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Abstract Background Subarachnoid hemorrhage (SAH) prognosis remains poor. Vasospasm mechanism might be associated with inflammation. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as inflammation markers and prognostic predictors. Objective We aimed to investigate NLR and PLR in admission as predictors of angiographic vasospasm and functional outcome at 6 months. Methods This cohort study included consecutive aneurysmal SAH patients admitted to a tertiary center. Complete blood count was recorded at admission before treatment. White blood cell count, neutrophil count, lymphocyte count, platelet count, NLR, and PLR were collected as independent variables. Vasospasm occurrence-modified Rankin scale (mRS), Glasgow outcome scale (GOS), and Hunt-Hess score at admission and at 6 months were recorded as dependent variables. Multivariable logistic regression models were used to adjust for potential confounding and to assess the independent prognostic value of NLR and PLR at admission. Results A total of 74.1% of the patients were female, with mean age of 55.6 ± 12.4 years. At admission, the median Hunt-Hess score was 2 (interquartile range [IQR] 1), and the median mFisher was 3 (IQR 1). Microsurgical clipping was the treatment for 66.2% of the patients. Angiographic vasospasm incidence was 16.5%. At 6 months, the median GOS was 4 (IQR 0.75), and the median mRS was 3 (IQR 1.5). Twenty-one patients (15.1%) died. Neutrophil-to-lymphocyte ratio and PLR levels did not differ between favorable and unfavorable (mRS > 2 or GOS < 4) functional outcomes. No variables were significantly associated with angiographic vasospasm. Conclusion Admission NLR and PLR presented no value for prediction of functional outcome or angiographic vasospasm risk. Further research is needed in this field.

Resumo Antecedentes O prognóstico da hemorragia subaracnoidea (HSA) permanece ruim. Vasoespasmo pode estar associado à inflamação. Razões neutrófilo-linfócito (NLR) e plaqueta-linfócito (PLR) têm sido estudadas como marcadores de inflamação e prognóstico. Objetivo Investigar NLR e PLR na admissão como preditores de vasoespasmo angiográfico e desfecho aos 6 meses. Métodos Este estudo de coorte incluiu pacientes consecutivos com HSA aneurismática de um centro terciário. Contagem de leucócitos, neutrófilos, linfócitos e plaquetas, proporção de neutrófilos para linfócitos e de plaquetas para linfócitos foram coletados como variáveis independentes. Ocorrência de vasoespasmo, escala de Rankin modificada, escala de desfecho de Glasgow e o escore de Hunt-Hess na admissão e 6 meses após a mesma foram registradas como variáveis dependentes. Modelos de regressão logística multivariável foram usados para ajustar potenciais fatores de confusão e avaliar valor prognóstico independente de NLR e PLR. Resultados Um total de 74,1% pacientes eram do sexo feminino, com idade média de 55,6 ± 12,4 anos. Na admissão, a pontuação média de Hunt-Hess foi de 2 (IQR 1) e a mediana de mFisher foi de 3 (IQR 1). Clipagem microcirúrgica foi o tratamento escolhido para 66,2% dos pacientes. A incidência de vasoespasmo angiográfico foi de 16,5%. Aos 6 meses, a escala de desfecho de Glasgow mediana era 4 (IQR 0,75) e a escala de Rankin modificada mediana era 3 (IQR 1,5). Vinte e um pacientes (15,1%) morreram. Os níveis de NLR e PLR não diferiram entre resultados funcionais favoráveis e desfavoráveis (mRS > 2 ou GOS < 4). Nenhuma variável foi significativamente associada ao vasoespasmo angiográfico. Conclusão Razão neutrófilo-linfócito e a PLR não apresentaram valor preditivo de desfecho funcional ou risco de vasoespasmo angiográfico. Mais pesquisas são necessárias neste campo.

https://doi.org/10.1055/s-0043-1768662

Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023
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Teixeira, Ricardo Alkmim

