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Identification of phlebotomine sand fly (Diptera: Psychodidae) in Atlantic forest fragments and their dispersal to urban area
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SILVA, FRANCISCO A.
; COSTA, DIMÍTRI A.
; SILVA, BRENO HENRIQUE M.
; ALVES, ADRIANO FRANCISCO
; SOUZA, SÉRGIO JOEL DE
; SILVA, GEUBA MARIA B. DA
; MENESES, JANAÍNA M.
; MATOS-ROCHA, THIAGO JOSÉ
; CHRISTOFFERSEN, MARTIN L.
; CAVALCANTI, MARÍLIA GABRIELA S.
.
Anais da Academia Brasileira de Ciências
- Métricas do periódico
Abstract The geographical distribution of sand flies in Brazil has been the subject of some studies, yet there is no information about the phlebotomine fauna in João Pessoa, State of Paraíba, Brazil. The aim of this work is to evaluate the occurrence and distribution of sand flies in the Atlantic forest fragments and to evaluate a possible dispersion in 06 nearby districts. Light traps were used during three consecutive nights, supplemented by an aspirator during the dry period and rainy season. A total of 222 sand flies were found, 143 (130 males and 13 females) in the Atlantic forest, and 79 in urban areas. During the entire dry season, three species of phlebotomine sand flies were recorded in 11 forest fragments, Lutzomyia longipalpis, Lu. migonei and Lu. whitmani. During the rainy season, only Lu. longipalpis was found. This was the only species identified in the studied neighborhoods during both seasons. The differences in diversity of sand flies encountered between natural habitats and urban areas may thus be correlated mostly with adaptations to particular habitats and availability of food. One species (Lu. longipalpis) appears to be rapidly adapting to urban areas because of deforestation.
2.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
3.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
4.
How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation
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Perini, Guilherme Fleury
; Fischer, Thais
; Gaiolla, Rafael Dezen
; Rocha, Talita Bueno
; Bellesso, Marcelo
; Teixeira, Larissa Lane Cardoso
; Delamain, Marcia Torresan
; Scheliga, Adriana Alves de Souza
; Ribeiro, Glaciano Nogueira
; Vaz Neto, Jorge
; Baiocchi, Otávio Cesar Carvalho Guimaraes
; Abdo, André Neder Ramires
; Arrais-Rodrigues, Celso
; Fogliatto, Laura M.
; Bigni, Ricardo de Sá
; Schaffel, Rony
; Biasoli, Irene
; Pereira, Juliana
; Nabhan, Samir Kanaan
; Souza, Cármino Antônio de
; Chiattone, Carlos Sérgio
.
Hematology, Transfusion and Cell Therapy
- Métricas do periódico
ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.
https://doi.org/10.1016/j.htct.2020.04.002
435 downloads
5.
Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol
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Ferreira, Juliana C.
; Ho, Yeh-Li
; Besen, Bruno A.M.P.
; Malbuisson, Luiz M.S.
; Taniguchi, Leandro U.
; Mendes, Pedro V.
; Costa, Eduardo L.V.
; Park, Marcelo
; Daltro-Oliveira, Renato
; Roepke, Roberta M.L.
; Silva Jr, João M.
; Carmona, Maria José C.
