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ABSTRACT Background: Approximately 71 million people are chronically infected with hepatitis C virus (HCV) worldwide. A significant number of these individuals will develop liver cirrhosis and/or hepatocellular carcinoma. Beyond the liver, there is a sizeable body of scientific evidence linking cardiovascular disease and chronic hepatitis C (CHC); however, the biological mechanisms behind the concurrence of these conditions have not been completely clarified yet. Objective: To evaluate associations between hepatic histology, clinical comorbidities and lipid profile in patients with CHC. To investigate associations between liver histology and demographic, nutritional, biochemical and virological parameters. Methods: Eight-five patients with CHC prospectively underwent hepatic biopsy. Liver fragments were obtained from each patient by percutaneous route using a Menghini needle. Fibrosis was evaluated according to the METAVIR scoring system, as follows: F0, no fibrosis; F1, fibrous portal expansion; F2, fibrous portal widening with few septa; F3, bridging fibrosis with architectural distortion; and F4, liver cirrhosis. The activity was classified based on the degree of lymphocyte infiltration and hepatocyte necrosis, from A0 to A3. The diagnosis of liver disease was based on clinical, biochemical, histological, and radiological methods. The data were analyzed by logistic regression models. Results: This cross-sectional study included 85 outpatients followed at the tertiary care ambulatory centre with a mean age of 57.2±10.7 years and 45 (52.9%) were females. There were 10 patients with cirrhosis. Patients with a METAVIR F3-F4 were significantly older (P=0.02) and had higher levels of ALT (P=0.0006), AST (P<0.0001), γ-GT (P=0.03) and bilirubin (P=0.001) and higher prothrombin time than patients with F0-F2 score. Albumin levels (P=0.01) were significantly lower in METAVIR F3-F4. Age (OR=1.09; 95%CI=1.02-1.16; P=0.02), steatosis (OR=4.03; 95%CI=1.05-15.45; P=0.04) and high-density lipoprotein cholesterol (HDL-C) <60 mg/dL (OR=7.67; 95%CI=1.71-34.49; P=0.008) were independently associated with fibrosis. Hypertension (OR=6.36; 95%CI=1.31-30.85; P=0.02) and HDL-C <60 mg/dL (OR=9.85; 95%CI=2.35-41.39; P=0.002) were independently associated with necroinflammatory activity. Hypertension (OR=6.94; 95%CI=1.92-25.05; P=0.003) and HDL-C <60 mg/dL (OR=3.94; 95%CI=1.27-12.3; P=0.02) were associated with interface inflammatory activity. Triglycerides (TG ≥150 mg/dL) remained associated with lobular inflammatory activity. Conclusion: cholesterol levels <60 mg/dL were independently associated with necroinflammatory activity in chronic hepatitis C. Patients with hypertension are at an increased risk of developing necroinflammatory activity.

