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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

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

Occurrence of avian reovirus and picobirnavirus in wild birds from an environmental protection area in the Brazilian Amazon
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PEREIRA, Diego

; SOUTO, Lizandra Caroline dos Santos

; GUERRA, Sylvia de Fátima dos Santos

; PENHA-JÚNIOR, Edvaldo Tavares da

; LOBO, Patrícia dos Santos

; SOARES, Luana da Silva

; PINHEIRO, Helder Henrique Costa

; CHAGAS, Elaine Hellen Nunes

; GUIMARÃES, Ricardo José de Paula Souza e

; RAMOS, Bruna Alves

; CHAGAS, Liliane Leal das

; FREITAS, Maria Nazaré Oliveira

; FURTADO, Erilene Cristina da Silva

; RODRIGUES, Jéssica Cecília Pinheiro

; CASSEB, Alexandre do Rosário

; MARTINS, Lívia Caricio

; MASCARENHAS, Joana D’Arc Pereira

Acta Amazonica

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2024, Volume 54 N. 1 elocation e54hs23012

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

ABSTRACT Wild birds have great prominence in the transmission of diseases to humans, mainly due to their ease of access to human populations, raising concerns about the potential impact of that proximity on public health. The present study reports ARV and PBV occurrence in wild birds from an environmental protection area in the Amazon biome, in Pará state, Brazil. We obtained 155 fecal specimens from 47 species of wild birds for RNA extraction, ARV and PBV detection utilizing molecular methods, nucleotide sequencing, and phylogenetic analysis. ARV prevalence was 0.6% (1/155), being positive in an individual of Myrmotherula longipennis, and PBV prevalence was 1.29% (2/155), affecting two individuals of Guira guira. The PBV strains were assigned to genogroup I based on phylogenetic analysis, and they shared a strong phylogenetic link with strains isolated from different geographic locations. The ARV strain was more closely related to strains that had previously circulated in the same region. The presence of ARV and PBV in this habitat suggests that infection cycles of these agents occur naturally in the wild ecosystem, potentially triggering transmission events between bird species and humans. This is the first study on ARV detection in wild birds in Brazil and the first report on the occurrence of PBV in wild Guira guira. Additional studies are required to determine the epidemiology, origin, evolution, and emergence of new potentially pathogenic viruses in the Amazon.

RESUMO As aves silvestres têm grande destaque na transmissão de doenças ao homem, principalmente pela facilidade de acesso à população humana, levantando preocupações sobre o potencial impacto dessa proximidade no contexto da saúde pública. O presente estudo relata a ocorrência de ARV e PBV em aves silvestres de uma área de proteção ambiental no bioma Amazônico. Obtivemos 155 espécimes fecais de 47 espécies de aves silvestres, que foram submetidos a extração de RNA, detecção de ARV e PBV por técnicas moleculares, sequenciamento nucleotídico e análise filogenética. A prevalência de infecção por ARV foi 0,6% (1/155), sendo positivo em um indivíduo de Myrmotherula longipennis, e a prevalência de PBV foi 1,29% (2/155), afetando dois insdivíduos de Guira guira. A análise filogenética agrupou as cepas de PBV no genogrupo I, mostrando intensa relação filogenética com cepas isoladas de outras regiões geográficas. A cepa de ARV esteve mais relacionada filogeneticamente a cepas previamente circulantes na mesma região. Este é o primeiro estudo sobre detecção de ARV em aves silvestres no Brasil e o primeiro relato sobre a ocorrência de PBV em Guira guira. A circulação de ARV e PBV nesse ambiente demonstra que os ciclos desses agentes estão ocorrendo de forma natural no ecossistema silvestre, o que pode desencadear possíveis eventos de transmissão entre as espécies aviárias e humanos. Estudos adicionais são necessários para determinar a epidemiologia, origem, evolução e surgimento de novos vírus potencialmente patogênicos na Amazônia.

https://doi.org/10.1590/1809-4392202300120

Biogran Grafting in Rat Tibia Defects - A Model of High Bone Metabolism Site
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Ferreira, Luiza de Almeida Queiroz

