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au:ANDRADE, LUIZ ANTONIO BOTELHO
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Panorama das Intervenções Coronárias Percutâneas em Oclusões Totais Crônicas em Centros Participantes do LATAM CTO Registry no Brasil
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Silva, Antonio Carlos Botelho da
; Paula, João Eduardo Tinoco de
; Campos, Carlos M.
; Ribeiro, Marcelo Harada
; Martins Filho, Evandro
; Oliveira, Marcos Danillo Peixoto
; Côrtes, Leandro Assumpção
; Abelin, Aníbal Pereira
; Zukowski, Cleverson Neves
; Martinelli, Gustavo Cervino
; Brito, Fábio Sândoli de
; Muniz, Antônio José
; Cantarelli, Marcelo José de Carvalho
; Andrade, Pedro Beraldo de
; Medeiros, César Rocha
; Falcão, Breno de Alencar Araripe
; Fuchs, Felipe Costa
; Silva, Leonardo Sinnott
; Fattah, Tammuz
; Degrazia, Ramiro Caldas
; Mangione, José Armando
; Bezerra, Cristiano Guedes
; Baradel, Sandra
; Silveira, João Brum
; Ybarra, Luiz Fernando
; Weillenmann, Daniel
; Gottschall, Carlos
; Lemke, Viviana
; Silva, Franciele Rosa da
; Schmidt, Marcia Moura
; Belli, Karlyse Claudino
; Oliveira, Pedro Piccaro de
; Quadros, Alexandre Schaan de
.
Abstract Background Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries. Objectives To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil. Methods Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months. Results Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%. Conclusions CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centers. (PCIs CTOs, , (CTOs) realworld real world countries characteristics aspects Registry 1 over attempt 100 artery months 119 included 85% 85 (85% andor moderatesevere moderate severe 24%. 24 24% . (24%) 84 84% 81 reentry re entry 9 9% 10 10% Inhospital In hospital 23 2 2.3 cases 075 0 75 0.75% rates (CTOs 11 8 (85 (24% 2. 07 7 0.75 (8 (24 0.7 ( (2 0.
Resumo Fundamento Tem sido observado um grande avanço nas técnicas e nos dispositivos para a realização de intervenções coronárias percutâneas (ICP) em oclusões totais coronarianas crônicas (OTC), mas existem poucos dados da prática do mundo real em países em desenvolvimento. Objetivos Relatar as características clínicas e angiográficas, os aspectos dos procedimentos e os resultados clínicos da ICP de OTC em centros dedicados a esse procedimento no Brasil. Métodos Os pacientes incluídos foram submetidos à ICP de OTC em centros participantes do LATAM CTO Registry, um registro multicêntrico latino-americano dedicado à coleta prospectiva desses dados. Os critérios de inclusão foram procedimentos realizados no Brasil, idade acima de 18 anos e presença de OTC com tentativa de ICP. A definição de OTC foi lesão de 100% em uma artéria coronária epicárdica, conhecida ou estimada como tendo pelo menos 3 meses de evolução. Resultados Foram incluídos dados de 1.196 ICPs de OTC. Os procedimentos foram realizados principalmente para controle da angina (85%) e/ou tratamento de uma grande área isquêmica (24%). A taxa de sucesso técnico foi de 84% e foi alcançada com técnicas de fios anterógrados em 81%, dissecção/reentrada anterógrada em 9% e retrógrada em 10% dos procedimentos. Os eventos cardiovasculares adversos intra-hospitalares ocorreram em 2,3% dos casos, sendo a mortalidade de 0,75%. Conclusões As OTC podem ser tratadas no Brasil por intervenção coronária percutânea de forma efetiva e com baixas taxas de complicações. O desenvolvimento científico e tecnológico observado nessa área na última década reflete-se na prática clínica de centros brasileiros dedicados a essa técnica. (ICP OTC, , (OTC) angiográficas Registry latinoamericano latino americano 1 100 epicárdica evolução 1196 196 1.19 85% 85 (85% eou 24%. 24 24% . (24%) 84 81 81% dissecçãoreentrada dissecção reentrada 9 10 intrahospitalares intra hospitalares 23 2 2,3 casos 075 0 75 0,75% complicações refletese reflete se técnica (OTC 119 19 1.1 8 (85 (24% 2, 07 7 0,75 11 1. (8 (24 0,7 ( (2 0,
2.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
