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ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença.

https://doi.org/10.1590/1984-0462/2024/42/2022184

[SciELO Preprints] - Study of Health in Pomerode (SHIP-Brazil): aims, methodological issues and descriptive results
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Santa Helena, Ernani Tiaraju de Sousa, Clóvis Arlindo de Silveira, João Luiz Gurgel Calvet da Nunes, Carlos Roberto de Oliveira Azevedo, Luciane Coutinho de Nilson, Luana Gabriele Valente, Caroline Prado, Rosana Leal do Cordova, Caio Mauricio Mendes de Batista, Keila Zaniboni Siqueira Botelho, Tatiani Karini Rensi Cunha, Angela Duebbers Starke, Siegmar Zimmermann, Sergio Luiz Damasceno, Nágila Raquel Teixeira Santos, Raul Dias Ittermann, Till Völzke, Henry Markus, Marcello Ricardo Paulista

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Publication date: 2023-11-22

Abstract: En Pt

Background Few studies compared populations with similar genetic and culture background on different continents with standardized methods. Objective To describe methodological issues of the Study of Health in Pomerode - SHIP-Brazil and some characteristics of the participants of the baseline examination. Design and Setting Prospective, population-based cohort study of a representative sample of residents (aged 20 to 79 years) of Pomerode, Santa Catarina, Brazil. Methods Data for the baseline survey (from 2014 to 2018) were collected through interviews and medical examinations, including socio-demographic and lifestyle information, clinical and subclinical conditions, oral and mental health, among others. Biosamples (blood, urine, stool, and saliva) were collected and stored. Methods of data collection and quality control are described. Preliminary descriptive statistics were performed. Results The response rate was 67.6% (n=2,488 individuals). The Kappa test-retest of some variables varied from 0.54 to 1.0. German culture participants are older (46.5 vs 38.7 years), self-declared white (97.3% vs 82.1%), more frequently never smokers (71.4% vs 66.9%) but had higher risk of consuming alcohol (16.9% vs 13.4%) compared to participants with non-German background. Germans were taller (169 cm vs 166 cm), had greater abdominal circumference among men (101.9 cm vs 97.3 cm). Furthermore, they reported more multimorbidity (56.7% vs 43.6%) , had more arterial hypertension (30.7% vs 18.5%), but less depression (15.4% vs 19,1%) than non-Germans. Conclusions The interaction of genetic and social/environmental issues should be examined to understand the role of risk factors on clinical conditions observed.

Introdução Poucos estudos compararam populações com histórico genético e cultural semelhante em diferentes continentes com métodos padronizados. Objetivos Descrever questões metodológicas do estudo de “Vida e Saúde em Pomerode - SHIP-Brazil” e algumas características dos participantes do exame inicial do estudo. Desenho de estudo e local Estudo de coorte prospectivo de base populacional em amostra representativa de moradores (20 a 79 anos) de Pomerode, Santa Catarina. Métodos As informações para a linha de base (de 2014 a 2018) foram coletadas por meio de entrevistas e exames médicos, incluindo dados sociodemográficos, de estilo de vida, condições clínicas e subclínicas, saúde bucal e mental, entre outros. Amostras biológicas (sangue, urina, fezes e saliva) foram coletadas e armazenadas. A coleta de dados e o controle de qualidade foram descritos. Foram realizadas análises descritivas preliminares. Resultados A taxa de resposta foi de 67,6% (n=2.488 indivíduos). O Kappa teste-reteste de algumas variáveis variou  de 0,54 a 1,0. Os participantes de cultura alemã são mais velhos (46,5 vs 38,7 anos ), autodeclarados brancos (97,3% vs 82,1%), com menor número de fumantes (71,4% vs 66,9%), mas tiveram maior risco de consumir álcool (16,9% vs 13,4%), eram mais altos (169 cm vs 166 cm), tinham maior circunferência abdominal entre os homens (101,9 cm vs 97,3 cm) em comparação com participantes “não-alemães”. Pessoas de cultura alemã relataram mais multimorbidade (56,7% vs 43,6%), apresentavam mais hipertensão arterial (30,7% vs 18,5%), mas menos depressão (15,4% vs 19,1%). Conclusões A interação genética e social/ambiental devem ser examinadas para melhor entender o papel desses fatores de risco nas condições clínicas observadas.

https://doi.org/10.1590/SciELOPreprints.7276

Sowing date influence on the soybean tolerance to defoliation at the beginning of pod formation
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Leolato, Lucieli Santini