; Lehman, Luiz Felipe Cardoso

; Diniz, Marina Gonçalves

; Ferreira, Anderson José

; Silva, Rosangela Maria Ferreira da Costa e

; Silva, Tarcília Aparecida

; Mesquita, Ricardo Alves

; Oliveira, Rafaela Férrer de

; Noronha, Mariana Saturnino

; Leão, Daniel Marques

; Andrade, Ângela Leão

; Domingues, Rosana Zacarias

; Diniz, Ivana Márcia Alves

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24230003

Abstract: En | Text: En | PDF: En

Abstract We investigated the Biogran on bone repair and metabolism at several time-intervals upon grafting into rat tibia artificial defects. The biomaterial was thoroughly characterized in vitro, and its dissolution behavior upon immersion was assessed in simulated body fluid (SBF) solution for 1, 3, 7, 14, and 30 days. Biogran was also assessed by in vitro hydroxyapatite formation in SBF solution, which is a marker for bioactive behavior. In vivo, distal and proximal bone defects were performed in the Wistar rat's right tibia and filled according to the experimental groups: I) negative control, no filling; II) positive control, 10 mg of autogenous bone; and III) 10 mg of Biogran. Animals were euthanized at 1, 2, 3, 4, 7, and 10 weeks. Bone neoformation was analyzed using histomorphometry (proximal defect), and local levels of bone morphogenetic protein 2 (BMP-2) were measured using the ELISA assay (distal defect). In vitro, the Biogran sample showed a fast dissolution rate within the first 7 days, parallel to the formation of the hydroxyapatite layer. In vivo, the sample was progressively resorbed at a higher rate within the first month until it became almost absent at week 10th. The sample presented similar or higher bone neoformation concerning the autogenous bone. BMP-2 levels were sustained in the Biogran group (around 200 pg/mg) and detected until the last experimental time with a significant difference compared with the controls. Results suggest Biogran is a candidate for hard tissue engineering even in highly active bone remodeling sites.

https://doi.org/10.1590/1678-4324-2024230003

Impact of harvest delay on the physiological and sanitary quality of Sorghum sp. seeds
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Martins, Antonio Guimarães

; Zuffo, Alan Mario

; Barrozo, Leandra Matos

; Mezzomo, Ricardo

; Silva, Francisco Charles dos Santos

; Steiner, Fabio

; Santos, Raianara Andrade dos

; Alves, Charline Zaratin

Revista Ciência Agronômica

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2024, Volume 55 elocation e20238802

Abstract: En | Text: En | PDF: En

ABSTRACT Harvest delay can alter the physiological and sanitary quality of sorghum seeds due to the longer exposure time of seeds to adverse environmental conditions in the field. In this study, we investigated the impact of delayed Sorghum sp. harvest on the physiological and sanitary quality of seeds in four hybrids grown in the tropical soil of the Brazilian Cerrado region. Plants from four Sorghum sp. hybrids (IPA SUDAN 4202, BRS 658, BRS 810, and BRS 373) were grown and submitted to four seed harvest periods (0, 7, 14, and 21 days after stage 9 - seed physiological maturity). The treatments were arranged in a completely randomized block design in a 4 × 4 factorial, with four replicates. At each harvest period, the thousand-seed weight, water content, first count of the germination test, germination, seedling emergence, emergence speed index, seedling dry matter, accelerated aging, electrical conductivity, and sanitary quality of seeds were determined. Seeds of higher physiological and sanitary quality of the IPA SUDAN 4202 and BRS 658 sorghum hybrids can be obtained when the harvest is carried out up to 7 days after the physiological maturity stage. However, the delay in seed harvesting at 14 and 21 days after physiological maturity results in a higher incidence of Colletotrichum sp., Curvularia sp., Rhizoctonia sp., and Alternaria sp. on the seeds of these hybrids. Delaying the harvest of sorghum seeds from 7 days after the physiological maturity stage compromises seed vigor and viability and increases the incidence of pathogens.

https://doi.org/10.5935/1806-6690.20230068

Leprosy in children under fifteen years of age in the most hyperendemic municipality in Brazil
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Costa, Ricardo Milhomem

; Menezes, Marcela Silva

; Guimarães, Maria Sortênia Alves

; Franchi, Eliane Patrícia Pereira

; Monteiro, Lorena Dias

; Alvim, Mariana Caroline Tocantins

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2023022

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

ABSTRACT Objective: To describe leprosy involvement and physical disability profiles in children and adolescents under 15 years old. Methods: Ecological time series study, based on data from the Brazilian Notifiable Diseases Information System, including new cases of leprosy residing in Palmas (TO), from 2001 to 2020. Results: A total of 471 notified cases in children and adolescents under 15 years of age were evaluated, resulting in a detection coefficient of 26.5 per 100,000 inhabitants. Of these, 52% (n=243) were women, 5% (n=24) corresponded to grade two disability, and 36% (n=168) were diagnosed through spontaneous demand. The temporal trend analysis showed a 0.5% reduction in the detection coefficient. There was a significant decrease in the diagnosis of the undetermined and tuberculoid clinical forms and a significant increase in the dimorphous form. Diagnosis through contact examination increased significantly by 13.1% and that through spontaneous demand decreased by 4.9%. The detection coefficient of cases with grade two disability reduced significantly by 7.4% while those with grade one increased by 16.8%. Conclusions: Despite the downward trend in the detection coefficient in children and adolescents under 15 years of age and in cases with grade two disability, other factors indicate failure in the adequate management of leprosy in Palmas.

