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1.
[SciELO Preprints] - CAN NEUTROPHIL-LYMPHOCYTE RATIO (NLR) AND PLATELET-LYMPHOCYTE RATIO (PLR) BE PROGNOSTIC INDICATORS FOR OPERATIVE COMPLICATIONS AND SURVIVAL IN BONE METASTASES?
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Teixeira, Matheus Silva
Ribas, Carmen Austrália Paredes Marcondes
Franck , Claudio Luciano
Tabushi , Fernando Issamu
Teixeira , Ana Valeria Rigolino
Mello , Glauco Jose Pauka
Carmo , Alexsandro Batista da Costa
Santos , Carlos Eduardo Oliveira dos
Nascimento-Filho , Geraldo Odilon do
Collaço, Luiz Martins
Introduction: In general, inflammation stimulates the production and release of neutrophils and, at the same time, decreases the production of lymphocytes. Lymphopenia reflects that cell-mediated immunity is impaired, while neutrophilia represents a response to systemic inflammation in these cancers.
Objective: To review the incidence of complications and postoperative survival rates in patients with bone metastases in long bones, correlating them with markers NLR and PLR.
Method: Narrative review carried out collecting information published on virtual platforms in Portuguese and English, initially carried out by searching for descriptors related to the topic, which were: “lower extremity, surgery, metastasis, epidemiology, postoperative complications, neutrophils, lymphocytes, platelets”. The extension incorporated AND or OR, by title and/or summary, and full reading of the texts most related to the topic.
Result: 21 articles were included.
Conclusion: The higher both the NLR and PLR are associated with lower survival in patients with bone metastases when undergoing surgical treatment, especially after 3 months postoperatively. However, there is still no confirmation that they signal any outcome, favorable or not, in relation to postoperative complications.
Introdução : De um modo geral, a inflamação estimula a produção e liberação de neutrófilos e, ao mesmo tempo, diminui a produção de linfócitos. A linfopenia reflete que a imunidade mediada pelas células é prejudicada, enquanto a neutrofilia representa resposta à inflamação sistêmica nesses cânceres.
Objetivo : Revisar nos pacientes com metástase óssea em ossos ao longo da incidência de complicações e taxas de sobrevida pós-operatória correlacionando-as com os marcadores NLR e PLR.
Método : Revisão narrativa feita colhendo informações publicadas em plataformas virtuais em português e inglês inicialmente realizada por busca dos descritores relacionados ao tema que foram: “extremidade inferior, cirurgia, metástase, epidemiologia, complicações pós-operatórias, neutrófilos, linfócitos, plaquetas” e seus equivalentes em inglês “ extremidade inferior, cirurgia, metástase, epidemiologia, sobrevivência, complicações, neutrófilos, linfócitos, plaquetas sanguíneas ”. A extensão incorporou AND ou OR, pelo título e/ou resumo, e leitura na íntegra dos textos mais relacionados ao tema.
Resultado : Foram incluídos 21 artigos.
Conclusão : Quanto maiores, tanto o NLR quanto o PLR estão associados à menor sobrevida em pacientes com MO quando submetidos ao tratamento cirúrgico, especialmente após 3 meses de pós-operatório. Contudo, ainda não há confirmação de que eles sinalizam algum estágio, positivo ou não, em relação às complicações pós-operatórias.
2.
Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-2019
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Rodríguez, Elias Carlos Aguirre
; Rodríguez, Elen Yanina Aguirre
; Marins, Fernando Augusto Silva
; Silva, Aneirson Francisco da
; Nascimento, Luiz Fernando Costa
.
ABSTRACT Objective: To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. Methods: Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran’s index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran’s index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran’s index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. Results: A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran’s index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). Conclusions: The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births.
RESUMO Objetivo: Analisar a distribuição espacial dos nascimentos prematuros e sua associação com indicadores maternos, sociais e de serviços de saúde na região metropolitana de São Paulo, Brasil, 2010-2019. Métodos: Estudo ecológico utilizando dados sobre recém-nascidos pré-termo dos 39 municípios da região metropolitana de São Paulo. Utilizou-se o índice de Moran (Im) global univariado para avaliar a associação espacial da prematuridade, e o índice de Moran local univariado por meio do mapa de clusters (LISA) para a identificação de padrões e aglomerados espaciais. Também foi utilizado o índice de Moran global bivariado para analisar a autocorrelação espacial com os indicadores maternos, sociais e de serviços de saúde. Resultados: Foram registrados 3.103.898 nascidos vivos no período 2010-2019, dos quais 331.174 (10,7%) foram prematuros. O índice de Moran global mostrou independência espacial (Im=0,05; p-valor=0,233) da proporção dos nascimentos prematuros entre municípios. No entanto, na análise espacial local foi possível identificar aglomerado espacial estatisticamente significativo entre os municípios de Biritiba Mirim, Guararema e Salesópolis, com proporções altas de nascimentos pré-termo. Na análise bivariada, identificou-se associação espacial significativa positiva com proporções de mães menores de 20 anos (Im=0,17; p-valor=0,024) e mães com baixa escolaridade (Im=0,17; p-valor=0,020), e associação espacial significativa negativa com IDH (Im=-0,14; p-valor=0,039). Conclusão: A abordagem espacial local identificou agrupamento espacial situado no extremo leste da região metropolitana de São Paulo, onde ações dos gestores de saúde são necessárias para minimizar a ocorrência de partos prematuros.
3.
Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-2019 Paulo Brazil 20102019 2010 2019 2010-201 2010201 201 2010-20 201020 20 2010-2 20102 2 2010-
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Rodríguez, Elias Carlos Aguirre
; Rodríguez, Elen Yanina Aguirre
; Marins, Fernando Augusto Silva
; Silva, Aneirson Francisco da
; Nascimento, Luiz Fernando Costa
.
