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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

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Publication date: 2024-04-08

Abstract: Pt Es En

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.

https://doi.org/10.1590/SciELOPreprints.8394

Agronomic characteristics and postharvest quality of strawberry in a semi-hydroponic cultivation system semihydroponic semi hydroponic
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Silva, Lidiane Rodrigues da

; Campos, Andreza Aparecida Alves

; Moreira, Leandra Cardoso

; Barral, Dalyla Macedo

; Andrade, Gabriel Faria Parreiras de

; Guimarães, Amanda Gonçalves

; Silva, Isabel Moreira da

; Tannure, Michelle Pires

; Pinto, Nísia Andrade Villela Dessimoni

; Costa, Márcia Regina da

; Zanuncio, José Cola

Pesquisa Agropecuária Brasileira

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2024, Volume 59 elocation e03384

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

Resumo O objetivo deste trabalho foi avaliar a influência do uso de sistema semi-hidropônico sobre as variáveis agronômicas e de pós-colheita de cultivares de morangueiro. O experimento foi conduzido em delineamento de blocos ao acaso, com as cultivares Aromas, Camarosa, Festival, Merced, Oso Grande e San Andreas, com oito plantas por parcela e cinco repetições. Foram avaliadas variáveis agronômicas e de pós-colheita. A cultivar San Andreas apresentou os maiores valores para as variáveis agronômicas número de frutos comerciais e produção total e comercial por planta, com as maiores produtividades em outubro, novembro e dezembro. As variáveis de pós-colheita umidade, firmeza, pH, acidez titulável e açúcares redutores não diferiram entre as cultivares. Em sistema semi-hidropônico, a cultivar San Andreas apresenta os melhores resultados para as variáveis agronômicas de produção de frutos, com as maiores produtividades em outubro e novembro. semihidropônico semi hidropônico póscolheita pós colheita morangueiro acaso Aromas Camarosa Festival Merced repetições póscolheita. colheita. planta dezembro umidade firmeza pH semihidropônico, hidropônico,

Abstract The objective of this work was to evaluate the influence of using a semi-hydroponic system on the agronomic and postharvest variables of strawberry cultivars. The experiment was conducted in a randomized complete block design, with cultivars Aromas, Camarosa, Festival, Merced, Oso Grande, and San Andreas, with eight plants per plot and five replicates. Agronomic and postharvest variables were evaluated. Cultivar San Andreas showed the highest values for the agronomic variables number of commercial fruits and total and commercial yield per plant, with the highest yield in October, November, and December. The postharvest variables moisture, firmness, pH, titratable acidity, and reducing sugars did not differ between cultivars. In a semi-hydroponic system, the San Andreas cultivar presents the best results for the agronomic variables related to fruit yield, with the highest yield in October and November. semihydroponic semi hydroponic design Aromas Camarosa Festival Merced Grande replicates evaluated plant November December moisture firmness pH acidity

https://doi.org/10.1590/s1678-3921.pab2024.v59.03384

Incidence of Intestinal Constipation During the COVID-19 Pandemic Period in Medical Students from a Private Institution in São Paulo, SP COVID19 COVID 19 COVID-1 Paulo COVID1 1 COVID-
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Corrêa Neto, Isaac José Felippe

; Silva, Alisson de Lucena

; Tajiri, Renato Cardoso de Melo

; Theis, Cláudia

; Schelle, Gabriela

; Pinto, Rodrigo Ambar

; Nishiyama, Victor Keniti Gomes

; Robles, Laercio

Journal of Coloproctology (Rio de Janeiro)

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2023, Volume 43 N. 1 Pages 30 - 35

