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1.
Vitamin D levels and their association with oxidative stress and inflammation markers in patients with cystic fibrosis
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Marques-Queiroz, Dayanna Joyce
; Silva, Alexandre Sérgio
; Costa-da Silva Júnior, Celso
; Camati-Persuh, Darlene
; da Silva-Diniz, Alcides
; Lira-Formiga-Cavalcanti-de Lima, Rafaela
; de Paiva, Maria Paula
; Braga-Cartaxo, Constantino Giovanni
; Gomes-de Matos-Bezerra, Patrícia
; Duarte-Ribeiro, Mateus
; Rodrigues-Gonçalves, Maria da Conceição
.
Abstract Introduction: cystic fibrosis is a disease that causes inflammation, oxidative stress and metabolic changes that lead to nutrient deficiency, such as vitamin D deficiency. On the other hand, it is suggested that vitamin D has anti-inflammatory and antioxidant actions. Objective: to evaluate the prevalence of hypovitaminosis D and the association between serum 25 hydroxyvitamin D levels with markers of oxidative stress and inflammation in patients with cystic fibrosis. Method: a cross-sectional study was carried out with 48 patients with cystic fibrosis including children, adolescents and adults in the northeast region of Brazil. Blood collection was performed for analysis of 25-hydroxyvitamin D, calcium, parathyroid hormone, inflammatory process (C-reactive protein [CRP] and alpha-1-acid glycoprotein-A1 [A1GPA]) and oxidative stress (malondialdehyde (MDA) and total antioxidant capacity [CAOT]). The statistical analysis was performed using the "Statistical Package for the Social Sciences", adopting a significance level of p < 0.05. Results: vitamin D insufficiency/deficiency was found in 64.6 % of patients. After multiple linear regression analysis, MDA showed an inverse association with blood values of 25-hydroxyvitamin D (p < 0.05) conditioned by the presence of inflammatory process markers. When only oxidative stress was evaluated, this association disappeared. Conclusion: in conclusion, there was a high prevalence of hypovitaminosis D, with 25(OH)D levels associated with greater oxidative stress when combined with inflammatory markers. Improved vitamin D levels may be an alternative to reduce the damage caused by excess oxidative stress and inflammation in CF patients.
Resumen Introducción: la fibrosis quística es una enfermedad que cursa con inflamación, estrés oxidativo y cambios metabólicos que conducen a deficiencia de nutrientes como la vitamina D. Por otro lado, se sugiere que la vitamina D tiene acción antiinflamatoria y antioxidante. Objetivo: evaluar la prevalencia de hipovitaminosis D y la asociación entre los niveles séricos de 25 hidroxivitamina D con los marcadores de estrés oxidativo e inflamación en pacientes con fibrosis quística. Método: estudio transversal realizado con 48 pacientes con fibrosis quística, niños, adolescentes y adultos, de la región nordeste de Brasil. Se realizó una extracción de sangre para el análisis de 25-hidroxivitamina D, calcio, hormona paratiroidea, proceso inflamatorio (proteína C-reactiva [PCR] y alfa-1-glucoproteína ácida-A1 [A1GPA]) y estrés oxidativo (malondialdehído [MDA] y capacidad antioxidante total [CAOT]). El análisis estadístico se realizó utilizando el "Paquete Estadístico para las Ciencias Sociales", adoptando un nivel de significancia de p < 0,05. Resultados: se encontró insuficiencia/deficiencia de vitamina D en el 64,6 % de los pacientes. Después de un análisis de regresión lineal múltiple, la MDA mostró una asociación inversa con los valores sanguíneos de 25-hidroxivitamina D (p < 0,05) condicionado a la presencia de marcadores de proceso inflamatorio; cuando solo se evalúa el estrés oxidativo, esta asociación desaparece. Conclusión: en conclusión, hubo una alta prevalencia de hipovitaminosis D, con niveles de 25(OH)D asociados a mayor estrés oxidativo cuando se combina con marcadores inflamatorios. La mejora de los niveles de vitamina D puede ser una alternativa para reducir el daño causado por el exceso de estrés oxidativo y la inflamación en pacientes con FQ.
2.
Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH
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Cardoso, Viviane Cunha
; Grandi, Carlos
; Silveira, Rita C.
