Pesquisa | SciELO

Resumo O aleitamento materno (AM) é um direito humano e deve ser iniciado desde o nascimento. A adequação das estratégias da Rede Cegonha (RC) pode contribuir na promoção do AM. O objetivo foi identificar os fatores associados ao AM na primeira e nas 24 horas de nascidos vivos a termo em maternidades vinculadas à RC. Estudo transversal com dados do segundo ciclo avaliativo 2016-2017 da RC, que abrangeu todo o Brasil. Foram obtidas razões de chance por meio de regressão logística binária segundo modelo hierarquizado, com intervalos de confiança a 95% e p-valor < 0,01. A prevalência de AM na primeira hora foi de 31%, e nas 24 horas, de 96,6%. Aumentaram as chances de AM na primeira hora: presença de acompanhante na internação, contato pele a pele, parto vaginal, assistência ao parto por enfermeira e acreditação da unidade na Iniciativa Hospital Amigo da Criança. Resultados semelhantes nas 24 horas, e associação com idade materna inferior a 20 anos. O AM na primeira hora foi menos satisfatório do que nas 24h, provavelmente pela elevada prevalência de cesariana, fator associado à menor chance de AM precoce. A capacitação dos profissionais sobre AM de forma contínua e a presença de enfermeiro obstetra no parto são recomendadas para ampliar o AM na primeira hora.

Abstract Breastfeeding (BF) is a human right, and it must start from birth. The adequacy of Rede Cegonha (RC) strategies can contribute to the promotion of BF. The objective was to identify factors associated with BF in the first and 24 hours of live births at full-term maternity hospitals linked to CR. Cross-sectional study with data from the second evaluation cycle 2016-2017 of the RC that covered all of Brazil. Odds ratios were obtained through binary logistic regression according to a hierarchical model, with 95% confidence intervals and p-value < 0.01. The prevalence of BF in the first hour was 31% and in the 24 hours 96.6%. The chances of BF in the first hour increased: presence of a companion during hospitalization, skin-to-skin contact, vaginal delivery, delivery assistance by a nurse and accreditation of the unit in the Baby-Friendly Hospital Initiative. Similar results at 24 hours, and association with maternal age below 20 years. BF in the first hour was less satisfactory than in the 24 hours, probably due to the high prevalence of cesarean sections, a factor associated with a lower chance of early BF. Continuous training of professionals about BF and the presence of an obstetric nurse during childbirth are recommended to expand BF in the first hour.

https://doi.org/10.1590/1413-81232024294.04332023

Trends in the epidemiological and microbiological profiles of infectious keratitis in southeastern Brazil
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Freitas, Carolina Saliba de

; Mesquita, Marcelo Oliveira

; Sasaki, Mayara Seyko Kaczorowski

; Azevedo, Alice Zaidan

; Veloso, Artur Willian Caldeira Abreu

; Tanure, Marco Antônio Guarino

; Vasconcelos-Santos, Daniel Vítor

Arquivos Brasileiros de Oftalmologia

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Jul 2023, Volume 86 Nº 4 Páginas 345 - 352

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients’ (3.1% of the total) endophthalmitis evolving to evisceration. The patients’ microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis.

RESUMO Objetivo: Investigar a susceptibilidade a antibióticos, o perfil clínico, epidemiológico e microbiológico das ceratites infecciosas. Métodos: Estudo retrospectivo longitudinal. Registros médicos e laboratoriais de 2015 a 2019 foram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-positivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente.

https://doi.org/10.5935/0004-2749.20230050

Determinants of the clinical presentation of acute coronary syndromes
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de Abreu, Maximiliano

; Zylberman, Marcelo

; Vensentini, Natalia

; Gagliardi, Juan A.

