Pesquisa | SciELO

ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

https://doi.org/10.1590/s1677-5538.ibju.2023.0065

Cross preferences and genetic diversity of Psidium interspecific hybrids through morphoagronomic traits and resistance to Meloidogyne enterolobii
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ALMEIDA, ODIMAR F. DE

; VIANA, ALEXANDRE P.

; GOMES, VICENTE M.

; SOUZA, RICARDO M. DE

; SANTOS, PAULO RICARDO DOS

; AMARAL JÚNIOR, ANTÔNIO T. DO

; RODRIGUES, DANIELE L.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Nº 4 elocation e20190120

Resumo: En | Texto: En | PDF: En

Abstract The introgression of M. enterolobii resistance-related genes in guava breeding programs can be compromised by incompatibility among Psidium species. This study aimed to evaluate the female parent preference and genetic diversity of Psidium interspecific hybrids using morphoagronomic traits and resistance to M. enterolobii. There were evaluated cross successes and germination from crosses between accesses of P. cattleyanum, P. guineense and P. guajava and the genetic diversity by Ward-MLM method of hybrids according to descriptors developed for the genus. Crosses were more successful when P. cattleyanum was the female parent. Germination was more successful in crosses involving P. cattleyanum and P. guajava. Four groups were formed. The group IV clustered the most resistant genotypes, composed by genotypes of P. cattleyanum x P. guineense, while the group II was the most susceptible. The groups I and III grouped some genotypes of P. cattleyanum x P. guajava with low levels of susceptibility. There are preferences of female parent species among crosses. Some individuals of groups I and III can be used as source of resistance genes for the breeding program, due the presence of favorable alleles inherited from guava parent. The high susceptibility leads to reduction in root development. M resistancerelated related P WardMLM Ward MLM genus formed susceptible program development

https://doi.org/10.1590/0001-3765202320190120

Cushing’s syndrome due to ectopic adrenocorticotropin secretion by a parotid carcinoma
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Antonacio, Fernanda F.

; Harada, Guilherme

; Vilela, Rafael S.

; Freitas, Thais C.

; Lima Jr., Jose V.

; Kowalski, Luiz Paulo

; Almeida, Madson Q.

; Castro Junior, Gilberto de

Archives of Endocrinology and Metabolism

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Fev 2022, Volume 66 Nº 1 Páginas 92 - 96

Resumo: En | Texto: En | PDF: En

SUMMARY We report a rare case of Cushing’s syndrome in a 37-year-old female who initially presented with localized acinic cell carcinoma of the parotid gland. In January 2014, she underwent a right parotidectomy with facial nerve preservation and adjuvant radiotherapy. In August 2018, she presented a histologically-proven local regional relapse. The patient was considered for salvage surgery with facial nerve sacrifice and remained with no evidence of disease. One year later the patient developed pulmonary dissemination and started to gain weight and developed facial plethora and acne on the face and upper trunk. In a physical examination, the patient presented moon face, buffalo hump, acne and stage 2 hypertension. Biochemical evaluation confirmed ACTH-dependent Cushing’s syndrome. IHC for ACTH in the lung biopsy revealed strong positive staining for ACTH confirming a diagnosis of ectopic ACTH secretion by a metastatic parotid acinic cell carcinoma. Ketoconazole (600 mg/d) was started to treat the CS. In addition, as chemotherapy was initiated to treat the metastatic disease. After the fifth cycle of chemotherapy, ketoconazole was suspended and the patient remained in remission of CS for four months, when CS recurred. A unique feature of this case is related to the clinical CS relapse associated with disease progression, which needed prompt treatment with ketoconazole, resulting in a significant improvement in the patient’s condition. Although rare, should be attentive for possible CS features in patients with high-grade salivary gland carcinomas, since the diagnosis of ectopic secretion of ACTH may significantly impact their management and outcomes.

https://doi.org/10.20945/2359-3997000000426

Retrospective study of poxviruses diagnosed in cattle from Goiás State, Brazil (2010-2018)
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Silva, Lorena F.

; Leal, Antônio A.

; Cunha, Paulo H.J.

; Cargnelutti, Juliana F.

; Flores, Eduardo F.

; Almeida, Thiago B.

; Sant’Ana, Fabiano J.F.

