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Os reflexos do bolsonarismo sobre políticas de saúde da mulher e os direitos sexuais e reprodutivos
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Medeiros, Henrique Gonçalves Dantas de

; Araújo Júnior, José Luiz do Amaral Corrêa de

Trabalho, Educação e Saúde

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2024, Volume 22 elocation e02811259

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo O bolsonarismo é definido como movimento neofascista cuja principal base social é a alta classe média e que, portanto, logrou atrair parte da categoria médica. Ele comporta diversos elementos ideológicos que se refletiram na política de saúde entre 2019 e 2022, entre eles: o antipetismo/anticomunismo, o neoliberalismo, o conservadorismo moral, a homofobia, o fundamentalismo cristão, o negacionismo científico, o antifeminismo e a misoginia. Buscou-se analisar os reflexos do bolsonarismo sobre as políticas relacionadas à saúde da mulher e aos direitos sexuais e reprodutivos nesse período. Por intermédio de métodos de procedimento histórico e monográfico, com uma abordagem qualitativa, de caráter descritivo e exploratório, utilizaram-se a documentação indireta e a observação direta intensiva para a coleta de dados, a condensação de significado e a hermenêutica-dialética para sua análise. O conservadorismo moral e o fundamentalismo religioso associados ao antifeminismo e à misoginia marcaram as políticas voltadas à saúde da mulher e aos direitos sexuais e reprodutivos. Analisaram-se o combate do Conselho Federal de Medicina ao conceito de violência obstétrica, as medidas para obstaculizar o acesso ao aborto legal, as dificuldades para a reprodução assistida e o desmonte da Rede Cegonha, revelando a associação entre a corporação médica e o governo Bolsonaro. portanto 201 2022 eles antipetismoanticomunismo antipetismo anticomunismo antipetismo/anticomunismo neoliberalismo homofobia cristão científico Buscouse Buscou período monográfico qualitativa exploratório utilizaramse utilizaram dados hermenêuticadialética hermenêutica dialética análise Analisaramse Analisaram obstétrica legal Cegonha Bolsonaro 20 202 2

Abstract Bolsonarism is defined as a neo-fascist movement whose main social base is the upper middle class. Therefore, it managed to attract part of the medical category. It includes several ideological elements that were reflected in health policy between 2019 and 2022, including antipetism/anti-communism, neoliberalism, moral conservatism, homophobia, Christian fundamentalism, scientific denialism, antifeminism, and misogyny. We sought to analyze Bolsonarism’s reflexes on policies related to women’s health and sexual and reproductive rights during this period. Through historical and monographic procedures, with a qualitative, descriptive, and exploratory approach, indirect documentation and intensive direct observation were used for data collection, condensation of meaning, and hermeneutics-dialectics for its analysis. Moral conservatism and religious fundamentalism associated with anti-feminism and misogyny have marked policies aimed at women’s health and sexual and reproductive rights. We analyzed the fight of the Federal Council of Medicine against the concept of obstetric violence, the measures to hinder access to legal abortion, the difficulties for assisted reproduction, and the dismantling of the Stork Network, revealing the association between the medical profession and the Bolsonaro government. neofascist neo fascist class Therefore category 201 2022 antipetism/anticommunism, antipetismanticommunism antipetism/anti communism, antipetism anti communism antipetism/anti-communism neoliberalism homophobia denialism antifeminism Bolsonarisms s womens women period procedures qualitative descriptive approach collection meaning hermeneuticsdialectics hermeneutics dialectics analysis feminism violence abortion reproduction Network government 20 202 anticommunism antipetism/anticommunism antipetismanti 2

Resumen El bolsonarismo se define como un movimiento neofascista cuya principal base social es la clase media alta y que, por tanto, ha logrado atraer a una parte de los profesionales de la medicina. Incluye varios elementos ideológicos que se reflejaron en la política sanitaria entre 2019 y 2022, entre ellos: antipetismo/anticomunismo, neoliberalismo, conservadurismo moral, homofobia, fundamentalismo cristiano, negacionismo científico, antifeminismo y misoginia. El objetivo fue analizar los efectos del gobierno de Bolsonaro en las políticas relacionadas con la salud y los derechos sexuales y reproductivos de las mujeres durante este período. A través de métodos procedimentales históricos y monográficos, con enfoque cualitativo, descriptivo y exploratorio, se utilizó la documentación indirecta y la observación directa intensiva para la recolección de datos, y la condensación de sentido y la hermenéutica dialéctica para su análisis. El conservadurismo moral y el fundamentalismo religioso combinados con el antifeminismo y la misoginia han marcado las políticas dirigidas a la salud y los derechos sexuales y reproductivos de las mujeres. La lucha del Consejo Federal de Medicina contra el concepto de violencia obstétrica, las medidas para obstaculizar el acceso al aborto legal, las dificultades para la reproducción asistida y el desmantelamiento de la Red Cigüeña fueron analizados, revelando la asociación entre la corporación médica y el gobierno Bolsonaro. tanto medicina 201 2022 ellos antipetismoanticomunismo antipetismo anticomunismo antipetismo/anticomunismo neoliberalismo homofobia cristiano científico período monográficos cualitativo exploratorio datos análisis obstétrica legal analizados 20 202 2

https://doi.org/10.1590/1981-7746-ojs2811

The nutritional value of gliricidia in different fed forms: a systematic review forms
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Silva, Pedro Henrique Ferreira da

