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Abstract Background The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous. Objectives To evaluate compression therapy with elastic stockings for 7 days after phlebectomy. Methods We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) – wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) – given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume. Results Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls. Conclusions Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Resumo Contexto O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável. Objetivos Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia. Métodos Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) – uso de meia elástica por 24 horas após a cirurgia – e grupo controle (40 membros) – uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia. Resultados Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle. Conclusões O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.

https://doi.org/10.1590/1677-5449.202200522

Diretrizes brasileiras de diagnóstico e tratamento de lesões vasculares traumáticas
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Góes Junior, Adenauer Marinho de Oliveira

; Parreira, José Gustavo

; Kleinsorge, Gustavo Henrique Dumont

; Dalio, Marcelo Bellini

; Alves, Pedro Henrique Ferreira

; Gomes, Francisco João Sahagoff de Deus Vieira

; Araujo, Walter Junior Boim de

; Joviliano, Edwaldo Edner

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230042

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

Abstract Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities.

Resumo Trauma é uma causa importante de morbimortalidade, que acomete principalmente jovens. A hemorragia incoercível é o principal mecanismo de óbito precoce nessas vítimas, e as lesões vasculares não compressíveis representam grandes desafios para os cirurgiões. O traumatismo vascular impacta diretamente a viabilidade de membros traumatizados, aumentando o risco de amputação. Nas últimas décadas, muitas condutas de diagnóstico e tratamento de lesões vasculares traumáticas foram modificadas. A angiotomografia suplantou a angiografia como padrão ouro para diagnóstico, as técnicas endovasculares foram incorporadas ao arsenal terapêutico e o conceito de “controle de danos” foi estabelecido. No entanto, há lacunas na literatura nacional sobre a normatização de condutas em trauma vascular, principalmente considerando as limitações do Brasil. Por isso, a Sociedade Brasileira de Angiologia e de Cirurgia Vascular e a Sociedade Brasileira de Atendimento Integrado ao Traumatizado revisaram a literatura disponível sobre trauma vascular e organizaram diretrizes sobre o diagnóstico e tratamento dessas lesões.

https://doi.org/10.1590/1677-5449.202300421

Sistemas integrados de produção agropecuária: efeitos sobre a qualidade física de um planossolo no semiárido brasileiro
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Silva, Pedro Luan Ferreira da

; Oliveira, Flávio Pereira de

; Amaral, André Júlio do

; Martins, Adriana Ferreira

; Pereira, Walter Esfrain

; Tavares, Danillo Dutra

; Nóbrega, Camila Costa da

Ciencia del suelo

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dec 2021, Volume 39 N. 2 Pages 106 - 121

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

RESUMO Os solos do semiárido brasileiro estão sob um constante processo de degradação e estratégias sustentáveis de produção agropecuária devem ser adotadas de forma a mitigar este problema. Sendo assim, o objetivo deste trabalho foi avaliar o comportamento físico-hídrico do solo quatro anos após a implantação de sistemas de integração lavoura-pecuária-floresta no semiárido Brasileiro. O experimento foi instalado no município de Alagoinha, PB, em um Planossolo Háplico de textura franco-arenosa. Foram avaliados cinco sistemas de integração em delineamento de blocos ao acaso (DBC) com quatro repetições: i) Ipê roxo (Tabebuia impetiginosa) + Urochloa decumbens (iPF1); ii) Gliricídia (Gliricidia sepium) + Urochloa decumbens (iPF2); iii) Sabiá (Mimosa caesalpiniifolia) + Urochloa decumbens (iPF3); iv) Milho (Zea mays) + Urochloa decumbens (iLP); v) Urochloa decumbens (Pastagem). Os dados submetidos a análise de variância e teste de Tukey (p<0,05) demonstraram que a integração Lavoura-Pecuária-Floresta, após o período de quatro anos, ainda não promoveu melhoria física significativa dos atributos físicos do Planossolo em estudo, porém, o índice S apresentou valores satisfatórios. Em relação a condição antecedente a implantação dos sistemas, verifica-se uma alteração positiva na estrutura, refletindo na redução da densidade do solo e aumento da porosidade total.

