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1.
Optic disc edema and visual loss from paracentral acute middle maculopathy mimicking optic neuritis
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Pereira, Clarissa R.
; Benassi, Thais S. A.
; Mello, Luiz Guilherme M.
; Cunha, Leonardo P.
; Preti, Rony Carlos
; Zacharias, Leandro C.
; Souza, Eduardo C. de
; Monteiro, Mário L. R.
.
ABSTRACT Optic neuritis is an important cause of unilateral and acute visual loss in young adults, but other differential diagnoses should be considered, especially when the disease has an atypical presentation. This report presents the case of a young woman with reduced visual acuity in her right eye, associated with optic disc edema and a relative afferent pupillary defect, that was initially misdiagnosed as optic neuritis and subsequently found to have paracentral acute middle maculopathy, possibly secondary to subtle impending central retinal vein occlusion. This case emphasizes the need to remember that retinal vascular diseases can occasionally mimic optic neuritis. Detailed anamnesis and ophthalmic examination can avoid unnecessary interventions. adults considered presentation eye defect maculopathy occlusion interventions
2.
Annotation of Alkaloids of Fusaea longifolia and Evaluation of Anti-Plasmodium Activity in vitro and in silico AntiPlasmodium Anti Plasmodium
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Adrião, Asenate A. X.
; Silva, Carlos V. A. da
; Araujo, Morgana S.
; Paz, Weider H. P.
; Medeiros, Lívia S. de
; Silva, Felipe M. A. da
; Bezerra, Daniel P
; Salimo, Zeca M.
; Monteiro, Wuelton M.
; Melo, Gisely C. de
; Costa, Emmanoel V.
; Tavares, Josean F.
; Koolen, Hector H. F.
.
Isoquinoline alkaloids, especially from the Annonaceae family, have shown biological potential against parasites. Thus, this study aimed to evaluate the potential of the alkaloid fractions of the plant Fusaea longifolia against Plasmodium falciparum and annotate the compounds present in these samples. The tentative characterization of the alkaloids from the leaves and branches of F. longifolia was performed using liquid chromatography coupled to mass spectrometry (LC-MS/MS) and molecular networks. Through manual interpretation of the MS/MS spectra, 18 alkaloids were dereplicated from F. longifolia, 17 of which were reported for the first time in this species. An unpublished putative glycosylated alkaloid was annotated by interpreting the fragmentation data profile. Regarding biological activity, the fractions studied showed high activity against P. falciparum with half-maximal inhibitory concentration (IC50) of 2.42 and 1.60 μg mL-1 for branches and from the leaves, respectively, both similar to the reference standard quinine (IC50 of 1.24 μg mL-1). The structures of the 17 alkaloids were subjected to in silico analysis using molecular docking against four enzymes related to anti-Plasmodium activity (wild type (dm-PfDHFR) and mutant type (qm-PfDHFR), dihydroorotate dehydrogenase (PfDHODH) and purine nucleoside phosphorylase (PfPNP)). Molecular docking revealed strong interactions, especially between oxoxylopine 17 and hydroxycassythicine N-oxide 10, which may be potential new sources against P. falciparum. family parasites Thus samples F LCMS/MS LCMSMS LC MS (LC-MS/MS networks MSMS spectra 1 species profile P halfmaximal half maximal IC50 IC 242 2 42 2.4 160 60 1.6 mL1 mL mL- respectively (IC5 124 24 1.2 mL1. . mL-1) antiPlasmodium anti wild dmPfDHFR dm PfDHFR (dm-PfDHFR qmPfDHFR, qmPfDHFR qm , (qm-PfDHFR) PfDHODH (PfDHODH PfPNP. PfPNP (PfPNP)) interactions Noxide N oxide 10 LCMS IC5 4 2. 16 6 1. (IC 12 (qm-PfDHFR (PfPNP) (PfPNP
3.
Silvopastoral system with high-density of trees accelerates degradation of tropical grass highdensity high density
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Monteiro, Alyce
; Gomes, Fagner Junior
; Mota, Lucas Gimenes
; Motta, Luiz Jardel Müller
; Barros, Lívia Vieira de
; Silva, Felipe Gomes da
; Cabral, Carla Heloísa Avelino
; Cabral, Carlos Eduardo Avelino
.
