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RESUMO Aplicações exógenas de compostos químicos estimulam modificações no metabolismo vegetal e conferem tolerância a diferentes estresses ambientais, incluindo o déficit hídrico. Esta pesquisa teve como objetivo avaliar os efeitos do uso de ácido salicílico (AS) e prolina na redução do estresse hídrico em uma variedade tradicional de feijão-caupi em um clima típico do semiárido brasileiro. Foi utilizado um delineamento inteiramente casualizado em esquema fatorial 2 × 4 com cinco repetições. Foram utilizadas duas lâminas de irrigação, correspondentes a 100% (W100) e 50% da evapotranspiração diária (W50) e quatro tratamentos com atenuadores: controle (água destilada), AS (550 mg L-1), prolina (690 mg L-1) e 690 mg L-1 prolina + 550 mg L-1 AS. Os elicitores promoveram alterações no metabolismo osmótico e antioxidante, o que pode contribuir para o mecanismo de tolerância das plantas de feijão-caupi sob restrição hídrica. A aplicação de ácido salicílico aumentou a síntese de osmorreguladores, a concentração de proteínas e modulou a atividade de enzimas antioxidantes em plantas de feijão-caupi sob estresse. A concentração de prolina aumentou sinergicamente nas plantas tratadas com prolina e AS, principalmente em 50% de reposição de água.

ABSTRACT Exogenous applications of chemical compounds stimulate changes in plant metabolism and promote tolerance to different environmental stresses, including water deficit. This study aimed to evaluate the ability of salicylic acid (SA) and proline (PRO) to reduce water stress in a traditional variety of cowpea in a typical Brazilian semiarid climate. A completely randomized design was used in a 2 × 4 factorial scheme, with five replicates. Two irrigation regimes were evaluated corresponding to 100% (W100) and 50% of daily evapotranspiration (W50), respectively, with the addition of the following four attenuators: control (distilled water), SA (550 mg L-1), PRO (690 mg L-1), and 690 mg L-1 PRO + 550 mg L-1 SA. The treatments promoted changes in osmotic and antioxidant metabolism, which may contribute to the tolerance mechanisms of cowpea plants to water stress. The application of SA increased osmoregulator synthesis and protein concentrations, and modulated antioxidant enzyme activity in the cowpea plants under water stress. PRO concentrations increased synergistically in plants treated with PRO and SA, particularly in 50% of water replacement.

https://doi.org/10.1590/1807-1929/agriambi.v27n1p18-25

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis

; Pujol-Luz, José Roberto

; Rafael, José Albertino

; Riccardi, Paula Raile

; Rodrigues, João Paulo Vinicios

; Roque, Fabio de Oliveira

; Sallum, Maria Anice Mureb

; Santis, Marcelo Domingos de

; Santos, Charles Morphy Dias dos

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Shimabukuro, Paloma Helena Fernandes

; Silva, Vera Cristina

; Schelesky-Prado, Daniel de Castro

; Silva-Neto, Alberto Moreira da

; Camargo, Alexssandro

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Wiedenbrug, Sofia

; Yamaguchi, Carolina

; Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

https://doi.org/10.1590/1806-9665-rbent-2023-0051

PHYSIOLOGICAL ADJUSTMENTS, YIELD INCREASE AND FIBER QUALITY OF 'BRS RUBI' NATURALLY COLORED COTTON UNDER SILICON DOSES
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FERRAZ, RENER LUCIANO DE SOUZA

; COSTA, PATRÍCIA DA SILVA

; MAGALHÃES, IVOMBERG DOURADO

; VIÉGAS, PEDRO ROBERTO ALMEIDA

; DANTAS NETO, JOSÉ

; MELO, ALBERTO SOARES DE

Revista Caatinga

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jun 2022, Volume 35 N. 2 Pages 371 - 381

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

RESUMO Globalmente, demanda por alimentos e bens de consumo tem acompanhado o crescimento populacional, pressionando o setor agropecuário a otimizar os sistemas de produção. No caso específico da agricultura, a utilização de cultivares de plantas alimentícias e energéticas melhoradas e associadas ao uso de substâncias atenuadoras dos estresses abióticos, são estratégias adotadas para solucionar esse problema. Objetivou-se avaliar se o silício (Si) promove ajustes fisiológicos, aumento de produção, rendimento e qualidade de fibras de algodoeiro naturalmente coloridas. Foram testadas cinco doses de silício (0 (controle), 5, 10, 15, 20 kg ha−1 de Si), em delineamento inteiramente casualizado, em vasos. Foram avaliadas variáveis fisiológicas, produção, rendimento e qualidade de fibras da cultivar BRS Rubi. Os dados foram submetidos às análises de componentes principais, variância multivariada e univariada e regressão linear múltipla. O silício promove ajustes fisiológicos, aumento de produção, rendimento e qualidade de fibras de algodão. A qualidade das fibras de plantas tratadas com Si está dentro dos valores esperados para esta cultivar e em conformidade com a norma internacional D-4605 da American Society for Testing and Materials. Recomenda-se aplicações de 10 kg ha−1 de Si para aumentar a qualidade de fibras de algodão naturalmente coloridas cv. BRS Rubi.