RESUMO Contexto: Aproximadamente 71 milhões de pessoas estão infectadas pelo vírus da hepatite C em todo o mundo. Um número significativo desses indivíduos desenvolverá cirrose hepática e/ou carcinoma hepatocelular. Além do fígado, há evidências científicas que associam doenças cardiovasculares e hepatite C crônica; no entanto, os mecanismos biológicos implicados na ocorrência dessas condições ainda não foram completamente esclarecidos. Objetivo: Avaliar a associação entre histologia hepática, comorbidades clínicas e perfil lipídico em pacientes com hepatite C crônica. Investigar associações entre histologia hepática e parâmetros demográficos, nutricionais, bioquímicos e virológicos. Métodos: Oitenta e cinco pacientes com hepatite C crônica foram prospectivamente submetidos à biópsia hepática. Biópsias hepáticas foram obtidas de cada paciente por via percutânea com agulha de Menghini. A fibrose foi avaliada de acordo com o sistema de pontuação METAVIR, como segue: F0, sem fibrose; F1, expansão portal fibrosa; F2, alargamento portal fibroso com poucos septos; F3, fibrose em ponte com distorção arquitetônica; e F4, cirrose hepática. A atividade foi classificada com base no grau de infiltração de linfócitos e necrose de hepatócitos, de A0 a A3. O diagnóstico da doença hepática foi baseado em métodos clínicos, bioquímicos, histológicos e radiológicos. Os dados foram analisados por modelos de regressão logística. Resultados: Neste estudo transversal, realizado em um ambulatório do hospital universitário, foram incluídos 85 pacientes que tinham média de idade de 57,2±10,7 anos, sendo 45 (52,9%) do sexo feminino. Havia 10 pacientes com cirrose. Os pacientes com METAVIR F3-F4 eram significativamente mais velhos (P=0,02) e tinham níveis mais elevados de ALT (P=0,0006), AST (P<0,0001), γ-GT (P=0,03) e bilirrubina (P=0,001) e, maior tempo de protrombina do que pacientes com escore F0-F2. Os níveis de albumina (P=0,01) foram significativamente mais baixos naqueles classificados como METAVIR F3-F4. Idade (OR=1,09; IC95%=1,02-1,16; P=0,02), esteatose (OR=4,03; IC95%=1,05-15,45; P=0,04) e HDL-C <60 mg/dL (OR=7,67; 95%IC=1,71-34,49; P=0,008) foram independentemente associados à fibrose. Hipertensão (OR=6,36; IC95%=1,31-30,85; P=0,02) e HDL-C <60 mg/dL (OR=9,85; IC95%=2,35-41,39; P=0,002) foram independentemente associados à atividade necroinflamatória. Hipertensão (OR=6,94; IC 95%=1,92-25,05; P=0,003) e HDL-C <60 mg/dL (OR=3,94; IC95%=1,27-12,3; P=0,02) foram associados à atividade inflamatória de interface. Os triglicerídeos (TG >150 mg/dL) permaneceram associados à atividade inflamatória lobular. Conclusão: Níveis de coleterol HDL <60 mg/dL foram independentemente associados à atividade necroinflamatória na hepatite C crônica. Pacientes com hipertensão têm risco aumentado de desenvolver atividade necroinflamatória.

https://doi.org/10.1590/s0004-2803.230302023-03

Effects of Calendula officinalis extract on liver histopathology, lipid profile, and oxidative stress in rats submitted to a diet rich in cholesterol and carbohydrates
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Fontes, Gleide Gatti

; Freitas, Rodrigo de Barros

; Almeida, Palloma Porto

; Lima, Luciana Moreira

; Cardoso, Silvia Almeida

; Pizziolo, Virginia Ramos

; Tabach, Ricardo

; Wanderley, Almir Gonçalves

; Arida, Ricardo Mario

; Caricati-Neto, Afonso

; Taha, Murched Omar

; Carvalho, Camilo Amaro de

; Tallo, Fernando Sabia

; Menezes-Rodrigues, Francisco Sandro

Acta Cirúrgica Brasileira

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2023, Volume 38 elocation e383723

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: To evaluate the modulatory properties of Calendula officinalis L. (Asteraceae) (C. officinalis) extract on cafeteria diet-fed rats. Methods: A cafeteria diet was administered ad libitum for 45 days to induce dyslipidemia. Then, the rats were treated with the formulations containing C. officinalis in the doses of 50, 100, and 150 mg/kg or only with the vehicle formulation; the control group received a commercial ration. Results: The cafeteria diet decreased glutathione S-transferase activity and high-density lipoprotein plasmatic levels and damaged the hepatic architecture. The C. officinalis extract was able to reduce lipid infiltration in liver tissue and to modulate oxidative stress and lipid profile markers. Conclusions: The correlations between the variables suggest a pathological connection between oxidative stress markers and serum lipid profile.

https://doi.org/10.1590/acb383723

Toxicity of Agave sisalana extracts on Cordyceps and their effect and the association with fungi on Nasutitermes corniger (Isoptera: Termitidae)
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Da Silva Lopes, Rosineide

; Barroso Martins, Mônica Cristina

; De Lima, Geiziquele

; Gonçalves De Oliveira, Luciana

; Félix Da Costa, Antonio

; Felipe Dos Santos, Venézio

; Dos Santos Correia, Maria Tereza

; Da Silva, Nicácio Henrique

; Correia De Albuquerque, Auristela

; De Luna Alves Lima, Elza Áurea

; De Menezes Lima, Vera Lúcia

Revista Colombiana de Entomología

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Dez 2022, Volume 48 Nº 2 elocation e11537

