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ABSTRACT Objective: To determine the frequency of reoperations in the treatment of adult patients diagnosed with septic arthritis of the knee, the average number of debridements needed to control the infection, the mortality rate, and to assess factors associated with a greater need for reoperation and mortality. Methods: Retrospective cohort study evaluating 38 adult patients diagnosed with septic arthritis who underwent arthrotomy via a medial parapatellar approach for joint cleaning and debridement. Demographic, clinical, surgical, and microbiological variables of the cases were analyzed by review of medical records. Tests for equality of two proportions, chi-square, and multivariate logistic regression analysis were performed, defining a significance level at 0.05, with 95% confidence interval. Results: A total of 50% of the cases underwent reoperation, with an average number of required debridement of 2.02 and a mortality rate of 10.5%. Patients with infection caused by Staphylococcus aureus were more likely to need a reoperation compared to patients with positive cultures for other agents (OR 6.0). Conclusion: In 50% of cases, an average of 2.02 debridements were necessary and the mortality rate was 10.5%. Staphylococcus aureus infection is associated with a 6 times greater chance of additional surgeries. /Level of Evidence IV, Case Series.

RESUMO Objetivo: Determinar a frequência de reabordagens cirúrgicas no tratamento de pacientes adultos com diagnóstico de artrite séptica do joelho, a média de desbridamentos necessários para o controle da infecção e a taxa de mortalidade, assim como avaliar os fatores associados à maior necessidade de reabordagem e mortalidade. Métodos: Estudo retrospectivo tipo coorte que avaliou 38 pacientes adultos com diagnóstico de artrite séptica submetidos à artrotomia por via parapatelar medial para limpeza e desbridamento da articulação. Foram analisadas variáveis demográficas, clínicas, cirúrgicas e microbiológicas dos casos, por revisão de prontuário médico, e realizados testes de igualdade de duas proporções, qui-quadrado e análise multivariada de regressão logística, sendo definido um nível de significância de 0,05, com 95% de confiança estatística. Resultados: 50% dos casos foram submetidos à reabordagem cirúrgica, sendo a média de desbridamentos necessários de 2,02 e a taxa de mortalidade de 10,5%. Pacientes com infecção causada por Staphylococcus aureus apresentaram mais chances de necessitar de reabordagem quando comparados aos pacientes com culturas positivas para outros agentes (OR 6,0). Conclusão: Em 50% dos casos foram necessários, em média, 2,02 desbridamentos e a taxa de mortalidade foi de 10,5%. A infecção por Staphylococcus aureus está associada com seis vezes mais chances de cirurgias adicionais. Nível de Evidência IV, Série de Casos.

https://doi.org/10.1590/1413-785220233102e260592

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Resumo: En | Texto: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.

https://doi.org/10.1590/0074-02760220259

COVID-19 outcomes in people living with HIV: Peering through the waves
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Sales, Thaís Lorenna Souza

; Souza-Silva, Maíra Viana Rego

; Delfino-Pereira, Polianna

; Neves, João Victor Baroni

; Sacioto, Manuela Furtado

; Assis, Vivian Costa Morais de

; Duani, Helena

; Oliveira, Neimy Ramos de

; Sampaio, Natália da Cunha Severino

; Ramos, Lucas Emanuel Ferreira

; Schwarzbold, Alexandre Vargas

; Jorge, Alzira de Oliveira

; Scotton, Ana Luiza Bahia Alves

; Castro, Bruno Mateus de

; Silva, Carla Thais Cândida Alves da

; Ramos, Carolina Marques

; Anschau, Fernando

; Botoni, Fernando Antonio

; Grizende, Genna Maira Santos

; Nascimento, Guilherme Fagundes

; Ruschel, Karen Brasil

; Menezes, Luanna Silva Monteiro

; Castro, Luís César de

; Nasi, Luiz Antônio

; Carneiro, Marcelo

; Godoy, Mariana Frizzo de

; Nogueira, Matheus Carvalho Alves

; Guimarães Júnior, Milton Henriques

; Ziegelmann, Patricia Klarmann

; Almeida, Rafaela Charão de

; Francisco, Saionara Cristina

; Silveira Neto, Sidney Teodoro

; Araújo, Silvia Ferreira

; Avelino-Silva, Thiago Junqueira

; Aliberti, Márlon Juliano Romero

; Pires, Magda Carvalho

; Silva, Eduardo Sérgio da

; Marcolino, Milena Soriano

Clinics

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2023, Volume 78 elocation 100223

Resumo: En | Texto: En | PDF: En

Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group.

https://doi.org/10.1016/j.clinsp.2023.100223

Prescrição de Exercício Aeróbio na Reabilitação Cardíaca Baseada na Frequência Cardíaca dos Estágios do Teste da Fala e do Teste de Caminhada de 6 Minutos
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Althoff, Amanda

; Vieira, Ariany Marques

; Silveira, Lucas Santos da

; Benetti, Magnus

; Karsten, Marlus

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 9 elocation e20230086

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

Abstract Background Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited. Objective To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET). Methods Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman’s test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT−), and at the peak of the 6MWT. Pearson’s or Spearman’s test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%. Results The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT− (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT− (p = 0.68). Conclusions HR at TT+ and TT− reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.

