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1.
Tensile bond strength of adhesive mortars with hydroxypropyl methyl cellulose and vinyl acetate-ethylene polymers after thermal storage
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KOTOVIEZY, LEIDIMARA A.M.
; PEREIRA, EDUARDO
; SILVA, ISAC J.
; COSTA, MARIENNE R.M.M.
; TRENTIN, PRISCILA O.
; MEDEIROS-JUNIOR, RONALDO A.
.
Abstract The properties of adhesive mortars can change due to heating, compromising the durability of the coating systems. The aim of this article was to evaluate the influence of cement and polymer contents on the tensile bond strength of adhesive mortars after thermal storage. Ceramic tiling system specimens were prepared with seventeen formulations of adhesive mortars. These specimens were stored under dry (reference) at temperature of 23 ± 2 °C and 60 ± 5% of relative humidity and thermal (temperature of 70 ± 2 °C) conditions. The results showed that the cement content was the major factor concerning tensile bond strength. The vinyl acetate-ethylene (VAE) polymer improved the tensile bond strength of mortars under thermal storage. However, the hydroxypropyl methyl cellulose (HPMC) content contributed to the tensile bond strength only when higher cement contents were used. Besides, microstructure analysis showed that ettringite was degraded during thermal storage.
2.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
3.
Chlorhexidine gluconate bathing of adult patients in intensive care units in São Paulo, Brazil: Impact on the incidence of healthcare-associated infection
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Reis, Mariana Andrade Oliveira
; de Almeida, Maria Claudia Stockler
; Escudero, Daniela
; Medeiros, Eduardo A.
.
Abstract Background There is an increasing use of daily chlorhexidine gluconate (CHG) bathing to decrease healthcare associated infections (HAI). Daily bathing of patients with CHG has been successfully used to prevent multidrug-resistant organisms (MDROs) HAI in intensive care units (ICU). Methods This was a 12-month, single-center, open, cluster randomized trial, conducted at four ICUs of the University Hospital of Universidade Federal de São Paulo, Unifesp, Brazil. ICUs were randomized to either perform daily bathing of the patients with pH neutral soap and water – control units, or daily bathing with 2% CHG detergent solution – intervention units. We evaluated the incidence density rate of central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), catheter associated urinary tract infection (CAUTI), Klebsiella pneumoniae carbapenemase (KPC)-producing enterobacteria HAI, and death in the intervention and control units. Results A total of 1,640 admissions of 1,487 patients occurred during the study period (41.2% control group, and 58.8% intervention group). Incidence density rates of KPC-producing enterobacteria HAI were 5.01 and 2.25 infections/1000 patient-days in the control units and in the intervention units (p = 0.013) and mortality rates were 28.7% and 18.7% in the control units and in the intervention units (p<0.001), respectively. No difference between groups was observed in CLABSI incidence (p = 0.125), VAP incidence (p = 0.247) and CAUTI incidence (p = 0.435). No serious skin reactions were noted in either study group. Daily 2% CHG detergent solution bathing is a feasible, low cost option for HAI prevention in ICU.
4.
Factors associated with hospitalizations for Covid-19 in patients with rheumatoid arthritis: data from the Reumacov Brazil registry
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Gomides, Ana Paula Monteiro
; Albuquerque, Cleandro Pires de
; Mota, Licia Maria Henrique da
; Devidé, Guilherme
; Dias, Laiza Hombre
; Duarte, Angela Luzia Branco Pinto
; Giovelli, Raquel Altoé
; Karnopp, Thais Evelyn
; Lima, Hugo Deleon de
; Marinho, Adriana
; Oliveira, Marianne Schrader de
; Omura, Felipe
; Ranzolin, Aline
; Resende, Gustavo
; Ribeiro, Francinne Machado
; Ribeiro, Sandra Lúcia Euzébio
; Sacilotto, Nathália de Carvalho
; Santos, Wander Gonzaga dos
; Shinjo, Samuel Katsuyuki
; Studart, Samia Araujo de Sousa
; Teixeira, Flávia Patricia Sena
; Yazbek, Michel Alexandre
; Ferreira, Gilda Aparecida
; Monticielo, Odirlei A.
; Paiva, Eduardo
; Pileggi, Gecilmara Cristina Salviato
; Reis Neto, Edgard Torres dos
; Pinheiro, Marcelo de Medeiros
; Marques, Claudia D. L.
.
Abstract Background: Patients using immunosuppressive drugs may have unfavorable results after infections. However, there is a lack of information regarding COVID 19 in these patients, especially in patients with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the risk factors associated with COVID 19 hospitalizations in patients with RA. Methods: This multicenter, prospective cohort study is within the ReumaCoV Brazil registry and included 489 patients with RA. In this context, 269 patients who tested positive for COVID 19 were compared to 220 patients who tested negative for COVID 19 (control group). All patient data were collected from the Research Electronic Data Capture database. Results: The participants were predominantly female (90.6%) with a mean age of 53 ±12 years. Of the patients with COVID 19, 54 (20.1%) required hospitalization. After multiple adjustments, the final regression model showed that heart disease (OR =4.61, 95% CI 1.06–20.02. P < 0.001) and current use of glucocorticoids (OR =20.66, 95% CI 3.09–138. P < 0.002) were the risk factors associated with hospitalization. In addition, anosmia was associated with a lower chance of hospitalization (OR =0.26; 95% CI 0.10–0.67, P < 0.005). Conclusion: Our results demonstrated that heart disease and the use of glucocorticoids were associated with a higher number of hospital admissions for COVID 19 in patients with RA. Trial registration: Brazilian Registry of Clinical Trials RBR 33YTQC.
