Pesquisa | SciELO

RESUMO: O queijo após processado gera o soro de leite, sendo este um resíduo que possui potencial benefício à saúde humana. No entanto, ainda são poucos os estudos que buscam avaliar a composição e os potenciais benefícios do soro de leite de cabra, mesmo esta sendo uma fonte láctea promissora. Apesar disso, a geração em larga escala deste resíduo pode favorecer o impacto ambiental quando descartado inadequadamente. Em vista disso, a utilização de todo conteúdo gerado na produção de lácteos pode reverter este impacto e aumentar o rendimento da indústria de laticínios. Diante disso, é importante buscar o desenvolvimento de novos produtos para favorecer a redução do impacto gerado. Assim, este trabalho teve como objetivo elaborar um produto em pó, à base de soro de leite de cabra a partir da secagem pela técnica de spray drying e avaliar sua composição físico-química por métodos químicos analíticos e perfil proteico através da eletroforese em gel de poliacrilamida. O produto elaborado apresentou maior teor de carboidratos do que proteína, e a identificação das frações proteicas mostrou que as bandas mais expressivas representavam beta-lactoglobulina e alfa-lactoalbumina. Portanto, o produto elaborado apresenta potencial para geração de novos produtos para consumo humano e com prováveis benefícios à saúde. RESUMO humana entanto promissora disso inadequadamente laticínios Assim pó físicoquímica físico química poliacrilamida proteína betalactoglobulina beta lactoglobulina alfalactoalbumina. alfalactoalbumina alfa lactoalbumina. lactoalbumina alfa-lactoalbumina Portanto

ABSTRACT: The cheese after processing, generates whey, which is a residue that has potential benefit to human health. However, there are still few studies that seek to evaluate the composition and potential benefits of goat milk whey, even though it is a promising dairy source. Despite this, the large-scale generation of this waste can favor the environmental impact when improperly disposed of. Given this, the use of all content of dairy production can reverse this impact and increase the income of the dairy industry. Thus, this research prepared a powdered product based on goat’s milk whey from the spray drying technique and evaluate its physicochemical composition by chemical analytical methods and protein profile through polyacrylamide gel electrophoresis. The elaborated product had a higher carbohydrate content than protein, and the identification of protein fractions showed that the most expressive bands represented beta-lactoglobulin and alpha-lactoalbumin. Therefore, the elaborated product has the potential to generate novel products for human consumption and with potential health benefits. ABSTRACT processing However source largescale large scale industry Thus goats s electrophoresis betalactoglobulin beta lactoglobulin alphalactoalbumin. alphalactoalbumin alpha lactoalbumin. lactoalbumin alpha-lactoalbumin Therefore

https://doi.org/10.1590/0103-8478cr20220317

Efficacy, Safety, and Acceptability of Misoprostol in the Treatment of Incomplete Miscarriage: A Systematic Review and Meta-analysis
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Silva, Thiago Menezes da

; Araujo, Moema Alves Guerra de

; Simões, Ana Carolina Zimmermann

; Oliveira, Ronnier de

; Medeiros, Kleyton Santos de

; Sarmento, Ayane Cristine

; Medeiros, Robinson Dias de

; Costa, Ana Paula Ferreira

; Gonçalves, Ana Katherine

Revista Brasileira de Ginecologia e Obstetrícia

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Dez 2023, Volume 45 Nº 12 Páginas 808 - 817

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

Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients.

Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07–0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96–4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52–0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes.

https://doi.org/10.1055/s-0043-1776029

EVALUATION OF TENOTOMY IN THE HIP SUBLUXATION TREATMENT OF CHILDREN WITH ZIKA SYNDROME
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de Almeida, Thiago Danilo Rodrigues

; Carvalho, Paulo Roberto Carvalho

; Cavalcanti, Brauner de Souza

; Cordeiro, Gabriel Guerra

; Siqueira, Caio César Barbosa

; Aires, Vinicius Gueiros Buenos

; Rolim Filho, EpitÁcio Leite

Acta Ortopédica Brasileira

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2023, Volume 31 Nº spe1 elocation e256215