Abstract: En | Text: En | PDF: En

Abstract Introduction Chronic intestinal constipation (CIC) presents an incidence of 2.6 to 30.7% in the overall population and due to the social reality imposed by the coronavirus pandemic, some behavior changes in the Brazilian population occurred that might or not be associated with alterations of CIC prevalence. Objective To assess CIC incidence in medical students before and during the COVID-19 pandemic in Brazil in a private higher educational institution in the city of São Paulo, state of São Paulo. Methods Clinic data were collected through Google Forms software from the same students seeking to analyze the variables before (year of 2019) and during the coronavirus pandemic. The data were: age, sex, body mass index, constipation referred in a subjective way and confirmed through the ROME III criteria, feces consistency and anxiety and/or depression during the pandemic. Results A total of 126 medical students from a private higher education institution from São Paulo, SP were included. The average age was 22.9 years old, 70.6% were female and the average BMI was 23.3 kg/m2. Regarding the ROME III criteria, 32.5% presented > 2 in 2019 and 42.1% during the pandemic. Concerning the feces consistency, 31.75 and 35.71% presented dry Bristol 1 feces or in both periods, respectively. Conclusion It was observed an increase in the prevalence of chronic intestinal constipation in medical students from a private higher education institution from São Paulo, state of São Paulo, during the COVID-19 pandemic, as well as dryness in the feces. (CIC 26 6 2. 307 30 7 30.7 COVID19 COVID 19 COVID-1 Paulo year sex index criteria andor 12 included 229 22 9 22. old 706 70 70.6 233 23 3 23. kgm2 kgm kg m2 m kg/m2 325 32 5 32.5 201 421 42 42.1 3175 31 75 31.7 3571 35 71 35.71 periods respectively 30. COVID1 COVID- 70. kg/m 32. 20 4 42. 317 31. 357 35.7 35.

https://doi.org/10.1055/s-0043-1764193

Avaliação da pentoxifilina e do sulfato ferroso no tratamento da úlcera varicosa dos membros inferiores
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Lemos, Priscilla Cardoso

; Lins, Esdras Marques

; Pinto, Flavia Cristina Morone

; Aguiar, José Lamartine de Andrade

; Appolonio, Fernanda

; Breno, Francisco

Jornal Vascular Brasileiro

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2021, Volume 20 elocation e2020167

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

Resumo Contexto A úlcera varicosa (UV) é o estágio mais avançado da doença venosa crônica (DVC) dos membros inferiores (MMII), frequentemente associada a episódios de hemorragia que podem provocar anemia crônica (AC) e retardar a sua cicatrização. Não há, na literatura, trabalhos que avaliem a prevalência da AC nos portadores de UV dos MMII, e poucos trabalhos analisam o uso da pentoxifilina no tratamento das UV dos MMII. Objetivos Avaliar a prevalência da AC nos pacientes portadores de UV de MMII e a resposta terapêutica ao sulfato ferroso (SF) e a associação da pentoxifilina com SF no tratamento adjuvante das UV dos MMII. Métodos Foram avaliados 67 pacientes portadores de UV de MMII atendidos no ambulatório de Cirurgia Vascular do Hospital das Clínicas, Recife, PE. Após as avaliações clínica e laboratorial iniciais, os pacientes diagnosticados com AC foram randomizados em dois grupos: o grupo controle, que recebeu SF (900 mg/dia via oral), e o grupo de estudo, tratado com SF (900 mg/dia via oral) e pentoxifilina (1.200 mg/dia). Todos foram reavaliados após 90 dias. Resultados Entre os pacientes avaliados, 27 (40%) apresentavam AC. Após o tratamento, foram observados aumento dos níveis de hemoglobina e de hematócrito e melhora das taxas da cinética do ferro, assim como a diminuição da profundidade e da área das UV em ambos os grupos, sem diferença estatística. Conclusões Foi encontrada alta prevalência de anemia na população estudada. A associação do SF com a pentoxifilina não se mostrou mais eficaz do que o emprego isolado do SF no tratamento adjuvante da UV dos MMII.

Abstract Background Venous ulcers (VU) are the most advanced stage of chronic venous disease (CVD) of the lower limbs. They are frequently associated with episodes of hemorrhage that can provoke chronic anemia (CA), delaying healing. There are no studies in the literature analyzing the prevalence of CA among patients with VU of the lower limbs and few studies have analyzed use of pentoxifylline to treat VU of the lower limbs. Objectives To evaluate the prevalence of CA in patients with lower limb VU and responses to treatment with ferrous sulfate (SF) compared with a combination of SF plus pentoxifylline as adjuvant treatment for VU of the lower limbs. Methods A total of 67 patients with lower limb VU were recruited from a Lymphedema and Angiodysplasia Clinic at the Hospital das Clínicas, Recife, PE, Brazil. After initial clinical and laboratory assessments, patients diagnosed with CA were randomized into one of two groups: a control group, given SF (900 mg/day oral route), or a study group, treated with SF (900 mg/day oral route) and pentoxifylline (1,200 mg/day). All were reassessed after 90 days. Results Twenty-seven patients (40%) had CA. After treatment, increases were observed in hemoglobin and hematocrit levels, iron kinetics had improved, and both depth and area of VU had reduced in both groups, without statistically significant differences. Conclusions A high prevalence of anemia was detected in the study population. The combination of SF and pentoxifylline was not more effective than SF alone for adjuvant treatment of VU of the lower limbs.

