Abstract Objective Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS). Methods This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs. Results In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars. Conclusions Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.

An infection of the fungus Moniliophthora perniciosa in cocoa trees reduces productivity of the plant. In this study, the concentrations of mineral nutrients in healthy leaves and in leaves of vegetative broom of the cocoa plant were determined, and the relationship between the disease and the nutritional composition of the leaves was assessed. The samples were analyzed using the wet digestion method and the concentrations were determined by inductively coupled plasma optical emission spectrometry and the Kjeldahl method. Results indicate that leaves of vegetative broom have lower concentrations of Ca, Mg, S, Fe, Mn, and Ni than healthy leaves. Concentrations of P and Cu were lower in healthy leaves and higher in leaves of vegetative broom. In contrast, concentrations of K, N, and Zn were the same for both types of leaves. In short, plant-fungal interaction was reflected in the nutritional composition of the leaves, demonstrated by the differences in nutrient concentrations between healthy and infected leaf tissue.

Coprecipitation is one of the most practical methods used to synthesize ferrite nanoparticles. Fine characteristics of these materials can be improved by means of a series of modifications in the synthesis method. In this paper we present a study of influence of glycerol as structure directing and stabilizing agent in the synthesis of zinc ferrite nanoparticle, exploring its chelating capacity and oxidation. The studied materials include two series of zinc ferrite samples and its precursors obtained with or without glycerol throughout different stages during the synthesis process. The structural and morphological characteristics were evaluated by means of different techniques such as X-ray diffraction, Fourier transformed infrared spectroscopy, scanning and transmission electron microscopy and thermal analysis. The oxidation of glycerol was determined by high-performance liquid chromatograph. The obtained results demonstrate that zinc ferrite crystals synthesized in the presence of glycerol are initially bigger than those synthesized in absence of it, but according to the oxidation process they tend to decrease giving rise to intermediate phases. Interestingly, these samples grow back during more advanced stages and become structurally better organized, compared to the series of samples produced in absence of glycerol. These results indicate that glycerol is capable to modify the synthesis route of zinc ferrite nanoparticles via coprecipitation, acting directly over the size and morphology of the crystals.

Four new epimeric spirostanol and furostanol-type steroidal saponins, (25R,S)-5α-spirostan-2α,3β-diol 3-O-β-D-glucopyranosyl-(1→4)-β-D-galactopyranosyl-(1→4)-β-D-galactopyranoside, (25R,S)-5α-spirostan-2α,3β-diol 3-O-β-D-glucopyranosyl-(1→2)-α-L-rhamnopyranosyl-(1→4)-β-D-galactopyranoside, 26-O-β-D-glucopyranosyl-(25R,S)-5α-furost-20-ene,2α,3β-diol 3-O-β-D-galactopyranoside and 26-O-β-D-glucopyranosyl-(25R,S)-5α-furost-20-ene,2α,3β-diol 3-O-β-D-galactopyranosyl-(1→4)-β-D-galactopyranoside, in addition to the known (25R,S)-5α-spirostan-2α,3β-diol 3-O-β-D-galactopyranoside, were isolated from Cestrum laevigatum. Compounds were submitted to cytotoxic activity assays using colorectal adenocarcinoma (HCT-116), human promyelocytic leukemia (HL-60), ovarian carcinoma (OVCAR-8), glioma (SF-295) human cancer cell lines, and the antimicrobial activity was evaluated against Candida parapsilosis, C. albicans, C. krusei, Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilis.

RESUMO A utilização de resíduos orgânicos em cultivos é uma alternativa capaz de reduzir quantidades de adubos minerais aplicados ao solo. Objetivou-se, com este trabalho, avaliar o acúmulo de macronutrientes na cultura do girassol cultivar Hélio 250 adubado com manipueira. O delineamento experimental foi em blocos ao acaso, com seis tratamentos (0; 8,5; 17; 34; 68 e 136 m3 ha-1 de manipueira) em quatro repetições. Foram avaliados os acúmulos de nitrogênio (N), fósforo (P), potássio (K), cálcio (Ca), magnésio (Mg) e enxofre (S) nas folhas, caules, capítulos e aquênios. A dose de 136 m3 ha-1 de manipueira foi a que proporcionou o maior acúmulo para todos os nutrientes avaliados. O acúmulo dos macronutrientes ocorre na seguinte ordem por órgão: folhas Ca > K > N > Mg > S > P; caule K > Ca > Mg > N > P > S; capítulos N > K > P > Mg > Ca > S; aquênios N > P > K > Mg > S > Ca. A ordem de acumulação dos nutrientes pelas plantas inteiras de girassol é: N > K > Ca > Mg > P > S. A manipueira, por ter fornecido concentrações suficientes de N, P, K, Ca, Mg e S, apresenta potencial, como fertilizante orgânico para a cultivar estudada do girassol.

