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Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan Prospective randomized pressurelimiting pressure limiting communityacquired community acquired STAMINA trial)
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Maia, Israel Silva
; Medrado Jr, Fernando Azevedo
; Tramujas, Lucas
; Tomazini, Bruno Martins
; Oliveira, Júlia Souza
; Sady, Erica Regina Ribeiro
; Barbante, Letícia Galvão
; Nicola, Marina Lazzari
; Gurgel, Rodrigo Magalhães
; Damiani, Lucas Petri
; Negrelli, Karina Leal
; Miranda, Tamiris Abait
; Santucci, Eliana
; Valeis, Nanci
; Laranjeira, Ligia Nasi
; Westphal, Glauco Adrieno
; Fernandes, Ruthy Perotto
; Zandonai, Cássio Luis
; Pincelli, Mariangela Pimentel
; Figueiredo, Rodrigo Cruvinel
; Bustamante, Cíntia Loss Sartori
; Norbin, Luiz Fernando
; Boschi, Emerson
; Lessa, Rafael
; Romano, Marcelo Pereira
; Miura, Mieko Cláudia
; Alencar Filho, Meton Soares de
; Dantas, Vicente Cés de Souza
; Barreto, Priscilla Alves
; Hernandes, Mauro Esteves
; Grion, Cintia Magalhães Carvalho
; Laranjeira, Alexandre Sanches
; Mezzaroba, Ana Luiza
; Bahl, Marina
; Starke, Ana Carolina
; Biondi, Rodrigo Santos
; Dal-Pizzol, Felipe
; Caser, Eliana Bernadete
; Thompson, Marlus Muri
; Padial, Andrea Allegrini
; Veiga, Viviane Cordeiro
; Leite, Rodrigo Thot
; Araújo, Gustavo
; Guimarães, Mário
; Martins, Priscilla de Aquino
; Lacerda, Fábio Holanda
; Hoffmann Filho, Conrado Roberto
; Melro, Livia
; Pacheco, Eduardo
; Ospina-Táscon, Gustavo Adolfo
; Ferreira, Juliana Carvalho
; Freires, Fabricio Jocundo Calado
; Machado, Flávia Ribeiro
; Cavalcanti, Alexandre Biasi
; Zampieri, Fernando Godinho
.
RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5
ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5
2.
Repertório lexical de crianças de 24 e 30 meses falantes do português brasileiro: resultados preliminares 2 3 brasileiro
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Providello, Carolina Felix
; Carrilho, Ana Paola Nicolielo
; Peixoto, Vânia
; Maia, Maria de Fátima Serdoura Cardoso
; Hage, Simone Rocha de Vasconcellos
.
RESUMO Objetivo Verificar o repertório lexical de crianças falantes do português brasileiro aos 24 e 30 meses e a associação entre a quantidade de palavras faladas e as variáveis: nível socioeconômico, escolaridade dos pais, presença de irmãos no convívio familiar, frequentar ou não escola e uso exacerbado de tablets e celulares pelas crianças. Método 30 pais de crianças com 24 meses, residentes no estado de São Paulo participaram do estudo. Por meio de plataformas de videoconferência eles foram submetidos à anamnese fonoaudiológica, entrevista com o serviço social e preencheram o “Inventário MacArthur de Desenvolvimento Comunicativo - Primeiras Palavras e Gestos”, quando seus filhos tinham 24 e 30 meses. Foi aplicada estatística indutiva inferencial, quantitativa e qualitativa. Resultados A mediana das palavras emitidas foi de 283 aos 24 meses e 401 aos 30 meses, indicando aumento em torno de 118 palavras após seis meses. A criança estar frequentando ambiente escolar apresentou relação significativa com o aumento do vocabulário. Conclusão O estudo reforça o crescimento do vocabulário conforme o avanço da idade e corrobora o fato de as crianças com 24 meses já possuírem um repertório maior que 50 palavras. Aqueles que frequentam escola diariamente produzem pelo menos 70 palavras a mais dos que não frequentam. 2 3 variáveis socioeconômico familiar fonoaudiológica Inventário Gestos, Gestos , Gestos” inferencial qualitativa 28 40 11 5 7 4 1
ABSTRACT Purpose To check the lexical repertoire of Brazilian Portuguese-speaking children at 24 and 30 months of age and the association between the number of words spoken and the following variables: socioeconomic status, parents’ education, presence of siblings in the family, whether or not they attend school, and excessive use of tablets and cell phones. Methods 30 parents of children aged 24 months living in the state of São Paulo participated in the study. Using videoconferencing platforms, they underwent a speech-language pathology anamnesis, an interview with social services, and then they completed the “MacArthur Communicative Development Inventory - First Words and Gestures” as soon as their children were 24 and 30 months old. Quantitative and qualitative inferential inductive statistics were applied. Results the median number of words produced was 283 at 24 months and 401 at 30 months, indicating an increase of around 118 words after six months. The child attending a school environment had a significant relationship with increased vocabulary. Conclusion The study reinforces the fact that vocabulary grows with age and corroborates the fact that children aged 24 months already have a repertoire greater than 50 words. Those who attend school every day produce at least 70 more words than those who do not. Portuguesespeaking Portuguese speaking 2 3 variables status education family phones platforms speechlanguage speech language anamnesis services MacArthur Gestures old applied 28 40 11 5 7 4 1
3.
Methodological Quality of Systematic Reviews Addressing Orthodontic Interventions: Methodological Study Interventions
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Notaro, Sarah Queiroz
; Hermont, Ana Paula
; Cruz, Poliana Valdelice
; Maia, Raiane Machado
; Avila, Walesca Melo
; Pericic, Tina Poklepovic
; Abreu, Lucas Guimarães
; Jiao, Ruimin
; Martins-Pfeifer, Carolina Castro
.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
- Journal Metrics
ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions. Objective SRs (SRs Methods searched PROSPERO #CRD42020180852. CRD42020180852 CRD #CRD42020180852 . #CRD42020180852) 201 2020 AMSTAR 2 data Results 4 195 19 5 19.5 Fiftyfour Fifty four 348 34 8 34.8 criteria Conclusion CRD4202018085 #CRD4202018085 20 202 1 19. 3 34. CRD420201808 #CRD420201808 CRD42020180 #CRD42020180 CRD4202018 #CRD4202018 CRD420201 #CRD420201 CRD42020 #CRD42020 CRD4202 #CRD4202 CRD420 #CRD420 CRD42 #CRD42 CRD4 #CRD4 #CRD
4.
Brazilian Psychiatric Association Consensus for the Management of Acute Intoxication: general management and specific interventions for drugs of abuse Intoxication
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Baldaçara, Leonardo
; Pettersen, Amanda de Gouvêa
; Leite, Verônica da Silveira
; Ismael, Flávia
; Motta, Carolina Pereira
; Freitas, Railson Alves
; Fasanella, Nicoli Abrazo
; Pereira, Lucas Alves
; Barros, Maria Elisa Lima
; Barbosa, Leonardo
; Teles, Ana Luiza Silva
; Palhano, Ruy
; Guimaraes, Helio Penna
; Braga, Maria Aparecida
; Castaldelli-Maia, João Mauricio
; Bicca, Carla
; Gligliotti, Analice
; Marques, Ana Cecilia Petta Roseli
; da Silva, Antônio Geraldo
.
