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1.
[SciELO Preprints] - Vertical Transmission of Oropouche Virus in a Newly Affected Extra-Amazon Region: A Case Study of Fetal Infection and Death in Ceará, Brazil
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Garcia Filho, Carlos
Lima Neto, Antônio Silva
Maia, Ana Maria Peixoto Cabral
Silva, Luiz Osvaldo Rodrigues
Cavalcante, Robson da Costa
Monteiro, Higor da Silva
Marques , Kamilla Carneiro Alves
Oliveira, Rebeca de Souza
Gadelha, Sami de Andrade Cordeiro
Melo, Deborah Nunes de
Mota, Anacelia Gomes de Matos
Lima, Shirlene Telmos Silva de
Cavalcante, Karene Ferreira
Duarte, Larissa Maria Façanha
Cavalcante, Ítalo José Mesquita
Mello, Leda Maria Simões
Alencar, Carlos Henrique
Freitas, Andre Ricardo Ribas
Cavalcanti, Luciano Pamplona de Góes
A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou o RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.
A transmissão do vírus Oropouche (OROV) para novas regiões, juntamente com um aumento de casos e o surgimento de formas graves, anteriormente não suspeitas, expressas preocupações de saúde pública. Uma fazendeira grávida de 40 anos, com 30 semanas de gestação, desenvolvimento de febre, mialgia e dor de cabeça, com infecção por OROV confirmada por RT-qPCR. as avaliações maternas e fetais não foram inicialmente concluídas. No entanto, na semana seguinte, um paciente notou diminuição dos movimentos fetais, e o ultrassom confirmou a morte fetal. O diagnóstico molecular detectou RNA do OROV em vários espécimes fetais. Este caso de transmissão vertical ressalta a necessidade urgente de proteger as mulheres grávidas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais profundamente os potenciais mecanismos patogênicos do vírus.
A propagação do vírus Oropouche (OROV) em novas regiões, junto com um aumento de casos e o aparecimento de formas graves não reconhecidas anteriormente, suscitou preocupações importantes de saúde pública. Uma granjera embarazada de 40 anos em 30 semanas de gestação apresentou febre, mialgia e dor de cabeça, e a infecção por OROV foi confirmada por RT-qPCR. As avaliações maternas e fetais não foram avaliadas inicialmente. No entanto, na semana seguinte, o paciente notou uma diminuição dos movimentos fetais e a ecografia confirmada a morte fetal. Os diagnósticos moleculares detectam ARN de OROV em múltiplas amostras fetais. Este caso de transmissão vertical justifica a necessidade urgente de proteger as mulheres embaraçadas, incorporar o OROV no diagnóstico diferencial de doenças febris e investigar mais o fundo dos possíveis mecanismos patogênicos do vírus.
2.
Curva de Aprendizagem da Mortalidade Hospitalar da Substituição da Válvula Aórtica Transcateter: Insights do Registro Nacional Brasileiro Transcateter
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Bernardi, Fernando Luiz de Melo
; Abizaid, Alexandre A.
; Brito Jr, Fábio Sândoli de
; Lemos, Pedro A.
; Siqueira, Dimytri Alexandre Alvim de
; Costa, Ricardo Alves
; Leite, Rogério Eduardo Gomes Sarmento
; Mangione, Fernanda Marinho
; Thiago, Luiz Eduardo Koenig São
; Mangione, José A.
; Lima, Valter Correia de
; Oliveira, Adriano Dourado
; Marino, Marcos Antônio
; Cardoso, Carlos José Francisco
; Caramori, Paulo R. A.
; Tumelero, Rogério
; Portela, Antenor Lages Fortes
; Prudente, Mauricio
; Henriques, Leônidas Alvarenga
; Souza, Fabio Solano
; Bezerra, Cristiano Guedes
; Prado Jr, Guy F. A.
; Freitas, Leandro Zacaris Figueiredo
; Nogueira, Ederlon Ferreira
; Meireles, George César Ximenes
; Pope, Renato Bastos
; Guerios, Enio
; Andrade, Pedro Beraldo de
; Santos, Luciano de Moura
; Marchi, Mauricio Felippi de Sá
; Fundão, Nelson Henrique Fantin
; Ribeiro, Henrique Barbosa
.