; Medeiros, Geovergue Rodrigues de

; Carvalho, Chrislanne Barreira de Macêdo

; Cavalcante, Iara Tamires Rodrigues

; Santos, Severino Guilherme Caetano Gonçalves dos

; Neves, Romildo da Silva

; Ribeiro, Neila Lidiany

; Costa, José Henrique Souza

; Sales-Silva, Tafnes Bernardo

Ciência Rural

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2024, Volume 54 N. 11 elocation e20230475

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Diferentes tipos de volumosos podem causar perdas na composição química e digestibilidade da gliricídia (Gliricidia sepium [Jacq.] Kunth ex Walp.) dependendo de sua confecção e do manejo da alimentação. O objetivo deste estudo foi sumarizar dados de trabalhos científicos com gliricídia e comparar seu valor nutritivo em diferentes formas de alimentação, sob uma abordagem de revisão sistemática e análise de componentes principais (ACP). Realizou-se um levantamento robusto de trabalhos científicos em web indexadores de periódicos, e em base de dados, de 1990 a 2023. Dados de 100 trabalhos foram sumarizados e analisados. Em 40% dos trabalhos, o valor nutricional da gliricídia foi determinado como folhas in natura, enquanto 30% foi na forma de ‘folhas + caules finos’, em 11% das oportunidades, a gliricídia foi avaliada na forma de silagem, seguido por 10% como farelo de folhas, e 9% como feno. Carboidratos não-fibrosos, proteína bruta (PB) e digestibilidade da matéria orgânica (MO) tiveram correlações negativas com fibra em detergente neutro (FDN), fibra em detergente ácido (FDA) e lignina. Os teores de FDN, FDA e PB foram capazes de explicar 71,00% da variação total dos dados no CP 1 e 2. Além disso, não houve discriminação entre as formas de alimentação, que tiveram composições semelhantes. Eventuais perdas de nutrientes relatadas em trabalhos científicos devido aos processos de ensilagem, fenação ou fabricação de farelo de folhas não descaracterizam o valor nutritivo da gliricídia. As diversas maneiras de confecção de volumosos e manejo da alimentação tradicionalmente utilizadas por agricultores são capazes de conservar a excelente qualidade nutricional da gliricídia. RESUMO Gliricidia Jacq. Jacq [Jacq. Walp. Walp ACP. ACP . (ACP) Realizouse Realizou se periódicos 199 2023 10 analisados 40 natura 30 finos, finos , finos’ 11 oportunidades silagem 9 feno nãofibrosos, nãofibrosos fibrosos, fibrosos não-fibrosos (PB MO (MO FDN (FDN) (FDA lignina 7100 71 00 71,00 2 disso semelhantes ensilagem [Jacq (ACP 19 202 4 3 (FDN 710 7 0 71,0 20 71,

ABSTRACT: Different types of supplied roughage may cause losses in the chemical composition and digestibility of gliricidia (Gliricidia sepium [Jacq.] Kunth ex Walp.) depending on their making and fed-out management. This study has summarized data from scientific studies on gliricidia and compared its nutritional value in various fed forms using a systematic review approach and principal component analysis (PCA). A robust survey of scientific papers was realized on web indexes of periodicals and databases from 1990 to 2023. Data from 100 scientific researches has been compiled and analyzed. In 40% of the trials, the gliricidia nutritional value was determined as fresh leaves, while 30% was in the form of ‘leaves + thin stems’. Gliricidia was evaluated as silage in 11% of the opportunities, followed by 10% as leaf meal and 9% as hay. Non-fiber carbohydrates, crude protein (CP), and organic matter digestibility (OM) had negative correlations with neutral detergent fiber (NDF), acid detergent fiber (ADF), and lignin. Only NDF, ADF, and CP contents could explain 71% of the total data variation (PC1 and PC2). There was no discrimination among fed forms, so they showed similar nutrient compositions. Eventual nutrient losses reported in the scientific researches owing to ensilage, haymaking, and leaf meal-making processes do not mischaracterize the gliricidia nutritional value. The assorted manners of roughage making, and fed-out management traditionally performed by farmers can conserve the excellent nutritional quality of gliricidia. ABSTRACT Jacq. Jacq [Jacq. Walp. Walp fedout out PCA. PCA . (PCA) 199 2023 10 analyzed 40 trials leaves 30 stems. stems stems’ 11 opportunities 9 hay Nonfiber Non carbohydrates CP, , (CP) OM (OM NDF (NDF) ADF (ADF) lignin 71 PC1 PC (PC PC2. PC2 PC2) compositions ensilage haymaking mealmaking [Jacq (PCA 19 202 1 4 3 (CP (NDF (ADF 7 20 2

https://doi.org/10.1590/0103-8478cr20230475

To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis B B2 positive outcomes
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Resende, Gustavo Gomes

