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1.
A brazilian nationwide multicenter study on deficiency of deaminase-2 (DADA2)
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Melo, Adriana
; Carvalho, Luciana Martins de
; Ferriani, Virginia Paes Leme
; Cavalcanti, André
; Appenzeller, Simone
; Oliveira, Valéria Rossato
; Chong Neto, Herberto
; Rosário, Nelson Augusto
; Poswar, Fabiano de Oliveira
; Guimaraes, Matheus Xavier
; Kokron, Cristina Maria
; Maia, Rayana Elias
; Silva, Guilherme Diogo
; Keller, Gabriel
; Ferreira, Mauricio Domingues
; Vasconcelos, Dewton Moraes
; Toledo-Barros, Myrthes Anna Maragna
; Barros, Samar Freschi
; Rosa Neto, Nilton Salles
; Krieger, Marta Helena
; Kalil, Jorge
; Mendonça, Leonardo Oliveira
.
Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t).
2.
Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil
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Toledo, Ricardo Acayaba de
; Grizzo, Felipe Merchan Ferraz
; Fernandes, Vander
; Calheiros, Renato
; Russo, Ricardo T.
; Rosal, Gustavo
; Marchese, Luiz Roberto Delboni
; Tunala, Roberto
; Watanabe, Renato
; Birck, Marina Gabriela
; Julian, Guilherme Silva
; Forestiero, Francisco Jose
.
Abstract Background The aim of this study was to evaluate disease activity among patients with axial spondyloarthritis (AS) treated with tumor necrosis factor inhibitors (TNFi) and/or nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 12 weeks in private outpatient settings in Brazil. Methods This was a cross-sectional, real-world study conducted in 17 Brazilian private health care institutes. Patients were selected if diagnosed with AS or axial radiographic spondyloarthritis (AxSpA) and treated with NSAIDs or TNFi for at least 12 weeks within the last 26 weeks prior to enrollment. The data were collected from interviewed-based and self-administered questionnaires from patients and physicians. Disease activity was defined as active (≥ 4), low /suboptimal (≥ 2 and < 4) and inactive (< 4) by Bath AS Disease Activity Index (BASDAI) and/or very high (≥ 3.5), high (≥ 2.1 to < 3.5), low (≥ 1.3 to < 2.1), and inactive (< 1.3) by AS Disease Activity Score (ASDAS-CRP). Both patients and physicians’ perceptions of disease control were assessed using a numeric rating scale (NRS; 0—inactive to 10—very active disease). Results The cohort included 378 patients with a mean age of 46 years, and the median time since diagnosis until enrollment was 5.4 years (interquartile range 2.7–10.5). Most patients were treated with TNFi alone (74%), followed by TNFi in combination with NSAID (15%), and NSAID alone (11%). About half AS patients showed active disease and 24% of patients showed low activity/suboptimal disease control despite having been treated for at least 12 weeks. Although TNFi showed better disease control than NSAID, inactive disease was experienced by few patients. The NRS (mean [standard deviation]) score for disease perception was 4.24 (3.3) and 2.85 (2.6) for patients and physicians, respectively. Conclusion This real-world study showed that most AS patients on TNFi and/or NSAID had not achieved an adequate disease control, as almost 75% of them exhibited active disease or low activity/suboptimal disease control. There remains a need for improved disease management among patients with AS.
3.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
4.
The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA
; BACCARO, FABRICIO
; CRONEMBERGER, CECILIA
; HIPÓLITO, JULIANA
; BARROS, CLAUDIA FRANCA
; RODRIGUES, DOMINGOS DE JESUS
; NECKEL-OLIVEIRA, SELVINO
; OVERBECK, GERHARD E.
; DRECHSLER-SANTOS, ELISANDRO RICARDO
; ANJOS, MARCELO RODRIGUES DOS
; FERREGUETTI, ÁTILLA C.
; AKAMA, ALBERTO
; MARTINS, MARLÚCIA BONIFÁCIO
; TOMAS, WALFRIDO MORAES
; SANTOS, SANDRA APARECIDA
; FERREIRA, VANDA LÚCIA
; CUNHA, CATIA NUNES DA
; PENHA, JERRY
; PINHO, JOÃO BATISTA DE
; SALIS, SUZANA MARIA
; DORIA, CAROLINA RODRIGUES DA COSTA
; PILLAR, VALÉRIO D.