; Fagundes, Alexsandro Alves

; Baggio Junior, José Mário

; Oliveira, Júlio César de

; Medeiros, Paulo de Tarso Jorge

; Valdigem, Bruno Pereira

; Teno, Luiz Antônio Castilho

; Silva, Rodrigo Tavares

; Melo, Celso Salgado de

; Elias Neto, Jorge

; Moraes Júnior, Antonio Vitor

; Pedrosa, Anisio Alexandre Andrade

; Porto, Fernando Mello

; Brito Júnior, Hélio Lima de

; Souza, Thiago Gonçalves Schroder e

; Mateos, José Carlos Pachón

; Moraes, Luis Gustavo Belo de

; Forno, Alexander Romeno Janner Dal

; D’Avila, Andre Luiz Buchele

; Cavaco, Diogo Alberto de Magalhães

; Kuniyoshi, Ricardo Ryoshim

; Pimentel, Mauricio

; Camanho, Luiz Eduardo Montenegro

; Saad, Eduardo Benchimol

; Zimerman, Leandro Ioschpe

; Oliveira, Eduardo Bartholomay

; Scanavacca, Mauricio Ibrahim

; Martinelli Filho, Martino

; Lima, Carlos Eduardo Batista de

; Peixoto, Giselle de Lima

; Darrieux, Francisco Carlos da Costa

; Duarte, Jussara de Oliveira Pinheiro

; Galvão Filho, Silas dos Santos

; Costa, Eduardo Rodrigues Bento

; Mateo, Enrique Indalécio Pachón

; Melo, Sissy Lara De

; Rodrigues, Thiago da Rocha

; Rocha, Eduardo Arrais

; Hachul, Denise Tessariol

; Lorga Filho, Adalberto Menezes

; Nishioka, Silvana Angelina D’Orio

; Gadelha, Eduardo Barreto

; Costa, Roberto

; Andrade, Veridiana Silva de

; Torres, Gustavo Gomes

; Oliveira Neto, Nestor Rodrigues de

; Lucchese, Fernando Antonio

; Murad, Henrique

; Wanderley Neto, José

; Brofman, Paulo Roberto Slud

; Almeida, Rui M. S.

; Leal, João Carlos Ferreira

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 1 elocation e20220892

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

https://doi.org/10.36660/abc.20220892

Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study
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Yoshikawa, Marcia Harumy

; Rabelo, Nícollas Nunes

; Telles, João Paulo Mota

; Pipek, Leonardo Zumerkorn

; Barbosa, Guilherme Bitencourt

; Barbato, Natália Camargo

; Coelho, Antônio Carlos Samaia da Silva

; Teixeira, Manoel Jacobsen

; Figueiredo, Eberval Gadelha

Acta Cirúrgica Brasileira

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2023, Volume 38 elocation e387923

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: Temporary arterial occlusion (TAO) is a widespread practice in the surgical treatment of intracranial aneurysms. This study aimed to investigate TAO’s role during ruptured aneurysm clipping as an independent prognostic factor on short- and long-term outcomes. Methods: This prospective cohort included 180 patients with ruptured intracranial aneurysms and an indication of microsurgical treatment. Patients who died in the first 12 hours after admission were excluded. Results: TAO was associated with intraoperative rupture (IOR) (odds ratio – OR = 10.54; 95% confidence interval – 95%CI 4.72–23.55; p < 0.001) and surgical complications (OR = 2.14; 95%CI 1.11–4.07; p = 0.01). The group with TAO and IOR had no significant difference in clinical (p = 0.06) and surgical (p = 0.94) complications compared to the group that had TAO, but no IOR. Among the 111 patients followed six months after treatment, IOR, number of occlusions, and total time of occlusion were not associated with Glasgow Outcome Scale (GOS) in the follow-up (respectively, p = 0.18, p = 0.30, and p = 0.73). Among patients who underwent TAO, IOR was also not associated with GOS in the follow-up (p = 0.29). Conclusions: TAO was associated with IOR and surgical complications, being the latter independent of IOR occurrence. In long-term analysis, neither TAO nor IOR were associated with poor clinical outcomes.

https://doi.org/10.1590/acb387923

Could outcomes of intracranial aneurysms be better predict using serum creatinine and glomerular filtration rate?
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Rabelo, Nícollas Nunes