; Doval, Hernán

; Tajer, Carlos

Medicina (Buenos Aires)

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Abr 2023, Volume 83 Nº 1 Páginas 35 - 45

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: Existen dos formas de presentación clínica de los síndromes coronarios agudos (SCA): con elevación del segmento ST (SCACEST) y sin elevación (SCASEST). Los mecanismos que determi nan ambas presentaciones no se conocen completamente. El objetivo del estudio fue definir la asociación entre factores de riesgo cardiovascular y otras variables clínicas con la presentación de los SCA como SCACEST o SCASEST. Métodos: Analizamos información de pacientes incluidos prospectivamente en el Registro Epi-Cardio con diagnóstico de SCA desde abril de 2006 a abril de 2018.Se incluyeron un total de 10 019 pacientes. Resul tados: En el análisis multivariado, el sexo masculino (OR 1.5) y el tabaquismo activo (OR 1.71) se asociaron positivamente con el SCACEST. Contrariamente, la hipertensión (OR 0.71), las dislipidemias (OR 0.74), la edad (OR 0.97 por quintilo), historia de infarto (OR 0.57), angina crónica (OR 0.44), presencia de comorbilidades (OR 0.64), y la extensión de enfermedad coronaria (OR 0.84) se asociaron negativamente con el SCACEST. Las mujeres presentaron mayor incidencia de SCASEST, debido a una mayor proporción de SCA sin obstrucción coronaria significativa. Conclusión: Concluimos que algunos factores de riesgo cardiovascular y otras variables clínicas se asociaron independientemente con la presentación clínica como SCACEST o SCASEST, confirmando su influencia en la fisiopatología y en la presentación clínica y electrocardiográfica de los SCA.

Abstract Introduction: Two clinical presentations of acute coronary syndrome (ACS) have been defined: ST- segment elevation ACS (STEACS) or non-ST-segment elevation ACS (NSTEACS). The mecha nism that determines the clinical presentation of ACS is not clearly understood. The aim of this study was to define the association between cardiovascular risk factors and other clinical variables with the clinical presentation of ACS as STEACS or NSTEACS. Methods: We analyzed data of patients prospectively included in the Epi-Cardio Registry with a diagnosis of ACS from April 2006 to April 2018. A total of 10 019 patients were included in the study. Results: In the multivariate analysis, male sex (OR 1.5) and active smoking (OR 1.71) were positively associated with STEACS presentation. Conversely, hypertension (OR 0.71), dyslipidemia (OR 0.74), age (OR 0.97 per quintile), history of myocardial infarction (OR 0.57), chronic angina (OR 0.44), presence of comorbidities (OR 0.64), and extension of coronary heart disease (OR 0.84) were negatively associated with STEACS. Women differed from men by presenting a higher incidence of NSTEACS, due to a greater proportion of ACS without obstructive coronary heart disease. Conclusion: Some cardiovascular risk factors and other clinical variables are independently associated with the presentation of ACS as ST EACS or NSTEACS. These findings confirm the influence of risk factors and clinical history on the pathophysiology, clinical and electrocardiographic presentation of ACS.

Evaluation of functionality and socioeconomic status of patients with chronic pain
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Costa, Michelle dos Santos Severino

; Gomez, Renato Santiago

; Lages, Gustavo Rodrigues Costa

; Américo, Ariel de Freitas Quintão

; Abreu, Joao Marcelo Guimarães de

; Faria, Fernanda Ribeiro

; Azevedo, Letícia Maia

Revista da Associação Médica Brasileira

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Fev 2023, Volume 69 Nº 2 Páginas 308 - 313

Resumo: En | Texto: En | PDF: En

SUMMARY OBJECTIVE: This study aimed to evaluate the influence of chronic pain on functionality and its consequences on work and patient income. METHODS: A total of 103 patients from the Multidisciplinary Pain Center of the Clinics Hospital of Universidade Federal de Minas Gerais were interviewed between January 2020 and June 2021, applying questionnaires on mobile devices. Socioeconomic data, multidimensional characterization of pain, and instruments for assessing pain functionality and intensity were analyzed. Pain intensity was categorized as mild, moderate, or intense for comparative analysis. Ordinal logistic regression was used to identify risk factors and variables that jointly influence the outcome of pain intensity. RESULTS: The patients had a median age of 55 years, were predominantly female, married or in a stable relationship, white race, and completed high school. The median family income was R$2,200. Most patients were retired due to disability and pain-related causes. Functionality analysis showed severe disability directly associated with pain intensity. The financial impacts observed were correlated with the pain intensity of the patients. Age was a risk factor for pain intensity, while sex, family income, and duration of pain served as protective factors. CONCLUSION: Chronic pain was associated with severe disability, decreased productivity, and exit from the labor market, with a negative impact on financial condition. Age, sex, family income, and duration of pain were directly associated with pain intensity.