ABSTRACT Globally, the demand for food and consumer products has accompanied population growth, forcing the agriculture and livestock sector to optimize the production systems. In the specific case of agriculture, using improved edible and energetic plant cultivars associated with abiotic stress-reducing substances is a strategy adopted to solve this problem. This investigation aimed to evaluate whether silicon (Si) promotes physiological adjustments, an increase in production, higher yield, and improved quality of naturally colored cotton fibers. Five doses of silicon (0 (control), 5, 10, 15, and 20 kg ha−1) were tested in a completely randomized design. The variables assessed were physiological adjustments, production, yield and quality of fibers produced by BRS Rubi cultivar. Data were submitted to principal component analysis, multivariate and univariate analyses of variance, and multiple linear regression analysis. Silicon promotes physiological adjustments, enhanced production, yield, and quality of naturally colored cotton fibers of BRS Rubi cultivar grown in the Brazilian semiarid region. Fiber quality in plants that have been treated with Si is within the expected values for this cultivar and by the international standard D-4605 of the American Society for Testing and Materials. 10 kg ha−1 of Si is recommended to increase fiber quality of naturally colored cotton cv. BRS Rubi.

https://doi.org/10.1590/1983-21252022v35n213rc

Evaluation of the Quality of Life of Patients Using Circular External Fixator in a Trauma Hospital
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Vogt, Paulo Henrique

; Hobi, Renê

; Faggion, Heloisa Zimmermann

; Yoshiysu, Giro Alberto

; Marcon, Lucas Antônio Ferraz

; Hiraga, Cássio Kenji

Revista Brasileira de Ortopedia

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apr 2022, Volume 57 N. 2 Pages 214 - 217

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

Resumo Objetivo Avaliar a qualidade de vida dos pacientes em uso do fixador externo do tipo Ilizarov para tratamento de fraturas complexas e de suas sequelas Método Trata-se de um estudo observacional e transversal, em que foi aplicado o questionário 36-item short form survey (SF-36) (traduzido para a língua portuguesa) durante as consultas ambulatoriais em 2 períodos, nos meses de julho de 2018 e janeiro de 2019. Os pacientes que participaram do estudo realizaram seus procedimentos cirúrgicos no período de janeiro a junho de 2018. Resultados Foram avaliados 36 pacientes em uso de fixador externo do tipo Ilizarov. Foi observado predomínio do sexo masculino e idade média de 37,9 anos. As fraturas de ossos da perna e suas complicações representaram metade da amostra. Foi observada melhora na capacidade funcional e nos aspectos emocionais dos pacientes ao longo do tratamento. Conclusão O uso do fixador externo circular constitui um método importante e eficaz para o tratamento cirúrgico de fraturas complexas e de suas sequelas. Este trabalho permitiu concluir que, após o tratamento, os pacientes alcançaram retorno funcional às atividades diárias com adequada qualidade de vida.

Abstract Objective To evaluate the quality of life of patients using an Ilizarov type external fixator for the treatment of complicated fractures and their sequelae. Method This is an observational and cross-sectional study, in which the 36-item short form survey (SF-36) questionnaire (translated into Portuguese) was applied during outpatient consultations in 2 periods, in the months of July 2018 and January 2019. The patients who participated in the study underwent their surgical procedures between January and June 2018. Results We evaluated 36 patients using an external Ilizarov fixator. We observed a predominance of male patients, with a mean age of 37.9 years. Fractures of leg bones and their complications represented half of the sample. Improvement in functional capacity and emotional aspects of the patients was observed throughout the treatment. Conclusion The use of the circular external fixator is an important and effective method for the surgical treatment of complex fractures and their sequelae. This study allowed us to conclude that, after treatment, patients achieved functional return to daily activities with adequate quality of life.

https://doi.org/10.1055/s-0041-1732383

Water restriction in cowpea plants [Vigna unguiculata (L.) Walp.]: Metabolic changes and tolerance induction
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Melo, Alberto S. de

; Melo, Yuri L.

; Lacerda, Claudivan F. de

; Viégas, Pedro R. A.

; Ferraz, Rener L. de S.

; Gheyi, Hans R.

