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[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães Barroso, Weimar Kunz Sebba Mion Júnior, Décio Nobre, Fernando Mota-Gomes, Marco Antonio Jardim, Paulo Cesar Brandão Veiga Amodeo, Celso Camargo, Adriana Alessi, Alexandre Sousa, Ana Luiza Lima Brandão, Andréa Araujo Pio-Abreu, Andrea Sposito, Andrei Carvalho Pierin, Angela Maria Geraldo Paiva, Annelise Machado Gomes de Spinelli, Antonio Carlos de Souza Machado, Carlos Alberto Poli-de-Figueiredo, Carlos Eduardo Rodrigues, Cibele Isaac Saad Forjaz, Cláudia Lúcia de Moraes Sampaio, Diogo Pereira Santos Barbosa, Eduardo Costa Duarte Freitas, Elizabete Viana de Cestário , Elizabeth do Espírito Santo Muxfeldt, Elizabeth Silaid Lima Júnior, Emilton Campana, Erika Maria Gonçalves Feitosa, Fabiana Gomes Aragão Magalhães Consolim-Colombo, Fernanda Marciano Almeida, Fernando Antônio de Silva, Giovanio Vieira da Moreno Júnior, Heitor Finimundi, Helius Carlos Guimarães, Isabel Cristina Britto Gemelli, João Roberto Barreto Filho, José Augusto Soares Vilela-Martin, José Fernando Ribeiro, José Marcio Yugar-Toledo, Juan Carlos Magalhães, Lucélia Batista Neves Cunha Drager, Luciano Ferreira Bortolotto, Luiz Aparecido Alves, Marco Antonio de Melo Malachias, Marcus Vinícius Bolívar Neves, Mario Fritsch Toros Santos, Mayara Cedrim Dinamarco, Nelson Moreira Filho, Osni Passarelli Júnior, Oswaldo Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira Miranda, Roberto Dischinger Bezerra, Rodrigo Pedrosa, Rodrigo Pinto Paula, Rogério Baumgratz de Okawa, Rogério Toshiro Passos Póvoa, Rui Manuel dos Santos Fuchs, Sandra C. Inuzuka, Sayuri Ferreira-Filho, Sebastião R. Paffer Fillho, Silvio Hock de Jardim, Thiago de Souza Veiga Guimarães Neto, Vanildo da Silva Koch, Vera Hermina Gusmão, Waléria Dantas Pereira Oigman, Wille Nadruz, Wilson

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Data de publicação: 2023-09-23

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Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

https://doi.org/10.1590/SciELOPreprints.7057

The landscape of hematology research in Brazil: an analysis of data from citation databases
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Paula, Erich Vinicius De

; Martins, Marcio Souza

; Lorenzo, Ana Luisa Bortoluzo De

; Duarte, Bruno Kosa Lino

; Rezende, Suely Meireles

; Costa, Fernando Ferreira

Hematology, Transfusion and Cell Therapy

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Jul 2023, Volume 45 Supl. 2 Páginas S57 - S67

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Scientometrics is the field concerned with measuring and analyzing academic literature, using specific metrics and data from bibliometric databases. Hematology is a broad area of science and medicine, from which several landmark scientific discoveries have emerged. Objective: The aim of this report is to provide a snapshot of the landscape of hematology research in Brazil, based on a comprehensive analysis of published studies in hematology whose authors were affiliated to Brazilian institutions from 1980 to 2020. Method: Articles, reviews and letters to the editor with at least one author affiliated to a Brazilian institution were retrieved from Incytes/Web of Science or Scopus databases. Importantly, only papers classified in the subject area “Hematology” by the embedded algorithms of each database were included. Results: Considering all published papers, Brazil is in the 22nd position, contributing with around 1.1% of papers in this period. A clear and sustained increase in publication output can be observed from the early 1990’s to the present moment. Publicly-funded higher education institutions were the main contributors to the development and consolidation of the hematology scientific community, which has grown in diversity, with an increasing number of contributions from private institutions. In regard to funding, public agencies have been and remain by large as the most important funder of research in hematology in Brazil. Conclusion: We suggest that continuous monitoring of the temporal trends of some of the data compiled in our report could potentially contribute to a clearer picture of the development of hematology research in Brazil.

