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1.
Outcomes of decompressive craniectomy for malignant middle cerebral artery stroke in an academic hospital in Brazil
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Rodrigues de Oliveira, Luiz Fernando
; Camilo, Millene Rodrigues
; Franciscatto, Luisa
; Podolsky-Gondim, Guilherme Gozzoli
; Alves, Frederico Fernandes Alessio
; Martins Filho, Rui Kleber do Vale
; Dias, Francisco Antunes
; Tanaka, Koji
; Colli, Benedicto Oscar
; Pontes Neto, Octávio Marques
.
Abstract Background Ischemic stroke is an important cause of death in the world. The malignant middle cerebral artery infarction (MMCAI) has mortality as high as 80% when clinically treated. In this setting, decompressive craniectomy is a life-saving measure, in spite of high morbidity among survivors. Objective To evaluate the outcomes of patients with MMCAI treated with decompressive craniectomy in a Brazilian academic tertiary stroke center. Methods A prospective stroke database was retrospectively evaluated, and all patients treated with decompressive craniectomy for MMCAI between January 2014 and December 2017 were included. The demographics and clinical characteristics were evaluated. The functional outcome, measured by the modified Rankin Scale (mRS), was assessed at hospital discharge, after 3-months and 1-year of follow-up. Results We included 53 patients on the final analysis. The mean age was 54.6 ± 11.6 years and 64.2% were males. The median time from symptoms to admission was 4.8 (3–9.7) hours and the mean time from symptoms to surgery was 36 ± 17 hours. The left hemisphere was the affected in 39.6%. The median NIHSS at admission was 20 (16–24). The in-hospital mortality was 30.2%. After a median of 337 [157–393] days, 47.1% of patients had achieved favorable outcome (mRS ≤ 4) and 39.6% had died. Conclusion Decompressive craniectomy is a life-saving measure in the setting of MMCAI, and its effects remains important in the scenario of a middle-income country in real-world situations.
Resumo Antecedentes O acidente vascular cerebral (AVC) isquêmico é uma causa importante da morte em todo o mundo. O infarto maligno da artéria cerebral média (IMACM) tem mortalidade de até 80% quando tratado clinicamente. Nesse contexto, a craniectomia descompressiva é uma medida salvadora de vidas, apesar da alta morbidade entre os sobreviventes. Objetivo Avaliar os desfechos dos pacientes com IMACM tratados com craniectomia descompressiva em um centro acadêmico terciário de AVC no Brasil. Métodos Um banco de dados prospectivo de AVC foi avaliado retrospectivamente e todos os pacientes tratados com craniectomia descompressiva para IMACM entre janeiro de 2014 e dezembro de 2017 foram incluídos. As características clínicas e demográficas foram avaliadas. Os desfechos funcionais, medidos pela escala modificada da Rankin (mRS), foram avaliados na alta hospitalar, após 3 meses e após 1 ano de seguimento. Resultados Foram incluídos 53 pacientes na análise final. A idade média foi 54,6 ± 11,6 anos e 64,2% eram homens. A mediana do tempo dos sintomas à admissão foi 4,8 (3–9,7) horas e o tempo médio dos sintomas à cirurgia foi 36 ± 17 horas. O hemisfério esquerdo foi o afetado em 39,6%. A pontuação na escala de AVC do National Institute of Health (NIHSS) à admissão foi 20 (16–24). A mortalidade hospitalar foi 30,2%. Após uma mediana de 337 (157–393) dias, 47,1% dos pacientes tinham atingido um desfecho favorável (mRS ≤ 4) e 39,6% tinham morrido. Conclusão Craniectomia descompressiva é uma medida salvadora de vidas no contexto do IMACM e seus efeitos permanecem importantes no cenário de um país em desenvolvimento em situação de vida real.
2.
Productive performance, egg quality and the morphometry of the organs of Japanese quails (Cotournix cotournix japônica) kept at different temperatures
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MATOS JÚNIOR, Joab Jorge Leite de
; FURTADO, Dermeval Araújo
; RIBEIRO, Neila Lidiany
; MARQUES, Jordânio Inácio
; LEITE, Patrício Gomes
; NASCIMENTO, José Wallace Barbosa do
; RODRIGUES, Valéria Pereira
; LOPES NETO, José Pinheiro
; RODRIGUES, Ladyanne Raia
; SANTOS, Severino Guilherme Caetano Gonçalves dos
; OLIVEIRA, Airton Gonçalves de
; SILVA, Ricardo de Sousa
.