Resumo Fundamento Embora o Teste da Fala (TF) seja um teste confiável e de baixo custo, seu uso para prescrição de exercício aeróbio ainda é limitado. Objetivo Analisar a frequência cardíaca (FC) dos estágios do TF e no pico do teste de caminhada de 6 minutos (TC6min) como parâmetro para a prescrição de exercício aeróbio comparando com a FC no primeiro e segundo limiares ventilatórios (LV1 e LV2) do teste cardiopulmonar de exercício (TCPE). Métodos Pacientes com doença cardiovascular compareceram a 3 dias de avaliação: 1) anamnese e TCPE; 2) TC6min; e 3) TF. Foram usados ANOVA unidirecional de medidas repetidas ou teste de Friedman para comparar a FC no LV1 e LV2 com a FC nos estágios do TF: último positivo (TF+), primeiro equívoco (TF±) e negativo (TF−) e no pico do TC6min. O teste de Pearson ou Spearman avaliou se há correlação entre FC em LVs, estágios do TF e TC6min. A significância estatística foi fixada em 5%. Resultados O estudo incluiu 22 pacientes cardíacos (13 homens, 61 ± 8 anos). A FC no LV1 foi semelhante à FC no TF+ (p = 0,987) e TF± (p = 0,154), e moderadamente correlacionada com o TF+ (r = 0,479, p = 0,024). A FC no LV2 foi semelhante ao TF− (p = 0,383), com forte correlação (r = 0,757, p < 0,001). A FC no pico do TC6min foi significativamente diferente da FC no TF+, TF± e LV1 (p = 0,001, p = 0,005 e p < 0,001, respectivamente), mas semelhante ao TF− (p = 0,68). Conclusões A FC no TF+ e TF− reflete a FC no LV1 e LV2, respectivamente, diferentemente do TC6min, que foi semelhante apenas ao LV2. O TF pode ser um teste objetivo para auxiliar a prescrição de exercício aeróbio na reabilitação cardíaca.

https://doi.org/10.36660/abc.20230086

Análise da aptidão física com a utilização de exergames em jovens futebolistas e não futebolistas: um estudo piloto
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Getirana-Mota, Márcio

; Paz, Ângelo de Almeida

; Vieira-Souza, Lúcio Marques

; Matos, Ricardo Santos

; Rosa, José Lucas Santos

; Costa, Lúcio Flávio Gomes Ribeiro da

; Teles, Luan José Lopes

; Aidar, Felipe José

Motricidade

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Dez 2022, Volume 18 Nº 2 Páginas 230 - 236

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

ABSTRACT The objective of this research was to identify whether the use of exergames can help improve physical fitness through Burpee and analyse whether exergames can improve agility and spatial-temporal perception in young soccer players and non-players. This is a descriptive exploratory research with qualitative-quantitative data analysis. Participants were children (10.8 ± 1.8 years). For this sample, it was observed that exergames did not promote a significant increase in physical fitness (Group 1 × Group 2= 95%CI (-6.39–6.59), p> 1.00; Group 3 × Group 4= 95%CI (-1.27–3.47), p> 1.00). In contrast, exergames promoted a significant improvement in agility and spatiotemporal perception for group 2 (Agility Pre × Post: Z= -2.828; p= 0.05; Spatiotemporal perception Pre × Post: Z= -2.828; p= 0.05). We understand that exergames did not improve physical fitness in young soccer players and that they also did not provide improvements in agility or spatiotemporal perception. However, for the non-athlete public, there was a significant improvement in agility and spatial-temporal perception.

RESUMO O objetivo desta pesquisa foi identificar se a utilização do exergames pode auxiliar na melhora da aptidão física através do Burpee, como também, analisar se os exergames podem melhorar a agilidade e a percepção espaço-temporal em jovens jogadores de futebol e não jogadores. Esta pesquisa tem caráter exploratório descritivo com analise quali-quantitativa dos dados. Os participantes do estudo foram crianças (10,8± 1,8 anos). Para essa amostra, foi observado que o exergames não promoveu aumento significativo da aptidão física (Grupo 1 × Grupo 2= IC95% (-6,39–6,59), p> 1,00; Grupo 3 × Grupo 4= IC95% (-1,27–3,47), p> 1,00). Em contrapartida, o exergames promoveu melhora significativa da agilidade e da percepção espaço-temporal para o grupo 2 (Agilidade Pré × Pós: Z= -2,828; p= 0,05; Percepção espaço-temporal Pré × Pós: Z= -2,828; p= 0,05). Depreendemos que os exergames não proporciona melhora da aptidão física em jovens jogadores de futebol, e que também não proporcionou melhoras na agilidade ou na percepção espaço-temporal. Porém, para o público não atleta, houve melhora significativa para a agilidade e percepção espaço-temporal.

