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1.
Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves
; Guimarães, Camila
; Rêgo, Jozelia
; Machado, Ketty Lysie Libardi Lira
; Miyamoto, Samira Tatiyama
; Burian, Ana Paula Neves
; Dias, Laiza Hombre
; Pretti, Flavia Zon
; Batista, Danielle Cristina Filgueira Alves
; Mill, José Geraldo
; Oliveira, Yasmin Gurtler Pinheiro de
; Gadelha, Carolina Strauss Estevez
; Gouveia, Maria da Penha Gomes
; Moulin, Anna Carolina Simões
; Souza, Bárbara Oliveira
; Aguiar, Laura Gonçalves Rodrigues
; Vieira, Gabriel Smith Sobral
; Grillo, Luiza Lorenzoni
; Lima, Marina Deorce de
; Pasti, Laís Pizzol
; Surlo, Heitor Filipe
; Faé, Filipe
; Moulaz, Isac Ribeiro
; Macabú, Mariana de Oliveira
; Ribeiro, Priscila Dias Cardoso
; Magalhães, Vanessa de Oliveira
; Aguiar, Mariana Freitas de
; Biegelmeyer, Erika
; Peixoto;, Flávia Maria Matos Melo Campos
; Kayser, Cristiane
; Souza, Alexandre Wagner Silva de
; Castro, Charlles Heldan de Moura
; Ribeiro, Sandra Lúcia Euzébio
; Telles, Camila Maria Paiva França
; Bühring, Juliana
; Lima, Raquel Lima de
; Santos, Sérgio Henrique Oliveira Dos
; Dias, Samuel Elias Basualto
; Melo, Natália Seixas de
; Sanches, Rosely Holanda da Silva
; Boechat, Antonio Luiz
; Sartori, Natália Sarzi
; Hax, Vanessa
; Dória, Lucas Denardi
; Rezende, Rodrigo Poubel Vieira de
; Baptista, Katia Lino
; Fortes, Natália Rodrigues Querido
; Melo, Ana Karla Guedes de
; Melo, Tâmara Santos
; Vieira, Rejane Maria Rodrigues de Abreu
; Vieira, Adah Sophia Rodrigues
; Kakehasi, Adriana Maria
; Tavares, Anna Carolina Faria Moreira Gomes
; Landa, Aline Teixeira de
; Costa, Pollyana Vitoria Thomaz da
; Azevedo, Valderilio Feijó
; Martins-Filho, Olindo Assis
; Peruhype-Magalhães, Vanessa
; Pinheiro, Marcelo de Medeiros
; Monticielo, Odirlei André
; Reis-neto, Edgard Torres Dos
; Ferreira, Gilda Aparecida
; Souza, Viviane Angelina de
; Teixeira-Carvalho, Andréa
; Xavier, Ricardo Machado
; Sato, Emilia Inoue
; Valim, Valeria
; Pileggi, Gecilmara Salviato
; Silva, Nilzio Antonio da
.
Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26
2.
Preparation of PLGA Nanoparticles Loaded with the Anti-Infective Ctn[15-34] Peptide for Antifungal Application AntiInfective Anti Infective Ctn1534 Ctn 15 34 Ctn[15-34 Ctn153 1 3 Ctn[15-3 Ctn15 Ctn[15- Ctn1 Ctn[15 Ctn[1 Ctn[
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Santos, Ana Paula dos
; Oliveira, Roberta Carolina Rangel de
; Louchard, Bianca Oliveira
; Uchoa, Antônia Flávia Justino
; Ricardo, Nágila Maria Pontes Silva
; Leal, Luzia Kalyne Almeida Moreira
; Rádis-Baptista, Gandhi
; Araújo, Tamara Gonçalves de
.