Abstract Objectives To present the Brazilian Psychiatric Association’s Consensus on the Management of Acute Intoxication. Methods A group of experts selected by the Brazilian Psychiatric Association searched for articles on the MEDLINE (by PubMed) and Cochrane databases, limited to human studies and acute intoxication. Working groups reviewed these materials for appropriateness to the topic and the quality of the work. A survey was conducted using the Delphi method to produce a table of agreed recommendations presented at the end of the systematic review. Three survey rounds were held to reach consensus. Results Support for intoxication should start with Initial Management: Resuscitation/Life Support/Differential Diagnosis. For this, the group proposed the following sequence of assessments: A (airway), B (breathing), C (circulation), D.1 (disability), D.2 (differential diagnosis), D.3 (decontamination), D.4 (drug antidotes), E (enhanced elimination). The group of experts then presented specific interventions for the main drugs of abuse. Conclusions Management of intoxication with drugs of abuse is complex and requires systematic protocols. The group suggests adoption of the A-B-C-D-E technique first, with constant investigation. Then, specific conduct and support until remission of intoxication. The literature is still scarce in evidence on the subject. Therefore, this consensus was necessary. We believe that at present this document can help psychiatric, general, and emergency physicians deal with emergency psychiatric episodes due to acute intoxication. This work could stimulate future studies on the topic. Associations s Intoxication PubMed databases review ResuscitationLife Resuscitation Life SupportDifferential Differential Diagnosis assessments airway, airway , (airway) breathing, breathing (breathing) circulation, circulation (circulation) D1 D 1 D. disability, disability (disability) D2 2 differential diagnosis, diagnosis diagnosis) D3 3 decontamination, decontamination (decontamination) D4 4 drug antidotes, antidotes antidotes) enhanced elimination. elimination . elimination) protocols ABCDE first investigation Then subject Therefore necessary general (airway (breathing (circulation (disability (decontamination
5.
Análise das Notificações Recebidas pela Central de Transplantes do Estado de Roraima de 2017 a 2021 201 202 20 2
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Oliveira, Lidiane Cristina Santiago de
; Mendes, Larissa Lima Araújo
; Brum, Matheus Dantas
; Lima, Mykaelle Soares
; Lobo, Ana Carolina Ferrer
; França, Jéssica Anne Pereira Corrêa
; Santos Junior, Carlos Henrique dos
; Mota, Lueli Evelin Leite
; Maia Neto, Geraldo Pereira
; Araújo, José Egberg Santos de
; Rabelo, Matilde Nascimento
; Paz, Thaís Lorena Pereira da
; Lustosa, Victor Hugo Souza
; Santos, Bárbara Carvalho dos
; Linhares, Marcelo Moura
.
RESUMO Objetivos: Analisar as notificações de morte encefálica (ME) recebidas pela Central de Transplantes (CET) do estado de Roraima (RR) de 2017 a 2021. Métodos: Trata-se de estudo transversal, quantitativo e observacional no qual foram analisadas todas as notificações recebidas pela CET no período de 2017 a 2021, resultando em 120 pacientes, dos seguintes centros de saúde: Hospital Geral de Roraima (HGR), Hospital Confederação Nacional das Cooperativas Médicas (UNIMED), Hospital da Criança Santo Antônio (HCSA), Hospital das Clínicas (HC) e Hospital Lotty Íris (HLI). Os dados foram coletados do sistema de gerenciamento de dados da central e repassados para a ficha de coleta desenvolvida pela pesquisadora. Resultados: Este estudo analisou 119 notificações após a exclusão de uma devido a dados conflitantes. Houve predominância do sexo masculino (58%), com trauma cranioencefálico sendo a causa mais frequente de ME. Ao todo, foram realizadas seis captações de órgãos, todas no HGR. Este estudo não encontrou associações significativas entre a captação de órgãos e sexo, idade, local de internação e ano. Conclusão: Há grandes desafios em relação à doação de órgãos em RR, com uma taxa de captação baixa ao longo de 5 anos. Apenas o HGR obteve sucesso em realizar captações de órgãos, diferentemente de outros hospitais notificadores. São necessárias melhorias, destacando a importância de se realizarem mais estudos para uma análise mais aprofundada dos dados. Objetivos ME (ME (CET RR (RR 201 2021 Métodos Tratase Trata transversal 12 pacientes saúde HGR, , (HGR) UNIMED, UNIMED (UNIMED) HCSA, HCSA (HCSA) HC (HC HLI. HLI . (HLI) pesquisadora Resultados 11 conflitantes 58%, 58 58% (58%) todo idade ano Conclusão anos notificadores melhorias 20 202 1 (HGR (UNIMED (HCSA (HLI (58% 2 (58 (5 (
ABSTRACT Objectives: To analyze brain death (BD) notifications received by Central de Transplantes (CET) in the state of Roraima (RR) from 2017 to 2021. Methods: This is a cross-sectional, quantitative, and observational study, where all notifications received by CET from 2017 to 2021 were analyzed, resulting in 120 patients from health the following centers: Hospital Geral de Roraima (HGR), Hospital Confederação Nacional das Cooperativas Médicas (UNIMED), Hospital da Criança Santo Antônio (HCSA), Hospital das Clínicas (HC), and Hospital Lotty Íris (HLI). The data were collected from the center’s data management system and passed on to the collection form developed by the researcher. Results: This study analyzed 119 notifications after excluding one due to conflicting data. There was a predominance of males (58%), with traumatic brain injury being the most frequent cause of BD. Six organ harvestings were carried out, all at the HGR. This study found no significant associations between organ procurement and sex, age, place of hospitalization, and year. Conclusion: There are considerable challenges concerning organ donation in RR, with a low uptake rate over five years. Only the HGR successfully carried out organ harvesting, while other reporting hospitals were unsuccessful. Improvements are needed, highlighting the importance of more studies for a more in-depth data analysis. Objectives BD (BD (CET RR (RR 201 Methods crosssectional, crosssectional cross sectional, sectional cross-sectional quantitative 202 12 centers HGR, , (HGR) UNIMED, UNIMED (UNIMED) HCSA, HCSA (HCSA) HC, HC (HC) HLI. HLI . (HLI) center s researcher Results 11 58%, 58 58% (58%) sex age hospitalization year Conclusion years harvesting unsuccessful needed indepth depth analysis 20 1 (HGR (UNIMED (HCSA (HC (HLI 5 (58% 2 (58 (5 (
6.
Which Dental Procedures Lead to Greater Distress During Children’s Dental Treatment? A Cohort Study Childrens Children s Treatment
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Maia, Haline Cunha de Medeiros
; Moro, Bruna Lorena Pereira
; Acosta, Carolina de Picoli
; Freitas, Raiza Dias
; Vale, Mayume Amorim do
; Crispim, Ana Carla
; Imparato, José Carlos P
; Raggio, Daniela Prócida
; Braga, Mariana Minatel
; Mendes, Fausto Medeiros
.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
- Journal Metrics
ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3–10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment. Objective childrens s selfreported self Methods 16 3–10 310 3 10 (3–1 old teeth study 74 WBFS (WBFS KruskalWallis Kruskal Wallis outcomes Results p=0.017, p0017 p p=0.017 , 0 017 (p=0.017) 55 5 5. treatments Similarly p<0.001. p0001 p<0.001 . 001 (p<0.001) older OR 0.52 052 52 0.300.87 030087 0.30 0.87 30 87 0.30-0.87 p=0.014. p0014 p=0.014 014 p=0.014) consultations interventions Conclusion appointments childs child 1 3–1 31 (3– p001 p=0.01 01 (p=0.017 p000 p<0.00 00 (p<0.001 0.5 05 300 0.300.8 03008 030 0.3 087 0.8 8 0.30-0.8 3– (3 p00 p=0.0 (p=0.01 p<0.0 (p<0.00 0. 0.300. 0300 03 08 0.30-0. ( p0 p=0. (p=0.0 p<0. (p<0.0 0.300 0.30-0 p=0 (p=0. p<0 (p<0. 0.30- p= (p=0 p< (p<0 (p= (p< (p
7.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
; Slipinski, Adam
; Linzmeier, Adelita M.
; Calor, Adolfo R.
; Garda, Adrian A.
