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1.
HIGH-INTENSITY INTERVAL TRAINING POSES NO RISK TO HYPERTENSIVE WOMEN
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Vieira-Souza, Lucio Marques
; Aidar, Felipe José
; Mota, Márcio Getirana
; Reis, Gracielle Costa
; Lima Júnior, Cássio Murilo Almeida
; Silva, Fábio José Antônio da
; Jesus, Joseane Barbosa de
; Azevedo, David Edson Ramos de
; Marçal, Anderson Carlos
; Santos, Jymmys Lopes dos
.
RESUMO Introdução: O objetivo deste estudo foi avaliar se uma única sessão de treinamento intervalado de alta intensidade (HIIT) promoveria efeito hipotensor e risco cardiovascular em mulheres hipertensas, bem como aumentar a biodisponibilidade de óxido nítrico. Métodos: A amostra foi composta por 10 mulheres hipertensas (63,7 ± 10,34 anos; 66, ± 7,67 kg e 153,7 ± 9,08 cm) e a carga de treinamento foi estabelecida em 60% da velocidade aeróbica máxima. Resultados: Observamos um efeito hipotensor muito alto entre os momentos de interação durante a intervenção (Int. Pré: 122,40 ± 18,58; Int. Pós: 143,00 ± 24,90; Int. Pós 60 min.: 121,40 ± 13,87; p < 0,001, η2P = 0,569). Nenhum risco cardiovascular foi observado durante a intervenção (DP = Int. Pré: 9138,20 ± 1805,34; Int. Pós: 14849,70 ± 3387,94; Int. Pós: 60 min.: 9615,90 ± 1124,41, p < 0,001, η2P = 0,739) e não houve aumento da biodisponibilidade de óxido nítrico. Conclusões: Em conclusão, este trabalho revela que uma sessão de HIIT é capaz de gerar efeito hipotensor sem apresentar risco cardiovascular em mulheres hipertensas. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significativa, mas com intervalos de confiança estreitos .
ABSTRACT Introduction: The aim of this study was to evaluate whether a single session of high-intensity interval training (HIIT) would promote a hypotensive effect and cardiovascular risk in hypertensive women, in addition to increasing the bioavailability of nitric oxide. Methods: The sample consisted of 10 hypertensive women (63.7 ± 10.34 years; 66 ± 7.67 kg and 153.7 ± 9.08 cm) and the training load was established at 60% of the maximum aerobic speed. Results: We observed a very high hypotensive effect between the interaction moments during the intervention (Int. Pre: 122.40 ± 18.58; Int. Post: 143.00 ± 24.90; Int. Post 60min: 121.40 ± 13.87; p<0.001, η2P = 0.569). No cardiovascular risk was observed during the intervention (DP = Int. Pre: 9138.20 ± 1805.34; Int. Post: 14849.70 ± 3387.94; Int. Post 60min: 9615.90 ± 1124.41, p< 0.001, η2P = 0.739) and there was no increase in the bioavailability of nitric oxide. Conclusion: In conclusion, this work reveals that an HIIT session is capable of generating a hypotensive effect while not posing cardiovascular risk in hypertensive women. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals .
RESUMEN Introducción: El objetivo de este estudio fue evaluar si una única sesión de entrenamiento de intervalos de alta intensidad (HIIT) podría promover un efecto hipotensor y riesgo cardiovascular en mujeres hipertensas, así como aumentar la biodisponibilidad del óxido nítrico. Métodos: La muestra fue compuesta por 10 mujeres hipertensas (63,7 ± 10,34 años; 66 ± 7,67 kg y 153,7 ± 9,08 cm) y la carga de entrenamiento se estableció en el 60% de la velocidad aeróbica máxima. Resultados: Se observó un efecto hipotensor muy elevado entre los momentos de interacción durante la intervención (Int. Pre: 122,40 ± 18,58; Int. Post: 143,00 ± 24,90; Int. Post 60 min: 121,40 ± 13,87; p <0,001, η2P = 0,569). No se observó ningún riesgo cardiovascular durante la intervención (DP = Int. Pre: 9138,20 ± 1805,34; Int. Post: 14849,70 ± 3387,94; Int. Post 60 min: 9615,90 ± 1124,41, p <0,001, η2P = 0,739) y no hubo aumento de la biodisponibilidad de óxido nítrico. Conclusiones: En conclusión, este trabajo revela que una sesión de HIIT es capaz de generar efecto hipotensor sin presentar riesgo cardiovascular en mujeres hipertensas. Nivel de evidencia I; Estudio clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.
