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ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

https://doi.org/10.1590/1516-3180.2022.0681.r1.10042023

Safety and effectiveness of adding fentanyl or sufentanil to spinal anesthesia: systematic review and meta-analysis of randomized controlled trials
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Fonseca, Neuber Martins

; Guimarães, Gabriel Magalhães Nunes

; Pontes, João Paulo Jordão

; Azi, Liana Maria Tores de Araujo

; de Ávila Oliveira, Ricardo

Brazilian Journal of Anesthesiology

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Abr 2023, Volume 73 Nº 2 Páginas 198 - 216

Resumo: En | Texto: En | PDF: En

Abstract Introduction Spinal infusions of either fentanyl or sufentanil have been reported in international reports, articles, and scientific events worldwide. This study aimed to determine whether intrathecal fentanyl or sufentanil offers safety in mortality and perioperative adverse events. Methods MEDLINE (via PubMed), EMBASE, CENTRAL (Cochrane library databases), gray literature, hand-searching, and clinicaltrials.gov were systematically searched. Randomized controlled trials with no language, data, or status restrictions were included, comparing the effectiveness and safety of adding spinal lipophilic opioid to local anesthetics (LAs). Data were pooled using the random-effects models or fixed-effect models based on heterogeneity. Results The initial search retrieved 4469 records; 3241 records were eligible, and 3152 articles were excluded after reading titles and abstracts, with a high agreement rate (98.6%). After reading the full texts, 76 articles remained. Spinal fentanyl and sufentanil significantly reduced postoperative pain and opioid consumption, increased analgesia and pruritus. Fentanyl, but not sufentanil, significantly reduced both postoperative nausea and vomiting, and postoperative shivering; compared to LAs alone. The analyzed studies did not report any case of in-hospital mortality related to spinal lipophilic opioids. The rate of respiratory depression was 0.7% and 0.8% when spinal fentanyl or sufentanil was added and when it was not, respectively. Episodes of respiratory depression were rare, uneventful, occurred intraoperatively, and were easily manageable. Conclusion There is moderate to high quality certainty that there is evidence regarding the safety and effectiveness of adding lipophilic opioids to LAs in spinal anesthesia.

https://doi.org/10.1016/j.bjane.2021.10.010

Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital
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Buffo, Thais Helena

; Stelini, Rafael Fantelli

; Serrano, Juliana Yumi Massuda

; Pontes, Luciana Takata

; Magalhães, Renata Ferreira

; de Moraes, Aparecida Machado

Anais Brasileiros de Dermatologia

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Fev 2023, Volume 98 Nº 1 Páginas 36 - 46

Resumo: En | Texto: En | PDF: En

Abstract Background Mohs micrographic surgery is an established technique in the treatment of cutaneous neoplasms. It offers higher cure rates and the main indications are non-melanoma malignant skin tumors. Few studies have been performed on the treatment of rare tumors through this technique. Objective To study rare skin tumors and rare variants of basal cell carcinoma and squamous cell carcinoma submitted to Mohs micrographic surgery in a tertiary service in relation to frequency, disease-free evolution, and applicability of this surgical procedure for this group of tumors. Methods This was a retrospective observational study including rare skin tumors and less common variants of basal cell carcinoma and squamous cell carcinoma treated using Mohs micrographic surgery, between October 2008 and April 2021. Results During the study period, 437 tumors were treated using Mohs micrographic surgery, and 22 (5%) rare skin tumors were selected. The tumors comprised three dermatofibrosarcomas protuberans, two atypical fibroxanthomas, two spiradenomas, two hypercellular fibrohistiocytomas, one primary cutaneous adenocarcinoma, one trichoblastoma, one porocarcinoma, one chondroid syringoma, one cutaneous angiosarcoma, one Merkel cell carcinoma, and one sebaceous carcinoma. Six other cases of rare basal cell carcinoma variants with trichoepitheliomatous differentiation, metatypical basal cell carcinoma, and clear cell squamous cell carcinoma were included. There were no cases of recurrence after an average of six years of follow-up. Study limitations This is a retrospective study on rare neoplasms carried out in a single referral center, and this surgical technique isn’t widely available in the public service. Conclusion This retrospective case series showed that Mohs micrographic surgery is an appropriate treatment for rare skin tumors. They corresponded to 5% of the tumors treated by the technique during a 12-year-period, with no recurrences identified.

