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ABSTRACT The objective of this study is to present the protocol of a cluster randomized clinical trial to be conducted through the TeleICU project - Qualification of Intensive Care by Telemedicine. The study will consist of a cluster randomized clinical trial, open label, in pediatric intensive care units, with an allocation ratio of 1:1, to compare the intervention group (support of Telemedicine for patients admitted to the pediatric intensive care unit) with a control group (pediatric intensive care unit usual care). The study proposed to select 16 pediatric intensive care units, including 100 participants per site, with a total of 1,600 participants. The intervention group will receive telerounds from Monday to Friday and will have specialists and continuing education activities available. The primary outcome measure will be the length of stay in the pediatric intensive care unit, defined as the difference between the date of discharge of the participant and the date of admission to the intensive care unit. The secondary outcomes will be mortality rate, invasive mechanical ventilation-free days, days using antibiotics, days using vasoactive drugs and days using sedoanalgesia. This study will be conducted in accordance with Resolution 466/12 of the National Health Council, with approval by the Research Ethics Committee of the institutions involved. The present study has the potential to reproduce studies on Telemedicine in intensive care and may make important contributions to care in intensive care units in Brazil and other settings. If Telemedicine shows positive clinical care results compared to conventional treatment, more pediatric patients may benefit. ClinicalTrials.gov registry: NCT05260710

RESUMO O objetivo deste estudo será apresentar o protocolo de um ensaio clínico randomizado em cluster a ser realizado por meio do projeto TeleUTI - Qualificação da Assistência em Terapia Intensiva por Telemedicina. O estudo consistirá em um ensaio clínico randomizado por cluster, open label, em unidades de terapia intensiva pediátricas, com proporção de alocação de 1:1, com o intuito de comparar o grupo de intervenção (apoio da telemedicina para os pacientes internados na unidade de terapia intensiva pediátrica) com um grupo controle (cuidados habituais da unidade de terapia intensiva pediátrica). O estudo se propõe a selecionar 16 unidades de terapia intensiva pediátricas, incluindo 100 participantes por local, com o total de 1.600 participantes. O grupo intervenção receberá telerounds de segunda-feira a sexta-feira e terá à disposição especialistas e atividades de educação continuada. O desfecho primário a ser avaliado será o tempo de permanência nas unidades de terapia intensiva pediátricas, definido pela diferença entre a data de alta do participante com a data de admissão na unidade de terapia intensiva. Os desfechos secundários serão: taxa de mortalidade; dias livres de ventilação mecânica, dias de uso de antibióticos, dias de uso de drogas vasoativas e dias de uso de sedoanalgesia. Este estudo será conduzido em conformidade com a resolução 466/12 do Conselho Nacional de Saúde, com aprovação pelo Comitê de Ética em Pesquisa das instituições hospitalares envolvidas. O trabalho tem o potencial de reproduzir estudos sobre Telemedicina em cuidados intensivos, podendo trazer contribuições importantes ao atendimento em unidades de terapia intensiva no Brasil e em outras realidades. Se a Telemedicina mostrar resultados clínicos assistenciais positivos em relação ao tratamento convencional, mais pacientes pediátricos poderão ser beneficiados. Registro ClinicalTrials.gov: NCT05260710

https://doi.org/10.5935/2965-2774.20230223-en

Dermatological manifestations of hematologic neoplasms. Part II: nonspecific skin lesions/paraneoplastic diseases neoplasms II lesionsparaneoplastic lesions paraneoplastic
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Souza, Patricia Karla de

; Amorim, Rafael Oliveira

; Sousa, Letícia Siqueira

; Batista, Mariana Dias

Anais Brasileiros de Dermatologia

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apr 2023, Volume 98 N. 2 Pages 141 - 158

Abstract: En | Text: En | PDF: En

Abstract Cutaneous manifestations occur in the course of hematologic malignancies and precede, accompany or occur late in relation to the diagnosis. They result from paraneoplastic phenomena, tumor infiltrations, immunosuppression resulting from the hematologic disease itself or its treatment. The dermatologist must be aware of these conditions that may be helpful both in the diagnosis of the underlying disease and in reducing patient morbidity. This review (part II) addresses the paraneoplastic dermatological changes associated with systemic hematologic malignancies. precede phenomena infiltrations treatment morbidity part II

https://doi.org/10.1016/j.abd.2022.08.005

Dermatological manifestations of hematologic neoplasms. Part I: secondary specific skin lesions neoplasms I
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Souza, Patricia Karla de