; Pipek, Leonardo Zumerkorn

; Nascimento, Rafaela Farias Vidigal

; Telles, João Paulo Mota

; Barbato, Natalia Camargo

; Coelho, Antônio Carlos Samaia da Silva

; Barbosa, Guilherme Bitencourt

; Yoshikawa, Marcia Harumy

; Teixeira, Manoel Jacobsen

; Figueiredo, Eberval Gadelha

Acta Cirúrgica Brasileira

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2022, Volume 37 N. 1 elocation e370107

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To analyze the role of serum creatinine levels as a biomarker of intracranial aneurysm outcomes. Methods: This is a prospective analysis of outcomes of patients with intracranial aneurysm. One hundred forty-seven patients with serum creatinine at admission and 6 months follow up were included. Linear and logistic regressions were used to analyze the data. Modified Rankin scale (mRS) was used to assess outcome. Results: Creatinine level was not directly related to aneurysm outcome nor aneurysm rupture (p > 0.05). However, patients with a glomerular filtration rate (GFR) lower than 72.50 mL·min–1 had an odds ratio (OR) of 3.049 (p = 0.006) for worse outcome. Similarly, aneurysm rupture had an OR of 2.957 (p = 0.014) for worse outcomes. Stepwise selection model selected 4 variables for outcomes prediction: serum creatinine, sex, hypertension and treatment. Hypertensive patients had, on average, an increase in 0.588 in mRS (p = 0.022), while treatment with microsurgery had a decrease in 0.555 (p = 0.038). Conclusions: Patients with higher GFR had better outcomes after 6 months. Patients with higher GFR had better outcomes after 6 months. Creatinine presented an indirect role in GFR values and should be included in models for outcome prediction.

https://doi.org/10.1590/acb370107

Typical Brazilian cheeses: safety, mineral content and adequacy to the nutritional labeling
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MESSIAS, Tayanna Bernardo Oliveira Nunes

; MAGNANI, Marciane

; PIMENTEL, Tatiana Colombo

; SILVA, Luana Martiniano da

; ALVES, Juliane

; GADELHA, Tatiane Santi

; MORGANO, Marcelo Antônio

; PACHECO, Maria Teresa Bertoldo

; OLIVEIRA, Maria Elieidy Gomes de

; QUEIROGA, Rita de Cássia Ramos do Egypto

Food Science and Technology

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2022, Volume 42 elocation e37121

Abstract: En | Text: En | PDF: En

Abstract This study aimed to evaluate the physicochemical and microbiological characteristics of six typical Brazilian cheeses (bovine milk coalho, goat milk coalho, fresh ricotta, manteiga, fresh Minas, and Padrão Minas). Padrão Minas cheese presented high acidity and the highest contents of protein, fat, and ash, while Ricotta cheese presented the lowest contents of protein, fat, and ash. Bovine milk coalho and Minas fresh cheeses were characterized as source of zinc. Manteiga cheese was characterized by the yellow color (higher b* values). Goat milk coalho cheese was characterized by the white color (higher L* values) and presented the highest concentration of minerals (potassium, iron, magnesium, calcium, manganese, and phosphorus). Part of the typical Brazilian cheeses did not agree with the legislation for moisture (5.9%) and fat in the dry matter (11.8%) classifications, as well as, did not have adequate concentrations of protein (65.4%) and fat (44.9%) stated in the label, being the non-conformity dependent on the cheese type. Furthermore, 30% of the cheeses (30%) disagreed with the microbiological Brazilian legislation, as they presented coliforms and/or coagulase-positive Staphylococcus counts above the limits. It can be concluded that the Brazilian cheeses are nutritive, but the microbial quality and nutritional labels need improvement.

https://doi.org/10.1590/fst.37121

Microsurgery versus embolization: different risk factors for short- and longterm outcomes of patients with ruptured aneurysms
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Yoshikawa, Marcia Harumy

; Rabelo, Nícollas Nunes

; Telles, João Paulo Mota

; Barbosa, Guilherme Bitencourt

; Barbato, Natália Camargo

; Coelho, Antônio Carlos Samaia da Silva

; Pipek, Leonardo Zumerkorn

; Teixeira, Manoel Jacobsen

; Figueiredo, Eberval Gadelha

Acta Cirúrgica Brasileira

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2022, Volume 37 N. 8 elocation e370806

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods: Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS). Results: Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group. Conclusions: Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.

https://doi.org/10.1590/acb370806

Translating science into policy: mental health challenges during the COVID-19 pandemic
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Mari, Jair J.