ABSTRACT The soils of the Brazilian semi-arid are under a constant process of degradation and sustainable agricultural production strategies must be adopted in order to alleviate this problem. Therefore, the objective of this work was to evaluate the physical-water behavior of an Albaqualfs four years after the implantation of crop-livestock-forest integration systems in the Brazilian semiarid. The experiment was installed in the county of Alagoinha, PB, in an Albaqualfs with a sandy-loam texture. Five integration systems in randomized block design (DBC) with four replications were evaluated: i) Purple Ipe (Tabebuia impetiginosa) + Brachiaria decumbens (iPF1); ii) Gliricidia (Gliricidia sepium) + Urochloa decumbens (iPF2); iii) Sabiá (Mimosa caesalpiniifolia) + Urochloa decumbens (iPF3); iv) Maize (Zea mays) + Urochloa decumbens (iLP); v) Urochloa decumbens (pasture). The data submitted to analysis of variance and Tukey's test (p<0.05) demonstrated that the crop-livestock-forest integrated system, after the period of four years, has not yet promoted significant physical improvement of the attributes of the Albaqualfs under study, however, an attribute such as the S index, presented satisfactory values. Regarding the condition prior to the implantation of the systems, there is a positive change in the structure, reflecting in the reduction of the bulk density of the soil and an increase in the total porosity.

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Seasonality affects the community of endophytic fungi in coconut (Cocos nucifera) crop leaves
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Oliveira, Rafael José Vilela de

; Sousa, Natalia Mirelly Ferreira de

; Pinto Neto, Walter de Paula

; Bezerra, José Luiz

; Silva, Gladstone Alves da

; Cavalcanti, Maria Auxiliadora de Queiroz

Acta Botanica Brasilica

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dec 2020, Volume 34 N. 4 Pages 704 - 711

Abstract: En | Text: En | PDF: En

ABSTRACT The diversity of endophytic fungi in healthy coconut palm leaves (Cocos nucifera) was assessed by analyzing fungal isolates from three coconut cultivars (yellow dwarf, green dwarf, and a hybrid cultivar PB121) used agriculturally in Brazil. The influence of season (rainy or dry) on the endophytic fungal community was also analyzed. Overall, 318 fungal isolates were obtained from 972 coconut leaf fragments. The rDNA ITS region was sequenced from representative species of the isolated endophytic fungi and the most common species identified were Nigrospora oryzae, Pestalotiopsis sp., and Zasmidium musae. The alpha diversity of the endophytic fungi was also calculated. Nonmetric multidimensional scaling (NMDS) ordination and permutational analysis of variance (PERMANOVA) revealed significant seasonal effects on the composition of the endophyte community. However, practically no influence was observed on the fungal communities for the different cultivars of coconut.

https://doi.org/10.1590/0102-33062020abb0106 341 downloads

Secondary syphilis presenting as Syphilide psoriasiforme: lessons from the older syphilology literature
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Martins, Carlos José

; Lima, Ricardo Barbosa

; Eyer-Silva, Walter de Araujo

; Almenara, Camila Bastos

; Carvalho-Rangel, Isabelle

; Carvalho, Ricardo de Souza

; Basílio-de-Oliveira, Rodrigo Panno

; Araujo, Luciana Ferreira de

; Ferry, Fernando Raphael de Almeida

; Silva, Leila Rangel da

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e21

Abstract: En | Text: En | PDF: En

ABSTRACT It is essential for health care providers to be familiared with the full spectrum of clinical presentations of syphilis. We present herein a case of syphilide psoriasiforme, an uncommon but well recognized clinical presentation of secondary syphilis. A 46-year-old HIV-infected female patient was referred to our attention with a presumptive diagnosis of palmoplantar psoriasis. On examination, there were exuberant pinkish-red papules and plaques covered with a thick silvery scale in the palms, flexor surfaces of the wrists, and the medial longitudinal arches of the feet. Serological and histopathological analyses uncovered the diagnosis of syphilis. Clinical remission was obtained after treatment. A detailed review of the literature on syphilide psoriasiforme, including descriptions from older syphilology textsis provided. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.

https://doi.org/10.1590/s1678-9946202062021 1430 downloads

Consequências negativas de adoecer e sobreviver ao osteossarcoma no cotidiano de adultos jovens: uma revisão narrativa
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Collodel-Benetti, Idonézia