; PODGAISKI, LUCIANA R.
; MENIN, MARCELO
; BÍGIO, NARCÍSIO COSTA
; ARAGÓN, SUSAN
; MANZATTO, ANGELO GILBERTO
; VÉLEZ-MARTIN, EDUARDO
; SILVA, ANA CAROLINA BORGES LINS E
; IZZO, THIAGO JUNQUEIRA
; MORTATI, AMANDA FREDERICO
; GIACOMIN, LEANDRO LACERDA
; ALMEIDA, THAÍS ELIAS
; ANDRÉ, THIAGO
; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA
; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA
; MESSIAS, MARILUCE REZENDE
; MARQUES, MARCIA C.M.
; PADIAL, ANDRE ANDRIAN
; MARQUES, RENATO
; BITAR, YOUSZEF O.C.
; SILVEIRA, MARCOS
; MORATO, ELDER FERREIRA
; PAGOTTO, RUBIANI DE CÁSSIA
; STRUSSMANN, CHRISTINE
; MACHADO, RICARDO BOMFIM
; AGUIAR, LUDMILLA MOURA DE SOUZA
; FERNANDES, GERALDO WILSON
; OKI, YUMI
; NOVAIS, SAMUEL
; FERREIRA, GUILHERME BRAGA
; BARBOSA, FLÁVIA RODRIGUES
; OCHOA, ANA C.
; MANGIONE, ANTONIO M.
; GATICA, AILIN
; CARRIZO, MARÍA CELINA
; RETTA, LUCÍA MARTINEZ
; JOFRÉ, LAURA E.
; CASTILLO, LUCIANA L.
; NEME, ANDREA M.
; RUEDA, CARLA
; TOLEDO, JOSÉ JULIO DE
; GRELLE, CARLOS EDUARDO VIVEIROS
; VALE, MARIANA M.
; VIEIRA, MARCUS VINICIUS
; CERQUEIRA, RUI
; HIGASHIKAWA, EMÍLIO MANABU
; MENDONÇA, FERNANDO PEREIRA DE
; GUERREIRO, QUÊZIA LEANDRO DE MOURA
; BANHOS, AUREO
; HERO, JEAN-MARC
; KOBLITZ, RODRIGO
; COLLEVATTI, ROSANE GARCIA
; SILVEIRA, LUÍS FÁBIO
; VASCONCELOS, HERALDO L.
; VIEIRA, CECÍLIA RODRIGUES
; COLLI, GUARINO RINALDI
; CECHIN, SONIA ZANINI
; SANTOS, TIAGO GOMES DOS
; FONTANA, CARLA S.
; JARENKOW, JOÃO A.
; MALABARBA, LUIZ R.
; RUEDA, MARTA P.
; ARAUJO, PUBLIO A.
; PALOMO, LUCAS
; ITURRE, MARTA C.
; BERGALLO, HELENA GODOY
; MAGNUSSON, WILLIAM E.
.
Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.
https://doi.org/10.1590/0001-3765202120201604
1034 downloads
5.
Biosafety in Dental Practices Versus COVID-19 Outbreak
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Santos, Ingrid Garcia
; Souza, Vívian Gonçalves Carvalho
; Silva, Guilherme Thomaz Verly da
; Lourenço, Aneliese Holetz de Toledo
; Laxe, Laísa Araujo Cortines
; Apolônio, Ana Carolina Morais
.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
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ABSTRACT Objective: To evaluate the dentists' knowledge about biosafety considering the SARS-CoV-2 and the risks of increasing the COVID-19 outbreak by dental practices during the pandemic in Brazil. Material and Methods: A cross-sectional study was performed by internet-based snowball sampling technique. A questionnaire with questions about different content was applied, and then analyzed the following two parameters: participants' Brazilian region and professional's specialty. Results: A total of 413 e-questionnaires from all Brazilian regions were considered valid. There were no significant differences among biosafety measures adopted by participants from different Brazilian regions (p≥0.05), except for those from North region, which have applied less previous oral antisepsis, temperature screening, and specific anamnesis tracking COVID-19 symptoms (p<0.05). The unique use of N95 mask was positively associated with North region (p<0.05). Expert participants of Groups 2 (oral surgery and correlate areas) and 4 (orthodontics, oral radiology and facial jaw orthopedics) were more updated than other ones (p<0.05). Conclusion: The biosafety protocols applied by participants were not adequate for the epidemiologic status of COVID-19 in each region of Brazil, from 13th May to 17th June 2020. Specialties linked to microbiology area or structured social networks have better applied preventive measures for COVID-19.
https://doi.org/10.1590/pboci.2021.034
486 downloads
6.