Resumo Fundamento Dados robustos sobre a curva de aprendizagem (LC) da substituição da válvula aórtica transcateter (TAVR) são escassos nos países em desenvolvimento. Objetivo Avaliar a LC da TAVR no Brasil ao longo do tempo. Métodos Analisamos dados do registro brasileiro de TAVR de 2008 a 2023. Pacientes de cada centro foram numerados cronologicamente em número sequencial de caso (NSC). A LC foi realizada usando um spline cúbico restrito ajustado para o EuroSCORE-II e o uso de próteses de nova geração. Ainda, os desfechos hospitalares foram comparados entre grupos definidos de acordo com o nível de experiência, com base no NSC: 1º ao 40º caso (experiência inicial), 41º ao 80º caso (experiência básica), 81º ao 120º caso (experiência intermediária) e 121º caso em diante (experiência alta). Análises adicionais foram conduzidas de acordo com o número de casos tratados antes de 2014 (>40 e ≤40 procedimentos). O nível de significância adotado foi p <0,05. Resultados Foram incluídos 3194 pacientes de 25 centros. A idade média foi 80,7±8,1 anos e o EuroSCORE II médio foi 7±7,1. A análise da LC demonstrou uma queda na mortalidade hospitalar ajustada após o tratamento de 40 pacientes. Um patamar de nivelamento na curva foi observado após o caso 118. A mortalidade hospitalar entre os grupos foi 8,6%, 7,7%, 5,9%, e 3,7% para experiência inicial, básica, intermediária e alta, respectivamente (p<0,001). A experiência alta foi preditora independente de mortalidade mais baixa (OR 0,57, p=0,013 vs. experiência inicial). Centros com baixo volume de casos antes de 2014 não mostraram uma redução significativa na probabilidade de morte com o ganho de experiência, enquanto centros com alto volume de casos antes de 2014 apresentaram uma melhora contínua após o caso de número 10. Conclusão Observou-se um fenômeno de LC para a mortalidade hospitalar do TAVR no Brasil. Esse efeito foi mais pronunciado em centros que trataram seus 40 primeiros casos antes de 2014 que naqueles que o fizeram após 2014. (LC (TAVR desenvolvimento tempo 200 2023 NSC. NSC . (NSC) EuroSCOREII geração Ainda º inicial , inicial) básica básica) alta. alta) 201 >40 (>4 ≤4 procedimentos. procedimentos procedimentos) 005 0 05 <0,05 319 2 80781 80 7 8 1 80,7±8, 771 7±7,1 4 118 86 6 8,6% 77 7,7% 59 5 9 5,9% 37 3 3,7 p<0,001. p0001 p<0,001 001 (p<0,001) OR 057 57 0,57 p0013 013 p=0,01 vs inicial. 10 Observouse Observou se 20 202 (NSC >4 (> ≤ 00 <0,0 31 8078 80,7±8 7±7, 11 8,6 7,7 5,9 3, p000 p<0,00 (p<0,001 0,5 p001 01 p=0,0 > ( <0, 807 80,7± 7±7 8, 7, 5, p00 p<0,0 (p<0,00 0, p=0, <0 80,7 7± p0 p<0, (p<0,0 p=0 < 80, p<0 (p<0, p= p< (p<0 (p< (p
Abstract Background Robust data on the learning curve (LC) of transcatheter aortic valve replacement (TAVR) are lacking in developing countries. Objective To assess TAVR’s LC in Brazil over time. Methods We analyzed data from the Brazilian TAVR registry from 2008 to 2023. Patients from each center were numbered chronologically in case sequence numbers (CSNs). LC was performed using restricted cubic splines adjusted for EuroSCORE-II and the use of new-generation prostheses. Also, in-hospital outcomes were compared between groups defined according to the level of experience based on the CSN: 1st to 40th (initial-experience), 41st to 80th (early-experience), 81st to 120th (intermediate-experience), and over 121st (high-experience). Additional analysis was performed grouping hospitals according to the number of cases treated before 2014 (>40 and ≤40 procedures). The level of significance adopted was <0.05. Results A total of 3,194 patients from 25 centers were included. Mean age and EuroSCORE II were 80.7±8.1 years and 7±7.1, respectively. LC analysis demonstrated a drop in adjusted in-hospital mortality after treating 40 patients. A leveling off of the curve was observed after case #118. In-hospital mortality across the groups was 8.6%, 7.7%, 5.9%, and 3.7% for initial-, early-, intermediate-, and high-experience, respectively (p<0.001). High experience independently predicted lower mortality (OR 0.57, p=0.013 vs. initial experience). Low-volume centers before 2014 showed no significant decrease in the likelihood of death with gained experience, whereas high-volume centers had a continuous improvement after case #10. Conclusion A TAVR LC phenomenon was observed for in-hospital mortality in Brazil. This effect was more pronounced in centers that treated their first 40 cases before 2014 than those that reached this milestone after 2014. (LC (TAVR countries TAVRs s time 200 2023 CSNs. CSNs . (CSNs) EuroSCOREII newgeneration new generation prostheses Also inhospital hospital CSN st th initialexperience, initialexperience , (initial-experience) earlyexperience, earlyexperience early (early-experience) intermediateexperience, intermediateexperience intermediate (intermediate-experience) highexperience. highexperience high (high-experience) 201 >40 (>4 ≤4 procedures. procedures procedures) 005 0 05 <0.05 3194 3 194 3,19 2 included 80781 80 7 8 1 80.7±8. 771 7±7.1 4 118 #118 Inhospital In 86 6 8.6% 77 7.7% 59 5 9 5.9% 37 3.7 initial, initial- early, early- intermediate, intermediate- highexperience, high-experience p<0.001. p0001 p p<0.001 001 (p<0.001) OR 057 57 0.57 p0013 013 p=0.01 vs experience. experience) Lowvolume Low volume highvolume 10 #10 20 202 (CSNs (initial-experience (early-experience (intermediate-experience (high-experience >4 (> ≤ 00 <0.0 319 19 3,1 8078 80.7±8 7±7. 11 #11 8.6 7.7 5.9 3. p000 p<0.00 (p<0.001 0.5 p001 01 p=0.0 #1 > ( <0. 31 3, 807 80.7± 7±7 8. 7. 5. p00 p<0.0 (p<0.00 0. p=0. # <0 80.7 7± p0 p<0. (p<0.0 p=0 < 80. p<0 (p<0. p= p< (p<0 (p< (p
3.
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
4.
The Challenges of Implementing a Text Message Intervention to Promote Behavioral Change in Primary Care Patients With Hypertension and Diabetes
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Oliveira, João Antonio de Queiroz
; Cimini, Christiane
; Almeida, Vania
; Maia, Junia Xavier
; Resende, Raissa Eda
; Gualberto, Leticia Alves
; Santos, Pedro Henrique Lauar
; Gomes, Paulo R.
; Bonisson, Leonardo
; Paixão, Maria Cristina
; Costa, Janaina Moutinho
; Cardoso, Clareci Silva
; Santo, Karla
; Ribeiro, Antonio
; Martins, Maria Auxiliadora
; Marcolino, Milena S.
