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1.
Mining waste associated with bioinoculants and cattle manure for the mineral nutrition and growth of maize
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Silva, Vitor M. B. da
; Rocha, Josinaldo L. A.
; Lima, Adriana S.
; Soares, Anny K. de F.
; Sá, Francisco V. da S.
; Lima, Geovani S. de
; Mesquita, Evandro F. de
; Santos, José Z. L.
.
Revista Brasileira de Engenharia Agrícola e Ambiental
- Journal Metrics
ABSTRACT Vermiculite mining residues, although of low solubility, contain nutrients such as calcium, magnesium, and potassium at concentrations that allow their agricultural use. Beneficial bacteria can increase the solubility of this waste and its efficiency. The objective of the present study was to evaluate the influence of bio-inoculation of vermiculite residue, associated with cattle manure, on the release of nutrients and initial growth of maize. A completely randomized design was performed in a greenhouse with seven treatments and four replications. The treatments were: T1 - soil without fertilization; T2 - soil fertilized with soluble sources of nutrients (conventional fertilization); T3 - application of vermiculite residue (VR); T4 - VR enriched with cattle manure (CM); T5 - VR + CM with Bacillus subtilis; T6 - VR + CM + B. amyloliquefaciens, and T7 - VR + CM +B. subtilis + B. amyloliquefaciens). Regardless of the use of cattle manure or beneficial microorganisms, vermiculite mining waste increased the availability of Ca and K in the soil, but was not able to match the soluble sources of nutrients. Mining waste associated with cattle manure and beneficial microorganisms (B. subtilis and B. amyloliquefaciens) increased microbial activity and enhanced the release of available calcium for maize. VR increased the growth and the dry mass production of maize compared to the non-fertilized soil, but was consistently inferior to conventional fertilizer.
RESUMO Os resíduos da mineração de vermiculita, embora de baixa solubilidade, contêm nutrientes como cálcio, magnésio e potássio em concentrações que permitem seu uso agrícola. Bactérias benéficas podem aumentar a solubilidade deste resíduo e sua eficiência. Objetivou-se avaliar a influência da bioinoculação do resíduo de vermiculita, associado ao esterco bovino, na liberação de nutrientes e no crescimento inicial do milho. Foi realizado delineamento inteiramente casualizado em casa de vegetação com sete tratamentos e quatro repetições. Os tratamentos foram: T1 - solo sem adubação; T2 - solo adubado com fontes solúveis de nutrientes (fertilização convencional); T3 - aplicação de resíduo de vermiculita (VR); T4 - VR enriquecido com esterco bovino (CM); T5 -VR+CM com Bacillus subtilis; T6 - VR + CM + B. amyloliquefaciens e T7 - VR + CM + B. subtilis + B. amyloliquefaciens). O VR aumentou a disponibilidade de Ca e K no solo, porém seu desempenho foi inferior às fontes solúveis. Independentemente da utilização de esterco bovino ou de microrganismos benéficos, os resíduos da mineração de vermiculita aumentaram a disponibilidade de Ca e K no solo, mas não foram capazes de igualar as fontes solúveis de nutrientes. Os resíduos de mineração associados ao esterco bovino e aos microrganismos benéficos (B. subtilis e B. amyloliquefaciens) aumentaram a atividade microbiana e aumentaram a liberação de cálcio disponível para o milho. Os resíduos da mineração de vermiculita aumentaram o crescimento e a produção de massa seca do milho em comparação ao solo não fertilizado, mas foram consistentemente inferiores ao fertilizante convencional.
2.
Growth of wild passion fruit (Passiflora foetida L.) rootstock under irrigation water salinity
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Souza, Gleyse L. F. de
; Nascimento, Adriana P. J.
; Silva, Josevan de A.
; Bezerra, Francisco T. C.
; Silva, Roberto Í. L. da
; Cavalcante, Lourival F.
; Mendonça, Rejane M. N.
.