5.
COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience
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Gomes, Walter J.
; Rocco, Isadora
; Pimentel, Wallace S.
; Pinheiro, Aislan H. B.
; Souza, Paulo M. S.
; Costa, Luiz A. A.
; Teixeira, Marjory M. P.
; Ohashi, Leonardo P.
; Bublitz, Caroline
; Begot, Isis
; Moreira, Rita Simone L
; Hossne Jr, Nelson A.
; Vargas, Guilherme F.
; Branco, João Nelson R.
; Teles, Carlos A.
; Medeiros, Eduardo A. S.
; Sáfadi, Camila
; Rampinelli, Amândio
; Moratelli Neto, Leopoldo
; Rosado, Anderson Rosa
; Mesacasa, Franciele Kuhn
; Capriata, Ismael Escobar
; Segalote, Rodrigo Coelho
; Palmieri, Deborah Louize da Rocha Vianna
; Jardim, Amanda Cristina Mendes
; Vianna, Diego Sarty
; Coutinho, Joaquim Henrique de Souza Aguiar
; Jazbik, João Carlos
; Coutinho, Henrique Madureira da Rocha
; Kikuta, Gustavo
; Almeida, Zely Sant'Anna Marotti de
; Feguri, Gibran Roder
; Lima, Paulo Ruiz Lucio de
; Franco, Anna Carolina
; Borges, Danilo de Cerqueira
; Cruz, Felipe Ramos Honorato De La
; Croti, Ulisses Alexandre
; Borim, Bruna Cury
; Marchi, Carlos Henrique De
; Goraieb, Lilian
; Postigo, Karolyne Barroca Sanches
; Jucá, Fabiano Gonçalves
; Oliveira, Fátima Rosane de Almeida
; Souza, Rafael Bezerra de
; Zilli, Alexandre Cabral
; Mas, Raul Gaston Sanchez
; Bettiati Junior, Luiz Carlos
; Tranchesi, Ricardo
; Bertini Jr, Ayrton
; Franco, Leandro Vieira
; Fernandes, Priscila
; Oliveira, Fabiana
; Moraes Jr, Roberto
; Araújo, Thiago Cavalcanti Vila Nova de
; Braga, Otávio Penna
; Pedrosa Sobrinho, Antônio Cavalcanti
; Teixeira, Roberta Tavares Barreto
; Camboim, Irla Lavor Lucena
; Gomes, Eduardo Nascimento
; Reis, Pedro Horigushi
; Garcia, Luara Piovan
; Scorsioni, Nelson Henrique Goes
; Lago, Roberto
; Guizilini, Solange
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.
6.
Posicionamento Brasileiro sobre o Uso da Multimodalidade de Imagens na Cardio-Oncologia – 2021
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Melo, Marcelo Dantas Tavares de
; Paiva, Marcelo Goulart
; Santos, Maria Verônica Câmara
; Rochitte, Carlos Eduardo
; Moreira, Valéria de Melo
; Saleh, Mohamed Hassan
; Brandão, Simone Cristina Soares
; Gallafrio, Claudia Cosentino
; Goldwasser, Daniel
; Gripp, Eliza de Almeida
; Piveta, Rafael Bonafim
; Silva, Tonnison Oliveira
; Santo, Thais Harada Campos Espirito
; Ferreira, Waldinai Pereira
; Salemi, Vera Maria Cury
; Cauduro, Sanderson A.
; Barberato, Silvio Henrique
; Lopes, Heloísa M. Christovam
; Pena, José Luiz Barros
; Rached, Heron Rhydan Saad
; Miglioranza, Marcelo Haertel
; Pinheiro, Aurélio Carvalho
; Vrandecic, Bárbara Athayde Linhares Martins
; Cruz, Cecilia Beatriz Bittencourt Viana
; Nomura, César Higa
; Cerbino, Fernanda Mello Erthal
; Costa, Isabela Bispo Santos da Silva
; Coelho Filho, Otavio Rizzi
; Carneiro, Adriano Camargo de Castro
; Burgos, Ursula Maria Moreira Costa
; Fernandes, Juliano Lara
; Uellendahl, Marly
; Calado, Eveline Barros
; Senra, Tiago
; Assunção, Bruna Leal
; Freire, Claudia Maria Vilas
; Martins, Cristiane Nunes
; Sawamura, Karen Saori Shiraishi
; Brito, Márcio Miranda
; Jardim, Maria Fernanda Silva
; Bernardes, Renata Junqueira Moll
; Diógenes, Tereza Cristina
; Vieira, Lucas de Oliveira
; Mesquita, Claudio Tinoco
; Lopes, Rafael Willain
; Segundo Neto, Elry Medeiros Vieira
; Rigo, Letícia
; Marin, Valeska Leite Siqueira
; Santos, Marcelo José
; Grossman, Gabriel Blacher
; Quagliato, Priscila Cestari
; Alcantara, Monica Luiza de
; Teodoro, José Aldo Ribeiro
; Albricker, Ana Cristina Lopes
; Barros, Fanilda Souto
; Amaral, Salomon Israel do
; Porto, Carmen Lúcia Lascasas
; Barros, Marcio Vinícius Lins
; Santos, Simone Nascimento dos
; Cantisano, Armando Luís
; Petisco, Ana Cláudia Gomes Pereira
; Barbosa, José Eduardo Martins
; Veloso, Orlando Carlos Glória
; Spina, Salvador
; Pignatelli, Ricardo
; Hajjar, Ludhmilla Abrahão
; Kalil Filho, Roberto
; Lopes, Marcelo Antônio Cartaxo Queiroga
; Vieira, Marcelo Luiz Campos
; Almeida, André Luiz Cerqueira
.