https://doi.org/10.1590/1806-9282.20221093

O artesanato do cuidar: encontros, narrativas e memórias no campo da Saúde Coletiva
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Maciel, Marcelo de Abreu

Cadernos de Saúde Pública

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2023, Volume 39 Nº 4 elocation e00028723

Resumo: Pt | Texto: Pt | PDF: Pt

https://doi.org/10.1590/0102-311xpt028723

PROGNOSTIC FACTORS OF LIVER TRANSPLANTATION FOR ACUTE-ON-CHRONIC LIVER FAILURE
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CRONST, Jane

; PREDIGER, Lucas

; PINTO, Marcelo Abreu

; FERRAZ, Julia

; MATTOS, Angelo Zamban de

; ALVARES-DA-SILVA, Mario Reis

; KRUEL, Cleber Rosito Pinto

; CHEDID, Marcio Fernandes

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2023, Volume 36 elocation e1779

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT BACKGROUND: Liver transplantation (LT) is the only treatment that can provide long-term survival for patients with acute-on-chronic liver failure (ACLF). Although several studies identify prognostic factors for patients in ACLF who do not undergo LT, there is scarce literature about prognostic factors after LT in this population. AIM: Evaluate outcomes of ACLF patients undergoing LT, studying prognostic factors related to 1-year and 90 days post-LT. METHODS: Patients with ACLF undergoing LT between January 2005 and April 2021 were included. Variables such as chronic liver failure consortium (CLIF-C) ACLF values and ACLF grades were compared with the outcomes. RESULTS: The ACLF survival of patients (n=25) post-LT at 90 days, 1, 3, 5 and 7 years, was 80, 76, 59.5, 54.1 and 54.1% versus 86.3, 79.4, 72.6, 66.5 and 61.2% for patients undergoing LT for other indications (n=344), (p=0.525). There was no statistical difference for mortality at 01 year and 90 days among patients with the three ACLF grades (ACLF-1 vs. ACLF-2 vs. ACLF-3) undergoing LT, as well as when compared to non-ACLF patients. CLIF-C ACLF score was not related to death outcomes. None of the other studied variables proved to be independent predictors of mortality at 90 days, 1 year, or overall. CONCLUSIONS: LT conferred long-term survival to most transplant patients. None of the studied variables proved to be a prognostic factor associated with post-LT survival outcomes for patients with ACLF. Additional studies are recommended to clarify the prognostic factors of post-LT survival in patients with ACLF.

RESUMO RACIONAL: O transplante hepático (TH) é o único tratamento a proporcionar sobrevida a longo prazo para pacientes com “acute-on-chronic liver failure” (ACLF). Vários estudos identificaram fatores prognósticos para pacientes em ACLF que não realizam TH, porém há poucos dados na literatura sobre fatores prognósticos nessa população transplantada. OBJETIVOS: Avaliar desfechos de pacientes ACLF submetidos a TH, e seus preditores de mortalidade. MÉTODOS: Foram avaliados pacientes em ACLF submetidos a TH entre janeiro de 2005 e abril de 2021. Variáveis como valores CLIF-C ACLF e pontuação no ACLF foram comparadas com os desfechos. RESULTADOS: A sobrevida de ACLF pós TH de pacientes (n=25) em 90 dias, 1, 3, 5 e 7 anos, foi de 80, 76, 59,5, 54,1 e 54,1% versus 86,3, 79,4, 72,6, 66,5 e 61,2% para pacientes submetidos a TH por outras indicações (n=344), (p=0,525). Não houve diferença estatística para mortalidade em 01 ano e 90 dias entre pacientes com os três graus de ACLF (ACLF-1 vs. ACLF-2 vs. ACLF-3), bem como quando comparados a pacientes não ACLF. O escore “chronic liver failure consortium” (CLIF-C) ACLF não se correlacionou com desfechos de óbito. Nenhuma das outras variáveis estudadas mostrou-se preditora independente de mortalidade em 90 dias, após um ano ou global. CONCLUSÕES: TH conferiu sobrevida em longo prazo à maioria dos pacientes transplantados, semelhante aos pacientes submetidos à TH por outras indicações. Nenhuma das variáveis estudadas mostrou-se fator prognóstico associado a desfechos de sobrevida pós-TH para pacientes com ACLF. Estudos adicionais são necessários para estabelecer fatores prognósticos pós-TH em pacientes com ACLF.