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

ABSTRACT Objectives: Evaluate the efficacy and effects of releasing the muscles of subluxated hips of patients with SCZ. Methods: This is a retrospective study with 29 patients with subluxation of the hip, corresponding to 55 hips operated in a public hospital in Recife, Brazil. Preoperative femoral head migration (PM) percentages were evaluated and compared with 6- and 12-month postoperative results. Results: Twenty-nine patients were eligible, representing 55 hips evaluated. 19 were female (65.5%), with a mean age of 31.45 months (ranging from 23 to 42 years). 19 patients were GMFCS level V (65.5%), 34.5% were level IV, and 20 of the 29 patients (69%) had no complications. The PM had an absolute reduction of 11.6% (GMFCS IV) and 13.31% (GMFCS V) in the first six months. After 12 months, there was a regression of MP of 7.14% (GMFCS V) and 11.25% (GMFCS IV) compared to preoperative values, with no significant statistical difference among MP values presented between 6 and 12 months after surgery. Conclusions: The surgery was effective in PM regression during the analyzed period and presented a low complication rate. Level of Evidence III; Comparative retrospective study.

RESUMO Objetivos: Avaliar a eficácia e os efeitos da liberação das musculaturas de quadris subluxados de pacientes com SCZ. Métodos: Trata-se de um estudo do tipo retrospectivo com 29 pacientes CZS com subluxação do quadril, correspondendo a 55 quadris operados em um hospital público de Recife, Brasil. Foram avaliados os percentuais migratórios da cabeça femoral (PM) no pré-operatório e comparados com os resultados pós-operatórios de 6 e 12 meses. Resultados: Foram elegíveis 29 pacientes, representando 55 quadris avaliados. 19 eram do sexo feminino (65,5%), com média de idade de 31,45 meses (variando de 23 a 42 anos). 19 pacientes eram GMFCS nível V (65,5%), 34,5% eram nível IV e 20 dos 29 pacientes (69%) não apresentaram complicações. O PM teve redução absoluta de 11,6% (GMFCS IV) e de 13,31% (GMFCS V), nos primeiros seis meses. Após 12 meses, houve regressão do PM de 7,14% (GMFCS V) e de 11,25% (GMFCS IV) em relação aos valores pré-operatórios, sem diferença estatística entre os valores do PM apresentados entre 6 e 12 meses da cirurgia. Conclusões: A cirurgia foi eficaz em regredir o PM no período analisado e apresentou uma baixa taxa de complicações. Nível de Evidência III; Estudo retrospectivo comparativo.

https://doi.org/10.1590/1413-785220233101e256215

COVID-19-associated coagulopathy and acute kidney injury in critically ill patients
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Silva, Bruno Caldin da

; Cordioli, Ricardo Luiz

; Santos, Bento Fortunato Cardoso dos

; Guerra, João Carlos de Campos

; Rodrigues, Roseny dos Reis

; Souza, Guilherme Martins de

; Ashihara, Carolina

; Midega, Thais Dias

; Campos, Niklas Söderberg

; Carneiro, Bárbara Vieira

; Campos, Flávia Nunes Dias

; Guimarães, Hélio Penna

; Matos, Gustavo Faissol Janot de

; Aranda, Valdir Fernandes de

; Ferraz, Leonardo José Rolim

; Corrêa, Thiago Domingos

einstein (São Paulo)

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2023, Volume 21 elocation eAO0119

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.

https://doi.org/10.31744/einstein_journal/2023ao0119

Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery
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Harduin, Leonardo de Oliveira