Profiling the Cymbopogon nardus Ethanol Extract and Its Antifungal Potential against Candida Species with Different Patterns of Resistance
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Toledo, Luciani G. de
; Ramos, Matheus A. S.
; Spósito, Larissa
; Castilho, Elza M.
; Pavan, Fernando R.
; Lopes, Érica O.
; Silva, Isabel C. da
; Zocolo, Guilherme J.
; Ribeiro, Paulo R. V.
; Oda, Fernando B.
; Pereira, Juhan A. S.
; Santos, André G. dos
; Bauab, Taís M.
; Almeida, Margarete T. G. de
.
Journal of the Brazilian Chemical Society
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The essential oil of Cymbopogon nardus, citronella, has been extensively studied. However, the chemical and biological properties of the ethanolic extract (EE) of C. nardus have not been evaluated. The aim of this study was to characterize the chemical composition of the EE of C. nardus and its active fraction (FrD). Moreover, the cytotoxic and antifungal properties of these extracts against Candida species with different resistance profiles to conventional drugs were evaluated. The compounds identified in EE were mono-C- and di-C-glycosyl flavones and phenylpropanoid glycosides. Phenylpropanoid glycosides were identified in FrD. EE showed antifungal activity, with minimum inhibitory concentration (MIC) values ranging from 62. 5 to 500 µg mL-1. FrD was more effective against C. glabrata, as evidenced by the lowest MIC value (15. 6 µg mL-1). EE inhibited yeast growth similar to amphotericin-B, as demonstrated by similar time-kill curves. EE inhibited C. albicans hyphae formation and mature biofilm of C. albicans, C. krusei and C. parapsilosis. The results of the chemical and biological analyses of EE and its fractions provided novel information and may contribute to control of infections caused by Candida species.
https://doi.org/10.21577/0103-5053.20200093
454 downloads
7.
Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil
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Silva Júnior, João Manoel
; Chaves, Renato Carneiro de Freitas
; Corrêa, Thiago Domingos
; Assunção, Murillo Santucci Cesar de
; Katayama, Henrique Tadashi
; Bosso, Fabio Eduardo
; Amendola, Cristina Prata
; Serpa Neto, Ary
; Malbouisson, Luiz Marcelo Sá
; Oliveira, Neymar Elias de
; Veiga, Viviane Cordeiro
; Rojas, Salomón Soriano Ordinola
; Postalli, Natalia Fioravante
; Alvarisa, Thais Kawagoe
; Lucena, Bruno Melo Nobrega de
; Oliveira, Raphael Augusto Gomes de
; Sanches, Luciana Coelho
; Silva, Ulysses Vasconcellos de Andrade e
; Nassar Junior, Antonio Paulo
; Réa-Neto, Álvaro
; Amaral, Alexandre
; Teles, José Mário
; Freitas, Flávio Geraldo Rezende de
; Bafi, Antônio Tonete
; Pacheco, Eduardo Souza
; Ramos, Fernando José
; Vieira Júnior, José Mauro
; Pereira, Maria Augusta Santos Rahe
; Schwerz, Fábio Sartori
; Menezes, Giovanna Padoa de
; Magalhães, Danielle Dourado
; Castro, Cristine Pilati Pileggi
; Henrich, Sabrina Frighetto
; Toledo, Diogo Oliveira
; Parra, Bruna Fernanda Camargo Silva
; Dias, Fernando Suparregui
; Zerman, Luiza
; Formolo, Fernanda
; Nobrega, Marciano de Sousa
; Piras, Claudio
; Piras, Stéphanie de Barros
; Conti, Rodrigo
; Bittencourt, Paulo Lisboa
; D’Oliveira, Ricardo Azevedo Cruz
; Estrela, André Ricardo de Oliveira
; Oliveira, Mirella Cristine de
; Reese, Fernanda Baeumle
; Motta Júnior, Jarbas da Silva
; Câmara, Bruna Martins Dzivielevski da
; David-João, Paula Geraldes
; Tannous, Luana Alves
; Chaiben, Viviane Bernardes de Oliveira
; Miranda, Lorena Macedo Araújo
; Brasil, José Arthur dos Santos
; Deucher, Rafael Alexandre de Oliveira
; Ferreira, Marcos Henrique Borges
; Vilela, Denner Luiz
; Almeida, Guilherme Cincinato de
; Nedel, Wagner Luis
; Passos, Matheus Golenia dos
; Marin, Luiz Gustavo
; Oliveira Filho, Wilson de
; Coutinho, Raoni Machado
; Oliveira, Michele Cristina Lima de
; Friedman, Gilberto
; Meregalli, André
; Höher, Jorge Amilton
; Soares, Afonso José Celente
; Lobo, Suzana Margareth Ajeje
.
RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.
ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.
https://doi.org/10.5935/0103-507x.20200005
1048 downloads
8.
Anurans of the Caparaó National Park and surroundings, southeast Brazil
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Zornosa-Torres, Camila
; Augusto-Alves, Guilherme
; Lyra, Mariana L.
; Silva Júnior, José Cassimiro da
; Garcia, Paulo C.A.
; Leite, Felipe
; Verdade, Vanessa
; Rodrigues, Miguel T.
; Gasparini, João Luiz
; Haddad, Célio F.B.
; Toledo, Luís Felipe
.
Resumo A Mata Atlântica (MA) é considerada um dos hotspots de biodiversidade do mundo, sendo o bioma mais degradado no Brasil. Este bioma compreende muitas fitofisionomias, como floresta ombrófila, semidecidual, e campos de altitude. Esta complexidade, aliada à enorme variação latitudinal e altitudinal, disponibiliza habitats e condições diversas à especiação dos anfíbios. Como resultado, atualmente são conhecidas mais de 600 espécies de anfíbios que ocorrem na MA. Dentro deste bioma o Parque Nacional do Caparaó (PNC) é relevante, pois inclui o ponto mais alto da Mata Atlântica, o Pico da Bandeira com cerca de 3000 m de elevação, assim como diferentes fitofisionomias, como campos rupestres e florestas úmidas. Apesar disso, sua fauna de anfíbios é ainda pobremente descrita. Realizamos inventários de anfíbios no PNC e entorno de 2016 a 2018 e registramos 47 espécies de anuros, das quais duas são endêmicas e pelo menos seis ainda não foram descritas. Adicionalmente, compilamos dados de coletas anteriores (2004 a 2008) e dados secundários de coleções científicas. Ao juntar todos os dados registramos um total de 61 espécies de anuros de 12 famílias para o PNC e arredores, colocando esta área entre as 10 áreas mais ricas em anfíbios da MA. Algumas destas espécies estão representadas apenas por um ou dois exemplares em coleções e não foram registradas no PNC desde a década de 1980, como Thoropa lutzi e Hylodes vanzolinii. Estas espécies podem ser exemplos de declínios populacionais ou mesmo de extinções locais, destacando a necessidade de maiores esforços amostrais neste local altamente biodiverso.
Abstract The Atlantic Forest (AF) is one of the biodiversity hotspots of the world, and the most fragmented biome of Brazil. This biome includes different phytophysiognomies, as riparian, slope, cloudy forests, and grasslands. Such complexity, allied to huge latitudinal and high elevational range, provides diverse habitats and conditions for amphibian speciation. As a result, there are over 600 amphibian species known to occur in the AF. Within this biome the Caparaó National Park (CNP) is relevant, as it includes the highest peak of the biome, the Pico da Bandeira at almost 3,000 m above sea level, as well as different phytophysiognomies as rocky fields and humid forests. In spite of that, its amphibian fauna is still poorly described. We inventoried amphibians at the CNP and surrounding areas from 2016 to 2018 and recorded 47 anuran species, of which two are locally endemic and at least six have not been described yet. Additionally, we compiled data from previous surveys (2004 to 2008) and secondary data from scientific collections. All together, we registered a total of 61 anuran species from 12 families for the CNP and surroundings, placing this area among the 10 amphibian richest sites in the AF. Some of these species are represented by only one or two collected specimens and have not been registered in the CNP since the 1980’s, such as Thoropa lutzi and Hylodes vanzolinii. These species could be examples of population declines or even past local extinctions, highlighting the need of further sampling efforts in that highly biodiverse site.
https://doi.org/10.1590/1676-0611-bn-2019-0882
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9.
