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Abstract Objective: To determinate the accuracy of computed tomography (CT) imaging assessed by deep neural networks for predicting the need for mechanical ventilation (MV) in patients hospitalized with severe acute respiratory syndrome due to coronavirus disease 2019 (COVID-19). Materials and Methods: This was a retrospective cohort study carried out at two hospitals in Brazil. We included CT scans from patients who were hospitalized due to severe acute respiratory syndrome and had COVID-19 confirmed by reverse transcriptionpolymerase chain reaction (RT-PCR). The training set consisted of chest CT examinations from 823 patients with COVID-19, of whom 93 required MV during hospitalization. We developed an artificial intelligence (AI) model based on convolutional neural networks. The performance of the AI model was evaluated by calculating its accuracy, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve. Results: For predicting the need for MV, the AI model had a sensitivity of 0.417 and a specificity of 0.860. The corresponding area under the ROC curve for the test set was 0.68. Conclusion: The high specificity of our AI model makes it able to reliably predict which patients will and will not need invasive ventilation. That makes this approach ideal for identifying high-risk patients and predicting the minimum number of ventilators and critical care beds that will be required.

Resumo Objetivo: Determinar a acurácia da tomografia computadorizada (TC), avaliada por redes neurais profundas, na ventilação mecânica, de pacientes hospitalizados por síndrome respiratória aguda grave por COVID-19. Materiais e Métodos: Trata-se de estudo de coorte retrospectivo, realizado em dois hospitais brasileiros. Foram incluídas TCs de pacientes hospitalizados por síndrome respiratória aguda grave e COVID-19 confirmada por RT-PCR. O treinamento consistiu em TC de tórax de 823 pacientes com COVID-19, dos quais 93 foram submetidos a ventilação mecânica na hospitalização. Nós desenvolvemos um modelo de inteligência artificial baseado em redes de convoluções neurais. A avaliação do desempenho do uso da inteligência artificial foi baseada no cálculo de acurácia, sensibilidade, especificidade e área sob a curva ROC. Resultados: A sensibilidade do modelo foi de 0,417 e a especificidade foi de 0,860. A área sob a curva ROC para o conjunto de teste foi de 0,68. Conclusão: Criamos um modelo de aprendizado de máquina com elevada especificidade, capaz de prever de forma confiável pacientes que não precisarão de ventilação mecânica. Isso significa que essa abordagem é ideal para prever com antecedência pacientes de alto risco e um número mínimo de equipamentos de ventilação e de leitos críticos.

https://doi.org/10.1590/0100-3984.2022.0049

Improving feathering in different nursery apple trees by plant growth regulators
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Carra, Bruno

; Cabrera, Danilo

; Rodriguez, Pablo

; Dini, Maximiliano

Revista Brasileira de Fruticultura

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2023, Volume 45 elocation e-965

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

Abstract Feathering in apple nursery trees is a critical operation used to increase the quality of planting material. Plant growth regulators (PGR) could be used to form feathers in apple nursery trees. The main goal was to study the impact of different PGR and concentrations on feathering promotion in different nursery apple trees. The study had three different trials where the specific aims were to study the impact of: i) different rates of 6-benzyladenine (6-BA); ii) different PGR (6-BA and 6-BA + GA4+7) on feathering promotion, and; iii) 6-BA on feathering promotion and prohexadione calcium (P-Ca) on trunk thickening under greenhouse conditions. Both 6-BA and 6-BA + GA4+7 were effective inducing feathering in the different cultivars tested. 6-BA reduced final young plants grafted height only in one out of three seasons, reducing an average of 15 and 10 cm on ‘Early Red One’ and ‘Fuji’ apple nursery trees, respectively. P-Ca reduced tree growth rate 4-5 weeks after sprayed, but the difference did not persist until the end of the season. Trunk diameter was not affected by the different plant growth regulators and concentrations tested. 6-BA alone or in combination with GA4+7 is an efficient tool to feathering formation in different nursery apple cultivars and conditions.