https://doi.org/10.6063/motricidade.27175

Effect of the COVID-19 pandemic on patients with inherited neuromuscular disorders
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Moreno, Cristiane Araujo Martins

; Camelo, Clara Gontijo

; Sampaio, Pedro Henrique Marte de Arruda

; Fonseca, Alulin Tácio Quadros Santos Monteiro

; Estephan, Eduardo de Paula

; Silva, André Macedo Serafim

; Pirola, Renann Nunes

; Silva, Luiz Henrique Libardi

; Lima, Karlla Danielle Ferreira

; Albuquerque, Marco Antônio Veloso de

; Camelo Filho, Antonio Edvan

; Marques, Marcos Vinícius Oliveira

; Yanagiura, Mario Teruo

; Cavalcante, Wagner Cid Palmeira

; Matsui Junior, Ciro

; Isihi, Lucas Michielon de Augusto

; Mendonça, Rodrigo Holanda

; Pouza, Ana Flávia Pincerno

; Carvalho, Mary Souza de

; Reed, Umbertina Conti

; Zanoteli, Edmar

Arquivos de Neuro-Psiquiatria

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Jun 2022, Volume 80 Nº 6 Páginas 563 - 569

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

RESUMO Antecedentes: A Pandemia por COVID-19 tem trazido desafios subtanciais para a prática clínica no tratamento das doenças neuromusculares hereditárias (DNMh). A infecção não tem sido a única preocupação para os pacientes. O distanciamento social tem comprometido a assistência multidisciplinar, atividade física e tem trazido problemas mentais em decorrência do próprio isolamento. Nós apresentamos aqui um seguimento de 363 pacientes com DNMh de um centro terciário Brasileiro durante o pico da Pandemia de Covid-19. Objetivos: Mostrar a frequência e gravidade da infecção por Sars-Cov-2 em pacientes com DNMh e demonstrar os efeitos da pandemia nos hábitos de vida, na progressão da doença e no cuidado multidisciplinary. Métodos Trezentos e sessenta e três pacientes (58% homens and 42% mulheres) foram acompanhados por 3 meses através de 3 teleconsultas durante o pico da Pandemia de Covid-19 no Brasil. Resultados Houve um decréscimo no número de pacientes que faziam terapia física, respiratória e fonoaudiológica. Em muitos pacientes, o apetite (33%) e hábitos do sono (25%) se alteraram. Exercícios físicos e terapias foram interrompidas pela maioria dos pacientes. Physical exercises and therapies were interrupted for most of the patients. Eles relataram piora ou aparecimento de fadiga (17%), dor (17%), retrações (14%), e escoliose (7%). Irritabilidade, mudanças no sono, peso e apetite, sendo principalmente diminuição do apetite e peso foram mais frequentemente encontrados em pacientes que apresentaram piora clinica da doença. Houve uma baixa taxa de contaminação por Covid-19 (0.8%), e todos os pacientes infectado apresentaram quadro clinico leve. Conclusão O isolamento por si só se mostrou protetor na perspectiva de infecção por Covid-19, mas pode desencadear um cenário complexo com mudanças nos hábitos de vida e curso desfavorável da doença de base.

ABSTRACT Background The COVID-19 pandemic has brought substantial challenges for current practices in treating hereditary neuromuscular disorders (hNMDs). However, this infection has not been the only concern for these patients. Social distancing has compromised multidisciplinary assistance and physical activity, and has brought about several mental health issues. We presented a follow-up on 363 patients with hNMDs at a Brazilian tertiary center during the peak of the COVID-19 pandemic. Objective We aimed to show the frequency and severity of SARS-CoV-2 infection among hNMD patients and to demonstrate the effects of the pandemic on life habits, disease progression and multidisciplinary supportive care status. Methods Three hundred and sixty-three patients (58% male and 42% female) were followed for three months through three teleconsultations during the peak of the COVID-19 pandemic in Brazil. Results There were decreases in the numbers of patients who underwent physical, respiratory and speech therapies. For several patients, their appetite (33%) and sleep habits (25%) changed. Physical exercises and therapies were interrupted for most of the patients. They reported new onset/worsening of fatigue (17%), pain (17%), contractions (14%) and scoliosis (7%). Irritability and sleep, weight and appetite changes, and especially diminished appetite and weight loss, were more frequent in the group that reported disease worsening. There was a low COVID-19 contamination rate (0.8%), and all infected patients had a mild presentation. Conclusion The isolation by itself was protective from a COVID-19 infection perspective. However, this isolation might also trigger a complex scenario with life habit changes that are associated with an unfavorable course for the NMD.

