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au:Oliveira, Gustavo Nunes de

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Efeitos do Exercício em Choque Cardiogênico e Balão Intra-Aórtico: Um Relato de Caso IntraAórtico Intra Aórtico Intra-Aórtico
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Ferreira, Vanessa M.

; Rodrigues, Dayane Nunes

; Contreras, Carlos Alberto Mendez

; Rossi, João M.

; Ramos, Rui Fernando

; Oliveira, Gustavo

; Oliveira, Mayron F.

Arquivos Brasileiros de Cardiologia

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jan 2024, Volume 121 N. 1 elocation e20230537

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

Resumo O presente relato de caso descreve o programa de exercícios aplicado a um paciente do sexo masculino, de 54 anos, internado com choque cardiogênico, aguardando transplante cardíaco e assistido por balão intra-aórtico, um dispositivo de suporte circulatório mecânico temporário. O dispositivo de suporte circulatório mecânico temporário, um balão intra-aórtico, foi colocado na artéria subclávia esquerda, possibilitando o protocolo de exercícios. Antes e após um protocolo de exercícios, foram obtidos dados a partir de cateter de Swan-Ganz, amostra de sangue, peptídeo natriurético cerebral (NT-proBNP), proteína C reativa de alta sensibilidade (PCR-as), teste de caminhada de seis minutos (TC6min) e medição da saturação venosa de oxigênio (SvO2). O protocolo de treinamento físico envolveu a utilização de um cicloergômetro adaptado ao leito, sem carga, uma vez ao dia, por no máximo 30 minutos, até o limite da tolerância. Não foram observados eventos adversos tampouco relacionados ao deslocamento do balão intra-aórtico durante o protocolo de exercícios. O programa de exercícios resultou em maior SvO2 com aumento do TC6min e menores escores de dispneia de Borg (312 metros vs. 488 metros e cinco pontos vs. três pontos, respectivamente). Após completar o protocolo de exercícios de dez dias, o paciente foi submetido a uma cirurgia de transplante cardíaco sem complicações e recuperação total na UTI. O presente estudo demonstrou que o exercício é uma opção viável para pacientes com choque cardiogênico em uso de balão intra-aórtico e que é bem tolerado, além de não haver relatos de eventos adversos. masculino 5 anos intraaórtico, intraaórtico intra aórtico, aórtico temporário esquerda SwanGanz, SwanGanz Swan Ganz, Ganz Swan-Ganz sangue NTproBNP, NTproBNP NT proBNP , (NT-proBNP) PCRas, PCRas PCR as (PCR-as) TCmin TC min (TC6min SvO2. SvO . (SvO2) leito carga dia 3 tolerância 312 (31 vs 48 respectivamente. respectivamente respectivamente) dias UTI tolerado (NT-proBNP (PCR-as (SvO2 31 (3 4 (SvO (

Abstract This case report describes the exercise program on a hospitalized 54-year-old male patient with cardiogenic shock waiting for a heart transplant assisted by an intra-aortic balloon pump, a temporary mechanical circulatory support device. The temporary mechanical circulatory support device, an intra-aortic balloon pump, was placed in the left subclavian artery, enabling the exercise protocol. Measurements and values from Swan-Ganz catheter, blood sample, brain natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP), as well as the six-minute walk test (6MWT) and venous oxygen saturation (SvO2) were obtained before and after an exercise protocol. The exercise training protocol involved the use of an unloaded bed cycle ergometer once a day, for a maximum of 30 minutes, to the tolerance limit. No adverse events or events related to the dislocation of the intra-aortic balloon pump were observed during the exercise protocol. The exercise program resulted in higher SvO2 levels, with an increased 6MWT with lower Borg dyspnea scores (312 meters vs. 488 meters and five points vs. three points, respectively). After completing the ten-day exercise protocol, the patient underwent a non-complicated heart transplant surgery and a full recovery in the ICU. This study showed that exercise is a feasible option for patients with cardiogenic shock who are using an intra-aortic balloon pump and that it is well-tolerated with no reported adverse events. 54yearold yearold 54 year old intraaortic intra aortic device artery SwanGanz Swan Ganz catheter sample NTproBNP, NTproBNP NT proBNP , (NT-proBNP) highsensitivity high sensitivity Creactive C reactive hsCRP, hsCRP hs CRP (hs-CRP) sixminute six minute MWT (6MWT SvO (SvO2 day 3 minutes limit levels 312 (31 vs 48 respectively. respectively . respectively) tenday ten noncomplicated non complicated ICU welltolerated tolerated 5 (NT-proBNP (hs-CRP (SvO 31 (3 4 (

https://doi.org/10.36660/abc.20230537

Sarcoid-like reaction induced by neoadjuvant immunotherapy in Stage III non-small cell lung cancer Sarcoidlike Sarcoid like nonsmall non small
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Machado, Leonardo Chaves

; Fonseca, Eduardo Kaiser Ururahy Nunes

; Oliveira Júnior, Genival Viana de

; Schvartsman, Gustavo

; Chate, Rodrigo Caruso

einstein (São Paulo)

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2024, Volume 22 elocation eAI0810

Abstract: En | Text: En | PDF: En

https://doi.org/10.31744/einstein_journal/2024ai0810

Leaf gas exchange and water relations in two assai cultivars submitted to water-deficit waterdeficit deficit
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Navegantes, Patricia Cardoso Andrade

; Lopes Filho, Wagner Romulo Lima

; Rodrigues, Flávio Henrique Santos

; Monteiro, Gabriel Gustavo Tavares Nunes

; Chaves, Rosane Patrícia Ferreira

; Oliveira Neto, Candido Ferreira

; Cunha, Roberto Lisboa

; Pinheiro, Hugo Alves

Revista Brasileira de Fruticultura

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2024, Volume 46 elocation e-716