RESUMO A densidade de árvores é um aspecto importante no planejamento de sistemas silvipastoris (SPS), uma vez que a baixa luminosidade pode limitar a perenidade da forragem, principalmente para forrageiras tropicais de metabolismo C4. O objetivo com este estudo foi verificar se um SPS com alta densidade de árvores acelera o processo de degradação da pastagem e altera a composição química da forragem. O experimento foi realizado comparando a pastagem de capim-marandu [Urochloa brizantha (Hochst. ex A. Rich.) R. D. Webster] em dois sistemas: silvipastoril e pastagem aberta. No SPS foi plantada teca (Tectona grandis) com densidade de 750 árvores ha-1. As avaliações foram realizadas ao longo de três anos (2015, 2016 e 2017). O sombreamento SPS reduziu a massa de forragem, a densidade de perfilhos e a cobertura do solo ao longo dos anos. No capim-marandu no SPS houve maior proporção de colmos, o que favoreceu menor potencial digestível de matéria seca no primeiro ano. Mesmo com maior quantidade de colmo, maior concentração de proteína bruta e minerais foram observados no SPS. Devido à alta densidade de árvores, o sombreamento excessivo acelerou o processo de degradação da pastagem, o que demonstra que o planejamento da ordenação espacial das espécies arbóreas é fundamental. SPS, , (SPS) forragem C4 C capimmarandu capim marandu Urochloa Hochst. Hochst (Hochst Rich. Rich R D Webster aberta Tectona grandis 75 ha1. ha1 ha 1. 1 ha-1 2015, 2015 (2015 201 2017. 2017 . 2017) colmos ano colmo fundamental (SPS 7 ha- (201 20 (20 2 (2 (
ABSTRACT Tree density is an important aspect in silvopastoral system (SPS) planning, since low luminosity can limit forage perenniality, especially for tropical forages of C4 metabolism. The objective with this study was to verify if an SPS with high tree density accelerates the pasture degradation process and changes the forage chemical composition. The experiment was carried out by comparison of marandu palisade grass [Urochloa brizantha (Hochst. ex A. Rich.) R. D. Webster] pasture in two systems: silvopastoral and open pasture. In the SPS, teak (Tectona grandis) was planted with a density of 750 trees ha-1. Evaluations were carried out over three years (2015, 2016 and 2017). SPS shading reduced herbage mass, tiller density and soil cover over the years. In the marandu palisade grass in the SPS there was a greater stem proportion, which favoured lesser potential digestible dry matter in the first year. Even with a higher amount of stem, higher crude protein concentration and minerals were observed in the SPS. Due to the high density of trees, excessive shading accelerated the process of degradation of the pasture, which demonstrates that planning of the spatial arrangement of tree species is crucial. (SPS perenniality C metabolism composition Urochloa Hochst. Hochst (Hochst A Rich. Rich R D Webster systems Tectona grandis 75 ha1. ha1 ha 1. 1 ha-1 2015, 2015 (2015 201 2017. 2017 . 2017) mass proportion year crucial 7 ha- (201 20 (20 2 (2 (
4.
Severe bilateral visual loss as the first sign of IgA nephropathy
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Cunha, Leonardo Provetti
; Defina, Raphael Lucas Sampaio
; Preti, Rony Carlos
; Costa-Cunha, Luciana Virgínia Ferreira
; Zacharias, Leandro Cabral
; Hokazono, Kenzo
; Monteiro, Mário Luiz Ribeiro
.