; Oliveira, Walter Ferreira de

Psicología, Conocimiento y Sociedad

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2020, Volume 10 N. 3 Pages 135 - 150

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

Resumen: El osteossarcoma es un cáncer raro, cuya incidencia, en Brasil, está estimada en 350 nuevos casos / año, presentando escasa literatura en salud mental. Caracterizada como una revisión narrativa, esta investigación propone discutir el impacto psicológico provocado por el osteossarcoma en el paciente joven. Es un trabajo discursivo, expositivo-argumentativo, que versa sobre un tema específico, anclado en bases de datos nacionales e internacionales, en el espacio temporal entre 2005 y 2015. Los resultados apuntan a una enfermedad que puede provocar crisis existenciales y demanda tratamiento psicosocial.

Abstract: Osteosarcoma is a rare type of cancer, whose incidence in Brazil is estimated in 350 new cases/ year presenting little literature in mental health. Characterized as a narrative review, this study aims at discussing the psychological impact brought about osteosarcoma in the young patient. It is an expository-argumentative and discursive work, which explores a specific theme, anchored in the national and international data base resources, from the years 2000 to 2015. The results point out to a disease that can cause existential crisis and demands psychosocial treatment.

Resumo: O osteossarcoma é um câncer raro, cuja incidência, no Brasil, está estimada em 350 novos casos/ano, apresentando escassa literatura em saúde mental. Caracterizada como um estudo teórico, esta investigação se propõe a discutir sobre o impacto psicológico trazido pelo osteossarcoma no paciente jovem. É um trabalho discursivo, expositivo-argumentativo, que versa sobre um tema específico, ancorado em bases de dados nacionais e internacionais, no espaço-temporal entre 2005 e 2015. Os resultados apontam para uma enfermidade que pode provocar crises existenciais e exigir tratamento psicossocial.

https://doi.org/10.26864/pcs.v10.n3.9

Mucocele of the vermiform appendix: diagnostic challenges and therapeutic approach
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Cunha, Carlos Magno Queiroz da

; Lima, Douglas Marques Ferreira de

; Troiani Neto, Giovanni

; Lima, Francisco Fernando Pimenta

; Pimenta, Caio Regis de Oliveira Medeiros

; Gomes, José Walter Feitosa

Journal of Coloproctology (Rio de Janeiro)

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sep 2019, Volume 39 N. 3 Pages 258 - 261

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

RESUMO Introdução: A mucocele do apêndice é definida como a dilatação obstrutiva do apêndice vermiforme pelo acúmulo anormal de substância mucinosa em seu lúmen. Os exames de imagem podem ser úteis, porém não raramente falham em evidenciar a etiologia em questão. Em relação à abordagem terapêutica, existem diferentes opções de conduta. A apendicectomia foi o tratamento rotineiramente utilizado em cistoadenomas simples, com bons resultados. Todavia, em casos de neoplasias, é necessária ressecção mais agressiva, sendo a conduta terapêutica a hemicolectomia direita. Relato de caso: Paciente compareceu ao ambulatório de cirurgia com ressonância magnética apresentando cisto anexial de cerca de 11,0 × 4,5 cm à direita. Apresentava quadro de dor em fossa ilíaca direita há 6 meses. Devido ao achado radiológico e persistência do quadro clínico foi realizado videolaparoscopia, sendo identificada massa apendicular sugestiva de mucocele. Foi realizada apendicectomia videolaparoscópica, sem extravasamento do conteúdo mucinoso. A análise histopatológica confirmou o diagnóstico. Discussão: A mucocele raramente é diagnosticada de maneira eficaz no pré-operatório. Neste contexto, os exames de imagem não raramente falham em evidenciar tal etiologia. Diante da importância do diagnóstico pré-operatório para a definição da conduta, é essencial que sempre se leve em conta tal afecção como uma hipótese diagnóstica.