; Barroso, Thiago Almeida

; Guerra, Julia Bandeira

; Filippo, Marcio Gomes

; Almeida, Leonardo Cortizo de

; Castro-Santos, Guilherme de

; Oliveira, Fabio Augusto Cypreste

; Cavalcanti, Douglas Eduardo Tavares

; Procopio, Ricardo Jayme

; Lima, Eduardo Cavalcanti

; Pinhati, Matheus Eduardo Soares

; Reis, Jose Maciel Caldas dos

; Moreira, Barbara D’Agnoluzzo

; Galhardo, Adriano Martins

; Joviliano, Edwaldo Edner

; Araujo, Walter Junior Boim de

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230052

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

Resumo A doença renal crônica é um problema de saúde pública global e em seu estágio terminal está associada à necessidade de terapia dialítica. A grande maioria dos pacientes que necessitam realizar a terapia renal substitutiva, a fazem através da hemodiálise. Portanto, o acesso vascular é de extrema importância para a população dialítica, implicando diretamente na qualidade de vida e na morbimortalidade deste grupo de pacientes. Sendo a confecção, gerenciamento e resgate dos acessos vasculares uma das áreas de atuação do cirurgião vascular, é de grande importância a elaboração de uma diretriz que oriente o especialista no manejo mais adequado do acesso vascular para hemodiálise. Assim, o objetivo desta diretriz é apresentar um conjunto de recomendações para guiar as decisões na referenciação, avaliação, escolha, vigilância e gestão das complicações do acesso vascular para hemodiálise. dialítica substitutiva hemodiálise Portanto confecção Assim referenciação avaliação escolha

Abstract Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis. problem endstage end stage Therefore population making surgeon importance Thus referral evaluation choice

https://doi.org/10.1590/1677-5449.202300522

Molecular cytogenetics reveals an uncommon structural and numerical chromosomal heteromorphism in Zephyranthes brachyandra (Amaryllidaceae)
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Nascimento, Thiago

; Gongalves, S Raquel

; Bàez, Mariana

; Seijo, Guillermo

; Guerra, Marcelo

Boletín de la Sociedad Argentina de Botánica

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Mar 2022, Volume 57 Nº 1 Páginas 31 - 40

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

Summary Background and aims : Zephyranthes brachyandra belongs to a tribe of ornamental Amaryllidaceae native of South America, whose genera circumscription and phylogenetic relationships are still unclear. Cytologically, Z. brachyandra is a tetraploid whose chromosomes are of similar size and morphology, hindering the identification of its 2n = 24 chromosomes. The aim of this study was to investigate the stability of the many CMA+ and DAPI+ bands and the occurrence of B chromosomes by a cytomolecular approach. M&M : For this investigation we conducted a cytomolecular analysis with CMA/DAPI staining and fluorescence in situ hybridization with 5S and 35S rDNA probes, and the TTTAGGG telomeric probe. Results : In the present work, a cytomolecular analysis of Z. brachyandra, revealed a large and variable number of CMA+ and DAPI+ heterochromatic bands and 5S and 35S rDNA sites, and a regular distribution of the TTTAGGG telomeric sequences. In addition, one individual was monotrisomic with 2n = 24, and another one had a B chromosome. Both numerical and structural chromosome alterations were clearly characterized by CMA/DAPI bands and rDNA sites. Conclusions : Comparing the present data with the cytological data for other species of Zephyranthes, it becomes clear that a cytomolecular approach is fundamental to the understanding of the chromosome variation and cytotaxonomy of the group.

Resumen Introducción y objetivos : Zephyranthes brachyandra pertenece a una tribu de Amaryllidaceae ornamentales nativa de América del Sur, cuya circunscripción de géneros y relaciones filogenéticas aún no están claras. Citológicamente, Z. brachyandra es un tetraploide cuyos cromosomas son de tamaño y morfología similar, lo que dificulta la identificación de sus 2n = 24 cromosomas. El objetivo de este estudio fue investigar la estabilidad de las numerosas bandas CMA+ y DAPI+ y la aparición de cromosomas B mediante un enfoque citomolecular. M&M : Para esta investigación realizamos un análisis citomolecular con tinción CMA/ DAPI e hibridación fluorescente in situ con sondas de ADNr 5S y 35S, y la sonda telomérica TTTAGGG. Resultados : En el presente trabajo se realizaron varios análisis citomoleculares de Z. brachyandra, que revelaron un número alto y variable de bandas heterocromáticas CMA+ y DAPI+ y de sitios de ADNr 5S y 35S, además de una distribución típica de las secuencias teloméricas TTTAGGG. Además, un individuo era monotrisómico con 2n = 24 y otro tenía un cromosoma B. Las alteraciones cromosómicas tanto numéricas como estructurales se caracterizaron claramente por bandas CMA / DAPI y sitios de ADNr. Conclusión : Al comparar los datos actuales con la literatura citológica de otras especies del género Zephyranthes, queda claro que un enfoque citomolecular es fundamental para la comprensión de la variación cromosómica y la citotaxonomía del grupo.

