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1.
[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio
Simões, Marcus V.
Correia, Edileide de Barros
Marcondes-Braga, Fabiana G.
Coelho-Filho, Otavio Rizzi
Mesquita, Cláudio Tinoco
Mathias-Junior, Wilson
Rochitte, Carlos Eduardo
Ramires, Felix José Alvarez
Alves, Silvia Marinho Martins
Montera, Marcelo Westerlund
Lopes, Renato Delascio
Oliveira-Junior, Mucio Tavares
Scolari, Fernando L.
Avila, Walkiria Samuel
Canesin, Manoel Fernandes
Bacal, Fernando
Bocchi, Edimar Alcides
Moura, Lídia Ana Zytynski
Saad, Eduardo Benchimol
Scanavacca, Mauricio I.
Valdigem, Bruno Pereira
Cano , Manuel Nicolas
Abizaid , Alexandre
Ribeiro, Henrique Barbosa
Lemos-Neto, Pedro Alves
Ribeiro, Gustavo Calado de Aguiar
Jatene, Fabio Biscegli
Dias, Ricardo Ribeiro
Beck-da-Silva, Luis
Rohde, Luis Eduardo P.
Bittencourt, Marcelo Imbroinise
Pereira, Alexandre
Krieger, José Eduardo
Villacorta, Humberto
Martins, Wolney de Andrade
Figueiredo-Neto, José Albuquerque de
Cardoso , Juliano Novaes
Pastore, Carlos Alberto
Jatene, Ieda Biscegli
Tanaka, Ana Cristina Sayuri
Hotta, Viviane Tiemi
Romano, Minna Moreira Dias
Albuquerque, Denilson Campos de
Mourilhe-Rocha, Ricardo
Hajjar, Ludhmila Abrahão
Brito, Fabio Sandoli de
Caramelli , Bruno
Calderaro, Daniela
Farsky, Pedro Silvio
Colafranceschi , Alexandre Siciliano
Pinto, Ibraim Masciarelli
Vieira , Marcelo Luiz Campos
Danzmann, Luiz Claudio
Barberato , Silvio Henrique
Mady, Charles
Martinelli-Filho, Martino
Torbey , Ana Flavia Malheiros
Schwartzmann, Pedro Vellosa
Macedo, Ariane Vieira Scarlatelli
Ferreira , Silvia Moreira Ayub
Schmidt, Andre
Melo , Marcelo Dantas Tavares de
Lima-Filho, Moysés Oliveira
Sposito, Andrei C.
Brito, Flavio de Souza
Biolo, Andreia
Madrini-Junior, Vagner
Rizk, Stéphanie Itala
Mesquita, Evandro Tinoco
A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE. Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).
La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).
Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.
2.
Alcohol consumption during pregnancy by women from southern Brazil: a cross-sectional study Brazil crosssectional cross sectional
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Zottis, Laira Francielle Ferreira
; Souza, Mateus Arenhardt de
; Hartmann, Jéssica Karine
; Gama, Thiago Kenji Kurogi
; Rizental, Laís Borges
; Maciel, Anita Machado
; Gresele, Merialine
; Rosa, Ernani Bohrer da
; Nunes, Maurício Rouvel
; Rocha, Juliana Trevisan da
; Telles, Jorge Alberto Bianchi
; Cunha, André Campos da
; Zen, Paulo Ricardo Gazzola
; Rosa, Rafael Fabiano Machado
.
ABSTRACT BACKGROUND: Some maternal characteristics are related to alcohol intake during pregnancy, which irreversibly compromises the maternal-fetal binomial integrity. OBJECTIVES: To identify the frequency, impact, and factors associated with alcohol consumption during pregnancy. DESIGN AND SETTING: A cross-sectional study was performed at the Hospital Materno Infantil Presidente Vargas (HMIPV) in Porto Alegre/RS between March and December 2016. METHODS: A structured questionnaire was administered along with a medical records review. They refer to the maternal sociodemographic and gestational status, alcohol consumption patterns, and characteristics of the fetus/newborn. In the statistical analysis, P values < 0.05 were considered significant. RESULTS: The frequency of alcohol intake was 37.3%; this was characterized by the consumption of fermented beverages (89.3%), especially during the first trimester (79.6%). Risky consumption (high and/or early) occurred for 30.2% of participants. Risk factors associated with maternal alcohol consumption during pregnancy were tobacco use (P < 0.001) and abortion attempt (P = 0.023). Living with a partner (P = 0.002) and planning pregnancy (P = 0.009) were protective factors. Risky consumption was related to all of the aforementioned variables as well as threatened abortion (P = 0.023). CONCLUSIONS: Alcohol intake during pregnancy is common and affects nearly one-third of pregnant women. Knowledge of the population at risk and protective factors is essential for the development of campaigns that seek to reduce consumption and, therefore, its consequences for the mother and fetus. BACKGROUND maternalfetal fetal integrity OBJECTIVES impact SETTING crosssectional cross sectional HMIPV (HMIPV AlegreRS Alegre RS 2016 METHODS review status patterns fetusnewborn fetus newborn fetus/newborn analysis 005 0 05 0.0 significant RESULTS 37.3% 373 37 3 89.3%, 893 89.3% , 89 (89.3%) 79.6%. 796 79.6% . 79 6 (79.6%) high andor or early 302 30 2 30.2 participants 0.001 0001 001 0.023. 0023 0.023 023 0.023) 0.002 0002 002 0.009 0009 009 CONCLUSIONS onethird one third women therefore 201 00 0. 37.3 89.3 8 (89.3% 79.6 7 (79.6% 30. 0.00 000 0.02 02 20 37. 89. (89.3 79. (79.6 (89. (79. (89 (79 (8 (7 (
3.