; Saad, Carla Goncalves Schahin

; Marques, Claudia Diniz Lopes

; Ribeiro, Sandra Lúcia Euzébio

; Gavi, Maria Bernadete Renoldi de Oliveira

; Yazbek, Michel Alexandre

; Marinho, Adriana de Oliveira

; Menin, Rita de Cássia

; Ochtrop, Manuella Lima Gomes

; Soares, Andressa Miozzo

; Cavalcanti, Nara Gualberto

; Carneiro, Jamille Nascimento

; Werner de Castro, Glaucio Ricardo

; Fernandes, José Mauro Carneiro

; Souza, Elziane da Cruz Ribeiro E

; Alvarenga, Corina Quental de Menezes

; Vieira, Rejane Maria Rodrigues de Abreu

; Machado, Natalia Pereira

; Ximenes, Antônio Carlos

; Gazzeta, Morgana Ohira

; Albuquerque, Cleandro Pires de

; Skare, Thelma Larocca

; Keiserman, Mauro Waldemar

; Kohem, Charles Lubianca

; Benacon, Gabriel Sarkis

; Rocha, Vítor Florêncio Santos

; Lage, Ricardo da Cruz

; Malheiro, Olivio Brito

; Golebiovski, Rywka Tenenbaum Medeiros

; Oliveira, Thauana Luiza

; Duque, Ruben Horst

; Londe, Ana Carolina

; Pinheiro, Marcelo de Medeiros

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2024, Volume 64 elocation 33

Abstract: En | Text: En | PDF: En

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±

https://doi.org/10.1186/s42358-024-00372-0

Evaluation of the morphology and development of preantral ovarian follicles in mice submitted to a chronic diet of dietary supplementation with Pereskia aculeata Miller leaves
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Ferreira, Alesandro Silva

; Ferreira, Francisco Glauber Peixoto

; Nascimento, Etho Roberio Medeiros

; Tetaping, Gildas Mbemya

; Lima, Laritza Ferreira de

; Fonseca, Said Gonçalves da Cruz

; Figueiredo, José Ricardo de

; Sousa, Daniel Freire de

; Celestino, Juliana Jales de Hollanda

Animal Reproduction

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2024, Volume 21 N. 2 elocation e20240012

Abstract: En | Text: En | PDF: En

Abstract This study aimed to investigate the effect of including mouse feed with different concentrations (5, 10, or 20%) of Pereskia aculeata Miller (PAM) leaves on the morphology and development of preantral ovarian follicles and ovarian stromal cell density. The oral toxicity was performed using repeated dose toxicity assays subdivided into experiments of 30 days and 90 days of treatment. After the experiments, the ovaries of each animal were collected and submitted to classical histology. At 30 and 90 days, there was an equivalent percentage of normal, primordial, and developing follicles (P > 0.05) between PAM treatments compared to the control. Regarding the different stages of follicular development, after 90 days, there was a higher percentage (P < 0.05) of developing follicles only in the control group compared to day 30. The PAM 5% treatment was the only one that affected the cell density in the stroma after 90 days of treatment. Thus, we observed that supplementing the diet with P. aculeata did not pose any risk concerning animal consumption; specifically, there were no toxic reproductive effects observed from adding Pereskia aculeata Miller to the mouse diet. 5, 5 (5 10 20% 20 (PAM 3 9 histology normal primordial P 0.05 005 0 05 Thus consumption specifically ( 1 2 0.0 00 0.

https://doi.org/10.1590/1984-3143-ar2024-0012

Increasing levels of cornmeal improve chemical and fermentation parameters of maniçoba silage
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Silva, Pedro Henrique Ferreira da

; Neves, Romildo da Silva

; Medeiros, Geovergue Rodrigues de

; Costa, José Henrique Souza

; Ribeiro, Neila Lidiany

; Carvalho, Chrislanne Barreira de Macêdo

; Cavalcante, Iara Tamires Rodrigues

; Santos, Severino Guilherme Caetano Gonçalves dos

Ciência Animal Brasileira

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2024, Volume 25 elocation 75861E

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A ensilagem da maniçoba (Manihot pseudoglaziovii) é importante para preservar os nutrientes dessa planta forrageira. Todavia, o teor de umidade da planta pode gerar fermentações indesejáveis. Objetivou-se avaliar efeito de níveis de fubá de milho (0, 10, 20 e 30%) sobre a composição bromatológica e parâmetros fermentativos da silagem de maniçoba, além de identificar as variáveis mais afetada pelo aditivo. As concentrações de matéria seca (MS), carboidratos não-fibrosos (CNF), nutrientes digestíveis totais (NDT) e ácido propiônico aumentaram em função dos níveis de fubá de milho (P<0,05). Os teores de proteína bruta (PB), lignina e ácido butírico, além do pH, foram reduzidos pelo aditivo (P<0,05). Dois grupos foram formados na análise de componentes principais. O grupo I foi formado por variáveis afetadas positivamente pela inclusão do fubá de milho: MS, hemicelulose, CNF e NDT. O grupo II foi formado por variáveis que tiveram seus valores reduzidos pela inclusão do aditivo: PB, lignina, matéria mineral e ácido butírico. A silagem de maniçoba, com ou sem fubá de milho, apresenta bom perfil fermentativo e composição bromatológica adequada para a alimentação de ruminantes. Os teores de MS e NDT são as variáveis da composição químico-bromatológica mais influenciadas pela inclusão do fubá de milho, enquanto pH e ácido butírico são as variáveis do perfil fermentativo mais afeadas pelo aditivo absorvente. Sugere-se a inclusão de níveis moderados de fubá na silagem de maniçoba para obter melhor perfil de fermentação e a maior concentração de nutrientes digestíveis, sem descaracterizar o alimento como volumoso. Manihot pseudoglaziovii forrageira Todavia indesejáveis Objetivouse Objetivou se 0, 0 (0 10 2 30% 30 , (MS) nãofibrosos não fibrosos CNF, (CNF) (NDT P<0,05. P005 P P<0,05 . 05 (P<0,05) PB (PB) principais hemicelulose ruminantes químicobromatológica químico absorvente Sugerese Sugere volumoso ( 1 3 (MS (CNF P00 P<0,0 (P<0,05 (PB P0 P<0, (P<0,0 P<0 (P<0, P< (P<0 (P< (P