; Sangoi, Luís

; Martins Junior, Marcos Cardoso

; Oliveira, Vander de Liz

; Durli, Murilo Miguel

; Souza, Clovis Arruda de

Revista Ceres

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jan 2023, Volume 70 N. 1 Pages 78 - 86

Abstract: En | Text: En | PDF: En

ABSTRACT Late sowings anticipate flowering and decrease the soybean vegetative plasticity. These changes may limit the ability of plants to tolerate leaf area losses. The objective of this research was to evaluate the sowing date effect on soybean tolerance to defoliation at the beginning of pod formation. The experiment was set in Lages (Santa Catarina State, Brazil) during the 2016/2017 growing season. Two sowing dates were tested: November 2, 2016 (preferential) and December 15, 2016 (late). Five levels of defoliation (0%, 17%, 33%, 50% and 67%) of cultivar NA 5909 RG were imposed at the R3 growth stage. Grain yield showed a quadratic response to defoliation, ranging from 4,313 to 6,478 kg ha-1 in the preferential sowing date and from 3,374 to 4,443 kg ha-1 in the late sowing date. The plants tolerated up to 45.6% of defoliation in early sowing and 55.8% in late sowing, without yield losses, in comparison to the control. The highest level of defoliation reduced grain yield by 26.9% and 13.4% in early and late sowings, respectively, compared to the control. The delay of sowing date did not increase the sensitivity of cultivar NA 5909 RG to defoliation at the beginning of pod formation.

https://doi.org/10.1590/0034-737x202370010009

Estimation of genetic parameters and selection gains for sweet potato using Bayesian inference with a priori information
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Valadares, Nermy Ribeiro

; Fernandes, Ana Clara Gonçalves

; Rodrigues, Clóvis Henrique Oliveira

; Guedes, Lis Lorena Melúcio

; Magalhães, Jailson Ramos

; Alves, Rayane Aguiar

; Andrade Júnior, Valter Carvalho de

; Azevedo, Alcinei Mistico

Acta Scientiarum. Agronomy

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2023, Volume 45 elocation e56160

Abstract: En | Text: En | PDF: En

ABSTRACT. The selection of superior sweet potato genotypes using Bayesian inference is an important strategy for genetic improvement. Sweet potatoes are of social and economic importance, being the material for ethanol production. The estimation of variance components and genetic parameters using Bayesian inference is more accurate than that using the frequently used statistical methodologies. This is because the former allows for using a priori knowledge from previous research. Therefore, the present study estimated genetic parameters and selection gains, predicted genetic values, and selected sweet potato genotypes using a Bayesian approach with a priori information. Root shape, soil insect resistance, and root and shoot productivity of 24 sweet potato genotypes were measured. Heritability, genotypic variation coefficient, residual variation coefficient, relative variation index, and selection gains direct, indirect and simultaneous were estimated, and the data were analyzed using Bayesian inference. Data from 11 experiments were used to obtain a priori information. Bayesian inference was a useful tool for decision-making, and significant genetic gains could be achieved with the selection of the evaluated genotypes. Root shape, soil insect resistance, commercial root productivity, and total root productivity showed higher heritability values. Clones UFVJM06, UFVJM40, UFVJM54, UFVJM09, and CAMBRAIA can be used as parents in future breeding programs.

https://doi.org/10.4025/actasciagron.v45i1.56160

Post-acute COVID-19 in three doses vaccinated autoimmune rheumatic diseases patients: frequency and pattern of this condition
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Silva, Clovis Artur

; Kupa, Leonard de Vinci Kanda

; Medeiros-Ribeiro, Ana Cristina

; Pasoto, Sandra Gofinet

; Saad, Carla Gonçalves Schahin

; Yuki, Emily Figueiredo Neves

; Landim, Joaquim Ivo Vasques Dantas

; Léda, Victor Hugo Ferreira e

; Correia, Luisa Sacchi de Camargo

; Sartori, Artur Fonseca

; Martins, Carolina Campagnoli Machado Freire

; Ribeiro, Carolina Torres

; Waridel, Filipe

; Martins, Victor Adriano de Oliveira

; Shinjo, Samuel Katsuyuki

; Andrade, Danieli Castro Oliveira

; Sampaio-Barros, Percival Degrava

; Borba Neto, Eduardo Ferreira

; Aikawa, Nadia Emi

; Bonfa, Eloisa

Advances in Rheumatology

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2023, Volume 63 elocation 26