Early ultra-processed foods consumption and hyperactivity/inattention in adolescence
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Ferreira, Ricardo Campos
; Marin, Angela Helena
; Vitolo, Marcia Regina
; Campagnolo, Paula Dal Bo
.
ABSTRACT OBJECTIVE To investigate the relationship between childhood consumption of ultra-processed foods and symptoms of hyperactivity/inattention in adolescents from São Leopoldo, a city in southern Brazil. METHODS Data were collected at four distinct stages: when participants were 12-16 months old in 2001 and 2002 and later when they were 3–4, 7–8, and 12–13 years old. During the interview at 12–16 months, mothers were asked about the introduction of sugar in their child’s diet. Two 24-hour recall surveys were conducted with children aged 3–4, 7–8, and 12–13 years to assess their consumption of ultra-processed foods. At the age of 12–13 years, the participants completed the Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), which screens for mental health problems. RESULTS Among the 173 adolescents, 22.5% exhibited hyperactivity symptoms. The consumption of ultra-processed foods in grams, kilocalories, and as a percentage of energy intake at 3-4 years old were found to be predictors of hyperactivity/inattention symptoms (RR: 0.81, 95%CI: 0.69–0.95; RR: 1.01, 95%CI: 1.00–1.02; RR: 1.02, 95%CI:1.01–1.02; RR: 1.25, 95%CI:1.04–1.51, respectively). CONCLUSION The consumption of ultra-processed foods at an early age was associated with hyperactivity and inattention symptoms in adolescence.
4.
Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio
; Simões, Marcus V.
; Correia, Edileide de Barros
; Marcondes-Braga, Fabiana Goulart
; Coelho-Filho, Otavio Rizzi
; Mesquita, Cláudio Tinoco
; Mathias Junior, Wilson
; Antunes, Murillo de Oliveira
; Arteaga-Fernández, Edmundo
; Rochitte, Carlos Eduardo
; Ramires, Felix José Alvarez
; Alves, Silvia Marinho Martins
; Montera, Marcelo Westerlund
; Lopes, Renato Delascio
; Oliveira Junior, Mucio Tavares de
; Scolari, Fernando Luis
; Avila, Walkiria Samuel
; Canesin, Manoel Fernandes
; Bocchi, Edimar Alcides
; Bacal, Fernando
; Moura, Lidia Zytynski
; Saad, Eduardo Benchimol
; Scanavacca, Mauricio Ibrahim
; Valdigem, Bruno Pereira
; Cano, Manuel Nicolas
; Abizaid, Alexandre Antonio Cunha
; Ribeiro, Henrique Barbosa
; Lemos Neto, Pedro Alves
; Ribeiro, Gustavo Calado de Aguiar
; Jatene, Fabio Biscegli
; Dias, Ricardo Ribeiro
; Beck-da-Silva, Luis
; Rohde, Luis Eduardo Paim
; Bittencourt, Marcelo Imbroinise
; Pereira, Alexandre da Costa
; Krieger, José Eduardo
; Villacorta Junior, Humberto
; Martins, Wolney de Andrade
; Figueiredo Neto, José Albuquerque de
; Cardoso, Juliano Novaes
; Pastore, Carlos Alberto
; Jatene, Ieda Biscegli
; Tanaka, Ana Cristina Sayuri
; Hotta, Viviane Tiemi
; Romano, Minna Moreira Dias
; Albuquerque, Denilson Campos de
; Mourilhe-Rocha, Ricardo
; Hajjar, Ludhmila Abrahão
; Brito Junior, Fabio Sandoli de
; Caramelli, Bruno
; Calderaro, Daniela
; Farsky, Pedro Silvio
; Colafranceschi, Alexandre Siciliano
; Pinto, Ibraim Masciarelli Francisco
; Vieira, Marcelo Luiz Campos
; Danzmann, Luiz Claudio
; Barberato, Silvio Henrique
; Mady, Charles
; Martinelli Filho, Martino
; Torbey, Ana Flavia Malheiros
; Schwartzmann, Pedro Vellosa
; Macedo, Ariane Vieira Scarlatelli
; Ferreira, Silvia Moreira Ayub
; Schmidt, Andre
; Melo, Marcelo Dantas Tavares de
; Lima Filho, Moysés Oliveira
; Sposito, Andrei C.