https://doi.org/10.1590/0102-672020230061e1779

Occult hepatitis B virus infection in patients with chronic liver disease of different etiology in a Brazilian referral center: comparison of two different hepatitis B virus deoxyribonucleic acid amplification protocols: a cross-sectional study
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Faria, Alessandra Coutinho de

; Correa, Bernardo Henrique Mendes

; Faria, Luciana Costa

; Vidigal, Paula Vieira Teixeira

; Xavier, Marcelo Antônio Pascoal

; Ferrari, Teresa Cristina Abreu

Sao Paulo Medical Journal

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2023, Volume 141 Nº 3 elocation e2022147

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Occult hepatitis B virus infection (OBI) is defined as the presence of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) in the liver of individuals with undetectable hepatitis B virus surface antigen (HBsAg) in the serum. The actual prevalence of OBI and its clinical relevance are not yet fully understood. OBJECTIVE: To evaluate the prevalence of HBV DNA in liver biopsies of HBsAg-negative patients with chronic liver disease of different etiologies in a referral center in Brazil and compare two different HBV DNA amplification protocols to detect HBV. DESIGN AND SETTING: This cross-sectional observational study was conducted at the Liver Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil, between January 2016 and December 2019. METHODS: HBV DNA was investigated in 104 liver biopsy samples from individuals with chronic liver disease of different etiologies, in whom HBsAg was undetectable in serum by nested-polymerase chain reaction (nested-PCR), using two different protocols. RESULTS: OBI, diagnosed by detecting HBV DNA using both protocols, was detected in 6.7% of the 104 individuals investigated. Both protocols showed a good reliability. CONCLUSION: In addition to the differences in the prevalence of HBV infection in different regions, variations in the polymerase chain reaction technique used for HBV DNA amplification may be responsible for the large variations in the prevalence of OBI identified in different studies. There is a need for better standardization of the diagnostic methods used to diagnose this entity.

https://doi.org/10.1590/1516-3180.2022.0147.r1.12072022

™Small steam turbine operating at low pressure for generating electricity in the Amazon
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Oliveira, Davi Cavalcante de

; Vaz, Jerson Rogério Pinheiro

; Silva, Marcelo de Oliveira e

; Abreu, Edson Bruno Soares de

; Galhardo, Marcos André Barros

; Araújo, Leonam Ferreira de

Matéria (Rio de Janeiro)

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2023, Volume 28 Nº 2 elocation e20230059

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract In the Amazon, local electrical energy production is very important due to the large number of isolated communities, usually far from the conventional grid. In this context, steam turbines are relevant technologies to be used in the region, since waste biomass is widely available in several communities, besides, where sustainable agricultural activities take place, such as the use of açaí seeds, sugarcane bagasse, among others. Currently, there are not many relevant studies in the literature for small steam turbines operating at low pressure, conditioned to the reality of the Amazon region. Hence, the main goal of this work is to develop an experimental study of a small steam turbine operating at low pressure, in order to apply it to small energy demand, typically found in the Amazon. We developed measurements on the behavior of mechanical and electrical powers in relation to the shaft rotational speed of the small steam turbine, taking into account pressures of 0.1, 0.2 and 0.3 MPa. We concluded that the preliminary experimental survey, made in this work, demonstrates a good mechanical behavior of the small turbine and could be an alternative for electricity generation system to supply small demands in isolated communities in the Amazon, taking advantage of biomass from sustainable agricultural activities.