https://doi.org/10.1016/j.abd.2022.01.009

Dimensões do assédio na escola: diálogos sobre gênero com jovens estudantes de ensino médio de São Paulo/Brasil
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Silva, Cristiane Gonçalves da

; Leite, Vanessa Jorge

; Pontes, Júlia Clara de

; Santos, Fernanda Farias dos

; Oliveira, João Vitor Saldanha de

; Hiraishi, Vitória Lopes

; Pereira, Sasha Cruz Alves

; Simões, Júlio Assis

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e210649

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

Resumen En este artículo discutimos los usos de la categoría “acoso” empleada por jóvenes estudiantes de escuelas públicas de enseñanza media para dar sentido a la experiencia de violencia y discriminación de género ocurridas dentro y fuera de la escuela. El análisis se basa en registros de trabajo en campo producidos en el ámbito de una investigación multicéntrica y de métodos mixtos, realizada en nueve escuelas de São Paulo (SP/BR). El acoso parece como una categoría polisémica que, al nombrar la violencia, ayuda en el enfrentamiento de las jerarquías y desigualdades de género y generación. Concluimos que las jóvenes han puesto en tela de juicio normativas y actitudes que alimentan las desigualdades de género de las escuelas, además de denunciar el silenciamiento o la inadecuación de la institución en el enfrentamiento del problema, lo que posibilita la identificación de convergencias con una nueva sensibilidad alrededor de la violencia contra mujeres que los discursos feministas globalizados hicieron surgir.

Abstract In this article, we discuss uses of “harassment” as a category employed by young students from public high schools to make sense of violence and gender discrimination experiences that occur in and out of school. The analysis is based on fieldwork records produced within the scope of a multicenter, mixed-methods research carried out in nine schools located in São Paulo. Harassment appears as a polysemic category that, by naming violence, helps to face gender and generation hierarchies and inequalities. We infer that the young girls have questioned norms and attitudes that feed gender inequalities in schools; in addition, they have denounced the silence or inadequacy of the institution in facing the problem. This enables to identify convergences with a new sensibility regarding violence against women that globalized feminist discourses have brought to the surface.

Neste artigo, discutimos os usos da categoria “assédio” empregada por jovens estudantes de escolas públicas de Ensino Médio para dar sentido a experiências de violência e discriminação de gênero ocorridas dentro e fora da escola. A análise baseia-se em registros de trabalho de campo produzidos no âmbito de uma pesquisa multicêntrica e de métodos mistos, realizada em nove escolas de São Paulo (SP/BR). O assédio aparece como uma categoria polissêmica que, ao nomear a violência, ajuda no enfrentamento das hierarquias e desigualdades de gênero e geração. Depreendemos que as jovens têm questionado normativas e atitudes que alimentam as desigualdades de gênero nas escolas, além de denunciarem o silenciamento ou inadequação da instituição no enfrentamento do problema, o que possibilita identificar convergências com uma nova sensibilidade em torno da violência contra mulheres que os discursos feministas globalizados fizeram emergir.

https://doi.org/10.1590/interface.210649

Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazil
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Freitas, Vera Lúcia Teixeira de

; Piotto, Mariana Ramos

; Esper, Helena Rangel

; Nakanishi, Erika Yoshie Shimoda

; Fonseca, Claudia de Abreu

; Assy, João Guilherme Pontes Lima

; Berreta, Olívia Campos Pinheiro

; França, Francisco Oscar de Siqueira

; Lopes, Marta Heloísa

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e7

Resumo: En | Texto: En | PDF: En

ABSTRACT This study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient’s biological sample. Nested and multiplex PCR targeting the 24Sα (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba’s outbreak, and T. cruzi TcI, from Cachoeira do Arua’s outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease’s emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, disease.