ABSTRACT The utilization of organic wastes in agriculture is an alternative that can reduce the amounts of mineral fertilizers applied to the soil. The aim of this study was to evaluate the accumulation of macronutrients in sunflower cv. 'Hélio 250' fertilized with cassava wastewater. The experiment was conducted in randomized block design, with six treatments (0; 8.5; 17; 34; 68 and 136 m3 ha-1 of cassava wastewater) and four replications. The accumulation of nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg) and sulfur (S) were evaluated in leaves, stem, capitulum and achenes. The cassava wastewater dose of 136 m3 ha-1 promoted the greatest accumulation of all evaluated nutrients. The pattern of macronutrients accumulation occurred in the following order: leaves - Ca > K > N > Mg > S > P; stem - K > Ca > Mg > N > P > S; capitulum - N > K > P > Mg > Ca > S; and achenes - N > P > K > Mg > S > Ca. The extraction of nutrients by whole sunflower plants occurred in the following order: N > K > Ca > Mg > P > S. Cassava wastewater provided appropriate concentrations of N, P, K, Ca, Mg and S; therefore, it has potential as an organic fertilizer for the studied sunflower cultivar.

Uma estirpe variante do vírus da bronquite infecciosa (VBI) associada com o desenvolvimento de nefrite em galinhas, foi isolado e identificado como variante por análise do gene S1. A estirpe IBV/Brazil/PR05 foi testada quanto à sua capacidade de induzir a expressão de interleucina-6 (IL-6) nos tecidos renais e traqueais. Galinhas vacinadas com a estirpe Massachusetts H120 e não vacinadas foram desafiadas com a estirpe IBV/Brazil/PR05. Cinco dias após a infecção, traquéias e rins foram coletados para análise por RT-qPCR, imunohistoquímica e histopatologia. Foi determinada a expressão relativa de IL-6 e da carga viral. A expressão de IL-6 e carga viral foram correlacionadas com o desenvolvimento de nefrite e lesão traqueal. A expressão de IL-6 foi maior quando houve aumento da carga viral na traqueia e nos rins. A carga viral presente nos rins foi inferior quando as aves foram vacinadas, entretanto foi observada nefrite acentuada. Houve alta correlação entre o desenvolvimento de nefrite e o nível de expressão de IL-6, bem como a expressão de IL-6 e a carga viral. A expressão de IL-6, presente tanto nos rins e nas traqueias, foi relacionada a carga viral presente nestes tecidos, e o desenvolvimento das lesões foi relacionado com a expressão de IL-6. Estes dados sugerem que a variante IBV/Brazil/PR05 pode induzir a expressão de citocinas pró-inflamatórias de forma correlacionada com a carga viral, e o aumento de IL-6 está envolvido com o influxo de células inflamatórias no tecido, o que evolui para o desenvolvimento de nefrite. Isto pode contribuir como um modelo para o desenvolvimento de agentes imunossupressores da IL-6 para evitar processos inflamatórios agudos contra infecção com o VBI e talvez outros coronavírus, bem como contribuir para o entendimento da imunopatogênese das estirpes nefropatogênicas deste vírus.

A Brazilian field isolate (IBV/Brazil/PR05) of avian infectious bronchitis virus (IBV), associated with development of nephritis in chickens, was previously genotyped as IBV variant after S1 gene sequencing. The aim of this study was to evaluate the levels of IL-6 in kidneys and trachea of birds vaccinated and challenged with IBV/Brazil/PR05 strain, correlating these results with scores of microscopic lesions, specific IBV antigen detection and viral load. The up-regulation of IL-6 and the increased levels of viral load on renal and tracheal samples were significantly correlated with scores of microscopic lesions. Reduced levels of viral load were detected in kidneys of birds previously vaccinated and challenged, compared to non-vaccinated challenged group, although markedly microscopic lesions were observed for both groups. The expression of IL-6, present both in the kidney and in the tracheas, was dependent on the load of the virus present in the tissue, and the development of lesions was related with IL-6 present in the tissues. These data suggest that variant IBV/Brazil/PR05 can induce the expression of proinflammatory cytokines in a manner correlated with viral load and increased IL-6 is involved in the tissue with the influx of inflammatory cells and subsequent nephritis. This may contribute with a model to the development of immunosuppressive agents of IL-6 to prevent acute inflammatory processes against infection with IBV and perhaps other coronaviruses, as well as contribute to the understanding of the immunopathogenesis of IBV nephropatogenic strains.

