Pesquisa | SciELO

ABSTRACT Objective: To evaluate the clinical and radiographic results of the surgical treatment of fractures of the middle third of the clavicle, using the technique of minimally invasive plate osteosynthesis (MIPO) with locking. Methods: Prospective case series, evaluating displaced fractures of the middle third of the clavicle submitted to MIPO with locking, with procedures performed by a single surgeon. Patients were evaluated at 12 months using the University of Los Angeles (UCLA) scale and anteroposterior radiographs of the clavicles with 45° cranial and caudal inclination, as well as reporting complications. Results: In total, 15 patients were evaluated. The median of surgical time was 50 minutes (IQR 35). The UCLA scale had a median of 35 (IQR 2) at 12 months. All patients presented fracture healing. Minor complications occurred in three cases (20%), with two (13.3%) evolving with plate prominence and one (6.7%) with local paresthesia, while major complications occurred in only one case (6.7%), with suture dehiscence requiring surgical re-approach. Conclusion: MIPO with locking is a viable option for the treatment of displaced fractures of the middle third of the clavicle, with excellent results according to the UCLA scale, fracture healing in all cases, and a low rate of complications. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar os resultados clínicos e radiográficos do tratamento cirúrgico de fraturas do terço médio da clavícula pela técnica de osteossíntese minimamente invasiva com placa (OMIP) bloqueada. Métodos: Série de casos prospectiva que avaliou fraturas desviadas do terço médio da clavícula submetidas à OMIP bloqueada, com procedimentos realizados por um único cirurgião. Os pacientes foram avaliados aos 12 meses por meio da escala da Universidade da Califórnia em Los Angeles (UCLA) e por radiografias das clavículas em anteroposterior (AP) com inclinação cranial e caudal de 45°, além de relatos de complicações. Resultados: Foram avaliados 15 pacientes. A mediana do tempo cirúrgico foi de 50 minutos (IIQ 35). A escala da UCLA aos 12 meses teve mediana de 35 (IIQ 2). Todos os pacientes apresentaram consolidação da fratura. Complicações menores ocorreram em três casos (20%): dois (13,3%) com proeminência da placa e um (6,7%) com parestesia local. Maiores complicações ocorreram em apenas um caso (6,7%), com deiscência de sutura, necessitando de reabordagem cirúrgica. Conclusão: A OMIP bloqueada se mostrou uma opção viável ao tratamento das fraturas desviadas do terço médio da clavícula, com resultados excelentes de acordo com a escala UCLA, consolidação em todos os casos e baixo índice de complicações. Nível de Evidência IV, Série de Casos.

https://doi.org/10.1590/1413-785220233102e263742

Evaluation of dexmedetomidine anesthesia-related temperature changes: preliminary retrospective observational study
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Cruz, Felipe Aparecido Ferreira da

; Falcão, Luiz Fernando dos Reis

; Amaral, José Luiz Gomes do

; Silva, Helga Cristina Almeida da

Brazilian Journal of Anesthesiology

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Abr 2022, Volume 72 Nº 2 Páginas 232 - 240

Resumo: En | Texto: En | PDF: En

Abstract Introduction and objective: Dexmedetomidine is a potent adrenergic alpha-2 agonist, and analgesic, sedative, anxiolytic and sympatholytic. Given there have been reports of dexmedetomidine associated temperature changes, in which these events have been associated with complications, our objective was to describe both temperature increase and decrease, during the intra and postoperative period (initial 24 hours), and factors associated, in patients who received dexmedetomidine for anesthesia/sedation in the surgical suite. Method: Retrospective observational study, analyzing charts of patients ≥ 18 years submitted to anesthesia/sedation with dexmedetomidine, between 1/1/2017 and 31/12/2017. Upper temperature threshold was considered ≥ 37.8°C, and lower, < 35°C. The association with dexmedetomidine was assessed by the OMS/UMC causality system and by the Naranjo algorithm. Results: The sample included 42 patients who received dexmedetomidine and whose temperature data were available, with predominance of men 26 (62%), 49.4/16.5 years old (mean/standard deviation), and weight 65/35.8 kg. None of the patients presented intraoperative temperature equal to or above 37.8°C or below 35°C. During the postoperative period, one patient presented an increase ≥ 37.8°C (2.4%) and three, temperature decrease < 35°C (7%). Surgery/anesthesia time and exposure time to dexmedetomidine were not appropriate linear predictors of maximum temperature. Older age (p < 0.01), longer exposure to dexmedetomidine (p < 0.05) and shorter surgery time (p < 0.01) were significant linear predictors for lower minimum temperature. Abbreviations: MH, malignant hyperthermia; UMC, Uppsala Monitoring Centre; ICU, Intensive Care Unit; WHO, World Health Organization. Conclusions: Increase ≥ 37.8°C/decrease < 35°C of temperature possibly associated with dexmedetomidine did not occur in the intraoperative period and had a low frequency during the postoperative period.