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

Resumen Nasutitermes corniger es una termita arbórea que causa daños económicos en las zonas urbanas, y su control es mediante insecticidas químicos. Una alternativa para el control de insectos es el uso de hongos entomopatógenos y extractos de plantas, o el efecto sinérgico de la asociación de estos. Se examinó la toxicidad de los extractos acuosos e hidroetanólicos de Agave sisalana sobre los aspectos biológicos de los hongos Cordyceps farinosa, C. fumosorosea y C. javanica y la acción de los extractos y su efecto sinérgico sobre N. corniger. Se evaluó el efecto de los extractos sobre hongos por germinación, esporulación y crecimiento micelial de los hongos en medio Sabouraud mediante el estudio de aspectos biológicos bajo condiciones de laboratorio y se examinó el control de N. corniger, por ingestión de extractos y de la asociación extracto y hongo sobre papel de filtro, siendo el porcentaje de mortalidad de soldados y obreras de la termita diaria. En general, los extractos resultaron inofensivos para los hongos a concentraciones de 10, 25, 50, 100 y 200 mg.mL-1. Los extractos demostraron acciones termiticidas a las concentraciones ensayadas, provocando la mortalidad de alrededor del 100% de los trabajadores después del tercer y sexto día (LC50: 0.778 a 0.803 mg.mL-1) y del 100% de los soldados entre el cuarto y séptimo días (LC50: 0.146 a 0.956 mg.mL-1). La asociación de los extractos con C. farinosa ESALQ1355 fue más eficiente para inducir la mortalidad en N. corniger. Estos resultados demostraron la eficiencia in vitro de los extractos de sisal en el control de las termitas de N. corniger, solas o en combinación con hongos, lo que sugiere su potencial utilidad conjunta en el control biológico de plagas de insectos.

Abstract Nasutitermes corniger is an arboreal termite that causes economic damage in urban areas, and its control is for chemical insecticides. An alternative for insect control is the use of entomopathogenic fungi and plant extracts, or the synergistic effect of the association of these. The toxicity of aqueous and hydroethanolic extracts of Agave sisalana on the biological aspects of the fungal Cordyceps farinosa, C. fumosorosea and C. javanica and the action of the extracts and their synergistic effect on N. corniger was examined. The effect of the extracts on fungi was evaluated by germination, sporulation and mycelial growth of fungi in Sabouraud medium through the study of biological aspects under laboratory conditions; and control of N. corniger were examined, by ingestion of extracts and of the association extract plus fungus on filter paper, being the percentage of mortality of soldiers and workers of the termite daily. In general, the extracts were inoffensive to the fungi at concentrations 10, 25, 50, 100 and 200 mg.mL-1. The extracts demonstrated termiticidal actions at concentrations tested, causing the mortalities about 100% of the workers after the third and sixth days (LC50: 0.778 to 0.803 mg.mL-1) and 100% of the soldiers between the fourth and seventh days (LC50:0.146 to 0.956 mg.mL-1). The association of the extracts with C. farinosa ESALQ1355 was more efficient in inducing the mortality in N. corniger. These results demonstrated the efficiency in vitro of the sisal extracts in controlling N. corniger termites, alone or in combination with fungi, suggesting their potential joint usefulness in the biological control of insect pests.

https://doi.org/10.25100/socolen.v48i2.11537

[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

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Data de publicação: 2022-10-11

Resumo: En Pt

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;

https://doi.org/10.1590/SciELOPreprints.4820

Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence?
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Silva, Letícia S. C. da

; Finamor, Luciana P. S.

; Andrade, Gabriel C.

; Lima, Luiz H.

; Zett, Claudio

; Muccioli, Cristina

; Sarraf, Eduardo P.

; Marinho, Paula M.

; Peruchi, Julia

; Oliveira, Raiza D. de L.

; Giralt, Lena

; Charcan, Ivonne

; Fonollosa, Alex

; Diaz, Jose D.

; Davis, Janet L.

