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Trombocitemia essencial incipiente: caso clínico
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Costa-Freitas, Tiago

; Tavares, Pedro Filipe

; Silva, Leonor Ferreira da

; Braga, Madalena

; Pereira, Nuno Mendanha

; Malheiro, Felicidade

; Fernandes, Gustavo

; Magalhães, Miguel

Revista Portuguesa de Medicina Geral e Familiar

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feb 2024, Volume 40 N. 1 Pages 83 - 87

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

Resumo Introdução: A trombocitemia essencial (TE) é uma condição pouco comum e assintomática na maioria dos casos. No entanto, podem surgir sintomas como cefaleias, síncope, vertigem, dor torácica, eritromelalgia e distúrbios visuais transitórios. Os eventos hemorrágicos e tromboembólicos são os grandes riscos desta patologia. O objetivo da partilha deste caso clínico é alertar para uma patologia rara que pode passar despercebida e causar eventos potencialmente graves. Descrição do caso: Sexo feminino, 43 anos, raça caucasiana, antecedentes de hepatite B crónica, sem antecedentes cirúrgicos nem medicação habitual, incluindo método contracetivo hormonal. Recorreu a consulta com queixas de enfartamento precoce, dispepsia e epigastralgia com três dias de evolução, negando alterações do trânsito intestinal, características das fezes, náuseas ou vómitos. Exame físico e endoscopia digestiva alta recente sem alterações de relevo. Foi consultado o estudo analítico que a utente realizava regularmente no hospital, verificando-se que o valor do número de plaquetas se encontrava consistentemente a rondar os 500.000/uL desde há três anos. Pediu-se ecografia abdominal que descrevia trombose parcial da veia porta e do seu ramo esquerdo. A doente foi medicada com enoxaparina 60 mg 12h/12 h. Foi realizado angio-TC abdominal, estudo pró-trombótico e estudo genético e iniciou varfarina 5 mg 1x/dia, inicialmente sobreposta com enoxaparina 60 mg 12/12h. O angio-TC viria a confirmar a trombose da veia porta e confirmou-se positiva a mutação JAK2 V617F. Assumido o diagnóstico de TE e iniciado tratamento citorredutor com hidroxiureia 500 mg em dias alternados. Comentário: Este caso chama a atenção pelo excesso de plaquetas secundário à TE, ainda que ligeiramente acima do valor de referência, ter originado uma trombose da veia porta. Pretende-se alertar os médicos de família para a importância de realizar um estudo atento, valorizando pequenas variações sustentadas fora dos intervalos da normalidade e fazer uma referenciação correta e atempada quando necessário.

Abstract Introduction: Essential thrombocythemia (ET) is an asymptomatic rare condition in most cases. Nonetheless, symptoms like headache, syncope, vertigo, thoracic pain, erythromelalgia, and transient visual disturbances may surge. The major concerns of this pathology are hemorrhagic and thromboembolic events. The aim of sharing this case report is to alert for the existence of this rare pathology that can go unnoticed and cause potentially serious events. Case description: Female, 43-year-old, Caucasian. Background of chronic B hepatitis, without surgical background nor usual medication, including the contraceptive pill. She appealed to a medical appointment with an early feeling of fullness when eating, dyspepsia, and epigastric pain in the last three days. She denied changes in intestinal habits, feces characteristics, nausea, or vomiting. Physical examination and recent upper endoscopic study were normal. The hospital medical record was examined, verifying that platelet levels were consistently rounding 500,000/uL for the past three years. An abdominal ultrasonography was requested, and it described a partial portal vein and left branch thrombosis. The patient started enoxaparin 60 mg every 12 hours. It was conducted an abdominal angiotomography, prothrombotic, and genetic study, including the JAK2 V617F mutation. The patient started warfarin 5 mg one time daily, initially overlaid with enoxaparin 60 mg 12h/12h. The abdominal angiotomography would confirm the portal vein thrombosis and the JAK2 V617F mutation study was positive. It was assumed the diagnosis of ET and was initiated cytoreductive therapy with hydroxyurea 500 mg on alternated days. Comment: This case report shows that the excessive platelet count, secondary to ET, even if slightly above the reference value, caused a portal vein thrombosis. We aim to alert family physicians to the importance of doing a careful study, valuing little sustained variations out of the normal intervals, and referring correctly and promptly when necessary.