https://doi.org/10.1590/1677-5449.200167 387 downloads

The omission of meals is associated with excess weight in adolescents
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Brito, Larissa Cardoso de

; Barros, Natassia Ellen Rodrigues Paiva

; Braga, Ribanna Aparecida Marques

; Silva, Francisco Ranilson Alves

; Pinto, Francisco José Maia

; Arruda, Soraia Pinheiro Machado

; Maia, Carla Soraya Costa

Revista chilena de nutrición

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dec 2020, Volume 47 N. 6 Pages 960 - 964

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

ABSTRACT The aim of this study was to investigate the association between skipping meals and excess weight in adolescents. This study used a secondary database based on cross-sectional research. Weight and height were measured for the classification of nutritional status and the omission of meals was determined from the 24-hour food record. Statistical analyses were performed on a sample stratified by age from 10 to 13 years and 14 to 19 years. There was a high prevalence of excess weight (overweight and obesity) in the sample and a high frequency of meal omission among adolescents. The omission of lunch and dinner among adolescents between 14 and 19 years and those between 10 to 13 years, respectively, was directly associated with excess weight.

RESUMEN El objetivo de este estudio fue investigar la asociación entre omisión de comidas y condición de exceso de peso en adolescentes. Este es un estudio con datos secundarios de una investigación transversal. El peso y la altura se midieron para clasificar el estado nutricional y la omisión de las comidas se determinó a partir del registro de alimentos de 24 horas. Los análisis estadísticos se realizaron en una muestra estratificada por edad de 10 a 13 años y de 14 a 19 años. Hubo una alta prevalencia de exceso de peso en la muestra y una alta frecuencia de omisión de comidas entre los adolescentes. La omisión del almuerzo y la cena, en los rangos de 14 a 19 años y de 10 a 13 años, respectivamente, se asoció directamente con el exceso de peso.

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Professional practice of nurses and influences on moral sensitivity
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Moreira, Danielle de Araújo

; Ferraz, Cecília Maria Lima Cardoso

; Costa, Iluska Pinto da

; Amaral, Jéssica Martins

; Lima, Thaís Teixeira

; Brito, Maria José Menezes

Revista Gaúcha de Enfermagem

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2020, Volume 41 elocation e20190080

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

RESUMO Objetivo: Compreender a prática profissional do enfermeiro e suas influências para o desenvolvimento da sensibilidade moral. Métodos: Estudo qualitativo, descritivo, realizado entre novembro de 2015 e fevereiro de 2016, em unidades de internação da clínica médica, de dois hospitais de grande porte, localizados em Belo Horizonte, Minas Gerais. Participaram 14 enfermeiros. A coleta de dados ocorreu por meio de entrevistas, guiadas por roteiros semiestruturados. Os dados foram submetidos à análise de conteúdo. Resultados: Emergiram duas categorias: Prática profissional do enfermeiro: bens internos e externos e; Sensibilidade moral e a interface com a prática profissional de enfermeiros. O desenvolvimento da Sensibilidade moral dos enfermeiros, sofre influência de fatores relacionados à prática profissional, como as relações interpessoais, a educação ética e as atividades de gestão. Considerações finais: Na prática profissional, a Sensibilidade moral é parte integrante do processo de tomada de decisão ética nos serviços, sendo essencial para o cuidado de qualidade.

ABSTRACT Objective: To understand the professional practice of nurses and their influence on the development of moral sensibility. Methods: A qualitative and descriptive study, conducted between November 2015 and February 2016 in the hospitalization units of the medical clinic of two large hospitals located in Belo Horizonte, Minas Gerais. 14 nurses participated. Data collection was done through interviews, guided by semi-structured scripts. The data were submitted to content analysis. Results: Two categories emerged: Professional practice of the nurse: internal and external goods and Moral sensitivity and the interface with the professional practice of nurses. The development of the moral sensitivity of nurses is influenced by factors related to professional practice, such as interpersonal relations, ethical education and management activities. Final considerations: In the professional practice, moral sensibility is an integral part of the ethical decision-making process in services, being essential for quality care.