RESUMO Objetivo: Analisar a distribuição espacial dos nascimentos prematuros e sua associação com indicadores maternos, sociais e de serviços de saúde na região metropolitana de São Paulo, Brasil, 2010-2019. Métodos: Estudo ecológico utilizando dados sobre recém-nascidos pré-termo dos 39 municípios da região metropolitana de São Paulo. Utilizou-se o índice de Moran (Im) global univariado para avaliar a associação espacial da prematuridade, e o índice de Moran local univariado por meio do mapa de clusters (LISA) para a identificação de padrões e aglomerados espaciais. Também foi utilizado o índice de Moran global bivariado para analisar a autocorrelação espacial com os indicadores maternos, sociais e de serviços de saúde. Resultados: Foram registrados 3.103.898 nascidos vivos no período 2010-2019, dos quais 331.174 (10,7%) foram prematuros. O índice de Moran global mostrou independência espacial (Im=0,05; p-valor=0,233) da proporção dos nascimentos prematuros entre municípios. No entanto, na análise espacial local foi possível identificar aglomerado espacial estatisticamente significativo entre os municípios de Biritiba Mirim, Guararema e Salesópolis, com proporções altas de nascimentos pré-termo. Na análise bivariada, identificou-se associação espacial significativa positiva com proporções de mães menores de 20 anos (Im=0,17; p-valor=0,024) e mães com baixa escolaridade (Im=0,17; p-valor=0,020), e associação espacial significativa negativa com IDH (Im=-0,14; p-valor=0,039). Conclusão: A abordagem espacial local identificou agrupamento espacial situado no extremo leste da região metropolitana de São Paulo, onde ações dos gestores de saúde são necessárias para minimizar a ocorrência de partos prematuros. Objetivo maternos Paulo Brasil 20102019. 20102019 2010 2019. 2019 2010-2019 Métodos recémnascidos recém prétermo pré termo 3 Utilizouse Utilizou se Im (Im prematuridade LISA (LISA espaciais Resultados 3103898 103 898 3.103.89 20102019, 2019, 331174 331 174 331.17 10,7% 107 10 7 (10,7% Im=0,05 Im005 0 05 (Im=0,05 pvalor=0,233 pvalor0233 pvalor p valor=0,233 valor 233 p-valor=0,233 entanto Mirim Salesópolis prétermo. termo. bivariada identificouse 2 Im=0,17 Im017 17 (Im=0,17 pvalor=0,024 pvalor0024 valor=0,024 024 p-valor=0,024 pvalor=0,020, pvalor0020 valor=0,020 , 020 p-valor=0,020) Im=0,14 Im014 Im= 0,14 14 (Im=-0,14 pvalor=0,039. pvalor0039 valor=0,039 . 039 p-valor=0,039) Conclusão 2010201 201 2010-201 310389 89 3.103.8 33117 33 331.1 10,7 1 (10,7 Im=0,0 Im00 (Im=0,0 pvalor=0,23 pvalor023 valor0233 valor=0,23 23 p-valor=0,23 Im=0,1 Im01 (Im=0,1 pvalor=0,02 pvalor002 valor0024 valor=0,02 02 p-valor=0,02 pvalor=0,020 valor0020 p-valor=0,020 014 0,1 (Im=-0,1 pvalor=0,039 pvalor003 valor0039 valor=0,03 03 p-valor=0,039 201020 2010-20 31038 8 3.103. 3311 331. 10, (10, Im=0, Im0 (Im=0, pvalor=0,2 pvalor02 valor023 valor=0,2 p-valor=0,2 pvalor=0,0 pvalor00 valor002 valor=0,0 p-valor=0,0 01 0, (Im=-0, pvalor=0,03 valor003 p-valor=0,03 20102 2010-2 3103 3.103 (10 Im=0 (Im=0 pvalor=0, pvalor0 valor02 valor=0, p-valor=0, valor00 (Im=-0 2010- 310 3.10 (1 (Im= pvalor=0 valor0 valor=0 p-valor=0 (Im=- 31 3.1 ( pvalor= valor= p-valor= 3. p-valor
ABSTRACT Objective: To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. Methods: Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran’s index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran’s index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran’s index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. Results: A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran’s index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). Conclusions: The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births. Objective maternal social Paulo Brazil 20102019. 20102019 2010 2019. 2019 2010-2019 Methods 3 Morans Moran s Im (Im prematurity LISA (LISA clusters Results 3103898 103 898 3,103,89 20102019, 2019, 331174 331 174 331,17 10.7% 107 10 7 (10.7% Im=0.05 Im005 0 05 (Im=0.05 pvalue=0.233 pvalue0233 pvalue p value=0.233 value 233 p-value=0.233 However Mirim Salesópolis 2 Im=0.17 Im017 17 (Im=0.17 pvalue=0.024 pvalue0024 value=0.024 024 p-value=0.024 pvalue=0.020, pvalue0020 value=0.020 , 020 p-value=0.020) Im=0.14 Im014 Im= 0.14 14 (Im=-0.14 pvalue=0.039. pvalue0039 value=0.039 . 039 p-value=0.039) Conclusions 2010201 201 2010-201 310389 89 3,103,8 33117 33 331,1 10.7 1 (10.7 Im=0.0 Im00 (Im=0.0 pvalue=0.23 pvalue023 value0233 value=0.23 23 p-value=0.23 Im=0.1 Im01 (Im=0.1 pvalue=0.02 pvalue002 value0024 value=0.02 02 p-value=0.02 pvalue=0.020 value0020 p-value=0.020 014 0.1 (Im=-0.1 pvalue=0.039 pvalue003 value0039 value=0.03 03 p-value=0.039 201020 2010-20 31038 8 3,103, 3311 331, 10. (10. Im=0. Im0 (Im=0. pvalue=0.2 pvalue02 value023 value=0.2 p-value=0.2 pvalue=0.0 pvalue00 value002 value=0.0 p-value=0.0 01 0. (Im=-0. pvalue=0.03 value003 p-value=0.03 20102 2010-2 3103 3,103 (10 Im=0 (Im=0 pvalue=0. pvalue0 value02 value=0. p-value=0. value00 (Im=-0 2010- 310 3,10 (1 (Im= pvalue=0 value0 value=0 p-value=0 (Im=- 31 3,1 ( pvalue= value= p-value= 3, p-value
4.
Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023 202 20 2
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Feitosa, Audes Diogenes de Magalhães
; Barroso, Weimar Kunz Sebba
; Mion Junior, Decio
; Nobre, Fernando
; Mota-Gomes, Marco Antonio
; Jardim, Paulo Cesar Brandão Veiga
; Amodeo, Celso
; Oliveira, Adriana Camargo
; Alessi, Alexandre
; Sousa, Ana Luiza Lima
; Brandão, Andréa Araujo
; Pio-Abreu, Andrea
; Sposito, Andrei C.
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Rodrigues, Cibele Isaac Saad
; Forjaz, Claudia Lucia de Moraes
; Sampaio, Diogo Pereira Santos
; Barbosa, Eduardo Costa Duarte
; Freitas, Elizabete Viana de
; Cestario, Elizabeth do Espirito Santo
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Feitosa, Fabiana Gomes Aragão Magalhães
; Consolim-Colombo, Fernanda Marciano
; Almeida, Fernando Antônio de
; Silva, Giovanio Vieira da
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Guimarães, Isabel Cristina Britto
; Gemelli, João Roberto
; Barreto-Filho, José Augusto Soares
; Vilela-Martin, José Fernando
; Ribeiro, José Marcio
; Yugar-Toledo, Juan Carlos
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano F.
; Bortolotto, Luiz Aparecido
; Alves, Marco Antonio de Melo
; Malachias, Marcus Vinícius Bolívar
; Neves, Mario Fritsch Toros
; Santos, Mayara Cedrim
; Dinamarco, Nelson
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Vitorino, Priscila Valverde de Oliveira
; Miranda, Roberto Dischinger
; Bezerra, Rodrigo
; Pedrosa, Rodrigo Pinto
; Paula, Rogerio Baumgratz de
; Okawa, Rogério Toshiro Passos
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C.
; Lima, Sandro Gonçalves de
; Inuzuka, Sayuri
; Ferreira-Filho, Sebastião Rodrigues
; Fillho, Silvio Hock de Paffer
; Jardim, Thiago de Souza Veiga
; Guimarães Neto, Vanildo da Silva
; Koch, Vera Hermina Kalika
; Gusmão, Waléria Dantas Pereira
; Oigman, Wille
; Nadruz Junior, Wilson
.
5.
Challenges of Congenital Heart Surgery in Brazil: It is Time to Designate Pediatric Congenital Heart Surgery Subspecialty Brazil
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Pinto Júnior, Valdester Cavalcante
; Miana, Leonardo Augusto
; Navarro, Fábio Binhara
; Rocha, Bruno da Costa
; Assad, Renato Samy
; Oliveira, Marcos Aurélio Barboza de
; Salum, Fábio Said
; Croti, Ulisses Alexandre
; Furlanetto, Beatriz Helena Sanches
; Jatene, Marcelo Biscegli
; Caneo, Luiz Fernando
; Monteiro, Andrey José de Oliveira
; Moraes Neto, Fernando Ribeiro de
; Antoniali, Fernando
; Salerno, Pedro Rafael
; Nina, Vinicius José da Silva
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
ABSTRACT Congenital heart disease (CHD) affects eight to ten out of every 1,000 births, resulting in approximately 23,057 new cases in Brazil in 2022. About one in four children with CHD requires surgery or other procedures in the first year of life, and it is expected that approximately 81% of these children with CHD will survive until at least 35 years of age. Professionals choosing to specialize in CHD surgery face numerous challenges, not only related to mastering surgical techniques and the complexity of the diseases but also to the lack of recognition by medical societies as a separate subspecialty. Furthermore, families face difficulties when access to services capable of providing treatment for these children. To address these challenges, it is essential to have specialized hospitals, qualified professionals, updated technologies, sustainable industry, appropriate financing, quality assessment systems, and knowledge generation. The path to excellence involves specialization across all involved parties. As we reflect on the importance of Pediatric Cardiovascular Surgery and Congenital Heart Diseases establishing themselves as a subspecialty of Cardiovascular Surgery, it is essential to look beyond our borders to countries like the United States of America and United Kingdom, where this evolution is already a reality. This autonomy has led to significant advancements in research, education, and patient care outcomes, establishing a care model. By following this path in Brazil, we not only align our practice with the highest international standards but also demonstrate our maturity and the ability to meet the specific needs of patients with CHD and those with acquired childhood heart disease. (CHD 1000 1 000 1,00 births 23057 23 057 23,05 2022 life 81 3 age challenges Furthermore hospitals professionals technologies industry financing systems generation parties Kingdom reality research education outcomes model 100 00 1,0 2305 2 05 23,0 202 8 10 0 1, 230 23, 20
6.
