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Abstract This study aimed to investigate the epidemiological and pathological findings of type 1 and 2 abomasal ulcers in cattle with different primary comorbidities. A total of 201 animals; 40/201 (20%) were young cattle under the age of two years and 161/201 (80%) were adult cattle over the age of two years, which were hospitalized for clinical care 152/201 (75,62%), 19/201 (9,45%) obstetric care, 17/201 (8,46%) surgical care and 13/201 (6,47%) for anatomopathological diagnosis, being euthanized or had natural death. The diagnosis of ulcers was based on the result of the post-mortem examination (macroscopic and histopathological analysis). Histopathological examination was performed on 201 fragments of ulcers and classified as type 1 or type 2. Of these, 193/201 (96.01%) corresponded to type 1 ulcers, of which 12/193 (5.97%) corresponded to subtype 1a lesions, 101/193 (50.25%) to subtype 1b, 77/ 193 (38.31%) to subtype 1c, 03/193 (1.49%) to subtype 1d, while 08/201 (3.98%) were type 2 ulcers. The ulcers were characterized by a focal, focally extensive, multifocal or diffuse inflammatory process, mainly by mononuclear cells. Abomasitis associated with ulcerated mucosa was found in 160/201 (79.60%). In 26/201 (12.93%) the abomasitis had diffuse foci of multifocal lymphocytic proliferation by atypical lymphocytes. Digestive and reproductive comorbidities were seen more frequently in cattle with type 1 or type 2 ulcers. The Subtype 1b focal ulcers and subtype 1a and 1b multifocal ulcers were more prevalent. In addition to the presence of comorbidities, most cases occur in the dry period, associated with feeding with higher amounts of concentrates and silages.

Resumo Objetivou-se estudar os achados epidemiológico e anatomopatológico de úlceras do abomaso tipo 1 e 2 em bovinos com diferentes comorbidades primárias. Um total de 201 animais; 40/201 (20%) eram bovinos jovens com idade inferior a dois anos e 161/201 (80%) eram bovinos adultos com idade superior a dois anos, os quais foram internados para atendimento clínico 152/201 (75,62%), 19/201 (9,45%) obstétrico, 17/201 (8,46%) para atendimento clínico-cirúrgico e 13/201 (6,47%) para diagnóstico anatomopatológico, sendo eutanasiados ou tiveram morte natural. O diagnóstico das úlceras foi baseado no exame post-mortem (análise macroscópica e histopatológica). O exame histopatológico foi realizado em 201 fragmentos de úlceras e classificado como tipo 1 ou do tipo 2. Destes, 193/201 (96,01%) corresponderam a úlceras tipo 1, das quais, 12/193 (5,97%) corresponderam a lesões subtipo 1a, 101/193 (50,25%) a subtipo 1b, 77/193 (38,31%) a subtipo 1c, 03/193 (1,49%) ao subtipo 1d, enquanto 08/201 (3,98%) foram úlceras tipo 2. As úlceras foram caracterizadas por processo inflamatório focal, focalmente extenso, multifocais ou difusos, principalmente por células mononucleares. Abomasite associada à mucosa ulcerada foi encontrada em 160/201 (79,60%). Em 26/201 (12,93%) a abomasite apresentava focos difusos de proliferação linfocítica multifocal por linfócitos atípicos. As comorbidades digestivas e reprodutivas foram observadas com maior frequência em bovinos com úlceras tipo 1 ou tipo 2. As úlceras focais subtipo 1b e úlceras multifocais subtipo 1a e 1b foram mais prevalentes. Além da presença de comorbidades, a maioria dos casos ocorrerem no período seco, associados à alimentação com maiores aportes de concentrados e silagens.

https://doi.org/10.1590/1809-6891v24e-74772e

Calcinose em área de queimadura tardia: relato de caso e discussão da conduta
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SIMÕES, MARIANA CIONEK

; PIETRESKI-SILVA, LUANA MARY

; DAMIN, RENATA

; FONSECA FILHO, RICARDO DA

; SILVA, TAYNAH BASTOS LIMA DA

Revista Brasileira de Cirurgia Plástica

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dec 2022, Volume 37 N. 4 Pages 514 - 517

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

ABSTRACT Introduction: Cutaneous calcinosis is a rare disease characterized by the precipitation of calcium crystals in the skin tissue. It can be localized, generalized, dystrophic, metastatic, iatrogenic, or idiopathic. Case Report: Female patient, 66 years old, victim of second and third-degree burns by fire in the lower abdomen and thighs at 8 years old, reaching 25% of the body surface. After 58 years, she was diagnosed with dystrophic calcinosis in the burn scar, which was confirmed through biopsy and histopathological analysis. She underwent surgical excision associated with rotation of the upper abdomen dermal-fat flap and total skin graft for scar correction. Conclusion: Although the best therapeutic choice is still unclear, treating complications leading to functional disability is essential to reduce morbidity and increase the patient’s quality of life.