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

Resumo As cultivares de açaí (Euterpe oleracea Mart.) BRS-Pará (BRS-PA) e BRS-Pai d’Égua (BRS-PDE) foram selecionadas para cultivo em regiões de terra firme da Amazônia. Como essas cultivares foram desenvolvidas a partir de diferentesprogenitores,nós postulamos que essas cultivares podem diferir na tolerância ao déficithídrico. Para testar essa hipótese, plantas de ambas os cultivares foram avaliadas em condiçõesadequadas de irrigação (controle) e déficit hídrico (potencial hídrico foliar naantemanhã de – 2,33MPa). Em relação ao controle, o déficit hídrico reduziu a taxa de assimilaçãolíquida de CO2(A) e a transpiração, em 82%, e 86% em ambas as cultivares, enquanto acondutância estomática(gs) foi reduzida em 93% e 87%, nas plantas estressadas de BRS-PDE e BRS-PA. O déficit hídrico aumentou a eficiência instantânea do uso da água em 43%, em ambas as cultivares,enquanto a eficiência intrínseca do uso da água (A/gs) aumentou 193% na BRS-PDE e 33% na BRS-PA. O déficit hídrico induziu o aumento de 44% na prolina foliare um decréscimo de 27% nos carboidratos solúveis totais, enquanto a sacarose foliar diminuiu53% na BRS-PA e 16% na BRS-PDE, em relação ao controle. O conteúdo relativo de águanas plantas estressadas de ambas as cultivares diminuiu em 8,5% em relação ao controle. Emconclusão, o controle da abertura estomática mais eficiente e a maior A/gs, na BRS-PDE,indicam que esta cultivar respondeu melhor ao déficit hídrico que a BRS-PA. Euterpe Mart. Mart BRSPará BRS Pará BRSPA PA (BRS-PA BRSPai Pai dÉgua d Égua BRSPDE PDE (BRS-PDE Amazônia diferentesprogenitoresnós diferentesprogenitores nós déficithídrico hipótese (controle potencial 2,33MPa. 233MPa MPa 2,33MPa . 2 33MPa 2,33MPa) CO2A COA CO2 A CO CO2(A transpiração 82 82% 86 estomáticags gs estomática(gs 93 87 87% BRSPA. PA. 43 43% cultivaresenquanto A/gs Ags (A/gs 193 33 44 27 totais diminuiu53 16 BRSPDE, PDE, 85 8 5 8,5 Emconclusão BRSPDE,indicam BRSPDEindicam PDE,indicam indicam 9 4 19 3 diminuiu5 1 8, PDEindicam

Abstract: Assai (Euterpe oleracea Mart.) cultivars BRS-Pará (BRS-PA) and BRS-Pai d’Égua (BRS-PDE) were selected for cultivation in upland regions of the Amazon. Given these cultivars were developed from different progenitors, we postulated that they differ regarding water-deficit tolerance. To test this hypothesis, plants of both cultivars were evaluated under well-watered (control) and water-deficit conditions (pre-dawn leaf water potential of – 2.33 MPa). Relative to control, the water-deficit decreased net CO2 assimilation rate (A) and transpiration by 82% and 86% in both cultivars, while the stomatal conductance (gs) was reduced by 93% and 87% in stressed plants of BRS-PDE and BRS-PA. The water-deficit improved instantaneous water-use efficiency by 43% in both cultivars, while intrinsic water-use efficiency (A/gs) increased by 193% and 33% in BRS-PDE and BRS-PA. The water-deficit induced 44% increase in foliar proline and 27% decrease in soluble carbohydrates in both cultivars, while foliar sucrose decreased by 53% in BRS-PA and 16% in BRS-PDE in relation to control. The relative water content in stressed plants of both cultivars was decreased by 8.5% in relation to control. In conclusion, the more efficient stomatal opening control and higher A/gs in BRS-PDE indicate this cultivar better copes with drought than BRS-PA. Abstract Euterpe Mart. Mart BRSPará BRS Pará BRSPA PA (BRS-PA BRSPai Pai dÉgua d Égua BRSPDE PDE (BRS-PDE Amazon progenitors waterdeficit deficit tolerance hypothesis wellwatered well watered (control predawn pre dawn 233 2 33 2.3 MPa. MPa . MPa) CO A (A 82 86 gs (gs 93 87 BRSPA. PA. wateruse use 43 Ags (A/gs 193 44 27 53 16 85 8 5 8.5 conclusion 23 3 2. 9 4 19 1 8.

https://doi.org/10.1590/0100-29452024716

Age as a predictive factor for reduced intracranial compliance in patients with headache
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Cherain, Luiz Gabriel Gonçalves

; Barbosa, Mateus Gonçalves de Sena

; Francisco, Ghaspar Gomes de Oliveira Alves

; Cherain, Luiz Miguel Gonçalves

; Frigieri, Gustavo

; Rabelo, Nícollas Nunes

Arquivos de Neuro-Psiquiatria

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2024, Volume 82 N. 2 elocation s00441779029

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

Resumo Antecedentes O aumento da pressão intracraniana (PIC) consiste em um conjunto de sinais e sintomas relacionados a mudanças na complacência intracraniana (CIC) e na PIC. Objetivo Este estudo apresenta uma análise retrospectiva de pacientes que foram submetidos ao monitoramento não invasivo da CIC com base em queixas de cefaleia, correlacionando a diminuição da complacência cerebral e o aumento da pressão intracraniana. Métodos O monitoramento não invasivo da CIC foi realizado utilizando um dispositivo Brain4Care, que contém um medidor de tensão e um gravador conectado a um dispositivo mecânico que toca a superfície do couro cabeludo na área frontoparietal lateral à sutura sagital. Esta ferramenta monitora a PIC identificando pequenas alterações nas medidas do crânio que são causadas por variações de pressão, ou seja, a deformação do crânio está associada à detecção de alterações na PIC média. Uma avaliação clínica de 32 pacientes com queixas de cefaleia ocorreu a partir da análise de seus prontuários médicos. Resultados Dos 32 pacientes inicialmente escolhidos, foi possível concluir a análise de 18 devido à disponibilidade de dados nos prontuários médicos. A partir do monitoramento não invasivo da CIC, foram coletados os seguintes dados: time-to-peak, relação P2/P1, idade e sexo. Da análise estatística de idade e relação P2/P1, observou-se que à medida em que a idade aumenta, a CIC tende a diminuir independentemente do sexo (p < 0,05). Conclusão Este estudo concluiu que existe uma correlação entre as mudanças na CIC e a queixa de cefaleia em pacientes ambulatoriais. Houve também uma relação entre idade e diminuição da CIC, mas sem um padrão de dor específico. (PIC (CIC Brain4Care BrainCare Brain Care sagital seja média 3 médicos escolhidos 1 timetopeak, timetopeak time to peak, peak time-to-peak P2P1 PP P2 P1 P P2/P1 observouse observou se aumenta p 0,05. 005 0,05 . 0 05 0,05) ambulatoriais específico P2P P2/P 00 0,0 0,