RESUMO Objetivo: Descrever os perfis de acometimento de hanseníase e incapacidade física em menores de 15 anos. Métodos: Estudo ecológico de série temporal, baseado em dados do Sistema Nacional de Agravos de Notificação, incluindo casos novos de hanseníase residentes em Palmas (TO), no período de 2001 a 2020. Resultados: Foram avaliados 471 casos notificados em crianças e adolescentes menores de 15 anos, resultando em um coeficiente de detecção de 26,5 por cem mil habitantes. Destes, 52% (n=243) eram do gênero feminino, 5% (n=24) correspondiam ao grau dois de incapacidade física, e 36% (n=168) foram diagnosticados por demanda espontânea. A análise de tendência temporal mostrou queda do coeficiente de detecção em 0,5%. Houve queda significativa no diagnóstico das formas clínicas indeterminada e tuberculoide e aumento significativo da dimorfa. O diagnóstico por exame de contato teve um aumento significativo de 13,1% e o por demanda espontânea, queda significativa de 4,9%. O coeficiente de detecção de casos com grau dois de incapacidade apresentou uma queda significativa de 7,4%, enquanto o de casos com grau um, apresentou um aumento de 16,8%. Conclusões: Apesar da tendência de queda do coeficiente de detecção em menores de 15 anos e do coeficiente de detecção de casos com grau dois de incapacidade, outros fatores indicam falha no manejo adequado da hanseníase em Palmas.

https://doi.org/10.1590/1984-0462/2024/42/2023022

Mast cells in oral lichen planus and oral lichenoid lesions related to dental amalgam contact
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NORONHA, Mariana Saturnino de

; SOUTO, Giovanna Ribeiro

; FELIX, Fernanda Aragão

; ABREU, Lucas Guimarães

; AGUIAR, Maria Cássia Ferreira

; MENDONÇA, Elismauro Francisco

; MESQUITA, Ricardo Alves

Brazilian Oral Research

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2024, Volume 38 elocation e005

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral lichen planus (OLP) and oral lichenoid lesions related to dental amalgam. Nineteen specimens of OLP, OLLC, and healthy oral mucosa were selected. Mononuclear inflammatory cells were analyzed. Histochemical and immunohistochemical analyses were performed using toluidine blue, anti-c-kit and anti-tryptase reagents, and the results were quantified in areas A and B of connective tissue. Mast cells of all OLP and OLLC samples were positive for toluidine blue, c-kit, and tryptase. The density of toluidine blue+, c-kit+ and tryptase+ mast cells was higher in tissue with OLP and OLLC compared with healthy controls (p < 0.05). No difference was noted in mast cells density between OLP and OLLC (p > 0.05). The density of tryptase+ mast cells was higher in the subepithelial region (area A) than the region below it (Area B) in OLLC (p = 0.047). The mononuclear inflammatory cell density was higher in OLLC compared to OLP, but without statistical significance (p > 0.05). A positive statistical correlation was found between mononuclear immune cells and density of c-kit+ and tryptase+ mast cells in OLP (r = 0.943 and r = 0.886, respectively). Our data demonstrate that the etiopathogenesis process of OLP and OLLC modulates the expansion and degranulation of mast cells; mast cells density, however, was similar between OLP and OLLC. The distribution of mast cells appears to vary along the lamina propria.

https://doi.org/10.1590/1807-3107bor-2024.vol38.0005

Nitrogen efficiency in marandupalisadegrass pastures under increasing nitrogen levels
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Quadros, Fernando Luiz Ferreira de

; Ongaratto, Fernando

; Malheiros, Euclides Braga

; Lima, Laís de Oliveira

; Dallantonia, Erick Escobar

; Romanzini, Eliéder Prates

; Velludo, Igor de Martin

; Cardoso, Abmael da Silva

; Val, Guilherme Alves do

; Rigobello, Izabela Larosa

; Fernandes, Márcia Helena Machado da Rocha

; Reis, Ricardo Andrade

Ciência Rural

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2024, Volume 54 N. 3 elocation e20230049

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

ABSTRACT: The use of nitrogen (N) in pastoral ecosystems leads to increased productivity, as it allows the plant to elongate its leaves and, therefore, grazing herbivores harvest the green leaves. However, there are very volatile N sources, which can be replaced by ammonium nitrate, which is less volatile and less dependent on the application in rainy days. The treatments are compound of Marandu palisade grass pastures managed under continuous stocking at a canopy height of 25 cm, with different levels of N fertilizer: 0, 75, and 150 kg ha-1year-1, as ammonium nitrate (32% of N), with four replicates (pastures) in a completely randomized design. Nitrogen uptake (54.9, 96.5, 113.8 kg N ha-1) and N nutrition index (0.67, 0.98, 1.15) were different between N level, respectively, 0, 75 and 150 kg ha-1 year-1. The N recovery (58.3, 40.9 %) differed between 75 and 150 kg ha-1 year-1, respectively. The dose of 75 kg N kg ha-1 year-1 results in better N utilization, while the dose of 150 kg N ha-1 year-1 enables greater stocking rate; therefore, requiring less grazing area.