Abstract: En | Text: En | PDF: En

Abstract Background Data on post-acute COVID-19 in autoimmune rheumatic diseases (ARD) are scarce, focusing on a single disease, with variable definitions of this condition and time of vaccination. The aim of this study was to evaluate the frequency and pattern of post-acute COVID-19 in vaccinated patients with ARD using established diagnosis criteria. Methods Retrospective evaluation of a prospective cohort of 108 ARD patients and 32 non-ARD controls, diagnosed with SARS-CoV-2 infection (RT-PCR/antigen test) after the third dose of the CoronaVac vaccine. Post-acute COVID-19 (≥ 4 weeks and > 12 weeks of SARS-CoV-2 symptoms) were registered according to the established international criteria. Results ARD patients and non-ARD controls, balanced for age and sex, had high and comparable frequencies of ≥ 4 weeks post-acute COVID-19 (58.3% vs. 53.1%, p = 0.6854) and > 12 weeks post-acute COVID-19 (39.8% vs. 46.9%, p = 0.5419). Regarding ≥ 4 weeks post-acute COVID-19, frequencies of ≥ 3 symptoms were similar in ARD and non-ARD controls (54% vs. 41.2%, p = 0.7886), and this was also similar in > 12 weeks post-acute COVID-19 (68.3% vs. 88.2%, p = 0.1322). Further analysis of the risk factors for ≥ 4 weeks post-acute COVID-19 in ARD patients revealed that age, sex, clinical severity of COVID-19, reinfection, and autoimmune diseases were not associated with this condition (p > 0.05). The clinical manifestations of post-acute COVID-19 were similar in both groups (p > 0.05), with fatigue and memory loss being the most frequent manifestations. Conclusion We provide novel data demonstrating that immune/inflammatory ARD disturbances after third dose vaccination do not seem to be a major determinant of post-acute COVID-19 since its pattern is very similar to that of the general population. Clinical Trials platform (NCT04754698).

https://doi.org/10.1186/s42358-023-00309-z

β-Cyclodextrins alter the energy metabolism-related enzyme activities in rats
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IANISKI, FRANCINE R.

; OLIVEIRA, AMANDA L. DE

; MEZZOMO, NATHANA JAMILLE

; FRANCESCHI, ITIANE D. DE

; CARMO, GUILHERME M. DO

; CREMONESE, CAMILA R.

; BALDISSERA, MATHEUS D.

; ZANON, JENIFER P.

; KOLLING, JENIFER

; FRIEDERICH, JORDANA DANIELA

; SILVA, IVANA Z.

; GIONGO, JANICE L.

; FEKSA, LUCIANE R.

; VAUCHER, RODRIGO A.

; WANNMACHER, CLOVIS MILTON D.

; RECH, VIRGINIA C.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 N. 2 elocation e20201783

Abstract: En | Text: En | PDF: En

Abstract Although widely used in medicine, separation technology, and other fields, the effects of cyclodextrins on the activities of phosphoryl transfer enzymes have not been previously evaluated. In vivo studies evaluated the function of cyclodextrins as active compounds. Despite the use of cyclodextrins as active compounds, the effects of cyclodextrins on hepatic and renal tissues remain to be fully elucidated. The primary objective of this study was to evaluate the effects of β- cyclodextrins, methyl-β-cyclodextrin (M-β- cyclodextrins), and (2-hydroxypropyl)-β-cyclodextrin (HP-β-cyclodextrins) on enzyme activities regulating the maintenance of energy homeostasis in the kidney and liver tissues in relation to toxicity. Serum levels of liver and kidney markers were measured, and oxidative stress parameters were assessed. After 60-day treatments, we observed that the administration of β-cyclodextrins and M-β-cyclodextrins inhibited the hepatic activity of pyruvate kinase, an irreversible enzyme within the glycolytic pathway. Additionally, administration of HP-β-cyclodextrins inhibited creatine kinase activity and increased the total sulfhydryl content in kidneys. Here, we demonstrated for the first time that β-cyclodextrins, M-β-cyclodextrins, and HP-β-cyclodextrins cause bioenergetic dysfunction in renal and hepatic tissues. These findings suggest that understanding the balance between cyclodextrins’ efficacy and adverse effects is essential for better accepting their use in medicine.

https://doi.org/10.1590/0001-3765202320201783

Case for diagnosis. Stewart-Treves syndrome after mastectomy
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Sato, Roberta Akeme de Oliveira