Abstract Background Increased intracranial pressure (ICP) consists of a set of signs and symptoms related to changes in intracranial compliance (ICC) and ICP. Objective This study presents a retrospective analysis of patients who underwent non-invasive monitoring of ICC based on complaints of headache, correlating decreased brain compliance and increased intracranial pressure. Methods Noninvasive ICC monitoring was performed using a Brain4care device, which contains a strain gauge and a recorder connected to a mechanical device that touches the scalp surface in the frontoparietal area lateral to the sagittal suture. This tool monitors the ICP by identifying small changes in skull measurements that are caused by pressure variations, i.e., skull deformation is associated with the detection of changes in mean ICP. A clinical evaluation of 32 patients with complaints of headache occurred from the analysis of their medical records. Results Of the 32 patients initially chosen, it was possible to complete the analysis of 18 due to the availability of data in the medical records. From the non-invasive monitoring of the ICC, the following data were collected: time-to-peak, P2/P1 ratio, age, and gender. From the statistical analysis of age and P2/P1 ratio, it was noted that as age increases, ICC tends to decrease regardless of sex (p < 0.05). Conclusion This study concluded that there is a correlation between changes in intracranial compliance and headache complaints in outpatients. There was also a relationship between age and decreased intracranial compliance but without a specific pain pattern. (ICP (ICC noninvasive non invasive Braincare Brain care suture variations ie i e i.e. 3 records chosen 1 collected timetopeak, timetopeak time peak, peak time-to-peak P2P1 PP P2 P1 P P2/P ratio gender increases p 0.05. 005 0.05 . 0 05 0.05) outpatients pattern i.e P2P 00 0.0 0.

https://doi.org/10.1055/s-0044-1779029

III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND
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PESSOA, Ricardo Rangel de Paula

; BESTETTI, Alexandre Moraes

; OLIVEIRA, Victor Lira de

; ARAUJO, Wladimir Campos de

; GUARALDI, Simone

; RODRIGUES SILVA, Rodrigo Roda

; OLIVEIRA, Francisco Antonio Araujo

; RIBEIRO, Maria Sylvia Ierardi

; CARNEIRO, Fred Olavo Aragão Andrade

; D’ASSUNÇÃO, Marco Aurélio

; MEDRADO, Bruno Frederico Oliveira Azevedo

; RETES, Felipe Alves

; PAULO, Gustavo Andrade de

; SCHNEIDER, Nutianne Camargo

; ROSSINI, Lucio Giovanni Battista

; VALLINOTO, Leonardo

; ARDENGH, Jose Celso

; COELHO NETO, Djalma Ernesto

; IDE, Edson

; SILVA, Marcos Clarencio Batista

; FRANCO, Matheus Cavalcante

; MATUGUMA, Sergio Eiji

; MOURA, Diogo Turiani Hourneaux de

; ARANTES, Vitor Nunes

; NAHOUM, Rafael

; BRUNALDI, Vitor Ottoboni

; SANTOS, Marcos Eduardo Lera dos

; CHAVES, Dalton Marques

; MICELLI-NETO, Otávio

; SALOMAO, Bruno Chaves

; MALUF-FILHO, Fauze

; LUZ, Gustavo de Oliveira

Arquivos de Gastroenterologia

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2024, Volume 61 elocation e24062

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

RESUMO Contexto: Nas últimas décadas, a ecoendoscopia evoluiu de uma ferramenta diagnóstica para uma plataforma para diversas intervenções terapêuticas. Vários avanços tecnológicos surgiram desde o último Consenso Brasileiro, demandando uma revisão e atualização das recomendações baseadas nas melhores evidências científicas. Métodos: Um grupo de 32 ecoendoscopistas renomados selecionou oito tópicos relevantes para serem discutidos a fim de gerar questões clínicas. Em seguida, foi realizada uma revisão da literatura para responder a essas perguntas com base nas evidências mais atualizadas. Resultados: Trinta e três tópicos foram formulados e votados pelos especialistas para alcançar um consenso. O Sistema de Oxford foi utilizado para classificar o nível de evidência. Conclusão: Há evidências moderadas para sustentar que a forma da agulha, calibre ou técnica de aspiração não influenciam no rendimento da amostragem tecidual guiada por ultrassom endoscópico (USE) de lesões sólidas pancreáticas. Há evidências moderadas para sustentar o uso da biópsia transcutânea guiada por USE da parede cística para diferenciar entre neoplasias císticas mucinosas e não mucinosas. Existem poucas evidências para apoiar o tratamento guiado por USE de varizes gástricas. Há um alto nível de evidência para sustentar que a drenagem biliar guiada por USE e a CPRE apresentam resultados semelhantes em pacientes com obstrução biliar maligna distal. Há um alto nível de evidência para o uso da USE no diagnóstico de cistos pancreáticos neoplásicos e na detecção de necrose antes de indicar a drenagem. Há evidências moderadas para sustentar a preferência pela gastroenterostomia guiada por USE em relação ao stent duodenal para obstrução maligna da saída gástrica em pacientes com expectativa de vida superior a 2 meses. Há um alto nível de evidência para sustentar o uso da ablação por radiofrequência no tratamento de ambos os tipos, funcionantes e não funcionantes, de tumores neuroendócrinos. Contexto décadas terapêuticas Brasileiro científicas Métodos 3 clínicas seguida atualizadas Resultados consenso Conclusão agulha (USE pancreáticas gástricas distal meses tipos neuroendócrinos