; Brito, Flávio de Souza
; Biolo, Andreia
; Madrini Junior, Vagner
; Rizk, Stephanie Itala
; Mesquita, Evandro Tinoco
.
5.
Diretriz Brasileira de Ergometria em População Adulta – 2024 202 20 2
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Carvalho, Tales de
; Freitas, Odilon Gariglio Alvarenga de
; Chalela, William Azem
; Hossri, Carlos Alberto Cordeiro
; Milani, Mauricio
; Buglia, Susimeire
; Precoma, Dalton Bertolim
; Falcão, Andréa Maria Gomes Marinho
; Mastrocola, Luiz Eduardo
; Castro, Iran
; Albuquerque, Pedro Ferreira de
; Coutinho, Ricardo Quental
; Brito, Fabio Sandoli de
; Alves, Josmar de Castro
; Serra, Salvador Manoel
; Santos, Mauro Augusto dos
; Colombo, Clea Simone Sabino de Souza
; Stein, Ricardo
; Herdy, Artur Haddad
; Silveira, Anderson Donelli da
; Castro, Claudia Lucia Barros de
; Silva, Miguel Morita Fernandes da
; Meneghello, Romeu Sergio
; Ritt, Luiz Eduardo Fonteles
; Malafaia, Felipe Lopes
; Marinucci, Leonardo Filipe Benedeti
; Pena, José Luiz Barros
; Almeida, Antônio Eduardo Monteiro de
; Vieira, Marcelo Luiz Campos
; Stier Júnior, Arnaldo Laffitte
.
6.
Mortality, hospitalizations, and persistence of symptoms in the outpatient setting of the first COVID-19 wave in Brazil: results of SARS-Brazil cohort study Mortality hospitalizations COVID19 COVID 19 COVID-1 Brazil SARSBrazil SARS COVID1 1 COVID-
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Fonseca, Henrique Andrade Rodrigues
; Pereira, Adriano Jose
; Nawa, Ricardo Kenji
; Sant’Anna, Viviane Aparecida Rodrigues
; Almeida, Tatiana Ferreira de
; Guimarães, Hélio Penna
; Tognon, Alexandre Pereira
; Marques, Lucas Miranda
; Silva, Lucas Santana Coelho da
; Bittencourt, Rafaela de Souza
; Gomes, Camila Pachêco
; Martins, Priscila de Aquino
; Oliveira, Aryadne Lyrio de
; Milan, Eveline Pipolo
; Dall’Orto, Frederico Toledo Campos
; Hoffman Filho, Conrado Roberto
; Almeida, Guacyra
; Hohmann, Fábio Barlem
; Moia, Diogo Duarte Fagundes
; Piano, Luciana Pereira Almeida
; Machado, Felipe Pinheiro
; Soares, Ronaldo Vicente Pereira
; Damiani, Lucas Petri
; Assis, Silvia Regina Lamas
; Amaro Junior, Edson
; Rizzo, Luiz Vicente
; Berwanger, Otávio
.
ABSTRACT Objective To evaluate deaths, hospitalizations, and persistence of symptoms in patients with COVID-19 after infection in an outpatient setting during the first COVID-19 wave in Brazil. Methods This prospective cohort was between April 2020 and February 2021. Hospitalized or non-hospitalized COVID-19 patients until five days after symptom onset were included. The outcomes measured were incidence of death, hospitalization, and persistence of more than two symptoms 60 days after discharge. Results Out of 1,198 patients enrolled in the study, 66.7% were hospitalized. A total of 289 patients died (1 [0.3%] non-hospitalized and 288 [36%] hospitalized). At 60 days, patients non-hospitalized during admission had more persistent symptoms (16.2%) compared to hospitalized (37.1%). The COVID-19 severity variables associated with the persistence of two or more symptoms were increased age (OR= 1.03; p=0.015), respiratory rate at hospital admission (OR= 1.11; p=0.005), length of hospital stay of more than 60 days (OR= 12.24; p=0.026), and need for intensive care unit admission (OR= 2.04; p=0.038). Conclusion COVID-19 survivors who were older, tachypneic at admission, had a hospital length of stay >60 days, and were admitted to the intensive care unit had more persistent symptoms than patients who did not require hospitalization in the early COVID-19 waves. ClinicalTrials.gov Identifier: NCT04479488. deaths hospitalizations COVID19 COVID 19 COVID-1 Brazil 202 2021 nonhospitalized non included death 6 discharge 1198 1 198 1,19 study 667 66 7 66.7 28 ( 0.3% 03 0 3 [0.3% 36% 36 [36% . hospitalized) 16.2% 162 16 2 (16.2% 37.1%. 371 37.1% 37 (37.1%) OR= OR (OR 1.03 103 p=0.015, p0015 p p=0.015 , 015 p=0.015) 1.11 111 11 p=0.005, p0005 p=0.005 005 p=0.005) 12.24 1224 12 24 p=0.026, p0026 p=0.026 026 p=0.026) 2.04 204 04 p=0.038. p0038 p=0.038 038 p=0.038) older >6 waves ClinicalTrialsgov ClinicalTrials gov Identifier NCT04479488 NCT COVID1 COVID- 20 119 1,1 66. 0.3 [0.3 [36 16.2 (16.2 37.1 (37.1% 1.0 10 p001 p=0.01 01 1.1 p000 p=0.00 00 12.2 122 p002 p=0.02 02 2.0 p003 p=0.03 > NCT0447948 1, 0. [0. [3 16. (16. 37. (37.1 1. p00 p=0.0 12. 2. NCT044794 [0 [ (16 (37. p0 p=0. NCT04479 (37 p=0 NCT0447 (3 p= NCT044 NCT04 NCT0
7.