Abstract Ensiling maniçoba (Manihot pseudoglaziovii) is essential to preserve the nutrients of this forage plant. However, the plant moisture content may generate undesirable fermentations. The objective of this study was to evaluate the effects of different cornmeal inclusion levels (0%, 10%, 20%, and 30%) on the chemical composition and fermentation parameters of maniçoba silage, in addition to identifying the variables most affected by cornmeal. The concentrations of dry matter (DM), non-fiber carbohydrates (NFC), total digestible nutrients (TDN), and propionic acid increased with cornmeal inclusion levels (P < 0.05). Crude protein (CP), lignin, and butyric acid contents, as well as pH, were reduced by the additive (P < 0.05). Principal component analysis resulted in two main groups. Group I was formed by variables positively affected by cornmeal inclusion, namely DM, hemicellulose, NFC, and TDN. Group II contained variables that were negatively affected by cornmeal, namely CP, lignin, mineral matter, and butyric acid. Regardless of the addition of cornmeal, maniçoba silage displays an adequate chemical composition and a good fermentation profile for ruminant feeding. Dry matter and total digestible nutrients are the chemical variables most influenced by cornmeal inclusion, whereas pH and butyric acid are the fermentative parameters most affected by the moisture-absorbent additive. Including moderate levels of cornmeal in maniçoba silage is recommended to achieve the best fermentation profile and the highest concentration of digestible nutrients without mischaracterizing it as a roughage feed. Manihot pseudoglaziovii However fermentations 0%, 0 (0% 10 10% 20 20% 30% 30 DM , (DM) nonfiber non fiber NFC (NFC) TDN, TDN (TDN) P 0.05. 005 0.05 . 05 0.05) CP (CP) lignin contents groups hemicellulose feeding moistureabsorbent absorbent feed 0% (0 1 2 3 (DM (NFC (TDN 00 0.0 (CP ( 0.

https://doi.org/10.1590/1809-6891v25e-75861e

CodiReal-PT: National Survey on Current Practices in Right Colon Oncological Surgery CodiRealPT CodiReal PT CodiReal-PT
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Azevedo, José Gonçalves Moreira de

; Sousa, Maria João Morais do Carmo Couto de

; Cunha, Miguel Fernandes da Conceição

; Fernandez, Laura Melina

; Rama, Nuno José Gomes

; Quintanilha, Rui Paulo de Medeiros

Journal of Coloproctology (Rio de Janeiro)

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2024, Volume 44 N. 3 Pages 171 - 179

Abstract: En | Text: En | PDF: En

Abstract Introduction Colorectal cancer (CRC) is the third most prevalent tumor. Right colon cancer (RCC) comprises one-third of CRC cases and is associated with poorer outcomes, emphasizing the need for optimized treatment strategies. The present study aims to explore the nuances in the management of RCC across Portugal, focusing on surgical approaches and multidisciplinary treatment. Materials and Methods The CodiReal-PT was a cross-sectional survey-based study adhering to the guidelines of the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), focusing on current practices in RCC oncological surgery. The survey comprised 31 questions divided into 4 sections (demographics, multidisciplinary approach, surgery practices regarding RCC, and postoperative management). It was made available via e-mail to all active members of the Portuguese Society of Surgery (Sociedade Portuguesa de Cirurgia, SPCIR, in Portuguese), and data collection lasted from November to December 2022. Results Data from 69% of Portuguese public hospitals was obtained. All the participant hospitals had multidisciplinary team meetings to manage CRC cases. However, 17% (n = 6) did not discuss all elective-setting cases during their meetings. Dedicated colorectal surgical teams were present in 86% (n = 31) of hospitals. Furthermore, the presence of these dedicated teams was associated with better practices, namely a higher volume of right colectomies (mean: 51.8 ± 32.6 versus 23.8 ± 4.8; p = 0.001), a preference for the laparoscopic approach (93.5 versus 60.0%; p = 0.021), and standardization of anastomotic techniques (83.9 versus 40.0%; p = 0.029). Conclusion The present nationwide survey-based study provides a comprehensive landscape of RCC management practices across Portugal, underscoring the significant role of dedicated colorectal surgical teams and the need for further practice standardization. Nevertheless, multidisciplinary team meetings in all surveyed hospitals are an important indicator of improved RCC care. Future research should focus on the impact of specific surgical techniques on oncological outcomes and the potential benefits of centralizing care to high-volume centers. (CRC tumor (RCC onethird one strategies Portugal CodiRealPT CodiReal PT crosssectional cross sectional surveybased based ESurveys E Surveys CHERRIES, CHERRIES , (CHERRIES) 3 demographics, demographics (demographics management. . management) email e mail Sociedade Cirurgia SPCIR Portuguese, Portuguese) 2022 69 obtained However 17 n 6 electivesetting elective setting 86 Furthermore mean (mean 518 51 8 51. 326 32 32. 238 23 23. 4.8 48 0.001, 0001 0.001 0 001 0.001) 93.5 935 93 5 (93. 60.0% 600 60 0.021, 0021 0.021 021 0.021) 83.9 839 83 9 (83. 40.0% 400 40 0.029. 0029 0.029 029 0.029) Nevertheless highvolume high centers (CHERRIES 202 1 2 4. 000 0.00 00 93. (93 60.0 002 0.02 02 83. (83 40.0 20 0.0 (9 60. (8 40. 0. (

https://doi.org/10.1055/s-0044-1788912

História da Educação e a História Política
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Vieira, Carlos Eduardo