https://doi.org/10.36660/abc.20200266
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7.
[SciELO Preprints] - Structural vulnerability of hospitals, cemeteries, and crematoriums of the city of São Paulo to COVID-19
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Gaiarsa, Marilia Palumbo
Marquitti, Flávia Maria D.
Lemos-Costa, Paula
Burin, Gustavo
Medeiros, Lucas P.
Velásquez, Viviana Márquez
Santana, Pamela C.
Santana, Erika Marques
Maia, Kate P.
Muniz, Danilo
Cosmo, Leandro G.
Assis, Ana Paula A.
Birskis-Barros, Irina
Cantor, Mauricio
Emer, Carine
Andreazzi, Cecilia Siliansky de
Pires, Mathias M.
Côrtes, Marina C.
Melo, Diogo
Cruz, Wesley F. Dáttilo da
Raimundo, Rafael Luís G.
Migon, Eduardo X. F. G.
Guimarães Jr, Paulo R.
This is the first report by the COVID19 Observatory - Group: Contagion Networks analyzing mortality data from the city of São Paulo. In this report, we integrated mortality data for the city of São Paulo between 04/02/2020 and 04/28/2020, with information on the flow of victims between hospitals and cemeteries/crematoriums. We included in our analyzes both confirmed and suspected deaths from COVID-19. The main objectives of this report were: (1) to describe the structure of the flow of victims between locations and (2) to suggest changes in the current flow based on geographical distances in order to avoid a potential overload of the mortuary system. We suggest that the city of São Paulo should plan for a potential overload of the mortuary system (that is, the number of burials), based on the presented results. Thus, our results reinforce the need to adopt specific planning for the management of the extraordinary number of victims of this pandemic. Our predictions are based on the structural analysis of the COVID-19 victim flow network, which shows several hotspots with high vulnerability to system overload. These hotspots concentrate with either the greatest number of deaths (hospital) or of burials (cemetery or crematorium), and therefore have high potential to become overwhelmed by receiving many bodies due to the increase in victims of the pandemic. We recommend special attention to be given to localities on the east side of São Paulo, which has both the most vulnerable hospitals in the city, and also houses cemeteries and crematoriums that have a central role in the network and / or are vulnerable. Based on our optimization analysis, we suggest logistical changes in the current flow of bodies from hospitals to cemeteries/crematoriums so as not to overload the funeral system and minimize transportation costs. In this sense, our results are potentially useful for improving the operational planning of the Municipality of São Paulo, ratifying or rectifying actions underway at the municipal level.
Este é o primeiro relatório do Observatório COVID19 - Grupo: Redes de Contágio analisando os dados de óbitos da cidade de São Paulo. Neste relatório, integramos os dados de óbitos da cidade de São Paulo entre os dias 02/04/2020 e 28/04/2020 com informações sobre o fluxo de vítimas entre os hospitais e os cemitérios e crematórios da cidade de São Paulo. Incluímos em nossas análises óbitos confirmados e óbitos suspeitos de COVID-19. Os principais objetivos deste relatório são: (1) descrever a estrutura do fluxo de vítimas entre localidades e (2) sugerir mudanças no fluxo com base em distâncias geográficas de maneira a evitar uma potencial sobrecarga do sistema funerário. Sugere-se à prefeitura da cidade de São Paulo que seja realizado um planejamento para uma potencial sobrecarga do sistema funerário (isto é, número de sepultamentos) da cidade de São Paulo com base nos resultados apresentados. Desta forma, nossos resultados reforçam a necessidade de ser adotado planejamento específico para a gestão dos casos extraordinários visualizados no contexto da pandemia. Esta previsão está baseada na análise estrutural da rede de fluxos de vítimas da COVID-19, que indica a concentração de vários locais com alta vulnerabilidade à sobrecarga do sistema. Tais locais concentram a maior quantidade de óbitos (hospitais) ou a maior concentração de sepultamentos (cemitérios ou crematórios) e tem portanto alto potencial de tornarem-se sobrecarregados por receberem muitos corpos devido ao aumento de vítimas da pandemia. Recomenda-se especial atenção à localidades da zona leste de São Paulo, que apresenta os hospitais mais vulneráveis da cidade e abriga cemitérios e crematórios que possuem papel central na rede e/ou encontram-se vulneráveis. Com base em nossa análise de otimização, sugerimos mudanças logísticas no atual fluxo de corpos de hospitais para cemitérios/crematórios de modo a não sobrecarregar o sistema funerário e minimizar os custos de transporte. Neste sentido, nossos resultados são potencialmente úteis ao aperfeiçoamento do planejamento operacional da Prefeitura Municipal de São Paulo, ratificando ou retificando ações em curso no âmbito municipal.