; Nascimento, Heloisa

; Belfort Jr, Rubens

Arquivos Brasileiros de Oftalmologia

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Abr 2022, Volume 85 Nº 2 Páginas 158 - 165

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

RESUMO Objetivos: o principal objetivo deste estudo foi descrever pacientes com achados vasculares retinianos temporalmente relacionados à vacinação contra COVID-19. Com maior notificação de possíveis eventos adversos similares, esperamos compreender a real dimensão e relevância do que foi apresentado. Métodos: Onze pacientes com queixas visuais após vacinação contra COVID-19 foram estudados. Os dados analisados foram: idade, gênero, tipo de vacinação, tempo de aparecimento de sintomas, achados sistêmicos, antecedentes pessoais, acuidade visual com melhor correção, biomicroscopia e imagem retiniana multimodal (retinografia colorida, red-free, SD-OCT, OCTA e angiofluoresceinografia). Os critérios de inclusão foram a presença de alterações oftalmológicas ocorridas dentro de 30 dias após a primeira ou segunda dose de qualquer vacina contra COVID-19. Resultados: Onze pacientes foram incluídos: 5 com oclusão arterial (45,4%), 4 com oclusão venosa (36,4%) e 2 (18,2%) com alterações não específicas vasculares sugestivas de isquemia retiniana como exsudatos algodonosos. A idade média dos pacientes foi de 57 anos (DP=16; com intervalo de 27 a 84 anos). A média de tempo de aparecimento de sintomas após a vacinação foi de 10 dias (DP=5,4; com intervalo de 3 a 16 dias). Nove dos onze pacientes eram do sexo feminino (81,8%). Fatores de risco sistêmicos foram observados em 36,4% dos pacientes. Dois pacientes tiveram sintomas neurológicos e visuais, com oclusão arterial. 36,4% dos pacientes tiveram infecção prévia por COVID-19 no último ano. Sete pacientes (63,6%) receberam a vacina ChAdOx1 nCoV-19 (AZD1222). Conclusões: nossos dados sugerem que eventos retinianos temporalmente relacionados à vacinação contra COVID-19 são possíveis, porém raros. A relação entre estes eventos pós-vacinais exigem futura atenção antes de maiores conclusões.

ABSTRACT Purpose: The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented. Methods: Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine. Results: Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine. Conclusions: Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.

https://doi.org/10.5935/0004-2749.20220071

Two years of the COVID-19 pandemic: an anesthesiology perspective
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Schmidt, André P.

; Módolo, Norma S.P.

; de Amorim, Célio G.

; Simões, Cláudia M.

; Kraychete, Durval C.

; Joaquim, Eduardo H.G.

; Lineburger, Eric B.

; Papa, Fábio V.

; Fernandes, Fátima C.

; Mendes, Florentino F.

; Guimarães, Gabriel M.N.

; Barros, Guilherme A.M.

; Silva-Jr, João M.

; Lima, Laís H. Navarro e

; Azi, Liana M.T.A.

; Carvalho, Lorena I.M.

; Stefani, Luciana C.

; Garcia, Luis V.

; Carmona, Maria José C.

; Salgado Filho, Marcello F.

; Nascimento Junior, Paulo do

; Alves, Rodrigo L.

; Carvalho, Vanessa H.

; Quintão, Vinicius C.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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Abr 2022, Volume 72 Nº 2 Páginas 165 - 168

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.02.004

Samanea tubulosa Benth. (Fabaceae): Antinociceptive effect on acute pain in mice: K+ATP channel and opioid activity
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ALIXANDRE, TAMNATA F.

; SOUSA, RENATO P.

; GOMES, BRUNO S.

; SILVA, ARÊTHA H.S.

; SOUSA NETO, BENEDITO P.

; SOUSA, ELCILENE A.

; LIMA, MARLUCE P.D.

; LOPES, EVERTON M.

; PIAUILINO, CELYANE A.

; NASCIMENTO, REJANE T.

; REIS FILHO, ANTÔNIO C.

; ALMEIDA, FERNANDA R.C.

; OLIVEIRA, FRANCISCO A.

; CHAVES, MARIANA H.

; COSTA, LUCIANA M.

; ALVES, MICHEL M. MORAES

; COSTA, AMILTON P.R.

Anais da Academia Brasileira de Ciências

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2022, Volume 94 Nº 2 elocation e20210715

Resumo: En | Texto: En | PDF: En

Abstract Samanea tubulosa Benth. it has been widely used in traditional medicine to treat inflammatory processes. The present study aimed to investigate the antinociceptive effect and mechanism of action of the fractions obtained from the Samanea tubulosa pods in mice. The antinociceptive activity was evaluated in formalin, capsaicin and glutamate tests and the. The possible mechanisms of action involved in the antinociceptive effect of the hexane and ethyl acetate fraction in the opioid system, also the the K + ATP channels and the L-arigine pathways of nitric oxide were evaluated. The chemical characterization analysis revealed in the hexane fraction the presence of triterpenes such as lupenone and lupeol. In the glutamate test, the hexane and ethyl acetate fractions showed antinociceptive activity at the dose of 12.5 and 25 mg kg-1. The antinociception produced by the hexane and ethyl acetate fractions was significantly reversed by naloxone, indicating that the fractions act through the opioid pathway. Antinociceptive response of the ethyl acetate fraction was blocked by glibenclamide, indicating that this fraction acts via the K + ATP channels activation. It is concluded that the fractions under study exert antinociceptive activity possibly related to the opioid route and through K+ ATP channels activation.