Homologous equivalence study of immunogenicity after third dose of Covid-19 vaccine (recombinant) with an interval of six months after the second dose, comparing the interval of eight and 12 weeks between the first two doses Covid19 Covid 19 Covid-1 recombinant (recombinant 1 Covid1 Covid-
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Vianna, Clarice Monteiro
; da Silva e Sá, Gloria Regina
; Seid, Maria Vitória Hadland
; Camacho, Luiz Antonio Bastos
; Xavier, Janaína Reis
; da Gama, Vitor Cardoso
; de Castro, Thalita da Matta
; dos Santos, Ewerton Alves Portela
; de Almeida, Camila Dias
; Cruz, Robson Leite de Souza
; Siqueira, Marilda
; Maia, Maria de Lourdes de Sousa
; Ferroco, Clara Lucy de Vasconcellos
; de Araújo, Mia Ferreira
; Tort, Luis Fernando López
; Caetano, Braulia Costa
.
BACKGROUND In response to the coronavirus disease 2019 (Covid-19) pandemic, Brazil authorised the Astra Zeneca/Fiocruz vaccine in January 2021. As the Delta variant emerged in May 2021, interval between vaccine doses was adjusted. By September 2021, the Brazilian National Immunisation Program recommended a booster dose for individuals over 70, and later expanded the recommendation to all adults. OBJECTIVES Assess the equivalence of IgG antibody response against the Covid-19 S protein before and approximately 28 days after the third dose of a Covid-19 recombinant vaccine. Two groups received initial two doses with intervals of eight and 12 weeks. METHODS This is a phase IV clinical study, uncontrolled, non-randomised. The study proposes calculating the ratio of geometric means titres (GMT) 28 days after the third dose, with a target ratio of confidence interval (CI) between 0.77 and 1.3. FINDINGS In the primary endpoint, there was no equivalence between the eight- and 12-week intervals with a slight variation favouring the eight-week group. Post-third dose, both groups showed increases titres at 28 days, three months, six months and 12 months. Both groups responded similarly to Delta and Omicron BA.1, with a more significant increase for Delta. MAIN CONCLUSIONS The study showed strong and consistent immune response in all age groups receiving the Covid-19 recombinant vaccine. Third dose elicited an increase in GMT by at least three times aligned with Ministry of Health strategies emphasising Bio-Manguinhos crucial role in pandemic control in the country. 201 Covid19 Covid 19 (Covid-19 ZenecaFiocruz Zeneca Fiocruz 2021 adjusted 70 adults Covid-1 2 1 weeks uncontrolled nonrandomised. nonrandomised non randomised. randomised non-randomised (GMT CI (CI 077 0 77 0.7 13 3 1.3 endpoint 12week week eightweek group Postthird Post BA1 BA BA.1 BioManguinhos Bio Manguinhos country 20 Covid1 (Covid-1 202 7 Covid- 07 0. 1. BA. (Covid- (Covid
7.
Coleoptera of Brazil: what we knew then and what we know now. Insights from the Catálogo Taxonômico da Fauna do Brasil Brazil now
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Caron, Edilson
; Monné, Marcela L.
; Ferreira, Vinicius S.
; Costa, Cleide
; Cupello, Mario
; Aloquio, Sergio
; Linzmeier, Adelita M.
; Vaz-de-Mello, Fernando Z.
; Leivas, Fernando W.T.
; Souza-Gonçalves, Igor
; Mermudes, José R.M.
; Almeida, Lúcia M.
; Moura, Luciano de A.
; Ferreira Júnior, Nelson
; Grossi, Paschoal C.
; Vanin, Sergio A.
; Ślipiński, Adam
; Anichtchenko, Alexander
; Newton, Alfred F.
; Sampaio, Aline
; Carelli, Allan
; Puker, Anderson
; Ferreira, André da S.
; Fernandes, André S.
; Roza, André S.
; Cline, Andrew
; Sampaio, Brunno H.L.
; Clarkson, Bruno
; Castro, Camila F. de
; Bicho, Carla de L.
; Benetti, César J.
; Ribeiro-Costa, Cibele S.
; Lopes-Andrade, Cristiano
; Manfio, Daiara
; Colpani, Daniara
; Basílio, Daniel S.
; Bená, Daniela de C.
; Pollock, Darren A.
; Souza, Diego de S.
; Rodrigues, Diego F.
; Chandler, Donald S.
; Nascimento, Elynton A. do
; Spiessberger, Erich L.
; Agrain, Federico A.
; Barbosa, Felipe F.
; Shockley, Floyd
; Nascimento, Francisco E. de L.
; Biffi, Gabriel
; Powell, Gareth S.
; Morse, Geoffrey E.
; Flores, Gustavo E.
; Escalona, Hermes
; Quintino, Hingrid Y.S.
; Rainho, Hugo L.
; Maddalena, Italo S.C.P.
; Hájek, Jiří
; McHugh, Joseph V.
; Botero, Juan P.
; Fuhrmann, Juares
; Churata-Salcedo, Julissa M.
; Vieira, Letícia M.
; Silveira, Luiz F.L. da
; Cruz, Luiza S. da
; Sekerka, Lukás
; Bologna, Marco A.
; Bevilaqua, Marcus V.O.
; Passos, Maria I.
; Chamorro, Maria L.
; Cherman, Mariana A.
; Bento, Matheus
; Gimmel, Matthew
; Segura, Melissa O.
; Ivie, Michael A.
; Thomas, Michael C.
; Monné, Miguel A.
; Lord, Nathan
; Hamada, Neusa
; Degallier, Nicolas
; Santos, Paula B. dos
; Duarte, Paulo R.M.
; Gnaspini, Pedro
; Bulirsch, Petr
; Regalin, Renato
; Leschen, Richard A.B.
; Constantin, Robert
; Corrêa, Rodrigo C.
; Gerstmeier, Roland
; Rosa, Simone P.
; Campos, Stéphanie V.N.
; Peck, Stewart B.
; Pacheco, Thaynara L.
; Polizei, Thiago T.S.
; McElrath, Thomas C.
; Grzymala, Traci L.
; Smith, Trevor R.
; Costa-Silva, Vinicius da
; Sandoval-Gómez, Vivian E.