8.
Guideline of the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019
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Lopes, Marcelo Antônio Cartaxo Queiroga
; Oliveira, Gláucia Maria Moraes de
; Ribeiro, Antonio Luiz Pinho
; Pinto, Fausto J.
; Rey, Helena Cramer Veiga
; Zimerman, Leandro Ioschpe
; Rochitte, Carlos Eduardo
; Bacal, Fernando
; Polanczyk, Carisi Anne
; Halperin, Cidio
; Araújo, Edson Correia
; Mesquita, Evandro Tinoco
; Arruda, José Airton
; Rohde, Luis Eduardo Paim
; Grinberg, Max
; Moretti, Miguel
; Caramori, Paulo Ricardo Avancini
; Botelho, Roberto Vieira
; Brandão, Andréa Araújo
; Hajjar, Ludhmila Abrahão
; Santos, Alexandre Fonseca
; Colafranceschi, Alexandre Siciliano
; Etges, Ana Paula Beck da Silva
; Marino, Bárbara Campos Abreu
; Zanotto, Bruna Stella
; Nascimento, Bruno Ramos
; Medeiros, Cesar Rocha
; Santos, Daniel Vitor de Vasconcelos
; Cook, Daniela Matos Arrowsmith
; Antoniolli, Eduardo
; Souza Filho, Erito Marques de
; Fernandes, Fábio
; Gandour, Fabio
; Fernandez, Francisco
; Souza, Germano Emilio Conceição
; Weigert, Guilherme de Souza
; Castro, Iran
; Cade, Jamil Ribeiro
; Figueiredo Neto, José Albuquerque de
; Fernandes, Juliano de Lara
; Hadlich, Marcelo Souza
; Oliveira, Marco Antonio Praça
; Alkmim, Maria Beatriz
; Paixão, Maria Cristina da
; Prudente, Maurício Lopes
; Aguiar Netto, Miguel A. S.
; Marcolino, Milena Soriano
; Oliveira, Monica Amorim de
; Simonelli, Osvaldo
; Lemos Neto, Pedro A.
; Rosa, Priscila Raupp da
; Figueira, Renato Minelli
; Cury, Roberto Caldeira
; Almeida, Rodrigo Coelho
; Lima, Sandra Regina Franco
; Barberato, Silvio Henrique
; Constancio, Thiago Inocêncio
; Rezende, Wladimir Fernandes de
.
https://doi.org/10.5935/abc.20190205
5274 downloads
9.
The urban and rural capybaras (Hydrochoerus hydrochaeris) as reservoir of Salmonella in the western Amazon, Brazil
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Farikoski, Itacir O.
; Medeiros, Luciana S.
; Carvalho, Yuri K.
; Ashford, David A.
; Figueiredo, Eduardo E. S.
; Fernandes, Dandara V.G.S.
; Silva, Paula J.B.
; Ribeiro, Vânia M.F.
.
RESUMO: A capivara (Hydrochoerus hydrochaeris) é o maior roedor do mundo. No estado do Acre, Brasil, as populações de capivaras têm aumentado significativamente. O papel das capivaras na transmissão de certas infecções zoonóticas bacterianas não é bem compreendido, incluindo as bactérias do gênero Salmonella. Salmonella spp. geralmente causam enterite ou septicemia em mamíferos, porém muitas espécies de mamíferos podem carregar a bactéria de forma assintomática e eliminá-la em suas fezes. Para entender melhor o possível papel das capivaras como reservatórios de Salmonellaspp., realizamos um estudo para identificação de Salmonella spp. em amostras fecais de capivaras no Acre. Em uma amostra de conveniência, 54 capivaras de duas áreas urbanas e duas áreas rurais do Acre foram capturadas e mantidas por três a quatro dias para amostragem. Nenhum dos animais era sintomático de qualquer doença intestinal. Três amostras fecais foram coletadas de cada animal, durante sua permanência em cativeiro. Cada amostra foi cultivada para a presença de Salmonella spp. no Laboratório de Bacteriologia Veterinária da Universidade Federal do Acre. As amostras foram semeadas em caldo de pré-enriquecimento tetrationato e em peptona de caldo de pré-enriquecimento. Após 24 horas de incubação, todas as amostras foram semeadas em ágar MacConkey (MC) e ágar Salmonella-Shigella (SS). Colônias sugestivas foram submetidas a análises bioquímicas. Colônias compatíveis com Salmonella de acordo com o perfil bioquímico foram submetidas à sorotipagem (Sorokit para Salmonella - Probac do Brasil). Além disso, a primeira amostra de cada uma das 54 capivaras foi testada para Salmonella spp. usando PCR, visando gene hilA. Oito (5%) das 162 amostras examinadas por cultura bacteriana foram positivas para Salmonella spp. Enquanto quatro (7%) das 54 examinadas pela PCR foram positivas. Dos oito animais positivos em cultura, cinco eram de área urbana e três de área rural. Na PCR, apenas um animal positivo era de área urbana e quatro de área rural. Considerando o diagnóstico conjunto por ambos os testes, PCR e cultura, um animal foi considerado positivo. Todas as amostras foram coletadas em animais livres, sem sinais clínicos aparentes de salmonelose, indicando o potencial da capivara como reservatório nesse ecossistema.
