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ABSTRACT Purpose: To compare the differences between the apparent and actual chord μ. Methods: In this prospective, comparative, non-randomized, and non-interventional study, imaging examinations using Pentacam and the HD Analyzer were performed in the same room under the same scotopic conditions. The inclusion criteria were patients aged 21-71 years, able to provide informed consent, myopia up to 4D, and anterior topographic astigmatism up to 1D. Patients using contact lenses, those with previous eye diseases or surgeries, corneal opacities, corneal tomographic changes, or suspected keratoconus were excluded. Results: Altogether, 116 eyes of 58 patients were analyzed. The patients’ mean age was 30.69 (±7.85) years. In the correlation analyses, Pearson’s correlation coefficient of 0.647 indicates a moderate positive linear relationship between apparent and actual chord μ. The mean actual and apparent chord μ were 226.21 ± 128.53 and 278.66 ± 123.90 μm, respectively, with a mean difference of 52.45 μm (p=0.01). The analysis of mean pupillary diameter resulted in 5.76 mm using the HD Analyzer and 3.31 mm using the Pentacam. Conclusions: We found a correlation between the two measurement devices, and even though we found considerable differences, both can be used in daily practice. Given their differences, we should respect their peculiarities as well.

RESUMO Objetivo: Comparar as diferenças entre a chord aparente μ e o chord real μ. Métodos: Estudo prospectivo, comparativo, não randomizado e não intervencionista. Os exames de imagem (Pentacam e HD Analyzer) foram realizados na mesma sala e nas mesmas condições escotópicas. Os critérios de inclusão foram idade de 21 a 71 anos; compreensão do termo de consentimento; miopia até 4D e astigmatismo topográfico anterior até 1D. Os critérios de exclusão foram usuários de lentes de contato; pacientes com doenças oculares prévias ou cirurgias; opacidades da córnea; a presença de alterações tomográficas da córnea ou suspeita de ceratocone. Resultados: Em nosso estudo foram analisados 116 olhos de 58 pacientes. A média de idade foi de 30,69 anos (± 7,85). Análises de correlação foram desenvolvidas e o coeficiente de correlação de Pearson (0,647) indica uma relação linear positiva moderada entre as variáveis. A média do chord μ real foi 226,21 ± 128,53 μm e a média do chord μ média foi 278,66 ± 123,90 μm, com diferença média de 52,45 μm (p=0,01). A análise do diâmetro pupilar médio apresentou: 5,76mm no HD Analyzer e 3,31mm no Pentacam. Conclusões: Entendemos a existência de uma diferença significativa entre os métodos e assim a medida de ambos os dispositivos com base em princípios diferentes devemos respeitar suas peculiaridades. Como encontramos correlação entre as duas medidas, acreditamos que ambas podem ser utilizadas na prática diária.

https://doi.org/10.5935/0004-2749.2022-0035

Revisores 2023
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Molas de la Quintana, Adriana Beatriz

; Jimenez Genchi, Alejandro

; Carrizales, Alexia

; Gotti, Amanda

; Martinez Ortiz, Ana

; Rocío Martínez Yacelga, Ana del

; Camilo Ciantelli, Ana Paula

; Jimenez Figueroa, Andres

; Neumann, Angélica Paula

; Parodi Svartman, Bernardo

; Vazquez Rodriguez, Carolina

; Da Silva, Cecilia

; Baroni, Cecilia

; Lanza Perez, Cintia Beatriz

; Mola, Débora

; Alarcón Rubio, David

; Perales Mejia, Felipe de Jesús

; Sarachu, Gerardo

; Gelpi, Gonzalo

; Sosa, Gustavo

; Viana Batista, Helder

; Moizéis, Heloísa Bárbara Cunha

; Carrasco, Jimena

; Ungaretti, Joaquín

; Moreira, Karen

; Tomatis, Karina

; Oros, Laura Beatriz

; Mazaro, Lisabelle Manente

; Chiavone, Luciana

; Perilla Toro, Lyria Esperanza

; Campagnoli, Mabel Alicia

; Ruiz Barbot, Mabela

; Brenlla, María Elena

; Folle Chavannes, María Ana

; Freytes Frey, Marcela

; Rossal, Marcelo

; Ortiz, Maria Victoria

; Nabergoi, Mariela

; Montenegro, Marisela

; Lladó, Mónica

; Freitas De León, Paribanú

; Solís García, Patricia

; Ruiz Santos, Paul

; Fiorati, Regina Célia

; Martins, Rita de Cássia Andrade

; Dominguez-Lara, Sergio Alexis

; Herranz, Silvana Melisa

; Yoma, Solana María

; Gondim, Sonia Maria Guedes

; Rostagnol, Susana

; Wittke, Tommy

; Ballesteros, Virginia

; Tamayo, William

Psicología, Conocimiento y Sociedad

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dec 2023, Volume 13 N. 3 Pages 116 - 118

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.26864/pcs.v13.n3.rev

Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial
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Reis, Andréa Dias