Abstract This article aims to report the preparation and optimized formulation of Ctn[15-34], a designed anti-infective peptide, with poly(lactic acid-co-glycolic acid), PLGA, nanoparticles. Ctn[15-34] is a short peptide derived from crotalicidin, a cathelicidin-related antimicrobial peptide from the venom of the South American rattlesnake (Crotalus durissus terrificus), that has arisen as a promising antifungal and microbicide agent. The PLGA nanoparticles were prepared and loaded with carboxyfluorescein (CF)-Ctn[15-34] using the double emulsion/solvent evaporation method. After a preformulation study, which tested different formulation parameters, Poly (vinyl alcohol) 87-89% hydrolyzed and sonication with Sonifier® were choosen to prepare unloaded PLGA nanoparticles by that method, resulting in smaller particle size and Polydispersity Index (PDI) values and higher zeta potential values of nanoparticles. This better condition was used to prepare CF-Ctn[15-34]-loaded PLGA nanoparticles, resulting in homogeneous and spherical nanoparticles, with an average size of 213.2 ± 2.00 nm, PDI of 0.044 ± 0.04 and zeta potential of -16.03 ± 1.20 mV. An excellent encapsulation efficiency was obtained, corresponding to 93.3 ± 0.10 %. The drug-release profile showed a rapid initial release of the peptide, approximately 27 % in the first 24 hours, followed by a sustained release for at least 16 days. Another relevant aspect in the peptide formulation is that the CF-Ctn[15-34]-loaded nanoparticles potentiated the antifungal effect against the opportunistic pathogenic yeast Cryptococcus neoformans compared with the free, in solution Ctn[15-34], in equivalent volume dosage. A preparation method of CF-Ctn[15-34]-loaded PLGA nanoparticles was established and validated, representing a successful approach to deliver CF-Ctn[15-34] for pharmaceutical applications. Ctn1534, Ctn1534 Ctn 15 34 , antiinfective anti infective polylactic poly lactic acidcoglycolic acid co glycolic acid, acid) Ctn[15-34 crotalicidin cathelicidinrelated cathelicidin related Crotalus terrificus, terrificus terrificus) agent CFCtn1534 CFCtn CF (CF)-Ctn[15-34 emulsionsolvent emulsion solvent study parameters vinyl alcohol 8789% 8789 87 89% 89 87-89 Sonifier (PDI CFCtn1534loaded CFCtnloaded 2132 213 2 213. 200 00 2.0 nm 0044 0 044 004 04 0.0 16.03 1603 03 -16.0 120 1 20 1.2 mV obtained 933 93 3 93. 010 10 0.1 drugrelease drug hours days free dosage validated CF-Ctn[15-34 applications Ctn153 Ctn[15-3 CFCtn153 (CF)-Ctn[15-3 878 8 87-8 21 2. 0. 16.0 160 -16. 12 1. 9 01 CF-Ctn[15-3 Ctn15 Ctn[15- CFCtn15 (CF)-Ctn[15- 87- 16. -16 CF-Ctn[15- Ctn1 Ctn[15 CFCtn1 (CF)-Ctn[15 -1 CF-Ctn[15 Ctn[1 (CF)-Ctn[1 - CF-Ctn[1 Ctn[ (CF)-Ctn[ CF-Ctn[ (CF)-Ctn CF-Ctn
3.
Processing tomato waste as a potential bioactive compounds source: phenolic compounds, antioxidant capacity and bioacessibility studies
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Gomes, Flavia dos Santos
; Silva, Luis Otávio Moreira
; Beres, Carolina
; Pagani, Monica Marques
; Brígida, Ana Iraidy Santa
; Santiago, Manuela Cristina Pessanha de Araújo
; Pacheco, Sidney
; Godoy, Ronoel Luiz de Oliveira
; Cabral, Lourdes Maria Corrêa
.
RESUMO: Foi realizado um estudo comparativo com a extração convencional e assistida por ultrassom em resíduos do processamento de tomate. A extração ultrassônica exibiu teor de fenólicos e flavonóides ligeiramente maiores, bem como maior capacidade antioxidante ABTS + (4,63 mg AG.g-1, 0,96 mg RUE.g-1 e 27,90 μmol TE.g -1, respectivamente). Em ambos os extratos, uma alta porcentagem de flavonóides foi perdida durante a digestão simulada, resultando em uma bioacessibilidade de aproximadamente 13%. Os extratos apresentaram boa estabilidade durante as condições de armazenamento, o que indica uma possível aplicação tecnológica.