.
International Journal of Cardiovascular Sciences
- Journal Metrics
Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program’s long-term effects on clinical outcomes. solutions lowincome low income selfreported self 20 activity adherence motivation Mucuri MG diseases months 13 11 86.0% 860 86 0 (86.0% 86.3%, 863 86.3% , 3 (86.3%) 90.6%, 906 90.6% 90 (90.6%) 65.0% 650 65 (65.0%) 846 84 84.6 healthier 85.5%, 855 85.5% 85 (85.5%) 65.8%, 658 65.8% (65.8%) 56.4%. 564 56.4% . 56 4 (56.4%) 60.7% 607 60 7 (60.7% acquaintances 89.7% 897 89 (89.7% 95.7%. 957 95.7% 95 (95.7%) lowresource resource settings programs s longterm long term outcomes 2 1 86.0 (86.0 86.3 (86.3% 90.6 9 (90.6% 65.0 (65.0% 84. 85.5 (85.5% 65.8 (65.8% 56.4 (56.4% 60.7 (60.7 89.7 (89.7 95.7 (95.7% 86. (86. (86.3 90. (90.6 65. (65.0 85. (85.5 (65.8 56. (56.4 60. (60. 89. (89. 95. (95.7 (86 (90. (65. (85. (56. (60 (89 (95. (8 (90 (65 (85 (56 (6 (95 ( (9 (5
5.
Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023 202 20 2
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Teixeira, Ricardo Alkmim
; Fagundes, Alexsandro Alves
; Baggio Junior, José Mário
; Oliveira, Júlio César de
; Medeiros, Paulo de Tarso Jorge
; Valdigem, Bruno Pereira
; Teno, Luiz Antônio Castilho
; Silva, Rodrigo Tavares
; Melo, Celso Salgado de
; Elias Neto, Jorge
; Moraes Júnior, Antonio Vitor
; Pedrosa, Anisio Alexandre Andrade
; Porto, Fernando Mello
; Brito Júnior, Hélio Lima de
; Souza, Thiago Gonçalves Schroder e
; Mateos, José Carlos Pachón
; Moraes, Luis Gustavo Belo de
; Forno, Alexander Romeno Janner Dal
; D’Avila, Andre Luiz Buchele
; Cavaco, Diogo Alberto de Magalhães
; Kuniyoshi, Ricardo Ryoshim
; Pimentel, Mauricio
; Camanho, Luiz Eduardo Montenegro
; Saad, Eduardo Benchimol
; Zimerman, Leandro Ioschpe
; Oliveira, Eduardo Bartholomay
; Scanavacca, Mauricio Ibrahim
; Martinelli Filho, Martino
; Lima, Carlos Eduardo Batista de
; Peixoto, Giselle de Lima
; Darrieux, Francisco Carlos da Costa
; Duarte, Jussara de Oliveira Pinheiro
; Galvão Filho, Silas dos Santos
; Costa, Eduardo Rodrigues Bento
; Mateo, Enrique Indalécio Pachón
; Melo, Sissy Lara De
; Rodrigues, Thiago da Rocha
; Rocha, Eduardo Arrais
; Hachul, Denise Tessariol
; Lorga Filho, Adalberto Menezes
; Nishioka, Silvana Angelina D’Orio
; Gadelha, Eduardo Barreto
; Costa, Roberto
; Andrade, Veridiana Silva de
; Torres, Gustavo Gomes
; Oliveira Neto, Nestor Rodrigues de
; Lucchese, Fernando Antonio
; Murad, Henrique
; Wanderley Neto, José
; Brofman, Paulo Roberto Slud
; Almeida, Rui M. S.
; Leal, João Carlos Ferreira
.
6.
Telehealth for Parkinson disease patients during the COVID-19 pandemic: the TeleParkinson study COVID19 COVID 19 COVID-1 pandemic COVID1 1 COVID-
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Lima, Danielle Pessoa
; Gomes, Vlademir Carneiro
; Viana Júnior, Antonio Brazil
; Assis, Francisco Mateus Carvalho de
; Oliveira, Pedro Henrique Avelino
; Cunha, Letícia Chaves Vieira
; Braga, Isabelly Cavalcante
; Marques, Miriam Lindsay Silva
; Assunção, Jézica de Sousa
; Damasceno, Adeline Louise Lopes
; Barbosa, Ana Lara Guerra
; Moreira, Arthur Holanda
; Rocha, Maria Eduarda Quidute Arrais
; Porto, Maria Eduarda Mendes Pontes
; Chaves, Érica Carneiro Barbosa
; Oliveira, Liliane Maria de
; Roriz Filho, Jarbas de Sá
; Sobreira Neto, Manoel Alves
; Braga Neto, Pedro
.