; Sousa, Wesley O. de
; Tomaszewska, Wioletta
.
ABSTRACT In 2000, Cleide Costa published a paper presenting the state of knowledge of the Neotropical Coleopte ra, with a focus on the Brazilian fauna. Twenty-four years later, thanks to the development of the Coleoptera section of the Taxonomic Catalog of the Brazilian Fauna (CTFB - Catálogo Taxonômico da Fauna do Brasil) through the collaboration of 100 coleopterists from all over the globe, we can build on Costa’s work and present an updated overview of the state of knowledge of the beetles from Brazil. There are currently 35,699 species in 4,958 genera and 116 families known to occur in the country, including representatives of all extant suborders and superfamilies. Our data show that the Brazilian beetle fauna is the richest on the planet, concentrating 9% of the world species diversity, with some estimates accounting to up to 15% of the global total. The most diverse family in numbers of genera is Cerambycidae (1,056 genera), while in number of species it is Chrysomelidae (6,079 species). Conotrachelus Dejean, 1835 (Curculionidae) is the most species-rich genus, with 570 species. The French entomologist Maurice Pic is the author who has contributed the most to the naming of species recorded from Brazil, with 1,794 valid names in 36 families, whereas the Brazilians Ubirajara R. Martins and Maria Helena M. Galileo are the only ones among the top-ten authors to have named species in the 21st century. Currently, approximately 144 new species of Brazilian beetles are described each year, and this average is projected to increase in the next decade to 180 species per year, or about one new Brazilian beetle every two days. 2000 ra Twentyfour Twenty four later CTFB Brasil 10 globe Costas s Brazil 35699 35 699 35,69 4958 4 958 4,95 11 country superfamilies planet 9 diversity 15 total 1,056 1056 1 056 (1,05 genera, , genera) 6,079 6079 6 079 (6,07 . species) Dejean 183 Curculionidae (Curculionidae speciesrich rich genus 57 1794 794 1,79 3 R M topten top ten st century Currently 14 year 18 days 200 3569 69 35,6 495 95 4,9 1,05 105 05 (1,0 6,07 607 07 (6,0 5 179 79 1,7 20 356 35, 49 4, 1,0 0 (1, 6,0 60 (6, 17 7 1, 2 (1 6, (6 (
8.
Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio
; Simões, Marcus V.
; Correia, Edileide de Barros
; Marcondes-Braga, Fabiana Goulart
; Coelho-Filho, Otavio Rizzi
; Mesquita, Cláudio Tinoco
; Mathias Junior, Wilson
; Antunes, Murillo de Oliveira
; Arteaga-Fernández, Edmundo
; Rochitte, Carlos Eduardo
; Ramires, Felix José Alvarez
; Alves, Silvia Marinho Martins
; Montera, Marcelo Westerlund
; Lopes, Renato Delascio
; Oliveira Junior, Mucio Tavares de
; Scolari, Fernando Luis
; Avila, Walkiria Samuel
; Canesin, Manoel Fernandes
; Bocchi, Edimar Alcides
; Bacal, Fernando
; Moura, Lidia Zytynski
; Saad, Eduardo Benchimol
; Scanavacca, Mauricio Ibrahim
; Valdigem, Bruno Pereira
; Cano, Manuel Nicolas
; Abizaid, Alexandre Antonio Cunha
; Ribeiro, Henrique Barbosa
; Lemos Neto, Pedro Alves
; Ribeiro, Gustavo Calado de Aguiar
; Jatene, Fabio Biscegli
; Dias, Ricardo Ribeiro
; Beck-da-Silva, Luis
; Rohde, Luis Eduardo Paim
; Bittencourt, Marcelo Imbroinise
; Pereira, Alexandre da Costa
; Krieger, José Eduardo
; Villacorta Junior, Humberto
; Martins, Wolney de Andrade
; Figueiredo Neto, José Albuquerque de
; Cardoso, Juliano Novaes
; Pastore, Carlos Alberto
; Jatene, Ieda Biscegli
; Tanaka, Ana Cristina Sayuri
; Hotta, Viviane Tiemi
; Romano, Minna Moreira Dias
; Albuquerque, Denilson Campos de
; Mourilhe-Rocha, Ricardo
; Hajjar, Ludhmila Abrahão
; Brito Junior, Fabio Sandoli de
; Caramelli, Bruno
; Calderaro, Daniela
; Farsky, Pedro Silvio
; Colafranceschi, Alexandre Siciliano
; Pinto, Ibraim Masciarelli Francisco
; Vieira, Marcelo Luiz Campos
; Danzmann, Luiz Claudio
; Barberato, Silvio Henrique
; Mady, Charles
; Martinelli Filho, Martino
; Torbey, Ana Flavia Malheiros
; Schwartzmann, Pedro Vellosa
; Macedo, Ariane Vieira Scarlatelli
; Ferreira, Silvia Moreira Ayub
; Schmidt, Andre
; Melo, Marcelo Dantas Tavares de
; Lima Filho, Moysés Oliveira
; Sposito, Andrei C.
; Brito, Flávio de Souza
; Biolo, Andreia
; Madrini Junior, Vagner
; Rizk, Stephanie Itala
; Mesquita, Evandro Tinoco
.
9.
Soil acidity levels for blackberry liming recommendation and yield increase
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Silva, Enilson de Barros
; Lima, Ramony Cristina
; Gaurat, Jéssica Oliveira
; Braga Neto, Ari Medeiros
; Cruz, Maria do Céu Monteiro da
; Bié, Dalila Costa Aparecida
; Gonçalves, Emerson Dias
; Silva, Luiz Fernando de Oliveira
; Moura, Pedro Henrique Abreu
; Souza, Shirley Macedo de
.
