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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio
Simões, Marcus V.
Correia, Edileide de Barros
Marcondes-Braga, Fabiana G.
Coelho-Filho, Otavio Rizzi
Mesquita, Cláudio Tinoco
Mathias-Junior, Wilson
Rochitte, Carlos Eduardo
Ramires, Felix José Alvarez
Alves, Silvia Marinho Martins
Montera, Marcelo Westerlund
Lopes, Renato Delascio
Oliveira-Junior, Mucio Tavares
Scolari, Fernando L.
Avila, Walkiria Samuel
Canesin, Manoel Fernandes
Bacal, Fernando
Bocchi, Edimar Alcides
Moura, Lídia Ana Zytynski
Saad, Eduardo Benchimol
Scanavacca, Mauricio I.
Valdigem, Bruno Pereira
Cano , Manuel Nicolas
Abizaid , Alexandre
Ribeiro, Henrique Barbosa
Lemos-Neto, Pedro Alves
Ribeiro, Gustavo Calado de Aguiar
Jatene, Fabio Biscegli
Dias, Ricardo Ribeiro
Beck-da-Silva, Luis
Rohde, Luis Eduardo P.
Bittencourt, Marcelo Imbroinise
Pereira, Alexandre
Krieger, José Eduardo
Villacorta, Humberto
Martins, Wolney de Andrade
Figueiredo-Neto, José Albuquerque de
Cardoso , Juliano Novaes
Pastore, Carlos Alberto
Jatene, Ieda Biscegli
Tanaka, Ana Cristina Sayuri
Hotta, Viviane Tiemi
Romano, Minna Moreira Dias
Albuquerque, Denilson Campos de
Mourilhe-Rocha, Ricardo
Hajjar, Ludhmila Abrahão
Brito, Fabio Sandoli de
Caramelli , Bruno
Calderaro, Daniela
Farsky, Pedro Silvio
Colafranceschi , Alexandre Siciliano
Pinto, Ibraim Masciarelli
Vieira , Marcelo Luiz Campos
Danzmann, Luiz Claudio
Barberato , Silvio Henrique
Mady, Charles
Martinelli-Filho, Martino
Torbey , Ana Flavia Malheiros
Schwartzmann, Pedro Vellosa
Macedo, Ariane Vieira Scarlatelli
Ferreira , Silvia Moreira Ayub
Schmidt, Andre
Melo , Marcelo Dantas Tavares de
Lima-Filho, Moysés Oliveira
Sposito, Andrei C.
Brito, Flavio de Souza
Biolo, Andreia
Madrini-Junior, Vagner
Rizk, Stéphanie Itala
Mesquita, Evandro Tinoco
A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE. Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).
La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).
Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.
2.
Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan Prospective randomized pressurelimiting pressure limiting communityacquired community acquired STAMINA trial)
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Maia, Israel Silva
; Medrado Jr, Fernando Azevedo
; Tramujas, Lucas
; Tomazini, Bruno Martins
; Oliveira, Júlia Souza
; Sady, Erica Regina Ribeiro
; Barbante, Letícia Galvão
; Nicola, Marina Lazzari
; Gurgel, Rodrigo Magalhães
; Damiani, Lucas Petri
; Negrelli, Karina Leal
; Miranda, Tamiris Abait
; Santucci, Eliana
; Valeis, Nanci
; Laranjeira, Ligia Nasi
; Westphal, Glauco Adrieno
; Fernandes, Ruthy Perotto
; Zandonai, Cássio Luis
; Pincelli, Mariangela Pimentel
; Figueiredo, Rodrigo Cruvinel
; Bustamante, Cíntia Loss Sartori
; Norbin, Luiz Fernando
; Boschi, Emerson
; Lessa, Rafael
; Romano, Marcelo Pereira
; Miura, Mieko Cláudia
; Alencar Filho, Meton Soares de
; Dantas, Vicente Cés de Souza
; Barreto, Priscilla Alves
; Hernandes, Mauro Esteves
; Grion, Cintia Magalhães Carvalho
; Laranjeira, Alexandre Sanches
; Mezzaroba, Ana Luiza
; Bahl, Marina
; Starke, Ana Carolina
; Biondi, Rodrigo Santos
; Dal-Pizzol, Felipe
; Caser, Eliana Bernadete
; Thompson, Marlus Muri
; Padial, Andrea Allegrini
; Veiga, Viviane Cordeiro
; Leite, Rodrigo Thot
; Araújo, Gustavo
; Guimarães, Mário
; Martins, Priscilla de Aquino
; Lacerda, Fábio Holanda
; Hoffmann Filho, Conrado Roberto
; Melro, Livia
; Pacheco, Eduardo
; Ospina-Táscon, Gustavo Adolfo
; Ferreira, Juliana Carvalho
; Freires, Fabricio Jocundo Calado
; Machado, Flávia Ribeiro
; Cavalcanti, Alexandre Biasi
; Zampieri, Fernando Godinho
.
RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5
ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5
3.
The interaction between polygenic risk score and trauma affects the likelihood of post-traumatic stress disorder in female victims of sexual assault posttraumatic post traumatic
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Bugiga, Amanda Victória Gomes
; Carvalho, Carolina Muniz
; Oliveira, Adrielle Martins
; Coimbra, Bruno Messina
; Chehimi, Samar Nasser
; Zanardo, Evelin Aline
; Kulikowski, Leslie Domenici
; Mello, Andrea Feijó
; Ota, Vanessa Kiyomi
; Mello, Marcelo Feijo
; Belangero, Sintia Iole
.