Abstract The objective of this study was to evaluate the productive performance, egg quality and the morphometry of the organs of Japanese quails (Cotournix cotournix japônica) when kept in comfort and under thermal stress. 192 nine-week-old quail were used, distributed in a completely randomized design at two temperatures (T1 = 24 °C and T2 = 32 °C), with 12 replicates of eight birds each, with an experimental period of 63 days, divided into three 21-day periods. Feed intake (g fowl-1 day-1), water consumption (mL fowl-1 day-1), egg production (%), egg weight (g), egg mass (g fowl- 1 day-1) and feed conversion (kg kg-1 and kg dozen-1). Laying quails after their production cycle are marketed as beef animals. It is observed that the average final live weight was reduced (P = 0.0362) by 27.58 g in birds kept at a temperature of 32 oC, which can compromise its commercial value. The feed intake of the birds was reduced (P = 0.0051) by 14.75% with an increase in ambient temperature. Birds kept at a temperature of 32 oC for 12 h daily showed a reduction in feed intake, final weight, yolk, and gizzard weight, but without affecting egg production, weight and mass.
3.
Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery
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Kikuchi, Rodrigo
; Nhuch, Claudio
; Drummond, Daniel Autran Burlier
; Santiago, Fabricio Rodrigues
; Coelho Neto, Felipe
; Mauro, Fernanda de Oliveira
; Silveira, Fernando Trés
; Peçanha, Guilherme Peralta
; Merlo, Ivanesio
; Corassa, Jose Marcelo
; Stambowsky, Leonardo
; Figueiredo, Marcondes
; Takayanagi, Miriam
; Gomes Flumignan, Ronald Luiz
; Evangelista, Solange Seguro Meyge
; Campos Jr., Walter
; Joviliano, Edwaldo Edner
; Araujo, Walter Junior Boim de
; Oliveira, Julio Cesar Peclat de
.
Abstract The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.
Resumo A Sociedade Brasileira de Angiologia e de Cirurgia Vascular organizou uma comissão para fornecer novas recomendações baseadas em evidências sobre questões críticas de atendimento ao paciente com insuficiência venosa crônica. São abordados aqui os temas de classificação, diagnóstico, tratamento conservador, tratamento invasivo e tratamento de pequenos vasos. Esta última série está muito relacionada à atividade de angiologistas e cirurgiões vasculares, que possuem forte atuação no tratamento de pequenas veias superficiais. Estas diretrizes destinam-se a auxiliar na tomada de decisões clínicas de médicos assistentes e gestores de saúde. A decisão de seguir uma recomendação de diretriz deve ser feita pelo médico responsável caso a caso, levando em consideração a condição específica do paciente, bem como recursos locais, regulamentos, leis e recomendações de prática clínica.
4.
Association between exposure to pesticides and allergic diseases in children and adolescents: a systematic review with meta-analysis
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Rodrigues, Marina de Barros
; Carvalho, Denise Siqueira de
; Chong-Silva, Débora Carla
; Urrutia-Pereira, Marilyn
; Albuquerque, Guilherme Souza Cavalcanti de
; Cieslak, Fabrício
; Chong Neto, Herberto José
.
Abstract Objective: The study aimed to conduct a systematic review of the literature to verify the association between exposure to pesticides and allergic diseases (asthma, allergic rhinitis, and atopic dermatitis) in children and adolescents. Method: A systematic review and meta-analysis were performed using the PRISMA method with the question “What is the association between exposure to pesticides and allergic diseases in children (asthma, allergic rhinitis, and atopic dermatitis)?” MEDLINE, EMBASE, SciELO, and Cochrane electronic databases were searched throughout the period in the literature up to September 2020. A total of 1296 studies were found, and 24 were selected. Results: Exposure to pesticides showed a two-fold greater risk of developing or exacerbating asthma in children and adolescents (odds ratio [OR] = 2.14 95% confidence interval [CI] 1.26-3.64, p < 0.01). There was no association between exposure to pesticides and the development of allergic rhinitis (OR = 2.73, 95% CI 0.13-57.8, p = 0.52) and atopic dermatitis (OR = 2.19, 95% CI 0.51-9.36, p = 0.29). Conclusions: Exposure to pesticides increases the risk of developing or exacerbating asthma in children and adolescents. There was no evidence of an association between exposure to pesticides and the development of allergic rhinitis and atopic dermatitis in children and adolescents, possibly due to the low number of studies found in this review.
5.