Revista Brasileira de Engenharia Agrícola e Ambiental

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mar 2022, Volume 26 N. 3 Pages 190 - 197

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

RESUMO As mudanças climáticas globais tendem intensificar a indisponibilidade de água, principalmente na região semiarida brasileira, impactando diretamente a produção agrícola. O feijão-caupi é uma das culturas de grande importância socioeconômica no semiárido, cultivado principalmente em regime de sequeiro e considerado moderadamente tolerante à restrição hídrica. Essa espécie apresenta mecanismos fisiológicos e bioquímicos de adaptação a esses fatores de estresse, mas ainda não há uma visão clara de como essas respostas podem permitir não apenas a sobrevivência, mas também garantir avanços na produtividade no campo. Além dos mecanismos de aclimatação, a aplicação exógena de eliciadores abióticos (ácido salicílico, silício, prolina, metionina e nitrato de potássio) e bióticos (rizobactérias) é promissora na mitigação dos efeitos da restrição hídrica. A presente revisão de literatura pretende discutir os mecanismos de aclimatação do feijão-caupi e algumas técnicas de cultivo, principalmente a aplicação de eliciadores, que podem contribuir para a manutenção da produtividade da cultura em diferentes cenários hídricos. A aplicação de eliciadores é uma forma alternativa de aumentar a sustentabilidade da produção em sistemas de sequeiro no semiárido. No entanto, o uso de substâncias eliciadoras no feijão-caupi ainda apresenta um campo a ser explorado com cautela, dadas as dificuldades causadas pela variabilidade genotípica e edafoclimática em condições de cultivo no campo.

ABSTRACT Global climate change tends to intensify water unavailability, especially in semi-arid regions, directly impacting agricultural production. Cowpea is one of the crops with great socio-economic importance in the Brazilian semi-arid region, cultivated mainly under rainfed farming and considered moderately tolerant to water restriction. This species has physiological and biochemical mechanisms of adaptation to these stress factors, but there is still no clear vision of how these responses can not only allow survival, but also ensure yield advances in the field. Besides acclimation mechanisms, the exogenous application of abiotic (salicylic acid, silicon, proline, methionine, and potassium nitrate) and biotic (rhizobacteria) elicitors is promising in mitigating the effects of water restriction. The present literature review discusses the acclimation mechanisms of cowpea and some cultivation techniques, especially the application of elicitors, which can contribute to maintaining crop yield under different water scenarios. The application of elicitors is an alternative way to increase the sustainability of production in rainfed farming in semi-arid regions. However, the use of eliciting substances in cowpea still needs to be carefully explored, given the difficulties caused by genotypic and edaphoclimatic variability under field conditions.

https://doi.org/10.1590/1807-1929/agriambi.v26n3p190-197

Vitamin A deficiency and association between serum retinol and IGF-1 concentrations in Brazilian children with Down syndrome
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Ferraz, Ivan Savioli

; Vieira, Débora Mônica Costa

; Ciampo Jr., Luiz Antonio Del

; Ued, Fábio da Veiga

; Almeida, Ane Cristina Fayão

; Jordão Jr., Alceu Afonso

; Aragon, Davi Casale

; Martinez, Edson Zangiacomi

; Martinelli Jr., Carlos Eduardo

; Nogueira-de-Almeida, Carlos Alberto

Jornal de Pediatria

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feb 2022, Volume 98 N. 1 Pages 76 - 83

Abstract: En | Text: En | PDF: En

Abstract Objective: To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. Methods: Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirão Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 μmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. Results: VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). Conclusion: a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.

https://doi.org/10.1016/j.jped.2021.04.003

Relationship between physiology and production of maize under different water replacements in the Brazilian semi-arid
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Anjos, Franklin A. dos

; Ferraz, Rener L. de S.

; Azevedo, Carlos A. V. de

; Costa, Patrícia da S.

; Melo, Alberto S. de

; Ramalho, Vitória R. R. de A. R.

Revista Brasileira de Engenharia Agrícola e Ambiental

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jan 2022, Volume 26 N. 1 Pages 21 - 27

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

RESUMO A restrição hídrica provoca desordens fisiológicas e reduz o rendimento do milho no semiárido. Objetivou-se relacionar variáveis fisiológicas instantâneas com rendimento de grãos de milho sob percentagens de reposição da água perdida por evapotranspiração e ajustar um modelo de regressão múltipla para estimativa do rendimento de grãos no período de estiagem no semiárido brasileiro. O experimento foi montado no delineamento de blocos casualizados, com seis percentagens de reposição da evapotranspiração de referência - ETo (50, 75, 100, 125, 150 e 175%). O híbrido AG 7088 teve maior taxa de assimilação de CO2, condutância estomática, transpiração, eficiência instantânea do uso da água e redução da temperatura foliar e do déficit de pressão de vapor sob irrigação plena (100% da ETo, 458 mm), com produção de 5,75 t ha-1, podendo chegar a 6,8 (572 mm) e 7,65 t ha-1 (801 mm) com reposições de 125 e 175% da ETo, respectivamente. Mensurações de trocas gasosas foliares, déficit de pressão de vapor e temperatura foliar podem ser realizadas no estádio fenológico R1 para estimar o rendimento de grãos com maior robustez quando combinados com lâminas de água aplicadas durante o ciclo da cultura.