https://doi.org/10.32385/rpmgf.v40i1.13605

Reed's Syndrome: A Rare Systemic Genodermatosis
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Braga, Madalena

; Silva, Leonor Ferreira da

; Pereira, Nuno Mendanha

; Fernandes, Gustavo

; Magalhães, Miguel

Gazeta Médica

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sep 2023, Volume 10 N. 3 Pages 225 - 228

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

Abstract Reed's syndrome is an autosomal dominant rare genodermatosis, characterized by the presence of multiple cutaneous and uterine leiomyomatosis. This syndrome can be associated with renal cell carcinoma and leiomyosarcoma. A 55-year-old woman presented to routine consultation. Physical examination was notorious for the presence of multiple asymmetrical, irregular, skin-colored, with a smooth surface papules and nodules on her chest and left arm. They had been present for about two decades. The patient's past medical history was significant for myomectomy and hysterectomy. A cutaneous papule’s biopsy revealed a leiomyoma. Clinical and histological findings combined with surgical history suggested Reed's syndrome, which was later confirmed by genetic tests. Her family was referred for genetic counseling. Systematic review of skin lesions is essential, as they can be the diagnostic clue for systemic diseases.

Resumo A síndrome de Reed é uma genodermatose rara, autossómica dominante, caracterizada pela presença de múltiplos leiomiomas cutâneos e uterinos, podendo estar associada a carcinoma de células renais e leiomiossarcoma. Uma mulher de 55 anos foi observada em consulta de rotina. À observação, apresentava múltiplas pápulas e nódulos no tórax e braço esquerdo, assimétricos, irregulares, cor de pele e de superfície lisa, que referia estarem presentes há cerca de duas décadas. A doente tinha antecedentes de miomectomia e histerectomia. A biópsia de uma pápula torácica revelou um leiomioma. De acordo com os achados clínicos e histológicos e antecedentes cirúrgicos, foi colocada a hipótese diagnóstica de síndrome de Reed, confirmada posteriormente por teste genético. A família da utente foi também referenciada para aconselhamento genético. O exame sistemático de lesões cutâneas é de grande relevância, pois estas podem ser elementos clínicos orientadores do diagnóstico de doenças sistémicas.

https://doi.org/10.29315/gm.v1i1.624

PARALLELIZATION OF SHORTEST PATH CLASS ALGORITHMS: A COMPARATIVE ANALYSIS
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Souza, Flávio Henrique Batista de

; Abreu, Marcos Henrique Gonçalves

; Trindade, Paulo Ricardo Fonseca

; Fernandes, Gustavo Alves

; Carvalho, Luiz Melk de

; Couto, Braulio Roberto Gomes Marinho

; Rodrigues, Diva de Souza e Silva

Pesquisa Operacional

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2023, Volume 43 elocation e272130

Abstract: En | Text: En | PDF: En

ABSTRACT The problem of finding the shortest path between a source and a destination node, commonly represented by graphs, has several computational algorithms as an attempt to find what is called the minimum path. Depending on the number of nodes in-between the source and destination, the process of finding the shortest path can demand a high computational cost (with polynomial complexity). A solution to reduce the computational cost is the use of the concept of parallelism, which divides the algorithm tasks between the processing cores. This article presents a comparative analysis of the main algorithms of the shortest path class: Dijkstra, Bellman-Ford, Floyd-Warshall and Johnson. The performance of each algorithm was evaluated considering different parallelization approaches and they were applied on general and open-pit mining databases present in the literature. The experimental results showed an improvement in performance of about 55% on the execution time depending on the chosen parallelization point.

https://doi.org/10.1590/0101-7438.2023.043.00272130

Transparency of subnational governments: the impact of inequality on transparency governments
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Fernandes, Gustavo Andrey de Almeida Lopes

; Fernandes, Ivan Filipe

; Teixeira, Marco Antonio Carvalho

Revista de Administração Pública

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2023, Volume 57 N. 6 elocation e2023-0025