; Kury, Adriano B.
; Fernandes, Agatha C.S.
; Agudo-Padrón, Aisur I.
; Akama, Alberto
; Silva Neto, Alberto M. da
; Burbano, Alejandro L.
; Menezes, Aleksandra
; Pereira-Colavite, Alessandre
; Anichtchenko, Alexander
; Lees, Alexander C.
; Bezerra, Alexandra M.R.
; Domahovski, Alexandre C.
; Pimenta, Alexandre D.
; Aleixo, Alexandre L.P.
; Marceniuk, Alexandre P.
; Paula, Alexandre S. de
; Somavilla, Alexandre
; Specht, Alexandre
; Camargo, Alexssandro
; Newton, Alfred F.
; Silva, Aline A.S. da
; Santos, Aline B. dos
; Tassi, Aline D.
; Aragão, Allan C.
; Santos, Allan P.M.
; Migotto, Alvaro E.
; Mendes, Amanda C.
; Cunha, Amanda
; Chagas Júnior, Amazonas
; Sousa, Ana A.T. de
; Pavan, Ana C.
; Almeida, Ana C.S.
; Peronti, Ana L.B.G.
; Henriques-Oliveira, Ana L.
; Prudente, Ana L.
; Tourinho, Ana L.
; Pes, Ana M.O.
; Carmignotto, Ana P.
; Wengrat, Ana P.G. da Silva
; Dornellas, Ana P.S.
; Molin, Anamaria Dal
; Puker, Anderson
; Morandini, André C.
; Ferreira, André da S.
; Martins, André L.
; Esteves, André M.
; Fernandes, André S.
; Roza, André S.
; Köhler, Andreas
; Paladini, Andressa
; Andrade, Andrey J. de
; Pinto, Ângelo P.
; Salles, Anna C. de A.
; Gondim, Anne I.
; Amaral, Antonia C.Z.
; Rondón, Antonio A.A.
; Brescovit, Antonio
; Lofego, Antônio C.
; Marques, Antonio C.
; Macedo, Antonio
; Andriolo, Artur
; Henriques, Augusto L.
; Ferreira Júnior, Augusto L.
; Lima, Aurino F. de
; Barros, Ávyla R. de A.
; Brito, Ayrton do R.
; Romera, Bárbara L.V.
; Vasconcelos, Beatriz M.C. de
; Frable, Benjamin W.
; Santos, Bernardo F.
; Ferraz, Bernardo R.
; Rosa, Brunno B.
; Sampaio, Brunno H.L.
; Bellini, Bruno C.
; Clarkson, Bruno
; Oliveira, Bruno G. de
; Corrêa, Caio C.D.
; Martins, Caleb C.
; Castro-Guedes, Camila F. de
; Souto, Camilla
; Bicho, Carla de L.
; Cunha, Carlo M.
; Barboza, Carlos A. de M.
; Lucena, Carlos A.S. de
; Barreto, Carlos
; Santana, Carlos D.C.M. de
; Agne, Carlos E.Q.
; Mielke, Carlos G.C.
; Caetano, Carlos H.S.
; Flechtmann, Carlos H.W.
; Lamas, Carlos J.E.
; Rocha, Carlos
; Mascarenhas, Carolina S.
; Margaría, Cecilia B.
; Waichert, Cecilia
; Digiani, Celina
; Haddad, Célio F.B.
; Azevedo, Celso O.
; Benetti, Cesar J.
; Santos, Charles M.D. dos
; Bartlett, Charles R.
; Bonvicino, Cibele
; Ribeiro-Costa, Cibele S.
; Santos, Cinthya S.G.
; Justino, Cíntia E.L.
; Canedo, Clarissa
; Bonecker, Claudia C.
; Santos, Cláudia P.
; Carvalho, Claudio J.B. de
; Gonçalves, Clayton C.
; Galvão, Cleber
; Costa, Cleide
; Oliveira, Cléo D.C. de
; Schwertner, Cristiano F.
; Andrade, Cristiano L.
; Pereira, Cristiano M.
; Sampaio, Cristiano
; Dias, Cristina de O.
; Lucena, Daercio A. de A.
; Manfio, Daiara
; Amorim, Dalton de S.
; Queiroz, Dalva L. de
; Queiroz, Dalva L. de
; Colpani, Daniara
; Abbate, Daniel
; Aquino, Daniel A.
; Burckhardt, Daniel
; Cavallari, Daniel C.
; Prado, Daniel de C. Schelesky
; Praciano, Daniel L.
; Basílio, Daniel S.
; Bená, Daniela de C.
; Toledo, Daniela G.P. de
; Takiya, Daniela M.
; Fernandes, Daniell R.R.
; Ament, Danilo C.
; Cordeiro, Danilo P.
; Silva, Darliane E.
; Pollock, Darren A.
; Muniz, David B.
; Gibson, David I.
; Nogueira, David S.
; Marques, Dayse W.A.
; Lucatelli, Débora
; Garcia, Deivys M.A.
; Baêta, Délio
; Ferreira, Denise N.M.
; Rueda-Ramírez, Diana
; Fachin, Diego A.
; Souza, Diego de S.
; Rodrigues, Diego F.
; Pádua, Diego G. de
; Barbosa, Diego N.
; Dolibaina, Diego R.
; Amaral, Diogo C.
; Chandler, Donald S.
; Maccagnan, Douglas H.B.
; Caron, Edilson
; Carvalho, Edrielly
; Adriano, Edson A.
; Abreu Júnior, Edson F. de
; Pereira, Edson H.L.
; Viegas, Eduarda F.G.
; Carneiro, Eduardo
; Colley, Eduardo
; Eizirik, Eduardo
; Santos, Eduardo F. dos
; Shimbori, Eduardo M.
; Suárez-Morales, Eduardo
; Arruda, Eliane P. de
; Chiquito, Elisandra A.
; Lima, Élison F.B.
; Castro, Elizeu B. de
; Orlandin, Elton
; Nascimento, Elynton A. do
; Razzolini, Emanuel
; Gama, Emanuel R.R.
; Araujo, Enilma M. de
; Nishiyama, Eric Y.
; Spiessberger, Erich L.
; Santos, Érika C.L. dos
; Contreras, Eugenia F.
; Galati, Eunice A.B.
; Oliveira Junior, Evaldo C. de
; Gallardo, Fabiana
; Hernandes, Fabio A.
; Lansac-Tôha, Fábio A.
; Pitombo, Fabio B.
; Dario, Fabio Di
; Santos, Fábio L. dos
; Mauro, Fabio
; Nascimento, Fabio O. do
; Olmos, Fabio
; Amaral, Fabio R.
; Schunck, Fabio
; Godoi, Fábio S. P. de
; Machado, Fabrizio M.
; Barbo, Fausto E.
; Agrain, Federico A.
; Ribeiro, Felipe B.
; Moreira, Felipe F.F.
; Barbosa, Felipe F.
; Silva, Fenanda S.
; Cavalcanti, Fernanda F.
; Straube, Fernando C.
; Carbayo, Fernando
; Carvalho Filho, Fernando
; Zanella, Fernando C.V.
; Jacinavicius, Fernando de C.
; Farache, Fernando H.A.
; Leivas, Fernando
; Dias, Fernando M.S.
; Mantellato, Fernando
; Vaz-de-Mello, Fernando Z.
; Gudin, Filipe M.
; Albuquerque, Flávio
; Molina, Flavio B.
; Passos, Flávio D.
; Shockley, Floyd W.
; Pinheiro, Francielly F.
; Mello, Francisco de A.G. de
; Nascimento, Francisco E. de L.
; Franco, Francisco L.
; Oliveira, Francisco L. de
; Melo, Francisco T. de V.
; Quijano, Freddy R.B.
; Salles, Frederico F.
