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Abstract Access to medical care is essential to achieve quality primary health care (PHC). In Brazil, access difficulties still persist. The Doctors for Brazil Program (PMpB in Portuguese) aims to expand the offer of medical services in places of difficult provision or high vulnerability. It innovates insofar as it prioritizes smaller and rather isolated cities, by selecting professionals through an isonomic process, offering them training in Family and Community Medicine and a chance to build their first federal medical career in PHC. The program offers competitive salaries, progression and financial incentives that value long-term commitment and performance. The PMpB is rolled out by the Agency for the Development of Primary Health Care (Adaps), which allows better management of public policies. The first nine months of the program showed promising results, as approximately 23,000 candidates seeking to join the program through its selection process, i.e., 97.1% vacancies were filled and retention rate after admittance was 95.4%. These results show to what extent PMpB has improved in quality compared to previous policies, as well as how essential it is to keep implementing the program so that it may reach its full PHC coverage potential within the Brazilian public health system.

Resumo O acesso ao cuidado médico é essencial para o alcance da atenção primária à saúde (APS) de qualidade. No Brasil, ainda persistem dificuldades de acesso. O Programa Médicos pelo Brasil (PMpB) pretende ampliar a oferta de serviços médicos em locais de difícil provimento ou alta vulnerabilidade. Traz como inovações a priorização das menores e mais isoladas cidades; a seleção de profissionais por processo isonômico; a formação em medicina de família e comunidade; e o fato de ser a primeira carreira médica federal na APS, com salários competitivos, progressão e incentivos financeiros que valorizam a longitudinalidade e o desempenho. O PMpB é executado pela Agência para o Desenvolvimento da Atenção Primária à Saúde (Adaps), o que permite mais eficiência na gestão da política pública. Os primeiros nove meses do programa mostram resultados promissores, com aproximadamente 23 mil médicos interessados em ingressar no programa por meio de seu processo seletivo, 97,1% de ocupação das vagas e 95,4% de permanência após o ingresso. Tais resultados sinalizam o avanço de qualidade do PMpB em relação às políticas anteriores, bem como a necessidade de continuar com sua implementação, a fim de que ela atinja todo o seu potencial de cobertura na APS do SUS.

https://doi.org/10.1590/1413-812320232811.00072023

Disposition Effect: Brazilian Investors’ Behavior during the Covid-19 Pandemic
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Barreto, Pedro Lucas de Albuquerque

; Barbedo, Claudio Henrique da Silveira

; Camilo-da-Silva, Eduardo

BBR. Brazilian Business Review

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feb 2023, Volume 20 N. 1 Pages 1 - 17

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

Abstract This study investigates the disposition effect with regard to Brazilian investors, with focus on the year 2020. The database is composed by more than 12,000 trades by 274 investors. We follow the method of Odean (1998) to estimate the proportions of gains and losses realized and test the null hypothesis of equality of these proportions in each portfolio. The results suggest that Brazilian investors behave in line with the disposition effect. They sell winning stocks too early and hold losing stocks too long. A stock that is gaining value is more likely to be sold from day to day compared to a stock that is losing value. The disposition effect was not found in March, which suggests that investors employed a loss-limit during periods of market stress, no matter if the stock went up or down.

Resumo Este trabalho investiga a presença do efeito disposição em investidores brasileiros no ano de 2020. A base de dados compreende 274 investidores distintos que, em conjunto, realizaram mais de 12 mil transações. Aplica-se a metodologia utilizada por Odean (1998). A partir das carteiras de investimento de cada indivíduo, estima-se a proporção de ganhos e de perdas realizadas e testa-se a hipótese de igualdade dessas proporções. O estudo identificou que os investidores brasileiros estão propícios à influência dessa anomalia comportamental nas suas decisões, ou seja, vendem seus investimentos com ganhos mais rapidamente e mantêm seus investimentos perdedores por mais tempo e que uma posição com lucro possui mais chance de ser vendida do que uma posição com prejuízo. Os resultados não indicam efeito disposição no mês de março, e isso sugere que, em momentos de maior incerteza, investidores buscam limitar perdas, independentemente do lucro ou prejuízo auferido com o ativo.