; Pereira, Paula Tâmara Vieira Teixeira

; Castro Filha, Jurema Gonçalves Lopes

; Rodrigues, Evelyn Feitosa

; Laranjeira, Isadora Pinheiro

; Ramallo, Bianca Trovello

; Castro, Marcela Rodrigues de

; Rossi, Fabrício Eduardo

; Freitas Júnior, Ismael Forte

; Garcia, João Batista Santos

Revista Brasileira de Ginecologia e Obstetrícia

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may 2023, Volume 45 N. 5 Pages 242 - 252

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

Abstract Objective Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. Methods This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). Results The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). Conclusion Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

Resumo Objetivo Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. Métodos Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). Resultados Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). Conclusão O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

https://doi.org/10.1055/s-0043-1770126

Brazilian consensus for diagnosis, management and treatment of hereditary transthyretin amyloidosis with peripheral neuropathy: second edition
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Pinto, Marcus Vinicius

; França Jr, Marcondes Cavalcante

; Gonçalves, Marcus Vinicius Magno

; Machado-Costa, Marcela Câmara

; Freitas, Marcos Raimundo Gomes de

; Gondim, Francisco de Assis Aquino

; Marrone, Carlo Domenico

; Martinez, Alberto Rolim Muro

; Moreira, Carolina Lavigne

; Nascimento, Osvaldo J. M.

; Covaleski, Anna Paula Paranhos

; Oliveira, Acary Souza Bulle de

; Pupe, Camila Castelo Branco

; Rodrigues, Marcia Maria Jardim

; Rotta, Francisco Tellechea

; Scola, Rosana Herminia

; Marques Jr, Wilson

; Waddington-Cruz, Márcia

Arquivos de Neuro-Psiquiatria

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mar 2023, Volume 81 N. 3 Pages 308 - 321

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

Abstract Hereditary transthyretin amyloidosis with peripheral neuropathy (ATTRv-PN) is an autosomal dominant inherited sensorimotor and autonomic polyneuropathy with over 130 pathogenic variants identified in the TTR gene. Hereditary transthyretin amyloidosis with peripheral neuropathy is a disabling, progressive and life-threatening genetic condition that leads to death in ~ 10 years if untreated. The prospects for ATTRv-PN have changed in the last decades, as it has become a treatable neuropathy. In addition to liver transplantation, initiated in 1990, there are now at least 3 drugs approved in many countries, including Brazil, and many more are being developed. The first Brazilian consensus on ATTRv-PN was held in the city of Fortaleza, Brazil, in June 2017. Given the new advances in the area over the last 5 years, the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology organized a second edition of the consensus. Each panelist was responsible for reviewing the literature and updating a section of the previous paper. Thereafter, the 18 panelists got together virtually after careful review of the draft, discussed each section of the text, and reached a consensus for the final version of the manuscript.

Resumo Polineuropatia amiloidótica familiar associada a transtirretina (ATTRv-PN) é uma polineuropatia sensitivo-motora e autonômica hereditária autossômica dominante com mais de 130 variantes patogênicas já identificadas no gene TTR. A ATTRv-PN é uma condição genética debilitante, progressiva e que ameaça a vida, levando à morte em ~ 10 anos se não for tratada. Nas últimas décadas, a ATTRv-PN se tornou uma neuropatia tratável. Além do transplante de fígado, iniciado em 1990, temos agora 3 medicamentos modificadores de doença aprovados em muitos países, incluindo o Brasil, e muitas outras medicações estão em desenvolvimento. O primeiro consenso brasileiro em ATTRv-PN foi realizado em Fortaleza em junho de 2017. Devido aos novos avanços nesta área nos últimos 5 anos, o Departamento Científico de Neuropatias Periféricas da Academia Brasileira de Neurologia organizou uma segunda edição do consenso. Cada panelista ficou responsável por rever a literatura e atualizar uma parte do manuscrito. Finalmente, os 18 panelistas se reuniram virtualmente após revisão da primeira versão, discutiram cada parte do artigo e chegaram a um consenso sobre a versão final do manuscrito.

https://doi.org/10.1055/s-0043-1764412

Wood quality of ten clonal progenies of rubber tree as raw material for bioenergy
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Amorim, Erick Phelipe

; Longui, Eduardo Luiz

; Menezes Freitas, Miguel Luiz

; Yamaji, Fábio Minoru

; Gomes da Silva Júnior, Francides

; de Moraes Silvestre, Marcela Aparecida

; Cambuim, José

; Teixeira de Moraes, Mario Luiz

; de Souza Gonçalves, Paulo

Maderas. Ciencia y tecnología

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2023, Volume 25 elocation 28

