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OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

https://doi.org/10.6061/clinics/2021/e3547

Características epidemiológicas de las onicomicosis en la consulta dermatológica
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Insfrán Duarte, Lorena Stefani

; Meza, Mariana Yissel

; Monserrat Aldama Negrete, María Teresa

; Aldama, Olga María

; Pereira Brunelli, José Guillermo

; Aldama Caballero, Arnaldo Benjamín Feliciano

; Insaurralde Molas, Sonia Clemencia

; García Duarte, Jesús Manuel

Revista del Nacional (Itauguá)

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Dez 2019, Volume 11 Nº 2 Páginas 5 - 18

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

ABSTRACT Introduction: onychomycosis is an infection of nails caused by dermatophyte fungi, not dermatophytes or yeasts. It constitutes a frequent disease in medical practice, with considerable emotional, social, labor and economic impact. Objective: to describe the epidemiological characteristics of onychomycosis in patients who attended in a dermatological service. Materials and Methods: a retrospective cross-sectional observational study, where epidemiological records of patients who attended the Dermatology service of the Itauguá National Hospital and the Dermatological Specialties Center in the period from july 2016 to august 2019 were analyzed. Results: 464 patients with onychomycosis were analyzed. The culture was positive in 83 % (385/464) of the cases. It was mainly observed in women 72 % (276/385), age group was between 31 and 65 years 70.1 % (270/385), of urban areas 76 % (292/385) their activities were house as and household chores activity 41 % (157 / 385). 23 % (87/385) presented one or more comorbidities associated with onychomycosis, with diabetes in 70 % (61/385) of these. The location was in toenails in 58.2 % (259/400), fingernail in 31.2 % (141/400) and in 10.1 % (45/400) of the cases onychomycosis were observed in Both locations. The most frequently isolated genera were Trichophyton and Candida, and the species were T. rubrum and Candida parapsilosis. In the onychomycosis of the toenails, dermatophytes were isolated in 63.7 % (165/259), while in the fingernails, Candida spp. in 77.3 % (107/141). Conclusion: onychomycosis produces an affectation that is mostly adult patients, usually women who are engaged in household activities, from urban areas, the main involvement were toenails, being the most frequent agent isolated were, T. rubrum and C. parapsilosis.

RESUMEN Introducción: la onicomicosis es la infección del aparato ungueal causada por hongos dermatofitos, no dermatofitos o levaduras. Constituye una enfermedad frecuente en la práctica médica, con impacto considerable en lo emocional, social, laboral y económico. Objetivo: describir las características epidemiológicas de la onicomicosis en pacientes que consultaron en un servicio dermatológico. Materiales y Métodos: estudio observacional retrospectivo de corte transverso, donde se analizaron fichas epidemiológicas de pacientes que acudieron al servicio de Dermatología del Hospital Nacional de Itauguá y el Centro de Especialidades Dermatológicas en el periodo comprendido entre julio del 2016 a agosto del 2019. Resultados: se analizaron 464 pacientes con onicomicosis. El cultivo fue positivo en el 83 % (385/464) de los casos. Se observó preferentemente en mujeres 72 % (276/385), franja etaria entre los 31 y 65 años 70,1 % (270/385), de procedencia urbana 76 % (292/385) y actividad quehaceres domésticos 41 % (157/385). El 23 % (87/385) presentó una o más comorbilidades asociadas a la aparición de onicomicosis, siendo la diabetes en el 70 % (61/385) de éstas. La localización fue en uñas de pies en 58,2 % (259/ 400), uña de manos en 31,2 % (141/400) y en el 10,1 % (45/400) de los casos se observó onicomicosis en ambas localizaciones. Los géneros aislados con mayor frecuencia fueron Trichophyton y Candida, y las especies fueron T. rubrum y Candida parapsilosis. En las onicomicosis de uñas de los pies se aislaron dermatofitos en un 63,7% (165/259), mientras que en uñas de las manos se aislaron Candida spp. en el 77,3 % (107/141). Conclusión: la onicomicosis produce una afectación que se observa mayoritariamente en pacientes adultos, generalmente mujeres que se dedican a los quehaceres domésticos, procedentes de áreas urbanas, con afectación principal de las uñas de los pies, siendo los agentes causales más frecuentes, T. rubrum y C. parapsilosis.

https://doi.org/10.18004/rdn2019.0011.02.005-018 1033 downloads

Determination of Colchicine in Pharmaceutical Formulations and Urine by Multiple-Pulse Amperometric Detection in an FIA System Using Boron-Doped Diamond Electrode
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Moreira, Débora A. R.