; Duarte, José Luiz Bandeira
; Viana, Maria Cândida Ferrarez Bouzada
; Ferreira, Daniela Marques de Lima Mota
; Alves Junior, José Mariano Sales
; Embrizi, Laís Furlan
; Gimenes, Carolina Boschi
; Mello e Silva, Nathalia Moura de
; Melo, Fernanda Pegoraro de Godoi
; Venzon, Paulyne Stadler
; Gomez, Dafne Barcala
; Vale, Marynéa Silva do
; Bentlin, Maria Regina
; Barros, Marina Carvalho de Moraes
; Bigélli, Laura Emilia Monteiro
; Diniz, Edna Maria de Albuquerque
; Luz, Jorge Hecker
; Marba, Sérgio Tadeu Martins
; Almeida, João Henrique Carvalho Leme de
; Aragon, Davi Casale
; Carmona, Fabio
.
Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.
3.
Diagnosis of the impact of Covid-19 on artisanal cheese production in the semi-arid region of Brazil
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BEZERRA, Joadilza da Silva
; RANGEL, Adriano Henrique do Nascimento
; MARQUES JÚNIOR, Sérgio
; SALES, Danielle Cavalcanti
; GALVÃO JÚNIOR, José Geraldo Bezerra
; BRITO, Acácio Sanzio de
; MEDEIROS, Pedro Alexandro Azevedo de
; ARAUJO, José Rangel de
; MENDONÇA, Fabio de Souza
.
Abstract The objective of this study was to present information on the impacts resulting from Covid-19 on the artisanal coalho cheese production chain about: access to information; socioeconomic; income and government support; healthcare. The interviews were conducted using the Google Forms tool, with milk and artisanal coalho cheese producers in Rio Grande do Norte, Brazil. The producers obtained a lot of information transmitted on television (66%); the majority to adhere to health protocols. There was instability in the production, with an initial need to reduce production resulting from prohibitive measures to trade. The level of demand with regard to the consumer market increased with the quality of milk and cheeses. An allegation of lack of support from the government to maintain the activity was also verified in 78.7% of the interviewees, but 83% had resorted to emergency aid. Therefore, it can be concluded that the challenges imposed by the pandemic are not just sanitary. The study confirmed the need to restructure public services and policies. These results can provide compelling evidence about the rural context in the country.
4.
Endoscopic Biliary Darinage (EBD) versus Percutaneous Transhepatic Biliary Drainage (PTBD) for biliary drainage in patients with Perihilar Cholangiocarcinoma (PCCA): A systematic review and meta-analysis
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Moll, Caroline Flaksbaum
; Moura, Diogo Turiani Hourneaux de
; Ribeiro, Igor Braga
; Proença, Igor Mendoça
; Monte Junior, Epifanio Silvino do
; Sánchez-Luna, Sergio A.
; Merchán, Maria Fernanda Shinin
; Intriago, Josselyn Mariana Vera
; Bernardo, Wanderley Marques
; Moura, Eduardo Guimarães Hourneaux de
.
Abstract Biliary drainage for Perihilar Cholangiocarcinoma (PCCA) can be performed either by endoscopic retrograde cholangiopancreatography or Percutaneous Transhepatic Biliary Drainage (PTBD). To date there is no consensus about which method is preferred. Taking that into account, the aim of this study is to compare Endoscopic Biliary Drainage (EBD) versus percutaneous transhepatic biliary drainage in patients with perihilar cholangiocarcinoma through a systematic review and metanalysis. A comprehensive search of multiple electronic databases was performed. Evaluated outcomes included technical success, clinical success, post drainage complications (cholangitis, pancreatitis, bleeding, and major complications), crossover, hospital length stay, and seeding metastases. Data extracted from the studies were used to calculate Mean Differences (MD). Seventeen studies were included, with a total of 2284 patients (EBD = 1239, PTBD = 1045). Considering resectable PCCA, the PTBD group demonstrated lower rates of crossover (RD = 0.29; 95% CI 0.07–0.51; p = 0.009 I2 = 90%), post-drainage complications (RD = 0.20; 95% CI 0.06–0.33; p < 0.0001; I2 = 78%), and post-drainage pancreatitis (RD = 0.10; 95% CI 0.05–0.16; p < 0.0001; I2 = 64%). The EBD group presented reduced length of hospital stay (RD = -2.89; 95% CI -3.35 - -2,43; p < 0.00001; I2 = 42%). Considering palliative PCCA, the PTBD group demonstrated a higher clinical success (RD = -0.19; 95% CI -0.27 - -0.11; p < 0.00001; I2 = 0%) and less post-drainage cholangitis (RD = 0.08; 95% CI 0.01-0.15; p = 0.02; I2 = 48%) when compared to the EBD group. There was no statistical difference between the groups regarding: technical success, post-drainage bleeding, major post-drainage complications, and seeding metastases.
