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ABSTRACT Rituximab, a monoclonal antibody with the ability to bind itself to CD20, leads to a rapid depletion of B-cells (in around 24-72 hours), limiting antibody formation. The marker CD20 does not exist in any other cell type, which makes the action of rituximab specific. This antibody has been used in autoimmune entities such as rheumatoid arthritis and in hematological malignancies, but recently it has gained popularity as an important immunosuppressor in selected kidney diseases. In nephrology, this anti-CD20 antibody had its first indication in anti-neutrophil cytoplasmic antibody-associated vasculitis, but can now be used in primary membranous nephropathy, minimal change disease, lupus nephritis and others. There is also some data that indicates rituximab might have a promising role in other glomerular diseases in the future, but to date evidence is still lacking to recommend its widespread use. The aim of this document is to compile the most recent scientific evidence as to when rituximab should be used in the treatment of various glomerular diseases, and which other may come to benefit from it in the future.

https://doi.org/10.32932/pjnh.2023.07.244

Isolated and combined association of excessive screen time and physical inactivity with negative self-rated health in adolescents
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Marco, Jean Carlos Parmigiani de

; Souza, Fernanda Ulsula de

; Pinto, André de Araújo

; Bim, Mateus Augusto

; Barbosa, Rita Maria dos Santos Puga

; Nahas, Markus Vinicius

; Pelegrini, Andreia

Revista Paulista de Pediatria

Journal Metrics
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2023, Volume 41 elocation e2022077

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

Abstract Objective: The aim of this study was to analyze isolated and combined associations of physical inactivity excessive screen time with negative self-rated health, according to sex, among school adolescents. Methods: In this cross-sectional study conducted with 2,517 adolescents in Amazonas State, participants were asked about their self-rated health with the following question: How do you rate your health? Responses were dichotomized into positive (excellent and good) and negative (regular, bad, and terrible). Information on sex, age group, family income, physical activity, and screen time (watching TV, using a computer, or playing video games) was collected through a self-administered questionnaire. Adolescents simultaneously classified as physically inactive (<60 min/day) and having excessive screen time (>2 h/day) were considered to have two risk factors. Data was analyzed using binary logistic regression. Results: Out of every 10 adolescents, 2 had a negative self-rated health. After adjusting for age and family income, there were no isolated or combined associations between physical inactivity or excessive screen time and negative self-rated health in girls. In boys, negative self-rated health was associated with insufficient levels of physical activity (odds ratio [OR]: 2.39; 95% confidence interval [CI]: 1.03–5.59) and with the accumulation of two risk factors (OR: 1.61; 95%CI 1.10–2.34). Conclusions: Being insufficiently active and the combination of physical inactivity and excessive screen time become exposure factors to the negative self-rated health of adolescent boys.

RESUMO Objetivo: Analisar a associação isolada e combinada do tempo excessivo de tela e inatividade física com a autopercepção negativa de saúde, de acordo com o sexo, em adolescentes estudantes. Métodos: Estudo transversal conduzido em 2.517 adolescentes amazonenses, os quais foram questionados sobre a autopercepção de saúde: “Como você considera a sua saúde?”, dicotomizada em positiva (excelente, boa) e negativa (regular, ruim, péssima). Informações sobre sexo, faixa etária, renda familiar, atividade física e tempo excessivo de tela (assistindo TV, usando o computador ou jogando videogame) foram coletadas mediante questionário autoadministrado. Aqueles classificados, simultaneamente, como fisicamente inativos (<60 min/dia) e com tempo excessivo de tela (>2 horas/dia) foram considerados com dois fatores de risco. Os dados foram analisados utilizando-se a regressão logística binária. Resultados: Dois em cada dez adolescentes apresentaram autopercepção negativa de saúde. Após o ajuste pelas variáveis idade e renda familiar, não foram observadas, no sexo feminino, associações da inatividade física e do tempo excessivo de tela, de maneira isolada ou agrupada, com a autopercepção negativa de saúde. No sexo masculino, a percepção negativa de saúde foi associada com os níveis insuficientes de atividade física (odds ratio — OR: 2,39; intervalo de confiança — IC95% 1,03–5,59) e com o acúmulo de dois fatores de risco (OR: 1,61; IC95% 1,10–2,34). Conclusões: Ser insuficientemente ativo e associar a inatividade física com tempo excessivo de tela tornam-se fatores de exposição à percepção negativa em saúde de meninos adolescentes.

https://doi.org/10.1590/1984-0462/2023/41/2022077

AGREEMENT AND VALIDITY BETWEEN BODY FAT ESTIMATED BY SKINFOLD MEASUREMENT AND AIR DISPLACEMENT PLETHYSMOGRAPHY IN ADOLESCENTS
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Bim, Mateus Augusto