https://doi.org/10.15728/bbr.2023.20.1.1.en

[SciELO Preprints] - Doctors for Brazil Program: first results
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Santos, Caroline Martins José dos Andrade, Soraya Zacarias Drumond de Wollmann, Lucas Frade, Fernanda Valentim Conde de Castro Andreato, Neiane da Silva Azevedo Silveira Junior, Roberto Rosa da Andrade, Polyanna Peres Silva, Alexandre Pozza Urnau

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Publication date: 2023-01-16

Abstract: En Pt

Access to medical care is essential for achieving quality Primary Health Care (PHC). In Brazil, access difficulties persist. The Doctors for Brazil Program (PMpB in Portuguese) intends to expand the offer of medical services in places of difficult provision or high vulnerability. It brings as innovations the prioritization of smaller and more isolated cities; the selection of professionals through an isonomic process; training in Family Practice and; the first federal medical career in the PHC, with competitive salaries, progression and financial incentives that value longitudinality and performance. The PMpB is executed by the Agency for the Development of Primary Health Care (Adaps), which allows for more efficient management. The first nine months of the program show promising results, with approximately 23,000 physicians interested in joining the program through its selection process, 97,1% of occupying vacancies and 95,4% of retention. Such results indicate an improvement in the quality of the PMpB in relation to previous policies, as well as the need to continue with its implementation, so that it reaches its full potential of coverage in the PHC of the public health system.

O acesso ao cuidado médico é essencial para o alcance da Atenção Primária à Saúde (APS) de qualidade. No Brasil, ainda persistem dificuldades de acesso. O Programa Médicos pelo Brasil (PMpB) pretende ampliar a oferta de serviços médicos em locais de difícil provimento ou alta vulnerabilidade. Ele traz como inovações a priorização das menores e mais isoladas cidades; a seleção de profissionais por processo isonômico; a formação em Medicina de Família e Comunidade e; a primeira carreira médica federal na APS, com salários competitivos, progressão e incentivos financeiros que valorizam a longitudinalidade e o desempenho. O PMpB é executado pela Agência para o Desenvolvimento da Atenção Primária à Saúde (Adaps), o que permite mais eficiência na gestão da política pública. Os primeiros nove meses do programa mostram resultados promissores, com aproximadamente 23 mil médicos interessados em ingressar no programa através de seu processo seletivo, 97,1% de ocupação das vagas e 95,4 % de permanência após o ingresso. Tais resultados sinalizam o avanço de qualidade do PMpB em relação às políticas anteriores, bem como a necessidade de continuar com sua implementação, a fim de que ela atinja todo o seu potencial de cobertura na APS do SUS.

https://doi.org/10.1590/SciELOPreprints.5364

Programa Médicos pelo Brasil: primeiros resultados
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Santos, Caroline Martins José dos

; Andrade, Soraya Zacarias Drumond de

; Wollmann, Lucas

; Frade, Fernanda Valentim Conde de Castro

; Andreato, Neiane da Silva Azevedo

; Silveira Junior, Roberto Rosa da

; Andrade, Polyanna Peres

; Silva, Alexandre Pozza Urnau

Ciência & Saúde Coletiva

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2023, Volume 28 N. 11 Pages 3273 - 3279

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

https://doi.org/10.1590/1413-812320232811.00072023

Physicochemical characterization, phenolic composition and antioxidant activity of genotypes and commercial cultivars of blueberry fruits
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Bergmann, Amanda Radmann

; Siebeneichler, Tatiane Jéssica

; Fischer, Lucas de Oliveira

; Holz, Ígor Ratzmann

; Rombaldi, César Valmor

; Oliveira, Bruna Andressa dos Santos

; Fischer, Doralice Lobato de Oliveira

; Silva, Catia Silveira da

; Helbig, Elizabete

Ciência Rural

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2023, Volume 53 N. 12 elocation e20220450