ABSTRACT: A comparative study was perfomed with conventional and ultrasound assisted extraction on tomato processing waste. Ultrasound extraction exhibited slightly higher phenolic and flavonoids content, as well as higher ABTS + radical scavenging capacity (4.63 mg GAE.g-1, 0.96 mg RUE.g-1 and 27.90 μmol TE.g -1 respectively). On both extracts, a high percentage of flavonoids was lost during simulated digestion, resulting on a bioacessibility of approximately 13 %. Extracts presented good stability during storage conditions, which indicates a possible technological application.
https://doi.org/10.1590/0103-8478cr20201070
166 downloads
4.
The Indian Protective Service Accused: The Logic of Defamation in the Dispute for the Control of Indigenous Territories in the State of Amazonas, 1931
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Resumo O presente artigo analisa o Inquérito na Inspetoria dos Índios no Amazonas e Acre, instaurado em 1931 por ordem do Interventor Federal no Amazonas. Em uma aproximação a contextos locais e regionais, articula o inquérito aos conflitos fundiários ocorridos na década anterior, em torno da imposição do monopólio comercial sobre um recurso que se configurava, historicamente, como o “remédio da pobreza” - os castanhais. O artigo demonstra como as narrativas acerca desses conflitos são acionadas, no inquérito, segundo a lógica circular da detratação, visando a criminalização de indígenas e representantes do SPI, como forma de acumular legitimidade para o exercício extralegal do poder. Por fim, ilumina o caráter propriamente simbólico das disputas, que buscavam restringir os sentidos legais da categoria “índio”, retirando a legitimidade da Inspetoria na atuação entre os chamados “semicivilizados”, e alijando os indígenas de canais de acesso ao Estado.
Abstract The present article analyzes the Inquiry into the Indian Inspectorate in Amazonas and Acre, established in 1931 by order of the Federal Intervenor of the Amazonas. Taking as our approach an analysis of regional contexts, we link the inquiry to land conflicts that occurred in the previous decade, which gravitated around the imposition of a commercial monopoly on a resource historically configured as a “remedy for poverty” - Brazil nut trees. We demonstrate how narratives regarding these conflicts were triggered in the inquiry according to a logic that aimed to criminalize indigenous peoples and Indian Protective Service representatives as a way of accumulating legitimacy for the extralegal exercise of power. Finally, we illuminate the symbolic character of these disputes, which sought to restrict the legal meanings of “Indian” in order to question the legitimacy of the Indian Service in its administration of the so-called “semi-civilized peoples” and to restrict indigenous peoples’ access to State resources.
Resumen Este artículo analiza la Investigación de la Inspección de Indios en Amazonas y Acre, iniciada en 1931 por orden del Interventor Federal en Amazonas. En una aproximación a los contextos locales y regionales, articula la investigación a los conflictos territoriales ocurridos en la década anterior, en torno a la imposición del monopolio comercial sobre un recurso que históricamente se configuró como el “remedio de la pobreza”: las castañas. El artículo demuestra cómo, en la Investigación, se desencadenan las narrativas sobre estos conflictos según la lógica circular de la difamación, apuntando a la criminalización de los representantes indígenas y del SPI, como una forma de acumular legitimidad para el ejercicio extralegal del poder. Ilumina el carácter propiamente simbólico de las disputas, que buscaban restringir los significados jurídicos de la categoría “indígena”, quitando la legitimidad del SPI en la administración de los llamados “semi-civilizados”, y removiendo a los indígenas de los canales de acceso al Estado.
5.