RESUMO Nosso objetivo é descrever uma paciente de 33 anos de idade, com perda visual bilateral grave por maculopatia hipertensiva exsudativa como o primeiro sinal da nefropatia por imunoglobulina A. A fundoscopia revelou a presença de manchas algodonosas, hemorragias em chama-de-vela, estreitamento arteriolar difuso, edema de disco óptico e maculopatia exsudativa bilateral. A pressão arterial sistólica foi de 240mmHg e a diastólica de 160 mmHg associado a proteinúria e hematúria, sugerindo a presença de doença renal. A biópsia renal confirmou a nefropatia por imunoglobulina A. A paciente foi tratada como corticoide sistêmico, drogas anti-hipertensivas e uma única dose intravítrea de Aflibercept em ambos os olhos. Houve rápida melhora do edema macular e da acuidade visual. Nosso caso chama a atenção para o fato de que a perda visual bilateral grave pode ser a primeira apresentação de uma doença hipertensiva sistêmica. Causas secundárias como a nefropatia por imunoglobulina A devem ser afastadas. 3 idade algodonosas chamadevela, chamadevela vela, vela chama-de-vela difuso 16 hematúria sistêmico antihipertensivas anti hipertensivas olhos sistêmica afastadas 1
ABSTRACT We describe a case of a 33-years-old woman who presents with severe acute bilateral visual loss secondary to massive exudative hypertensive maculopathy as the first sign of immunoglobulin A nephropathy. The patient’s ophthalmic examination showed bilateral cotton-wool spots, flame-shaped retinal hemorrhages, diffuse narrow arterioles, optic disk edema, and exudative maculopathy. Systemic workup demonstrated a systolic and diastolic blood pressure of 240 mmHg and 160 mmHg, respectively, proteinuria, and hematuria, suggesting kidney disease as the causative condition. A kidney biopsy confirmed immunoglobulin A nephropathy. She was treated with systemic corticosteroids, antihypertensive drugs, and a single bilateral intravitreal injection of aflibercept. There was a prompt resolution of macular edema and vision improvement. Our case draws attention to the fact that severe bilateral visual loss can be the first sign of severe hypertension. Secondary causes, such as immunoglobulin A nephropathy, should be ruled out. 33yearsold yearsold 33 years old nephropathy patients patient s cottonwool cotton wool spots flameshaped flame shaped hemorrhages arterioles 24 16 respectively proteinuria hematuria condition corticosteroids drugs aflibercept improvement hypertension causes out 3 2 1
5.
[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;
6.
Llamamiento a adoptar medidas urgentes para limitar los aumentos de temperatura en el mundo, restablecer la diversidad biológica y proteger la salud
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Atwoli, Lukoye
; Baqui, Abdullah H.
; Benfield, Thomas
; Bosurgi, Raffaella
; Godlee, Fiona
; Hancocks, Stephen
; Horton, Richard
; Monteiro, Carlos A.
; Norman, Ian
; Patrick, Kirsten
; Praities, Nigel
; Rikkert, Marcel GM Olde
; Rubin, Eric J.
; Sahni, Peush
; Smith, Richard
; Talley, Nick
; Turale, Sue
; Vázquez, Damián
; Langton, Laurie Laybourn
.
7.
Severe bilateral visual loss as the first sign of IgA nephropathy
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Cunha, Leonardo Provetti
; Defina, Raphael Lucas Sampaio
; Preti, Rony Carlos
; Costa-Cunha, Luciana Virgínia Ferreira
; Zacharias, Leandro Cabral
; Hokazono, Kenzo
; Monteiro, Mário Luiz Ribeiro
.
RESUMO Nosso objetivo é descrever uma paciente de 33 anos de idade, com perda visual bilateral grave por maculopatia hipertensiva exsudativa como o primeiro sinal da nefropatia por imunoglobulina A. A fundoscopia revelou a presença de manchas algodonosas, hemorragias em chama-de-vela, estreitamento arteriolar difuso, edema de disco óptico e maculopatia exsudativa bilateral. A pressão arterial sistólica foi de 240mmHg e a diastólica de 160 mmHg associado a proteinúria e hematúria, sugerindo a presença de doença renal. A biópsia renal confirmou a nefropatia por imunoglobulina A. A paciente foi tratada como corticoide sistêmico, drogas anti-hipertensivas e uma única dose intravítrea de Aflibercept em ambos os olhos. Houve rápida melhora do edema macular e da acuidade visual. Nosso caso chama a atenção para o fato de que a perda visual bilateral grave pode ser a primeira apresentação de uma doença hipertensiva sistêmica. Causas secundárias como a nefropatia por imunoglobulina A devem ser afastadas.