ABSTRACT: The capybara (Hydrochoerus hydrochaeris) is the largest rodent in the world. In the state of Acre, Brazil, populations of capybaras have been increasing significantly. The role of capybaras in the transmission of certain bacterial zoonotic infections is not well understood, including bacteria of the genus Salmonella. Salmonella spp. generally cause enteritis or septicemia in mammals, however many mammalian species can carry the bacteria asymptomatically and shed it in their feces. To better understand the possible role of capybaras as reservoirs of Salmonella spp., we conducted a study of Salmonella within fecal samples from capybara in Acre. In a convenience sample, 54 capybaras from two urban and two rural areas of Acre were captured and kept for three to four days for sampling. None of the animals were symptomatic of any intestinal illness. Three separate fecal samples were collected from each animal, during their stays in captivity. Each sample was cultured for the presence of Salmonella spp. at the bacteriology laboratory of the Veterinary College of the Federal University of Acre. Samples were seeded in tetrationate pre-enrichment broth and in pre-enrichment broth peptone. After a 24 hour of incubation all samples were streaked on MacConkey Agar (MC) and Salmonella-Shigella Agar (SS). Suggestive colonies were submitted to biochemical analysis. Salmonella compatible colonies according to biochemical profile were submitted to serotyping (Sorokit for Salmonella - Probac do Brasil). In addition, the first sample from each of the 54 capybara was tested for Salmonella spp. using PCR targeting gene hilA. Eight (5%) of the 162 samples examined by bacterial culture were positive for Salmonella spp., while four (7%) of the 54 examined by PCR were positive. From the eight positive animals on culture, five were from urban area and three from rural area. On PCR, only one positive animal was from urban area and four were from rural area. Overall, by either test, one of the 54 animals was positive. All samples were collected in free - living animals with no apparent clinical signs of salmonellosis, indicating the potential of capybara as reservoir on this ecosystem.
https://doi.org/10.1590/1678-5150-pvb-5761
1320 downloads
10.
Impact of C4 , C4A and C4B gene copy number variation in the susceptibility, phenotype and progression of systemic lupus erythematosus
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Pereira, Kaline Medeiros Costa
; Perazzio, Sandro
; Faria, Atila Granado A.
; Moreira, Eloisa Sa
; Santos, Viviane C.
; Grecco, Marcelle
; Silva, Neusa Pereira da
; Andrade, Luis Eduardo Coelho
.
Abstract Background Complement component 4 (C4) gene copy number (GCN) affects the susceptibility to systemic lupus erythematosus (SLE) in different populations, however the possible phenotype significance remains to be determined. This study aimed to associate C4A , C4B and total C4 GCN and SLE, focusing on the clinical phenotype and disease progression. Methods C4 , C4A and C4B GCN were determined by real-time PCR in 427 SLE patients and 301 healthy controls, which underwent a detailed clinical evaluation according to a pre-established protocol. Results The risk of developing SLE was 2.62 times higher in subjects with low total C4 GCN (< 4 copies, OR = 2.62, CI = 1.77 to 3.87, p < 0.001) and 3.59 times higher in subjects with low C4A GCN (< 2 copies; OR = 3.59, CI = 2.15 to 5.99, p < 0.001) compared to those subjects with normal or high GCN of total C4 (≥4) and C4A (≥2), respectively. An increased risk was also observed regarding low C4B GCN, albeit to a lesser degree (OR = 1.46, CI = 1.03 to 2.08, p = 0.03). Furthermore, subjects with low C4A GCN had higher permanent disease damage as assessed by the Systemic Lupus International Collaborating Clinics – Damage Index (SLICC-DI; median = 1.5, 95% CI = 1.2–1.9) than patients with normal or high copy number of C4A (median = 1.0, 95% CI = 0.8–1.1; p = 0.004). There was a negative association between low C4A GCN and serositis ( p = 0.02) as well as between low C4B GCN and arthritis ( p = 0.02). Conclusions This study confirms the association between low C4 GCN and SLE susceptibility, and originally demonstrates an association between low C4A GCN and disease severity.
https://doi.org/10.1186/s42358-019-0076-6
1754 downloads
11.
Association between the consumption of antioxidant nutrients with lipid alterations and cardiometabolic risk in adolescents
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NASCIMENTO, Larisse Monteles
; GOMES, Keila Rejane Oliveira
; MASCARENHAS, Marcio Denis Medeiros
; MIRANDA, Cassio Eduardo Soares
; ARAÚJO, Telma Maria Evangelista de
; FROTA, Karoline de Macedo Gonçalves
.