5.
Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023
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Oliveira, Gláucia Maria Moraes de
; Almeida, Maria Cristina Costa de
; Rassi, Daniela do Carmo
; Bragança, Érika Olivier Vilela
; Moura, Lidia Zytynski
; Arrais, Magaly
; Campos, Milena dos Santos Barros
; Lemke, Viviana Guzzo
; Avila, Walkiria Samuel
; Lucena, Alexandre Jorge Gomes de
; Almeida, André Luiz Cerqueira de
; Brandão, Andréa Araujo
; Ferreira, Andrea Dumsch de Aragon
; Biolo, Andreia
; Macedo, Ariane Vieira Scarlatelli
; Falcão, Breno de Alencar Araripe
; Polanczyk, Carisi Anne
; Lantieri, Carla Janice Baister
; Marques-Santos, Celi
; Freire, Claudia Maria Vilas
; Pellegrini, Denise
; Alexandre, Elizabeth Regina Giunco
; Braga, Fabiana Goulart Marcondes
; Oliveira, Fabiana Michelle Feitosa de
; Cintra, Fatima Dumas
; Costa, Isabela Bispo Santos da Silva
; Silva, José Sérgio Nascimento
; Carreira, Lara Terra F.
; Magalhães, Lucelia Batista Neves Cunha
; Matos, Luciana Diniz Nagem Janot de
; Assad, Marcelo Heitor Vieira
; Barbosa, Marcia M.
; Silva, Marconi Gomes da
; Rivera, Maria Alayde Mendonça
; Izar, Maria Cristina de Oliveira
; Costa, Maria Elizabeth Navegantes Caetano
; Paiva, Maria Sanali Moura de Oliveira
; Castro, Marildes Luiza de
; Uellendahl, Marly
; Oliveira Junior, Mucio Tavares de
; Souza, Olga Ferreira de
; Costa, Ricardo Alves da
; Coutinho, Ricardo Quental
; Silva, Sheyla Cristina Tonheiro Ferro da
; Martins, Sílvia Marinho
; Brandão, Simone Cristina Soares
; Buglia, Susimeire
; Barbosa, Tatiana Maia Jorge de Ulhôa
; Nascimento, Thais Aguiar do
; Vieira, Thais
; Campagnucci, Valquíria Pelisser
; Chagas, Antonio Carlos Palandri
.
6.
COVID-19 outcomes in people living with HIV: Peering through the waves
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Sales, Thaís Lorenna Souza
; Souza-Silva, Maíra Viana Rego
; Delfino-Pereira, Polianna
; Neves, João Victor Baroni
; Sacioto, Manuela Furtado
; Assis, Vivian Costa Morais de
; Duani, Helena
; Oliveira, Neimy Ramos de
; Sampaio, Natália da Cunha Severino
; Ramos, Lucas Emanuel Ferreira
; Schwarzbold, Alexandre Vargas
; Jorge, Alzira de Oliveira
; Scotton, Ana Luiza Bahia Alves
; Castro, Bruno Mateus de
; Silva, Carla Thais Cândida Alves da
; Ramos, Carolina Marques
; Anschau, Fernando
; Botoni, Fernando Antonio
; Grizende, Genna Maira Santos
; Nascimento, Guilherme Fagundes
; Ruschel, Karen Brasil
; Menezes, Luanna Silva Monteiro
; Castro, Luís César de
; Nasi, Luiz Antônio
; Carneiro, Marcelo
; Godoy, Mariana Frizzo de
; Nogueira, Matheus Carvalho Alves
; Guimarães Júnior, Milton Henriques
; Ziegelmann, Patricia Klarmann
; Almeida, Rafaela Charão de
; Francisco, Saionara Cristina
; Silveira Neto, Sidney Teodoro
; Araújo, Silvia Ferreira
; Avelino-Silva, Thiago Junqueira
; Aliberti, Márlon Juliano Romero
; Pires, Magda Carvalho
; Silva, Eduardo Sérgio da
; Marcolino, Milena Soriano
.
Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group.
7.