RESUMO Introdução: Calcinose cutânea é uma doença rara caracterizada por precipitações de cristais de cálcio no tecido cutâneo. Pode ser localizada ou generalizada, distrófica, metastática, iatrogênica ou idiopática. Relato do Caso: Paciente feminina, 66 anos, vítima de queimaduras de segundo e terceiro graus por fogo em abdome inferior e coxas aos 8 anos de idade atingindo 25% de superfície corpórea. Após 58 anos, recebeu o diagnóstico de calcinose distrófica na cicatriz da queimadura, contemplado através de biópsia e análise histopatológica. Submetida a exérese cirúrgica associada a rotação de retalho dermogorduroso de abdome superior e enxertia de pele total para correção de cicatrizes. Conclusão: Embora a melhor escolha terapêutica ainda não seja clara, o tratamento de complicações que podem culminar em incapacidade funcional é fundamental para reduzir a morbidade e aumentar a qualidade de vida do paciente.

https://doi.org/10.5935/2177-1235.2022rbcp.621-pt

Cardiometabolic risk factors and hypovitaminosis D in adolescents with overweight from a sunny region in northeast Brazil: a cross-sectional study
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Souza, Angélica Luiza de Sales

; Araújo, Eduarda Pontes dos Santos

; Souza, Thatyane Oliveira

; Pimentel, Jéssica Bastos

; Ferreira, Adriana Leão de Miranda

; Silva, David Franciole de Oliveira

; Evangelista, Karine Cavalcanti Maurício Sena

; Arrais, Ricardo Fernando

; Rezende, Adriana Augusto de

; Lima, Severina Carla Vieira Cunha

Nutrición Hospitalaria

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feb 2022, Volume 39 N. 1 Pages 73 - 81

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background: obesity can influence vitamin D levels, which in turn might be associated with cardiometabolic risk factors. Objectives: this study assessed the association between 25-hydroxyvitamin D [25(OH)D] levels and cardiometabolic risk factors in adolescents with overweight living in a region of northeastern Brazil. Material and methods: a cross-sectional study was carried out by non-probabilistic sampling in adolescents diagnosed with overweight or obesity. The subjects were divided according to their 25(OH) D status into two groups: sufficient vitamin D and hypovitaminosis D. Biodemographic, lifestyle, cardiometabolic, and biochemical factors were evaluated. A logistic regression model was applied to determine the predictors of hypovitaminosis D. Results: we found a high frequency of hypovitaminosis D (45.6 %) in adolescents. Weekly sun exposure was negatively associated with hypovitaminosis D (OR = 0.96; 95 % CI: 0.92-0.99), while significant positive associations were observed between hypovitaminosis D and blood pressure above the 95th percentile (OR = 4.00; 95 % CI: 1.19-13.37), body weight (OR = 1.04; 95 % CI: 1.01-1.07), and fasting insulin (OR = 1.13; 95 % CI: 1.05-1.22). Conclusion: hypovitaminosis D showed a high prevalence in adolescents with overweight living in a sunny region of northeastern Brazil, and cardiometabolic risk factors such as systemic arterial hypertension, high body weight, and hyperinsulinemia are predictors of hypovitaminosis D.