https://doi.org/10.1590/s1678-9946202365007

Dimensões do assédio na escola: diálogos sobre gênero com jovens estudantes de ensino médio de São Paulo/Brasil
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Silva, Cristiane Gonçalves da

; Leite, Vanessa Jorge

; Pontes, Júlia Clara de

; Santos, Fernanda Farias dos

; Oliveira, João Vitor Saldanha de

; Hiraishi, Vitória Lopes

; Pereira, Sasha Cruz Alves

; Simões, Júlio Assis

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e210649

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

https://doi.org/10.1590/interface.210649

Ninety-day outcomes in patients diagnosed with COVID-19 in São Paulo, Brazil: a cohort study
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Fumis, Renata Rego Lins

; Costa, Eduardo Leite Vieira

; Tomazini, Bruno Martins

; Taniguchi, Leandro Utino

; Costa, Livia do Valle

; Morinaga, Christian Valle

; Sá, Marcia Martiniano de Sousa e

; Azevedo, Luciano Cesar Pontes de

; Nascimento, Teresa Cristina

; Ledo, Carla Bernardes

; Oliveira, Maura Salaroli de

; Cardoso, Luiz Francisco

; Pastore Junior, Laerte

; Vieira Junior, José Mauro

Jornal Brasileiro de Pneumologia

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2023, Volume 49 Nº 3 elocation e20230056

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

ABSTRACT Objective: COVID-19 has been associated with a significant burden to those who survive the acute phase. We aimed to describe the quality of life and symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) at 90 days after hospital discharge of COVID-19 patients. Methods: Patients with COVID-19 admitted to a private hospital in the city of São Paulo, Brazil, between April of 2020 and April of 2021 were interviewed by telephone at 30 and 90 days after discharge to assess the quality of life and symptoms of depression, anxiety, and PTSD. Results: A total of 2,138 patients were included. The mean age was 58.6 ± 15.8 years, and the median length of hospital stay was 9.0 (5.0-15.8) days. Between the two time points, depression increased from 3.1% to 7.2% (p < 0.001), anxiety increased from 3.2% to 6.2% (p < 0.001), and PTSD increased from 2.3% to 5.0% (p < 0.001). At least one physical symptom related to COVID-19 diagnosis persisted in 32% of patients at day 90. Conclusions: Persistence of physical symptoms was high even at 90 days after discharge. Although the prevalence of symptoms of anxiety, depression, and PTSD was low, these symptoms persisted for three months, with a significant increase between the time points. This finding indicates the need to identify at-risk patients so that they can be given an appropriate referral at discharge.

RESUMO Objetivo: A COVID-19 tem sido associada a um fardo significativo para aqueles que sobrevivem à fase aguda. Nosso objetivo foi descrever a qualidade de vida e sintomas de ansiedade, depressão e transtorno de estresse pós-traumático (TEPT) 90 dias após a alta hospitalar em pacientes com COVID-19. Métodos: Pacientes com COVID-19 internados em um hospital privado na cidade de São Paulo (SP) entre abril de 2020 e abril de 2021 foram entrevistados por telefone 30 e 90 dias após a alta para avaliar a qualidade de vida e sintomas de depressão, ansiedade e TEPT. Resultados: Foram incluídos 2.138 pacientes. A média de idade foi de 58,6 ± 15,8 anos, e a mediana do tempo de internação hospitalar foi de 9,0 (5,0-15,8) dias. Entre os dois momentos, a depressão aumentou de 3,1% para 7,2% (p < 0,001), a ansiedade, de 3,2% para 6,2% (p < 0,001), e o TEPT, de 2,3% para 5,0% (p < 0,001). Pelo menos um sintoma físico relacionado ao diagnóstico de COVID-19 persistia em 32% dos pacientes no 90º dia. Conclusões: A persistência dos sintomas físicos foi elevada mesmo 90 dias após a alta. Embora a prevalência de sintomas de ansiedade, depressão e TEPT tenha sido baixa, esses sintomas persistiram por três meses, com aumento significativo entre os momentos. Esse achado indica a necessidade de identificar os pacientes de risco para que possam receber o encaminhamento adequado no momento da alta.