; Pinto, André de Araújo

; Gonzaga, Isadora

; Marco, Jean Carlos Parmigiani De

; Angelo, Hector Cris Colares De

; Claumann, Gaia Salvador

; Pelegrini, Andreia

Journal of Physical Education

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2023, Volume 34 elocation e3403

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

ABSTRACT Objective: Assess the agreement and validity between relative body fat percentages estimated using anthropometric measurements and air displacement plethysmography (ADP). Methods: A cross-sectional study was conducted on 118 adolescents (60 females) aged 10 to 14 years (x̄=12.19, sd=1.18). Adolescents were classified as eutrophic or with overweight according to body mass index (body weight/height2) (x̄=20,12, sd=3,56). Measurements of skinfold thickness (triceps and medial calf) were collected and used to estimate relative body fat by the Slaughter equation. ADP was used as a reference method for the estimation of relative body fat. Agreement between body fat measurement methods (anthropometry × ADP) was analyzed by the Bland-Altman method. The mean error (ME) was calculated by subtracting the body fat percentage estimated by the Slaughter equation from the body fat percentage estimated by ADP. Validity was tested with the concordance correlation coefficient (CCC). Results: There was no agreement between the methods, regardless of sex and weight status. For boys with overweight (ME = 4.52; p = 0.007), eutrophic girls (ME = 6.37; p < 0.001), and girls with overweight (ME = 5.55; p < 0.001), the Slaughter equation resulted in overestimation of body fat compared with ADP. Skinfold equations did not demonstrate validity when compared with ADP. Conclusion: Slaughter's skinfold equations did not demonstrate agreement and validity compared with ADP in either sex or weight status. Skinfold equations should be used with caution and, whenever possible, in combination with other body composition indicators.

RESUMO Objetivo: Avaliar a concordância e validade entre os percentuais de gordura corporal estimados usando medidas antropométricas e pletismografia por deslocamento de ar (PDA). Métodos: Um estudo transversal foi conduzido em 118 adolescentes (60 meninas) com idade entre 10 e 14 anos (x̄=12,19, dp=1,18). Os adolescentes foram classificados como eutróficos ou com sobrepeso de acordo com o índice de massa corporal (peso/altura2) (x̄=20,12, dp=3,56). Medidas de dobras cutâneas (tríceps e panturrilha medial) foram coletadas e utilizadas para estimar a gordura corporal relativa pela equação de Slaughter. A PDA foi utilizada como método de referência para a estimativa da gordura corporal relativa. A concordância entre os métodos de medida de gordura corporal (antropometria × PDA) foi analisada pelo método de Bland-Altman. O erro médio (EM) foi calculado subtraindo o percentual de gordura corporal estimado pela equação de Slaughter do percentual de gordura corporal estimado pela PDA. A validade foi testada com o coeficiente de correlação de concordância (CCC). Resultados: Não houve concordância entre os métodos, independente do sexo e status de peso. Para meninos com excesso de peso (EM = 4,52; p = 0,007), meninas eutróficas (EM = 6,37; p < 0,001) e meninas com excesso de peso (EM = 5,55; p < 0,001), a equação de Slaughter resultou em superestimação da gordura corporal comparada com PDA. As equações de dobras cutâneas não demonstraram validade quando comparadas ao PDA. Conclusão: As equações de dobras cutâneas de Slaughter não demonstraram concordância e validade em comparação com PDA em ambos os sexos ou status de peso. As equações de dobras cutâneas devem ser utilizadas com cautela e, sempre que possível, acompanhada de outros indicadores de composição corporal.

https://doi.org/10.4025/jphyseduc.v34i1.3403

High waist-to-height ratio and associated factors in adolescents from a city in Southern Brazil: a cross-sectional study
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Bim, Mateus Augusto

; Pinto, André de Araújo

; Claumann, Gaia Salvador

; Pelegrini, Andreia

Revista Paulista de Pediatria

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2022, Volume 40 elocation e2020468

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

RESUMO Objetivo: Verificar a prevalência de obesidade abdominal, por meio da razão cintura-estatura (RCE), e fatores associados em adolescentes de uma cidade do sul do Brasil. Métodos: Participaram 965 adolescentes (499 meninos) de 15 a 18 anos. A variável dependente foi a RCE elevada e as variáveis independentes foram idade, nível econômico, maturação sexual, nível de atividade física, tempo de tela e adiposidade corporal. Os dados foram analisados por meio de estatística descritiva e regressão logística. Resultados: 36,7% dos adolescentes apresentaram RCE elevada (50,2% das meninas e 23,9% dos meninos). Independentemente do sexo, os adolescentes com adiposidade corporal elevada apresentaram maiores chances de terem RCE elevada (masculino: OR 30,91; IC95% 17,37–55,00; feminino: OR 19,18; IC95% 10,39–35,40). Nas meninas, observou-se associação da RCE elevada com idade (OR 1,88; IC95% 1,20–2,94) e, nos meninos, com nível econômico (OR 2,35; IC95% 1,01–5,46). Conclusões: Um em cada três adolescentes tem obesidade abdominal. Adolescentes com adiposidade corporal elevada, meninas de 15–16 anos e meninos de nível econômico alto são os grupos mais expostos à obesidade abdominal.