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Low platelet reactivity in patients with myocardial infarction treated with aspirin plus ticagrelor
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Costa, Thiago Guarato Rodrigues

; Katz, Marcelo

; Lemos Neto, Pedro Alves

; Guerra, João Carlos de Campos

; Franken, Marcelo

; Pesaro, Antonio Eduardo Pereira

einstein (São Paulo)

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2022, Volume 20 elocation eAO7001

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: Low platelet reactivity levels are associated with higher risk of bleeding in patients receiving dual antiplatelet therapy relative to patients with optimal platelet blockade. This study set out to evaluate the prevalence of low platelet reactivity in patients with acute myocardial infarction treated with ticagrelor and aspirin. Methods: Patients admitted with acute myocardial infarction who were already undergoing dual antiplatelet therapy with aspirin and ticagrelor were enrolled. Blood samples were collected 1 hour before and 2 hours after the maintenance dose of ticagrelor to investigate trough and the peak effects of the drug respectively. Platelet reactivity was measured by three methods: Multiplate®, PFA-100® with Innovance® PFA-P2Y cartridge and PFA-100® with Collagen/ADP cartridge. Platelet reactivity was assessed in the presence of peak levels of ticagrelor and defined according to previously validated cut-offs for each method (<19 AUC, >299 seconds and >116 seconds respectively). The level of significance was set at p<0.05. Results: Fifty patients were enrolled (44% with ST-elevation). Median duration of DAPT was 3 days (interquartile range, 2-5 days). On average, peak and trough platelet reactivity were markedly low and did not differ between different methods. Low platelet reactivity was common, but varied according to analytic method (PFA-100®/Innovance®PFA-P2Y: 86%; Multiplate®: 74%; PFA-100®/Collagen/ADP: 48%; p<0.001). Conclusion: Low platelet reactivity was very common in patients with acute myocardial infarction submitted to dual antiplatelet therapy with ticagrelor and aspirin. Findings of this study justify the investigation of less intensive platelet inhibition strategies aimed at reducing the risk of bleeding in this population, such as lower dose regimens or monotherapy with P2Y12 inhibitors.

https://doi.org/10.31744/einstein_journal/2022ao7001

Prevalência, características e fatores associados às lesões esportivas em atletas de jiu-jitsu brasileiro
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Borges, Moisés Augusto de Oliveira

; Guerra, Laryssa Rangel

; Pereira, Janderson Francisco

; Rosa, Thiago de Souza

; Camões, José Camilo

; Ruffoni, Ricardo

Cuadernos de Psicología del Deporte

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Ago 2021, Volume 21 Nº 2 Páginas 146 - 162

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

ABSTRACT Objective: to determine the occurrence and characteristics of musculoskeletal and osteoarticular injuries in Brazilian Jiu-Jitsu (BJJ) athletes. Method: A closed questionnaire was applied to 146 BJJ athletes about the injuries suffered, self-diagnosed or clinically diagnosed, in the last 12 months. The data were analyzed using the SPSS © 20.0 program. Results: In total, 403 injuries were reported. Most of the athletes participating in this research are at the beginner level, with the blue graduation range having the largest sample size (43.15%). The age group between 18 and 28 years old (50.68%) was the one that reported the highest number of injuries (53.35%). In addition, it was observed that most athletes train between 2 and 6 hours per week (65%), with this portion of the sample being the most affected by injuries (246 in total). In general, the knee was the most affected area (25.1%) and finger dislocation was the most frequent injury (12.7%). Among other results found, it is noteworthy that the higher the weekly training hours, the lower the risk of injuries (r = -0.85). As well as that, the older the athlete, the greater the frequency of injuries (r = 0.93). It is noteworthy that the injuries occurred, to a large extent, during training (81.5%), the majority of which were severe in nature (58%).