Desenvolvimento de um modelo híbrido Migha-RNA para calibração de rugosidades absolutas em redes de distribuição de água
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Sousa, David Lopes de
; Bezerra, Alessandro de Araújo
; Castro, Marco Aurélio Holanda de
; Rodrigues Neto, Guilherme Costa
; Araujo, Rafael Brito Aguiar de
.
RESUMO Este trabalho teve como objetivo desenvolver um novo método híbrido de calibração de rugosidades absolutas em redes de distribuição de água, com base na combinação do método iterativo do gradiente hidráulico alternativo (Migha) com uma rede neural artificial (RNA) do tipo Perceptron Multicamadas. Foram testadas diferentes configurações para o modelo, em vários cenários que diferiam quanto ao número de pressões observadas utilizadas. Os resultados encontrados sugerem que a combinação dos métodos foi favorável à calibração das rugosidades, com erros absolutos médios inferiores a 0,016 mm no modelo que calculava apenas um valor por material para o parâmetro. A boa performance também ficou evidente quando analisadas as pressões e vazões retornadas pela simulação da rede calibrada, as quais apresentaram erros relativos médios de 0,12 e 0,36%, respectivamente, no cenário com 14% dos nós com pressões conhecidas, erros consideravelmente inferiores àqueles obtidos pela configuração inicial da rede e pelo uso exclusivo do Migha.
ABSTRACT This work aimed to develop a new hybrid method for the calibration of absolute roughness in water distribution networks, starting from the combination of the Alternative Hydraulic Gradient Iterative Method (Migha) with a Multilayer Perceptron Artificial Neural Network (ANN). Different configurations were tested for the model, in different scenarios that differed in the number of observed pressures used. The results found suggest that the combination of methods was favorable to roughness calibration, with mean absolute errors lower than 0.016 mm in the model that calculated only one value per material for the parameter. The good performance was also evident when analyzing the pressures and flows returned by the calibrated network simulation, which showed average relative errors of 0.12 and 0.36%, respectively, in the scenario with 14% of nodes with known pressures, errors considerably lower than those obtained by the initial configuration of the network and the exclusive use of Migha.
6.
Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency
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Andrade, Bruna M. R. de
; Valença, Eugenia H. O.
; Salvatori, Roberto
; Oliveira Neto, Luiz A.
; Souza, Anita H. O.
; Oliveira, Alaíde H. A.
; Oliveira, Mario C.P.
; Melo, Enaldo V.
; Carvalho, Susana de
; Sales, Neuza J
; Monteiro, Gisane C.
; Lima, José Marcel de
; Annunziato, Marcos Felipe Harder
; Mannis, Guilherme Daniel Breternitz
; Souza, Lucas E. de A.
; Goes, Yasmin D.
; Carvalho, Thayza S.
; Farias, Celiane de
; Santos, Michela P. dos
; Cardoso, Gabriela P. F.
; Sousa, Carla S. Pereira
; Santana, Julia Rodrigues
; Sales, Ester Almeida
; d’Avila, Jeferson Sampaio
; Aguiar-Oliveira, Manuel H.
.
ABSTRACT Objectives: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves “short long-lived people”, rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Material and methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusions: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.
7.
Characterization of the organic matter in pockmark areas of the Southwestern Atlantic upper slope
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Lourenço, Rafael André
; Kunrath, Nathalia Araujo
; Nagaoka, Doris
; Magalhães, Caio Augusto
; Pereira, Antonio Derley de Sousa
; Sotão Neto, Basílio Magno Tavares
; Timoszczuk, Cristian Taboada
; Santos, Felipe Rodrigues dos
; Pedrão, Guilherme Augusto
; Araujo, Lígia Dias de
; Nascimento, Lorena Sampaio
; Carvalho, Nayara Ferreira
; Silva, Josilene da
; Taniguchi, Satie
; Mahiques, Michel Michaelovitch de
; Bícego, Márcia Caruso
; Sumida, Paulo Yukio Gomes
.
Abstract Pockmarks are circular or elliptical structures formed at the seabed by the expulsion of gas from the subsurface. They are widely distributed along the continental margin off southeastern Brazil and can be over a kilometer wide and 100 meters deep. However, studies concerning the organic characteristics of these pockmark areas are scarce. This study sought to evaluate the organic composition of the sedimentary matter in pockmark areas located in the continental slope region of the southern Brazilian coast. Hydrocarbons, sterols, long-chain alcohols, stable isotopes of C and N, total organic carbon, and total nitrogen were assessed to provide an organic molecular characterization of the pockmarks located in the Southwestern Atlantic Ocean. These compounds did not reflect the organic characteristics of the scape of fluids that generate pockmark structures.