Objective: Post-traumatic stress disorder (PTSD) is triggered by traumatic events, but genetic vulnerability and a history of childhood trauma may also increase the risk of PTSD onset. Thus, we investigated the interaction between genetic susceptibility according to polygenic risk score (PRS), and traumatic events. Methods: We evaluated 68 women with PTSD who had been sexually assaulted and 63 healthy controls with no history of sexual assault. DNA was genotyped using the Infinium Global Screening Array (Illumina, San Diego, CA, USA), and PRS analysis was performed using PRSice. Logistic regression models were also used to determine the interaction between childhood trauma, traumatic life events, and PRS and how they contribute to PTSD risk. Results: We found a significant association between PRS, childhood trauma (p = 0.03; OR = 1.241), and PTSD. There was also an interaction between PRS, traumatic life events, and childhood trauma, particularly physical and emotional neglect (p = 0.028; OR = 1.010). When examining neglect separately, we found a modest association between emotional neglect and PTSD (p = 0.014; OR = 1.086). Conclusion: Our findings highlight the importance of considering genetic vulnerability and traumatic experiences in understanding the etiology of PTSD. Objective Posttraumatic Post (PTSD events onset Thus , (PRS) Methods 6 assault Illumina, Illumina (Illumina Diego CA USA, USA USA) PRSice Results p 0.03 003 0 03 1.241, 1241 1.241 1 241 1.241) 0.028 0028 028 1.010. 1010 1.010 . 010 1.010) separately 0.014 0014 014 1.086. 1086 1.086 086 1.086) Conclusion (PRS 0.0 00 124 1.24 24 0.02 002 02 101 1.01 01 0.01 001 108 1.08 08 0. 12 1.2 2 10 1.0 1.
4.
Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio
; Simões, Marcus V.
; Correia, Edileide de Barros
; Marcondes-Braga, Fabiana Goulart
; Coelho-Filho, Otavio Rizzi
; Mesquita, Cláudio Tinoco
; Mathias Junior, Wilson
; Antunes, Murillo de Oliveira
; Arteaga-Fernández, Edmundo
; Rochitte, Carlos Eduardo
; Ramires, Felix José Alvarez
; Alves, Silvia Marinho Martins
; Montera, Marcelo Westerlund
; Lopes, Renato Delascio
; Oliveira Junior, Mucio Tavares de
; Scolari, Fernando Luis
; Avila, Walkiria Samuel
; Canesin, Manoel Fernandes
; Bocchi, Edimar Alcides
; Bacal, Fernando
; Moura, Lidia Zytynski
; Saad, Eduardo Benchimol
; Scanavacca, Mauricio Ibrahim
; Valdigem, Bruno Pereira
; Cano, Manuel Nicolas
; Abizaid, Alexandre Antonio Cunha
; Ribeiro, Henrique Barbosa
; Lemos Neto, Pedro Alves
; Ribeiro, Gustavo Calado de Aguiar
; Jatene, Fabio Biscegli
; Dias, Ricardo Ribeiro
; Beck-da-Silva, Luis
; Rohde, Luis Eduardo Paim
; Bittencourt, Marcelo Imbroinise
; Pereira, Alexandre da Costa
; Krieger, José Eduardo
; Villacorta Junior, Humberto
; Martins, Wolney de Andrade
; Figueiredo Neto, José Albuquerque de
; Cardoso, Juliano Novaes
; Pastore, Carlos Alberto
; Jatene, Ieda Biscegli
; Tanaka, Ana Cristina Sayuri
; Hotta, Viviane Tiemi
; Romano, Minna Moreira Dias
; Albuquerque, Denilson Campos de
; Mourilhe-Rocha, Ricardo
; Hajjar, Ludhmila Abrahão
; Brito Junior, Fabio Sandoli de
; Caramelli, Bruno
; Calderaro, Daniela
; Farsky, Pedro Silvio
; Colafranceschi, Alexandre Siciliano
; Pinto, Ibraim Masciarelli Francisco
; Vieira, Marcelo Luiz Campos
; Danzmann, Luiz Claudio
; Barberato, Silvio Henrique
; Mady, Charles
; Martinelli Filho, Martino
; Torbey, Ana Flavia Malheiros
; Schwartzmann, Pedro Vellosa
; Macedo, Ariane Vieira Scarlatelli
; Ferreira, Silvia Moreira Ayub
; Schmidt, Andre
; Melo, Marcelo Dantas Tavares de
; Lima Filho, Moysés Oliveira
; Sposito, Andrei C.
; Brito, Flávio de Souza
; Biolo, Andreia
; Madrini Junior, Vagner
; Rizk, Stephanie Itala
; Mesquita, Evandro Tinoco
.
5.
Evaluation of Brazilian women’s participation in the CNPQ in the field of medical research womens women s
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Keffer, Gabriele Martins
; Sousa, Árlen Almeida Duarte de
; Oliveira, Fabrício Emanuel
; Magalhães, Marcelo José da Silva
; Oliveira, Eduardo Araújo
; Martelli Júnior, Hercílio
.