; Amorim, Rafael Oliveira

; Sousa, Letícia Siqueira

; Batista, Mariana Dias

Anais Brasileiros de Dermatologia

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feb 2023, Volume 98 N. 1 Pages 5 - 12

Abstract: En | Text: En | PDF: En

Abstract Cutaneous manifestations occur during the course of hematologic malignancies and precede, follow, or are late events in relation to the diagnosis. They result from paraneoplastic phenomena, tumor infiltrations, and immunosuppression resulting from the hematologic neoplasia itself or its treatment. The dermatologist must be aware of these conditions, which can help both in the diagnosis of the underlying disease and in the reduction of patient morbidity. This review (part I) addresses skin lesions associated with direct infiltration by systemic hematologic malignancies. precede follow phenomena infiltrations treatment conditions morbidity part I

https://doi.org/10.1016/j.abd.2022.06.002

The ratio between the whole-body and primary tumor burden, measured on 18F-FDG PET/CT studies, as a prognostic indicator in advanced non-small cell lung cancer
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Oliveira, Felipe Renê Alves

; Santos, Allan de Oliveira

; Lima, Mariana da Cunha Lopes de

; Toro, Ivan Felizardo Contrera

; Souza, Thiago Ferreira de

; Amorim, Bárbara Juarez

; Barbeiro, Aristoteles Souza

; Etchebehere, Elba

Radiologia Brasileira

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oct 2021, Volume 54 N. 5 Pages 289 - 294

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

Resumo Objetivo: Avaliar se a carga metabólica tumoral do corpo inteiro medida na tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose (18F-FDG PET/CT) é um indicador prognóstico em pacientes com câncer de pulmão de células não pequenas (CPCNP) em estágio avançado (estágio III ou IV). Materiais e Métodos: Avaliamos, prospectivamente, a carga tumoral na 18F-FDG-PET/CT de estadiamento em pacientes com CPCNP avançado. Os parâmetros avaliados do tumor primário (tu) e do corpo inteiro (wb) (incluindo o primário) foram: SUV máximo (wbSUVmax e tuSUVmax), volume metabólico tumoral (wbMTV e tuMTV), glicólise total da(s) lesão(ões) (wbTLG e tuTLG), além das seguintes razões: wbSUVmax/tuSUVmax, wbMTV/tuMTV e wbTLG/tuTLG. Os parâmetros medidos na 18F-FDG-PET/CT, variáveis clínicas e patológicas foram correlacionados com a sobrevida global (SG) e a sobrevida livre de progressão (SLP). Resultados: 18F-FDG-PET/CT foi realizada em 52 pacientes (tempos mediano/médio de sobrevida = 11,0/11,7 meses). A SLP mediana foi de 9,6 meses e a SG foi de 11,6 meses. Houve correlação significativa da wbTLG (hazard ratio [HR] = 1,001; intervalo de confiança de 95% [IC 95%]: 1,000-1,001; p = 0,0361) e wbTLG/tuTLG (HR = 1,705; IC 95%: 1,232-2.362; p = 0,0013) com a SG. Na análise multivariada, a razão wbTLG/tuTLG associou-se independentemente com a SG (HR = 1,660; IC 95%: 1,193-2,310; p = 0,0027). Conclusão: A razão wbTLG/tuTLG é um indicador prognóstico independente de SG em CPCNP avançado.

Abstract Objective: To determine whether the whole-body tumor burden, as quantified by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT), is a prognostic indicator in advanced (stage III or IV) non-small cell lung cancer (NSCLC). Materials and Methods: This was a prospective study in which we evaluated 18F-FDG PET/CT staging parameters to quantify tumor burdens in patients with stage III or IV NSCLC. The following parameters were evaluated for the whole body (including the primary tumor) and for the primary tumor alone, respectively: maximum standardized uptake volume (wbSUVmax and tuSUVmax); metabolic tumor volume (wbMTV and tuMTV); and total lesion glycolysis (wbTLG and tuTLG). To determine whether the 18F-FDG PET/CT parameters were associated with overall survival (OS) and progression-free survival (PFS), we evaluated the wbSUVmax/tuSUVmax, wbMTV/tuMTV, and wbTLG/tuTLG ratios. Results: 18F-FDG PET/CT was performed for staging in 52 patients who were followed for a median of 11.0 months (mean, 11.7 months). The estimated median PFS and OS were 9.6 months and 11.6 months, respectively. In the univariate analysis, OS was found to correlate significantly with wbTLG (hazard ratio [HR] = 1.001; 95% confidence interval [95 CI]: 1.000-1.001; p = 0.0361) and with the wbTLG/tuTLG ratio (HR = 1.705; 95% CI: 1.232-2.362; p = 0.0013). In the multivariate analysis, only the wbTLG/tuTLG ratio was independently associated with OS (HR = 1.660; 95% CI: 1.193-2.310; p = 0.0027). Conclusion: The wbTLG/tuTLG ratio is an independent prognostic indicator of OS in advanced-stage NSCLC.