RESUMEN Objetivo: Comprender la práctica profesional de la enfermera y su influencia en el desarrollo de la Sensibilidad moral. Métodos: Estudio cualitativo y descriptivo realizado entre noviembre de 2015 y febrero de 2016 en unidades de internación de la clínica médica de dos hospitales de gran porte, ubicados en Belo Horizonte, Minas Gerais. Participaron 14 enfermeras. La recolección de datos se efectuó por medio de entrevistas, guiadas por guiones semiestructurados. Los datos se sometieron a análisis de contenido. Resultados: Surgieron dos categorías: Práctica profesional de la enfermera: bienes internos y externos y Sensibilidad moral y la interfaz con la práctica profesional de las enfermeras. El desarrollo de la sensibilidad moral de las enfermeras sufre la influencia de factores relacionados con la práctica profesional, como las relaciones interpersonales, la educación ética y las actividades de gestión. Consideraciones finales: En la práctica profesional, la Sensibilidad moral es parte integrante del proceso de toma de decisiones éticas en los servicios, siendo esencial para un cuidado de calidad.

https://doi.org/10.1590/1983-1447.2019.20190080 1478 downloads

Professional practice of nurses and influences on moral sensitivity
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Moreira, Danielle de Araújo

; Ferraz, Cecília Maria Lima Cardoso

; Costa, Iluska Pinto da

; Amaral, Jéssica Martins

; Lima, Thaís Teixeira

; Brito, Maria José Menezes

Revista Gaúcha de Enfermagem

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2020, Volume 41 elocation e20190080

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

https://doi.org/10.1590/1983-1447.2019.20190080 33 downloads

Teste do pezinho: condições materno-fetais que podem interferir no exame em recém-nascidos atendidos na unidade de terapia intensiva
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Rodrigues, Letícia Pinto

; Tanaka, Sarah Cristina Sato Vaz

; Haas, Vanderlei José

; Cunali, Valéria Cardoso Alves

; Marqui, Alessandra Bernadete Trovó de

Revista Brasileira de Terapia Intensiva

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jun 2019, Volume 31 N. 2 Pages 186 - 192

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

RESUMO Objetivo: Descrever as características do teste do pezinho dos neonatos atendidos na unidade de terapia intensiva de um hospital universitário, bem como verificar se existiam condições maternas e fetais que pudessem interferir no resultado desse exame. Métodos: Estudo retrospectivo longitudinal de abordagem quantitativa que avaliou 240 prontuários médicos. Os dados coletados foram submetidos à análise estatística descritiva. Resultados: Houve predomínio de gestantes com idades entre 20 a 34 anos, com Ensino Médio completo e que realizaram mais de seis consultas pré-natais. As intercorrências ou patologias maternas ocorreram em 60% das mães, e a maioria (67,5%) não apresentou nenhuma condição que pudesse interferir no resultado do teste do pezinho. A maioria dos neonatos era prematura e exibiu baixo peso ao nascimento. Cerca de 90% dos neonatos exibiram condições que poderiam influenciar no exame, principalmente prematuridade, nutrição parenteral e transfusão sanguínea. Dos 240 neonatos, 25% apresentaram resultado alterado no teste do pezinho, sobretudo para fibrose cística e hiperplasia adrenal congênita. Conclusão: Existem condições maternas e neonatais que podem interferir no teste do pezinho e, nesse sentido, sua investigação é imprescindível, visando direcionar ações que promovam a saúde materno-infantil e consolidem a triagem neonatal nessa população.

ABSTRACT Objective: To describe the characteristics of the heel prick test in newborns admitted to the intensive care unit of a university hospital as well as to determine whether maternal and fetal conditions could have affected the results of this test. Methods: Retrospective longitudinal study with a quantitative approach that evaluated 240 medical records. The data collected were analyzed by descriptive statistical analysis. Results: There was a predominance of pregnant women aged 20 to 34 years who had a complete secondary education and who had more than six prenatal care visits. Maternal complications or pathologies occurred in 60% of the mothers, and most (67.5%) did not present any condition that could have affected the heel prick test results. Most newborns were premature and exhibited low birth weight. Approximately 90% of newborns exhibited conditions that could have influenced the test, especially prematurity, parenteral nutrition and blood transfusion. Of the 240 newborns, 25% had abnormal heel prick test results, especially for cystic fibrosis and congenital adrenal hyperplasia. Conclusion: There are maternal and neonatal conditions that can affect heel prick test results, and therefore, their investigation is essential, aiming to guide measures that promote mother and child health and consolidate neonatal screening in this population.