RESUMO: O uso de nitrogênio (N) em ecossistemas pastoris leva ao aumento da produtividade, pois permite que a planta alongue suas folhas e, portanto, os herbívoros colham as folhas verdes. Porém, existem fontes de nitrogênio muito voláteis, que devem ser substituídas por nitrato de amônio, que é menos volátil e menos dependente da aplicação em dias chuvosos. Os tratamentos foram compostos por pastagens de capim-marandu, manejadas sob lotação contínua, na altura do dossel a 25 cm, com diferentes doses de N: 0, 75 e 150 kg ha-1 ano-1, na forma de nitrato de amônio (32% de N), com quatro repetições (piquetes), em delineamento inteiramente casualizado. A absorção de nitrogênio (54,9; 96,5; 113,8 kg N ha-1) e o índice nutricional de N (0,67; 0,98; 1,15) foram diferentes entre as doses de N, respectivamente, 0, 75 e 150 kg ha-1 ano-1. A recuperação de N (58,3; 40,9%) diferiu entre 75 e 150 kg ha-1 ano-1, respectivamente. A dose de 75 kg N kg ha-1 ano-1 resultou em melhor aproveitamento do N, enquanto a dose de 150 kg N ha-1 ano-1 possibilita maior taxa de lotação; portanto, exigindo menos área de pastagem.

https://doi.org/10.1590/0103-8478cr20230049

[SciELO Preprints] - PETROBRAS AND THE DEVELOPMENT PROJECT: THE POST-COUP MANAGEMENT SHOCK
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Souza, Ricardo Alves de Americano, Dáphine Marcelle Terra

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Publication date: 2023-09-18

Abstract: En Pt

This article proposes to analyze the management shock that occurred on Petrobras after the 2016 parliamentary coup that took place in Brazil. We seek to systematize and relate changes in the conduct of this company with a profound change in the national political scenario. The 2018 election, in which the extreme right-wing candidate Jair Bolsonaro was victorious, supported by sectors of the financial market and with an extremely liberal program, can be understood as an offshoot of this scenario. We will carry out an analysis of the evolution of the company’s spending on productive investment during the 2000s. This empirical research will be contrasted with academic productions that analyze the changes in the relationship of forces between classes and class fractions in the Brazilian State.

Este artigo se propõe a analisar o choque de gestão ocorrido na Petrobras após o golpe parlamentar de 2016 ocorrido no Brasil. Buscamos sistematizar e relacionar mudanças na conduta desta empresa com uma profunda mudança no cenário político nacional. A eleição de 2018, na qual saiu vitorioso o candidato de extrema direita Jair Bolsonaro, apoiado por setores do mercado financeiro e com um programa extremamente liberal, pode ser entendida como um desdobramento desse cenário. Faremos uma análise da evolução dos gastos da empresa em investimento produtivo durante os anos 2000. Esta pesquisa empírica será contrastada com produções acadêmicas que analisam as mudanças na relação de forças entre classes e frações de classe no Estado brasileiro.

https://doi.org/10.1590/SciELOPreprints.6829

Open Fracture of the Femoral Neck in an Adult: Case Report and Surgical Solution
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Campos, Roni Serra

; Correia, Marcos Alves

; Menezes, Ricardo

; Duarte, Maria Eugenia Leite

; Guimarães, João Antonio Matheus

Revista Brasileira de Ortopedia

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aug 2023, Volume 58 N. 4 Pages 662 - 666

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

Abstract Intracapsular proximal femoral fracture is a frequent injury in elderly patients, often associated with low-energy trauma and reduced bone mass. In young patient, it is uncommon, usually caused by high-energy trauma and accompanied by damage to the adjacent soft tissues. However, reports of open intracapsular proximal femoral fracture due to indirect trauma are rare in the orthopedic literature. In the present article, we describe a case of this injury in a 35-year-old man involved in a car accident. The proximal femur was exposed at the gluteal region due to a mechanism similar to dislocation of the posterior hip. We describe the initial treatment and subsequent management until achieving a definitive solution using total hip arthroplasty and muscle transfer to reconstruct the abductor mechanism of the hip. At 10 months of follow-up, the patient presented good functional outcome, with gradual recovery of the abductive strength and a Harris Hip Score of 91 points. In addition, a radiographic study showed that the cemented total prosthesis was well-positioned. This therapeutic strategy (total hip arthroplasty with muscle transfer to reconstruct the abductor musculature) was successful to treat an intracapsular proximal femoral fracture with bone exposure.