ABSTRACT Introduction: Mucocele of the appendix is defined as the obstructive dilatation of the vermiform appendix by the abnormal accumulation of mucinous substance in its lumen. Imaging tests may be useful, but they commonly fail to evidence the etiology in question. Regarding the therapeutic approach, there are different options for treatment. Appendectomy was routinely used in simple cystadenomas, with good results. However, in cases of neoplasias, more aggressive resection is necessary, and the therapeutic course of choice is the right hemicolectomy. Case report: Patient presented to the surgery outpatient clinic with magnetic resonance imaging presenting an adnexal cyst of about 11.0 × 4.5 cm on the right. The patient had pain in the right iliac fossa for 6 months. Due to the radiological finding and persistence of the clinical picture, videolaparoscopy was performed, and an appendicular mass suggestive of mucocele was identified. A laparoscopic appendectomy was performed, with no signs of mucus extravasation. Histopathological analysis confirmed the diagnosis. Discussion: Mucocele is rarely diagnosed effectively in the preoperatively. In this context, imaging tests do rarely evidence such etiology. Given the importance of preoperative diagnosis for the definition of conduct, it is essential that this condition be always taken into account as a diagnostic hypothesis.

https://doi.org/10.1016/j.jcol.2018.11.006 478 downloads

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura
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Catapan, Soraia de Camargo

; Oliveira, Walter Ferreira de

; Rotta, Tatiana Marcela

Ciência & Saúde Coletiva

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sep 2019, Volume 24 N. 9 Pages 3417 - 3429

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

Resumo A inserção do palhaço no hospital é relativamente recente e mais de 700 organizações realizam a palhaçoterapia nessas instituições no Brasil e em outras ao redor do mundo. Dada a ênfase na integralidade do cuidado e humanização da assistência à saúde, torna-se oportuno compreender e analisar a produção nacional e internacional do conhecimento científico sobre esta prática que desafia o modelo hegemônico de cuidado e potencialmente contribui na recuperação da saúde. Foi realizada uma revisão de literatura utilizando análise de conteúdo temática que analisou 18 publicações. As categorias que emergiram foram: respostas fisiológicas, comportamentais e emocionais; ansiedade pré-operatória; e ressignificação das práticas e do ambiente hospitalar. A literatura analisada aponta que a palhaçoterapia provoca diminuição significativa da ansiedade pré-operatória em crianças, comparativamente maior do que a obtida com o uso de um fármaco indutor de anestesia. A maior parte dos estudos investigou o uso da palhaçoterapia na adaptação à hospitalização, auxiliando na atribuição de novos significados. Apesar da baixa representatividade do tema no campo científico e mesmo não sendo amplamente aceita como prática de saúde, os resultados encontrados sugerem benefícios na utilização da palhaçoterapia em ambiente hospitalar.

Abstract The presence of clowns in hospitals is relatively recent and more than 700 organizations now perform clown therapy in hospitals in Brazil and around the world. Considering the emphasis on comprehensive care and the humanization of health, it is timely to understand and analyze the national and international scientific literature on clown therapy. This practice challenges the hegemonic biomedical model and potentially helps in the recuperation of health. A review of the literature was conducted and 18 publications were analyzed using thematic content analysis. The following categories arose from the analysis: physiological, behavioral, and emotional responses; presurgical anxiety and attribution of new meanings to practices and the hospital environment. Results have shown that clown therapy leads to a significant decrease in preoperative anxiety in children, even compared with the results obtained with the use of anesthesia-inducing drugs. Most studies investigated the use of clown therapy during patients’ adaptation to hospitalization, helping them to attribute new meanings to this situation. Despite its low representation in the scientific field and the fact that it has not been widely accepted as a health practice, several studies have shown the benefits of using clown therapy in the hospital setting.

https://doi.org/10.1590/1413-81232018249.22832017 7286 downloads

Comment on the study Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the Bypass Registry that was presented at the 46th Congress of the Brazilian Society of Cardiovascular Surgery, Nova Lima, BH, Brazil, April 5 and 6, 2019
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Dallan, Luís Alberto O.

; Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D’Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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aug 2019, Volume 34 N. 4 Pages 504 - 506

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2019-0606 335 downloads

10.

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
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Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D'Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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apr 2019, Volume 34 N. 2 Pages 142 - 148

Abstract: En | Text: En | PDF: En

Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.

https://doi.org/10.21470/1678-9741-2018-0313 1270 downloads

11.

