Pesquisa | SciELO

ABSTRACT Introduction: Optimal fluid balance in peritoneal dialysis requires adequate urinary and peritoneal water and sodium removal and restriction of dietary sodium intake (<2 g/day). We aim to study the relationship between sodium intake, blood pressure control and medication burden in peritoneal dialysis patients. Methods: Observational, cross-sectional study of chronic peritoneal dialysis patients followed in our hospital in March 2022. We estimated patient’s sodium intake according to the equations proposed by Kim et al. Mean ambulatory blood pressure was categorized in controlled, stage one, stage two and stage three hypertension. A qualitative evaluation of sodium intake was done by asking patients about their compliance with a low-salt diet. Results: Eighty-two patients: mostly men, with a mean age of 54.1±14.7 years and dialysis vintage of 26.2±18.7 months. Most patients were on continuous ambulatory peritoneal dialysis (63.4%) and the mean weekly Kt/V was 2.2±0.4. A percentage of 85.4% of our patients had residual diuresis, averaged at 1257±867 mL/day. Mean dietary sodium intake was 3.5±1.1 g; it was higher in men and patients with uncontrolled hypertension, regardless of age, dialysis vintage and other comorbidities. We found a strong correlation between dietary sodium intake and residual diuresis, systolic blood pressure, diastolic blood pressure and the number of anti-hypertensive drugs. Patients with a sodium intake ≥ 3.3 g had higher risk of uncontrolled BP and higher medication burden. Qualitative evaluation of this sub-population revealed that only 2.3% (n=1) admitted non-compliance with a low-sodium diet. Conclusion: We found a strong correlation between estimated dietary sodium consumption, blood pressure control and medication burden. Most importantly, there was a striking difference between patient’s perception of sodium consumption and the actual results. Our results highlight the importance of dietary salt restriction in blood pressure control and reinforce the need for a dietary consultation in peritoneal dialysis patients.

https://doi.org/10.32932/pjnh.2023.11.265

Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer
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Tobias-Machado, Marcos

; Ornellas, Antonio A.

; Hidaka, Alexandre K.

; Medina, Luis G.

; Mattos, Pablo A. L.

; Besio, Ruben S.

; Abreu, Diego

; Castro, Pedro R.

; Nishimoto, Ricardo H.

; Astigueta, Juan

; Dourado, Aurus

; Machado, Roberto D.

; Magnabosco, Wesley J.

; Corona-Montes, Victor

; Villoldo, Gustavo M.

; Zampolli, Hamilton C.

; Taha, Anis

; Auad, Pericles R.

; Faria, Eliney F.

; Arantes, Paulo B. O.

; Tavares, Alessandro

; Nascimento, Francisco S. M. S.

; Brazão Jr., Eder S.

; Rocha, Maurício M.

; Costa, Walter H.

; Panico, Vinicius

; Reis, Leonardo O.

; Almeida-Carrera, Roberto J.

; Silva, Rafael C.

; Zequi, Stênio C.

; Calixto, José R. R.

; Sotelo, Rene

International braz j urol

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Out 2023, Volume 49 Nº 5 Páginas 580 - 589

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

https://doi.org/10.1590/s1677-5538.ibju.2023.0065

Recent Synthetic Developments of Asymmetric Multicomponent Transformations: Strecker, Mannich, Passerini and Ugi Reactions
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Carvalho, Marcelo H. R.

; Amarante, Giovanni W.

; Castro, Pedro P. de

Journal of the Brazilian Chemical Society

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Ago 2023, Volume 34 Nº 8 Páginas 1041 - 1070

Resumo: En | Texto: En | PDF: En

Multicomponent reactions (MCRs) are important transformations, which allow the attainment of structurally complex derivatives in a single step, starting from three or more compounds with relatively simple structures. These reactions are generally associated with the principles of green chemistry, allowing the incorporation of most (or all) atoms of the starting materials in the products (atom economy) and reducing purification steps (and, consequently, the need for solvents and waste production). For a long time, asymmetric methodologies (in special enantioselective protocols) for most multicomponent transformations remained a gap in the literature, limiting the use of these reactions to produce derivatives only as racemates or in low diastereoselectivities. Over the last two decades, a better comprehension of the mechanisms associated with these transformations allowed the development of efficient enantio- and diastereoselective procedures, attracting the interest of both academia and industry. In this review, selected examples of four important multicomponent reactions (Strecker, Mannich, Passerini and Ugi) will be discussed, presenting a general overview of the development of this field and pointing out possible advantages and limitations of the above mentioned methodologies. In some cases, discussions around mechanisms, proposed transition states and activation modes will be detailed disclosed.