; Carvalho, Carlos Roberto Ribeiro
; Hirota, Adriana
; Kanasiro, Alberto Kendy
; Crescenzi, Alessandra
; Fernandes, Amanda Coelho
; Miethke-Morais, Anna
; Bellintani, Arthur Petrillo
; Canasiro, Artur Ribeiro
; Carneiro, Bárbara Vieira
; Zanbon, Beatriz Keiko
; Batista, Bernardo Pinheiro De Senna Nogueira
; Nicolao, Bianca Ruiz
; Besen, Bruno Adler Maccagnan Pinheiro
; Biselli, Bruno
; Macedo, Bruno Rocha De
; Toledo, Caio Machado Gomes De
; Pompilio, Carlos Eduardo
; Carvalho, Carlos Roberto Ribeiro De
; Mol, Caroline Gomes
; Stipanich, Cassio
; Bueno, Caue Gasparotto
; Garzillo, Cibele
; Tanaka, Clarice
; Forte, Daniel Neves
; Joelsons, Daniel
; Robira, Daniele
; Costa, Eduardo Leite Vieira
; Silva Júnior, Elson Mendes Da
; Regalio, Fabiane Aliotti
; Segura, Gabriela Cardoso
; Marcelino, Gustavo Brasil
; Louro, Giulia Sefrin
; Ho, Yeh-Li
; Ferreira, Isabela Argollo
; Gois, Jeison de Oliveira
; Silva Junior, Joao Manoel Da
; Reusing Junior, Jose Otto
; Ribeiro, Julia Fray
; Ferreira, Juliana Carvalho
; Galleti, Karine Vusberg
; Silva, Katia Regina
; Isensee, Larissa Padrao
; Oliveira, Larissa dos Santos
; Taniguchi, Leandro Utino
; Letaif, Leila Suemi
; Lima, Lígia Trombetta
; Park, Lucas Yongsoo
; Chaves Netto, Lucas
; Nobrega, Luciana Cassimiro
; Haddad, Luciana
; Hajjar, Ludhmila
; Malbouisson, Luiz Marcelo
; Pandolfi, Manuela Cristina Adsuara
; Park, Marcelo
; Carmona, Maria José Carvalho
; Andrade, Maria Castilho Prandini H De
; Santos, Mariana Moreira
; Bateloche, Matheus Pereira
; Suiama, Mayra Akimi
; Oliveira, Mayron Faria de
; Sousa, Mayson Laercio
; Louvaes, Michelle
; Huemer, Natassja
; Mendes, Pedro
; Lins, Paulo Ricardo Gessolo
; Santos, Pedro Gaspar Dos
; Moreira, Pedro Ferreira Paiva
; Guazzelli, Renata Mello
; Reis, Renato Batista Dos
; Oliveira, Renato Daltro De
; Roepke, Roberta Muriel Longo
; Pedro, Rodolpho Augusto De Moura
; Kondo, Rodrigo
; Rached, Samia Zahi
; Fonseca, Sergio Roberto Silveira Da
; Borges, Thais Sousa
; Ferreira, Thalissa
; Cobello Junior, Vilson
; Sales, Vivian Vieira Tenório
; Ferreira, Willaby Serafim Cassa
.
OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital’s electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.
https://doi.org/10.6061/clinics/2020/e2294
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6.
Top 10 evidence-based recommendations from the Brazilian Society of Infectious Diseases for the Choosing Wisely Project
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Pasqualotto, Alessandro C.
; Almeida, Camila S.
; Kliemann, Dimas A.
; Barcellos, Guilherme B.
; Queiroz-Telles, Flávio
; Abdala, Edson
; Resende, Mariangela
; Batista, Filipe P.
; Vidal, José E.
; Rocha, Jaime
; Raboni, Sonia M.
; Cimerman, Sergio
; Gales, Ana C.
.
Brazilian Journal of Infectious Diseases
- Métricas do periódico
ABSTRACT The Choosing Wisely Initiative aims to collect statements from medical societies all over the world on medical interventions that result in no benefit to patients, with the potential to cause harm. In this article we present the views of the Diagnostic Laboratory Group at the Brazilian Society of Infectious Diseases (SBI). Ten experts from SBI were asked to list 10 diagnostic tests that were perceived as unnecessary in the field of infectious diseases. After voting for the more relevant topics, a questionnaire was sent to all SBI members, in order to select for the most important items. A total of 482 votes were obtained, and the top 10 results are shown in this manuscript. The Choosing Wisely statements of SBI should facilitate clinical practice by optimizing the use of diagnostic resources in the field of infectious diseases.
https://doi.org/10.1016/j.bjid.2019.08.004
372 downloads
7.