; Pinto, Clovis Antônio Lopes

; Alves, Celia Antonia Xavier de Moraes

; Ferreira, Juliana Arêas de Souza Lima Beltrame

Anais Brasileiros de Dermatologia

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oct 2022, Volume 97 N. 5 Pages 651 - 653

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.abd.2021.12.003

Soybean tolerance to defoliation at the beginning of pod formation as affected by plant density
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Durli, Murilo Miguel

; Sangoi, Luis

; Souza, Clovis Arruda

; Oliveira, Vander de Liz

; Martins Junior, Marcos Cardoso

; Kuneski, Hugo François

; Leolato, Lucieli Santini

Revista Ceres

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aug 2022, Volume 69 N. 4 Pages 408 - 415

Abstract: En | Text: En | PDF: En

ABSTRACT Soybean tolerance to defoliation may be affected by population density, as the plant population interferes with the crop leaf area index . This study aimed to evaluate the effect of defoliation at the beginning of pod formation on the agronomic performance of soybean at different plant densities. The experiment was conducted under field conditions in Campos Novos, SC, Brazil, during 2016/2017 and 2017/2018 growing season. The experimental design was a randomized block in a split-plot arrangement. The main plot consisted of three densities (100,000, 300,000, and 500,000 plants ha−1), whereas the subplots consisted of the cultivar NA 5909 RG submitted to five defoliation levels (0, 16.6, 33.3, 50, and 66.6%). Grain yield ranged from 4,219 to 5,356 kg ha−1 in the 2016/2017 growing season and 3,732 to 5,186 kg ha−1 in the 2017/2018 growing season. Plant density did not interfere with the grain yield response to defoliation performed at the beginning of pod formation. The 16.6% defoliation increase grain yield by 7.5 and 5.6% relative to the control in 2016/2017 and 2017/2018 growing seasons, respectively. The soybean tolerate defoliation of up to 33.3% at R3 with no significant decrease in grain yield, regardless of the plant density.

https://doi.org/10.1590/0034-737x202269040004

Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review
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Santos, Priscilla Araújo dos

; Oliveira, Alice Miranda de

; Alves, Caroline Queiroz

; Souza Filho, Clóvis Figueiredo

; Ladeia, Ana Marice Teixeira

; Petto, Jefferson

Revista Brasileira de Ginecologia e Obstetrícia

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jul 2022, Volume 44 N. 7 Pages 710 - 718

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Descrever os efeitos do contraceptivo oral combinado (COC) no sistema renina-angiotensina-aldosterona (SRAA). Fontes dos dadosTrata-se de uma revisão sistemática de acordo com os critérios do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), registrada no PROSPERO sob ID: CRD42020200019. As buscas foram realizadas entre agosto de 2020 e dezembro de 2021 nas bases de dados: Medline via Pubmed, Biblioteca Cochrane Central, Scientific Electronic Library Online, e Literatura Latino-americana e do Caribe em Ciências da Saúde via Biblioteca Virtual em Saúde. Consultado os artigos sobre os efeitos do contraceptivo oral combinado nos valores da atividade da renina plasmática, valores plasmáticos da renina, valores do angiotensinogênio – também conhecido como substrato da renina plasmática –, valores da angiotensina e/ou aldosterona. Seleção dos estudosForam selecionados 877 estudos e, destes, 10 artigos preencheram os critérios de elegibilidade e foram incluídos nesta revisão. Coleta de dadosOs dados foram combinados por meio de síntese qualitativa e inclusos em uma planilha elaborada previamente pelos autores. Síntese dos dadosAs amostras coletadas variavam entre 18 e 137 participantes, totalizando 501 mulheres com idade entre 18 e 49 anos em todos os estudos. Os estudos apresentaram aumento da atividade da renina plasmática, do substrato da renina plasmática, da angiotensina II e da aldosterona nessa população. Conclusão Os achados deste estudo sugerem que o COC promove maior ativação do SRAA. Apoiando a ideia de que o seu uso esteja relacionado ao aumento do risco de eventos cardiovasculares, incluindo a hipertensão arterial sistêmica.