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

Resumo Quais são os efeitos das instituições informais extrativas no processo de accountability horizontal numa democracia em desenvolvimento? Este artigo apresenta evidências sobre os efeitos nocivos das instituições informais extrativistas na accountability horizontal dos governos subnacionais no Brasil. Após três décadas de eleições livres e competitivas, o desenho institucional das instituições de fiscalização dos governos estaduais praticamente não mudou. Exploramos a hipótese de que instituições informais mais extrativas, medidas pelo nível de desigualdade de renda, estão associadas a níveis decrescentes de transparência. Dada a sua extensa diversidade social, política e econômica, inserida num quadro institucional formal centralizado, o Brasil oferece um cenário apropriado para testar a hipótese de que as instituições informais extrativas responsáveis pelo aumento da desigualdade de rendimentos podem minar a accountability horizontal nas novas democracias. desenvolvimento competitivas mudou renda transparência social econômica centralizado democracias

Resumen ¿Cuáles son los efectos de las instituciones informales extractivas sobre el proceso de accountability horizontal en una democracia en desarrollo? Este artículo presenta evidencia sobre los efectos dañinos de las instituciones informales extractivas sobre la accountability horizontal dentro de los gobiernos subnacionales en Brasil. Después de tres décadas de elecciones libres y competitivas, el diseño institucional de las instituciones de supervisión de los gobiernos estatales apenas ha cambiado. Exploramos la hipótesis de que las instituciones informales más extractivas, medidas por el nivel de desigualdad de ingresos, están asociadas con niveles decrecientes de transparencia. Dada su amplia diversidad social, política y económica integrada en un marco institucional formal, general y centralizado, Brasil proporciona un entorno apropiado para probar la hipótesis de que las instituciones informales extractivas, responsables de una mayor desigualdad de ingresos, pueden socavar la accountability horizontal en las nuevas democracias. Cuáles desarrollo competitivas cambiado ingresos transparencia social formal centralizado democracias

Abstract What are the effects of extractive informal institutions on the horizontal accountability process in a developing democracy? This paper presents evidence about the harmful effects of extractive informal institutions on horizontal accountability within subnational governments in Brazil. After three decades of free and competitive elections, the institutional design of oversight institutions for state governments has hardly changed. We explore the hypothesis that more extractive informal institutions, measured by the level of income inequality, is associated with decreasing transparency levels. Given its extensive social, political, and economic diversity embedded in an overall centralized formal institutional framework, Brazil provides an appropriate setting to test the hypothesis that extractive informal institutions responsible for increased income inequality can undermine horizontal accountability in new democracies. democracy elections changed levels social political framework democracies

https://doi.org/10.1590/0034-761220230025x

Diretriz Brasileira de Cardio-oncologia – 2020
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Hajjar, Ludhmila Abrahão

; Costa, Isabela Bispo Santos da Silva da

; Lopes, Marcelo Antônio Cartaxo Queiroga

; Hoff, Paulo Marcelo Gehm

; Diz, Maria Del Pilar Estevez

; Fonseca, Silvia Moulin Ribeiro

; Bittar, Cristina Salvadori

; Rehder, Marília Harumi Higuchi dos Santos

; Rizk, Stephanie Itala

; Almeida, Dirceu Rodrigues

; Fernandes, Gustavo dos Santos

; Beck-da-Silva, Luís

; Campos, Carlos Augusto Homem de Magalhães

; Montera, Marcelo Westerlund

; Alves, Sílvia Marinho Martins

; Fukushima, Júlia Tizue

; Santos, Maria Verônica Câmara dos

; Negrão, Carlos Eduardo

; Silva, Thiago Liguori Feliciano da

; Ferreira, Silvia Moreira Ayub

; Malachias, Marcus Vinicius Bolivar

; Moreira, Maria da Consolação Vieira

; Valente Neto, Manuel Maria Ramos

; Fonseca, Veronica Cristina Quiroga

; Soeiro, Maria Carolina Feres de Almeida

; Alves, Juliana Barbosa Sobral

; Silva, Carolina Maria Pinto Domingues Carvalho

; Sbano, João

; Pavanello, Ricardo

; Pinto, Ibraim Masciarelli F.