ABSTRACT Background: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence. Methods: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions. After that, a literature review was conducted to answer these questions based on the most updated evidence. Results: Thirty-three statements were formulated and voted on by the experts to reach a consensus. The Oxford System was used to grade the level of evidence. Conclusion: There is moderate evidence to support that the needle shape, gauge, or aspiration technique does not influence the yield of endoscopic ultrasound (EUS)-guided tissue sampling of pancreatic solid lesions. There is moderate evidence to support using EUS-TTNB of the cyst wall to differentiate between mucinous and non-mucinous cystic neoplasms. There is little evidence to support the EUS-guided treatment of gastric varices. There is a high level of evidence to support that EUS-guided biliary drainage and ERCP present similar outcomes in patients with distal malignant biliary obstruction. There is a high level of evidence for using EUS to diagnose neoplastic pancreatic cysts and detect necrosis before indicating drainage. There is moderate evidence to support EUS-GE over duodenal stent for malignant gastric outlet obstruction in patients with a life expectancy higher than 2 months. There is a high level of evidence to support the use of RFA in treating both functioning and non-functioning types of NET. Background decades interventions Consensus Methods 3 Results Thirtythree Thirty three consensus Conclusion shape gauge EUSguided guided lesions EUSTTNB TTNB nonmucinous non neoplasms varices EUSGE GE months nonfunctioning NET

https://doi.org/10.1590/s0004-2803.24612024-062

Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals asbestosexposed asbestos exposed
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Santos, Ubiratan Paula

; Algranti, Eduardo

; Capitani, Eduardo Mello De

; Prado, Gustavo Faibischew

; Carneiro, Ana Paula Scalia

; Rodrigues, Sílvia Carla Sousa

; Freitas, Jefferson Benedito Pires de

; Chate, Rodrigo Caruso

; Mizutani, Rafael Futoshi

; Castro, Hermano Albuquerque de

; Arbex, Marcos Abdo

; Ribeiro, Patrícia Canto

; Tietboehl Filho, Carlos Nunes

; Castellano, Maria Vera Cruz de Oliveira

; Leite, Guilherme Ward

; Almeida, Gustavo Corrêa de

Jornal Brasileiro de Pneumologia

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2024, Volume 50 N. 3 elocation e20240156

Abstract: En | Text: En | PDF: En

ABSTRACT Asbestos was largely used in Brazil. It is a mineral that induces pleural and pulmonary fibrosis, and it is a potent carcinogen. Our objective was to develop recommendations for the performance of adequate imaging tests for screening asbestos-related diseases. We searched peer-reviewed publications, national and international technical documents, and specialists’ opinions on the theme. Based on that, the major recommendations are: Individuals exposed to asbestos at the workplace for ≥ 1 year or those with a history of environmental exposure for at least 5 years, all of those with a latency period > 20 years from the date of initial exposure, should initially undego HRCT of the chest for investigation. Individuals with pleural disease and/or asbestosis should be considered for regular lung cancer monitoring. Risk calculators should be adopted for lung cancer screening, with a risk estimate of 1.5%. Brazil fibrosis carcinogen asbestosrelated related diseases peerreviewed peer reviewed publications documents specialists theme are 2 investigation andor monitoring 15 1.5% 1.5 1.

https://doi.org/10.36416/1806-3756/e20240156

Using the cell phone while standing or walking affects balance and mobility in people with Parkinson’s disease Parkinsons Parkinson s
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Lino, Tayla Borges

; Silva, Milena Nunes de Oliveira da

; Paula, Isabela Corrêa de

; Melo, Sarah Jane Lemos de

; Barbosa, Suzi Rosa Miziara

; Christofoletti, Gustavo

Arquivos de Neuro-Psiquiatria

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apr 2023, Volume 81 N. 4 Pages 377 - 383

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

Resumo Antecedentes Aparelhos celulares fazem parte da vida das pessoas. A literatura aponta riscos quando o uso do celular está associado a uma tarefa motora. Estudos abordando esse tema na doença de Parkinson são escassos. Objetivo Investigar o impacto de tarefas-duplas com o celular sobre equilíbrio e mobilidade de pessoas com doença de Parkinson, na comparação com controles saudáveis. Métodos Participantes com e sem doença de Parkinson foram submetidos a três tarefas: (1) Ficar em pé e caminhar sem o celular; (2) Ficar em pé e caminhar enquanto conversa ao celular; e (3) Ficar em pé e caminhar enquanto digita mensagens. As avaliações envolveram testes de equilíbrio e mobilidade. Os procedimentos estatísticos envolveram testes de análise múltipla de variâncias, com análise de efeito principal para os fatores grupo (doença de Parkinson x controle), tarefa (com celular × sem celular) e interação (grupo × tarefa). Significância foi estipulada em 5%. Tamanhos de efeito foram reportados. Resultados Participantes com doença de Parkinson apresentaram pior equilíbrio (p = 0,001; tamanho do efeito: 0,471) e mobilidade (p = 0,001; tamanho do efeito: 0,472) que controles. O uso do celular afetou ambos os grupos (p = 0,005, tamanho do efeito de 0,673 para equilíbrio e p = 0,001, tamanho do efeito de 0,549 para mobilidade). O impacto da tarefa-dupla, contudo, foi maior no grupo Parkinson (p = 0,009; tamanho do efeito de 0,407 para mobilidade). Conclusão Tarefas simultâneas com o celular causam desequilíbrio e problemas de mobilidade na doença de Parkinson. As pessoas devem ter cuidado ao utilizar celulares durante atividades em pé e ao caminhar. motora escassos tarefasduplas tarefas duplas saudáveis 1 (1 2 (2 3 (3 mensagens variâncias controle, controle , controle) tarefa. . tarefa) 5 5% reportados 0,001 0001 0 001 0,471 0471 471 0,472 0472 472 0005 005 0,005 0673 673 0,67 0549 549 0,54 mobilidade) tarefadupla, tarefadupla dupla, dupla tarefa-dupla contudo 0,009 0009 009 0407 407 0,40 ( 0,00 000 00 0,47 047 47 067 67 0,6 054 54 0,5 040 40 0,4 0,0 04 4 06 6 0, 05

