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1.
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
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2.
Correction of the weight and length for juveniles Atherinella brasiliensis (Actinopterygii: Atherinopsidae) after fixation in formalin and preservation in ethanol
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Melo, Marcelo T.
; Saturnino, Cíntia
; Santos, Joaquim N. S.
; Vasconcellos, Ruan M.
; Cruz-Filho, Antonio G.
; Araújo, Francisco G.
.
The present study compared losses of weight and length in specimens of Atherinella brasiliensis (Quoy & Gaimard, 1825) after fixation in formalin 10% during ten days, and posterior preservation in ethanol 70% for 45 days, in two solvents: freshwater and marine water. Additionally, correction factors were proposed to calculate the correction for weight and length from preserved specimens. The specimens were weighted and measured after collection (fresh), and with 10, 20, 27, 34, 41 and 55 days of fixation plus preservation. The largest losses in weight occurred during the first 20 days (10.35 ± 0.31% - freshwater; 11.29 ± 0.44% - marine water), continuing with lesser intensity up to the 27th day in freshwater dilution, and up to the 34th day in marine water dilution. Weight losses stabilized by the 34th day for both freshwater (11.77 ± 0.33%) and marine water (13.62 ± 0.41%). The largest losses in the total length for the two methods were also observed in the first 20 days (7.42 ± 0.27% - freshwater; 9.76 ± 0.26 - marine water), stabilizing after the 27th day in freshwater (8.60 ± 0.26%) and 20th day in marine water (9.76 ± 0.26%). The losses of weight and total length were significantly dependent on fish size, with smaller individuals suffering the most significant losses. Complete regression equations were proposed for the retro-calculation of fresh weight and total length from the preserved specimens for freshwater (Wfresh = 1.0536W P + 0.0416; TLfresh = 0.9588TL P + 5.8437) and marine water (Wfresh = 1.0868W P + 0.0451; TLfresh = 0.8621TL P + 10.425).
1781 downloads
3.
Henoch-Schönlein purpura in adults: a case series from a multidisciplinary study group
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Cruz, Boris A.
; Melo, Ana Lúcia V. Vaz de
; Silva, Mariana P. G. Ubirajara
; Fuzikawa, Alberto Kazuo
; Cabrera, Zaida J.
; Tavares Filho, Hélcio Antônio
; Fagioli, Felipe
; Rutkowski, Carolina
; Salomão Filho, Abrahão
; Coelho, Austenir Maciel
; Damasceno, Rejane Pinheiro
.
INTRODUÇÃO: púrpura de Henoch-Schönlein (PHS) é uma vasculite sistêmica que acomete vasos de pequeno calibre com depósitos de imunocomplexos contendo IgA. Esta vasculite já foi extensamente estudada em crianças, mas sua história natural em adultos é menos conhecida. OBJETIVOS: descrever uma série de pacientes adultos com PHS. PACIENTES E MÉTODOS: membros do Grupo Mineiro de Estudo das Vasculites foram convidados a reportar pacientes com PHS apresentando-se na idade adulta. Foi realizada revisão padronizada de prontuários. RESULTADOS: 11 pacientes, dois homens e nove mulheres, com idade + desvio padrão (DP) de 39,4 +/- 20,1 anos foram estudados. Nove pacientes apresentaram púrpura; sete apresentaram artrite; quatro apresentaram envolvimento gastrintestinal e dez (91%) pacientes apresentaram glomerulonefrite (GN). Oito pacientes foram submetidos à biópsia renal. Seis deles apresentaram GN endocapilar proliferativa e dois apresentaram apenas proeminência mesangial mínima. Em outros três pacientes, o diagnóstico de PHS foi confirmado através de biópsia de pele. Todos os pacientes receberam corticóide, em cinco associado a outros agentes imunossupressores. Após seguimento (média + DP) 39,0 + 64,6 meses, quatro pacientes (36%) apresentaram comprometimento da função renal, mas apenas um (9%) desenvolveu insuficiência renal terminal e foi submetido a transplante renal com sucesso. Após o seguimento, sete (64%) estão em remissão completa e quatro em remissão parcial. CONCLUSÃO: em adultos, PHS representa uma entidade clínica distinta, com maior freqüência de envolvimento renal e vasculite sistêmica mais grave. Entretanto, o prognóstico nesta série foi tão bom quanto em crianças, talvez pela terapia imunossupressiva mais vigorosa.