https://doi.org/10.1016/j.htct.2022.02.001

Functional Shoulder Evaluation after Osteosynthesis of Greater Tuberosity Fracture: Is There any Influence of Glenohumeral Dislocation?
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Mouraria, Guilherme Grisi

; Cunha, Renato Mason Rodrigues da

; Coelho, Sérgio de Paula

; Brigatto, Rafael Mulati

; Cruz, Márcio Alves

; Etchebehere, Maurício

Revista Brasileira de Ortopedia

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Abr 2023, Volume 58 Nº 2 Páginas 265 - 270

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

Abstract Objective To evaluate the postoperative functional and radiographic outcomes of the shoulder of patients submitted to transosseous suturing of a greater tuberosity fracture (GTF) through an anterolateral route and the influence of the glenohumeral dislocation on these outcomes. Methods We conducted a retrospective study and functional assessment using the Constant-Murley score. The distance between the greater tuberosity and the joint surface of the proximal humerus (in true anteroposterior radiographs) after the union was calculated. We used the Fisher exact test for the categorical independent variables, and the Student t or Mann-Whitney test for the non-categorical variables. Results In total, 26 patients met the inclusion criteria, and 38% of the sample presented an association between glenohumeral dislocation and GTF. The mean Constant-Murley score was of 82.5 + 8.02 points. The presence of an associated dislocation did not alter the functional outcome. The mean distance between the greater tuberosity of the humerus and the joint surface of the humeral head after the union was of 9 + 4.3 mm below the articular line of the humeral head. The dislocation led to a lower level of reduction, but this did not influence the Constant-Murley score. Conclusion The cases of GTF submitted to surgical treatment with transosseous sutures had good functional outcomes. The presence of dislocation made the anatomical reduction of the greater tuberosity difficult. However, it did not influence the Constant-Murley score.

Resumo Objetivo Avaliar os resultados funcional e radiográfico pós-operatórios do ombro, em pacientes submetidos a sutura transóssea de fratura da tuberosidade maior (FTM) por acesso anterolateral, e a influência da luxação glenoumeral nesses resultados. Métodos Realizou-se estudo retrospectivo e avaliação funcional (pela escala de Constant-Murley). Calculou-se a distância entre a tuberosidade maior e a superfície articular do úmero proximal (por meio de radiografia em incidência anteroposterior verdadeira) após a consolidação. Usou-se o teste Exato de Fisher para as variáveis independentes categóricas, e os testes tde Student ou de Mann-Whitney para as não categóricas. Resultados Ao todo, 26 pacientes preencheram os critérios de inclusão. A associação de luxação glenoumeral com FTM foi observada em 38% da amostra. A média da pontuação na escala de Constant-Murley foi de 82,5 + 8,02. A presença de luxação associada não alterou o resultado funcional. A distância média da consolidação da tuberosidade maior do úmero em relação à superfície articular da cabeça umeral foi de 9 + 4,3 mm abaixo da linha articular da cabeça umeral. Pacientes com luxação associada evoluíram com redução menor, mas isso não influenciou na pontuação na escala de Constant-Murley. Conclusão As FTMs submetidas ao tratamento cirúrgico com sutura transóssea evoluíram com bom resultado funcional. A presença de luxação dificultou a redução anatômica da tuberosidade maior. Entretanto, isso não influenciou na pontuação na escala de Constant-Murley.

https://doi.org/10.1055/s-0042-1749417

Cancer mortality in Guarapari, Espiríto Santo State, Brazil, with areas of high natural radioactivity
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Ferreira, Rafael Gonçalves

; Angeli, Marcio Vinicius de Nardi de

; Barboza, Debora Rocha

; Carvalho-Silva, Gustavo de Paula Batista de

; Azevedo Junior, Romildo Rocha

; Pereira, Fausto Edmundo Lima

Cadernos de Saúde Pública

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2023, Volume 39 Nº 3 elocation e00089422