2.
Molecular profile of patients with myelofibrosis: a 10-year experience
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Dias, Lara Faria Souza
; Pereira, Carolina Leme de Moura
; Centurião, Newton de Freitas
; Nascimento, Jade Zezzi Martins do
; Ribeiro, Andreza Alice Feitosa
; Hamerschlak, Nelson
; Marques, Carolina Perrone
; Lima, Ana Carolina Vieira de
; Costa, Luana Nóbrega da
; Silva, Anderson Felipe da
; Lima, Viviane de Jesus Torres
; Kerbauy, Mariana Nassif
; Kerbauy, Lucila Nassif
; Arcuri, Leonardo Javier
; Campregher, Paulo Vidal
; Rocha, Juliana Dall´Agnol da
; Datoguia, Tarcila Santos
; Santos, Fabio Pires de Souza
.
ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient’s risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.
3.
Synchronous jawbone diseases: a multicenter retrospective study
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REZENDE, Diogo dos Santos da Mata
; SOUZA, Lucas Lacerda de
; UCHÔA, Daniel Cavalléro Colares
; FERNANDES, Lais Albuquerque
; LEMOS, Jeanne Gisele Rodrigues de
; SANTOS-SILVA, Alan Roger
; LOPES, Márcio Ajudarte
; ARBOLEDA, Lady Paola Aristizabal
; ROCHA, André Caroli
; GONÇALVES, Fábio Luiz Neves
; PONTES, Flávia Sirotheau Corrêa
; FONSECA, Felipe Paiva
; PONTES, Hélder Antônio Rebelo
.
Abstract The aim of this study is to report an original case series of synchronous jawbone diseases. Data of patients seen over 13 years were extracted from the files of three Oral Radiology and Pathology diagnostic centers in Brazil. The clinical, radiographic, and laboratory characteristics were tabulated and analyzed by the authors; the patients were described according to lesion type. Seventy-two synchronous jawbone diseases were included in this study. Florid osseous dysplasia, Gorlin-Goltz syndrome, and cherubism were the most frequent disorders reported in this case series. In addition, the posterior mandible area was the main site of manifestation. Florid osseous dysplasia and Gorlin-Goltz syndrome represented two-thirds of our samples. With the utilization of adequate demographic, clinical, and radiologic information, it is possible to diagnose most of the synchronous lesions of jawbones. Sometimes, however, we need complementary exams, such as histopathologic and biochemical analysis or dosing of calcium, phosphorus, and alkaline phosphatase.
4.
Accurate diagnosis of breast lesions Number 4 – April 2023
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Andrade, Alexandre Vicente de
; Lucena, Clécio Ênio Murta de
; Santos, Danielle Chambô dos
; Pessoa, Eduardo Carvalho
; Mansani, Fabio Postiglione
; Andrade, Felipe Eduardo Martins de
; Tosello, Giuliano Tavares
; Pasqualette, Henrique Alberto Portella
; Couto, Henrique Lima
; Francisco, Jose Luis Esteves
; Costa, Rodrigo Pepe
; Teixeira, Sandra Regina Campos
; Moraes, Thaís Paiva
; Silva Filho, Agnaldo Lopes da
.
Revista Brasileira de Ginecologia e Obstetrícia
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5.
Challenges of breast cancer screening: Number 9 – September 2023
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Andrade, Alexandre Vicente de
; Lucena, Clécio Ênio Murta de
; Santos, Danielle Chambô dos
; Pessoa, Eduardo Carvalho
; Mansani, Fabio Postiglione
; Andrade, Felipe Eduardo Martins de
; Tosello, Giuliano Tavares
; Pasqualette, Henrique Alberto Portella
; Couto, Henrique Lima
; Francisco, Jose Luis Esteves
; Costa, Rodrigo Pepe
; Teixeira, Sandra Regina Campos
; Moraes, Thaís Paiva
; Silva Filho, Agnaldo Lopes da
.