Resumo A formação de ramos laterais em mudas de macieira é uma operação crítica utilizada para aumentar a qualidade das mudas e seu potencial para maiores rendimentos, nos primeiros anos após o plantio. Os reguladores vegetais podem ser utilizados para a formação de ramos laterais em mudas de macieira. A 6-benziladenina (6-BA), aplicada isoladamente ou combinada com giberelinas 4 + 7 (6-BA + GA4+7), é o PGR mais frequentemente utilizados para aumentar a formação de ramos laterais em mudas. O objetivo principal do estudo foi estudar o impacto dos reguladores vegetais e concentrações na ramificação lateral de diferentes mudas prode macieira. O estudo contou com três diferentes experimentos cujos objetivosespecíficos foram estudar o impacto de: i) diferentes concentrações de 6-BA; ii)diferentes reguladores vegetais (6-BA e 6-BA + GA4+7) na promoção de ramificação lateral, e iii) 6-BA na promoção de ramificação lateral e da prohexadiona cálcica (P-Ca) no diâmetro de troncoem ambiente protegido. Tanto a 6-BA quanto a combinação de 6-BA + GA4+7 foram eficazes naindução de ramos laterais em mudas, nas diferentes cultivares de macieira testadas. A6-BA reduziu a altura final das mudas apenas em um dos três anos, reduzindo em média de 15 a 10 cm a altura de mudas de macieiras ‘Early Red One’ e ‘Fuji’, respectivamente. A P-Careduziu a taxa de crescimento das plantas 4-5 semanas após a pulverização, mas a diferença não persistiu até ao final da estação de crescimento. O diâmetro do tronco não foi afetadopelos diferentes reguladores vegetais e pelas concentrações testadas. A 6-BA sozinha ou emcombinação com a GA4+7 é uma ferramenta eficiente para a indução de ramos laterais emdiferentes cultivares de macieiras e condições.

https://doi.org/10.1590/0100-29452023965

The new obesity classification based on weight history is not proposed as a guideline
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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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dec 2022, Volume 66 N. 6 Pages 936 - 937

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000571

ACCURACY OF ABBREVIATED PROTOCOL OF MAGNETIC RESONANCE CHOLANGIO-PANCREATOGRAPHY IN THE DIAGNOSIS OF CHOLEDOCHOLITHIASIS
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AGOSTINI, Ângela de Figueiredo Pinto

; HOCHHEGGER, Bruno

; FORTE, Gabriele Carra

; SUSIN, Luiza Aguirre

; DIFINI, João Pedro Miranda

Arquivos de Gastroenterologia

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jun 2022, Volume 59 N. 2 Pages 188 - 192

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

RESUMO Contexto: Protocolos abreviados de ressonância magnética (RM) surgiram a fim de reduzir o tempo de exame, eliminando sequências de pulso desnecessárias para responder a uma questão clínica específica, sem comprometer o diagnóstico. Objetivo: O objetivo do estudo foi avaliar a acurácia diagnóstica de um protocolo abreviado de colangiopancreatografia por ressonância magnética (colangioRM) em pacientes com suspeita de coledocolitíase. Métodos Estudo retrospectivo, com pacientes acima de 10 anos que realizaram exame de colangioRM, entre outubro de 2019 a junho de 2020, com suspeita clínica de coledocolitíase. Os observadores, radiologistas especialistas, primeiro avaliaram a árvore biliar usando um protocolo abreviado de colangioRM composto por quatro sequências de pulso e, posteriormente, revisaram o protocolo convencional de colangioRM de 11 sequências. A presença de coledocolitíase, o tamanho do cálculo, o calibre do ducto hepático comum e achados adicionais foram avaliados. Resultados Um total de 148 pacientes foram incluídos, sendo 62,8% do sexo feminino, com média de 50,9 anos de idade. A prevalência de coledocolitíase foi de 32,2%. A acurácia do protocolo abreviado de colangioRM para coledocolitíase foi de 98,7%. Não houve diferença entre o desempenho dos protocolos abreviado e convencional de colangioRM para a detecção de coledocolitíase (k=0,970), com uma sensibilidade de 98% e uma especificidade de 99%. Além disso, observou-se excelente concordância entre observadores na avaliação de coledocolitíase em ambos os protocolos de colangioRM (k=0,925). Conclusão O protocolo abreviado de colangioRM apresentou excelente acurácia para o diagnóstico de coledocolitíase quando comparado ao protocolo convencional.