Abstract: En | Text: En | PDF: En

Abstract: The use of wood as a bioenergetic source requires knowledge of its technical properties. The rubber tree Hevea brasiliensis has an economic life cycle of 25 to 30 years in Brazil. It is used for extracting rubber and generating residual wood for fuel. Our goal was to characterize the wood quality of 10 clonal progenies as a source of raw material for bioenergy. Ten clonal progenies of 12-year-old Hevea brasiliensis from an experimental planting in Selvíria municipality were evaluated. Three trees per clone were evaluated for individual properties of Higher Heating Value, immediate chemical analysis, chemical composition, fiber dimensions, thermogravimetric analysis of wood under nitrogen atmosphere and Fourier Transform Infrared Spectroscopy analysis. We highlight clone IAC 311 for fuel because it presents elevated Higher Heating Value and fixed carbon and less volatile material. However, the other genetic materials studied also meet the specifications for energy use and can be highly viable given their physical, chemical, energy, and thermal properties.

https://doi.org/10.4067/s0718-221x2023000100428

Measurement of the visual axis through two different methods: quantification and differences for measuring chord μ
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Rodrigues, Pablo Felipe

; Moscovici, Bernardo Kaplan

; Lamazales, Luciano

; Freitas, Marcela Mara Silva

; Gomes, José Álvaro Pereira

; Nosé, Walton

; Campos, Mauro Silveira

Arquivos Brasileiros de Oftalmologia

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2023, N. ahead

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

https://doi.org/10.5935/0004-2749.2022-0035

Ensino remoto emergencial na Medicina: aspectos positivos e negativos no ensino e na aprendizagem em tempos de pandemia
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Paulino, Joao Lucas Paiva

; Freire, Marcela de Oliveira Torres Bezerra

; Ribeiro, Louise Helena de Freitas

; Nascimento, Ellany Gurgel Cosme do

; Cunha, Andrea Taborda Ribas da

; Fernandes, Thales Allyrio Araújo de Medeiros

Revista Brasileira de Educação Médica

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2023, Volume 47 N. 1 elocation e048

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

Abstract: Introduction: Distance learning emerged as an emergency tool used in Higher Education during the COVID-19 pandemic. These circumstances led to the increased use of Information and Communication Technologies (ICTs) for teaching and learning in Medicine courses. Objective: To conduct an integrative review to clarify the main positive and negative aspects found in the exercise of medical education in these atypical conditions. Method: Articles were searched on the following databases: Virtual Health Library (VHL), Embase, Education Resources Information Center (ERIC), Medline (via PubMed), Scopus and Web of Science Result: At the end of the screening and selection processes, 69 articles were included, from which information was extracted regarding the characteristics, positive and negative aspects of each remote medical teaching experience offered during the pandemic. Among the main positive aspects, we highlight the positive evaluation of the curricular component by the students, greater student autonomy, greater participation and communication among students and the absence of any learning deficit. The main negative points include the suspension of practical classes, complications arising from the use of technologies (connectivity, training and organization) and lack of social contact. Conclusion: It is observed that student autonomy and self-discipline is a crucial factor in taking full advantage of the distance learning approach, and perhaps the classic face-to-face student was not prepared for such a sudden change. Still, it is clear that, due to the urgency of implementing this new form of learning, distance learning has not had enough time to mature and be perfected to the point of being considered a medical education strategy applicable in the long term. Distance learning was crucial for the continued training of new doctors for an extended period of time. However, it needs to be reassessed and improved as a pedagogical strategy that uses ICTs for medical education.

Resumo: Introdução: O ensino remoto surgiu como ferramenta emergencial no processo de educação superior durante a pandemia da Covid-19. Nesse cenário, amplia-se a possibilidade de ensinar e aprender por meio das tecnologias da informação e comunicação (TIC) nos cursos de Medicina. Objetivo: Este estudo teve como objetivo realizar uma revisão integrativa que esclareça os principais aspectos positivos e negativos encontrados no exercício do ensino médico, nessas condições atípicas. Método: A busca dos artigos se deu nas seguintes bases: Biblioteca Virtual em Saúde (BVS), Embase, Education Resources Information Center (ERIC), Medline (via PubMed), Scopus e Web of Science. Resultado: Ao final dos processos de triagem e seleção, incluíram-se 69 artigos, dos quais foram extraídas informações quanto às características dos aspectos positivos e negativos de cada experiência de ensino remoto médico ofertado nesse período pandêmico. Entre os principais aspectos positivos, destacam-se a avaliação positiva do componente curricular pelos estudantes, a maior autonomia do aluno, a maior participação e comunicação entre os alunos, e a ausência de déficit de aprendizado. Entre os principais pontos negativos, observam-se a suspensão das aulas práticas, as complicações decorrentes do uso das tecnologias (conectividade, capacitação e organização) e a ausência de contato social. Conclusão: Observa-se que a autonomia e a autodisciplina discentes são fatores cruciais para o aproveitamento pleno de abordagem de aprendizagem remotamente, e talvez o aluno presencial clássico não estivesse preparado para tal mudança brusca. Ainda, percebe-se que, pela urgência de implantação dessa nova forma de aprendizagem, o ensino remoto não tenha tido tempo e maturidade o suficiente para que fosse aperfeiçoado ao ponto de ser considerado uma estratégia de educação médica aplicável em longo prazo. O ensino remoto foi crucial para que a formação de novos médicos não fosse descontinuada por um período de tempo tão extenso. Porém, o ensino remoto precisa ser reavaliado e aperfeiçoado como estratégia pedagógica que utiliza TIC para o ensino médico.