; Simão, Antônio Felipe

; Dracoulakis, Marianna Deway Andrade

; Hoff, Ana Oliveira

; Assunção, Bruna Morhy Borges Leal

; Novis, Yana

; Testa, Laura

; Alencar Filho, Aristóteles Comte de

; Cruz, Cecília Beatriz Bittencourt Viana

; Pereira, Juliana

; Garcia, Diego Ribeiro

; Nomura, Cesar Higa

; Rochitte, Carlos Eduardo

; Macedo, Ariane Vieira Scarlatelli

; Marcatti, Patricia Tavares Felipe

; Mathias Junior, Wilson

; Wiermann, Evanius Garcia

; Val, Renata do

; Freitas, Helano

; Coutinho, Anelisa

; Mathias, Clarissa Maria de Cerqueira

; Vieira, Fernando Meton de Alencar Camara

; Sasse, André Deeke

; Rocha, Vanderson

; Ramires, José Antônio Franchini

; Kalil Filho, Roberto

Arquivos Brasileiros de Cardiologia

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nov 2020, Volume 115 N. 5 Pages 1006 - 1043

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

https://doi.org/10.36660/abc.20201006 4180 downloads

Os desafios do financiamento do enfrentamento à COVID-19 no SUS dentro do pacto federativo
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Fernandes, Gustavo Andrey de Almeida Lopes

; Pereira, Blenda Leite Saturnino

Revista de Administração Pública

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aug 2020, Volume 54 N. 4 Pages 595 - 613

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

Resumo O aprimoramento das regras de financiamento do Sistema Único de Saúde (SUS) em estados e municípios é um dos grandes desafios da saúde pública no Brasil. O objetivo deste artigo é contribuir para este amplo debate, analisando a resposta governamental ao desafio de combate à COVID-19, sob o prisma do financiamento público dos serviços de saúde dos governos subnacionais brasileiros. Uma abordagem quali-quantitativa é adotada, mesclando-se análise documental e análise de regressão. Resultados mostram que não houve mudança substantiva nos critérios de repasse, pouco sensíveis a fatores epidemiológicos. Ajustes nas normas de aplicação foram realizados para dar maior agilidade aos gastos. Tamanho populacional, produção de riquezas locais e número de leitos de internação parecem ser os principais fatores que definem a distribuição dos recursos. O desenho de financiamento do combate à COVID-19, assim como o volume de recursos parecem ser insuficientes frente à dimensão da crise.

Abstract The improvement of rules to fund the Brazilian health system (SUS) in states and municipalities is one of the major public health challenges in Brazil. The purpose of this article is to contribute to this broad debate, analyzing the government's response to the challenge of combating COVID-19, from the perspective of public financing of health services of Brazilian subnational governments. A qualitative and quantitative approach is adopted, combining documentary analysis and regression analysis. The results show that there was no substantive change in the criteria for transfers, which are not sensitive to epidemiological factors. Adjustments to the application rules were made to speed up spending. Population size, production of local wealth, and the number of hospital beds are the main factors that define the distribution of resources. The funding design for combating COVID-19, as well as the volume of resources, are insufficient in view of the scale of the crisis.

Resumen La mejora de las normas de financiación del Sistema Único de Salud (SUS) en los estados y municipios es uno de los principales desafíos de salud pública en Brasil. El propósito de este artículo es contribuir a este amplio debate, analizando la respuesta del gobierno al desafío de combatir COVID-19, bajo el prisma de la financiación pública para los servicios de salud de los gobiernos subnacionales brasileños. Se adopta un enfoque cualitativo cuantitativo, que combina el análisis documental y el análisis de regresión. Los resultados muestran que no hubo cambios sustanciales en los criterios de transferencia, poco sensibles a los factores epidemiológicos. Se hicieron ajustes a las reglas de aplicación para acelerar el gasto. El tamaño de la población, la producción de riqueza local y el número de camas de hospital parecen ser los principales factores que definen la distribución de los recursos. El diseño de financiamiento para combatir COVID-19, así como el volumen de recursos, parece ser insuficiente en vista de la magnitud de la crisis.

https://doi.org/10.1590/0034-761220200290 6294 downloads

A 10-Year Trend Analysis of Heart Failure in the Less Developed Brazil
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Fernandes, Amanda D. F.

; Fernandes, Gilson C.

; Mazza, Manuel Rivera

; Knijnik, Leonardo M.

; Fernandes, Gustavo Soares

; Vilela, Andre Telis de

; Badiye, Amit

; Chaparro, Sandra V.