https://doi.org/10.21577/0103-5053.20230082

Life and Sleep Quality amongst Peritoneal Dialysis Patients: A Comparative Study
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Castro, Pedro Almiro e

; Correia, Ana Luísa

; Mira, Filipe

; Cerqueira, Sofia

; Oliveira, Nuno Afonso

; Maia, Pedro

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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Mar 2023, Volume 37 Nº 1 Páginas 21 - 24

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Sleep disorders affect up to 70% of peritoneal dialysis (PD) patients and appear to have significant negative effects on their quality of life (QoL). We compared life and sleep quality between patients on automated PD (APD) and continuous ambulatory PD (CAPD). Material and Methods: Cross-sectional study in chronic PD patients followed in our Dialysis Unit in February 2022. We evaluated sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) and QoL with EUROHIS-QOL-8. Results: Fifty-two patients, mostly men (65.4%, n=32), with a mean age of 52.7±14.2 years and PD vintage of 24.3±17.1 months. Our sample had similar distribution between APD and CAPD; we found no difference between groups regarding demographic data, PD-related quality parameters or prevalence of previous sleep disturbances. Mean QoL index was 69.9%±9.3% and similar between APD and CAPD patients; EUROHIS-QOL-8 negatively correlated with the scores on ESS (p=0.004) and PSQI (p=0.011). Regarding sleep quality, the mean ESS was 8.8±4.2 and PSQI was 7.6±3.6. APD patients had similar scores on ESS, but higher prevalence of severe daytime sleepiness (ESS≥18) (p=0.04) and higher scores on PSQI (p=0.002). Within the PSQI, sleep’ latency (p=0.003), duration (p=0.002) and efficiency (p=0.013) were the most affected parameters. Higher PSQI scores also correlated with worse blood pressure control; a cut-off value for PSQI of 6 was found to increase the risk of uncontrolled hypertension. Conclusion: In our series, APD patients had worse global sleep quality (PSQI) when compared to ACPD patients. This difference was mainly due to worse sleep latency, duration and efficiency. The assessment of the quality of life showed no difference between groups, however there was a clear link between quality of life and sleep quality.

https://doi.org/10.32932/pjnh.2023.02.223

Systemic Lupus Concealed in the Shadow of a Primary Membranous Nephropathy Diagnosis
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Castro, Pedro Almiro e

; Mira, Filipe

; Oliveira, Nuno Afonso

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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Mar 2023, Volume 37 Nº 1 Páginas 36 - 39

Resumo: En | Texto: En | PDF: En

ABSTRACT A 43-year-old male patient followed for 27 years in a Nephrology consultation with negative autoimmune diagnostic workup and a histologically proven membranous nephropathy (MN), interpreted as a primary MN. During the follow-up he had multiple relapses, requiring continuous immunosuppression. Eventually, end-stage renal disease developed and the patient started hemodialysis (HD) in January 2018. Soon after initiating HD, he was admitted to the ward due to persistent fever of unknown origin, refractory to antipyretic and antibiotic therapy, but responsive to prednisolone (40 mg/day). Again, the diagnostic workup was negative and the patient was discharged with a corticosteroid taper over 16 weeks. In a posterior admission, after prednisolone suspension, the patient presented to the emergency room with persistente fever, involuntary weight loss, pruriginous macular rash and inflammatory joint pain. As the anti-nuclear antibody and anti-dsDNA came up positive and there was complement consumption, a diagnosis of a systemic lupus flare was established. His stay was complicated by sudden respiratory distress associated with hemoptysis and hemoglobin drop, with a confirmed diffuse alveolar hemorrhage. Daily plasma Exchange and intensive immunosuppression was necessary and the patient evolved into complete clinical remission with partial serological response. Usually, patients with systemic lupus erythematosus (SLE) develop clinical and serological remission upon initiating HD, reducing the number of flares and need for medication. This case depicts a lupus flare after starting HD, on a previously serologically negative patient, complicated with a rare type of lung parenchyma involvement, which is associated with a high mortality and required intensive immunosuppression for disease control. One can speculate whether or not the initial glomerulopathy was the first manifestation of SLE, previously controlled due to the continuous use of immunosuppression.

https://doi.org/10.32932/pjnh.2023.02.221

Effects of public health emergencies of international concern on disease control: a systematic review
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de Araújo, Giovanna Rotondo

; de Castro, Pedro A.S.V.