; Biffi, Gabriel
; Queiroz, Gabriel C.
; Bizarro, Gabriel L.
; Hrycyna, Gabriela
; Leviski, Gabriela
; Powell, Gareth S.
; Santos, Geane B. dos
; Morse, Geoffrey E.
; Brown, George
; Mattox, George M.T.
; Zimbrão, Geraldo
; Carvalho, Gervásio S.
; Miranda, Gil F.G.
; Moraes, Gilberto J. de
; Lourido, Gilcélia M.
; Neves, Gilmar P.
; Moreira, Gilson R.P.
; Montingelli, Giovanna G.
; Maurício, Giovanni N.
; Marconato, Gláucia
; Lopez, Guilherme E.L.
; Silva, Guilherme L. da
; Muricy, Guilherme
; Brito, Guilherme R.R.
; Garbino, Guilherme S.T.
; Flores, Gustavo E.
; Graciolli, Gustavo
; Libardi, Gustavo S.
; Proctor, Heather C.
; Gil-Santana, Helcio R.
; Varella, Henrique R.
; Escalona, Hermes E.
; Schmitz, Hermes J.
; Rodrigues, Higor D.D.
; Galvão Filho, Hilton de C.
; Quintino, Hingrid Y.S.
; Pinto, Hudson A.
; Rainho, Hugo L.
; Miyahira, Igor C.
; Gonçalves, Igor de S.
; Martins, Inês X.
; Cardoso, Irene A.
; Oliveira, Ismael B. de
; Franz, Ismael
; Fernandes, Itanna O.
; Golfetti, Ivan F.
; S. Campos-Filho, Ivanklin
; Oliveira, Ivo de S.
; Delabie, Jacques H.C.
; Oliveira, Jader de
; Prando, Jadila S.
; Patton, James L.
; Bitencourt, Jamille de A.
; Silva, Janaina M.
; Santos, Jandir C.
; Arruda, Janine O.
; Valderrama, Jefferson S.
; Dalapicolla, Jeronymo
; Oliveira, Jéssica P.
; Hájek, Jiri
; Morselli, João P.
; Narita, João P.
; Martin, João P.I.
; Grazia, Jocélia
; McHugh, Joe
; Cherem, Jorge J.
; Farias Júnior, José A.S.
; Fernandes, Jose A.M.
; Pacheco, José F.
; Birindelli, José L.O.
; Rezende, José M.
; Avendaño, Jose M.
; Duarte, José M. Barbanti
; Ribeiro, José R. Inácio
; Mermudes, José R.M.
; Pujol-Luz, José R.
; Santos, Josenilson R. dos
; Câmara, Josenir T.
; Teixeira, Joyce A.
; Prado, Joyce R. do
; Botero, Juan P.
; Almeida, Julia C.
; Kohler, Julia
; Gonçalves, Julia P.
; Beneti, Julia S.
; Donahue, Julian P.
; Alvim, Juliana
; Almeida, Juliana C.
; Segadilha, Juliana L.
; Wingert, Juliana M.
; Barbosa, Julianna F.
; Ferrer, Juliano
; Santos, Juliano F. dos
; Kuabara, Kamila M.D.
; Nascimento, Karine B.
; Schoeninger, Karine
; Campião, Karla M.
; Soares, Karla
; Zilch, Kássia
; Barão, Kim R.
; Teixeira, Larissa
; Sousa, Laura D. do N.M. de
; Dumas, Leandro L.
; Vieira, Leandro M.
; Azevedo, Leonardo H.G.
; Carvalho, Leonardo S.
; Souza, Leonardo S. de
; Rocha, Leonardo S.G.
; Bernardi, Leopoldo F.O.
; Vieira, Letícia M.
; Johann, Liana
; Salvatierra, Lidianne
; Oliveira, Livia de M.
; Loureiro, Lourdes M.A. El-moor
; Barreto, Luana B.
; Barros, Luana M.
; Lecci, Lucas
; Camargos, Lucas M. de
; Lima, Lucas R.C.
; Almeida, Lucia M.
; Martins, Luciana R.
; Marinoni, Luciane
; Moura, Luciano de A.
; Lima, Luciano
; Naka, Luciano N.
; Miranda, Lucília S.
; Salik, Lucy M.
; Bezerra, Luis E.A.
; Silveira, Luis F.
; Campos, Luiz A.
; Castro, Luiz A.S. de
; Pinho, Luiz C.
; Silveira, Luiz F.L.
; Iniesta, Luiz F.M.
; Tencatt, Luiz F.C.
; Simone, Luiz R.L.
; Malabarba, Luiz R.
; Cruz, Luiza S. da
; Sekerka, Lukas
; Barros, Lurdiana D.
; Santos, Luziany Q.
; Skoracki, Maciej
; Correia, Maira A.
; Uchoa, Manoel A.
; Andrade, Manuella F.G.
; Hermes, Marcel G.
; Miranda, Marcel S.
; Araújo, Marcel S. de
; Monné, Marcela L.
; Labruna, Marcelo B.
; Santis, Marcelo D. de
; Duarte, Marcelo
; Knoff, Marcelo
; Nogueira, Marcelo
; Britto, Marcelo R. de
; Melo, Marcelo R.S. de
; Carvalho, Marcelo R. de
; Tavares, Marcelo T.
; Kitahara, Marcelo V.
; Justo, Marcia C.N.
; Botelho, Marcia J.C.
; Couri, Márcia S.
; Borges-Martins, Márcio
; Felix, Márcio
; Oliveira, Marcio L. de
; Bologna, Marco A.
; Gottschalk, Marco S.
; Tavares, Marcos D.S.
; Lhano, Marcos G.
; Bevilaqua, Marcus
; Santos, Marcus T.T.
; Domingues, Marcus V.
; Sallum, Maria A.M.
; Digiani, María C.
; Santarém, Maria C.A.
; Nascimento, Maria C. do
; Becerril, María de los A.M.
; Santos, Maria E.A. dos
; Passos, Maria I. da S. dos
; Felippe-Bauer, Maria L.
; Cherman, Mariana A.
; Terossi, Mariana
; Bartz, Marie L.C.
; Barbosa, Marina F. de C.
; Loeb, Marina V.
; Cohn-Haft, Mario
; Cupello, Mario
; Martins, Marlúcia B.
; Christofersen, Martin L.
; Bento, Matheus
; Rocha, Matheus dos S.
; Martins, Maurício L.
; Segura, Melissa O.
; Cardenas, Melissa Q.
; Duarte, Mércia E.
; Ivie, Michael A.
; Mincarone, Michael M.
; Borges, Michela
; Monné, Miguel A.
; Casagrande, Mirna M.
; Fernandez, Monica A.
; Piovesan, Mônica
; Menezes, Naércio A.
; Benaim, Natalia P.
; Reategui, Natália S.
; Pedro, Natan C.
; Pecly, Nathalia H.
; Ferreira Júnior, Nelson
; Silva Júnior, Nelson J. da
; Perioto, Nelson W.
; Hamada, Neusa
; Degallier, Nicolas
; Chao, Ning L.
; Ferla, Noeli J.
; Mielke, Olaf H.H.
; Evangelista, Olivia
; Shibatta, Oscar A.
; Oliveira, Otto M.P.
; Albornoz, Pablo C.L.
; Dellapé, Pablo M.
; Gonçalves, Pablo R.
; Shimabukuro, Paloma H.F.
; Grossi, Paschoal
; Rodrigues, Patrícia E. da S.
; Lima, Patricia O.V.
; Velazco, Paul
; Santos, Paula B. dos
; Araújo, Paula B.
; Silva, Paula K.R.
; Riccardi, Paula R.
; Garcia, Paulo C. de A.
; Passos, Paulo G.H.
; Corgosinho, Paulo H.C.