Optimization of red blood cell unit storage during SARS-COV-2 Pandemic: adopting new strategies to ensure supply in a decentralized blood bank in Brazil
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Costa, Cristiano Batista
; Cortez, Afonso José Pereira
; Adão, Daiane Daniela
; Almeida, Carolina Maganha de
; Taguchi, Ellen Mari
; Oliveira, Ingrid de
; Santos, Janaína Fernanda de Oliveira
; Rosa, Ana Paula Rodrigues da
; Tokunaga, Juliana Trapanotto da Silva
; Arnoni, Carine Prisco
; Latini, Flavia Roche Moreira
.
ABSTRACT Introduction: As coronavirus disease-2019 (COVID-19) spread worldwide and social restrictions were intensified, difficulties in blood supply were expected to result in a shortage of blood donors, logistic issues and a change in blood consumption. Consequences could be detrimental to the meeting of the blood supply demand, especially in a decentralized blood bank in the State of São Paulo responsible for providing blood to more than 100 hospitals, mostly of the public health system. Aiming to minimize negative effects and focusing on maintenance of the blood supply, a different approach was discussed and adopted. Materials and methods: Briefly, strategies were related to monitoring and promoting measures to achieve a positive RBC unit balance. Thus, the number of donors, transfusions, RBC unit inventory, RBC unit loss and RBC units within up to 5 days from the expiration date were evaluated. Results: Several strategies were adopted to ensure sufficient availability of RBC units: blood donation was improved with social media and extra blood collections, a restrictive transfusion protocol was implemented, a new logistic process to use RBC units closer to the expiration date was established and non-isogroup transfusions were avoided. Conclusion: Altogether, described strategies were crucial to optimize blood storage during the pandemic. Investing in monitoring and logistics contributed to a positive RBC unit balance and conserving these strategies could be useful.
https://doi.org/10.1016/j.htct.2021.03.002
18 downloads
6.
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
7.
Análise do Sistema de Informação da Vigilância de Eventos Adversos Pós-Vacinação no Brasil, 2014 a 2016
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Pacheco, Flávia Caselli
; Domingues, Carla Magda Allan Santos
; Maranhão, Ana Goretti Kalume
; Carvalho, Sandra Maria Deotti
; Teixeira, Antonia Maria da Silva
; Braz, Rui Moreira
; Rebelo, Renata Cristina Freitas
; Guilhem, Dirce Bellezi
.
RESUMO Objetivo Descrever as características das notificações de eventos adversos pós-vacinação (EAPV) no Sistema de Informação da Vigilância de EAPV (SI-EAPV) on-line nos primeiros 2 anos de operação do sistema. Método Foi realizado um estudo descritivo dos registros de EAPV notificados no SI-EAPV entre julho de 2014 e junho de 2016. Resultados Durante o período do estudo, foram registradas 24 732 notificações. De 5 570 municípios brasileiros, 2 571 (46,2%) realizaram notificação de algum EAPV. Entretanto, somente 1 622 (6,6%) notificações estavam encerradas no momento do estudo; dessas, 89,9% não apresentaram gravidade. Entre as notificações encerradas, 19,7% não tiveram o preenchimento da variável “atendimento médico” e 98,7% não apresentaram registro de exames laboratoriais. As manifestações clínicas sistêmicas neurológicas foram as mais frequentes entre os eventos adversos graves encerrados, correspondendo a 59,5% dos sinais e sintomas. Em relação à idade, os maiores coeficientes de notificação foram registrados entre os menores de 4 anos. Conclusão O SI-EAPV mostra-se útil no monitoramento da segurança das vacinas. Contudo, os municípios precisam ampliar a adesão ao sistema, bem como realizar as investigações e notificações dos EAPV, preenchendo a ficha de notificação de forma adequada e oportuna. O conhecimento sobre EAPV pode ser aplicado na prática dos serviços de vigilância em saúde, melhorando a segurança de utilização dos imunobiológicos.