Revista Brasileira de Engenharia Agrícola e Ambiental
- Journal Metrics
RESUMO Espécies silvestres de maracujazeiro, devido à maior tolerância aos estresses ambientais, revelam potencial como porta-enxerto interespecífico, P. foetida é uma espécie silvestre potencialmente tolerante à salinidade. Portanto, o objetivo com a pesquisa foi avaliar os efeitos da salinidade da água de irrigação no crescimento de porta-enxertos de maracujazeiro-bravo (P. foetida L.). O experimento foi realizado em ambiente protegido. Os tratamentos consistiram na condutividade elétrica da água de irrigação (0,3; 1,0; 2,0; 3,0 e 4,0 dS m-1), distribuídos em blocos casualizados. As avaliações foram realizadas aos 7, 14, 21, 28 e 35 dias após o transplantio e consistiram em: altura e diâmetro do caule, número de folhas, tamanho médio da folha, área foliar, massas das matérias secas da parte aérea, das raízes e total. Nos porta-enxertos jovens, os efeitos deletérios da salinidade sobre o crescimento em altura e os componentes foliares foram observados sob menores condutividades elétricas, sendo a tolerância aumentada com a acréscimo da idade. Entretanto, o acúmulo de biomassa seca foi restringido com maior severidade pela salinidade com o aumento da idade dos porta-enxertos. Os porta-enxertos de P. foetida são tolerantes à salinidade e podem ser irrigados com água de até 4,0 dS m-1.
ABSTRACT Wild passion fruit species, due to the greater tolerance to environmental stresses, reveal potential as interspecific rootstocks. Passiflora foetida is a wild species potentially tolerant to salinity. Therefore, the objective with the study was to evaluate the effects of irrigation water salinity on the growth of wild passion fruit (P. foetida L.) rootstocks. The experiment was carried out in a protected environment. The treatments consisted of the electrical conductivity of the irrigation water (0.3; 1.0; 2.0; 3.0 and 4.0 dS m-1), distributed in randomized blocks. The assessments were performed at 7, 14, 21, 28 and 35 days after transplanting and consisted of: stem height and diameter, number of leaves, average leaf size, leaf area, and dry matter of shoots, roots and total. In younger rootstocks, the deleterious effects of salinity on height growth and leaf components were observed under lower electrical conductivities, with tolerance increasing with age. However, dry biomass accumulation was more severely restricted by salinity with increasing rootstock age. P. foetida rootstocks are salinity tolerant and can be irrigated with water of up to 4.0 dS m-1.
3.
Aging-related predictive factors for oxygenation improvement and mortality in COVID-19 and acute respiratory distress syndrome (ARDS) patients exposed to prone position: A multicenter cohort study
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Cunha, Marieta C.A.
; Schardong, Jociane
; Righi, Natiele C.
; Lunardi, Adriana C.
; Sant’Anna, Guadalupe N.
; Isensee, Larissa P.
; Xavier, Rafaela F.
; Pompeu, Jose E.
; Weigert, Renata M.
; Matte, Darlan L.
; Cardoso, Rozana A.
; Abras, Ana C.V.
; Silva, Antonio M.V.
; Dorneles, Camila C.
; Werle, Roberta W.
; Starke, Ana C.
; Ferreira, Juliana C.
; Plentz, Rodrigo D.M.
; Carvalho, Celso R.F.
.
Abstract Background: Elderly patients are more susceptible to Coronavirus Disease-2019 (COVID-19) and are more likely to develop it in severe forms, (e.g., Acute Respiratory Distress Syndrome [ARDS]). Prone positioning is a treatment strategy for severe ARDS; however, its response in the elderly population remains poorly understood. The main objective was to evaluate the predictive response and mortality of elderly patients exposed to prone positioning due to ARDS-COVID-19. Methods: This retrospective multicenter cohort study involved 223 patients aged ≥ 65 years, who received prone position sessions for severe ARDS due to COVID-19, using invasive mechanical ventilation. The PaO2/FiO2 ratio was used to assess the oxygenation response. The 20-point improvement in PaO2/FiO2 after the first prone session was considered for good response. Data were collected from electronic medical records, including demographic data, laboratory/image exams, complications, comorbidities, SAPS III and SOFA scores, use of anticoagulants and vasopressors, ventilator settings, and respiratory system mechanics. Mortality was defined as deaths that occurred until hospital discharge. Results: Most patients were male, with arterial hypertension and diabetes mellitus as the most prevalent comorbidities. The non-responders group had higher SAPS III and SOFA scores, and a higher incidence of complications. There was no difference in mortality rate. A lower SAPS III score was a predictor of oxygenation response, and the male sex was a risk predictor of mortality. Conclusion: The present study suggests the oxygenation response to prone positioning in elderly patients with severe COVID-19-ARDS correlates with the SAPS III score. Furthermore, the male sex is a risk predictor of mortality.