ABSTRACT We describe a case of a 33-years-old woman who presents with severe acute bilateral visual loss secondary to massive exudative hypertensive maculopathy as the first sign of immunoglobulin A nephropathy. The patient’s ophthalmic examination showed bilateral cotton-wool spots, flame-shaped retinal hemorrhages, diffuse narrow arterioles, optic disk edema, and exudative maculopathy. Systemic workup demonstrated a systolic and diastolic blood pressure of 240 mmHg and 160 mmHg, respectively, proteinuria, and hematuria, suggesting kidney disease as the causative condition. A kidney biopsy confirmed immunoglobulin A nephropathy. She was treated with systemic corticosteroids, antihypertensive drugs, and a single bilateral intravitreal injection of aflibercept. There was a prompt resolution of macular edema and vision improvement. Our case draws attention to the fact that severe bilateral visual loss can be the first sign of severe hypertension. Secondary causes, such as immunoglobulin A nephropathy, should be ruled out.
8.
SIMULATION OF EFFICIENCY IN AVAILABILITY FOR DIFFERENT SUGARCANE (Saccharum spp.) TRANSPORT EQUIPMENT
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ABSTRACT Brazil is the world’s largest sugarcane producer destined for mills producing alcohol, sugar, and electricity cogeneration. Sugarcane transport to the mills is carried out by trucks with trailers and tractors with semi-trailers, which transport the raw material harvested in the field to the mill. The modal road system of sugarcane transport uses this equipment to meet the continuous demand of the harveste draw material, with punctuality in the transport execution and generating a minimum cost. This study aimed to analyze the influence of availability efficiency on the operational and economic performance of different sugarcane transport equipment. A computational model called TransporteCana was developed in a spreadsheet due to the difficulty in meeting the objective under field conditions. The model was checked for possible routine errors, validated, and used in the analysis of variables and generation of results. The results showed that increasing availability efficiency reduces the operational cost of producing the equipment. Large managerial investments for the means of execution are required for high availability efficiencies.
9.
Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios - A Marker for Developing Functionally Efficient Teams
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Nina, Vinicius
; Mendes, Augusto Gonçalves
; Sevdalis, Nick
; Marath, Aubyn
; Mejia, Omar Vilca
; Brandão, Carlos Manuel A.
; Monteiro, Rosangela
; Mendes, Vinícius Giuliano
; Jatene, Fabio B
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
Abstract Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach’s alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn’s post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach’s alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: an individual’s skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patient-related disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues’ disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR. Introduction errordriven error driven . (OR) Methods (DiSI unit Cronbachs Cronbach s coefficient Nonparametric Non parametric KruskalWallis Kruskal Wallis Dunns Dunn posttest post surgeons, (surgeons nurses anesthesiologists technicians. technicians) P005 P 0 05 P<0.0 significant individual 0.85, 085 0.85 , 85 (0.85) 0.88, 088 0.88 88 (0.88) 0.81, 081 0.81 81 (0.81) 0.92, 092 0.92 92 (0.92) patientrelated patient 0.89, 089 0.89 89 (0.89) 0.83, 083 0.83 83 (0.83) 0.83. 27.4% 274 27 4 (27.4% 25.4%, 254 25.4% 25 (25.4%) 23.3%, 233 23.3% 23 3 (23.3%) 23.0% 230 (23.0% P=0.005. P0005 P=0.005 005 (P=0.005) colleagues P=0.0001. P00001 P=0.0001 0001 (P=0.0001) Conclusion selfperception self position teams (OR P00 P<0. 08 0.8 8 (0.85 (0.88 (0.81 09 0.9 9 (0.92 (0.89 (0.83 27.4 2 (27.4 25.4 (25.4% 23.3 (23.3% 23.0 (23.0 P000 P=0.00 00 (P=0.005 P0000 P=0.000 000 (P=0.0001 P0 P<0 0. (0.8 (0.9 27. (27. 25. (25.4 23. (23.3 (23. P=0.0 (P=0.00 (P=0.000 P< (0. (27 (25. (23 P=0. (P=0.0 (0 (2 (25 P=0 (P=0. ( P= (P=0 (P= (P
https://doi.org/10.21470/1678-9741-2020-0685
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10.
Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos
; Feitosa Filho, Gilson Soares
; Petriz, João Luiz
; Furtado, Remo Holanda de Mendonça
; Précoma, Dalton Bertolim
; Lemke, Walmor
; Lopes, Renato Delascio
; Timerman, Ari
; Marin Neto, José A.