8.
Archaeometallurgy of ferrous artefacts of the Patriótica Iron Factory (XIX century, Ouro Preto, Brazil)
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Landgraf, Fernando José Gomes
; Ribeiro, Matheus Yuri Quisbert
; Rosa, Guilherme Inácio Lima da
; Carvalho, Paulo Sérgio Germano
; Rodrigues, Daniel Luiz
; Maia, Rafael Rocha
; Beneduce Neto, Flávio
; Azevedo, Cesar Roberto Farias
.
Abstract The article reviews the metallurgical processes used in the first industrial ironworks operated in Brazil, the Patriótica Iron Factory, from 1812 to 1831. It discusses its impact on the ironmaking plants that spread in Minas Gerais's state during the XIX century. The remnants of this Factory in Ouro Preto were the first industrial site listed by the Brazilian Historic Heritage Authority (SPHAN) in 1938. Vale SA, owner of the site, and the National Historic and Artistic Heritage Institute (IPHAN) authorised collecting samples from two ferrous artefacts found in the old Factory, a hammer and an eyebolt nailed to the remnants of one of the reduction furnaces. The eyebolt’s microstructure suggests that this part was produced in the Patriótica Iron Factory, while the hammer’s microstructure indicates that this component was not produced in the Patriótica Iron Factory.
https://doi.org/10.1590/0370-44672021740019
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9.
Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
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Becker, Jefferson
; Ferreira, Lis Campos
; Damasceno, Alfredo
; Bichuetti, Denis Bernardi
; Christo, Paulo Pereira
; Callegaro, Dagoberto
; Peixoto, Marco Aurélio Lana
; Sousa, Nise Alessandra De Carvalho
; Almeida, Sérgio Monteiro De
; Adoni, Tarso
; Santiago-Amaral, Juliana
; Junqueira, Thiago
; Pereira, Samira Luisa Apóstolos
; Gomes, Ana Beatriz Ayroza Galvão Ribeiro
; Pitombeira, Milena
; Paolilo, Renata Barbosa
; Grzesiuk, Anderson Kuntz
; Piccolo, Ana Claudia
; D´Almeida, José Arthur Costa
; Gomes Neto, Antonio Pereira
; Oliveira, Augusto Cesar Penalva De
; Oliveira, Bianca Santos De
; Tauil, Carlos Bernardo
; Vasconcelos, Claudia Ferreira
; Kaimen-Maciel, Damacio
; Varela, Daniel
; Diniz, Denise Sisterolli
; Oliveira, Enedina Maria Lobato De
; Malfetano, Fabiola Rachid
; Borges, Fernando Elias
; Figueira, Fernando Faria Andrade
; Gondim, Francisco De Assis Aquino
; Passos, Giordani Rodrigues Dos
; Silva, Guilherme Diogo
; Olival, Guilherme Sciascia Do
; Santos, Gutemberg Augusto Cruz Dos
; Ruocco, Heloisa Helena
; Sato, Henry Koiti
; Soares Neto, Herval Ribeiro
; Cortoni Calia, Leandro
; Gonçalves, Marcus Vinícius Magno
; Vecino, Maria Cecilia Aragón De
; Pimentel, Maria Lucia Vellutini
; Ribeiro, Marlise De Castro
; Boaventura, Mateus
; Parolin, Mônica Koncke Fiuza
; Melo, Renata Brant De Souza
; Lázaro, Robson
; Thomaz, Rodrigo Barbosa
; Kleinpaul, Rodrigo
; Dias, Ronaldo Maciel
; Gomes, Sidney
; Lucatto, Simone Abrante
; Alves-Leon, Soniza Vieira
; Fukuda, Thiago
; Ribeiro, Taysa Alexandrino Gonsalves Jubé
; Winckler, Thereza Cristina D’ávila
; Fragoso, Yara Dadalti
; Nascimento, Osvaldo José Moreira Do
; Ferreira, Maria Lucia Brito
; Mendes, Maria Fernanda
; Brum, Doralina Guimarães
; Glehn, Felipe Von
.
RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.
ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.
https://doi.org/10.1590/0004-282x-anp-2021-0162
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10.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
11.
COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro
; Uchôa, Caroline Louise Mesquita
; Mazzoco, Marina Flaborea
; Cruz, Isabella D'Andrea Garcia da
; Echegaray, Mariana V.F.
