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Prevalence of intestinal parasitic infections versus knowledge, attitudes and practices of male residents in Brazilian urban slums: a cross-sectional study
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Bordignon, Julio Cesar Pegado
; Paulino, Érica Tex
; Silva, Milena Enderson Chagas da
; Alencar, Maria de Fatima Leal
; Gomes, Keyla Nunes Farias
; Sotero-Martins, Adriana
; Santos, José Augusto Albuquerque dos
; Boia, Marcio Neves
; Moraes Neto, Antonio Henrique Almeida de
.
Revista do Instituto de Medicina Tropical de São Paulo
- Métricas do periódico
ABSTRACT Intestinal parasitic infections (IPIs) are neglected diseases caused by helminths and protozoa, with the relationships between parasite, host and environment having the potential to produce high morbidity and incapacity to work and mortality in vulnerable areas. This study assessed the prevalence of IPIs concerning socio-environmental conditions and analyzed the knowledge, attitudes and practices related to these diseases among men living in the slums of Rio de Janeiro city, Rio de Janeiro State, Brazil. A cross-sectional study was conducted in an agglomeration of urban slums between 2018 and 2019, with men aged between 20 and 59 years. A socioeconomic status questionnaire and an IPIs knowledge, attitudes and practices questionnaire (KAPQ) were applied. Coproparasitological diagnoses (n=454) were performed using four methods and samples of water for household consumption (n=392) were subjected to microbiological and physicochemical analysis. A total of 624 participants were enrolled. About 40% of the households had “water unsuitable for consumption”. Only one Major Area, MA 3 was not statistically significant for IPIs (AOR=0.75; 95% CI: 0.30-1.88; p=0.55). The overall prevalence of IPIs was 23.8%. Endolimax nana (n=65, 14.3%) and hookworm (n=8, 1.7%) were the most frequently identified parasites. The analysis of the frequency of responses to the KAPQ has shown that men reported to seeking medical care if they were suspicious of IPIs, and around 35% would self-medicate. The results have shown the need to adopt integrated health education practices targeting male residents in urban slums to qualify the care with water for human consumption and promote self-care about IPIs. The household can be considered strategic for Primary Health Care activities for men.
2.
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
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
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
3.
Fraud with the addition of cow's milk alters the lipid fraction of buffalo mozzarella
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VIANA, Mirelle Pignata
; FERNANDES, Sergio Augusto de Albuquerque
; SILVA, Andréa Gomes da
; PEDREIRA, Márcio dos Santos
; VIANA, Pablo Teixeira
; RODRIGUES, Valdirene Santana
; LACERDA, Ellen Cristina Quirino
.
Abstract The shortage of milk at certain times of the year leads to adulteration of buffalo mozzarella, and these frauds alter the composition of milk and buffalo derivatives. This study describes the dynamics of the adulteration on the nutritional quality of mozzarella. Mozzarella was produced from buffalo milk incorporated with cow milk at 0, 10, 20, 30, 40 and 50% (v/v). The chemical composition, fatty acids profile and cholesterol content of the cheeses were evaluated. The results showed that the fat and protein contents of buffalo cheeses decreased with the addition of cow milk. Furthermore, C4:0, C16:0, C22:0 and C16:1 fatty acids decreased while C8:0 and C10:0 acids fatty acids increased. The most dramatic observation was the elevation of the cholesterol content when cow milk was added. The altered content of short-chain saturated fatty acids and cholesterol content, due to the addition of cow milk to buffalo milk for mozzarella production, modified the nutritional indices. The addition of cow milk to buffalo milk for mozzarella production altered the content of short-chain SFA and the cholesterol content, thereby modifying the nutritional indices.
https://doi.org/10.1590/fst.19619
526 downloads
4.
Effect of spray drying on the fatty acids content and nutritional indices of buffalo powdered milk
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ALVES, Mariana Ferreira
; BORGES, Marília Viana
; FLORÊNCIO FILHO, Daniel
; CHAVES, Modesto Antônio
; LANNA, Dante Pazzanese
; PEDREIRA, Márcio dos Santos
; FERRÃO, Sibelli Passini Barbosa
; FERNANDES, Sérgio Augusto de Albuquerque
.