https://doi.org/10.1016/j.bjane.2021.02.062

Development and optimization by factorial design of polymeric nanoparticles for simvastatin delivery
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Malaquias, Dalila Pinto

; Dourado, Lays Fernanda Nunes

; Lana, Ângela Maria Quintão

; Souza, Fernando

; Vilela, José

; Andrade, Margareth

; Roa, Juan Pedro Bretas

; Carvalho-Junior, Álvaro Dutra de

; Leite, Elaine Amaral

Polímeros

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2022, Volume 32 Nº 2 elocation e2022016

Resumo: En | Texto: En | PDF: En

Abstract Controlled release systems can modify the release rate of drugs and direct them to specific sites of action, making them more effective and/or reducing the adverse effects. The objective of this study was investigated, poly(β-hydroxybutyrate) (PHB) and poly(ε-caprolactone) (PCL) nanospheres to improve the delivery of Simvastatin (SIM). Nanospheres were prepared by the emulsion/evaporation technique of the solvent, varying the amount of SIM added. The SIM quantification was performed using a validated high-performance liquid chromatography method. The average diameter and PDI of formulations without SIM were lower 250 nm and 0.3, respectively. Nanospheres containing 30% of SIM showed values of 265 nm and 0.09, respectively. The average zeta potential was -31.8 mV, suggesting the predominance of repulsive forces that prevent aggregation. In vitro release suggest transport occurs by diffusion. Morphological analysis demonstrated spherical particles and rough surfaces. In conclusion, data suggest that PHB/PCL nanospheres are promising delivery systems to SIM.

https://doi.org/10.1590/0104-1428.20220016

ACUTE EFFECTS OF DIFFERENT INTENSITIES RESISTANCE TRAINING ON INFLAMMATORY MARKERS OF WOMEN WITH SEVERE OBESITY
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Cavalcanti, Thaurus Vinícius de Oliveira

; Diniz, Luís Felipe de Almeida

; Silva, Bárbara Amaral Bruno

; Santos, José Cristiano Faustino dos

; Lima, Luiz Fernando de

; Diniz, Madi Veiga

; Lorena, Virgínia Maria Barros de

; Carvalho, Paulo Roberto Cavalcanti

Journal of Physical Education

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2022, Volume 33 elocation e3358

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

RESUMO Este estudo objetivou comparar os efeitos agudos entre uma sessão de treinamento de força de alta versus moderada intensidade sobre marcadores inflamatórios em mulheres com obesidade severa. Estudo experimental do tipo cross-over, realizado com mulheres adultas com obesidade severa (IMC ≥ 40,0 kg/m²; idade ≥ 18 anos). Cada participante realizou uma sessão de treinamento de força de alta e de moderada intensidade (HIRT e MIRT, respectivamente) com intervalo de 7 dias entre as sessões. Quatro exercícios foram realizados em ambos os protocolos, com volume total de treino equalizado. O MIRT consistiu em 3 séries de 8 repetições cada, com intensidade de 75% de 1RM, enquanto o HIRT consistiu em 2 séries de 6 repetições, seguidas de um descanso de 20 segundos, com nova execução de 2 a 3 repetições, com mais um descanso de 20s e finalização com mais 2 a 3 repetições, com intensidade de 85% de 1RM. Amostras de sangue foram coletadas antes, 15 minutos após e 24 horas após ambos os protocolos de treino. Os marcadores inflamatórios analisados foram IL-2, IL-4, IL-6, IL-10, TNF-α e IFN-γ. Nove participantes completaram a intervenção (n=9; 35,2 ± 10,93 anos; IMC = 48,3 ± 5,06 kg/m²). O teste U de Mann-Whitney mostrou que não houve diferença significativa entre HIRT e MIRT na concentração dos marcadores. O teste de Friedman não mostrou diferenças significativas entre as medidas intragrupo para HIRT e MIRT. Esta pesquisa sugere que uma única sessão de treinamento de força de alta ou moderada intensidade não altera o estado inflamatório de mulheres com obesidade severa.