Arquivos Brasileiros de Cardiologia

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feb 2020, Volume 114 N. 2 Pages 222 - 231

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

Resumo Fundamento: Dados sobre a epidemiologia da insuficiência cardíaca (IC) em áreas pouco desenvolvidas são escassos. Objetivos: Nosso objetivo foi determinar a morbidade e a mortalidade por IC na Paraíba e no Brasil, e sua tendência em dez anos. Métodos: Realizou-se uma busca retrospectiva de 2008 a 2017 utilizando-se o banco de dados do DATASUS incluindo pacientes com idade ≥ 15 anos, com diagnóstico primário de IC. Os dados da morbimortalidade por IC foram coletados e estratificados por ano, sexo e idade. Foram realizados correlação de Pearson e teste para tendências de Mantel-Haenzsel. Um nível de 5% foi definido como estatisticamente significativo. Resultados: De 2008 a 2017, as internações por IC diminuíram 62% (p = 0,004) na Paraíba, e 34% (p = 0,004) no Brasil. A taxa de mortalidade hospitalar aumentou na Paraíba e no Brasil [65,1% (p = 0,006) e 30,1% (p = 0,003), respectivamente], mas a mortalidade hospitalar em números absolutos apresentou uma diminuição significativa somente na Paraíba [37,5% (p = 0,013)], o que foi mantido após a estratificação por idade, exceto para os grupos 15-19, 60-69 e > 80 anos. Observou-se um aumento no período de internação [44% (p = 0,004) na Paraíba e 12,3% (p = 0,004) no Brasil]. De 2008 a 2015, a taxa de mortalidade por IC na população diminuiu 10,7% na Paraíba (p = 0,047) e 7,7% (p = 0,017) no Brasil. Conclusões: Apesar de a taxa de mortalidade por IC estar diminuindo na Paraíba e no Brasil, observou-se um aumento na taxa de mortalidade hospitalar e na duração da internação por IC. Devem ser realizados estudos clínicos em hospitais para serem identificadas as causas dessa tendência de aumento.

Abstract Background: Data on heart failure (HF) epidemiology in less developed areas of Brazil are scarce. Objective: Our aim was to determine the HF morbidity and mortality in Paraiba and Brazil and its 10-year trends. Methods: A retrospective search was conducted from 2008 to 2017 using the DATASUS database and included patients ≥ 15 years old with a primary diagnosis of HF. Data on in-hospital and population morbidity and mortality were collected and stratified by year, gender and age. Pearson correlation and linear-by-linear association test for trends were calculated, with a level of significance of 5%. Results: From 2008 to 2017, HF admissions decreased 62% (p = 0.004) in Paraiba and 34% (p = 0.004) in Brazil. The in-hospital mortality rate increased in Paraiba and Brazil [65.1% (p = 0.006) and 30.1% (p = 0.003), respectively], but the absolute in-hospital mortality had a significant decrease only in Paraiba [37.5% (p = 0.013)], which was maintained after age stratification, except for groups 15-19, 60-69 and > 80 years. It was observed an increase in the hospital stay [44% (p = 0.004) in Paraiba and 12.3% (p = 0.004) in Brazil]. From 2008 to 2015, mortality rate for HF in the population decreased 10.7% (p = 0.047) in Paraiba and 7.7% (p = 0.017) in Brazil. Conclusions: Although HF mortality rate has been decreasing in Paraiba and Brazil, an increase in the in-hospital mortality rate and length of stay for HF has been observed. Hospital-based clinical studies should be performed to identify the causes for these trends of increase.

https://doi.org/10.36660/abc.20180321 1861 downloads

A comparison between SOLiD 5500XLand Ion Torrent PGM-derived miRNA expression profiles in two breast cell lines
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Branco, Gabriela Pereira

; Valieris, Renan

; Povoa, Lucas Venezian

; Araújo, Luiza Ferreira de

; Fernandes, Gustavo Ribeiro

; Souza, Jorge Estefano Santana de

; Amorim, Maria Galli de

; Ferreira, Elisa Napolitano e

; Silva, Israel Tojal da

; Nunes, Diana Noronha

; Dias-Neto, Emmanuel

Genetics and Molecular Biology

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2020, Volume 43 N. 2 elocation e20180351