ABSTRACT Objective: To verify the prevalence of abdominal obesity with the waist-to-height ratio (WHtR) and associated factors in adolescents from a city in Southern Brazil. Methods: A total of 960 adolescents (494 boys) aged 15–18 years old participated in this study. The dependent variable was WHtR; independent variables were self-reported age, economic level, sexual maturation, physical activity level, screen time, and body fat. Data were analyzed using descriptive statistics and logistic regression. Results: It was observed that 36.7% of the adolescents presented high WHtR (50.2% in girls and 23.9% in boys). Regardless of sex, adolescents with high body fat were more likely of having high WHtR (boys: Odds Ratio [OR] 29.79; 95% confidence interval [95%CI] 16.87–52.62; girls: OR 19.43; 95%CI 10.51–35.94). In girls, high WHtR was associated with age (OR 1.83; 95%CI 1.17–2.87), and in boys, with economic level (OR 2.34; 95%CI 1.01–5.45). Conclusions: One in each three adolescents has abdominal obesity. Among adolescents with high body fat, girls aged 15–16 and boys with high-income are the groups most exposed to abdominal obesity.

https://doi.org/10.1590/1984-0462/2022/40/2020468 164 downloads

Pregnant patient with prune belly syndrome: case report
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Moreno, André Emídio Carvalho

; Montenegro, Mariana Albuquerque

; Santos, Paula Andrade Neiva

; Andrade, Dennyse Araújo

; Pinto, Laura Alencar

; Patrocínio, Manoel Cláudio Azevedo

; Alves, Júlio Augusto Gurgel

einstein (São Paulo)

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2022, Volume 20 elocation eRC6903

Abstract: En | Text: En | PDF: En

ABSTRACT Prune belly syndrome is a rare congenital disease of unknown etiology that is present in one in every 40 thousand live births, and predominantly affects males, at a ratio of 4:1. In males, it presents with anomalies in the urinary system, absence of abdominal muscles, bilateral cryptorchidism, and infertility. In women, the syndrome has variable presentations, but fertility is preserved. Searching the medical literature, we found only one case of prune belly syndrome in pregnant women. Therefore, the patient in this report is the second case. She was primiparous, 25-years-old, with no abdominal muscles, severe congenital kyphoscoliosis, and pulmonary restriction. Elective cesarean section was performed at 37 weeks of gestation due to maternal risk of uterine rupture by transverse presentation and fetal risk of intrauterine growth restriction. The pre-anesthetic approach defined that general anesthesia might have more risks for the patient due to severe maternal lung disease compared to ultrasound-guided locoregional anesthesia. During prenatal care, there were some maternal complications, such as asthma exacerbations, abdominal pain, and constipation. The newborn was born small for gestational age and this can possibly be explained by maternal restrictive lung capacity. The newborn presented with Apgar score 8/9 and tachypnea, but improved after two hours of life.

https://doi.org/10.31744/einstein_journal/2022rc6903

CARDIAC AUTONOMIC MODULATION RESPONSE AND FUNCTIONAL CAPACITY IN OLDER WOMEN
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Pires, Flavio de Oliveira

; Pinto, Leandro Moraes

; Costa, Herikson Araújo

; Brito-Monzani, Janaína de Oliveira

; Sevilio, Mário Noberto de Oliveira

; Castro, Henrique de Oliveira

; Gadelha, André Bonadias

; Mostarda, Cristiano Teixeira

; Ferreira, Andressa Coelho

; Dibai Filho, Almir Vieira

; Dias, Carlos José

; Martins, Denílson Silva

Revista Brasileira de Medicina do Esporte

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jun 2021, Volume 27 N. 2 Pages 129 - 133

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

RESUMO Objetivo: Analisar a resposta da modulação autonômica cardíaca e a capacidade funcional em idosas fisicamente ativas. Métodos: Setenta e cinco mulheres idosas (60 a 70 anos) da comunidade foram divididas nos seguintes grupos: sedentária (n = 19), hidroginástica (n = 18), pilates (n = 19) e dança (n = 19). A pressão arterial, a composição corporal, a variabilidade da frequência cardíaca e a capacidade funcional foram avaliadas para a caracterização dos grupos em repouso e 48 horas depois da última sessão de exercício físico. Resultados: O grupo sedentário apresentou maior relação cintura-quadril, pressão arterial diastólica e frequência cardíaca em repouso quando comparado aos outros grupos (p <0,05). Observou-se também que o grupo da dança apresentou melhores escores de capacidade funcional e VO2pico (todos p < 0,05). Com relação à modulação autonômica cardíaca, os grupos de dança e pilates demonstraram melhores escores para RMSSD (26,71 ± 9,07 e 29,82 ± 7,16, respectivamente; p < 0,05), LF (45,79 ± 14,81 e 45,95 ± 15,16 nu, respectivamente; p<0,05) e LF/HF (0,92 ± 0,56 e 0,58 ± 0,26, respectivamente; p < 0,05). Na análise simbólica, o grupo da dança apresentou maior predominância da modulação autonômica parassimpática do que os demais grupos (p < 0,05). Conclusão: Esses resultados concluem que idosas fisicamente ativas praticantes de hidroginástica, pilates ou dança, têm benefícios fisiológicos, como melhor capacidade funcional e melhora das variáveis hemodinâmicas e da modulação cardíaca autonômica. Além disso, o grupo que praticava dança teve maior modulação parassimpática e maior capacidade funcional quando comparado com outras modalidades. Nível de evidência: I; STARD: estudos de precisão diagnóstica.