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

Taxas de mortalidade maiores para os cânceres mais frequentes foram registradas entre 1996 e 2000 em Guarapari, um município do Espírito Santo, Brasil, onde se localizam praias com alta radioatividade natural. Para verificar a existência desse excesso de mortalidade por câncer em Guarapari, taxas de mortalidade por todas as causas, todos os cânceres e pelos cânceres mais prevalentes no município foram estudadas entre 2000 e 2018 e comparadas com aquelas observadas no estado. Dados de mortalidade por todas as causas, por câncer e por câncer de esôfago, estômago, laringe, traqueia, brônquios e pulmão, próstata, mama e leucemias foram coletados no Departamento de Informática do SUS (DATASUS) de 2000 a 2018. As taxas de mortalidade foram calculadas pelo método direto. As taxas padronizadas ajustadas por idade (TPAI) foram calculadas com base na população mundial padrão da Organização Mundial da Saúde (OMS). Foram calculadas taxas brutas de mortalidade para cada município e as TPAI para o estado e para os nove municípios onde foi avaliada a radioatividade natural. A mortalidade por todas as causas, todos os cânceres e pelos diferentes cânceres investigados em Guarapari não diferiu significativamente daqueles observados no estado ou em municípios com mais de 100 mil habitantes. Não houve correlação entre os níveis de radioatividade e as taxas de mortalidade nos nove municípios onde a radioatividade natural era conhecida. Em conclusão, os resultados mostraram que a mortalidade por câncer e por todas as causas em Guarapari não diferiu daquelas observadas no restante do estado. Além disso, não houve correlação entre os níveis de radioatividade natural e a mortalidade por câncer nas áreas onde a radioatividade natural foi avaliada.

Las mayores tasas de mortalidad por cáncer se registraron entre 1996 y 2000 en Guarapari, un municipio del estado de Espírito Santo, Brasil, donde existen playas con alta radiactividad natural. Para verificar la existencia de mayor mortalidad por cáncer en Guarapari, se estudiaron las tasas de mortalidad por distintas causas, por los tipos de cáncer y por los tipos más prevalentes en este municipio entre 2000 y 2018, y se las compararon con las observadas en todo el estado. Los datos sobre la mortalidad por distintas causas, por cáncer y por cáncer de esófago, estómago, laringe, tráquea, bronquios y pulmón, próstata, mama y leucemias se recogieron del Departamento de Informática de SUS (DATASUS) sobre el periodo de 2000 a 2018. Las tasas de mortalidad se calcularon utilizando el método directo. Las tasas estandarizadas ajustadas por edad (TEAE) se calcularon con base en las de la población mundial estándar de la Organización Mundial de Salud (OMS). Se calcularon las tasas brutas de mortalidad para cada municipio y las TEAE para el estado y para los nueve municipios donde se evaluó la radiactividad natural. La mortalidad por distintas causas, por los tipos de cáncer y por los diferentes tipos de cáncer investigados en Guarapari no difirió significativamente de la observada en el estado o en los municipios con más de 100.000 habitantes. No hubo correlación entre los niveles de radiactividad y las tasas de mortalidad en los nueve municipios donde existe radiactividad natural. Se concluye que la mortalidad por cáncer y por distintas causas en Guarapari no difiere de los resultados observados en todo el estado. Además, no hubo correlación entre los niveles de radiactividad natural y la mortalidad por cáncer en las áreas donde se evaluó la radiactividad natural.

Guarapari, a municipality of the state of Espírito Santo, Brazil, reported higher mortality rates for the most common cancers from 1996 to 2000. This municipality has beaches with high natural radioactivity. To verify whether this excessive cancer mortality rate still exist in Guarapari, mortality rates for all causes, cancers, and the most prevalent cancers in this municipality were studied from 2000 to 2018 and compared with those observed in the state. Data on all-cause mortality, all-cancer mortality, and mortality from cancer of the esophagus, stomach, larynx, trachea, bronchi and lung, prostate, breast, and leukemias were collected in Brazilian Health Informatics Department (DATASUS) from 2000 to 2018. Mortality rates were calculated by direct method. Standardized age-adjusted rates (SAAR) were calculated based on standard of the World Health Organization (WHO) world population. Crude mortality rates were calculated for each municipality and SAAR for the state and nine municipalities where natural radioactivity was evaluated. Mortality rates from all causes, all cancers, and different cancers observed in Guarapari did not differ significantly from those observed in the state or municipalities with more than 100,000 inhabitants. Radioactivity levels and mortality rates showed no correlation in nine municipalities where natural radioactivity was known. In conclusion, results showed that mortality from cancer and all causes in Guarapari did not differ from those observed in the state and that there was no correlation between the levels of natural radioactivity and mortality from cancer in areas where natural radioactivity was evaluated.