https://doi.org/10.5935/0103-507x.20190030 8014 downloads

Evaluation of three recombinant proteins for the development of ELISA and immunochromatographic tests for visceral leishmaniasis serodiagnosis
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Santos, Anna Raquel Ribeiro dos

; Serufo, Ângela Vieira

; Figueiredo, Maria Marta

; Godoi, Lara Carvalho

; Vitório, Jéssica Gardone

; Marcelino, Andreza Pain

; Avelar, Daniel Moreira de

; Rodrigues, Fernandes Tenório Gomes

; Machado-Coelho, George Luiz Lins

; Medeiros, Fernanda Alvarenga Cardoso

; Jerônimo, Selma Maria Bezerra

; Oliveira, Edward José de

; Nascimento, Frederico Crepaldi

; Teixeira, Santuza Maria Ribeiro

; Gazzinelli, Ricardo Tostes

; Nagem, Ronaldo Alves Pinto

; Fernandes, Ana Paula

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e180405

Abstract: En | Text: En | PDF: En

BACKGROUND Visceral Leishmaniasis (VL) is an infectious disease that is a significant cause of death among infants aged under 1 year and the elderly in Brazil. Serodiagnosis is a mainstay of VL elimination programs; however, it has significant limitations due to low accuracy. OBJECTIVE This study aimed to evaluate three recombinant Leishmania infantum proteins (rFc, rC9, and rA2) selected from previous proteomics and genomics analyses to develop enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests (ICT) for the serodiagnosis of human VL (HVL) and canine VL (CVL). METHODS A total of 186 human (70 L. infantum-infected symptomatic, 20 other disease-infected, and 96 healthy) and 185 canine (82 L. infantum-infected symptomatic, 27 L. infantum-infected asymptomatic, and 76 healthy) sera samples were used for antibody detection. FINDINGS Of the three proteins, rA2 (91.5% sensitivity and 87% specificity) and rC9 (95.7% sensitivity and 87.5% specificity) displayed the best performance in ELISA-HVL and ELISA-CVL, respectively. ICT-rA2 also displayed the best performance for HVL diagnosis (92.3% sensitivity and 88.0% specificity) and had high concordance with immunofluorescence antibody tests (IFAT), ELISA-rK39, IT-LEISH®, and ELISAEXT. ICT-rFc, ICT-rC9, and ICT-rA2 had sensitivities of 88.6%, 86.5%, and 87.0%, respectively, with specificity values of 84.0%, 92.0%, and 100%, respectively for CVL diagnosis. MAIN CONCLUSIONS The three antigens selected by us are promising candidates for VL diagnosis regardless of the test format, although the antigen combinations and test parameters may warrant further optimisation.

https://doi.org/10.1590/0074-02760180405 1700 downloads

10.

Methotrexate use, not interleukin 33, is associated with lower carotid intima-media thickness in patients with rheumatoid arthritis
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Pinto, Maria Raquel Costa

; Kakehasi, Adriana Maria

; Souza, Adriano José

; Tavares Jr, Wilson Campos

; Rocha, Monaliza Angela

; Trant, Cyntia Gabriele Michel Cardoso

; Andrade, Marcus Vinicius

Advances in Rheumatology

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2019, Volume 59 elocation 15

Abstract: En | Text: En | PDF: En

Abstract Background: Rheumatoid arthritis is a risk factor for early mortality due to cardiovascular disease. Interleukin-33 appears to protect against the development of atherosclerosis. The purpose of this study was to investigate the relationship between serum levels of interleukin-33 and its soluble receptor with the presence of subclinical carotid atherosclerosis in rheumatoid arthritis patients. Methods: Rheumatoid arthritis patients without atherosclerotic disease were subjected to clinical and laboratory assessments, including carotid ultrasound. Interleukin-33 and its soluble receptor serum levels were measured by ELISA. Results: 102 patients were included. The prevalence of carotid plaques was 23.5% and the median intima-media thickness was 0.7 mm. The median interleukin-33 and its soluble receptor concentration was 69.1 and 469.8 pg/ml. No association was found between serum interleukin-33 or its soluble receptor and intima-media thickness or plaque occurrence. Each 0.1 mm increase of intima-media thickness raised the odds of plaque occurrence by 5.3-fold, and each additional year of rheumatoid arthritis duration increased the odds of plaque occurrence by 6%. Each additional year in patients age and each one-point increase in the Framingham Risk Score were associated with a 0.004 mm and 0.012 mm increase in intima-media thickness. Methotrexate use was associated with a 0.07 mm reduction in intima-media thickness. Conclusions: Interleukin-33 and its soluble receptor were not associated with subclinical atherosclerosis. Traditional risk factors for atherosclerosis and rheumatoid arthritis duration were associated with intima-media thickness and plaque occurrence; methotrexate use was associated with a lower intima-media thickness.

