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1.
Effects of different agricultural systems on organic matter and aggregation of a medium-textured soil in subtropical region mediumtextured medium textured
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Ozório, Jefferson Matheus Barros
; Rosset, Jean Sérgio
; Carvalho, Laércio Alves de
; Gonçalves, Andrea dos Santos
; Santos, Wesley Vieira dos
; Oliveira, Naelmo de Souza
; Monteiro, Felipe das Neves
; Panachuki, Elói
.
Resumo O presente trabalho teve como objetivo avaliar o impacto de diferentes sistemas agrícolas sobre as frações húmicas da matéria orgânica (MOS) e a agregação do solo, sob solo de textura média em uma região subtropical do Brasil. Foram avaliadas três áreas manejadas e uma área de referência: pastagem permanente (PP), plantio direto (PD), plantio direto+Brachiaria (PD+B) e mata nativa (NF). Foram coletadas amostras de solo deformadas nas camadas 0-0,05; 0,05-0,10; 0,10-0,20 e 0,20-0,40 m, e amostras de solo indeformadas nas camadas 0-0,05 e 0,05-0,10 m. Após a coleta, foram realizadas análises de carbono orgânico total (COT), fracionamento químico da MOS; análise de estabilidade de agregados. A área PP apresentou os maiores teores de COT e C-AF nas três primeiras camadas avaliadas. Na camada de 0,10-0,20 m os teores de C-HUM na área PD+B foram 1,9 vezes maiores que na área PD, e em 0,20-0,40 m foram 6,6 vezes maiores. A área PP obteve os melhores indicadores estruturais, especialmente maior DMP, DMG e % de macroagregados. As duas áreas com plantio direto apresentaram percentual de macroagregados superior a 37,28% na camada superficial. O manejo do PP proporcionou aumentos nos teores de COT e, consequentemente, de substâncias húmicas, além da formação de agregados mais estáveis. O sistema PD+B mostrou-se promissor no aumento do COT e das substâncias húmicas, principalmente em profundidade, mesmo com um curto período de implantação. O aumento do COT e das substâncias húmicas proporcionado pelas gramíneas contribui para a formação de agregados mais estáveis e, consequentemente, para a melhoria da qualidade dos solos agrícolas de textura média. MOS (MOS Brasil referência PP, , (PP) PD (PD) diretoBrachiaria Brachiaria PDB B (PD+B NF. NF . (NF) 00,05 0005 0 0,05 05 0,050,10 005010 0,10 10 0,100,20 010020 0,20 20 0,10-0,2 0,200,40 020040 0,40 40 0,20-0,4 0-0,0 0,05-0,1 coleta COT, (COT) CAF C AF CHUM HUM 19 1 9 1, 66 6 6, estruturais DMP 3728 37 28 37,28 superficial consequentemente mostrouse mostrou se profundidade implantação (PP (PD (NF 00 00,0 000 005 0,0 050 0,050,1 00501 010 0,1 100 0,100,2 01002 020 0,2 2 0,10-0, 200 0,200,4 02004 040 0,4 4 0,20-0, 0-0, 0,05-0, (COT 372 3 37,2 00, 0, 0,050, 0050 01 0,100, 0100 02 0,10-0 0,200, 0200 04 0,20-0 0-0 0,05-0 37, 0,050 0,100 0,10- 0,200 0,20- 0- 0,05-
Abstract This work evaluates the impact of different agricultural systems on the humic fractions of organic matter (SOM) and soil aggregation in a medium-textured soil in a subtropical region of Brazil. Three managed areas and a reference area were evaluated: permanent pasture (PP), no-till (NT), no-till+Brachiaria (NT+B) and native forest (NF). Deformed soil samples were collected in the layers 0-0.05; 0.05-0.10; 0.10-0.20 and 0.20-0.40 m, and unformed soil samples in the layers 0-0.05 and 0.05-0.10 m. After collection, total organic carbon (TOC) analysis, chemical fractioning of SOM and aggregate stability analysis were performed. The PP area presented the highest TOC and C-FA contents in the first three layers evaluated. In the 0.10-0.20 m layer, the C-HUM contents in the NT+B area were 1.9 times higher than in the NT area, and in 0.20-0.40 m they were 6.6 times higher. The PP area obtained the best structural indicators, especially higher WMD, GMD and % of macroaggregates. The two areas using direct seeding presented a percentage of macroaggregates higher than 37.28% in the superficial layer. The PP management provided increases in TOC levels and, consequently, humic substances, besides the formation of more stable aggregates. The NT+B system showed promise in increasing TOC and humic substances, especially at depth, even with a short implementation period. The increase in TOC and humic substances provided by the grasses contributes to the formation of more stable aggregates and, consequently, to the improvement of the quality of medium-textured agricultural soils. (SOM mediumtextured medium textured Brazil evaluated PP, , (PP) notill no till NT, (NT) notill+Brachiaria notillBrachiaria till+Brachiaria Brachiaria NTB B (NT+B NF. NF . (NF) 00.05 0005 0 0.05 05 0.050.10 005010 0.10 10 0.100.20 010020 0.20 20 0.10-0.2 0.200.40 020040 0.40 40 0.20-0.4 0-0.0 0.05-0.1 collection (TOC performed CFA C FA layer CHUM HUM 19 1 9 1. 66 6 6. indicators WMD 3728 37 28 37.28 consequently depth period soils (PP (NT tillBrachiaria (NF 00 00.0 000 005 0.0 050 0.050.1 00501 010 0.1 100 0.100.2 01002 020 0.2 2 0.10-0. 200 0.200.4 02004 040 0.4 4 0.20-0. 0-0. 0.05-0. 372 3 37.2 00. 0. 0.050. 0050 01 0.100. 0100 02 0.10-0 0.200. 0200 04 0.20-0 0-0 0.05-0 37. 0.050 0.100 0.10- 0.200 0.20- 0- 0.05-
2.