Abstract The buffalo’s reproductive seasonality determines the decrease in milk and cheese production generating economic losses on the production system. Among various food process, we find the spray-dryer as an essential tool which helps food conservation. We achieved the milk powder in three replicates and each repetition processed 10 L of buffalo milk. After obtaining the final product, three samples (200 g) were packaged for each evaluated storage time (0, 30, 60, 90, 120 and 150 days at room temperature). In this context, we assessed the effects of drying buffalo’s milk by atomization (spray dryer) and storage time effects on the milk fat. We observed that the spray drying did not alter the fatty acid content and nutritional indices evaluated, except the ratio DHA / EPA. Also, the storage time did not change the lipid content (fatty acid) and nutritional indices assessed. The processing of buffalo milk by a spray dryer and the milk powder hermetically stored can be used as a strategy for mitigating the economic losses caused by reproductive seasonality.
https://doi.org/10.1590/fst.36418
1147 downloads
5.
Comment on the study Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the Bypass Registry that was presented at the 46th Congress of the Brazilian Society of Cardiovascular Surgery, Nova Lima, BH, Brazil, April 5 and 6, 2019
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Dallan, Luís Alberto O.
; Paez, Rodrigo Pereira
; Hossne Junior, Nelson Américo
; Santo, José Amalth do Espírito
; Berwanger, Otavio
; Santos, Renato Hideo Nakagawa
; Kalil, Renato Abdala Karam
; Jatene, Fabio B.
; Cavalcanti, Alexandre Biasi
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D’Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Oliveira, Juliana Aparecida Borges de
; Gomes, Walter J.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
https://doi.org/10.21470/1678-9741-2019-0606
335 downloads
6.
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
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Paez, Rodrigo Pereira
; Hossne Junior, Nelson Américo
; Santo, José Amalth do Espírito
; Berwanger, Otavio
; Santos, Renato Hideo Nakagawa
; Kalil, Renato Abdala Karam
; Jatene, Fabio B.
; Cavalcanti, Alexandre Biasi
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D'Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Oliveira, Juliana Aparecida Borges de
; Gomes, Walter J.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.
https://doi.org/10.21470/1678-9741-2018-0313
1270 downloads
7.
Brazilian guidelines for the diagnosis and treatment of cystic fibrosis
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Athanazio, Rodrigo Abensur
; Silva Filho, Luiz Vicente Ribeiro Ferreira da
; Vergara, Alberto Andrade
; Ribeiro, Antônio Fernando
; Riedi, Carlos Antônio
; Procianoy, Elenara da Fonseca Andrade
; Adde, Fabíola Villac
; Reis, Francisco José Caldeira
; Ribeiro, José Dirceu
; Torres, Lídia Alice
; Fuccio, Marcelo Bicalho de
; Epifanio, Matias
; Firmida, Mônica de Cássia
; Damaceno, Neiva
; Ludwig-Neto, Norberto
; Maróstica, Paulo José Cauduro
; Rached, Samia Zahi
; Melo, Suzana Fonseca de Oliveira
; Pinto, Leonardo Araújo
; Monte, Luciana Freitas Velloso
; Higa, Laurinda Yoko Shinzato
; Folescu, Tania Wrobel
; Marson, Fernando Augusto de Lima
; Sad, Isabela
; Servidoni, Maria de Fátima Correa Pimenta
; Kussek, Paulo
; Raskin, Salmo
; Zuana, Adriana Della
; Augustin, Albin
; Hoffmann, Anneliese
; Barbisan, Beatriz
; Hochhegger, Bruno
; Levy, Carlos Emilio
; Veiga, Claudine Sarmento da
; Ricachinevsky, Claudio
; Esposito, Concetta
; Escuissato, Dante
; Brandemburgo, Diego
; Marques, Elisabeth
; Aquino, Evanirso de
; Fischer, Gilberto Bueno
; Rodrigues, Joaquim Carlos
; Machado, Leticia
; Muramato, Lucia
; Costa, Lusmaia Damasceno Camargo
; Donadio, Marcio
; Castro, Marcos César Santos de
; Ribeiro, Maria Angela
; Santana, Maria Angélica
; Canan, Mariane
; Almeida, Marina Buarque de
; Britto, Murilo
; Dalcin, Paulo Roth Tarso
; Ramos, Regina Terse Trindade
; Chiba, Sonia
; Martins, Valéria de Carvalho
; Lacerda, Claudine
; Barbosa, Eliana
; Guimarães, Elizabet Vilar
; Hessel, Gabriel
; Gurmini, Jocemara
; Neri, Lenycia
; Nogueira, Marcelo Coelho
; Wayhs, Mônica Chang
; Simon, Miriam Isabel Santos
; Fernandes, Arlene Gonçalves dos Santos
; Silva, Claudia de Castro de
; Albuquerque, Cristiano Túlio Maciel
; Souza, Edna Lúcia
; Silva, Fernando Antonio de Abreu e
; Dalcin, Paulo de Tarso
; Noronha, Renata Maria de
; Teixeira, Ricardo
; Machado, Sandra Helena
; Camargo, Spencer Marcantonio
; Rozov, Tatiana
; Rodrigues, Ticiana da Costa
.
