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1.
How can we reduce maternal mortality due to preeclampsia? The 4P rule preeclampsia P
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Korkes, Henri Augusto
; Cavalli, Ricardo Carvalho
; Oliveira, Leandro Gustavo De
; Ramos, José Geraldo Lopes
; Martins Costa, Sérgio Hofmeister de Almeida
; Sousa, Francisco Lázaro Pereira de
; Vieira da Cunha Filho, Edson
; de Souza Mesquita, Maria Rita
; Dias Corrêa Júnior, Mário
; Pinheiro Fernandes Araújo, Ana Cristina
; Zaconeta, Alberto Carlos Moreno
; Freire, Carlos Henrique Esteves
; Poli de Figueiredo, Carlos Eduardo
; Rocha Filho, Edilberto Alves Pereira da
; Sass, Nelson
; Peraçoli, José Carlos
; Costa, Maria Laura
.
Abstract In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management. middleincome middle income Brazil complications morbidity factors highrisk high risk women prevention followup, followup follow up, up diagnosis sulphate cases 4 " Rule Adequate Parturition (Parturition Postpartum. Postpartum . Postpartum) rule "rule management
2.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
3.
2021 recommendations of the Brazilian Society of Rheumatology for the gynecological and obstetric care of patients with Sjogren’s syndrome
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Oliveira, Fabiola Reis
; Valim, Valeria
; Pasoto, Sandra Gofinet
; Fernandes, Marilena Leal Mesquita Silvestre
; Lopes, Maria Lucia Lemos
; Souza Fialho, Sonia Cristina de Magalhães
; Pinheiro, Aysa César
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Fidelix, Tania
; Ribeiro, Sandra Lucia Euzébio
; Brito, Danielle Christinne Soares Egypto de
; Libório, Tatiana
; Santos, Maria Carmen Lopes Ferreira Silva
; Tanure, Leandro
; Gennari, Juliana DAgostino
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Rocha Filho, César Ramos
; Miyamoto, Samira Tatiyama
; Guedes, Lissiane Karine Noronha
; Pugliesi, Alisson
; Trevisani, Virginia Fernandes Moça
.
Abstract Sjogren’s syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.
https://doi.org/10.1186/s42358-021-00208-1
54 downloads
4.
COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves
; Ximenez, João Paulo Bianchi
; Seiva, Fábio Rodrigues Ferreira
; Panis, Carolina
; Bezerra, Rafael dos Santos
; Ferrasa, Adriano
; Cecchini, Alessandra Lourenço
; Medeiros, Alexandra Ivo de
; Almeida, Ana Marisa Fusco
; Ramão, Anelisa
; Boldt, Angelica Beate Winter
; Moya, Carla Fredrichsen
; Chin, Chung Man
; Paula, Daniel de
; Rech, Daniel
; Gradia, Daniela Fiori
; Malheiros, Danielle
; Venturini, Danielle
; Tavares, Eliandro Reis
; Carraro, Emerson
; Ribeiro, Enilze Maria de Souza Fonseca
; Pereira, Evani Marques
; Tuon, Felipe Francisco
; Follador, Franciele Aní Caovilla
; Fernandes, Glaura Scantamburlo Alves
; Volpato, Hélito
; Cólus, Ilce Mara de Syllos
; Oliveira, Jaqueline Carvalho de
; Rodrigues, Jean Henrique da Silva
; Santos, Jean Leandro dos
; Visentainer, Jeane Eliete Laguila
; Brandi, Juliana Cristina
; Serpeloni, Juliana Mara
; Bonini, Juliana Sartori
; Oliveira, Karen Brajão de
; Fiorentin, Karine
; Lucio, Léia Carolina
; Faccin-Galhardi, Ligia Carla
; Ferreto, Lirane Elize Defante
; Lioni, Lucy Megumi Yamauchi
; Consolaro, Marcia Edilaine Lopes
; Vicari, Marcelo Ricardo
; Arbex, Marcos Abdo
; Pileggi, Marcos
; Watanabe, Maria Angelica Ehara
; Costa, Maria Antônia Ramos
; Giannini, Maria José S. Mendes
; Amarante, Marla Karine
; Khalil, Najeh Maissar
; Lima Neto, Quirino Alves de
; Herai, Roberto H.