https://doi.org/10.1590/0100-3984.2020.0054 146 downloads

BNCC e Ensino de História: horizontes possíveis
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Ralejo, Adriana Soares

; Mello, Rafaela Albergaria

; Amorim, Mariana de Oliveira

Educar em Revista

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2021, Volume 37 elocation e77056

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

RESUMO A Base Nacional Comum Curricular (BNCC) tem suscitado importantes debates sobre a constituição de um currículo escolar. Neste artigo, desenvolvemos uma reflexão sobre como essa proposta curricular tem mobilizado discussões sobre as possibilidades de constituição e de desenvolvimento do ensino de História. Enquanto dispositivo regulador da educação, que tipo de poder esse documento exerce sobre aquilo que é praticado nas escolas? Para além dos constrangimentos e amarras que o currículo gera no ensino, poderíamos também enxergar potencialidades para um ensino de História que dialogue com as realidades vividas por nossos alunos e alunas e compartilhadas no espaço escolar? A partir dessas questões norteadoras, desenvolvemos este artigo em três partes: em um primeiro momento, apresentamos a trajetória de publicação da BNCC e os embates em torno do ensino de História, bem como os conceitos de currículo e de Ensino de História com os quais trabalhamos. Em um segundo momento, apresentamos como a comunidade disciplinar (GOODSON, 1997) tem debatido sobre os sentidos de História presentes na BNCC, a partir de um levantamento de artigos científicos que têm apresentado este currículo como tema de pesquisa. E em um terceiro momento, apresentamos algumas chaves de leitura do documento a partir dos conceitos de “competências gerais” e da “atitude historiadora”. Por fim, teremos condição de responder à questão: que possibilidades a BNCC pode proporcionar para um ensino significativo no ensino de História?

ABSTRACT The Base Nacional Comum Curricular (BNCC) [National Common Core Curriculum] has raised significant debates about the constitution of a school curriculum. In this article, we develop a reflection on how this curricular proposal has mobilized discussions about the possibilities of constituting and developing History teaching. As a regulatory device of education, what kind of power does this document have over what is practiced in schools? In addition to the constraints and moorings that the curriculum generates in teaching, could we also see the potential for teaching History that dialogs with the realities experienced by our students and shared in the school space? Based on these guiding questions, we have developed this article in three parts: first, we present the publication path of BNCC and the clashes surrounding the teaching of History, as well as the concepts of curriculum and History teaching with which we work. In a second step, we present how the disciplinary community (GOODSON, 1997) debated the History meanings present at the BNCC, based on a survey of scientific articles that presented this curriculum as a research theme. And in a third moment, we exhibit some keys for reading the document based on the concepts of "general competencies" and "Historian attitude”. Finally, we can answer the question: what possibilities can the BNCC provide for meaningful teaching in History teaching?

https://doi.org/10.1590/0104-4060.77056 408 downloads

CRITÉRIOS PARA ESCOLHA DO ACOMPANHANTE DURANTE O TRABALHO DE PARTO
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Amorim, Torcata

; Aguiar, Larissa Aarestrup de Aquino

; Pereira, Mariana de Assis Cabral

; Marcatto, Juliana de Oliveira

; Borgonove, Kelly Cristina Almeida

Revista Baiana de Enfermagem

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2020, Volume 34 elocation e36833

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

Objective to describe the criteria that lead the parturient to choose her companion during labor. Method descriptive study with a qualitative approach, developed in the maternity of a public teaching hospital in Belo Horizonte, Minas Gerais, Brazil. The participants 17 puerperas aged over 18 years. For data collection, the semi-structured interview was used. Content analysis was used to explore the speeches. Results the criterion of choice was the relationship of the companion with the puerpera or availability at the moment. Most were the newborn's own companion and father. In the analysis, the statements were organized into one category – Criteria for choosing the companion – and four subcategories: How participants were informed about the right to have a companion; Reactions generated by the companion’s presence; Companion’s attitudes that caused discomfort; Desire to have another companion. Conclusion paternal participation proved to be a relevant criterion for parturients.