; Gadelha, Ary

; Kieling, Christian

; Ferri, Cleusa P.

; Kapczinski, Flavio

; Nardi, Antonio E.

; Almeida-Filho, Naomar

; Sanchez, Zila M.

; Salum, Giovanni A.

Brazilian Journal of Psychiatry

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dec 2021, Volume 43 N. 6 Pages 638 - 649

Abstract: En | Text: En | PDF: En

Several stressors associated with the coronavirus disease 2019 (COVID-19) are expected to affect the mental health of global populations: the effects of physical distancing, quarantine, and social isolation; the emotional suffering of health and other frontline workers; neuropsychiatric sequelae in those affected by the virus; the impact to families of lives lost to the disease; differential effects for those with severe mental disorders; and the consequences of social and economic deterioration. In this context, we sought: to form a panel of Brazilian experts on child and adolescent health, neurodevelopment, health services, and adult and elderly mental health; and to compile evidence-based interventions to support suggested policy changes in Brazil to mitigate the expected increase in mental health disorders during the pandemic and its mental health consequences. The following actions are recommended: 1) invest in prevention programs for the safe return of students to schools; 2) adopt evidence-based psychosocial interventions to maintain an adequate environment for child and adolescent development; 3) target socially vulnerable populations and those experiencing discrimination; 4) train primary care teams to solve common mental health problems, provide needs-based assessments, and manage long-term, at-home care for older patients; 5) invest in technological advancements (e.g., telemedicine, e-Health, and web-based algorithms) to promote coordinated care; 6) increase access to and literacy in the use of computers and mobile phones, especially among older adults; 7) expand protocols for remote, brief psychotherapy interventions and psychoeducation to manage common mental health problems.

https://doi.org/10.1590/1516-4446-2020-1577 2 downloads

COVID-19 pandemic and distinct patterns of psychotic outbreaks
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Costardi, Carlos Gustavo

; Cavalcante, Daniel A.

; Macêdo, Marcos Antônio

; Cerqueira, Raphael de O.

; Rios, Maria Carolina

; Noto, Cristiano

; Gadelha, Ary

Trends in Psychiatry and Psychotherapy

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dec 2021, Volume 43 N. 4 Pages 335 - 337

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/2237-6089-2020-0188

Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism
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Garmes, Heraldo Mendes

; Boguszewski, César Luiz

; Miranda, Paulo Augusto Carvalho

; Martins, Manoel Ricardo Alves

; Silva, Silvia Regina Correa da

; Abucham Filho, Julio Zaki

; Musolino, Nina Rosa de Castro

; Vilar, Lucio

; Portari, Luiz Henrique Corrêa

; Gadelha, Mônica Roberto

; Kasuki, Leandro

; Naves, Luciana Ansaneli

; Czepielewski, Mauro Antônio

; Almeida, Tobias Skrebsky de

; Duarte, Felipe Henning Gaia

; Glezer, Andrea

; Bronstein, Marcello Delano

Archives of Endocrinology and Metabolism

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apr 2021, Volume 65 N. 2 Pages 212 - 230

Abstract: En | Text: En | PDF: En

ABSTRACT Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Pituitary hormone deficiencies can induce significant clinical changes with consequent increased morbidity and mortality rates, while hormone replacement based on current guidelines protects these patients. In this review, we will first discuss the different etiologies of hypopituitarism and then address one by one the clinical aspects, diagnostic evaluation, and therapeutic options for deficiencies of TSH, ACTH, gonadotropin, and GH. Finally, we will detail the hormonal interactions that occur during replacement of pituitary hormones.

https://doi.org/10.20945/2359-3997000000335 625 downloads

10.