; Guembarovski, Roberta Losi
; Shinsato, Rogério N.
; Mainardes, Rubiana Mara
; Giuliatti, Silvana
; Yamada-Ogatta, Sueli Fumie
; Gerber, Viviane Knuppel de Quadros
; Pavanelli, Wander Rogério
; Silva, Weber Claudio da
; Petzl-Erler, Maria Luiza
; Valente, Valeria
; Soares, Christiane Pienna
; Cavalli, Luciane Regina
; Silva Jr, Wilson Araujo
.
Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.
5.
Guideline of the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019
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Lopes, Marcelo Antônio Cartaxo Queiroga
; Oliveira, Gláucia Maria Moraes de
; Ribeiro, Antonio Luiz Pinho
; Pinto, Fausto J.
; Rey, Helena Cramer Veiga
; Zimerman, Leandro Ioschpe
; Rochitte, Carlos Eduardo
; Bacal, Fernando
; Polanczyk, Carisi Anne
; Halperin, Cidio
; Araújo, Edson Correia
; Mesquita, Evandro Tinoco
; Arruda, José Airton
; Rohde, Luis Eduardo Paim
; Grinberg, Max
; Moretti, Miguel
; Caramori, Paulo Ricardo Avancini
; Botelho, Roberto Vieira
; Brandão, Andréa Araújo
; Hajjar, Ludhmila Abrahão
; Santos, Alexandre Fonseca
; Colafranceschi, Alexandre Siciliano
; Etges, Ana Paula Beck da Silva
; Marino, Bárbara Campos Abreu
; Zanotto, Bruna Stella
; Nascimento, Bruno Ramos
; Medeiros, Cesar Rocha
; Santos, Daniel Vitor de Vasconcelos
; Cook, Daniela Matos Arrowsmith
; Antoniolli, Eduardo
; Souza Filho, Erito Marques de
; Fernandes, Fábio
; Gandour, Fabio
; Fernandez, Francisco
; Souza, Germano Emilio Conceição
; Weigert, Guilherme de Souza
; Castro, Iran
; Cade, Jamil Ribeiro
; Figueiredo Neto, José Albuquerque de
; Fernandes, Juliano de Lara
; Hadlich, Marcelo Souza
; Oliveira, Marco Antonio Praça
; Alkmim, Maria Beatriz
; Paixão, Maria Cristina da
; Prudente, Maurício Lopes
; Aguiar Netto, Miguel A. S.
; Marcolino, Milena Soriano
; Oliveira, Monica Amorim de
; Simonelli, Osvaldo
; Lemos Neto, Pedro A.
; Rosa, Priscila Raupp da
; Figueira, Renato Minelli
; Cury, Roberto Caldeira
; Almeida, Rodrigo Coelho
; Lima, Sandra Regina Franco
; Barberato, Silvio Henrique
; Constancio, Thiago Inocêncio
; Rezende, Wladimir Fernandes de
.
https://doi.org/10.5935/abc.20190205
5274 downloads
6.
Pre-eclampsia/Eclampsia
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Peraçoli, José Carlos
; Borges, Vera Therezinha Medeiros
; Ramos, José Geraldo Lopes
; Cavalli, Ricardo de Carvalho
; Costa, Sérgio Hofmeister de Almeida Martins
; Oliveira, Leandro Gustavo de
; Souza, Francisco Lazaro Pereira de
; Korkes, Henri Augusto
; Brum, Ione Rodrigues
; Nascimento, Maria Laura Costa do
; Corrêa Junior, Mário Dias
; Sass, Nelson
; Diniz, Angélica Lemos Debs
; Cunha Filho, Edson Viera da
.
