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Abstract Background The distinction between sensory neuronopathies (SN), which is by definition purely sensory, and sensory polyneuropathies (SP) and sensory multineuropathies (SM) is important for etiologic investigation and prognosis estimation. However, this task is often challenging in clinical practice. We hypothesize that F-wave assessment might be helpful, since it is able to detect subtle signs of motor involvement, which are found in SP and SM, but not in SN. Objective The aim of the present study was to determine whether F-waves are useful to distinguish SN from SP and SM. Methods We selected 21 patients with SP (12 diabetes mellitus, 4 transthyretin familial amyloid polyneuropathy, 4 others), 22 with SM (22 leprosy), and 26 with SN (13 immune-mediated, 10 idiopathic, 3 others) according to clinical-electrophysiological-etiological criteria. For every subject, we collected data on height and performed 20 supramaximal distal stimuli in median, ulnar, peroneal, and tibial nerves, bilaterally, to record F-waves. Latencies (minimum and mean) and persistences were compared across groups using the Kruskal-Wallis and Bonferroni tests. P-values < 0.05 were considered significant. Results All groups were age, gender, and height-matched. Overall, there were no significant between-group differences regarding F-wave latencies. In contrast, F-wave persistence was able to stratify the groups. Peroneal F-wave persistence was higher, bilaterally, in the SN group compared to SM and SP (p < 0.05). In addition, F-waves persistence of the ulnar and tibial nerves was also helpful to separate SN from SP (p < 0.05). Conclusion F-wave persistence of the peroneal nerves might be an additional and useful diagnostic tool to differentiate peripheral sensory syndromes.

Resumo Antecedentes A distinção entre neuronopatias sensitivas (SN) e polineuropatias sensitivas (SP) e multineuropatias sensitivas (SM) é importante para a investigação etiológica e para o prognóstico. Contudo, esta tarefa é desafiadora na prática clínica. Hipotetizou-se que a avaliação das ondas-F pode ser útil, por ser capaz de detectar envolvimento motor nas SP e SM, mas não nas SN. Objetivo Determinar se as ondas-F podem ajudar a distinguir entre SN, SP e SM. Métodos Selecionou-se 21 pacientes com SP (12 diabetes mellitus, 4 ATTR-FAP e 4 com outras neuropatias), 22 com SM (22 hanseníases) e 26 com SN (13 imunomediadas, 10 idiopáticas e 3 com outras neuronopatias), de acordo com critérios clínicos, etiológicos e eletrofisiológicos. Para cada indivíduo, foi aferida a altura e foram aplicados 20 estímulos distais supramáximos nos nervos mediano, ulnar, fibular e tibial, bilateralmente, para registrar as ondas-F. Uma comparação foi feita, por grupo, das latências (mínimas e médias) e persistências pelos testes Kruskal-Wallis e Bonferroni. Valores de p < 0.05 foram considerados estatisticamente significativos. Resultados Todos os grupos foram pareados por idade, sexo e altura. Não houve diferença estatística significativa entre os grupos quanto às latências das ondas-F. A persistência da onda-F foi capaz de estratificar os grupos, sendo as dos nervos fibulares bilateralmente maiores no grupo SN que nos grupos SM e SP (p < 0.05). Adicionalmente, a persistência das ondas-F dos nervos ulnares e tibiais também foi útil para distinguir SN de SP (p < 0.05). Conclusão A persistência das ondas-F dos nervos fibulares pode ser uma ferramenta adicional e útil para diferenciar síndromes sensitivas periféricas.

https://doi.org/10.1055/s-0043-1772599

Detection of Bartonella henselae DNA in the blood of patients with livedoid vasculopathy
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Drummond, Marina Rovani

; Santos, Luciene Silva dos

; Souza, Lais Bomediano

; Mitsuushi, Gabriela Nero

; Cintra, Maria Letícia

; França, Andrea Fernandes Eloy da Costa

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Anais Brasileiros de Dermatologia

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Ago 2023, Volume 98 Nº 4 Páginas 472 - 479