Abstract Objective To describe the effects of combined oral contraceptives (COC) on the renin-angiotensin-aldosterone system (RAAS). Data sourcesThis is a systematic review according to the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), registered in PROSPERO under the ID: CRD42020200019. Searches were performed between August 2020 and December 2021, in the following databases: Medline via Pubmed, Cochrane Central Library, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences via Virtual Health Library. The effects of the combined oral contraceptive on plasma renin activity values, plasma renin values, angiotensinogen values— also known as plasma renin substrate— angiotensin, and/or aldosterone values. Study selectionA total of 877 studies were selected and, of these, 10 articles met the eligibility criteria and were included in this review. Data collectionData were combined through qualitative synthesis and included in a spreadsheet previously prepared by the authors. Data synthesisThe collected samples ranged from 18 to 137 participants, totaling 501 women aged between 18 and 49 years throughout all studies. The studies showed increased activity of plasma renin, plasma renin substrate, angiotensin II, and aldosterone in this population. Conclusion The findings of this study suggest that the COC promotes greater activation of the RAAS. Supporting the idea that its use is related to an increased risk of cardiovascular events, including systemic arterial hypertension.

https://doi.org/10.1055/s-0042-1745790

10.

Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19: Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia e Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Stein, Cinara

; Amaral, José Luiz Gomes do

; Azevedo, Luciano Cesar Pontes de

; Belli, Karlyse Claudino

; Colpani, Verônica

; Cunha, Clóvis Arns da

; Dal-Pizzol, Felipe

; Dias, Maria Beatriz Souza

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Monteiro, José Tadeu

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Prado, Clementina Corah Lucas

; Santos, Vania Cristina Canuto

; Silva, Rosemeri Maurici da

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Vidal, Ávila Teixeira

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Machado, Flávia Ribeiro

; Carvalho, Carlos Roberto Ribeiro de

Revista Brasileira de Terapia Intensiva

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mar 2022, Volume 34 N. 1 Pages 1 - 12

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivos: Há diversas terapias sendo utilizadas ou propostas para a COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é elaborar recomendações para subsidiar decisões sobre o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: Um grupo de 27 membros, formado por especialistas, representantes do Ministério da Saúde e metodologistas, integra essa diretriz. Foi utilizado o método de elaboração de diretrizes rápidas, tomando por base a adoção e/ou a adaptação de recomendações a partir de diretrizes internacionais existentes (GRADE ADOLOPMENT), apoiadas pela plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Foram geradas 16 recomendações. Entre elas, estão recomendações fortes para o uso de corticosteroides em pacientes em uso de oxigênio suplementar, para o uso de anticoagulantes em doses de profilaxia para tromboembolismo e para não uso de antibacterianos nos pacientes sem suspeita de infecção bacteriana. Não foi possível fazer uma recomendação quanto à utilização do tocilizumabe em pacientes hospitalizados com COVID-19 em uso de oxigênio, pelas incertezas na disponibilidade e de acesso ao medicamento. Foi feita recomendação para não usar azitromicina, casirivimabe + imdevimabe, cloroquina, colchicina, hidroxicloroquina, ivermectina, lopinavir/ ritonavir, plasma convalescente e rendesivir. Conclusão: Até o momento, poucas terapias se provaram efetivas no tratamento do paciente hospitalizado com COVID-19, sendo recomendados apenas corticosteroides e profilaxia para tromboembolismo. Diversos medicamentos foram considerados ineficazes, devendo ser descartados, de forma a oferecer o melhor tratamento pelos princípios da medicina baseada em evidências e promover economia de recursos não eficazes.

ABSTRACT Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.

https://doi.org/10.5935/0103-507x.20220001-pt

11.

Multimodal exercise program contributes to balance and motor functions in men and women with Parkinson's disease differently: an intervention study
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Mafra, Margit

; Lenzi, Otávio Matheus Werpachowski

; Silveira, Fábio Souza

; Schmitt, Maiara Vargas

; Oliveira, João Filipe de

; Sousa, Clóvis Arlindo de

Motriz: Revista de Educação Física

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2022, Volume 28 elocation e10220015221

Abstract: En | Text: En | PDF: En

Abstract Aim: To verify the effects of a multimodal exercise program on balance and motor functions, and the differences by sex, in people with Parkinson's disease (PD). Methods: The intervention study, was composed of 16 people with PD, that were assessed before and after 16 weeks of interventions with the multimodal exercise program. The effects were analyzed generally and by sex, using the Wilcoxon Test. The significance level was established at 5%. Results: Overall, there was an improvement in the strength of the lower limbs (LL) (p = 0.035) and upper limbs (UL) (p = 0.009), functional mobility (p = 0.003), gait (p = 0.050), balance (p = 0.001) and in motor scores of UPDRS III (p = 0.005), which categorize motor symptoms of the disease. In regards to sex, women affected muscle strength (p = 0.044) and flexibility of LL (p = 0.028), gait (p = 0.018), and motor aspects of the UPDRS III (p = 0.042). The men presented effects in muscle strength of the UL (p = 0.042). Women and men had a significant increase in functional mobility (p = 0.046 and p = 0.027, respectively) and in balance (p = 0.012 and p = 0.042, respectively). There was no significant difference for both sexes, in body mass and the reach behind the backtest. Conclusion: the multimodal exercise program contributed to the improvement in motor function and balance in men and women with PD. Nevertheless, the effects were more significant in women. The comprehension of the differences between men and women grants us a more directional and efficient approach to their treatment.

https://doi.org/10.1590/s1980-657420220015221

12.