RESUMO Objetivo Esta pesquisa teve como objetivo verificar as associações entre o consumo de nutrientes antioxidantes e as alterações lipídicas e o risco cardiometabólico em adolescentes. Métodos Trata-se de estudo transversal com 327 adolescentes de 14 a 19 anos de idade. Investigaram-se dados sociodemográficos, antropométricos, pressóricos, bioquímicos e de consumo alimentar. O risco cardiometabólico foi calculado por meio da agregação dos fatores de risco, expressa pela soma dos escores Z. Realizou-se a regressão de Poisson para estimar as razões de prevalência. Resultados O baixo consumo de zinco associou-se a elevados níveis de CT e triglicérides para os meninos, e a níveis baixos de HDL-c e elevados de LDL-c e CT para as meninas, demonstrando risco. Além disso, a baixa ingestão de cobre associou-se a altos níveis de triglicérides e risco cardiometabólico para as meninas. A razão de prevalência nos níveis elevados de LDL-c, CT e risco cardiometabólico foi maior entre os adolescentes que apresentavam baixa ingestão de vitamina A. Foram observadas também associações, no sexo feminino, da menor ingestão de vitamina A com altos níveis de triglicérides. A baixa ingestão de vitamina C nos meninos mostrou associações com LDL-c e triglicérides elevado, enquanto nas meninas essa vitamina associou-se com menores níveis de HDL-c. O baixo consumo de vitamina E, para as meninas, apresentou associações com níveis baixos de HDL-c e elevados de CT. Conclusão As associações entre os micronutrientes antioxidantes e as alterações lipídicas e risco cardiometabólico ressaltam a importância de estimular o consumo de alimentos que sejam fonte desses nutrientes, com o objetivo de modular as alterações lipídicas e o risco cardiometabólico.
ABSTRACT Objective This study aimed at validating the associations between the consumption of antioxidant nutrients as well as lipid alterations and cardiometabolic risks in adolescents. Methods This cross-sectional study included 327 adolescents aged 14-19 years. Sociodemographic and dietary information, anthropometric and blood pressure measurements, and biochemical data were obtained. Cardiometabolic risk was calculated by aggregating the risk factors, which were expressed as the sum of Z-scores. Poisson regression was performed to estimate the prevalence ratios. Results In boys, low intake of zinc was associated with elevated total cholesterol and triglyceride levels, whereas it was associated with low high-density lipoprotein cholesterol levels and high low-density lipoprotein cholesterol and total cholesterol levels in girls, thus indicating a cardiometabolic risk. Furthermore, low intake of copper was associated with high triglyceride levels and cardiometabolic risk in girls. The high prevalence ratios of high low-density lipoprotein cholesterol and total cholesterol levels and cardiometabolic risk were higher in those with low intake of vitamin A. Among girls, associations were also observed between lower intake of vitamin A and high triglyceride levels. Low intake of vitamin C among boys was associated with elevated high low-density lipoprotein cholesterol and triglyceride levels. Among girls, the intake of this vitamin was associated with lower low high-density lipoprotein cholesterol levels. In girls, low intake of vitamin E was associated with low low high-density lipoprotein cholesterol levels and high total cholesterol levels. Conclusion The associations between antioxidant micronutrients as well as lipid alterations and cardiometabolic risk emphasize the importance of encouraging the consumption of foods that are rich in these nutrients to modulate lipid alterations and cardiometabolic risk.
https://doi.org/10.1590/1678-98652018000200005
1954 downloads
12.
BETWEEN JUGGLING, STUNTS, AND ANTICS: THE MEANING OF WORK FOR CIRCUS ARTISTS
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MEDEIROS, ANGELA MARIA DE L.
; LIMA, TEREZA CRISTINA B. DE
; PAIVA, LUIS EDUARDO B.
; ARAÚJO, RAFAELA DE A.
.
RAM. Revista de Administração Mackenzie
- Journal Metrics
RESUMO Objetivo: Este estudo teve como objetivo investigar os sentidos do trabalho dos artistas circenses, nas três dimensões: individual, organizacional e social, seguindo a adaptação do modelo de Morin (2001), propostas por Oliveira et al. (2004) e Morin, Tonelli e Pliopas (2007). Originalidade/valor: O artigo se destaca por tratar de uma categoria de artistas que está perdendo espaço dentro da sociedade, sendo cada vez mais marginalizada. Diante disso, torna-se relevante entender qual o sentido de uma atividade que está em declínio. Design/metodologia/abordagem: Trata-se de um estudo descritivo e exploratório, de natureza qualitativa, em que, por meio de entrevistas semiestruturadas, foram coletados dados primários com dez artistas circenses. Para coleta de dados, utilizou-se a técnica da análise de conteúdo com o uso do software Atlas.ti. Resultados: Os resultados apontam que há sentido no trabalho para os artistas circenses em todas as dimensões: 1. Na dimensão individual, o fator que predominou foi o prazer, pois em mais de um momento todos os entrevistados enalteceram sua satisfação em pertencer ao circo; 2. Na dimensão organizacional, a utilidade predominou, já que todos consideram contribuir e atender às necessidades do circo; e 3. Na dimensão social, as relações interpessoais demonstraram que, mesmo com o preconceito em evidência, é possível relacionamentos externos ao circo. Os resultados contribuem para a literatura que envolve pesquisas com artistas circenses, levando-se em conta os seus sentidos do trabalho.