https://doi.org/10.36416/1806-3756/e20230056

Perspectivas de estudantes da área de saúde sobre participação em programa intergeracional: potencialidades e desafios
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Lopes, Marcos Marinho

; Nogueira, Inara Suelane Pontes

; Cordeiro, Marina Ferraz

; Costa, Anacely Guimarães

Revista Brasileira de Educação Médica

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2023, Volume 47 Nº 3 elocation e084

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

Abstract: Introduction: Communication skills (CS) are indispensable competencies for any healthcare professional as such skills lead to greater patient compliance, understanding, and overall satisfaction. The constant aging of the Brazilian population increasingly results in the presence of the older people in the healthcare system. This has led medical schools to think about a reformulation of their curricular components within the scope of CS, since this subject still presents gaps. In this context, intergenerational programs play a valuable role in the development of CS by allowing interaction between different generations. Objective: To investigate the perspectives of health students about their participation in an intergenerational program in the city of Paulo Afonso/BA entitled “[Tec-Idoso]: utilização de tecnologia como ferramenta de inclusão digital e de apoio psicossocial ao idoso” [Tec-Idoso: use of technology as a tool for digital including and psychosocial support for the elderly], linked to the Federal University of Vale of São Francisco (UNIVASF). Method: This is an exploratory qualitative study based on semi-structured interviews, using the data analysis method. Results: The following thematic categories were defined: intergenerational contact, perception and stigma about old age, CS, impact on academic performance and impact on future professional practices. Conclusion: Given the above, the results obtained from this research include improved academic performance and social interaction through the development of CS, change of paradigms facing aging, and preparation for handling personal and professional life situation with more confidence.

Resumo: Introdução: As habilidades de comunicação (HC) são competências indispensáveis para qualquer profissional da área de saúde, pois permitem maior adesão, compreensão e satisfação geral do paciente. O constante envelhecimento da população brasileira resulta cada vez mais na presença do público idoso no sistema de saúde. Esse cenário tem levado as escolas médicas a pensar em uma reformulação dos seus componentes curriculares no âmbito das HC, visto que esse assunto ainda apresenta lacunas. Nesse contexto, os programas intergeracionais possuem um valioso papel no desenvolvimento das HC por permitirem a interação entre diferentes gerações. Objetivo: Este estudo teve como objetivo investigar as perspectivas de estudantes da área de saúde sobre a participação em um programa intergeracional no município de Paulo Afonso, na Bahia, intitulado “[Tec-Idoso]: utilização de tecnologia como ferramenta de inclusão digital e de apoio psicossocial ao idoso”, vinculado à Universidade Federal do Vale do São Francisco (Univasf). Método: Trata-se de um estudo qualitativo e exploratório, realizado a partir de entrevistas semiestruturadas, utilizando o método de análise de conteúdo. Resultado: As seguintes categorias temáticas foram definidas: contato intergeracional, percepção e estigma com pessoas idosas, HC, impacto no desempenho acadêmico e impacto nas práticas profissionais futuras. Conclusão: Os resultados da presente pesquisa incluem melhora do desempenho acadêmico e da interação social por meio do desenvolvimento das HC, mudança de perspectivas perante o envelhecimento e preparação para o enfrentamento com mais confiança de situações da vida pessoal e profissional.

https://doi.org/10.1590/1981-5271v47.3-2022-0156

10.

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

11.