Microhabitat preferences of the freshwater prawn Macrobrachium jelskii (Decapoda: Palaemonidae)
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RESUMO Nós analisamos as preferências de micro-habitat de machos e fêmeas de Macrobrachium jelskii (Miers, 1877) em um açude urbano em Cruz das Almas, Bahia, Brasil. As amostras foram coletadas mensalmente, de março de 2015 a fevereiro de 2016, com o auxílio de uma peneira em três diferentes micro-habitats. Cada micro-habitat teve predomínio de uma espécie de macrófita: Eleocharis sp. (M1), Cabomba sp. (M2) e Nymphaea sp. (M3). Os camarões foram categorizados como machos (jovens e adultos) e fêmeas jovens, adultas não ovígeras e ovígeras e tiveram seu comprimento de carapaça medido. A ANOVA foi usada para comparar as diferenças entre o número e o tamanho dos indivíduos entre os micro-habitats. A razão sexual e a frequência de fêmeas ovígeras em cada micro-habitat também foram calculadas. A razão sexual foi desviada para as fêmeas em M1, mas em M2 e M3 não houve diferença do padrão 1: 1. Quando os camarões foram separados nas cinco categorias, observamos que as fêmeas adultas não ovígeras foram mais abundantes em M1, enquanto os machos adultos foram a categoria demográfica mais abundante em M2 e M3. Indivíduos jovens não mostraram preferência por nenhum dos micro-habitats. M1 e M2 se mostraram adequados para fêmeas ovígeras, devido à maior frequência destas nestes dois micro-habitats se comparado à M3. As fêmeas adultas foram os maiores indivíduos em todos os micro-habitats. A disponibilidade de alimento, a menor profundidade e a menor pressão de predação em M1 são os principais fatores que tornam este micro-habitat mais adequado para M. jelskii, particularmente para fêmeas adultas não ovígeras e machos adultos e fêmeas jovens de maiores tamanhos. Além disso, consideramos também a competição intraespecífica por abrigo em M1, a qual as fêmeas adultas vencem devido ao seu maior tamanho corporal. Como consequência, os machos adultos são encontrados em maior abundância em M2 e M3 e os juvenis de ambos os sexos se espalham uniformemente em todos os micro-habitats. Nossos resultados ajudam a entender o papel ecológico e a utilização de nicho por M. jelskii. Futuros estudos sobre a escolha do habitat e relação presa-predador em condições de laboratório poderão ajudar a entender melhor o comportamento dessa espécie.
ABSTRACT We analyzed the microhabitat preferences of Macrobrachium jelskii (Miers, 1877) males and females inhabiting an urban water reservoir in Cruz das Almas, Bahia, Brazil. Prawns were collected monthly, from March 2015 to February 2016, in three microhabitats, using a sieve. Each microhabitat was dominated by one macrophyte species: Eleocharis sp. (M1), Cabomba sp. (M2), and Nymphaea sp. (M3). The prawns were measured (carapace length), and categorized as juvenile males, adult males, juvenile females, non-ovigerous adult females and ovigerous adult females. An analysis of variance (ANOVA) was used to compare the number and size of individuals. The sex ratio and frequency of ovigerous females in the three microhabitats were also calculated. The sex ratio was biased towards females in M1 and did not deviate from 1:1 in M2 and M3. When prawns were separated into five categories we observed that non-ovigerous adult females were more abundant in M1, while adult males were the most abundant demographic category in M2 and M3. Juveniles of both sexes and ovigerous females showed no microhabitat preference, although M1 and M2 appeared to be more suitable for the latter. Adult females were the largest individuals in all microhabitats. Food availability, lower depth and lower predation pressure in M1 are the main factors that make M1 more suitable for M. jelskii, particularly non-ovigerous adult females and larger adult males. Intraspecific competition for shelter in M1 might also occur and adult females win this competition due to their larger body size. Therefore, adult males are found in higher abundance in M2 and M3 and the juvenile of both sexes spread evenly across all microhabitats. Our results help to understand the ecological role and the niche used by M. jelskii. Future studies on the habitat choice and predation under laboratory conditions should help to understand the behavior of this species.
https://doi.org/10.1590/1678-4766e2019027
1324 downloads
8.
Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases
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Pileggi, Gecilmara Salviato
; Mota, Licia Maria Henrique Da
; Kakehasi, Adriana Maria
; Souza, Alexandre Wagner De
; Rocha, Aline
; Melo, Ana Karla Guedes de
; Fonte, Caroline Araujo M. da
; Bortoletto, Cecilia
; Brenol, Claiton Viegas
; Marques, Claudia Diniz Lopes
; Zaltman, Cyrla
; Borba, Eduardo Ferreira
; Reis, Enio Ribeiro
; Freire, Eutilia Andrade Medeiros
; Klumb, Evandro Mendes
; Christopoulos, Georges Basile
; Laurindo, Ieda Maria M.