; Bezerra Neto, Luiz
; Gomes, Bruno Ferraz de Oliveira
; Santos, Eduardo Cavalcanti Lapa
; Piegas, Leopoldo Soares
; Soeiro, Alexandre de Matos
; Negri, Alexandre Jorge de Andrade
; Franci, Andre
; Markman Filho, Brivaldo
; Baccaro, Bruno Mendonça
; Montenegro, Carlos Eduardo Lucena
; Rochitte, Carlos Eduardo
; Barbosa, Carlos José Dornas Gonçalves
; Virgens, Cláudio Marcelo Bittencourt das
; Stefanini, Edson
; Manenti, Euler Roberto Fernandes
; Lima, Felipe Gallego
; Monteiro Júnior, Francisco das Chagas
; Correa Filho, Harry
; Pena, Henrique Patrus Mundim
; Pinto, Ibraim Masciarelli Francisco
; Falcão, João Luiz de Alencar Araripe
; Sena, Joberto Pinheiro
; Peixoto, José Maria
; Souza, Juliana Ascenção de
; Silva, Leonardo Sara da
; Maia, Lilia Nigro
; Ohe, Louis Nakayama
; Baracioli, Luciano Moreira
; Dallan, Luís Alberto de Oliveira
; Dallan, Luis Augusto Palma
; Mattos, Luiz Alberto Piva e
; Bodanese, Luiz Carlos
; Ritt, Luiz Eduardo Fonteles
; Canesin, Manoel Fernandes
; Rivas, Marcelo Bueno da Silva
; Franken, Marcelo
; Magalhães, Marcos José Gomes
; Oliveira Júnior, Múcio Tavares de
; Filgueiras Filho, Nivaldo Menezes
; Dutra, Oscar Pereira
; Coelho, Otávio Rizzi
; Leães, Paulo Ernesto
; Rossi, Paulo Roberto Ferreira
; Soares, Paulo Rogério
; Lemos Neto, Pedro Alves
; Farsky, Pedro Silvio
; Cavalcanti, Rafael Rebêlo C.
; Alves, Renato Jorge
; Kalil, Renato Abdala Karam
; Esporcatte, Roberto
; Marino, Roberto Luiz
; Giraldez, Roberto Rocha Corrêa Veiga
; Meneghelo, Romeu Sérgio
; Lima, Ronaldo de Souza Leão
; Ramos, Rui Fernando
; Falcão, Sandra Nivea dos Reis Saraiva
; Dalçóquio, Talia Falcão
; Lemke, Viviana de Mello Guzzo
; Chalela, William Azem
; Mathias Júnior, Wilson
.
https://doi.org/10.36660/abc.20210180
3052 downloads
11.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
12.
Relationship between serum concentrations of uric acid, insulin resistance and metabolic alterations in adolescents
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Sodré, Malene L. G.
; Ferreira, Alice S.
; Ferreira, Andressa C.
; Silva, Anne Caroline S.
; Sá, Carla Milena A.
; D. Filho, Carlos Alberto
; Monteiro, Sally Cristina M.
.
Jornal Brasileiro de Patologia e Medicina Laboratorial
- Journal Metrics
RESUMO Objetivo: Verificar a possível relação entre concentrações séricas de ácido úrico e resistência insulínica em adolescentes. Métodos: Estudo de caráter transversal com 74 participantes oriundos de uma escola pública de São Luís, Maranhão, com idades entre 10 e 19 anos. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do Hospital Universitário da Universidade Federal do Maranhão (UFMA) sob o parecer 2.673.791. Medidas antropométricas, pressão arterial e coleta de sangue foram feitas. A divisão dos participantes foi realizada em dois grupos: grupo 1 (com hiperuricemia) e grupo 2 (sem hiperuricemia). A análise de dados foi realizada por meio do programa Stata. Resultados: As medidas antropométricas, como índice de massa corporal (IMC) e circunferência da cintura, tiveram significância estatística (p < 0,05) entre os dois grupos, assim como a porcentagem de gordura corporal (p = 0,0423) e a pressão arterial sistólica e diastólica (p = 0,0235). Os parâmetros bioquímicos referentes a colesterol total (p = 0,0172), triglicerídeos (p = 0,0268), glicose (p = 0,0284) e índice TyG (p = 0,0416) tiveram significância estatística no grupo com hiperuricemia, quando comparados com o grupo sem hiperuricemia. Conclusão: De acordo com os resultados obtidos, os participantes com resistência insulínica, a partir do cálculo pelo índice TyG, apresentaram níveis séricos elevados de ácido úrico, demonstrando correlação estatística significativa.