Impacto na saúde mental de enfermeiros pediátricos: um estudo transversal em hospital pediátrico terciário durante a pandemia de COVID-19
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Robba, Hingrid Cristiane Silva

; Costa, Andréa Aoki

; Kozu, Kátia Tomie

; Silva, Clóvis Artur

; Farhat, Sylvia Costa Lima

; Ferreira, Juliana Caires de Oliveira Achili

Revista Latino-Americana de Enfermagem

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2022, Volume 30 elocation e3583

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo: avaliar problemas de saúde mental em enfermeiros pediátricos durante a pandemia causada pelo coronavírus 2019. Método: estudo transversal realizado com enfermeiros pediátricos do Instituto da Criança e do Adolescente, por meio de uma pesquisa online de autoavaliação sobre prática clínica e impacto na saúde mental, durante a pandemia de COVID-19. Foram avaliadas escalas de autoavaliação validadas para ansiedade, depressão e burnout. Resultados: 107/298(36%) enfermeiros responderam, dos quais 90% eram do sexo feminino, a mediana de idade atual era 41(23-64) anos, 68% trabalhavam com adolescentes, 66% trabalhavam na linha de frente. Burnout, ansiedade e depressão moderada/grave ocorreram em 65%, 72% e 74% dos enfermeiros, respectivamente. Falta de protocolo de tratamento padronizado nas enfermarias (27% vs. 10%, p=0,049), depressão moderada/grave (74% vs. 16%, p=0,002) e burnout (82% vs. 58%, p=0,01) foram significativamente maiores em enfermeiros pediátricos com ansiedade, em comparação com enfermeiros sem essa condição. Os enfermeiros pediátricos que trabalhavam com adolescentes apresentaram maior frequência de burnout, quando comparados aos que não trabalhavam com esse grupo (77% vs. 32%, p=0,0001). A análise multivariada revelou que o cumprimento adequado da quarentena aumentou a presença de ansiedade em 4,6 vezes [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusão: a maioria dos enfermeiros pediátricos atuava na linha de frente da COVID-19, em condições precárias, trabalhando com equipe reduzida e enfrentando perdas expressivas de renda. A ansiedade atual foi um tema relevante e o burnout também foi uma condição mental importante para esses profissionais, reforçando a cultura do bom trabalho em equipe, das práticas de colaboração e do cuidado psicológico/psiquiátrico.

Abstract Objective: to assess mental health issues in pediatric nurses during coronavirus pandemic in 2019. Method: cross-sectional study was conducted with pediatric nurses at the Instituto da Criança e do Adolescente based on online self-rated survey about clinical practice and mental health impact during COVID-19 pandemic. Validated self-reported scales for anxiety, depression and burnout were used for assessing these professionals. Results: 107/298 (36%) nurses answered, 90% were female, median age was 41(23-64) years, 68% worked with adolescents, 66% in frontline. Burnout, anxiety and moderate/severe depression occurred in 65%, 72% and 74%, respectively. Lack of standardized treatment protocol for nurses (27%vs.10%, p=0.049), moderate/severe depression (74% vs. 16%, p=0.002) and burnout (82% vs. 58%, p=0.01) were significantly higher in pediatric nurses with anxiety compared to those without. Pediatric nurses that worked with adolescents compared to those that did not showed higher frequency of burnout in the former group (77% vs. 32%, p=0.0001). Multivariable analysis revealed that adequate quarantine adherence increased the presence of anxiety in 4.6 times [OR4.6(CI 1.1-20.2), p=0.04]. Conclusion: most pediatric nurses who had worked in the frontline of COVID-19 were under precarious conditions, working with reduced team, and with an expressive changes in their monthly income. Current anxiety was a relevant issue, burnout was also an important mental condition for these professionals, reinforcing culture of good teamwork, collaboration practices and psychological/psychiatric approach.