ABSTRACT Objective: To analyze cardiac autonomic modulation response and functional capacity in physically active older women. Methods: Seventy-five older women (60-70 years) from the community were divided into the following groups: sedentary (n=19), hydro-gymnastics (n=18), pilates (n=19), and dance (n=19). Blood pressure, body composition, heart rate variability, and functional capacity were assessed for the characterization of the groups at rest and 48 hours after the last physical exercise session. Results: The sedentary group presented higher waist-to-hip ratio, diastolic blood pressure, and resting heart rate compared to the other groups (p<0.05). It was also observed that the dance group presented better functional capacity and VO2peak scores (all p<0.05). Regarding cardiac autonomic modulation, both dance and pilates groups demonstrated better RMSSD (26.71 ± 9.07 and 29.82 ± 7.16, respectively; p<0.05), LF (45.79 ± 14.81 and 45.95 ± 15.16 n.u., respectively; p<0.05), and LF/HF (0.92 ± 0.56 and 0.58 ± 0.26, respectively; p<0.05) scores. In the symbolic analysis, the dance group had a greater predominance of parasympathetic autonomic modulation than the other groups (p<0.05). Conclusion: These results conclude that physically active elderly women, practicing hydro-gymnastics, pilates or dance, presented physiological benefits, such as better functional capacity and improvements in hemodynamic variables and autonomic cardiac modulation. In addition, the group that practiced dance presented greater parasympathetic modulation, as well as greater functional capacity, when compared to the other modalities. Level of evidence: I; STARD: studies of diagnostic accuracy.

RESUMEN Objetivo: Analizar la respuesta de la modulación autonómica cardíaca y la capacidad funcional en mujeres mayores físicamente activas. Métodos: Setenta y cinco mujeres mayores (60 a 70 años) de la comunidad fueron divididas en los siguientes grupos: sedentaria (n = 19), hidrogimnasia (n = 18), pilates (n = 19) y danza (n = 19). La presión arterial, la composición corporal, la variabilidad de la frecuencia cardíaca y la capacidad funcional fueron evaluadas para la caracterización de los grupos en reposo y 48 horas después de la última sesión de ejercicio físico. Resultados: El grupo sedentario presentó mayor relación cintura-cadera, presión arterial diastólica y frecuencia cardíaca en reposo cuando comparado a los otros grupos (p <0,05). Se observó que el grupo de danza presentó mejores puntajes de capacidad funcional y VO2Pico (todos p <0,05). Con relación a la modulación autonómica cardíaca, los grupos de danza y pilates demostraron mejores puntajes para RMSSD (26,71 ± 9,07 y 29,82 ± 7,16, respectivamente; p <0,05), LF (45,79 ± 14,81 y 45,95 ± 15,16 nu, respectivamente; p <0,05), y LF/HF (0,92 ± 0,56 y 0,58 ± 0,26, respectivamente; p <0,05). En el análisis simbólico, el grupo de danza presentó mayor predominancia de la modulación autonómica parasimpática que los demás grupos (p <0,05). Conclusión: Esos resultados concluyen que las mujeres mayores físicamente activas, practicantes de hidrogimnasia, pilates o danza, tienen beneficios fisiológicos, como mejor capacidad funcional y mejora de las variables hemodinámicas y de la modulación cardíaca autonómica. Además, el grupo que practicaba danza tuvo mayor modulación parasimpática y mayor capacidad funcional cuando comparado con las otras modalidades. Nivel de evidencia: I; STARD: estudios de precisión diagnóstica.

https://doi.org/10.1590/1517-8692202127022020_0029 277 downloads

Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring
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Seguro, Fernanda Salles

; Silva, Carolina Maria Pinto Domingues Carvalho

; Moura, Carla Maria Boquimpani de

; Conchon, Monika

; Fogliatto, Laura

; Funke, Vaneuza Araujo Moreira

; Abdo, André

; Macedo, Ariane Vieira Scarlatelli

; Santos, Marilia Harumi Higushi dos

; Saraiva, José Francisco Kerr

Hematology, Transfusion and Cell Therapy

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jun 2021, Volume 43 N. 2 Pages 191 - 200