BACKGROUND: Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA. It has been extensively studied in children, but in adults, its natural history is much less known. OBJECTIVES: to report a series of patients with HSP presenting in their adulthood. PATIENTS AND METHODS: the Minas Gerais Vasculitis Study Group´s Members (MGVSG) were invited to report patients with HSP who appeared in their adulthood. A standardized retrospective chart review was done. RESULTS: eleven patients, two male and nine female, age 39.4 +/- 20.1 yearsold were studied. Nine patients presented purpura, seven presented arthritis, four patients had gastrointestinal involvement and ten patients (91%) presented glomerulonephritis (GN). Eight patients were subjected to renal biopsies. Six of them presented endocapillary proliferative GN and only two of them had minimal mesangial proliferation. In the other three patients, HSP was confirmed by skin biopsies. All patients received steroids, in five of them steroids were combined with other immunosuppressive agents. After a follow-up of 39.0 +/- 64.6 months, four patients (36%) presented impairment of renal function, but only one (9%) developed end stage renal disease and was successfully appeared to renal transplantation. At the end of follow-up, seven patients (64%) are in complete remission and four in partial remission. CONCLUSION: in adulthood, HSP represents a distinct clinical syndrome with a higher frequency of renal involvement and more severe systemic vasculitis. Nevertheless, the final outcome in this series was as good as reported in children, maybe due to aggressive immunosuppressive therapy.
7305 downloads
4.
Diretrizes para Avaliação e Tratamento de Pacientes com Arritmias Cardíacas
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Feitosa, Gilson Soares
; Nicolau, José Carlos
; Lorga, Adalberto
; Lorga Filho, Adalberto
; D'Ávila, André
; Rassi Jr, Anis
; Paola, Angelo A. V. de
; Pedrosa, Anísio
; Costa, Álvaro Barros da
; Peres, Ayrton
; Grupi, César
; Cirenza, Cláudio
; Moreira, Dalmo
; Sobral, Dário
; Hachul, Denise
; D'Andréa, Eduardo
; Sosa, Eduardo
; God, Epotamênides M. Good
; Brito, Fábio Sândoli de
; Cruz, Fernando
; Fenelon, Guilherme
; Lima, Gustavo Glotz
; Brito, Hélio
; Maia, Ivan G.
; Atié, Jacob
; Jorge, José Carlos Moura
; Andrade, José Carlos de
; Mateos, José Carlos Pachón
; Ribeiro, José Carlos
; Pimenta, João
; Vasconcelos, José Tarcísio de
; Gizzi, Júlio
; Zimerman, Leandro
; Castilho, Luiz Antonio Teno
; Fagundes, Márcio
; Figueiredo, Márcio
; Martinelli Filho, Martino
; Scanavacca, Maurício I.
; Valente, Ney
; Medeiros, Paulo
; Brofman, Paulo
; Miranda, Reynaldo Castro
; Costa, Roberto
; Kunyioshi, Ricardo
; Sá, Roberto
; Rassi, Sérgio G.
; Siqueira, Sérgio
; Galvão, Silas
; Nishioka, Silvana
; Grillo, Tereza
; Rodrigues, Thiago da Rocha
; Maciel, Washington
.
119261 downloads
5.
Distribuição e abundância relativa de bagres marinhos (Siluriformes, Ariidae) na Baía de Sepetiba, Rio de Janeiro
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Azevedo, Márcia Cristina Costa de
; Araújo, Francisco Gerson
; Cruz Filho, Antônio Gomes da
; Santos, Alexandre Clístenes de Alcântara
.
Marine catfish (Ariidae) are abundant resources in otter trawl fisheries carried out at Sepetiba Bay, Rio de Janeiro (Lat. 22º54, 23º04'S; Long. 43º34\ 44º10'W). Relative abundance and distribution were assessed, based in 158 fishing sampling at seven sites in the Bay, between July-1993 e June-1996. Five species were recorded in the following abundance rank order: Genidens genidens (Valenciennes, 1839), Caihorops spixii (Agassiz,1829), Sciadeichthys lunisculis (Valenciennes, 1840), Nelunia barba (Lacépède, 1803), and Bagre marinus (Mitchill, 1814), the latter have been caught in only two samples. Marine catfish showed higher abundance in the inner Bay, with indication of spatial segregation. G genidens was abundant in ali sites of lhe inner Bay, C. spixii e N. barba, near to rivers mouths, andS lunisculis, being widespread in ali studied area. Sazonality was not evident, with few exceplions in some of the three annual cycles; G. genidens and S. luniscutis were more abundant in biomass in summer 1994/95 (G. genidens) and 1993/94 (S. luniscutis). G. genidens e N. barba show higher abundance (CPUE and biomass) between July-93 and June-95 and C. spixii e S. luniscutis between July-95 and June-96. Total association index indicates a overall positive association among ali species, with. higher Jaccard and Sorensen similarities coefficient for the pairs C. spixii/G. genidens, G. genidens/S. luniscutis, e C. spixii/S. luniscutis. Pearson linear correlation and Sperman rank indicate that G. genidens and N. barba are inversely correlated to C. spixii and S. luniscutis. Spatial segregation strategy may be explaining the coexistence of the marine catfish at Sepetiba Bay.
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