Resumo A fratura intracapsular do fêmur proximal é uma lesão frequente no paciente idoso, e em geral está associada a trauma de baixa energia e redução da massa óssea. No jovem, esta lesão é pouco frequente, decorre de trauma de alta energia, e resulta em dano das partes moles adjacentes. Contudo, o relato de fratura intracapsular do fêmur proximal com exposição óssea por trauma indireto é raro na literatura ortopédica. Neste relato, esta lesão foi diagnosticada em um homem de 35 anos, vítima de acidente automobilístico. Mediante um mecanismo semelhante ao da luxação posterior do quadril, o segmento proximal do fêmur determinou exposição óssea através da região glútea. Foram descritos o tratamento inicial e os tratamentos subsequentes até a solução definitiva por artroplastia total do quadril associada a transposição muscular para reconstrução do mecanismo abdutor do quadril. Após 10 meses de seguimento, o paciente apresentava boa recuperação funcional, com retorno gradual da força abdutora, Harris Hip Score de 91 pontos, com estudo radiográfico revelando prótese total cimentada bem posicionada. A estratégia terapêutica utilizada neste paciente (artroplastia total do quadril com transferência muscular para a reconstrução da musculatura abdutora) foi uma solução eficiente para tratar a fratura intracapsular do fêmur proximal com exposição óssea.

https://doi.org/10.1055/s-0040-1721842

10.

Asociación entre niveles de empatía en médicos y satisfacción del paciente
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Baro Vila, Rocio C.

; Sigal, Alan R.

; Massa, Maximiliamo

; Benzadon, Mariano

; Gelpi, Ricardo J.

; Alves de Lima, Alberto

Medicina (Buenos Aires)

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jun 2023, Volume 83 N. 2 Pages 212 - 218

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

Resumen Introducción: Una buena relación médico-paciente es crucial para la práctica médica. Un elemento fundamen tal de la misma es la empatía del médico tratante, y esta puede ser cuantificada mediante una escala validada llamada Escala de Empatía de Jefferson. Métodos: En este estudio buscamos correlacionar los valores de empatía de los médicos del servicio con los resultados de las encuestas de satisfacción del pa ciente ambulatorio, medido mediante una herramienta llamada HCAPS. Resultados: Encontramos que los pacientes percibían un mayor trato respetuoso y que se les explicaba mejor sus opciones de tratamiento por parte de los médicos con mayores niveles de empatía. No hubo diferencias en los niveles de empatía de los médicos según su edad, sexo, o tiempo desde la obtención del título de especialista. Discusión: Los resultados validan a la empatía como una habilidad clave dentro de la relación médico-paciente.

Abstract Introduction: A good doctor-patient relationship is crucial to medical practice. A fundamental element of it is the empathy of the treating physician, and it can be quantified by means of a validated scale called the Jefferson Empathy Scale. Methods: In this study we sought to correlate the empathy values of our physicians with the results of outpatient satisfaction surveys, measured using a tool called HCAPS. Results: We found that patients perceived greater respectful treatment and had their treatment options better explained to them by physicians with higher lev els of empathy. There were no differences in physicians’ empathy levels according to their age, gender, or time since qualifying as a specialist. Discussion: These results validate empathy as a key skill in the doctor-patient relationship.

11.

Correlação entre variáveis antropométricas e o desempenho físico em bombeiros guarda vidas
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Mello, Ricardo Castro Ferreira de

; Freitas, Fabio Henrique de

; Souza, Francine Ribeiro de Oliveira

; Souza, Rafaella Alves de Oliveira

; Gonçalves, Michel Moraes

; Sirieiro, Paolo Veiga

; Gomes, Diego Viana

; Miranda, Humberto Lameira

Motricidade

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jun 2023, Volume 19 N. 2 Pages 198 - 204

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

ABSTRACT Some scientific evidence shows that military personnel, including lifeguard firefighters, with high levels of physical fitness may be able to perform their work tasks more efficiently and make the best decisions. The present work aimed to investigate the correlation between anthropometric variables and physical performance in lifeguard firefighters. The sample consisted of 105 men, lifeguard firefighters from the military fire department of the state of Rio de Janeiro. On the first visit, the following procedures were performed: a) completion of the par-Q and the Informed Consent Form; b) anthropometric and body composition measurements. On the second visit, the following tests were performed: 1) 20-meter sprint; 2) zigzag COD; 3) Running Anaerobic Sprint Test. Positive correlations were observed between abdominal perimeter and time in the 20-meter sprint, time in the zig-zag COD, total time in the Running Anaerobic Sprint Test; between waist-to-hip ratio and time in the 20-meter sprint, total time in the Running Anaerobic Sprint Test. Furthermore, negative correlations were observed between abdominal perimeter and velocity in the 20-meter sprint, velocity in the zig-zag COD; between waist-to-hip ratio and speed in the 20-meter sprint. However, no correlations were observed between the perimeter of the abdomen and the fatigue index; between waist-to-hip ratio and zig-zag time and speed COD, fatigue index. it was verified that, in lifeguard firefighters, high scores of abdominal circumference and waist-to-hip ratio negatively influence physical performance.