Revista Brasileira de Ginecologia e Obstetrícia
- Journal Metrics
Resumo A pré-eclâmpsia é uma doença multifatorial e multissistêmica específica da gestação. É classicamente diagnosticada pela presença de hipertensão arterial associada à proteinúria em gestante previamente normotensa após a 20a semana de gestação. A préeclâmpsia também é considerada na ausência de proteinúria se houver lesão de órgãoalvo. A presente revisão tem uma abordagem geral focada em aspectos de interesse prático na assistência clínica e obstétrica dessas mulheres. Assim, explora a etiologia ainda desconhecida, aspectos atuais da fisiopatologia e do diagnóstico e diagnóstico diferencial de convulsões, a abordagem da predição da doença, seus resultados adversos e prevenção. A conduta baseia-se em princípios gerais, tratamento clínico não farmacológico e farmacológico de situações graves ou não graves, com ênfase na crise hipertensiva e eclâmpsia. O controle obstétrico se fundamenta na pré-eclâmpsia sem ou com sinais de deterioração clínica e/ou laboratorial, estratificação da idade gestacional abaixo de 24 semanas, entre 24 e menos de 34 semanas e 34 ou mais semanas de gestação e orientação na via de parto. Uma abordagem imediata do puerpério e repercussões na vida futura de gestantes que desenvolvem pré-eclâmpsia também foram apresentadas.
Abstract Pre-eclampsia is a multifactorial and multisystemic disease specific to gestation. It is classically diagnosed by the presence of hypertension associated with proteinuria manifested in a previously normotensive pregnant woman after the 20th week of gestation. Pre-eclampsia is also considered in the absence of proteinuria if there is target organ damage. The present review takes a general approach focused on aspects of practical interest in the clinical and obstetric care of these women. Thus, it explores the still unknown etiology, current aspects of pathophysiology and of the diagnosis, the approach to disease prediction, its adverse outcomes and prevention. Management is based on general principles, on nonpharmacological and on pharmacological clinical treatment of severe or nonsevere situations with emphasis on the hypertensive crisis and eclampsia. Obstetric management is based on preeclampsia without or with signs of clinical and/or laboratory deterioration, stratification of gestational age
https://doi.org/10.1055/s-0039-1687859
10438 downloads
7.
Correlation and comparative analysis of the CPQ8-10 and child-OIDP indexes for dental caries and malocclusion
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Duarte-Rodrigues, Lucas
; Ramos-Jorge, Joana
; Drumond, Clarissa Lopes
; Diniz, Priscilla Barboza
; Marques, Leandro Silva
; Ramos-Jorge, Maria Letícia
.
Abstract: The aim of this study was to evaluate the correlation between the Child Perceptions Questionnaire 8 to 10 (CPQ8-10) and child-Oral Impact on Daily Performances (child-OIDP) indexes according to their total and item scores, as well as assess the discriminative validity of these assessment tools regarding dental caries and malocclusion among schoolchildren. A sample of 300 children aged between 8 and 10 years answered the questionnaires in two distinct steps. First, half of the sample (G1 = 150) answered the CPQ8-10 and the other half (G2 = 150) answered the child-OIDP. A week after, G1 answered the child-OIDP and G2 answered the CPQ8-10. Dental Aesthetic Index and WHO criteria were used to categorize malocclusion and dental caries, respectively. Descriptive analysis, Spearman's correlation and Mann-Whitney test were performed in this study. The CPQ8-10 and child-OIDP demonstrated a statistically significant and moderate correlation between their total scores. Regarding the discriminative validity, CPQ8-10 demonstrated a significant association between the “emotional status” daily activity and dental caries, and between the “eating”, “sleeping”, and “studying” daily activities and malocclusion. Concerning the child-OIDP, a significant difference was found only between the “social contact” activity and presence of dental caries. Both instruments were not capable of distinguishing children with and without dental caries and/or malocclusion by their total scores. However, the instruments were able to discriminate between children with and without those oral disorders in different dimensions. Thus, the CPQ8-10 and the child-OIDP demonstrated a different capacity to assess the impact on OHRQoL among schoolchildren.
https://doi.org/10.1590/1807-3107bor-2017.vol31.0111
1669 downloads
8.