4.
Potential of a native araticum species as the rootstock of atemoya cultivars propagated by grafting methods
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Silva, Edvan Costa da
; Villa, Fabíola
; Silva, Daniel Fernandes da
; Possenti, Jean Carlo
; Silva, Adriana de Castro Correia da
; Masiero, Michel Anderson
.
ABSTRACT. Technical and secure information on the production of quality atemoya seedlings (Annona squamosa L. x Annona cherimola Mill.) are of paramount importance due to the growing interest in this crop. This study aimed to assess the formation of atemoya seedlings propagated by grafting methods and cultivars using araticum (Annona sylvatica) rootstocks. The experiment was carried out in a screened environment at the Western Paraná State University (Unioeste), Campus of Marechal Cândido Rondon, Paraná State, Brazil. Atemoya grafts (Thompson, African Pride, and Gefner) were collected from plants from the CATI seedling nursery, located in São Bento do Sapucaí, São Paulo State, Brazil. Grafting was performed using 1-year-old araticum rootstocks with 8-10 mm in diameter at a height of 15 cm from the ground and grafts measuring, on average, 8.5 cm in length, 10 mm in diameter, and three buds. The experimental design consisted of randomized blocks in a 3 × 3 factorial arrangement (three grafting methods: cleft graft, whip and tongue graft, and chip budding × three cultivars: African Pride, Thompson, and Gefner), with four replications and 10 seedlings per replication, totaling 40 seedlings per treatment. The percentage of graft success (%), percentage of sprouting (%), number of sprouts, number of leaves, and longest sprout length (cm) were assessed at 60 days after grafting. The cleft graft method is efficient for producing atemoya seedlings. The cultivar African Pride can be grafted onto rootstocks by the cleft graft and whip and tongue graft methods, as they promote a higher percentage of graft success. The Annona sylvatica rootstock has potential for the production of atemoya seedlings, but chip budding is not viable.
5.
Physiological responses of oregano under different water management and application of fermented bokashi compost
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Wenneck, Gustavo Soares
; Saath, Reni
; Moro, Adriana Lima
; Carvalho, Gleyson Pablo da Silva
; Santi, Danilo Cesar
; Rezende, Roberto
.
ABSTRACT. Growing conditions such as water supply and soil fertility influence oregano morphological development and physiological responses. Our study aimed to analyse the physiological responses of oregano plants grown under different water conditions and bokashi application rates. The experiment was carried out in a greenhouse under a randomized block design and a 3 x 4 factorial scheme. Treatments encompassed three water replacement levels (60, 80, and 100% crop evapotranspiration - ETc) and four bokashi rates (0, 100, 200, and 300 g m-2), with five replications each. Oregano seedlings were transplanted and grown in a spacing of 0.3 m between plants and 1 m between bed rows. After 60 days, treatments were evaluated for photosynthetic rate (A), stomatal conductance (Gs), internal CO2 rate (Ci), transpiration (E), and water-use efficiency (WUE). Data underwent variance analysis by F-teste, multivariate analysis, and Pearson's linear correlation. Oregano physiological responses were significantly influenced by water replacement level and the application rate of fermented bokashi compost. The multivariate analysis allowed us to analyse the interaction effect between water replacement level and bokashi rate on photosynthesis, stomatal conductance, internal CO2, and transpiration.
6.
Herpetofauna of protected areas in the Caatinga VIII: An updated checklist for the Serra das Confusões region with new data from Serra Vermelha, Piauí, Brazil
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Marques, Ricardo
; Garda, Adrian A.
; Furtado, Adriana P.
; Bruinjé, Andre C.
; Protázio, Arielson dos S.
; de Carvalho, Breno F.
; Vieira, Cecília R.
; Gomes, Dandara
; Pantoja, Davi L.
; Figueiredo, Diainara da S.
; Shepard, Donald B.
; Camurugi, Felipe
; Coelho, Felipe E. A.
; Magalhães, Felipe M.