Abstract Background Cell phones are part of peoples’ lives. The literature indicates risks when cell phones are used during a secondary motor task. Studies addressing this topic in people with Parkinson’s disease are still scarce. Objective To investigate the impact of daily dual tasks with cell phone on balance and mobility in people with Parkinson’s disease, compared to healthy control peers. Methods Participants with Parkinson’s disease and controls underwent three motor tasks: (1) Standing and walking without using a cell phone; (2) Standing and walking while talking on the phone; and (3) Standing and walking while texting messages on the phone. Assessments involved balance and mobility tests. Statistical analysis was performed with multivariate analysis of variance, comparing main effect for group (Parkinson’s disease × control), task (using × not using cell phone) and interactions (group × task). Significance was set at 5%. Effect sizes are reported. Results Participants with Parkinson’s disease showed worse balance (p = 0.001, effect size of 0.471) and mobility (p = 0.001, effect size of 0.472) than control peers. The use of cell phone while performing a secondary motor task affected both groups (p = 0.005, effect size of 0.673 for balance and p = 0.001, effect size of 0.549 for mobility). The dual task impact, however, was higher in the Parkinson’s disease group (p = 0.009, effect size of 0.407 for mobility). Conclusion Daily dual tasks with cell phones increase imbalance and mobility risks in Parkinson’s disease. People should be careful when using their cell phone while standing or walking. peoples lives Parkinsons Parkinson s scarce peers 1 (1 2 (2 3 (3 tests variance control, , control) . task) 5 5% reported 0001 0 001 0.001 0.471 0471 471 0.472 0472 472 0005 005 0.005 0673 673 0.67 0549 549 0.54 mobility. mobility) however 0009 009 0.009 0407 407 0.40 ( 000 00 0.00 0.47 047 47 067 67 0.6 054 54 0.5 040 40 0.4 0.0 04 4 06 6 0. 05

https://doi.org/10.1055/s-0043-1767825

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal SISBIOTADiptera SISBIOTA Network longterm long term Amazon Cerrado
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis

; Pujol-Luz, José Roberto

; Rafael, José Albertino

; Riccardi, Paula Raile

; Rodrigues, João Paulo Vinicios

; Roque, Fabio de Oliveira

; Sallum, Maria Anice Mureb

; Santis, Marcelo Domingos de

; Santos, Charles Morphy Dias dos

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Shimabukuro, Paloma Helena Fernandes

; Silva, Vera Cristina

; Schelesky-Prado, Daniel de Castro

; Silva-Neto, Alberto Moreira da

; Camargo, Alexssandro

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Wiedenbrug, Sofia

; Yamaguchi, Carolina

; Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists. SISBIOTABRASIL SISBIOTA BRASIL threeyear year multimilliondollar multimillion dollar endangeredunderstudied endangered understudied Brazil flora processes premise Sul Rondônia forest Savannah, Savannah , Savannah) relevance surveys Therefore literature lands 9 2 researchers postdocs students technicians 300000 300 000 300,00 60 ~6 Here 4 treated 2130 130 2,13 51 altogether 29 combined respectively Overall 1 speciesrich rich Tachinidae Cecidomyiidae Tabanidae Psychodidae Sarcophagidae Stratiomyidae Bombyliidae Syrphidae Tephritidae Asilidae Mycetophilidae Muscidae Dolichopodidae Chloropidae far 11 taxonomic phylogenetic specialists 30000 30 00 300,0 6 ~ 213 13 2,1 5 3000 3 0 300, 21 2,

https://doi.org/10.1590/1806-9665-rbent-2023-0051

Gestational and congenital syphilis: gaps to be elucidated syphilis
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Carvalho, Déborah Esteves

; Pimentel, João Victor Andrade

; Silva, Luise Oliveira Ribeiro da

; Rodrigues, Letícia Maria Cardoso Lima

; Andrade, Leonardo Santana

; Santana, Carlos Ramon Costa

; Menezes, Marcelo Antônio Silva

; Silva, Eloyse Emanuelle Nunes

; Santos, Gabryelle Eduarda Gama dos

; Santos, Sayron Natanael Lopes Pereira

; Gomes, Breno Gustavo do Nascimento

; Meira, Letícia Almeida

; Santos, Helga Machado de Farias

; Lopes, Izailza Matos Dantas

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0038-2023

Abstract: En | Text: En | PDF: En

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil. Brazil tests Venereal Laboratory 22yearold yearold 22 year old treatment test 2

https://doi.org/10.1590/0037-8682-0038-2023

10.

Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development Pacing Whom When Why How
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Ferrari, Andres Di Leoni

; Oliveira, Eduardo Bartholomay

; Tagliari, Ana Paula

; Kochi, Adriano Nunes

; Beuren, Thaís Mariel Andara

; Cabral, Gustavo Chiari

; Ferreira, Flávio Vinicius Costa

; Danzmann, Luiz Cláudio

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 2 Pages 278 - 288

Abstract: En | Text: En | PDF: En

ABSTRACT Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients. synchronous (synchronous abnormalities dyssynchronopathy “dyssynchronopathy consequences pacinginduced PiCM. . (PiCM) perfusion activationcontraction damage inflammation tissue multifactorial condition cardiomyopathies detection disease commonly percentage reflected function) patients (PiCM

https://doi.org/10.21470/1678-9741-2021-0629

11.