ABSTRACT Water restriction causes physiological disorders and reduces maize yield in semi-arid regions. The objective of this study was to correlate instantaneous physiological variables with the grain yield of maize using different replacement percentages of water lost through evapotranspiration and to fit a multiple regression model to estimate grain yield in the dry season in the Brazilian semi-arid region. The experiment was installed in a randomized block design, with six percentages of reference evapotranspiration (ETo) repositioning (50, 75, 100, 125, 150, and 175%). The AG 7088 hybrid had a higher CO2 assimilation rate, stomatal conductance, transpiration, and instantaneous water use efficiency, and reduced leaf temperature and vapor pressure deficit under full irrigation (100% of ETo, 458 mm), with yields of 5.75 t ha-1, reaching 6.8 t ha-1 (572 mm) and 7.65 t ha-1 (801 mm) with replacements of 125 and 175% of ETo, respectively. Measurements of leaf gas exchange, vapor pressure deficit, and leaf temperature can be performed at phenological stage R1 to estimate grain yield with greater robustness when combined with water rates applied during the crop cycle.

https://doi.org/10.1590/1807-1929/agriambi.v26n1p21-27 61 downloads

Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos

; Feitosa Filho, Gilson Soares

; Petriz, João Luiz

; Furtado, Remo Holanda de Mendonça

; Précoma, Dalton Bertolim

; Lemke, Walmor

; Lopes, Renato Delascio

; Timerman, Ari

; Marin Neto, José A.

; Bezerra Neto, Luiz

; Gomes, Bruno Ferraz de Oliveira

; Santos, Eduardo Cavalcanti Lapa

; Piegas, Leopoldo Soares

; Soeiro, Alexandre de Matos

; Negri, Alexandre Jorge de Andrade

; Franci, Andre

; Markman Filho, Brivaldo

; Baccaro, Bruno Mendonça

; Montenegro, Carlos Eduardo Lucena

; Rochitte, Carlos Eduardo

; Barbosa, Carlos José Dornas Gonçalves

; Virgens, Cláudio Marcelo Bittencourt das

; Stefanini, Edson

; Manenti, Euler Roberto Fernandes

; Lima, Felipe Gallego

; Monteiro Júnior, Francisco das Chagas

; Correa Filho, Harry

; Pena, Henrique Patrus Mundim

; Pinto, Ibraim Masciarelli Francisco

; Falcão, João Luiz de Alencar Araripe

; Sena, Joberto Pinheiro

; Peixoto, José Maria

; Souza, Juliana Ascenção de

; Silva, Leonardo Sara da

; Maia, Lilia Nigro

; Ohe, Louis Nakayama

; Baracioli, Luciano Moreira

; Dallan, Luís Alberto de Oliveira

; Dallan, Luis Augusto Palma

; Mattos, Luiz Alberto Piva e

; Bodanese, Luiz Carlos

; Ritt, Luiz Eduardo Fonteles

; Canesin, Manoel Fernandes

; Rivas, Marcelo Bueno da Silva

; Franken, Marcelo

; Magalhães, Marcos José Gomes

; Oliveira Júnior, Múcio Tavares de

; Filgueiras Filho, Nivaldo Menezes

; Dutra, Oscar Pereira

; Coelho, Otávio Rizzi

; Leães, Paulo Ernesto

; Rossi, Paulo Roberto Ferreira

; Soares, Paulo Rogério

; Lemos Neto, Pedro Alves

; Farsky, Pedro Silvio

; Cavalcanti, Rafael Rebêlo C.

; Alves, Renato Jorge

; Kalil, Renato Abdala Karam

; Esporcatte, Roberto

; Marino, Roberto Luiz

; Giraldez, Roberto Rocha Corrêa Veiga

; Meneghelo, Romeu Sérgio

; Lima, Ronaldo de Souza Leão

; Ramos, Rui Fernando

; Falcão, Sandra Nivea dos Reis Saraiva

; Dalçóquio, Talia Falcão

; Lemke, Viviana de Mello Guzzo

; Chalela, William Azem

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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jul 2021, Volume 117 N. 1 Pages 181 - 264

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

https://doi.org/10.36660/abc.20210180 3052 downloads

Pediatric multisystem inflammatory syndrome associated with COVID-19: urgent attention required
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Nogueira-de-Almeida, Carlos Alberto

; Ciampo, Luiz Antonio Del

; Ferraz, Ivan Savioli

; Ciampo, Ieda Regina Lopes Del

; Contini, Andrea Aparecida

; Ued, Fábio da Veiga

Revista da Associação Médica Brasileira

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2021, Volume 67 Suppl. 1 Pages 115 - 120