; Ballalai, Isabella
; Costa, Izaias Pereira Da
; Michelin, Lessandra
; Valadares, Lilian David de Azevêdo
; Chebli, Liliana Andrade
; Lacerda, Marcus
; Toscano, Maria Amazile Ferreira
; Yazbek, Michel Alexandre
; Vieira, Rejane Maria R. De Abreu
; Magalhães, Renata
; Kfouri, Renato
; Richtmann, Rosana
; Merenlender, Selma Da Costa Silva
; Valim, Valeria
; Assis, Marcos Renato De
; Kowalski, Sergio Candido
; Trevisani, Virginia Fernandes Moça
.
Abstract Background: In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Main body of the abstract: Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations. Conclusion: This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV.
https://doi.org/10.1186/s42358-019-0056-x
1111 downloads
9.
Testing a new surgical instrument to obtain bovine hoof biopsy samples
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Mendes, Heloisa M.F.
; Rocha Júnior, Sérgio S.
; Paz, Cahuê F.R.
; Valadares, Rodrigo C.
; Ribeiro, Rodrigo M.
; Azevedo, David S.D.
; Vasconcelos, Anilton C.
; Faleiros, Rafael R.
.
RESUMO: A avaliação das propriedades histológicas e da expressão de genes e proteínas em biópsias tem sido determinante para o entendimento da fisiopatologia, o diagnóstico e o prognóstico das enfermidades. Entretanto, a obtenção de biópsias do casco é um procedimento com limitações devido à ausência de técnicas e instrumentos específicos. O objetivo foi desenvolver e testar, na espécie bovina, um instrumento cirúrgico especificamente desenvolvido para realização de biópsias de casco nominado lamelótomo de Falcão-Faleiros (INPI, BR102013018765-8). Utilizaram-se cinco bovinos adultos que foram sedados, contidos em decúbito lateral e tiveram dois dígitos anestesiados. Em seguida, uma serra circular acoplada a uma microretífica foi usada para o desgaste do estrato córneo na parede dorsal até próximo do estrato lamelar. Após incisões retilíneas delimitando a borda interna da área desgastada, utilizou-se o lamelótomo para obtenção da amostra. Os fragmentos de 16mm de comprimento e 6mm de profundidade foram fixados em formalina e processados para histologia com colorações HE, PAS, Shorr e tricrômico de Masson. Nenhum dos animais apresentou claudicação ou complicação relevantes no período pós-opertório. As amostras foram consideradas adequadas quanto à integridade das lâminas e à preservação de sua arquitetura. Obtiveram-se média de 85 lâminas epidérmicas viáveis por biópsia. Conclui-se que o lamelótomo de Falcão-Faleiros é apropriado e seguro para a obtenção de biópsias de casco em bovinos, se mostrando promissor para uso em estudos clínicos e na rotina de diagnóstico de problemas podais em bovinos.
ABSTRACT: The histological and molecular analysis of biopsy samples are fundamental steps for the understanding of physiopathology, diagnosis and prognosis of the diseases. However, harvest of tissue biopsies from hoof lamellar tissue is a procedure with limitations due to lack of effective surgical instruments and techniques. The aim of the current study is to develop and test in vivo a surgical instrument with the specific purpose of harvesting lamellar tissue in cattle. A prototype called Falcão-Faleiros’ lamellotome (INPIBR102013018765-8) was designed, produced and tested. After sedation, five adult cattle were restrained in lateral recumbency and locally anesthetized in two digits. The stratum corneum was worn down using a rotary tool coupled to a 3/8” high-speed cutter until the soft tissue proximity was reached. Next, the inner edge of the worn area was bounded with a scalpel. The lamellotome was introduced to obtain and hold the sample. The histological specimens of 16mm length by 6mm depth were stained with HE, PAS, Masson’s thricome and Shorr. The structures of interest were differentiated in the histological analysis without technical artifacts and a mean number of 85 epidermal laminae per sample were counted. No relevant lameness or wound complication were seen following the procedure. In conclusion the technique using the lamellotme was effective in obtaining lamellar tissue biopsy samples without causing clinical harm in cattle. The procedure showed potential to be used in clinical research or even as a supplementary diagnosis method for routine bovine podiatry.
https://doi.org/10.1590/1678-5150-pvb-5073
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10.
Brazilian legislation on genetic heritage harms Biodiversity Convention goals and threatens basic biology research and education
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ALVES, RUY JOSÉ V.
; WEKSLER, MARCELO
; OLIVEIRA, JOÃO A.