https://doi.org/10.1590/0004-282x-anp-2021-0166

Aspects of trauma related to violence, accidents and falls before and during the COVID-19 pandemic
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Fermandes, Paulo Cesar Rozental

; Ilias, Elias Elias Jirjoss

; Ribeiro, Ana Paula

; Garcia, Diego Ferreira Andrade

; Pereira, Thales Felipe dos Santos

; Freitas, Letícia Dantas Marques de

; Leite, Isabelle Sacchi

; Nascimento, Lucas Netto

; França, Carolina Nunes

; Juliano, Yara

; Novo, Neil Ferreira

Medicina Legal de Costa Rica

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Mar 2022, Volume 39 Nº 1 Páginas 81 - 97

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

Resumen Introducción: El trauma es la segunda causa de mortalidad y la sexta de hospitalización en el país, siendo la violencia, los accidentes y las caídas las más prevalentes. Sin embargo, el país está experimentando reflejos de una pandemia de COVID-19, junto a una falta de estudios sobre el trauma, así como sobre la atención clínica. Objetivo: Analizar las características clínicas y epidemiológicas del trauma junto a la violencia, accidentes y caídas entre los años 2019, 2020 y 2021, considerados antes y durante la pandemia COVID-19. Materiales y métodos: Estudio de cohorte retrospectivo, con adultos de 25 a 55 años, que sufrieron trauma relacionado con violencia, caídas y otros accidentes, en el período comprendido entre marzo y junio de 2019, 2020 y 2021, en la ciudad de São Paulo. Las encuestas de datos fueron realizadas por el sistema TABNET, por el Departamento Municipal de Salud. Dentro de este sistema, la búsqueda se realizó a través del Sistema de Información para la Vigilancia de Accidentes, de la Coordinación de Vigilancia en Salud, en el cual las situaciones de violencia fueron notificadas y registradas por el Sistema Nacional de Información de Enfermedades Notificables. Posteriormente, se accedió al Sistema de Información de Vigilancia de Violencia y Accidentes, con enfoque en notificaciones y registro de caídas y otros accidentes. Resultados: El trauma siguió siendo más prevalente para los hombres, con educación primaria completa y raza predominantemente entre blancos y morenos. Al analizar los diferentes tipos de violencia: física, tortura y sexual, hubo mayores porcentajes de prevalencia durante el año 2019, período prepandémico de COVID-19, a excepción de la violencia psicológica / moral, que fue mayor en 2021. Nótese que los diferentes mecanismos de violencia fueron significativamente más prevalentes en 2019, así como las diferentes causas de violencia, caídas y traumatismos automovilísticos que involucran a peatones, ocupantes, conductores y pasajeros. La atención ambulatoria confirmó la tendencia de superioridad en el período prepandémico, sin embargo, la atención hospitalaria de emergencia mostró un mayor número de solicitudes en 2020 y 2021. Conclusión: Los traumas de violencia, accidentes y caídas son más prepandémico en comparación con el período durante la pandemia COVID-19; así como la búsqueda de asistencia sanitaria en hospitales y clínicas. Estos hallazgos muestran una posible reducción en los informes de trauma y una menor demanda de asistencia durante la pandemia.

Abstract Introduction: Trauma is the second leading cause of mortality and the sixth leading cause of hospitalization in the country, with violence, accidents, and falls being the most prevalent. However, the country is experiencing reflexes of the COVID-19 pandemic, together with a lack of studies on trauma, as well as on clinical care. Objective: To analyze the clinical and epidemiological characteristics of trauma related to violence, accidents, and falls among the years 2019, 2020, and 2021, considered as before and during the COVID-19 pandemic. Material and Methods: Retrospective cohort study, with adults aged 25-55 years, who suffered trauma related to violence, falls, and other accidents, in the period between March and June of 2019, 2020, and 2021, in the city of São Paulo. Data surveys were carried out using the TABNET system, of the Municipal Health Department. Within this system, the search was carried out through the Information System for the Surveillance of Accidents, of the Coordination of Health Surveillance, in which situations of violence were notified and recorded by the National Information System for Notifiable Diseases. Subsequently, the Information System for Surveillance of Violence and Accidents was accessed, focusing on notifications and records of falls and other accidents. Results: Trauma remained more prevalent for males, with complete primary education, and ethnicity predominantly between white or brown. When analyzing the different types of violence: physical, torture, and sexual, there was a prevalence of higher percentages during the year 2019, the pre-pandemic period of COVID-19, except for psychological/moral violence, which was higher in 2021. It should also be noted that the different mechanisms of violence were significantly more prevalent in 2019, as well as the different causes of violence, falls, and car trauma involving pedestrians, occupants, drivers, and passengers. Outpatient care confirmed the higher trend in the pre-pandemic period; however, emergency hospital care showed a greater number of requests in 2020 and 2021. Conclusión: Trauma from violence, accidents, and falls was higher pre-pandemic compared to the period during the COVID-19 pandemic; as well as the search for health care in hospitals and outpatient clinics. These findings show a possible reduction in trauma reports and lower demand for assistance during the pandemic.