; Humes, Eduardo de Castro
; Silveira, Júlia Belizário
; Santi, Talita Di
; Miguel, Euripedes Constantino
; Corchs, Felipe
; Fatori, Daniel
; Campello, Guilherme
; Oliveira, Gabriel M. de
; Argolo, Felipe C.
; Ferreira, Felipe de M.
; Machado, Gustavo
; Argeu, Adriana
; Oliveira, Graça Maria Ramos de
; Serafim, Antônio de Pádua
; Siqueira, Luciana de Lima
; Rossi, Luciane de
; Rios, Izabel Cristina
; Oliveira, Talita Rodrigues de
; Antoniazzi, Leilane C. K.
; Gagliotti, Daniel Augusto Mori
; Abelama Neto, Emílio
; Oliveira Junior, Paulo Novais de
; Correia, Aline Villalobo
; Gonçalves, Luca Schilling
; Tortato, Liana Silva
; Busato, Wagner Machado Moraes
; Guimarães-Fernandes, Flávio
; Alves, Marcos
; Leite Netto, Oswaldo Ferreira
; Schoueri, Patrícia de Campos Lindenberg
; Roque, Márcio de Assis
; Merlin, Silvia Stahl
; Boer, Giovana Cardoso Machado
; Sallet, Paulo Clemente
; Malbergier, André
; Spedo, Mariana Abrahão
; Kamitsuji, Carla Satie
; Faria, Elizabeth de
; Moreira, Moacyr Vergara de Godoy
; Kaufman, Arthur
; Abdo, Carmita
; Scanavino, Marco de Tubino
; Lancman, Selma
; Tavares, Hermano
; Polanczyk, Guilherme
; Brunoni, André R.
; Forlenza, Orestes V.
; Barros-Filho, Tarcísio Eloy Pessoa de
.
OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.
12.
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
; Brentani, Alexandra V. M.
; Neto, Álvaro José S.
; Ihara, Amanda
; Santos, Andrea R.
; Canton, Ana Pinheiro M.
; Watanabe, Andreia
; Santos, Angélica C. dos
; Pastorino, Antonio C.
; Franco, Bernadette D. G. M.
; Caruzo, Bruna
; Ceneviva, Carina
; Martins, Carolina C. M. F.
; Prado, Danilo
; Abellan, Deipara M.
; Benatti, Fabiana B.
; Smaria, Fabiana
; Gonçalves, Fernanda T.
; Penteado, Fernando D.
; Castro, Gabriela S. F. de
; Gonçalves, Guilherme S.
; Roschel, Hamilton
; Disi, Ilana R.
; Marques, Isabela G.
; Castro, Inar A.
; Buscatti, Izabel M.
; Faiad, Jaline Z.
; Fiamoncini, Jarlei
; Rodrigues, Joaquim C.
; Carneiro, Jorge D. A.
; Paz, Jose A.
; Ferreira, Juliana C.
; Ferreira, Juliana C. O.
; Silva, Katia R.
; Bastos, Karina L. M.
; Kozu, Katia
; Cristofani, Lilian M.
; Souza, Lucas V. B.
; Campos, Lucia M. A.
; Silva Filho, Luiz Vicente R. F.
; Sapienza, Marcelo T.
; Lima, Marcos S.
; Garanito, Marlene P.
; Santos, Márcia F. A.
; Dorna, Mayra B.
; Aikawa, Nadia E.
; Litvinov, Nadia
; Sakita, Neusa K.
; Gaiolla, Paula V. V.
; Pasqualucci, Paula
; Toma, Ricardo K.
; Correa-Silva, Simone
; Sieczkowska, Sofia M.
; Imamura, Marta
; Forsait, Silvana
; Santos, Vera A.
; Zheng, Yingying
.
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
13.
Lesion localization and performance on Theory of Mind tests in stroke survivors: a systematic review
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Bomfim, Ana Julia de Lima
; Ferreira, Bianca Letícia Cavalmoretti
; Rodrigues, Guilherme Riccioppo
; Pontes Neto, Octavio Marques
; Chagas, Marcos Hortes Nisihara
.