Resumo Introdução: A produção científica brasileira apresentou crescimento substancial e visibilidade internacional. Contudo, em geral, a participação das mulheres em atividades científicas ainda é limitada. Objetivo: Este estudo objetivou avaliar os indicadores de produtividade científica de mulheres bolsistas do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) na área de medicina. Método: Foi realizado estudo transversal com 541 (211 mulheres, 39%) pesquisadores cadastrados como bolsistas de produtividade em medicina do CNPq conforme lista disponibilizada em dezembro de 2022. Resultado: Houve predomínio de pesquisadores do sexo masculino (n = 330; 61%). Em ambos os grupos, masculino e feminino, a maioria dos investigadores encontra-se no nível 2, sendo 62,5% mulheres e 47,2% homens (p = 0,018). Todos os 211 pesquisadores foram distribuídos em 37 instituições diferentes e publicaram 34.969 artigos em revistas científicas, com média de 165,7 artigos por pesquisador. De 2018 a 2022, foram publicados 9.679 artigos. Ao longo de suas carreiras, os 211 pesquisadores orientaram 5.440 alunos de iniciação científica, 4.144 alunos de mestrado e 2.923 alunos de doutorado. Houve diferença significativa entre os níveis de bolsas quanto ao desenvolvimento de recursos humanos em iniciação científica (p = 0,040), mestrado (p = 0,027) e doutorado (p < 0,001). Conclusão: Ainda há menor participação de mulheres do que de homens entre os pesquisadores médicos do CNPq. Contudo, foi possível observar participação substancial das mulheres em todos os quesitos avaliados, incluindo a produção técnica e científica e a formação de recursos humanos. Introdução internacional Contudo geral limitada Objetivo (CNPq Método 54 (21 39% 39 2022 Resultado n 330 61%. 61 61% . 61%) grupos feminino encontrase encontra se 2 625 62 5 62,5 472 47 47,2 p 0,018. 0018 0,018 0 018 0,018) 21 3 34969 34 969 34.96 1657 165 7 165, pesquisador 201 9679 9 679 9.67 carreiras 5440 440 5.44 4144 4 144 4.14 2923 923 2.92 0,040, 0040 0,040 , 040 0,040) 0,027 0027 027 0,001. 0001 0,001 001 0,001) Conclusão avaliados (2 202 33 6 62, 47, 0,01 01 3496 96 34.9 16 20 967 67 9.6 544 44 5.4 414 14 4.1 292 92 2.9 004 0,04 04 0,02 002 02 000 0,00 00 ( 0,0 349 34. 1 9. 5. 41 4. 29 2. 0,
Abstract Introduction: Brazilian scientific production has shown substantial growth and achieved international visibility. However, in general, the participation of women in scientific activities remains limited. Objective: This study aimed to evaluate the indicators of scientific productivity of women fellows of the Council for Scientific and Technological Development (CNPq) in the field of Medicine. Method: This cross-sectional study was conducted on 541 (211 women, 39%) researchers registered as recipients of CNPq research productivity (PQ) scholarships in Medicine according to a list provided in December 2022. Results: There was a predominance of male researchers (n=330; 61%). In both the male and female groups, most researchers were at level 2, with 62.5% women and 47.2% men (p=0.018). All 211 female PQ scholars were distributed among 37 different institutions and published 34,969 papers in scientific journals, averaging 165.7 articles per researcher. In the last five years of the study period (from 2018 to 2022), 9,679 papers were published. Over their careers, the 211 researchers supervised 5,440 undergraduate research students, 4,144 master’s degree students, and 2,923 PhD candidates. There was a significant difference between the scholarship levels for the development of human resources in undergraduate research (p=0.040), master’s degree (p=0.027), and PhD. (p<0.001). Conclusion: There are still less women participating in CNPq medical research than men. However, we observed a substantial participation of women in all the assessed items, including technical and scientific production and the human resources training. Introduction visibility However general limited Objective (CNPq Method crosssectional cross sectional 54 (21 39% 39 (PQ 2022 Results n=330 n330 n 330 (n=330 61%. 61 61% . 61%) groups 2 625 62 5 62.5 472 47 47.2 p=0.018. p0018 p p=0.018 0 018 (p=0.018) 21 3 34969 34 969 34,96 journals 1657 165 7 165. researcher from 201 2022, , 2022) 9679 9 679 9,67 careers 5440 440 5,44 students 4144 4 144 4,14 masters master s 2923 923 2,92 candidates p=0.040, p0040 p=0.040 040 (p=0.040) p=0.027, p0027 p=0.027 027 (p=0.027) p<0.001. p0001 p<0.001 001 (p<0.001) Conclusion items training (2 202 n=33 n33 33 (n=33 6 62. 47. p001 p=0.01 01 (p=0.018 3496 96 34,9 16 20 967 67 9,6 544 44 5,4 414 14 4,1 292 92 2,9 p004 p=0.04 04 (p=0.040 p002 p=0.02 02 (p=0.027 p000 p<0.00 00 (p<0.001 ( n=3 n3 (n=3 p00 p=0.0 (p=0.01 349 34, 1 9, 5, 41 4, 29 (p=0.04 (p=0.02 p<0.0 (p<0.00 n= (n= p0 p=0. (p=0.0 p<0. (p<0.0 (n p=0 (p=0. p<0 (p<0. p= (p=0 p< (p<0 (p= (p< (p
6.
Impact of withholding early antibiotic therapy in nonseptic surgical patients with suspected nosocomial infection: a retrospective cohort analysis infection
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Bassi, Estevão
; Tomazini, Bruno Martins
; Carneiro, Bárbara Vieira
; Siqueira, Amanda Rodrigues de Oliveira
; Siqueira, Sara Rodrigues de Oliveira
; Guimarães, Thais
; Novo, Fernando da Costa Ferreira
; Utiyama, Edivaldo Massazo
; Pelosi, Paolo
; Malbouisson, Luiz Marcelo Sá
.