Resumo O objetivo deste trabalho foi determinar os níveis de acidez para obter os atributos químicos do solo adequados à máxima produção de frutos de amoreiras-pretas cultivadas em solos ácidos submetidos a doses crescentes de calcário. Foram avaliadas as cultivares de amoreira-preta BRS Tupy, Brazos, Guarani e BRS Xavante nos solos Latossolo Vermelho Distroférico (LVdf) e Latossolo Vermelho distrófico (LVd), aos quais foram aplicadas quatro doses de calcário dolomítico (0, 1,5, 3,0 e 6,0 Mg ha-1). Foram avaliados o efeito da calagem sobre os atributos químicos do solo, em arranjo fatorial 2×4 (solos e doses de calcário), bem como o teor de nutrientes foliares e a produção de frutos, em arranjo fatorial 2×4×4 (solos, doses de calcário e cultivares). A produção máxima de frutos foi obtida com 3,3 Mg ha-1 de calcário dolomítico. As cultivares de amoreira-preta apresentaram alta demanda por Ca, Mg e saturação por bases e baixa tolerância ao alumínio nos solos. A partir de 3,3 Mg ha-1 de calcário dolomítico, a produção máxima de frutos de amoras-pretas cultivadas em solos ácidos é obtida com pH 5,6, saturação máxima tolerada de alumínio de 6%, concentração de Ca e Mg de 45,3 mmolc kg-1 e saturação por bases de 48,3%. amoreiraspretas amoreiras pretas amoreirapreta amoreira preta Tupy Brazos LVdf (LVdf LVd, LVd , (LVd) 0, 0 (0 15 1 5 1,5 30 3 3, 60 6 6, ha1. ha1 ha . ha-1) 24 2 4 2× calcário, calcário) 244 2×4× solos, cultivares. cultivares) 33 ha- amoraspretas amoras 56 5,6 6% 453 45 45, kg1 kg kg- 483 48 48,3% (LVd ( 1, 5, 48,3 48,
Abstract The objective of this work was to determine the acidity levels to obtain adequate soil chemical attributes for the maximum fruit yield of blackberry trees grown in acidic soils subjected to increasing limestone rates. The BRS Tupy, Brazos, Guarani, and BRS Xavante blackberry cultivars were evaluated on the Typic Hapludox (LVdf) and Rhodic Hapludox (LVd) soils, to which four rates of dolomitic limestone were applied (0, 1.5, 3.0, and 6.0 Mg ha-1). The effect of liming on soil chemical attributes, in a 2×4 factorial arrangement (soils and limestone rates), as well as leaf nutrient content and fruit yield, in a 2×4×4 factorial arrangement (soils, limestone rates, and cultivars), were evaluated. The maximum fruit yield was obtained with 3.3 Mg ha-1 dolomitic limestone. The blackberry cultivars showed a high demand for Ca, Mg, and base saturation and a low tolerance to aluminum in the soils. From 3.3 Mg ha-1 dolomitic limestone, the maximum fruit yield of blackberry trees grown in acidic soils is obtained with pH 5.6, maximum tolerated aluminum saturation of 6%, Ca and Mg concentration of 45.3 mmolc kg-1, and base saturation of 48.3%. Tupy Brazos Guarani LVdf (LVdf LVd (LVd 0, 0 (0 15 1 5 1.5 30 3 3.0 60 6 6. ha1. ha1 ha . ha-1) 24 2 4 2× , rates) 244 2×4× cultivars, cultivars) 33 3. ha- 56 5.6 6% 453 45 45. kg1, kg1 kg 1, kg-1 483 48 48.3% ( 1. 5. kg- 48.3 48.
10.
hTERT gene methylation in circulating DNA, tumor, and surrounding tissue in breast cancer: a prospective study DNA tumor cancer
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Queiroz, Luiz Fernando de
; Silva, Marcelo Soares da Mota e
; Souza, Heitor Siffert Pereira de
; Rosas, Siane Lopes Bittencourt
; Carvalho, Maria da Glória da Costa
.
ABSTRACT BACKGROUND: The human telomerase reverse transcriptase (hTERT) enzyme, encoded by the hTERT gene, synthesizes protective telomeric sequences on chromosomes and plays a fundamental role in cancer formation. Methylation of the hTERT gene has an upregulatory effect, increasing hTERT enzyme synthesis and allowing continuous tumor cell division. OBJECTIVE: In a group of patients with breast cancer, we aimed to analyze the methylation status of hTERT in the tumor, surrounding tissue, and circulating free deoxyribonucleic acid (cfDNA) of blood collected on the day of mastectomy and then approximately one year later. DESIGN AND SETTING: A prospective study was conducted at a university hospital in Rio de Janeiro, Brazil. METHODS: Samples were collected from 15 women with breast cancer on the day of mastectomy and approximately one year postoperatively. cfDNA was analyzed by sodium bisulfite conversion, followed by polymerase chain reaction, electrophoresis, and silver nitrate staining. RESULTS: Methylation of hTERT was detected in the tumors and surrounding tissues of all 15 patients. Five patients displayed hTERT methylation in the cfDNA from the blood of the first collection. Of the ten patients who returned for the second collection, three showed methylation. Two patients with methylation in the first collection did not display methylation in the second collection. One patient with no methylation in the first collection displayed methylation in the second collection, and one patient had a diminished level of methylation in the second collection. CONCLUSION: Only one-third of patients displayed methylation in their cfDNA, which may be related to the success of chemotherapy. BACKGROUND (hTERT formation effect division OBJECTIVE tissue (cfDNA later SETTING Janeiro Brazil METHODS 1 postoperatively conversion reaction electrophoresis staining RESULTS CONCLUSION onethird third chemotherapy
11.