Objetivo describir los criterios que llevan las parturientas a elegir a su compañero durante el trabajo de parto. Método estudio descriptivo con un enfoque cualitativo, desarrollado en la maternidad de un hospital público de enseñanza en Belo Horizonte, Minas Gerais, Brasil. Participaron 17 mujeres puerperas mayores de 18 años. Para la recopilación de datos, se utilizó la entrevista semiestructurada. El análisis de contenido se utilizó para explorar los discursos. Resultados el criterio de elección era la relación del compañero con la puerpera o la disponibilidad en el momento. La mayoría era el propio compañero y padre del recién nacido. En el análisis, las declaraciones se organizaron en una categoría – Criterios para elegir el compañero – y cuatro subcategorías: Como las participantes se informaron sobre el derecho a tener un compañero; Reacciones generadas por la presencia del compañero; Actitudes del compañero que causaron malestar; Deseo en tener otro compañero. Conclusión la participación paterna resultó ser un criterio relevante para las parturientas.

Objetivo descrever os critérios que levam a parturiente a escolher o seu acompanhante durante o trabalho de parto. Método estudo descritivo de abordagem qualitativa, desenvolvido na maternidade de um hospital público de ensino de Belo Horizonte, Minas Gerais, Brasil. Participaram 17 puérperas maiores de 18 anos. Para a coleta de dados foi utilizada a entrevista semiestruturada. Utilizou-se a análise de conteúdo para explorar as falas. Resultados o critério de escolha foi o vínculo do acompanhante com a puérpera ou a disponibilidade no momento. A maioria era o próprio companheiro e pai do recém-nascido. Na análise, as falas foram organizadas em uma categoria – Critérios de escolha do acompanhante – e quatro subcategorias: Como as participantes informaram-se sobre o direito de ter um acompanhante; Reações geradas pela presença do acompanhante; Atitudes do acompanhante que causaram incômodo; Desejo de ter outro acompanhante. Conclusão a participação paterna mostrou-se um critério relevante para as parturientes.

https://doi.org/10.18471/rbe.v34.36833 203 downloads

Estimated date of delivery in Chihuahua breed bitches, based on embryo-fetal biometry, assessed by ultrasonography
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Vieira, Catharina de Albuquerque

; Bittencourt, Rodrigo Freitas

; Biscarde, Carmo Emanuel Almeida

; Fernandes, Maíra Planzo

; Nascimento, Alessandro Bitencourt

; Romão, Elton Amorim

; Carneiro, Isabella de Matos Brandão

; Silva, Mariana Alves de Andrade

; Barreto, Renata Oliveira

; Loiola, Marcus Vinícius Galvão

Animal Reproduction

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2020, Volume 17 N. 3 elocation e20200037

Abstract: En | Text: En | PDF: En

Abstract Due to the peculiarities of the reproductive cycle of the female dog, which makes it difficult to accurately ascertain the date of conception, it may be challenging to precisely estimate the gestational age in bitches. Using fetal measurements obtained by ultrasound, it is possible to estimate the gestational age in dogs; however, due to the differences in size of the various breeds, such estimates may have a significant standard deviation, which represents less accuracy when specifying the date of birth. The purpose of this study was to evaluate pregnant female Chihuahuas, establishing relations between the fetal dimensions measured by ultrasound and the remaining time until delivery. Using 13 pregnant female Chihuahuas, weekly ultrasound assessments and measurements were performed, of the inner chorionic cavity, cranial-caudal length, biparietal diameter, abdominal diameter and thoracic diameter. Such parameters were retroactively correlated to the date of delivery, and linear regressions were established between the gestational measurements and remaining days until delivery. The fetal measurement presenting the highest correlation (r = 0.99; P<0.0001) and reliability (R2 = 0.98, P<0.0001) with the probable date of delivery was the biparietal diameter, a measurement that can be easily and safely obtained and, when applying a specific formula (Y = -15.46X1 + 38.72), can accurately predict the date of delivery in Chihuahua female dogs.

https://doi.org/10.1590/1984-3143-ar2020-0037 1286 downloads

Atualização das Diretrizes em Cardiogeriatria da Sociedade Brasileira de Cardiologia – 2019
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Feitosa Filho, Gilson Soares

; Peixoto, José Maria

; Pinheiro, José Elias Soares

; Afiune Neto, Abrahão

; Albuquerque, Afonso Luiz Tavares de

; Cattani, Álvaro César

; Nussbacher, Amit

; Camarano, Ana Amelia

; Sichinels, Angela Hermínia

; Sousa, Antonio Carlos Sobral

; Alencar Filho, Aristóteles Comte de

; Gravina, Claudia F.