RESUMO Algumas evidências mostram que militares, dentre eles os bombeiros guarda-vidas, com elevados níveis de aptidão física podem ser capazes de executar suas tarefas laborais com maior eficiência e tomar as melhores decisões. O objetivo do presente trabalho foi investigar a correlação entre variáveis antropométricas e desempenho físico, em bombeiros guarda-vidas. A amostra foi composta por 105 homens, bombeiros guarda-vidas do corpo de bombeiros militares do estado do Rio de Janeiro. Foram observadas correlações positivas entre perímetro do abdômen e tempo no sprint de 20 metros, tempo no zig zag COD, tempo total no Running Anaerobic Sprint Test; entre relação cintura quadril e tempo no sprint de 20 metros, tempo total no Running Anaerobic Sprint Test. Além do mais, foram observadas correlações negativas entre perímetro do abdômen e velocidade no sprint de 20 metros, velocidade no zig zag COD; entre relação cintura quadril e velocidade no sprint de 20 metros. Entretanto, não foram observadas correlações entre perímetro do abdômen e índice de fadiga; entre relação cintura quadril e tempo e velocidade no zig zag COD, índice de fadiga. Verifica-se que, em bombeiros guarda-vidas, elevados escores de circunferência abdominal e relação cintura quadril influenciam, de forma negativa, no desempenho físico.

https://doi.org/10.6063/motricidade.29357

12.

Quality of Tanzania grass (Panicum maximum) haylage in relation to plant dry matter content
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Loiola Edvan, Ricardo

; Linhares dos Santos, Francigeferson

; Rodrigues do Nascimento, Romilda

; Morgana Alves Barros, Dhiéssica

; Santos, Edson Mauro

; de Azevedo, Felipe Luênio

; de Sousa Barros, Lucas

; dos Santos Nascimento, Keuven

; Dias-Silva, Tairon Pannunzio

; Araújo, Marcos Jácome de

Revista de la Facultad de Ciencias Agrarias. Universidad Nacional de Cuyo

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jun 2023, Volume 55 N. 1 Pages 38 - 52

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

Resumen El objetivo fue evaluar la calidad del henolaje del pasto Tanzania (Panicum maximum) con diferentes contenidos de materia seca y un almacenamiento de 90 días, a través de la composición química, cuantificación de gases, ácidos grasos volátiles, perfil microbiológico, estabilidad aeróbica, pH y nitrógeno amoniacal. El diseño experimental utilizado fue completamente al azar con cuatro tratamientos y cinco repeticiones. Los tratamientos consistían de cuatro contenidos de materia seca (MS) de la planta en el momento de la producción del henolaje del pasto Tanzania siendo: en materia fresca (sin deshidratación), 400, 500 y 600 g kg-1 de MS (deshidratados en pleno sol). El tratamiento con 600 g kg-1 de MS de la planta proporcionó la mayor estimación (p < 0,01) de MS en el henolaje con 581,6 ± 15,4 g/kg, y el mayor (p < 0,01) contenido de carbohidratos solubles con 45,4 ± 1,24 g/kg MS. Después de 90 días de almace namiento, el tratamiento en materia fresca presentó mayores (p < 0,01) cantidades de O2 en el interior de los fardos. En relación al CO2 los mayores índices fueron observados para los tratamientos con 500 y 600 g kg-1 de MS. También se observó el mayor (p < 0,01) contenido de ácido acético en los tratamientos materia fresca y con 500 y 600 g kg-1 de MS de la planta, con 36,4 ± 1,6, 38,2 ± 1,6 y 48,9 ± 1,6 g kg-1 de MS, respectivamente. Para el ácido butírico se obtuvo la mejor (p < 0,01) valoración de 27,0 ± 0,5 g kg-1 de MS en el tratamiento en materia fresca. El tratamiento con 600 g kg-1 de MS mostró mayor (p < 0,01) valor de pH en la hora cero con 6,36 ± 0,03. El tratamiento en materia fresca presentó mayor valor de N-NH3 en la hora cero de exposición al aire con 4,65 ± 0,12. El pasto Tanzania con 500 y 600 g kg-1 de MS, presenta el henolaje de mejor calidad.

Abstract This study aimed to evaluate the quality of Tanzania grass (Panicum maximum) haylage with varying contents of dry matter (DM) and stored for 90 days. The quality of this grass was evaluated through the lens of a variety of physiochemical properties (e.g., chemical composition, aerobic stability, pH, microbial profile, etc.). A completely randomized design was used with four treatments (in natura, 400, 500, and 600 g kg-1 DM) and five replicates. Treatment with 600 g kg-1 DM yielded the highest DM haylage (p < 0.01) and soluble carbohydrate content (p < 0.01). Treatment in natura resulted in the highest O2 concentration inside the bales (p < 0.01), whereas treatments with 500 and 600 g kg-1 DM resulted in the highest CO2 values. The highest acetic acid concentrations of 36.4 ± 1.6, 38.2±1.6, and 48.9 ± 1.6 g kg-1 DM (p < 0.01) were observed post the in natura, 500 g kg-1 DM, and 600 g kg-1 DM treatments, respectively. Treatment with 600 g kg-1 DM yielded the highest pH value at hour zero (p < 0.01). Tanzania grass with 500 and 600 g kg-1 DM produced the highest quality haylage.