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: To identify epidemiological and clinical characteristics of multisystemic inflammatory syndrome associated with coronavirus infection as one of the severe forms of COVID-19 involvement in children and adolescents. METHODS: review was based on articles published in 2020 in the PubMed, Medline, Scopus, SciELO and Cochrane databases. SUMMARY: Multisystemic inflammatory syndrome is a serious clinical disorder that affects children and adolescents and is associated with the detection of previous exposure to SARS-CoV-2. It is characterized by the installation of a shock picture, with a significant increase in inflammatory markers such as presentations of Kawasaki Disease or shock syndrome related to Kawasaki Disease, or even toxic shock syndrome, with the clinical picture being characterized by fever of difficult control, rash, conjunctivitis, peripheral edema, generalized pain in the extremities and gastrointestinal symptoms. CONCLUSIONS: Although the vast majority of children with COVID-19 have mild symptoms, it is necessary to consider that some have a hyperinflammatory response. It is essential that health professionals receive information that can assist in the recognition of this clinical condition, differentiating it from other diagnoses, so that early and appropriate treatment is instituted.

https://doi.org/10.1590/1806-9282.67.suppl1.20200691 177 downloads

10.

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; DIAS, André Roncon

; FORONES, Nora Manoukian

; CARVALHO, Marineide Prudêncio de

; CASTRO, Osvaldo Antonio Prado

; KASSAB, Paulo

; COSTA-JÚNIOR, Wilson Luiz da

; WESTON, Antônio Carlos

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira

; ZeideCharruf, Amir

; Brandalise, André

; Silva, André Maciel da

; Alves, Barlon

; Marins, Carlos Augusto Martinez

; Malheiros, Carlos Alberto

; Leite, Celso Vieira

; Bresciani, Claudio José Caldas

; Szor, Daniel

; Mucerino, Donato Roberto

; Wohnrath, Durval R.

; JirjossIlias, Elias

; Martins Filho, Euclides Dias

; PinatelLopasso, Fabio

; Coimbra, Felipe José Fernandez

; Felippe, Fernando E. Cruz

; Tomasisch, Flávio Daniel Saavedra

; Takeda, Flavio Roberto

; Ishak, Geraldo

; Laporte, Gustavo Andreazza

; Silva, Herbeth José Toledo

; Cecconello, Ivan

; Rodrigues, Joaquim José Gama

; Grande, José Carlos Del

; Lourenço, Laércio Gomes

; Motta, Leonardo Milhomem da

; Ferraz, Leonardo Rocha

; Moreira, Luis Fernando

; Lopes, Luis Roberto

; Toneto, Marcelo Garcia

; Mester, Marcelo

; Rodrigues, Marco Antônio Gonçalves

; Franciss, Maurice Youssef

; AdamiAndreollo, Nelson

; Corletta, Oly Campos

; Yagi, Osmar Kenji

; Malafaia, Osvaldo

; Assumpção, Paulo Pimentel

; Savassi-Rocha, Paulo Roberto

; Colleoni Neto, Ramiro

; Oliveira, Rodrigo Jose de

; AissarSallun, Rubens Antonio

; Weschenfelder, Rui

; Oliveira, Saint Clair Vieira de

; Abreu, Thiago Boechat de

; Castria, Tiago Biachi de

; Ribeiro Junior, Ulysses

; Barra, Williams

; Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 1 elocation e1563

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

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.

ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

https://doi.org/10.1590/0102-672020210001e1563 768 downloads

11.