Abstract: En | Text: En | PDF: En

ABSTRACT This manuscript summarizes the results of the consensus meeting composed of hematologists and cardiologists to establish recommendations for the prevention and follow-up of cardiovascular (CV) risk in patients with chronic myeloid leukemia (CML) treated with BCR-ABL tyrosine kinase inhibitors (TKIs) from the point of view of clinical practice and from the perspective of hematology consultation.In the first medical appointment, the CV risk factors should be identified to perform the baseline risk stratification, based on the Brazilian Guideline of Dyslipidemia and Atherosclerosis Prevention Update (risk levels: very high, high, intermediate and low).Once stratified, the treatment of the CV risk factors should be administered. If the patient presents risk factors, such as hypertension, diabetes, renal disease, smoking and hypercholesterolemia, the evaluation and initial treatment may be done by the hematologist, being an option the request for evaluation by a specialist. If the patient has a history of previous CV disease, we recommend referral to a specialist. As the CV risk score is dynamic and the control of risk factors can reduce the patient risk, this expert consensus recommends that the re-evaluation of the CV risk after the baseline should be performed at 3 months, 6 months and 12 months. After this period, it should be done annually and, for specific patients, at the clinician's discretion.The evaluation of the baseline CV risk and the safe administration of a TKI allow the patient to benefit from the maximum treatment, avoiding unwanted effects.

https://doi.org/10.1016/j.htct.2020.04.009 83 downloads

Prevalência e fatores sociodemográficos associados ao deslocamento passivo para a escola: comparação entre adolescentes de distintas regiões do Brasil
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Pinto, André de Araújo

; Françosi, Felipe Leite

; Nahas, Markus Vinicius

; Barbosa, Rita Maria dos Santos Puga

; Silva, Diego Augusto Santos

; Costa, Andreina Medeiros

; Bim, Mateus Augusto

; Scarabelot, Karoline Sousa

; Claumann, Gaia Salvador

; Pelegrini, Andreia

Motricidade

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mar 2021, Volume 17 N. 1 Pages 15 - 22

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

RESUMO Esse estudo teve como objetivo comparar as prevalências de deslocamento passivo para a escola e analisar os fatores sociodemográficos associados em adolescentes de duas cidades brasileiras. Adolescentes das cidades de São José, Santa Catarina, Sul do Brasil (n= 1.024) e Manaus, Amazonas, Norte do Brasil (n= 1.109), de ambos os sexos, de 15 a 18 anos, participaram desse estudo epidemiológico transversal, de base escolar. Um questionário autoadministrado contendo informações sobre o tipo de deslocamento para a escola, a idade, o sexo e a renda familiar foi auto preenchido. Empregou-se a regressão de Poisson para estimativas de razão de prevalência e intervalos de confiança de 95% (IC95%). Os adolescentes catarinenses foram mais passivos no deslocamento para a escola (53,5%; IC95%: 50,1– 56,0) em relação aos amazonenses (37,3%; IC95%: 34,5– 39,7). Ser do sexo feminino e pertencer às famílias com maior renda mensal aumentaram as chances de se deslocar passivamente para a escola nas duas cidades. Ter 16 e 17 anos diminui as chances dos adolescentes de Manaus se deslocarem passivamente para a escola. Medidas para evitar e reduzir o deslocamento passivo devem ser direcionadas principalmente ao sexo feminino e aos adolescentes com maior renda familiar.

ABSTRACT The level of physical activity of adolescents has been a concern for public health agencies, suggesting the maximum use of the physical activities available in daily life. This study aimed to compare the prevalence of passive commuting to school and analyze the sociodemographic factors associated with adolescents from two Brazilian cities. The participants of this cross-sectional, epidemiologic, and school-based study were adolescents boys and girls, aged 15 to 18, from a city of Southern Brazil, São José/Santa Catarina (= 1024), and from a city of Northern Brazil city, Manaus/Amazonas (n= 1109). Participants completed a self-administered questionnaire with information regarding commuting to school, age, gender, and Family income. Poisson regression was used to estimate the prevalence ratios and confidence intervals of 95% (CI95%). The adolescents from Santa Catarina were more passive (53.5%; CI95%: 50.1– 56.0) than adolescents from Amazonas (37.3%; CI95%: 34.5– 39.7) in commuting to school. Female gender and being part of a Family with higher monthly income were associated with increased chances of passively commuting to school in both cities. The ages of 16 and 17 were associated with diminished chances of passively commuting to school in adolescents from Amazonas. Measures to avoid and reduce passive commuting should target, especially, girls and adolescents from higher-income Families.

https://doi.org/10.6063/motricidade.19453 120 downloads

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Abstract: En | Text: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

10.