; Lucinda, Paulo
; Costa, Paulo M.S.
; Alves, Paulo P.
; Roth, Paulo R. de O.
; Coelho, Paulo R.S.
; Duarte, Paulo R.M.
; Carvalho, Pedro F. de
; Gnaspini, Pedro
; Souza-Dias, Pedro G.B.
; Linardi, Pedro M.
; Bartholomay, Pedro R.
; Demite, Peterson R.
; Bulirsch, Petr
; Boll, Piter K.
; Pereira, Rachel M.M.
; Silva, Rafael A.P.F.
; Moura, Rafael B. de
; Boldrini, Rafael
; Silva, Rafaela A. da
; Falaschi, Rafaela L.
; Cordeiro, Ralf T.S.
; Mello, Ramon J.C.L.
; Singer, Randal A.
; Querino, Ranyse B.
; Heleodoro, Raphael A.
; Castilho, Raphael de C.
; Constantino, Reginaldo
; Guedes, Reinaldo C.
; Carrenho, Renan
; Gomes, Renata S.
; Gregorin, Renato
; Machado, Renato J.P.
; Bérnils, Renato S.
; Capellari, Renato S.
; Silva, Ricardo B.
; Kawada, Ricardo
; Dias, Ricardo M.
; Siewert, Ricardo
; Brugnera, Ricaro
; Leschen, Richard A.B.
; Constantin, Robert
; Robbins, Robert
; Pinto, Roberta R.
; Reis, Roberto E. dos
; Ramos, Robson T. da C.
; Cavichioli, Rodney R.
; Barros, Rodolfo C. de
; Caires, Rodrigo A.
; Salvador, Rodrigo B.
; Marques, Rodrigo C.
; Araújo, Rodrigo C.
; Araujo, Rodrigo de O.
; Dios, Rodrigo de V.P.
; Johnsson, Rodrigo
; Feitosa, Rodrigo M.
; Hutchings, Roger W.
; Lara, Rogéria I.R.
; Rossi, Rogério V.
; Gerstmeier, Roland
; Ochoa, Ronald
; Hutchings, Rosa S.G.
; Ale-Rocha, Rosaly
; Rocha, Rosana M. da
; Tidon, Rosana
; Brito, Rosangela
; Pellens, Roseli
; Santos, Sabrina R. dos
; Santos, Sandra D. dos
; Paiva, Sandra V.
; Santos, Sandro
; Oliveira, Sarah S. de
; Costa, Sávio C.
; Gardner, Scott L.
; Leal, Sebastián A. Muñoz
; Aloquio, Sergio
; Bonecker, Sergio L.C.
; Bueno, Sergio L. de S.
; Almeida, Sérgio M. de
; Stampar, Sérgio N.
; Andena, Sérgio R.
; Posso, Sergio R.
; Lima, Sheila P.
; Gadelha, Sian de S.
; Thiengo, Silvana C.
; Cohen, Simone C.
; Brandão, Simone N.
; Rosa, Simone P.
; Ribeiro, Síria L.B.
; Letana, Sócrates D.
; Santos, Sonia B. dos
; Andrade, Sonia C.S.
; Dávila, Stephane
; Vaz, Stéphanie
; Peck, Stewart B.
; Christo, Susete W.
; Cunha, Suzan B.Z.
; Gomes, Suzete R.
; Duarte, Tácio
; Madeira-Ott, Taís
; Marques, Taísa
; Roell, Talita
; Lima, Tarcilla C. de
; Sepulveda, Tatiana A.
; Maria, Tatiana F.
; Ruschel, Tatiana P.
; Rodrigues, Thaiana
; Marinho, Thais A.
; Almeida, Thaís M. de
; Miranda, Thaís P.
; Freitas, Thales R.O.
; Pereira, Thalles P.L.
; Zacca, Thamara
; Pacheco, Thaynara L.
; Martins, Thiago F.
; Alvarenga, Thiago M.
; Carvalho, Thiago R. de
; Polizei, Thiago T.S.
; McElrath, Thomas C.
; Henry, Thomas
; Pikart, Tiago G.
; Porto, Tiago J.
; Krolow, Tiago K.
; Carvalho, Tiago P.
; Lotufo, Tito M. da C.
; Caramaschi, Ulisses
; Pinheiro, Ulisses dos S.
; Pardiñas, Ulyses F.J.
; Maia, Valéria C.
; Tavares, Valeria
; Costa, Valmir A.
; Amaral, Vanessa S. do
; Silva, Vera C.
; Wolff, Vera R. dos S.
; Slobodian, Verônica
; Silva, Vinícius B. da
; Espíndola, Vinicius C.
; Costa-Silva, Vinicius da
; Bertaco, Vinicius de A.
; Padula, Vinícius
; Ferreira, Vinicius S.
; Silva, Vitor C.P. da
; Piacentini, Vítor de Q.
; Sandoval-Gómez, Vivian E.
; Trevine, Vivian
; Sousa, Viviane R.
; Sant’Anna, Vivianne B. de
; Mathis, Wayne N.
; Souza, Wesley de O.
; Colombo, Wesley D.
; Tomaszewska, Wioletta
; Wosiacki, Wolmar B.
; Ovando, Ximena M.C.
; Leite, Yuri L.R.
.
ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
8.
Fatores associados à osteoporose em pessoas idosas em um centro de referência
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Colares, Thomaz de Figueiredo Braga
; Vasconcelos, Ana Carolina Bromenschenkel
; Maia, Luciana Colares
; Caldeira, Antônio Prates
; Rossi-Barbosa, Luiza Augusta Rosa
.
Abstract This study aimed to estimate the prevalence of osteoporosis among elderly individuals receiving treatment at a designated reference center and to identify associated factors. The research employed a cross-sectional, analytical design, involving the collection of data from medical records and interviews with elderly individuals undergoing treatment at the Reference Center for Health Care for the Elderly (CRASI), specifically those who underwent bone densitometry examinations in the years 2017 and 2018. Bivariate analysis was conducted to explore the association between osteoporosis and various group characteristics, including sociodemographic profile, Body Mass Index (BMI), lifestyle habits, care, and health conditions. Variables showing an association up to a significance level of 20% (p ≤ .20) were collectively evaluated through Poisson multiple regression with a robust estimator. Only variables demonstrating a significance level of up to 5% were admitted to the final model. The prevalence of osteoporosis was found to be 48.5%. In the final model, the following variables were identified as being associated: female sex (RP = 1.88; 95%CI: 1.36 - 2.60), age over 80 years old (RP = 1.55; 95%CI: 1.29 - 1.85), BMI less than 22 (RP = 1.23; 95%CI: 1.02 - 1.49), and as a protective factor, BMI above 27 (RP = .52; 95%CI: .41 - .67). In conclusion, a high prevalence of osteoporosis was observed, with associations identified between osteoporosis and modifiable factors such as low weight, as well as non-modifiable factors including sex and age. No significant associations were discerned with variables related to lifestyle habits.
Resumo Este estudo objetivou estimar a prevalência de osteoporose em idosos atendidos em um centro de referência e identificar fatores associados. Trata-se de um estudo transversal, analítico, com coleta de dados em prontuários médicos e entrevistas aos idosos atendidos no Centro de Referência em Assistência à Saúde dos Idosos (CRASI), e que realizaram exame de densitometria óssea nos anos de 2017 e 2018. Utilizou-se análise bivariada para investigar a associação entre osteoporose e características do grupo: perfil sociodemográfico, Índice de Massa Corporal (IMC), hábitos de vida, cuidados e condições de saúde. As variáveis com associação até o nível de 20% (p ≤ .20) foram avaliadas de forma conjunta por regressão múltipla de Poisson com estimador robusto, admitindo-se para o modelo final apenas as variáveis com nível de significância de até 5%. A prevalência de osteoporose foi de 48.5%. No modelo final ficaram associadas as variáveis: sexo feminino (RP = 1.88; IC95%: 1.36 - 2.60), idade acima de 80 anos (RP = 1.55; IC95%: 1.29 - 1.85), IMC menor que 22 (RP = 1.23; IC95%: 1.02 - 1.49) e como protetor IMC acima de 27 (RP = .52; IC95%: .41 - .67). Concluindo,verificou-se alta prevalência de osteoporose e associação como fator modificável o baixo peso e outros não modificáveis: sexo e idade. Não foram identificadas associações com variáveis relacionadas aos hábitos de vida.