; Sobral Filho, Dario Celestino

; Pitthan, Eduardo

; Costa, Elisa Franco de Assis

; Duarte, Elizabeth da Rosa

; Freitas, Elizabete Viana de

; Moriguchi, Emilio Hideyuki

; Mesquita, Evandro Tinoco

; Fernandes, Fábio

; Fuchs, Felipe Costa

; Feitosa, Gilson Soares

; Pierre, Humberto

; Pereira Filho, Ilnei

; Helber, Izo

; Borges, Jairo Lins

; Garcia, Jéssica Myrian de Amorim

; Souza, José Antonio Gordillo de

; Zanon, José Carlos da Costa

; Alves, Josmar de Castro

; Mohallem, Kalil Lays

; Chaves, Laura Mariana de Siqueira Mendonça

; Moura, Lídia Ana Zytynski

; Silva, Márcia Cristina Amélia da

; Toledo, Maria Alice de Vilhena

; Assunção, Maria Elisa Lucena Sales de Melo

; Wajngarten, Mauricio

; Gonçalves, Mauro José Oliveira

; Lopes, Neuza Helena Moreira

; Rodrigues, Nezilour Lobato

; Toscano, Paulo Roberto Pereira

; Rousseff, Pedro

; Maia, Ricardo Antonio Rosado

; Franken, Roberto Alexandre

; Miranda, Roberto Dischinger

; Gamarski, Roberto

; Rosa, Ronaldo Fernandes

; Santos, Silvio Carlos de Moraes

; Galera, Siulmara Cristina

; Grespan, Stela Maris da Silva

; Silva, Teresa Cristina Rogerio da

; Esteves, William Antonio de Magalhães

Arquivos Brasileiros de Cardiologia

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may 2019, Volume 112 N. 5 Pages 649 - 705

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

https://doi.org/10.5935/abc.20190086 15622 downloads

Mutation screening in the genes PAX-8, NKX2-5, TSH-R, HES-1 in cohort of 63 Brazilian children with thyroid dysgenesis
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Cerqueira, Taíse Lima de Oliveira

; Ramos, Yanne Rocha

; Strappa, Giorgia Bruna

; Jesus, Mariana Souza de

; Santos, Jailciele Gonzaga

; Sousa, Camila

; Carvalho, Gildásio

; Fernandes, Vladimir

; Boa-Sorte, Ney

; Amorim, Tatiana

; Silva, Thiago Magalhães

; Ladeia, Ana Marice Teixeira

; Acosta, Angelina Xavier

; Ramos, Helton Estrela

Archives of Endocrinology and Metabolism

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aug 2018, Volume 62 N. 4 Pages 466 - 471

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the candidate genes PAX-8, NKX2-5, TSH-R and HES-1 in 63 confirmed cases of thyroid dysgenesis. Subjects and methods: Characterization of patients with congenital hypothyroidism into specific subtypes of thyroid dysgenesis with hormone levels (TT4 and TSH), thyroid ultrasound and scintigraphy. DNA was extracted from peripheral blood leukocytes and the genetic analysis was realized by investigating the presence of mutations in the transcription factor genes involved in thyroid development. Results: No mutations were detected in any of the candidate genes. In situ thyroid gland represented 71.1% of all cases of permanent primary congenital hypothyroidism, followed by hypoplasia (9.6%), ectopia (78%), hemiagenesis (6.0%) and agenesis (5.5%). The highest neonatal screening TSH levels were in the agenesis group (p < 0.001). Conclusions: Thyroid dysgenesis is possibly a polygenic disorder and epigenetic factors could to be implicated in these pathogeneses.

https://doi.org/10.20945/2359-3997000000065 1088 downloads

10.