Resumo Na Amazônia, a produção local de energia elétrica é muito importante devido ao grande número de comunidades isoladas, geralmente distantes da rede convencional. Nesse contexto, as turbinas a vapor são tecnologias relevantes a serem utilizadas na região, uma vez que a biomassa está amplamente disponível em diversas comunidades, inclusive, onde ocorrem atividades agrícolas sustentáveis como a utilização do caroço do açaí, bagaço de cana, entre outros. Atualmente, não existem muitos estudos relevantes na literatura para pequenas turbinas a vapor operando em baixa pressão, condicionadas à realidade da região amazônica. Assim, o objetivo principal deste trabalho é desenvolver um estudo experimental de uma pequena turbina a vapor operando em baixa pressão, a fim de aplicá-la a pequenas demandas de energia, tipicamente encontradas na região. Desenvolvemos medições do comportamento das potências mecânica e elétrica em relação à velocidade de rotação do eixo da pequena turbina a vapor, levando em consideração as pressões de 0,1, 0,2 e 0,3 MPa. Concluímos que o levantamento experimental preliminar, feito neste trabalho, demonstra um bom comportamento mecânico da pequena turbina e pode ser uma alternativa para o sistema de geração de energia elétrica suprir pequenas demandas em comunidades isoladas na Amazônia, aproveitando a biomassa oriunda de atividades agrícolas sustentáveis.

https://doi.org/10.1590/1517-7076-rmat-2023-0059

EPIDEMIOLOGICAL PROFILE AND EVOLUTION IN MUSCULOSKELETAL TUMORS AT THE LEVEL OF THE ELBOW
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MAZZOLIN, VINICIUS DE ABREU

; KALLUF, JULIA ROCHA

; OGATA, FIAMA KURODA

; OLIVEIRA, NATHALIA SUNDIN PALMEIRA DE

; GARCIA, JAIRO GRECO

; PETRILLI, MARCELO DE TOLEDO

; KORUKIAN, MARCOS

; VIOLA, DAN CARAI MAIA

Acta Ortopédica Brasileira

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2023, Volume 31 Nº 1 elocation e261309

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To present the epidemiological profile of bone and soft tissue tumors that affect the elbow region treated at an oncology referral center in Brazil. Methods: Retrospective observational case series study to evaluate the results of elbow cancer undergoing clinical and/or surgical treatment with the first visit from 1990 to 2020. The dependent variables were benign bone tumor, malignant bone tumor, benign soft tissue tumor, malignant soft tissue tumor. Independent variables were sex, age; presence of symptoms (pain/increase in local volume/fracture); diagnosis; treatment and recurrence. Results: In total, 37 patients were included, 51.35% of whom were female, with a mean age at diagnosis of 33.5 years. Soft tissue neoplasms correspond to 51% of cases against 49% of bone tumors. Among the symptoms, the general prevalence of pain was 56.75%, the general increase in local volume occurred in 54.04% of the patients and the presence of fractures in 13.43%. Surgical treatment occurred in 75.67% of cases and recurrence in 16.21% of cases. Conclusion: The tumors that affect the elbow in our series correspond mostly to benign tumors, involving bone or soft tissues, with a higher occurrence in young adult patients. Level of Evidence IV, Case Series.