https://doi.org/10.1590/0102-311xen089422

First official record of Aedes (Stegomyia) albopictus (Diptera: Culicidae) in the Acre State, Northern Brazil
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Rocha, Ricardo da Costa

; Cardoso, Acigelda da Silva

; Souza, Janis Lunier de

; Pereira, Eliana da Silva

; Amorim, Marcio Fernandes de

; Souza, Maria Socorro Martins de

; Medeiros, Cleomar de Lima

; Monteiro, Maria Francisca Mendes

; Meneguetti, Dionatas Ulises de Oliveira

; Paula, Marcia Bicudo de

; Brilhante, Andreia Fernandes

; Lima-Camara, Tamara Nunes

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e20

Resumo: En | Texto: En | PDF: En

ABSTRACT Aedes (Stegomyia) albopictus (Skuse, 1854) was reported in Brazil for the first time in 1986 and has shown marked expansion throughout the Brazilian territory. During a routine activity to control dengue fever conducted by the Division of Entomology of the Municipal Health Department in Rio Branco city, adults and immatures of Culicidae were collected in a peri-urban area. The identified Culicidae forms indicated that they belonged to the species Ae. albopictus. This is the first official record of the presence of Ae. albopictus in the Acre State, confirming its current presence in all Brazilian states.

https://doi.org/10.1590/s1678-9946202365020

The Hertel classification can’t predict the risk of humeral head osteonecrosis after osteosynthesis using an anterolateral approach
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Cruz, Márcio Alves

; Mouraria, Guilherme Grisi

; Kikuta, Fernando Kenji

; Zogbi, Daniel Romano

; Coelho, Sérgio de Paula

; Etchebehere, Maurício

Clinics

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2023, Volume 78 elocation 100173

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Proximal humeral fractures can progress to osteonecrosis of the humeral head. Hertel developed a binary classification system (12 subtypes) and demonstrated that some patterns have more risk to develop osteonecrosis. Hertel described the prevalence and the risk factors for Humeral head osteonecrosis after osteosynthesis using a Deltopectoral approach. Few studies have evaluated the prevalence and the capacity of Hertel’s classification to predict Humeral Head osteonecrosis following osteosynthesis of proximal Humeral fractures through the anterolateral approach. The objectives of this study were to correlate osteonecrosis predictors established by the Hertel classification with the risk of developing osteonecrosis and its prevalence after osteosynthesis using the anterolateral approach. Methods: This was a retrospective study of patients who underwent osteosynthesis of proximal humerus fractures using an anterolateral approach. Patients were divided into two groups: high risk for necrosis (group 1) and low risk for necrosis (group 2) according to Hertel’s criteria. The overall prevalence of osteonecrosis and the prevalence in each group were calculated. A radiological examination was performed in the true anteroposterior (Grashey), scapular, and axillary views, before and after the operation (minimum 1 year after surgery). A KaplanMeier curve was used to assess the pattern of the temporal evolution of osteonecrosis. The groups were compared using the Chi-square test or Fisher’s exact test. The unpaired t-test (parametric variables - age) and the MannWhitney test (non-parametric time between trauma and surgery) were used. Results: In total, 39 patients were evaluated. The postoperative follow-up time was 14.5 ± 3.3 months. The time to onset of necrosis was 14.1 ± 3.9 months. Sex, age, and time between trauma and surgery did not influence the risk of necrosis. Type 2, 9, 10, 11, and 12, or fractures with posteromedial head extension less than or equal to 8 mm, or diaphysis deviation greater than 2 mm, as well as grouping did not influence the risk for osteonecrosis. Conclusions: Hertel’s criteria were not able to predict the development of osteonecrosis after osteosynthesis of proximal humerus fractures performed through the anterolateral approach. The total prevalence of osteonecrosis was 17.9% with a tendency toward an increased incidence after 1 year of surgical treatment.