; BUCKUP, PAULO A.
; POMBAL JR., JOSÉ P.
; SANTANA, HÉLCIO R.G.
; PERACCHI, ADRIANO LÚCIO
; KELLNER, ALEXANDER W.A.
; ALEIXO, ALEXANDRE
; LANGGUTH, ALFREDO
; ALMEIDA, ALZIRA MARIA P. DE
; ALBERNAZ, ANA LUISA
; RIBAS, CAMILA C.
; ZILBERBERG, CARLA
; GRELLE, CARLOS EDUARDO V.
; ROCHA, CARLOS F.D.
; LAMAS, CARLOS JOSÉ E.
; HADDAD, CÉLIO F.B.
; BONVICINO, CIBELE R.
; PRADO, CYNTHIA P.A.
; LIMA, DANIELA O. DE
; ROSSA-FERES, DENISE C.
; SANTOS, FABRÍCIO R. DOS
; SALIMENA, FÁTIMA REGINA G.
; PERINI, FERNANDO A.
; BOCKMANN, FLÁVIO A.
; FRANCO, FRANCISCO LUÍS
; GIUDICE, GISELE M.L. DEL
; COLLI, GUARINO R.
; VIEIRA, IMA CÉLIA G.
; MARINHO-FILHO, JADER
; WERNECK, JANE M.C.F.
; SANTOS, JORGE A.D. DOS
; NASCIMENTO, JORGE LUIZ DO
; NESSIMIAN, JORGE LUIZ
; CORDEIRO, JOSÉ LUIS P.
; CLARO, KLEBER DEL
; SALLES, LEANDRO O.
; CASATTI, LILIAN
; PY-DANIEL, LUCIA HELENA R.
; SILVEIRA, LUÍS FÁBIO
; TOLEDO, LUÍS FELIPE
; OLIVEIRA, LUIZ F. DE
; MALABARBA, LUIZ ROBERTO
; SILVA, MARCELO D. DA
; COURI, MÁRCIA S.
; MARTINS, MÁRCIO
; TAVARES, MARCOS D.S.
; SOBRAL, MARCOS EDUARDO G.
; VIEIRA, MARCUS VINÍCIUS
; OLIVEIRA, MARIA DE LOURDES A.
; PINNA, MÁRIO DE
; HOPKINS, MICHAEL J.G.
; SOLÉ, MIRCO
; MENEZES, NAÉRCIO A.
; PASSOS, PAULO
; D’ANDREA, PAULO SERGIO
; PINTO, PEDRO C.E.A.
; VIANA, PEDRO L.
; TOLEDO, PETER M.
; REIS, ROBERTO E.
; VILELA, ROBERTO
; BASTOS, ROGÉRIO P.
; COLLEVATTI, ROSANE G.
; CERQUEIRA, RUI
; CASTROVIEJO-FISHER, SANTIAGO
; CARAMASCHI, ULISSES
.
Anais da Academia Brasileira de Ciências
- Métricas do periódico
https://doi.org/10.1590/0001-3765201820180460
7311 downloads
11.
Planet Boundary Layer Parameterization in Weather Research and Forecasting (WRFv3.5): Assessment of Performance in High Spatial Resolution Simulations in Complex Topography of Mexico
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González-Rocha, Sergio Natan
; Juárez-Pérez, Fredy
; Aguilar-Meléndez, Armando
; Salas, Alfredo Cristóbal
; Calderón-Ramón, Celia
; Escalante-Martínez, Jesús E.
; Baldasano Recio, José M.
.
Abstract: This paper presents the application of the Weather Research and Forecasting (WRF version 3.5) with high spatial resolution (3 and 1 km) testing four Planet Boundary Layer (PBL) schemes to the complex topography of Mexico in different numerical experiments that have tried to find the best configuration. The WRF is a Numerical Weather Prediction (NWP) model giving support for weather forecasting and modeling in Chemical Transport (CTM) or Air Quality Models as CMAQ or CHIMERE. For the above, the objectives in this work were assess the performance, the best grid parameterization, meteorological initial conditions, temporal resolution, time step and PBL schemes used in order to minimize the execution time and to show changes in speedup and efficiency. Mare Nostrum III supercomputer was used for the computational processing in the cluster. The computational performance indicators were execution time, speedup and efficiency. The sensitivity analysis was performed using the mean bias (MB) and root mean square error (RMSE) from variables obtained by WRFv3.5 such as temperature, wind-speed, sea level pressure and the METAR Veracruz airport station observations. The results show that Mellor-Yamada-Janjic (MYJ) scheme was better in computational parallel execution with at least 8 processors and a time step of 18 seconds. The sensitivity analyses show that time step is not a key in the accuracy of the meteorological values obtained. It is necessary consider the lack of data in METAR stations in Mexico.
https://doi.org/10.13053/cys-21-1-2581
902 downloads
12.