; Oliveira, Fernando M. de

; Pimentel, Dilton M.

; Guedes, Tiago J.

; Luz, Rita C. S.

; Damos, Flávio S.

; Pereira, Arnaldo C.

; Silva, Rodrigo A. B. da

; Santos, Wallans T. P. dos

Journal of the Brazilian Chemical Society

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Set 2018, Volume 29 Nº 9 Páginas 1796 - 1802

Resumo: En | Texto: En | PDF: En

This work presents a simple and fast method for colchicine (CO) determination in pharmaceutical formulations and urine by multiple pulse amperometry (MPA) with flow injection analysis (FIA) system using a boron-doped diamond electrode. In optimized conditions, it was possible to quantify CO in urine samples without interference of uric acid and ascorbic acid. The working linear range for CO quantification was achieved from 1.0 × 10-7 to 0.5 × 10-3mol L-1 with a low limit of detection of 2.14 × 10-8mol L-1. Furthermore, the proposed method showed high repeatability for 10 consecutive injections of 1.0 × 10-4mol L-1 CO (relative standard deviation = 1.28%) and good analytical frequency (30 determinations per hour). The addition and recovery studies in all pharmaceutical samples were approximately 100% and the results for CO determination were compared by high performance liquid chromatography (HPLC) with UV detection.

https://doi.org/10.21577/0103-5053.20180055 798 downloads

Performance of cryptococcal antigen lateral flow assay in serum, cerebrospinal fluid, whole blood, and urine in HIV-infected patients with culture-proven cryptococcal meningitis admitted at a Brazilian referral center
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Vidal, José E.

; Toniolo, Carolina

; Paulino, Adriana

; Colombo, Arnaldo L.

; Martins, Marilena dos Anjos

; Meira, Cristina da Silva

; Azevedo, Renata Guise Soares

; Pereira-Chioccola, Vera Lucia

; Gomes, Hélio Rodrigues

; Lazera, Marcia dos Santos

; Oliveira, Augusto C. Penalva de

; Boulware, David R.

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e1

Resumo: En | Texto: En | PDF: En

ABSTRACT Cryptococcal meningitis is the most common cause of opportunistic meningitis in HIV-infected patients in Brazil and causes unacceptable high mortality rates. In this study, HIV-infected patients with a first episode of culture-proven cryptococcal meningitis in cerebrospinal fluid (CSF) were prospectively included in order to evaluate sensitivity of cryptococcal antigen (CrAg) lateral flow assay (LFA) in serum, CSF, whole blood (fingerstick), and fresh urine. In addition, HIV-infected patients with other neurological confirmed diseases were included in order to evaluate the specificity of CrAg LFA in serum. Twenty patients with cryptococcal meningitis were included and in 19 of them, CrAg LFA in CSF, serum, and whole blood were positive (95% sensitivity). In 18 patients, India ink test was positive in CSF (90% sensitivity), and in 16 cases, CrAg LFA was positive in urine (80% sensitivity). Thirty-six HIV-infected patients with other neurological diseases had negative results of CrAg LFA in serum (100% specificity). In conclusion, CrAg LFA in serum, CSF, and whole blood showed high sensitivity and specificity. Whole blood CrAg LFA seems to be a good and reliable strategy to improve AIDS-related cryptococcal meningitis diagnosis in Brazil.

https://doi.org/10.1590/s1678-9946201860001 2016 downloads

Estudo biomecânico da rigidez da osteossíntese com placas em ponte em tíbias de cadáveres humanos
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Sunada, Edwin Eiji

; Ejnisman, Leandro

; Leal, Rafael Demura

; Pailo, Alexandre Felício

; Malavolta, Eduardo Angeli

; Sakaki, Marcos Hideyo

; Pereira, César Augusto Martins

; Zumiotti, Arnaldo Valdir

; Sato, João Ricardo

Acta Ortopédica Brasileira

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2010, Volume 18 Nº 2 Páginas 66 - 70