Resumen Introducción: la obesidad puede influir en los niveles de vitamina D, lo que a su vez podría estar asociado con factores de riesgo cardiometabólico. Objetivos: este estudio evaluó la asociación entre los niveles de 25-hidroxivitamina D [25(OH)D] y los factores de riesgo cardiometabólico en adolescentes con sobrepeso que viven en una región del noreste de Brasil. Material y métodos: se realizó un estudio transversal mediante muestreo no probabilístico con adolescentes diagnosticados de sobrepeso u obesidad. Los sujetos se dividieron según su estado de 25(OH) D en dos grupos: suficiente vitamina D e hipovitaminosis D. Se evaluaron factores biodemográficos, de estilo de vida, cardiometabólicos y bioquímicos. Se aplicó un modelo de regresión logística para determinar los predictores de la hipovitaminosis D. Resultados: encontramos una alta frecuencia de hipovitaminosis D (45,6 %) en los adolescentes. La exposición semanal al sol se asoció negativamente a la hipovitaminosis D (OR = 0,96; IC 95 %: 0,92-0,99), mientras que se observaron asociaciones positivas significativas entre hipovitaminosis D y presión arterial por encima del percentil 95 (OR = 4,00; IC 95 %: 1,19-13,37), peso corporal (OR = 1,04; IC del 95 %: 1,01-1,07) e insulina en ayunas (OR = 1,13; IC del 95 %: 1,05-1,22). Conclusión: la hipovitaminosis D mostró una alta prevalencia entre los adolescentes con sobrepeso que viven en una región soleada del noreste de Brasil, y los factores de riesgo cardiometabólico, como hipertensión arterial sistémica, peso corporal elevado e hiperinsulinemia, son predictores de hipovitaminosis D.

https://doi.org/10.20960/nh.03745

Post Ligation Cardiac Syndrome: an Educational Presentation
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Silva, Isaac Azevedo

; Corso, Ricardo Barros

; Pina, Glauco

; Santos, Marcus Vinicius Nascimento

; Souza, Helmgton José Brito de

; Fenelon, Maria Paula Meireles

; Alves, Leonardo Jadyr Silva Rodrigues

; Vasconcelos, Diane Lucio

; Marques, Viviane Bastos Paixão

Brazilian Journal of Cardiovascular Surgery

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feb 2022, Volume 37 N. 1 Pages 128 - 130

Abstract: En | Text: En | PDF: En

ABSTRACT Although technically simple, surgical correction of patent ductus arteriosus can have serious complications. In this context, acute ventricular failure must be remembered, as its prompt diagnosis and proper management can change clinical outcomes.

https://doi.org/10.21470/1678-9741-2020-0278

INTRA- AND INTER-RATER RELIABILITY OF A BIOPHOTOGRAMMETRIC ASSESSMENT PROTOCOL FOR PRETERM INFANTS
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Campos, Juliana Vieira

; Moreno, Mariana Alves

; Silva, Ricardo de Bastos

; Silva, Jessica Neves Quirino da

; Carvalho, Milena Ferreira de

; Santos, Rayssa Christina Abreu dos

; Peres, Rodrigo Tosta

; Santos, Rosana da Silva

; Ferreira, Halina Cidrini

Revista Paulista de Pediatria

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2021, Volume 39 elocation e2020034

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

RESUMO Objetivo: Mensurar a confiabilidade intra e interexaminador de um protocolo de avaliação biofotogramétrica da mobilidade toracoabdominal de prematuros. Métodos: Estudo de caráter transversal e analítico. Incluíram-se filmagens de 40 prematuros em duas vistas (lateral e superior), realizadas em supino, pelve retrovertida e joelhos em semiflexão. Marcadores de acrílico foram posicionados sobre Micropores em oito pontos anatômicos predeterminados. Foram analisadas 4 variáveis na vista lateral e 11 na vista superior (angulares e lineares) (ImageJ®), divididas em duas etapas: (1-Frames iguais) análises de fotogramas previamente selecionados pela pesquisadora principal por três avaliadores cegos (análise interexaminador 1), com reanálise desses mesmos fotogramas após 15 dias (análise intraexaminador 1); (2-Frames diferentes) cada avaliador selecionou os fotogramas por meio do vídeo original e repetiu o protocolo (análise interexaminador 2), com reanálise após 15 dias (análise intraexaminador 2). Em (2), foi testada a confiabilidade de todo o processo de análise, desde a separação das imagens até a análise das variáveis. A concordância e reprodutibilidade dos dados foram obtidas pelo coeficiente de correlação intraclasse (CCI). Resultados: Houve concordância forte, com ênfase nas variáveis angulares (CCI [0,82 a 0,99]). As variáveis lineares apresentaram variação entre muito boa e excelente na análise 1 (frames iguais: CCI 0,64 a 0,99) e na análise 2 (frames diferentes: CCI entre 0,44 e 0,89). Conclusões: O presente estudo sugere forte confiabilidade do protocolo proposto para análise da movimentação toracoabdominal de neonatos prematuros.