Microbiome and virome on indoor surfaces of an Antarctic research ship
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Prado, Tatiana

; Magalhães, Maithê Gaspar Pontes

; Moreira, Daniel Andrade

; Brandão, Martha Lima

; Fumian, Tulio Machado

; Ferreira, Fernando Cesar

; Chame, Marcia

; Leomil, Luciana

; Degrave, Wim Maurits Sylvain

; Leite, José Paulo Gagliardi

; Miagostovich, Marize Pereira

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e230084

Resumo: En | Texto: En | PDF: En

BACKGROUND Few studies have focused on microbial diversity in indoor environments of ships, as well as the role of the microbiome and its ecological interconnections. In this study, we investigated the microbiome and virome present on the internal surfaces of a polar ship in different stages (beginning, during, and at the end) of the Brazilian Antarctic expedition in order to evaluate abundance of microorganisms in different periods. OBJECTIVES AND METHODS We used shotgun metagenomic analysis on pooled samples from sampling surfaces in the ship’s interior to track the microbial diversity. FINDINGS Considering the total fraction of the microbiome, the relative abundance of bacteria, eukaryotes, viruses, and archaea was 83.7%, 16.2%, 0.04%, and 0.002%, respectively. Proteobacteria was the most abundant bacterial phyla, followed by Firmicutes, Actinobacteria, and Bacteroidetes. Concerning the virome, the greatest richness of viral species was identified during the middle of the trip, including ten viral families after de novo assembly: Autographiviridae, Chrysoviridae, Genomoviridae, Herelleviridae, Myoviridae, Partitiviridae, Podoviridae, Potyviridae, Siphoviridae, and Virgaviridae. MAIN CONCLUSIONS This study contributed to the knowledge of microbial diversity in naval transportation facilities, and variations in the abundance of microorganisms probably occurred due to factors such as the number of passengers and activities on the ship.

https://doi.org/10.1590/0074-02760230084

12.

Dilated optic nerve sheath by ultrasound predicts mortality among patients with acute intracerebral hemorrhage
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Dias, Francisco Antunes

; Zotin, Maria Clara Zanon

; Alessio-Alves, Frederico Fernandes

; Martins Filho, Rui Kleber do Vale

; Barreira, Clara Monteiro Antunes

; Vincenzi, Otavio Costa

; Venturelli, Paula Muñoz

; Boulouis, Gregoire

; Goldstein, Joshua Norkin

; Pontes-Neto, Octavio Marques

Arquivos de Neuro-Psiquiatria

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2023, Volume 81 Nº 10 Páginas 861 - 867

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

Abstract Background Intracerebral hemorrhage (ICH) is a deadly disease and increased intracranial pressure (ICP) is associated with worse outcomes in this context. Objective We evaluated whether dilated optic nerve sheath diameter (ONSD) depicted by optic nerve ultrasound (ONUS) at hospital admission has prognostic value as a predictor of mortality at 90 days. Methods Prospective multicenter study of acute supratentorial primary ICH patients consecutively recruited from two tertiary stroke centers. Optic nerve ultrasound and cranial computed tomography (CT) scans were performed at hospital admission and blindly reviewed. The primary outcome was mortality at 90-days. Multivariate logistic regression, ROC curve, and C-statistics were used to identify independent predictors of mortality. Results Between July 2014 and July 2016, 57 patients were evaluated. Among those, 13 were excluded and 44 were recruited into the trial. Their mean age was 62.3 ± 13.1 years and 12 (27.3%) were female. On univariate analysis, ICH volume on cranial CT scan, ICH ipsilateral ONSD, Glasgow coma scale, National Institute of Health Stroke Scale (NIHSS) and glucose on admission, and also diabetes mellitus and current nonsmoking were predictors of mortality. After multivariate analysis, ipsilateral ONSD (odds ratio [OR]: 6.24; 95% confidence interval [CI]: 1.18–33.01; p = 0.03) was an independent predictor of mortality, even after adjustment for other relevant prognostic factors. The best ipsilateral ONSD cutoff was 5.6mm (sensitivity 72% and specificity 83%) with an AUC of 0.71 (p = 0.02) for predicting mortality at 90 days. Conclusion Optic nerve ultrasound is a noninvasive, bedside, low-cost technique that can be used to identify increased ICP in acute supratentorial primary ICH patients. Among these patients, dilated ONSD is an independent predictor of mortality at 90 days.