INDICATORS OF NEUROMUSCULAR FATIGUE IN LEG PRESS EXERCISE IN MEN AND WOMEN
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Barros, Camila Brasileiro Azevedo

; Costa, Manoel da Cunha

; Neto, Antônio Gonçalves dos Santos

; Gadelha, José Hildemar Teles

; Silva, Brendha Stephany Rodrigues da

; Gurjão, André Luiz Demantova

Revista Brasileira de Medicina do Esporte

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jun 2020, Volume 26 N. 3 Pages 243 - 247

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

RESUMO Introdução A fadiga muscular é caracterizada pela redução na capacidade de produzir força ou potência máxima e pode diferir entre homens e mulheres. As alterações na velocidade de movimento durante o exercício e na capacidade de produzir força após o exercício podem auxiliar na comparação da fadiga em homens e mulheres. Objetivo Analisar as diferenças entre homens e mulheres em relação ao número de repetições, cinética, cinemática e desempenho da curva força-tempo isométrica e sua respectiva ativação muscular no exercício leg press horizontal. Métodos Quinze homens e 15 mulheres foram submetidos às avaliações da curva força-tempo (Cf-t) isométrica e atividade eletromiográfica (EMG) antes e após realizarem um exercício leg press horizontal. Os exercícios foram realizados em três séries até a exaustão voluntária a 70% de uma repetição máxima. Durante os exercícios, as variáveis cinéticas e cinemáticas foram obtidas através de dois transdutores de força, um potenciômetro linear de posição e um acelerômetro adaptados para o equipamento leg press horizontal e sincronizados por uma placa condicionadora de sinais. Resultados A velocidade média propulsiva foi reduzida significativamente entre a primeira e a última repetição de cada série com uma redução similar em homens (-12,4 a -29,2%) e mulheres (-29,2 a -35,6%). O mesmo comportamento foi observado para as demais variáveis cinéticas e cinemáticas. A contração voluntária máxima e a taxa de desenvolvimento de força de pico foram reduzidas igualmente tanto para homens (-15,1 ± 8,7% e -26,9 ± 21,2%, respectivamente) quanto para mulheres (-13,9 ± 10,4% e -28,2 ± 11,5%, respectivamente). Conclusão Com base nas diferentes variáveis utilizadas para quantificar o efeito da fadiga durante e após o exercício leg press horizontal, a pesquisa revelou que não há, praticamente, diferenças entre homens e mulheres. Nível de evidência II; Estudo prospectivo comparativo.

ABSTRACT Introduction Muscle fatigue is characterized by reduced ability to produce maximum strength or power, and may differ between men and women. Changes in velocity of movement during exercise, and in the ability to produce strength after exercise, may help when comparing fatigue in men and women. Objective To analyze the differences between men and women in relation to number of repetitions, kinetics, kinematics and isometric force-time curve performance, and their respective muscle activation in horizontal leg press exercises. Methods Fifteen men and fifteen women underwent isometric force-time curve (Cf-t) and electromyographic (EMG) assessments before and after performing horizontal leg press exercises. The exercises were performed in three sets until voluntary exhaustion, at 70% maximal repetition. During the exercises, kinetic and kinematic variables were obtained by means of two force transducers, a linear position potentiometer and accelerometer adapted for the horizontal leg press and synchronized by a signal conditioning plate. Results The mean propulsive velocity significantly reduced between the first and last repetition of each series, with a similar reduction for men (-12.4 to -29.2%) and women (-29.2 to -35.6%). The same pattern was observed for the other kinetic and kinematic variables. The maximum voluntary contraction and peak force development rate also decreased for both men (-15.1 ± 8.7% and -26.9 ± 21.2%, respectively) and women (-13.9 ± 10.4% and -28.2 ± 11.5%, respectively). Conclusion Based on the different variables used to quantify the effect of fatigue during and after horizontal leg press exercises, the research found practically no differences between men and women. Level of evidence II; Comparative prospective study.