; Jesuíno, Isabella de Andrade
; Reis, Luiz Fernando Lima
; Mattos, Renata Rodrigues de
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Spadoni, Clayse Carla da Silva
; Moro, Elisângela Emilene
; Bueno, Flávia Regina
; Sampaio, Camila Santana Justo Cintra
; Silva, Débora Patrício
; Baldassare, Franca Pellison
; Silva, Ana Cecilia Alcantara
; Veiga, Thabata
; Barbante, Leticia
; Lambauer, Marianne
; Campos, Viviane Bezerra
; Santos, Elton
; Santos, Renato Hideo Nakawaga
; Laranjeiras, Ligia Nasi
; Valeis, Nanci
; Santucci, Eliana
; Miranda, Tamiris Abait
; Patrocínio, Ana Cristina Lagoeiro do
; Carvalho, Andréa de
; Sousa, Eduvirgens Maria Couto de
; Sousa, Ancelmo Honorato Ferraz de
; Malheiro, Daniel Tavares
; Bezerra, Isabella Lott
; Rodrigues, Mirian Batista
; Malicia, Julliana Chicuta
; Silva, Sabrina Souza da
; Gimenes, Bruna dos Passos
; Sesin, Guilhermo Prates
; Zavascki, Alexandre Prehn
; Sganzerla, Daniel
; Medeiros, Gregory Saraiva
; Santos, Rosa da Rosa Minho dos
; Silva, Fernanda Kelly Romeiro
; Cheno, Maysa Yukari
; Abrahão, Carolinne Ferreira
; Oliveira Junior, Haliton Alves de
; Rocha, Leonardo Lima
; Nunes Neto, Pedro Aniceto
; Pereira, Valéria Chagas
; Paciência, Luis Eduardo Miranda
; Bueno, Elaine Silva
; Caser, Eliana Bernadete
; Ribeiro, Larissa Zuqui
; Fernandes, Caio Cesar Ferreira
; Garcia, Juliana Mazzei
; Silva, Vanildes de Fátima Fernandes
; Santos, Alisson Junior dos
; Machado, Flávia Ribeiro
; Souza, Maria Aparecida de
; Ferronato, Bianca Ramos
; Urbano, Hugo Corrêa de Andrade
; Moreira, Danielle Conceição Aparecida
; Souza-Dantas, Vicente Cés de
; Duarte, Diego Meireles
; Coelho, Juliana
; Figueiredo, Rodrigo Cruvinel
; Foreque, Fernanda
; Romano, Thiago Gomes
; Cubos, Daniel
; Spirale, Vladimir Miguel
; Nogueira, Roberta Schiavon
; Maia, Israel Silva
; Zandonai, Cassio Luis
; Lovato, Wilson José
; Cerantola, Rodrigo Barbosa
; Toledo, Tatiana Gozzi Pancev
; Tomba, Pablo Oscar
; Almeida, Joyce Ramos de
; Sanches, Luciana Coelho
; Pierini, Leticia
; Cunha, Mariana
; Sousa, Michelle Tereza
; Azevedo, Bruna
; Dal-Pizzol, Felipe
; Damasio, Danusa de Castro
; Bainy, Marina Peres
; Beduhn, Dagoberta Alves Vieira
; Jatobá, Joana D’Arc Vila Nova
; Moura, Maria Tereza Farias de
; Rego, Leila Rezegue de Moraes
; Silva, Adria Vanessa da
; Oliveira, Luana Pontes
; Sodré Filho, Eliene Sá
; Santos, Silvana Soares dos
; Neves, Itallo de Lima
; Leão, Vanessa Cristina de Aquino
; Paes, João Lucidio Lobato
; Silva, Marielle Cristina Mendes
; Oliveira, Cláudio Dornas de
; Santiago, Raquel Caldeira Brant
; Paranhos, Jorge Luiz da Rocha
; Wiermann, Iany Grinezia da Silva
; Pedroso, Durval Ferreira Fonseca
; Sawada, Priscilla Yoshiko
; Prestes, Rejane Martins
; Nascimento, Glícia Cardoso
; Grion, Cintia Magalhães Carvalho
; Carrilho, Claudia Maria Dantas de Maio
; Dantas, Roberta Lacerda Almeida de Miranda
; Silva, Eliane Pereira
; Silva, Antônio Carlos da
; Oliveira, Sheila Mara Bezerra de
; Golin, Nicole Alberti
; Tregnago, Rogerio
; Lima, Valéria Paes
; Silva, Kamilla Grasielle Nunes da
; Boschi, Emerson
; Buffon, Viviane
; Machado, André Sant’Ana
; Capeletti, Leticia
; Foernges, Rafael Botelho
; Carvalho, Andréia Schubert de
; Oliveira Junior, Lúcio Couto de
; Oliveira, Daniela Cunha de
; Silva, Everton Macêdo
; Ribeiro, Julival
; Pereira, Francielle Constantino
; Salgado, Fernanda Borges
; Deutschendorf, Caroline
; Silva, Cristofer Farias da
; Gobatto, Andre Luiz Nunes
; Oliveira, Carolaine Bomfim de
; Dracoulakis, Marianna Deway Andrade
; Alvaia, Natália Oliveira Santos
; Souza, Roberta Machado de
; Araújo, Larissa Liz Cardoso de
; Melo, Rodrigo Morel Vieira de
; Passos, Luiz Carlos Santana
; Vidal, Claudia Fernanda de Lacerda
; Rodrigues, Fernanda Lopes de Albuquerque
; Kurtz, Pedro
; Shinotsuka, Cássia Righy
; Tavares, Maria Brandão
; Santana, Igor das Virgens
; Gavinho, Luciana Macedo da Silva
; Nascimento, Alaís Brito
; Pereira, Adriano J
; Cavalcanti, Alexandre Biasi
.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
3.