RESUMO A fibrose cística (FC) é uma doença genética autossômica recessiva caracterizada pela disfunção do gene CFTR. Trata-se de uma doença multissistêmica que ocorre mais frequentemente em populações descendentes de caucasianos. Nas últimas décadas, diversos avanços no diagnóstico e tratamento da FC mudaram drasticamente o cenário dessa doença, com aumento expressivo da sobrevida e qualidade de vida. Atualmente, o Brasil dispõe de um programa de ampla cobertura para a triagem neonatal de FC e centros de referência distribuídos na maior parte desses estados para seguimento dos indivíduos. Antigamente confinada à faixa etária pediátrica, tem-se observado um aumento de pacientes adultos com FC tanto pelo maior número de diagnósticos de formas atípicas, de expressão fenotípica mais leve, assim como pelo aumento da expectativa de vida com os novos tratamentos. Entretanto, ainda se observa uma grande heterogeneidade no acesso aos métodos diagnósticos e terapêuticos para FC entre as diferentes regiões brasileiras. O objetivo dessas diretrizes foi reunir as principais evidências científicas que norteiam o manejo desses pacientes. Um grupo de 18 especialistas em FC elaborou 82 perguntas clínicas relevantes que foram divididas em cinco categorias: características de um centro de referência; diagnóstico; tratamento da doença respiratória; tratamento gastrointestinal e nutricional; e outros aspectos. Diversos profissionais brasileiros atuantes na área da FC foram convidados a responder as perguntas formuladas pelos coordenadores. A literatura disponível foi pesquisada na base de dados PubMed com palavras-chave, buscando-se as melhores respostas às perguntas dos autores.
ABSTRACT Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease. Previously, CF was limited to the pediatric age group. However, an increase in the number of adult CF patients has been observed, because of the greater number of individuals being diagnosed with atypical forms (with milder phenotypic expression) and because of the increase in life expectancy provided by the new treatments. However, there is still great heterogeneity among the different regions of Brazil in terms of the access of CF patients to diagnostic and therapeutic methods. The objective of these guidelines was to aggregate the main scientific evidence to guide the management of these patients. A group of 18 CF specialists devised 82 relevant clinical questions, divided into five categories: characteristics of a referral center; diagnosis; treatment of respiratory disease; gastrointestinal and nutritional treatment; and other aspects. Various professionals working in the area of CF in Brazil were invited to answer the questions devised by the coordinators. We used the PubMed database to search the available literature based on keywords, in order to find the best answers to these questions.
https://doi.org/10.1590/s1806-37562017000000065
75529 downloads
8.
The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients
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Gomes, Walter J.
; Moreira, Rita Simone
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D' Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Kalil, Renato Abdala Karam
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Paez, Rodrigo Pereira
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Santo, José Amalth do Espírito
; Oliveira, Juliana Aparecida Borges de
; Berwanger, Otavio
; Cavalcanti, Alexandre Biasi
; Jatene, Fabio B.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
Abstract Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. Results: 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%. Conclusion: This first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.
https://doi.org/10.21470/1678-9741-2017-0053
1883 downloads
9.
Clinical and pathological evaluation of fibrolamellar hepatocellular carcinoma: a single center study of 21 cases
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Chagas, Aline Lopes
; Kikuchi, Luciana
; Herman, Paulo
; Alencar, Regiane S.S.M.
; Tani, Claudia M.
; Diniz, Márcio Augusto
; Pugliese, Vincenzo
; Rocha, Manoel de Souza
; D′Albuquerque, Luiz Augusto Carneiro
; Carrilho, Flair Jose
; Alves, Venancio A.F.
.