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa

; Pereira, Maria Fernanda Badue

; Santos, Angélica Carreira dos

; Fink, Thais Toledo

; Paula, Camila Sanson Yoshino de

; Litvinov, Nadia

; Schvartsman, Claudio

; Delgado, Artur Figueiredo

; Gibelli, Maria Augusta Bento Cicaroni

; Carvalho, Werther Brunow de

; Odone Filho, Vicente

; Tannuri, Uenis

; Carneiro-Sampaio, Magda

; Grisi, Sandra

; Duarte, Alberto José da Silva

; Antonangelo, Leila

; Francisco, Rossana Pucineli Vieira

; Okay, Thelma Suely

; Batisttella, Linamara Rizzo

; Carvalho, Carlos Roberto Ribeiro de

; Brentani, Alexandra Valéria Maria

; Silva, Clovis Artur

; Eisencraft, Adriana Pasmanik

; Rossi Junior, Alfio

; Fante, Alice Lima

; Cora, Aline Pivetta

; Reis, Amelia Gorete A. de Costa

; Ferrer, Ana Paula Scoleze

; Andrade, Anarella Penha Meirelles de

; Watanabe, Andreia

; Gonçalves, Angelina Maria Freire

; Waetge, Aurora Rosaria Pagliara

; Silva, Camila Altenfelder

; Ceneviva, Carina

; Lazari, Carolina dos Santos

; Abellan, Deipara Monteiro

; Santos, Emilly Henrique dos

; Sabino, Ester Cerdeira

; Bianchini, Fabíola Roberta Marim

; Alcantara, Flávio Ferraz de Paes

; Ramos, Gabriel Frizzo

; Leal, Gabriela Nunes

; Rodriguez, Isadora Souza

; Pinho, João Renato Rebello

; Carneiro, Jorge David Avaizoglou

; Paz, Jose Albino

; Ferreira, Juliana Carvalho

; Ferranti, Juliana Ferreira

; Ferreira, Juliana de Oliveira Achili

; Framil, Juliana Valéria de Souza

; Silva, Katia Regina da

; Kanunfre, Kelly Aparecida

; Bastos, Karina Lucio de Medeiros

; Galleti, Karine Vusberg

; Cristofani, Lilian Maria

; Suzuki, Lisa

; Campos, Lucia Maria Arruda

; Perondi, Maria Beatriz de Moliterno

; Diniz, Maria de Fatima Rodrigues

; Fonseca, Maria Fernanda Mota

; Cordon, Mariana Nutti de Almeida

; Pissolato, Mariana

; Peres, Marina Silva

; Garanito, Marlene Pereira

; Imamura, Marta

; Dorna, Mayra de Barros

; Luglio, Michele

; Rocha, Mussya Cisotto

; Aikawa, Nadia Emi

; Degaspare, Natalia Viu

; Sakita, Neusa Keico

; Udsen, Nicole Lee

; Scudeller, Paula Gobi

; Gaiolla, Paula Vieira de Vincenzi

; Severini, Rafael da Silva Giannasi

; Rodrigues, Regina Maria

; Toma, Ricardo Katsuya

; Paula, Ricardo Iunis Citrangulo de

; Palmeira, Patricia

; Forsait, Silvana

; Farhat, Sylvia Costa Lima

; Sakano, Tânia Miyuki Shimoda

; Koch, Vera Hermina Kalika

; Cobello Junior, Vilson

Clinics

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2021, Volume 76 elocation e3488

Abstract: En | Text: En | PDF: En

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

https://doi.org/10.6061/clinics/2021/e3488

12.

Genetic variability among jarina palm (Phytelephas macrocarpa Ruíz & Pavón) progenies based on seed, germination and seedling characteristics
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Ferraz, Pedro de Albuquerque

; Ferreira, Sidney Alberto do Nascimento

; Ferreira, Evandro José Linhares

; Ticona-Benavente, Cesar Augusto

; Carvalho, Josiane Celerino de

Journal of Seed Science

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2021, Volume 43 elocation e202143037

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

Resumo: Jarina é uma palmeira da Amazônia ocidental, cujas sementes possuem características semelhantes ao marfim animal, usadas na confecção de artesanatos. O objetivo deste trabalho foi avaliar a variabilidade genética de progênies de jarina, a partir de características morfofisiológicas da semente, germinação e estádios da plântula. O delineamento experimental adotado foi inteiramente casualizado, com 15 tratamentos (progênies), 3 repetições com 15 sementes por unidade experimental. Foram utilizadas 31 características morfofisiológicas das sementes e plântulas. Com as características que tiveram variabilidade significativa foi feito o agrupamento das progênies pelo método UPGMA. Os resultados mostraram variabilidade genética entre progênies para 24 características. Considerando 50% da dissimilaridade foram identificados quatro grupos: Grupo 1 - P05; Grupo 2 - P04, P11 e P12; Grupo 3 - P06, P10, P08, P14, P15, P07, P09, P02 e P13; e Grupo 4 - P01 e P03. Caracteres morfofisiológicos da semente, germinação e da plântula são uteis para detectar variabilidade genética entre progênies de jarina. Três progénies (P04, P11 e P12) se destacaram por apresentar os maiores percentuais de germinação e dos diferentes estádios da plântula, além de maiores índices de velocidade e menores tempo, em relação à germinação e estádios da plântula.

Abstract: Jarina is a palm tree from the western Amazon region, whose seeds have characteristics like those of animal ivory, used for making handicrafts. The aim of this work was to evaluate the genetic variability of jarina palm progenies, from seed morphophysiological characteristics, germination and seedling stages. The experimental design adopted was completely randomized, with 15 treatments (progenies), 3 repetitions, and 15 seeds per experimental unit. Thirty-one morphophysiological characteristics of the seed and seedling were used. With the characteristics that had significant variability, the progenies were grouped using the UPGMA method. The results showed genetic variability among progenies for 24 traits. Considering 50% of dissimilarity, four groups were identified: Group 1 - P05; Group 2 - P04, P11 and P12; Group 3 - P06, P10, P08, P14, P15, P07, P09, P02 and P13; and Group 4 - P01 and P03. Morphophysiological traits of the seed, germination and seedling are useful to detect genetic variability among jarina palm progenies. Three progenies (P04, P11 and P12) stood out for having the highest percentage of germination and the different seedling stages, as well as the highest speed indices and shortest times, in relation to germination and seedling stages.

https://doi.org/10.1590/2317-1545v43251724 1 downloads

13.