Resumen Objetivo: evaluar los problemas de salud mental en enfermeros pediátricos durante la pandemia del coronavirus 2019. Método: estudio transversal realizado con enfermeros pediátricos del Instituto da Criança e do Adolescente mediante una encuesta de autoevaluación en línea sobre la práctica clínica y el impacto en la salud mental durante la pandemia de COVID-19. Se evaluaron escalas de autoevaluación validadas para ansiedad, depresión y burnout. Resultados: respondieron 107/298 (36%) de los enfermeros, de los cuales 90% eran del sexo femenino, la mediana de edad actual fue de 41 (23-64) años, 68% trabajaban con adolescentes, 66% trabajaban en primera línea. Burnout, ansiedad y depresión moderada/grave ocurrieron en 65%, 72% y 74% de los enfermeros, respectivamente. Falta de protocolo de tratamiento estandarizado en las enfermerías (27% vs. 10%, p=0,049), depresión moderada/grave (74% vs. 16%, p=0,002) y burnout (82% vs. 58%, p=0,01) fueron significativamente mayores en enfermeros pediátricos con ansiedad en comparación con enfermeros sin esta condición. Los enfermeros pediátricos que trabajaban con adolescentes presentaron mayor frecuencia de burnout en comparación con los que no trabajaban con adolescentes (77% vs. 32%, p=0,0001). El análisis multivariado reveló que el adecuado cumplimiento de la cuarentena aumentó 4,6 veces la presencia de ansiedad [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusión: La mayoría de los enfermeros pediátricos trabajaban en la primera línea de la COVID-19, en condiciones precarias, trabajando con un equipo reducido y enfrentando importantes pérdidas de ingresos. La ansiedad actual fue un tema relevante y el burnout también fue una condición mental importante para estos profesionales, reforzando la cultura del buen trabajo en equipo, las prácticas colaborativas y la atención psicológica/psiquiátrica.

https://doi.org/10.1590/1518-8345.5750.3583

13.

Spotlight on latent tuberculosis infection screening for juvenile idiopathic arthritis in two countries, comparing high and low risk patients
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Piotto, Daniela

; Nicacio, Aline

; Neto, Agna

; Mourão, Ana Filipa

; Oliveira-Ramos, Filipa

; Campanilho-Marques, Raquel

; Guedes, Margarida

; Cabral, Marta

; Santos, Maria José

; Fonseca, João Eurico

; Canhão, Helena

; Aikawa, Nádia Emi

; Oliveira, Sheila K. F.

; Ferriani, Virginia P. L.

; Pileggi, Gecilmara C. S.

; Magalhães, Claudia S.

; Silva, Clovis Artur

; Terreri, Maria Teresa

Advances in Rheumatology

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2022, Volume 62 elocation 20

Abstract: En | Text: En | PDF: En

Abstract Background: Rheumatic diseases are associated with an increase in overall risks of tuberculosis (TB). The aim of this study was to evaluate the frequency of TB and the frequency of latent TB infection (LTBI), in clinical practice, for juvenile idiopathic arthritis (JIA) patients from high and low risk of TB incidence endemic countries. Methods: This is an international, multicenter, cross-sectional, observational study of data collection from Brazil and Registry of Portugal at REUMA.PT. The inclusion criteria were patients with Juvenile Idiopathic Arthritis (JIA) with age ≤ 18 years who underwent screening for Mycobacterium tuberculosis infection [tuberculin skin test (TST) and/or interferon gamma release assay (IGRA)]. Chest X-rays and history of exposure to TB were also assessed. Results: 292 JIA patients were included; mean age 14.3 years, mean disease duration 7.5 years, 194 patients (66.4%) performed only TST, 14 (4.8%) only IGRA and 84 (28.8%) both. The frequency of LTBI (10.6%) and TB was similar between the two countries. The reasons for TB screening were different; in Brazil it was performed more often at JIA onset while in Portugal it was performed when starting Disease Modified Anti-Rheumatic Drugs (DMARD) treatment (p < 0.001). Isoniazid therapy was prescribed in 40 (13.7%) patients (31 with LTBI and 9 with epidemiologic risks and/or due to contact with sick people). Only three patients (1%) developed active TB. Conclusion: We found nearly 10% of patients with LTBI, a small percentage of patients with treatment due to epide-miologic risks and only 1% with active TB. Distinct reasons and screening methods for LTBI were observed between the two countries.

https://doi.org/10.1186/s42358-022-00251-6

14.