Temporal trend analysis of hospitalizations and in-hospital deaths due to female breast cancer in the state of Alagoas from 2009 to 2019: a cross-sectional study
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Leão, Myra Jurema da Rocha

; Cardoso, Vitória Ingryd dos Santos

; Lima, Ayara Jhulia Palmeira Dantas

; Santos, Samilla Cristinny

; de Araújo, Emmylly Maria Correia Ferro

; Paixão, Karen da Costa

; Santos, Lucas Gomes

; Fraga, Carlos Alberto de Carvalho

; de Souza, Carlos Dornels Freire

; de Sales Marques, Carolinne

Sao Paulo Medical Journal

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Fev 2022, Volume 140 Nº 2 Páginas 268 - 277

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Breast cancer is a common neoplasm in women worldwide. Its varying patterns of incidence and clinical prognosis in Brazil make it an important and complex public health problem that needs to be solved. OBJECTIVES: To analyze the temporal dynamics of hospital admissions and deaths due to female breast cancer in the state of Alagoas, Brazil, from 2009 to 2019. DESIGN AND SETTING: Cross-sectional study including secondary data from hospital admissions and deaths due to female breast cancer in Alagoas. METHODS: A joinpoint regression model was constructed for temporal analysis of hospital admissions and deaths due to female breast cancer in Alagoas, over this period. The hospital information system of the Department of Informatics of the National Health System was used. RESULTS: There were 5,801 hospitalizations and 633 hospital deaths due to neoplasm in Alagoas over the period. The age group from 50 to 59 years old stood out, corresponding to 28.1% of hospitalizations and 31.1% of registered deaths. An increasing trend in the rate of hospital admissions was observed (average annual percentage change, AAPC = 14.0; P-value < 0.001), from 14.9/100,000 inhabitants in 2009 to 53.6 in 2019. There was a growth trend in the in-hospital mortality rate (AAPC = 19.8; P-value < 0.001), from 6.3% in 2009 to 11.0% in 2019. CONCLUSION: The results indicated an increasing trend of hospital admissions and mortality rates in the state of Alagoas, with a higher percentage of hospitalizations and deaths in the 50-59 age group.

https://doi.org/10.1590/1516-3180.2021.0385.r1.23072021

Shotgun metagenomic sequencing of the first case of monkeypox virus in Brazil, 2022
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Claro, Ingra Morales

; Romano, Camila Malta

; Candido, Darlan da Silva

; Lima, Evelyn Lepka de

; Lindoso, José Angelo Lauletta

; Ramundo, Mariana Severo

; Moreira, Filipe Romero Rebello

; Barra, Luiz Alberto Costa

; Borges, Luciana Marques Sansão

; Medeiros, Lucas Alberto

; Tomishige, Marcia Y. S.

; Moutinho, Tomas

; Silva, Anderson José Dias da

; Rodrigues, Camila Cristina Martini

; Azevedo, Luiz Cesar Fernandes de

; Villas-Boas, Lucy Santos

; Silva, Camila Alves Maia da

; Coletti, Thaís Moura

; Manuli, Erika R.

; O’Toole, Aine

; Quick, Joshua

; Loman, Nicholas

; Rambaut, Andrew

; Faria, Nuno R.

; Figueiredo-Mello, Claudia

; Sabino, Ester Cerdeira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e48

Resumo: En | Texto: En | PDF: En

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

https://doi.org/10.1590/s1678-9946202264048

10.

First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections
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Lima, Evelyn Lepka de

; Barra, Luiz Alberto Costa

; Borges, Luciana Marques Sansão

; Medeiros, Lucas Alberto

; Tomishige, Marcia Y. S.

; Santos, Lucas de Souza Loureiro Abbud

; Silva, Anderson José Dias da

; Rodrigues, Camila Cristina Martini

; Azevedo, Luiz Cesar Fernandes de

; Villas-Boas, Lucy Santos

; Silva, Camila Alves Maia da

; Coletti, Thaís Moura

; Manuli, Erika R.

; Claro, Ingra Morales

; Romano, Camila Malta

; Ramundo, Mariana Severo

; Moutinho, Tomas

; Sabino, Ester Cerdeira

; Lindoso, José Angelo Lauletta

; Figueiredo-Mello, Claudia

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e54

Resumo: En | Texto: En | PDF: En

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

https://doi.org/10.1590/s1678-9946202264054

11.