Revista Brasileira de Ginecologia e Obstetrícia
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6.
Diagnosis and treatment of systemic mastocytosis in Brazil: Recommendations of a multidisciplinary expert panel
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Velloso, Elvira D. Rodrigues Pereira
; Padulla, Geórgia A.
; Cerqueira, Ana Maria Mósca de
; Sousa, Adriana Martins de
; Sandes, Alex Freire
; Traina, Fabiola
; Seguro, Fernanda Salles
; Nogueira, Frederico Lisboa
; Pereira, Grazielly de Fátima
; Boechat, José Laerte
; Pagnano, Katia Borgia Barbosa
; Marchi, Luan Lima
; Ensina, Luis Felipe
; Giavina-Bianchi, Mara
; Aun, Marcelo Vivolo
; Agondi, Rosana Câmara
; Santos, Fabio Pires de Souza
; Giavina-Bianchi, Pedro
.
ABSTRACT Introduction: Systemic Mastocytosis comprises a group of neoplastic diseases characterized by clonal expansion and infiltration of mast cells into several organs. The diagnosis and treatment of this disease may be challenging for non-specialists. Objective: Make suggestions or recommendations in Systemic Mastocytosis based in a panel of Brazilian specialists. Method and results: An online expert panel with 18 multidisciplinary specialists was convened to propose recommendations on the diagnosis and treatment of Systemic Mastocytosis in Brazil. Recommendations were based on discussions of topics and multiple-choice questions and were graded using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Chart. Conclusion: Twenty-two recommendations or suggestions were proposed based on a literature review and graded according to the findings.
7.
Modelagem Bayesiana aplicada para cálculo da probabilidade de falha em Sistemas de Saúde IoT
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Kinjo, Erika Midori
; Librantz, André Felipe Henriques
; Souza, Edson Melo de
; Santos, Fábio Cosme Rodrigues dos
.
RISTI - Revista Ibérica de Sistemas e Tecnologias de Informação
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Resumo A implantação da tecnologia da Internet das Coisas (IoT) traz benefícios à vida, como controle remoto de pragas na agricultura, monitoramento da cadeia de suprimentos, melhoria na educação e monitoramento de pacientes. No entanto, apesar dos benefícios, existem desafios embutidos na implementação desta tecnologia. Um dos maiores desafios da área é a violação de privacidade e segurança de dados. Portanto, é necessário avaliar a probabilidade de falha dos elementos e, consequentemente, a causa desse problema. Assim, é neste contexto que este trabalho se propõe a identificar, modelar e calcular a probabilidade de falha através de uma análise sistemática, utilizando Redes Bayesianas. Os resultados mostraram que através do uso do modelo proposto foi possível avaliar diferentes cenários para o uso de redes de Internet das Coisas, bem como simular o efeito da probabilidade de falha nos elementos críticos do sistema.
Abstract The implementation of the Internet of Things (IoT) technology provides benefits to life, such as remote pest control in agriculture, monitoring the supply chain, improvement environment in education, and monitoring patients. However, despite the benefits, there are challenges embedded in the implementation of this technology. One of the biggest challenges in the area is the violation of privacy and data security. Therefore, it is necessary to assess the probability of failure of the components and, consequently, the cause of this problem. So, it is in this context that this work proposes to identify, model, and calculate the failure probability through a systematic analysis, using Bayesian Networks. The results showed that through the use of the proposed model it was possible to evaluate different scenarios for the use of Internet of Things networks, as well as to simulate the effect of the probability of failure in the critical components of the system.
8.
Cover crops and controlled-release urea decrease nitrogen mobility and improve nitrogen stock in a tropical sandy soil with cotton cultivation
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Cordeiro, Carlos Felipe dos Santos
; Rodrigues, Daniel Rodela
; Rorato, Ana Flávia de Souza
; Echer, Fábio Rafael
.