; Galak, Eduardo Lautaro

; Gondra, José Gonçalves

; Neta, Olívia Morais de Medeiros

; Campos, Raquel Discini de

Revista Brasileira de História da Educação

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2024, Volume 24 elocation e345

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.4025/rbhe.v24.2024.e245

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

Advances in Rheumatology

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2024, Volume 64 elocation 58

Abstract: En | Text: En | PDF: En

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

https://doi.org/10.1186/s42358-024-00397-5

Novos ventos, sustentabilidade e outros desafios ventos
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Vieira, Carlos Eduardo

; Galak, Eduardo Lautaro

; Gondra, José Gonçalves

; Neta, Olívia Morais de Medeiros

; Campos, Raquel Discini de

; Godoy, Sergio Luiz de

Revista Brasileira de História da Educação

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2023, Volume 23 elocation e294

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.4025/rbhe.v23.2023.e294

10.

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

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 1 elocation e20220892

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20220892

11.

Assessment of healthcare accessibility and travel distance on intrapartum fetal death: a retrospective cohort study
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Moterani, Vinicius Cesar

; Abbade, Joelcio Francisco

; Borges, Vera Therezinha Medeiros

; Fonseca, Cecilia Guimarães Ferreira

; Desiderio, Nathalia

; Moterani Junior, Nino Jose Wilson

; Gonçalves Moterani, Laura Bresciani Bento

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e149

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo. Determinar se existe alguma relação entre a morte fetal intraparto e dois fatores: a distância percorrida para o parto e o acesso à assistência ao parto, avaliando o período antes e durante a pandemia de COVID-19. Métodos. Este é um estudo de coorte de base populacional. As pacientes tiveram parto após o início do trabalho de parto; o desfecho primário foi morte fetal intraparto. A cidade de residência foi classificada de acordo com a razão entre os partos realizados e o total de nascimentos entre os residentes; valores inferiores a 0,1 indicavam baixo acesso à assistência ao parto. A distância percorrida foi calculada usando a fórmula de Haversine. Foram incluídos o nível de escolaridade, a idade materna e o sexo de nascimento. Em cada período, o risco relativo foi avaliado usando um modelo linear generalizado com variância de Poisson. Resultados. Foram registrados 2 267 534 partos com nascimento após o início do trabalho de parto. A maioria das pacientes tinha entre 20 e 35 anos de idade, entre 8 e 11 anos de escolaridade e residia em cidades com alto nível de acesso à assistência ao parto. O baixo acesso à assistência ao parto aumentou o risco de morte fetal intraparto no período anterior à pandemia (risco relativo [RR]: 2,02; intervalo de confiança [IC] de 95%: 1,64–2,47; p < 0,01) e durante a pandemia (RR: 1,69; IC 95%: 1,09–2,55; p = 0,015). Isso ocorreu independentemente de outros fatores de aumento de risco, como a distância percorrida e menor escolaridade. Conclusões. O baixo acesso ao atendimento de parto está associado ao risco de morte fetal intraparto, e a acessibilidade diminuiu durante a pandemia. A realização do parto por médicos de família e obstetrizes, bem como a existência de canais oficiais de comunicação entre médicos de atenção primária e especialistas, poderiam melhorar o comportamento de busca de saúde por parte das pacientes.

ABSTRACT Objective. To determine if there was an association between intrapartum stillbirths and both traveled distance for delivery and delivery care accessibility, assessing periods before and during the COVID-19 pandemic. Methods. This is a population-based cohort study. Patients had birth occurring after the onset of labor; the primary outcome was intrapartum stillbirth. City of residence was classified according to the ratio between deliveries performed and total births among its residents; values lower than 0.1 indicated low delivery care accessibility. Travel distance was calculated using the Haversine formula. Education level, maternal age, and birth sex were included. In each period, relative risk was assessed by generalized linear model with Poisson variance. Results. There were 2 267 534 deliveries with birth occurring after the onset of labor. Most patients were between age 20 and 35 years, had between 8 and 11 years of education, and resided in cities with high delivery care accessibility. Low delivery care accessibility increased risk of intrapartum stillbirth in the pre-pandemic (relative risk [RR] 2.02; 95% CI [1.64, 2.47]; p < 0.01) and the pandemic period (RR 1.69; 95% CI [1.09, 2.55]; p = 0.015). This was independent of other risk-increasing factors, such as travel distance and fewer years of education. Conclusions. Low delivery care accessibility is associated with the risk of intrapartum stillbirths, and accessibility reduced during the pandemic. Delivery of patients by family physicians and midwives, as well as official communication channels between primary care physicians and specialists, could improve patient healthcare-seeking behavior.