Early ultra-processed foods consumption and hyperactivity/inattention in adolescence ultraprocessed ultra processed hyperactivityinattention hyperactivity inattention
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Ferreira, Ricardo Campos
; Marin, Angela Helena
; Vitolo, Marcia Regina
; Campagnolo, Paula Dal Bo
.
ABSTRACT OBJECTIVE To investigate the relationship between childhood consumption of ultra-processed foods and symptoms of hyperactivity/inattention in adolescents from São Leopoldo, a city in southern Brazil. METHODS Data were collected at four distinct stages: when participants were 12-16 months old in 2001 and 2002 and later when they were 3–4, 7–8, and 12–13 years old. During the interview at 12–16 months, mothers were asked about the introduction of sugar in their child’s diet. Two 24-hour recall surveys were conducted with children aged 3–4, 7–8, and 12–13 years to assess their consumption of ultra-processed foods. At the age of 12–13 years, the participants completed the Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), which screens for mental health problems. RESULTS Among the 173 adolescents, 22.5% exhibited hyperactivity symptoms. The consumption of ultra-processed foods in grams, kilocalories, and as a percentage of energy intake at 3-4 years old were found to be predictors of hyperactivity/inattention symptoms (RR: 0.81, 95%CI: 0.69–0.95; RR: 1.01, 95%CI: 1.00–1.02; RR: 1.02, 95%CI:1.01–1.02; RR: 1.25, 95%CI:1.04–1.51, respectively). CONCLUSION The consumption of ultra-processed foods at an early age was associated with hyperactivity and inattention symptoms in adolescence. ultraprocessed ultra processed hyperactivityinattention Leopoldo Brazil stages 1216 12 16 12-1 200 34 3 4 3–4 78 7 8 7–8 1213 13 12–1 childs child s diet 24hour hour 24 HyperactivityInattention Hyperactivity Inattention SDQ, SDQ , (SDQ) problems 17 225 22 5 22.5 grams kilocalories 3- RR (RR 081 0 81 0.81 95%CI 95CI CI 95 0.69–0.95 069095 69 101 1 01 1.01 1.00–1.02 100102 00 02 102 1.02 95%CI1.01–1.02 95CI101102 1.01–1.02 95%CI:1.01–1.02 125 25 1.25 95%CI1.04–1.51, 95CI104151 1.04–1.51, 04 51 95%CI:1.04–1.51 respectively. respectively . respectively) adolescence 121 12- 20 3– 7– 12– 2 (SDQ 22. 08 0.8 9 0.69–0.9 06909 6 10 1.0 1.00–1.0 10010 CI1 95%CI1.01–1.0 95CI10110 101102 1.01–1.0 95%CI:1.01–1.0 1.2 95%CI1.04–1.51 95CI10415 104151 1.04–1.51 95%CI:1.04–1.5 0. 0.69–0. 0690 1. 1.00–1. 1001 95%CI1.01–1. 95CI1011 10110 1.01–1. 95%CI:1.01–1. 95%CI1.04–1.5 95CI1041 10415 1.04–1.5 95%CI:1.04–1. 0.69–0 069 1.00–1 100 95%CI1.01–1 95CI101 1011 1.01–1 95%CI:1.01–1 95%CI1.04–1. 95CI104 1041 1.04–1. 95%CI:1.04–1 0.69– 06 1.00– 95%CI1.01– 95CI10 1.01– 95%CI:1.01– 95%CI1.04–1 104 1.04–1 95%CI:1.04– 0.69 1.00 95%CI1.01 95CI1 95%CI:1.01 95%CI1.04– 1.04– 95%CI:1.04 0.6 95%CI1.0 95%CI:1.0 95%CI1.04 1.04 95%CI1. 95%CI:1. 95%CI1 95%CI:1
8.