Relationship between vitamin D deficiency and psychophysiological variables: a systematic review of the literature
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Silva, Mariluce Rodrigues Marques

; Barros, Waleska Maria Almeida

; Silva, Mayara Luclécia da

; Silva, José Maurício Lucas da

; Souza, Ana Patrícia da Silva

; Silva, Ana Beatriz Januário da

; Fernandes, Matheus Santos de Sousa

; Souza, Sandra Lopes de

; Souza, Viviane de Oliveira Nogueira

Clinics

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2021, Volume 76 elocation e3155

Resumo: En | Texto: En | PDF: En

Vitamin D is a fat-soluble vitamin that plays a role not only in calcium homeostasis, but also in several other functions, including cell growth and immune functions, and is considered a neurosteroid. Vitamin D deficiency is highly prevalent worldwide and has been suggested to be associated with an increased risk of emotional disorders. Therefore, the association between vitamin D levels and psychophysiological disorders, such as depression, anxiety, and mood, has been investigated. To list these variables, a bibliographical literature research was conducted in the MEDLINE/PubMed, Web of Science, Scopus, Science Direct and PsycINFO databases, between November and December 2020, with no year limits of publication. The studies involved humans aged between 18 and 59 years without associated diseases. This review presents evidence of the main variables involved in this association, main tools used to verify these variables, and methods used to verify circulating vitamin D levels in populations. Most studies have indicated that the main psychophysiological variables involved with vitamin D levels are depression and anxiety followed by mood, and an association has been observed between increased serum vitamin D levels and reduction in symptoms of depression, anxiety, and mood, and there is a heterogeneity of methods for assessing vitamin D. More studies are clearly needed to improve our understanding of their role in modulating the psychophysiological aspects of vitamin D levels.

https://doi.org/10.6061/clinics/2021/e3155 52 downloads

12.

‘Tropical Sunki’ mandarin and hybrid citrus rootstocks under ‘Pera’ sweet orange in cohesive soil and As climate without irrigation
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Ribeiro, Lucas de Oliveira

; Costa, Danilo Pereira

; Ledo, Carlos Alberto da Silva

; Carvalho, Luciana Marques de

; Carvalho, Hélio Wilson Lemos de

; Soares Filho, Walter dos Santos

; Girardi, Eduardo Augusto

Bragantia

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2021, Volume 80 elocation e1321

Resumo: En | Texto: En | PDF: En

ABSTRACT The search for alternative rootstocks to the ‘Rangpur’ lime tree is a challenge to the sustainability of citrus in the Tabuleiros Costeiros (Coastal Tablelands) of Northeastern Brazil. New varieties should meet high drought tolerance with water deficit, cohesive soils, resistance to citrus diseases and inducing high production of fruit. In this work, the performance of ‘Pera’ sweet orange was evaluated on ‘Tropical Sunki’ mandarin and 27 hybrid citrus rootstocks in Umbaúba, Sergipe. A local selection of the ‘Rangpur’ lime was the control. Planting was in 2013 at tree spacing of 6.0 × 3.0 m, without irrigation. Tree size, fruit yield and quality, tree survival rate and graft-compatibility were assessed until 2019. Experimental design was completely randomized blocks with 29 treatments, three replicates and four plants in the plot. Two selection indices were applied to the data to assist in decision making. The ‘Tropical Sunki’ mandarin induced similar cumulative fruit yield in relation to the ‘Rangpur’ lime, suggesting a good drought tolerance of the former rootstock. The TSKC × (LCR × TR) - 073 induced slightly lower productivity, compensated by higher productive efficiency and higher concentration of soluble solids, whereas LCR × TR - 001 and HTR - 166 were highly efficient dwarfing rootstocks. The multiplicative and the rank sum indices showed high correlation, both classifying ‘Tropical Sunki’ mandarin, ‘Santa Cruz Rangpur’ lime, LVK × LCR - 010 and - 038, HTR - 127, in addition to the three aforementioned hybrids, as superior to the local selection of ‘Rangpur’ lime.

https://doi.org/10.1590/1678-4499.20200407 682 downloads

13.

Ecophysiological response of Astronium fraxinifolium (Anacardiaceae) in degraded and non-degraded brazilian Cerrado
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Leite, Marilaine Cristina Marques

; Araujo, Maycon Anderson

; Souza, Lucas Anjos

; Martins, Aline Redondo

; Camargos, Liliane Santos

Rodriguésia

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2021, Volume 72 elocation e00662020