Influence of morbid obesity on physical capacity, knee-related symptoms and overall quality of life: A cross-sectional study
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Revista da Associação Médica Brasileira
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Resumo Objetivo: Avaliar o impacto da obesidade mórbida sobre a capacidade física, sintomas osteoarticulares e qualidade de vida global. Método: Estudo transversal realizado em hospital universitário, envolvendo 39 indivíduos admitidos em um serviço de cirurgia bariátrica. A capacidade física foi avaliada através do teste de caminhada de 6 minutos e pela escala de percepção de esforço de Borg. Os sintomas relacionados ao joelho foram avaliados pelos escores de KOOS e Lysholm; a qualidade de vida foi avaliada por meio do questionário SF-36. Resultados: No teste de caminhada de 6 minutos, a distância média foi de 374,1±107,5 m. O escore médio de Borg foi 12,9±2,4. Os seguintes escores foram observados no KOOS: dor (64,3±24); outros sintomas (67,2±25,5); atividades da vida diária (60,4±26,8); atividades esportivas e lazer (28,5±32,2); qualidade de vida (35,9±33,5); o escore de Lysholm médio foi 55,3±25,4. O SF-36 mostrou estes escores: capacidade funcional (41±27,4); limitação por aspectos físicos (34,6±39,2); dor (45,7±23,6); estado geral de saúde (63,1±26,2); vitalidade (53,5±12,1); aspectos sociais (52,6±29,3); aspectos emocionais (41±44,9); saúde mental (55±27,7). Conclusão: A obesidade levou à perda significativa de capacidade física, a prejuízo à marcha, a sintomas relacionados ao joelho e a impacto negativo sobre a qualidade de vida global.
Summary Objective: To evaluate the impact of morbid obesity on physical capacity, joint-related symptoms, and on the overall quality of life. Method: Cross-sectional study carried out at a university hospital, enrolling 39 individuals admitted to a bariatric surgery service. Physical capacity was assessed by Six-Minute Walk Test (SMWT) and the Borg rating of perceived exertion (RPE). Knee-related symptoms were evaluated by Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lysholm Score. Quality of life was evaluated by Short Form 36 Health Questionnaire (SF-36). Results: On SMWT, the mean distance walked was 374.1±107.5 m. The mean Borg score was 12.9±2.4. KOOS questionnaire found the following scores: pain (64.3±24), other symptoms (67.2±25.5), function in daily living (60.4±26.8), function in sport and recreation (28.5±32.2), knee-related quality of life (35.9±33.5), mean Lysholm scale score (55.3±25.4). SF-36 provided the following scores: physical functioning (41±27.4), physical role functioning (34.6±39.2), bodily pain (45.7±23.6), general health perceptions (63.1±26.2), vitality (53.5±12.1), social role functioning (52.6±29.3), emotional role functioning (41±44.9), mental health (55±27.7). Conclusion: Obesity led to significant loss of physical capacity, gait impairment, knee-related symptoms, and a negative impact on the overall quality of life.
https://doi.org/10.1590/1806-9282.63.02.142
2552 downloads
13.
Melhora cognitiva durante tap test em pacientes com hidrocefalia de pressão normal
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Rocha, Samanta
; Almeida, Sergio M.
; Pizzanni, Luciana
; Romero, Bruna
; Perboni, Talita
; Krause, Ricardo M.
; Kowacs, Pedro A.
; Ramina, Ricardo
.