ABSTRACT Sandy soil often has low nitrogen (N) stock. Thus, crops grown in sandy soil rely on high levels of N fertilization. The use of cover crops and efficient fertilizers can increase N stock in the soil and N availability in the topsoil, and reduce overall fertilizer costs. The objective of this study was to evaluate the effects of cover crops (fallow, a single grass species (ruzigrass), two grass species (ruzigrass + millet), one grass species (millet) with legumes [lime-yellow pea (2018) and velvet bean (2019)], and a mixture of three cover crops [two grass species (ruzigrass + millet) and one legume (lime-yellow pea (2018)] and velvet bean (2019), N sources (conventional urea and controlled-release urea) and N doses (70, 100 and 130 kg ha-1) on N dynamics in an Oxisol (Latossolo) with sandy texture in Brazil cultivated with cotton. Systems with the cover crops (average) had 17 % more total N stock in the soil than fallow systems. Inorganic N increased only in systems with legumes. The systems with cover crop mixtures had 70 % more ammonium than fallow systems. Systems only with grass species had low percentages of inorganic N in relation to total N in the soil. The increase in N-fertilizer rates augmented the N stock in the soil (total and inorganic). In the first year, controlled-release urea reduced the availability of inorganic N in cotton flowering, except for the system with mixed cover crops. After the cotton harvest, areas of controlled-release urea application had 12 % more inorganic N than the areas with conventional urea. Our findings show that the combined use of cover crops with high biomass production, moderate dose of N and controlled-release N can increase the availability of inorganic nitrogen in the upper layers of the soil in tropical areas with sandy soil and this can reduce nitrogen fertilizer consumption in the medium and long term in cotton fields.
9.
The REBECGA Brazilian Registry of Pregnancy and Heart Disease: Rationale and Design
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Avila, Walkiria Samuel
; Rivera, Maria Alayde Mendonça
; Marques-Santos, Celi
; Rivera, Ivan Romero
; Costa, Maria Elizabeth Navegantes Caetano
; Lucena, Alexandre Jorge Gomes de
; Freire, Claudia Maria Vilas
; Carvalho, Regina Coeli Marques de
; Born, Daniel
; Campanharo, Felipe Favorette
; Silva, Fabio Bruno
.
International Journal of Cardiovascular Sciences
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Abstract Background: Maternal mortality rates in Brazil remain above the goals established by the United Nations Sustainable Development Goals. Heart disease is estimated to affect 4% of all pregnancies and remains by itself the main indirect obstetric cause of maternal death. In the last decades, a significant improvement in the prognosis of heart diseases has made pregnancy possible in women with heart disease and provided better maternal and fetal outcomes. Objective: To establish a multicenter Brazilian Registry of pregnant women with heart disease; to study the causes of immediate and late maternal mortality; and to assess the prevalence of heart disease in the country’s macro-regions. Method: This is an observational study, with retrospective and prospective stages, of the clinical and obstetric progression of pregnant women with heart disease. These women consecutively received care during pregnancy and will be followed up for up to a year after delivery at public and private hospitals with infrastructure for the execution of this project, a principal investigator, and approval by Ethics and Research Committees. Results: Our results will be presented after data collection and statistical analysis, aiming to demonstrate immediate and late maternal mortality rates, as well as the prevalence of heart disease in the country and its cardiovascular and obstetric complications during pregnancy. Conclusion: REBECGA will be the Brazilian Registry of heart disease and pregnancy and it will contribute to planning preventive measures, raising financial resources for the improvement of high-risk prenatal care, and reducing immediate and late maternal mortality due to heart disease.
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
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11.
Official matches and training sessions: physiological demands of elite junior badminton players
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Sales, Karen Christie Gomes
; Santos, Marcos Antônio Pereira
; Nakamura, Fabio Yuzo
; Silvino, Valmir Oliveira
; Sena, Alyson Felipe da Costa
; Ribeiro, Sérgio Luís Galan
; Rodrigues Júnior, Jefferson Fernando Coelho
; Cabido, Christian Emmanuel Torres
; Mendes, Thiago Teixeira
.