Resumo Antecedentes A hemorragia intraparenquimatosa (HIP) aguda apresenta elevada morbimortalidade e a presença de hipertensão intracraniana (HIC) confere um pior prognóstico. Objetivo Avaliamos se a dilatação do diâmetro da bainha do nervo óptico (DBNO) através do ultrassom do nervo óptico (USNO) na admissão hospitalar seria preditora de mortalidade. Métodos Estudo multicêntrico e prospectivo de pacientes consecutivos com HIP supratentorial primária aguda admitidos em dois centros terciários. Ultrassom do nervo óptico e tomografia computadorizada (TC) de crânio foram realizados na admissão e revisados de forma cega. O desfecho primário do estudo foi a mortalidade em 3 meses. Análises de regressão logística, curva de característica de operação do receptor (ROC, na sigla em inglês) e estatística-C foram utilizadas para identificação dos preditores independentes de mortalidade. Resultados Entre julho de 2014 e julho de 2016, 44 pacientes foram incluídos. A idade média foi 62,3 (±13,1) anos e 12 (27,3%) eram mulheres. Na análise univariada, o volume da HIP na TC de crânio, DBNO ipsilateral à HIP, glicemia, escala de coma de Glasgow (ECG) e NIHSS na admissão hospitalar, e também diabetes mellitus e não-tabagista foram preditores de mortalidade. Após análise multivariada, o DBNO ipsilateral à HIP permaneceu como preditor independente de mortalidade (odds ratio [OR]: 6,24; intervalo de confiança [IC] de 95%: 1,18–33,01; p = 0,03). O melhor ponto de corte do DBNO ipsilateral como preditor de mortalidade em 3 meses foi 5,6mm (sensibilidade 72% e especificidade 83%) e área sob a curva (AUC, na sigla em inglês) 0,71 (p = 0,02). Conclusão O USNO é um método não-invasivo, beira-leito, de baixo custo, que pode ser empregado para estimar a presença de HIC em pacientes com HIP supratentorial primária aguda. A presença de DBNO dilatada é um preditor independente de mortalidade em 3 meses nesses pacientes.

https://doi.org/10.1055/s-0043-1775885

13.

Point-Of-Care Cardiac Ultrasound:is it time for anesthesiologists to embrace and achieve competence? PointOfCare Point Of Care Ultrasoundis Ultrasound is competence
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Papa, Fabio de V.

; Galhardo Jr, Carlos

; Pontes, João Paulo Jordão

; Alves, Rodrigo Leal

; Zamper, Raffael

; Salgado, Marcello

; da Costa, Luiz Guilherme Villares

; Lineburger, Eric Benedet

; dos Reis Falcão, Luiz Fernando

Brazilian Journal of Anesthesiology

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2023, Volume 73 Nº 4 Páginas 367 - 369

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.06.001

14.

Comments on “Criteria for selection and classification of studies in medical events” Criteria events
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Pontes-Silva, André

Revista da Associação Médica Brasileira

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2023, Volume 69 Nº 8 elocation e20230574

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1806-9282.20230574

15.

Comments on “Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia” Evaluation sarcopenia
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Anselmo-e-Silva, Cassius Iury

; Santos, Leticia Menegalli

; Lopes, André Luiz

; Maciel, Erika da Silva

; Quaresma, Fernando Rodrigues Peixoto

; Santos-de-Araújo, Aldair Darlan

; Pontes-Silva, André

Revista da Associação Médica Brasileira

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2023, Volume 69 Nº 8 elocation e20230583

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1806-9282.20230583

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