Molecular monitoring by CDKN2A/p16INK4A and RB1 gene methylation in breast cancer CDKN2Ap16INK4A CDKNApINKA CDKN2A p16INK4A CDKN A p INK RB Ap CDKNA pINKA
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Queiroz, Luiz Fernando de
; Silva, Marcelo Soares da Mota e
; Rosman, Fernando Colonna
; Rosas, Siane Lopes Bittencourt
; Souza, Heitor Siffert Pereira de
; Carvalho, Maria da Glória da Costa
.
SUMMARY OBJECTIVE: This prospective study aimed to provide a comprehensive analysis of the methylation status of two pivotal genes, CDKN2A/p16INK4A (cyclin-dependent kinase inhibitor 2A) and RB1 (retinoblastoma transcriptional corepressor 1), in breast cancer patients. METHODS: Samples were obtained from 15 women diagnosed with breast cancer and who underwent a total mastectomy. DNA was extracted from the tumor, non-tumor tissue, and peripheral blood (circulating cell-free DNA). The methylation pattern of cell-free DNA extracted from blood collected on the day of mastectomy was compared with the methylation pattern of cell-free DNA from blood collected 1 year post-surgery. The methylation analysis was carried out by sodium bisulfite conversion and polymerase chain reaction, followed by electrophoresis. RESULTS: Methylation of CDKN2A/p16INK4A was identified in 13 tumor samples and 12 non-tumor tissue samples. Two patients exhibited CDKN2A/p16INK4A methylation in the cell-free DNA of the first blood collection, while another showed methylation only in the cell-free DNA of the subsequent blood collection. Regarding RB1, 11 tumors and 8 non-tumor tissue samples presented methylation of the gene. CONCLUSION: This study presents a novel approach for monitoring breast cancer patients through the analysis of cell-free DNA methylation. This analysis can detect changes in methylation patterns before any visible sign of cancer appears in breast tissue and could help predict the recurrence of malignant breast tumors. OBJECTIVE genes CDKN2Ap16INK4A CDKNApINKA CDKN2A p16INK4A CDKN A p INK cyclindependent cyclin dependent 2A RB retinoblastoma 1, , 1) METHODS nontumor non circulating cellfree cell free DNA. . DNA) postsurgery. postsurgery post surgery. surgery post-surgery reaction electrophoresis RESULTS collection gene CONCLUSION Ap CDKNA pINKA
12.
PROCESS INTEGRATION MODEL AND ARTIFACTS CONSISTENCY ASSESSMENT IN MANAGEMENT SYSTEMS
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Resende Junior, Pedro Carlos
; Silva, Luiz Fernando Costa Pereira da
; Santana, Ronaldo Soares
; Fujihara, Ricardo Ken
; Viana, William Souza
.
RESUMO A pesquisa teve como objetivo desenvolver um modelo de gestão da capacidade de integração de processos na área de Recursos Humanos em uma grande organização brasileira que integra uma rede global de prestação de serviços. Utilizou-se de abordagem qualitativa e quantitativa para analisar os dados da cadeia de valor da organização e para avaliar a consistência das integrações e artefatos mapeados diante dos requisitos dos stakeholders, sob a abordagem da Teoria das Restrições. Entre os principais resultados, foram desenvolvidas duas escalas de aferição de consistência organizacional: a) de validação do nível de atualização dos artefatos; e b) diagnóstico da aderência tecnológica. Com o modelo, foram mapeados todos os 16 subsistemas organizacionais do contexto, 142 artefatos e 666 integrações. O modelo aplicado resultou em ganhos globais significativos na integração de processos na cadeia de valor pesquisada. serviços Utilizouse Utilizou se stakeholders Restrições resultados organizacional b tecnológica 1 contexto 14 66 pesquisada 6
ABSTRACT This research aimed to develop a management model to increase the capacity of integrating processes in the human resources area in a large Brazilian service organization. The research used a qualitative and quantitative approach to analyze data from the organization’s value chain and to evaluate the consistency of integrations and artifacts mapped in light of stakeholder requirements under the theory of constraints. Among the main results, two scales were developed to measure organizational consistency: a) validation of the level of updating of artifacts; and, b) diagnosis of technological adherence. With the model, all 16 organizational subsystems of the context, 142 artifacts and 666 integrations were mapped. The applied model resulted in significant global gains in the processes’ integration of the researched value chain. organization organizations s constraints results b adherence 1 context 14 66 6
RESUMEN Esta investigación tuvo como objetivo desarrollar un modelo de gestión de la capacidad de integración de procesos en el área de recursos humanos en una gran organización brasileña que forma parte de una red global de prestación de servicios. La investigación utilizó un enfoque cualitativo y cuantitativo para analizar datos de la cadena de valor de la organización y evaluar la consistencia de las integraciones y artefactos mapeados a la luz de los requisitos de los stakeholders, bajo el enfoque de la teoría de las restricciones. Entre los principales resultados, se desarrollaron dos escalas para medir la consistencia organizacional: a) validación del nivel de actualización de los artefactos; y, b) diagnóstico de adherencia tecnológica. Con el modelo se mapearon los 16 subsistemas organizativos del contexto, 142 artefactos y 666 integraciones. El modelo aplicado resultó en importantes ganancias globales en la integración de procesos en la cadena de valor investigada. servicios stakeholders restricciones resultados organizacional b tecnológica 1 contexto 14 66 investigada 6
13.
Task force of the Brazilian Society of Otology — evaluation and management of peripheral facial palsy
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Pauna, Henrique Furlan
; Silva, Vagner Antonio Rodrigues
; Lavinsky, Joel
; Hyppolito, Miguel Angelo
; Vianna, Melissa Ferreira
; Gouveia, Mariana de Carvalho Leal
; Monsanto, Rafael da Costa
; Polanski, José Fernando
; Silva, Maurício Noschang Lopes da
; Soares, Vítor Yamashiro Rocha
; Sampaio, André Luiz Lopes
; Zanini, Raul Vitor Rossi
; Abrahão, Nicolau M.