Prognostic significance of gastrointestinal dysfunction in critically ill patients with COVID-19 COVID19 COVID 19 COVID-1 COVID1 1 COVID-
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Lima, Ricardo Antônio Correia
; Blaser, Annika Reintam
; Ramalho, Júlia Falconiere Paredes
; Lacerda, Barbara Cristina de Almeida Campos
; Sadigurschi, Gabriela
; Aarestrup, Paula Fonseca
; Sales, Rafael Aguilar
; Mansur Filho, João
; Ferreira, Roberto Muniz
.
RESUMO Objetivo: Analisar a morbidade e a mortalidade intra-hospitalar e em 1 ano associadas à disfunção gastrintestinal aguda em pacientes graves com COVID-19 por meio de um sistema de pontuação predefinido. Métodos: Entre março e julho de 2020, pacientes consecutivos hospitalizados com COVID-19 de uma única instituição foram analisados retrospectivamente por meio de revisão de prontuários médicos. Foram incluídos somente aqueles que permaneceram na unidade de terapia intensiva por mais de 24 horas. A disfunção gastrintestinal foi avaliada segundo um sistema predefinido de pontuação de lesão gastrintestinal progressiva de cinco pontos, considerando os primeiros 7 dias de hospitalização. Também se registraram os dados laboratoriais, as comorbidades, a necessidade de ventilação mecânica, a duração da internação na unidade de terapia intensiva e as taxas de mortalidade intra-hospitalar e em 1 ano. Resultados: Do total de 230 pacientes examinados, 215 foram incluídos na análise. A idade mediana foi de 68 anos (54 - 82), e 57,7% eram do sexo masculino. Os escores totais de disfunção gastrintestinal foram zero (79,1%), I (15,3%), II (4,7%), III (0,9%) e IV (0%). Qualquer manifestação de disfunção gastrintestinal estava presente em 20,9% de todos os pacientes e foi associada à maior duração da internação (20 dias [11 - 33] versus 7 dias [4 - 16]; p < 0,001) e a níveis mais altos de proteína C-reativa na admissão (12,8mg/mL [6,4 - 18,4] versus 5,7mg/mL [3,2 - 13,4]; p < 0,001). O escore de disfunção gastrintestinal foi significativamente associado à mortalidade (RC 2,8; IC95% 1,7 - 4,8; p < 0,001) e à necessidade de ventilação mecânica (RC 2,8; IC95% 1,7 - 4,6; p < 0,001). As taxas de mortalidade hospitalar e em 1 ano aumentaram progressivamente com o aumento dos escores de disfunção gastrintestinal. Conclusão: Na série atual de pacientes de unidades de terapia intensiva com COVID-19, a gravidade da disfunção gastrintestinal, conforme definida por um sistema de pontuação predefinido, foi preditiva de resultados adversos no hospital e em 1 ano. Objetivo intrahospitalar intra COVID19 COVID 19 COVID-1 Métodos 2020 médicos 2 horas pontos hospitalização laboratoriais comorbidades Resultados 23 examinados 21 análise 6 54 (5 82, 82 , 82) 577 57 57,7 masculino 79,1%, 791 79,1% 79 (79,1%) 15,3%, 153 15,3% 15 3 (15,3%) 4,7%, 47 4,7% 4 (4,7%) 0,9% 09 0 9 (0,9% 0%. 0% . (0%) 209 20 20,9 (2 11 [1 33 [ 16 16] 0,001 0001 001 Creativa C reativa 12,8mg/mL 128mgmL mgmL 12 8mg mL mg 6,4 64 [6, 18,4 184 18 57mgmL 5 7mg 3,2 32 [3, 13,4 134 13 13,4] 0,001. RC 2,8 28 8 IC95 IC 17 1, 4,8 48 4,6 46 Conclusão COVID19, 19, COVID1 COVID- 202 ( 57, 79,1 (79,1% 15,3 (15,3% 4,7 (4,7% 0,9 (0,9 (0% 20, 0,00 000 00 6, [6 18, 3, [3 13, 2, IC9 4, 79, (79,1 15, (15,3 (4,7 0, (0, (0 0,0 (79, (15, (4, (79 (15 (4 (7 (1
ABSTRACT Objective: To analyze in-hospital and 1-year morbidity and mortality associated with acute gastrointestinal dysfunction in critically ill patients with COVID-19 via a prespecified scoring system. Methods: Between March and July 2020, consecutive hospitalized patients with COVID-19 from a single institution were retrospectively analyzed by medical chart review. Only those who remained in the intensive care unit for more than 24 hours were included. Gastrointestinal dysfunction was assessed according to a predefined 5-point progressive gastrointestinal injury scoring system, considering the first 7 days of hospitalization. Laboratory data, comorbidities, the need for mechanical ventilation, the duration of intensive care unit stay, and subsequent in-hospital and 1-year mortality rates were also recorded. Results: Among 230 patients who were screened, 215 were included in the analysis. The median age was 68 years (54 - 82), and 