ABSTRACT Objective: To measure the intra- and inter-rater reliability of a biophotogrammetric assessment protocol for thoracoabdominal motion in preterm infants. Methods: This is an analytical cross-sectional study. Footage of 40 preterm infants was made in two views (lateral and anterior). The babies were placed in the supine position, with retroverted pelvis and semiflexed knees. Acrylic markers were positioned on surgical tape in eight predetermined anatomical points. We analyzed 4 variables in lateral view and 11 in anterior view (angular and linear) (ImageJ®), divided into two stages: 1. same frames - three blinded evaluators analyzed frames previously selected by the main researcher (inter-rater analysis 1), reviewing these same frames after 15 days (intra-rater analysis 1); 2. different frames - each evaluator selected the frames from the original video and repeated the protocol (inter-rater analysis 2), with a review after 15 days (intra-rater analysis 2). In stage 2, we tested the reliability of the entire process, from image selection to the analysis of variables. Data agreement and reproducibility were obtained by the intraclass correlation coefficient (ICC). Results: Agreement was high, particularly in angular variables (ICC 0.82 to 0.99). Linear variables ranged between very good and excellent in analysis 1 (same frames: ICC 0.64 to 0.99) and analysis 2 (different frames: ICC 0.44 to 0.89). Conclusions: The present study suggests that the proposed protocol for the thoracoabdominal motion analysis of preterm neonates has high reliability.

https://doi.org/10.1590/1984-0462/2021/39/2020034 776 downloads

Aneurisma de artéria pancreatoduodenal inferior: tratamento endovascular
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Metzger, Patrick Bastos

; Costa, Kamilla Rosales

; Silva, Simone Lessa e

; Gouveia, Alan Costa

; Berbert, Murilo Quadro

; Mello, Milton Oliveira de Albuquerque

; Oliveira, Fabrício Mascarenhas de

; Melo, Ricardo Fernandes Ferraz

Jornal Vascular Brasileiro

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2021, Volume 20 elocation e20200101

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

Resumo Os aneurismas das artérias pancreatoduodenais constituem uma afecção rara. Seu diagnóstico é realizado, na maioria das vezes, em situações de emergência por complicações como a rotura, a qual está associada a altas taxas de mortalidade (21-26%). A embolização do saco aneurismático é o tratamento de escolha, devido à sua alta efetividade e menor mortalidade. Neste artigo, é apresentado e discutido um caso de aneurisma de artéria pancreatoduodenal inferior com diagnóstico obtido durante investigação de sintomas gastrointestinais. O tratamento instituído foi a embolização com micromolas, com completa exclusão do aneurisma e boa evolução clínica.

Abstract Aneurysms of the pancreaticoduodenal arteries are a rare condition. In the majority of cases, diagnosis is made in emergency situations due to complications such as rupture, which is associated with high mortality rates (21-26%). Embolization of the aneurysm sac is the treatment of choice, because of its high efficacy and lower mortality. This article presents and discusses a case of inferior pancreaticoduodenal artery aneurysm that was diagnosed during investigation of gastrointestinal symptoms. The treatment provided was microcoil embolization, with complete exclusion of the aneurysm and a good clinical course.

https://doi.org/10.1590/1677-5449.200101 331 downloads

Physiological and productive aspects of cassava under different irrigation levels
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Silva, Ricardo Barros

; Teodoro, Iêdo

; Souza, José Leonaldo de

; Ferreira Júnior, Ricardo Araújo

; Magalhães, Ivomberg Dourado

; Santos, Marcos Alex dos

; Lyra, Guilherme Bastos

; Lyra, Gustavo Bastos

; Moura Filho, Gilson

; Souza, Renan Cantalice de

; Silva, Lennon Kledson dos Santos

; Santos, Jônatas Vieira

; Oliveira, José Dailson Silva de

Bragantia

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2021, Volume 80 elocation e5321

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this research was to evaluate the physiological and productive aspects of irrigated cassava crop. The statistical design used was randomised blocks, with six treatments and four replications. The used treatments were irrigation levels, based on the crop evapotranspiration – ETC – (L0 = 0% [rainfed], L1 = 40%, L2 = 80%, L3 = 120%, L4 = 160% and L5 = 200% of the ETC) and the analysed physiological variables were: gas exchange, the quantum efficiency of photosystem II (PSII) and the soil plant analysis development (SPAD) index. The growth and crop productivity were also evaluated through of the leaf area index (LAI), the number and productivity of commercial roots and total biomass. In this research, the total irrigation depth was defined as the irrigation depth plus the effective rainfall. The estimated ETC was 1,030 mm over the 12-month production cycle and the greatest value for LAI and SPAD were 7.6 and 57.4, respectively, obtained in irrigated areas with the level of 80% of the ETC. While, in the areas irrigated with 120% of the ETC, were obtained the highest values of root productivity (93 Mg·ha–1), total biomass yield (149 Mg·ha–1) and photosynthetic rate (22.4 μmol CO2·m–2·s–1). On the other hand, with irrigation equivalent at 200% of the ETC were obtained the greatest values of internal CO2 concentration (245 μmol CO2·m–2·s–1), stomatal conductance (0.35 μmol H2O·m–2·s–1) and effective quantum efficiency (0.68).