Influence of initial CaO/SiO2 ratio on the hydration of rice husk ash-Ca(OH)2 and sugar cane bagasse ash-Ca(OH)2 pastes
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Souza, Lourdes Maria Silva de
; Fairbairn, Eduardo de Moraes Rego
; Toledo Filho, Romildo Dias
; Cordeiro, Guilherme Chagas
.
This work presents the results of a study on the hydration of pastes containing calcium hydroxide and either rice husk ash (RHA) or sugar cane bagasse ash (SCBA) in various initial CaO/SiO2 molar ratios. The products of the reactions were characterized by thermal analyses X-ray diffraction, and scanning electron microscopy. In the case of the RHA pastes, the product was composed of CaO-SiO2-H2O (type I C-S-H) or CaO-SiO2-H2O (type II C-S-H) according to the CaO/SiO2 ratio of the mixture. In contrast, in the case of the SBCA pastes, the product was composed primarily of CaO-SiO2-H2O that differed from both the previous types; the product also contained inclusions of calcium aluminate hydrates.
https://doi.org/10.5935/0100-4042.20140258
3367 downloads
10.
Using genetic diversity information to establish core collections of Stylosanthes capitata and Stylosanthes macrocephala
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Santos-Garcia, Melissa Oliveira
; Toledo-Silva, Guilherme de
; Sassaki, Rodrigo Possidonio
; Ferreira, Thais Helena
; Resende, Rosângela Maria Simeão
; Chiari, Lucimara
; Karia, Cláudio Takao
; Carvalho, Marcelo Ayres
; Faleiro, Fábio Gelape
; Zucchi, Maria Imaculada
; Souza, Anete Pereira de
.
Stylosanthes species are important forage legumes in tropical and subtropical areas. S. macrocephala and S. capitata germplasm collections that consist of 134 and 192 accessions, respectively, are maintained at the Brazilian Agricultural Research Corporation Cerrados (Embrapa-Cerrados). Polymorphic microsatellite markers were used to assess genetic diversity and population structure with the aim to assemble a core collection. The mean values of H O and H E for S. macrocephala were 0.08 and 0.36, respectively, whereas the means for S. capitata were 0.48 and 0.50, respectively. Roger's genetic distance varied from 0 to 0.83 for S. macrocephala and from 0 to 0.85 for S. capitata. Analysis with STRUCTURE software distinguished five groups among the S. macrocephala accessions and four groups among those of S. capitata. Nei's genetic diversity was 27% in S. macrocephala and 11% in S. capitata. Core collections were assembled for both species. For S. macrocephala, all of the allelic diversity was represented by 23 accessions, whereas only 13 accessions were necessary to represent all allelic diversity for S. capitata. The data presented herein evidence the population structure present in the Embrapa-Cerrados germplasm collections of S. macrocephala and S. capitata, which may be useful for breeding programs and germplasm conservation.
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Cited 2 times in SciELO
11.
Antropometria e somatotipo: fatores determinantes na seleção de atletas no voleibol brasileiro
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Cabral, Breno Guilherme de Araujo T.
; Cabral, Suzet de Araujo Tinôco
; Toledo, Isabella Vianna R. G.
; Dantas, Paulo Moreira Silva
; Miranda, Hênio Ferreira de
; Knakcfuss, Maria Irany
.
Objetivo: Analisar a antropometria e somatotipo de atletas do voleibol brasileiro. Metodologia: a amostra foi composta por 54 atletas convocadas para as seleções nacionais, sendo 16 da adulta (25,6±5,3anos), 17 da juvenil (17,89±0,32 anos) e 21 da infanto-juvenil (15,86±0,36 anos). Para o somatotipo utilizou-se o método de Heath e Carter. O tratamento estatístico utilizado foi o descritivo com valores de tendência central e seus derivados, e o inferencial ANOVA e post hoc de Tukey. Para o somatotipo recorreu-se ao cálculo da distância espacial entre os somatótipos (DES). Resultados: A variável estatura não apresenta diferença significativa entre as seleções, somente entre as posições de jogo. O somatotipo da seleção infanto-juvenil foi diferente das demais. A seleção adulta classificou-se como ectomorfo-mesomorfo (2,24/3,16/3,58), juvenil como central (3,12/3,40/3,30) e infanto-juvenil como ecto-endomorfico (3,07/2,25/3,81). Conclusão: a estatura e linearidade são variáveis importantes na seleção de atletas para o alto rendimento.