ABSTRACT This study objective to compare the acute effects between one resistance training bout with high versus moderate intensities on inflammatory markers in women with severe obesity. Experimental crossover study, performed with adult women with severe obesity (BMI ≥ 40.0 kg/m²; age ≥ 18 years old). Each participant performed a high and moderate intensity resistance training (HIRT and MIRT, respectively) with an interval of 7 days between bouts. Four exercises were performed in the both protocols, with total training volume equalized. MIRT consisted of 3 sets of 8 repetitions each, with an intensity of 75% of 1RM, while HIRT consisted of 2 sets of 6 repetitions, followed by a 20-second rest, with a new performance of 2 to 3 repetitions, with one more rest of 20s and finishing with 2 to 3 more repetitions, at an intensity of 85% of 1RM. Blood samples were collected before, 15 minutes after and 24 hours after both training protocols. The inflammatory markers analyzed were IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ. Nine participants have completed the intervention (n=9; 35.2 ± 10.93 years old; BMI = 48.3 ± 5.06 kg/m²). The Mann-Whitney U test showed that there was no significant difference between the HIRT and MIRT in the concentration of markers. Friedman's test did not report significant differences between intragroup measures for the HIRT as well as MIRT. This research suggests that a single session of high or moderate intensity resistance training does not change the inflammatory status of women with severe obesity.

https://doi.org/10.4025/jphyseduc.v33i1.3358

Surface and micromechanical analysis of polyurethane plates with hydroxyapatite for bone structure
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Amaral, Wenderson da Silva do

; Mendes, Milton Thélio de Albuquerque

; Câmara, João Victor Frazão

; Pierote, Josué Junior Araujo

; Reis, Fernando da Silva

; Matos, José Milton Elias de

; Fialho, Ana Cristina Vasconcelos

; Moura, Walter Leal de

Polímeros

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2022, Volume 32 Nº 4 elocation e2022040

Resumo: En | Texto: En | PDF: En

Abstract To analyze the surface topography and mechanical properties of a polyurethane derived from castor oil reinforced with hydroxyapatite (PU–HA) for bone fixation. The surface analysis was performed by Scanning Electron Microscopy (SEM) and the mechanical properties by Vickers microhardness and tensile tests. The SEM images showed that the PU surface presented important characteristics for materials intended for bone fixation, such as an irregular and porous surface. The analysis showed a surface with alternating areas with depressions and elevations of approximately 80±100 µm, presence of pores of 12 µm in size. The microhardness analysis showed values of 0.42±1.01 HV for PU–HA plates, lower in relation to the poly lactic-co-glycolic acid (PLGA) plate (control group). The elastic modulus and ultimate tensile strength of 317.4 MPa, and 35.57 MPa for PLGA sample, 1.187 MPa, and 0.29 MPa for PU–HA sample. The PU produced showed good surface properties, however demands better mechanical properties.

https://doi.org/10.1590/0104-1428.20220058

Incidence and risk factors of postoperative visual function impairment in elderly patients undergoing nonocular surgery: a prospective cohort study
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Badessa, Guinther G.

; Almeida, Juliano Pinheiro

; Fukushima, Julia Tizue

; Badessa, Marianne

; Colella, Felipe

; Torres, Marcelo L.

; Alves, Milton Ruiz

; Falcão, Luiz Fernando R.

; Silveira, Cirilo Haddad

; Alfano, Adeli Mariane Vieira Lino

; Amaral Neto, Mauricio

; Nakashima, Aloísio Fumio

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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Dez 2021, Volume 71 Nº 6 Páginas 599 - 606

Resumo: En | Texto: En | PDF: En

Abstract Background: Elderly patients may present with visual function impairment after surgery, which may increase the incidence of postoperative delirium and falls and decrease their quality of life. The aim of this study was to assess visual function in elderly patients after long-duration nonocular surgery to determine the incidence and risk factors for visual function impairment after surgery. Methods: This prospective and observational study included patients aged between 60 and 80 years who had been scheduled for elective non-ocular surgery expected to last longer than 120 minutes under general anaesthesia. Ocular examinations were performed before surgery, on post-operative day 3 and on post-operative day 21 and consisted of a LogMAR-Snellen chart test, a Jager chart test, biomicroscopy, optical tonometry, ocular motility assessment and fundoscopy. Baseline characteristics of all patients as well as intraoperative and postoperative data were collected. Results: A total of 107 patients were included in the final analysis. Visual function impairment was diagnosed in 21 patients (19.6%) at POD 3. Of those, 7 patients (6.5%) still presented with visual changes at POD 21. On POD 3, compared with that at baseline, visual acuity assessed by the Snellen chart test had decreased in these patients. Significant differences regarding refraction tests and intraocular pressure measures were also found. Multivariable analysis identified diabetes mellitus, duration of surgery, hypotension during anaesthesia induction, lower peripheral oxygen saturation at the end of the procedure and body mass index as independent risk factors for postoperative visual impairment. Conclusion: In elderly patients undergoing long-duration non-ocular procedures under general anaesthesia, the incidence of visual function impairment was considerably high. Most patients recovered to baseline visual function, but clinically significant visual changes may still be present 3 weeks after surgery. Obesity, diabetes mellitus, and the duration of surgical and anaesthetic techniques appear to increase the risk of visual impairment after surgery.