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

OBJETIVO: comparar a rigidez de três diferentes montagens de placa em ponte com a da haste intramedular bloqueada, em tíbias de cadáveres com fratura tipo C. MATERIAIS E MÉTODOS: vinte tíbias humanas captadas de cadáveres, submetidas à fratura do tipo C; quinze fixadas com placas em ponte, divididas em 03 grupos, de acordo com o tamanho das placas (10, 14 e 18 furos) e 05 fixadas com hastes intramedulares bloqueadas. Todas as tíbias foram expostas a cargas progressivas e semelhantes. Foram medidos os deslocamentos de ambos fragmentos (proximal e distal), nos planos sagital, coronal e axial do espaço, conforme incremento gradual de carga. RESULTADOS: tíbias fixadas com placas em ponte de 18 furos apresentam um comportamento biomecânico semelhante às fixadas com haste intramedular bloqueada. CONCLUSÕES: Em fraturas do tipo C em tíbias há maior mobilidade do segmento ósseo distal no plano coronal, quando a fratura é fixada com placas em ponte de 14 e 18 furos que quando fixada com haste intramedular bloqueada sem fresagem. Apesar dessa maior mobilidade, os movimentos relativos entre os fragmentos fraturários nos GHB e GP18 tendem a ser semelhantes entre si.

OBJECTIVE: To compare the stiffness of three different assemblies of bridging plates with intramedullary locking nails in cadaveric models of tibial fractures type C. MATERIALS AND METHODS: Twenty cadaveric tibias subjected to type C fractures; fifteen were fixed with the bridging plate technique and divided into three groups, according to the plate size (10, 14 and 18 holes), and five were fixed with intramedullary nail. All the tibias were exposed to similar and progressive loads. Dislocation of both fragments (proximal and distal) was measured on three planes (sagittal, coronal and axial), as the load was increased. RESULTS: tibias fixed with the 18 hole bridging plate have the same biomechanical behavior of tibias fixed with intramedullary locking nails. CONCLUSIONS: In type C tibial fractures, there is more mobility at the distal segment on the coronal plane when the fracture is fixed with 14 and 18 holes bridging plates as compared to fractures fixed with non-reamed intramedullary locking nails. Even with this mobility, the relative movements between the fragments at GHB and GP18 seem to be similar.

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Electrochemical and electrocatalytic studies of toluidine blue immobilized on a silica gel surface coated with niobium oxide
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Santos, Antonio S.

; Pereira, Arnaldo C.

; Kubota, Lauro T.

Journal of the Brazilian Chemical Society

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Ago 2002, Volume 13 Nº 4 Páginas 495 - 501

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

O comportamento eletroquímico do azul de toluidina (AT) adsorvido sobre a superfície da sílica modificada com óxido de nióbio (SN) foi investigado, utilizando-se eletrodo de pasta de carbono modificada. A imobilização do AT sobre a SN proporcionou alta estabilidade ao eletrodo, por evitar a lixiviação do mediador da superfície do eletrodo. O potencial formal (E0') do AT adsorvido foi --113 mV vs. ECS, indicando um deslocamento de aproximadamente 100 mV para valores mais positivos de potenciais, comparado ao AT dissolvido em solução aquosa ou adsorvido em pasta de carbono. Em solução com pH no intervalo entre 5 e 8 não foi observada nenhuma diferença na estabilidade nem no potencial formal do sistema. A atividade eletrocatalítica, em soluções com pH neste intervalo, permaneceu praticamente constante, apresentando uma sensibilidade de 1,2 10-4 A L mol-1 cm-2 e um K Mapp de 4,9 10-5 mol L-1. Em soluções a pH 7,0 foi observada uma resposta linear para concentração de NADH no intervalo entre 2,0 10-4 e 4,0 10-3 mol L-1 aplicando um potencial de --50 mV vs. ECS. O sensor apresentou limite de detecção de 3,4 10-5 mol L-1, uma precisão de 1,0 %, expresso em desvio padrão relativo para 10 replicatas e tempo de resposta de aproximadamente 2 s.

The electrochemical behavior of toluidine blue (TB) adsorbed on a silica surface modified with niobium oxide (SN) was investigated using a modified carbon paste electrode. The presence of SN gave the electrode high stability, avoiding the leaching out of the mediator from the electrode surface. The formal potential (E0') of the adsorbed TB was --113 mV vs. SCE, indicating a shift of almost 100 mV towards more positive potential values, compared to TB dissolved in aqueous solution or adsorbed on carbon paste. The stability and formal potential remained constant upon changing the solution pH in the range 5 to 8. In these solution pH values the electrocatalytic activity remained almost constant with a sensitivity of 1.2 10-4 A L mol-1 cm-2 and a K Mapp of 4.9 10-5 mol L-1. A linear response range for NADH concentration between 2.0 10-4 and 4.0 10-3 mol L-1 at pH 7.0, with a detection limit of 3.4 10-5 mol L-1 was observed for the sensor. A response time of 2 s and a precision of 1.0 %, expressed as relative standard deviation for 10 replicates, were observed for the sensor developed.