RESUMO Objetivo: Apresentar o perfil epidemiológico dos tumores ósseos e de partes moles que acometem a região do cotovelo. Métodos: Estudo observacional retrospectivo de série de casos para avaliação dos resultados de neoplasia do cotovelo submetidos a tratamento clínico e/ou cirúrgico cujo primeiro atendimento se deu entre 1990 e 2020. As variáveis dependentes foram: tumor ósseo benigno, tumor ósseo maligno, tumor de partes moles benigno, tumor de partes moles maligno. A variáveis independentes foram: sexo; idade; presença de sintomas (dor, aumento de volume local, fratura); lateralidade; diagnóstico; tratamento; e recidiva. Resultados: Foram incluídos 37 pacientes, sendo 51,35% do sexo feminino, com média de idade ao diagnóstico de 33,5 anos. As neoplasias de partes moles correspondem a 51% dos casos contra 49% de tumores ósseo. Dentre os sintomas a prevalência geral de dor foi de 56,75%, foi observado o aumento geral de volume local em 54,04% pacientes e a presença de fraturas em 13,43%. O tratamento cirúrgico ocorreu em 75,67% dos casos e a recidiva em 16,21%. Conclusão: Nesta série, os tumores que acometem o cotovelo são majoritariamente tumores benignos, de acometimento ósseo ou de partes moles, com maior ocorrência em pacientes adultos jovens. Nível de Evidência IV, Série de Casos.

https://doi.org/10.1590/1413-785220233101e261309

10.

Growth and light environment of fruit trees in silvipastoral systems for rearing of dairy herds
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Giustina, Carolina Della

; Carvalho, Carlos Augusto Brandão de

; Carnevalli, Roberta Aparecida

; Romano, Marcelo Ribeiro

; Pereira, Francisco das Chagas de Abreu

Ciência Rural

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2023, Volume 53 Nº 12 elocation e20220017

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT: Silvopastoral systems can have animal welfare and sustainability benefits because trees continually remove carbon from atmosphere, reducing greenhouse effects. Thisstudy identified the most promising fruit trees for inclusion in silvopastoral systems to dairy cattle calves. This experiment was conducted at EmbrapaAgrossilvipastoril, Brazil, between 2014 and 2018. Five silvopastoral systems with fruit trees and ‘Tifton-85’ grass were designed to evaluate tree growth and light environment under the canopies. Data were analyzed using SAS® and PDIFF (P < 0.10). Caja fruit trees had the greatest tree height (5.4 m) and trunk diameter (23.4 cm), while acerola fruit tree had the smallest (1.8 m and 8.3 cm, respectively). At 42 months (drought 2017), caja, cashew, and guava trees had similar heights. Guava trees had the highest light interception (89.3%), both cashew cultivars provided medium levels of shade (50 to 60% LI) and with greater constancy between the rainy and dry seasons. The systems that showed increased light interception during the drought period were those with CCP76 in 2017 and EMB51 in 2018. Higher incidences of wavelengths of the spectral composition of light occurred between the rainfall (2015) and drought (2017) periods, and greater differences in the ratio of red:far red in 2015. By 2018, there were no more differences between the rainy and dry seasons for the spectral composition of light under the tree canopies. Cashews and guava trees have adequate growth and light environment to support silvopastoral systems but Caja and acerola fruit trees showed limitations.

RESUMO: Sistemas silvipastoris beneficiam tanto o bem-estar animal como a sustentabilidade, pois as árvores removem o carbono da atmosfera, reduzindo o efeito estufa. O objetivo foi identificar as fruteiras mais promissoras para inclusão em sistemas silvipastoris. Este experimento foi conduzido na Embrapa Agrossilvipastoril, entre 2014 e 2018. Cinco sistemas silvipastoris com fruteiras e ‘Tifton-85’ foram projetados para avaliar o crescimento das árvores e o ambiente luminoso sob as copas. Os dados foram analisados com SAS® e PDIFF (P < 0,10). As cajazeiras apresentaram as maiores alturas (5,4 m) e maiores diâmetros do tronco (23,4 cm), enquanto as aceroleiras tiveram os menores (1,8 m e 8,3 cm, respectivamente). Aos 42 meses (seca de 2017), cajazeiras, cajueiros e goiabeiras apresentavam alturas semelhantes. As goiabeiras apresentaram a maior interceptação de luz (89,3%), as cultivares de cajueiro proporcionaram níveis médios de sombra (50 a 60% LI) e com maior constância entre as estações chuvosa e seca. Os sistemas que apresentaram maior interceptação de luz durante o período de seca foram aqueles com CCP76 em 2017 e EMB51 em 2018. Maiores incidências de comprimentos de onda da composição espectral da luz ocorreram entre os períodos de chuva (2015) e seca (2017) e maiores diferenças na proporção de vermelho: vermelho distante em 2015. Em 2018, não havia mais diferenças entre as estações chuvosa e seca para a composição espectral da luz sob as copas das árvores. Os cajueiros e as goiabeiras têm crescimento e ambiente luminoso adequado para suportar sistemas silvipastoris, mas as cajazeiras e aceroleiras apresentam limitações.