https://doi.org/10.1590/1678-4499.20200501 77 downloads

Analysis of Measurements of Direct Normal and Global Solar Radiation for Maceió, Alagoas State, Northeastern Brazil
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Lopes Júnior, José Marcelo

; Souza, José Leonaldo de

; Ferreira Junior, Ricardo Araujo

; Santos, Cícero Manoel dos

; Lyra, Gustavo Bastos

; Tiba, Chigueru

; Silva Júnior, Rosiberto Salustiano da

Revista Brasileira de Meteorologia

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dec 2020, Volume 35 N. 4 Pages 659 - 674

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

Resumo Estudar a radiação solar é essencial para o conhecimento humano, visto que ela está presente em praticamente todas suas atividades. Assim, o objetivo desse trabalho é analisar a variação climática e sazonal da radiação solar direta normal e global na região de Maceió, estado de Alagoas, Nordeste do Brasil com condições do céu caracterizada pelo índice de claridade (Kt). O Kt foi determinado pela razão entre irradiância solar global e irradiância solar no topo da atmosfera. As maiores ocorrências de irradiância solar direta normal diária em condições de Kt ≥ 0,6 foram registradas entre 400 W m−2 e 700 W m−2 em todas as estações do ano. Sob condições de 0,4 ≤ Kt < 0,6, a irradiância solar direta normal diária ocorreu entre 200 W m−2 e 500 W m−2 e para condições de Kt < 0,4, seu valor máximo foi de 200 W m−2. Observou-se que os níveis de incidência solar na região de estudo dependem das condições de cobertura de nuvens, com pouca influência da sazonalidade.

Abstract Studying solar radiation is essential for human knowledge, since it is present in practically all its activities. Thus, the aim of this work was to analyze the climatic and seasonal variation of direct normal and global solar radiation in the region of Maceió, Alagoas State, Northeastern Brazil with sky conditions characterized by clearness index (Kt). The Kt was determined by the ratio between global solar irradiance and solar irradiance at the top of the atmosphere. The highest occurrences of daily direct normal solar irradiance under conditions of Kt ≥ 0.6 were recorded between 400 W m−2 and 700 W m−2 for all seasons. Under conditions of 0.4 ≤ Kt < 0.6, the daily direct normal solar irradiance occurred between 200 W m−2 and 500 W m−2 and for conditions of Kt < 0.4, its maximum value was 200 W m−2. It was observed that the levels of solar incidence in the study region depend on cloud cover conditions, with little influence of seasonality.

https://doi.org/10.1590/0102-77863540070 373 downloads

Straw management effects on sugarcane growth, nutrient cycling and water use in the Brazilian semiarid region
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Souza, Carlos Andre Alves de

; Silva, Thieres George Freire da

; Souza, Luciana Sandra Bastos de

; Moura, Magna Soelma Beserra de

; Silva, Paulo Pedro

; Marin, Fábio Ricardo

Bragantia

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dec 2020, Volume 79 N. 4 Pages 525 - 533

Abstract: En | Text: En | PDF: En

ABSTRACT It was evaluated how straw management modifies the development, growth, nutrient cycling and crop water productivity of sugarcane in the semiarid region of Brazil. The experiment was carried out using two plots with 5 ha each, being one without straw on the soil surface and one with 26 Mg·ha-1 covering the soil. Sugarcane growth and development and straw decomposition coefficient were evaluated, whereas the industrial yield, juice quality, dry matter partitioning, and crop water productivity were determined at harvesting. The straw decomposition coefficient was 0.0049 Mg·ha-1·day-1, and the remaining dry mass was equal to 24%. The straw affected the sugarcane growth and development until the first 100 days. The individual internode volume can be adopted as an indicator of the effect of straw on sugarcane growth because the internode volumes up to the sixth position in the with-straw treatment crop were lower than in the no-straw treatment, which was not observed in other variables of the stalks. Keeping straw on the soil surface reduced the crop lodging. Yield and juice quality were not affected, but crop water productivity was increased by keeping sugarcane straw in the field.

https://doi.org/10.1590/1678-4499.20200227 84 downloads

10.