Archives of Clinical Psychiatry (São Paulo)
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Abstract Background: Theory of Mind (ToM) is the ability to attribute mental states to oneself and others. Individuals with a brain lesion following a stroke exhibit a compromised ability to perform ToM tasks. Objective: To analyze studies that evaluated ToM in stroke survivors considering the lesion localization and performance on ToM tests. Methods: The searches were carried out until November 28, 2018, using the following search terms: “social cognition” or “Theory of Mind” and “stroke”. Searches were conducted in the PubMed, PsycInfo, Web of Science and Scopus data bases. The initial search led to the retrieval of 425 articles. After the exclusion of duplicates and the analysis of the titles, abstracts and full texts, 20 articles were selected for the present review. Results: The studies showed that patients with lesion in the right hemisphere present lower performance on ToM tasks compared to those with lesion in the left hemisphere. In addition, patients with lesion in the right hemisphere presented significant impairment in the performance on ToM tasks compared to healthy individuals. Furthermore, the studies that evaluated lesions in specific regions such as temporal lobe, prefrontal cortex, posterior parietal cortex, and temporo-parietal junction, indicated a significant deficit in ToM performance of these patients compared to healthy individuals. Discussion: This review showed that stroke survivors have a poor performance on ToM tasks. The right hemisphere and prefrontal cortex seem to be associated with the deficit of this ability.
https://doi.org/10.1590/0101-60830000000250
157 downloads
14.
Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology
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MONT’ALVERNE, Francisco José Arruda
; LIMA, Fabrício Oliveira
; NOGUEIRA, Raul Gomes
; FREITAS, Carlos Clayton Macedo de
; NETO, Octávio Marques Pontes
; SILVA, Gisele Sampaio
; OLIVEIRA, Maura Salaroli de
; FRUDIT, Michel
; CALDAS, Jose Guilherme Mendes Pereira
; ABUD, Daniel Giansante
; CONFORTO, Adriana Bastos
; CARVALHO, Fernanda Martins Maia
; DIAS, Francisco Antunes
; BAZAN, Rodrigo
; AVELAR, Wagner Mauad
; MORO, Carla Heloísa Cabral
; MAGALHÃES, Pedro Silva Correa de
; MIRANDA, Maramelia
; BARBOSA, Leandro de Assis
; FIOROT JUNIOR, José Antonio
; CARDOSO, Fabrício Buchdid
; REBELLO, Leticia Costa
; PARENTE, Bruno de Sousa Mendes
; FARIA, Mário de Barros
; FREITAS, Gabriel Rodriguez de
; ZÉTOLA, Viviane de Hiroki Flumignan
; OLIVEIRA-FILHO, Jamary
; BEZERRA, Daniel da Cruz
; RODRIGUES, Jorge Luis Nobre
; KUSTER, Gustavo
; MARTINS, Sheila
; CARVALHO, João José Freitas de
.
RESUMO Introdução: A pandemia causada pelo novo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2, COVID-19) apresenta novos e importantes desafios à gestão de saúde no Brasil. Além da difícil missão de prestar atendimento aos milhares de pacientes infectados pelo COVID-19, os sistemas de saúde têm que manter a assistência às emergências médicas comuns em períodos sem pandemia, tais como o acidente vascular cerebral (AVC), que continuam ocorrendo e requerem tratamento com presteza e eficiência. A alocação de recursos materiais e humanos para o enfrentamento à pandemia não pode comprometer o atendimento ao AVC agudo, uma emergência cujo tratamento é tempo-dependente e se não realizado implica em importante impacto na mortalidade e incapacitação a longo prazo. Objetivo: Este trabalho resume as recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, da Sociedade Brasileira de Doenças Cerebrovasculares e da Sociedade Brasileira de Neurorradiologia para o tratamento do AVC agudo e para a realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19, incluindo o uso adequado de ferramentas de triagem e equipamentos de proteção pessoal (para pacientes e profissionais de saúde), além da alocação apropriada de pacientes.
ABSTRACT Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.
https://doi.org/10.1590/0004-282x20200053
2310 downloads
15.
How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation
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Perini, Guilherme Fleury
; Fischer, Thais
; Gaiolla, Rafael Dezen
; Rocha, Talita Bueno
; Bellesso, Marcelo
; Teixeira, Larissa Lane Cardoso
; Delamain, Marcia Torresan
; Scheliga, Adriana Alves de Souza
; Ribeiro, Glaciano Nogueira
; Vaz Neto, Jorge
; Baiocchi, Otávio Cesar Carvalho Guimaraes
; Abdo, André Neder Ramires
; Arrais-Rodrigues, Celso
; Fogliatto, Laura M.
; Bigni, Ricardo de Sá
; Schaffel, Rony
; Biasoli, Irene
; Pereira, Juliana
; Nabhan, Samir Kanaan
; Souza, Cármino Antônio de
; Chiattone, Carlos Sérgio
.
ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.
https://doi.org/10.1016/j.htct.2020.04.002
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