Abstract Background: Systemic inflammatory responses mimicking infectious complications are often present in surgical patients. Methods: The objective was to assess the association between withholding early antimicrobial therapy while investigating alternative diagnoses and worse outcomes in nonseptic patients with suspected nosocomial infection in a retrospective cohort of critically ill surgical patients. The initiation of antibiotic therapy within 24 h of the suspicion of infection was defined as the Early Empirical Antibiotic strategy (EEA) group and the initiation after 24 h of suspicion or not prescribed was defined as the Conservative Antibiotic strategy (CA) group. Primary outcome was composite: death, sepsis, or septic shock within 14 days. Main exclusion criteria were sepsis or an evident source of infection at inclusion. Results: Three hundred and forty patients were eligible for inclusion (74% trauma patients). Age, sex, reason for hospital admission, SAPS3 score, SOFA score, and use of vasopressors or mechanical ventilation were not different between the groups. Within 14 days of inclusion, 100% (130/130) of EEA patients received antibiotics compared to 57% (120/210) of CA patients. After adjusting for confounding variables, there was no association between primary outcome and the groups. In a post hoc subgroup analysis including only patients with a posteriori confirmed infection (by microbiological cultures), delay in initiation of adequate antimicrobial therapy was independently associated with the primary outcome (Odds Ratio = 1.19 per day of delay; 95% CI 1.05–1.37). Conclusions: Withholding early empiric antibiotic therapy was not associated with progression of organ dysfunction within 14 days in nonseptic surgical patients with suspected nosocomial infection without an obvious source. Background Methods 2 (EEA (CA composite death 1 Results 74% 74 (74 . patients) Age sex admission SAPS score groups 100 130/130 130130 130 (130/130 57 120/210 120210 120 210 (120/210 variables by cultures, cultures , cultures) Odds 119 19 1.1 95 1.05–1.37. 105137 1.05–1.37 05 37 1.05–1.37) Conclusions 7 (7 10 130/13 13013 13 (130/13 5 120/21 12021 12 21 (120/21 11 1. 9 10513 1.05–1.3 0 3 ( 130/1 1301 (130/1 120/2 1202 (120/2 1051 1.05–1. 130/ (130/ 120/ (120/ 105 1.05–1 (130 (120 1.05– (13 (12 1.05 (1 1.0
7.
Estatística Cardiovascular – Brasil 2023 202 20 2
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Oliveira, Gláucia Maria Moraes de
; Brant, Luisa Campos Caldeira
; Polanczyk, Carisi Anne
; Malta, Deborah Carvalho
; Biolo, Andreia
; Nascimento, Bruno Ramos
; Souza, Maria de Fatima Marinho de
; Lorenzo, Andrea Rocha De
; Fagundes Júnior, Antonio Aurélio de Paiva
; Schaan, Beatriz D.
; Silva, Christina Grüne de Souza e
; Castilho, Fábio Morato de
; Cesena, Fernando Henpin Yue
; Soares, Gabriel Porto
; Xavier Junior, Gesner Francisco
; Barreto Filho, Jose Augusto Soares
; Passaglia, Luiz Guilherme
; Pinto Filho, Marcelo Martins
; Machline-Carrion, M. Julia
; Bittencourt, Marcio Sommer
; Pontes Neto, Octavio M.
; Villela, Paolo Blanco
; Teixeira, Renato Azeredo
; Stein, Ricardo
; Sampaio, Roney Orismar
; Gaziano, Thomaz A.
; Perel, Pablo
; Roth, Gregory A.
; Ribeiro, Antonio Luiz Pinho
.
8.
Historical shipwrecks in international waters contributes to coastal pollution
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Bezerra, Luis Ernesto Arruda
; Teixeira, Carlos Eduardo Peres
; Sampaio, Claudio L. S.
; Cavalcante, Rivelino Martins
; Soares, Marcelo de Oliveira
.
Abstract In 2021, rubber bales appeared along the Brazilian coastline, causing environmental impacts. In this research paper, we identified a Second World War shipwreck that was associated with this event. Numerical simulations provided robust evidence to support the hypothesis that the origin of the 2021 bales was the MV Weserland . Moreover, it was sunk to a depth of approximately 5,000 m with a cargo containing rubber, tin, and wolframite. Tin is currently considered a strategic metal, with prices rising from USD 13,375/t in March 2020 to USD 34,462/t in May 2021. We provided evidence that the departure of rubber bales from the wreck and the increase in the price of its metal cargo were temporally associated; this reinforced the hypothesis of deep-sea unauthorized salvage in international waters (areas beyond national jurisdiction). The novel results demonstrate that historical shipwrecks are ticking time-bombs with risks of high and unmapped pollution in oceans worldwide. coastline impacts paper event 202 Moreover 5000 5 000 5,00 tin wolframite 13375t t 13 375 34462t 34 462 deepsea deep sea areas jurisdiction. jurisdiction jurisdiction) timebombs time bombs worldwide 20 500 00 5,0 1 37 3 46 2 50 0 5, 4
9.
[SciELO Preprints] - Cardiovascular Statistics – Brazil 2023
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Oliveira, Gláucia Maria Moraes de
Brant, Luisa Campos Caldeira
Polanczyk, Carisi Anne
Malta, Deborah Carvalho
Biolo, Andreia
Nascimento, Bruno Ramos
Souza, Maria de Fatima Marinho de
Lorenzo, Andrea Rocha De
Fagundes Júnior, Antonio Aurélio de Paiva
Schaan, Beatriz D.
Silva, Christina Grüne de Souza e
Castilho, Fábio Morato de
Cesena, Fernando Henpin Yue
Soares, Gabriel Porto
Xavier Junior, Gesner Francisco
Barreto-Filho, Jose Augusto Soares
Passaglia, Luiz Guilherme
Pinto-Filho, Marcelo Martins
Machline-Carrion, M. Julia
Bittencourt, Marcio Sommer
Pontes Neto, Octavio M.
Villela, Paolo Blanco
Teixeira, Renato Azeredo
Stein, Ricardo
Sampaio, Roney Orismar
Gaziano, Thomaz A.
Perel, Pablo
Roth, Gregory A.
Ribeiro, Antonio Luiz Pinho
The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil. The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke. Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG).
A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil. Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG).
10.