Mecânica respiratória de pacientes com obesidade mórbida
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Sant’Anna Jr, Mauricio de

; Carvalhal, Renata Ferreira

; Oliveira, Fernando da Franca Bastos de

; Zin, Walter Araújo

; Lopes, Agnaldo José

; Lugon, Jocemir Ronaldo

; Guimarães, Fernando Silva

Jornal Brasileiro de Pneumologia

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2019, Volume 45 N. 5 elocation e20180311

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

RESUMO Objetivo avaliar os diferentes componentes da resistência do sistema respiratório e a força muscular respiratória, bem como investigar a ocorrência de limitação de fluxo expiratório (LFE) de pacientes obesos mórbidos (OM) na posição sentada. Métodos a amostra foi composta de OM (IMC ≥ 40 kg/m2) e de indivíduos não obesos (NO) com IMC entre 18 e 30 kg/m2. O protocolo foi composto de: avaliação antropométrica e da função respiratória (espirometria, pressões inspiratória (PIM) e expiratória máximas (PEM) e oscilometria de impulso). Na comparação entre os grupos, foi utilizado o teste T para amostras não pareadas. As correlações foram avaliadas pelo teste de Pearson, e o nível de significância foi de 5%. Resultados Foram avaliados 50 OM (idade 40,0 ± 10,4 anos, 1,64 ± 0,09 m, 138,8 ± 33,6 kg e 50,7 ± 8,9 kg/m2), além de 30 NO (idade 37,6 ± 11,5 anos, 1,67 ± 0,09 m, 65,2 ± 10,3 kg e 23,2 ± 22 kg/m2). Os OM apresentaram maiores valores de resistência total, central, de vias aéreas, tecidual e periférica quando comparados aos NO. Nenhum paciente apresentou LFE. A circunferência abdominal se associou com variáveis espirométricas PIM e PEM. A relação cintura-quadril se correlacionou com variáveis de mecânica respiratória, além das espirométricas PIM e PEM. Conclusões pacientes com obesidade mórbida e sem padrão espirométrico obstrutivo apresentam aumento nas resistências total, de vias aéreas, periférica e tecidual do sistema respiratório quando comparados a não obesos. Esses indivíduos, entretanto, não apresentam limitação de fluxo expiratório e redução da força muscular respiratória.

ABSTRACT Objective To evaluate the different components of the resistance of the respiratory system, respiratory muscle strength and to investigate the occurrence of expiratory flow limitation (EFL) in patients with morbid obesity (MO) when seated. Methods The sample was composed of MO (BMI≥40 kg/m2) and non-obese individuals (NO) with a BMI between 18 and 30 kg/m2. The protocol consisted of the anthropometric assessment and the following measures of respiratory function: spirometry, maximal inspiratory and expiratory pressures (MIP and MEP, respectively) and impulse oscillometry. The group comparison was performed using T-test for unpaired samples. The correlations were evaluated by the Pearson test with a significance level of 5%. Results Fifty MO (age 40±10.4 years, 1.64±0.09 m, 138.8±33.6 kg and 50.7±8.9 kg/m2), and 30 NO (age 37.6±11.5 years, 1.67±0.09 m, 65.2±10.3 kg and 23.2±22 kg/m2) were evaluated. The MO showed higher values of total, peripheral, airways, tissue and central resistance when compared to the NO. No patient showed EFL. The waist circumference was associated with spirometric variables, MIP, and MEP. The waist-to-hip ratio was correlated to respiratory mechanics and spirometric variables, MIP, and MEP. Conclusion Morbidly obese patients with no obstructive spirometric pattern show increased total, airway, peripheral, and tissue respiratory system resistance when compared to nonobese. These individuals, however, do not present with expiratory flow limitation and reduced respiratory muscles strength.

https://doi.org/10.1590/1806-3713/e20180311 2576 downloads

12.

Physical, Chemical, and Microbiological Properties of Soil under Different Plant Covers in the Seridó Desertification Region in the Brazilian Semiarid
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Martins, Adriana Ferreira

; Salcedo, Ignácio Hernan

; Oliveira, Flávio Pereira de

; Pereira, Walter Esfrain

Revista Brasileira de Ciência do Solo

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2019, Volume 43 elocation e0180162