RESUMEN Objetivo. Determinar si hubo una asociación entre la mortinatalidad durante el parto y la distancia recorrida o la accesibilidad de la atención para el parto, mediante la evaluación de un período anterior y de otro coincidente con la pandemia de COVID-19. Métodos. Se realizó un estudio de cohorte de base poblacional. Se incluyó a las pacientes que dieron a luz tras el inicio de un trabajo de parto; el criterio de valoración principal fue la mortinatalidad durante el parto. Se clasificaron las ciudades de residencia conforme al cociente entre el número de partos atendidos y el total de partos habidos entre sus residentes; los valores inferiores a 0,1 indican que la accesibilidad de la atención del parto es baja. La distancia recorrida para el parto se calculó utilizando la fórmula de Haversine. Se utilizaron datos del nivel de estudios y la edad de la madre y del sexo biológico neonatal. Para cada período, se evaluó el riesgo relativo mediante un modelo lineal generalizado con varianza de Poisson. Resultados. Hubo 2 267 534 partos que se produjeron tras el inicio de un trabajo de parto. La mayoría de las pacientes tenían edades comprendidas entre 20 y 35 años, tenían entre 8 y 11 años de estudios y residían en ciudades donde la accesibilidad de la atención del parto era alta. Una accesibilidad baja de la atención del parto se asoció a un aumento del riesgo de mortinatalidad durante el parto en el período prepandémico (riesgo relativo [RR] = 2,02; IC del 95% = [1,64, 2,47]; p < 0,01) y también durante la pandemia (RR = 1,69; IC del 95% = [1.09, 2.55]; p = 0,015). Este resultado fuer independiente de otros factores que incrementan el riesgo, como la distancia recorrida para dar a luz y un menor nivel de estudios. Conclusiones. Una accesibilidad baja de la atención del parto se asocia a un mayor riesgo de mortinatalidad durante el parto; y se observó una reducción de la accesibilidad durante la pandemia. Los partos asistidos por personal de medicina de familia o de partería y los canales de comunicación oficiales entre el personal médico de atención primaria y el especializado podrían mejorar el comportamiento de las pacientes a la hora de buscar atención de salud.

https://doi.org/10.26633/rpsp.2023.149

12.

First record of Psocodea (Psocoptera) on coffee (Coffea canephora) in the Brazilian Amazon (Rondônia state)
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COSTA, José Nilton Medeiros

; TEIXEIRA, César Augusto Domingues

; CUTRIM, Marcelo

; SILVA NETO, Alberto Moreira da

; RAFAEL, José Albertino

; SOUZA, Jéssica Gonçalves de

Acta Amazonica

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dec 2022, Volume 52 N. 4 Pages 285 - 288

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Há muita informação sobre a associação de Psocoptera e café como peste em grãos armazenados, mas pouco se sabe sobre sua presença nas plantas do café. Nós realizamos uma amostragem em uma plantação de café de Coffea canephora no município de Candeias do Jamari, Rondônia, onde obtivemos o primeiro registro de uma planta de café como hospedeira de Psocoptera na Amazônia brasileira e o primeiro registro de um representante da família Archipsocidae (Archipsocus lenkoi) para o estado de Rondônia. A população de psocídeos estava concentrada e não distribuída uniformemente na área de amostragem, o que indica um padrão de distribuição irregular. Não detectamos danos ou injúrias nas plantas de café e, portanto, não podemos considerar esses psocídeos como uma praga na plantação de café.

ABSTRACT There is much information regarding the association of Psocoptera and coffee as stored grain pests and little is known about their presence in coffee plants. We conducted a survey in a coffee plantation of Coffea canephora in the municipality of Candeias do Jamari, Rondônia state, Brazil, where we obtained the first record of a coffee plant as a host of Psocoptera in the Brazilian Amazon region, and the first record of a representative of the family Archipsocidae (Archipsocus lenkoi) for the state of Rondônia. The psocid population was concentrated and not evenly distributed over the survey area, which indicates an irregular distribution pattern. We have not detected damage or injury to the coffee plants and therefore we cannot consider these psocids as a pest in the coffee plantation.

https://doi.org/10.1590/1809-4392202200451

13.

Tendência da Cobertura Vacinal em crianças de zero a 12 meses – Piauí, Brasil, 2013-2020 1 Piauí Brasil 20132020 2013 2020 2013-202 2013202 201 202 2013-20 201320 20 2013-2 20132 2 2013-
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Freitas, Antonieldo Araújo de

; Moreira, Frankeline Gonçalves de Arêa Leão

; Borges, José Wicto Pereira

; Lima, Carlos Eduardo Batista de

; Rodrigues, Malvina Thais Pacheco

; Mascarenhas, Márcio Dênis Medeiros

Saúde em Debate

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dec 2022, Volume 46 N. spe5 Pages 57 - 66