https://doi.org/10.1016/j.bjane.2021.09.002

Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
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Becker, Jefferson

; Ferreira, Lis Campos

; Damasceno, Alfredo

; Bichuetti, Denis Bernardi

; Christo, Paulo Pereira

; Callegaro, Dagoberto

; Peixoto, Marco Aurélio Lana

; Sousa, Nise Alessandra De Carvalho

; Almeida, Sérgio Monteiro De

; Adoni, Tarso

; Santiago-Amaral, Juliana

; Junqueira, Thiago

; Pereira, Samira Luisa Apóstolos

; Gomes, Ana Beatriz Ayroza Galvão Ribeiro

; Pitombeira, Milena

; Paolilo, Renata Barbosa

; Grzesiuk, Anderson Kuntz

; Piccolo, Ana Claudia

; D´Almeida, José Arthur Costa

; Gomes Neto, Antonio Pereira

; Oliveira, Augusto Cesar Penalva De

; Oliveira, Bianca Santos De

; Tauil, Carlos Bernardo

; Vasconcelos, Claudia Ferreira

; Kaimen-Maciel, Damacio

; Varela, Daniel

; Diniz, Denise Sisterolli

; Oliveira, Enedina Maria Lobato De

; Malfetano, Fabiola Rachid

; Borges, Fernando Elias

; Figueira, Fernando Faria Andrade

; Gondim, Francisco De Assis Aquino

; Passos, Giordani Rodrigues Dos

; Silva, Guilherme Diogo

; Olival, Guilherme Sciascia Do

; Santos, Gutemberg Augusto Cruz Dos

; Ruocco, Heloisa Helena

; Sato, Henry Koiti

; Soares Neto, Herval Ribeiro

; Cortoni Calia, Leandro

; Gonçalves, Marcus Vinícius Magno

; Vecino, Maria Cecilia Aragón De

; Pimentel, Maria Lucia Vellutini

; Ribeiro, Marlise De Castro

; Boaventura, Mateus

; Parolin, Mônica Koncke Fiuza

; Melo, Renata Brant De Souza

; Lázaro, Robson

; Thomaz, Rodrigo Barbosa

; Kleinpaul, Rodrigo

; Dias, Ronaldo Maciel

; Gomes, Sidney

; Lucatto, Simone Abrante

; Alves-Leon, Soniza Vieira

; Fukuda, Thiago

; Ribeiro, Taysa Alexandrino Gonsalves Jubé

; Winckler, Thereza Cristina D’ávila

; Fragoso, Yara Dadalti

; Nascimento, Osvaldo José Moreira Do

; Ferreira, Maria Lucia Brito

; Mendes, Maria Fernanda

; Brum, Doralina Guimarães

; Glehn, Felipe Von

Arquivos de Neuro-Psiquiatria

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Nov 2021, Volume 79 Nº 11 Páginas 1049 - 1061

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

RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.

ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

https://doi.org/10.1590/0004-282x-anp-2021-0162 1 downloads

Atualização da Diretriz Brasileira de Hipercolesterolemia Familiar – 2021
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Izar, Maria Cristina de Oliveira

; Giraldez, Viviane Zorzanelli Rocha

; Bertolami, Adriana

; Santos Filho, Raul Dias dos

; Lottenberg, Ana Maria

; Assad, Marcelo Heitor Vieira

; Saraiva, José Francisco Kerr

; Chacra, Ana Paula M.

; Martinez, Tania L. R.

; Bahia, Luciana Ribeiro

; Fonseca, Francisco Antonio Helfenstein

; Faludi, Andre Arpad

; Sposito, Andrei C.

; Chagas, Antônio Carlos Palandri

; Jannes, Cinthia Elim

; Amaral, Cristiane Kovacs

; Araújo, Daniel Branco de

; Cintra, Dennys Esper

; Coutinho, Elaine dos Reis

; Cesena, Fernando

; Xavier, Hermes Toros

; Mota, Isabela Cardoso Pimentel

; Giuliano, Isabela de Carlos Back

; Faria Neto, José Rocha

; Kato, Juliana Tieko

; Bertolami, Marcelo Chiara

; Miname, Marcio Hiroshi

; Castelo, Maria Helane Costa Gurgel

; Lavrador, Maria Sílvia Ferrari

; Machado, Roberta Marcondes

; Souza, Patrícia Guedes de

; Alves, Renato Jorge

; Machado, Valeria Arruda

; Salgado Filho, Wilson

Arquivos Brasileiros de Cardiologia

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Out 2021, Volume 117 Nº 4 Páginas 782 - 844