ABSTRACT Purpose: This study aimed to investigate the meanings of the work of circus artists in three dimensions, individual, organizational, and social, following the adaptation to the model of Morin (2001) proposed by Oliveira, Piccinini, Fontoura, and Schweig (2004) and Morin, Tonelli, and Pliopas (2007). Originality/value: The article stands out because it deals with a category of artists that is losing space within society, being increasingly marginalized. Given this, it becomes relevant to understand the meaning of an activity that is in decline. Design/methodology/approach: This is a descriptive and exploratory study of a qualitative nature, in which primary data were collected through semi-structured interviews with ten circus artists. For data collection, the content analysis technique was used in Atlas.ti software. Findings: The results point out that there is meaning in work for the circus artists across all dimensions: 1. In the individual dimension, the pleasure was the predominant factor, since in more than one moment, all the interviewees expressed their satisfaction in belonging to the circus; 2. In the organizational dimension, utility prevailed, since everyone considered contributing and meeting the needs of the circus; 3. In the social dimension, interpersonal relations, demonstrating that even with evidence of prejudice, external relationships can be formed in the circus. The results contribute to the literature that involves studies with circus artists, considering their meanings of work.
https://doi.org/10.1590/1678-6971/eramd180061
1168 downloads
13.
Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment
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Marques, Claudia Diniz Lopes
; Duarte, Angela Luzia Branco Pinto
; Ranzolin, Aline
; Dantas, Andrea Tavares
; Cavalcanti, Nara Gualberto
; Gonçalves, Rafaela Silva Guimarães
; Rocha Junior, Laurindo Ferreira da
; Valadares, Lilian David de Azevedo
; Melo, Ana Karla Guedes de
; Freire, Eutilia Andrade Medeiros
; Teixeira, Roberto
; Neto, Francisco Alves Bezerra
; Medeiros, Marta Maria das Chagas
; Carvalho, Jozélio Freire de
; Santos, Mario Sergio F.
; Océa, Regina Adalva de L. Couto
; Levy, Roger A.
; Andrade, Carlos Augusto Ferreira de
; Pinheiro, Geraldo da Rocha Castelar
; Abreu, Mirhelen Mendes
; Verztman, José Fernando
; Merenlender, Selma
; Ribeiro, Sandra Lucia Euzebio
; Costa, Izaias Pereira da
; Pileggi, Gecilmara
; Trevisani, Virginia Fernandes Moça
; Lopes, Max Igor Banks
; Brito, Carlos
; Figueiredo, Eduardo
; Queiroga, Fabio
; Feitosa, Tiago
; Tenório, Angélica da Silva
; Siqueira, Gisela Rocha de
; Paiva, Renata
; Vasconcelos, José Tupinambá Sousa
; Christopoulos, Georges
.
Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias, visto que metade dos casos evolui com artrite crônica, persistente e incapacitante. Os dados na literatura sobre terapêuticas específicas nas diversas fases da artropatia ocasionada pela infecção pelo vírus chikungunya (CHIKV) são limitados, não existem estudos randomizados de qualidade que avaliem a eficácia das diferentes terapias. Há algumas poucas publicações sobre o tratamento das manifestações musculoesqueléticas da febre chikungunya, porém com importantes limitações metodológicas. Os dados atualmente disponíveis não permitem conclusões favoráveis ou contrárias a terapêuticas específicas, bem como uma adequada avaliação quanto à superioridade entre as diferentes medicações empregadas. O objetivo deste trabalho foi elaborar recomendações para o tratamento da febre chikungunya no Brasil. Foi feita uma revisão da literatura com seleção de artigos baseados em evidência, nas bases de dados Medline, SciELO, PubMed e Embase e de resumos de anais de congressos, além da opinião dos especialistas para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Este artigo refere-se à parte 2 das Recomendações da Sociedade Brasileira de Reumatologia para Diagnóstico e Tratamento da Febre Chikungunya, que trata especificamente do tratamento.
Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.
https://doi.org/10.1016/j.rbre.2017.06.004
38509 downloads
14.
Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations
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Marques, Claudia Diniz Lopes
; Duarte, Angela Luzia Branco Pinto
; Ranzolin, Aline
; Dantas, Andrea Tavares
; Cavalcanti, Nara Gualberto
; Gonçalves, Rafaela Silva Guimarães
; Rocha Junior, Laurindo Ferreira da
; Valadares, Lilian David de Azevedo
; Melo, Ana Karla Guedes de
; Freire, Eutilia Andrade Medeiros
; Teixeira, Roberto
; Bezerra Neto, Francisco Alves
; Medeiros, Marta Maria das Chagas
; Carvalho, Jozélio Freire de
; Santos, Mario Sergio F.
; Océa, Regina Adalva de L. Couto
; Levy, Roger A.