ABSTRACT Objective: To verify the possible relationship between serum uric acid concentrations and insulin resistance in adolescents. Methods: This is a cross-sectional study with 74 participants from a public school in São Luís, Maranhão, aged between 10 and 19 years. The study was approved by the Ethics and Research Committee of the University Hospital of the Universidade Federal do Maranhão (UFMA) under report 2,673,791. Anthropometric measurements, blood pressure and blood collection were performed. The participants were divided into two groups: group 1 (with hyperuricemia) and group 2 (without hyperuricemia). Data analysis was performed by means of the Stata program. Results: Anthropometric measurements, such as body mass index and waist circumference, had statistical significance (p < 0.05) among groups with hyperuricemia and without hyperuricemia, as well as the percentage of body fat (p = 0.0423) and systolic and diastolic blood pressure (p = 0.0235). Biochemical parameters for total cholesterol (p = 0.0172), triglycerides (p = 0.0268), glucose (p = 0.0284) and TyG index (p = 0.0416) had statistical significance in the hyperuricemia group when compared to the group without hyperuricemia. Conclusion: According to the obtained results, the participants with insulin resistance calculated by the TyG index presented high serum acid levels, demonstrating a statistically significant correlation.
RESUMEN Objetivo: Verificar la posible relación entre concentraciones séricas de ácido úrico y resistencia a la insulina en adolescentes. Métodos: Estudio transversal con 74 participantes de una escuela pública en São Luís, Maranhão, con edades entre 10 y 19 años. El estudio es aprobado por el Comité de Ética e Investigación del Hospital Universitario de la Universidad Federal de Maranhão (UFMA) bajo dictamen 2.673.791. Se realizaron mediciones antropométricas, de presión arterial y extracción de sangre. Los participantes se dividieron en dos grupos: grupo 1 (con hiperuricemia) y grupo 2 (sin hiperuricemia). El análisis de datos se realizó utilizando el programa Stata. Resultados: Las medidas antropométricas, como el índice de masa corporal (IMC) y la circunferencia de la cintura, tuvieron significancia estadística (p < 0,05) entre los dos grupos, así como el porcentaje de grasa corporal (p = 0,0423) y la presión arterial sistólica y diastólica (p = 0,0235). Los parámetros bioquímicos referentes a colesterol total (p = 0,0172), triglicéridos (p = 0,0268), glucosa (p = 0,0284) e índice TyG (p = 0,0416) fueron estadísticamente significativos en el grupo con hiperuricemia, en comparación con el grupo sin hiperuricemia. Conclusión: De acuerdo a los resultados obtenidos, los participantes con resistencia a la insulina, en base al cálculo mediante el índice TyG, presentaron niveles séricos elevados de ácido úrico, mostrando una correlación estadísticamente significativa.
https://doi.org/10.5935/1676-2444.20210020
101 downloads
13.
Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa
; Pereira, Maria Fernanda Badue
; Santos, Angélica Carreira dos
; Fink, Thais Toledo
; Paula, Camila Sanson Yoshino de
; Litvinov, Nadia
; Schvartsman, Claudio
; Delgado, Artur Figueiredo
; Gibelli, Maria Augusta Bento Cicaroni
; Carvalho, Werther Brunow de
; Odone Filho, Vicente
; Tannuri, Uenis
; Carneiro-Sampaio, Magda
; Grisi, Sandra
; Duarte, Alberto José da Silva
; Antonangelo, Leila
; Francisco, Rossana Pucineli Vieira
; Okay, Thelma Suely
; Batisttella, Linamara Rizzo
; Carvalho, Carlos Roberto Ribeiro de