First Evaluation of the Brazilian Advanced Life Support Training (TECA A)
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Furtado, Fabrício Nogueira
; Carvalho, Antonio Carlos de Camargo
; Gonçalves Junior, Iran
; Canesin, Manoel Fernandes
; Timerman, Sergio
; Gonçalves, Rodrigo Marques
; Alfieri, Daniela Frizon
; Almeida, Dirceu
.
International Journal of Cardiovascular Sciences
- Journal Metrics
Abstract Background Cardiac arrest (CA) is a common condition associated with high mortality. The Brazilian advanced life support training TECA A (Treinamento em Emergências Cardiovasculares Avançado — Advanced Cardiovascular Emergency Training) was created to train healthcare professionals in the management of CA. However, there are no studies evaluating the effectiveness of TECA A. Objective To assess the impact of TECA A on the management of CA using a simulated CA situation. Methods Fifty-six students underwent a simulated case of CA in a manikin. The students’ performance in the management of CA was assessed for the time to first chest compression and defibrillation and for a global assessment score using a structured tool. These items were assessed and compared before and after the TECA A. Exclusion criteria were previous participation in CA trainings and absence from class. Categorical variables were compared using the McNemar test and quantitative variables using the Wilcoxon test. All tests were two-tailed, and statistical significance was set at p < 0.05. Results Compared with before TECA A, median global assessment scores were higher after TECA A (pre-training: 4.0 points [2.0-5.0] vs. 10 points [9.0-10.0]; p<0.001), the time to start chest compressions was shorter (pre-training: 25 seconds [15-34] vs. 19 seconds [16.2-23.0]; p=0.002) and so was the time to defibrillation (pre-training: 82.5 seconds [65.0-108.0] vs. 48 seconds [39.0-53.0]; p<0.001). Conclusions The TECA A promoted a higher adherence to cardiopulmonary resuscitation (CPR) guidelines and a reduction in the time elapsed from CA to first chest compression and defibrillation.
8.
Systematic review of pharmacological management in Creutzfeldt-Jakob disease: no options so far?
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Miranda, Luiz Henrique Lélis
; Oliveira, André Felipe Pastick de Holanda
; Carvalho, Davi Mariano de
; Souza, Gustavo Marques Figueredo
; Magalhães, João Guilherme Monteiro
; Cabral Júnior, Joselmo Alberto
; Lima, Pedro Thadeu Mertens Brainer de Queiroz
; Aguiar Júnior, Renato Melo
; Lins Filho, Sérgio Pereira
; Melo, Hugo Moura de Albuquerque
.
Abstract Background The Creutzfeldt-Jakob disease (CJD) is a spongiform encephalopathy that manifests as a rapidly progressive dementia syndrome. Currently, CJD has no cure, and many patients die within the first year, but some drugs are being studied as options for managing this condition. Objective To evaluate the effectiveness of pharmacological treatments offered to patients with CJD as a means to increase survival and reduce cognitive deterioration. Methods A systematic review of the literature was performed using 4 independent reviewers and 1 extra reviewer to resolve possible divergences in the search and analysis of papers indexed in MedLINE (PubMed), SciELO and Lilacs databases. The Medical Subject Heading (MeSH) terms used were: prion diseases, Creutzfeldt-Jakob disease, pharmacologic therapy, therapeutics, quinacrine, doxycycline, flupirtine, and pentosan polysulfate, with the Boolean operators AND and OR. This search included controlled clinical trials, uncontrolled clinical trials, and case series published from the year 2000 onwards, in the English language. Results A total of 85 papers were found using the descriptors used. At the end of the selection analyses, 9 articles remained, which were analyzed fully and individually. Conclusions None of the drugs evaluated proved significantly effective in increasing survival in patients with CJD. Flupirtine appears to have a beneficial effect in reducing cognitive deterioration in patients with CJD. However, additional studies are needed to establish better evidence and therapeutic options for the management of patients with CJD.