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

Resumo Plantas nativas do Cerrado geralmente apresentam características peculiares que permitem tolerar o estresse hídrico e nutricional. Astronium fraxinifolium, é uma das espécies arbóreas de Anacardiaceae do Cerrado brasileiro. O objetivo desta pesquisa foi caracterizar morfofisiologicamente as folhas de A. fraxinifolium, com o objetivo de reconhecer características relacionadas a aclimatação da espécie em diferentes condições de solo. Para tanto, duas populações de A. fraxinifolium foram amostradas em diferentes áreas de estudo, A1 (Solo degradado) e A2 (“Solo não degradado”). A partir dessas amostras foram quantificados compostos nitrogenados, carboidratos totais, amido, clorofila, conteúdo nutricional, densidade estomática, trocas gasosas, alocação de carbono e altura da parte aérea, comparando as áreas de estudo. Um número elevado de estômatos foi observado na superfície abaxial das folhas de A. fraxinifolium, com uma densidade estomática mais elevada ocorrendo em indivíduos de A1. Já os valores de clorofila a, b e total foram significativamente maiores em A2. O conteúdo nutricional não diferiu entre as áreas, exceto o boro, que apresenta maior concentração nas plantas de A2. É possível que a menor concentração de boro nas plantas A1 esteja relacionado a produção de clorofila. Em relação às demais análises, não houve diferenças significativas entre as áreas. Os resultados mostram que esta espécie sofre alterações na produção de clorofila, mas a fotossíntese líquida não é perturbada, sendo o baixo teor de clorofila em A1 compensado pela maior densidade estomática. Assim, essas mudanças podem ser o resultado da aclimatação dessa espécie às diferentes condições ambientais às quais está exposta.

Abstract Plants native from Cerrado generally have peculiar characteristics that allow tolerating water and nutritional stress. Astronium fraxinifolium is a Anacardiaceae tree of from Brazilian Cerrado. The aim of this research was to characterize A. fraxinifolium leaves morphophysiologically, in order to recognize characteristics related to acclimatization of the species in different soil conditions. Two populations of A. fraxinifolium were sampled in different study areas, A1 (Degraded Soil) and A2 (“Undegraded Soil”). Nitrogen compounds, total carbohydrates, chlorophyll, nutritional content, stomatal density and gas exchanges were quantified, comparing the areas. A high number of stomata was observed on the abaxial surface of A. fraxinifolium leaves, with a higher density occurring in A1 individuals. The values of chlorophyll and boron content were significantly higher in A2 plants. It’s possible that the lowest concentration of boron in A1 plants is related to chlorophyll production. Regardinf the other analysis, there weren’t significant differences between the areas. The results show that this species undergoes changes in production of chlorophyll, but liquid photosynthesis isn’t impaired, considering the low chlorophyll content in A1 being compensated by the higher stomatal density. Thus, these changes may be the result of acclimating this species to different environmental conditions to which it’s exposed.

https://doi.org/10.1590/2175-7860202172066 40 downloads

14.

Three-dimensional Educational Technology for the prevention of accidents caused by falls in the elderly
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Lima, Rayanne Branco dos Santos

; Barbosa, Rachel Gabriel Bastos

; Diniz, Jamylle Lucas

; Costa, Joyce da Silva

; Marques, Marília Braga

; Coutinho, Janaína Fonseca Victor

Revista Brasileira de Enfermagem

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2021, Volume 74 Supl. 5 elocation e20190806

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

RESUMO Objetivo: Avaliar uma gerontotecnologia educacional tridimensional para prevenção de quedas em idosos no domicílio. Métodos: Estudo transversal, descritivo, compreendendo Desenvolvimento de gerontotecnologia; Avaliação por especialistas e público-alvo - realizado em Fortaleza, Ceará, Brasil, de junho de 2017 a outubro de 2018. Para o desenvolvimento, utilizaram-se os passos adotados em uma cartilha e o projeto Casa Segura para idosos. Participaram da avaliação 16 especialistas e 30 idosos, utilizando o Modelo de Promoção da Saúde, de Nola Pender. Resultados: A maquete possui área de 160 cm2, com quatro cômodos em material do tipo Medium Density Fiberboard. Os especialistas consideraram a tecnologia adequada, com nível de concordância de 87,7% IC95% [87,71-88,42]. Todos os idosos relataram que a maquete se assemelhava ao seu domicílio, e 13 destes (43,3%) sugeriram a construção de um quintal, possibilidade de dois andares, corredores e escadas. Conclusão: A gerontotecnologia foi considerada apta para utilização na prevenção de quedas em idosos.

ABSTRACT Objective: Evaluate a three-dimensional educational gerontotechnology for the prevention of falls in the elderly at home. Methods: Cross-sectional, descriptive study, involving the Development of gerontotechnology; Evaluation by specialists and target audience, took place in Fortaleza, State of Ceara, Brazil, from June 2017 to October 2018. For the development, it was used the steps adopted in a booklet and the Casa Segura project for the elderly. 16 specialists and 30 elderly participated in the evaluation, using the Health Promotion Model, by Nola Pende. Results: The scale model has an area of 160 cm2, with four rooms made of Medium Density Fiberboard . Specialists consider technology adequate, with a level of compliance of 87.7% IC95% [87,71-88,42]. All the elderly related that the scale model looked their homes, and 13 of them (43.3%) suggested the construction of a backyard, a possible second floor, corridors, and stairs. Conclusion: Gerontotechnology was considered fit to be used in the prevention of falls in the elderly.