https://doi.org/10.1590/1981-5271v47.1-20220233

General Approach to Acute Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Systematic Review
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Oliveira, Marcos Aurélio Barboza de

; Ósti, Alan Vinicius Gamero

; Cavalheiro, Bruno Vargas Teixeira

; Naves, Déborah Barbosa

; Oliveira, Emanuelle Ribeiro de

; Campos, Gabriel Freitas de

; Lobo, Gabriel Mael Sussuarana Silva

; Oliveira, Gabriely de

; Mainardi, Marcela Paula

; Guimarães, Marília Cardoso

; Barbosa, Robert Filipe

; Fé, Vilian Veloso de Moura

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220046

Abstract: En | Text: En | PDF: En

Abstract Background Acute myocardial infarction (AMI) without obstructive coronary arteries (MINOCA) is a medical condition of great relevance, with clinical characteristics of AMI, but without evidence of coronary artery obstruction. The mechanism involved in the pathophysiology of the disease and its possible etiologies are important objects of study due to their impact on the morbidity and mortality of affected patients. Objectives The aim of this study was to systematically review MINOCA and its characteristics, with emphasis on the clinical profile of patients, etiology, pathophysiology, diagnosis, and treatment of the syndrome. Methods Relevant articles related to MINOCA were analyzed in the PubMed and LILACS databases. In the initial search stage, 619 eligible articles were obtained, with final inclusion criteria being: original systematic reviews with clinical, epidemiological, diagnostic, or treatment data on MINOCA, published in Portuguese or English, with an abstract, and a publication date limit of September 2020. Results A total of 10 articles classified as systematic reviews that considered clinical data on MINOCA were included in this review. Conclusion After analyzing various literature, the present study provided a tool to better understand MINOCA, not only regarding its casuistry but also in grouping parameters and information that contribute to a healthy approach to this clinical situation. It was possible to identify and better outline the clinical profile of patients who presented this condition and the use of appropriate tools for correct diagnosis and ideal treatment.

https://doi.org/10.36660/ijcs.20220046

Economic evaluations of colorectal cancer screening: A systematic review and quality assessment
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Ramos, Marcela Castro

; Passone, Julio Augusto de Lima

; Lopes, Ana Carolina de Freitas

; Safatle-Ribeiro, Adriana Vaz

; Ribeiro Júnior, Ulysses

; Soárez, Patrícia Coelho de

Clinics

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2023, Volume 78 elocation 100203

Abstract: En | Text: En | PDF: En

Abstract Colorectal Cancer (CRC) is the third most common type of cancer worldwide and ranks second in mortality. Screening programs for early detection and treatment have been implemented in several countries. Economic evaluations are an important tool to support decision-making about reimbursement and coverage decisions in health systems and, therefore, to support efficient resource allocation. The article aims to review the up-to-date evidence on economic evaluations of CRC screening strategies. MEDLINE, EMBASE, Web of Science, SCOPUS, SciELO, Lilacs, CRD databases, and lists of references were reviewed to identify relevant literature regarding full economic evaluations of CRC screening in asymptomatic average-risk individuals over 40 years old. Searches were conducted with no restriction to language, setting, or date. Qualitative syntheses described CRC screening strategies and comparators (baseline context), study designs, key parameter inputs and incremental cost-effectiveness ratios. Seventy-nine articles were included. Most of the studies were from high-income countries and a third-party payer perspective. Markov models were predominantly used, although microsimulation has been increasingly adopted in the last 15 years. The authors found 88 different screening strategies for CRC, which differed in the type of technique, the interval of screening, and the strategy, i.e., isolated or combined. The annual fecal immunochemical test was the most predominant screening strategy. All studies reported cost-effective results in their scenarios compared to no screening scenarios. One-quarter of the publications reported cost-saving results. It is still necessary to develop future economic evaluations in Low- and Middle-Income Countries (LMICs), which account for the high burden of disease.

https://doi.org/10.1016/j.clinsp.2023.100203

10.

Going Viral on Advertising YouTube Video: Detecting the Influences
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Isabella, Giuliana

; Melo, Andressa Freitas de

; Gonzalez, Marcela Carvalho

Revista de Administração Contemporânea

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2023, Volume 27 N. 4 elocation e220300

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

ABSTRACT Objective: this research aims to identify the key characteristics that influence viewers to watch and share ads. Theoretical approach: by exploring both technical and subjective attributes, this study provides valuable insights for advertisers to enhance their video performance. It farsighted to study the attributes that motivate the sharing video ads behavior using the characteristics present in the videos altogether. Method: the research employed a multi-method approach. The qualitative study analyzed 35 YouTube ads to identify potential attributes for evoking sharing behavior. Subsequently, an experimental study was conducted based on the derived qualitative propositions. Result: the propositions produced the attributes: narrative, purpose, interaction, real characters, celebrities, technical themes, humor, and market. With them, we formed 16 bundles, converted into ad visual scripts analyzed by a conjoint. Conclusions: the study highlighted that congruency of service announcements from service companies, addressing real problems with non-technical themes, have the highest potential for sharing, while ads focusing on technical topics with elements of humor performed poorly. This research sheds light on the discussion of two goals established by the United Nations - SDG 9 and SDG 12, providing valuable insights for advertisers.