Reemerging of natural infection by Trypanosoma evansi in horses in Arari, Marajó Island, Brazil
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Silva, Josileide Araújo da
; Domiciano, Tarcísio Oliveira
; Montão, Daniele Pina
; Sousa, Paulo Geovani Silva
; Ramos, Leandro Lopes
; Paredes, Laura Jamille Argolo
; Monteiro, Silvia Gonzalez
; Rivero, Gabriela Riet Correa
; Scofield, Alessandra
; Bezerra Júnior, Pedro
; Bezerra, Isis Abel
; Cerqueira, Valíria Duarte
.
RESUMO: São relatados dois surtos de tripanossomíase por Trypanosoma evansi , em cavalos no município de Chaves, Ilha do Marajó, Pará, Brasil. O primeiro surto ocorreu em abril de 2011 em uma fazenda com 147 cavalos, em que 47 (31,97%) adoeceram e 40 (27,21%) morreram. O segundo ocorreu em maio de 2012 e envolveu nove propriedades. De um total de 679 cavalos, 209 (30,07%) adoeceram e 183 (26,97%) morreram. Os principais sinais clínicos observados foram perda de peso, edema abdominal, emboletamento dos membros e atrofia da musculatura da região pélvica e membros posteriores. A necropsia foi realizada em dois cavalos, um de cada surto. O equino do primeiro surto não apresentou lesões macroscópicas, enquanto o segundo, do segundo surto, apresentava emagrecimento, palidez e icterícia, aumento do baço com protrusão da polpa branca ao corte. O sistema nervoso central de ambos os animais revelou uma leve à severa encefalite linfoplasmocitária, difusa, com presença de células de Mott. A imunohistoquímica para T. evansi revelou estruturas similares a formas tripomastigotas nas lesões. Entre novembro e dezembro de 2013, um levantamento epidemiológico foi realizado nos municípios de Cachoeira do Arari, Santa Cruz do Arari, Salvaterra, Soure e Chaves. Somente Santa Cruz do Arari e Chaves relataram casos da doença. Foram coletadas amostras de sangue de 243 equinos e realizada a reação em cadeia de polimerase (PCR) para a detecção do DNA de T. evansi das quais 20 foram positivas.
ABSTRACT: Two outbreaks of trypanosomiasis by Trypanosoma evansi in horses in the municipality of Chaves, Marajó Island, Pará State, Brazil are reported. The first outbreak occurred in April 2011 in a farm with 147 horses; of these, 47 (31.97%) got sick, and 40 (27.21%) died. The second outbreak occurred in May 2012 and involved nine properties. Of a total of 679 horses, 209 (30.07%) got sick, and 183 (26.97%) died. The main clinical signs observed in these horses were weight loss, abdominal edema, toe dragging, and pelvic muscle atrophy. Necropsy was performed in two horses, one from each outbreak. Macroscopic alterations were not seen in the horse from the first outbreak; however, the horse from the second outbreak exhibited emaciation, pallor and icterus, as well as enlarged spleen with prominent white pulp at cut surface. Histopathology of the central nervous system of both animals revealed mild to severe, diffuse lymphoplasmacytic encephalitis, with presence of Mott cells. Immunohistochemistry for T. evansi revealed structures similar to intralesional trypomastigote forms. Between November and December of 2013, an epidemiological survey was carried out in the municipalities of Cachoeira do Arari, Santa Cruz do Arari, Salvaterra, Soure, and Chaves. Only Santa Cruz do Arari and Chaves had reported cases of the disease. Blood samples were collected from 243 horses for detection of T. evansi DNA by polymerase chain reaction (PCR) and 20 were positive.
https://doi.org/10.1590/0103-8478cr20160047
1499 downloads
9.