; Ávila, Isabela R.

; Bezerra, Juliana Maria T.

; Barbosa, David S.

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e74

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

RESUMEN Objetivos. Evaluar el conocimiento acumulado acerca de los efectos de las emergencias de salud pública de importancia internacional en el control de enfermedades y en los sistemas de salud locales, y contribuir a una mejor comprensión de estos efectos en los programas y sistemas de salud. Métodos. Se hizo una revisión sistemática de bibliografía gris y publicada (en español, inglés o portugués) para la que se realizaron búsquedas en bases de datos electrónicas (BVS/LILACS, PubMed y SciELO) y en Google Scholar. Los términos de búsqueda fueron: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (Outbreaks OR epidemics) AND (public health systems OR public health surveillance). Resultados. Se encontraron 3 508 estudios, de los cuales 31 cumplieron los criterios de inclusión. En los estudios se abordaban los efectos de las emergencias en: los sistemas de notificación de enfermedades transmisibles; la vigilancia, el control y el tratamiento de la malaria, el VIH/sida, la tuberculosis y la poliomielitis; la microcefalia; el dengue; y las vacunas. Las poblaciones afectadas por las emergencias experimentaron una reducción de los servicios de salud, incluida una reducción de las consultas de salud, errores en la cadena de diagnóstico, una disminución de la vacunación y el aumento de la incidencia o subnotificación de enfermedades de notificación obligatoria. Conclusiones. La inequidad socioeconómica es un determinante de los efectos de las emergencias de salud pública de importancia internacional en los grupos poblacionales afectados. El desvío de recursos y atención de las autoridades de salud afecta desproporcionadamente a los grupos vulnerables y puede suponer, con el tiempo, un debilitamiento de los sistemas de salud. El análisis de los efectos de las emergencias de salud pública es crucial para la elaboración de nuevos protocolos que puedan mejorar la respuesta ante futuras crisis.

RESUMO Objetivos. Avaliar o conhecimento acumulado sobre os efeitos das emergências de saúde pública de importância internacional no controle de doenças e nos sistemas de saúde locais e contribuir para uma melhor compreensão desses efeitos sobre os programas e sistemas de saúde. Métodos. Trata-se de uma revisão sistemática da literatura branca e cinzenta (em inglês, português ou espanhol) realizada por meio de pesquisas nos bancos de dados eletrônicos BVS/LILACS, PubMed e SciELO e no Google Scholar. Foram utilizados os seguintes termos de busca: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (outbreaks OR epidemics) AND (public health systems OR public health surveillance). Resultados. Foi identificado um total de 3 508 estudos, dos quais 31 preencheram os critérios de inclusão. Os estudos abordavam os efeitos das emergências sobre: sistemas de notificação de doenças transmissíveis; vigilância, controle e tratamento de HIV/AIDS, tuberculose, poliomielite e malária; microcefalia; dengue; e vacinações. As populações afetadas pelas emergências enfrentaram uma redução nos serviços de saúde, como menos consultas médicas, problemas na cadeia de diagnóstico, diminuição da vacinação e maior incidência ou subnotificação de doenças de notificação compulsória. Conclusões. A desigualdade socioeconômica é um fator determinante dos efeitos das emergências de saúde pública de importância internacional nas populações afetadas. O desvio dos recursos e da atenção das autoridades sanitárias afeta desproporcionalmente as populações vulneráveis e pode levar, com o passar do tempo, a um enfraquecimento dos sistemas de saúde. A análise dos efeitos das emergências de saúde pública é importante para a elaboração de novos protocolos que possam enfrentar melhor futuras crises.

ABSTRACT Objectives. To assess the accumulated knowledge of the effects of public health emergencies of international concern on disease control and local health systems, and contribute to a better understanding of their effects on health programs and systems. Methods. This was a systematic review of published and gray literature (in English, Portuguese, or Spanish). Electronic databases (BVS/LILACS, PubMed, and SciELO) and Google Scholar were searched. Search terms were: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (outbreaks OR epidemics) AND (public health systems OR public health surveillance). Results. A total of 3 508 studies were retrieved, of which 31 met the inclusion criteria. The studies addressed the effects of the emergencies on: communicable diseases notification systems; malaria, HIV/AIDS, tuberculosis, poliomyelitis, and malaria surveillance, control, and treatment; microcephaly; dengue; and vaccinations. The populations affected by the emergencies experienced reduced health services, which included fewer health visits, failures in the diagnostic chain, decrease in vaccination, and increased incidence or underreporting of notifiable diseases. Conclusions. Socioeconomic inequity is a determinant of the effects of public health emergencies of international concern within affected populations. The diversion of resources and attention from health authorities disproportionately affects vulnerable populations and can lead, over time, to a weakening of health systems. The analysis of the effects of public health emergencies is important for the development of new protocols that can better respond to future crises.