4-Phenyl-1,3-thiazole-2-amines as scaffolds for new antileishmanial agents
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Rodrigues, Carina Agostinho

; Santos, Paloma Freire dos

; Costa, Marcela Oliveira Legramanti da

; Pavani, Thais Fernanda Amorim

; Xander, Patrícia

; Geraldo, Mariana Marques

; Mengarda, Ana

; Moraes, Josué de

; Rando, Daniela Gonçales Galasse

Journal of Venomous Animals and Toxins including Tropical Diseases

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2018, Volume 24 elocation 26

Abstract: En | Text: En | PDF: En

Abstract Background: There is still a need for new alternatives in pharmacological therapy for neglected diseases, as the drugs available show high toxicity and parenteral administration. That is the case for the treatment of leishmaniasis, particularly to the cutaneous clinical form of the disease. In this study, we present the synthesis and biological screening of eight 4-phenyl-1,3-thiazol-2-amines assayed against Leishmania amazonensis. Herein we propose that these compounds are good starting points for the search of new antileishmanial drugs by demonstrating some of the structural aspects which could interfere with the observed activity, as well as suggesting potential macromolecular targets. Methods: The compounds were easily synthesized by the methodology of Hantzsch and Weber, had their purities determined by Gas Chromatography-Mass spectrometry and assayed against the promastigote forms of Leishmania amazonensis as well as against two white cell lines (L929 and THP-1) and the monkey's kidney Vero cells. PrestoBlue® and MTT viability assays were the methodologies applied to measure the antileishmanial and cytotoxic activities, respectively. A molecular modeling target fishing study was performed aiming to propose potential macromolecular targets which could explain the observed biological behavior. Results: Four out of the eight compounds tested exhibited important anti-promastigote activity associated with good selectivity indexes when considering Vero cells. For the most promising compound, compound 6, IC50 against promastigotes was 20.78 while SI was 5.69. Compounds 3 (IC50: 46.63 μM; SI: 26.11) and 4 (IC50: 53.12 μM; SI: 4.80) also presented important biological behavior. A target fishing study suggested that S-methyl-5-thioadenosine phosphorylase is a potential target to these compounds, which could be explored to enhance activity and decrease the potential toxic side effects. Conclusions: This study shows that 4-phenyl-1,3-thiazol-2-amines could be good scaffolds to the development of new antileishmanial agents. The S-methyl-5-thioadenosine phosphorylase could be one of the macromolecular targets involved in the action.

https://doi.org/10.1186/s40409-018-0163-x 610 downloads

11.

O uso de analgesia farmacológica influencia no desfecho de parto?
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Felisbino-Mendes, Mariana Santos

; Santos, Luiza Oliveira

; Amorim, Torcata

; Costa, Isabela Nascimento

; Martins, Eunice Francisca

Acta Paulista de Enfermagem

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oct 2017, Volume 30 N. 5 Pages 458 - 465

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

Resumo Objetivo: Investigar associação entre analgesia farmacológica e desfechos do parto. Métodos: Estudo transversal que utilizou amostra representativa dos partos realizados em 2013, em uma maternidade de Belo Horizonte, Minas Gerais. Foram incluídos dados de 978 partos, excluindo-se as cesarianas eletivas. A exposição principal foi o uso de analgesia farmacológica durante o trabalho de parto e o desfecho classificado como parto vaginal, vaginal instrumentalizado e cesariana. Verificou-se a associação entre analgesia e os desfechos do parto por meio de regressão logística multinominal para obter as estimativas de Odds Ratio (OR) com seus respectivos intervalos de 95% de confiança, e o modelo final foi ajustado por idade da mulher, número de partos anteriores, presença de acompanhante ou doula e dilatação cervical no momento da analgesia. Resultados: Do total de nascimentos, 87,1% foram vaginais e 12,9% cesariana. A prevalência do uso de analgesia farmacológica foi 34,2% e do parto instrumentalizado de 8,4%. Cerca de 70% das mulheres tiveram gestação de risco habitual. Mesmo após ajuste por confundidores, o uso da analgesia aumentou em 3,5 vezes a chance de parto instrumentalizado (p<0,0001) e para as mulheres com gestação de alto risco esse aumento foi ainda superior (OR=4,62; p<0,0001). Não houve associação do uso da analgesia com a cesariana (p=0,320). Conclusão: O uso de analgesia farmacológica modifica o desfecho do parto, aumentando as chances de parto instrumentalizado, principalmente em mulheres com gravidez de alto risco. Nesse contexto considera-se importante orientar as mulheres quanto aos potenciais riscos e benefícios da analgesia para uma escolha segura.