Biochemical responses to chilling injury in sweet potato after cold storage
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Tello, Jean Paulo de Jesus
; Araujo, Fernanda Ferreira de
; Araújo, Nícolas Oliveira de
; Krause, Marcelo Rodrigo
; Véras, Mário Leno Martins
; Santos, Mirelle Nayana de Sousa
; Finger, Fernando Luiz
.
ABSTRACT. This study examined biochemical changes associated with chilling injury (CI) in sweet potato roots stored at low temperatures and reconditioned at ambient temperature. Sweet potato cultivars BRS Amélia and BRS Rubissol were stored at 6 or 13°C for 4 days at ambient temperature (“ambient reconditioning”: 21 ± 2°C). CI on the outer surface of the roots occurred earlier in BRS Amélia than in BRS Rubissol. The CI index on the inner surface of the BRS Amélia was higher when it was stored at 6°C for 40 + 4 days. BRS Amélia showed higher proline content and electrolyte leakage when stored at 6°C. Ascorbate peroxidase was induced by storage at 6°C for 30 + 4 days in BRS Amélia and from 40 + 4 days in BRS Rubissol. The malondialdehyde and phenolic compounds of BRS Rubissol increased during storage at 6°C. CI in both cultivars was associated with increased peroxidase and polyphenol oxidase activities. Storage of sweet potato cultivars at 6°C for 50 + 4 days caused severe damage to the roots. Cultivars BRS Amélia and BRS Rubissol showed similar symptoms of CI and can be characterized as being sensitive to low temperatures. ABSTRACT (CI 13C C 13 reconditioning reconditioning” 2 2°C. 2C 2°C . 2°C) 6C 3 activities 5 1
11.
Distribution of nutrients and chlorophyll across an equatorial reef region: Insights on coastal gradients region
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Barroso, Hortência de Sousa
; Lima, Isabelle de Oliveira
; Bezerra, Antonia Diana Alves
; Garcia, Tatiane Martins
; Tavares, Tallita Cruz Lopes
; Alves, Ravena Santiago
; Souza Junior, Edmilson Ferreira de
; Teixeira, Carlos Eduardo Peres
; Viana, Michael Barbosa
; Soares, Marcelo O.
.
Abstract We evaluate how the concentrations of inorganic nutrients and chlorophyll a vary in a heterogeneous area (Equatorial SW Atlantic), covering a gradient from stations closer to the coast to others more distant associated or not with turbid-zone reefs. Vertical temperature (27.9 ± 0.10 °C; mean ± standard deviation) and salinity (36.2 ± 0.14) profles showed that the water column is well mixed (0-30 m depth). The oligotrophic condition was marked by low concentrations of phosphate (0.30 ± 0.22 µM) and dissolved inorganic nitrogen (0.64 ± 0.74 µM). Moreover, dissolved reactive silicon (DSi) was low in most samples (< 2.0 µM), but higher (>10 µM) in nearshore stations, probably related to continental runoff and/or resuspension of the bottom sediments. The pelagic phytoplankton biomass indicated that chlorophyll a (0.25 ± 0.08 µg L-1) was low, positively correlated with light and negatively correlated with nutrients, indicating possible phytoplankton uptake. Chlorophyll a concentrations were lower in stations closer to the coast and higher in some stations near the reefs, indicating that the latter could be more prone to phytoplankton development and depletion of nutrients, especially DSi. Therefore, although oligotrophy is present along this coast, we found some unexpected heterogeneity of nutrient and chlorophyll a distributions, which were probably infuenced by benthic-pelagic coupling due to the presence of extensive reefs, sponge gardens (18-30 m depth), and the proximity to the coast. These results highlight the importance of understanding the heterogeneity of ocean productivity, especially in lesser known low-latitude areas, which showed distinct nutrient and chlorophyll a levels related to the occurrence of tropical reefs that are capable of supporting important fsh stocks and unique biological communities. Equatorial Atlantic, Atlantic , Atlantic) turbidzone turbid zone 27.9 279 27 9 (27. 010 0 10 0.1 °C C deviation 36.2 362 36 2 (36. 0.14 014 14 030 30 (0-3 depth. depth . depth) 0.30 (0.3 022 22 0.2 µM 0.64 064 64 (0.6 074 74 0.7 µM. Moreover DSi (DSi < ( 20 2. µM, >10 (>1 andor sediments 0.25 025 25 (0.2 008 08 0.0 L1 L 1 L-1 uptake Therefore distributions benthicpelagic benthic 1830 18 (18-3 depth, productivity lowlatitude latitude areas communities 27. (27 01 0. 36. 3 (36 03 (0- 0.3 (0. 02 0.6 06 6 07 7 >1 (> 00 L- 183 (18- (2 (3 (0 > (18 (1
12.
Affordances in the home environment of children at risk of developmental delay
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Santos, Janaína Araujo Teixeira
; Lima, Amanda Larissa Oliveira
; Silva, Letícia Dias dos Santos
; Braga, Fernanda da Costa
; Alécio, Marcelo Machado
; Chagas, Paula Silva de Carvalho
; Defilipo, Érica Cesário
; Toledo, Aline Martins de
; Gutierres Filho, Paulo José Barbosa
; Ayupe, Kênnea Martins Almeida
.