https://doi.org/10.26633/rpsp.2023.74

Epidemiological aspects of pediculosis by Pediculus humanus capitis (Phthiraptera: Pediculidae) in Minas Gerais: a systematic review
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Castro, Pedro Alves Soares Vaz de

; Paranhos, Laura Silva

; Pessoa, Grasielle Caldas D’Ávila

; Barbosa, David Soeiro

; Carneiro, Mariângela

; Bezerra, Juliana Maria Trindade

Cadernos Saúde Coletiva

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2023, Volume 31 Nº 1 elocation e30040425

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

Abstract Background Head lice, or head pediculosis, is a parasitosis considered a serious public health problem that affects mainly resource-limited countries. Objective To describe epidemiological aspects of the pediculosis capitis in Minas Gerais, in Brazil. Method This systematic review was conducted through the standards established by the Preferred Reporting Items in Systematic Reviews and Metanalyses (PRISMA). PubMed, LILACS, and SciELO databases, as well as the gray literature, were searched. Results Nine of 1,167 studies were included, published between 1988 and 2019. These studies reported a total prevalence of parasitosis that ranged from 1.4% to 57.4%. The prevalence of head lice ranged from 0.0% to 66.7% for males and 2.3% to 57.4% for females, thus being higher in black-skinned people (1.4% to 40.3%). Regarding age, the highest prevalence was 10-12 years old (45.3%). As for the characteristics of the hair, there was a greater infestation in people with long (16.0% to 79.5%), wavy (0.0% to 44.7%), dark (0.0% to 36.6%), with low capillary density (35.4%), and thick hair (39.2%). Conclusion Head pediculosis affects both sexes, different ages, and races, representing an important health problem in Minas Gerais, not only due to the presence of ectoparasite but also to the secondary complications that can be generated from this parasitism.

Resumo Introdução A pediculose de cabeça é uma parasitose considerada um sério problema de saúde pública, afetando principalmente países com recursos limitados. Objetivo Descrever os aspectos epidemiológicos da pediculose de cabeça em Minas Gerais, Brasil. Método Revisão sistemática conduzida por meio dos padrões estabelecidos pelo Preferred Reporting Items in Systematic Reviews and Metanalyses (PRISMA). Foram pesquisadas as bases de dados PubMed, LILACS e SciELO, bem como a literatura cinza. Resultados Nove de 1.167 estudos foram incluídos, publicados entre 1988 e 2019. Relatou-se uma prevalência total da parasitose que variou de 1,4% a 57,4%. Ela variou de 0,0% a 66,7% para homens e 2,3% a 57,4% para mulheres, sendo maior em pessoas de cor negra (1,4% a 40,3%). Em relação à idade, a maior prevalência foi de 10 a 12 anos (45,3%). Quanto às características dos cabelos, houve maior infestação em pessoas com cabelos longos (16,0% a 79,5%), ondulados (0,0% a 44,7%), escuros (0,0% a 36,6%), com baixa densidade capilar (35,4%) e fios grossos (39,2%). Conclusão A pediculose atinge ambos os sexos, diferentes idades e raças, representando um importante problema de saúde em Minas Gerais, não só pela presença do ectoparasita, mas também pelas complicações secundárias que podem ser geradas desse parasitismo.

https://doi.org/10.1590/1414-462x202230040425

Epidemiology of arthropods envenomation in Brazil: a public health issue
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CASTRO, PEDRO HENRIQUE C.

; PAIVA, ANA LUIZA B.

; PEIXOTO, GUSTAVO VINÍCIUS M.

; OLIVEIRA-MENDES, BÁRBARA BRUNA R.