https://doi.org/10.1016/j.clinsp.2023.100173

Influence of anxiety and catastrophizing on pain perception in orthodontic treatment and its association with inflammatory cytokines
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Santos, Lucineide Lima dos

; Conti, Ana Cláudia de Castro Ferreira

; Fernandes, Thais Maria Freire

; Garlet, Gustavo Pompermaier

; Almeida, Marcio Rodrigues de

; Oltramari, Paula Vanessa Pedron

Brazilian Oral Research

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2023, Volume 37 elocation e010

Resumo: En | Texto: En | PDF: En

Abstract Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman’s correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0010

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

Cancer mortality in Guarapari, Espiríto Santo State, Brazil, with areas of high natural radioactivity
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Ferreira, Rafael Gonçalves

; Angeli, Marcio Vinicius de Nardi de

; Barboza, Debora Rocha

; Carvalho-Silva, Gustavo de Paula Batista de

; Azevedo Junior, Romildo Rocha

; Pereira, Fausto Edmundo Lima

Cadernos de Saúde Pública

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2023, Volume 39 Nº 3 elocation e00089422

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

https://doi.org/10.1590/0102-311xen089422

10.

The role of TNF-α and NFkβ in an experimental model of intestinal carcinogenesis with 1,2-dimethyhydrazine
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Barreira, Márcio Alencar

; Campelo, Márcio Wilker Soares

; Rebouças, Conceição da Silva Martins

; Campelo, Ana Paula Bomfim Soares

; Vasconcelos, Paulo Roberto Leitão de

Acta Cirúrgica Brasileira

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2023, Volume 38 elocation e383623

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: To analyze the potential of tumor necrosis factor-α (TNF-α) and factor nuclear kappa B (NF-κB) as colorectal cancer (CRC) biomarkers in an experimental model of intestinal carcinogenesis with 1,2-dimethyhydrazine (1,2-DMH). Methods: Twenty-four male Wistar rats were divided into two groups: sham and 1,2-DMH. First, 1,2-DMH (20 mg/kg/week) was administered for 15 consecutive weeks. In the 25th week, proctocolectomy was conducted. Histopathological analysis, immunohistochemistry, and gene expression of TNF-α and NF-κB were performed. Statistical analysis was performed using GraphPad Prism. The location of aberrant crypt foci (ACF) was analyzed by Kruskal-Wallis’ test. For analyses with two groups with parametric data, the t-test was used; for non-parametric data, the Mann-Whitney’s test was used. P < 0.05 was considered significant. Results: The number of ACF and macroscopic lesions was significantly higher (p < 0.5) in the 1,2-DMH group compared to the sham group, and most ACF were concentrated in the distal segment of the colon. There was a statistically significant increase (p < 0.5) in protein and gene expression of TNF-α and NF-κB in the 1,2-DMH group compared to the sham group. Conclusions: Our results provide supportive evidence that TNF-α and NF-κB pathways are strongly involved in CRC development in rats and might be used as early biomarkers of CRC pathogenesis in experimental studies.

https://doi.org/10.1590/acb383623

11.

Soils under seal carcasses with varying degrees of decomposition: oasis of nutrients and vegetation in Antarctica
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SCHAEFER, CARLOS ERNESTO G.R.

; SENRA, EDUARDO O.

; SCHMITZ, DANIELA

; SIQUEIRA, RAFAEL G.

; PAULA, MAYARA D. DE

; PUTZKE, JAIR

; OLIVEIRA, FABIO S. DE

; MAIA, LARA G.

; IBRAIMO, ANIFO S.M.

; FRANCELINO, MÁRCIO R.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Supl. 3 elocation e20230747

Resumo: En | Texto: En | PDF: En

Abstract Areas of high concentration of seal carcasses have been observed in localized areas of James Ross Island, Antarctica. Such carcasses show an unusual vegetation development, in a semi-arid area with bare soils under intense winds, high salinity and sandy texture. We investigated carcasses of seals around a lake in James Ross Island, with four different stages of decomposition, with three replicates: Seal (S01), with recently mummified carcasses; S02, with partially degraded carcasses; S03, with broken carcasses with partially degraded exposed bones, and S04, with completely broken, scattered skeletons. The vegetation showed a maximum degree of development in carcasses at stages S02 and S03, with the environment between the skin and the skeleton as the preferred place for vegetation establishment. The chemical alteration was greater with increasing carcass decomposition but reduced with the spreading and final decomposition of the bones, with anomalous values observed only in the vicinity of the carcasses. It is concluded that the presence of carcasses of seals, concentrated in wet places, even in a semi-desert climate, represent important oases of nutrients, with a combination of physical and chemical effects throughout the decomposition process that favor plant establishment and succession.

https://doi.org/10.1590/0001-3765202320230747

12.