Tubulovillous adenoma of the duodenal papilla: radiological-endoscopic and anatomopathological correlation in the surgical proposal
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Fernandes, Daniel Alvarenga

; Boteon, Yuri Longatto

; Boteon, Amanda Pinter Carvalheiro da Silva

; Sousa, Rachid Marwan Pinheiro

; Martins, Daniel Lahan

; Penachim, Thiago José

; Barros, Ricardo Hoelz de Oliveira

; Martins, Rita de Cássia Perina

; Costa, Larissa Bastos Eloy da

; Cazzo, Everton

; Gestic, Martinho Antônio

; Chaim, Elinton Adami

; Caserta, Nelson Marcio Gomes

Revista da Associação Médica Brasileira

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sep 2020, Volume 66 N. 9 Pages 1190 - 1195

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

RESUMO Os adenomas túbulo-vilosos da ampola duodenal são neoplasias raras. Neste trabalho apresentamos um caso com correlação radiológico-endoscópica e patológica, tendo a paciente sido submetida à duodenopancreatectomia com boa evolução pós-operatória. Com os avanços dos métodos de imagem, em especial da ressonância magnética e ultrassonografia endoscópica, aspectos locorregionais, além da invasão extraluminal, linfovascular e metastática, têm sido discutidos de maneira crescente como contribuintes na decisão terapêutica. Essa evolução contribui para o melhor estadiamento destas lesões e é especialmente útil para selecionar candidatos elegíveis ao tratamento endoscópico.

SUMMARY Tubulovillous adenomas of the duodenal ampulla are rare neoplasms. The present report describes a case with radiological-endoscopic and pathological correlation in which the patient underwent duodenal pancreatectomy with good postoperative progression. With advanced imaging methods, especially magnetic resonance and endoscopic ultrasound, locoregional aspects and extraluminal, lymphovascular, and metastatic invasion have been increasingly discussed as contributors to therapeutic decision making. This progression improves lesion staging and is especially useful in selecting eligible candidates for endoscopic treatment.

https://doi.org/10.1590/1806-9282.66.9.1190 600 downloads

11.

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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STUDART-NETO, Adalberto

; GUEDES, Bruno Fukelmann

; TUMA, Raphael de Luca e

; CAMELO FILHO, Antonio Edvan

; KUBOTA, Gabriel Taricani

; IEPSEN, Bruno Diógenes

; MOREIRA, Gabriela Pantaleão

; RODRIGUES, Júlia Chartouni

; FERRARI, Maíra Medeiros Honorato

; CARRA, Rafael Bernhart

; SPERA, Raphael Ribeiro

; OKU, Mariana Hiromi Manoel

; TERRIM, Sara

; LOPES, Cesar Castello Branco

; PASSOS NETO, Carlos Eduardo Borges

; FIORENTINO, Matheus Dalben

; DE SOUZA, Julia Carvalhinho Carlos

; BAIMA, José Pedro Soares

; DA SILVA, Tomás Fraga Ferreira

; MORENO, Cristiane Araujo Martins

; SILVA, Andre Macedo Serafim

; HEISE, Carlos Otto

; MENDONÇA, Rodrigo Holanda

; FORTINI, Ida

; SMID, Jerusa

; ADONI, Tarso

; GONÇALVES, Marcia Rubia Rodrigues

; PEREIRA, Samira Luisa Apóstolos

; PINTO, Lecio Figueira

; GOMES, Helio Rodrigues

; ZANOTELI, Edmar

; BRUCKI, Sonia Maria Dozzi

; CONFORTO, Adriana Bastos

; CASTRO, Luiz Henrique Martins

; NITRINI, Ricardo

Arquivos de Neuro-Psiquiatria

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aug 2020, Volume 78 N. 8 Pages 494 - 500

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

RESUMO Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomas neurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doenças neurológicas prévias podem exigir tratamento especial e estar associadas a piores desfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmente pouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitar consultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com 900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico de COVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas as interconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foram analisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dados disponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionais conforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões de consenso. Após o diagnóstico, os neurologistas participaram da condução dos casos. Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) em pacientes internados por COVID-19 durante o período. Os principais diagnósticos neurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%), doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornos neuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomas leves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em um hospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetar o desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecer sintomas neurológicos. Os neurologistas são membros importantes da equipe médica no atendimento hospitalar à COVID-19.