A hidrocefalia de pressão normal (HPN) em geral ocorre entre 7ª e 8ª décadas de vida. Composta por uma tríade de sintomas (marcha, urinária e cognição), é uma das causas de demência potencialmente reversíveis, através do tratamento cirúrgico (implante de válvula cerebral). Exames complementares como o tap test em série (exame da punção lombar) podem melhorar o diagnóstico. O objetivo foi estudar o impacto do tap test sobre a cognição de portadores de HPN. 17 participante (sete homens e 10 mulheres), idade entre 76 e 41 anos e escolaridade de 9,1 anos, selecionados de um grupo de 53 sujeitos segundo critérios de Relkin foram avaliados em três etapas envolvendo domínio cognitivo e marcha: antes da punção (pré-tap); Após a primeira punção lombar (pós-tap 1); e no dia seguinte, após a nova punção (pós tap 2). Neste subgrupo análise estatística apontou diferença significativa entre os resultados pré-tap e póstap na prova de dígitos ordem direta (p<0,013), dígitos ordem inversa (p<0,013); fluência de animais (p<0,004) e na primeira etapa do teste de Stroop (p<0,033). Neste grupo os pacientes obtiveram melhora do desempenho em alguns testes de funções executivas, o que parece estar relacionado a melhora na velocidade de processamento mental.
Idiopathic normal pressure hydrocephalus (INPH) is a syndrome characterized by the classic triad of gait disturbance, potentially reversible dementia (progressive mental deterioration) and urinary incontinence. The dementia can involve executive dysfunction, memory failures and bradyphrenia. The criteria for referral for ventriculoperitoneal shunting are still controversial but include the results of a spinal tap, which is performed to simulate the effect of shunting and to analyze the impact of cerebrospinal fluid (CSF) drainage on the patient’s gait. Objective: To evaluate the immediate effect of a spinal tap on the executive functions of patients with a diagnosis of probable INPH. Methods: Seventeen participants (seven men and ten women) aged 76.41+6.24 years (mean+SD) with 9.01+4.40 years (mean+SD) of schooling were selected from a group of 130 individuals tested. The neuropsychological tests of executive functions used were the Stroop test, digit span task, verbal fluency (animals and letters) (FAR) and MMSE. Patients were evaluated in three stages: before the first CSF drainage and after the first and second CSF drainages. Results: Statistical analysis showed significant differences between the pre-spinal tap and post-spinal tap results in the forward (p<0.013) and backward (p<0.037) digit span task, the animal fluency (p<0.004) and the first stage of the Stroop test (p<0.033). Significant differences were not observed in the orientation test (WMS), mental control (WMS) or MMSE. Conclusion: Of the various tests performed, executive function tests most clearly showed changes resulting from CSF drainage in patients with normal pressure hydrocephalus (NPH). The improvement appears to be related to an improvement in mental processing speed.
https://doi.org/10.15309/16psd170110
8241 downloads
14.
Consenso chileno de prevención, diagnóstico y tratamiento de la diarrea asociada a Clostridium difficile
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Hernández-Rocha, Cristian
; Pidal, Paola
; Ajenjo, M. Cristina
; Quera, Rodrigo
; Quintanilla, Marcela
; Lubascher, Jaime
; Jemenao, M. Irene
; Ibáñez, Patricio
; Álvarez-Lobos, Manuel
; Diomedi, Alexis
; Marcotti, Alejandra
; Acuña, Mirta
; Arab, Juan P
; Riquelme, Arnoldo
; Candía, Roberto
; Carvajal, Sergio
.
Background: Clostridium dijfficile-associated diarrhea (CDAD) has become very important due to the increase in its incidence, severity, recurrence and the associated economic burden. Having a national consensus guideline is essential to improve its management. Objective: To build a multidisciplinary and evidence-based consensus in prevention, diagnosis and treatment of CDAD. Methods: We convened a panel of experts in the field of infectious diseases, gastroenterology, evidence-based medicine and consensus methodology. The panel conducted a structured review of published literature in CDAD evaluating evidence levels and recommendation degree according to the methodology proposed by the GRADE working-group. A modified three-round Delphi technique was used to reach a consensus among the experts. Results: A group of 16 experts was established, 12 of them answered 18 clinically relevant questions. The levels of agreement achieved by the panel of 16 experts were 79% in the first round and 100% in the second and third round. The main consensus recommendations in prevention are: restricting the use of proton-pump inhibitors, primary prophylaxis with probiotics in antibiotics users, education of health personnel, isolation for patients hospitalized with CDAD, and cleaning the rooms exposed to C. difficile with products based in chlorine or hydrogen peroxide. In the diagnosis: use of biology molecular-based techniques is preferred and if not available, glutamate dehydrogenase-based algorithms may be recommended. With regard to treatment: the use of oral metronidazole in mild-moderate CDAD and oral vancomycin in severe CDAD are recommended. Treat the first recurrence with the same antibiotics according to severity. In the case of second and subsequent recurrences consider prolonged therapy with vancomycin, rifaximin or fecal microbiota transplant. Conclusion: The first Chilean consensus on prevention, diagnosis and treatment of CDAD is presented, which is a major step in improving national standards in the management of this disease.