Agroclimatic referential for Acrocomia aculeata (Jacq.) Lodd. ex Mart. based on its diversity center in Minas Gerais, Brazil
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Silveira, Vitor Alves da

; Paula, Hígor Brandão de

; Francelino, Márcio Rocha

; Filpi, Heitor Eduardo Ferreira Campos Morato

; Kuki, Kacilda Naomi

; Zanuncio, José Cola

; Imbuzeiro, Hewlley Maria Acioli

Ciência Florestal

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2023, Volume 33 Nº 4 elocation e64546

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

ABSTRACT The production chain of the macauba palm (Acrocomia aculeata) includes the cosmetics, food and bioenergy sectors, which highlights the relevance of defining bioclimatically favorable areas for the cultivation of this plant in the state of Minas Gerais, Brazil, the center of its origin. The mesoregions of this state were characterized according to the average annual temperature (AMT), annual precipitation (AP), precipitation in the driest quarter (PDQ), and aridity index (AI), following the Boolean logic. A total of 45.18% of the area of this state is bioclimatically favorable for the cultivation of A. aculeata, which facilitates the planning of farming activities, conservation, and management of this plant in other regions with conditions similar to those observed in this state. This palm can also be cultivated with irrigation in regions with adequate bioclimatic conditions, but without adequate rainfall pattern. This information can boost the rational and sustainable use of A. aculeata for the production of green vegetable oil.

RESUMO A cadeia produtiva da palmeira macaúba (Acrocomia aculeata) inclui os setores de cosméticos, alimentos e bioenergia, aumentando a importância de se definir as áreas bioclimaticamente favoráveis para o cultivo dessa planta no estado de Minas Gerais, Brasil, centro de sua origem. As mesorregiões desse estado foram caracterizadas de acordo com a temperatura média anual (TMA), precipitação anual (PA), precipitação no trimestre mais seco (PTS) e índice de aridez (IA), seguindo a lógica booleana. Um total de 45,18% da área do estado de Minas Gerais é, bioclimaticamente, favorável ao cultivo da A. aculeata, facilitando o planejamento de atividades agropecuárias, conservação e manejo dessa planta. Essa palmeira pode, também, ser cultivada com irrigação em regiões com déficit de precipitação, mas com as outras condições bioclimáticas semelhantes às definidas nesse estado para essa planta. Essas informações aumentam as possibilidades do uso racional e sustentável de A. aculeata para produção de óleo vegetal verde.

https://doi.org/10.5902/1980509864546

13.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

14.

Brazilian Society of Otology task force - Vestibular Schwannoma - evaluation and treatment
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Silva, Vagner Antonio Rodrigues

; Lavinsky, Joel

; Pauna, Henrique Furlan

; Vianna, Melissa Ferreira

; Santos, Vanessa Mazanek

; Ikino, Cláudio Márcio Yudi

; Sampaio, André Luiz Lopes

; Lopes, Paula Tardim

; Lamounier, Pauliana

; Maranhão, André Souza de Albuquerque

; Soares, Vitor Yamashiro Rocha

; Polanski, José Fernando

; Denaro, Mariana Moreira de Castro

; Chone, Carlos Takahiro

; Bento, Ricardo Ferreira

; Castilho, Arthur Menino

Brazilian Journal of Otorhinolaryngology

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2023, Volume 89 Nº 6 elocation 101313

Resumo: En | Texto: En | PDF: En

Abstract Objective: To review the literature on the diagnosis and treatment of vestibular schwannoma. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on vestibular schwannoma were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: (1) Diagnosis – audiologic, electrophysiologic tests, and imaging; (2) Treatment – wait and scan protocols, surgery, radiosurgery/radiotherapy, and systemic therapy. Conclusions: Decision making in VS treatment has become more challenging. MRI can diagnose increasingly smaller tumors, which has disastrous consequences for the patients and their families. It is important to develop an individualized approach for each case, which highly depends on the experience of each surgical team.

https://doi.org/10.1016/j.bjorl.2023.101313

15.