ALTERAÇÕES COGNITIVAS E FUNCIONAIS ENCONTRADAS NA SÍNDROME PÓS-COVID-19 EM PESSOAS IDOSAS: REVISÃO INTEGRATIVA PÓSCOVID19 PÓSCOVID PÓS COVID 19 PÓS-COVID-1 IDOSAS PÓSCOVID1 1 PÓS-COVID- PÓS-COVID
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Rodrigues, Ingridy Fátima Alves
; Silva, Karla Helena Coelho Vilaça e
; Stephanus, Andrea Dias
; Carvalho, Luiz Sérgio Fernandes de
.
RESUMO: Objetivo: identificar as alterações cognitivas e funcionais mais frequentes em pessoas idosas após a fase aguda da COVID-19. Método: revisão integrativa da literatura com busca de artigos nas bases de dados LILACS, MEDLINE, PubMed e Scopus, entre junho e julho de 2024. A seleção foi realizada independentemente por dois revisores e validada por um terceiro revisor. Foram incluídos os estudos originais primários que envolveram participantes com maioria ou mediana de idade superior a 60 anos, com alterações cognitivas e funcionais pós-COVID-19. Resultados: observou-se a heterogeneidade nas amostras, com vasto espectro de características clínicas, sendo as mais prevalentes: dispneia, fadiga, alterações no padrão de sono e déficit cognitivo. Conclusão: os resultados contribuem para uma melhor avaliação e conduta. Apontam a necessidade de criação de protocolos específicos de atendimento às pessoas idosas com síndrome pós-COVID-19 e desenvolvimento de intervenções mais adequadas e direcionadas à prevenção, redução ou minimização dos sintomas persistentes. RESUMO Objetivo COVID19. COVID19 COVID 19. 19 COVID-19 Método LILACS MEDLINE Scopus 2024 revisor 6 anos pósCOVID19. pósCOVID19 pósCOVID pós Resultados observouse observou se amostras clínicas prevalentes dispneia fadiga cognitivo Conclusão conduta pós-COVID-1 prevenção persistentes COVID1 1 COVID-1 202 pósCOVID1 pós-COVID- COVID- 20 pós-COVID 2
ABSTRACT Objective: To identify the most frequent cognitive and functional changes in elderly people after the acute phase of COVID-19. Method: Integrative literature review with a search for articles in the LILACS, MEDLINE, PubMed, and Scopus databases, between June and July 2024. The selection was conducted independently by two reviewers and validated by a third reviewer. Original primary studies were included that involved participants with a majority or median age over 60 years, with post-COVID-19 cognitive and functional changes. Results: Heterogeneity was observed in the samples, with a wide range of clinical characteristics, the most prevalent being: dyspnea, fatigue, changes in sleep patterns, and cognitive deficit. Conclusion: The results contribute to a better assessment and conduct. They point to the need to create specific care protocols for elderly people with post-COVID-19 syndrome and to develop more appropriate and targeted interventions for the prevention, reduction, or minimization of persistent symptoms. Objective COVID19. COVID19 COVID 19. 19 COVID-19 Method LILACS MEDLINE PubMed databases 2024 reviewer 6 years postCOVID19 postCOVID post post-COVID-1 Results samples characteristics being dyspnea fatigue patterns deficit Conclusion conduct prevention reduction symptoms COVID1 1 COVID-1 202 postCOVID1 post-COVID- COVID- 20 post-COVID 2
RESUMEN Objetivo: identificar los cambios cognitivos y funcionales más frecuentes en personas mayores después de la fase aguda de COVID-19. Método: revisión integrativa de la literatura con búsqueda de artículos en las bases de datos LILACS, MEDLINE, PubMed y Scopus, entre junio y julio de 2024. La selección fue realizada independientemente por dos revisores y validada por un tercer revisor. Se incluyeron los estudios originales primarios que involucraron participantes con mayoría o mediana de edad superior a 60 años, con alteraciones cognitivas y funcionales post-COVID-19. Resultados: se observó la heterogeneidad en las muestras, con un amplio espectro de características clínicas, siendo las más prevalentes: disnea, fatiga, alteraciones en el patrón de sueño y déficit cognitivo. Conclusión: los resultados contribuyen a una mejor evaluación y conducta. Señalan la necesidad de crear protocolos específicos de atención para las personas mayores con síndrome post-COVID-19 y desarrollar intervenciones más adecuadas y dirigidas a la prevención, reducción o minimización de los síntomas persistentes. Objetivo COVID19. COVID19 COVID 19. 19 COVID-19 Método LILACS MEDLINE Scopus 2024 revisor 6 años postCOVID19. postCOVID19 postCOVID post Resultados muestras clínicas prevalentes disnea fatiga cognitivo Conclusión conducta post-COVID-1 prevención persistentes COVID1 1 COVID-1 202 postCOVID1 post-COVID- COVID- 20 post-COVID 2
3.
How can we reduce maternal mortality due to preeclampsia? The 4P rule preeclampsia P
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Korkes, Henri Augusto
; Cavalli, Ricardo Carvalho
; Oliveira, Leandro Gustavo De
; Ramos, José Geraldo Lopes
; Martins Costa, Sérgio Hofmeister de Almeida
; Sousa, Francisco Lázaro Pereira de
; Vieira da Cunha Filho, Edson
; de Souza Mesquita, Maria Rita
; Dias Corrêa Júnior, Mário
; Pinheiro Fernandes Araújo, Ana Cristina
; Zaconeta, Alberto Carlos Moreno
; Freire, Carlos Henrique Esteves
; Poli de Figueiredo, Carlos Eduardo
; Rocha Filho, Edilberto Alves Pereira da
; Sass, Nelson
; Peraçoli, José Carlos
; Costa, Maria Laura
.
