an integrative approach based on the alkaloid profile analysis by leaf spray mass spectrometry (LS-MS), followed by a robust dereplication through high-performance liquid chromatography coupled with diode array detector and atmospheric pressure chemical ionization tandem mass spectrometry, (HPLC-DAD-APCI-MS/MS) and nuclear magnetic resonance (NMR) analysis was adopted. LS-MS allowed the tentative identification of reticuline, norjuziphine, nornuciferine, O-methylisopiline, nuciferine, N-methyl-O-methylisopiline, anonaine, and N-methylanonaine. HPLC-DAD-MS/MS analysis supported the tentative identification of N-methylasimilobine, asimilobine, norushinsunine, N-methylisopiline, isopiline, liriodenine, and lysicamine. Moreover, the integration of MS and NMR data allowed the additional identification of stepholidine and isocorypalmine. The applied integrative approach proposed herein enabled a comprehensive analysis of the alkaloid content from the O. amazonicum, showing to be a useful strategy for the dereplication of isoquinoline-derived alkaloids.
https://doi.org/10.21577/0103-5053.20190125
775 downloads
13.
Rapid detection of Mycobacterium tuberculosis DNA and genetic markers for Isoniazid resistance in Ziehl-Neelsen stained slides
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Bello, Graziele Lima
; Morais, Franciele Costa Leite
; de Jesus, Sheile Pinheiro
; Wolf, Jonas Michel
; Gehlen, Mirela
; de Almeida, Isabela Neves
; Figueiredo, Lida Jouca de Assis
; Soares, Tainá dos Santos
; Barcellos, Regina Bones
; Dalla Costa, Elis Regina
; de Miranda, Silvana Spíndola
; Rossetti, Maria Lucia Rosa
.
BACKGROUND Early diagnosis of tuberculosis (TB) and identification of strains of Mycobacterium tuberculosis resistant to anti-TB drugs are considered the main factors for disease control. OBJECTIVES To standardise a real-time polymerase chain reaction (qPCR) assay technique and apply it to identify mutations involved in M. tuberculosis resistance to Isoniazid (INH) directly in Ziehl-Neelsen (ZN) stained slides. METHODS Were analysed 55 independent DNA samples extracted from clinical isolates of M. tuberculosis by sequencing. For application in TB diagnosis resistance, 59 ZN-stained slides were used. The sensitivity, specificity and Kappa index, with a 95% confidence interval (CI95%), were determined. FINDINGS The agreement between the tests was, for the katG target, the Kappa index of 0.89 (CI95%: 0.7-1.0). The sensitivity and specificity were 97.6% (CI95%: 87.7-99.9) and 91.7% (CI95%: 61.5-99.5), respectively. For inhA, the Kappa index was 0.92 (CI95%: 0.8-1.0), the sensitivity and specificity were 94.4% (CI95%: 72.7-99.8) and 97.3% (CI95%: 85.8-99.9), respectively. The use of ZN-stained slides for drug-resistant TB detection showed significant results when compared to other standard tests for drug resistance. MAIN CONCLUSIONS qPCR genotyping proved to be an efficient method to detect genes that confer M. tuberculosis resistance to INH. Thus, qPCR genotyping may be an alternative instead of sequencing.
https://doi.org/10.1590/0074-02760190407
985 downloads
14.
Migraine in 746 patients with multiple sclerosis
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Fragoso, Yara Dadalti
; Adoni, Tarso
; Alves-Leon, Soniza V.
; Apostolos-Pereira, Samira L.
; Carneiro, Marcos A. Diniz
; Chikota, Edila M.
; Diniz, Denise Sisterolli
; Eboni, Audred C. B.
; Gomes, Sidney
; Gonçalves, Marcus Vinicius M.
; Goncalves, Ricardo Pereira
; Inojosa, José Luiz
; Junqueira, Thiago F.
; Machado, Suzana Costa
; Malfetano, Fabiola Rachid
; Mansur, Letícia Fezer
; Mendes, Maria Fernanda
; Muniz, Andre
; Nobrega Junior, Adaucto W.
; Olival, Guilherme Sciascia do
; Parolin, Monica Fiuza
; Pimentel, Maria Lucia V.
; Rocha, Cristiane Franklin
; Ruocco, Heloisa Helena
; Santos, Gutemberg C.
; Siquineli, Fabio
; Soares, José Otavio D.
; Sousa, Nise Alessandra C.
; Tauil, Carlos Bernardo
; Winckler, Thereza Cristina A.