13.

Pulmonary Cement Embolism
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Morgado, Margarida

; Vilares, Ana Teresa

; Alves, Filipe Barros

; Castro, Ricardo

; Madureira, António J.

Acta Radiológica Portuguesa

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apr 2023, Volume 35 N. 1 Pages 48 - 49

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

Abstract Vertebroplasty and kyphoplasty are widely used procedures for patients with symptomatic spinal compression fractures. Cement leakage into the paravertebral veins leading to pulmonary embolism is not an uncommon complication and the risk is increased when treating bone metastases. We present a case and images of a patient with previous vertebral compression fractures from metastatic breast cancer treated with vertebroplasty and kyphoplasty which presented imaging findings consistent with pulmonary cement embolism.

Resumo A vertebroplastia e a cifoplastia são procedimentos amplamente utilizados em doentes sintomáticos com fraturas vertebrais compressivas. O extravasamento de cimento ósseo para as veias paravertebrais com consequente embolia pulmonar não é uma complicação incomum e o risco é superior no tratamento de metástases ósseas. Apresentamos um caso clínico com imagens de uma doente com antecedentes de fraturas vertebrais compressivas por metastização óssea de cancro da mama, tratadas com vertebroplastia e cifoplastia, que evidenciou achados imagiológicos compatíveis com embolia pulmonar por cimento ósseo.

https://doi.org/10.25748/arp.28000

14.

Treatment of Acute Spinal Cord Injuries: A Survey Among Iberolatinoamerican Spine Surgeons – Part 1: Use of High-Dose Corticosteroids
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Ribau, Ana

; Alves, Jorge

; Rodrigues-Pinto, Ricardo

Revista Brasileira de Ortopedia

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apr 2023, Volume 58 N. 2 Pages 331 - 336

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

Abstract Objective The aim of the present study was to evaluate the current practice of using of methylprednisolone sodium succinate (MPSS) in acute spinal cord Injuries (ASCIs) among spine surgeons from Iberolatinoamerican countries. Methods A descriptive cross-sectional study design as a survey was conducted. A questionnaire composed of 2 sections, one on demographic data regarding the surgeons and MPSS administration, was sent by email to members of the Sociedad Ibero Latinoamericana de Columna (SILACO, in the Spanish acronym) and associated societies. Results A total of 182 surgeons participated in the study: 65.4% (119) orthopedic surgeons and 24.6% (63) neurosurgeons. Sixty-nine (37.9%) used MPSS in the initial management of ASCIs. There were no significant differences between countries (p = 0.451), specialty (p = 0.352), or surgeon seniority (p = 0.652) for the use of corticosteroids in the initial management of ASCIs. Forty-five (65.2%) respondents reported using an initial high-dose bolus (30 mg/Kg) followed by a perfusion (5.4 mg/ kg/h). Forty-six (66.7%) surgeons who used MPSS only prescribed it if the patients presented within 8 hours of the ASCI. Most of the surgeons (50.7% [35]) administered high-dose corticosteroids because of the conviction that it has clinal benefits and improves neurological recovery. Conclusion Results from the present survey show that MPSS use in ASCI is not widespread within spine surgeons and that the controversy regarding its use remains unresolved. This is probably due to the low level of evidence of the available data, to variations over the years, to inconsistencies in acute care protocols, and to health service pathways.

Resumo Objetivo O objetivo do presente estudo foi avaliar a prática atual de uso do succinato sódico de metilprednisolona (MPSS, na sigla em inglês) nas lesões agudas da medula espinal (LAMEs) entre cirurgiões de coluna de países ibero-americanos. Métodos Um estudo transversal descritivo foi realizado. O questionário continha duas seções, uma sobre os dados demográficos dos cirurgiões e acerca da administração de MPSS, e foi enviado por correio eletrônico aos membros da Sociedad Ibero Latinoamericana de Columna (SILACO, na sigla em espanhol) e sociedades associadas. Resultados No total, 182 cirurgiões participaram do estudo: 65,4% (119) eram cirurgiões ortopédicos e 24,6% (63), neurocirurgiões. Sessenta e nove (37,9%) usaram MPSS no tratamento inicial da LAME. Não houve diferenças significativas entre países (p = 0,451), especialidades (p = 0,352) ou senioridade do cirurgião (p =0,652) em relação ao uso de corticosteroides no tratamento inicial da LAME. Destes, 45 (65,2%) relataram a administração de um bolus de alta dose (30 mg/kg) seguido por perfusão (5,4 mg/kg/h). Quarenta e seis (66,7%) dos cirurgiões que usam MPSS apenas o prescrevem a pacientes tratados nas primeiras 8 horas após a LAME. A maioria dos cirurgiões (50,7% [35]) administrou corticosteroides em alta dose devido à convicção de seus benefícios clínicos e melhora da recuperação neurológica. Conclusão Os resultados do presente questionário mostram que o uso de MPSS na LAME não está disseminado entre os cirurgiões de coluna e que a controvérsia sobre sua administração ainda não foi resolvida. É provável que isto se deva ao baixo nível de evidência dos dados existentes, a variações ao longo dos anos, a inconsistências nos protocolos terapêuticos agudo e a diferentes sistemas de saúde.