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

https://doi.org/10.36660/abc.20210788 231 downloads

Effect of anesthetic technique on the quality of anesthesia recovery for abdominal histerectomy: a cross-observational study
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Carli, Daniel de

; Meletti, José Fernando Amaral

; Camargo, Rodrigo Pauperio Soares de

; Gratacós, Larissa Schneider

; Gomes, Victor Cristiano Ramos

; Marques, Nicole Dutra

Brazilian Journal of Anesthesiology

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Jun 2021, Volume 71 Nº 3 Páginas 221 - 227

Resumo: En | Texto: En | PDF: En

Abstract Introduction Spinal anesthesia combined with sedation and general anesthesia combined with epidural are two techniques often used for patients undergoing abdominal hysterectomy. There is no consensus that one of these techniques is superior regarding the perception of patients towards the quality of postoperative recovery. This observational cross-sectional study aimed to assess the quality of postoperative recovery in women undergoing open abdominal hysterectomy by comparing both anesthetic techniques. Method We recruited 162 women aged between 30 and 74 years to be submitted to abdominal hysterectomy. The anesthetic technique used followed the preference of the attending anesthesiologist without interference of the investigators. After applying the exclusion criteria, 80 patients underwent spinal anesthesia combined with sedation (Group 1) and 62 women underwent epidural anesthesia combined with general anesthesia (Group 2). The quality of postoperative recovery was evaluated using the questionnaire Quality of Recovery-40 (QoR-40) completed 24 hours after the end of the surgery. Results Eighty patients in Group 1 answered the QoR-40 questionnaire with an average rating of 179.4 points, median of 186.5, standard deviation of 17.4 and a confidence interval of 3.8. The 60 patients in Group 2 answered the QoR-40 with an average of 174.9 points, median of 178 points, standard deviation of 16 points and a confidence interval of 4.0 (p= 0.024). Conclusion Women who received spinal anesthesia combined with sedation considered quality of postoperative recovery better.

https://doi.org/10.1016/j.bjane.2021.01.013 2 downloads

10.

Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba

; Rodrigues, Cibele Isaac Saad

; Bortolotto, Luiz Aparecido

; Mota-Gomes, Marco Antônio

; Brandão, Andréa Araujo

; Feitosa, Audes Diógenes de Magalhães

; Machado, Carlos Alberto

; Poli-de-Figueiredo, Carlos Eduardo

; Amodeo, Celso

; Mion Júnior, Décio

; Barbosa, Eduardo Costa Duarte

; Nobre, Fernando

; Guimarães, Isabel Cristina Britto

; Vilela-Martin, José Fernando

; Yugar-Toledo, Juan Carlos

; Magalhães, Maria Eliane Campos

; Neves, Mário Fritsch Toros

; Jardim, Paulo César Brandão Veiga

; Miranda, Roberto Dischinger

; Póvoa, Rui Manuel dos Santos

; Fuchs, Sandra C

; Alessi, Alexandre

; Lucena, Alexandre Jorge Gomes de

; Avezum, Alvaro

; Sousa, Ana Luiza Lima

; Pio-Abreu, Andrea

; Sposito, Andrei Carvalho

; Pierin, Angela Maria Geraldo

; Paiva, Annelise Machado Gomes de

; Spinelli, Antonio Carlos de Souza

; Nogueira, Armando da Rocha

; Dinamarco, Nelson

; Eibel, Bruna

; Forjaz, Cláudia Lúcia de Moraes

; Zanini, Claudia Regina de Oliveira

; Souza, Cristiane Bueno de

; Souza, Dilma do Socorro Moraes de

; Nilson, Eduardo Augusto Fernandes

; Costa, Elisa Franco de Assis

; Freitas, Elizabete Viana de

; Duarte, Elizabeth da Rosa

; Muxfeldt, Elizabeth Silaid

; Lima Júnior, Emilton

; Campana, Erika Maria Gonçalves

; Cesarino, Evandro José

; Marques, Fabiana

; Argenta, Fábio

; Consolim-Colombo, Fernanda Marciano

; Baptista, Fernanda Spadotto

; Almeida, Fernando Antonio de

; Borelli, Flávio Antonio de Oliveira

; Fuchs, Flávio Danni

; Plavnik, Frida Liane

; Salles, Gil Fernando

; Feitosa, Gilson Soares

; Silva, Giovanio Vieira da

; Guerra, Grazia Maria

; Moreno Júnior, Heitor

; Finimundi, Helius Carlos

; Back, Isabela de Carlos

; Oliveira Filho, João Bosco de

; Gemelli, João Roberto

; Mill, José Geraldo

; Ribeiro, José Marcio

; Lotaif, Leda A. Daud

; Costa, Lilian Soares da

; Magalhães, Lucélia Batista Neves Cunha

; Drager, Luciano Ferreira

; Martin, Luis Cuadrado

; Scala, Luiz César Nazário

; Almeida, Madson Q.