Abstract: En | Text: En | PDF: En

Abstract Next-generation sequencing (NGS) platforms allow the analysis of hundreds of millions of molecules in a single sequencing run, revolutionizing many research areas. NGS-based microRNA studies enable expression quantification in unprecedented scale without the limitations of closed-platforms. Yet, whereas a massive amount of data produced by these platforms is available, comparisons of quantification/discovery capabilities between platforms are still lacking. Here we compare two NGS-platforms: SOLiD and PGM, by evaluating their microRNA identification/quantification capabilities using two breast-derived cell-lines. A high expression correlation (R2 > 0.9) was achieved, encompassing 97% of the miRNAs, and the few discrepancies in miRNA counts were attributable to molecules that have very low expression. Quantification divergences indicative of artefactual representation were seen for 14 miRNAs (higher in SOLiD-reads) and another 10 miRNAs more abundant in PGM-data. An inspection of these revealed an increased and statistically significant count of uracyls and uracyl-stretches for PGM-enriched miRNAs, compared to SOLiD and to the miRBase. In parallel, adenines and adenine-stretches were enriched for SOLiDderived miRNA reads. We conclude that, whereas both platforms are overall consistent and can be used interchangeably for microRNA expression studies, particular sequence features appear to be indicative of specific platform bias, and their presence in microRNAs should be considered for database-analyses.

https://doi.org/10.1590/1678-4685-gmb-2018-0351 2766 downloads

Multiple sclerosis has a distinct lipid signature in plasma and cerebrospinal fluid
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OLIVEIRA, Enedina Maria Lobato de

; MONTANI, Daniela Antunes

; OLIVEIRA-SILVA, Diogo

; RODRIGUES-OLIVEIRA, André Filipe

; MATAS, Sandro Luiz de Andrade

; FERNANDES, Gustavo Bruniera Peres

; SILVA, Ismael Dale Cotrim Guerreiro da

; LO TURCO, Edson Guimarães

Arquivos de Neuro-Psiquiatria

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oct 2019, Volume 77 N. 10 Pages 696 - 704

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

RESUMO Embora o diagnóstico da EM tenha se modificado na última década, ainda tem como requisito básico a demonstração da disseminação no tempo e no espaço, através do quadro clínico e do exame de ressonância magnética. A síntese intratecal de imunoglobulina pode ser um marcador inespecífico e não há biomarcadores plasmáticos que sejam úteis no diagnóstico da EM, impondo desafios à sua detecção precoce. Métodos Realizamos uma análise lipidômica preliminar por espectrometria de massas, não direcionada, qualitativa, comparando amostras de LCR e plasma de pacientes com EM, outras doenças neurológicas inflamatórias e hipertensão intracraniana idiopática (HII). Resultados A identificação lipídica revelou que os ácidos graxos e esfingolipídios foram as classes mais abundantes de lipídios no LCR e que glicerolipídios e ácidos graxos foram a principal classe de lipídios no plasma de pacientes com EM. A AUC foi de 0,995 (0,912–1) e 0,78 (0,583–0,917), respectivamente. O teste de permutação indicou que essa combinação de íons foi útil para distinguir a EM de outras doenças inflamatórias (p < 0,001 e 0,055, respectivamente). Conclusão Este estudo sugere que o líquido cefalorraquidiano (LCR) e o plasma de pacientes com EM possuem uma assinatura lipídica única, pode ser útil como um biomarcador diagnóstico.

ABSTRACT The diagnosis of multiple sclerosis (MS) has changed over the last decade, but remains a composite of clinical assessment and magnetic resonance imaging to prove dissemination of lesions in time and space. The intrathecal synthesis of immunoglobulin may be a nonspecific marker and there are no plasma biomarkers that are useful in the diagnosis of MS, presenting additional challenges to their early detection. Methods We performed a preliminary untargeted qualitative lipidomics mass spectrometry analysis, comparing cerebrospinal fluid (CSF) and plasma samples from patients with MS, other inflammatory neurological diseases and idiopathic intracranial hypertension. Results Lipid identification revealed that fatty acids and sphingolipids were the most abundant classes of lipids in the CSF and that glycerolipids and fatty acids were the main class of lipids in the plasma of patients with MS. The area under the curve was 0.995 (0.912–1) and 0.78 (0.583–0.917), respectively. The permutation test indicated that this ion combination was useful for distinguishing MS from other inflammatory diseases (p < 0.001 and 0.055, respectively). Conclusion This study concluded that the CSF and plasma from patients with MS bear a unique lipid signature that can be useful as a diagnostic biomarker.

https://doi.org/10.1590/0004-282x20190122 2107 downloads

10.