RESUMO Objetivo: esta pesquisa tem como objetivo identificar as principais características que influenciam os espectadores a assistir e compartilhar anúncios. Marco teórico: ao explorar atributos técnicos e subjetivos, este estudo fornece insights valiosos para anunciantes aprimorarem o desempenho de seus vídeos. É previdente estudar os atributos que motivam o comportamento de compartilhamento de anúncios de vídeo usando as características presentes nos vídeos em conjunto. Método: um estudo multimétodo foi realizado. O estudo qualitativo analisou 35 anúncios do YouTube para identificar os atributos que poderiam evocar compartilhamento. Então, um estudo experimental utilizou as proposicoes vindas da pesquisa qualitativa. Resultado: as proposições produziram os atributos: narrativa, propósito, interação, personagens reais, celebridades, temas técnicos, humor e mercado. Com eles formamos 16 bundles, convertidos em 16 roteiros visuais de anúncios analisados por um conjunto. Conclusões: o estudo destacou que a congruência de anúncios de serviços de empresas de serviço, abordando problemas reais com temas não técnicos, tem o maior potencial de compartilhamento, enquanto os anúncios que se concentram em tópicos técnicos com elementos de humor tiveram um desempenho ruim. Esta pesquisa traz luz à discussão de duas metas estabelecidas pelas Nações Unidas - ODS 9 e ODS 12, fornecendo informação para quaisquer anunciantes.

https://doi.org/10.1590/1982-7849rac2023220300.en

11.

Association between dysphagia and tongue strength in patients with amyotrophic lateral sclerosis
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Borges, Alda Linhares de Freitas

; Velasco, Leandro Castro

; Ramos, Hugo Valter Lisboa

; Imamura, Rui

; Roldão, Paula Martins Alves de Castro

; Petrillo, Marcela Vieira Barbosa

; Costa, Claudiney Cândido

Brazilian Journal of Otorhinolaryngology

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oct 2022, Volume 88 N. 5 Pages 752 - 757

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

Resumo Introdução A esclerose lateral amiotrófica é a doença do neurônio motor mais comum nos adultos, a despeito da baixa incidência e da raridade. É uma doença neurodegenerativa na qual a disfagia é um sintoma comum e debilitante. A disfagia pode ser avaliada por exames complementares como a videoendoscopia da deglutição e testes de força de língua, uma vez que se trata de um dos principais músculos envolvidos na deglutição. Objetivo Comparar os resultados da força e resistência da língua aferidos pelo Iowa Oral Performance Instrument com os achados do exame à videoendoscopia da deglutição, em pacientes acometidos por esclerose lateral amiotrófica. Método Estudo transversal, feito em um hospital terciário especializado em tratamento e reabilitação. Vinte e cinco pacientes com diagnóstico de esclerose lateral amiotrófica foram submetidos a questionários de disfagia, exame de videoendoscopia da deglutição e teste de força e resistência de língua com o Iowa Oral Performance Instrument para avaliar a presença de disfagia. Resultado Quarenta e oito por cento da amostra apresentavam disfagia à videoendoscopia da deglutição e 76% apresentavam teste de força de língua alterado. Noventa por cento dos pacientes com disfagia apresentaram pressão de língua média inferior a 34,2 KPa. O teste de força de língua apresentou sensibilidade de 91,67% e especificidade de 38,46% e acurácia de 64%. Houve relação estatisticamente significante entre força da língua e disfagia e entre resistência da língua e disfagia. Conclusão Testes de força de língua, como o Iowa Oral Performance Instrument, mostrou‐se eficaz para avaliar disfagia, mostrou sua associação com a força e resistência da língua. Esse resultado deve fomentar a feitura de novas pesquisas para facilitar o diagnóstico precoce da disfagia.

Abstract Introduction Amyotrophic lateral sclerosis is the most common motor neuron disease in adults despite it being rare. It is a neurodegenerative disease in which dysphagia is a common and debilitating symptom. Dysphagia can be assessed by complementary exams, such as fiberoptic endoscopic evaluation of swallowing and the tongue strength test, as this is one of the main muscles involved in swallowing. Objective To compare the results of tongue strength and endurance measured by the Iowa oral performance instrument with the findings of the fiberoptic endoscopic evaluation of swallowing examination in patients affected by amyotrophic lateral sclerosis. Methods Cross-sectional study, carried out in a tertiary hospital specialized in treatment and rehabilitation. Twenty-five patients diagnosed with amyotrophic lateral sclerosis underwent dysphagia questionnaires, fiberoptic endoscopic evaluation of swallowing examination and tongue strength and resistance test with the Iowa oral performance instrument to assess the presence of dysphagia. Results Forty-eight percent of the sample had dysphagia at the fiberoptic endoscopic evaluation of swallowing and 76% had an altered tongue strength test. Ninety percent of patients with dysphagia had an average tongue pressure lower than 34.2 KPa. The tongue strength test showed sensitivity of 91.67% and specificity of 38.46% and accuracy of 64%. There was a statistically significant relationship between tongue strength and dysphagia and between tongue resistance and dysphagia. Conclusion Tongue strength tests, such as the Iowa oral performance instrument, proved to be effective in assessing dysphagia. This result should encourage further research to facilitate the early diagnosis of dysphagia.