Prevalence of overweight and obesity in Brazilian children and adolescents: a systematic review
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Pelegrini, Andreia

; Bim, Mateus Augusto

; Souza, Fernanda Ulsula de

; Kilim, Karoline Sisnandes da Silva

; Pinto, André de Araújo

Revista Brasileira de Cineantropometria & Desempenho Humano

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2021, Volume 23 elocation e80352

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

resumo É importante conhecer a situação de sobrepeso e obesidade de crianças e adolescentes brasileiros. O presente estudo teve como objetivo atualizar a produção científica, por meio de uma revisão sistemática, sobre a prevalência e os fatores associados ao sobrepeso e à obesidade em crianças e adolescentes brasileiros. Nove bases de dados foram verificadas e 1.316 referências foram examinadas de 2018 a 2019. A busca eletrônica foi realizada por três pesquisadores independentes. Todas as etapas de revisão seguiram uma estratégia baseada no PRISMA. 40 estudos foram incluídos nesta revisão sistemática. A maioria dos estudos usou os critérios de classificação da Organização Mundial da Saúde. A prevalência de excesso de peso em crianças e adolescentes brasileiros variou de 8,8% a 22,2% (meninos: 6,2% a 21%; meninas: 6,9% a 27,6%). A prevalência de obesidade variou de 3,8% a 24% (meninos: 2,4% a 28,9%; meninas: 1,6% a 19,4%). Observou-se que os fatores socioeconômicos (sexo, cor da pele, nível econômico, região, escolaridade da mãe, morar em casa alugada e sem acesso à internet), hereditários/genéticos (histórico familiar de dislipidemia e excesso de peso e genótipo rs9939609) e comportamentais (atividade física, tempo de tela, hábitos alimentares, peso corporal percebido, vulnerabilidade à saúde, presença de resultado próximo a casa, bebida alcoólica, consumo de cigarro) estiveram associados ao desfecho. Conclui-se que as prevalências de sobrepeso e obesidade entre crianças e adolescentes brasileiros são preocupantes e a maioria dos fatores associados aos desfechos está sujeita a mudanças a partir da adoção de um estilo de vida saudável.

abstract It is important to know about overweight and obesity situation of Brazilian children and adolescents. The present study aims to update scientific production, through a systematic review, on the prevalence and factors associated with overweight and obesity in Brazilian children and adolescents. Nine databases were verified, and 1,316 references were examined from 2018 to 2019. The electronic search was conducted by three independent researchers. All review steps followed a strategy based on PRISMA. 40 studies were included in this systematic review. Most studies use the World Health Organization classification criteria. The prevalence of overweight in Brazilian children and adolescents varies from 8.8% to 22.2% (boys: 6.2% to 21%; girls: 6.9% to 27.6%). The prevalence of obesity varied from 3.8% to 24% (boys: 2.4% to 28.9%; girls: 1.6% to 19.4%). It was observed that the socioeconomic factors (sex, skin color, economic level, region, mother's educational level, living in a rented house and without access to the internet), hereditary/genetic (family history of dyslipidemia and overweight and rs9939609 genotype) and behavioral (physical activity, screen time, eating habits, perceived body weight, health vulnerability, presence of a result close to home, alcoholic beverages, cigarette consumption) were associated with the outcome. It is concluded that the prevalence of overweight and obesity among Brazilian children and adolescents are worrisome and most of the factors associated with the outcomes are subject to change from the adoption of a healthy lifestyle.

https://doi.org/10.1590/1980-0037.2021v23e80352 352 downloads

11.

Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato

; Ferreira, Gilda Aparecida

; Gomides Reis, Ana Paula Monteiro

; Reis Neto, Edgard Torres

; Abreu, Mirhelen Mendes

; Albuquerque, Cleandro Pires

; Araújo, Nafice Costa

; Bacchiega, Ana Beatriz

; Bianchi, Dante Valdetaro

; Bica, Blanca

; Bonfa, Eloisa Duarte

; Borba, Eduardo Ferreira

; Brito, Danielle Christinne Soares Egypto

; Duarte, Ângela Luzia Branco Pinto

; Santo, Rafaela Cavalheiro Espírito

; Fernandes, Paula Reale

; Guimarães, Mariana Peixoto

; Gomes, Kirla Wagner Poti

; Kakehasi, Adriana Maria

; Klumb, Evandro Mendes

; Lanna, Cristina Costa Duarte

; Marques, Claudia Diniz Lopes

; Monticielo, Odirlei André

; Mota, Licia Maria Henrique

; Munhoz, Gabriela Araújo

; Paiva, Eduardo Santos

; Pereira, Helena Lucia Alves

; Provenza, José Roberto

; Ribeiro, Sandra Lucia Euzébio

; Rocha Junior, Laurindo Ferreira

; Sampaio, Camila Santana Justo Cintra

; Sampaio, Vanderson Souza

; Sato, Emília Inoue

; Skare, Thelma

; de Souza, Viviane Angelina

; Valim, Valeria

; Lacerda, Marcus Vinícius Guimarães

; Xavier, Ricardo Machado

; Pinheiro, Marcelo Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 60

Abstract: En | Text: En | PDF: En

Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

https://doi.org/10.1186/s42358-021-00217-0 22 downloads

12.