Abstract Aim: To evaluate the intensity of training and official badminton matches (international championship) in junior elite players. Methods: Twelve elite players from the Brazilian junior national team (6 male and 6 female) were monitored during 19 training sessions and 50 official men's and women's single and double matches in the XXVII Pan-American Junior Games. Subjects underwent an incremental running step test to determine maximal oxygen uptake (VO2max), and an individual relationship between heart rate (HR) and VO2max was established to estimate exercise intensity and oxygen uptake at official matches (OMs) and training sessions. HR was monitored during multi-shuttlecock (MS), technical-tactical (TT), and physical (PS) training methods, as well as during simulated matches (SMs) and OMs. Variables such as %HRmax, HR zones, %VO2max, and energy expenditure were also calculated. Results: OM was the most intense activity monitored for male and female athletes, followed by SM according to %HRmax (86.8 ± 4.1% and 84.4 ± 5.0% for female and male, respectively, in OM vs. 74.6 ± 2.3% and 75.0 ± 5.0% for female and male, respectively, in SM). OM mean energy expenditure was 10.7 ± 0.5 kcal.min-1 for females and 14.9 ± 4.6 kcal.min−1 for males. Conclusion: MS training has less physiological demand and OM presented higher intensity. SM, on the other hand, had the closest physiological demand to an OM.
https://doi.org/10.1590/s1980-65742021021520
226 downloads
12.
Identification and characterisation of SARS-CoV-2 and Human alphaherpesvirus 1 from a productive coinfection in a fatal COVID-19 case
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Herlinger, Alice Laschuk
; Monteiro, Fábio Luís Lima
; D’arc, Mirela
; Moreira, Filipe Romero Rebello
; Westgarth, Harrison James
; Galliez, Rafael Mello
; Mariani, Diana
; da Costa, Luciana Jesus
; de Almeida, Luiz Gonzaga Paula
; Voloch, Carolina Moreira
; Melo, Adriana Suely de Oliveira
; Aguiar, Renato Santana de
; dos Santos, André Felipe Andrade
; Castiñeiras, Terezinha Marta Pereira Pinto
; de Vasconcelos, Ana Tereza Ribeiro
; João Filho, Esaú Custódio
; Escosteguy, Claudia Caminha
; Ferreira Junior, Orlando da Costa
; Tanuri, Amilcar
; Higa, Luiza Mendonça
.
BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.
13.
COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves
; Ximenez, João Paulo Bianchi
; Seiva, Fábio Rodrigues Ferreira
; Panis, Carolina
; Bezerra, Rafael dos Santos
; Ferrasa, Adriano
; Cecchini, Alessandra Lourenço
; Medeiros, Alexandra Ivo de
; Almeida, Ana Marisa Fusco
; Ramão, Anelisa
; Boldt, Angelica Beate Winter
; Moya, Carla Fredrichsen
; Chin, Chung Man
; Paula, Daniel de
; Rech, Daniel
; Gradia, Daniela Fiori
; Malheiros, Danielle
; Venturini, Danielle
; Tavares, Eliandro Reis
; Carraro, Emerson
; Ribeiro, Enilze Maria de Souza Fonseca
; Pereira, Evani Marques
; Tuon, Felipe Francisco
; Follador, Franciele Aní Caovilla
; Fernandes, Glaura Scantamburlo Alves
; Volpato, Hélito
; Cólus, Ilce Mara de Syllos
; Oliveira, Jaqueline Carvalho de
; Rodrigues, Jean Henrique da Silva
; Santos, Jean Leandro dos
; Visentainer, Jeane Eliete Laguila
; Brandi, Juliana Cristina
; Serpeloni, Juliana Mara
; Bonini, Juliana Sartori
; Oliveira, Karen Brajão de
; Fiorentin, Karine
; Lucio, Léia Carolina
; Faccin-Galhardi, Ligia Carla
; Ferreto, Lirane Elize Defante
; Lioni, Lucy Megumi Yamauchi
; Consolaro, Marcia Edilaine Lopes
; Vicari, Marcelo Ricardo
; Arbex, Marcos Abdo
; Pileggi, Marcos
; Watanabe, Maria Angelica Ehara
; Costa, Maria Antônia Ramos
; Giannini, Maria José S. Mendes
; Amarante, Marla Karine
; Khalil, Najeh Maissar
; Lima Neto, Quirino Alves de
; Herai, Roberto H.