https://doi.org/10.1186/s42358-019-0060-1 592 downloads

11.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel
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Piltcher, Otávio Bejzman

; Kosugi, Eduardo Macoto

; Sakano, Eulalia

; Mion, Olavo

; Testa, José Ricardo Gurgel

; Romano, Fabrizio Ricci

; Santos, Marco Cesar Jorge

; Di Francesco, Renata Cantisani

; Mitre, Edson Ibrahim

; Bezerra, Thiago Freire Pinto

; Roithmann, Renato

; Padua, Francini Greco

; Valera, Fabiana Cardoso Pereira

; Lubianca Neto, José Faibes

; Sá, Leonardo Conrado Barbosa

; Pignatari, Shirley Shizue Nagata

; Avelino, Melissa Ameloti Gomes

; Caixeta, Juliana Alves de Souza

; Anselmo-Lima, Wilma Terezinha

; Tamashiro, Edwin

Brazilian Journal of Otorhinolaryngology

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jun 2018, Volume 84 N. 3 Pages 265 - 279

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

Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into ‘consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

https://doi.org/10.1016/j.bjorl.2018.02.001 22744 downloads

12.

An outbreak of caprine toxoplasmosis - investigation and case report
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Ferreira Neto, José Mauricio

; Ferreira, Fernanda Pinto

; Miura, Ana Carolina

; Almeida, Jonatas Campos de

; Martins, Felippe Danyel Cardoso

; Souza, Marielen de

; Bronkhorst, Dalton Evert

; Romanelli, Paulo Roberto

; Pasquali, Aline Kuhn Sbruzzi

; Santos, Hannah Lia Ettiene Peruch Lemos dos

; Benitez, Aline do Nascimento

; Caldart, Eloiza Teles

; Zanella, Luiz Francisco

; Freire, Roberta Lemos

; Navarro, Italmar Teodorico

Ciência Rural

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2018, Volume 48 N. 5 elocation e20170790

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

RESUMO: O presente estudo teve como objetivo investigar um surto de aborto em um rebanho de cabras leiteiras no município de Arapoti, Paraná, Brasil. No início do surto, foram coletadas amostras de sangue de 33 cabras com sinais clínicos; mais tarde, de todo o rebanho caprino, dois gatos e dois cachorros. Foram obtidas amostras de leite das 78 cabras em lactação. Quatro amostras ambientais de solo e quatro de resíduos de comedouro também foram coletadas. O teste de imunofluorescência (IFI) foi utilizado para o sorodiagnóstico, a análise molecular foi conduzida por meio da reação em cadeia da polimerase (PCR), para isolamento do agente etiológico utilizou-se o bioensaio. Os resultados da IFI revelaram que 76,53% (137/179) das cabras, todos os cães e gatos eram soropositivos para Toxoplasma gondii. O bioensaio revelou uma amostra de camada leucocitária e duas de leite contaminadas com T. gondii viável. Na PCR, 11 amostras de sangue total, oito de leite, três resíduos alimentares e todas as amostras de solo foram positivas. Os resultados do presente estudo confirmaram um surto causado por contaminação ambiental (de solo e alimentos) com oocistos de T. gondii que, provavelmente, foram eliminados por gatos que permaneceram na fazenda e tinham acesso ao estoque de alimento dos caprinos, reforçando a necessidade de assistência técnica veterinária e boas práticas de manejo.