9.
Influence of music on the behavior of children during dental care
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SILVEIRA, Rafael Dias
; CAMIZÃO, Marcela Santana
; ROCHA, Yvina Santos Silva
; BARROS, Leandro Almeida Nascimento
; MAIA, Ana Carolina Del-Sarto Azevedo
; SANTOS, Nilton César Nogueira dos
.
RESUMO Objetivo: avaliar o papel da música como técnica de distração para minimizar a ansiedade durante o atendimento odontológico em crianças de 7 a 9 anos de idade quando submetidas a procedimento anestésico local. Métodos: Este estudo foi realizado no Módulo de Odontologia da Universidade Estadual do Sudoeste da Bahia, situado na cidade de Jequié – BA. Foi realizado a partir da aplicação da Facial Image Scale, mensuração da frequência cardíaca e pressão arterial com auxílio do esfigmomanômetro digital em dois momentos distintos ao longo do atendimento em odontopediatria com e sem a influência da música clássica. Os dados foram tabulados no software Statistical Package for Social Sciences, versão 21.0, expressos como medianas e intervalo interquartílico. Para a estatística inferencial, utilizou-se o teste de normalidade Shapiro-Wilk e a análise do efeito da música foi calculada utilizando os testes T-pareado e o Wilcoxon, considerando nível de significância de 95%. Resultados: A amostra foi constituída por 7 crianças, pertencendo sua maioria ao sexo masculino, com uma mediana de 8 anos de idade. Em relação às variáveis psicofisiológicas, não foram observadas variações significativas em comparação ao antes e depois nos grupos com música e sem música. Conclusões: Neste estudo não foram encontradas diferenças no que diz respeito à redução da ansiedade no grupo em que a música foi utilizada, havendo necessidade de estudos adicionais, com amostra representativa. Objetivo local Métodos Bahia BA Scale clássica Sciences 210 21 0 21.0 interquartílico inferencial utilizouse utilizou se ShapiroWilk Shapiro Wilk Tpareado T pareado Wilcoxon 95 95% Resultados masculino psicofisiológicas Conclusões utilizada adicionais representativa 2 21.
ABSTRACT Objective: To evaluate the role of music as a distraction technique to minimize anxiety during dental care in children aged 7 to 9 years when submitted to local anesthetic procedure. Method: This study was carried out in the Dentistry Module of the State University of Southwestern Bahia, located in the city of Jequié, Bahia, Brazil. It was performed through the application of the Facial Image Scale, measurement of heart rate and blood pressure with the aid of the digital sphygmomanometer at two different times during pediatric dentistry care with and without the influence of classical music. Data were tabulated in the Statistical Package for Social Sciences software, version 21.0, expressed as medians and interquartile range. For inferential statistics, the Shapiro-Wilk normality test was used and the analysis of the effect of music was calculated using the paired T-tests and Wilcoxon, considering a significance level of 95%. Results: The sample consisted of 7 children, mostly male, with a median of 8 years of age. Regarding the psychophysiological variables, no significant variations were observed compared to before and after in the groups with music and without music. Conclusion: In this study, no differences were found regarding the reduction of anxiety in the group in which music was used. Additional studies with a representative sample are needed. Objective procedure Method Bahia Jequié Brazil Scale software 210 21 0 21.0 range statistics ShapiroWilk Shapiro Wilk Ttests T tests Wilcoxon 95 95% Results male age variables Conclusion needed 2 21.
10.
Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease
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de Lima, Ana Carolina Bastos
; Mendes, Veronica Gonçalves
; Ferreira, Roberto Rodrigues
; Nisimura, Lindice Mitie
; Horita, Samuel Iwao Maia
; Veloso, Henrique H
; Costa, Andréa R
; da Silva, Gilberto Marcelo S
; Sangenis, Luiz Henrique C
; Holanda, Marcelo T
; Rimolo, Lorena
; Cunha, Ademir B
; Garzoni, Luciana Ribeiro
; Hasslocher-Moreno, Alejandro Marcel
; Mediano, Mauro Felippe F
; Moreira, Otacílio da Cruz
; Britto, Constança
; Saraiva, Roberto M
.
BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR. (PCR . (CD) clinical electrocardiographic T singlecentre single centre crosssectional cross sectional analysis 005 0 05 0.0 significant 33 56.4% 564 56 4 (56.4 men 6 1 years, years , years) 411 41 41.1% odds OR (OR 053 53 0.5 95% 95 [95 (CI 0.300.93 030093 0.30 0.93 30 93 0.30-0.93] 0.03, 003 0.03 03 0.03} 178 78 1.7 (95 1.092.89 109289 1.09 2.89 09 2 89 1.09-2.89) 0.02, 002 0.02 02 0.02] 013 13 0.1 0.040.38 004038 0.04 0.38 04 38 0.04-0.38) 0.0002. 00002 0.0002 0002 0.0002] n 39, 39 39) 10% (10% parameters (CD 00 0. 3 56.4 5 (56. 41.1 9 [9 300 0.300.9 03009 030 0.3 093 0.9 0.30-0.93 17 7 1. (9 092 1.092.8 10928 109 1.0 289 2.8 8 1.09-2.89 01 040 0.040.3 00403 004 038 0.04-0.38 0000 0.000 000 (10 56. (56 41. [ 0.300. 0300 0.30-0.9 ( 1.092. 1092 28 2. 1.09-2.8 0.040. 0040 0.04-0.3 0.00 (1 (5 0.300 0.30-0. 1.092 1.09-2. 0.040 0.04-0. 0.30-0 1.09-2 0.04-0 0.30- 1.09- 0.04-
11.
Development and validation of the Brazilian Version of Lay Persons’ Social Judgements about Cleft-lip Scale (B-LSojCleft-S) Persons Cleftlip Cleft lip BLSojCleftS B LSojCleft S (B-LSojCleft-S
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Maia, Ana Carolina Del-Sarto Azevedo
; Grimaldi, Débora Evelyn do Amaral
; Jural, Lucas Alves
; Lima, Stefanni Olga Aguiar Sales
; Magno, Marcela Baraúna
; Maia, Lucianne Cople
; Pithon, Matheus Melo
; Prado, Fabio Ornellas
.
Abstract The aim of this study was to develop and analyze the psychometric properties of the Brazilian Version of Lay Person's Social Judgement about Cleft-lip Scale (B-LSojCleft-S). A standardized photograph of a 16-year-old girl was manipulated by using photo editing software, to simulate different cleft-lip situations. The cleft-free image was used as a control. The researchers structured an initial questionnaire that was evaluated by experts and a sample of the target population to evaluate the construct. After analysis by the researchers, a final version of the B-LSojCleft-S containing 14 items was generated. Each answer was awarded score from 1 to 3 points, yielding a total score of 14 to 42 points. Higher scores represented better social judgements. The B-LSojCleft-S was applied online to 103 test participants and 73 retest participants with an interval of 20 days between application. Aspects of acceptability, discriminant property, internal consistency, reliability and construct validity were evaluated. Construct validity was assessed using the Friedman test (p < 0.05). Reliability was determined using an intraclass correlation coefficient > 0.70, and internal consistency using Cronbach's alpha > 0.81. The B-LSojCleft-S showed high acceptability, strong discriminant property, excellent internal consistency and reliability, but had a floor and ceiling effect. The instrument reached valid and reliable scores and had acceptable psychometric properties to evaluate the social judgments of lay persons about different cleft lip situations in a Brazilian population. Persons Person s Cleftlip Cleft BLSojCleftS. BLSojCleftS B LSojCleft S . (B-LSojCleft-S) 16yearold yearold 16 year old software cleftlip cleftfree free control generated points 4 judgements 10 7 2 application acceptability property p 0.05. 005 0.05 0 05 0.05) 070 70 0.70 Cronbachs Cronbach 081 81 0.81 effect (B-LSojCleft-S 00 0.0 07 0.7 08 8 0.8 0.