Pesquisa Veterinária Brasileira

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2022, Volume 42 elocation e07014

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

RESUMO: Foi realizado um estudo retrospectivo das infecções por poxvírus diagnosticadas em bovinos do estado de Goiás (GO), entre 2010 e 2018. Todos os casos foram investigados pela Agência Goiana de Defesa Agropecuária (Agrodefesa). Foram revisados formulários técnicos e protocolos de laboratórios de diagnóstico veterinário. Na maioria dos casos, amostras de tecidos orais ou cutâneos e/ou swabs foram encaminhadas para diagnóstico virológico. Foram notificados 37 surtos/casos de doença vesicular em bovinos em 25 municípios; em 33 casos os animais apresentavam lesões clinicamente compatíveis com poxvírus. A etiologia de 25 de 33 surtos/casos foi confirmada como poxvírus por PCR e/ou isolamento viral: 13 como vírus vaccínia (VACV), seis como vírus pseudocowpox (PCPV), cinco como vírus da estomatite papular bovina (BPSV) e um caso de coinfecção (VACV e um parapoxvírus semelhante ao Orf vírus). Os casos confirmados laboratorialmente ocorreram principalmente em bovinos leiteiros (19/25) e durante a estação seca (22/25). Em bovinos adultos, alterações macroscópicas foram observadas principalmente nas tetas e úbere e incluíram vesículas, úlceras, crostas, pápulas e cicatrizes e variaram quanto ao tipo, gravidade e região afetada, dependendo da espécie do poxvírus. Em bezerros, as principais lesões foram úlceras na boca e focinho. Lesões zoonóticas compatíveis com infecção por poxvírus foram observadas em todas as poxviroses diagnosticadas, afetando principalmente as mãos dos ordenhadores e outros trabalhadores rurais. Nossos dados demonstram a relevância sanitária e econômica dessas doenças e a ampla circulação de diferentes poxvírus em bovinos de GO.

ABSTRACT: A retrospective study of poxvirus infections diagnosed in cattle from Goiás state (GO), Brazil, from 2010 to 2018, was performed. All cases have been investigated by the GO Official Veterinary Service (Agrodefesa), from which technical forms and protocols of veterinary diagnosis laboratories were reviewed. In most cases, samples of oral or cutaneous tissues and/or swabs were submitted for virological diagnosis by polymerase chain reaction (PCR) and/or virus isolation. Thirty seven outbreaks/cases of vesicular disease were notified in cattle of 25 counties; in 33 cases the animals presented lesions clinically compatible with poxviruses. The etiology of 25 out of 33 outbreaks/cases was confirmed as poxviruses by PCR and/or viral isolation: 13 as bovine vaccinia virus (VACV), six as pseudocowpox virus (PCPV), five as bovine papular stomatitis virus (BPSV) and one coinfection (VACV and an Orf virus-like parapoxvirus). The laboratory confirmed that cases occurred mainly in dairy cattle (19/25) and during the dry season (22/25). In adult cattle, gross changes were observed mainly in the teats and udder and included vesicles, ulcers, crusts, papules and scars and varied of type, severity and affected region, depending on the poxvirus species. In calves, the main lesions were ulcers in the mouth and muzzle. Zoonotic lesions compatible with poxvirus infections were observed for all diagnosed poxviruses, affecting especially the hands of milkers and other farm workers. Our data demonstrate the sanitary and economic relevance of these diseases and the wide circulation of different poxviruses in cattle from GO.

https://doi.org/10.1590/1678-5150-pvb-7014

Genetic parameters and gains with the selection of fig tree genotypes
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Almeida, Patrícia de

; Pavan, Bruno Ettore

; Rodrigues, Maria Gabriela Fontanetti

; Gaspar, Guilherme de Freitas

; Giro, Leonardo de Paula

; Silva, Renan Furquim da

Acta Scientiarum. Agronomy

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2022, Volume 44 elocation e55796