Resumo Antecedentes A doença de Creutzfeldt-Jakob (DCJ) é uma encefalopatia espongiforme que se manifesta como síndrome demencial rapidamente progressiva. Atualmente, a DCJ não possui cura e muitos pacientes morrem no primeiro ano de doença, mas alguns medicamentos vêm sendo estudados como opções no manejo desta condição. Objetivo Avaliar a eficácia dos tratamentos farmacológicos oferecidos aos pacientes com DCJ no aumento de sobrevida e na redução da deterioração cognitiva. Métodos Foi realizada uma revisão sistemática da literatura utilizando 4 revisores independentes e 1 extra para resolver divergências eventuais na busca e na análise de trabalhos indexados nas bases de dados MedLINE (via PubMed), SciELO e Lilacs. Os termos Medical Subjects Heading (MeSH) utilizados foram: prion diseases, creutzfeldt jakob disease, pharmacologic therapy, therapeutics, quinacrine, doxycycline, flupirtine e pentosan polysulfate, com os operadores booleanos AND e OR. Essa pesquisa incluiu ensaios clínicos controlados, não controlados e séries de casos, publicados a partir do ano 2000 no idioma inglês. Resultados Ao todo, foram encontrados 85 trabalhos através dos descritores utilizados. Ao final das análises de seleção, restaram 9 artigos, que foram analisados na íntegra individualmente. Conclusões Nenhuma das drogas avaliadas se mostrou significativamente eficaz no aumento da sobrevida dos pacientes com DCJ. A flupirtina parece ter um efeito benéfico na redução da deterioração cognitiva dos pacientes com DCJ. Entretanto, estudos adicionais são necessários para o estabelecimento de melhores evidências e opções terapêuticas para o manejo dos pacientes com DCJ.
9.
The impact of multivisceral liver resection on short- and long-term outcomes of patients with colorectal liver metastasis: A systematic review and meta-analysis
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Silveira Junior, Sergio
; Tustumi, Francisco
; Magalhães, Daniel de Paiva
; Jeismann, Vagner Birk
; Fonseca, Gilton Marques
; Kruger, Jaime Arthur Pirola
; Coelho, Fabricio Ferreira
; Herman, Paulo
.
Abstract The impact of Multivisceral Liver Resection (MLR) on the outcome of patients with Colorectal Liver Metastasis (CRLM) is unclear. The present systematic review aimed to compare patients with CRLM who underwent MLR versus standard hepatectomy regarding short- and long-term outcomes. MLR is a feasible procedure but has a higher risk of major complications. MLR did not negatively affect long-term survival, suggesting that an extended resection is an option for potentially curative treatment for selected patients with CRLM.
10.
Intenção de usar criptomoedas por gestores de empreendimentos turísticos: uma abordagem utilizando o Technology Acceptance Model (TAM)
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Abstract In a scenario increasingly governed by information and communication technologies (ICT), the presence of various forms of payments available in the market is common. Among the options, there is a new payment method, Cryptocurrencies. There is still distrust and lack of knowledge in the tourism sector for the effective adoption of digital currencies. This study aims to evaluate the acceptance and adoption of Cryptocurrencies by managers of tourism enterprises through the Technology Acceptance Model - TAM (Davis, 1989), in order to support the investigation of factors that influence the intention to use cryptocurrencies. The study is exploratory-descriptive, with a quantitative approach. Data collection was carried out through a survey with 61 respondents. The data was processed by the IBM SPSS version 22 software for Windows. Descriptive statistics, exploratory factor analysis and structural equation modeling were used for data analysis. Based on the results achieved, the study reflects on the need for modernization and adaptation of processes within tourist organizations, in which entrepreneurs need to be updated on the benefits that new technological payment methods can bring to their companies.
Resumen En un escenario cada vez más regido por las tecnologías de la información y la comunicación (TIC), es habitual la presencia de diversas formas de pago disponibles en el mercado. Entre las opciones, hay un nuevo método de pago, Criptomonedas. Aún existe desconfianza y desconocimiento en el sector turístico para la adopción efectiva de las monedas digitales. Así, este estudio tiene como objetivo evaluar la aceptación y adopción de Criptomonedas por parte de gerentes de empresas turísticas, a través de la teoría Technology Acceptance Model - TAM (Davis, 1989), con el fin de apoyar la investigación de factores que influyen la intención de utilizar criptomonedas. El estudio es exploratorio-descriptivo, con enfoque cuantitativo. La recolección de datos se realizó a través de una encuesta com 61 participantes, con los datos procesados por el software IBM SPSS versión 22 para Windows. Para el análisis de datos se utilizó estadística descriptiva, análisis factorial exploratoria y modelada de ecuaciones estructurales. A partir de los resultados obtenidos, el estudio reflexiona sobre la necesidad de modernización y adecuación de procesos dentro de las organizaciones turísticas, y los emprendedores necesitan estar actualizados sobre los beneficios que los nuevos métodos de pago tecnológicos pueden traer a sus empresas.