; Guembarovski, Roberta Losi
; Shinsato, Rogério N.
; Mainardes, Rubiana Mara
; Giuliatti, Silvana
; Yamada-Ogatta, Sueli Fumie
; Gerber, Viviane Knuppel de Quadros
; Pavanelli, Wander Rogério
; Silva, Weber Claudio da
; Petzl-Erler, Maria Luiza
; Valente, Valeria
; Soares, Christiane Pienna
; Cavalli, Luciane Regina
; Silva Jr, Wilson Araujo
.
Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.
14.
INFLAMMATORY BOWEL DISEASE CARE IN BRAZIL: HOW IT IS PERFORMED, OBSTACLES AND DEMANDS FROM THE PHYSICIANS’ PERSPECTIVE
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VILELA, Eduardo Garcia
; ROCHA, Henrique Carvalho
; MORAES, Antônio Carlos
; SANTANA, Genoile Oliveira
; PARENTE, José Miguel
; SASSAKI, Ligia Yukie
; MISZPUTEN, Sender Jenkiel
; QUARESMA, Abel Botelho
; CLARA, Ana Paula Hamer Sousa
; JESUS, Adélia Carmen Silva de
; PINTO, Arlene dos Santos
; SILVA, Bianca Loyo Pona Schiavetti da
; SILVA, Bruno César da
; FREIRE, Caio César Furtado
; SANTOS, Carlos Henrique Marques dos
; BRITO, Carlos
; TEIXEIRA, Ellen Francioni Lima
; MIRANDA, Eron Fabio
; ZABOT, Gilmara Pandolfo
; DUARTE, Jozelda Lemos
; LUDVIG, Juliano Coelho
; CAMPOS-LOBATO, Luiz Felipe de
; CASSOL, Ornella Sari
; SOUZA, Mardem Machado de
; ALMEIDA, Neogélia Pereira de
; PARRA, Rogério Serafim
; LIMA JÚNIOR, Sérgio Figueiredo de
; SAAD-HOSSNE, Rogério
.
RESUMO CONTEXTO: As doenças inflamatórias intestinais (DII) são afecções inflamatórias crônicas de caráter recorrente, cujas taxas de incidência e prevalência têm aumentado, inclusive no Brasil. A longo prazo, são responsáveis por danos estruturais que impactam na qualidade de vida, morbidade e mortalidade dos pacientes. OBJETIVO: Avaliar o perfil dos médicos que atendem pacientes com DII, assim como as características deste atendimento, demandas não atendidas e dificuldades. MÉTODOS: Um questionário contendo 17 variáveis foi elaborado e enviado para médicos, selecionados a partir do cadastro da Comissão das Estaduais do Grupo de Estudos da Doença Inflamatória Intestinal do Brasil (GEDIIB), totalizando 286 médicos de 101 cidades brasileiras distribuídas por 21 estados e Distrito Federal. RESULTADOS: A maioria dos médicos que respondeu o questionário foram Gastroenterologistas e Coloproctologistas. Mais de 60% tinham até 20 anos de atuação na especialidade e 53,14% trabalhavam em três locais ou mais. A dificuldade no acesso ou liberação de medicamentos ficou evidenciada neste questionário, assim como a dificuldade no encaminhamento para profissionais não médicos que atuam em DII. Mais de 75% dos médicos relataram dificuldades para realização de enteroscopia por duplo balão e cápsula endoscópica, e 67,8% para realização da calprotectina. Em relação ao número de pacientes atendidos por cada médico, foi evidenciado que não há uma concentração de pacientes sob a responsabilidade de poucos médicos. O infliximabe e o adalimumabe foram os biológicos mais utilizados e ficou evidenciada prescrição maior de derivados de 5-ASA para retocolite ulcerativa quando comparada à doença de Crohn. Os corticoides foram prescritos para uma parcela menor de pacientes em ambas doenças. Os temas “falha a terapia biológica” e “novas drogas” foram referidos como aqueles com maior prioridade para discussão em eventos científicos. Em relação às possíveis diferenças entre cada região e o restante do país, os médicos da região Norte relataram maior dificuldade no acesso a exames complementares e os médicos da região Nordeste, maior dificuldade no acesso ou liberação de medicamentos. CONCLUSÃO: Os dados obtidos por meio deste estudo mostram o perfil do atendimento médico especializado em DII e podem se constituir em ferramenta útil para para elaboração de políticas governamentais e para sociedade brasileira como um todo.