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O estudo teve como objetivo analisar a tendência temporal da Cobertura Vacinal (CV) em crianças de zero a 12 meses de idade. Trata-se de estudo ecológico de série temporal da CV em crianças de zero a 12 meses de idade, Piauí, de 2013 a 2020, utilizando dados do Sistema de Informações do Programa Nacional de Imunizações. Empregou-se o modelo autorregressivo de Prais-Winsten para estimar a tendência da CV para oito imunobiológicos. As tendências foram categorizadas em decrescente, crescente ou estacionária. Verificou-se redução na CV de todos os imunobiológicos. Observou-se tendência decrescente na CV de Hepatite B (Variação Percentual Anual [VPA] = -4,5; IC95%: -7,3; -1,6), Meningocócica C (VPA = -1,7; IC95%: -3,1; -0,2), Pentavalente (VPA = -4,2; IC95%: -7,0; -1,3) e Febre Amarela (VPA = -3,2; IC95%: -5,9; -0,5); e estacionária para BCG (VPA = -2,5; IC95%: -5,7; 0,9), Rotavírus Humano (VPA = -1,5; IC95%: -3,2; 0,2), Pneumocócica (VPA -0,7; IC95%: -2,7; 1,3) e Poliomielite (VPA = -2,1; IC95%: -5,3; 1,1). Concluiu-se que, com as tendências decrescentes e estacionárias das CV, é necessário o desenvolvimento de políticas públicas para esclarecimento e recrutamento da população acerca da vacinação em crianças de zero a 12 meses de idade. (CV 1 idade Tratase Trata se Piauí 201 2020 Imunizações Empregouse Empregou PraisWinsten Prais Winsten imunobiológicos Verificouse Verificou Observouse Observou Variação VPA [VPA 4,5 45 4 5 -4,5 IC95% IC95 IC 7,3 73 7 3 -7,3 1,6, 16 1,6 , 6 -1,6) 1,7 17 -1,7 3,1 31 -3,1 0,2, 02 0,2 0 2 -0,2) 4,2 42 -4,2 7,0 70 -7,0 1,3 13 -1,3 3,2 32 -3,2 5,9 59 9 -5,9 0,5 05 -0,5) 2,5 25 -2,5 5,7 57 -5,7 0,9, 09 0,9 0,9) 1,5 15 -1,5 0,2) 0,7 07 -0,7 2,7 27 -2,7 2,1 21 -2,1 5,3 53 -5,3 1,1. 11 1,1 . 1,1) Concluiuse Concluiu que 20 202 4, -4, IC9 7, -7, 1, -1,6 -1, 3, -3, 0, -0,2 5, -5, -0,5 2, -2, -0, -4 -7 -1 -3 -5 -2 -0 -

ABSTRACT The study aimed to analyze the temporal trend of Vaccination Coverage (VC) in children from 0 to 12 months of age. This is an ecological time series study of VC in children aged 0 to 12 months, Piauí, from 2013 to 2020, using data from the National Immunization Program Information System. The Prais-Winsten autoregressive model was used to estimate the VC trend for eight immunobiologicals. Trends were categorized as decreasing, increasing, or stationary. There was a reduction in the VC of all immunobiologicals. There was a decreasing trend in the VC of Hepatitis B (annual percentgage change [APC] = -4.5; 95%CI: -7.3; -1.6), Meningococcal C (APC = -1.7; 95%CI: -3.1; -0.2), Pentavalent (APC = -4.2; 95%CI: -7.0; -1.3) and Yellow Fever (APC = -3.2; 95%CI: -5.9; -0.5); and stationary values for BCG (APC = -2.5; 95%CI: -5.7; 0.9), Human Rotavirus (APC = -1.5; 95%CI: -3.2; 0.2), Pneumococcal (APC -0.7; 95%CI: -2.7; 1.3); and Poliomyelitis (APC = -2.1; 95%CI: -5.3; 1.1). It was concluded that with the decreasing and stationary trends of VC, it is necessary to develop public policies to clarify and recruit the population about vaccination in children from 0 to 12 months of age. (VC 1 age Piauí 201 2020 System PraisWinsten Prais Winsten immunobiologicals increasing annual APC [APC 4.5 45 4 5 -4.5 95%CI 95CI CI 95 7.3 73 7 3 -7.3 1.6, 16 1.6 , 6 -1.6) 1.7 17 -1.7 3.1 31 -3.1 0.2, 02 0.2 2 -0.2) 4.2 42 -4.2 7.0 70 -7.0 1.3 13 -1.3 3.2 32 -3.2 5.9 59 9 -5.9 0.5 05 -0.5) 2.5 25 -2.5 5.7 57 -5.7 0.9, 09 0.9 0.9) 1.5 15 -1.5 0.2) 0.7 07 -0.7 2.7 27 -2.7 1.3) 2.1 21 -2.1 5.3 53 -5.3 1.1. 11 1.1 . 1.1) 20 202 4. -4. 7. -7. 1. -1.6 -1. 3. -3. 0. -0.2 5. -5. -0.5 2. -2. -0. -4 -7 -1 -3 -5 -2 -0 -

https://doi.org/10.1590/0103-11042022e505

14.

Tendência da Cobertura Vacinal em crianças de zero a 12 meses – Piauí, Brasil, 2013-2020
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Freitas, Antonieldo Araújo de

; Moreira, Frankeline Gonçalves de Arêa Leão

; Borges, José Wicto Pereira

; Lima, Carlos Eduardo Batista de

; Rodrigues, Malvina Thais Pacheco

; Mascarenhas, Márcio Dênis Medeiros

Saúde em Debate

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dec 2022, Volume 46 N. spe5 Pages 57 - 66

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/0103-11042022e505

15.

SURGICAL MANAGEMENT OF ADULT CROHN’S DISEASE AND ULCERATIVE COLITIS PATIENTS: A CONSENSUS FROM THE BRAZILIAN ORGANIZATION OF CROHN’S DISEASE AND COLITIS (GEDIIB) CROHNS CROHN S PATIENTS GEDIIB (GEDIIB
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ZABOT, Gilmara Pandolfo

; CASSOL, Ornella Sari

; QUARESMA, Abel Botelho

; GONÇALVES FILHO, Francisco de Assis

; BAIMA, Júlio Pinheiro

; IMBRIZI, Marcello

; ROLIM, Alexandre de Sá

; CARMO, Alexandre Medeiros do

; ALVES JUNIOR, Antonio Jose Tiburcio

; SANTOS, Carlos Henrique Marques dos

; SOBRADO JUNIOR, Carlos Walter

; MIRANDA, Eron Fábio

; ALBUQUERQUE, Idblan Carvalho de

; SOUZA, Mardem Machado de

; KAISER JUNIOR, Roberto Luiz

; PARRA, Rogerio Serafim

; KOTZE, Paulo Gustavo

; SAAD-HOSSNE, Rogério

Arquivos de Gastroenterologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 59 Suppl. 1 Pages 1 - 19