; CALAÇA, PAULA

; MATAVEL, ALESSANDRA

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Supl. 1 elocation e20220850

Resumo: En | Texto: En | PDF: En

Abstract Brazil is located between the Equator and Tropic of Capricorn, which allows diverse climates, reliefs, and habitats for arthropods, which sting represents a risk to human health and a public health issue. This manuscript updates the epidemiological data of cases of human envenoming by spiders, scorpions, and insects with medical relevance in Brazil from 2010 to 2021. Epidemiological data were taken using the Brazilian Notifiable Diseases Information System. Statistics of non-parametric data used the Kruskal-Wallis followed by the Nemenyi test. On average, more than 145,000 envenomation and 145 deaths are recorded annually, and more than 60% of deaths are caused by scorpion bites. When the number of deaths was pondered by the number of cases with each arthropod, bees kill the most. Most stings cause mild symptoms and affect men of working age. The incidence decreases during the colder months, which is better noticeable in regions with well-defined seasons. The distribution is distinct among the regions: Southeast, Northeast, and South have the highest rate of bites. The growing number of cases of envenomation reported annually is a serious public health concern, especially involving scorpions, and highlights the importance of studying arthropod venom and improving the therapies.

https://doi.org/10.1590/0001-3765202320220850

Effects of face mask on pulse rate and blood oxygenation
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Castro, Pedro Alves Soares Vaz de

; Freire, Bruno Rodarte

; Petroianu, Andy

einstein (São Paulo)

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2023, Volume 21 elocation eAO0349

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders. Methods A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks. Results The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01). Conclusion The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort.

https://doi.org/10.31744/einstein_journal/2023ao0349

10.

A contribuição de pós-doutores Bolsistas CAPES no conjunto da produção científica: o caso UFRRJ
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Calvosa, Marcello Vinicius Doria

; Santos, Yasmin Chales

; Santos, Isabel Chales

; Castro, Pedro Marcos Roma de

Avaliação: Revista da Avaliação da Educação Superior (Campinas)

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Dez 2022, Volume 27 Nº 3 Páginas 446 - 469

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

The aim of the work was to analyze the action and performance of the teaching staff of the UFRRJ - Universidade Federal Rural do Rio de Janeiro trained with the post-doctorate, on the contribution of their set of scientific production, from the specific cut of the survey who carried out the post-doctoral internship with the support of grants from the CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The data survey was carried out in a census manner, involving all the permanent professors from all areas of knowledge at UFRRJ, Ex scholarship holders CAPES who work in the institution's graduate system. The analysis was carried utilizing their Curriculum Lattes. Recent PhDs (i.e. with low interstice between PhD. and post-doctoral internship) showed a decrease in their scientific and technological productions. In the institution, the post-doctorate proved to be more advantageous for the group of senior doctors, who increase the averages of their annual production and influence the postgraduate system and program more.

O objetivo do trabalho foi analisar a ação e a atuação do quadro docente da Universidade Federal Rural do Rio de Janeiro (UFRRJ), capacitados com o pós-doutorado, em suas contribuições ao conjunto de produção científica e tecnológica, a partir do específico recorte dos pesquisadores que realizaram o estágio pós-doutoral com o apoio de bolsas da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). O levantamento de dados ocorreu em forma censitária, envolvendo todo os docentes permanentes de todas as áreas do conhecimento da UFRRJ, ex-bolsistas CAPES e que atuam no sistema de pós-graduação da instituição. A análise foi realizada por meio dos seus Currículos Lattes. Os doutores recentes (i. e. com baixo interstício entre o doutorado e o pós-doutorado) apresentaram queda nas suas produções tecnológicas e científicas. Na instituição, o pós-doutorado mostrou ser mais vantajoso para o grupo de doutores seniores, que aumentam as médias de sua produção anual e influenciam mais o sistema e programa de pós-graduação.

https://doi.org/10.1590/s1414-40772022000300004

11.

New technique for the assessment of the growth capacity and development of fetal lungs under compressive circumstances using MRI and 3D models
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Castro, Pedro Teixeira

; Araujo Júnior, Edward

; Lopes, Jorge

; Ribeiro, Gerson

; Werner, Heron

Radiologia Brasileira

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Out 2022, Volume 55 Nº 5 Páginas 324 - 325

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/0100-3984.2022.0025

12.