2312 downloads

Consumo e fermentação ruminal de proteínas em função de suplementação alimentar energética e protéica em novilhos
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Barbosa, Natália Guarino Souza

; Lana, Rogério de Paula

; Jham, Gulab Newandram

; Borges, Arnaldo Chaer

; Mâncio, Antônio Bento

; Pereira, José Carlos

; Oliveira, Juliana Silva

Revista Brasileira de Zootecnia

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Out 2001, Volume 30 Nº 5 Páginas 1558 - 1565

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

Objetivou-se analisar o efeito de suplementação energética sobre o consumo e a fermentação ruminal de proteínas em dois níveis de proteína dietética (6 e 20%). Quatro novilhos mestiços fistulados no rúmen foram utilizados em um quadrado latino e os tratamentos arranjados em um fatorial 2 × 2, em que as dietas testadas constituíram-se de: A. só feno; B. feno + 2,8 kg de farelo de soja; C. feno + 2,8 kg de fubá de milho; e D. feno + 2,8 kg de farelo de soja + 2,8 kg de fubá de milho. Foram realizados quatro períodos experimentais constituídos de 18 dias, sendo sete dias para adaptação dos animais, sete dias para determinação do consumo de matéria seca e quatro dias para coleta de amostras. As coletas foram feitas através de fístula ruminal nos tempos zero, dois, quatro e seis horas após a alimentação, sendo utilizadas para determinações das concentrações de amônia, pH e AGV do líquido ruminal. Não houve interações entre o fubá de milho e o farelo de soja, assim como não ocorreu efeito do tempo de coleta sobre os parâmetros estudados. O farelo de soja reduziu a relação acetato:propionato (A:P) em 13%, aumentou o consumo de matéria seca total (CMSt) em 41,2%, sem alterar o consumo de forragem e o pH, e aumentou as concentrações de amônia (790%), propionato (48%), AGV total (39%), isobutirato (165%), isovalerato (208%) e valerato (201%). O fubá de milho não afetou a fermentação de proteína, embora tenha causado aumento no CMSt (35%) e decréscimo no pH ruminal (6%) e na relação A:P (18%).

The objective was to evaluate the effect of energetic supplementation on feed intake and ruminal fermentation of proteins in two protein levels in the diet (6 and 20%). There were used four rumen fistulated crossbred steers in a Latim square and the treatments were arranjed in a 2 × 2 factorial, in which the combinations were: A. only hay; B. hay + 2.8 kg of soybean meal; C. hay + 2.8 kg of corn meal; and D. hay + 2.8 kg of soybean meal + 2.8 kg of corn meal. Four experimental periods of 18 days were used, in which seven was for adaptation, seven for determination of dry matter intake and four for sampling. Ruminal samples were collected at 0, 2, 4 and 6 hours after feeding for determination of ammonia, pH and VFA. There was no interaction between corn meal and soybean meal, as well as no sampling time effect on the evaluated parameters. Soybean meal decreased 13% acetate:propionate (A:P) ratio and increased 41.2% DMI, with no effect on forage intake and pH and increased ammonia (790%), propionate (48%), total VFA (39%), isobutyrate (165%), isovalerate (208%) and valerate (201%). Corn meal did not affect protein fermentation, although it caused increase in DMI (35%) and decrease in ruminal pH (6%) and A:P ratio (18%).

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Gotas suspensas: uma proposta para amostragem e análise de gases traços da atmosfera
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Cardoso, Arnaldo A.

; Pereira, Elisabete A.

; Rocha, Júlio C.

Química Nova

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Abr 1998, Volume 21 Nº 2 Páginas 217 - 220

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

In the present paper, we report on the analytical use of a dynamic droplet based gas collection and an analysis system. A droplet formed at the tip of a tube represents a sampling approach that provides an indefinitely renewable surface and uses very little reagent. Sample gas flows past the droplet at a low flow rate. After the gas was sampled , the analysis can be carried out by different methodologies. The feasibility of the sensor is demonstrated by continuos determination of gaseous as: NO2, Cl2 and SO2.

3810 downloads

Migração de projétil de arma de fogo do crânio para o canal raqueano
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Pereira, Walter C.

; Rocha, Arnaldo G. da

Arquivos de Neuro-Psiquiatria

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Mar 1966, Volume 24 Nº 1 Páginas 39 - 42

Resumo: Pt | Texto: Pt | PDF: Pt

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