RESUMO Objetivo: determinar a ocorrência e características de lesões musculoesqueléticas e osteoarticulares em atletas de Jiu-Jitsu Brasileiro (BJJ). Método: Foi aplicado um questionário fechado para 146 atletas de BJJ acerca das lesões sofridas, autodiagnosticadas ou diagnosticadas clinicamente, nos últimos 12 meses. Os dados foram analisados pelo programa SPSS© 20.0. Resultados: No total, foram relatadas 403 lesões sofridas. A maioria dos atletas participantes dessa pesquisa são do nível iniciante, sendo a faixa de graduação azul a de maior tamanho amostral (43,15%). O grupo etário de 18 a 28 anos (50,68%) foi o que relatou o maior número de lesões (53,35%). Além disso, observou-se que a maior parte dos atletas treina entre 2 e 6 horas por semana (65%), sendo essa parcela da amostra a mais acometida por lesões (246 no total). Em geral, o joelho foi a área mais afetada (25,1%) e a luxação de dedos a lesão mais frequente (12,7%). Dentre outros resultados encontrados, destaca-se que, quanto maior a carga horária de treinamento semanal, menor o risco de lesões (r = -0,85). Assim como que, quanto maior a idade do atleta, maior a frequência de lesões (r = 0,93). Destaca-se que as lesões ocorreram, em grande parte, durante os treinamentos (81,5%), sendo a maioria de natureza grave (58%).

RESUMEN Objetivo: determinar la ocurrencia y características de lesiones musculoesqueléticas y osteoarticulares en atletas brasileños de Jiu-Jitsu (BJJ). Método: Se aplicó un cuestionario cerrado a 146 atletas de BJJ sobre las lesiones sufridas, autodiagnosticadas o diagnosticadas clínicamente, en los últimos 12 meses. Los datos se analizaron con el programa SPSS © 20.0. Resultados: En total, se reportaron 403 heridos. La mayoría de los atletas que participan en esta investigación se encuentran en el nivel principiante, y el rango de graduación azul tiene el tamaño de muestra más grande (43,15%). El grupo de edad entre 18 y 28 años (50,68%) fue el que reportó mayor número de lesiones (53,35%). Además, se observó que la mayoría de los deportistas entrena entre 2 y 6 horas semanales (65%), siendo esta parte de la muestra la más afectada por lesiones (246 en total). En general, la rodilla fue la zona más afectada (25,1%) y la luxación de los dedos fue la lesión más frecuente (12,7%). Entre otros resultados encontrados, es de destacar que cuanto mayores son las horas semanales de entrenamiento, menor es el riesgo de lesiones (r = -0,85). Además, cuanto mayor es el deportista, mayor es la frecuencia de lesiones (r = 0,93). Es de destacar que las lesiones ocurrieron, en gran medida, durante el entrenamiento (81,5%), la mayoría de las cuales fueron de carácter grave (58%).

Implementing healthcare professionals’ training during COVID-19: a pre and post-test design for simulation training
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Santos, Thiago Martins

; Pedrosa, Rafaela Batista dos Santos

; Carvalho, Danielle Rachel dos Santos

; Franco, Mário Henrique

; Silva, Juliany Lino Gomes

; Franci, Daniel

; de Jorge, Bruno

; Munhoz, Daniel

; Calderan, Thiago

; Grangeia, Tiago de Araujo Guerra

; Cecilio-Fernandes, Dario

Sao Paulo Medical Journal

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Mai 2021, Volume 139 Nº 5 Páginas 514 - 519