.
RESUMO Enxaqueca piora o sofrimento do paciente que tem esclerose múltipla (EM). ID-migraine é uma ferramenta útil para seleção de pacientes com enxaqueca e Migraine Disability Assessment (MIDAS) é um questionário que avalia o impacto da doença. O objetivo do presente estudo foi avaliar a presença e impacto de enxaqueca em pacientes com EM. Métodos: Pacientes diagnosticados com EM e tratados em clínicas especializadas foram convidados a responder um questionário online se também apresentassem cefaleia. Resultados: O estudo incluiu 746 participantes com cefaleia e EM que preencheram completamente as respostas. Foram 625 mulheres e 121 homens, sendo 69% dos pacientes com idade entre 20 e 40 anos. Enxaqueca foi identificada em 404 pacientes (54,1%) e moderado a grave impacto da doença foi observado em 68,3% dos casos. Conclusão: Enxaqueca é uma cefaleia primária frequente e incapacitante relatada por pacientes com EM.
ABSTRACT Migraine adds to the burden of patients suffering from multiple sclerosis (MS). The ID-migraine is a useful tool for screening migraine, and the Migraine Disability Assessment questionnaire can evaluate disease burden. The aim of the present study was to assess the presence and burden of migraine in patients with MS. Methods: Patients diagnosed with MS attending specialized MS units were invited to answer an online survey if they also experienced headache. Results: The study included 746 complete responses from patients with MS and headache. There were 625 women and 121 men, and 69% of all the patients were aged between 20 and 40 years. Migraine was identified in 404 patients (54.1%) and a moderate-to-high burden of disease was observed in 68.3% of the patients. Conclusion: Migraine is a frequent and disabling type of primary headache reported by patients with MS.
https://doi.org/10.1590/0004-282x20190100
1666 downloads
15.
Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis
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Marques, Vanessa Daccach
; Passos, Giordani Rodrigues dos
; Mendes, Maria Fernanda
; Callegaro, Dagoberto
; Lana-Peixoto, Marco Aurélio
; Comini-Frota, Elizabeth Regina
; Vasconcelos, Cláudia Cristina Ferreira
; Sato, Douglas Kazutoshi
; Ferreira, Maria Lúcia Brito
; Parolin, Mônica Koncke Fiuza
; Damasceno, Alfredo
; Grzesiuk, Anderson Kuntz
; Muniz, André
; Matta, André Palma da Cunha
; Oliveira, Bianca Etelvina Santos de
; Tauil, Carlos Bernardo
; Maciel, Damacio Ramón Kaimen
; Diniz, Denise Sisteroli
; Corrêa, Eber Castro
; Coronetti, Fernando
; Jorge, Frederico M. H.
; Sato, Henry Koiti
; Gonçalves, Marcus Vinícius Magno
; Sousa, Nise Alessandra de C.
; Nascimento, Osvaldo J. M.
; Gama, Paulo Diniz da
; Domingues, Renan
; Simm, Renata Faria
; Thomaz, Rodrigo Barbosa
; Morales, Rogério de Rizo
; Dias, Ronaldo Maciel
; Apóstolos-Pereira, Samira dos
; Machado, Suzana Costa Nunes
; Junqueira, Thiago de Faria
; Becker, Jefferson
.
RESUMO O crescent arsenal terapêutico na esclerose múltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que é melhor para cada paciente, com base em evidências e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratégias de tratamento na EM.
ABSTRACT The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS.
https://doi.org/10.1590/0004-282x20180078
8891 downloads
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Glossary and search help
You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.
For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:ti:dengue and publication_year:2015 and aff_country:Brasil
See below the complete list of search indexes that can be used:
Index code | Element |
---|---|
ti | article title |
au | author |
kw | article keywords |
subject | subject (title words, abstract and keywords) |
ab | abstract |
ta | journal short title (e.g. Cad. Saúde Pública) |
journal_title | journal full title (e.g. Cadernos de Saúde Pública) |
la | publication language code (e.g. pt - Portuguese, es - Spanish) |
type | document type |
pid | publication identifier |
publication_year | publication year of publication |
sponsor | sponsor |
aff_country | country code of the author's affiliation |
aff_institution | author affiliation institution |
volume | article volume |
issue | article issue |
elocation | elocation |
doi | DOI number |
issn | journal ISSN |
in | SciELO colection code (e.g. scl - Brasil, col - Colômbia) |
use_license | article usage license code |