Physiological adjustments, fiber yield and quality of colored cotton BRS Topázio cultivar under leaf silicon spraying
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Ferraz, Rener Luciano de Souza

; Costa, Patrícia da Silva

; Magalhães, Ivomberg Dourado

; Medeiros, Aldair de Souza

; Viégas, Pedro Roberto Almeida

; Melo, Alberto Soares de

Ciência e Agrotecnologia

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2021, Volume 45 elocation e005721

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

RESUMO Estresses abióticos reduzem o rendimento e a qualidade da produção de algodão e isso pode ser atenuado pelo uso de eliciadores exógenos. Este estudo investigou ajustes fisiológicos, melhoria da produtividade, rendimento e qualidade da fibra do algodão naturalmente colorido cultivar BRS Topázio sob pulverização de silício foliar. Foram testadas cinco doses de silício (0, 50, 100, 150, 200 mg L-1), em delineamento inteiramente casualizado; e avaliadas variáveis fisiológicas, produção, rendimento e qualidade de fibra. Os dados foram submetidos às análises de componentes principais, variância multivariada e univariada e regressão linear múltipla. O silício promove ajustes fisiológicos, aumento de produção, rendimento e qualidade de fibra de algodão. A dose ideal de silício varia em função da variável resposta avaliada. A qualidade da fibra de plantas tratadas com silício está dentro dos valores esperados para a cultivar e em conformidade com a norma internacional D-4605 da American Society for Testing and Materials. Portanto, o plantio da cultivar BRS Topázio com aplicações foliares de silício pode ser recomendado para melhoria da cadeia produtiva de algodão de fibra naturalmente colorida no semiárido do Brasil.

ABSTRACT Abiotic stresses reduce the yield and quality of cotton production, however, this problem may be mitigated by exogenous elicitors. This study investigated physiological adjustments, improvement in productivity, and fiber yield and quality from naturally colored cotton BRS Topázio cultivar under leaf silicon spraying. Five doses of silicon (0, 50, 100, 150, and 200 mg L-1) were tested in a completely randomized design. The variables assessed were physiological, production, fiber yield and quality. Data were submitted to principal component analysis, multivariate and univariate variance, and multiple linear regression. Silicon promotes physiological adjustments, increased production, cotton fiber yield and quality. Optimum silicon dose varies depending on the variable response. Fiber quality from plants treated with silicon is within the expected pattern for this cultivar and the international standard D-4605 of the American Society for Testing and Materials. Therefore, planting BRS Topázio cultivar under silicon foliar applications may be recommended to improve the naturally colored fiber cotton production chain in the Brazilian semiarid region.

https://doi.org/10.1590/1413-7054202145005721 307 downloads

14.

COVID-19 and obesity in childhood and adolescence: a clinical review,
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Nogueira-de-Almeida, Carlos Alberto

; Del Ciampo, Luiz A.

; Ferraz, Ivan S.

; Del Ciampo, Ieda R.L.

; Contini, Andrea A.

; Ued, Fábio da V.

Jornal de Pediatria

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dec 2020, Volume 96 N. 5 Pages 546 - 558

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

Resumo Objetivo: Identificar fatores que contribuem para o aumento da suscetibilidade e gravidade da COVID-19 em crianças e adolescentes obesos e suas consequências para a saúde. Fontes de dados: Estudos publicados entre 2000 e 2020 nas bases de dados PubMed, Medline, Scopus, SciELO e Cochrane. Síntese dos dados: A obesidade é uma comorbidade altamente prevalente em casos graves de COVID-19 em crianças e adolescentes e o isolamento social pode levar ao aumento do acúmulo de gordura. Tecido adiposo excessivo, déficit de massa magra, resistência à insulina, dislipidemia, hipertensão, altos níveis de citocinas pró-inflamatórias e baixa ingestão de nutrientes essenciais são fatores que comprometem o funcionamento dos órgãos e sistemas no indivíduo obeso. Esses fatores estão associados a danos nos sistemas imunológico, cardiovascular, respiratório e urinário, juntamente com a modificação da microbiota intestinal (disbiose). Na infecção por SARS-CoV-2, essas alterações orgânicas causadas pela obesidade podem aumentar a necessidade de assistência ventilatória, risco de tromboembolismo, taxa de filtração glomerular reduzida, alterações na resposta imune inata e adaptativa e perpetuação da resposta inflamatória crônica. Conclusões: A necessidade de isolamento social pode ter o efeito de causar ou agravar a obesidade e suas comorbidades e pediatras precisam estar cientes desse problema. Diante de crianças com suspeita ou confirmação de COVID-19, os profissionais de saúde devem 1) diagnosticar o excesso de peso; 2) aconselhar sobre cuidados de saúde em tempos de isolamento; 3) fazer a triagem de comorbidades, garantindo que o tratamento não seja interrompido; 4) medir os níveis de imunonutrientes; 5) orientar a família respeitando as especificidades da situação; e 6) encaminhamento a unidades qualificadas para cuidar de crianças e adolescentes obesos, quando necessário.