; Gowdak, Marcia Maria Godoy

; Klein, Marcia Regina Simas Torres

; Malachias, Marcus Vinícius Bolívar

; Kuschnir, Maria Cristina Caetano

; Pinheiro, Maria Eliete

; Borba, Mario Henrique Elesbão de

; Moreira Filho, Osni

; Passarelli Júnior, Oswaldo

; Coelho, Otavio Rizzi

; Vitorino, Priscila Valverde de Oliveira

; Ribeiro Junior, Renault Mattos

; Esporcatte, Roberto

; Franco, Roberto

; Pedrosa, Rodrigo

; Mulinari, Rogerio Andrade

; Paula, Rogério Baumgratz de

; Okawa, Rogério Toshiro Passos

; Rosa, Ronaldo Fernandes

; Amaral, Sandra Lia do

; Ferreira-Filho, Sebastião R.

; Kaiser, Sergio Emanuel

; Jardim, Thiago de Souza Veiga

; Guimarães, Vanildo

; Koch, Vera H.

; Oigman, Wille

; Nadruz, Wilson

Arquivos Brasileiros de Cardiologia

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Mar 2021, Volume 116 Nº 3 Páginas 516 - 658

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

https://doi.org/10.36660/abc.20201238 10948 downloads

11.

SYNTHESIS, CHARACTERIZATION, DFT MODELING AND IN VITRO ANTIMYCOBACTERIAL ACTIVITY ASSAYS OF A SILVER(I)-ISONIAZID COMPLEX
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Paris Junior, José Alberto

; Cavicchioli, Maurício

; Machado, Rachel Temperani Amaral

; Pavan, Fernando Rogério

; Nakahata, Douglas Hideki

; Corbi, Pedro Paulo

; Costa, Adão Marcos Ferreira

; Pereira, Douglas Henrique

; Massabni, Antonio Carlos

Química Nova

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Mar 2021, Volume 44 Nº 3 Páginas 278 - 283

Resumo: En | Texto: En | PDF: En

In the present work, a silver(I) complex with the antimycobacterial drug isoniazid (inh) is described. Elemental and thermogravimetric analyses confirmed a 1:1 metal:ligand ratio for the silver-isoniazid (Ag-inh) complex with molecular composition AgC6H7N3O·NO3. Infrared (IR) analysis suggests a bidentate coordination of isoniazid to silver by the nitrogen of the NH2 group and by the oxygen of the C=O group, and also confirms the presence of free nitrate anion. Coordination by the NH2 group was reinforced by NMR measurements. Computational simulations using the density functional theory (DFT) reinforced that the ligand coordinates to the silver atom by the NH2 and C=O groups. The silver complex presented a minimal inhibitory concentration (MIC90) of 0.78 µg/mL against the standard Mycobacterium tuberculosis strain H37Rv. The data reported herein warrants further investigation on Ag-inh complex as a potential agent against tuberculosis.

https://doi.org/10.21577/0100-4042.20170681 103 downloads

12.

Ações realizadas na atenção primária à saúde às pessoas com transtorno mental: revisão integrativa
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Miranda, Priscilla Ingrid Gomes

; Amaral, Jackeline Vieira

; Sales, Jaqueline Carvalho e Silva

; Silva Júnior, Fernando José Guedes da

; Costa, Ana Paula Cardoso

Rev Rene

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2021, Volume 22 elocation e60496

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

ABSTRACT Objective to synthesize the types of actions developed by the multiprofessional team in the primary health care to people with mental disorders. Methods integrative review, carried out in the databases Medical Literature Analysis and Retrieval System Online, via PubMed, Web Of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem, and Índice Bibliográfico Espanhol de Ciências de Saúde. Results six studies were selected and grouped into the following axes: actions with the use of digital technologies (PyDeSalud.com platform; Partnering to Achieve School Success; Audio computer-assisted self-interview version of the Alcohol, Smoking and Substance Involvement Screening Test) and traditional actions (questionnaires during consultation; intervention in stages; support network to stop smoking). Conclusion evidences show that traditional or digital actions in mental health are necessary to offer an integral care. The multiprofessional team has the tendency to incorporate digital technologies to care for these people.