; Caetano, Gabriel H. O.
; Colli, Guarino R.
; Paulino, Henrique M.
; Carvalho, Izabelle T. S.
; Graciene, Joedma
; Alvarenga, Júlio M.
; Clay, Natalie A.
; Albuquerque, Ralph L.
; Bosque, Renan J.
; Faria, Renato
; da Silveira-Filho, Ricardo R.
; Mângia, Sarah
; Cavalcante, Vitor H. G. L.
; Vieira, Washington L. S.
; da Silva, Willianilson P.
; Soares, Yan F. F.
; Mesquita, Daniel O.
.
Abstract It is repeatedly stressed the need to characterize the extant biodiversity in tropical ecosystems. However, inventory studies are still progressing slowly in dry ecosystems, leading to the underestimation of their true biodiversity and hindering conservation efforts. In this study, we present primary and secondary data, along with an updated list of amphibians and reptiles from two localities in the São Francisco-Gurguéia region in Piauí. Additionally, we compare the species composition between nine areas within the Caatinga, which were sampled using standardized methods over the past ten years, to examine broader spatial patterns of community composition. To survey reptiles and amphibians, we employed similar methods and sampling efforts in two areas within the Serra das Confusões National Park (SCNP) region. Our surveys recorded a total of 73 species of amphibians and reptiles, of which 24 are new distribution records for the SCNP region. Consequently, our findings increase the known herpetofauna in the region to 94 species. Despite their proximity, the two sites in the SCNP region exhibited only 42% similarity in species composition, and they differed significantly from other areas within the Caatinga. Furthermore, even the closer Caatinga areas presented differences in species composition, highlighting the necessity to evaluate biodiversity across the landscape and contribute to understanding biogeographic patterns.
Resumo É repetidamente enfatizada a necessidade de caracterizar a biodiversidade vivente em ecossistemas tropicais. No entanto, os estudos de inventário ainda estão progredindo lentamente em ecossistemas secos, levando à subestimação de sua verdadeira biodiversidade e dificultando os esforços de conservação. Neste estudo, apresentamos dados primários e secundários, juntamente com uma lista atualizada de anfíbios e répteis de duas localidades na região de São Francisco-Gurguéia, do Piauí. Além disso, comparamos a composição de espécies entre nove áreas dentro da Caatinga, que foram amostradas usando métodos padronizados nos últimos dez anos, para examinar padrões espaciais mais amplos de composição da comunidade. Para estudar répteis e anfíbios, utilizamos métodos e esforços de amostragem semelhantes em duas áreas na região do Parque Nacional da Serra das Confusões (PNSC). Nossos levantamentos registraram um total de 73 espécies de anfíbios e répteis, das quais 24 são novos registros de distribuição para a região do PNSC. Consequentemente, nossos resultados aumentam a herpetofauna conhecida na região para 94 espécies. Apesar da proximidade, os dois locais na região do PNSC exibiram apenas 42% de similaridade na composição de espécies e diferiram significativamente de outras áreas dentro da Caatinga. Mesmo áreas mais próximas da Caatinga apresentaram diferenças na composição de espécies, destacando a necessidade de avaliar a biodiversidade em toda a paisagem e contribuir para a compreensão de padrões biogeográficos.
7.
Multidisciplinary Scientific Cruises for Environmental Characterization in the Santos Basin – Methods and Sampling Design
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Moreira, Daniel L.
; Dalto, Adriana G.
; Figueiredo JR, Alberto G.
; Valerio, Aline M.
; Detoni, Amalia M. S.
; Bonecker, Ana C. T.
; Signori, Camila N.
; Namiki, Cláudia
; Sasaki, Dalton K.
; Pupo, Daniel V.
; Silva, Danilo A.
; Kutner, Deborah S.
; Duque-Castaño, Diana C.
; Marcon, Eduardo H.
; Gallotta, Fabiana D. C.
; Paula, Fabiana S.
; Gallucci, Fabiane
; Roque, Gabriela C. F.
; Campos, Giulia S.
; Fonseca, Gustavo
; Mattos, Gustavo
; Lavrado, Helena P.
; Silveira, Ilson C. A. da
; Costa, Jessica O.
; Santos Filho, João R. dos
; Carneiro, Juliane C.
; Moreira, Julio C.F.