ABSTRACT BACKGROUND: Inflammatory bowel diseases (IBD) are chronic inflammatory affections of recurrent nature whose incidence and prevalence rates have increased, including in Brazil. In long term, they are responsible for structural damage that impacts quality of life, morbidity and mortality of patients. OBJECTIVE: To describe the profile of physicians who treat IBD patients as well as the characteristics of IBD care, unmet demands and difficulties. METHODS: A questionnaire containing 17 items was prepared and sent to 286 physicians from 101 Brazilian cities across 21 states and the Federal District, selected from the register of the State Commission of the “Study Group of Inflammatory Bowel Disease of Brazil” (GEDIIB). RESULTS: The majority of the physicians who answered the questionnaire were gastroenterologists and colorectal surgeons. More than 60% had up to 20 years of experience in the specialty and 53.14% worked at three or more locations. Difficulties in accessing or releasing medicines were evident in this questionnaire, as was referrals to allied healthy professionals working in IBD-related fields. More than 75% of physicians reported difficulties in performing double-balloon enteroscopy and capsule endoscopy, and 67.8% reported difficulties in measuring calprotectin. With regard to the number of patients seen by each physician, it was shown that patients do not concentrate under the responsibility of few doctors. Infliximab and adalimumab were the most commonly used biological medicines and there was a higher prescription of 5-ASA derivatives for ulcerative colitis than for Crohn’s disease. Steroids were prescribed to a smaller proportion of patients in both diseases. The topics “biological therapy failure” and “new drugs” were reported as those with higher priority for discussion in medical congresses. In relation to possible differences among the country’s regions, physicians from the North region reported greater difficulty in accessing complementary exams while those from the Northeast region indicated greater difficulty in accessing or releasing medicines. CONCLUSION: The data obtained through this study demonstrate the profile of specialized medical care in IBD and are a useful tool for the implementation of government policies and for the Brazilian society as a whole.
https://doi.org/10.1590/s0004-2803.202000000-77
1133 downloads
15.
Sensory attributes and Lipid oxidation of smoked lamb sausage formulated with passion fruit meal, potassium chloride and calcium chloride
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MAIA JUNIOR, Jonhny de Azevedo
; HENRY, Fábio da Costa
; DELLA LUCIA, Suzana Maria
; SANTOS JUNIOR, Alexandre Cristiano
; CABRAL, Natália de Oliveira
; QUIRINI, Célia Raquel
; VALLE, Felipe Roberto Amaral Ferreira
.
Abstract This study evaluated the sensory attributes and lipid peroxidation of smoked lamb sausage prepared with passion fruit meal, potassium chloride and calcium chloride. The samples were produced and smoked at Instituto Federal do Espírito Santo, where they were kept vacuum packed and frozen until laboratory analysis. The formulations with passion fruit meal presented lower weight loss by smoking. No microbiological growth was detected in the 90-day study period. Formulation 1 was the best in the attributes color, aroma, flavor, texture, overall impression and purchase intention. The use of passion fruit meal to replace fat, potassium chloride and calcium chloride did not affect oxidation of the product during the study period. The addition of passion fruit meal, potassium chloride and calcium chloride to smoked lamb sausage, especially in Formulation 1, produced the best results and the levels of these ingredients did not interfere in oxidation.
https://doi.org/10.1590/fst.02419
662 downloads
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