; Guimarães, Guilherme Correa
; Chone, Carlos Takahiro
; Castilho, Arthur Menino
.
Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (
14.
[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães
Barroso, Weimar Kunz Sebba
Mion Júnior, Décio
Nobre, Fernando
Mota-Gomes, Marco Antonio
Jardim, Paulo Cesar Brandão Veiga
Amodeo, Celso
Camargo, Adriana
Alessi, Alexandre
Sousa, Ana Luiza Lima
Brandão, Andréa Araujo
Pio-Abreu, Andrea
Sposito, Andrei Carvalho
Pierin, Angela Maria Geraldo
Paiva, Annelise Machado Gomes de
Spinelli, Antonio Carlos de Souza
Machado, Carlos Alberto
Poli-de-Figueiredo, Carlos Eduardo
Rodrigues, Cibele Isaac Saad
Forjaz, Cláudia Lúcia de Moraes
Sampaio, Diogo Pereira Santos
Barbosa, Eduardo Costa Duarte
Freitas, Elizabete Viana de
Cestário , Elizabeth do Espírito Santo
Muxfeldt, Elizabeth Silaid
Lima Júnior, Emilton
Campana, Erika Maria Gonçalves
Feitosa, Fabiana Gomes Aragão Magalhães
Consolim-Colombo, Fernanda Marciano
Almeida, Fernando Antônio de
Silva, Giovanio Vieira da
Moreno Júnior, Heitor
Finimundi, Helius Carlos
Guimarães, Isabel Cristina Britto
Gemelli, João Roberto
Barreto Filho, José Augusto Soares
Vilela-Martin, José Fernando
Ribeiro, José Marcio
Yugar-Toledo, Juan Carlos
Magalhães, Lucélia Batista Neves Cunha
Drager, Luciano Ferreira
Bortolotto, Luiz Aparecido
Alves, Marco Antonio de Melo
Malachias, Marcus Vinícius Bolívar
Neves, Mario Fritsch Toros
Santos, Mayara Cedrim
Dinamarco, Nelson
Moreira Filho, Osni
Passarelli Júnior, Oswaldo
Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira
Miranda, Roberto Dischinger
Bezerra, Rodrigo
Pedrosa, Rodrigo Pinto
Paula, Rogério Baumgratz de
Okawa, Rogério Toshiro Passos
Póvoa, Rui Manuel dos Santos
Fuchs, Sandra C.
Inuzuka, Sayuri
Ferreira-Filho, Sebastião R.
Paffer Fillho, Silvio Hock de
Jardim, Thiago de Souza Veiga
Guimarães Neto, Vanildo da Silva
Koch, Vera Hermina
Gusmão, Waléria Dantas Pereira
Oigman, Wille
Nadruz, Wilson
Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population.
Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care.
It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations.
Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced.
Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM).
Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance.
Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.
La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial.
La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización.
Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones.
Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA.
La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA).
Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia.
Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.
A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial.
A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização.
Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações.
Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA.
A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA).
Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz).
Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.
15.
Effects of water immersion on cardiac responses in people living with HIV at rest and during exercise
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Masi, Fabrízio Di
; Silva, Gabriel Costa e
; Silveira, Anderson Luiz Bezerra da
; Conceição, Rodrigo Rodrigues da
; Ribeiro, Luiz Claudio Pereira
; Ferry, Fernando Raphael de Almeida
.
ABSTRACT The present research aimed to compare the HRV of people living with HIV (PLWH) with non-infected individuals in aquatic and dryland environments. Twenty participants were divided into two groups. PLWH composed the experimental group (EG), and seronegative participants composed the control group (CG). In dryland, HRV was measured in time and frequency domains, as follows: 10 minutes in rest (RES), 20 minutes of moderate and intense aerobic exercise (EXE), and 30 minutes post-exercise recovery (REC). After 72 hours, the same procedures were repeated in the aquatic environment. HRV analysis demonstrated significant differences in Mean r-r (Δ%= 3.5%, p< 0.01) and rMSSD (Δ%= −19.4%, p< 0.05) when compared dryland vs aquatic environment in RES. We observed similar results in rMSSD (Δ%= 49.2%, p< 0.01), pNN50(%) (Δ%= 79.1%, p< 0.01), and SD1 (Δ%= 49.3%, p< 0.01), during REC. Significant differences (p< 0.01) were also demonstrated for the HF during RES (Δ%= −43.4%) and REC (Δ%= −28.8%). However, the EG intra-group analysis showed no significant differences. The inter-group analysis at RES in dryland demonstrated significant differences in rMSSD (Δ%= −36.5%, p< 0.05), pNN50(%) (Δ%= −54.8%, p< 0.05), and SD1 (Δ%= 46.5%, p< 0.05). We also observed significant differences in mean R-R intervals (Δ%= −17.8%, p< 0.01), SDNN (Δ%= −41.2%, p< 0.01), rMSSD (Δ%= −50.5%, p< 0.01), pNN50 (Δ%= −73.6%, p< 0.001), and SD1 (Δ%= −50.4%, p< 0.001) during water immersion as well as the HF (Δ%= −67.6%, p< 0.01). The mean R-R interval (Δ%= −16.3%, p< 0.01), SDNN (Δ%= −46.4%, p< 0.001), rMSSD (Δ%= −57.0%, p< 0.001), pNN50 (Δ%= −73.1, p< 0.001), and SD1 (Δ%= −57.1, p< 0.001) also showed significant differences during REC. Water immersion increases the CG vagal modulation as expected. However, without any influence in EG. The results indicate a decreased vagal modulation in PLHIV in ART, indicating a possible autonomic dysfunction over the heart for this group.
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