RESUMEN Introducción La fatiga muscular se caracteriza por la reducción en la capacidad de producir fuerza o potencia máxima y puede diferir entre hombres y mujeres. Las alteraciones en la velocidad de movimiento durante el ejercicio y en la capacidad de producir fuerza después del ejercicio pueden ayudar en la comparación de la fatiga en hombres y mujeres. Objetivo Analizar las diferencias entre hombres y mujeres con relación al número de repeticiones, cinética, cinemática y desempeño de la curva de fuerza-tiempo isométrica y su respectiva activación muscular en el ejercicio leg press horizontal. Métodos Quince hombres y quince mujeres fueron sometidos a evaluaciones de curva fuerza-tiempo isométrica (Cf-t) y actividad electromiográfica (EMG) antes y después de realizar un ejercicio leg press horizontal. Los ejercicios fueron realizados en tres series hasta el agotamiento voluntario a 70% de una repetición máxima. Durante los ejercicios, las variables cinéticas y cinemáticas se obtuvieron mediante dos transductores de fuerza, un potenciómetro lineal de posición y un acelerómetro adaptados para el equipamiento leg press horizontal y sincronizados por una placa de acondicionamiento de señal. Resultados La velocidad promedio propulsiva fue reducida significativamente entre la primera y la última repetición de cada serie con una reducción similar en hombres (-12,4 a -29,2%) y mujeres (-29,2 a -35,6%). El mismo comportamiento fue observado para las demás variables cinéticas y cinemáticas. La contracción voluntaria máxima y la tasa de desarrollo de la fuerza de pico fueron reducidas igualmente tanto para hombres (-15,1 ± 8,7% y -26,9 ± 21,2%, respectivamente) como para mujeres (-13.9 ± 10,4% y -28,2 ± 11,5%, respectivamente). Conclusión Con base en las diferentes variables utilizadas para cuantificar el efecto de la fatiga durante y después del ejercicio leg press horizontal, la investigación reveló que no hay, prácticamente, diferencias entre hombres y mujeres. Nivel de evidencia II; Estudio prospectivo comparativo.

https://doi.org/10.1590/1517-869220202603216124 1530 downloads

11.

Body self-image disturbances in women with prolactinoma
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Pereira, Helen S.

; Naliato, Erika C.

; Moraes, Aline B.

; Gadelha, Monica R.

; Vieira Neto, Leonardo

; Almeida, Renan M.

; Nardi, Antonio E.

; Violante, Alice H.

Brazilian Journal of Psychiatry

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feb 2020, Volume 42 N. 1 Pages 33 - 39

Abstract: En | Text: En | PDF: En

Objective: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. Methods: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients’ dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. Results: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. Conclusion: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.

https://doi.org/10.1590/1516-4446-2018-0325 680 downloads

12.

Healthcare telemonitoring and business dynamics: challenges and opportunities for SUS
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Paula, Antonio da Cruz

; Maldonado, José Manuel Santos de Varge

; Gadelha, Carlos Augusto Grabois

Revista de Saúde Pública

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2020, Volume 54 elocation 65

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

RESUMO OBJETIVO Apontar desafios e oportunidades para o Sistema Único de Saúde (SUS) com o uso do telemonitoramento para enfrentar o aumento crescente dos custos com as doenças crônicas não transmissíveis, a partir do seu panorama geral no Brasil, dinâmica empresarial e reaplicação de dados de estudos americanos. MÉTODOS Este trabalho se enquadra na abordagem quali-quantitativa com pesquisa do tipo exploratória, e o trabalho de campo se concentrou na análise do mercado nacional a partir das empresas privadas, pois não se identificaram experiências ou estudos relacionados a esse tema no SUS. Para análise do panorama e da dinâmica do mercado, investigou-se a oferta a partir dos produtos e serviços disponíveis e a demanda por meio dos hospitais de referência, bem como as dez maiores empresas de planos de saúde privados. Para subsidiar a discussão central deste estudo, analisou-se a redução de custos com as internações hospitalares pelo SUS decorrentes das doenças crônicas não transmissíveis mais impactadas pelo telemonitoramento (IDCST), utilizando-se dados do Datasus e de alguns estudos americanos da base de dados MEDLINE/PubMed. RESULTADOS Embora em fase embrionária, os agentes empresariais se posicionam na busca por novas oportunidades de negócios, enquanto na saúde coletiva não há aparentemente iniciativas públicas para o uso do telemonitoramento. A reaplicação dos dados estadunidenses implicaria uma redução significativa nos gastos com IDCST pelo SUS, sem considerar outros benefícios, tais como a redução nos atendimentos nas salas de emergência, internações agudas, reinternações e tempo de cuidados domiciliares, entre outros, que apontam para ganhos econômicos ainda superiores com o uso do telemonitoramento. CONCLUSÕES O desenvolvimento de um grande projeto para a redução das IDCST a partir dessa tecnologia tem potencial para avançar em uma rede integral de atenção básica, contribuir para uma maior dinamização da base produtiva e inovativa nacional e induzir inovações em toda a cadeia dessa indústria emergente.