RESUMEN Objetivo: Evaluar gerontotecnología educacional tridimensional para prevención de caídas en ancianos en domicilio. Métodos: Estudio transversal, descriptivo, comprendiendo Desarrollo de gerontotecnología; Evaluación por especialistas y público objeto - realizado en Fortaleza, Ceará, Brasil, de junio de 2017 a octubre de 2018. Para el desarrollo, utilizaron los pasos adoptados en una cartilla y el proyecto Casa Segura para ancianos. Participaron de la evaluación 16 especialistas y 30 ancianos, utilizando el Modelo de Promoción de la Salud, de Nola Pender. Resultados: La maqueta posee área de 160 cm2, con cuatro cómodos en material del tipo Medium Density Fiberboard . Los especialistas consideraron la tecnología adecuada, con nivel de concordancia de 87,7% IC95% [87,71-88,42]. Todos los ancianos informaron que la maqueta se asemeja al domicilio, y 13 de estos (43,3%) sugirieron la construcción de un patio, posibilidad de dos pisos, pasillos y escaleras. Conclusión: La gerontotecnología ha considerada apta para utilización en la prevención de caídas por ancianos.

https://doi.org/10.1590/0034-7167-2019-0806 1099 downloads

15.

EFFICACY OF LOW-LEVEL LASER THERAPY ON FISTULA-IN-ANO TREATMENT
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SANTOS, Carlos Henrique Marques dos

; GUIMARÃES, Felipe dos Santos

; BARROS, Fernanda Helene Reis

; LEME, Guilherme Apolinário Laureano

; SILVA, Lucas Dutra Madrid da

; SANTOS, Sandro Endrick de Oliveira

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 Nº 1 elocation e1572

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

RESUMO Racional: Tratamento de fístulas anais ainda é grande desafio devido à possibilidade de incontinência fecal pós-operatória; o uso do laser vem ganhando espaço na medicina, inclusive como método indutor de cicatrização. Objetivo: Avaliar a eficácia da terapia a laser de baixa potência no tratamento de fístula perianal em ratos. Métodos: Foram utilizados 15 ratos Wistar machos com peso aproximado de 250-300 g, os quais foram submetidos à indução da fístula anal e após 30 dias foram distribuídos em dois grupos: grupo controle (GC, n=5) e grupo laser (GL, n=10) observado por mais 30 dias. No GC nenhum tratamento foi realizado e no LG laserterapia de baixa intensidade foi aplicada nos trajetos fistulosos diariamente. Foram avaliados o fechamento do trajeto fistuloso, a área do trajeto remanescente, o infiltrado inflamatório e a congestão vascular. Resultados: Não houve fechamento completo do trajeto fistuloso em nenhum dos animais. A área média do trajeto remanescente foi de 847,2µm2 no GC e 248,5µm2 no GL (p=0,001). O escore médio do infiltrado inflamatório foi de 2,4 no GC e 1,3 no GL (p=0,0285), enquanto na avaliação da congestão vascular foi observado 1,6 no GC e 0,6 no GL (p=0,031). Conclusões: A terapia a laser de baixa potência foi capaz de reduzir a área dos trajetos fistulosos, bem como diminuir o processo inflamatório e a congestão vascular local.

ABSTRACT Background: Treating anal fistulae is still a great challenge due to the possibility of fecal incontinence after surgery and that the use of laser has been gaining space in medicine, including as an inducing method of healing. Aim: To evaluate the efficacy of low-level laser therapy on fistula-in-ano treatment in rats. Methods: Fifteen male Wistar rats weighing approximately 250-300g were used, which were subjected to the anal fistula induction procedure and after 30 days were distributed into two groups: control group (CG, n=5) and laser group (LG, n=10) observed for another 30 days. In the CG no treatment was performed and, in the LG, low-level laser therapy was applied in fistulous tracts daily. The closure of the fistulous tract, the area of the remaining tract, the inflammatory infiltrate and vascular congestion were evaluated. Results: There was no complete closure of the tract in any of the animals. The mean area of the remaining tract was 847.2 µm2 in the CG and 248.5 µm2 in the LG (p=0.001). The mean inflammatory infiltrate score was 2.4 in the CG and 1.3 in the LG (p=0.0285), while in the evaluation of vascular congestion, 1.6 was observed in the CG and 0.6 in the LG (p=0.031). Conclusions: Low-level laser therapy was able to reduce the area of the fistulous tracts as well as decrease the inflammatory process and local vascular congestion.

https://doi.org/10.1590/0102-672020210001e1572 605 downloads

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