Resumo: En | Texto: En | PDF: En

Abstract Background: Livedoid vasculopathy (LV) manifests as ulcers and atrophic white scars on the lower extremities. The main known etiopathogenesis is hypercoagulability with thrombus formation, followed by inflammation. Thrombophilia, collagen and myeloproliferative diseases may induce LV, but the idiopathic (primary) form predominates. Bartonella spp. may cause intra-endothelial infection and skin manifestations caused by these bacteria may be diverse, including leukocytoclastic vasculitis and ulcers. Objective: The aim of this study was to investigate the presence of bacteremia by Bartonella spp. in patients with difficult-to-control chronic ulcers diagnosed as primary LV. Methods: Questionnaires and molecular tests (conventional PCR, nested PCR and real-time PCR) were applied and liquid and solid cultures were performed in the blood samples and blood clot of 16 LV patients and 32 healthy volunteers. Results: Bartonella henselae DNA was detected in 25% of LV patients and in 12.5% of control subjects but failed to reach statistically significant differences (p = 0.413). Study limitations: Due to the rarity of primary LV, the number of patients studied was small and there was greater exposure of the control group to risk factors for Bartonella spp. infection. Conclusion: Although there was no statistically significant difference between the groups, the DNA of B. henselae was detected in one of every four patients, which reinforces the need to investigate Bartonella spp. in patients with primary LV.

https://doi.org/10.1016/j.abd.2022.07.007

Characterization of meibomian gland dysfunction in patients with rosacea
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Barbosa, Eduardo Buzolin

; Tavares, Carla Melo

; Silva, Dimitri Felipe Luz da

; Santos, Lorraine Souza

; França, Andrea Fernandes Eloy da Costa

; Alves, Monica

Arquivos Brasileiros de Oftalmologia

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Jul 2023, Volume 86 Nº 4 Páginas 365 - 371

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

ABSTRACT Purpose: To compare ocular surface parameters in rosacea patients with those of controls. Methods: Ninety-three participants took part in this cross-sectional, observational, non-interventional study. These consisted of a rosacea group (n=40) and a control group (n=53). We compared objective parameters of the ocular surface, including conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, and ocular surface staining, between the two groups. Results: In the rosacea group, 69.23% were female. The mean age was 47.34 ± 12.62 years old. No statistically significant differences between groups were found in visual acuity (p=0.987), tear film parameters (tear meniscus height (p=0.338), noninvasive tear film rupture time (p=0.228), invasive rupture time (p=0.471), Schirmer’s test scores (p=0.244), conjunctival hyperemia (p=0.106), and fluorescein staining (p=0.489). Significant differences were found in meibography evaluations (p=0.026), mucous layer integrity (p=0.015), and ocular surface symptoms (p<0.0001). Rosacea patients also showed important eyelid differences in glandular expressibility (p<0.001), glandular secretion pattern (p<0.001), and telangiectasia (p<0.001) compared to controls. Conclusion: Meibomian gland dysfunction is frequently associated with dermatological conditions. It can be observed in morphological findings from meibography as well as lipid secretion impairment, leading to evaporative dry eye, ocular surface dysfunction, and inflammation.

RESUMO Objetivo: Avaliar as alterações da superfície ocular em pacientes com Rosácea, e comparar com grupo controle. Métodos: Noventa e três indivíduos foram selecionados para este estudo transversal, observacional e não intervencionista, dividido em dois grupos: rosácea (n=40) e controles (n=53). Foram avaliados parâmetros objetivos da superfície ocular (hiperemia conjuntival, estabilidade e volume do filme lacrimal, disfunção da glândula meibomiana, doença do olho seco, coloração da superfície ocular) e comparado indivíduos saudáveis com pacientes com rosácea. Resultados: 69,23% dos indivíduos com rosácea eram mulheres, com média de idade de 47,34 ± 12,62 anos. Em comparação com controles pareados, não foram evidenciadas diferenças estatisticamente significativas em relação à acuidade visual (p=0,987) e parâmetros do filme lacrimal (altura do menisco lacrimal (p=0,338), tempo de ruptura do filme lacrimal não invasivo (p=0,228), tempo invasivo de ruptura (p=0,471) e teste de Schirmer (p=0,244), bem como hiperemia conjuntival (p=0,106) e coloração com fluoresceína (p=0,489). Associação significativa foi encontrada na avaliação da meibografia (p=0,026), integridade da camada mucosa (p=0,015) e sintomas de superfície ocular (p<0,0001). Pacientes com rosácea também apresentaram alterações importantes na borda palpebral: expressibilidade glandular (p<0,001), padrão de secreção glandular (p<0,001) e telangiectasia (p<0,001). Conclusão: A disfunção da glândula de Meibômio está frequentemente associada a condições dermatológicas e é caracterizada por achados morfológicos na meibografia, bem como comprometimento da secreção lipídica que leva ao olho seco evaporativo e alterações da superfície ocular e inflamação.