https://doi.org/10.1590/0103-8478cr20220017

11.

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Resumo: En | Texto: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.

https://doi.org/10.1590/0074-02760220259

12.

Parasitism by Amblyomma rotundatum on Teiidae lizards in the eastern part of the state of Acre, Brazil
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Tojal, Simone Delgado

; Costa, Ivaneide Nunes da

; Aguirre, André de Abreu Rangel

; Martins, Thiago Fernandes

; Labruna, Marcelo Bahia

; Meneguetti, Dionatas Ulises de Oliveira

; Bernarde, Paulo Sérgio

; Cruz, Karoline Silva da

; Lima, Jônatas Machado

; Prolo Júnior, Sergio Luiz

; Camargo, Luís Marcelo de Aranha

Revista Brasileira de Parasitologia Veterinária

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2023, Volume 32 Nº 3 elocation e004923

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract The aim of the present study was to report on the occurrence of parasitism by Amblyomma rotundatum ticks on two species of Teiidae lizards and test the presence of rickettsiae in the collected ticks, in the western Brazilian Amazon region. Ticks were collected in July 2019, from a fragment of terra firme forest in the municipality of Senador Guiomard, Acre, Brazil. Two lizards that were infested by immature stages of ticks were caught using mist net and Tomahawk traps. Ectoparasites were collected manually, and the lizard specimens were identified and released at the same location where they had been caught. Three nymphs and 49 larvae were collected from Ameiva ameiva, while 25 nymphs and nine larvae were collected from Tupinambis cuzcoensis, which are both in the family Teiidae. The ticks were identified morphologically as belonging to the genus Amblyomma. Nymphs were identified at species level through molecular analysis, resulting in the tick species Amblyomma rotundatum. This is the first record of parasitism by the tick A. rotundatum on T. cuzcoensis lizard, and the first report of an association between A. rotundatum and the lizard species A. ameiva and T. cuzcoensis in Acre, in the western part of the Amazon region.

Resumo O objetivo do presente estudo foi relatar a ocorrência de parasitismo por carrapatos Amblyomma rotundatum em duas espécies de lagartos Teiidae, e testar a presença de riquétsias nos carrapatos coletados, na região da Amazônia Ocidental brasileira. Os carrapatos foram coletados em julho de 2019, em um fragmento de floresta de terra firme no município de Senador Guiomard, Acre, Brasil. Dois lagartos infestados por estágios imaturos de carrapatos foram capturados com rede de neblina e armadilhas Tomahawk. Os ectoparasitos foram coletados manualmente, e os espécimes de lagartos foram identificados e soltos no mesmo local onde foram capturados. Três ninfas e 49 larvas foram coletadas de Ameiva ameiva, enquanto 25 ninfas e nove larvas foram coletadas de Tupinambis cuzcoensis, ambas da família Teiidae. Os carrapatos foram identificados morfologicamente como pertencentes ao gênero Amblyomma. As ninfas foram identificadas em nível de espécie por meio de análise molecular, resultando na espécie de carrapato Amblyomma rotundatum. Este é o primeiro registro de parasitismo pelo carrapato A. rotundatum em lagarto T. cuzcoensis, e o primeiro relato de associação entre A. rotundatum e as espécies de lagartos A. ameiva e T. cuzcoensis, no Acre, na parte ocidental da região amazônica.

https://doi.org/10.1590/s1984-29612023050

13.

Influence Of Hulling And Storage Conditions On Maintaining Coffee Quality
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ABREU, GISELLE F.