https://doi.org/10.1590/0001-3765202220210175

Synthesis, in silico Study and Antileishmanial Evaluation of New Selenides Derived from 7-Chloro-quinoline and N-Phenylacetamides
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Huang, Min-Fu N.

; Luis, José A. S.

; Silva, Alison P. da

; Rocha, Juliana C.

; Lima, Tatjana K. S.

; Scotti, Marcus T.

; Scotti, Luciana

; Oliveira, Rafael F. de

; Souza, Helivaldo D. S.

; Athayde-Filho, Petrônio F. de

; Barbosa-Filho, José M.

Journal of the Brazilian Chemical Society

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Abr 2021, Volume 32 Nº 4 Páginas 712 - 721

Resumo: En | Texto: En | PDF: En

This study describes a virtual screening performed for two series of selenides (28 compounds), derived from N-phenylacetamides chlorides and 7-chloro-quinoline, to determine their potential for leishmanicidal activity against Leishmania amazonensis and Leishmania donovani. Seven compounds were predicted as potential leishmanicides; therefore, they were synthesized from elemental selenium, as a precursor for the production of NaHSe, and subsequent reactions with 4,7-dichloro-quinoline and N-phenylacetamides chlorides were performed. The compounds were characterized by infrared (IR), 1H and 13C nuclear magnetic resonance (NMR), and sent for in vitro cytotoxicity tests against L. amazonensis and were found to be active and selective, and two compounds presented half-maximal inhibitory concentrations (IC50) of 5.67 and 10.81 µg mL-1. They also presented good interaction energies in the docking study, suggesting that may exert their effects by inhibiting the N-myristoyltransferase and O-acetylserine sulfhydrylase enzymes in parasites.

https://doi.org/10.21577/0103-5053.20200223 183 downloads

Intraoperative clonidine to prevent postoperative emergence delirium following sevoflurane anesthesia in pediatric patients: a randomized clinical trial
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Sousa-Júnior, Fernando A.

; Souza, Alex S.R.

; Lima, Luciana C.

; Santos, Ítalo G.M.

; Menezes, Leonardo A.P.

; Ratis, Pedro A.P.L.

; Couceiro, Tania C.M.

Brazilian Journal of Anesthesiology

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Fev 2021, Volume 71 Nº 1 Páginas 5 - 10

Resumo: En | Texto: En | PDF: En

Abstract Introduction and objective Emergence Delirium (ED), particularly in children, is characterized by mental confusion, irritability, disorientation, and inconsolable crying. ED prolongs the time required in the Post-Anesthesia Care Unit (PACU) and increases concern and anxiety in parents. The present study aimed to determine the effectiveness and safety of low-dose clonidine in preventing ED in children receiving sevoflurane anesthesia for tonsillectomy/adenotonsillectomy. Methods A randomized, double-blind clinical trial was conducted between November 2013 and January 2014. Sixty-two children aged 2-12 years, scheduled to undergo tonsillectomy/adenotonsillectomy, and classified as American Society of Anesthesiologists (ASA) physical status I/II were included, with 29 being randomized to receive 1 µg.kg-1 clonidine intravenously, and 33 allocated to a control group that received no clonidine. Anesthesia was induced and maintained with sevoflurane. Children with altered state of consciousness, neurological deficit, history of allergy to dipyrone, or receiving other drugs such as preanesthetic agents were excluded from the study. The primary outcome was the presence of ED in the initial 20 minutes in the PACU according to the Pediatric Anesthesia Emergence Delirium (PAED) scale. The Chi-Square test and Fisher’s two-tailed exact test were used for statistical analysis, as applicable. Significance level was set at 5%, and Risk Ratios (RR) and their 95% Confidence Intervals (95% CI) were calculated. Results The frequency of ED was significantly decreased in the group of children who received clonidine (17.2% vs. 57.6%; RR = 0.30; 95% CI 0.13-0.70; p= 0.001). There was no difference between groups with respect to the frequency of postoperative self-harm (falls and bruises), dislodged catheters, and for most of the other adverse events evaluated. Conclusions The use of 1 µg.kg-1 intravenous clonidine during anesthesia induction can effectively reduce the incidence of ED in children undergoing elective tonsillectomy/adenotonsillectomy under general inhalation anesthesia with sevoflurane. ClinicalTrials.gov Identifier NCT02181543.

https://doi.org/10.1016/j.bjane.2020.12.003 100 downloads

10.