https://doi.org/10.5935/0004-2749.20230043

Bartonella henselae as a putative trigger for chronic type 2 leprosy reactions
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Santos, Luciene Silva dos

; Drummond, Marina Rovani

; Goulart, Isabela Maria Bernardes

; França, Andrea Fernandes Eloy da Costa

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Brazilian Journal of Infectious Diseases

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2023, Volume 27 Nº 6 elocation 103701

Resumo: En | Texto: En | PDF: En

Abstract Leprosy reactions are an acute inflammatory phenomenon that can arise before diagnosis, during treatment, or after cure of leprosy. These reactions are considered one of the main diseases that cause physical disabilities. Immunosuppressive treatment for these immune responses makes these patients susceptible to coinfections, which can trigger new leprosy reactions. The main objective of this study was to evaluate the occurrence of infection by Bartonella sp. in blood samples from 47 patients who had untreatable episodes of type 2 leprosy reactions for more than six months, comparing them with a control group. Cultures and molecular methods (PCR) were used. Amplicons from species-specific reactions and sequencing showed a higher prevalence of Bartonella henselae infection in patients, 19/47 (40.4 %), compared to control, 9/50 (18.0 %), p= 0.0149. Five patients accepted treatment for coinfection, and all showed improvement in leprosy reactions with treatment for B. henselae infection. We conclude that these bacteria can trigger chronic reactions of type 2 leprosy and should be investigated in these patients. Summary line Patients who have chronic type 2 leprosy reactions are more susceptible to Bartonella henselae infection than controls: 19/47 (40.4 %) compared 9/50 (18.0 %), p= 0.0149.

https://doi.org/10.1016/j.bjid.2023.103701

Paclobutrazol as a strategy to induce reproductive precocity in sour passion fruit
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Teixeira, Ednilson Carvalho

; Matsumoto, Sylvana Naomi

; Pereira, Luanna Fernandes

; Silva, Delmira da Costa

; Viana, Anselmo Eloy Silveira

; Gonçalves, Aline Novais Santos

Revista Brasileira de Fruticultura

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2023, Volume 45 elocation e-501

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

Abstract The adoption of growth regulators can be an alternative method to modulate the quality of the propagation material and obtain reproductive precocity. The objective was to evaluate if a gibberellin biosynthesis inhibitor affects the morphophysiological, biochemical and anatomical parameters of sour passion fruit seedlings and if such alterations affect the reproductive period. Two trials were conducted. In trial I, 40 days after emergence, the seedlings were immersed up to the substrate level in paclobutrazol (PBZ) solutions at concentrations of: 0, 40, 80, 120 and 160 mg L-1. At 45 days after the application of PBZ - DAA, the morphophysiology, biochemistry and anatomy were evaluated. Trail II was conducted in pots, using seedlings from trail I with 45 DAA of PBZ. At 200 days after transplanting, accumulation of shoots and roots fresh and dry mass (g), flowering speed index, total number of reproductive organs and SPAD index were evaluated. In seedlings, restriction of shoot growth induced by PBZ was associated with root increment, seedling quality, photosynthetic pigments and optimization of gas exchange. A shorter period of transition from the juvenile – vegetative phase to reproductive is observed when the seedlings were submitted to PBZ concentrations.