Abstract: En | Text: En | PDF: En

ABSTRACT The Seridó Desertification Region is a result of inadequate management of the native Caatinga vegetation, which generated degraded areas with little or no capacity for plant production. The area has experienced a succession of different land uses, but little is known about the impact of these changes. The present study tested the hypothesis that the intense degradation of the Caatinga drastically decreased vegetal biomass production, which favored direct soil exposure and resulted in a lower abundance and diversity of species and groups of vegetation as well as microorganisms. This study aimed to quantify some of the main physical, chemical, and microbiological properties of Alfisol ( Luvissolo Crômico órtico lítico ) and Entisol ( Neossolo Litólico eutrófico típico ) under different plant covers in the Seridó Desertification Region, in the municipality of Parelhas, in the state of Rio Grande do Norte (RN), Brazil. Three different areas were studied: an area of preserved Caatinga, a recovery area with jurema [ Mimosa tenuiflora (Willd.) Poir.], and a degraded area. Soil samples were collected from the 0.00-0.10 m soil layer and later characterized in terms of their physical and chemical properties. The microbiological characteristics analyzed were microbial activity (microbial biomass carbon and microbial respiration) and glomalin. The soil under the Caatinga vegetation exhibited better properties than the other analyzed soils. Aggregate stability was the physical property with the highest potential for differentiating between areas. Glomalin, which is associated with the presence of mycorrhizae, and which, in turn, is related to the uptake of P, which is often deficient in these soils, was the most discriminating microbiological variable according to an analysis of canonical variables. The total of Ca2+ and Mg2+ was the most discriminating chemical properties, and played a positive role in soil aggregation, especially Ca2+.

https://doi.org/10.1590/18069657rbcs20180162 3102 downloads

13.

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura
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Catapan, Soraia de Camargo

; Oliveira, Walter Ferreira de

; Rotta, Tatiana Marcela

Ciência & Saúde Coletiva

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2019, Volume 24 N. 9 Pages 3417 - 3429

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

https://doi.org/10.1590/1413-81232018249.22832017

14.

Antiretroviral therapy-induced paradoxical worsening of previously healed Mycobacterium haemophilum cutaneous lesions in advanced HIV infection
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Eyer-Silva, Walter de Araujo

; Almeida, Marina Rodrigues de

; Martins, Carlos José

; Basílio-de-Oliveira, Rodrigo Panno

; Araujo, Luciana Ferreira de

; Basílio-de-Oliveira, Carlos Alberto

; Azevedo, Marcelo Costa Velho Mendes de

; Pinto, Jorge Francisco da Cunha

; Vasconcellos, Sidra Ezidio Gonçalves

; Rodrigues-dos-Santos, Ícaro

; MagdinierGomes, Harrison

; Suffys, Philip Noel

Revista do Instituto de Medicina Tropical de São Paulo

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2019, Volume 61 elocation e71

Abstract: En | Text: En | PDF: En

ABSTRACT Mycobacterium haemophilum is a nontuberculous mycobacterium that causes localized or disseminated disease, mainly in immunocompromised hosts. We report the case of a 35-year-old HIV-infected woman who presented with several enlarging cutaneous lesions over the arms and legs. Histopathological examination revealed the diagnosis of a cutaneous mycobacterial disease. Mycobacterial analyses unveiled M. haemophilum infection. Six months after completion of a successful antimycobacterial treatment, she developed an immune reconstitution inflammatory syndrome (IRIS). This paradoxical relapse presented as tenderness, redness and swelling at the precise sites of the healed lesions and took place in the setting of significant recovery of the CD4 cell count (from 05 to 318 cells/mm 3 ). Microbiological analyses of these worsening lesions were negative, and they spontaneously remitted without the initiation of a novel antimycobacterial treatment cycle. M. haemophilum infection should always be considered as a cause of skin lesions in immunocompromised subjects. Physicians should be aware of the possibility of IRIS as a complication of successful antiretroviral therapy in HIV-infected patients with M. haemophilum infection.

https://doi.org/10.1590/s1678-9946201961071 412 downloads

15.

Gastric cryptococcosis: an unusual presentation of a common opportunistic disorder
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Eyer-Silva, Walter de Araujo

; Oliveira, Thaynny Cândida de

; Carvalho, Ricardo de Souza

; Carvalho-Rangel, Isabelle de

; Basílio-de-Oliveira, Rodrigo Panno

; Araujo, Luciana Ferreira de

; Silva, Guilherme Almeida Rosa da

; Neves-Motta, Rogério

Revista do Instituto de Medicina Tropical de São Paulo

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2019, Volume 61 elocation e10

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1678-9946201961010 1716 downloads

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