57.7% were male. The total gastrointestinal dysfunction scores were 0 (79.1%), I (15.3%), II (4.7%), III (0.9%), and IV (0%). Any manifestation of gastrointestinal dysfunction was present in 20.9% of all patients and was associated with longer lengths of stay (20 days [11 - 33] versus 7 days [4 – 16]; p < 0.001] and higher C-reactive protein levels on admission (12.8mg/mL [6.4 - 18.4] versus 5.7mg/mL [3.2 - 13.4]; p < 0.001). The gastrointestinal dysfunction score was significantly associated with mortality (OR 2.8; 95%CI 1.7 - 4.8; p < 0.001) and the need for mechanical ventilation (OR 2.8; 95%CI 1.7 - 4.6; p < 0.001). Both in-hospital and 1-year death rates progressively increased as gastrointestinal dysfunction scores increased. Conclusion: In the current series of intensive care unit patients with COVID-19, gastrointestinal dysfunction severity, as defined by a prespecified scoring system, was predictive of adverse in-hospital and 1-year outcomes. Objective inhospital hospital 1year year 1 COVID19 COVID 19 COVID-1 system Methods 2020 review 2 5point point 5 hospitalization data comorbidities recorded Results 23 screened 21 analysis 6 54 (5 82, 82 , 82) 577 57 57.7 male 79.1%, 791 79.1% 79 (79.1%) 15.3%, 153 15.3% 15 3 (15.3%) 4.7%, 47 4.7% 4 (4.7%) 0.9%, 09 0.9% 9 (0.9%) 0%. 0% . (0%) 209 20 20.9 (2 11 [1 33 [ 16 16] 0.001 0001 001 Creactive C reactive 12.8mg/mL 128mgmL mgmL 12 8mg mL mg 6.4 64 [6. 18.4 184 18 57mgmL 7mg 3.2 32 [3. 13.4 134 13 13.4] 0.001. OR 2.8 28 8 95CI CI 95 17 1. 4.8 48 4.6 46 Conclusion COVID19, 19, severity outcomes COVID1 COVID- 202 ( 57. 79.1 (79.1% 15.3 (15.3% 4.7 (4.7% 0.9 (0.9% (0% 20. 0.00 000 00 6. [6 18. 3. [3 13. 2. 4. 79. (79.1 15. (15.3 (4.7 0. (0.9 (0 0.0 (79. (15. (4. (0. (79 (15 (4 (7 (1
9.
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
10.
The role of neck ultrasound in the follow-up of low- and intermediate- risk papillary thyroid cancer
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Lopes, Sara Gomes de Campos
; Ferreira, David Nuno Dias Silva
; Fernandes, Vera Adriana Ribeiro
; Marques, Helena Manuela da Costa Cardoso
; Pereira, Ricardo Fernando da Silva Santos
; Monteiro, Ana Margarida Carvalho
.
ABSTRACT Objective: The optimal time for a neck ultrasound (US) in the follow-up of papillary thyroid cancer (PTC) after the first year is undetermined. We aimed to verify the utility of routine neck US in the surveillance of patients diagnosed with low- and intermediate-risk PTC with no evidence of disease at the one-year assessment. Materials and methods: We conducted a retrospective longitudinal study of patients with low- and intermediate-risk PTC with normal neck US, unstimulated serum thyroglobulin (Tg) < 1 ng/mL and negative anti-Tg antibodies at the one-year follow-up. Patients were divided into group 1 [undetectable Tg (<0.20 ng/mL)] and group 2 [detectable Tg but < 1 ng/mL]. The negative predictive value (NPV) of the one-year unstimulated Tg at the five-year and last follow-up visits was calculated. Results: We included n = 88 patients in group 1 and n = 8 patients in group 2. No patient from group 1 presented suspicious US findings at the five-year evaluation [NPV: 100.0% (95% confidence interval (CI): 95.5%-100.0%)], and at the last visit, only one patient had developed a lymph node classified as suspicious [NPV: 98.8% (95% CI: 93.2%-100.0%); mean follow-up: 6.7 years]. In group 2, two patients’ USs presented suspicious findings at the five-year evaluation [NPV: 75.0% (95% CI: 34.9%-96.8%)]. At the last visit, only one patient persisted with suspicious findings in the US [NPV: 87.5% (95% CI: 47.4%-99.7%); mean follow-up: 6.5 years]. Conclusion: Low- and intermediate-risk PTC with an excellent response to treatment at the one-year assessment can be safely monitored with regular unstimulated Tg assessments. Conclusions should not be drawn for Tg levels between 0.20-0.99 ng/mL.
11.
Crop coefficient estimated by degree-days for ‘Marandu’ palisadegrass and mixed forage
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Pantojo de Souza, Débora
; Carniato Sanches, Arthur
; Campos Mendonça, Fernando
; Macedo Pezzopane, José Ricardo
; Morais Amorim, Danielle
; Lamede Ferreira de Jesus, Fernanda
.