Introducción: La diarrea asociada a Clostridium difficile (DACD) ha adquirido gran relevancia debido al aumento en su incidencia, gravedad, capacidad de recurrencia y carga económica asociada. Contar con una guía de consenso local es fundamental para mejorar su manejo. Objetivo: Elaborar un consenso multidisciplinara y basado en la evidencia en la prevención, diagnóstico y tratamiento de la DACD. Métodos: Se convocó a un panel de expertos en el área de enfermedades infecciosas, gastroenterología, medicina basada en la evidencia y metodología de consenso. El panel realizó una revisión estructurada de la literatura científica publicada en DACD evaluando el nivel de la evidencia y recomendación utilizando el sistema GRADE. Una técnica de Delfi modificada de tres rondas fue utilizada para alcanzar un consenso entre los expertos. Resultados: Se estableció un grupo de 16 expertos, 12 de ellos respondieron 18 preguntas de relevancia clínica. Los niveles de acuerdo alcanzados por el panel de 16 expertos fueron de 79% en la primera ronda y 100% en la segunda y tercera ronda. Las principales recomendaciones en prevención son: restricción del uso de inhibidores de la bomba de protones, profilaxis primaria con probióticos en usuarios de antimicrobianos de corto plazo, educación del personal de salud, aislamiento de contacto en pacientes hospitalizados con DACD y aseo de las habitaciones expuestas a C. difficile con productos en base a cloro o peróxido de hidrógeno. En el diagnóstico se recomienda: el uso de técnicas basadas en biología molecular y como alternativa algoritmos en base a glutamato deshidrogenasa. Con respecto al tratamiento, se recomienda el uso de metronidazol oral en DACD leve-moderada y vancomicina oral en DACD grave. El tratamiento de la primera recurrencia es con los mismos antimicrobianos de acuerdo a la gravedad, considerando en la segunda recurrencia y posteriores terapia prolongada con vancomicina, rifaximina o trasplante de microbiota fecal. Conclusión: Se presenta el primer consenso chileno en prevención, diagnóstico y tratamiento de DACD, paso trascendental en mejorar los estándares locales en el manejo de esta enfermedad.
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15.
Length-weight relationship and condition factor of Macrobrachium amazonicum (Heller, 1862) (Decapoda, Palaemonidae) from a reservoir in Bahia, Brazil
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Rocha, Sérgio Schwarz da
; Silva, Ricardo Loreno Souza da
; Santos, Jayane de Lima
; Oliveira, Guilherme de
.
ABSTRACT Macrobrachium amazonicum (Heller, 1862) is a freshwater prawn occurring in rivers and reservoirs of Central and South America. Given its broad geographical distribution, the species shows great intraspecific morphological, reproductive, physiological and ecological plasticity. Furthermore, it also stands out for its economic importance, especially in the states of North (Pará and Amapá) and Northeast Brazil. Despite the wide geographic distribution and economic importance of M. amazonicum, the biology of this species is poorly known, particularly in Northeast Brazil. We analyzed the length-weight relationships and condition factor of males and females of M. amazonicum. Specimens were collected monthly from September 2008 to August 2009 at the Pedra do Cavalo Reservoir, city of Cabaceiras do Paraguaçu, State of Bahia. All specimens were sexed, measured and weighted. After that, length-weight relationships and the allometric (K) and relative (Kr) condition factors were calculated. Altogether 2,974 specimens were analyzed, 334 of which were males (11%) and 2,640 were females (89%). Females were larger and heavier than males. Males and females showed isometric and negative allometric growth, respectively. Monthly variations in the condition factor were similar for both sexes, and correlated strongly with rainfall regime and temperature in the region. Such variations are not correlated with the reproductive cycle of the species, but are probably correlated with food availability and somatic growth.
https://doi.org/10.1590/S0104-64972015002308
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