Costs and financial viability of blueberry production in Pelotas
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Oliveira, Ícaro Pedroso de

; Marques, Léo Omar Duarte

; Belarmino, Luiz Clovis

; Mello-Farias, Paulo

; Canever, Mario Duarte

Revista de Economia e Sociologia Rural

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2022, Volume 60 N. 2 elocation e236746

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Abstract: Blueberry cultivation is a recent economic activity in Brazil. The productive and commercial systems still need improvement, especially to maintain the regularity of quality and productivity and the transparency of costs and prices. There is no study dedicated to analyze the economic viability of blueberry production under Brazilian conditions. Therefore, the objective of this study is to survey the costs and analyze the economic and financial viability of this crop in a farm located in Pelotas, state of Rio Grande do Sul (RS), Brazil. The data collection and analysis followed the procedure adopted by the Policy Analysis Matrix, and the viability indicators were net present value (NPV), internal rate of return (IRR) and payback period. The results showed a production cost of US$ 7,394.61 per hectare or US$ 2,310.88 per ton and financial viability for production, since the NPV for the 10-year period was US$ 26,214.81, the IRR was 26.36%, the net income was US$ 7,180.25 hectare/year-1, and the payback was 4.9 years. Therefore, blueberry production in southern RS is profitable, and the production chain can receive new investments given the technological and market conditions of this study.

Resumo: O cultivo do mirtilo é uma atividade econômica recente no Brasil. O sistema produtivo e comercial ainda precisa de melhorias, principalmente para oferecer regularidade, qualidade produtiva e transparência de custos e preços. Não se tem conhecimento de estudos dedicados a analisar a viabilidade econômica da produção de mirtilo nas condições brasileiras. Portanto, o objetivo deste trabalho é levantar os custos e analisar a viabilidade econômico-financeira desta cultura em uma fazenda localizada em Pelotas (RS). A coleta e análise dos dados seguiram o procedimento adotado pela Matriz de Análise de Política e os indicadores de viabilidade utilizados foram o Valor Presente Líquido (VPL), a Taxa Interna de Retorno (TIR) e o Payback. Os resultados mostraram um custo de produção de US$ 7.394,61 por hectare ou US$ 2.310,88 por tonelada e viabilidade financeira na produção, dado que o VPL para o período de 10 anos foi de US$ 26.214,81, a TIR de 26,36%, a renda líquida foi de US$ 7.180,25 hectare/ano-1 e o Payback foi de 4,9 anos. Desse modo, a produção de mirtilo no sul do RS é lucrativa e a cadeia produtiva pode receber novos investimentos, segundo as condições tecnológicas e mercadológicas indicadas neste estudo.

https://doi.org/10.1590/1806-9479.2021.236746 230 downloads

15.

Soybean tolerance to defoliation at the vegetative and reproductive stages as a function of water restriction
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Leolato, Lucieli Santini

; Sangoi, Luís

; Souza, Clovis Arruda

; Kuneski, Hugo François

; Scherer, Rafael Leandro

; Oliveira, Vander de Liz

; Martins Junior, Marcos Cardoso

; Kandler, Rodrigo

Acta Scientiarum. Agronomy

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2022, Volume 44 elocation e55639

Abstract: En | Text: En | PDF: En

ABSTRACT. Water deficiency reduces leaf expansion and photosynthetic efficiency, potentially reducing the ability to withstand leaf area (LA) loss. This study aimed to evaluate the effects of water restriction on soybean tolerance to defoliation in the vegetative and reproductive periods of development. Two experiments were conducted in a greenhouse located in Lages, Santa Catarina State Brazil, during the 2017/2018 growing season. Cultivar NA 5909 RG was subjected to three WR levels (none, moderate, and severe) and five defoliation levels (0, 17, 33, 50, and 67%). Defoliation occurred at the V6 stage in the first experiment and R3 in the second. WR occurred for 7 days after defoliation. LA at R2 and R5 after defoliation at V6 and R3 decreased by 27.5 and 64.6%, respectively, regardless of WR. LA between V6 and R2 was not influenced by WR or defoliation. Moderate or severe WR reduced plant ability to recover LA between R3 and R5. Severe WR decreased grain production by 22.2% in the vegetative period and 21.2% per plant in the reproductive period compared to that of the control, regardless of defoliation. The highest defoliation level reduced grain production per plant by 24.7 and 24.3% relative to the control at stages V6 and R3, respectively, regardless of WR. WR imposed at the vegetative and reproductive stages did not increase defoliation sensitivity.

https://doi.org/10.4025/actasciagron.v44i1.55639

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