https://doi.org/10.1016/j.bjorl.2020.10.015

12.

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil
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de Araújo, Laís Xavier

; Perez da Silva Pereira, Priscilla

; Cantanhede de Deus, Josimeire

; Oliveira Pontes, Daniela

; Tavares Hang, Adriana

; Gadelha Freitas, Jeanne Lúcia

; Moreira da Silva, Valéria

; de Paula Paiva, Karla

; Moura de Souza, Caren Juliana

; Suaris Meireles, Carla Vanessa

; Delfino Rodrigues, Mariana

; da Silva Tavares, Daniella Thamara

; Sanches Rosa, Marcela Miranda

Revista Cuidarte

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aug 2022, Volume 13 N. 2 elocation e10

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

Resumo Introdujo: Pacientes neurocirúrgicos apresentam elevado risco de complicates locais e sistemicas que podem aumentar o tempo de internado e o risco de morte. Este estudo tem como objetivo avaliar a incidencia de infectes relacionadas a assistencia a saúde e os fatores de risco associados em pacientes submetidos as neurocirurgias. Materiais e Métodos: Estudo de coorte prospectiva, realizado em um Hospital de grande porte do estado de Rondonia, no período de 2018 a 2019, incluindo 36 pacientes. Resultados: A incidencia de infectes relacionada a assistencia a saúde foi 19,4 a cada 100 pacientes (IC95%: 8,19 - 36,02). Ter utilizado sonda nasoenteral aumentou em 6,5 vezes o risco de IRAS (IC 95%: 1,26 - 33,5), a ventilagáo mecánica aumentou 5,52 vezes o risco (IC95%: 1,23 - 24,6), a presenta de traqueostomia aumentou seis vezes (IC95%: 1,34 - 26,8) e realizagáo de exame invasivo aumentou o risco em 6,79 para ter infecto (IC95%: 1,31 - 35,05). Na análise ajustada as variáveis náo apresentaram significáncia estatística. Discussao: A incidencia de infectes foi maior do que em regióes com melhores condigóes socioeconómicas o que pode estar relacionado a menor adesáo de boas práticas na assistencia. Conclusao: Nas neurocirurgias além das infecgóes de sítio cirúrgico outras topografias também devem ser consideradas para investigagáo de infecgáo. O uso de dispositivos invasivos foi associado a ocorrencia de infecgóes relacionadas a assistencia a saúde, portanto as boas práticas no seu uso sáo essenciais no momento da indicagáo e uso destes dispositivos.

Abstract Introduction: Neurosurgical patients are at high risk of local and systemic complications that can increase the length of stay and the risk of death. This study aims to assess the incidence of healthcare-related infections and associated risk factors in patients undergoing neurosurgery. Materials and Methods: prospective cohort study, carried out in a large hospital in the state of Rondonia, in the period from 2018 to 2019, including 36 patients. Results: The incidence of healthcare-related infections was 19.4 per 100 patients (95% CI: 8,19 - 36,02). The use of nasoenteral tube increased the risk of HAI by 6.5 times (95% CI: 1,26 - 33,5), mechanical ventilation increased 5.52 times the risk (95% CI: 1,23 - 24,6), the presence of tracheostomy increased six times (95% CI: 1.34 - 26.8) and invasive examination increased the risk by 6.79 to have infection (95% CI: 1,31 - 35,05). In the adjusted analysis, the variables were not statistically significant. Discussion: The incidence of infections was higher than in regions with better socioeconomic conditions, which may be related to lower adherence to good care practices. Conclusion: in neurosurgeries, in addition to surgical site infections, other topographies should also be considered for investigation of infection. The use of invasive devices has been associated with the occurrence of healthcare-related infections, so good practices in their use are essential when referring and using these devices.