; Brentani, Alexandra Valéria Maria
; Silva, Clovis Artur
; Eisencraft, Adriana Pasmanik
; Rossi Junior, Alfio
; Fante, Alice Lima
; Cora, Aline Pivetta
; Reis, Amelia Gorete A. de Costa
; Ferrer, Ana Paula Scoleze
; Andrade, Anarella Penha Meirelles de
; Watanabe, Andreia
; Gonçalves, Angelina Maria Freire
; Waetge, Aurora Rosaria Pagliara
; Silva, Camila Altenfelder
; Ceneviva, Carina
; Lazari, Carolina dos Santos
; Abellan, Deipara Monteiro
; Santos, Emilly Henrique dos
; Sabino, Ester Cerdeira
; Bianchini, Fabíola Roberta Marim
; Alcantara, Flávio Ferraz de Paes
; Ramos, Gabriel Frizzo
; Leal, Gabriela Nunes
; Rodriguez, Isadora Souza
; Pinho, João Renato Rebello
; Carneiro, Jorge David Avaizoglou
; Paz, Jose Albino
; Ferreira, Juliana Carvalho
; Ferranti, Juliana Ferreira
; Ferreira, Juliana de Oliveira Achili
; Framil, Juliana Valéria de Souza
; Silva, Katia Regina da
; Kanunfre, Kelly Aparecida
; Bastos, Karina Lucio de Medeiros
; Galleti, Karine Vusberg
; Cristofani, Lilian Maria
; Suzuki, Lisa
; Campos, Lucia Maria Arruda
; Perondi, Maria Beatriz de Moliterno
; Diniz, Maria de Fatima Rodrigues
; Fonseca, Maria Fernanda Mota
; Cordon, Mariana Nutti de Almeida
; Pissolato, Mariana
; Peres, Marina Silva
; Garanito, Marlene Pereira
; Imamura, Marta
; Dorna, Mayra de Barros
; Luglio, Michele
; Rocha, Mussya Cisotto
; Aikawa, Nadia Emi
; Degaspare, Natalia Viu
; Sakita, Neusa Keico
; Udsen, Nicole Lee
; Scudeller, Paula Gobi
; Gaiolla, Paula Vieira de Vincenzi
; Severini, Rafael da Silva Giannasi
; Rodrigues, Regina Maria
; Toma, Ricardo Katsuya
; Paula, Ricardo Iunis Citrangulo de
; Palmeira, Patricia
; Forsait, Silvana
; Farhat, Sylvia Costa Lima
; Sakano, Tânia Miyuki Shimoda
; Koch, Vera Hermina Kalika
; Cobello Junior, Vilson
.
OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
14.
CHARACTERIZATION OF AQUATIC ORGANIC MATTER IN A NATURAL ENVIRONMENT IN NORTHEASTERN BRAZIL
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Monteiro, Adnívia S. Costa
; Santana, Maria Aparecida A.
; Chielle, Raisa de Siqueira Alves
; Garcia, Carlos Alexandre Borges
; Alves, José do Patrocínio Hora
.
The organic matter (OM) contained in a natural aquatic environment, located in a tropical region in Notheastern Brazil, was characterized using synchronous fluorescence spectroscopy and UV-Vis absorbance. The synchronous fluorescence spectra did not show qualitative differences for samples collected during dry and rainy seasons. They also revealed two peaks, one at 390 nm and other at 460 nm, associated with humic substances. The lack of peaks with significant fluorescence intensity at 270 - 300 nm and at 320 - 370 nm confirms it is an environment with natural OM. The A254/A436 ratios obtained during the dry and rainy seasons (13.55 to 14.97) indicate the presence of allochthonous OM of terrestrial origin, with high level of aromatic carbon associated with humic substances. The OM photodegradation by natural sunlight was more pronounced in the first five days, with a decrease of FImax from 23.6 to 55.4%. Also, titration with Cu(II) ions was used to determine the complexation ability of the two fluorescent sites, obtaining log K values of 4.26 and 4.27.
https://doi.org/10.21577/0100-4042.20170630
146 downloads
15.
Bovine digital dermatitis in the Brazilian Amazon biome and topical treatment with Copaifera reticulata oil
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Bomjardim, Henrique A.
; Oliveira, Mariana C.
; Brito, Marilene F.
; Oliveira, Carlos M.C.
; Monteiro, Bruno M.
; Silveira, Natalia S.S.
; Barbosa, José D.
.