Resumo: En | Texto: En | PDF: En

ABSTRACT. Fig tree (Ficus carica L., Moraceae), which originated in the Mediterranean Basin, is one of the many fruit trees grown in Brazil, with ‘Roxo-de-Valinhos’ being the exclusively used cultivar. In this context, research aimed at the improvement of this species to develop highly resistant and adaptable cultivars is paramount. Thus, the present study aimed to maintain fig accessions in an in vivo active germplasm bank (AGB) at the Faculty of Engineering of Ilha Solteira (FEIS), São Paulo State University (UNESP), as well as to characterize the agronomic traits of these accessions based on quantitative descriptors of genetic parameters and observe gains with the selection of specific genotypes to illustrate the AGB in terms of genetic variability. A total of 36 F. carica genotypes were evaluated in the field at the Teaching, Research and Extension Farm (FEPE) of the FEIS, UNESP. Qualitative traits, fruit parameters (e.g., insertion of the first fruit, fruit stalk length, fruit length, fruit diameter, and average fruit mass), and accumulated plant dry mass were measured. In addition, genetic parameters, variance components, and descriptive statistics, including genetic and environmental variances, heritability and average heritability of clones, coefficients of genotypic and environmental variation and their ratio (CV g %/Cv e %), general average, and selection gain, were evaluated. The selected fig tree accessions showed genetic variability in the assessed traits, exhibiting good heritability and achieving selection gains. For instance, the first 10 classified clones exhibited a heritability of 80.2% and achieved a selection gain of 98% for accumulated plant dry mass. Therefore, the maintenance of in vivo AGBs allows agronomic studies, offering promising results for continuing the breeding programs and preserving the genetic variability of species.

https://doi.org/10.4025/actasciagron.v44i1.55796

SPATIAL VARIABILITY OF ECOPHYSIOLOGICAL AND PRODUCTION COMPONENTS IN IRRIGATED NOBLE GARLIC
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Oliveira, Job T. de

; Oliveira, Rubens A. de

; Almeida, Edmilson I. B.

; Cunha, Fernando F. da

; Teodoro, Paulo E.

Engenharia Agrícola

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2022, Volume 42 Nº 3 elocation e20200191

Resumo: En | Texto: En | PDF: En

Abstract Among agricultural components, crop ecophysiological parameters play an essential role in garlic growth and yield. This study aimed to characterize the structure and spatialization of garlic crop parameters, evaluating spatial correlations among yield, lateral shoot growth, and plant ecophysiological components. These consisted of intercellular CO2 concentration, stomatal conductance, transpiration, water-use efficiency, carboxylation efficiency, photosynthetically active radiation, relative humidity around leaves, relative humidity in leaves, air temperature, leaf temperature, vapor pressure deficit, and water content in the air and leaves. Our results showed that irrigated purple garlic yield, lateral shoot growth, and ecophysiological components are spatially dependent. A cross-semivariogram between plant ecophysiological parameters showed negative spatial correlations and spatial dependence, with a coefficient of determination (r2) above 0.730. These findings indicate a close correlation between garlic yield and lateral shoot growth with the ecophysiological parameters studied. In short, purple garlic production had a high inter-spatial correlation with plant transpiration and water contents in the air and leaves.

https://doi.org/10.1590/1809-4430-eng.agric.v42n3e20200191/2022

Growth and longevity of the freshwater prawn Macrobrachium brasiliense (Decapoda: Palaemonidae)
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Nogueira, Caio S.

; Porto, Ana Carolina F.

; Barros-Alves, Samara P.

; Jacobucci, Giuliano B.

; Almeida, Ariádine C.

Revista mexicana de biodiversidad

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2022, Volume 93 elocation e933751

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

Resumen En el presente estudio se analizaron los parámetros de crecimiento y longevidad de machos y hembras de Macrobrachium brasiliense. Las muestras se obtuvieron mensualmente desde julio/2012 hasta junio/2013 en la región de Triângulo Mineiro, Minas Gerais, Brasil. Un total de 199 camarones adultos (97 machos, 102 hembras) fueron analizados y medidos según la longitud del caparazón (CL, mm). Los machos (9.64 ± 4.17 mm, CL) fueron más grandes que las hembras (7.7 ± 3.39 mm, CL). Las curvas de crecimiento para CL por el modelo de von Bertalanffy se describen mediante las ecuaciones: CL = 21.0 [1 - e -0.00446 (t)] para los machos y CL = 20.0 [1 - e -0.00454 (t)] para las hembras. Al comparar las curvas de crecimiento con la prueba tipo F, no hubo diferencias entre los coeficientes de crecimiento (K) de machos y hembras (GL22; F3.16 = 2.476; p = 0.088). La longevidad se estimó en 2.83 años para los machos y 2.78 años para las hembras. En general, la longevidad observada es similar a la de las especies de Macrobrachium.