Resumo A adoção de reguladores de crescimento pode ser um método alternativo para modular a qualidade do material de propagação e obter precocidade reprodutiva. Objetivouse avaliar se os parâmetros morfofisiológicos, bioquímicos e anatômicos de mudas de maracujazeiro azedo são afetados por um inibidor da biossíntese de giberelina e, se tais alterações afetam o período reprodutivo. Foram conduzidos dois ensaios. No ensaio I, aos 40 dias após a emergência, as mudas foram imersas até o nível do substrato em soluções de paclobutrazol (PBZ) nas concentrações de: 0, 40, 80, 120 e 160 mg L-1. Aos 45 dias após a aplicação de PBZ – DAA, avaliou-se a morfofisiologia, bioquímica e anatomia. O ensaio II foi conduzido em vasos, utilizando mudas do ensaio I com 45 DAA de PBZ. Aos 200 dias após o transplantio, foram avaliados acúmulo de massas fresca e seca da parte aérea e raiz (g), índice de velocidade de florescimento, número total de órgãos reprodutivos e índice SPAD. Em mudas, a restrição do crescimento da parte aérea induzida pelo PBZ foi associada à incremento radicular, qualidade de mudas, pigmentos fotossintéticos e otimização das trocas gasosas. Menor período de transição da fase juvenil – vegetativa para reprodutiva é observado quando as mudas foram submetidas a concentrações a PBZ.

https://doi.org/10.1590/0100-29452023501

Characterization of meibomian gland dysfunction in patients with rosacea
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Barbosa, Eduardo Buzolin

; Tavares, Carla Melo

; Silva, Dimitri Felipe Luz da

; Santos, Lorraine Souza

; França, Andrea Fernandes Eloy da Costa

; Alves, Monica

Arquivos Brasileiros de Oftalmologia

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2022, Nº ahead

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

https://doi.org/10.5935/0004-2749.20230043

Degenerative injuries of the metatarsophalangeal plantar plate on magnetic resonance imaging: a new perspective
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Mann, Tania Szejnfeld

; Nery, Caio Augusto de Souza

; Baumfeld, Daniel

; Fernandes, Eloy de Ávila

einstein (São Paulo)

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2022, Volume 20 elocation eAO6543

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective The magnetic resonance imaging diagnostic criteria for a complete tear of metatarsophalangeal plantar plate are well-established. However, more subtle abnormalities can also occur and be a source of pain. The objective of this study is to determine the prevalence of degenerative plantar plate injuries in patients with metatarsalgia who underwent forefoot magnetic resonance imaging and describe the main abnormalities found. The hypothesis is that mild capsular fibrosis will have high sensitivity but low specificity for plantar plate degenerative injuries. Methods A retrospective cross-sectional study was conducted with 85 patients (105 feet) with metatarsalgia who underwent forefoot magnetic resonance imaging using a specific protocol to study metatarsophalangeal plantar plate. The experiment observer classified second toe plantar plate as normal, complete rupture or degenerative lesion and described the main magnetic resonance imaging findings. Results A normal plantar plate was observed in 75 (71.4%) of the 105 feet assessed, in 25 (24%) feet there were degenerative plantar lesions, and in 5 (4.6%) feet there were complete ruptures. Degenerative injury of the plantar plate was best identified in coronal short axis intermediate-weighted images, with high sensitivity (92%). Pericapsular fibrosis below the intermetatarsal ligament was identified in 96% of cases, with high sensitivity (96%) for diagnosis of degenerative plantar plate injury. Conclusion Degenerative lesions of the metatarsophalangeal plantar plate were more prevalent than complete ruptures and were best viewed in coronal short axis intermediate-weighted sequences. Pericapsular fibrosis below the intermetatarsal ligament was the indirect finding most strongly associated with degenerative plantar plate injury.

https://doi.org/10.31744/einstein_journal/2022ao6543

Effects of ganglioside GM1 and erythropoietin on spinal cord injury in mice: Functional and immunohistochemical assessments
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Torelli, Alessandro Gonzalez

; Cristante, Alexandre Fogaça

; Barros-Filho, Tarcísio Eloy Pessoa de

; Santos, Gustavo Bispo dos

; Morena, Beatriz Cintra

; Correia, Felipe Fernandes

; Paschon, Vera

Clinics

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2022, Volume 77 elocation 100006