Objective: analyze the anthropometry and somatotype of Brazilian volleyball athletes. Methods: The sample was composed of 54 athletes convened for the national selections, 16 of the adult (25.6 ± 5, 3anos), 17 of juvenile (17.89 ± 0,32anos) and 21 under 17 (15.86 ± 0, 36anos). Heath and Carter Somatotype Method was used to collect somatotype. The statistical treatment used was descriptive with values of central tendency and derivates and the inferential ANOVA one-way and post hoc of Tukey. The spatial distance between the somatotypes (DES) was used to calculate the somatotype. Results: the height variable wasn't different between the selections, however, this difference is evident between the positions of the game. The somatotype of under 17 selection was different from the others.The adult selection was classified as ectomorphic-mesomorph (2.24 / 3,16 / 3.58), the juvenile as central (3.12 / 3.40 / 3.30) and under 17 as ecto-endomorphic (3.07 /2.25 / 3.81). Conclusion: the height and linearity are important variables in the selecions of athletes for high performance.
Objetivo: analizar la antropometría y el somatotipo de atletas del voleibol brasileño. Métodos: la muestra fue composta de 54 atletas convocadas a las selecciones nacionales, com 16 de la adulta (25,6±5,3anos) 17 de la juvenil (17,89±0,32anos) y 21 de la infanto-juvenil (15,86±0,36anos). Para el somatotipo se ha utilizado el método de Heath y Carter. El análisis estadístico utilizado fue el de los valores descriptivos de tendencia central y de sus derivados, inferencial y ANOVA one-way y post hoc de Tukey. Para el somatotipo se utiliza para calcular la distancia espacial entre el somatotipo (DES). Resultados: la variable de la altura no es significativamente diferente entre los equipos, sólo entre las posiciones del juego. El somatotipo de la selección infanto-juvenil fue distinto a las demás selecciones. La selecione adulta se clasificó como ectomorfo-mesomorfo (2,24/3,16/3,58), juvenil como central (3,12/3,40/3,30) e infanto-juvenil como ecto-endomorfico (3,07/2,25/3,81). Conclusíon: La estatura y linearidade son variables importantes en la selección de atletas para el alto rendimiento.
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12.
Mensuração de pressão venosa central por meio de cateteres venosos central e periférico: comparação entre os valores obtidos em cães e elaboração de índice de correção
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Aguiar, Eduardo Santiago Ventura de
; Dallabrida, Ademar Luiz
; Bopp, Simone
; Rocha, Guilherme Lages Savassi
; França, Evandro Pezzini
; Fonseca, Érika Toledo da
; Dalmolin, Fabíola
; Demori, Gustavo
; Silva, José Henrique Souza da
; Raiser, Alceu Gaspar
.
A Pressão Venosa Central (PVC) é a pressão de retorno do sangue ao lado direito do coração e é um importante parâmetro a ser aferido em numerosas situações clínicas, cirúrgicas e experimentais. Para sua realização, utiliza-se um Cateter Venoso Central (CVC) aplicado na veia jugular. Em virtude de este ser um aparato intravenoso de alto custo, optou-se por testar a validade de se aferir a PVC com um Cateter Venoso Periférico (CVP) aplicado à mesma veia, o qual apresenta custo reduzido. Como resultado, a medida da PVC, tomada com o CVC, deve sofrer um índice de redução, chegando-se, assim, ao valor da PVC que seria obtido com o uso do CVC. Os resultados deste estudo permitem concluir que o CVP é apropriado para a aferição da PVC em cães.
The Central Venous Pressure (CVP) is a very important pattern for monitorization in many clinical, surgical and experimental procedures, and it reflects the blood pressure that returns to the right heart side. For its measurement a Central Venous Catheter (CVC) must be used inside the jugular vein. Because of the high cost of the CVC, an option was taken to measure the CVP with a Peripheric Venous Catheter (PVC) inside the jugular vein, with low cost. The CVP measure obtained with the PVC must be subtracted to a reduction index, in this way the measure would correspond to the ones done with the CVC. This study alouds to conclude that the PVC is adequate for CVP measurement in dogs.
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