OBJECTIVES: Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor that differs from conventional hepatocellular carcinoma in several aspects. The aim of this study was to describe the clinical, surgical and histopathological features of fibrolamellar hepatocellular carcinoma and to analyze the factors associated with survival. METHODS: We identified 21 patients with histopathologically diagnosed fibrolamellar hepatocellular carcinoma over a 22-year period. Clinical information was collected from medical records and biopsies, and surgical specimens were reviewed. RESULTS: The median age at diagnosis was 20 years. Most patients were female (67%) and did not have associated chronic liver disease. Most patients had a single nodule, and the median tumor size was 120 mm. Vascular invasion was present in 31% of patients, and extra-hepatic metastases were present in 53%. Fourteen patients underwent surgery as the first-line therapy, three received chemotherapy, and four received palliative care. Eighteen patients had “pure fibrolamellar hepatocellular carcinoma,” whereas three had a distinct area of conventional hepatocellular carcinoma and were classified as having “mixed fibrolamellar hepatocellular carcinoma.” The median overall survival was 36 months. The presence of “mixed fibrolamellar hepatocellular carcinoma” and macrovascular invasion were predictors of poor survival. Vascular invasion was associated with an increased risk of recurrence in patients who underwent surgery. CONCLUSION: Fibrolamellar hepatocellular carcinoma was more common in young female patients without chronic liver disease. Surgery was the first therapeutic option to achieve disease control, even in advanced cases. Vascular invasion was a risk factor for tumor recurrence. The presence of macrovascular invasion and areas of conventional hepatocellular carcinoma were directly related to poor survival.
https://doi.org/10.6061/clinics/2015(03)10
2146 downloads
10.
II Diretriz de Ressonância Magnética e Tomografia Computadorizada Cardiovascular da Sociedade Brasileira de Cardiologia e do Colégio Brasileiro de Radiologia
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Sara, Leonardo
; Szarf, Gilberto
; Tachibana, Adriano
; Shiozaki, Afonso Akio
; Villa, Alexandre Volney
; Oliveira, Amarino Carvalho de
; Albuquerque, Andrei Skromov de
; Rochitte, Carlos Eduardo
; Nomura, César Higa
; Azevedo, Clerio Francisco
; Jasinowodolinski, Dany
; Tassi, Eduardo Marinho
; Medeiros, Fabio de Morais
; Kay, Fernando Uliana
; Junqueira, Flávia Pegado
; Azevedo, Guilherme S. A.
; Monte, Guilherme Urpia
; Pinto, Ibraim Masciarelli Francisco
; Gottlieb, Ilan
; Andrade, Joalbo
; Lima, João A. C.
; Parga Filho, José Rodrigues
; Kelendjian, Juliana
; Fernandes, Juliano Lara
; Iquizli, Leonardo
; Correia, Luis C. L.
; Quaglia, Luiz Augusto
; Gonçalves, Luiz Flavio Galvão
; Ávila, Luiz Francisco
; Zapparoli, Marcello
; Hadlich, Marcelo
; Nacif, Marcelo Souto
; Barbosa, Márcia de Melo
; Minami, Márcio Hiroshi
; Bittencourt, Marcio Sommer
; Siqueira, Maria Helena Albernaz
; Silva, Marly Conceição
; Lopes, Marly Maria Uellendahl
; Marques, Mateus Diniz
; Vieira, Mônica La Rocca
; Coellho Filho, Otávio Rizzi
; Schvartzman, Paulo R.
; Santos, Raul D.
; Cury, Ricardo C.
; Loureiro, Ricardo
; Cury, Roberto Caldeira
; Sasdelli Neto, Roberto
; Macedo, Robson
; Cerci, Rodrigo Julio
; Faria Filho, Rui Alberto de
; Cardoso, Sávio
; Naves, Thiago
; Magalhães, Tiago Augusto
; Senra, Tiago
; Burgos, Ursula Maria Moreira Costa
; Moreira, Valéria de Melo
; Ishikawa, Walther Yoshiharu
.
https://doi.org/10.5935/abc.2014S006
67586 downloads
11.
An analysis of tacrolimus-related complications in the first 30 days after liver transplantation
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Nacif, Lucas Souto
; David, André Ibrahim
; Pinheiro, Rafael Soares
; Diniz, Marcio Augusto
; Andraus, Wellington
; Cruz Junior, Ruy Jorge
; D′Albuquerque, Luiz A. Carneiro
.