Resumo Antecedentes A telemedicina permite que pacientes com doença de Parkinson (DP) superem barreiras físicas para acessar serviços de saúde e aumenta a acessibilidade para pessoas com mobilidade reduzida. Objetivo Investigar indicadores de viabilidade de uma intervenção em telessaúde para pacientes com DP, incluindo recrutamento, atendimento, aderência, problemas técnicos, satisfação e benefícios nos níveis de atividade física e sono. Métodos Foi conduzido um estudo de centro e braço únicos baseado em consultas por telessaúde com utilização do WhatsApp (Meta Platforms, Inc., Menlo Park, CA, EUA). Foram calculados indicadores de viabilidade como desfechos primários. Resultados As taxas de recrutamento, atendimento e problemas técnicos foram 61,3%, 90,5% e 13,3%, respectivamente, com bons escores de aceitação e satisfação com a intervenção. A intervenção melhorou os níveis de atividade física, incluindo o número de passos por pelo menos 10 minutos contínuos (p = 0,009) e o número de atividades intensas e moderadas com duração de pelo menos 10 minutos contínuos (p = 0,001). O Índice de Qualidade do Sono de Pittsburgh melhorou nos seguintes componentes: duração percebida do sono (p < 0,001) e escore total (p < 0,001). A média do tempo de viagem médio poupado foi de 289,6 minutos, e a economia financeira foi de R$ 106,67 reais (por volta de USD 18; quase 10% do salário mínimo atual do Brasil). Conclusões As consultas por vídeo provaram ser viáveis e efetivas, com impacto positivo nos níveis de atividade física e sono de pacientes com DP. DP (DP reduzida recrutamento aderência Meta Platforms Inc Inc. Park CA EUA. EUA . EUA) primários 613 61 3 61,3% 905 90 5 90,5 133 13 13,3% respectivamente 1 p 0,009 0009 0 009 0,001. 0001 0,001 001 componentes 2896 289 6 289, R 10667 106 67 106,6 18 Brasil. Brasil Brasil) efetivas 61,3 9 90, 13,3 0,00 000 00 28 1066 106, 61, 13, 0,0 2 0,
Abstract Background Telemedicine allows Parkinson disease (PD) patients to overcome physical barriers to access health care services and increases accessibility for people with mobility impairments. Objective To investigate the feasibility indicators of a telehealth intervention for PD patients, including patient recruitment, attendance, technical issues, satisfaction, and benefits on levels of physical activity and sleep. Methods We conducted a single-center, single-arm study of telehealth video consultations using WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA). Also, we collected the feasibility indicators as the primary endpoints. All the patients in the study were previously evaluated in person by the same team. Results Patient recruitment, attendance, and technical issues rates were 61.3%, 90.5%, and 13.3%, respectively, with good scores of patient acceptance and satisfaction with the study intervention. The telehealth intervention improved physical activity, including the number of walks for at least 10 continuous minutes (p = 0.009) and the number of moderate-intensity activities lasting at least 10 continuous minutes (p = 0.001). The Pittsburgh sleep quality index (PSQI) scores also improved for one of its components: perceived sleep duration (p < 0.001) and for total Pittsburgh score (p < 0,001). The average travel time saving was 289.6 minutes, and money-saving was R$106.67 (around USD 18; almost 10% of the current minimum wage in Brazil). Conclusions Direct-to-patient telehealth video consultations proved to be feasible and effective and had a positive impact on physical activity levels and sleep in PD patients. (PD impairments recruitment attendance singlecenter, singlecenter single center, center single-center singlearm arm Meta Platforms Inc Inc. Park CA USA. USA . USA) Also endpoints team 613 61 3 61.3% 905 90 5 90.5% 133 13 13.3% respectively 1 p 0.009 0009 0 009 moderateintensity moderate intensity 0.001. 0001 0.001 001 PSQI (PSQI components 0,001. 0,001 0,001) 2896 289 6 289. moneysaving money R10667 R 106 67 R$106.6 around 18 Brazil. Brazil Brazil) Directtopatient Direct 61.3 9 90.5 13.3 0.00 000 00 0,00 28 R1066 R$106. 61. 90. 13. 0.0 0,0 2 R106 R$106 0. 0, R10 R$10 R1 R$1 R$
7.
Falls in Parkinson's disease: the impact of disease progression, treatment, and motor complications
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Lima, Danielle Pessoa
; de-Almeida, Samuel Brito
; Bonfadini, Janine de Carvalho
; Carneiro, Alexandre Henrique Silva
; Luna, João Rafael Gomes de
; Alencar, Madeleine Sales de
; Viana-Júnior, Antonio Brazil
; Rodrigues, Pedro Gustavo Barros
; Pereira, Isabelle de Sousa
; Roriz-Filho, Jarbas de Sá
; Sobreira-Neto, Manoel Alves
; Braga-Neto, Pedro
.
RESUMO. Estima-se aumento na prevalência da doença de Parkinson (DP) em todo o mundo nas próximas décadas. Dessa forma, espera-se também aumento na incidência de quedas e seu impacto no sistema de saúde. Objetivo: O objetivo deste estudo foi avaliar fatores clínicos e medicamentos associados a quedas em pacientes com DP. Métodos: Trata-se de um estudo observacional transversal, realizado no ambulatório de Distúrbios do Movimento de hospital terciário no Brasil. Os dados sociodemográficos e clínicos foram coletados por meio de entrevista estruturada. A capacidade funcional foi avaliada pela Escala de Atividades de Vida Diária de Schwab e England e o estadiamento por Hoehn e Yahr modificado. A amostra foi dividida em não caidores (0 quedas) e caidores (≥1 queda) e não caidores recorrentes (≤1 queda) e caidores recorrentes (>1 queda). A informação sobre o número de quedas nos últimos seis meses foi confirmada com familiares e cuidadores. Resultados: A população do estudo foi de 327 pacientes (48% mulheres), com idade média de 70 anos e duração média da doença de 9,9±6,9 anos. As comorbidades mais prevalentes foram depressão (47,2%), hipertensão (44%) e diabetes mellitus tipo 2 (21,5%). A análise de regressão logística revelou que alucinações visuais, uso de amantadina e uso de entacapona foram independentemente associadas a quedas. Alucinações visuais, discinesia e uso de amantadina foram independentemente associados a quedas recorrentes neste estudo. Conclusões: Os profissionais de saúde desempenham um papel importante na prevenção de quedas em pacientes com DP, principalmente idosos que apresentam discinesia e alucinações visuais. Estudos prospectivos da amantadina devem ser realizados para investigar sua associação com quedas em pacientes com DP.