Association between chronic Anaplasma marginale and Babesia spp. infection and hematological parameters of taurine heifers spp
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Rahal, Natalia Machado

; Luz, Gabriela Bueno

; Martins, Kauê Rodriguez

; Gasperin, Bernardo Garziera

; Feijó, Josiane de Oliveira

; Dalto, André Gustavo Cabrera

; Rovani, Monique Tomazele

; Cunha, Rodrigo Casquero

; Corrêa, Marcio Nunes

Revista Brasileira de Parasitologia Veterinária

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2023, Volume 32 N. 3 elocation e006423

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

Resumo O objetivo deste estudo foi investigar a associação entre infecção crônica por Anaplasma marginale e Babesia spp. e parâmetros hematológicos de novilhas taurinas prenhes e não prenhes. Sangue de 94 fêmeas foi coletado no primeiro dia (D-10) do protocolo de inseminação artificial em tempo fixo (IATF) e no diagnóstico de gestação (D+34). Parâmetros hematológicos foram comparados entre novilhas prenhes (PG) e não prenhes (NPG) e dentro dos grupos entre dias de coleta. Usando-se PCR em tempo real (qPCR), determinou-se a infecção por A. marginale e Babesia bovis e quantificação absoluta de Babesia spp. Entre os grupos PG e NPG. A análise de correlação foi realizada entre o número de cópias (CN) de Babesia spp. e parâmetros hematológicos. No D-10, a concentração de hemoglobina foi maior para NPG e hematócrito, e proteína plasmática total foram maiores em D+34 para ambos os grupos. Não houve diferença para CN de Babesia spp. entre os grupos. Na primeira qPCR, todas as novilhas foram positivas para A. marginale e B. bovis. Correlações significativas foram encontradas entre hemoglobina/eritrócito e hemoglobina/hematócrito (r=0,8082 e r=0,3009, respectivamente). Baixos níveis de A. marginale e Babesia spp. não afetaram os parâmetros hematológicos de novilhas taurinas prenhes e não prenhes cronicamente infectadas. spp 9 D10 D 10 (D-10 IATF (IATF D+34. D34 . 34 (D+34) (PG (NPG coleta Usandose Usando se qPCR , (qPCR) determinouse determinou (CN D10, 10, D-10 hematócrito D+3 B hemoglobinaeritrócito eritrócito hemoglobinahematócrito r=0,8082 r08082 r 0 8082 (r=0,808 r03009 3009 r=0,3009 respectivamente. respectivamente respectivamente) infectadas D1 1 (D-1 D3 3 (D+34 (qPCR D-1 D+ r=0,808 r0808 808 (r=0,80 r0300 300 r=0,300 (D- (D+3 D- r=0,80 r080 80 (r=0,8 r030 30 r=0,30 (D (D+ r=0,8 r08 8 (r=0, r03 r=0,3 r=0, r0 (r=0 r=0 (r= r= (r

Abstract The aim of this study was to investigate the association between chronic Anaplasma marginale and Babesia spp. infection and hematological parameters of pregnant and non-pregnant taurine heifers. Blood samples from 94 females were collected on the first day (D-10) of timed artificial insemination (TAI) protocol and on pregnancy diagnosis (D+34). Hematological parameters were determined and compared between pregnant (PG) and non-pregnant (NPG) heifers, and within group at different sampling days. Real-time PCR (qPCR) was used to determine A. marginale and Babesia bovis infection, and for absolute quantification of Babesia spp. between PG and NPG groups. Correlation analysis was performed between the number of gDNA copies (CN) of Babesia spp. and hematological parameters. On D-10, mean hemoglobin concentration was higher for NPG, and hematocrit and total plasma protein were higher on D+34 for both groups. There was no difference in Babesia spp. CN between groups. In the first qPCR, all heifers were positive for A. marginale and B. bovis. Significant correlations were found between hemoglobin and erythrocyte and between hemoglobin and hematocrit (r = 0.8082 and r = 0.3009, respectively). Low levels of A. marginale and Babesia spp. did not affect hematological parameters of chronically infected pregnant and non-pregnant taurine heifers. spp nonpregnant non 9 D10 D 10 (D-10 TAI (TAI D+34. D34 . 34 (D+34) (PG (NPG days Realtime Real time qPCR (qPCR A groups (CN D10, 10, D-10 D+3 B 08082 0 8082 0.808 03009 3009 0.3009 respectively. respectively respectively) D1 1 (D-1 D3 3 (D+34 D-1 D+ 0808 808 0.80 0300 300 0.300 (D- (D+3 D- 080 80 0.8 030 30 0.30 (D (D+ 08 8 0. 03 0.3

https://doi.org/10.1590/s1984-29612023052

12.

Avaliação do Impacto da Implantação de um Sistema de Ambulância Pré-Hospitalar sobre Mortalidade por Infarto Agudo do Miocárdio em um País em Desenvolvimento PréHospitalar Pré Hospitalar
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Vieira, Rodrigo Costa Pereira