RESUMO: A dermatite digital bovina (DDB) foi estudada em vacas mestiças leiteiras nos municípios de Rondon do Pará no Pará, Açailândia e Cidelândia no Maranhão, bioma amazônico brasileiro. Para tanto, foram realizadas quatro visitas a 10 propriedades, nos meses de agosto e novembro em 2016 e abril e julho em 2017, e realizada a inspeção dos dígitos de 1.664 vacas em lactação durante a ordenha. Nestas propriedades as vacas eram criadas a pasto durante todo o ano e ordenhadas mecanicamente em oito propriedades. As quais, as salas de ordenha tinham piso concretado, com proteção contra as chuvas e era realizada a limpeza diariamente. No entanto, em três dessas propriedades, as salas de pré ou pós ordenha tinham piso não concretado e em duas, a ordenha era manual em piso de chão batido. Em todas elas não havia medidas profiláticas para afecções podais. A prevalência de DDB foi de 1,3% (22/1.664) e não se obteve diferença estatística entre os períodos chuvoso e não chuvoso (P = 0,72). As lesões observadas foram classificadas de acordo com o sistema M (M0-sem lesão; M1-lesão ulcerada <2cm; M2-lesão ulcerada >2cm; M3-lesão em cicatrização; M4-lesão crônica; M4.1- M4 com área ulcerada). De 22 lesões observadas, 22,7% (5/22) apresentavam-se em estágio M1, 36,4% (8/22) em M2, 22,7% (5/22) em M3, 13,6% (3/22) em M4 e 4,5% (1/22) em M4.1. Pelos hipertrofiados nos bordos das lesões, larvas de moscas do gênero Cochliomyia spp. e alterações no tecido córneo também foram observados. Nas lesões de 11 bovinos, em seis, foi realizado o tratamento tópico com extrato bruto de Copaifera reticulata (óleo de copaíba) e em cinco, com a pasta de ácido salicílico a 660mg/g e ambos os tratamentos foram protegidos com bandagem por sete dias. Após, as lesões foram acompanhadas semanalmente até a cura e obteve-se um índice de 83,4% (5/6) e 75% (3/4) de cura com esses tratamentos, respectivamente, com uma média de 7 semanas. Conclui-se que no bioma amazônico a DDB ocorre em baixa prevalência, não sazonal e com características macroscópicas semelhantes às lesões de vacas leiteiras criadas em sistema free stall. O tratamento com o óleo da copaíba apresentou resultados semelhante ao ácido salicílico e pode ser uma alternativa como medida de controle da DDB no bioma amazônico.
ABSTRACT: Bovine Digital Dermatitis (BDD) was studied in crossbred dairy cows grazing in Rondon do Pará, in the state of Pará, as well as in Açailândia and Cidelândia, in the state of Maranhão, Brazilian Amazon biome. The digits inspection from the dairy cows during milking was performed in ten farms comprising four visits (August and November 2016; April and July 2017). The cows were kept all year in pastures, and were mechanically milked on concrete floors and the animals were protected against the rains in eight farms, maintaining a daily cleaning, however, it could not be found a concrete floor in pre- or post-milking to ensure milking parlor on three farms. Manual milking on no concrete floors was performed in two farms. No preventive measures against hoof lesions were adopted. The BDD prevalence was 1.3% (22/1664), and no statistical difference among rainy or no rainy season was obtained (p = 0.72). The BDD lesions were classified according to “M system” (M0 = no lesion, M1 = active ulceration <2cm, M2 = active ulceration >2cm, M3 = healing stage, M4 = chronic stage, M4.1 = M4 with active ulceration). Regarding the 22 BDD lesions observed, 22.7% (5/22) were M1 stage, 36.4% (8/22) M2, 22.7% (5/22) M3, 13.6% (3/22) M4 and 4.5 (1/22) M4.1. Hypertrophic hairs at the edges of the lesions caused by fly larvae of genus Cochliomyia spp. as well as alterations on the hoof were also observed. Topical treatment was performed in six BDD lesions with a raw extract from trees of the genus Copaifera reticulata (Copaiba oil) and compared with the treatment of salicylic acid paste in five BDD lesions. The lesions were protected with a bandage for seven days and followed weekly until recovery. The complete therapeutic responses were 83.4% (5/6) and 75% (3/4), respectively, with an average time of seven weeks. The BDD in the Amazon biome occurs in low prevalence, not seasonal, and presents macro and microscopic features similar to BDD lesions from dairy cattle kept in free-stall housing. The treatment with copaiba oil showed similar results to the treatment of salicylic acid paste and can be used in control measures to BDD in the Amazon biome.
https://doi.org/10.1590/1678-5150-pvb-6715
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