Resumen Introducción: Los pacientes neuroquirúrgicos tienen un alto riesgo de complicaciones locales y sistémicas que pueden aumentar la duración de la estancia y el riesgo de muerte. Este estudio tiene como objetivo evaluar la incidencia de infecciones relacionadas con la atención médica y los factores de riesgo asociados en pacientes sometidos a neurocirugía. Materiales y métodos: estudio de cohorte prospectivo, realizado en un gran hospital del estado de Rondonia, en el período de 2018 a 2019, incluyendo 36 pacientes. Resultados: La incidencia de infecciones relacionadas con la asistencia sanitaria fue de 19,4 por 100 pacientes (IC del 95%: 8,19 - 36,02). Haber utilizado una sonda nasoenteral aumentó el riesgo de infecciones en 6,5 veces (IC 95%: 1,26 - 33,5), la ventilación mecánica aumentó 5,52 veces el riesgo (IC 95%: 1, 23 - 24,6), la presencia de traqueotomía aumentó seis veces (IC del 95%: 1,34 - 26,8) y el examen invasivo aumentó el riesgo en 6,79 de tener infecciones (IC del 95%: 1,31 - 35,05). En el análisis ajustado, las variables no fueron estadísticamente significativas. Discusión: La incidencia de infecciones fue mayor que en las regiones con mejores condiciones socioeconómicas, lo que puede estar relacionado con una menor adherencia a las buenas prácticas de atención. Conclusión: en neurocirugía, además de las infecciones del sitio quirúrgico, también deben considerarse otras topografías para la investigación de la infección. El uso de dispositivos invasivos se ha asociado con la aparición de infecciones relacionadas con la salud, por lo que las buenas prácticas en su uso son fundamentales a la hora de derivar y utilizar estos dispositivos.

https://doi.org/10.15649/cuidarte.2154 2 downloads

13.

Dilemas éticos durante a pandemia de covid-19
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Lima, Ana Flávia Silva

; Silva, Eli Borges de Freitas

; Guimarães, Marcela das Neves

; Comassetto, Isabel

; Santos, Regina Maria dos

Revista Bioética

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mar 2022, Volume 30 N. 1 Pages 19 - 26

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

Resumo Este artigo objetiva refletir acerca dos dilemas éticos enfrentados pelos profissionais de saúde, pacientes e familiares durante a pandemia da covid-19. A pandemia irrompeu questões éticas na saúde, ocasionadas pela falta de recursos materiais, humanos e o medo do desconhecido. Pacientes e familiares também foram afetados pelo distanciamento na internação e no luto. Profissionais da saúde depararam com dilemas éticos que suscitam questões sobre o dever de assistir o paciente e a garantia da segurança pessoal, lidando com o desafio de agir com ética em meio à sobrecarga e à insegurança do contexto. A família e os pacientes enfrentam um cenário de adaptação do cuidar em saúde com a carência de tecnologias que permitam acolhimento diante da necessidade de distanciamento, inclusive no processo dos rituais de despedida dos finados. Assim, investimentos em saúde podem impulsionar mudanças no cuidado, em observância da justiça social e do respeito à dignidade humana.

Abstract This article aims to reflect on the ethical dilemmas faced by health professionals, patients and family members during the COVID-19 pandemic. The pandemic raised ethical issues in health caused by the lack of material and human resources and the fear of the unknown. Patients and family members were also affected by social distancing in hospitalization and mourning. Health profissionals faced ethical dilemmas that raise questions about the duty to assist patients and the guarantee of personal safety, dealing with the challenge of acting ethically amid work overload and insecurity of the context. The family and patients face a scenario of adaptation of health care with the lack of technologies that allow feelings of care in the face of the need for distancing, including in the process of farewell rituals of the late. Investments in health can thus drive changes in care, in compliance with social justice and respect for human dignity.

Resumen Este artículo reflexionó sobre los dilemas éticos que enfrentan los profesionales de la salud, los pacientes y familiares durante la pandemia del covid-19. La pandemia hizo estallar cuestiones éticas en salud, provocadas por la falta de recursos materiales y humanos, y el miedo a lo desconocido. Los pacientes y sus familias fueron afectados por el distanciamiento en la hospitalización y el duelo. Los profesionales de la salud afrontaron dilemas éticos en cuanto al deber de asistir al paciente y la garantía de seguridad personal, y el desafío de actuar éticamente durante la sobrecarga e inseguridad en ese contexto. Los pacientes y sus familias enfrentan una adaptación de la atención a la falta de tecnología para acogerles ante el distanciamiento, incluso en el proceso de despedida al difunto. Las inversiones en salud pueden promover cambios en la atención en observancia de la justicia social y el respeto a la dignidad humana.

https://doi.org/10.1590/1983-80422022301502pt

14.

Effects of dietary supplementation with quebracho tannins on oxidation parameters and shelf life of lamb meat
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SANTOS, Sthefany Kamile dos

; ROSSET, Michele

; MIQUELETTO, Marcela Maíra

; JESUS, Rebecca Mayre Miranda de

; SOTOMAIOR, Cristina Santos

; MACEDO, Renata Ernlund Freitas de

Food Science and Technology

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2022, Volume 42 elocation e55920