Abstract Objective: To investigate the association between pharmacological analgesia and childbirth outcomes. Methods: A cross-sectional study using a representative sample of childbirth performed in 2013, at a maternity hospital in Belo Horizonte, Minas Gerais. Data from 978 childbirths were included, excluding elective cesareans. The main exposure was the use of pharmacological analgesia during labor, with the outcome classified as vaginal, instrumental vaginal, or cesarean delivery. The association between analgesia and childbirth outcomes was assessed using multinomial logistic regression to obtain Odds Ratio (OR) estimates with their respective 95% confidence intervals. The final model was adjusted for the woman's age, number of previous births, presence of companion or doula, and cervical dilatation at the time of analgesia. Results: Among the total number of births, 87.1% were vaginal and 12.9% were cesarean. The prevalence of the use of pharmacological analgesia was 34.2%, and delivery with instrumentation was 8.4%. About 70% of the women had a normal risk pregnancy. Even after adjusting for confounding variables, the use of analgesia increased the chance of delivery with instrumentation by 3.5 times (p<0.0001); for women with high-risk pregnancies, this increase was even higher (OR=4.62; p<0.0001). There was no association between analgesia and cesarean section (p=0.320). Conclusion: The use of pharmacological analgesia modifies the outcome of childbirth, increasing the chances of delivery with instrumentation, especially in women with high-risk pregnancies. In this context, it is important to guide women about the potential risks and benefits of analgesia so they may make a safe choice.

https://doi.org/10.1590/1982-0194201700067 4301 downloads

12.

O uso de analgesia farmacológica influencia no desfecho de parto?
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Felisbino-Mendes, Mariana Santos

; Santos, Luiza Oliveira

; Amorim, Torcata

; Costa, Isabela Nascimento

; Martins, Eunice Francisca

Acta Paulista de Enfermagem

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oct 2017, Volume 30 N. 5 Pages 458 - 465

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

https://doi.org/10.1590/1982-0194201700067 90 downloads

13.

The c.63A>G polymorphism in the NKX2.5 gene is associated with thyroid hypoplasia in children with thyroid dysgenesis
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Cerqueira, Taise Lima de Oliveira

; Ramos, Yanne

; Strappa, Giorgia

; Martin, Daniel San

; Jesus, Mariana

; Gonzaga, Jailciele

; Ferreira, Paulo

; Costa, Anabel

; Fernandes, Vladimir

; Amorim, Tatiana

; Ladeia, Ana Marice

; Ramos, Helton

Archives of Endocrinology and Metabolism

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dec 2015, Volume 59 N. 6 Pages 562 - 567

Abstract: En | Text: En | PDF: En

Objective To search for genetic alteration in NKX2.5 gene in patients presenting both congenital heart disease (CHD) and TD. Subjects and methods Individual phenotypes were carefully analyzed in 86 children with thyroid dysgenesis (TD) using thyroid function tests, scintigraphy, ultrasound and echocardiography. DNA was extracted and NKX2.5 gene coding region was amplified by polymerase chain reaction (PCR) and sequenced. Results CHD were found in 8.1% of patients with TD. The mutation screening revealed two known polymorphisms in patients with isolated TD or TD associated with CHD. None of them are predicted to result in codon change in conserved domain. The c.63A>G polymorphism was detected in 54/86 patients (49 with isolated TD and 5 with TD combined with CHD). There was a significant association of c.63A>G polymorphism with hypoplasia (p < 0.036). The c.541G>A polymorphism was observed in only one patient with isolated thyroid hypoplasia. Conclusion NKX2.5 mutations were not found. The c.63A>G polymorphism might be associated with thyroid hypoplasia.

https://doi.org/10.1590/2359-3997000000100 2224 downloads

14.

Toque terapêutico: influência nos parâmetros vitais de recém-nascidos
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Ramada, Nadia Christina Oliveira

; Almeida, Fabiane de Amorim

; Cunha, Mariana Lucas da Rocha

einstein (São Paulo)

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dec 2013, Volume 11 N. 4 Pages 421 - 425

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

OBJETIVO: Comparar os parâmetros vitais apresentados por recém-nascidos internados na unidade de terapia intensiva neonatal antes e após o toque terapêutico. MÉTODOS: Trata-se de um estudo quase-experimental, de abordagem quantitativa, desenvolvido na unidade de terapia intensiva neonatal de um hospital municipal, na cidade de São Paulo (SP). A amostra constituiu-se de 40 recém-nascidos submetidos ao toque terapêutico após realização de procedimento doloroso. Foram avaliados parâmetros vitais, como frequência cardíaca e respiratória, temperatura e a intensidade da dor, antes e após o toque terapêutico. RESULTADOS: A maioria dos recém-nascidos era do gênero masculino (n=28; 70%), pré-termo (n=19; 52%) e nascido de parto normal (n=27; 67%), sendo que o desconforto respiratório foi o principal motivo da internação (n=16; 40%). Houve queda de todos os parâmetros vitais após o toque terapêutico, principalmente do escore de dor - que apresentou redução considerável dos valores médios, de 3,37 (DP=1,31) para zero (DP=0,0). Todas as diferenças observadas foram estatisticamente significativas pelo teste de Wilcoxon (p<0,05). CONCLUSÃO: Os resultados evidenciam que o toque terapêutico promove o relaxamento do recém-nascido, favorecendo a redução dos parâmetros vitais e, consequentemente, a taxa de metabolismo basal.