Resumo Em um cenário cada vez mais regido por tecnologias da informação e comunicação (TIC), é comum a presença de diversas formas de pagamentos disponíveis no mercado. Dentre as opções, existe um novo meio de pagamento, as Criptomoedas. Ainda existe desconfiança e desconhecimento no setor turístico para que haja efetiva adoção das moedas digitais. Dessa forma, o presente estudo tem como objetivo avaliar a intenção de usar Criptomoedas pelos gestores de empreendimentos turísticos, por meio da teoria Technology Acceptance Model – TAM (Davis, 1989), visando dar suporte na investigação dos fatores que influenciam a intenção de uso de criptomoedas. O estudo apresenta um caráter exploratório-descritivo, com abordagem quantitativa. A coleta de dados foi realizada através de survey com 61 participantes, tendo seus dados processados pelo software IBM SPSS versão 22 para Windows. Para análise dos dados foram utilizadas estatísticas descritivas, análise fatorial exploratória e modelagem de equações estruturais. Mediante os resultados alcançados, o estudo traz a reflexão sobre a necessidade da modernização e adequação dos processos dentro das organizações turísticas, em que os empresários precisam estar atualizados sobre os benefícios que novas modalidades tecnológicas de pagamento podem trazer para suas empresas.
11.
Factors affecting the consumption of organic and functional foods in Brazil
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MARTINS, Adalgisa Paula de Oliveira
; BEZERRA, Maria de Fátima
; MARQUES JÚNIOR, Sérgio
; BRITO, André Fonseca de
; URBANO, Stela Antas
; BORBA, Luís Henrique Fernandes
; MACÊDO, Cláudia Souza
; OLIVEIRA, Juliana Paula Felipe de
; RANGEL, Adriano Henrique do Nascimento
.
Abstract The objective of this work was to investigate the factors which affect the consumption of organic foods enriched with functional properties. The study was developed by investigating the consumer profile of organic and functional foods by applying a questionnaire hosted on the Google Forms® platform (docs.google.com/forms/). The obtained results show that individuals in the age group 31 to 40 years old and those 51 and older, widowed, divorced and inhabitants of the Midwest, Southeast and South regions consume organic food more often. The education level did not influence the willingness to pay more for the purchase of an organic food, the consumption frequency or the interest in consuming organic food with functional potential. The interviewee group had a monthly income of up to R$4,686.00 (In Reais - 5 minimum monthly salaries) and showed a consumption frequency between “almost never” and “sometimes”, while those with an income higher than R$4,686.00 presented between “sometimes” and “often”. Residents of capital cities and from smaller cities showed similar behavior for all variables analyzed. We can conclude that the degree of confidence and the interest in consuming organic foods with functional potential were little influenced by socio-demographic differences.
https://doi.org/10.1590/fst.26820
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12.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
13.
Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba
; Rodrigues, Cibele Isaac Saad
; Bortolotto, Luiz Aparecido
; Mota-Gomes, Marco Antônio
; Brandão, Andréa Araujo
; Feitosa, Audes Diógenes de Magalhães
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Amodeo, Celso
; Mion Júnior, Décio
; Barbosa, Eduardo Costa Duarte
; Nobre, Fernando
; Guimarães, Isabel Cristina Britto
; Vilela-Martin, José Fernando
; Yugar-Toledo, Juan Carlos
; Magalhães, Maria Eliane Campos
; Neves, Mário Fritsch Toros
; Jardim, Paulo César Brandão Veiga
; Miranda, Roberto Dischinger
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C
; Alessi, Alexandre
; Lucena, Alexandre Jorge Gomes de
; Avezum, Alvaro
; Sousa, Ana Luiza Lima
; Pio-Abreu, Andrea
; Sposito, Andrei Carvalho
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Nogueira, Armando da Rocha
; Dinamarco, Nelson
; Eibel, Bruna
; Forjaz, Cláudia Lúcia de Moraes
; Zanini, Claudia Regina de Oliveira
; Souza, Cristiane Bueno de
; Souza, Dilma do Socorro Moraes de
; Nilson, Eduardo Augusto Fernandes
; Costa, Elisa Franco de Assis
; Freitas, Elizabete Viana de
; Duarte, Elizabeth da Rosa
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Cesarino, Evandro José
; Marques, Fabiana
; Argenta, Fábio
; Consolim-Colombo, Fernanda Marciano
; Baptista, Fernanda Spadotto
; Almeida, Fernando Antonio de
; Borelli, Flávio Antonio de Oliveira
; Fuchs, Flávio Danni
; Plavnik, Frida Liane
; Salles, Gil Fernando
; Feitosa, Gilson Soares
; Silva, Giovanio Vieira da
; Guerra, Grazia Maria
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Back, Isabela de Carlos
; Oliveira Filho, João Bosco de
; Gemelli, João Roberto
; Mill, José Geraldo
; Ribeiro, José Marcio
; Lotaif, Leda A. Daud
; Costa, Lilian Soares da
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano Ferreira
; Martin, Luis Cuadrado
; Scala, Luiz César Nazário
; Almeida, Madson Q.