RESUMO Objetivo sintetizar os tipos de ações desenvolvidas pela equipe multiprofissional na atenção primária às pessoas com transtornos mentais. Métodos revisão integrativa, realizada nas bases Medical Literature Analysis and Retrieval System Online, via PubMed, Web Of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem, Índice Bibliográfico Espanhol de Ciências de Saúde. Resultados foram selecionados seis estudos, agrupados em dois eixos: ações com uso de tecnologias digitais (Plataforma Web PyDeSalud.com; Partnering to Achieve School Success; Audio computer-assisted self-interview version of the Alcohol, Smoking and Substance Involvement Screening Test) e ações tradicionais (questionário durante consulta; intervenção escalonada; rede de apoio à cessação do tabagismo). Conclusão as evidências demonstram que ações tradicionais ou digitais, em saúde mental, são necessárias para integralidade do cuidado. Há tendência à incorporação, pela equipe multiprofissional, de tecnologias digitais para cuidado a essas pessoas.

https://doi.org/10.15253/2175-6783.20212260496 519 downloads

13.

Effect of anesthetic technique on the quality of anesthesia recovery for abdominal histerectomy: a cross-observational study
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Carli, Daniel de

; Meletti, José Fernando Amaral

; Camargo, Rodrigo Pauperio Soares de

; Gratacós, Larissa Schneider

; Gomes, Victor Cristiano Ramos

; Marques, Nicole Dutra

Brazilian Journal of Anesthesiology

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2021, Nº ahead

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.01.013 14 downloads

14.

Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
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Jácome, Cristina

; Amaral, Rita

; Almeida, Rute

; Pereira, Ana Margarida

; Couto, Mariana

; Araújo, Luís

; Alves-Correia, Magna

; Pereira, Mariana

; Ferreira-Magalhães, Manuel

; Loureiro, Cláudia Chaves

; Catarata, Maria Joana

; Santos, Lília Maia

; Cabral, Sara

; Pereira, João

; Ramos, Bárbara

; Lopes, Cristina

; Mendes, Ana

; Lopes, Anabela

; Rodrigues, José Carlos Cidrais

; Oliveira, Georgeta

; Aguiar, Ana Paula

; Afonso, Ivete

; Carvalho, Joana

; Arrobas, Ana Maria

; Costa, José

; Valério, Margarida

; Pereira, Marta

; Almeida, Teresa

; Dias, Joana

; Bom, Ana Todo

; Azevedo, João

; Ribeiro, Carmelita

; Alves, Marta

; Pinto, Paula Leiria

; Neuparth, Nuno

; Neves, Ana Castro

; Palhinha, Ana

; Marques, João Gaspar

; Martins, Pedro

; Trincão, David Pina

; Todo-Bom, Filipa

; Santos, Maria Alvarenga

; Branco, Joana

; Costa, Alberto

; Neto, Armandina Silva

; Santalha, Marta

; Lozoya, Carlos

; Santos, Natacha

; Silva, Diana

; Vasconcelos, Maria João

; Barata, Luís Taborda

; Teixeira, Maria Fernanda

; Pinto, Diana

; Alves, Rodrigo Rodrigues

; Moreira, Ana Sofia

; Pinto, Cláudia Sofia

; Silva, Pedro Morais

; Alves, Carlos

; Câmara, Raquel

; Coelho, Didina

; Bordalo, Diana

; Carvalho, Fernanda

; Fernandes, Ricardo

; Ferreira, Rosário

; Oliveira, José Ferraz de

; Menezes, Fernando

; Gomes, Ricardo

; Calix, Maria José

; Marques, Ana

; Cardoso, João

; Emiliano, Madalena

; Gerardo, Rita

; Nunes, Carlos

; Ferreira, José Alberto

; Lopes, Inês

; Alves, Adelaide

; Fonseca, João Almeida

Revista Portuguesa de Imunoalergologia

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Dez 2020, Volume 28 Nº 4 Páginas 231 - 240