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

ABSTRACT: The physicochemical characterization, antioxidant potential and phenolic composition of fruits of six genotypes (BB3, BB4, BB6, PW1, PW2 and PW5) and seven commercial cultivars (Bluebelle, Bluegem, Briteblue, Climax, Delite, Powderblue and Woodard) were carried out of blueberry, from the 2019/2020 production cycle. Color, soluble solids content, pH, titratable acidity, antioxidant activity (DPPH and ABTS), total phenolic compounds, total flavonoids, total anthocyanins and individual anthocyanins were analyzed. In general, all genotypes and cultivars are rich in phytochemicals. The genotypes PW1, PW2, PW5, BB3 and the cultivars Bluegem, Briteblue, Climax and Delite stand out. Thus, the blueberry genotypes in this study are considered as promising for the food industry and also for fresh consumption as commercial cultivars already consolidated in the fruit market, in view of the excellent phenolic composition present in these small fruits.

RESUMO: Fez-se a caracterização físico-química, potencial antioxidante e composição fenólica de frutos de seis genótipos (BB3, BB4, BB6, PW1, PW2 e PW5) e sete cultivares comerciais (Bluebelle, Bluegem, Briteblue, Climax, Delite, Powderblue e Woodard) de mirtileiro, oriundos do ciclo de produção 2019/2020. Analisou-se a cor, teor de sólidos solúveis, o pH, a acidez titulável, atividade antioxidante (DPPH e ABTS), compostos fenólicos totais, flavonoides totais, antocianinas totais e antocianinas individuais. De modo geral, todos os genótipos e cultivares são ricos em compostos fitoquímicos. Como destaque, estão os genótipos PW1, PW2, PW5, BB3 e as cultivares Bluegem, Briteblue, Climax e Delite. Assim, os genótipos de mirtileiro do presente estudo, são considerados tão promissores para a indústria alimentícia e também para o consumo in natura quanto as cultivares comerciais já consolidadas no mercado da fruticultura, tendo em vista a excelente composição fenólica presente nestes pequenos frutos.

https://doi.org/10.1590/0103-8478cr20220450

COVID-19 outcomes in people living with HIV: Peering through the waves
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Sales, Thaís Lorenna Souza

; Souza-Silva, Maíra Viana Rego

; Delfino-Pereira, Polianna

; Neves, João Victor Baroni

; Sacioto, Manuela Furtado

; Assis, Vivian Costa Morais de

; Duani, Helena

; Oliveira, Neimy Ramos de

; Sampaio, Natália da Cunha Severino

; Ramos, Lucas Emanuel Ferreira

; Schwarzbold, Alexandre Vargas

; Jorge, Alzira de Oliveira

; Scotton, Ana Luiza Bahia Alves

; Castro, Bruno Mateus de

; Silva, Carla Thais Cândida Alves da

; Ramos, Carolina Marques

; Anschau, Fernando

; Botoni, Fernando Antonio

; Grizende, Genna Maira Santos

; Nascimento, Guilherme Fagundes

; Ruschel, Karen Brasil

; Menezes, Luanna Silva Monteiro

; Castro, Luís César de

; Nasi, Luiz Antônio

; Carneiro, Marcelo

; Godoy, Mariana Frizzo de

; Nogueira, Matheus Carvalho Alves

; Guimarães Júnior, Milton Henriques

; Ziegelmann, Patricia Klarmann

; Almeida, Rafaela Charão de

; Francisco, Saionara Cristina

; Silveira Neto, Sidney Teodoro

; Araújo, Silvia Ferreira

; Avelino-Silva, Thiago Junqueira

; Aliberti, Márlon Juliano Romero

; Pires, Magda Carvalho

; Silva, Eduardo Sérgio da

; Marcolino, Milena Soriano

Clinics

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2023, Volume 78 elocation 100223

Abstract: En | Text: En | PDF: En

Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group.

https://doi.org/10.1016/j.clinsp.2023.100223

Randomized clinical trial on the efficacy of a new transcranial direct current stimulation (tDCS) device in the treatment of depression: a low-cost option for developing countries?
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Ribeiro, Rafael Bernardon