Percepção olfativa e gustativa na doença de Parkinson
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Almeida, Wigna Rayssa Pereira Lima

; Gomes, Adriana de Oliveira C.

; Belo, Luciana Rodrigues

; Leal, Leila Bastos

; Coriolano, Maria das Graças Wanderley de Sales

CoDAS

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2021, Volume 33 Nº 5 elocation e20200038

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

RESUMO Objetivo Analisar a percepção e discriminação olfativa e gustativa e a autopercepção do olfato e paladar em pessoas com Doença de Parkinson, comparando-as com indivíduos hígidos. Método Estudo observacional, analítico, transversal e quantitativo. Verificou-se a percepção e a discriminação olfativa e gustativa em indivíduos com Doença de Parkinson, comparados a um grupo controle, pareado por sexo e idade, por meio dos Testes de Percepção Olfativa e de Tiras Gustativas, respectivamente, após limpeza nasal e escovação oral. A autopercepção foi avaliada pela Escala Visual Analógica antes e após os testes específicos de percepção e discriminação. Resultados Foram incluídos indivíduos de ambos os sexos, sendo 35 com Doença de Parkinson e 20 designados ao grupo controle, pareados pela média de idade. A autopercepção olfativa do grupo com Doença de Parkinson melhorou após o teste olfativo. Não houve diferença na autopercepção gustativa no grupo Doença de Parkinson antes e após o teste gustativo. No teste de avaliação da percepção olfativa, o grupo Doença de Parkinson discriminou menos essências que o grupo controle. Ambos os grupos apresentaram semelhante percepção e discriminação gustativa. Conclusão A percepção olfativa das pessoas com Doença de Parkinson foi menor, comparativamente ao grupo de indivíduos hígidos e a autopercepção da eficácia olfativa melhorou após o teste, em ambos os grupos. Quanto ao paladar, não houve diferença na percepção e discriminação entre os grupos, o sabor azedo foi o mais identificado e houve melhora na autopercepção da eficácia gustativa somente no grupo sem a doença de Parkinson, após o teste.

ABSTRACT Purpose To analyze the olfactory and gustatory perception and discrimination and self-perception of smell and taste in people with Parkinson's disease, comparing them with healthy nodes. Methods Observational, analytical, cross-sectional, and quantitative study. Olfactory and gustatory perception and discrimination were verified following Parkinson's disease, compared to a control group, matched by sex and age, using the Olfactory Perception and Taste Strips Tests, respectively, after nasal cleaning and oral brushing. Self-perception was assessed by the Visual Analogue Scale before and after specific tests of perception and discrimination. Results We included individuals of both sexes, 35 with Parkinson's Disease and 20 assigned to the control group, matched for mean age. The olfactory self-perception of the group with Parkinson's disease improved after the olfactory test. There was no difference in taste self-perception in the Parkinson's disease group before and after the taste test. In the olfactory perception assessment test, the Parkinson's disease group discriminated fewer essences than the control group. Both groups have similar generation and taste discrimination. Conclusion The olfactory perception of people with Parkinson's disease was lower, compared to the group of healthy desires, and the self-perception of olfactory efficacy improved after the test, in both groups. As for taste, there was no difference in perception and discrimination between groups, the sour taste was the most identified and there was an improvement in self-perception of taste efficiency in the group without Parkinson's disease after the test.

https://doi.org/10.1590/2317-1782/20202020038 180 downloads

11.

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Resumo: En | Texto: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

12.

Nonalcoholic fatty liver disease in women with polycystic ovary syndrome: associated factors and noninvasive fibrosis staging in a single Brazilian center
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Taranto, Daniela Oliveira de Lima

; Guimarães, Thais Cristine Moura

; Couto, Claudia A.