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

Objetivos: Identificar clusters de controlo da asma baseados no Teste de Controlo da Asma e Rinite Alérgica (CARAT) e comparar as características dos doentes nos diferentes clusters. Métodos: Adultos e adolescentes (≥13 anos) com asma persistente foram recrutados em 29 centros no contexto de 2 estudos observacionais do projeto INSPIRERS. Foram recolhidos dados relativos a características demográficas e clínicas, adesão ao inalador, crenças sobre a medicação, sintomas de ansiedade e depressão, qualidade de vida e controlo da asma (CARAT, >24 bom controlo). Foi efetuada uma análise hierárquica de clusters usando a pontuação total do CARAT (CARAT-T).Resultados: Foram analisados 410 doentes (68% adultos), com uma idade mediana (percentil 25-percentil 75) de 28 (16-46) anos. Foram identificados três clusters [média CARAT-T(min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] e cluster 3 [10(2-13)]. Os doentes no cluster 1 (34%) apresentavam melhor controlo da asma, melhor qualidade de vida, maior adesão aos inaladores e usavam um único inalador. Os doentes nos clusters 2 (50%) e 3 (16%) tinham a asma não controlada, menor adesão aos inaladores, mais sintomas de ansiedade e depressão e mais de metade reportavam pelo menos uma exacerbação no último ano. Adicionalmente, os doentes no cluster 3 eram predominantemente mulheres, tinham mais consultas médicas não agendadas, apresentavam mais sintomas de ansiedade, percebiam uma maior necessidade dos inaladores, mas também uma maior preocupação associada ao seu uso. Não se verificaram diferenças na idade, índice de massa corporal, função pulmonar, hábitos tabágicos, hospitalizações ou tempo de seguimento pelo médico especialista. Conclusões: Um método não supervisionado baseado no CARAT-T, identificou 3 clusters de doentes com diferentes características clínicas. O cluster com melhor controlo apresenta um ponto de corte semelhante ao estabelecido no estudo de validação do CARAT. Este estudo sugere ainda a existência de um ponto de corte adicional para distinguir doença mais grave. Mais investigação é necessária para validar os clusters identificados

Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25-percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT-T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.

https://doi.org/10.32932/rpia.2020.12.046 633 downloads

15.

Infliximab-induced remission improves physical activity in patients with active Crohn's disease
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Lucca, Fernando de Azevedo

; Malaguti, Carla

; Chebli, Liliana Andrade

; Reboredo, Maycon Moura

; Pinheiro, Bruno Valle

; Ribeiro, Tarsila Campanha da Rocha

; Azevedo, Felipe Meirelles de

; Corrêa, José Otávio do Amaral

; Gaburri, Pedro Duarte

; Chebli, Julio Maria Fonseca

Revista da Associação Médica Brasileira

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Nov 2020, Volume 66 Nº 11 Páginas 1566 - 1572

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RESUMO OBJETIVO: Comparar o nível de atividade física (AF), capacidade de exercício e composição corporal antes e após remissão clínica induzida por infliximabe em pacientes com doença de Crohn (DC). MÉTODOS: Neste estudo longitudinal prospectivo, foram envolvidos 44 pacientes ambulatoriais adultos com DC ativa avaliados antes e depois de 24 semanas de terapia com infliximabe. Os pacientes foram avaliados quanto à AF, capacidade de exercício, força muscular e composição corporal. RESULTADOS: 38(86,4%) pacientes alcançaram remissão induzida por infliximabe em 24 semanas e apresentaram aumento no número de passos de 1092 (7440±2980 vs. 6348±3177, respectivamente; p=0,006). O tempo de inatividade foi reduzido quando comparado ao basal (454,2±106,3 vs. 427,9±97,8, respectivamente; p=0,033). Não houve diferença na distância percorrida antes e após a terapia com infliximabe, enquanto houve aumento no índice de massa gorda nos respondedores ao infliximabe em comparação ao basal (19,1±7,6 vs. 14,9±5,8; p=0,001). CONCLUSÕES: A remissão induzida pelo infliximabe mostrou-se eficaz no aumento da atividade física, melhorando o número de passos e reduzindo o tempo inativo. A manutenção da remissão clínica associada a incentivos à AF regular pode contribuir para que esses pacientes atinjam um nível ideal de AF.

SUMMARY AIM: To compare the level of physical activity (PA), exercise capacity, and body composition before and after infliximab-induced clinical remission in patients with Crohn's disease (CD). METHODS: This prospective longitudinal study evaluated 44 adult outpatients with active CD before infliximab administration and 24 weeks after infliximab therapy. The patients were evaluated for PA in daily life, exercise capacity, muscle strength, and body composition. RESULTS: 38 (86.4%) patients achieved infliximab-induced remission at 24 weeks and presented an increment in the number of steps taken of 1092 (7440±2980 vs. 6348±3177, respectively; p=0.006). The inactive time was reduced when compared to the baseline value (454.2±106.3 vs. 427.9±97.8, respectively; p=0.033). There was no difference in the distance walked before and after infliximab therapy, while there was an increase in the fat mass index in responders to infliximab compared to the baseline (19.1±7.6 vs. 14.9±5.8; p=0.001). CONCLUSIONS: Infliximab-induced remission was shown to be effective for increasing physical activity by improving the number of steps and reducing inactive time. The maintenance of clinical remission associated with incentives to regular PA may contribute to making these patients reach an ideal level of PA.

https://doi.org/10.1590/1806-9282.66.11.1566 618 downloads

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