OBJECTIVES:Orthotopic liver transplantation has improved survival in patients with end-stage liver disease; however, therapeutic strategies that achieve ideal immunosuppression and avoid early complications are lacking. To correlate the dose and level of Tacrolimus with early complications, e.g., rejection, infection and renal impairment, after liver transplantation. From November 2011 to May 2013, 44 adult liver transplant recipients were studied in this retrospective comparative study.RESULTS:The most frequent indication for liver transplantation was hepatitis C cirrhosis (47.7%), with a higher prevalence observed in male patients (68.18%). The ages of the subjects ranged from 19-71 and the median age was 55.5 years. The mean length of the hospital stay was 16.1±9.32 days and the mean Model for End-stage Liver Disease score was 26.18±4.28. There were five cases of acute cellular rejection (11.37%) and 16 cases of infection (36.37%). The blood samples that were collected and analyzed over time showed a significant correlation between the Tacrolimus blood level and the deterioration of glomerular filtration rate and serum creatinine (p<0.05). Patients with infections had a higher serum level of Tacrolimus (p= 0.012). The dose and presence of rejection were significantly different (p= 0.048) and the mean glomerular filtration rate was impaired in patients who underwent rejection compared with patients who did not undergo rejection (p= 0.0084).CONCLUSION:Blood Tacrolimus levels greater than 10 ng/ml were correlated with impaired renal function. Doses greater than 0.15 mg/kg/day were associated with the prevention of acute cellular rejection but predisposed patients to infectious disease.
https://doi.org/10.6061/clinics/2014(11)07
2067 downloads
12.
Prevalência da hipertensão arterial em adultos e fatores associados em São Luís - MA
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Barbosa, José Bonifácio
; Silva, Antonio Augusto Moura da
; Santos, Alcione Miranda dos
; Monteiro Júnior, Francisco das Chagas
; Barbosa, Márcio Mesquita
; Barbosa, Marcelo Mesquita
; Figueiredo Neto, José Albuquerque de
; Soares, Nivaldo de Jesus S.
; Nina, Vinicius José da Silva
; Barbosa, José Nicodemo
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
FUNDAMENTO: No Brasil, a prevalência de hipertensão arterial (HA) e seus fatores de risco são pouco conhecidos nas regiões menos desenvolvidas. OBJETIVO: Estimar a prevalência da hipertensão arterial na população > 18 anos em São Luís - MA e fatores associados, de acordo com os critérios do Seventh Report of the Joint National Committee (JNC 7). MÉTODOS: Realizou-se estudo transversal em São Luís - MA, de fevereiro a março de 2003, em 835 pessoas com idade > 18 anos que responderam a um questionário estruturado em domicílio. Foram medidos pressão arterial (PA), peso, altura e circunferência abdominal. Avaliaram-se outros fatores de risco para doença cardiovascular. Na identificação dos fatores associados à HA foi utilizado o modelo de regressão de Poisson, com estimativa da razão de prevalências (RP) e seu respectivo intervalo de confiança de 95%. RESULTADOS: A idade variou entre 18 e 94 anos (média de 39,4 anos), sendo 293 (35,1%) pessoas normotensas e 313 (37,5%) pré-hipertensas. A prevalência de HA foi de 27,4% (IC95% 24,4% a 30,6%), maior no sexo masculino (32,1%) que no feminino (24,2%). Na análise ajustada permaneceram independentemente associados à HA: sexo masculino (RP 1,52 IC95% 1,25-1,84), idade > 30 anos, sendo RP=6,65, IC95% 4,40-10,05 para idade > 60 anos, sobrepeso (RP 2,09 IC95% 1,64-2,68), obesidade (RP 2,68 IC95% 2,03-3,53) e diabete (RP 1,56 IC95% 1,24-1,97). CONCLUSÃO: Os resultados sugerem a necessidade de controle do sobrepeso, obesidade e diabete, sobretudo em mulheres e pessoas com idade maior ou igual a 30 anos para a redução da prevalência da hipertensão arterial.