Suicide by jumping from high places in a Brazilian city: regional peculiarities as a determining factor of variation in suicide methods
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Nunes, Emerson A.

; Fernandes, Gustavo X.

; Maia-de-Oliveira, João P.

; Lima, Amannda M.O.

Brazilian Journal of Psychiatry

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oct 2019, Volume 41 N. 5 Pages 462 - 464

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-4446-2019-0549 714 downloads

11.

How QUALIS CAPES influences Brazilian academic production? A stimulus or a barrier for advancement?
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FERNANDES, GUSTAVO ANDREY ALMEIDA LOPES

; MANCHINI, LEONARDO DE OLIVEIRA

Brazilian Journal of Political Economy

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jun 2019, Volume 39 N. 2 Pages 285 - 305

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

RESUMO Este estudo investiga as consequências (RESULTADOS?) do QUALIS CAPES. Para tanto, são coletados dados sobre os conselhos editoriais das revistas classificadas como A1 e A2 nas áreas de Administração, Contabilidade e Turismo; e Economia. Os resultados mostram que os EUA e o Reino Unido dominam a produção acadêmica. O Brasil e outros países emergentes não são relevantes. Foram analisadas as questões dos cinco principais periódicos de cada área, mostrando que o QUALIS pode direcionar a pesquisa no país para questões não relacionadas às questões brasileiras.

ABSTRACT This study delves into the consequences of QUALIS CAPES. To do that, data on the editorial boards of the journals classified as A1 and A2 in the areas of Business, Accounting and Tourism; and Economics are collected. Findings show that the US and the UK dominate the academic production. Brazil and other emerging countries are not relevant. Issues of the five top journals of each area were analyzed, showing that QUALIS may bias research in the country to issues not connected to Brazilian questions.

https://doi.org/10.1590/0101-31572019-3006 1329 downloads

12.

Neurofilament light chain in the assessment of patients with multiple sclerosis
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DOMINGUES, Renan Barros

; FERNANDES, Gustavo Bruniera Peres

; LEITE, Fernando Brunale Vilela de Moura

; SENNE, Carlos

Arquivos de Neuro-Psiquiatria

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jun 2019, Volume 77 N. 6 Pages 436 - 441

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

RESUMO A esclerose múltipla (EM) é uma doença autoimune, inflamatória e degenerativa do sistema nervoso central. A degeneração axonal é deflagrada pelo processo inflamatório e é o substrato patológico da incapacidade na EM. As intervenções terapêuticas reduzem a inflamação retardando a neurodegeneração e a progressão da incapacidade. A neurodegeneração é avaliada pelo quadro clínico e pela ressonância magnética. Estas mensurações não suficientemente acuradas, havendo necessidade de novos biomarcadores. Diversos biomarcadores têm sido estudados e, até o presente, o mais promissor é o neurofilamento de cadeia leve (NfL). O mesmo é um componente do citoesqueleto que é liberado no líquido cefalorraquidiano após injúria axonal. No presente estudo nós revisamos o conhecimento atual acerca do NfL na EM, síndrome clinica isolada e síndrome radiológica isolada, discutindo criticamente como a determinação deste biomarcador pode contribuir na tomada de decisões clínicas.

ABSTRACT Multiple sclerosis (MS) is an autoimmune, inflammatory, and degenerative disease of the central nervous system. Axonal degeneration is triggered by inflammation and is the pathological substrate of progressive disability in patients with MS. Therapeutic interventions can reduce inflammatory activity, thus delaying neurodegeneration and the progression of disability. Disease activity and neurodegeneration are assessed mainly through clinical evaluation and magnetic resonance imaging. These measures lack sensitivity and accuracy, so new biomarkers are necessary. Several markers have been studied and to date the most promising is neurofilament light (NfL), a component of the axonal cytoskeleton, which is released into cerebrospinal fluid (CSF) following axonal damage. In the present study, we review the current knowledge about CSF NfL determination in MS, clinically isolated syndrome, and radiologically isolated syndrome, and critically discuss how CSF NfL measurement may contribute to therapeutic decision-making in these patients.

https://doi.org/10.1590/0004-282x20190060 2393 downloads

13.