Abstract Growth and longevity parameters of males and females of Macrobrachium brasiliense were analyzed. Sampling was carried out monthly from July 2012 to June 2013 in Triângulo Mineiro region, Minas Gerais, Brazil. A total of 199 adult prawns (97 males and 102 females) were analyzed and measured according to the carapace length (CL, mm). Males (9.64 ± 4.17 mm, CL) were larger than females (7.7 ± 3.39 mm, CL). CL growth curves by the von Bertalanffy model are described by the equations CL = 21.0 [1 - e -0.00446 (t)] for males and CL = 20.0 [1 - e -0.00454 (t)] for females. Comparison of the growth curves by performing the F-type test, showed that there was no difference between the growth coefficients (K) of males and females (GL22; F3.16 = 2.476; p = 0.088). Longevity was estimated as 2.83 years for males and 2.78 years for females. In general, the observed longevity is similar to that of other Macrobrachium species.

https://doi.org/10.22201/ib.20078706e.2022.93.3751

COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience
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Gomes, Walter J.

; Rocco, Isadora

; Pimentel, Wallace S.

; Pinheiro, Aislan H. B.

; Souza, Paulo M. S.

; Costa, Luiz A. A.

; Teixeira, Marjory M. P.

; Ohashi, Leonardo P.

; Bublitz, Caroline

; Begot, Isis

; Moreira, Rita Simone L

; Hossne Jr, Nelson A.

; Vargas, Guilherme F.

; Branco, João Nelson R.

; Teles, Carlos A.

; Medeiros, Eduardo A. S.

; Sáfadi, Camila

; Rampinelli, Amândio

; Moratelli Neto, Leopoldo

; Rosado, Anderson Rosa

; Mesacasa, Franciele Kuhn

; Capriata, Ismael Escobar

; Segalote, Rodrigo Coelho

; Palmieri, Deborah Louize da Rocha Vianna

; Jardim, Amanda Cristina Mendes

; Vianna, Diego Sarty

; Coutinho, Joaquim Henrique de Souza Aguiar

; Jazbik, João Carlos

; Coutinho, Henrique Madureira da Rocha

; Kikuta, Gustavo

; Almeida, Zely Sant'Anna Marotti de

; Feguri, Gibran Roder

; Lima, Paulo Ruiz Lucio de

; Franco, Anna Carolina

; Borges, Danilo de Cerqueira

; Cruz, Felipe Ramos Honorato De La

; Croti, Ulisses Alexandre

; Borim, Bruna Cury

; Marchi, Carlos Henrique De

; Goraieb, Lilian

; Postigo, Karolyne Barroca Sanches

; Jucá, Fabiano Gonçalves

; Oliveira, Fátima Rosane de Almeida

; Souza, Rafael Bezerra de

; Zilli, Alexandre Cabral

; Mas, Raul Gaston Sanchez

; Bettiati Junior, Luiz Carlos

; Tranchesi, Ricardo

; Bertini Jr, Ayrton

; Franco, Leandro Vieira

; Fernandes, Priscila

; Oliveira, Fabiana

; Moraes Jr, Roberto

; Araújo, Thiago Cavalcanti Vila Nova de

; Braga, Otávio Penna

; Pedrosa Sobrinho, Antônio Cavalcanti

; Teixeira, Roberta Tavares Barreto

; Camboim, Irla Lavor Lucena

; Gomes, Eduardo Nascimento

; Reis, Pedro Horigushi

; Garcia, Luara Piovan

; Scorsioni, Nelson Henrique Goes

; Lago, Roberto

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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Dez 2021, Volume 36 Nº 6 Páginas 725 - 735

Resumo: En | Texto: En | PDF: En

Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

https://doi.org/10.21470/1678-9741-2021-0960

Accumulation of humic substances in an Oxisol fertilized with pig slurry for 15 years
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Sacomori, Wagner

; Cassol, Paulo C.

; Mafra, Maria S. H.

; Erdemann, Luiza F.