; Generoso, Marcelo Bruno

; Taiar, Ivan Trombino

; Lord, Ana Elisa De Conti

; Machado Netto, Geraldo Teles

; Gomes, July Silveira

; Garrocini, Lucas Pagnan

; Girão, Mara Fernandes Maranhão

; Araujo, Maria Augusta Azevedo de

; Silva, Samuel Araújo Leite da

; Shiozawa, Pedro

; Cordeiro, Quirino

Jornal Brasileiro de Psiquiatria

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2023, Volume 72 N. 4 Pages 205 - 212

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

ABSTRACT Objective: Verify the clinical efficacy and safety of a low-cost tDCS device, in a clinical trial for major depressive disorder. Methods: 168 persons were recruited; 32 depressed individuals with moderate or severe depressive symptoms (HDRS17 scores higher than 18) were included and randomized for the trial (16 individuals in each group). The intervention consisted of 10 active anodal tDCS sessions at 2 mA for 30 minutes over the left dorsolateral prefrontal cortex; or sham. The main outcome was HDRS17; secondary outcomes included satisfaction (TSQM II) and quality of life (WHOQOL-BREF). Assessments at baseline, endpoint and at 30 days follow-up. Results: The sample was composed by a total of 11 men and 21 women, mean age of 42.75 years (95% CI: 38.10-47.40). Active treatment was superior than sham: There was a significant interaction between group and time regarding HDRS-17 scores (F = 4.089, df = 2, p = 0.029; partial Eta squared = 0. 239). Post hoc analyses exhibited a statistically significant difference between active and sham group symptoms after a 30 days follow-up (difference = -7.75, p = 0.008, Cohen’s d = 1.069). There were 3 dropouts, all in the active group, due schedule issues. No severe adverse effects reported. Conclusion: The current active tDCS protocol was related with clinical improvement of depressive symptoms. Intervention was well-tolerated. Non-invasive brain stimulation techniques are still not routinely used, although a viable strategy for treatment-resistant patients, partial responders and people unable to use pharmacological treatment. We aim to increase knowledge and use of tDCS for the Brazilian population.

RESUMO Objetivo: Testar a eficácia clínica e a segurança de equipamento de estimulação elétrica transcraniana por corrente contínua (ETCC) de baixo custo em ensaio clínico para transtorno depressivo maior (TDM). Métodos: Foram recrutadas 168 pessoas e incluídos e randomizados 32 indivíduos com depressão moderada ou grave (escores na HDRS17 >18; 16 indivíduos em cada grupo). A intervenção consistiu de 10 sessões de ETCC ativa a 2 mA no córtex pré-frontal dorsolateral esquerdo por 30 minutos, ou sham. O desfecho principal foi HDRS17; os desfechos secundários foram satisfação (TSQM II) e qualidade de vida (WHOQOL-BREF). Avaliações no início, no final do tratamento e após 30 dias de seguimento. Resultados: A amostra foi composta de 11 homens e 21 mulheres, com idade média de 42,75 anos (IC 95%: 38,10 a 47,40). O tratamento ativo foi superior ao sham: houve interação significativa entre grupo e tempo em relação aos escores de HDRS17 na ANOVA (F = 4,089, df = 2, p = 0,029; partial Eta squared = 0,239). A análise post hoc mostrou diferença significativa na HDRS17 no follow-up após 30 dias (diferença = -7,75, p= 0,008, Cohen’s d = 1,069). Houve 3 dropouts, todos no grupo ativo, devido a problemas de agenda. Não houve registro de efeitos adversos graves. Conclusão: O tratamento ativo teve relação com melhora clínica de sintomas depressivos. A intervenção foi bem tolerada. Técnicas de estimulação cerebral não invasivas ainda não são rotina na prática clínica, apesar de estratégias viáveis para pacientes resistentes a tratamento, respondedores parciais e pessoas com intolerância a medicamentos. Esperamos ampliar o conhecimento e o uso de protocolos de ETCC na população brasileira.

https://doi.org/10.1590/0047-2085000000429

Mechanical and Acoustic Performance of Concrete Containing Vermiculite and Rubber
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Batista, Lucas Silveira

; Silva, Fabiana Maria da

; Gomes, Amauri Ernesto

; Gachet, Luísa Andréia

; Santos, José Maria Campos Dos

; Melo, Mirian Lourdes N.M.