Revista de la Facultad de Ciencias Agrarias. Universidad Nacional de Cuyo
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Resumen Considerando la importancia económica de los pastos, existe una necesidad de investigar los parámetros que afectan los coeficientes de cultivo utilizados para el manejo del riego. En este experimento, nuestro objetivo fue determinar el coeficiente de cultivo del pasto ‘Marandu’ en función de la acumulación de grados-días y estimar el consumo de agua del cultivo puro (pasto ‘Marandu’) y del cultivo mixto (pasto ‘Marandu’ + avena negra + raigrás italiano) regí menes de cultivo. La investigación se llevó a cabo en la Escuela de Agricultura Luiz de Queiroz en Piracicaba/SP, Brasil, entre 2016 y 2017, en este periodo se registró la evapotranspiración utilizando lisímetros de pesaje. La evapotranspiración del cultivo se calculó utilizando la variación de peso promedio registrada por lisímetros. Los datos de una estación meteoro lógica automatizada se utilizaron para estimar la evapotranspiración de referencia y calcular los grados-días. Se generaron ecuaciones y modelos de regresión con relación al coeficiente de cultivo y los grados-días acumulados durante dos períodos estacionales (primavera/verano y otoño/invierno). Los modelos matemáticos se probaron durante dos ciclos anuales, de 2015 a 2018 y mostraron mejores resultados, en términos de precisión y exactitud, en el sistema de cultivo único en primavera/verano en los años 2017/18.
Abstract Considering profitability in pasture-based systems, investigating parameters affecting crop coefficients for irrigation management becomes important. In this experiment, we determined the crop coefficient of ‘Marandu’ palisadegrass based on accumulated degree-days and estimated plant water consumption under single (‘Marandu’ palisade grass) and mixed (‘Marandu’ palisadegrass + black oats + Italian ryegrass) cropping regimes. The research was conducted at the Luiz de Queiroz College of Agriculture in Piracicaba, São Paulo, Brazil, between 2016 and 2017. Evapotranspiration was assessed using weighing lysimeters while crop evapotranspiration was calculated using mean weight variation. Reference evapotranspiration and degree-days were estimated. Data were obtained from an automated weather station. Equations and regression models relating crop coefficient with accumulated degree-days were generated for two seasons (spring/summer and autumn/ winter) and evaluated for two year-cycles, from 2015 to 2018. The results showed better prediction accuracy for the single cropping system in spring/summer 2017-18.
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12.
Posicionamento Brasileiro sobre o Uso da Multimodalidade de Imagens na Cardio-Oncologia – 2021
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Melo, Marcelo Dantas Tavares de
; Paiva, Marcelo Goulart
; Santos, Maria Verônica Câmara
; Rochitte, Carlos Eduardo
; Moreira, Valéria de Melo
; Saleh, Mohamed Hassan
; Brandão, Simone Cristina Soares
; Gallafrio, Claudia Cosentino
; Goldwasser, Daniel
; Gripp, Eliza de Almeida
; Piveta, Rafael Bonafim
; Silva, Tonnison Oliveira
; Santo, Thais Harada Campos Espirito
; Ferreira, Waldinai Pereira
; Salemi, Vera Maria Cury
; Cauduro, Sanderson A.
; Barberato, Silvio Henrique
; Lopes, Heloísa M. Christovam
; Pena, José Luiz Barros
; Rached, Heron Rhydan Saad
; Miglioranza, Marcelo Haertel
; Pinheiro, Aurélio Carvalho
; Vrandecic, Bárbara Athayde Linhares Martins
; Cruz, Cecilia Beatriz Bittencourt Viana
; Nomura, César Higa
; Cerbino, Fernanda Mello Erthal
; Costa, Isabela Bispo Santos da Silva
; Coelho Filho, Otavio Rizzi
; Carneiro, Adriano Camargo de Castro
; Burgos, Ursula Maria Moreira Costa
; Fernandes, Juliano Lara
; Uellendahl, Marly
; Calado, Eveline Barros
; Senra, Tiago
; Assunção, Bruna Leal
; Freire, Claudia Maria Vilas
; Martins, Cristiane Nunes
; Sawamura, Karen Saori Shiraishi
; Brito, Márcio Miranda
; Jardim, Maria Fernanda Silva
; Bernardes, Renata Junqueira Moll
; Diógenes, Tereza Cristina
; Vieira, Lucas de Oliveira
; Mesquita, Claudio Tinoco
; Lopes, Rafael Willain
; Segundo Neto, Elry Medeiros Vieira
; Rigo, Letícia
; Marin, Valeska Leite Siqueira
; Santos, Marcelo José
; Grossman, Gabriel Blacher
; Quagliato, Priscila Cestari
; Alcantara, Monica Luiza de
; Teodoro, José Aldo Ribeiro
; Albricker, Ana Cristina Lopes
; Barros, Fanilda Souto
; Amaral, Salomon Israel do
; Porto, Carmen Lúcia Lascasas
; Barros, Marcio Vinícius Lins
; Santos, Simone Nascimento dos
; Cantisano, Armando Luís
; Petisco, Ana Cláudia Gomes Pereira
; Barbosa, José Eduardo Martins
; Veloso, Orlando Carlos Glória
; Spina, Salvador
; Pignatelli, Ricardo
; Hajjar, Ludhmilla Abrahão
; Kalil Filho, Roberto
; Lopes, Marcelo Antônio Cartaxo Queiroga
; Vieira, Marcelo Luiz Campos
; Almeida, André Luiz Cerqueira
.
https://doi.org/10.36660/abc.20200266
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13.
Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021
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Marcondes-Braga, Fabiana G.
; Moura, Lídia Ana Zytynski
; Issa, Victor Sarli
; Vieira, Jefferson Luis
; Rohde, Luis Eduardo
; Simões, Marcus Vinícius
; Fernandes-Silva, Miguel Morita
; Rassi, Salvador
; Alves, Silvia Marinho Martins
; Albuquerque, Denilson Campos de
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Ramires, Felix José Alvarez
; Bacal, Fernando
; Rossi Neto, João Manoel
; Danzmann, Luiz Claudio
; Montera, Marcelo Westerlund
; Oliveira Junior, Mucio Tavares de
; Clausell, Nadine
; Silvestre, Odilson Marcos
; Bestetti, Reinaldo Bulgarelli
; Bernadez-Pereira, Sabrina
; Freitas Jr, Aguinaldo F.
; Biolo, Andréia
; Barretto, Antonio Carlos Pereira
; Jorge, Antônio José Lagoeiro
; Biselli, Bruno
; Montenegro, Carlos Eduardo Lucena
; Santos Júnior, Edval Gomes dos
; Figueiredo, Estêvão Lanna
; Fernandes, Fábio
; Silveira, Fabio Serra
; Atik, Fernando Antibas
; Brito, Flávio de Souza
; Souza, Germano Emílio Conceição
; Ribeiro, Gustavo Calado de Aguiar
; Villacorta, Humberto
; Souza Neto, João David de
; Goldraich, Livia Adams
; Beck-da-Silva, Luís
; Canesin, Manoel Fernandes
; Bittencourt, Marcelo Imbroinise
; Bonatto, Marcely Gimenes
; Moreira, Maria da Consolação Vieira
; Avila, Mônica Samuel
; Coelho Filho, Otavio Rizzi
; Schwartzmann, Pedro Vellosa
; Mourilhe-Rocha, Ricardo
; Mangini, Sandrigo
; Ferreira, Silvia Moreira Ayub
; Figueiredo Neto, José Albuquerque de
; Mesquita, Evandro Tinoco
.
https://doi.org/10.36660/abc.20210367
3168 downloads
14.
Selection of earthquake ground motion accelerograms for the continental margin of Southeastern Brazil
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Camelo, Cristian Yair Soriano
; Tarazona, Samuel Felipe Mollepaza
; Almeida, Maria Cascão Ferreira de
; Almeida, Márcio de Souza Soares de
; Borges, Ricardo Garske
.
Resumen Brasil se encuentra en una región intra-placa de baja a moderada sismicidad, esto quiere decir que hay una limitada disponibilidad de registros de acelerogramas representativos de la región. Parte de un estudio de respuesta local o del diseño sísmico de estructuras requiere del uso de registros aceleración-tiempo que sean compatibles con un espectro de diseño. El presente trabajo tiene como objetivo la aplicación de metodologías para obtener acelerogramas representativos de la región sudeste brasilera, en particular en la región offshore de la cuenca de Campos. Se utilizó la información del análisis probabilístico del riesgo sísmico desarrollado para la región de interés en este estudio para obtener el espectro de respuesta de diseño y para definir los escenarios sísmicos que generan mayor influencia. Adicionalmente, se utilizó la información de acelerogramas registrados a partir de dos sismos relativamente recientes ocurridos en la región sudeste brasilera, para la aplicación de una de las metodologías de obtención de acelerogramas sintéticos.
Abstract Brazil is in an intraplate area of low to moderate seismicity, this means that few or no records of strong ground motions are available. Part of the site response analysis and seismic design of structures require the use of acceleration time-histories compatible with a specified target response spectrum. This study aims to utilize methodologies based on the use of existing earthquake records from a well-known database and synthetic accelerograms to obtain ground motions representative of the Brazilian Southeast Region, particularly in the offshore Campos Basin. Information from a probabilistic seismic hazard assessment performed in the interest area was employed as input to the methodologies applied in terms of target response spectrum and the dominant earthquake scenarios. Besides, the acceleration time-histories of two relatively recent earthquakes that occurred in the Brazilian Southeast were used to apply one of the approaches to obtain a synthetic spectrum compatible accelerogram.
https://doi.org/10.15446/dyna.v88n217.93068
13 downloads
15.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
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