Normative values of handgrip strength in adolescents according to chronological age and sexual maturation
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Bim, Mateus Augusto

; Pinto, André de Araújo

; Silva, Diego Augusto Santos

; Rodrigues, Anna Mestriner

; Pelegrini, Andreia

Motriz: Revista de Educação Física

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2021, Volume 27 elocation e1021004421

Abstract: En | Text: En | PDF: En

Abstract Aim: Handgrip strength is considered an important health indicator. It is extremely important to establish normative values so that the handgrip strength is correctly interpreted in adolescents. The present study aims to establish normative values of handgrip strength (HGS) for adolescents, according to chronological age and sexual maturation. Methods: Data from three large projects carried out in Florianopolis and São José, Santa Catarina were used, corresponding to a sample of 2,637 adolescents aged 14 to 19 years old of both sexes (1,428 girls). The HGS of the right and left hands was measured by a manual dynamometer, and total HGS being defined by the sum of the left hand and the right-hand strength. Sexual maturation was determined by the development of pubic hair. The percentiles 3, 10, 15, 25, 50, 75, 85, 90, and 97 were calculated for the right, left, and total HGS. The percentile ranges < p15 (low), p15-p85 (normal) and > p85 (high) were used. ANOVA and Kruskal-Wallis tests were applied. Results: In boys, the mean total HGS ranged from 67.5 ± 16.5 to 86.9 ± 21.8 (p < 0.001) and 74.3 ± 17.5 to 82.2 ± 17.8 (p < 0.001) for age and sexual maturation, respectively, while in girls the mean HGS total ranged from 48.8 ± 11.3 to 56.4 ± 16.0 (p = 0.127) and 47.8 ± 10.6 to 54.3 ± 12.3 (p < 0.001). Conclusion: Reference values established by the percentile score, can be used to identify adolescents with better athletic condition and can be useful for prescribing exercises.

https://doi.org/10.1590/s1980-65742021004421 83 downloads

13.

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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STUDART-NETO, Adalberto

; GUEDES, Bruno Fukelmann

; TUMA, Raphael de Luca e

; CAMELO FILHO, Antonio Edvan

; KUBOTA, Gabriel Taricani

; IEPSEN, Bruno Diógenes

; MOREIRA, Gabriela Pantaleão

; RODRIGUES, Júlia Chartouni

; FERRARI, Maíra Medeiros Honorato

; CARRA, Rafael Bernhart

; SPERA, Raphael Ribeiro

; OKU, Mariana Hiromi Manoel

; TERRIM, Sara

; LOPES, Cesar Castello Branco

; PASSOS NETO, Carlos Eduardo Borges

; FIORENTINO, Matheus Dalben

; DE SOUZA, Julia Carvalhinho Carlos

; BAIMA, José Pedro Soares

; DA SILVA, Tomás Fraga Ferreira

; MORENO, Cristiane Araujo Martins

; SILVA, Andre Macedo Serafim

; HEISE, Carlos Otto

; MENDONÇA, Rodrigo Holanda

; FORTINI, Ida

; SMID, Jerusa

; ADONI, Tarso

; GONÇALVES, Marcia Rubia Rodrigues

; PEREIRA, Samira Luisa Apóstolos

; PINTO, Lecio Figueira

; GOMES, Helio Rodrigues

; ZANOTELI, Edmar

; BRUCKI, Sonia Maria Dozzi

; CONFORTO, Adriana Bastos

; CASTRO, Luiz Henrique Martins

; NITRINI, Ricardo

Arquivos de Neuro-Psiquiatria

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aug 2020, Volume 78 N. 8 Pages 494 - 500

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

RESUMO Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomas neurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doenças neurológicas prévias podem exigir tratamento especial e estar associadas a piores desfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmente pouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitar consultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com 900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico de COVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas as interconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foram analisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dados disponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionais conforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões de consenso. Após o diagnóstico, os neurologistas participaram da condução dos casos. Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) em pacientes internados por COVID-19 durante o período. Os principais diagnósticos neurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%), doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornos neuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomas leves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em um hospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetar o desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecer sintomas neurológicos. Os neurologistas são membros importantes da equipe médica no atendimento hospitalar à COVID-19.

ABSTRACT Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

https://doi.org/10.1590/0004-282x20200089 2651 downloads

14.