Ammonia volatilization from enhanced-efficiency urea on no-till maize in brazilian cerrado with improved soil fertility
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Cancellier, Eduardo Lopes
; Silva, Douglas Ramos Guelfi
; Faquin, Valdemar
; Gonçalves, Bruno de Almeida
; Cancellier, Leandro Lopes
; Spehar, Carlos Roberto
.
RESUMO A aplicação de ureia, frequentemente, gera grandes perdas de N por volatilização e o uso de revestimentos e inibidores de urease, podem reduzir essas perdas. Neste estudo, objetivou-se avaliar as perdas de nitrogênio pela ureia estabilizada e de liberação lenta ou controlada e sua absorção pelo milho cultivado em plantio direto, em solo de Cerrado, com fertilidade construída. Quatro fontes de N foram utilizadas: ureia convencional, ureia + N-(n-butyl)thiophosphoric triamide (NBPT), ureia + Cu + B e ureia revestida por enxofre e polímeros. Essas fontes de N foram aplicadas em superfície nas doses de 100, 150 e 200 kg ha-1. Não houve aplicação de N no controle. Avaliaram-se as perdas de N por volatilização, o acúmulo de N nos grãos e palhada e produção de grãos e de palhada. A ureia estabilizada e de liberação controlada foi eficiente em atrasar os picos de volatilização de amônia. Os inibidores de urease atrasaram os picos de volatilização em até dois dias, reduzindo a volatilização acumulada em até 18%, quando comparado à ureia comum. A ureia revestida por enxofre e polímeros resultou em uma redução de 37% na volatilização de amônia. O aumento da dose de N até 200 kg ha-1 resultou em aumento de 16% na produtividade e 37% no acúmulo de N em relação ao controle. Entretanto, a ureia estabilizada e de liberação controlada não aumentou o acúmulo de N ou a produtividade. Consequentemente, a eficiência no uso de N pelo milho não foi aumentada em relação ao use da ureia convencional.
ABSTRACT High nitrogen losses by ammonia volatilization are expected when urea is used as the source of N. The use of controlled-release urea and urease inhibitors are possible strategies to reduce such losses and increase nitrogen use efficiency. This study aimed to evaluate nitrogen losses by ammonia volatilization from stabilized, slow and controlled release urea and its absorption by maize grown under no-till in an improved Cerrado soil. Four N sources were used: conventional urea, urea + N-(n-butyl) thiophosphoric triamide (NBPT), urea + Cu and B and urea coated by sulfur + polymers. These N sources were surface applied along the rows using three N doses of 100, 150 and 200 kg ha-1. No N was added to the control. Data were collected regarding N losses by volatilization, the N contents accumulated in the stubble and grains, and the yields of the stubble and grains. Stabilized urea and slow release urea were efficient for postponing the ammonia volatilization peaks. The urease inhibitors postponed the peaks for up to two days, reducing the accumulated volatilization by 18% when compared with common urea. Polymer sulfur coated urea resulted in a 37% reduction in ammonia volatilization. Increasing the N application rate to 200 kg ha-1 resulted in 16% greater yields and 37% greater N accumulation in the plants relative to the control. However, the stabilized and slow-release urea did not improve the N accumulation or yield. Consequently, the nitrogen use efficiency of maize was not improved relative to the use of conventional urea.
https://doi.org/10.1590/1413-70542016402031115
3921 downloads
10.
Pioderma gangrenoso após quadrantectomia de mama com radioterapia intraoperatória: relato de caso intraoperatória
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SEMPÉRTEGUI, ALFONSO
; VASQUEZ, ISMAEL SANTIAGO VASQUEZ
; FERNANDES NETO, ANTONIO LUIZ ROCHA GESUALDI
; SANTOS, LEANDRO MENEZES LOPES DOS
; ALVARENGA, BRUNO CÉSAR FREITAS
; UEDA, WINSTON JOSEPH
; AVELAR, JOSE TADEU CAMPOS
; BRONZATT, ERNANE
; MOSCARDINI, LILIANA MARIA DE OLIVEIRA
; ALVES, GABRIELA RAMOS
; SILVA, HENRIQUE MORAES SALVADOR
.