Preditores de Mortalidade Hospitalar nos Pacientes Tratados por Angioplastia Primária: Um Estudo de Caso-Controle Multicêntrico
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Castro, Pedro Paulo Neves de

; Castro, Marco Antonio Nazaré

; Nascimento, Guilherme Abreu

; Moura, Isabel

; Pena, José Luiz Barros

Arquivos Brasileiros de Cardiologia

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Set 2022, Volume 119 Nº 3 Páginas 448 - 457

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

Resumo Fundamento A estratificação do risco de morte dos pacientes no contexto da angioplastia primária (ATC) é fundamental. Objetivo Identificar os fatores relacionados ao desfecho morte em pacientes submetidos a ATC. Métodos Estudo de caso-controle, utilizando como fonte de dados um registro brasileiro. A associação entre cada variável e o desfecho óbito foi avaliada via modelo de regressão logística binária. Consideramos significativo p<0,05. Resultados Foram analisados 26.990 registros, sendo 18.834 (69,8%) do sexo masculino, com idade mediana de 61 (17) anos. Na análise multivariada, as principais variáveis relacionadas ao desfecho óbito com seus respectivos odds ratio e intervalos de confiança (IC) com nível de significância de 95% foram a idade avançada 70 - 79 anos (2,46; 1,64 - 3,79) e ≥ 80 anos (3,68; 2,38 - 5,81), p<0,001, classificação de Killip II (2,71; 1,92 - 3,83), Killip III (8,14; 5,67 - 11,64), Killip IV (19,83; 14,85 - 26,69), p<0,001, disfunção global acentuada do ventrículo esquerdo (VE) (3,63; 2,39 - 5,68), p<0,001 e ocorrência de infarto após a intervenção (5,01; 2,57- 9,46), p<0,001. O principal fator protetor foi o fluxo TIMI III pós-intervenção (0,18; 0,13 - 0,24), p<0,001, seguido do TIMI II (0,59; 0,41 - 0,86), p=0,005, sexo masculino (0,79; 0,64 - 0,98), p= 0,032, dislipidemia (0,69; 0,59 - 0,85), p<0,001 e número de lesões tratadas (0,86; 0,9 - 0,94), p<0,001. Conclusão Os preditores de mortalidade nos pacientes submetidos a ATC foram: classificação de Killip, reinfarto, idade, disfunção global acentuada do VE, sexo feminino e fluxo TIMI 0/I pós-intervenção.

Abstract Background Identification of high-risk patients undergoing primary angioplasty (PCI) is essential. Objective Identify factors related to the causes of death in PCI patients. Methods This work consisted of a multicenter case-control study using a Brazilian registry of cardiovascular interventions as the data source. The association between each variable and death was assessed using a binary logistic regression model, p <0.05 was considered significant. Results A total of 26,990 records were analyzed, of which 18,834 (69.8%) were male patients, with a median age of 61 (±17) years. In the multivariate analysis, the main variables related to the causes of death with their respective odds ratios and 95%confidence intervals (CI) were advanced age, 70-79 years (2.46; 1.64-3.79) and ≥ 80 years (3.69; 2.38-5.81), p<0.001; the classification of Killip II (2.71; 1.92-3.83), Killip III (8.14; 5.67-11.64), and Killip IV (19.83; 14.85-26.69), p<0.001; accentuated global dysfunction (3.63; 2,39-5.68), p<0.001; and the occurrence of infarction after intervention (5.01; 2.57-9.46), p<0.001. The main protective factor was the post-intervention thrombolysis in myocardial infarction (TIMI) III flow (0.18; 0.13-0.24), p<0.001, followed by TIMI II (0.59; 0.41 -0.86), p=0.005, and male (0.79; 0.64-0.98), p = 0.032; dyslipidemia (0.69; 0.59-0.85), p<0.001; and number of lesions treated (0.86; 0.9-0.94), p<0.001. Conclusion The predictors of mortality in patients undergoing PCI were Killip’s classification, reinfarction, advanced age, severe left ventricular dysfunction, female gender, and post-intervention TIMI 0 / I flow.

https://doi.org/10.36660/abc.20210015

13.