ABSTRACT: The present study aimed to investigate an abortion outbreak in a dairy goat herd in the municipality of Arapoti, Parana, Brazil. At the beginning of the outbreak, blood samples were collected from 33 goats with clinical signs; later, of the whole goat herd, two cats and two dogs. Milk samples were collected from 78 lactating goats. Four environmental soil samples and four samples of feed residue from goat feeders were collected too. Immunofluorescence antibody test (IFA) was used for serodiagnosis, the molecular analysis was conducted by means of the polymerase chain reaction (PCR), for the isolation of the etiological agent the bioassay was used. The results of the IFA revealed that 76.53% (137/179) of the goats, two dogs and two cats were seropositive for Toxoplasma gondii. Bioassay revealed one buffy coat and two milk sample having viable T. gondii. In the PCR, 11 whole blood samples, eight milk, three feeder troughs, and all soil samples were positive. The findings of the present study confirmed an outbreak caused by environmental contamination (of soil and feed) with T. gondii oocysts that could have been shed by kittens that lived on the farm and had access to the stock of goat food, facilitating this contamination, which reinforces the need for veterinary assistance and good management practices on farms.

https://doi.org/10.1590/0103-8478cr20170790 1752 downloads

13.

Levels of primaquine and carboxyprimaquine in patients with malaria vivax from the Brazilian Amazon basin
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Mello, Amanda Gabryelle Nunes Cardoso

; Vieira, Michelle Valéria Dias Ferreira

; Sena, Luann Wendel Pereira de

; Paixão, Thiago Portal da

; Pinto, Ana Carla Godinho

; Grisólia, Daniella Paternostro de Araújo

; Silva, Margareth Tavares

; Vieira, José Luiz Fernandes

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e66

Abstract: En | Text: En | PDF: En

ABSTRACT In the last two years, a substantial increase in the number of malaria vivax cases has occurred in the Brazilian Amazon basin. The adequate exposure of hypnozoites to primaquine is a matter of interest as these dormant forms are responsible for the maintenance or even the increase of malaria burden in endemic areas. The aim of this study was to estimate the levels of primaquine and carboxyprimaquine in whole blood samples of patients with P. vivax treated with chloroquine and an abbreviated regimen of primaquine (0.5 mg/kg/d for 7 days), with adequate clinical and parasitological outcomes after 180 days of follow-up. A total of 40 male patients met the criteria for inclusion in the study. Primaquine and carboxyprimaquine were measured by high-performance liquid chromatography. The levels of primaquine in whole blood samples ranged from 40-238 ng/mL, 42-196 ng/mL and 42-150 ng/mL on days 1, 3 and 7. The levels of carboxyprimaquine in whole blood samples ranged from 87-234 ng/mL, 96-252 ng/mL and 74-448 ng/mL on days 1, 3 and 7. These data provide a reliable estimation of exposure of the infecting parasite to primaquine. Based on the regional pattern of relapse, the estimated blood levels of primaquine can be considered effective against hypnozoites of the local circulating strains of P. vivax.

https://doi.org/10.1590/s1678-9946201860066 1356 downloads

14.

Uso tópico do inteferon alfa-2b para neoplasia escamosa da superficie ocular em um caso de paciente com xeroderma pigmentoso
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Pinto, Nayara Queiroz Cardoso

; Ferreira, Jhonatan de Paula Araujo

; Carneiro, Gustavo Jose Arruda Mendes

; Silva, Jailton Vieira

; Bezerra, Luanna Biana Costa

; Nogueira, Natália Ponte

Revista Brasileira de Oftalmologia

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aug 2017, Volume 76 N. 4 Pages 202 - 206

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

Resumo Relato de um caso clínico de Xeroderma Pigmentoso com carcinoma espinocelular de conjuntiva bilateral que apresentou regressão importante das dimensões tumorais com o uso de Interferon alfa-2b tópico. Relato de caso: Paciente feminina com Xeroderma Pigmentoso em estágio avançado, com ausência de pele sadia, tendo sido submetida a cerca de 60 exéreses de lesões de pele malignas. A paciente compareceu com tumoração conjuntival em ambos os olhos, correspondendo a carcinoma espinocelular de conjuntiva e neoplasia intraepitelial de conjuntiva em olho esquerdo. Devido as dificuldades cirúrgicas, alta taxa de recidiva e elevada probabilidade de formação de simbléfaro foi-se iniciado terapêutica com Interferon alfa-2beta 1.000.000 unidades tópico, obtendo-se bons resultados com importante regressão do tamanho da lesão e resolução dos sintomas. Conclusão: O uso tópico de interferon alfa-2beta em neoplasia escamosa de conjuntiva, mostrou-se uma boa opção terapêutica em situações de elevado risco cirúrgico e de complicações pós operatórias.