ABSTRACT OBJECTIVE To point out challenges and opportunities for the Brazilian Unified Health System (SUS) with the use of telemonitoring to face the increasing costs of non-communicable chronic diseases, based on its general panorama in Brazil, business dynamics and reapplication of data from American studies. METHODS Quali-quantitative approach with exploratory research. The field work focused on the analysis of the national market from private companies, since no experiences or studies related to this theme were identified in the SUS. To analyze the panorama and market dynamics, we investigated the offer of this technology based on the products and services available and their demand by reference hospitals the ten largest private health plan companies. To support the central discussion, we analyzed the reduction of costs with hospital admissions by the SUS due to chronic non-communicable diseases sensitive to telemonitoring (HCDST), using data from Datasus and some American studies from the MEDLINE/PubMed database. RESULTS Although in the embryonic phase, business agents search for new business opportunities, whereas public initiatives for the use of telemonitoring in collective health seem inexistent. The reapplication of U.S. data would reduce spending on HCDST and provide benefits, such as the reduction in emergency room care, acute hospitalizations, readmissions and home care time, among others, which point to even greater economic gains. CONCLUSIONS The development of a major project to reduce HCDST using this technology has the potential to advance in a comprehensive network of primary care, contribute to a greater dynamism of the national productive and innovative base and induce innovations along the chain of this emerging industry.

https://doi.org/10.11606/s1518-8787.2020054001996

13.

Healthcare telemonitoring and business dynamics: challenges and opportunities for SUS
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Paula, Antonio da Cruz

; Maldonado, José Manuel Santos de Varge

; Gadelha, Carlos Augusto Grabois

Revista de Saúde Pública

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2020, Volume 54 elocation 65

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

https://doi.org/10.11606/s1518-8787.2020054001996 2033 downloads

14.

Seroprevalence of Corynebacterium pseudotuberculosis and Toxoplasma gondii in sheep in semi-arid region of Ceará state
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Moura, Gabriela Hémylin Ferreira

; Lelis, Ivana Cristina Nunes Gadelha

; Rocha, Célio Souza da

; Oliveira, Ilanna Vanessa Pristo de Medeiros

; Bezerra, José Artur Brilhante

; Calabuig, Cecilia Irene Pérez

; Martins, Patrícia Yoshida Faccioli

; Pinheiro, Raymundo Rizaldo

; Sousa, Maxmiana Mesquita de

; Santos, Vanderlan Warlington Souza dos

; Abreu, Antônio Rafael Albuquerque

; Antunes, João Marcelo Azevedo de Paula

Ciência Rural

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2020, Volume 50 N. 9 elocation e20190760

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

RESUMO: O presente estudo foi conduzido para investigar a soroprevalência em 20 fazendas de criação extensiva de ovinos quanto à presença de anticorpos para Corynebacterium pseudotuberculosis (n=402) e Toxoplasma gondii (n=228). Ensaio de imunoabsorção enzimático (ELISA) foi utilizado para a detecção de anticorpos contra C. pseudotuberculosis/T. gondii. Observou-se que C. pseudotuberculosis apresentou a maior prevalência na região (34,07%), com presença estatisticamente significante (p <0,05) nas categorias de ovelha. Anticorpos contra T. gondii foram encontrados em 14,91% dos animais estudados. Sobre a coinfecção de C. pseudotuberculosis/T. gondii, as categorias carneiro apresentaram diferenças significativas (p <0,05), sugerindo que esse gênero poderia perpetuar as doenças nos rebanhos. Concluiu-se que o conhecimento sobre as doenças na região em estudo facilitaria a execução de medidas profiláticas, principalmente contra as doenças que apresentam riscos à saúde pública e causam danos ao produtor.