Vascular Spectrum of Imaging Findings in COVID-19: Ischemic, Hemorrhagic, and Thromboembolic Complications
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Castro, Pedro Neves Paiva de

; Chagas, Lucia Antunes

; Wajnberg, Eduardo

; Santos, Roberto

; Cougo, Pedro

; Machado, Dequitier Carvalho

International Journal of Cardiovascular Sciences

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Ago 2022, Volume 35 Nº 4 Páginas 546 - 556

Resumo: En | Texto: En | PDF: En

Abstract Ischemic strokes secondary to occlusion of large vessels have been described in patients with COVID-19. Also, venous thrombosis and pulmonary thromboembolism have been related to the disease. Vascular occlusion may be associated with a prothrombotic state due to COVID-19-related coagulopathy and endotheliopathy. Intracranial hemorrhagic lesions can additionally be seen in these patients. The causative mechanism of hemorrhage could be associated with anticoagulant therapy or factors such as coagulopathy and endotheliopathy. We report on cases of ischemic, thrombotic, and hemorrhagic complications in six patients diagnosed with SARS-CoV-2 infection. Chest computed tomography (CT) showed typical SARS-CoV-2 pneumonia findings in all the cases, which were all confirmed by either serology or reverse transcription polymerase chain reaction (RT-PCR) tests.

https://doi.org/10.36660/ijcs.20210009

14.

Estudios de peligro, vulnerabilidad y riesgos asociados al agua en Santiago de Cuba
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Galbán Rodríguez, Liber

; González Trujillo, Mayelín

; Urquiza López, Yanet María

; Rodríguez Tamayo, Lázaro

; Cid Nacer, José Ramón

; García Naranjo, Lucía de la Caridad

; Vinajera Suarez, Virginia

; Torres Zapata, Yoan

; Machado Ferrer, Leonel

; Chuy Rodríguez, Tomás Jacinto

; Guardado Lacaba, Rafael

; Beira Fontaine, Eduardo

; Nápoles Fajardo, Nuria

; Vidaud Quitana, Ingrid Noelia

; Álvarez Rodríguez, Odalis

; Rodríguez Hernández, Silvio V.

; Rodríguez Matos, NerIs

; Velázquez Labrada, Yunior Ramón

; Cabrera Castro, Pedro

; Pérez Hernández, Onell

; Pacheco Moya, Rafael

; Durand Silveira, María Teresa

; Bermúdez Diéguez, Guadalupe

; Rojas, Eudel Michel

Anales de la Academia de Ciencias de Cuba

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Ago 2022, Volume 12 Nº 2 elocation e1094

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

ABSTRACT Introduction. Different environmental hazards associated with water converge in Santiago de Cuba, which constitutes a permanent threat to human life and to the socioeconomic development of the province (heavy rains, floods, tropical cyclones, among others). Its study in terms of disaster reduction is a priority for the Cuban State. Objective: Doing a group of research and development actions in order to assess the hazard, vulnerability and risk caused by water in nature, and in water supply systems of Santiago de Cuba province, in the face of the impact of environmental phenomena. Methods. Investigations of a multidisciplinary group structured in three parts are integrated: Studies of hazard, vulnerability and risks (HVR) in water systems of Santiago de Cuba; studies of HVR in watersheds and vulnerability behavior due to the impact of capillarity humidity in buildings from the historical center of Santiago de Cuba city. Results. Tools and solutions to strengthen forecasting and early warning systems for the population and institutions involved. Design of a new procedure for risk management based on the theory of processes, vulnerability studies in water supply systems, and water as a phenomenon of capillarity humidity in buildings. Watersheds diagnostics and flood modeling; the monthly rainfall series for the province was updated, as well as the design of professional software for early warning of extreme hydrometeorological events and community actions to improve risk culture.

RESUMEN Introducción. En Santiago de Cuba convergen distintos peligros ambientales asociados al agua que constituyen una amenaza permanente a la vida humana y al desarrollo socioeconómico de la provincia (intensas lluvias, inundaciones, ciclones tropicales, entre otros.). Su estudio en función de la reducción de desastres constituye una prioridad para el Estado cubano. Con el objetivo de realizar un conjunto de acciones de investigación y desarrollo encaminadas a determinar el peligro, la vulnerabilidad y el riesgo que causa el agua tanto en la naturaleza, como en las obras de infraestructura de la provincia Santiago de Cuba, ante el posible impacto de distintos fenómenos ambientales. Métodos. Se integran investigaciones de un grupo multidisciplinario estructurado en 3 partes: Estudios de peligro, vulnerabilidad y riesgos (PVR) en obras hidráulicas de Santiago de Cuba; estudios de PVR en cuencas hidrográficas de Santiago de Cuba y comportamiento espacial de la vulnerabilidad por el impacto de la humedad por capilaridad en edificaciones del centro histórico de la ciudad de Santiago de Cuba. Resultados. Herramientas y soluciones para fortalecer los sistemas de pronóstico y alerta temprana a la población e instituciones involucradas. Diseño de un nuevo procedimiento para la gestión de riesgos basado en la teoría de procesos, estudios de vulnerabilidad en obras hidráulicas y el agua como fenómeno de humedad capilar en las construcciones. Diagnósticos en cuencas hidrográficas y modelaciones de inundaciones; se actualizó la serie de precipitaciones mensuales de la provincia, así como diseño de software profesionales para la alerta temprana ante el impacto de eventos hidrometeorológicos extremos y acciones comunitarias para mejorar la cultura de riesgos.