[SciELO Preprints] - Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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Studart-Neto, Adalberto Guedes, Bruno Fukelmann Tuma, Raphael De Luca E Camelo Filho, Antonio Edvan Kubota, Gabriel Taricani Iepsen, Bruno Diógenes Moreira, Gabriela Pantaleão Rodrigues, Júlia Chartouni Ferrari, Maíra Medeiros Honorato Carra, Rafael Bernhard Spera, Raphael Ribeiro Oku, Mariana Hiromi Manoel Terrim, Sara Lopes, Cesar Castello Branco Passos Neto, Carlos Eduardo Borges Dalben, Matheus De Souza, Julia Carvalhinho Carlos Baima, José Pedro Soares Da Silva, Tomás Fraga Ferreira Moreno, Cristiane Araujo Martins Silva, Andre Macedo Serafim Heise, Carlos Otto Mendonça, Rodrigo Holanda Fortini, Ida Smid, Jerusa Adoni, Tarso Gonçalves, Marcia Rubia Rodrigues Pereira, Samira Luisa Apóstolos Pinto, Lecio Figueira Gomes, Helio Rodrigues Zanotelli, Edmar Brucki, Sonia Maria Dozzi Conforto, Adriana Bastos Castro, Luiz Henrique Martins Nitrini, Ricardo

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Publication date: 2020-07-16

Abstract: En Pt

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.

Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomasneurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doençasneurológicas prévias podem exigir tratamento especial e estar associadas a pioresdesfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmentepouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitarconsultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico deCOVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas asinterconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foramanalisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dadosdisponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionaisconforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões deconsenso. Após o diagnóstico, os neurologistas participaram da condução dos casos.Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) empacientes internados por COVID-19 durante o período. Os principais diagnósticosneurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%),doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornosneuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomasleves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em umhospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetaro desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecersintomas neurológicos. Os neurologistas são membros importantes da equipe médica noatendimento hospitalar à COVID-19.

https://doi.org/10.1590/0004-282X20200089

15.

Techniques to modify cluster architecture and their effect on the viticultural performance of the Sauvignon Blanc cultivar
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Brighenti, Alberto Fontanella

; Munhoz, Bruno

; Würz, Douglas André

; Pasa, Mateus da Silveira

; Ferreira Pinto, Felipe Augusto Moretti

; Araújo Filho, Jerônimo Vieira de

; Silva, Aparecido Lima da

Pesquisa Agropecuária Brasileira

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2020, Volume 55 elocation e01900

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

Resumo: O objetivo deste trabalho foi avaliar o efeito de diferentes técnicas para modificar a arquitetura de cachos de uva sobre a incidência e a severidade de podridão cinzenta, bem como sobre o desempenho vitícola da videira (Vitis vinifera) 'Sauvignon Blanc'. Associados aos fungicidas, quatro tratamentos foram testados: controle, 30 ppm de ácido giberélico aplicados por pulverização na plena florada, 1.000 ppm de prohexadiona de cálcio aplicados por pulverização na plena florada e raleio de bagas durante a compactação dos cachos. O experimento foi realizado nas safras 2015, 2016 e 2017. Os cachos foram tratados com fungicidas durante os estádios de plena florada, compactação do cacho, veraison e aproximadamente 15 dias antes da colheita. O raleio de bagas não causa perdas na produtividade e na qualidade de 'Sauvignon Blanc', e, embora tenha pouco efeito na arquitetura do cacho, é eficaz na redução da incidência e da severidade de Botrytis cinerea. A prohexadiona de cálcio melhora a maturação fenólica das uvas, é eficaz na redução da incidência e da severidade de B. cinerea e reduz a compactação do cacho ao diminuir o diâmetro das bagas. A aplicação de ácido giberélico por pulverização na plena florada não é recomendada por reduzir a produtividade e a fertilidade das gemas e aumentar a suscetibilidade das bagas à infecção por B. cinerea.

Abstract: The objective of this work was to evaluate the effect of different techniques to modify grape cluster architecture on the incidence and severity of botrytis bunch rot, as well as on the viticultural performance of the 'Sauvignon Blanc' grapevine (Vitis vinifera). Associated with fungicides, four treatments were tested: control, 30 ppm gibberellic acid sprayed at full bloom, 1,000 ppm prohexadione calcium sprayed at full bloom, and berry thinning at the stage of beginning of berry touch. The experiment was carried out in the 2015, 2016, and 2017 vintages. Clusters were treated with fungicides during the stages of full bloom, beginning of berry touch, veraison, and around 15 days before harvest. Berry thinning does not cause losses in the yield and quality of 'Sauvignon Blanc', and, despite having little effect on cluster architecture, is effective in reducing the incidence and severity of Botrytis cinerea. Prohexadione calcium improves grape phenolic maturation, is effective in reducing the incidence and severity of B. cinerea, and reduces cluster compactness by decreasing berry diameter. The application of gibberellic acid spray at full bloom is not recommended because it decreases yield and bud fertility and increases berry susceptibility to B. cinerea infection.

https://doi.org/10.1590/s1678-3921.pab2020.v55.01900 458 downloads

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