ABSTRACT. The prevalence of Parkinson's disease (PD) tends to increase worldwide in the coming decades. Thus, the incidence of falls is likely to increase, with a relevant burden on the health care system. Objective: The objective of this study was to evaluate clinical factors and drug use associated with falls in PD patients. Methods: We conducted a cross-sectional study at the Movement Disorders outpatient clinic of a tertiary hospital in Northeast Brazil. We performed structured interviews to collect sociodemographic and clinical data. Functional capacity was assessed using the Schwab and England Activities of Daily Living Scale and the modified Hoehn and Yahr Staging Scale. We divided the study sample into non-fallers (no falls) and fallers (≥1 fall), and non-recurrent (≤1 fall) and recurrent fallers (>1 fall). Results: The study population comprised 327 PD patients (48% women), with a mean age of 70 years. The mean disease duration was 9.9±6.9 years. The most prevalent comorbidities were depression (47.2%), hypertension (44.0%), and type 2 diabetes mellitus (21.5%). The logistic regression analysis revealed that hallucinations, amantadine, and catechol-O-methyltransferase inhibitors (entacapone) were independently associated with falls in PD patients. Also, hallucinations, dyskinesia, and the use of amantadine were independently associated with recurrent falls. Conclusions: Health care providers play an essential role in fall prevention in PD patients, particularly by identifying older adults experiencing dyskinesia and visual hallucinations. Prospective studies should investigate the use of amantadine as a risk factor for falls in PD patients.
8.
Fast surveillance response reveals the introduction of a new yellow fever virus sub-lineage in 2021, in Minas Gerais, Brazil
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Andrade, Miguel Souza
; Campos, Fabrício Souza
; Oliveira, Cirilo Henrique de
; Oliveira, Ramon Silva
; Campos, Aline Alves Scarpellini
; Almeida, Marco Antônio Barreto de
; Fonseca, Vagner de Souza
; Simonini-Teixeira, Danilo
; Sevá, Anaiá da Paixão
; Temponi, Andrea Oliveira Dias
; Magalhães, Fernando Maria
; Chaves, Danielle Costa Capistrano
; Pereira, Maira Alves
; Lamounier, Ludmila Oliveira
; Menezes, Givaldo Gomes de
; Aquino-Teixeira, Sandy Micaele
; Gonçalves-dos-Santos, Maria Eduarda
; Bernal-Valle, Sofía
; Müller, Nicolas Felipe Drumm
; Cardoso, Jader da Cruz
; Santos, Edmilson dos
; Mares-Guia, Maria Angélica
; Albuquerque, George Rêgo
; Romano, Alessandro Pecego Martins
; Franco, Ana Cláudia
; Ribeiro, Bergmann Morais
; Roehe, Paulo Michel
; Abreu, Filipe Vieira Santos de
.
BACKGROUND In Brazil, the yellow fever virus (YFV) is maintained in a sylvatic cycle involving wild mosquitoes and non-human primates (NHPs). The virus is endemic to the Amazon region; however, waves of epidemic expansion reaching other Brazilian states sporadically occur, eventually causing spillovers to humans. OBJECTIVES To report a surveillance effort that led to the first confirmation of YFV in NHPs in the state of Minas Gerais (MG), Southeast region, in 2021. METHODS A surveillance network was created, encompassing the technology of smartphone applications and coordinated actions of several research institutions and health services to monitor and investigate NHP epizootics. FINDINGS When alerts were spread through the network, samples from NHPs were collected and YFV infection confirmed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and genome sequencing at an interval of only 10 days. Near-complete genomes were generated using the Nanopore MinION sequencer. Phylogenetic analysis indicated that viral genomes were related to the South American genotype I, clustering with a genome detected in the Amazon region (state of Pará) in 2017, named YFVPA/MG sub-lineage. Fast YFV confirmation potentialised vaccination campaigns. MAIN CONCLUSIONS A new YFV introduction was detected in MG 6 years after the beginning of the major outbreak reported in the state (2015-2018). The YFV strain was not related to the sub-lineages previously reported in MG. No human cases have been reported, suggesting the importance of coordinated surveillance of NHPs using available technologies and supporting laboratories to ensure a quick response and implementation of contingency measures to avoid YFV spillover to humans.
9.
Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes
; Melo, Ana Karla Guedes de
; Cruz, Vítor Alves
; Souza, Viviane Angelina de
; Carvalho, Joana Starling de
; Machado, Ketty Lysie Libardi Lira
; Valadares, Lilian David de Azevedo
; Reis Neto, Edgard Torres dos
; Rezende, Rodrigo Poubel Vieira de
; Guimarães, Maria Fernanda Brandão de Resende
; Ferreira, Gilda Aparecida
; Braz, Alessandra de Sousa
; Vieira, Rejane Maria Rodrigues de Abreu
; Pinheiro, Marcelo de Medeiros
; Ribeiro, Sandra Lúcia Euzébio
; Bica, Blanca Elena Gomes Rios
; Baptista, Kátia Lino
; Costa, Izaias Pereira da
; Marques, Claudia Diniz Lopes
; Lopes, Maria Lúcia Lemos
; Martinez, José Eduardo
; Giorgi, Rina Dalva Neubarth
; Mota, Lícia Maria Henrique da
; Loures, Marcos Antônio Araújo da Rocha
; Paiva, Eduardo dos Santos
; Monticielo, Odirlei André
; Xavier, Ricardo Machado
; Kakehasi, Adriana Maria
; Pileggi, Gecilmara Cristina Salviato
.
Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.
10.
Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil
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Silva Júnior, João Manoel
; Chaves, Renato Carneiro de Freitas
; Corrêa, Thiago Domingos
; Assunção, Murillo Santucci Cesar de
; Katayama, Henrique Tadashi
; Bosso, Fabio Eduardo
; Amendola, Cristina Prata
; Serpa Neto, Ary
; Malbouisson, Luiz Marcelo Sá
; Oliveira, Neymar Elias de
; Veiga, Viviane Cordeiro
; Rojas, Salomón Soriano Ordinola
; Postalli, Natalia Fioravante
; Alvarisa, Thais Kawagoe
; Lucena, Bruno Melo Nobrega de
; Oliveira, Raphael Augusto Gomes de
; Sanches, Luciana Coelho
; Silva, Ulysses Vasconcellos de Andrade e
; Nassar Junior, Antonio Paulo
; Réa-Neto, Álvaro
; Amaral, Alexandre
; Teles, José Mário
; Freitas, Flávio Geraldo Rezende de
; Bafi, Antônio Tonete
; Pacheco, Eduardo Souza
; Ramos, Fernando José
; Vieira Júnior, José Mauro
; Pereira, Maria Augusta Santos Rahe
; Schwerz, Fábio Sartori
; Menezes, Giovanna Padoa de
; Magalhães, Danielle Dourado
; Castro, Cristine Pilati Pileggi
; Henrich, Sabrina Frighetto
; Toledo, Diogo Oliveira
; Parra, Bruna Fernanda Camargo Silva
; Dias, Fernando Suparregui
; Zerman, Luiza
; Formolo, Fernanda
; Nobrega, Marciano de Sousa
; Piras, Claudio
; Piras, Stéphanie de Barros
; Conti, Rodrigo
; Bittencourt, Paulo Lisboa
; D’Oliveira, Ricardo Azevedo Cruz
; Estrela, André Ricardo de Oliveira
; Oliveira, Mirella Cristine de
; Reese, Fernanda Baeumle
; Motta Júnior, Jarbas da Silva
; Câmara, Bruna Martins Dzivielevski da
; David-João, Paula Geraldes
; Tannous, Luana Alves
; Chaiben, Viviane Bernardes de Oliveira
; Miranda, Lorena Macedo Araújo
; Brasil, José Arthur dos Santos
; Deucher, Rafael Alexandre de Oliveira
; Ferreira, Marcos Henrique Borges
; Vilela, Denner Luiz
; Almeida, Guilherme Cincinato de
; Nedel, Wagner Luis
; Passos, Matheus Golenia dos
; Marin, Luiz Gustavo
; Oliveira Filho, Wilson de
; Coutinho, Raoni Machado
; Oliveira, Michele Cristina Lima de
; Friedman, Gilberto
; Meregalli, André
; Höher, Jorge Amilton
; Soares, Afonso José Celente
; Lobo, Suzana Margareth Ajeje
.
RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.
ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.
https://doi.org/10.5935/0103-507x.20200005
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11.
Chemical composition and in vitro antibacterial activity of essential oils from Murraya paniculata (L.) Jack (Rutaceae) ripe and unripe fruits against bacterial genera Mycobacterium and Streptococcus
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Silva, Flávia Fernanda Alves da
; Fernandes, Cassia Cristina
; Santiago, Mariana Brentini
; Martins, Carlos Henrique Gomes
; Vieira, Tatiana Manzini
; Crotti, Antônio Eduardo Miller
; Miranda, Mayker Lazaro Dantas
.
This study aims to investigate chemical composition of essential oils from Murraya paniculata (L.) Jack (Rutaceae) ripe and unripe fruits and determine their in vitro antibacterial activity. Essential oils were extracted by hydrodistillation from Murraya paniculata (L.) Jack ripe and unripe fruits collected in the Cerrado, in Rio Verde, southwestern Goiás, Brazil. They were analyzed by gas chromatography with flame ionization detector (GC-FID) and by gas chromatography-mass spectrometry (GC-MS). Sesquiterpenes, which represent the most abundant class of compounds in oils, predominated in both ripe and unripe fruits. Major constituents of essential oils extracted from ripe fruits (RF-EO) were (-caryophyllene (21.3%), (-ylangene (13.3%), germacrene-D (10.9%) and (-zingiberene (9.7%) whereas the ones of unripe fruits (UF-EO) were sesquithujene (25.0%), (-zingiberene (18.2%), germacrene-D (13.1%) and (-copaene (12.7%). In vitro antibacterial activity of essential oils was evaluated in terms of its minimum inhibitory concentration (MIC) values by the broth microdilution method in 96-well microplates. Both essential oils under investigation showed moderate anti-streptococcal activity against the following bacteria: Streptococcus mutans, S. mitis, S. sanguinis, S. sobrinus and S. salivarius. MIC values ranged between 100 and 400 µg/mL. Regarding the antimycobacterial activity, essential oils from M. paniculata (L.) Jack unripe and ripe fruits were active against Mycobacterium kansasii (MIC = 250 µg/mL), moderately active against M. tuberculosis (MIC = 500 µg/mL) and inactive against M. avium (MIC = 2000 µg/mL). This study was pioneer in revealing similar chemical profiles of both essential oils extracted from Murraya paniculata (L.) Jack unripe and ripe fruits, besides describing their in vitro anti-streptococcal and antimycobacterial activities.
https://doi.org/10.1590/s2175-97902019000418371
621 downloads
12.
Influence of strategic points in the dispersion of Aedes aegypti in infested areas
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Barbosa, Gerson Laurindo
; Lage, Mariana de Oliveira
; Andrade, Valmir Roberto
; Gomes, Antônio Henrique Alves
; Quintanilha, Jose Alberto
; Chiaravalloti-Neto, Francisco
.