; Andrade, Carlos Augusto Ferreira de
; Pinheiro, Geraldo da Rocha Castelar
; Abreu, Mirhelen Mendes
; Verztman, José Fernando
; Merenlender, Selma
; Ribeiro, Sandra Lucia Euzebio
; Costa, Izaias Pereira da
; Pileggi, Gecilmara
; Trevisani, Virginia Fernandes Moça
; Lopes, Max Igor Banks
; Brito, Carlos
; Figueiredo, Eduardo
; Queiroga, Fabio
; Feitosa, Tiago
; Tenório, Angélica da Silva
; Siqueira, Gisela Rocha de
; Paiva, Renata
; Vasconcelos, José Tupinambá Sousa
; Christopoulos, Georges
.
Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias. Até 2013, as Américas haviam registrado apenas casos importados quando, em outubro desse mesmo ano, foram notificados os primeiros casos na Ilha de Saint Martin, no Caribe. No Brasil, os primeiros relatos autóctones foram confirmados em setembro de 2014 e até a semana epidemiológica 37 de 2016 já haviam sido registrados 236.287 casos prováveis de infecção pelo chikungunya vírus (CHIKV), 116.523 confirmados sorologicamente. As mudanças ambientais causadas pelo homem, o crescimento urbano desordenado e o número cada vez maior de viagens internacionais têm sido apontados como os fatores responsáveis pela reemergência de epidemias em grande escala. Caracterizada clinicamente por febre e dor articular na fase aguda, em cerca de metade dos casos existe evolução para a fase crônica (além de três meses), com dor persistente e incapacitante. O objetivo deste trabalho foi elaborar recomendações para diagnóstico e tratamento da febre chikungunya no Brasil. Para isso, foi feita revisão da literatura nas bases de dados Medline, SciELO e PubMed, para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Foram geradas 25 recomendações, divididas em três grupos temáticos: (1) diagnóstico clínico, laboratorial e por imagem; (2) situações especiais e (3) tratamento. Na primeira parte estão os dois primeiros temas e o tratamento na segunda.
Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.
https://doi.org/10.1016/j.rbre.2017.05.006
37996 downloads
15.
Compactação ruminal e obstrução intestinal em bovinos, associadas ao consumo de Agave sisalana Perrine (Agavaceae)
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Resumo: A compactação dos pré-estômagos é um transtorno digestivo resultante da ingestão de forragem de baixa qualidade, rico em lignina e com baixos níveis de energia e proteína digerível, associada ou não a restrição hídrica. O acúmulo de vegetais ricos em fibras indigeríveis pode levar também a formação de fitobezoares, causando transtornos digestivos e obstruções intestinais. Objetivou-se com este trabalho descrever os aspectos epidemiológicos e as alterações clínico-patológicas de um surto de alterações digestórias em bovinos alimentados com Agave sisalana. O rebanho acometido era formado por 22 animais adultos, criados de forma semiextensiva, que, devido a escassez de forragem, receberam no cocho, quase que exclusivamente, durante dois meses, o caule do A. sisalana cortado manualmente. Seis vacas apresentaram diminuição do apetite, distensão abdominal, redução dos períodos de ruminação e da produção de fezes. Um animal foi encaminhado ao Hospital Veterinário da Universidade Federal de Campina Grande. O diagnóstico presuntivo de compactação ruminal e obstrução intestinal foi dado pela epidemiologia, sinais clínicos e análise de fluido ruminal. Na necropsia observou-se rúmen, retículo e omaso repletos, com conteúdo fibroso e ressecado constituído por fibras de A. sisalana. No abomaso observou-se a presença de conteúdo pastoso e esverdeado a acastanhado. Em todos os pré-estômagos e no abomaso havia fitobezoares, que mediam entre 4 e 12 cm de diâmetro. No duodeno um fitobezoar obstruía parcialmente a luz do órgão, com a porção anterior repleta de conteúdo e a posterior vazia. Conclui-se que a alimentação com caules de A. sisalana por longos períodos causa compactação de pre-estômagos e formação de fitobezoares.
Abstract: Indigestion due to compaction of the ruminal content is a digestive disorder resulting from low-quality forage intake, rich in lignin and with low levels of energy and digestible protein, with or without water restriction. The accumulation of plant residues rich in indigestible fibers can also lead to formation of phytobezoars, causing digestive disorders and intestinal obstructions. The objective of this paper was to describe the epidemiology and the clinical and pathological changes of an outbreak of indigestion and other digestive disorders in cattle fed Agave sisalana. The affected herd consisted of 22 adult cattle reared in a semi-extensive system, which ingested almost exclusively stalks of A. sisalana manually cut for two months. Six cows showed decreased appetite and rumination, abdominal distension, and reduced production of dried feces. One animal was referred to the Veterinary Hospital. The presumptive diagnosis of indigestion was made by the epidemiologic data, clinical signs, and laboratory evaluation. At necropsy, the rumen, reticulum and omasum were filled with fibrous and dried A. sisalana content. A viscous, greenish brownish content was present in the abomasum. Numerous phytobezoars were found in the pre-stomachs and abomasum measuring 4-12cm in diameter. One phytobezoar was partially obstructing the duodenum, with the cranial part of the organ filled with intestinal content, and the caudal portion was empty. It is concluded that the administration of A. sisalana stalks for long periods may cause indigestion due to ruminal compaction and formation of phytobezoars.
https://doi.org/10.1590/S0100-736X2016000800007
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in | SciELO colection code (e.g. scl - Brasil, col - Colômbia) |
use_license | article usage license code |