12.
Associação entre sintomas depressivos e inatividade física em trabalhadores técnico-administrativos de uma universidade pública do Nordeste do Brasil: estudo transversal técnicoadministrativos técnico administrativos Brasil
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Beck Filho, Jorge Augusto
; Pitta, Ana Maria Fernandes
; Bonfim, Camila Barreto
; Christovam, Barbara Pompeu
; Machado, Ana Carolina
; Guimarães, Lara Freitas
; Hora, Tatiane
; Brito, Luciara Leite
; Maia, Helena Maria Silveira Fraga
.
Resumo Objetivo: investigar a associação entre sintomas depressivos e inatividade física em trabalhadores técnico-administrativos de uma universidade pública do Nordeste do Brasil. Métodos: estudo transversal realizado no estado da Bahia. Os sintomas depressivos foram avaliados pelo Patient Health Questionnaire-9 e o nível de atividade física pelo International Physical Activity Questionnaire. Foi realizada análise de regressão de Poisson e estimadas as razões de prevalência (RP) e seus respectivos IC95%. Resultados: 301 servidores participaram do estudo, dos quais 71,1% do sexo feminino. A prevalência de sintomas depressivos foi de 25,7% e 52,0% dos servidores declararam ser fisicamente inativos. Sintomas depressivos e inatividade física se mostraram associados com os modificadores de efeito “tempo de trabalho na instituição ≤ 15 anos” (RP: 3,03; IC95%: 1,05;9,16) e “lotação em setores administrativos” (RP: 1,90; IC95%: 1,14;3,18). Conclusão: os resultados evidenciam a associação entre sintomas depressivos e inatividade física em trabalhadores técnico-administrativos de uma universidade pública do estado da Bahia, tendo como principais fatores associados o tempo de trabalho na instituição e a lotação do servidor. Objetivo técnicoadministrativos técnico administrativos Brasil Métodos Bahia Questionnaire9 Questionnaire 9 Questionnaire- RP (RP IC95 IC IC95% Resultados 30 711 71 1 71,1 feminino 257 25 7 25,7 520 52 0 52,0 inativos anos 3,03 303 3 03 1,059,16 105916 1,05 9,16 05 16 1,05;9,16 1,90 190 90 1,143,18. 114318 1,14 3,18 . 14 18 1,14;3,18) Conclusão servidor IC9 71, 2 25, 5 52, 3,0 059 1,059,1 10591 105 1,0 916 9,1 1,05;9,1 1,9 19 143 1,143,18 11431 114 1,1 318 3,1 1,14;3,18 3, 1,059, 1059 10 1, 91 9, 1,05;9, 1,143,1 1143 11 31 1,14;3,1 1,059 1,05;9 1,143, 1,14;3, 1,05; 1,143 1,14;3 1,14;
Abstract Objective: to investigate the association between depressive symptoms and physical inactivity in technical-administrative workers from a public university in the Northeast of Brazil. Methods: cross-sectional study. We assessed depressive symptoms and physical activity using, respectively, the Patient Health Questionnaire-9, and the International Physical Activity Questionnaire. We used Poisson regression analysis, and estimated the prevalence ratios (PR) and their respective 95%CI. Results: 301 workers participated, of which 71.1% were female. The prevalence of depressive symptoms was of 25.7%, and 52.0% of the workers declared being physically inactive. Depressive symptoms and physical inactivity were associated to the effect modifiers “time worked to the institution ≤ 15 years” (PR: 3.03; 95%CI: 1.05;9.16) e “work position at administrative sectors” (PR: 1.90; 95%CI: 1.14;3.18). Conclusion: the results evidence the association between depressive symptoms and physical inactivity in technical-administrative workers of a public university of the state of Bahia. The the main factor associated are time worked to the institution and work position at administrative sectors. Objective technicaladministrative technical Brazil Methods crosssectional cross sectional study using respectively Questionnaire9, Questionnaire9 Questionnaire 9, 9 Questionnaire-9 analysis PR (PR 95CI CI 95 95%CI Results 30 participated 711 71 1 71.1 female 257 25 7 25.7% 520 52 0 52.0 inactive years 3.03 303 3 03 1.059.16 105916 1.05 9.16 05 16 1.05;9.16 sectors 1.90 190 90 1.143.18. 114318 1.14 3.18 . 14 18 1.14;3.18) Conclusion Bahia Questionnaire- 71. 2 25.7 5 52. 3.0 059 1.059.1 10591 105 1.0 916 9.1 1.05;9.1 1.9 19 143 1.143.18 11431 114 1.1 318 3.1 1.14;3.18 25. 3. 1.059. 1059 10 1. 91 9. 1.05;9. 1.143.1 1143 11 31 1.14;3.1 1.059 1.05;9 1.143. 1.14;3. 1.05; 1.143 1.14;3 1.14;
13.
Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio
; Rassi Jr, Anis
; Oliveira, Gláucia Maria Moraes
; Correia, Luís Claudio Lemos
; Ramos Júnior, Alberto Novaes
; Luquetti, Alejandro Ostermayer
; Hasslocher-Moreno, Alejandro Marcel
; Sousa, Andréa Silvestre de
; Paola, Angelo Amato Vincenzo de
; Sousa, Antônio Carlos Sobral
; Ribeiro, Antonio Luiz Pinho
; Correia Filho, Dalmo
; Souza, Dilma do Socorro Moraes de
; Cunha-Neto, Edecio
; Ramires, Felix Jose Alvarez
; Bacal, Fernando
; Nunes, Maria do Carmo Pereira
; Martinelli Filho, Martino
; Scanavacca, Maurício Ibrahim
; Saraiva, Roberto Magalhães
; Oliveira Júnior, Wilson Alves de
; Lorga-Filho, Adalberto Menezes
; Guimarães, Adriana de Jesus Benevides de Almeida
; Braga, Adriana Lopes Latado
; Oliveira, Adriana Sarmento de
; Sarabanda, Alvaro Valentim Lima
; Pinto, Ana Yecê das Neves
; Carmo, Andre Assis Lopes do
; Schmidt, Andre
; Costa, Andréa Rodrigues da
; Ianni, Barbara Maria
; Markman Filho, Brivaldo
; Rochitte, Carlos Eduardo
; Macêdo, Carolina Thé
; Mady, Charles
; Chevillard, Christophe
; Virgens, Cláudio Marcelo Bittencourt das
; Castro, Cleudson Nery de
; Britto, Constança Felicia De Paoli de Carvalho
; Pisani, Cristiano
; Rassi, Daniela do Carmo
; Sobral Filho, Dário Celestino
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Mesquita, Evandro Tinoco
; Mendes, Fernanda de Souza Nogueira Sardinha
; Gondim, Francisca Tatiana Pereira
; Silva, Gilberto Marcelo Sperandio da
; Peixoto, Giselle de Lima
; Lima, Gustavo Glotz de
; Veloso, Henrique Horta
; Moreira, Henrique Turin
; Lopes, Hugo Bellotti
; Pinto, Ibraim Masciarelli Francisco
; Ferreira, João Marcos Bemfica Barbosa
; Nunes, João Paulo Silva
; Barreto-Filho, José Augusto Soares
; Saraiva, José Francisco Kerr
; Lannes-Vieira, Joseli
; Oliveira, Joselina Luzia Menezes
; Armaganijan, Luciana Vidal
; Martins, Luiz Cláudio
; Sangenis, Luiz Henrique Conde
; Barbosa, Marco Paulo Tomaz
; Almeida-Santos, Marcos Antonio
; Simões, Marcos Vinicius
; Yasuda, Maria Aparecida Shikanai
; Moreira, Maria da Consolação Vieira
; Higuchi, Maria de Lourdes
; Monteiro, Maria Rita de Cassia Costa
; Mediano, Mauro Felippe Felix
; Lima, Mayara Maia
; Oliveira, Maykon Tavares de
; Romano, Minna Moreira Dias
; Araujo, Nadjar Nitz Silva Lociks de
; Medeiros, Paulo de Tarso Jorge
; Alves, Renato Vieira
; Teixeira, Ricardo Alkmim
; Pedrosa, Roberto Coury
; Aras Junior, Roque
; Torres, Rosalia Morais
; Povoa, Rui Manoel dos Santos
; Rassi, Sergio Gabriel
; Alves, Silvia Marinho Martins
; Tavares, Suelene Brito do Nascimento
; Palmeira, Swamy Lima
; Silva Júnior, Telêmaco Luiz da
; Rodrigues, Thiago da Rocha
; Madrini Junior, Vagner
; Brant, Veruska Maia da Costa
; Dutra, Walderez Ornelas
; Dias, João Carlos Pinto
.