A influência de modificação química (por tratamento ácido seguido de funcionalização com trietilenotetramina, TETA) sobre a superfície de nanotubos de carbono de paredes múltiplas (MWCNT) foi estudada qualitativa e quantitativamente. A análise termogravimétrica (TGA) mostrou que, no caso do nanotubo funcionalizado com amina, 29% de perda de massa pode ser atribuída a -C(=O)TETA e grupos funcionais residuais que contêm oxigênio. A espectroscopia de fotoelétrons excitados por raios X (XPS) foi utilizada para observar as funções aminadas e oxigenadas ligadas covalentemente à superfície do nanotubo. As imagens de microscopia de força elétrica (EFM) indicaram que, à medida que se modifica a química superficial dos nanotubos em presença de ar, estes mostram respostas diferentes em função do potencial da ponta. Deslocamentos nos sinais de fase de EFM decrescem quando se modifica a superfície dos tubos com grupos funcionais contendo oxigênio e amina. Em atmosfera seca e inerte de N2, as três diferentes superfícies mostraram a mesma resposta à EFM. Além disso, o caráter hidrofílico dos "buckypapers" cresceu na ordem MWCNT < MWCNT-aminado < MWCNT-oxidado.

The influence of chemical modification by acid treatment followed by triethylenetetramine (TETA) functionalization on the surface of multi-walled carbon nanotubes (MWCNT) was evaluated, both qualitative and quantitatively. Thermogravimetric analysis (TGA) showed that, in the case of amine-functionalized nanotubes, 29% of mass loss can be attributed to -C(=O)TETA and residual oxygen-containing functional groups. X-ray photoelectron spectroscopy (XPS) was used to observe the oxygenated and aminated functions covalently linked to the nanotube surface. Electric force microscopy (EFM) images indicated that the nanotubes with diverse surface chemistry showed distinct responses to the tip potential in the presence of air. Shifts in EFM phase images decreased when the nanotube surface was modified with oxygen and amine-containing functional groups. In dry and inert N2 atmosphere, however, the three different surfaces showed the same response to EFM. In addition, the hydrophilic character of the buckypapers increased in the order MWCNT < aminated-MWCNT < oxidized-MWCNT.

INTRODUÇÃO: A eficácia e a segurança do stent farmacológico (SF) de segunda geração liberador de everolimus XienceTM V (Abbott Vascular, Santa Clara, Estados Unidos) já foram estabelecidas no tratamento de pacientes selecionados com lesões coronárias. No entanto, o impacto do stent XienceTM V em populações da prática clínica com lesões complexas ainda não está totalmente definido. MÉTODOS: O Registro BRAVO foi um estudo prospectivo, não-randomizado, multicêntrico, que avaliou os resultados clínicos tardios de pacientes minimamente selecionados tratados com o SF XienceTM V na prática diária brasileira. No total, foram incluídos 535 pacientes em 25 centros clínicos entre setembro de 2008 e setembro de 2010. Eventos cardíacos adversos maiores (ECAM) foram definidos como morte cardíaca, infarto agudo do miocárdio (IAM) e revascularização do vaso-alvo (RVA). RESULTADOS: A média de idade dos pacientes era de 62,7 ± 11,1 anos, 40% dos quais tinham diabetes, 24,9% apresentavam IAM prévio e 41,9% apresentaram-se com síndrome coronária aguda. Cerca de dois terços dos pacientes tinham lesões tipo B2/C e 46,1% trataram a artéria descendente anterior. Implante de múltiplos stents ocorreu em 13,8% dos casos, e o sucesso angiográfico foi > 99%. Na fase intra-hospitalar, a taxa de IAM periprocedimento foi de 1,9%. Já no seguimento de 6 meses, as taxas cumulativas de óbito cardíaco, IAM e RVA foram de 1,1%, 2,2% e 1,3%, respectivamente (taxa de ECAM de 4,3%). Com relação à trombose de stent (definida de acordo com os critérios do Academic Research Consortium ARC), foram reportados 4 casos até 6 meses, representando taxa de evento de 0,75% (0,4% definitiva/provável). CONCLUSÕES: Neste Registro, que incluiu pacientes e lesões complexos tratados em múltiplos centros nacionais, o SF de segunda geração XienceTM V demonstrou excelentes resultados imediatos e efetividade clínica e segurança sustentadas até o seguimento a médio prazo (6 meses). Os resultados do seguimento a longo prazo são aguardados.