BACKGROUND: Little is known about the prevalence of arterial hypertension (AH) and its risk factors in the less developed regions of Brazil. OBJECTIVE: To estimate the prevalence of arterial hypertension and its associated factors in the population > 18 years in São Luís, state of Maranhão according to the Seventh Report of the Joint National Committee (JNC 7) criteria. METHODS: A cross-sectional study was conducted in São Luís, MA, from February to March 2003, with 835 individuals >18 years who completed a structured household questionnaire. Measurements of arterial pressure (AP), weight, height and waist circumference were taken, and other risk factors for cardiovascular disease were assessed. The Poisson regression method was used for the identification of factors associated with AH, with an estimate of the prevalence ratio (PR) and its corresponding 95% confidence interval. RESULTS: Age varied from 18 and 94 years (mean age was 39.4 years), 293 (35.1%) individuals were normotensive and 313 (37.5%) were pre-hypertensive. The AH prevalence was 27.4% (95% CI - 24.4% to 30.6%), and it was higher among men (32.1%) than among women (24.2%). In the adjusted analysis, the following remained independently associated with AH: male gender (PR 1.52, 95% CI, 1.25-1.84), age > 30 years, with PR=6.65, 95% CI, 4.40-10.05 for >60 years of age, overweight (PR 2.09 95% CI 1.64-2.68), obesity (PR 2.68, 95% CI, 2.03-3.53) and diabete (PR 1.56, 95% CI, 1.24-1.97). CONCLUSION: These findings suggest the need to control overweight, obesity and diabete, especially among women and individuals > 30 years of age in order to reduce the prevalence of arterial hypertension.
12559 downloads
Citado 10 vezes em SciELO
13.
Estabilidade em análise de agrupamento: estudo de caso em ciência florestal
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Albuquerque, Márcio Augusto de
; Ferreira, Rinaldo Luiz Caraciolo
; Silva, José Antônio Aleixo da
; Santos, Eufrázio de Souza
; Stosic, Borko
; Souza, Agostinho Lopes de
.
Objetivou-se, neste trabalho, propor uma sistemática para o estudo e interpretação da estabilidade dos métodos de análise de agrupamento, através de vários algoritmos de agrupamento em dados de vegetação. Utilizaram-se dados provenientes de levantamento na Mata da Silvicultura, da Universidade Federal de Viçosa ,em Viçosa, MG. Para a análise de agrupamento, foram estimadas as matrizes de distância de Mahalanobis com base nos dados originais e via reamostragem "bootstrap", bem como aplicados os métodos da ligação simples, ligação completa e médias das distâncias, do centróide, da mediana e do Ward. Para a detecção de associação entre os métodos, foi aplicado o teste Qui-Quadrado (chi2) a 1 e 5% de probabilidade. Para os diversos métodos de agrupamento foi obtida a correlação cofenética. Os resultados de associação dos métodos foram semelhantes, indicando, em princípio, que qualquer algoritmo de agrupamento estudado está estabilizado e existem, de fato, grupos entre os indivíduos observados. No entanto, verificou-se que os métodos são coincidentes, exceto os métodos do centróide e Ward e os métodos do centróide e mediana, em comparação com o de Ward, respectivamente, com base nas matrizes de Mahalanobis a partir dos dados originais e "bootstrap". A sistemática proposta é promissora para o estudo e interpretação da estabilidade dos métodos de análise de agrupamento em dados de vegetação.
The main objective of this research was to propose a system to the study and interpretation of stability in cluster analysis through several cluster algorithms in vegetation data. The data set used derived from a survey in the Silviculture Forest at Federal University of Viçosa - MG. To perform the cluster analysis, the Mahalanobis distance matrices were estimated on basis of original data and bootstrap resampling. Also, the single linkage, complete linkage, average distances, centroid, median and Ward methods were used. Chi-square test was applied to detect the association among the methods. A co-phenetic correlation was obtained for the cluster methods. The results for the method associations were very similar, indicating that any algorithm of the studied clusters is stabilized, and in fact, that groups exist among the analyzed individuals. However, it was verified that the methods are coincident, except for the centroid and Ward, and also the centroid and median methods, when compared to Ward, respectively, based on the Mahalanobis matrices derived from the original data set and bootstrap. The methodology proposed is promising to the study and interpretation of the stability of cluster analysis methods in vegetation data.
3657 downloads
Citado 3 vezes em SciELO
14.
Avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa, Rio de Janeiro: estudo da população coberta e análise operacional de um subprograma
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Gaspar, Eneida Duarte
; Almeida, Márcio José de
; Taddei, José Augusto A. C.