RESUMO Objetivo Verificar a adequação das oportunidades de ação no ambiente doméstico de crianças em risco de atraso no desenvolvimento e identificar fatores associados à sua frequência. Métodos Este estudo transversal incluiu 97 famílias que responderam ao Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) para 3–18 meses (n=63) ou o Self Report (AHEMD-SR) para 18–42 meses (n=34). O teste de Mann-Whitney foi utilizado para identificar as diferenças entre as frequências de oportunidades de ação entre os grupos. A regressão linear múltipla foi utilizada para verificar a associação entre o sexo da criança, o estado civil, a escolaridade e nível socioeconômico da mãe, as idades da criança e da mãe, o número de residentes da casa, a renda per capita e os escores do AHEMD (α=0,05). Resultados A frequência das oportunidades de ação dos domicílios no AHEMD-IS variou de menos do que adequado a excelente; enquanto, no AHEMD-SR, a maior predominância foi de média frequência. A oferta de estímulos no AHEMD-IS foi significativamente maior. O maior nível socioeconômico e o número de moradores da casa foram associados a maiores oportunidades de ação. Conclusões Quanto maior o nível socioeconômico e o número de moradores, maiores são as oportunidades de ação nos domicílios das crianças em risco de atraso. É necessário oferecer às famílias algumas alternativas para tornar os seus ambientes domésticos mais ricos em oportunidades de ação que favoreçam o desenvolvimento infantil. 9 AHEMDIS IS (AHEMD-IS 318 3 18 3–1 n=63 n63 n 63 (n=63 AHEMDSR SR (AHEMD-SR 1842 42 18–4 n=34. n34 n=34 . 34 (n=34) MannWhitney Mann Whitney grupos civil mãe α=0,05. α005 α α=0,05 0 05 (α=0,05) excelente enquanto AHEMDSR, SR, AHEMD-SR infantil 31 1 3– n=6 n6 6 (n=6 184 4 18– n3 n=3 (n=34 α00 α=0,0 (α=0,05 n= (n= (n=3 α0 α=0, (α=0,0 (n α=0 (α=0, α= (α=0 (α= (α
Abstract Objective: The aim of this study was to verify the adequacy of affordances in the home environment of children at risk of developmental delay and to identify factors associated with their frequency. Methods: The cross-sectional study included 97 families who responded to the Affordances in the Home Environment for Motor Development — Infant Scale (AHEMD-IS) for 3–18 months (n=63), or AHEMD – Self-Report (AHEMD-SR) for 18–42 months (n=34). The Mann-Whitney U test was used to identify the differences between the frequencies of affordances between the groups. Multiple linear regression was used to verify the association between the child’s sex, mother’s marital status, education, socioeconomic level, child and mother’s ages, house residents’ number, per capita income, and AHEMD scores (α=0.05). Results: The home affordances’ frequency in the AHEMD-IS ranged from less than adequate to excellent, while in the AHEMD-SR, the highest predominance was medium. The offer of stimuli in the AHEMD-IS was significantly higher. Higher socioeconomic level and house residents’ number were associated with greater affordances. Conclusions: The higher the socioeconomic level and house residents’ number, the greater the affordances in the homes of children at risk of delay. It is necessary to provide families with some alternatives to make their home environments richer in affordances that favor child development. Objective Methods crosssectional cross sectional 9 AHEMDIS IS (AHEMD-IS 318 3 18 3–1 n=63, n63 n n=63 , 63 (n=63) SelfReport Self Report AHEMDSR SR (AHEMD-SR 1842 42 18–4 n=34. n34 n=34 . 34 (n=34) MannWhitney Mann Whitney groups childs s sex mothers mother status education ages residents income α=0.05. α005 α α=0.05 0 05 (α=0.05) Results excellent AHEMDSR, SR, AHEMD-SR medium Conclusions development 31 1 3– n6 n=6 6 (n=63 184 4 18– n3 n=3 (n=34 α00 α=0.0 (α=0.05 n= (n=6 (n=3 α0 α=0. (α=0.0 (n= α=0 (α=0. (n α= (α=0 (α= (α
13.
Relationship of residual feed intake with semen parameters and testicular ultrasound of Nellore bulls
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Borges, Marcelo Sant’Ana
; Silva, Marina de Oliveira
; Fernandes, Luana Gomes
; Rodrigues, Naiara Nantes
; Rossi, Guilherme Fazan
; Freitas-Dell’Aqua, Camila de Paula
; Bonilha, Sarah Figueiredo Martins
; Mercadante, Maria Eugênia Zerlotti
; Monteiro, Fabio Morato
.