ABSTRACT Background: Abbreviated magnetic resonance imaging protocols have emerged to reduce the examination time of the long protocols eliminating unnecessary pulse sequences to answer a targeted clinical question, without compromising diagnostic information. Objective: The objective of this study was to evaluate the diagnostic accuracy of an abbreviated magnetic resonance cholangiopancreatography (A-MRCP) protocol in patients with suspected choledocholithiasis. Methods: This retrospective study evaluated patients (ages 10 + years) that performed consecutive MRCP examination from October 2019 to June 2020, with the clinical suspicion of choledocholithiasis. Readers first evaluated the biliary tree using a four-sequence A-MRCP protocol and later reviewed the entire conventional eleven-sequence MRCP. Presence of choledocholithiasis, stone size, common bile duct caliber, and additional findings were evaluated. Results: A total of 148 patients with MRCP were included (62.8% female, mean 50.9 years). The prevalence of choledocholithiasis was 32.2%. The accuracy of the abbreviated MRCP protocol for choledocholithiasis was 98.7%. There was no difference between the performance of the abbreviated and conventional MRCP image sets for detection of choledocholithiasis (kappa=0.970), with a sensitivity of 98% and a specificity of 99%. There was excellent inter-reader agreement evaluating for choledocholithiasis on both imaging sets of MRCP protocols (kappa values were 0.970). Conclusion: An abbreviated MRCP protocol to evaluate for choledocholithiasis provides similar diagnostic over the conventional MRCP protocol, offering potential for decreased scanning time and improved patient tolerability.

https://doi.org/10.1590/s0004-2803.202202000-35

Proposal of an obesity classification based on weight history: an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO)
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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Kyle, Theodore K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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jun 2022, Volume 66 N. 3 Pages 139 - 151

Abstract: En | Text: En | PDF: En

ABSTRACT Obesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above 5%) is already associated with clinical improvement, while weight losses of 10%-15% bring even further benefits, independent from the final BMI. The percentage of weight reduction is accepted as a treatment goal since a greater decrease in weight is frequently difficult to achieve due to metabolic adaptation along with environmental and lifestyle factors. In this document, the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO) propose a new obesity classification based on the maximum weight attained in life (MWAL). In this classification, individuals losing a specific proportion of weight are classified as having “reduced” or “controlled” obesity. This simple classification – which is not intended to replace others but to serve as an adjuvant tool – could help disseminate the concept of clinical benefits derived from modest weight loss, allowing individuals with obesity and their health care professionals to focus on strategies for weight maintenance instead of further weight reduction. In future studies, this proposed classification can also be an important tool to evaluate possible differences in therapeutic outcomes between individuals with similar BMIs but different weight trajectories.

https://doi.org/10.20945/2359-3997000000465

Postoperative computed tomography of insufflated lung specimens obtained by video-assisted thoracic surgery: detection and margin assessment of pulmonary nodules
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Antunes, Milene da Silva

; Hochhegger, Bruno

; Alves, Giordano Rafael Tronco

; Gazzoni, Fernando Ferreira

; Forte, Gabriele Carra

; Andrade, Rubens Gabriel Feijó

; Felicetti, José Carlos

Radiologia Brasileira

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may 2022, Volume 55 N. 3 Pages 151 - 155

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

Resumo Objetivo: Investigar a utilidade da tomografia computadorizada (TC) para a detecção e avaliação de margens de nódulos pulmonares que foram insuflados após ressecção por cirurgia torácica videoassistida. Materiais e Métodos: Um inédito estudo multicêntrico foi conduzido em dois centros de referência nacional para doenças torácicas. Nódulos foram ressecados por cirurgia torácica videoassistida de pacientes com suspeita de câncer de pulmão e submetidos a TC pós-operatória. As medidas radiológicas da TC foram comparadas com as da análise patológica. Resultados: Um total de 37 pacientes foi avaliado. A idade média foi de 65 anos (variação: 36-84 anos) e 27 indivíduos (73%) eram do sexo feminino. A análise por TC dos espécimes insuflados identificou todas as 37 lesões e 33 delas com margens livres. A análise patológica revelou 30 casos de câncer de pulmão, todos com margens livres, e sete lesões não malignas. Conclusão: A TC pós-operatória de lesões pulmonares insufladas com suspeita de malignidade provê detecção em tempo real de nódulos pulmonares e aceitável avaliação de margens tumorais. Este estudo inicial demonstra que a TC de lesões pulmonares insufladas pode ser uma ferramenta valiosa em centros em que a análise histopatológica intraoperatória é indisponível.