; Cândido, Ana Lúcia

; Azevedo, Rosana Correa Silva

; Mattos, Fernanda Souza

; Elias, Maria Luiza Cândido

; Reis, Fernando M.

; Rocha, Ana Luiza L.

; Faria, Luciana C.

Archives of Endocrinology and Metabolism

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Jun 2020, Volume 64 Nº 3 Páginas 235 - 242

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective Polycystic ovary syndrome (PCOS) is a recognized risk factor for nonalcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence and factors associated with NAFLD in women with PCOS and evaluate noninvasive indices of hepatic fibrosis in patients with PCOS and NAFLD. Subjects and methods Patients with PCOS (n = 87) and women without PCOS (n = 40; controls) were included. NAFLD was diagnosed by abdominal ultrasonography after exclusion of alcohol consumption and viral or autoimmune liver disease. Anthropometric, clinical and metabolic variables, homeostasis model assessment of insulin resistance (HOMA-IR) index, lipid accumulation product (LAP), FIB-4 index, NAFLD score, and transient elastography (TE; FibroScan) were obtained in subsets of patients with PCOS and NAFLD. Results A total of 87 patients with PCOS were included (mean age: 34.4 ± 5.7 years, mean body mass index [BMI]: 34.7 ± 4.7 kg/m 2 ). NAFLD was present in 67 (77.0%) patients with PCOS versus 21 of 40 (52.5%) controls (p = 0.005). Women with PCOS and liver steatosis, compared with their NAFLD-free counterparts, had higher values of BMI, waist circumference, triglycerides, total cholesterol, alanine and aspartate aminotransferases, and γ-glutamyltransferase, along with higher frequencies of obesity, metabolic syndrome, and insulin resistance. NAFLD was independently associated with waist circumference, serum triglycerides, and alanine aminotransferase levels. The FIB-4 index was not compatible with advanced fibrosis in any of the evaluated patients, while NAFLD score and TE were compatible with advanced liver fibrosis in 1 of 26 (3.8%) and 3 of 25 (12%) patients, respectively. Conclusion Women with PCOS had a high risk of NAFLD, and a combination of both was associated with central obesity, dyslipidemia, insulin resistance, and metabolic syndrome. Noninvasive methods suggested low rates of severe hepatic fibrosis in Brazilian women with PCOS. Arch Endocrinol Metab. 2020;64(3):235-42

https://doi.org/10.20945/2359-3997000000242 1042 downloads

13.

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

Clinics

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2020, Volume 75 elocation e2294

Resumo: En | Texto: En | PDF: En

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 1957 downloads

14.

Neuroscience: unveiling the brain of Saimiri collinsi (Squirrel Monkey)
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BRANCO, ÉRIKA

; SENA, CAROLINE S.P. DE

; PANTOJA, LUCIANA F.

; SOARES, PAOLA C.

; LIMA, ANA RITA DE.

Anais da Academia Brasileira de Ciências

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Dez 2018, Volume 90 Nº 4 Páginas 3597 - 3606

Resumo: En | Texto: En | PDF: En

Abstract Behavioral intelligence among non-human primates is a somewhat puzzling area to study, since it is closely linked to the morphology of the central nervous system. However, this morphology is still unknown to science in the case of Saimiri collinsi. As a means of assisting future studies on the social behavior of this species, we analyzed the brains of six adult females from the National Primate Center / Pará, which were sent to the Animal Morphological Research Laboratory at the Federal Rural University of Amazônia after death by natural causes. The animals were fixed in formaldehyde solution (10%) and dissected. The brains were covered externally by the dura mater, with long cerebral hemispheres, although there was a complete absence of gyri. The internal structures which form a part of the telencephalon, diencephalon, midbrain, hindbrain and myelencephalon were identified, with the exception of the mammillary bodies. This condition, when linked to the lissencephaly found in these individuals raises questions about the real learning abilities of this species.

https://doi.org/10.1590/0001-3765201820180328 1295 downloads

15.

IV Brazilian Consensus on Rhinitis - an update on allergic rhinitis,
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Sakano, Eulalia

; Sarinho, Emanuel S.C.

; Cruz, Alvaro A.

; Pastorino, Antonio C.

; Tamashiro, Edwin

; Kuschnir, Fábio

; Castro, Fábio F.M.

; Romano, Fabrizio R.