; Gowdak, Marcia Maria Godoy
; Klein, Marcia Regina Simas Torres
; Malachias, Marcus Vinícius Bolívar
; Kuschnir, Maria Cristina Caetano
; Pinheiro, Maria Eliete
; Borba, Mario Henrique Elesbão de
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Coelho, Otavio Rizzi
; Vitorino, Priscila Valverde de Oliveira
; Ribeiro Junior, Renault Mattos
; Esporcatte, Roberto
; Franco, Roberto
; Pedrosa, Rodrigo
; Mulinari, Rogerio Andrade
; Paula, Rogério Baumgratz de
; Okawa, Rogério Toshiro Passos
; Rosa, Ronaldo Fernandes
; Amaral, Sandra Lia do
; Ferreira-Filho, Sebastião R.
; Kaiser, Sergio Emanuel
; Jardim, Thiago de Souza Veiga
; Guimarães, Vanildo
; Koch, Vera H.
; Oigman, Wille
; Nadruz, Wilson
.
https://doi.org/10.36660/abc.20201238
10948 downloads
14.
Safety and effectiveness of mycophenolate mofetil associated with tacrolimus for liver transplantation immunosuppression: a systematic review and meta-analysis of randomized controlled trials
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Tustumi, Francisco
; Miranda Neto, Antonio Afonso de
; Silveira Júnior, Sérgio
; Fernandes, Felipe Alexandre
; Silva, Miller Barreto de Brito e
; Ernani, Lucas
; Nacif, Lucas Souto
; Coelho, Fabricio Ferreira
; Andraus, Wellington
; Bernardo, Wanderley Marques
; Herman, Paulo
; Carneiro-D’Albuquerque, Luiz Augusto
.
A combination of immunosuppressants may improve outcomes due to the synergistic effect of their different action mechanisms. Currently, there is no consensus regarding the best immunosuppressive protocol after liver transplantation. This review aimed to evaluate the effectiveness and safety of tacrolimus associated with mycophenolate mofetil (MMF) in patients undergoing liver transplantation. We performed a systematic review and meta-analysis of randomized clinical trials. Eight randomized trials were included. The proportion of patients with at least one adverse event related to the immunosuppression scheme with tacrolimus associated with MMF was 39.9%. The tacrolimus with MMF immunosuppression regimen was superior in preventing acute cellular rejection compared with that of tacrolimus alone (risk difference [RD]=-0.11; p =0.001). The tacrolimus plus MMF regimen showed no difference in the risk of adverse events compared to that of tacrolimus alone (RD=0.7; p=0.66) and cyclosporine plus MMF (RD=-0.7; p=0.37). Patients undergoing liver transplantation who received tacrolimus plus MMF had similar adverse events when compared to patients receiving other evaluated immunosuppressive regimens and had a lower risk of acute rejection than those receiving in the monodrug tacrolimus regimen.
https://doi.org/10.6061/clinics/2021/e2597
395 downloads
15.
Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients
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Sobrado, Lucas Faraco
; Nahas, Caio Sergio Rizkallah
; Marques, Carlos Frederico Sparapan
; Cotti, Guilherme Cutait de Castro
; Imperiale, Antônio Rocco
; Averbach, Pedro
; Meira Júnior, José Donizeti de
; Horvat, Natally
; Ribeiro-Júnior, Ulysses
; Cecconello, Ivan
; Nahas, Sergio Carlos
.
OBJECTIVES: Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. METHODS: This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. RESULTS: A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (p<0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versushttps://doi.org/10.3 days, respectively, p<0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). CONCLUSION: Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.
https://doi.org/10.6061/clinics/2021/e2507
434 downloads
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