ABSTRACT Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

https://doi.org/10.1590/0004-282x20200089 2651 downloads

12.

[SciELO Preprints] - Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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Studart-Neto, Adalberto Guedes, Bruno Fukelmann Tuma, Raphael De Luca E Camelo Filho, Antonio Edvan Kubota, Gabriel Taricani Iepsen, Bruno Diógenes Moreira, Gabriela Pantaleão Rodrigues, Júlia Chartouni Ferrari, Maíra Medeiros Honorato Carra, Rafael Bernhard Spera, Raphael Ribeiro Oku, Mariana Hiromi Manoel Terrim, Sara Lopes, Cesar Castello Branco Passos Neto, Carlos Eduardo Borges Dalben, Matheus De Souza, Julia Carvalhinho Carlos Baima, José Pedro Soares Da Silva, Tomás Fraga Ferreira Moreno, Cristiane Araujo Martins Silva, Andre Macedo Serafim Heise, Carlos Otto Mendonça, Rodrigo Holanda Fortini, Ida Smid, Jerusa Adoni, Tarso Gonçalves, Marcia Rubia Rodrigues Pereira, Samira Luisa Apóstolos Pinto, Lecio Figueira Gomes, Helio Rodrigues Zanotelli, Edmar Brucki, Sonia Maria Dozzi Conforto, Adriana Bastos Castro, Luiz Henrique Martins Nitrini, Ricardo

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Publication date: 2020-07-16

Abstract: En Pt

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.

Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomasneurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doençasneurológicas prévias podem exigir tratamento especial e estar associadas a pioresdesfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmentepouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitarconsultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico deCOVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas asinterconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foramanalisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dadosdisponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionaisconforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões deconsenso. Após o diagnóstico, os neurologistas participaram da condução dos casos.Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) empacientes internados por COVID-19 durante o período. Os principais diagnósticosneurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%),doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornosneuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomasleves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em umhospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetaro desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecersintomas neurológicos. Os neurologistas são membros importantes da equipe médica noatendimento hospitalar à COVID-19.

https://doi.org/10.1590/0004-282X20200089

13.

Secondary syphilis presenting as Syphilide psoriasiforme: lessons from the older syphilology literature
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Martins, Carlos José

; Lima, Ricardo Barbosa

; Eyer-Silva, Walter de Araujo

; Almenara, Camila Bastos

; Carvalho-Rangel, Isabelle

; Carvalho, Ricardo de Souza

; Basílio-de-Oliveira, Rodrigo Panno

; Araujo, Luciana Ferreira de

; Ferry, Fernando Raphael de Almeida

; Silva, Leila Rangel da

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e21

Abstract: En | Text: En | PDF: En

ABSTRACT It is essential for health care providers to be familiared with the full spectrum of clinical presentations of syphilis. We present herein a case of syphilide psoriasiforme, an uncommon but well recognized clinical presentation of secondary syphilis. A 46-year-old HIV-infected female patient was referred to our attention with a presumptive diagnosis of palmoplantar psoriasis. On examination, there were exuberant pinkish-red papules and plaques covered with a thick silvery scale in the palms, flexor surfaces of the wrists, and the medial longitudinal arches of the feet. Serological and histopathological analyses uncovered the diagnosis of syphilis. Clinical remission was obtained after treatment. A detailed review of the literature on syphilide psoriasiforme, including descriptions from older syphilology textsis provided. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.

https://doi.org/10.1590/s1678-9946202062021 1430 downloads

14.

Ventilator-associated pneumonia agents in Brazilian Neonatal Intensive Care Units - a systematic review
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Silva, André Ricardo Araujo da

; Silva, Thais Carolina da

; Bom, Gabriel José Teixeira

; Vasconcelos, Raissa Maria Bastos

; Simões Junior, Robinson

Brazilian Journal of Infectious Diseases

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aug 2018, Volume 22 N. 4 Pages 338 - 344