; Wandalsen, Gustavo F.

; Chong-Neto, Herberto J.

; Mello Jr., João F. de

; Silva, Luciana R.

; Rizzo, Maria Cândida

; Miyake, Mônica A.M.

; Rosário Filho, Nelson A.

; Rubini, Norma de Paula M.

; Mion, Olavo

; Camargos, Paulo A.

; Roithmann, Renato

; Godinho, Ricardo N.

; Pignatari, Shirley Shizue N.

; Sih, Tania

; Anselmo-Lima, Wilma T.

; Solé, Dirceu

Brazilian Journal of Otorhinolaryngology

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Jan 2018, Volume 84 Nº 1 Páginas 3 - 14

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

Resumo Introdução As diretrizes sobre rinite alergica visam atualizar os conhecimentos sobre a doença e os cuidados para com esses pacientes. A iniciativa designada "Rinite Alergica e seu Impacto na Asma", cujo relatorio inicial foi publicado em 2001 e atualizada em 2008 e 2010, tem sido muito bem sucedida na disseminaçao de informaçoes e evidencias, bem como na formulaçao da classificaçao de gravidade e proposta de sistematizaçao do tratamento. Entretanto, visando a participaçao de outros profissionais medicos no atendimento da rinite alergica, e importante o desenvolvimento de algoritmos que indiquem com precisao o que deve e pode ser feito regionalmente. Objetivo Atualizar o III Consenso Brasileiro sobre Rinites-2012, com elaboraçao de algoritmo para conduta da rinite alergica. Método Foram convidados 24 especialistas indicados pelas Associaçao Brasileira de Alergia e Imunologia, Associaçao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial e Sociedade Brasileira de Pediatria para atualizaçao do documento de 2012. Resultados A atualizaçao do ultimo Consenso Brasileiro sobre Rinites, incorporou e adaptou para a realidade brasileira as informaçoes relevantes publicadas em todos os documentos da Iniciativa "Rinite Alergica e seu Impacto na Asma", trazendo novos conceitos como a rinite alergica local, novos medicamentos e metodos de avaliaçao de tratamento. Conclusão Proposto um fluxograma de tratamento para a rinite alergica.

Abstract Introduction The guidelines on allergic rhinitis aim to update knowledge about the disease and care for affected patients. The initiative called "Allergic Rhinitis and its Impact on Asthma", initially published in 2001 and updated in 2008 and 2010, has been very successful in disseminating information and evidence, as well as providing a classification of severity and proposing a systemized treatment protocol. In order to include the participation of other medical professionals in the treatment of allergic rhinitis, it is important to develop algorithms that accurately indicate what should and can be done regionally. Objective To update the III Brazilian Consensus on Rhinitis - 2012, with the creation of an algorithm for allergic rhinitis management. Methods We invited 24 experts nominated by the Brazilian Association of Allergy and Immunology, Brazilian Association of Otorhinolaryngology and Head and Neck Surgery and Brazilian Society of Pediatrics to update the 2012 document. Results The update of the last Brazilian Consensus on Rhinitis incorporated and adapted the relevant information published in all "Allergic Rhinitis and its Impact on Asthma" Initiative documents to the Brazilian scenario, bringing new concepts such as local allergic rhinitis, new drugs and treatment evaluation methods. Conclusion A flowchart for allergic rhinitis treatment has been proposed.

https://doi.org/10.1016/j.bjorl.2017.10.006 26131 downloads

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Veja abaixo a lista completa de índices de pesquisa que podem ser usados:

Cód. do Índice	Elemento
ti	título do artigo
au	autor
kw	palavras-chave do artigo
subject	assunto (palavras do título, resumo e palavras-chave)
ab	resumo
ta	título abreviado da revista (ex. Cad. Saúde Pública)
journal_title	título completo da revista (ex. Cadernos de Saúde Pública)
la	código do idioma da publicação (ex. pt - Português, es - Espanhol)
type	tipo do documento
pid	identificador da publicação
publication_year	ano de publicação do artigo
sponsor	financiador
aff_country	código do país de afiliação do autor
aff_institution	instituição de afiliação do autor
volume	volume do artigo
issue	número do artigo
elocation	elocation
doi	número DOI
issn	ISSN da revista
in	código da coleção SciELO (ex. scl - Brasil, col - Colômbia)
use_license	código da licença de uso do artigo

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