BACKGROUND: The XienceTM V everolimus-eluting stent (Abbott Vascular, Santa Clara, USA), a second-generation drug-eluting stent (DES) has demonstrated sustained efficacy and safety in the treatment of selected patients with coronary lesions. However, the impact of the XienceTM V stent in populations from daily clinical practice with complex lesions has not yet been fully determined. METHODS: The BRAVO Registry was a prospective, non-randomized, multicenter study that evaluated the late clinical outcomes of minimally selected patients treated with XienceTM V DES in the Brazilian daily clinical practice. Overall, 535 patients were included in 25 clinical sites between September/2008 and September/2010. Major adverse cardiac events (MACE) were defined as cardiac death, acute myocardial infarction (AMI) and target vessel revascularization (TVR). RESULTS: Mean age was 62.7 + 11.1 years, 40% had diabetes, 24.9% had a previous AMI and 41.9% presented with acute coronary syndrome. About two thirds of the patients had type B2/C lesions and 46.1% treated the left anterior descending artery. Multiple stenting procedures were performed in 13.8% of cases and angiographic success was > 99%. During hospitalization, periprocedural AMI rate was 1.9%. At the 6-month follow-up, cumulative rates of cardiac death, AMI and TVR were 1.1%, 2.2% and 1.3%, respectively (MACE rate: 4.3%). There were 4 cases of stent thrombosis (defined according to the Academic Research Consortium ARC) reported within 6 months, representing an event rate of 0.75% (0.4% definite/probable). CONCLUSIONS: In this Registry including complex patients and lesions treated at multiple sites in Brazil, the XienceTM V second generation DES demonstrated excellent immediate results and sustained clinical efficacy and safety at mid-term follow-up (6 months). Long-term results are expected.

Sistemas microemulsionados (MES) oferecem inúmeras vantagens como liberadores de fármacos já que favorecem a absorção do princípio ativo e são, em muitos casos, mais eficientes do que outros métodos de liberação de substâncias bioativas. Neste trabalho, um MES foi obtido visando uma formulação para uso tópico, contendo extrato etanólico de própolis (PEE). Neste estudo, Diagramas de fase pseudoternários foram utilizados para caracterização das regiões de microemulsão, bem como para definição da região de Winsor IV do sistema PEE-MES (Tween 80 como tensoativo e álcool etílico como co-tensoativo, em baixo percentual). Os resultados obtidos indicaram que o melhor sistema microemulsionado contém C/S (cotensoativo/tensoativo) na razão 1,0, fornecendo uma microemulsão do tipo O/A com ampla região de Winsor IV. A formulação PEE-MES poderá vir a ser utilizada comercialmente para uso tópico no combate a inflamações de boca e garganta. Considerando o amplo uso de própolis em formulações convencionais, onde sua solubilidade representa um dos maiores problemas, o sistema PEE-MES disponibiliza este produto natural para aplicações farmacológicas, com boa solubilidade em um sistema microemulsionado do tipo O/A. Adicionalmente, o efeito bactericida do sistema PEE-MES foi comprovado e uma nova metodologia de extração de própolis é apresentada.

Microemulsion systems (MES) offer advantages as drug delivery systems, among them favour drug absorption, being in most case more efficient than other methods in delivering of drug. In this work a new MES was obtained in order to be applied as a pressurized aerosol formulation containing bee propolis ethanolic extract (PEE). For that, pseudoternary phase diagrams were used to characterize the microemulsions boundaries and also to define the Winsor IV microemulsion region of the PEE-MES system containing Tween 80 as surfactant and the cosurfactant ethyl alcohol in small percentage. The obtained results indicated that the best MES was composed by Tween 80 and ethyl alcohol with C/S (cosurfactant/surfactant) ratio equal to 1.0, since it provided a large boundaries in the obtained O/W microemulsion region. This PEE-MES formulation, in which bee propolis consisting as oil phase, is herein designed for topical uses (PEE-MES spraying) in order to treat mouth and throat inflammatory infections. Considering the very large uses of bee propolis in conventional vehicles, MES type of delivery system has to be compatible with achieving the highest drug aim loadings, determined substantially by the specific MES application (drug solubilization in water systems) improving in this case, propolis farmacological aplications. Additionally, PEE-MES antibacterial effect was evidenced and the microemulsion system PEE-MES was also used as newest chemical approach for extraction of bee propolis material from resinous hive.