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections (HAI) in neonates admitted in neonatal intensive care units (NICUs). Methods We did a systematic review using PRISMA methodology to identify the main etiological agents in Brazilian NICUs. Eligible studies published without period restriction were identified in PUBMED, SCIELO, LILACS and DOAJ. Studies were included if they were conducted in neonates hospitalized at NICU. Studies done in outpatient care, neonates outside NICU, emergency department, primary care, long-term care facilities or a combination of these were excluded. Results We identified 6384 articles in the initial search and four papers met the inclusion criteria. In all studies included, rates of device-associated infections were described, including VAP rates. The VAP incidence density, in exclusively Brazilian NICU, ranged from 3.2 to 9.2 per 1000 ventilator-days. Pneumonia was described as the main HAI in NICU in one article, as the second type of HAI in two other articles and as the fourth type of HAI in the last one. The main pathogens causing all HAI types were described in three of four articles, but, none of the articles reported which pathogens were related or associated to VAP. Conclusion Etiological agents causing VAP in Brazilian NICUs are, until the present time, not known.

https://doi.org/10.1016/j.bjid.2018.06.002 814 downloads

15.

Phytosociology of a natural fragment of the floodplain forest in the Lower Tapajós River, Brazil
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dos Santos Vieira, Diego

; Romarco de Oliveira, Marcio Leles

; Vasconcelos Gama, João Ricardo

; Mendonça Machado, Evandro Luiz

; Bastos Görgens, Eric

; Oliveira Lafetá, Bruno

; Silva Garcia, Josinei

Bosque (Valdivia)

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2017, Volume 38 N. 2 Pages 357 - 369

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The aim of this study was to describe the floristic, structure and spatial pattern of species occurring in a natural fragment of the floodplain forest in the lower Tapajos River, Para. Three hundred and eight contiguous sampling unities of 100 m² were installed, comprising a sampling area of 3.08 ha. In each plot, all individuals with DBH (diameter at breast height of 1.30 cm) equal to or higher than 10 cm were measured, identified, and referenced in Cartesian coordinates (X, Y). The analyses of the diversity and spatial pattern were performed using the Shannon-Weaver index and the Ripley's K function, respectively. There were 1,022 individuals surveyed, including 64 tree species and 33 families. The diversity recorded was 3.03; the total density was determined to be 331.8 individuals ha-1 and basal area of 16.10 m² ha-1. The species of high ecological value were Campsiandra laurifolia, Hevea brasiliensis, Glicoxylon pedicellatum, Tetragastris altissima, Vantanea parviflora and Mabea caudata. The diametric distribution of the community and species, except for Hevea brasiliensis, behaved as expected for uneven-aged forests, and presented an exponential distribution with an inverted J form. The community spatial pattern showed variations depending on the considered distance, however there was a predominance of aggregated distribution. The spatial patterns detected on the species were: I - partially aggregated and random for Vantanea parviflora species, II - completely aggregated to the Hevea brasiliensis and Glicoxylon pedicellatum species, and III -predominantly aggregated to Campsiandra laurifolia, Tetragastris altissima and Mabea caudata.

El objetivo de este estudio fue describir la flora, estructura y distribución espacial de las especies que se producen en un fragmento natural de bosque inundable en el Bajo Río Tapajós, Pará. Se instalaron 308 unidades de muestreo contiguos de 100 m², que comprende un área de muestreo de 3,08 ha. En cada parcela, todos los individuos con diámetro a 1,30 cm del suelo superior o igual a 10 cm fueron medidos, identificados y referenciados en coordenadas cartesianas (X,Y). El análisis de la diversidad y el patrón espacial se realizó mediante el índice de Shannon-Weaver y la función K de Ripley, respectivamente. Se inventariaron 1.022 individuos, distribuidas en 64 especies y 33 familias. La diversidad registrada fue de 3,03, la densidad total de 331,8 individuos ha-1 y el área basal de 16,10 m² ha-1. Las especies de mayor importancia ecológica fueron Campsiandra laurifolia, Hevea brasiliensis, Glicoxylon pedicellatum, Tetragastris altissima, Vantanea parviflora y Mabea caudata. La distribución del diámetro para la comunidad y las especies, excepto la Hevea brasiliensis, se comportó como se espera para bosques multietáneos, es decir, distribución exponencial en forma de J-invertida. El patrón espacial de la comunidad mostró variaciones en función de la distancia, sin embargo, hubo predominio de la distribución agregada. Los patrones espaciales de las especies encontradas fueron: I) agregado parcialmente y aleatorio de la especie Vantanea parviflora; II) agregado por completo de las especies Hevea brasiliensis y Glicoxylon pedicellatum; y III) predominantemente agregado para Campsiandra laurifolia, Tetragastris altissima y Mabea caudata.

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