; Almeida, Jaime A. de

Revista Brasileira de Engenharia Agrícola e Ambiental

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Fev 2021, Volume 25 Nº 2 Páginas 109 - 115

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

RESUMO O crescimento da suinocultura no Brasil tem aumentado a produção e consequente aplicação de dejetos suínos nos solos. Além de fornecer nutrientes, a aplicação continuada desse resíduo geralmente aumenta o teor de carbono orgânico. Objetivou-se neste estudo determinar o teor de carbono orgânico e sua distribuição nas frações de substâncias húmicas (ácidos húmicos, ácidos fúlvicos e huminas) num Oxisol, após 15 anos de aplicações de dejeto líquido suíno. O experimento foi implantado em 2001 cultivado com a sucessão milho-aveia sob plantio direto no município de Campos Novos, SC. Os tratamentos foram: dejeto líquido suíno nas doses 0 (Testemunha), 25, 50, 100 e 200 m3 ha-1 ano-1; adubo mineral, e dejeto líquido suíno complementado com adubo mineral, aplicados superficialmente uma vez ao ano. Foram determinados os teores de carbono orgânico nas frações ácidos húmicos, ácidos fúlvicos e humina e índice de cor da razão E4/E6 do solo nas camadas de 0-2,5; 2,5-5; 5-10; 10-20; 20-40 e 40-60 cm. O aumento das doses de dejeto líquido suíno até 100 m3 ha-1 aumentou o teor de carbono orgânico total na camada de 5-10 cm, entretanto, diminuiu a proporção das frações de ácidos fúlvicos e ácidos húmicos no solo, favorecendo a acumulação de carbono orgânico na fração humina. A razão E4/E6 foi maior no adubo mineral em comparação aos tratamentos com dejeto líquido suíno.

ABSTRACT The growth of swine production in Brazil has increased the amount of production and use of pig slurry (PS) as soil fertilizer. This product provides nutrients to plants, and a continuous application of this residue usually increases total soil organic carbon (SOC) content. The objective of this study was to determine the SOC content and its distribution into humic substance fractions (humic acids, fulvic acids, and humin) in an Oxisol annually fertilized with PS for 15 years. The experiment was implemented in 2001 with a maize and oat crop rotation under no-tillage system in Campos Novos, SC, Brazil. The treatments used were: PS at rates of 0 (Control), 25, 50, 100, and 200 m3 ha-1 year-1, mineral fertilizer, and PS combined with mineral fertilizer, applied on the soil surface once a year. The 0-2.5, 2.5-5, 5-10, 10-20, 20-40, and 40-60 cm soil layers were evaluated for SOC content in the fractions humic acid, fulvic acid, and humin, and E4/E6 ratio of humic substances. Increases in PS rates up to 100 m3 ha-1 increased the SOC content in the 5-10 cm soil layer; however, decreased the proportion of the soil fulvic acid and humic acid fractions, favoring the accumulation of organic carbon in the humin fraction. The E4/E6 ratio was higher when using the soil mineral fertilizer than that found in treatments with PS.

https://doi.org/10.1590/1807-1929/agriambi.v25n2p109-115 541 downloads

10.

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Resumo: En | Texto: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

11.

Diretriz Brasileira de Cardio-oncologia – 2020
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Hajjar, Ludhmila Abrahão

; Costa, Isabela Bispo Santos da Silva da

; Lopes, Marcelo Antônio Cartaxo Queiroga

; Hoff, Paulo Marcelo Gehm

; Diz, Maria Del Pilar Estevez

; Fonseca, Silvia Moulin Ribeiro

; Bittar, Cristina Salvadori

; Rehder, Marília Harumi Higuchi dos Santos

; Rizk, Stephanie Itala

; Almeida, Dirceu Rodrigues

; Fernandes, Gustavo dos Santos

; Beck-da-Silva, Luís

; Campos, Carlos Augusto Homem de Magalhães

; Montera, Marcelo Westerlund

; Alves, Sílvia Marinho Martins

; Fukushima, Júlia Tizue

; Santos, Maria Verônica Câmara dos

; Negrão, Carlos Eduardo

; Silva, Thiago Liguori Feliciano da

; Ferreira, Silvia Moreira Ayub

; Malachias, Marcus Vinicius Bolivar

; Moreira, Maria da Consolação Vieira

; Valente Neto, Manuel Maria Ramos

; Fonseca, Veronica Cristina Quiroga

; Soeiro, Maria Carolina Feres de Almeida

; Alves, Juliana Barbosa Sobral

; Silva, Carolina Maria Pinto Domingues Carvalho

; Sbano, João

; Pavanello, Ricardo

; Pinto, Ibraim Masciarelli F.