; Rozo, Laura
; Araujo, Leandro F.M.
; Lazzari, Letícia
; Silva, Letícia O. da
; Michelazzo, Luan S.
; Fernandes, Luciano F.
; Dottori, Marcelo
; Araújo Jr., Marcus A. G. de
; Chuqui, Mateus G.
; Ceccopieri, Milena
; Borges-Silva, Milton
; Kampel, Milton
; Bergo, Natascha M.
; Silva, Paulo V. M.
; Tura, Pedro M.
; Moura, Rafael B. de
; Romano, Renato G.
; Martins, Renato P.
; Carreira, Renato S.
; Toledo, Rodrigo G.A.
; Bonecker, Sérgio L.C.
; Disaró, Sibelle T.
; Rodrigues, Silvana V.
; Corbisier, Thais N.
; Vicente, Thaisa M.
; Paiva, Vitor G. de
; Pellizari, Vivian H.
; Belo, Wellington C.
; Brandini, Frederico P.
; Sousa, Silvia H.M
.
Abstract The Santos Basin (SB) is the main petroliferous basin in the Brazilian continental margin and one of the most studied marine areas in Brazil. However, historical data suggest that new efforts should be carried out to acquire quantitative biological data, especially in the deep sea, to establish the baseline of essential ocean variables in different ecosystems for future monitoring programs. The Brazilian energy company Petrobras planned and executed 24 oceanographic cruises over a period of 2 years to assess the benthic (SANSED cruise) and pelagic (SANAGU cruise) systems of the SB (356 days at sea in 2019 and 2021/2022). These efforts were part of the Santos Project, which comprised a comprehensive environmental study aimed at investigating benthic and pelagic variables to characterize ecology, biogeochemistry, thermohaline properties of water masses, and ocean circulation patterns, geomorphology, and sedimentology, as well as organic and inorganic chemistry. Here we present the detailed sampling designs and the field methods employed on board, during the SB scientific cruises. All sampling protocols were based on standardized approaches. For the benthos analyses, triplicate sediment samples were performed using a GOMEX-type box corer (0.25 m²) or a large modified Van Veen grab (0.75 m²) at 100 stations ranging from 25 to 2400 m depth. At each station, 25 geochemical and physico-chemical parameters were analyzed in addition to micro-, meio-, and macrofauna and living foraminifera samples. For the pelagic system, 60 stations were selected to investigate the plankton community, ranging in size from pico- to macroplankton, through vertical, horizontal, and oblique net hauls (20, 200, and 500 μm mesh size), as well as 25 biogeochemical parameters collected with an aid of a CTD-rosette sampler. Part of this scientific information also serves the Regional Environmental Characterization Project (PCR-BS) in support of Petrobras’ Santos Basin drilling licensing process led by the Brazilian Environmental Agency – IBAMA. This project contributes to the sustainable development of the SB, in line with the guidelines of the United Nations Decade of Ocean Science for Sustainable Development.
8.
Morphophysiology and water relations of Spondias rootstocks under different irrigation frequencies
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Silva, Luderlândio de A.
; Soares, Lauriane A. dos A.
; Lima, Geovani S. de
; Roque, Iara A.
; Fátima, Reynaldo T. de
; Lima, Adriana S.
.
ABSTRACT The semi-arid region of northeastern Brazil is characterized by scarcity of water for irrigation purposes due to long periods of drought, compromising the development of species such as Spondias tuberosa L. and Spondias mombin L., which, despite being considered drought tolerant, can have their yield negatively affected by low water availability. The objective of this study was to evaluate the morphophysiology, quantum efficiency and water relations of S. tuberosa and S. mombin rootstocks under different irrigation intervals in the semi-arid region of Paraíba, Brazil. The experimental design was carried out in randomized blocks, in a 5 × 2 factorial scheme, referring to 5 irrigation intervals - INT (1, 2, 3, 4 and 5 days after each irrigation event) and two species of the genus Spondias - SPC (S. tuberosa and S. mombin) with four replicates and three plants per plot, totaling 120 plants. Irrigation management with a five-day irrigation interval reduced gas exchange and growth of rootstocks of the Spondias species. The quantum efficiency of photosystem II of Spondias rootstocks (S. tuberosa and S. mombin) was not compromised when the plants were irrigated every two and four days. Irrigation every three days in the early stages of development of Spondias species can be used with the lowest losses in gas exchange and growth of rootstocks.