; Russo, Maria Rachel de Araújo

; Lintz, Rosa Cristina Cecche

Materials Research

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2023, Volume 26 Suppl. 1 elocation e20230011

Abstract: En | Text: En | PDF: En

The excessive production of new tires and the inappropriate disposal of waste tires have caused serious environmental and public health problems. To properly dispose of this environmental liability, these rubber residues have been used in cement composites to improve some of their properties in the hardened state. This study evaluates the incorporation of rubber and vermiculite residues in concrete in terms of mechanical and acoustic properties. Different concrete compositions were defined where rubber waste and vermiculite were used to replace the natural sand mass. To characterize the concretes, mechanical and acoustic tests, and analysis of the microstructure of the material were carried out to better understand its properties. An improvement in the acoustic properties can be seen in the composites with rubber and vermiculite. Thus, the great contribution of this research is the development of concrete compositions for acoustic barriers, technically viable, adding environmental benefits. problems liability state mass concretes tests Thus barriers viable benefits

https://doi.org/10.1590/1980-5373-mr-2023-0011

Influence of the Incorporation of Rubber Fibers on The Properties of Concrete Reinforced with Steel Fibers
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Silva, Augusto Carlos Gomes da

; Batista, Lucas Silveira

; Silva, Fabiana Maria da

; Becker, Ariane Roberto

; Gomes, Amauri Ernesto

; Gachet, Luísa Andréia

; Lintz, Rosa Cristina Cecche

Materials Research

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2023, Volume 26 Suppl. 1 elocation e20230042

Abstract: En | Text: En | PDF: En

The use of steel fibers in concrete affects its rheological properties in the fresh state and increases its energy absorption capacity in the hardened state. Rubber fibers come from tires and when incorporated into concrete, they promote an improvement in its damping factor. This work aimed to evaluate the use of rubber fibers on the mechanical properties of concrete reinforced with steel fibers. The evaluated properties were: compressive strength, tensile strength, static and dynamic modulus of elasticity and damping. The mixes of the tested concretes varied the consumption of steel and rubber fibers. From the results found, it can be seen that the rubber associated with steel fibers within the concrete mixtures improves the damping rates of the material. factor were strength found material

https://doi.org/10.1590/1980-5373-mr-2023-0042

10.

The health-related quality of life in patients with post-COVID-19 after hospitalization: a systematic review
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Figueiredo, Eduardo Augusto Barbosa

; Silva, Whesley Tanor

; Tsopanoglou, Sabrina Pinheiro

; Vitorino, Débora Fernandes de Melo

; Oliveira, Luciano Fonseca Lemos de

; Silva, Keity Lamary Souza

; Luz, Hiago Daniel Herédia

; Ávila, Matheus Ribeiro

; Oliveira, Lucas Fróis Fernandes de

; Lacerda, Ana Cristina Rodrigues

; Mendonça, Vanessa Amaral

; Lima, Vanessa Pereira

; Mediano, Mauro Felippe Felix

; Figueiredo, Pedro Henrique Scheidt

; Rocha, Manoel Otávio Costa

; Costa, Henrique Silveira

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0741-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.

https://doi.org/10.1590/0037-8682-0741-2021

11.

The health-related quality of life in patients with Chagas disease: the state of the art
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Almeida, Igor Lucas Geraldo Izalino de

; Oliveira, Luciano Fonseca Lemos de

; Figueiredo, Pedro Henrique Scheidt

; Oliveira, Rafael Dias de Brito

; Damasceno, Thayrine Rosa

; Silva, Whesley Tanor

; Oliveira, Lucas Frois Fernandes de

; Ávila, Matheus Ribeiro

; Lima, Vanessa Pereira

; Lages, Ana Thereza Chaves

; Mediano, Mauro Felippe Felix

; Rocha, Manoel Otávio Costa

; Costa, Henrique Silveira

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0657-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

https://doi.org/10.1590/0037-8682-0657-2021

12.