; Simão, Antônio Felipe

; Dracoulakis, Marianna Deway Andrade

; Hoff, Ana Oliveira

; Assunção, Bruna Morhy Borges Leal

; Novis, Yana

; Testa, Laura

; Alencar Filho, Aristóteles Comte de

; Cruz, Cecília Beatriz Bittencourt Viana

; Pereira, Juliana

; Garcia, Diego Ribeiro

; Nomura, Cesar Higa

; Rochitte, Carlos Eduardo

; Macedo, Ariane Vieira Scarlatelli

; Marcatti, Patricia Tavares Felipe

; Mathias Junior, Wilson

; Wiermann, Evanius Garcia

; Val, Renata do

; Freitas, Helano

; Coutinho, Anelisa

; Mathias, Clarissa Maria de Cerqueira

; Vieira, Fernando Meton de Alencar Camara

; Sasse, André Deeke

; Rocha, Vanderson

; Ramires, José Antônio Franchini

; Kalil Filho, Roberto

Arquivos Brasileiros de Cardiologia

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Nov 2020, Volume 115 Nº 5 Páginas 1006 - 1043

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

https://doi.org/10.36660/abc.20201006 4180 downloads

12.

Programação por Metas para Ajuste Não Linear
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ALMEIDA, G.C.

; MARCUCCI, L. W.

; PINTO, E. R.

; OLIVEIRA, M. H.

; FLORENTINO, H. O.

; CANTANE, D. R.

; JONES, D. F.

TEMA (São Carlos)

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Ago 2020, Volume 21 Nº 2 Páginas 249 - 259

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

RESUMO O objetivo deste trabalho foi comparar a eficácia dos modelos de Programação por Metas como ferramenta de regressão não linear, com os métodos de ajustes não lineares clássicos. Aplicou-se os modelos a dados experimentais de inativação de Salmonella spp. em carne móıda suína. A investigação da eficiência dos métodos foi realizada pelo cálculo do erro absoluto.

ABSTRACT The aim of this work was to compare the effectiveness of Goal Programming models, as a nonlinear regression tool, with the classical nonlinear fitting methods. The models were applied to experimental data of inactivation Salmonella spp. in ground pork. The investigation of the methods’ efficiency was made by calculation of the maximum and absolute errors.

https://doi.org/10.5540/tema.2020.021.02.0002490249 389 downloads

13.

Medo da violência e adesão ao autoritarismo no Brasil: proposta metodológica e resultados em 2017
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Lima, Renato Sérgio de

; Jannuzzi, Paulo de Martino

; Moura Junior, James F.

; Segundo, Damião S. de Almeida

Opinião Pública

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Abr 2020, Volume 26 Nº 1 Páginas 34 - 65

Resumo O presente artigo examina o apoio da população brasileira a posições autoritárias e, de forma ampla, dialoga com as preocupações com os recentes rompimentos democráticos e o fortalecimento de posições antidemocráticas após 30 anos da Constituição Federal. Para tanto, foi realizado um levantamento com uma amostra representativa da população adulta a partir dos 16 anos. Foram entrevistadas 2.087 pessoas que responderam a uma versão de 17 itens da escala de autoritarismo de Adorno (Escala F). Os resultados indicam uma forte adesão às posições autoritárias em todos os estratos sociais, mas ainda mais intensas para segmentos sociais historicamente marginalizados. O medo da violência, que tem sido eficazmente explorado pelos porta-vozes da extrema direita política para o reforço do pânico moral, pode ter sido o propulsor das tendências autoritárias.

Abstract This article examines support to authoritarian positions from Brazilian population and dialogues with concerns about recent democratic disruptions and strengthening of antidemocratic positions post-30 years of the Federal Constitution. For this purpose, a survey was conducted with a representative sample of the adult population from the age of 16 years. 2,087 people interviewees answered a version of 17 items of the Adorno's authoritarianism scale (F Scale). The results indicate a strong adherence to authoritarian positions in all layers of society but even more intense for historically marginalized social segments. The fear of violence, which has been effectively exploited by the spokesmen of the extreme right-wing politician's to reinforce moral panic, may have been the propeller of authoritarian tendencies.