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Coronavirus disease-19 (COVID-19) has imposed a new reality that presents several challenges for healthcare professionals. The main challenge has been the lack of proper training in relation to an unknown disease. OBJECTIVE: To investigate healthcare professionals’ acquisition of knowledge of a new airway management protocol for COVID-19 through their participation in simulation training. DESIGN AND SETTING: Pre and post-test study with purpose sampling, carried out in a tertiary-level hospital in the city of Campinas, state of São Paulo, Brazil. METHODS: This was a cross-sectional pre and post-test intervention among healthcare professionals working in the intensive care unit and emergency department of a large hospital. The training was carried out using an in situ simulation scenario and the participants answered pre and post-tests consisting of a 20-item questionnaire about the new protocol. RESULTS: The paired-sample t test demonstrated that there was a significant increase in test score (t = −19.06; P < 0.001), from before the training (M = 8.62; standard deviation, SD = 3.53) to after the simulation training (M = 17.02; SD = 1.76). CONCLUSIONS: The simulated training had a positive impact on the healthcare professionals’ acquisition of the COVID-19 protocol. We also demonstrated that in situ simulation training was an efficient tool for implementing new protocols, thus bringing benefits to healthcare systems, professionals and patients.

https://doi.org/10.1590/1516-3180.2021.0190.r1.27052021 8 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.

Appropriate knowledge of the indications for medications in use among older individuals assisted in the Jornada Científica dos Acadêmicos de Farmácia-Bioquímica
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Didone, Thiago Vinicius Nadaleto

; Borelli, Primavera

; Casari, Patricia Baltrukonis Bucci

; Souza, Rodolfo Ribeiro de

; Jorge, Tamara Ramos

; Guerra-Shinohara, Elvira Maria

Brazilian Journal of Pharmaceutical Sciences

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2021, Volume 57 elocation e19043

Resumo: En | Texto: En | PDF: En

This study aimed to identify variables associated with the appropriate recall of indications and the drug classes that represented the most unmatching medications (i.e., when the individual who used it had not reported any illness that matched its indications). Community-dwelling individuals aged ≥60 years using ≥1 medication, from Santa Cruz da Esperança-SP, Brazil, were home-interviewed. Logistic regression models were used to evaluate the association between the appropriate recall of the indications for all medications in use and the following: gender, age, education, individual income, living arrangement, self-perceived health, and medication number, administration, payment, and identification. Medications whose indications were inappropriately recalled were classified as matching or unmatching. One hundred seventeen individuals used an average of 5.1 (standard deviation, 3.3) medications. Sixty-one (52.1%) appropriately recalled all indications. The appropriate recall of all indications was negatively associated with the number of medications in use (e.g., individuals taking 5-6 medications were 25 times less likely to appropriately recall all indications than those taking 1-2). Antithrombotic, acid-related disorder and psychoanaleptic classes showed greater frequencies of unmatching than matching medications. Therefore, counseling the elderly about drug indications should focus on those using ≥3 medications and/or antithrombotic, acid-related disorder, and psychoanaleptic agents.

https://doi.org/10.1590/s2175-97902020000419043 71 downloads

12.

Exercise training reduces sympathetic nerve activity and improves executive performance in individuals with obstructive sleep apnea
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Goya, Thiago Tanaka

; Ferreira-Silva, Rosyvaldo

; Gara, Elisangela Macedo

; Guerra, Renan Segalla

; Barbosa, Eline Rozária Ferreira

; Toschi-Dias, Edgar

; Cunha, Paulo Jannuzzi

; Negrão, Carlos Eduardo

; Lorenzi-Filho, Geraldo

; Ueno-Pardi, Linda Massako

Clinics

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2021, Volume 76 elocation e2786

Resumo: En | Texto: En | PDF: En

OBJECTIVE: To investigate the effects of exercise training (ET) on muscle sympathetic nerve activity (MSNA) and executive performance during Stroop Color Word Test (SCWT) also referred to as mental stress test. METHODS: Forty-four individuals with obstructive sleep apnea (OSA) and no significant co-morbidities were randomized into 2 groups; 15 individuals completed the control period, and 18 individuals completed the ET. Mini-mental state of examination and intelligence quotient were also assessed. MSNA assessed by microneurography, heart rate by electrocardiography, blood pressure (automated oscillometric device) were measured at baseline and during 3 min of the SCWT. Peak oxygen uptake (VO2 peak) was evaluated using cardiopulmonary exercise testing. Executive performance was assessed by the total correct responses during 3 min of the SCWT. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility (72 sessions, achieved in 40±3.9 weeks). RESULTS: Baseline parameters were similar between groups. Heart rate, blood pressure, and MSNA responses during SCWT were similar between groups (p>0.05). The comparisons between groups showed that the changes in VO2 (4.7±0.8 vs -1.2±0.4) and apnea-hypopnea index (-7.4±3.1 vs 5.5±3.3) in the exercise-trained group were significantly greater than those observed in the control group respectively (p<0.05) after intervention. ET reduced MSNA responses (p<0.05) and significantly increased the number of correct answers (12.4%) during SCWT. The number of correct answers was unchanged in the control group (p>0.05). CONCLUSIONS: ET improves sympathetic response and executive performance during SCWT, suggesting a prominent positive impact of ET on prefrontal functioning in individuals with OSA. ClinicalTrials.gov: NCT002289625.