No cronograma, a etnografia tem três fases, (situar-se, observar e descrever). A vivência do etnógrafo converte tais fases em atividades sincrônicas (andar, ver e escrever). O percurso no campo, sua observação e a descrição do contexto percorrido e observado são três fluxos que se misturam pela reciprocidade, interdependência e (inter)influências enquanto se tensionam pelas contradições e heterogeneidade das disposições e habilidades em jogo. Tudo isso compõe uma complexa ambiência, um contexto do qual deriva o estatuto do observador e as propriedades do universo observado. Cena de componentes tão inextricáveis impõe que a etnografia se torne o relato de um percurso. Dados e informações sobre a sociedade observada devem estar organizados no texto ao longo de uma espinha dorsal, o percurso do etnógrafo. Somente essa linha aglutinadora do material colhido poderá torná-lo legível. Tratase de pensar a etnografia como o relato de uma experiência conflituosa de um observador, condição para o entendimento do que foi observado.

In our mind, the field research has three phases, (to take a place there, to observe and to describe). In the experience of the anthropologist, nevertheless, such phases became tasks (to walk, to see and to write) developed at the same time. To stay in a field, to observe it and its description are three flows associate by reciprocity, interdependence and mutual influences and separate by the contradictions and different disposals and abilities necessary to achieve them. This arrangement composes a complex background, a context from what arises the status of the observer and the meaning of the observed universe. All around the scene are so tied to the observer that the ethnography only can be an account of a passage. Data and information on the observed society must be organized in the text throughout a spine, the passage of the ethnographer. Only this agglutinant line of the empiric data can be meaningful. In this sense the ethnography is the story of a conflicting experience of an observer, step to understand what occurs in the context.

Pós nanométricos de ferritas de níquel dopadas com cromo foram sintetizados por reação de combustão em forno de microondas. A influência da concentração de Cr3+ nas proporções de x = 0; 0,5 e 1 no sistema NiCr xFe2-xO4 foi investigada. Os pós foram preparados de acordo com o conceito da química dos propelentes e aquecidos em forno microondas com potência 980 W. Os pós sintetizados foram caracterizados por difratometria de raios X, adsorção de nitrogênio (método BET), microscopia eletrônica de varredura, picnometria de hélio e medidas magnéticas. Os resultados mostraram que foi possível obter nanopós de ferritas de níquel dopadas com cromo e que a elevação da concentração de cromo causou um aumento no tamanho de partículas (15 nm para 55 nm) e redução nos parâmetros magnéticos.

Chromium-doped nickel nanoferrite powder was prepared by combustion reaction, using microwave energy as the external heating source, and the influence of the Cr3+concentration on the NiCr xFe2-xO4 system was investigated. The powder, which was prepared according to the concept of propellant chemistry, was heated in a microwave oven under a power of 980 W. The resulting material was characterized by XRD, BET, SEM, helium picnometry and magnetic measurements. The results indicate that it was possible to obtain chromium-doped nickel ferrite nanopowders and that raising the chromium concentration caused an increase in particle size (from 15 nm to 55 nm), and a reduction in the magnetic parameters.

Um isolado do Sugarcane mosaic virus (SCMV) causando sintomas de mosaico em plantas de cana-de-açúcar do clone RB925268 foi identificado no estado do Paraná. Gemas axilares extraídas de colmos infectados, medindo de 4 a 8 mm, foram utilizadas como explantes e regeneradas em plântulas em meio de cultura MS, suplementado ou não com o antiviral ribavirina, nas concentrações variando de 10-60 mg/L. O efeito fitotóxico da ribavirina foi constatado, resultando na morte dos explantes em concentrações iguais ou superiores a 30 mg/L. Após seis meses de aclimatação das plantas em estufa plástica, o vírus não foi detectado nas plantas provenientes do meio MS contendo ribavirina na concentração de 25 mg/L, confirmado através dos ensaios de inoculação mecânica em sorgo 'Rio' e de RT-PCR.