; ROSA, STTELA D.V.F.

; COELHO, STEFÂNIA V.B.

; PEREIRA, CRISTIANE C.

; MALTA, MARCELO R.

; FANTAZZINI, TATIANA B.

; VILELA, AMANDA L.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Nº 4 elocation e20190612

Resumo: En | Texto: En | PDF: En

Abstract Storage is important in the coffee post-harvest. Determining the maximum period that coffee can remain storaged is important aiming to reduce losses in quality and, consequently, allow the producer to achieve maximum profitability. The aim was to determine the suitable storage period for natural and fully washed coffees, under different conditions. Beans were dried to 11% moisture content after dry processing (natural coffee, dry cherry coffee) and wet processing (parchment coffee, fully washed). Before storage, part of the coffee was hulled and part was not. The coffee was stored under refrigerated air (10ºC and 50% relative humidity) or in an environment at 25ºC. In the periods of 0, 3, 6, and 12 months, samples were taken for sensory, electrical conductivity and tetrazolium evaluation. Refrigerated environment favors conservation of sensory and physiological quality of the natural hulled coffee beans and fully washed coffee. Hulled beans of natural and fully washed coffee stored under refrigerated conditions have the initial quality conserved for up to 12 months and in non-controlled environmental, for up to 3 months. Mechanical damage caused by hulling, associated with the lack of tissue fruit parts, contributes to reduction hulled coffee quality in storage, regardless of the processing.

https://doi.org/10.1590/0001-3765202320190612

14.

The financial impact of neonatal sepsis on the Brazilian Unified Health System
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Abreu, Mariana Ferreira Carvalho Westerstahl de

; Ogata, Joice Fabíola Meneguel

; Fonseca, Marcelo Cunio Machado

; Sansone, Dayan

; Guinsburg, Ruth

Clinics

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2023, Volume 78 elocation 100277

Resumo: En | Texto: En | PDF: En

Abstract Objective To evaluate the hospital cost of newborn infants diagnosed with sepsis from the perspective of the Brazilian Public Health System over 11 years. Method Cross-sectional study that analyzed secondary data from the databases of the Hospital Information System of the Brazilian Public Health System. Infants hospitalized between 0‒29 days after birth with a diagnosis of sepsis from 2008 to 2018 were included. The diagnosis used in the study was the one that the hospital considered the main diagnosis at admission. Costs were analyzed in US dollars and reflected the amount paid by the Brazilian Public Health System to the hospitals for the informed diagnosis upon admission. The costs were evaluated as the total per admission, and they were compared among Brazilian geographic regions, among etiologic agents, and between neonates with the diagnosis of sepsis that survived or died. Results From 2008 to 2018, 47,554 newborns were hospitalized with sepsis (148.04 cases per 100,000 live births), with an average cost of US$ 3345.59 per hospitalization, ranging from US$ 2970.60 in the North region to US$ 4305.03 in the Midwest. Among sepsis with identified agents, the highest mean cost was related to Gram-negative agents, and the lowest to Streptococcus agalactiae sepsis. Patients with sepsis who died had a higher cost than the survivors (t-test; p= 0.046). Conclusions The evaluation of costs related to neonatal sepsis in the country during an 11-year period shows the economic impact of morbidity that may be avoided by improving the quality of neonatal care.

https://doi.org/10.1016/j.clinsp.2023.100277

15.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption
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PAIVA, Saul Martins

; PRADO, Ivana Meyer

; PERAZZO, Matheus França

; GUARNIZO-HERREÑO, Carol C.

; ACEVEDO, Ana Maria

; CASTILLO, Jorge Luis

; ABREU-PLACERES, Ninoska

; GIACAMAN, Rodrigo Andrés

; RICOMINI-FILHO, Antônio Pedro

; MARTIGNON, Stefania

; MALHEIROS, Zilson

; STEWART, Bernal

; BÖNECKER, Marcelo

Brazilian Oral Research

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2023, Volume 37 Supl. 1 elocation e121

Resumo: En | Texto: En | PDF: En

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0121

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