RESUMO O semiárido nordestino é caracterizado pela escassez hídrica para fins de irrigação em decorrência de longos períodos de estiagem, comprometendo o desenvolvimento de espécies como Spondias tuberosa e a Spondias mombin, que apesar de serem considerados tolerantes a seca, podem ter seu rendimento afetado negativamente pela baixa disponibilidade de água. Objetivou-se com este trabalho avaliar a morfofisiologia, a eficiência quântica e as relações hídricas de porta-enxertos de S. tuberosa e S. mombin sob diferentes turnos de rega no semiárido paraibano. O delineamento experimental realizado em blocos ao acaso, em esquema fatorial 5 × 2, referentes a 5 turnos de rega - INT (1, 2, 3, 4 e 5 dias após cada evento de irrigação) e duas espécies do gênero Spondias - SPC (S. tuberosa e S. mombin) com quatro repetições e três plantas por parcela, totalizando 120 plantas. O manejo da irrigação com turno de rega de cinco dias reduziu as trocas gasosas e o crescimento dos porta-enxertos das espécies de Spondias. A eficiência quântica do fotossistema II de porta-enxertos de Spondias (S. tuberosa e S. mombin) não é comprometida quando as plantas foram irrigadas a cada dois e quatro dias. A irrigação a cada três dias nas fases iniciais do desenvolvimento das espécies Spondias pode ser utilizada com as menores perdas nas trocas gasosas e no crescimento dos portaenxertos.
9.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
10.
Intra-annual colonization of Chironomidae on leaf litter in a Brazilian Cerrado stream
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Pio, Jéssica F.G.
; Hepp, Luiz U.
; Medeiros, Adriana O.
; Silva, Fabio L. da
; Copatti, Carlos E.
.
ABSTRACT In low-order streams, the processing of allochthonous leaf litter is essential in the carbon/energy flow dynamics. Benthic macroinvertebrates, such as chironomids, play critical roles in the breakdown of allochthonous materials, because their larvae take part in intricate trophic networks and have varied trophic ecologies. We evaluated the effects of intra-annual variability on the input of allochthonous leaf litter, and the interactions of leaf-detritus on the succession of Chironomidae assemblages in the dry, rainy, and transition seasons (rainy-dry and dry-rainy). The study took place in a stream in the Brazilian Cerrado. Leaves were incubated in the stream to ascertain the colonization process by Chironomidae and the loss of leaf litter mass after 90 days. Functional feeding groups (FFG) were less rich and less abundant in the dry and dry-rainy seasons, than in the other seasons. The FFG composition of Chironomidae demonstrated that temporal variation between seasons was affected by the exposure time of the leaf-detritus in the stream, and there was more segregation during the dry and rainy seasons. In conclusion, the colonization of leaf-detritus by Chironomidae larvae depended on how long allochthonous plant material remained in the stream, and the variability of the organic matter dynamics input into the stream.
11.
Identification of genomic imbalances in oral clefts
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Lustosa-Mendes, Elaine
; Santos, Ana P. dos
; Vieira, Társis P.
; Ribeiro, Erlane M.
; Rezende, Adriana A.
; Fett-Conte, Agnes C.
; Cavalcanti, Denise P.
; Félix, Têmis M.
; Monlleó, Isabella L.
; Gil-da-Silva-Lopes, Vera Lúcia
.
Abstract Objective This article presents a clinical and cytogenomic approach that focuses on the diagnosis of syndromic oral clefts (OCs). Methods The inclusion criteria were individuals with OC presenting four or more minor signs and no major defects (non-syndromic oral clefts [NSOCs]) as well as individuals with OC presenting at least another major defect, regardless of the number of minor signs (syndromic oral clefts [SOCs]). The exclusion criteria included NSOC with less than four minor signs, SOC with known etiology, as well as atypical oral clefts. Results Of 1647 individuals with OC recorded in the Brazilian Database of Craniofacial Anomalies, 100 individuals were selected for chromosome microarray analysis (CMA). Among these, 44 individuals were clinically classified as NSOC and 56 as SOC. CMA was performed for both groups, and abnormal CMA was identified in 9%, all previously classified as SCO. The clinical and CMA data analyses showed a significant predominance of abnormal CMA in individuals classified as SOC (p = 0.0044); prematurity, weight, length, and head circumference at birth were significantly lower in the group with abnormal CMA. Besides, minor signs were significantly higher in this group (p = 0.0090). Conclusion The rigorous selection of cases indicates that the significant variables could help in early recognition of SOC. This study reinforces the importance of applying the CMA technique to establish the diagnosis of SOC. This is an important and universal issue in clinical practice for intervention, care, and genetic counseling.