; Marcolino, Milena Soriano

; Silva, Luis Gustavo Silva e

; Pereira, Daniella Nunes

; Nascimento, Bruno Ramos

; Jorge, Alzira de Oliveira

; Ribeiro, Antonio Luiz P

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 756 - 763

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

Resumo Fundamento O manejo efetivo de pacientes com infarto agudo do miocárdio (IAM) é tempo-dependente. Objetivos Avaliar os impactos da implantação do atendimento pré-hospitalar nas taxas de internação e de mortalidade associadas ao IAM. Métodos Estudo retrospectivo e ecológico, que avaliou dados do Sistema Único de Saúde, de todos os 853 municípios de Minas Gerais, de 2008 a 2016. A assimetria excessiva da mortalidade geral e intra-hospitalar por IAM foi suavizada usando o método empírico de Bayes. Este estudo avaliou a relação entre o do Serviço de Atendimento Médico de Urgência (SAMU) em cada município e os seguintes 3 desfechos: taxa de mortalidade geral por IAM, taxa de mortalidade intra-hospitalar por IAM e taxa de internação por IAM, utilizando o modelo hierárquico de Poisson. As taxas foram corrigidas pela estrutura etária e destendenciadas pela sazonalidade e influências temporais. Foi adotado um intervalo de confiança de 95%. Resultados As taxas de mortalidade por IAM diminuíram ao longo do estudo, em média 2% por ano, com variação sazonal. A mortalidade intra-hospitalar também apresentou tendência de queda, de 13,81% em 2008 para 11,43% em 2016. A implantação do SAMU foi associada à diminuição da mortalidade por IAM ( odds ratio [OR] = 0,967, IC 95% 0,936 a 0,998) e mortalidade intra-hospitalar por IAM (OR = 0,914, IC 95% 0,845 a 0,986), sem associação significativa com internações (OR 1,003, IC 95% 0,927 a 1,083). Conclusão A implantação do SAMU esteve associada a uma redução modesta, mas significativa, na mortalidade intra-hospitalar. Esse achado reforça o papel fundamental do cuidado pré-hospitalar no cuidado do IAM e a necessidade de investimentos nesse serviço para melhorar os desfechos clínicos em países de baixa e média renda. (IAM tempodependente. tempodependente tempo dependente. dependente tempo-dependente préhospitalar pré hospitalar ecológico Saúde 85 Gerais 200 2016 intrahospitalar intra Bayes (SAMU Poisson temporais 95 2 ano sazonal queda 1381 13 81 13,81 1143 11 43 11,43 OR [OR 0967 0 967 0,967 0936 936 0,93 0,998 0998 998 0914 914 0,914 0845 845 0,84 0,986, 0986 0,986 , 986 0,986) 1003 1 003 1,003 0927 927 0,92 1,083. 1083 1,083 . 083 1,083) modesta intrahospitalar. hospitalar. renda 8 20 201 9 138 13,8 114 4 11,4 096 96 0,96 093 93 0,9 0,99 099 99 091 91 0,91 084 84 0,8 098 0,98 98 100 00 1,00 092 92 108 1,08 08 13, 11, 09 0, 10 1,0 1,

Abstract Background The effective management of patients with acute myocardial infarction (AMI) is time-dependent. Objectives To assess the impacts of the implementation of prehospital care on admission rates and mortality associated with AMI. Methods Retrospective, ecological study, which assessed data from the Brazilian Universal Health System, from all 853 municipalities of Minas Gerais, from 2008 to 2016. Excessive skewness of general and in-hospital mortality rates was smoothed using the empirical Bayes method. This study assessed the relationship between Mobile Emergency Care Service (SAMU) in each municipality and the following 3 outcomes: mortality rate due to AMI, AMI in-hospital mortality, and AMI hospitalization rate, using the Poisson hierarchical model. Rates were corrected by age structure and detrended by seasonality and temporal influences. A confidence interval of 95% was adopted. Results AMI mortality rates decreased throughout the study, on average 2% per year, with seasonal variation. AMI in-hospital mortality also showed a decreasing trend, from 13.81% in 2008 to 11.43% in 2016. SAMU implementation was associated with decreased AMI mortality (odds ratio [OR] = 0.967, 95% confidence interval [CI] 0.936 to 0.998) and AMI in-hospital mortality (OR = 0.914, 95% CI 0.845 to 0.986), with no relation with hospitalizations (OR = 1.003, 95% CI 0.927 to 1.083). Conclusion SAMU implementation was associated with a modest but significant decrease in AMI in-hospital mortality. This finding reinforces the key role of prehospital care in AMI care and the need for investments on this service to improve clinical outcomes in low- and middle-income countries. (AMI timedependent. timedependent time dependent. dependent time-dependent Retrospective System 85 Gerais 200 2016 inhospital hospital method (SAMU model influences 95 adopted 2 year variation trend 1381 13 81 13.81 1143 11 43 11.43 odds OR [OR 0967 0 967 0.967 [CI 0936 936 0.93 0.998 0998 998 0914 914 0.914 0845 845 0.84 0.986, 0986 0.986 , 986 0.986) 1003 1 003 1.003 0927 927 0.92 1.083. 1083 1.083 . 083 1.083) low middleincome middle income countries 8 20 201 9 138 13.8 114 4 11.4 096 96 0.96 093 93 0.9 0.99 099 99 091 91 0.91 084 84 0.8 098 0.98 98 100 00 1.00 092 92 108 1.08 08 13. 11. 09 0. 10 1.0 1.

https://doi.org/10.36660/abc.20210953

13.

The Brazilian version of the Hip Sports Activity Scale: translation and cross-cultural adaptation
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Mathias, Letícia Nunes Carreras Del Castillo

; Cardinot, Themis Moura

; Sá-Caputo, Danúbia da Cunha de

; Moura-Fernandes, Márcia Cristina

; Bernardo-Filho, Mário

; Soares, Gustavo Leporace de Oliveira Lomelino

; Batista, Luiz Alberto

; Oliveira, Liszt Palmeira de

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 2 Pages 261 - 267

Abstract: En | Text: En | PDF: En

Abstract BACKGROUND: The Hip Sports Activity Scale (HSAS) is a reliable and valid tool for determining the levels of sports activities among patients with femoroacetabular impingement (FAI). OBJECTIVE: To translate and cross-culturally adapt the HSAS to the Brazilian Portuguese language. DESIGN AND SETTING: This was a cross-sectional study conducted at the State University of Rio de Janeiro. METHODS: The Brazilian version of the HSAS was developed following a process that comprised six steps: translation, synthesis, back-translation, review by committee, pretesting and submission of documentation to the developers. The translation phase involved three independent bilingual translators whose mother language was Brazilian Portuguese. The back-translation phase involved three independent translators whose mother language was English. In order to verify comprehension of the questionnaire, 30 undergraduate students in physical education (65% men), with mean age 23.2 years (standard deviation = 6.8), participated in the pre-testing phase. RESULTS: During the translation step, some terms and expressions were changed to obtain cultural equivalence to the original HSAS. In the pre-testing phase, each item of the scale showed a comprehension level of 100%. CONCLUSION: The HSAS was translated from English to the Brazilian Portuguese language and adapted to Brazilian culture. The HSAS validation is ongoing.

https://doi.org/10.1590/1516-3180.2021.0157.r1.23072021

14.