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Contexto: Apesar da terapia medicamentosa otimizada, o risco contemporâneo de cirurgia nas doenças inflamatórias intestinais (DII) após 10 anos do diagnóstico é de 9,2% em pacientes com retocolite ulcerativa (RCU) e de 26,2% na doença de Crohn (DC) na era biológica. Objetivo: Este consenso visa detalhar as orientações para os procedimentos cirúrgicos mais adequados em diferentes cenários da DII. Além disso, detalha as indicações cirúrgicas e o manejo perioperatório de pacientes adultos com DC e RCU. Métodos: Nosso consenso foi desenvolvido por cirurgiões colorretais e gastroenterologistas representantes da Organização Brasileira de Doença de Crohn e Colite (GEDIIB), com a metodologia de revisão rápida sendo conduzida para respaldar as recomendações. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os fenótipos da doença, indicações cirúrgicas e técnicas. Após a estruturação das recomendações, a metodologia modificada do Painel Delphi foi utilizada para conduzir a votação por especialistas em cirurgia de DII e gastroenterologia. Esta consistiu em três rondas: duas com recurso a uma plataforma de votação online personalizada e anônima e uma reunião presencial. Sempre que os participantes não concordavam com afirmações ou recomendações específicas, era oferecida uma opção de delinear possíveis razões para permitir respostas em texto livre e dar a oportunidade para os especialistas elaborarem ou explicarem a discordância. O consenso de recomendações/declarações em cada rodada foi considerado alcançado se houve concordância ≥80%. Resultados e conclusão Este consenso abordou as informações mais relevantes para orientar o processo de tomada de decisão para o manejo cirúrgico adequado de DC e RCU. Ele sintetiza recomendações desenvolvidas a partir de evidências e conhecimento de alto nível. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os diferentes fenótipos da doença, indicações para cirurgia e manejo perioperatório. O foco específico do nosso consenso foi dado aos procedimentos cirúrgicos eletivos e de emergência, determinando quando indicar a cirurgia e quais procedimentos podem ser os mais adequados. O consenso é direcionado a gastroenterologistas e cirurgiões interessados no tratamento e manejo de pacientes adultos com DC ou RCU e apoia a tomada de decisões de pagadores de saúde, líderes institucionais e/ou administradores. Contexto otimizada (DII 1 92 9 2 9,2 (RCU 262 26 26,2 (DC biológica Objetivo disso Métodos GEDIIB, GEDIIB , (GEDIIB) técnicas gastroenterologia rondas presencial específicas discordância recomendaçõesdeclarações declarações 80 ≥80% nível emergência saúde eou administradores 9, 26, (GEDIIB 8 ≥80 ≥8 ≥

ABSTRACT Background: Despite optimized medical therapy, contemporary risk of surgery in inflammatory bowel diseases (IBD) after 10 years of diagnosis is 9.2% in patients with ulcerative colitis (UC) and 26.2% in Crohn’s disease, (CD) in the biological era. Objective: This consensus aims to detail guidance to the most appropriate surgical procedures in different IBD scenarios. In addition, it details surgical indications and perioperative management of adult patients with CD and UC. Methods: Our consensus was developed by colorectal surgeons and gastroenterologists representing the Brazilian Study Group of Inflammatory Bowel Diseases (GEDIIB), with the Rapid Review methodology being conducted to support the recommendations/statements. Surgical recommendations were structured and mapped according to the disease phenotypes, surgical indications, and techniques. After structuring the recommendations/statements, the modified Delphi Panel methodology was used to conduct the voting by experts in IBD surgery and gastroenterology. This consisted of three rounds: two using a personalized and anonymous online voting platform and one face-to-face presential meeting. Whenever participants did not agree with specific statements or recommendations, an option to outline possible reasons was offered to enable free-text responses and provide the opportunity for the experts to elaborate or explain disagreement. The consensus of recommendations/statements in each round was considered to have been reached if there was ≥80% agreement. Results and conclusion: This consensus addressed the most relevant information to guide the decision-making process for adequate surgical management of CD and UC. It synthesizes recommendations developed from evidence-based statements and state-of-art knowledge. Surgical recommendations were structured and mapped according to the different disease phenotypes, indications for surgery and perioperative management. Specific focus of our consensus was given to elective and emergency surgical procedures, determining when to indicate surgery and which procedures may be the more appropriate. The consensus is targeted to gastroenterologists and surgeons interested in the treatment and management of adult patients with CD or UC and supports decision-making of healthcare payors, institutional leaders, and/or administrators. Background therapy (IBD 1 92 9 2 9.2 (UC 262 26 26.2 Crohns Crohn s (CD era Objective scenarios addition Methods GEDIIB, GEDIIB , (GEDIIB) recommendationsstatements phenotypes techniques gastroenterology rounds facetoface face meeting freetext free text disagreement 80 ≥80 agreement conclusion decisionmaking decision making evidencebased evidence based stateofart state art knowledge payors leaders andor administrators 9. 26. (GEDIIB 8 ≥8 ≥

https://doi.org/10.1590/s0004-2803.2022005s1-01

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