Resumo: En | Texto: En | PDF: En

ABSTRACT Objectives: To evaluate the functional and immunohistochemical effects of ganglioside GM1 and erythropoietin following experimental spinal cord injury. Methods: Thirty-two male BALB/c mice were subjected to experimental spinal cord injury using the NYU Impactor device and were randomly divided into the following groups: GM1 group, receiving standard ganglioside GM1 (30 mg/kg); erythropoietin group, receiving erythropoietin (1000 IU/kg); combination group, receiving both drugs; and control group, receiving saline (0.9%). Animals were evaluated according to the Basso Mouse Scale (BMS) and Hindlimb Mouse Function Score (MFS). After euthanasia, the immunohistochemistry of the medullary tissue of mice was analyzed. All animals received intraperitoneal treatment. Results: The GM1 group had higher BMS and MFS scores at the end of the experiment when compared to all other groups. The combination group had higher BMS and MFS scores than the erythropoietin and control groups. The erythropoietin group had higher BMS and MFS scores than the control group. Immunohistochemical tissue analysis showed a significant difference among groups. There was a significant increase in myelinated axons and in the myelinated axon length in the erythropoietin group when compared to the other intervention groups (p < 0.01). Conclusion: Erythropoietin and GM1 have therapeutic effects on axonal regeneration in mice subjected to experimental spinal cord injury, and administration of GM1 alone had the highest scores on the BMS and MFS scales.

https://doi.org/10.1016/j.clinsp.2022.100006

Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
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Santos, Luciene Silva dos

; Drummond, Marina Rovani

; França, Andrea Fernandes Eloy da Costa

; Pavan, Maria Helena Postal

; Stelini, Rafael Fantelli

; Cintra, Maria Letícia

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e17

Resumo: En | Texto: En | PDF: En

ABSTRACT As leprosy and leprosy reactions are the most prevalent infectious cause of physical disability, it is important to commit efforts to better understand these chronic reactions. Infections, even when asymptomatic, can trigger leprosy reactions and Bartonella spp. in turn, can cause chronic infections. We presented a case of a 51-year-old man who was admitted presenting with chronic type 2 leprosy reactions. He had a lepromatous form of leprosy that was histologically diagnosed six months after the onset of signs and symptoms compatible with a chronic type 2 reaction. He reported a history of a previous hepatitis B diagnosis. During a 24-month multidrug therapy (MDT), chronic reactions were partially controlled with prednisone and thalidomide. Thirty-three months following the leprosy treatment, he still experienced chronic reactions, and whole bacilli as well as globi were found on a new skin biopsy. Since coinfections can trigger type 2 reactions and the patient had close contact with animals and ticks, we investigated the presence of a Bartonella sp. infection. Bartonella henselae DNA was detected in a skin fragment obtained before the beginning of the leprosy retreatment. However, even after six months of a second leprosy MDT, he continued to experience type 2 chronic reactions. He was admitted to the hospital to undergo an intravenous antibiotic therapy for 14 days and then complete the treatment per os for ten more weeks. Leprosy reactions improved following the treatment for B. henselae. After completing the MDT treatment, he has been accompanied for sixty months with no signs of leprosy or leprosy reactions. The asymptomatic infection by B. henselaein this patient was considered the putative trigger of chronic leprosy reactions and leprosy relapse.

https://doi.org/10.1590/s1678-9946202264017

10.

Teledermatology before and after coronavirus,
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Silva, Dimitri Luz Felipe

; Gameiro, Luiz

; Massuda, Juliana Yumi

; Magalhães, Renata Ferreira

; da Costa França, Andrea Fernandes Eloy

Anais Brasileiros de Dermatologia

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Mar 2021, Volume 96 Nº 2 Páginas 248 - 250

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.abd.2020.09.003 96 downloads

11.

Morphophysiology and quality of yellow passion fruit seedlings submitted to inhibition of gibberellin biosynthesis
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Teixeira, Ednilson Carvalho

; Matsumoto, Sylvana Naomi

; Ribeiro, André Felipe Fialho

; Viana, Anselmo Eloy Silveira

; Tagliaferre, Cristiano

; Carvalho, Franklin Damasceno

; Pereira, Luanna Fernandes

; Silva, Virgiane Amaral

Acta Scientiarum. Agronomy

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2021, Volume 43 elocation e51541