Economic voting in Brazilian presidential elections: evidence with panel data from municipalities in São Paulo
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Fernandes, Ivan Filipe de Almeida Lopes

; Fernandes, Gustavo Andrey de Almeida Lopes

Organizações & Sociedade

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mar 2019, Volume 26 N. 88 Pages 114 - 137

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

Resumo Este artigo utiliza um novo painel de dados de 625 municípios brasileiros em 5 anos eleitorais para analisar a influência do desempenho econômico no nível local na proporção de votos obtidos pelo candidato incumbente nas eleições nacionais. Examinamos municípios do estado de São Paulo, o mais populoso estado brasileiro, usando modelos de efeitos fixos e aleatórios. Os resultados sugerem que o desempenho da economia local é relevante nas eleições nacionais. Além disso, os resultados também indicam que os prefeitos desempenham um papel importante nas eleições nacionais ao transferir votos favoráveis à coalizão no poder, assim como os municípios mais ricos tendem a ser local mais propenso a um voto de oposição.

Abstract This paper uses a new data panel of 625 Brazilian municipalities over 5 election years to analyze the influence of the local level economic performance on the proportion of votes obtained by the incumbent in national elections. We examine municipalities from the State of São Paulo, the most populous Brazilian state, using fixed-effects and random- effects models. The results suggest that the performance of the local economy is relevant in the national elections. Apart from that, the results also suggest that the mayors play an important role in the national elections when it comes to transfer votes that are favorable to the coalition in power and that the richest municipalities tend to be more opposition prone.

https://doi.org/10.1590/1984-9260886 746 downloads

14.

Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis
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Domingues, Renan Barros

; Fernandes, Gustavo Bruniera Peres

; Leite, Fernando Brunale Vilela de Moura

; Senne, Carlos

Revista do Instituto de Medicina Tropical de São Paulo

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2019, Volume 61 elocation e24

Abstract: En | Text: En | PDF: En

ABSTRACT The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3, protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 – 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis.

https://doi.org/10.1590/s1678-9946201961024 1479 downloads

15.

The influence of Aloe vera with mesenchymal stem cells from dental pulp on bone regeneration: characterization and treatment of non-critical defects of the tibia in rats
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SOARES, Isadora Mello Vilarinho

; FERNANDES, Gustavo Vicentis de Oliveira

; CAVALCANTE, Larissa Cordeiro

; LEITE, Yulla Klinger Pereira de Carvalho

; BEZERRA, Dayseanny de Oliveira

; CARVALHO, Maria Acelina Martins de

; CARVALHO, Carmen Milena Rodrigues Siqueira

Journal of Applied Oral Science

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2019, Volume 27 elocation e20180103

Abstract: En | Text: En | PDF: En

Abstract Objective This study aimed to evaluate the inflammatory effect and bone formation in sterile surgical failures after implantation of a collagen sponge with mesenchymal stem cells from human dental pulp (hDPSCs) and Aloe vera. Material and Methods Rattus norvegicus (n=75) were divided into five experimental groups according to treatment: G1) control (blood clot); G2) Hemospon®; G3) Hemospon® in a culture medium enriched with 8% Aloe vera; G4) Hemospon® in a culture medium containing hDPSCs and G5) Hemospon® in a culture medium enriched with 8% Aloe vera and hDPSCs. On days 7, 15 and 30, the animals were euthanized, and the tibia was dissected for histological, immunohistochemistry and immunofluorescence analyses. The results were analyzed using nonparametric Kruskal-Wallis test and Dunn’s post-test. Results On days 7 and 15, the groups with Aloe vera had less average acute inflammatory infiltrate compared to the control group and the group with Hemospon® (p<0.05). No statistically significant difference was found between the groups regarding bone formation at the three experimental points in time. Osteopontin expression corroborated the intensity of bone formation. Fluorescence microscopy revealed positive labeling with Q-Tracker® in hDPSCs before transplantation and tissue repair. Conclusion The results suggest that the combination of Hemospon®, Aloe vera and hDPSCs is a form of clinical treatment for the repair of non-critical bone defects that reduces the inflammatory cascade’s effects.

https://doi.org/10.1590/1678-7757-2018-0103 2226 downloads

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