Challenges to implementing planning processes in Brazilian health regions
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Tanaka, Oswaldo Yoshimi

; Akerman, Marco

; Louvison, Marília Cristina Prado

; Bousquat, Aylene

; Pinto, Nicanor Rodrigues da Silva

; Meira, Ana Lígia Passos

; Godoi, Lídia Pereira da Silva

; Pereira, Ana Paula Chancharulo e Morais

; Spedo, Sandra Maria

; Oliveira, Monique Batista de

; Eshriqui, Ilana

; Paresque, Marcio Anderson Cardozo

Revista de Saúde Pública

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2023, Volume 57 Supl. 3 elocation 2s

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

RESUMO OBJETIVO Reconhecer elementos que facilitaram ou dificultaram as etapas do processo de implementação do PlanificaSUS. MÉTODOS Foi realizado um estudo de casos múltiplos em quatro regiões de saúde pré-selecionadas – Belo Jardim (PE), Fronteira Oeste (RS), Sul-Mato-Grossense (MT), Valença (BA) –, utilizando como condições traçadoras a hipertensão arterial sistêmica e a atenção materno infantil. Foi realizada observação participante na Comissão Intergestora Regional (CIR), bem como entrevistas em profundidade nas quatro regiões estudadas, com informantes-chave da gestão estadual e municipal e com profissionais dos serviços da atenção primária à saúde e atenção ambulatorial especializada envolvidos no projeto. Construiu-se análise em três dimensões: política, técnico operacional e contexto. RESULTADOS Na dimensão política, ficou evidenciado que, de alguma forma, as regiões identificaram no projeto uma oportunidade de articulação entre estados e municípios e uma aposta política importante para a construção de redes e linhas de cuidado, mas ainda com muitos caminhos a percorrer para enfrentar as barreiras identificadas nas disputas em jogo na construção do Sistema Único de Saúde (SUS). Na dimensão técnico operacional, é importante considerar que foi estimulada uma cultura de planejamento local na APS, além do favorecimento do uso de ferramentas tradicionais, no sentido de organizá-la e qualificá-la, como a organização dos cadastros, da agenda e da demanda. No entanto, os processos centralizados formativos e indutores da planificação nem sempre respondem às necessidades singulares dos territórios e podem produzir barreiras à implementação. CONCLUSÕES Cabe considerar o papel do gestor estadual na aposta relacionada ao projeto, tanto no nível central quanto no nível regional, e o efeito de processos de mobilização da atenção primária à saúde e amplificação de sua potência, mas ainda com muitos caminhos a percorrer para enfrentar as barreiras identificadas nas disputas em jogo na construção do SUS.

ABSTRACT OBJECTIVE To recognize elements that facilitated or hindered the PlanificaSUS implementation stages. METHODS A multiple case study was carried out in four pre-selected health regions in Brazil—Belo Jardim (PE), Fronteira Oeste (RS), Sul-Mato-Grossense (MT) and Valença (BA) using systemic arterial hypertension and maternal and child care as tracer conditions. Participant observation (in regional interagency commissions) and in-depth interviews with key informants from state and municipal management and primary health care and specialized outpatient care service professionals within the project were carried out in these four regions. Analysis was built according to political, technical-operational, and contextual dimensions. RESULTS The political dimension evinced that the regions found the project an opportunity to articulate states and municipalities and an important political bet to build networks and lines of care but that there remained much to be faced in the disputes related to building the Unified Health System (SUS). In the technical operational dimension, it is important to consider that primary health care stimulated a culture of local planning and favored traditional tools to organize and improve it, such as organizing registrations, agendas, and demands. However, centralized training and planning-inducing processes fail to always respond to local needs and can produce barriers to implementation. CONCLUSIONS It is worth considering the central and regional role of state managers in the commitment related to the project and the effect of mobilizing primary health care and expanding its power. There remains much to be faced in the disputes at stake in bullring SUS.

https://doi.org/10.11606/s1518-8787.2023057005138

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