ABSTRACT The objective of this study was to evaluate characteristics of the testicular parenchyma and vascular parameters of the pampiniform plexus obtained by ultrasound, semen quality parameters, and sperm freezability in Nellore bulls classified based on residual feed intake (RFI). Twenty-seven bulls (21.82±0.88 months of age) evaluated for feed efficiency were sampled for the study, including 15 with low RFI (−0.592±0.09 kg dry matter/day) and 12 with high RFI (0.792±0.10 kg dry matter/day). In ultrasound and Doppler assessment, the most efficient animals (low RFI) showed higher pulsatility and resistive indexes, as well as a tendency towards greater heterogeneity of the testicular parenchyma (0.625±0.032 vs. 0.508±0.032, 1.012±0.072 vs. 0.802±0.072, and 12.9±0.96 vs. 10.2±0.96, respectively, for low vs. high RFI). However, these animals tended to have lower peak diastolic velocity (5.19±0.50 for low RFI vs. 6.54±0.50 for high RFI). Analysis of fresh semen showed a lower percentage of minor defects in low RFI animals (2.67±1.19%) compared with high RFI animals (8.10±1.19%), without differences in the other parameters in fresh or thawed semen and after thermoresistance testing. Evaluation of flow cytometry parameters showed a higher quality of mitochondrial respiration in semen samples of low RFI animals (22.04±2.50%) compared with high RFI animals (12.29±2.71%). Therefore, although RFI exerts an effect on the Doppler parameters of the pampiniform plexus, it is not sufficient to affect the quality of fresh or thawed semen. RFI. . (RFI) Twentyseven Twenty seven 21.82±0.88 2182088 21 82 0 88 (21.82±0.8 age 1 −0.592±0.09 0592009 592 09 (−0.592±0.0 matter/day matterday matter day 0.792±0.10 0792010 792 10 (0.792±0.1 matter/day. assessment indexes 0.625±0.032 06250032 625 032 (0.625±0.03 vs 05080032 508 0.508±0.032 10120072 012 072 1.012±0.07 08020072 802 0.802±0.072 129096 9 96 12.9±0.9 102096 2 10.2±0.96 respectively However 5.19±0.50 519050 5 19 50 (5.19±0.5 654050 6 54 6.54±0.5 2.67±1.19% 267119 67 (2.67±1.19% 8.10±1.19%, 810119 8.10±1.19% , 8 (8.10±1.19%) testing 22.04±2.50% 2204250 22 04 (22.04±2.50% 12.29±2.71%. 1229271 12.29±2.71% 29 71 (12.29±2.71%) Therefore (RFI 21.82±0.8 218208 (21.82±0. −0.592±0.0 059200 59 (−0.592±0. 0.792±0.1 079201 79 (0.792±0. 0.625±0.03 0625003 62 03 (0.625±0.0 0508003 0.508±0.03 1012007 01 07 1.012±0.0 0802007 80 0.802±0.07 12909 12.9±0. 10209 10.2±0.9 5.19±0.5 51905 (5.19±0. 65405 6.54±0. 2.67±1.19 26711 (2.67±1.19 81011 8.10±1.19 (8.10±1.19% 22.04±2.50 220425 (22.04±2.50 122927 12.29±2.71 7 (12.29±2.71% 21.82±0. 21820 (21.82±0 −0.592±0. 05920 (−0.592±0 0.792±0. 07920 (0.792±0 0.625±0.0 062500 (0.625±0. 050800 0.508±0.0 101200 1.012±0. 080200 0.802±0.0 1290 12.9±0 1020 10.2±0. 5.19±0. 5190 (5.19±0 6540 6.54±0 2.67±1.1 2671 (2.67±1.1 8101 8.10±1.1 (8.10±1.19 22.04±2.5 22042 (22.04±2.5 12292 12.29±2.7 (12.29±2.71 21.82±0 2182 (21.82± −0.592±0 0592 (−0.592± 0.792±0 0792 (0.792± 0.625±0. 06250 (0.625±0 05080 0.508±0. 10120 1.012±0 08020 0.802±0. 129 12.9± 102 10.2±0 5.19±0 519 (5.19± 654 6.54± 2.67±1. 267 (2.67±1. 810 8.10±1. (8.10±1.1 22.04±2. 2204 (22.04±2. 1229 12.29±2. (12.29±2.7 21.82± 218 (21.82 −0.592± 059 (−0.592 0.792± 079 (0.792 0.625±0 0625 (0.625± 0508 0.508±0 1012 1.012± 0802 0.802±0 12.9 10.2± 5.19± 51 (5.19 65 6.54 2.67±1 26 (2.67±1 81 8.10±1 (8.10±1. 22.04±2 220 (22.04±2 122 12.29±2 (12.29±2. 21.82 (21.8 −0.592 05 (−0.59 0.792 (0.79 0.625± 062 (0.625 050 0.508± 101 1.012 080 0.802± 12. 10.2 5.19 (5.1 6.5 2.67± (2.67± 8.10± (8.10±1 22.04± (22.04± 12.29± (12.29±2 21.8 (21. −0.59 (−0.5 0.79 (0.7 0.625 06 (0.62 0.508 1.01 08 0.802 10. 5.1 (5. 6. 2.67 (2.67 8.10 (8.10± 22.04 (22.04 12.29 (12.29± 21. (21 −0.5 (−0. 0.7 (0. 0.62 (0.6 0.50 1.0 0.80 5. (5 2.6 (2.6 8.1 (8.10 22.0 (22.0 12.2 (12.29 (2 −0. (−0 0. (0 0.6 0.5 1. 0.8 ( 2. (2. 8. (8.1 22. (22. (12.2 −0 (− (8. (22 (12. − (8 (12 (1
14.
Panorama das Intervenções Coronárias Percutâneas em Oclusões Totais Crônicas em Centros Participantes do LATAM CTO Registry no Brasil
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Silva, Antonio Carlos Botelho da
; Paula, João Eduardo Tinoco de
; Campos, Carlos M.
; Ribeiro, Marcelo Harada
; Martins Filho, Evandro
; Oliveira, Marcos Danillo Peixoto
; Côrtes, Leandro Assumpção
; Abelin, Aníbal Pereira
; Zukowski, Cleverson Neves
; Martinelli, Gustavo Cervino
; Brito, Fábio Sândoli de
; Muniz, Antônio José
; Cantarelli, Marcelo José de Carvalho
; Andrade, Pedro Beraldo de
; Medeiros, César Rocha
; Falcão, Breno de Alencar Araripe
; Fuchs, Felipe Costa
; Silva, Leonardo Sinnott
; Fattah, Tammuz
; Degrazia, Ramiro Caldas
; Mangione, José Armando
; Bezerra, Cristiano Guedes
; Baradel, Sandra
; Silveira, João Brum
; Ybarra, Luiz Fernando
; Weillenmann, Daniel
; Gottschall, Carlos
; Lemke, Viviana
; Silva, Franciele Rosa da
; Schmidt, Marcia Moura
; Belli, Karlyse Claudino
; Oliveira, Pedro Piccaro de
; Quadros, Alexandre Schaan de
.