ABSTRACT Objective To describe the characteristics of vaccine adverse events (VAE) reports in the online VAE Reporting System (VAE-RS) after 2 years of operation. Method A descriptive analysis of VAE reports entered into the VAE-RS between July 2014 and June 2016 was performed. Results During the study period, 24 732 VAE were reported. Of 5 570 Brazilian municipalities, 2 571 (46.2%) reported at least one VAE; however, only 1 622 (6.6%) reports had been completed/closed at the end of the study period. Of these, 89.9% referred to mild VAE. Among the completed reports, 19.7% did not provide information on “type of medical care provided,” and 98.7% had no information regarding laboratory tests. Systemic neurological symptoms were the most frequent serious VAE among closed reports (59.5% of serious signs/symptoms). Concerning age, the highest VAE reporting coefficients were recorded for children aged ≤ 4 years. Conclusion The VAE-RS is useful to monitor immunization safety. However, municipal services must increase adherence to the system and perform the required investigation and reporting of VAE, with timely and adequate completion of the VAE-RS form. Knowledge regarding VAE can be used in the daily routine of surveillance services, improving the safety of immunobiological agents.
RESUMEN Objetivo Describir las características de las notificaciones de eventos adversos posvacunación (EAPV) en el Sistema de Información de Vigilancia de EAPV (SI-EAPV, un sistema en línea, durante los primeros 2 años de ejecución del sistema. Método Se realizó un estudio descriptivo de los registros de EAPV notificados en el SI-EAPV entre julio de 2014 y junio de 2016. Resultados Durante el período del estudio, se registraron 24 732 notificaciones. De 5 570 municipios brasileños, 2 571 (46,2%) notificaron algún EAPV. Sin embargo, solamente 1 622 (6,6%) notificaciones estaban cerradas al momento del estudio; de ellas, el 89,9% no presentó gravedad. Respecto a las notificaciones cerradas, en el 19,7% no fue anotada la variable “atención médica” y el 98,7% no presentó registro de exámenes de laboratorio. Entre los eventos adversos graves cerrados, las manifestaciones clínicas sistémicas neurológicas fueron las más frecuentes, representado el 59,5% de los signos y síntomas. En cuanto a la edad, los mayores coeficientes de notificación se registraron entre los menores de 4 años. Conclusión El SI-EAPV es útil para el monitoreo de la seguridad de las vacunas. Sin embargo, los municipios necesitan ampliar la adhesión al sistema, así como realizar las investigaciones y notificaciones de los EAPV, llenando la ficha de notificación de forma adecuada y oportuna. El conocimiento sobre EAPV puede ser aplicado en la práctica de los servicios de vigilancia en salud, mejorando la seguridad en la utilización de los productos inmunobiológicos.
https://doi.org/10.26633/rpsp.2018.12
100 downloads
8.
SUPPOSED IMPACTS, REAL VIOLENCE: THE CONSTRUCTION OF REALITY IN THE IMPLEMENTATION OF THE MINAS-RIO PROJECT
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Resumo O artigo analisa o licenciamento da mina e estrutura de beneficiamento de minério de ferro que compõe o Projeto Minas-Rio, complexo minerário formado por mina-mineroduto-porto, cujas instalações atravessam dois estados do Sudeste brasileiro. A análise objetiva demonstrar, a partir de uma leitura dos rituais políticos performatizados na cena pública do licenciamento, como mecanismos destinados a flexibilizar as normas ambientais se articularam ao longo do processo, gerando idéias-força e dispositivos que, agindo em cadeia, permitiram a operação do empreendimento, apesar da notória insuficiência no que se refere ao conhecimento/reconhecimento da população atingida.
Abstract The article analyzes the environmental impact assessment procedure of the mine and the iron ore processing structure which integrate the Minas-Rio Project, a mining complex composed by mine - pipeline - port, whose facilities extend across two states in the Brazilian Southeast. The analysis aims at demonstrating, through a reading of the political rituals performed in the participative scene of the licensing process, how mechanisms used to “bend” environmental norms were articulated throughout the process, generating strategies and force-ideas which, in articulation, allowed the operation of the venture despite the notorious lack of knowledge/acknowledgement of the affected population.
https://doi.org/10.1590/1809-43412017v14n2p159
1035 downloads
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