RESUMO Pioderma gangrenoso é uma doença inflamatória imunomediada e rara da pele, de diagnóstico extremamente desafiador. A evolução clínica é a base para o diagnóstico, cursando com lesões pustulosas superficiais, halo eritematoso doloroso, rápida progressão para ulcerações dolorosas e estéreis, sem resposta a antibióticos ou a novas intervenções cirúrgicas e, finalmente, com pronta melhora com uso de imunossupressores. O atraso no diagnóstico pode acarretar numerosas internações e terapias prolongadas, sendo que seu reconhecimento precoce, por outro lado, evita a progressão dessas ulcerações e sua morbidade. Relatou-se um caso de pioderma gangrenoso que evoluiu após cirurgia associada à radioterapia intraoperatória no tratamento conservador do câncer de mama, fazendo-se uma revisão de casos relatados na literatura e suas possibilidades terapêuticas. Questiona-se, também, se a radioterapia intraoperatória estaria relacionada com algum estímulo imunomediado, o que poderia ter facilitado o desencadeamento do quadro. pele desafiador superficiais doloroso estéreis finalmente imunossupressores prolongadas precoce lado morbidade Relatouse Relatou mama fazendose fazendo terapêuticas Questionase, Questionase Questiona se, Questiona-se também imunomediado quadro
ABSTRACT Pyoderma gangrenosum is an immune-mediated inflammatory and rare skin disease with an extremely challenging diagnosis. The clinical evolution of the disease is the basis for the diagnosis that involves pustular superficial lesions, painful erythematous halo, rapid progression to painful and sterile ulcerations, unresponsiveness to antibiotics or new surgical interventions, and finally, ready improvement with the use of immunosuppressive drugs. Delayed diagnosis may cause numerous hospitalizations and prolonged therapy, whereas early recognition can prevent the progression of the ulcerations and their morbidities. We report a case of pyoderma gangrenosum that evolved after surgery and was associated with intraoperative radiotherapy for the conservative treatment of breast cancer. In addition, we reviewed reported cases in the literature and therapeutic options. It is conjectured that intraoperative radiotherapy might be related to some immune-mediated stimuli that could trigger the clinical condition. immunemediated immune mediated lesions halo interventions finally drugs therapy morbidities cancer addition options condition
11.
Inflammatory root resorption in primary molars: prevalence and associated factors
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Vieira-Andrade, Raquel Gonçalves
; Drumond, Clarissa Lopes
; Alves, Laura Pereira Azevedo
; Marques, Leandro Silva
; Ramos-Jorge, Maria Letícia
.
This study aimed at determining the prevalence of inflammatory root resorption and associated factors in 1068 primary mandibular molars in 453 children 3 to 12 years of age. Age, dental history and medical history were recorded using a questionnaire administered to the children's parents/caregivers. Previously trained and calibrated examiners assessed radiographic images of the primary molars by direct observation, with the aid of a viewing box. Root resorption (physiological or inflammatory), dental crown status (healthy, carious with no pulp involvement, carious with pulp involvement and evidence of restoration), and pulpotomy or pulpectomy were determined. Data analysis involved descriptive statistics, the chi-square test and a multiple logistic regression (p < 0.05). The prevalence of inflammatory root resorption was 16.2% (n = 173). The male gender (OR: 1.4; 95% CI), the 3-to-7-years age bracket (OR: 1.5; 95% CI), an unhealthy dental crown (OR: 8.7; 95% CI), caries with pulp involvement (OR: 7.4; 95% CI), pulpotomy (OR: 3.1; 95% CI), and pulpectomy (OR: 5.4; 95% CI) were risk factors for the occurrence of inflammatory root resorption in primary molars. In conclusion, the prevalence of inflammatory root resorption in the present sample was 16.2%. Gender, age, an unhealthy tooth, caries with pulp involvement, pulpotomy, pulpectomy, and the absence of a restoration were associated with a higher occurrence of inflammatory root resorption in primary molars.
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