14.
Intake and apparent nutrient digestibility, ruminal parameters, and nitrogen balance of lambs fed with corn and forage-free diets with sodium bicarbonate digestibility parameters foragefree forage free
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Vicente, Ana Carolina Silva
; Carlis, Matheus Sousa de Paula
; Santos, Isabela Jorge dos
; Silva, Adrielly Lais Alves da
; Dias Junior, Paulo César Gonzales
; Eckermann, Nathalia Rubio
; Souza, Terezinha Teixeira de
; Polizel, Daniel Montanher
; Baggio, Marcelo
; Biava, Janaina Socolovski
; Pires, Alexandre Vaz
; Ferreira, Evandro Maia
.
RESUMO: O presente estudo avaliou a suplementação de bicarbonato de sódio (BS) em dietas sem forragem à base de milho moído sobre o consumo e a digestibilidade aparente dos nutrientes, os parâmetros ruminais e o balanço de N. Foram utilizados quatro cordeiros Dorper × Santa Inês, com um peso corporal inicial de 43,4 ± 0,85 kg (média ± desvio padrão). O delineamento experimental foi quadrado latino 4×4. Cada período experimental durou 21 dias. As dietas experimentais foram: controle positivo, sem BS, contendo 400 g/kg de MS de casca de soja (CONT) e três dietas à base de milho moído, sem casca de soja, contendo 10 (10BS), 20 (20BS) ou 30 (30BS) g/kg de MS de BS. O consumo de fibra em detergente neutro e ácido foi maior (P < 0,01)para o CONT quando comparado com BS. O consumo e a digestibilidade aparente da matéria seca, matéria orgânica, extrato etéreo e proteína bruta não diferiram entre os tratamentos. O consumo (P = 0,01) e digestibilidade (P < 0,01) dos carboidratos não fibrosos foram superiores para as dietas contendo BS e a digestibilidade da fibra em detergente neutro foi maior para o CONT. Os teores de nutrientes digestivos totais e energia metabolizável foram superiores para as dietas contendo BS (P = 0,04). A concentração ruminal de acetato (P < 0,01), isobutirato (P < 0,01), butirato (P < 0,01), isovalerato (P < 0,01) e ácidos graxos totais de cadeia curta (P < 0,01) foram mais elevadas para o CONT. O pHruminal apresentou resposta quadrática (P = 0,05) em relação aos níveis de BS, sendo observado maior pH para os animais alimentados com a dieta 20BS. O BS foi eficiente em aumentar o pHruminal no teor de 20 g/kg MS sem interferir no consumo e na digestibilidade aparente dos nutrientes. Portanto, 20 g/kg de MS é a dose indicada de BS em dietas sem forragem para terminação de cordeiros em confinamento. RESUMO (BS N Inês 434 43 4 43, 085 0 85 0,8 média padrão. padrão . padrão) 44 4×4 2 dias positivo 40 gkg g (CONT 1 10BS, 10BS , (10BS) 20BS (20BS 3 30BS (30BS P 0,01para 001para 0,01 01 seca orgânica tratamentos 001 0,04. 004 0,04 04 0,04) 0,01, 0,05 005 05 Portanto confinamento 08 8 0, 4× (10BS 01para 0,0 00
ABSTRACT: This study evaluated forage-free diets supplemented with sodium bicarbonate (SB) based on ground flint corn on intake, apparent nutrient digestibility, ruminal parameters, and N balance. Four rumen-cannulatedDorper × Santa Inês lambs, with a body weight of 43.4 ± 0.85 kg (mean ± standard deviation) were used. The experimental design was a 4×4 Latin square. Each experimental period lasted 21 days. Experimental diets were: positive control, a diet without SB containing 400 g/kg DM of soybean hulls (CONT), and three diets based on ground flint corn, containing 10 (10SB), 20 (20SB) or 30 (30SB) g/kg DM of SB. Intake of neutral and acid detergent fiber was greater for CONT (P < 0.01) when compared to SB. Intake and apparent nutrient digestibility of dry and organic matter, ether extract, and crude protein did not differ. Intake (P = 0.01) and digestibility (P < 0.01) of non-fiber carbohydrates were greater for SB diets and neutral detergent fiber digestibility was greater (P = 0.03) for CONT. The total digestible nutrients and metabolizable energy were greater for SB (P = 0.04). Rumen concentrations of acetate (P < 0.01), isobutyrate (P < 0.01), butyrate (P < 0.01), isovalerate (P < 0.01), and total short-chain fatty acids (P < 0.01) were greater for CONT. Ruminal pH showed a quadratic (P = 0.05) response to SB levels, with greater values for 20SB. Sodium bicarbonate was efficient in increasing ruminal pH at the level of 20 g/kg DM without interfering with the intake and apparent nutrient digestibility characteristics. ABSTRACT foragefree forage free (SB parameters balance rumencannulatedDorper rumen cannulatedDorper lambs 434 43 4 43. 085 0 85 0.8 mean deviation used 44 4× square 2 days control 40 gkg g CONT, , (CONT) 1 10SB, 10SB (10SB) 20SB (20SB 3 30SB (30SB P 0.01 001 01 matter extract differ nonfiber non 0.03 003 03 0.04. 004 0.04 . 04 0.04) 0.01, shortchain short chain 0.05 005 05 levels characteristics 08 8 0. (CONT (10SB 0.0 00
15.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
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au | author |
kw | article keywords |
subject | subject (title words, abstract and keywords) |
ab | abstract |
ta | journal short title (e.g. Cad. Saúde Pública) |
journal_title | journal full title (e.g. Cadernos de Saúde Pública) |
la | publication language code (e.g. pt - Portuguese, es - Spanish) |
type | document type |
pid | publication identifier |
publication_year | publication year of publication |
sponsor | sponsor |
aff_country | country code of the author's affiliation |
aff_institution | author affiliation institution |
volume | article volume |
issue | article issue |
elocation | elocation |
doi | DOI number |
issn | journal ISSN |
in | SciELO colection code (e.g. scl - Brasil, col - Colômbia) |
use_license | article usage license code |