Resumen El presente artículo examina el apoyo a posiciones autoritarias de la población brasileña y, de forma amplia, dialoga con las preocupaciones con los recientes rompimientos democráticos y fortalecimientos de posiciones antidemocráticas post-30 años de la Constitución Federal. Para ello, se realizó un levantamiento con una muestra representativa de la población adulta a partir de los 16 años. Se entrevistaron a 2.087 personas que respondieron a una versión de 17 ítems de la escala de autoritarismo de Adorno (Escala F). Los resultados indican una fuerte adhesión a las posiciones autoritarias en todos los estratos sociales, pero aún más intensas para segmentos sociales históricamente marginados. El miedo de la violencia, que ha sido eficazmente explotado por los portavoces de la extrema derecha política para el refuerzo del pánico moral, puede haber sido el propulsor de las tendencias autoritarias.

Résumé Cet article examine le soutien aux positions autoritaires de la population brésilienne et, de manière générale, dialogue avec les préoccupations suscitées par les récentes ruptures démocratiques et le renforcement des positions antidémocratiques après 30 ans de la Constitution Fédérale. Pour cela, une enquête a été réalisée avec un échantillon représentatif de la population adulte à partir de 16 ans. Nous avons interrogé 2 087 personnes qui ont répondu à une version de 17 éléments de l'échelle d'autoritarisme d'Adorno (échelle F). Les résultats indiquent une forte adhésion aux positions autoritaires dans toutes les couches sociales, mais encore plus intense pour les segments sociaux historiquement marginalisés. La peur de la violence, qui a été efficacement exploitée par les porte-parole de l'extrême droite politique pour renforcer la panique morale, a peut-être été le moteur des tendances autoritaires.

https://doi.org/10.1590/1807-0191202026134 2250 downloads

14.

Normative data for middle-aged Brazilians in Verbal Fluency (animals and FAS), Trail Making Test (TMT) and Clock Drawing Test (CDT)
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Carvalho, Guilherme Almeida

; Caramelli, Paulo

Dementia & Neuropsychologia

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Mar 2020, Volume 14 Nº 1 Páginas 14 - 23

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

RESUMO Estudos normativos de testes neuropsicológicos têm sido realizados no Brasil nos últimos anos. Entretanto, devido à heterogeneidade da educação da população brasileira, dados adicionais são necessários. Objetivo: O presente estudo fornece dados normativos de testes de funções executivas para brasileiros de meia-idade e investiga a influência da idade, sexo, educação e quociente de inteligência (QI) sobre o desempenho nestes testes. Métodos: Um total de 120 profissionais e cuidadores saudáveis de um hospital, selecionados aleatoriamente, foram submetidos aos testes de Fluência – animais e FAS – Teste de Trilhas (TT) e Teste do Desenho do Relógio (TDR). Foram divididos em seis grupos de 20, sendo dois por idade (45-54; 55-64) e três por anos de estudo (4-7; 8-11; 12+ anos). Resultados: Dados normativos são apresentados em médias e percentis. A educação influenciou as diferenças nos testes, exceto no TDR. Análises post-hoc evidenciaram diferenças entre os três níveis educacionais em TT e FAS. Surgiram diferenças por idade no TT e Fluência – letra F. Foi encontrada correlação moderada entre escolaridade e resultados do TT e Fluência. As correlações para QI foram semelhantes. Conclusão: O estudo fornece dados normativos para brasileiros de meia-idade, com quatro ou mais anos de escolaridade, em testes cognitivos frequentemente utilizados para avaliação de funções executivas. Os resultados confirmam a forte influência da educação, mesmo na comparação entre os níveis médio e superior.