https://doi.org/10.1055/s-0042-1749415

15.

Treatment of Acute Spinal Cord Injuries: A Survey Among Iberolatinoamerican Spine Surgeons - Part 2 Timing to Surgery
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Ribau, Ana

; Alves, Jorge

; Rodrigues-Pinto, Ricardo

Revista Brasileira de Ortopedia

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apr 2023, Volume 58 N. 2 Pages 337 - 341

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

Abstract Objective The objective of the present study was to evaluate the current practice in terms of timing to surgery in acute spinal cord injury (ASCI) patients among spinal surgeons from Iberolatinoamerican countries. Methods A descriptive cross-sectional study design as a questionnaire was sent by an email for all members of the Sociedad Ibero Latinoamericana de Columna (SILACO, in the Spanish acronym) and associated societies. Results A total of 162 surgeons answered questions related to the timing for surgery. Sixty-eight (42.0%) considered that ASCI with complete neurology injury should be treated within 12 hours, 54(33.3%) performed early decompression within 24 hours, and 40 (24,7%) until the first 48 hours. Regarding ASCI with incomplete neurological injury, 115 (71.0%) would operate in the first 12 hours. There was a significant difference in the proportion of surgeons that would operate ASCI within ≤ 24 hours, regarding the type of injury (complete injury:122 versus incomplete injury:155; p<0.01). In the case of patients with central cord syndrome without radiological evidence of instability, 152 surgeons (93.8%) would perform surgical decompression: 1 (0.6%) in the first 12 hours, 63 (38.9%) in 24 hours, 4 (2.5%) in 48 hours, 66 (40.7%) in the initial hospital stay, and 18 (11.1%) after neurologic stabilization. Conclusion All inquired surgeons favour early decompression, with the majority performing surgery in the first 24 hours. Decompression is performed earlier in cases of incomplete than in complete injuries. In cases of central cord syndrome without radiological evidence of instability, there is a tendency towards early surgical decompression, but the timing is still extremely variable. Future studies are needed to identify the ideal timing for decompression of this subset of ASCI patients.

Resumo Objetivo O objetivo do presente estudo foi avaliar a prática atual em termos de momento de realização da cirurgia em pacientes com lesão medularaguda (LMA) entre cirurgiões de coluna de países ibero-americanos. Métodos Estudo transversal descritivo com base em um questionário enviado por correio eletrônico para todos os membros da Sociedad Ibero Latinoamericana de Columna (SILACO, na sigla em espanhol) e sociedades associadas. Resultados Um total de 162 cirurgiões responderam a perguntas relacionadas ao momento da cirurgia. Sessenta e oito (42,0%) consideraram que a LMA com lesão neurológica completa deve ser tratada em até 12 horas, 54 (33,3%) realizariam a descompressão precoce em até 24 horas e 40 (24,7%) fariam este procedimento nas primeiras 48 horas. Em relação à LMA com lesão neurológica incompleta, 115 (71,0%) operariam nas primeiras 12 horas. Houve diferença significativa na proporção de cirurgiões que fariam o tratamento cirúrgico da LMA em ≤ 24 horas quanto ao tipo de lesão (lesão completa [122] versus lesão incompleta [155]; p<0.01). Em pacientes com síndrome medular central sem evidência radiológica de instabilidade, 152 cirurgiões (93,8%) realizariam a descompressão cirúrgica: 1 (0,6%) nas primeiras 12 horas, 63 (38,9%) em 24 horas, 4 (2,5%) em 48 horas, 66 (40,7%) no internamento inicial e 18 (11,1%) após a estabilização neurológica. Conclusão Todos os cirurgiões participantes favoreceram a descompressão precoce; a grande maioria realizaria a cirurgia nas primeiras 24 horas. A descompressão é feita antes em casos de lesões incompletas do que em lesões completas. Nos casos de síndrome medular central sem evidência radiológica de instabilidade, há uma tendência à descompressão cirúrgica precoce, mas o momento de intervenção ainda é extremamente variável. Estudos futuros são necessários para identificar o momento ideal para descompressão neste subconjunto de pacientes com LMA.

https://doi.org/10.1055/s-0042-1746181

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