Abstract In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management. middleincome middle income Brazil complications morbidity factors highrisk high risk women prevention followup, followup follow up, up diagnosis sulphate cases 4 " Rule Adequate Parturition (Parturition Postpartum. Postpartum . Postpartum) rule "rule management
4.
Inflammation and all-cause mortality in patients undergoing peritoneal dialysis allcause all cause
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Oliveira Júnior, Wander Valadares de
; Giarola, Luciane Teixeira Passos
; Ferreira, Letícia Gonçalves Resende
; Schettini, Isabella Viana Gomes
; Turani, Sylvia Dias
; Oliveira, Arlindo Ribeiro de
; Marinho, Maria Aparecida Silva
; Pinto, Sérgio Wyton Lima
; Barros-Pinheiro, Melina
; Figueiredo, Roberta Carvalho de
; Rios, Danyelle Romana Alves
.
ABSTRACT Objective This study aimed to evaluate inflammatory biomarkers in patients undergoing peritoneal dialysis and investigate their association with all-cause mortality or transfer to hemodialysis. Methods This prospective cohort study included 43 patients undergoing peritoneal dialysis. Plasma levels of cytokines were measured using flow cytometry and capture enzyme-linked immunosorbent assay. Biomarkers were categorized based on their respective median values. Survival analysis was conducted using the Kaplan-Meier estimator, considering two outcomes: all-cause mortality and transfer to hemodialysis. Results After adjusting for confounding factors, plasma levels above the median of the levels of CCL2 and plasma, as well as below the median of TNF-α, and the median of dialysate IL-17 levels, were associated with an increased risk of experiencing the specified outcomes after approximately 16 months of follow-up. Conclusion These findings suggest that inflammatory biomarkers may be a valuable tool for predicting all-cause mortality and transfer to hemodialysis in patients undergoing peritoneal dialysis. allcause all cause 4 enzymelinked enzyme linked assay values KaplanMeier Kaplan Meier estimator factors CCL TNFα, TNFα TNF α, α TNF-α IL17 IL 17 IL-1 1 followup. followup follow up. up follow-up IL1 IL-
5.
Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves
; Guimarães, Camila
; Rêgo, Jozelia
; Machado, Ketty Lysie Libardi Lira
; Miyamoto, Samira Tatiyama
; Burian, Ana Paula Neves
; Dias, Laiza Hombre
; Pretti, Flavia Zon
; Batista, Danielle Cristina Filgueira Alves
; Mill, José Geraldo
; Oliveira, Yasmin Gurtler Pinheiro de
; Gadelha, Carolina Strauss Estevez
; Gouveia, Maria da Penha Gomes
; Moulin, Anna Carolina Simões
; Souza, Bárbara Oliveira
; Aguiar, Laura Gonçalves Rodrigues
; Vieira, Gabriel Smith Sobral
; Grillo, Luiza Lorenzoni
; Lima, Marina Deorce de
; Pasti, Laís Pizzol
; Surlo, Heitor Filipe
; Faé, Filipe
; Moulaz, Isac Ribeiro
; Macabú, Mariana de Oliveira
; Ribeiro, Priscila Dias Cardoso
; Magalhães, Vanessa de Oliveira
; Aguiar, Mariana Freitas de
; Biegelmeyer, Erika
; Peixoto;, Flávia Maria Matos Melo Campos
; Kayser, Cristiane
; Souza, Alexandre Wagner Silva de
; Castro, Charlles Heldan de Moura
; Ribeiro, Sandra Lúcia Euzébio
; Telles, Camila Maria Paiva França
; Bühring, Juliana
; Lima, Raquel Lima de
; Santos, Sérgio Henrique Oliveira Dos
; Dias, Samuel Elias Basualto
; Melo, Natália Seixas de
; Sanches, Rosely Holanda da Silva
; Boechat, Antonio Luiz
; Sartori, Natália Sarzi
; Hax, Vanessa
; Dória, Lucas Denardi
; Rezende, Rodrigo Poubel Vieira de
; Baptista, Katia Lino
; Fortes, Natália Rodrigues Querido
; Melo, Ana Karla Guedes de
; Melo, Tâmara Santos
; Vieira, Rejane Maria Rodrigues de Abreu
; Vieira, Adah Sophia Rodrigues
; Kakehasi, Adriana Maria
; Tavares, Anna Carolina Faria Moreira Gomes
; Landa, Aline Teixeira de
; Costa, Pollyana Vitoria Thomaz da
; Azevedo, Valderilio Feijó
; Martins-Filho, Olindo Assis
; Peruhype-Magalhães, Vanessa
; Pinheiro, Marcelo de Medeiros
; Monticielo, Odirlei André
; Reis-neto, Edgard Torres Dos
; Ferreira, Gilda Aparecida
; Souza, Viviane Angelina de
; Teixeira-Carvalho, Andréa
; Xavier, Ricardo Machado
; Sato, Emilia Inoue
; Valim, Valeria
; Pileggi, Gecilmara Salviato
; Silva, Nilzio Antonio da
.
Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26
6.
Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH cohort
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Cardoso, Viviane Cunha
; Grandi, Carlos
; Silveira, Rita C.
; Duarte, José Luiz Bandeira
; Viana, Maria Cândida Ferrarez Bouzada
; Ferreira, Daniela Marques de Lima Mota
; Alves Junior, José Mariano Sales
; Embrizi, Laís Furlan
; Gimenes, Carolina Boschi
; Mello e Silva, Nathalia Moura de
; Melo, Fernanda Pegoraro de Godoi
; Venzon, Paulyne Stadler
; Gomez, Dafne Barcala
; Vale, Marynéa Silva do
; Bentlin, Maria Regina
; Barros, Marina Carvalho de Moraes
; Bigélli, Laura Emilia Monteiro
; Diniz, Edna Maria de Albuquerque
; Luz, Jorge Hecker
; Marba, Sérgio Tadeu Martins
; Almeida, João Henrique Carvalho Leme de
; Aragon, Davi Casale
; Carmona, Fabio
.
Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes. Objective INTERGROWTH21st INTERGROWTHst INTERGROWTH 21st st IG . (IG21) Methods (BNRN VLBW (VLBW tertiarycare tertiary care hospitals Outcome (CNMM inhospital hospital death 4 enterocolitis smallforgestationalage small gestational age SGA (SGA rd SGA3 (SGA3 th SGA10 (SGA10 BW largeforgestationalage large LGA (LGA BMI logbinomial log binomial Results 4072 072 4,07 included BNRN/IG21 BNRNIG21 BNRNIG (BNRN/IG21) 145 1 45 1.4 0.92–2.31/1.60 092231160 0.92–2.31 /1.60 0 92 31 60 (0.92–2.31)/1.6 1.27–2.02 127202 27 02 (1.27–2.02 090 90 0.9 0.55–1.47/1.05 055147105 0.55–1.47 /1.05 55 47 05 (0.55–1.47)/1.0 0.55–1.99 055199 99 (0.55–1.99 165 65 1.6 1.08–2.51/1.58 108251158 1.08–2.51 /1.58 08 51 58 (1.08–2.51)/1.5 1.28–1.96 128196 28 96 (1.28–1.96 stunting 148 48 1.02–2.17 102217 17 (1.02–2.17 variable >95% 95 (>95% 7090%, 7090 70 90% , (70-90%) Conclusion IG2 outcomes (IG21 SGA1 (SGA1 407 07 4,0 BNRN/IG2 BNRNIG2 (BNRN/IG21 14 1. 0.92–2.31/1.6 09223116 092231 0.92–2.3 160 /1.6 9 6 (0.92–2.31)/1. 1.27–2.0 12720 (1.27–2.0 09 0. 0.55–1.47/1.0 05514710 055147 0.55–1.4 105 /1.0 5 (0.55–1.47)/1. 0.55–1.9 05519 (0.55–1.9 16 1.08–2.51/1.5 10825115 108251 1.08–2.5 158 /1.5 (1.08–2.51)/1. 1.28–1.9 12819 (1.28–1.9 1.02–2.1 10221 (1.02–2.1 >95 (>95 7090% 709 7 (70-90% (IG2 40 BNRN/IG (BNRN/IG2 0.92–2.31/1. 0922311 09223 0.92–2. /1. (0.92–2.31)/1 1.27–2. 1272 (1.27–2. 0.55–1.47/1. 0551471 05514 0.55–1. 10 (0.55–1.47)/1 0551 (0.55–1. 1.08–2.51/1. 1082511 10825 1.08–2. 15 (1.08–2.51)/1 1.28–1. 1281 (1.28–1. 1.02–2. 1022 (1.02–2. >9 (>9 (70-90 (IG (BNRN/IG 0.92–2.31/1 0922 0.92–2 /1 (0.92–2.31)/ 1.27–2 127 (1.27–2 0.55–1.47/1 0.55–1 (0.55–1.47)/ 055 (0.55–1 1.08–2.51/1 1082 1.08–2 (1.08–2.51)/ 1.28–1 128 (1.28–1 1.02–2 102 (1.02–2 (> (70-9 0.92–2.31/ 092 0.92– / (0.92–2.31) 1.27– 12 (1.27– 0.55–1.47/ 0.55– (0.55–1.47) (0.55– 1.08–2.51/ 108 1.08– (1.08–2.51) 1.28– (1.28– 1.02– (1.02– ( (70- 0.92 (0.92–2.31 1.27 (1.27 0.55 (0.55–1.47 (0.55 1.08 (1.08–2.51 1.28 (1.28 1.02 (1.02 (70 (0.92–2.3 1.2 (1.2 0.5 (0.55–1.4 (0.5 1.0 (1.08–2.5 (1.0 (7 (0.92–2. (1. (0. (1.08–2. (0.92–2 (1 (0 (1.08–2 (0.92– (1.08– (0.92 (1.08 (0.9
7.
Cowpea strains resistant to CPSMV and CABMV intended for green-grain production
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Santana, Sérgio Rogério Alves de
; Santana, Jackeline Terto da Silva
; Costa, Antonio Félix da
; Carvalho, Rejane Rodrigues da Costa e
; Carvalho Filho, José Luiz Sandes de
.
RESUMO O feijão-caupi verde é uma importante alternativa para a geração de emprego e renda para os agricultores familiares, contribuindo para expansão de sua produção e consumo. No entanto, fatores bióticos como insetos, fungos, bactérias, nematoides e vírus têm limitado sua produção, destacando-se os vírus Cowpea Severe Mosaic Virus (CPSMV) e Cowpea aphid-borne mosaic virus (CABMV). O controle mais eficiente desses vírus é por meio da utilização de variedades resistentes, porém poucas são as variedades destinadas para a produção de feijão verde que são resistentes. Dessa forma, objetivou-se desenvolver e identificar linhagens superiores de feijão-caupi quanto à resistência simultânea aos vírus CPSMV e CABMV com características associadas à produção de grãos verdes. Foram realizados cruzamentos em casa de vegetação no Instituto Agronômico de Pernambuco-AIP entre os genótipos Sempre Verde Salgueiro (suscetível), CNC-0434 (imune ao CPSMV) e TVu-966 (resistente ao CABMV). A partir dos cruzamentos foram selecionadas 50 linhagens F2:5 com coloração do grão tipo Sempre Verde, sendo avaliada a resistência aos vírus em casa de vegetação e as suas características agronômicas para produção de grãos verdes em experimento na Estação Experimental do AIP em Belém do São Francisco-PE. O delineamento experimental foi em blocos casualizados completos, com três repetições. As linhagens L300.026, L300.039, L300.040 e L300.049 mostraram-se resistentes a ambos os vírus e possuem elevado potencial para a produção de grãos verdes; o índice de seleção de Mulamba e Mock facilitou a seleção de linhagens superiores e promissoras para futuro lançamentos de novas variedades resistentes destinadas à produção de grãos verdes.