MORTALITY IN PATIENTS > 90 YEARS OLD WITH PROXIMAL FEMORAL FRACTURES SUBJECTED TO SURGERY
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OLIVEIRA, CARLOS EDUARDO NUNES DE

; FEITOSA, ANDRÉ COELHO CITÓ

; FALÓTICO, GUILHERME GUADAGNINI

; FERREIRA, GABRIEL FERRAZ

; DURIGON, THOMAS STRAVINSKAS

; ARLIANI, GUSTAVO GONÇALVES

Acta Ortopédica Brasileira

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2022, Volume 30 N. 4 elocation e255534

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

RESUMO Introdução: As fraturas do fêmur proximal têm alta taxa de mortalidade entre os idosos, especialmente entre os considerados superidosos (> 80 anos). Objetivo: Analisar fatores preditivos para mortalidade hospitalar ou tardia de pacientes com idade superior a 90 anos que apresentaram fratura do fêmur proximal e foram submetidos ao tratamento cirúrgico. Métodos: O estudo incluiu dados de 230 pacientes com idade superior a 90 anos que apresentaram diagnóstico de fratura do fêmur proximal e foram submetidos ao tratamento cirúrgico entre janeiro e dezembro de 2017. A avaliação estatística foi realizada pela análise multivariada por meio da regressão logística. As associações foram estimadas pelo valor de odds ratio (OD) e intervalo de confiança (95%). A significância estatística foi determinada com p < 0,05. Resultados: O óbito tardio ocorreu em 51,3% (118 pacientes) da amostra e o hospitalar em 3,5% (8 pacientes). A maioria dos pacientes foram do sexo feminino (83,5%) e a fratura mais comum foi a transtrocanteriana (57,0%). Houve associação do óbito tardio com a duração do procedimento cirúrgico (p < 0,05), e do óbito hospitalar com a presença de cardiopatias (p < 0,05) ou endocrinopatias (p < 0,05). Conclusão: A maioria dos pacientes com idade superior a 90 anos com fratura do fêmur proximal submetida ao tratamento cirúrgico evoluiu para óbito em menos de um ano. O óbito tardio foi associado à duração do procedimento cirúrgico e o óbito hospitalar à presença de endocrinopatias ou cardiopatias prévias, sendo o sexo feminino fator de proteção para tal desfecho. Nível de Evidência III, Estudo Caso-Controle Retrospectivo.

ABSTRACT Introduction: Proximal femoral fractures have a high mortality rate among older adults, especially those aged > 80 years. Objective: To analyze predictive factors for hospital or late mortality of patients > 90 years old who showed proximal femoral fracture and subjected to surgery. Methods: The study included data from 230 patients aged > 90 years diagnosed with proximal femoral fracture and who underwent surgery between January and December 2017. The statistical evaluation was performed by multivariate analysis by a logistic regression. The associations were estimated by the odds ratio (OD) and confidence interval (95%). Statistical significance was determined with p < 0.05. Results: Late death occurred in 51.3% (118 patients) of the sample and hospital death in 3.5% (8 patients). Most patients were women (83.5%) and the most common fracture was transtrochanteric (57.0%). There was association between late death and the surgery duration (p < 0.05), and between hospital death and the presence of heart diseases (p < 0.05) or endocrinopathies (p < 0.05). Conclusion: Most patients aged > 90 years with proximal femoral fracture subjected to surgery died in less than one year. Late death was associated with the surgery duration and hospital death was associated with the presence of previous endocrinopathies or heart diseases, and the female gender was a protective factor from this outcome. Level of Evidence III, Retrospective Case-Control Study.

https://doi.org/10.1590/1413-785220223004e255534

15.

Impact of ERT and follow-up of 17 patients from the same family with a mild form of MPS II
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Stephan, Bruno de Oliveira

; Quaio, Caio Robledo

; Spolador, Gustavo Marquezani

; Paula, Ana Carolina de

; Curiati, Marco Antonio

; Martins, Ana Maria

; Leal, Gabriela Nunes

; Tenorio, Artur

; Finzi, Simone

; Chimelo, Flavia Teixeira

; Matas, Carla Gentile

; Honjo, Rachel Sayuri

; Bertola, Debora Romeo

; Kim, Chong Ae

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2022, Volume 77 elocation 100082

Abstract: En | Text: En | PDF: En

Abstract Background: Mucopolysaccharidosis type II, also known as Hunter syndrome, is a rare X-linked recessive disorder caused by deficiency of the lysosomal enzyme Iduronate-2- Sulfatase (IDS), leading to progressive accumulation of Glycosaminoglycans (GAGs) in several organs. Over the years, Enzyme Replacement Therapy (ERT) has provided significant benefits for patients, retarding the natural progression of the disease. Results: The authors evaluated 17 patients from the same family with a mild form of MPS type II; the proband had developed acute decompensated heart failure refractory to clinical measurements at 23 years and needed a rather urgent heart transplant; however, he died from surgical complications shortly after the procedure. Nevertheless, subsequent to his tragic death, 16 affected male relatives were detected after biochemical tests identifying the low or absent activity of the IDS enzyme and confirmed by molecular analysis of the IDS gene. Following diagnosis, different options of treatment were chosen: 6 patients started ERT with Elaprase® (Idursulfase) soon after, while the other 10 remained without ERT. Eventually, 4 patients in the latter group began ERT with Hunterase® (Idursulfase Beta). None presented adverse effects to either form of the enzyme. Among the 6 individuals without any ERT, two died of natural causes, after reaching 70 years. Despite the variable phenotype within the same family (mainly heart dysfunctions and carpal tunnel syndrome), all 14 remaining patients were alive with an independent lifestyle. Conclusion: Here, the authors report the variable progress of the disease with and without ERT in a large Brazilian family with a slowly progressive form of MPS II, harboring the same missense variant in the IDS gene.

https://doi.org/10.1016/j.clinsp.2022.100082

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