https://doi.org/10.1016/j.jped.2020.06.005
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12.
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
13.
Carbon and oxygen stable isotopes of freshwater fish otoliths from the São Francisco River, northeastern Brazil
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PEREIRA, NATAN S.
; SIAL, ALCIDES N.
; PINHEIRO, PATRÍCIA B.
; FREITAS, FABRÍCIO L.
; SILVA, ADRIANA M.C.
.
Abstract Fish otoliths store geochemical and isotopic signatures that can be used as proxies for environmental conditions in ecological investigations. We investigated the δ13C and δ18O of otoliths of four freshwater fish species (Astronotus ocellatus, Serrasalmus brandtii, Plagioscion squamosissimus, and Cichla ocellaris) from the Moxotó Reservoir in the São Francisco River, Brazil. The enriched δ13C signatures that distinguish A. ocellatus from other species could be caused by dissolved inorganic carbon (δ13CDIC) in reservoir waters. Macrophytes growing along the reservoir margins would favor photosynthetic uptake of 12C, leading to enriched δ13CDIC incorporated into the otoliths of those fish. Otolith δ18O signatures appear to reflect water column preferences, in which species preferentially inhabiting surface waters (such as S. Brandtii) show more enriched values (due to high surface evaporation ratios), while bottom water species show depleted δ18O values. Our results represent the first investigation of the isotopic compositions of fish otoliths in freshwater environments in the São Francisco River, and shed light on the interpretation of isotopic information stored in otoliths and how they can be used to infer the ecological strategies of freshwater fish.
https://doi.org/10.1590/0001-3765202120191050
516 downloads
14.
Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine
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Helito, Alberto C.
; Lindoso, Livia
; Sieczkowska, Sofia M.
; Astley, Camilla
; Queiroz, Ligia B.
; Rose, Natalia
; Santos, Claudia Renata P.
; Bolzan, Thalis
; Peralta, Rita María I.A.
; Franco, Ruth R.
; Cominato, Louise
; Pereira, Rosa Maria R.
; Tannuri, Uenis
; Campos, Lucia Maria A.
; Lourenço, Benito
; Toma, Ricardo K.
; Medeiros, Karina
; Watanabe, Andréia
; Grangeiro, Patricia Moreno
; Farhat, Sylvia C.
; Casella, Caio B.
; Polanczyk, Guilherme V.
; Gualano, Bruno
; Silva, Clovis A.
; Sallum, Adriana M. E.
; Iraha, Amanda Y.
; Ihara, Bianca P.
; Mazzolani, Bruna C.
; Martinez, Claudia A.
; Strabelli, Claudia A. A.
; Fonseca, Claudia B.
; Lima, Dandara C. C.
; Setoue, Debora N. D.
; Roz, Deborah F. P.
; Smaira, Fabiana I.
; Roschel, Hamilton
; Miyatani, Helena T.
; Marques, Isabela G.
; Oba, Jane
; Ferreira, Juliana C. O.
; Simon, Juliana R.
; Kozu, Katia
; Saccani, Ligia P.
; Martiniano, Lorena V. M.
; Miranda, Luana C. A.
; Silva, Luiz E. V.
; Laurentino, Moisés F.
; Aikawa, Nadia E.
; Sakita, Neusa K.
; Tanigava, Nicolas Y.
; Pereira, Paulo R. A.
; Palmeira, Patrícia
; Angelo, Simone S.
; Lavorato, Sofia S. M.
; Bernardes, Tamires M.
; Franco, Tathiane C.
; Viana, Vivianne S. L.
; Barros, Vera P. M. F. R.
; Zheng, Yingying
.
OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality.
15.
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.
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