Response to Chagas disease in Brazil: strategic milestones for achieving comprehensive health care
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Ramos Jr, Alberto Novaes
; Souza, Eliana Amorim de
; Guimarães, Maria Cristina Soares
; Vermeij, Debbie
; Cruz, Marly Marques
; Luquetti, Alejandro O.
; Diotaiuti, Liléia
; Palmeira, Swamy Lima
; Lima, Mayara Maia
; Costa, Veruska Maia da
; Andrade, Luiz Antonio Botelho
; Correia, Dalmo
; Sousa, Andréa Silvestre de
.
Revista da Sociedade Brasileira de Medicina Tropical
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4.
Ocean Literacy, formal education, and governance: A diagnosis of Brazilian school curricula as a strategy to guide actions during the Ocean Decade and beyond
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Pazoto, Carmen Edith
; Silva, Edson Pereira
; Andrade, Luiz Antonio Botelho
; Favero, Jana Menegassi del
; Alô, Camilla Ferreira Souza
; Duarte, Michelle Rezende
.
ABSTRACT Ocean Literacy (OL) was proposed by UNESCO as a goal for the Decade of Ocean Science for Sustainable Development (Ocean Decade) aiming to (1) increase understanding of the importance of the ocean, (2) significantly influence communication on related subjects, and (3) facilitate informed and responsible decision-making about the ocean and its resources. Formal education is essential to expand the reach of OL, providing people with tools to engage in coastal and marine issues consciously and knowingly. To this end, content analysis of school curricula can help planning strategies, especially to empower citizens to implement public policies. This study assessed the extent to which OL-related terms and words are present in Brazilian curricular documents at federal (National Curriculum Parameters-PCNs and Common National Curriculum Base-BNCC) and regional (Federative Units curricular guidelines-RCs) levels. Qualitative (content analysis) and quantitative analyses (descriptive and non-parametric statistics, and multivariate analysis) were performed. The number of occurrences of OL-related words and terms were registered and counted. Nineteen words were found, totaling 797 citations (a frequency of 0.0001 in the total number of words referring to content). The number of citations were higher in BNCC-based RCs than in PCN-based RCs (Kruskal-Wallis test, p = 0.0009). Principal component analysis separated the documents into two groups, one related to BNCC-based RCs of Northeast, North and Midwest regions, with a higher number of OL related terms, and the other group with the PCN based RCs of these same regions plus those documents of Southeast and South regions (principal component 1 explaining 97.90% of the total variation and having 0.93 correlation with the total frequency of citations). General results indicated that Brazilian production on fields and themes related to OL is still concentrated in national journals, books, and booklets, thus with a limited impact. In same way although school curricula in Brazil have a larger number of topics on marine environments than do other countries, they showed heterogeneity among Federative Units, but generally with the topics still representing a very small fraction of Brazilian curricula. Thus, it is necessary to expand the contents related to the ocean and marine environments in curricula to provide students with basic knowledge about the importance and functions of these environments, as well as their conservation. Therefore, results here emphasize the need to implement OL to highlight the importance of knowledge of the oceans and enable citizens to discuss marine conservation policies and promote ocean sustainability. This study provided some strategies to increase OL in formal education and, hence, reach various stakeholders, which is fundamental to implement the United Nations Ocean Decade in Brazil and the Global South.
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