ABSTRACT: The present study was conducted to investigate in 20 extensive sheep farms for the seroprevalence of Corynebacterium pseudotuberculosis (n=402) and Toxoplasma gondii (n=228). Enzyme-linked immunosorbent assay (ELISA) was used for the detection of antibodies to C. pseudotuberculosis/T. gondii. It was observed that C. pseudotuberculosis showed the highest prevalence in the region (34.07%) with statistically significant presence (p<0.05) in ewes. Antibodies to T. gondii was reported in 14.91% of the animals studied. About C. pseudotuberculosis/T. gondii coinfection the categories of rams showed significant (p<0.05) differences, suggesting that this gender could perpetuate the diseases in the flocks. It was concluded that the knowledge about the diseases in the region under study would facilitate the execution of prophylactic measures, especially against the diseases that pose risks to the public health and cause damages to the producer.

https://doi.org/10.1590/0103-8478cr20190760 722 downloads

15.

Pesquisa translacional e sistemas de inovação na saúde: implicações para o segmento biofarmacêutico
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Gadelha, Carlos Augusto Grabois

; Vargas, Marco Antonio

; Alves, Nathalia Guimarães

Saúde em Debate

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nov 2019, Volume 43 N. spe2 Pages 133 - 146

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

RESUMO A análise desenvolvida sobre a dinâmica de inovação em saúde no contexto do Sistema Nacional de Inovação em Saúde revela as potencialidades da articulação das instituições de Ciência, Tecnologia e Inovação (CT&I) com o Complexo Econômico-Industrial da Saúde (Ceis), a partir da interação entre as universidades e os institutos de pesquisa com o setor produtivo. A translação em saúde depende fortemente da dinâmica e da situação relativa do Ceis no Brasil ante o contexto internacional. O estudo faz uma análise das interações entre empresas farmacêuticas e grupos de pesquisa em saúde no País dos microdados da base de dados do Diretório de Grupos de Pesquisa do Conselho Nacional de Desenvolvimento Científico e Tecnológico (DGP-CNPq), utilizando uma abordagem metodológica apropriada aos estudos de redes de colaboração. Ademais, mostra o potencial de diversas instituições de CT&I brasileiras, revelando a presença de uma rede de interações com o setor produtivo na área biofarmacêutica, com potencial para o desenvolvimento do sistema de inovação em saúde. Essa interação poderá adquirir, de fato, uma perspectiva translacional para a utilização do conhecimento tecnológico pela sociedade brasileira na medida em que seja articulada com o desenvolvimento do Ceis no Brasil, como elo crítico no qual a pesquisa se transforma em produção de bens e serviços para atender às demandas do Sistema Único de Saúde.

ABSTRACT The analysis of the dynamics of innovation in health in the context of the National System of Innovation in Health reveals the potential of the articulation of Science, Technology and Innovation (ST&I) institutions with the Health Economic-Industrial Complex (HEIC), in view of the interactions between universities and research institutes with the productive sector. Translational health research depends heavily on the dynamics and relative situation of the HEIC in Brazil regarding the international context. The study analyzes the interactions between pharmaceutical companies and health research groups in the country, using microdata from the CNPq Research Group Directory database (DGP-CNPq), in a methodological approach appropriate to collaborative network studies. Furthermore, it shows the presence of a network of interactions with the productive sector in the biopharmaceutical area and highlights the potential of several Brazilian ST&I institutions to foster the development of the health innovation system. This interaction may acquire a translational perspective for the use of technological knowledge by the Brazilian society insofar as it is articulated with the development of the HEIC in Brazil as a critical link to meet the demands of the Unified Health System.

https://doi.org/10.1590/0103-11042019s210

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