RESUMO OBJETIVO: Avaliar se locais com grande quantidade de potenciais criadouros de formas imaturas de Aedes aegypti, denominados pontos estratégicos, influenciam a dispersão ativa do vetor aos imóveis no seu entorno. MÉTODOS: Foram selecionadas quatro áreas no município de Campinas, três delas com pontos estratégicos classificados como alto, médio e baixo risco segundo a infestação e uma área controle, sem ponto estratégico. Entre outubro de 2015 e setembro de 2016, instalaram-se mensalmente armadilhas de oviposição e avaliou-se a infestação por Ae. aegypti em todos os imóveis de cada área selecionada. Para verificar se houve dispersão do vetor a partir de cada ponto estratégico, com base em sua localização, investigou-se a formação de aglomerados com excesso de ovos ou de recipientes com larvas ou pupas, utilizando a estatística espacial Gi. RESULTADOS: o número de ovos coletados nas ovitrampas e o número de recipientes positivos para Ae. aegypti não apresentaram aglomerados de altos valores relativos à sua distância do ponto estratégico. Ambos apresentaram distribuição aleatória não associada espacialmente com o posicionamento dos pontos estratégicos na área. CONCLUSÕES: Pontos estratégicos não se confirmaram como responsáveis pela dispersão do vetor para os imóveis no seu entorno. Destaca-se a importância de rever a estratégia atual do programa de controle de vetores do Brasil, buscando um equilíbrio do ponto de vista técnico, operacional e econômico, sem desconsiderar o papel dos pontos estratégicos como grandes produtores de mosquitos e sua importância na disseminação de arboviroses em momentos de transmissão.
ABSTRACT OBJECTIVE: To evaluate whether sites with large amount of potential breeding sites for immature forms of Aedes aegypti, called strategic points, influence in the active vector's dispersion into properties in their surroundings. METHODS: We selected four areas in the municipality of Campinas, three of them with strategic points classified as high, moderate, and low risk according to infestation and a control area, without strategic points. Between October 2015 and September 2016, we monthly installed oviposition traps and evaluated the infestation by Ae. aegypti in all properties of each selected area. To verify if there was vector dispersion from each strategic point, based on its location, we investigated the formation of clusters with excess of eggs or larvae or pupae containers, using the Gi spatial statistics. RESULTS: The amount of eggs collected in the ovitraps and the number of positive containers for Ae. aegypti did not show clusters of high values concerning its distance from the strategic point. Both presented random distribution not spatially associated with the positioning of strategic points in the area. CONCLUSIONS: Strategic points are not confirmed as responsible for the vector's dispersion for properties in their surroundings. We highlight the importance of reviewing the current strategy of the vector control program in Brazil, seeking a balance from the technical, operational, and economic point of view, without disregarding the role of strategic points as major producers of mosquitoes and their importance in the dissemination of arboviruses in periods of transmission.
13.
Influence of strategic points in the dispersion of Aedes aegypti in infested areas
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Barbosa, Gerson Laurindo
; Lage, Mariana de Oliveira
; Andrade, Valmir Roberto
; Gomes, Antônio Henrique Alves
; Quintanilha, Jose Alberto
; Chiaravalloti-Neto, Francisco
.
RESUMO OBJETIVO: Avaliar se locais com grande quantidade de potenciais criadouros de formas imaturas de Aedes aegypti, denominados pontos estratégicos, influenciam a dispersão ativa do vetor aos imóveis no seu entorno. MÉTODOS: Foram selecionadas quatro áreas no município de Campinas, três delas com pontos estratégicos classificados como alto, médio e baixo risco segundo a infestação e uma área controle, sem ponto estratégico. Entre outubro de 2015 e setembro de 2016, instalaram-se mensalmente armadilhas de oviposição e avaliou-se a infestação por Ae. aegypti em todos os imóveis de cada área selecionada. Para verificar se houve dispersão do vetor a partir de cada ponto estratégico, com base em sua localização, investigou-se a formação de aglomerados com excesso de ovos ou de recipientes com larvas ou pupas, utilizando a estatística espacial Gi. RESULTADOS: o número de ovos coletados nas ovitrampas e o número de recipientes positivos para Ae. aegypti não apresentaram aglomerados de altos valores relativos à sua distância do ponto estratégico. Ambos apresentaram distribuição aleatória não associada espacialmente com o posicionamento dos pontos estratégicos na área. CONCLUSÕES: Pontos estratégicos não se confirmaram como responsáveis pela dispersão do vetor para os imóveis no seu entorno. Destaca-se a importância de rever a estratégia atual do programa de controle de vetores do Brasil, buscando um equilíbrio do ponto de vista técnico, operacional e econômico, sem desconsiderar o papel dos pontos estratégicos como grandes produtores de mosquitos e sua importância na disseminação de arboviroses em momentos de transmissão.
ABSTRACT OBJECTIVE: To evaluate whether sites with large amount of potential breeding sites for immature forms of Aedes aegypti, called strategic points, influence in the active vector's dispersion into properties in their surroundings. METHODS: We selected four areas in the municipality of Campinas, three of them with strategic points classified as high, moderate, and low risk according to infestation and a control area, without strategic points. Between October 2015 and September 2016, we monthly installed oviposition traps and evaluated the infestation by Ae. aegypti in all properties of each selected area. To verify if there was vector dispersion from each strategic point, based on its location, we investigated the formation of clusters with excess of eggs or larvae or pupae containers, using the Gi spatial statistics. RESULTS: The amount of eggs collected in the ovitraps and the number of positive containers for Ae. aegypti did not show clusters of high values concerning its distance from the strategic point. Both presented random distribution not spatially associated with the positioning of strategic points in the area. CONCLUSIONS: Strategic points are not confirmed as responsible for the vector's dispersion for properties in their surroundings. We highlight the importance of reviewing the current strategy of the vector control program in Brazil, seeking a balance from the technical, operational, and economic point of view, without disregarding the role of strategic points as major producers of mosquitoes and their importance in the dissemination of arboviruses in periods of transmission.
https://doi.org/10.11606/s1518-8787.2019053000702
2387 downloads
14.