https://doi.org/10.6061/clinics/2021/e2786 128 downloads

13.

Selection of experimental strawberry clones for fruit appearance attributes
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Souza, Douglas Correa de

; Ossani, Paulo César

; Costa, Aline Silva

; Guerra, Thiago Sampaio

; Araújo, Ana Luisa

; Resende, Francisco Vilela

; Resende, Luciane Vilela

Pesquisa Agropecuária Brasileira

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2021, Volume 56 elocation e02560

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

Resumo O objetivo deste trabalho foi realizar a caracterização morfológica de frutos de morango de diferentes genótipos, assim como verificar sua conservação pós-colheita. Seis cultivares comerciais (Albion, Aromas, Dover, Festival, Pircinque e San Andreas) e nove clones experimentais (MDA01, MDA19, MDA22, MDA23, MCA89, MCA94, MFA443, MOGSC468 e MFA443PR) foram avaliados. Os frutos foram produzidos em bancadas semi-hidropônicas, em cultivo protegido, e classificados quanto a tamanho, formato, coloração, brilho, posição do aquênio, coloração da polpa, coloração do “coração”, cavidade do fruto e posição das sépalas. Para a análise de póscolheita dos frutos, foram determinadas a perda de massa e a aparência dos frutos durante dez dias de armazenamento. Os genótipos avaliados apresentam alta similaridade entre si quanto à caracterização morfológica. MCA89 e 'Pircinque' são os genótipos mais divergentes em relação aos demais. Há uma associação entre as características cavidade grande, formato reniforme e cavidade média, o que contribui para a seleção indireta dos caracteres desejáveis. No décimo dia de armazenamento, os genótipos MDA01, MDA19, MCA89, MFA443 e 'Dover' ainda apresentam condições aceitáveis para comercialização.

Abstract The objective of this work was to carry out the morphological characterization of strawberry fruit of different genotypes, as well as to verify their postharvest conservation. Six commercial cultivars (Albion, Aromas, Dover, Festival, Pircinque, and San Andreas) and nine experimental clones (MDA01, MDA19, MDA22, MDA23, MCA89, MCA94, MFA443, MOGSC468, and MFA443PR) were evaluated. Fruit were produced on semi-hydroponic gutters in protected cultivation and classified according to size, shape, color, brightness, achene position, pulp color, “heart” color, fruit cavity, and sepal position. For the postharvest analysis of fruit, the loss of mass and the appearance of fruit during ten days of storage were determined. The evaluated genotypes show a high similarity to each other regarding morphological characterization. MCA89 and 'Pircinque' are the most divergent genotypes in relation to the others. There is an association between the characteristics large cavity, reniform shape, and medium cavity, which contributes to the indirect selection of desirable characters. On the tenth day of storage, the MDA01, MDA19, MCA89, MFA443, and 'Dover' genotypes still show acceptable conditions for commercialization.

https://doi.org/10.1590/s1678-3921.pab2021.v56.02560

14.