Abstract: En | Text: En | PDF: En

Abstract The physicochemical quality parameters of meat from finishing lambs supplemented with quebracho tannin extract (QTE) were evaluated. Lambs were assigned to four treatment groups: CON—animals fed basal diet (BD); QTE 1% (T1%)—BD + tannins at 1% dry matter intake (DMI); QTE 3% (T3%)—BD + tannins at 3% DMI; and QTE 6% (T6%)—BD + tannins at 6% DMI. Longissimus thoracis et lumborum samples were vacuum packaged and stored at 4 °C for 28 days. The samples were evaluated weekly for proximate composition, pH, color, myoglobin forms, cooking loss, shear force, lipid (thiobarbituric acid reactive substances—TBARS), and protein (carbonyl and thiol) oxidation. Chemical composition and pH did not vary among treatments. The meat from lambs fed with higher proportion of QTE (T6%) presented lower redness, chroma, and oxymyoglobin content, and higher yellowness, hue angle, cooking loss, shear force, TBARS, and carbonyl content than the meat from the other groups. Our findings indicate that higher dose of QTE may exert pro-oxidative effects in lamb meat, negatively affecting its quality.

https://doi.org/10.1590/fst.55920

15.

Post-tuberculosis lung disease: a comparison of Brazilian, Italian, and Mexican cohorts
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Silva, Denise Rossato

; Freitas, Alana Ambos

; Guimarães, Amanda Reis

; D’Ambrosio, Lia

; Centis, Rosella

; Muñoz-Torrico, Marcela

; Visca, Dina

; Migliori, Giovanni Battista

Jornal Brasileiro de Pneumologia

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2022, Volume 48 N. 2 elocation e20210515

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

RESUMO Objetivo: Avaliar a função pulmonar em uma coorte de pacientes com história de tuberculose pulmonar no Brasil, bem como avaliar o declínio da função pulmonar ao longo do tempo e compará-lo com o observado em coortes semelhantes no México e Itália. Métodos: As três coortes foram comparadas quanto à idade, tabagismo, testes de função pulmonar, teste de caminhada de seis minutos e gasometria arterial. Na coorte brasileira, os resultados dos testes de função pulmonar, do teste de caminhada de seis minutos e da gasometria arterial logo após o término do tratamento da tuberculose foram comparados com os obtidos no fim do período de acompanhamento. Resultados: As três coortes foram muito diferentes quanto aos resultados dos testes de função pulmonar. Os padrões ventilatórios mais comuns nas coortes brasileira, italiana e mexicana foram o padrão obstrutivo, o padrão misto e o padrão normal [em 58 pacientes (50,9%), em 18 pacientes (41,9%) e em 26 pacientes (44,1%), respectivamente]. Apenas 2 casos de tuberculose multirresistente foram incluídos na coorte brasileira, ao passo que na coorte mexicana foram incluídos 27 casos (45,8%). As médias da PaO2 e SaO2 foram mais baixas na coorte mexicana do que na brasileira (p < 0,0001 e p < 0,002 para PaO2 e SaO2, respectivamente). Na coorte brasileira, quase todos os parâmetros funcionais se deterioraram ao longo do tempo. Conclusões: Este estudo reforça a importância do tratamento precoce e eficaz de pacientes com tuberculose sensível, pois a tuberculose multirresistente aumenta o dano pulmonar. Quando o tratamento da tuberculose é concluído, os pacientes devem ser avaliados o quanto antes e, caso se estabeleça o diagnóstico de sequelas pulmonares da tuberculose, é preciso tratá-los e oferecer-lhes reabilitação pulmonar, pois há evidências de que ela é eficaz nesses pacientes.

ABSTRACT Objective: To evaluate lung function in a cohort of patients with a history of pulmonary tuberculosis in Brazil, as well as to evaluate the decline in lung function over time and compare it with that observed in similar cohorts in Mexico and Italy. Methods: The three cohorts were compared in terms of age, smoking status, pulmonary function test results, six-minute walk test results, and arterial blood gas results. In the Brazilian cohort, pulmonary function test results, six-minute walk test results, and arterial blood gas results right after the end of tuberculosis treatment were compared with those obtained at the end of the follow-up period. Results: The three cohorts were very different regarding pulmonary function test results. The most common ventilatory patterns in the Brazilian, Italian, and Mexican cohorts were an obstructive pattern, a mixed pattern, and a normal pattern (in 58 patients [50.9%], in 18 patients [41.9%], and in 26 patients [44.1%], respectively). Only 2 multidrug-resistant tuberculosis cases were included in the Brazilian cohort, whereas, in the Mexican cohort, 27 cases were included (45.8%). Mean PaO2 and mean SaO2 were lower in the Mexican cohort than in the Brazilian cohort (p < 0.0001 and p < 0.002 for PaO2 and SaO2, respectively). In the Brazilian cohort, almost all functional parameters deteriorated over time. Conclusions: This study reinforces the importance of early and effective treatment of drug-susceptible tuberculosis patients, because multidrug-resistant tuberculosis increases lung damage. When patients complete their tuberculosis treatment, they should be evaluated as early as possible, and, if post-tuberculosis lung disease is diagnosed, they should be managed and offered pulmonary rehabilitation because there is evidence that it is effective in these patients.

https://doi.org/10.36416/1806-3756/e20210515

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