An isolate of Sugarcane mosaic virus (SCMV) associated with mosaic symptoms in the RB925268 sugarcane clone was identified in Paraná state. Axilary buds of 4 to 8 mm used as explants were regenerated into plantlets using MS medium with and without ribavirin antiviral, at concentrations of 10 to 60 mg/L. Ribavirin was toxic to sugarcane at all concentrations, resulting in plant death at concentrations of 30 mg/L or higher. The complete elimination of SCMV was obtained in MS medium with 25 mg/L ribavirin concentration, confirmed by sap inoculation into Sorghum bicolor cv. Rio and by RT-PCR.

Chitin and chitosan are copolymers build from N-acetyl-D-glucosamine and D-glucosamine. The former is widely found in nature and yields the latter on deacetylation. The copolymers are being used for several purposes. Since 1977, when the First International Conference on Chitin and Chitosan was held in Boston, USA, the interest on chitin and chitosan has remarkably increased. This review emphasizes pharmaceutical applications of chitosan and its derivatives, and presents recent advances. Some therapeutical applications of these polymers are also discussed.

JUSTIFICATIVA E OBJETIVOS: A retirada precoce da ventilação mecânica (VM) é importante para reduzir a morbimortalidade de pacientes internados em Unidades de Terapia Intensiva. O objetivo deste estudo foi avaliar a utilização do teste de Tubo T (TT) como método de retirada de VM. MÉTODO: Foram incluídos neste estudo os pacientes admitidos na UTI que apresentavam os seguintes critérios: VM > 24 horas, ausência de doença neuromuscular, relação PaO2/FiO2 > 200, estabilidade hemodinâmica, reversão da causa da intubação traqueal e drive respiratório adequado. Todos foram submetidos ao teste de tubo T. Considerou-se falha a ocorrência de FR > 30 irpm, hipoxemia, taquicardia, disritmias cardíacas, hipertensão ou hipotensão arterial. Após 2 horas de teste TT sem critérios de falha, os pacientes foram extubados. Considerou-se como sucesso na retirada da VM a manutenção por 48 horas de autonomia ventilatória. RESULTADOS: Foram incluídos 49 pacientes com idade média de 51,8 ± 21,7 anos. As incidências de SDRA e choque séptico foram 26,5% e 32,7% e o tempo médio de VM foi 11,9 ± 13 dias. A retirada da VM ocorreu em 79,2%, re-intubação em 31,6%, com tempo médio 13 ± 8,7 horas, sendo 75% devido à falência respiratória. Não houve correlação entre extubação e níveis de hemoglobina, PaO2/FiO2, idade, sexo, SDRA ou choque séptico prévios. O sucesso da retirada da VM (48 horas de autonomia) não se correlacionou com nenhuma das variáveis descritas. Os resultados foram considerados significativos se p < 0,05. CONCLUSÕES: O tubo T mostrou ser método adequado para a retirada da VM na maioria dos pacientes. Entretanto, a taxa de re-intubação foi elevada, podendo ser conseqüência do longo tempo do TT, da ventilação mecânica prévia ou da falha dos critérios de indicação de extubação traqueal.

BACKGROUND AND OBJECTIVES: Weaning from mechanical ventilation (MV) is an important strategy to reduce morbidity and mortality in critical care patients. In this setting, this study aimed at evaluation of T-tube trial (TT) in weaning from MV. METHODS: Patient admitted in the ICU were included if they present the following inclusion criteria: MV > 24 hours, no neuromuscular disorders, PaO2/FiO2 ratio >200, hemodynamic stability, reversion of the cause of respiratory failure, adequate respiratory drive. All were submitted to TT. Failure was defined by the presence of one of these symptoms: RR > 30 ipm, hypoxemia, tachycardia, arrhythmia, hypertension or hypotension. After two hours of TT, patients without failure criteria were extubated. After 48 hours of adequate spontaneous respiration the patient was considered successful weaned. Results were considered significant if p < 0.05. RESULTS: Forty-nine patients were included with a mean age 51.8 ± 21.7 years. The incidence of ARDS and septic shock were 26.5% and 32.7% and mean duration of MV was 11.9 ± 13 days. Discontinuation of MV occurred in 79.2%, reintubation in 31.6%, in a mean time of 13 ± 8.7 hours and in 75% of the cases it was due to respiratory failure. There was no correlation between success in TT and hemoglobin levels, PaO2/FiO2 ratio, age, gender, prior ARDS or septic shock. Weaning success was not correlated with none of the above variables. CONCLUSIONS: TT was adequated for weaning from mechanical ventilation in the majority of the cases. However, reintubation rate was high. Possible causes are the long period of TT, prior mechanical ventilation or the failure in the criteria used to indicate extubation.