15.

Non-surgical management of vesicoureteral junction obstruction: a case report
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Kimura, Thais Yuki

; Castro, Pedro Alves Soares Vaz de

; Silva, Thiago Vasconcelos

; Mesquita, Jordana Almeida

; Silva, Ana Cristina Simões e

Brazilian Journal of Nephrology

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Jun 2022, Volume 44 Nº 2 Páginas 296 - 300

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

Resumo Objetivo: Relatar o caso de um paciente pediátrico com hidronefrose bilateral devido à obstrução da junção vesicoureteral (OJVU) que foi tratado não cirurgicamente e discutir a abordagem desta anomalia. Descrição do caso: Um menino de 25 meses de idade foi encaminhado sem queixas para consulta devido à ultrassonografia pré-natal que mostrou rins com cistos. Ele estava sob profilaxia antibiótica. Nenhum histórico familiar de doença renal e/ou distúrbios hereditários foi relatado. A ultrassonografia renal (USR) aos 2 dias de vida mostrou hidronefrose bilateral, descartando assim a possibilidade de doença renal cística. A cintilografia renal dinâmica (DTPA) mostrou uma retenção acentuada do marcador no sistema pielocalicial bilateralmente, com pouca resposta ao diurético. O paciente foi mantido em profilaxia antibiótica, quando uma nova USR apresentou dilatação ureteral bilateral, estenose abrupta na região de transição ureterovesical (calibre 0,2 cm), hidronefrose bilateral moderada e leve espessura cortical renal, confirmando o diagnóstico de OJVU. Aos 2 anos e 10 meses de idade, a DTPA mostrou hidronefrose e estase ureteral em ambos os rins secundárias à estenose no nível da junção vesicoureteral (JVU), com preservação da função renal e grau lento de esvaziamento. Optamos por uma abordagem não cirúrgica. A USR aos 10 anos de idade mostrou melhora significativa de todos os parâmetros, com diâmetro transverso ureteral de 9 mm, JVU preservada, e desenvolvimento renal bilateral adequado à idade. Comentários: A OJVU é uma das principais causas de hidronefrose pré-natal e pode desencadear uma deterioração da função renal. Seu tratamento ainda é controverso, mas deve levar em consideração a importância do acompanhamento clínico e da avaliação seriada por imagem.

Abstract Objective: To report the case of a pediatric patient with bilateral hydronephrosis due to vesicoureteral junction obstruction (VUJO) that was treated non-surgically and to discuss the approach of this anomaly. Case Description: A 25-month-old boy was referred without complaints for consultation due to prenatal ultrasound showing kidneys with cysts. He was under antibiotic prophylaxis. No family history of kidney disease and/or inherited disorders was reported. Renal ultrasound (RUS) at 2 days of life showed bilateral hydronephrosis, thus ruling out the possibility of kidney cystic disease. Dynamic renal scintigraphy (DTPA) showed marked retention of the marker in the pyelocaliceal system bilaterally, with little response to diuretic drug. He was maintained under antibiotic prophylaxis, when a new RUS showed bilateral ureteral dilatation, abrupt stenosis in the ureterovesical transition region (0.2 cm caliber), moderate bilateral hydronephrosis, and slight renal cortical thickness, confirming the diagnosis of VUJO. At 2 years and 10 months of age, DTPA showed hydronephrosis and ureteral stasis in both kidneys secondary to stenosis at the vesicoureteral junction (VUJ) level, with preservation of kidney function and slow degree of emptying. We opted for a non-surgical approach. RUS at 10 years of age showed significant improvement of all parameters, with ureteral transverse diameter of 9 mm, preserved VUJ, and age-appropriate bilateral kidney development. Comments: VUJO is a major cause of prenatal hydronephrosis and can trigger a deterioration of kidney function. Its treatment is still controversial but should take into account the importance of clinical follow-up and serial imaging evaluation.

https://doi.org/10.1590/2175-8239-jbn-2020-0152

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