ABSTRACT Normative studies of neuropsychological tests were performed in Brazil in recent years. However, additional data are needed because of the heterogeneity of education of the Brazilian population. Objective: The present study provides normative data of executive function tests for middle-aged Brazilians and investigates the influence of age, sex, education and intelligence quotient (IQ) on performance in these tests. Methods: A total of 120 healthy staff and caregivers from a hospital were randomly selected and submitted to Fluency – animals and FAS, Trail Making Test (TMT) and Clock Drawing Test (CDT). They were divided into six groups of 20: two groups for age (45-54 and 55-64 years) and three groups for years of schooling (4-7; 8-11; 12+ years). Results: Normative data are presented in mean values and percentiles. Education influenced differences in the tests, except the CDT. Post hoc analyses revealed differences between the three educational levels on the TMT and FAS. Age differences emerged on the TMT and fluency letter F. Moderate correlation was found between schooling and results on TMT and Fluency. The correlations for IQ were similar. Conclusion: This study provides normative data for middle-aged Brazilians with four or more years of schooling in frequently used cognitive tests to assess executive functions. The results confirm the strong influence of education, even in the comparison between middle and higher levels.

https://doi.org/10.1590/1980-57642020dn14-010003 1114 downloads

15.

Alimentação na Demência Avançada: Documento de Consenso da Sociedade Portuguesa de Medicina Interna e da Associação Portuguesa de Nutrição Entérica e Parentérica
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Pessoa, Ana

; Almeida, Paulo

; Marinho, Ricardo

; Duque, Sofia

; Amaral, Teresa F.

; Pinho, João

; Santos, Mariana

; Freire, Elga

; Mendes, Lino

; Santos, Lèlita

; Marinho, Aníbal

; Clara, João Gorjão

; Correia, João Araújo

Medicina Interna

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Mar 2020, Volume 27 Nº 1 Páginas 77 - 85

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

A demência é uma síndrome neurológica de agravamento progressivo, sem cura, cuja prevalência tem vindo a aumentar devido ao envelhecimento da população. Existe um grande desconhecimento entre profissionais de saúde e cuidadores relativamente à melhor abordagem da alimentação nos doentes com demência avançada. Dado não existirem recomendações nacionais acerca deste tema, foi elaborado um documento de consenso da Sociedade Portuguesa de Medicina Interna e da Associação Portuguesa de Nutrição Entérica e Parentérica que explicita as orientações existentes relativas à abordagem dos problemas alimentares nos doentes com demência avançada. A demência avançada é uma condição terminal em que deve ser privilegiado o conforto do doente, frequen-temente acamado, incapaz de comunicar verbalmente e com dificuldade na alimentação. Nesta população, a literatura atual não recomenda o uso de alimentação por sonda (nasogástrica, nasojejunal, gastrostomia percutânea ou jejunostomia percutânea), que está associada a maior risco de infeção, maior utilização de meios de contenção e desenvolvimento de úlceras de decúbito. Como alternativa, recomenda-se a alimentação por via oral de acordo com a tolerância e vontade do doente (alimentação de conforto). Do ponto de vista ético e legal, é legítimo não proceder à artificialização da alimentação na fase terminal da demência caso este procedimento seja contrário aos valores da pessoa e não se objetivem benefícios. Esta decisão deve ser tomada após discussão multidisciplinar incluindo o doente (se possível), representante legal, cuidadores, família e equipa de profissionais de saúde envolvidos, elaborando um plano individual de cuidados que permita a tomada de decisões no melhor interesse do doente.

Dementia is a progressive neurological syndrome without cure whose prevalence is increasing due to population ageing. There is a lack of knowledge among healthcare professionals and caregivers regarding the best feeding approach in patients with advanced dementia. As there are no national recommendations on this subject, a consensus report from the Portuguese Society of Internal Medicine and the Portuguese Enteral and Parental Nutrition Society was made, clarifying existing guidelines regarding the approach of eating difficulties in these patients. Advanced dementia is a terminal condition where patient comfort should be the goal. These patients are usually bedbound, have limited ability to communicate verbally and have difficulty eating. In this population, current literature does not support tube feeding (nasogastric tube, nasojejunal tube, percutaneous gastrostomy or percutaneous jejunostomy feeding), which is associated with higher rates of infection, greater use of chemical and physical restraints and development of pressure ulcers. As an alternative, careful hand feeding should be offered (comfort feeding). From an ethical and legal standpoint, it is acceptable not to use tube feeding in the terminal phase of dementia if it is against patient values and offers no benefits. This decision should be made using a multidisciplinary approach including the patient (if possible), legal representative, caregivers, family and healthcare professionals, in order to establish an individual care plan allowing decision making in the patient’s best interest.

https://doi.org/10.24950/Guidelines/Consensus/1/2020 1148 downloads

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