OBJECTIVE: To compare vital signs before and after the therapeutic touch observed in hospitalized newborns in neonatal intensive care unit. METHODS: This was a quasi-experimental study performed at a neonatal intensive care unit of a municipal hospital, in the city of São Paulo (SP), Brazil. The sample included 40 newborns submitted to the therapeutic touch after a painful procedure. We evaluated the vital signs, such as heart and respiratory rates, temperature and pain intensity, before and after the therapeutic touch. RESULTS: The majority of newborns were male (n=28; 70%), pre-term (n=19; 52%) and born from vaginal delivery (n=27; 67%). Respiratory distress was the main reason for hospital admission (n=16; 40%). There was a drop in all vital signs after therapeutic touch, particularly in pain score, which had a considerable reduction in the mean values, from 3.37 (SD=1.31) to 0 (SD=0.0). All differences found were statistically significant by the Wilcoxon test (p<0.05). CONCLUSION: The results showed that therapeutic touch promotes relaxation of the baby, favoring reduction in vital signs and, consequently in the basal metabolism rate.

19644 downloads

15.

Distribution of the endophytic fungi community in leaves of Bauhinia brevipes (Fabaceae)
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Hilarino, Mariana Patrícia Amorim

; Silveira, Fernando Augusto de Oliveira e

; Oki, Yumi

; Rodrigues, Leonardo

; Santos, Jean Carlos

; Corrêa Junior, Ary

; Fernandes, Geraldo Wilson

; Rosa, Carlos Augusto

Acta Botanica Brasilica

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dec 2011, Volume 25 N. 4 Pages 815 - 821

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

Fungos endofíticos representam um grande e ainda pouco explorado componente da biodiversidade. O trabalho avaliou a riqueza e a distribuição endofítica nas folhas de Bauhinia brevipes (Fabaceae). Foram obtidas 1110 colônias que foram agrupadas, por suas características morfológicas em 126 táxons. O número total de táxons por estágio foliar foi: 102 em folhas maduras, 93 em folhas recém-expandidas e 79 em não expandidas. O principal gênero de endofítico encontrado foi Phomopsis, seguido por Dothiorella, Pestalotiopsis e Acremonium. A riqueza e o número de isolados não foram estatisticamente influenciadas pela região foliar. Contudo, alguns táxons foram específicas de um estágio foliar; seis foram isoladas apenas em folhas não expandidas, nove em folhas recentemente expandidas e 17 foram encontradas apenas em folhas maduras. A composição endofítica variou de acordo com as regiões foliares; a similaridade (índice de Jaccard) entre as regiões das folhas de diferentes estágios variou de 0,36 a 0,46, indicando uma alta variação espacial da comunidade de fungos endofíticos dentro da folha. A alta riqueza de endofíticos neste hospedeiro demonstra uma significante contribuição dos fungos para a biodiversidade tropical e a necessidade de pesquisas futuras nesta área.

Endophytic fungi represent large, yet unexplored components of biodiversity. This work evaluated the richness and the distribution of endophytes in the leaves of Bauhinia brevipes (Fabaceae). A total of 1110 colonies were recovered from the samples and grouped by their morphological traits into 126 taxa. The total number of taxa according to leaf development was: 102 in mature leaves, 93 in recently expanded leaves and 79 for unfolded leaves. The major endophyte genera were Phomopsis, followed by Dothiorella, Pestalotiopsis and Acremonium. The richness and the isolate numbers of endophytes were not statistically affected by leaf region. However, some taxa were leaf-age specific; six were isolated only from unfolded leaves, nine from recently expanded leaves and 17 were exclusively found in mature leaves. The composition of endophytes varied with leaf region; the similarities (Jaccard's Index) among the leaf regions of different leaf ages ranged from 0.36 to 0.46, indicating a high spatial variation in the community of endophytic fungi inside the leaves. The high richness of endophytes in this host plant highlights a significant contribution of fungi to tropical biodiversity and the need for further research in this area.

https://doi.org/10.1590/S0102-33062011000400008 5329 downloads

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