Abstract Objective: To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. Sources: Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. Summary of findings: Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. Conclusions: The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.

https://doi.org/10.1016/j.jped.2020.07.001 8146 downloads

15.

Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
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Jácome, Cristina

; Amaral, Rita

; Almeida, Rute

; Pereira, Ana Margarida

; Couto, Mariana

; Araújo, Luís

; Alves-Correia, Magna

; Pereira, Mariana

; Ferreira-Magalhães, Manuel

; Loureiro, Cláudia Chaves

; Catarata, Maria Joana

; Santos, Lília Maia

; Cabral, Sara

; Pereira, João

; Ramos, Bárbara

; Lopes, Cristina

; Mendes, Ana

; Lopes, Anabela

; Rodrigues, José Carlos Cidrais

; Oliveira, Georgeta

; Aguiar, Ana Paula

; Afonso, Ivete

; Carvalho, Joana

; Arrobas, Ana Maria

; Costa, José

; Valério, Margarida

; Pereira, Marta

; Almeida, Teresa

; Dias, Joana

; Bom, Ana Todo

; Azevedo, João

; Ribeiro, Carmelita

; Alves, Marta

; Pinto, Paula Leiria

; Neuparth, Nuno

; Neves, Ana Castro

; Palhinha, Ana

; Marques, João Gaspar

; Martins, Pedro

; Trincão, David Pina

; Todo-Bom, Filipa

; Santos, Maria Alvarenga

; Branco, Joana

; Costa, Alberto

; Neto, Armandina Silva

; Santalha, Marta

; Lozoya, Carlos

; Santos, Natacha

; Silva, Diana

; Vasconcelos, Maria João

; Barata, Luís Taborda

; Teixeira, Maria Fernanda

; Pinto, Diana

; Alves, Rodrigo Rodrigues

; Moreira, Ana Sofia

; Pinto, Cláudia Sofia

; Silva, Pedro Morais

; Alves, Carlos

; Câmara, Raquel

; Coelho, Didina

; Bordalo, Diana

; Carvalho, Fernanda

; Fernandes, Ricardo

; Ferreira, Rosário

; Oliveira, José Ferraz de

; Menezes, Fernando

; Gomes, Ricardo

; Calix, Maria José

; Marques, Ana

; Cardoso, João

; Emiliano, Madalena

; Gerardo, Rita

; Nunes, Carlos

; Ferreira, José Alberto

; Lopes, Inês

; Alves, Adelaide

; Fonseca, João Almeida

Revista Portuguesa de Imunoalergologia

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dec 2020, Volume 28 N. 4 Pages 231 - 240

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

Objetivos: Identificar clusters de controlo da asma baseados no Teste de Controlo da Asma e Rinite Alérgica (CARAT) e comparar as características dos doentes nos diferentes clusters. Métodos: Adultos e adolescentes (≥13 anos) com asma persistente foram recrutados em 29 centros no contexto de 2 estudos observacionais do projeto INSPIRERS. Foram recolhidos dados relativos a características demográficas e clínicas, adesão ao inalador, crenças sobre a medicação, sintomas de ansiedade e depressão, qualidade de vida e controlo da asma (CARAT, >24 bom controlo). Foi efetuada uma análise hierárquica de clusters usando a pontuação total do CARAT (CARAT-T).Resultados: Foram analisados 410 doentes (68% adultos), com uma idade mediana (percentil 25-percentil 75) de 28 (16-46) anos. Foram identificados três clusters [média CARAT-T(min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] e cluster 3 [10(2-13)]. Os doentes no cluster 1 (34%) apresentavam melhor controlo da asma, melhor qualidade de vida, maior adesão aos inaladores e usavam um único inalador. Os doentes nos clusters 2 (50%) e 3 (16%) tinham a asma não controlada, menor adesão aos inaladores, mais sintomas de ansiedade e depressão e mais de metade reportavam pelo menos uma exacerbação no último ano. Adicionalmente, os doentes no cluster 3 eram predominantemente mulheres, tinham mais consultas médicas não agendadas, apresentavam mais sintomas de ansiedade, percebiam uma maior necessidade dos inaladores, mas também uma maior preocupação associada ao seu uso. Não se verificaram diferenças na idade, índice de massa corporal, função pulmonar, hábitos tabágicos, hospitalizações ou tempo de seguimento pelo médico especialista. Conclusões: Um método não supervisionado baseado no CARAT-T, identificou 3 clusters de doentes com diferentes características clínicas. O cluster com melhor controlo apresenta um ponto de corte semelhante ao estabelecido no estudo de validação do CARAT. Este estudo sugere ainda a existência de um ponto de corte adicional para distinguir doença mais grave. Mais investigação é necessária para validar os clusters identificados

Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25-percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT-T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.

https://doi.org/10.32932/rpia.2020.12.046 633 downloads

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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

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