ABSTRACT Green cowpea is an important alternative for generating employment and income for family farmers and helps broaden production and consumption of the grain. However, biotic factors such as insects, fungi, bacteria, nematodes and viruses have hampered production, especially the Cowpea Severe Mosaic Virus (CPSMV) and Cowpea Aphid-Borne Mosaic Virus (CABMV). The most efficient control of these viruses is via the use of resistant varieties, but few varieties intended for green-grain production are resistant. As such, the aim of this study was to develop and identify superior strains of cowpea in terms of joint resistance to the CPSM and CABM viruses that show characteristics associated with green-grain production. Crosses were carried out in a greenhouse at the Agronomic Institute of Pernambuco (AIP) between the following genotypes: Sempre Verde Salgueiro (susceptible), CNC-0434 (immune to CPSMV) and TVu-966 (resistant to CABMV). From these crosses, fifty F2:5 strains with the Sempre Verde type of grain colouring were selected, their resistance to the viruses assessed in a greenhouse, and their agronomic characteristics for green-grain production evaluated in an experiment at the Experimental Station of the AIP in Belém do São Francisco, Pernambuco. The experimental design was of completely randomised blocks, with three replications. The L300.026, L300.039, L300.040 and L300.049 strains proved to be resistant to both viruses, with a high potential for green-grain production. The Mulamba-Mock selection index facilitated the selection of superior strains that are promising for the future launch of new resistant varieties destined for the production of green grains.
8.
COVID-19 outcomes in people living with HIV: Peering through the waves COVID19 COVID 19 COVID-1 HIV COVID1 1 COVID-
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Sales, Thaís Lorenna Souza
; Souza-Silva, Maíra Viana Rego
; Delfino-Pereira, Polianna
; Neves, João Victor Baroni
; Sacioto, Manuela Furtado
; Assis, Vivian Costa Morais de
; Duani, Helena
; Oliveira, Neimy Ramos de
; Sampaio, Natália da Cunha Severino
; Ramos, Lucas Emanuel Ferreira
; Schwarzbold, Alexandre Vargas
; Jorge, Alzira de Oliveira
; Scotton, Ana Luiza Bahia Alves
; Castro, Bruno Mateus de
; Silva, Carla Thais Cândida Alves da
; Ramos, Carolina Marques
; Anschau, Fernando
; Botoni, Fernando Antonio
; Grizende, Genna Maira Santos
; Nascimento, Guilherme Fagundes
; Ruschel, Karen Brasil
; Menezes, Luanna Silva Monteiro
; Castro, Luís César de
; Nasi, Luiz Antônio
; Carneiro, Marcelo
; Godoy, Mariana Frizzo de
; Nogueira, Matheus Carvalho Alves
; Guimarães Júnior, Milton Henriques
; Ziegelmann, Patricia Klarmann
; Almeida, Rafaela Charão de
; Francisco, Saionara Cristina
; Silveira Neto, Sidney Teodoro
; Araújo, Silvia Ferreira
; Avelino-Silva, Thiago Junqueira
; Aliberti, Márlon Juliano Romero
; Pires, Magda Carvalho
; Silva, Eduardo Sérgio da
; Marcolino, Milena Soriano
.
Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group. COVID19 COVID 19 COVID-1 infection (202 2021. . 2021) records unit death sex comorbidities up 41. 41 4 1 4:1) ChiSquare Chi Square Fishers Fisher s study 17101 17 101 17,10 hospitalized 13 0.76% 076 0 76 (0.76% 5 IQR (IQR 43.064.0 430640 43.0 64.0 43 64 43.0;64.0 202 46.063.5 460635 46.0 63.5 46 63 46.0;63.5 (PLHIV differences inhospital 27.9% 279 27 9 (27.9 vs 17.7% 177 7 0.049, 0049 0.049 , 049 0.049) 25.0% 250 25 (25.0 25.1% 251 0.999. 0999 0.999 999 0.999) pandemic however group COVID1 COVID- (20 4:1 1710 10 17,1 0.76 07 (0.76 064 43.064. 43064 430 43. 640 64. 6 43.0;64. 20 063 46.063. 46063 460 46. 635 63. 46.0;63. 27.9 2 (27. 17.7 004 0.04 04 25.0 (25. 25.1 099 0.99 99 (2 4: 171 17, 0.7 (0.7 06 43.064 4306 43.0;64 46.063 4606 46.0;63 27. (27 17. 00 0.0 25. (25 09 0.9 ( 0. (0. 43.06 43.0;6 46.06 46.0;6 (0 43.0; 46.0;
9.
Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio
; Rassi Jr, Anis
; Oliveira, Gláucia Maria Moraes
; Correia, Luís Claudio Lemos
; Ramos Júnior, Alberto Novaes
; Luquetti, Alejandro Ostermayer
; Hasslocher-Moreno, Alejandro Marcel
; Sousa, Andréa Silvestre de
; Paola, Angelo Amato Vincenzo de
; Sousa, Antônio Carlos Sobral
; Ribeiro, Antonio Luiz Pinho
; Correia Filho, Dalmo
; Souza, Dilma do Socorro Moraes de
; Cunha-Neto, Edecio
; Ramires, Felix Jose Alvarez
; Bacal, Fernando
; Nunes, Maria do Carmo Pereira
; Martinelli Filho, Martino
; Scanavacca, Maurício Ibrahim
; Saraiva, Roberto Magalhães
; Oliveira Júnior, Wilson Alves de
; Lorga-Filho, Adalberto Menezes
; Guimarães, Adriana de Jesus Benevides de Almeida
; Braga, Adriana Lopes Latado
; Oliveira, Adriana Sarmento de
; Sarabanda, Alvaro Valentim Lima
; Pinto, Ana Yecê das Neves
; Carmo, Andre Assis Lopes do
; Schmidt, Andre
; Costa, Andréa Rodrigues da
; Ianni, Barbara Maria
; Markman Filho, Brivaldo
; Rochitte, Carlos Eduardo
; Macêdo, Carolina Thé
; Mady, Charles
; Chevillard, Christophe
; Virgens, Cláudio Marcelo Bittencourt das
; Castro, Cleudson Nery de
; Britto, Constança Felicia De Paoli de Carvalho
; Pisani, Cristiano
; Rassi, Daniela do Carmo
; Sobral Filho, Dário Celestino
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Mesquita, Evandro Tinoco
; Mendes, Fernanda de Souza Nogueira Sardinha
; Gondim, Francisca Tatiana Pereira
; Silva, Gilberto Marcelo Sperandio da
; Peixoto, Giselle de Lima
; Lima, Gustavo Glotz de
; Veloso, Henrique Horta
; Moreira, Henrique Turin
; Lopes, Hugo Bellotti
; Pinto, Ibraim Masciarelli Francisco
; Ferreira, João Marcos Bemfica Barbosa
; Nunes, João Paulo Silva
; Barreto-Filho, José Augusto Soares
; Saraiva, José Francisco Kerr
; Lannes-Vieira, Joseli
; Oliveira, Joselina Luzia Menezes
; Armaganijan, Luciana Vidal
; Martins, Luiz Cláudio
; Sangenis, Luiz Henrique Conde
; Barbosa, Marco Paulo Tomaz
; Almeida-Santos, Marcos Antonio
; Simões, Marcos Vinicius
; Yasuda, Maria Aparecida Shikanai
; Moreira, Maria da Consolação Vieira
; Higuchi, Maria de Lourdes
; Monteiro, Maria Rita de Cassia Costa
; Mediano, Mauro Felippe Felix
; Lima, Mayara Maia
; Oliveira, Maykon Tavares de
; Romano, Minna Moreira Dias
; Araujo, Nadjar Nitz Silva Lociks de
; Medeiros, Paulo de Tarso Jorge
; Alves, Renato Vieira
; Teixeira, Ricardo Alkmim
; Pedrosa, Roberto Coury
; Aras Junior, Roque
; Torres, Rosalia Morais
; Povoa, Rui Manoel dos Santos
; Rassi, Sergio Gabriel
; Alves, Silvia Marinho Martins
; Tavares, Suelene Brito do Nascimento
; Palmeira, Swamy Lima
; Silva Júnior, Telêmaco Luiz da
; Rodrigues, Thiago da Rocha
; Madrini Junior, Vagner
; Brant, Veruska Maia da Costa
; Dutra, Walderez Ornelas
; Dias, João Carlos Pinto
.
10.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
11.
Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II SBCe (SBCe migraine
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Santos, Paulo Sergio Faro
; Melhado, Eliana Meire
; Kaup, Alexandre Ottoni
; Costa, Aline Turbino Neves Martins da
; Roesler, Célia Aparecida de Paula
; Piovesan, Élcio Juliato
; Sarmento, Elder Machado
; Theotonio, Giselle Oliveira Martins
; Campos, Henrique Carneiro de
; Fortini, Ida
; Souza, Jano Alves de
; Maciel Júnior, Jayme Antunes
; Segundo, João Batista Alves
; Carvalho, João José Freitas de
; Speziali, José Geraldo
; Calia, Leandro Cortoni
; Barea, Liselotte Menke
; Queiroz, Luiz Paulo
; Souza, Marcio Nattan Portes
; Figueiredo, Marcos Ravi Cerqueira Ferreira
; Costa, Maria Eduarda Nobre de Magalhães
; Peres, Mário Fernando Prieto
; Jurno, Mauro Eduardo
; Peixoto, Patrícia Machado
; Kowacs, Pedro André
; Rocha Filho, Pedro Augusto Sampaio
; Moreira Filho, Pedro Ferreira
; Silva Neto, Raimundo Pereira
; Fragoso, Yara Dadalti
.
Resumo Antecedentes Migrânea afeta um bilhão de pessoas em todo o mundo e mais de 30 milhões de brasileiros; além disso, é um distúrbio subdiagnosticado e subtratado. Objetivo Sabe-se sobre a necessidade de difundir o conhecimento sobre o tratamento profilático da migrânea; por isso, a Sociedade Brasileira de Cefaleias (SBCe) nomeou um comitê de autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da migrânea episódica com base em artigos da literatura mundial, assim como da experiência pessoal. Métodos As reuniões foram realizadas inteiramente online, com a participação de 12 grupos que revisaram e escreveram sobre as categorias farmacológicas dos medicamentos e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de medicamentos estudadas na parte II deste Consenso foram: anti-hipertensivos, inibidores seletivos de recaptação de serotonina, inibidores de recaptação de serotonina e noradrenalina, bloqueadores dos canais de cálcio, outros medicamentos e politerapia racional. Resultados Desta lista de medicamentos, apenas o candesartan foi estabelecido como eficaz no controle da migrânea episódica. Flunarizina, venlafaxina, duloxetina e pizotifeno foram definidos como provavelmente eficazes, enquanto lisinopril, enalapril, escitalopram, fluvoxamina, quetiapina, atorvastatina, sinvastatina, ciproheptadina e melatonina foram possivelmente eficazes na profilaxia da doença. Conclusões Apesar do esforço da comunidade científica em encontrarmedicamentos realmente eficazes no tratamento da migrânea, dado o grande número de medicamentos testados para este fim, ainda dispomos de poucas opções terapêuticas. 3 brasileiros disso subtratado Sabese Sabe se isso SBCe (SBCe mundial pessoal online 1 final reuniramse reuniram documento antihipertensivos, antihipertensivos anti hipertensivos, hipertensivos anti-hipertensivos noradrenalina cálcio racional Flunarizina venlafaxina lisinopril enalapril escitalopram fluvoxamina quetiapina atorvastatina sinvastatina doença fim terapêuticas
Abstract Background Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. Objective The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. Methods Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. Results From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. Conclusions Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options. 3 Brazilians besides disorder known SBCe, SBCe (SBCe acronym experience online end document antihypertensives inhibitors blockers polytherapy Flunarizine venlafaxine duloxetine lisinopril enalapril escitalopram fluvoxamine quetiapine atorvastatin simvastatin cyproheptadine disease purpose options
12.
Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I SBCe (SBCe Migraine
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Melhado, Eliana Meire
; Santos, Paulo Sergio Faro
; Kaup, Alexandre Ottoni
; Costa, Aline Turbino Neves Martins da
; Roesler, Célia Aparecida de Paula
; Piovesan, Élcio Juliato
; Sarmento, Elder Machado
; Theotonio, Giselle Oliveira Martins
; Campos, Henrique Carneiro de
; Fortini, Ida
; Souza, Jano Alves de
; Maciel Júnior, Jayme Antunes
; Segundo, João Batista Alves
; Carvalho, João José Freitas de
; Speziali, José Geraldo
; Calia, Leandro Cortoni
; Barea, Liselotte Menke
; Queiroz, Luiz Paulo
; Souza, Marcio Nattan Portes
; Figueiredo, Marcos Ravi Cerqueira Ferreira
; Costa, Maria Eduarda Nobre de Magalhães
; Peres, Mário Fernando Prieto
; Jurno, Mauro Eduardo
; Peixoto, Patrícia Machado
; Kowacs, Pedro André
; Rocha-Filho, Pedro Augusto Sampaio
; Moreira Filho, Pedro Ferreira
; Silva-Neto, Raimundo Pereira
; Fragoso, Yara Dadalti
.
Resumo A Sociedade Brasileira de Cefaleia (SBCe) nomeou um Comitê de Autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da enxaqueca episódica com base em artigos da literatura mundial e da experiência pessoal. A enxaqueca é um distúrbio subdiagnosticado e subtratado que acomete um bilhão de pessoas no mundo e mais de 30 milhões de brasileiros. É conhecido na comunidade médica de neurologistas e, sobretudo, dos especialistas em cefaleia, a necessidade de se divulgar o conhecimento sobre o tratamento profilático da enxaqueca. Com esta finalidade, aliada às necessidades de atualizações de drogas e de se aumentar o conhecimento sobre a doença em si (frequência, intensidade, duração, impacto e talvez a progressão da enxaqueca), foi elaborado este Consenso, com metodologia totalmente on-line, por 12 grupos que revisaram e escreveram sobre as categorias farmacológicas das drogas e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de drogas estudadas para este Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais do antipeptídeo relacionado ao gene da calcitonina (peptídeo relacionado ao gene da calcitonina — anti-CGRP), betabloqueadores, anti-hipertensivos, inibidores dos canais de cálcio, outros antidepressivos (inibidores seletivos de recaptação de serotonina, ISRSs, e antidepressivos de ação dual), outras drogas, e politerapia. O tratamento hormonal, bem como anti-inflamatórios e triptanas em esquema de profilaxia mínima (miniprofilaxia), será abordado em um capítulo próprio. As classes de drogas estudadas na parte I do Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais anti-CGRP, e betabloqueadores. SBCe (SBCe pessoal 3 brasileiros sobretudo cefaleia finalidade frequência, frequência (frequência intensidade duração enxaqueca, , enxaqueca) online, online on line, line on-line 1 final reuniramse reuniram documento foram anticonvulsivantes tricíclicos peptídeo antiCGRP, antiCGRP anti CGRP anti-CGRP) betabloqueadores antihipertensivos, antihipertensivos hipertensivos, hipertensivos anti-hipertensivos cálcio serotonina ISRSs dual, dual dual) politerapia hormonal antiinflamatórios inflamatórios miniprofilaxia, miniprofilaxia (miniprofilaxia) próprio CGRP, anti-CGRP (miniprofilaxia
Abstract The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers. Sociedade Cefaleia SBCe Portuguese literature experience 3 Brazilians addition disorder neurologists specialists purpose frequency, frequency (frequency intensity duration migraine, , migraine) developed methodology process document were anticonvulsants anticalcitonin anti calcitonin generelated gene related antiCGRP CGRP (anti-CGRP antibodies betablockers, betablockers beta blockers, blockers beta-blockers antihypertensives inhibitors selective SSRIs dualaction dual action antidepressants) polytherapy antiinflammatories inflammatories miniprophylaxis (miniprophylaxis chapter betablockers. blockers.
13.
Comparison of digital games as a cognitive function assessment tool for current standardized neuropsychological tests
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Goulart, Ananaira Alves
; Lucatelli, André
; Silveira, Paulo Sergio Panse
; Siqueira, José de Oliveira
; Pereira, Valéria Fontanelle Angelim
; Carmona, Maria José Carvalho
; Valentin, Livia Stocco Sanches
; Vieira, Joaquim Edson
.