Resumo: En | Texto: En | PDF: En

ABSTRACT The aim of this study was to verify if a growth reduction of yellow passion fruit seedlings’ growth morphophysiology and quality could be changed by paclobutrazol applied through seedling immersion. The experiment was conducted in a greenhouse, with seedlings grown in polyethylene tubes (290 cm3), with substrate. At 40 days after sowing, the seedlings were immersed in an aqueous solution of paclobutrazol at concentrations of 0, 50, 100, 150, and 200 mg L-1. The experiment was conducted in a randomized block design, with five treatments (paclobutrazol concentrations) and four replicates. At 15 and 30 days after treatment, growth characteristics were evaluated. At the end of the assay, destructive evaluations related to mass determination, total leaf area, and seedling quality index were performed. Paclobutrazol treatment induced restrictions in seedling growth, except for fresh and dry mass of root and total fresh mass. Based on these characteristics, the increase in values induced by paclobutrazol was verified. The seedling quality, defined by the major value of the Dickson quality index and a smaller robustness index, was higher when submitted to paclobutrazol treatment.

https://doi.org/10.4025/actasciagron.v43i1.51541 51 downloads

12.

Spinal cord and cutaneous involvement in paracoccidioidomycosis
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França, Andrea Fernandes Eloy da Costa

; Velho, Paulo Eduardo Neves Ferreira

; Reis, Fabiano

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0115-2021

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/0037-8682-0115-2021 111 downloads

13.

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Resumo: En | Texto: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

14.

Tubulovillous adenoma of the duodenal papilla: radiological-endoscopic and anatomopathological correlation in the surgical proposal
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Fernandes, Daniel Alvarenga

; Boteon, Yuri Longatto

; Boteon, Amanda Pinter Carvalheiro da Silva

; Sousa, Rachid Marwan Pinheiro

; Martins, Daniel Lahan

; Penachim, Thiago José

; Barros, Ricardo Hoelz de Oliveira

; Martins, Rita de Cássia Perina

; Costa, Larissa Bastos Eloy da

; Cazzo, Everton

; Gestic, Martinho Antônio

; Chaim, Elinton Adami

; Caserta, Nelson Marcio Gomes

Revista da Associação Médica Brasileira

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Set 2020, Volume 66 Nº 9 Páginas 1190 - 1195

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

RESUMO Os adenomas túbulo-vilosos da ampola duodenal são neoplasias raras. Neste trabalho apresentamos um caso com correlação radiológico-endoscópica e patológica, tendo a paciente sido submetida à duodenopancreatectomia com boa evolução pós-operatória. Com os avanços dos métodos de imagem, em especial da ressonância magnética e ultrassonografia endoscópica, aspectos locorregionais, além da invasão extraluminal, linfovascular e metastática, têm sido discutidos de maneira crescente como contribuintes na decisão terapêutica. Essa evolução contribui para o melhor estadiamento destas lesões e é especialmente útil para selecionar candidatos elegíveis ao tratamento endoscópico.

SUMMARY Tubulovillous adenomas of the duodenal ampulla are rare neoplasms. The present report describes a case with radiological-endoscopic and pathological correlation in which the patient underwent duodenal pancreatectomy with good postoperative progression. With advanced imaging methods, especially magnetic resonance and endoscopic ultrasound, locoregional aspects and extraluminal, lymphovascular, and metastatic invasion have been increasingly discussed as contributors to therapeutic decision making. This progression improves lesion staging and is especially useful in selecting eligible candidates for endoscopic treatment.

https://doi.org/10.1590/1806-9282.66.9.1190 600 downloads

15.

Chiari malformation Type I - effect of the section of the filum terminale
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Milano, Jerônimo Buzetti

; Barcelos, Alecio Cristino Evangelista Santos

; Daniel, Jefferson Walter

; Joaquim, Andrei Fernandes

; Dantas, Fernando Luiz Rolemberg

; Brock, Roger Schmidt

; Rusafa Neto, Eloy

; Bertolini, Eduardo de Freitas

; Mudo, Marcelo Luis

; Onishi, Franz Jooji

; Oliveira, Ricardo Santos

; Botelho, Ricardo Vieira

Revista da Associação Médica Brasileira

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Ago 2020, Volume 66 Nº 8 Páginas 1021 - 1025

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1806-9282.66.7.1021 467 downloads

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