Intensive support recommendations for critically-ill patients with suspected or confirmed COVID-19 infection
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Corrêa, Thiago Domingos

; Matos, Gustavo Faissol Janot de

; Bravim, Bruno de Arruda

; Cordioli, Ricardo Luiz

; Garrido, Alejandra del Pilar Gallardo

; Assuncao, Murillo Santucci Cesar de

; Barbas, Carmen Silvia Valente

; Timenetsky, Karina Tavares

; Rodrigues, Roseny dos Reis

; Guimarães, Hélio Penna

; Rabello Filho, Roberto

; Lomar, Frederico Polito

; Scarin, Farah Christina de La Cruz

; Batista, Carla Luciana

; Pereira, Adriano José

; Guerra, João Carlos de Campos

; Carneiro, Bárbara Vieira

; Nawa, Ricardo Kenji

; Brandão, Rodrigo Martins

; Pesaro, Antônio Eduardo Pereira

; Silva Júnior, Moacyr

; Carvalho, Fabricio Rodrigues Torres de

; Silva, Cilene Saghabi de Medeiros

; Almeida, Ana Claudia Ferraz de

; Franken, Marcelo

; Pesavento, Marcele Liliane

; Eid, Raquel Afonso Caserta

; Ferraz, Leonardo José Rolim

einstein (São Paulo)

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2020, Volume 18 elocation eAE5793

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

RESUMO Em dezembro de 2019, uma série de pacientes com pneumonia grave foi identificada em Wuhan, província de Hubei, na China. Esses pacientes evoluíram para síndrome respiratória aguda grave e síndrome do desconforto respiratório agudo. Posteriormente, a COVID-19 foi atribuída a um novo betacoronavírus, o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2). Cerca de 20% dos pacientes com diagnóstico de COVID-19 desenvolvem formas graves da doença, incluindo insuficiência respiratória aguda hipoxêmica, síndrome respiratória aguda grave, síndrome do desconforto respiratório agudo e insuficiência renal aguda e requerem admissão em unidade de terapia intensiva. Não há nenhum ensaio clínico randomizado controlado que avalie potenciais tratamentos para pacientes com infecção confirmada pela COVID-19 no momento da publicação destas recomendações de tratamento. Dessa forma, essas recomendações são baseadas predominantemente na opinião de especialistas (grau de recomendação de nível C).

ABSTRACT In December 2019, a series of patients with severe pneumonia were identified in Wuhan, Hubei province, China, who progressed to severe acute respiratory syndrome and acute respiratory distress syndrome. Subsequently, COVID-19 was attributed to a new betacoronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Approximately 20% of patients diagnosed as COVID-19 develop severe forms of the disease, including acute hypoxemic respiratory failure, severe acute respiratory syndrome, acute respiratory distress syndrome and acute renal failure and require intensive care. There is no randomized controlled clinical trial addressing potential therapies for patients with confirmed COVID-19 infection at the time of publishing these treatment recommendations. Therefore, these recommendations are based predominantly on the opinion of experts (level C of recommendation).

https://doi.org/10.31744/einstein_journal/2020ae5793 23244 downloads

15.

Comment to: Intensive support recommendations for critically-ill patients with suspected or confirmed COVID-19 infection
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Corrêa, Thiago Domingos

; Matos, Gustavo Faissol Janot de

; Bravim, Bruno de Arruda

; Cordioli, Ricardo Luiz

; Garrido, Alejandra del Pilar Gallardo

; Assuncao, Murillo Santucci Cesar de

; Barbas, Carmen Silvia Valente

; Timenetsky, Karina Tavares

; Rodrigues, Roseny dos Reis

; Guimarães, Hélio Penna

; Rabello Filho, Roberto

; Lomar, Frederico Polito

; Scarin, Farah Christina de La Cruz

; Batista, Carla Luciana

; Pereira, Adriano José

; Guerra, João Carlos de Campos

; Carneiro, Bárbara Vieira

; Nawa, Ricardo Kenji

; Brandão, Rodrigo Martins

; Pesaro, Antônio Eduardo Pereira

; Silva Júnior, Moacyr

; Carvalho, Fabricio Rodrigues Torres de

; Silva, Cilene Saghabi de Medeiros

; Almeida, Ana Claudia Ferraz de

; Franken, Marcelo

; Pesavento, Marcele Liliane

; Eid, Raquel Afonso Caserta

; Ferraz, Leonardo José Rolim

einstein (São Paulo)

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2020, Volume 18 elocation eCE5931

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

https://doi.org/10.31744/einstein_journal/2020ce5931 214 downloads

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