Abstract Objective: Cognitive dysfunction may occur postoperatively. Fast and efficient assessment of Postoperative Cognitive Dysfunction (POCD) can minimize loss of quality of life, and therefore, a study comparing a digital game with standard neuropsychological tests to assess executive, mnemonic, and attention functions to evaluate POCD seems to be relevant both for research and clinical practice. Methods: A battery of standardized tests and a digital game (MentalPlus®) were administered to 60 patients at the Central Institute of Hospital das Clínicas in São Paulo (36 women and 24 men), with ages between 29 and 82 years, preand post-surgery performed under anesthesia. Correlation and linear regression model were used to compare the scores obtained from the standardized tests to the scores of the six executive and cognitive functions evaluated by the game (shortand long-term memory, selective and alternating attention, inhibitory control, and visual perception). Results: After correlation analysis, a statistically significant result was found mainly for the correlation between the scores from the phase of the digital game assessing the visuoperception function and the scores from the A and B cards of the Stroop Test (p < 0.001, r = 0.99 and r = 0.64, respectively), and the scores from TMTA (p = 0.0046, r = 0.51). We also found a moderate correlation between the phase of the game assessing short-memory function and VVLT (p < 0.001, r = 0.41). No statistically significant correlations were found for the other functions assessed. Conclusion: The digital game provided scores in agreement with standardized tests for evaluating visual perception and possibly short-term memory cognitive functions. Further studies are necessary to verify the correlation of other phases of the digital game with standardized tests assessing cognitive functions.
14.
Assessment of a digital game as a neuropsychological test for postoperative cognitive dysfunction
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Lucatelli, André
; Goulart, Ananaira Alves
; Silveira, Paulo Sergio Panse
; Siqueira, José de Oliveira
; Carmona, Maria José Carvalho
; Pereira, Valéria Fontenelle Angelim
; Valentin, Livia Stocco Sanches
; Vieira, Joaquim Edson
.
Abstract Objective: Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control. Methods: It was a non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the preand postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions preand post-surgery using a generalized linear mixed model (ANCOVA). Results: Sixty patients were evaluated, 40% male and 60% female, with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game. Conclusion: The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.
15.
Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes
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Oliveira, José Alberto Alves
; Ramos, Rossana Ribeiro de Melo
; Muniz Neto, Francisco Julio
; Almeida, Paulo Cesar de
; Ramos, Max Rogerio Freitas
; Carvalho, Paulo Sergio Teixeira de
.
Resumo Objetivos Avaliar a correlação entre as alterações radiológicas (Pfirrmann e Modic) e a intensidade da dor radicular em pacientes submetidos a cirurgia endoscópica transforaminal para hérnia de disco lombar. Métodos Uma sequência de casos com 39 pacientes, 50 discos intervertebrais em avaliação pré-operatória, no período de 29 de janeiro de 2018 a 28 de agosto de 2019, no serviço de cirurgia endoscópica da coluna vertebral. Os dados demográficos, indicação cirúrgica, detalhes operatórios e complicações foram todos obtidos junto aos prontuários clínicos. Os pacientes foram divididos em três grupos, com base na classificação Modic (ausência de Modic, Modic 1 e Modic 2) e em dois grupos, considerando a classificação de Pfirrmann (Pfirrmann IV e Pfirrmann V). Os dados foram processados no software IBM SPSS Statistics for Windows, versão 22.0 (IBM Corp., Armonk, NY, EUA), com nível de significância de p <0,05. Resultados Não houve diferença entre os gêneros; idade: 50,36 ± 15,05 anos; nível da doença: L2-L3 1 (2%), L3-L4 2 (4%), L4-L5 9 (18%), L5-S1 8 (16%), L3-L4 + L4-L5 4 (8%), e L4-L5 + L5-S1 26 (52%); localização: foraminal direito em 7 pacientes (14%), foraminal esquerdo em 15 pacientes (30%), central em 9 pacientes (18%), e difuso em 19 pacientes (38%); dor radicular: esquerda em 25 pacientes (50%), direita em 11 pacientes (22%), e bilateral em 14 pacientes (28%); escala visual analógica (EVA) pré-operatório: 9,5 ± 0,91, pós-operatório: 2,5 ± 1,79; tempo cirúrgico: 100 ± 31,36 minutos; e acompanhamento de 8,4 ± 6,7 meses. Foi registrada menos dor ciática pós-operatória nos grupos Modic 2 versus Modic 1 (p< 0,05). Não houve diferença na dor radicular pós-operatória entre os grupos Pfirrmann (IV versus V). Conclusão Embora não exista diferença clínica entre os grupos, em estágios avançados da degeneração discal, a discectomia transforaminal endoscópica mostrou-se eficaz na redução da dor radicular em pacientes com hérnia de disco lombar.
Abstract Objectives To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation. Methods Series of cases with 39 patients, 50 intervertebral discs in preoperative evaluation from January 29, 2018 to August 28, 2019 in an endoscopic spine surgery service. Demographic data, surgical indication, operative details and complications were obtained from medical records. The patients were divided into three groups based on the Modic classification (Modic absence, Modic 1 and Modic 2) and into two groups considering the Pfirrmann classification (Pfirrmann IV and Pfirrmann V). Data were processed in IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA), with a significance level of p< 0,05. Results There was no difference between genders; age: 50,36 ± 15,05 years old; disease level: L2-L3 1 (2%), L3-L4 2 (4%), L4-L5 9 (18%), L5-S1 8 (16%), L3-L4 + L4-L5 4 (8%), and L4-L5 + L5-S1 26 (52%); location: right foraminal 7 (14%), left foraminal 15 (30%), central 9 (18%) and diffuse 19 (38%); radicular pain: left 25 (50%), right 11 (22%), and bilateral 14 (28%); preoperative visual analogue scale (VAS): 9,5 ± 0,91, postoperative: 2,5 ± 1,79; surgery duration: 100 ± 31,36 minutes; and follow-up: 8,4 ± 6,7 months. Less postoperative sciatica was registered in the Modic 2 versus Modic 1 group (p< 0,05). There was no difference in the postoperative radicular pain between the Pfirrmann groups (IV versus V). Conclusion Although there is no clinical difference between the groups, in advanced stages of disc degeneration, endoscopic transforaminal discectomy proved to be effective in diminishing radicular pain in patients with lumbar disc herniation.
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