Resumo Fundamento Tem sido observado um grande avanço nas técnicas e nos dispositivos para a realização de intervenções coronárias percutâneas (ICP) em oclusões totais coronarianas crônicas (OTC), mas existem poucos dados da prática do mundo real em países em desenvolvimento. Objetivos Relatar as características clínicas e angiográficas, os aspectos dos procedimentos e os resultados clínicos da ICP de OTC em centros dedicados a esse procedimento no Brasil. Métodos Os pacientes incluídos foram submetidos à ICP de OTC em centros participantes do LATAM CTO Registry, um registro multicêntrico latino-americano dedicado à coleta prospectiva desses dados. Os critérios de inclusão foram procedimentos realizados no Brasil, idade acima de 18 anos e presença de OTC com tentativa de ICP. A definição de OTC foi lesão de 100% em uma artéria coronária epicárdica, conhecida ou estimada como tendo pelo menos 3 meses de evolução. Resultados Foram incluídos dados de 1.196 ICPs de OTC. Os procedimentos foram realizados principalmente para controle da angina (85%) e/ou tratamento de uma grande área isquêmica (24%). A taxa de sucesso técnico foi de 84% e foi alcançada com técnicas de fios anterógrados em 81%, dissecção/reentrada anterógrada em 9% e retrógrada em 10% dos procedimentos. Os eventos cardiovasculares adversos intra-hospitalares ocorreram em 2,3% dos casos, sendo a mortalidade de 0,75%. Conclusões As OTC podem ser tratadas no Brasil por intervenção coronária percutânea de forma efetiva e com baixas taxas de complicações. O desenvolvimento científico e tecnológico observado nessa área na última década reflete-se na prática clínica de centros brasileiros dedicados a essa técnica. (ICP OTC, , (OTC) angiográficas Registry latinoamericano latino americano 1 100 epicárdica evolução 1196 196 1.19 85% 85 (85% eou 24%. 24 24% . (24%) 84 81 81% dissecçãoreentrada dissecção reentrada 9 10 intrahospitalares intra hospitalares 23 2 2,3 casos 075 0 75 0,75% complicações refletese reflete se técnica (OTC 119 19 1.1 8 (85 (24% 2, 07 7 0,75 11 1. (8 (24 0,7 ( (2 0,
Abstract Background Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries. Objectives To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil. Methods Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months. Results Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%. Conclusions CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centers. (PCIs CTOs, , (CTOs) realworld real world countries characteristics aspects Registry 1 over attempt 100 artery months 119 included 85% 85 (85% andor moderatesevere moderate severe 24%. 24 24% . (24%) 84 84% 81 reentry re entry 9 9% 10 10% Inhospital In hospital 23 2 2.3 cases 075 0 75 0.75% rates (CTOs 11 8 (85 (24% 2. 07 7 0.75 (8 (24 0.7 ( (2 0.
15.
Classification of lentil seed vigor based on seedling image analysis techniques and interactive machine learning
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Limão, Marcelo Augusto Rocha
; Dias, Denise Cunha Fernandes dos Santos
; Araújo, Joyce de Oliveira
; Soares, Júlia Martins
; Nascimento, Warley Marcos
; Silva, Laércio Junio da
.
Resumo: A busca por técnicas que possibilitem avaliar o vigor de sementes de forma rápida e assertiva como o Sistema de Análise de Plântulas (SAPL®) e o ILASTIK® podem ser alternativas promissoras para a análise de imagem de plântulas. O objetivo do trabalho foi realizar a classificação do vigor de sementes de lentilha utilizando técnicas de análise de imagem de plântulas e aprendizagem interativa de máquina. Sementes de sete lotes foram caracterizadas quanto ao potencial fisiológico pelos testes de germinação e vigor. Para a análise computadorizada de plântulas, as sementes foram submetidas ao teste de crescimento de plântulas a 20 °C por três, quatro, cinco e dez dias e, em seguida, fotografadas utilizando uma câmera digital. As imagens foram processadas pelo software SAPL®, obtendo-se valores de comprimento total, da raiz, parte aérea e índices de vigor, crescimento e uniformidade. Pelo ILASTIK®, foram obtidos dados de porcentagem de plântulas vigorosas, não vigorosas e sementes mortas. O comprimento total das plântulas, raiz, parte aérea e os índices de vigor determinados aos 4 dias de germinação pelo SAPL® permitem classificar os lotes quanto ao vigor. Os dados obtidos pelo ILASTIK®, aos 4 dias de germinação, utilizados nos estudos de aprendizagem de máquina, permitem o desenvolvimento de modelos com alta precisão para avaliação do vigor das sementes. Resumo SAPL (SAPL® ILASTIK máquina 2 C três quatro seguida digital obtendose obtendo se raiz uniformidade mortas (SAPL
Abstract: The search for techniques that allow for the rapid and accurate assessment of seed vigor, such as the Seedling Analysis System (SAPL®) and ILASTIK®, can be promising alternatives for seedling image analysis. The objective of this work was to classify the vigor of lentil seeds using seedling image analysis techniques and interactive machine learning. Seeds from seven lots were characterized for physiological potential through germination and vigor tests. For computerized seedling analysis, the seeds were subjected to seedling growth tests at 20 °C for three, four, five, and ten days, and then photographed using a digital camera. The images were processed using SAPL® software, yielding values for total length, root length, shoot length, and vigor, growth, and uniformity indices. ILASTIK® provided data on the percentage of vigorous seedlings, non-vigorous seedlings, and dead seeds. The total length of seedlings, root length, shoot length, and vigor indices determined at 4 days of germination by SAPL® allowed for the classification of lots in terms of vigor. Data obtained by ILASTIK® at 4 days of germination, used in machine learning studies, enable the development of models with high accuracy for seed vigor assessment. Abstract SAPL (SAPL® ILASTIK 2 C three four five camera software seedlings nonvigorous non studies (SAPL
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