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations
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Silva, Whesley Tanor

; Oliveira, Lucas Frois Fernandes

; Xavier, Diego Mendes

; Figueiredo, Pedro Henrique Scheidt

; Lacerda, Ana Cristina Rodrigues

; Mendonça, Vanessa Amaral

; Ávila, Matheus Ribeiro

; Ferreira Júnior, Cláudio Luiz

; Lima, Márcia Maria Oliveira

; Mediano, Mauro Felippe Felix

; Rocha, Manoel Otávio da Costa

; Costa, Henrique Silveira

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0377-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

https://doi.org/10.1590/0037-8682-0377-2022

13.

ONLAY VERSUS SUBLAY TECHNIQUES FOR INCISIONAL HERNIA REPAIR: 30-DAY POSTOPERATIVE OUTCOMES
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Martins, Eduardo Ferreira

; Dal Vesco Neto, Marcos

; Martins, Pedro Klanovichs

; Difante, Lucas Dos Santos

; Silva, Lara Luz de Miranda

; Bosi, Henrique Rasia

; Volkweis, Bernardo Silveira

; Cavazzola, Leandro Totti

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2022, Volume 35 elocation e1692

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

RESUMO RACIONAL: O desenvolvimento de hérnia incisional é uma complicação comum após laparotomias. Também tem um impacto econômico importante nos sistemas de saúde e no orçamento da previdência social. O reforço com tela da parede abdominal foi um avanço importante para aumentar o sucesso dos reparos e ajudou a reduzir sua recorrência em longo prazo. Os dois locais mais comuns para colocação de tela em reparos de hérnia incisional incluem os planos pré-muscular (técnica onlay) e retromuscular (técnica sublay). Porém, até o momento, não há consenso na literatura sobre a localização ideal da tela. OBJETIVOS: Comparar as duas técnicas de reparo de hérnia incisional mais comuns (onlay e sublay) em relação à taxa de complicações nos primeiros 30 dias de pós-operatório. MÉTODO: Analisar 115 pacientes submetidos a reparos de hérnia incisional onlay ou sublay e avaliar, como desfecho, as ocorrências de sítio cirúrgico no pós-operatório de trinta dias e a recorrência precoce para cada técnica. RESULTADOS: Não encontramos diferença nos resultados entre os grupos, exceto na formação de seroma, que foi maior nos pacientes submetidos à técnica de sublay, provavelmente pela menor taxa de colocação de dreno neste grupo. CONCLUSÃO: Assim, ambas as técnicas de colocação de tela parecem ser adequadas no reparo de hérnias incisionais, sem grande diferença nos desfechos precoces, relacionados a ao sítio cirúrgico.

ABSTRACT BACKGROUND: The development of an incisional hernia is a common complication following laparotomy. It also has an important economic impact on healthcare systems and social security budget. The mesh reinforcement of the abdominal wall was an important advancement to increase the success of the repairs and reduce its long-term recurrence. The two most common locations for mesh placement in ventral hernia repairs include the premuscular (onlay technique) and retromuscular planes (sublay technique). However, until now, there is no consensus in the literature about the ideal location of the mesh. AIM: The aim of this study was to compare the two most common incisional hernia repair techniques (onlay and sublay) with regard to the complication rate within the first 30 days of postoperative care. METHOD: This study analyzes 115 patients who underwent either onlay or sublay incisional hernia repairs and evaluates the 30-day postoperative surgical site occurrences and hernia recurrence for each technique. RESULTS: We found no difference in the results between the groups, except in seroma formation, which was higher in patients submitted to the sublay technique, probably due to the lower rate of drain placement in this group. CONCLUSION: Both techniques of mesh placement seem to be adequate in the repair of incisional hernias, with no major difference in surgical site occurrences.

https://doi.org/10.1590/0102-672020220002e1692

14.

Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: a systematic review
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Almeida, Igor Lucas Geraldo Izalino de

; Figueiredo, Pedro Henrique Scheidt

; Silva, Whesley Tanor

; Mendonça, Vanessa Amaral

; Lacerda, Ana Cristina Rodrigues

; Lima, Vanessa Pereira

; Bastone, Alessandra de Carvalho

; Costa, Henrique Silveira

Jornal Vascular Brasileiro

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2022, Volume 21 elocation e20210229

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

Resumo Esta revisão sistemática objetivou discutir os principais achados sobre a confiabilidade e validade dos questionários de qualidade de vida relacionada à saúde na insuficiência venosa crônica. A busca foi realizada nas bases de dados MEDLINE, CINAHL, Web of Science, LILACS e Scopus. Os termos de busca foram relacionados a “insuficiência venosa” e “qualidade de vida”. O Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ)-20 e o CIVIQ-14 apresentaram consistência interna adequada e foram capazes de discriminar a gravidade da doença. O Venous Insufficiency Epidemiological and Economic Study – Quality of Life (VEINES-QoL) apresentou consistência interna adequada, mas não foi capaz de discriminar a gravidade da doença. A maioria dos estudos não demonstrou associação do VEINES-QoL com o componente mental do Short Form Health Survey (SF-36). O Aberdeen Varicose Vein Questionnaire (AVVQ) apresentou confiabilidade inadequada e validade duvidosa quando comparado ao SF-36. O VARIShort demonstrou consistência interna, reprodutibilidade e validade boas, mas apenas o estudo original foi incluído. Na úlcera venosa, o Charing Cross Venous Ulcer Questionnaire (CCVUQ) apresentou confiabilidade e validade adequadas quando comparado ao Venous Leg Ulcer Quality of Life (VLU-QoL).

Abstract This systematic review aimed to discuss the main findings regarding the reliability and validity of health-related quality of life questionnaires for chronic venous insufficiency. Searches were performed on the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases. The search terms used were related to “venous insufficiency”, and “quality of life”. The CIVIQ-20 and CIVIQ-14 instruments had adequate internal consistency and both were able to discriminate disease severity. The VEINES-QoL showed adequate internal consistency but was not able to discriminate disease severity. Most studies did not demonstrate a correlation between VEINES-QoL and the mental component of the SF-36. The AVVQ had inadequate reliability but its validity was also doubtful when compared to the SF-36. The VARIShort demonstrated good internal consistency, reproducibility, and validity, but only the original study was included. For venous leg ulcers, the CCVUQ showed adequate reliability and validity when compared to VLU-QoL.

https://doi.org/10.1590/1677-5449.202102292

15.

Determinants of minute ventilation-carbon dioxide production relationship in Chagas cardiomyopathy
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Oliveira, Lucas Frois Fernandes

; Andrade, Janaina Martins

; Figueiredo, Pedro Henrique Scheidt

; Ávila, Matheus Ribeiro

; Silva, Whesley Tanor

; Vianna, Marcus Vinicius Accetta

; Trede Filho, Renato Guilherme

; Costa, Henrique Silveira

; Rocha, Manoel Otávio Costa

; Lima, Vanessa Pereira

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0047-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) is among the main prognostic factors of Chagas cardiomyopathy whose determinants remain unknown. METHODS: Seventy-eight patients with Chagas cardiomyopathy were evaluated using clinical assessment, cardiopulmonary exercise test, echocardiography, and International Physical Activity Questionnaire. RESULTS: Age, functional class, International Physical Activity Questionnaire score, and dilated cardiomyopathy with systolic dysfunction were independent determinants of VE/VCO2 slope, and these variables explained 63% of its variance. CONCLUSIONS: The VE/VCO2 slope was related to age, functional class, physical activity level, and dilated cardiomyopathy with systolic dysfunction in patients with Chagas cardiomyopathy.

https://doi.org/10.1590/0037-8682-0047-2021

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