Abstract Report of a case of xeroderma pigmentosum with squamous cell carcinoma of bilateral conjunctiva that showed a significant regression in tumor size with the use of interferon alfa-2b topic. Case report: Female patient with Xeroderma pigmentosum in an advanced stage, with no healthy skin, having been subjected to about 60 excisions of malignant skin lesions. The patient appeared with conjunctival tumors in both eyes, corresponding to squamous cell carcinoma of the conjunctiva. Due to surgical difficulties, high relapse rate and high probability of symblepharon formation, therapy was started with interferon alpha 2beta 1,000,000 topic units, obtaining good results with a significant decrease in lesion size and resolution of symptoms. Conclusion: Topical use of alpha-interferon in 2beta squamous neoplasia of the conjunctiva proved to be a good therapeutic option for high surgical risk and situations of postoperative complications.

https://doi.org/10.5935/0034-7280.20170041 8535 downloads

15.

Quality of Minas fresh cheese made with milk from F1 Holstein/Zebu cows fed diets with different sources of nitrogen compounds
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Aguiar, Ana Cássia Rodrigues de

; Rocha Júnior, Vicente Ribeiro

; Caldeira, Luciana Albuquerque

; Ruas, José Reinaldo Mendes

; Almeida Filho, Silvio Humberto Cardoso de

; Monção, Flávio Pinto

; Melo, Marco Túlio Parrela de

; Pimentel, Paulo Roberto Silveira

Arquivos do Instituto Biológico

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2017, Volume 84 elocation e0192015

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

RESUMO: Objetivou-se avaliar rendimento, perfil de ácidos graxos, composição físico-química e sensorial do queijo Minas frescal produzido do leite de vacas alimentadas com dietas com diferentes fontes de compostos nitrogenados (farelo de soja, ureia, farelo de girassol e farelo de mamona detoxicado). Foram utilizadas oito vacas F1 Holandesas/Zebu, com produção média de 20 kg de leite corrigido para 3,5% de gordura dia-1, em dois quadrados latinos 4 × 4, sendo compostos de quatro tratamentos (dietas), quatro animais e quatro períodos experimentais cada. Os queijos foram fabricados no último dia de cada período experimental. A composição físico-química, o rendimento e a textura do queijo foram semelhantes entre dietas experimentais. As dietas utilizadas influenciaram a concentração do ácido graxo C11:0, sendo superior para as dietas com farelo de soja e farelo de girassol; o C18:2 C9-T11 (CLA) mostrou-se superior para as dietas com ureia, farelo de soja e farelo de girassol; e o C20:3 para as dietas com farelo de soja e ureia. Para os demais ácidos graxos saturados, monoinsaturados e poli-insaturados não foram observadas diferenças. Diferentes fontes de compostos nitrogenados na dieta de vacas, com produção média de 20 kg de leite corrigido para 3,5% de gordura, não alteram a composição físico-química, o rendimento nem a aceitação do queijo Minas frescal, entretanto pode influenciar o perfil de ácidos graxos da gordura do queijo.

ABSTRACT: This study aimed to evaluate yield, fatty acid profile, physical, chemical and sensory composition of Minas fresh cheese made with milk from cows fed diets containing different sources of nitrogen compounds (soybean meal, urea, sunflower meal and detoxified castor bean meal). Eight F1 Holstein/Zebu cows with average production of 20 kg milk corrected to 3.5% fat day-1 were distributed in two 4 × 4 Latin squares, consisting of four treatments (diets), four animals and four experimental periods. Cheese was produced on the last day of each experimental period. The physical and chemical composition, yield and texture of cheese were similar between diets. The used diets influenced the concentration of fatty acid C11:0, which was higher for diets with soybean meal and sunflower meal; C18:2 C9-T11 (CLA) was higher for diets with urea, soybean meal and sunflower meal and C20:3 for diets with soybean meal and urea. For the other saturated, monounsaturated and polyunsaturated fatty acids, differences were not detected. Different sources of nitrogen compounds in the diet for cows with average production of 20 kg milk corrected to 3.5% fat day-1 have no effect on the physical or chemical composition, yield, as well as acceptance of Minas fresh cheese. However, it can influence the fatty acid profile in the cheese fat.

https://doi.org/10.1590/1808-1657000192015 1078 downloads

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