; Ribeiro, Eliana Cláudia O.
; Pereira, Sandra da Silva
; Vilanova, Maria Cristina T.
; Cordeiro, Hésio de Albuquerque
; Souza, Jeiel C. Ferreira de
.
Foi realizada uma avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa do Estado do Rio de Janeiro, como resultado do convênio firmado entre o Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro e a Secretaria de Saúde do Estado. Através de estudo do nível de saúde entre os escolares e da análise operacional do subprograma de Registro de Saúde, diagnosticaram-se elevados índices de morbidade e pequena proporção de crianças com assistência médica prévia, além de determinar-se a efetividade do programa e de identificar-se problemas no processo técnico-administrativo do Serviço. Dentre as conclusões destaca-se a necessidade de completar a avaliação do Serviço, através da determinação dos critérios de eficiência, eficácia e rendimento, tendo em vista o fornecimento de subsídios para as tarefas de planejamento e administração. É enfatizada a necessidade de ampliação das medidas integradoras dos serviços universitários com os serviços da comunidade, no sentido de fornecer aos primeiros as condições de realizar, através de prestação de serviços, uma formação dos recursos humanos de acordo com a situação de saúde da comunidade, e aos segundos a necessária implementação de novas técnicas e modelos de assistência.
A preliminary evaluation of the School Health Service of the State of Rio de Janeiro's Ninth Administrative Region was performed as result of an agreement between the Institute of Social Medicine belonging to the State of Rio de Janeiro University and the State Department of Health. Through an analysis of the school-children's health level and an operational study of the health register subprogramme, high morbidity rates were found as was also a small percentage of children having received previous medical care. The effectiveness of the programme and the identification of problems in the technical and administrative area of the Service were determined. Among the results the need to complete the Service's evaluation through the use of the efficacy, efficiency and yielding criteria considering the availability of funds for planning and administration was emphasized. It is important to increase interaction between University and Community services in order to supply the former with conditions that enable the development of human resources adequate to the Community health conditions providing the latter with the necessary implementation of new techniques and patterns of attention.
1424 downloads
15.
Avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa, Rio de Janeiro: estudo da população coberta e análise operacional de um subprograma
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Gaspar, Eneida Duarte
; Almeida, Márcio José de
; Taddei, José Augusto A. C.
; Ribeiro, Eliana Cláudia O.
; Pereira, Sandra da Silva
; Vilanova, Maria Cristina T.
; Cordeiro, Hésio de Albuquerque
; Souza, Jeiel C. Ferreira de
.
Foi realizada uma avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa do Estado do Rio de Janeiro, como resultado do convênio firmado entre o Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro e a Secretaria de Saúde do Estado. Através de estudo do nível de saúde entre os escolares e da análise operacional do subprograma de Registro de Saúde, diagnosticaram-se elevados índices de morbidade e pequena proporção de crianças com assistência médica prévia, além de determinar-se a efetividade do programa e de identificar-se problemas no processo técnico-administrativo do Serviço. Dentre as conclusões destaca-se a necessidade de completar a avaliação do Serviço, através da determinação dos critérios de eficiência, eficácia e rendimento, tendo em vista o fornecimento de subsídios para as tarefas de planejamento e administração. É enfatizada a necessidade de ampliação das medidas integradoras dos serviços universitários com os serviços da comunidade, no sentido de fornecer aos primeiros as condições de realizar, através de prestação de serviços, uma formação dos recursos humanos de acordo com a situação de saúde da comunidade, e aos segundos a necessária implementação de novas técnicas e modelos de assistência.
A preliminary evaluation of the School Health Service of the State of Rio de Janeiro's Ninth Administrative Region was performed as result of an agreement between the Institute of Social Medicine belonging to the State of Rio de Janeiro University and the State Department of Health. Through an analysis of the school-children's health level and an operational study of the health register subprogramme, high morbidity rates were found as was also a small percentage of children having received previous medical care. The effectiveness of the programme and the identification of problems in the technical and administrative area of the Service were determined. Among the results the need to complete the Service's evaluation through the use of the efficacy, efficiency and yielding criteria considering the availability of funds for planning and administration was emphasized. It is important to increase interaction between University and Community services in order to supply the former with conditions that enable the development of human resources adequate to the Community health conditions providing the latter with the necessary implementation of new techniques and patterns of attention.
965 downloads
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