GREEN FERTILIZATION WITH RESIDUES OF LEGUMINOUS TREES FOR CULTIVATING MAIZE IN DEGRADED SOIL
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Oliveira, Francisco Ronaldo Alves de
; Souza, Henrique Antunes de
; Carvalho, Marco Antônio Rosa de
; Costa, Mirian Cristina Gomes
.
RESUMO Este estudo teve como objetivo avaliar o efeito da adição de resíduos de partes de leguminosas arbóreas no crescimento e nutrição de plantas de milho (Zea mays L.), bem como nos atributos químicos de um solo degradado, 65 dias após a aplicação dos resíduos. O experimento foi realizado em vasos, em delineamento de blocos ao acaso, com dez tratamentos e quatro repetições. Os tratamentos avaliados foram: T1 - Sem resíduo de leguminosas, T2 - Folhas de Mimosa caesalpiniifolia, T3 - Galhos de Mimosa caesalpiniifolia, T4 - Folhas + galhos de Mimosa caesalpiniifolia, T5 - Folhas de Mimosa hostilis, T6 - Galhos de Mimosa hostilis, T7 - Folhas + galhos de Mimosa hostilis, T8 - Folhas de Gliricidia sepium, T9 - Galhos de Gliricidia sepium e T10 - Folhas + galhos de Gliricidia sepium. Os vasos foram preenchidos com solo de área degradada e os resíduos adicionados na forma de massa verde após a semeadura do milho. Resíduos de leguminosas arbóreas influenciaram positivamente o crescimento de plantas de milho já aos 65 dias após a aplicação e favoreceram o acúmulo de nitrogênio, fósforo e potássio na parte aérea de plantas. Os adubos verdes utilizados melhoraram atributos químicos do solo logo aos 65 dias após a aplicação, com destaque para o N-nitrato (N-NO3 -), N-amônio (N-NH4 +), nitrogênio inorgânico total (N-NO3 - + N-NH4 +) e K, demonstrando que essas espécies são boas opções para recuperação de áreas degradadas no semiárido cearense.
ABSTRACT The objective of this study was to evaluate the effects of the addition of parts of leguminous trees on the growth and nutrition of maize (Zea mays L.), as well as on the chemical attributes of a degraded soil, 65 days after applying the residues. The experiment was conducted in pots, in a randomized block design with ten treatments and four replicates. The evaluated treatments were: T1 - No residues of leguminous trees, T2 - Leaves of Mimosa caesalpiniifolia, T3 - Branches of Mimosa caesalpiniifolia, T4 - Leaves + branches of Mimosa caesalpiniifolia, T5 - Leaves of Mimosa hostilis, T6 - Branches of Mimosa hostilis, T7 - Leaves + branches of Mimosa hostilis, T8 - Leaves of Gliricidia sepium, T9 - Branches of Gliricidia sepium and T10 - Leaves + branches of Gliricidia sepium. Pots were filled with soil from a degraded area and residues were added in the form of green mass after sowing the maize. Residues of leguminous trees positively influenced maize growth at 65 days after application and favored the accumulation of nitrogen, phosphorus and potassium in the shoots. Green fertilizers improved soil chemical attributes at 65 days after application, especially nitrate-N (NO3 --N), ammonium-N (NH4 +-N), total inorganic N (NO3 --N + NH4 +-N) and K, demonstrating that these species are good options for recovering degraded areas in the semi-arid region of Ceará.
https://doi.org/10.1590/1983-21252018v31n401rc
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15.
1º Posicionamento Brasileiro sobre o Impacto dos Distúrbios de Sono nas Doenças Cardiovasculares da Sociedade Brasileira de Cardiologia
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Drager, Luciano F.
; Lorenzi-Filho, Geraldo
; Cintra, Fatima Dumas
; Pedrosa, Rodrigo P.
; Bittencourt, Lia R. A.
; Poyares, Dalva
; Carvalho, Carolina Gonzaga
; Moura, Sonia Maria Guimarães Pereira Togeiro
; Santos-Silva, Rogerio
; Bruin, Pedro F. C. de
; Geovanini, Glaucylara R.
; Albuquerque, Felipe N.
; Oliveira, Wercules Antonio Alves de
; Moreira, Gustavo A.
; Ueno, Linda Massako
; Nerbass, Flávia Baggio
; Rondon, Maria Urbana Pinto Brandão
; Barbosa, Eline Rozária Ferreira
; Bertolami, Adriana
; Paola, Angelo Amato Vincenzo de
; Marques, Betânia Braga Silva
; Rizzi, Camila Futado
; Negrão, Carlos Eduardo
; Uchôa, Carlos Henrique Gomes
; Maki-Nunes, Cristiane
; Martinez, Denis
; Fernández, Edmundo Arteaga
; Maroja, Fabrizio U.
; Almeida, Fernanda R.
; Trombetta, Ivani C.
; Storti, Luciana J.
; Bortolotto, Luiz Aparecido
; Mello, Marco Túlio de
; Borges, Melania Aparecida
; Andersen, Monica Levy
; Portilho, Natanael de Paula
; Macedo, Paula
; Alves, Rosana
; Tufik, Sergio
; Fagondes, Simone C.
; Risso, Thaís Telles
.
https://doi.org/10.5935/abc.20180154
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