Abstract Objective: To investigate the utility of computed tomography (CT) scans to detect and assess the margin status of pulmonary nodules that were insufflated after being resected by video-assisted thoracic surgery. Materials and Methods: This was a novel multicenter study conducted at two national referral centers for thoracic diseases. Patients suspected of having lung cancer underwent video-assisted thoracic surgery for the resection of pulmonary nodules, which were submitted to postoperative CT. Measurements from the CT scans were compared with the results of the histopathological analysis. Results: A total of 37 pulmonary nodules from 37 patients were evaluated. The mean age of the patients was 65 years (range, 36-84 years), and 27 (73%) were female. A CT analysis of insufflated specimens identified all 37 nodules, and 33 of those nodules were found to have tumor-free margins. The histopathological analysis revealed lung cancer in 30 of the nodules, all with tumor-free margins, and benign lesions in the seven remaining nodules. Conclusion: Postoperative CT of insufflated suspicious lung lesions provides real-time detection of pulmonary nodules and satisfactory assessment of tumor margins. This initial study shows that CT of insufflated lung lesions can be a valuable tool at centers where intraoperative histopathological analysis is unavailable.

https://doi.org/10.1590/0100-3984.2021.0046

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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Kyle, Theodore K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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apr 2022, Volume 66 N. 2 Pages 139 - 151

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000465

Shear wave elastography and Doppler ultrasound in kidney transplant recipients
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Gonçalves, Luana Marinho

; Forte, Gabriele Carra

; Holz, Tiago Garcia

; Libermann, Lucas Lobraico

; Figueiredo, Carlos Eduardo Poli de

; Hochhegger, Bruno

Radiologia Brasileira

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feb 2022, Volume 55 N. 1 Pages 19 - 23

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

RESUMO Objetivo: Avaliar a associação entre parâmetros de elastografia por onda de cisalhamento e resistência arterial em pacientes transplantados renais. Materiais e Métodos: Estudo transversal prospectivo. O estudo incluiu de forma consecutiva indivíduos adultos transplantados renais. Foram coletados dados demográficos e clínicos. Todos os pacientes foram submetidos à técnica ultrassonográfica para avaliação do índice de resistência (IR) e à quantificação da elasticidade do tecido por ondas de cisalhamento para avaliar a rigidez do aloenxerto renal. Resultados: Foram avaliados 55 pacientes. A média de idade e a velocidade da onda de cisalhamento foram maiores em pacientes com IR ≥ 0,79 (respectivamente, 68,0 ± 8,6 anos e 2,6 ± 0,4 m/s) quando comparados a pacientes com IR < 0,79 (respectivamente, 42,6 ± 14,1 anos, p < 0,001 e 2,2 ± 0,4 m/s, p = 0,013). A análise multivariada identificou a idade (OR = 1,169, IC 95%: 1,056 a 1,294; p = 0,003) e a velocidade da onda de cisalhamento (OR = 17,1, IC 95%: 1,137 a 257,83; p = 0,040) como fatores independentes associados a resistência arterial. Conclusão: Observou-se associação entre a rigidez do córtex do transplante renal avaliada por elastografia por onda de cisalhamento e a resistência arterial em pacientes pós-transplantados renais avaliados por Doppler.

Abstract Objective: To evaluate the association between shear wave elastography parameters and arterial resistance in kidney transplant recipients. Materials and Methods: This was a prospective cross-sectional study involving consecutive adult kidney transplant recipients. All patients underwent color Doppler to evaluate the resistive index (RI) and ultrasound shear wave elastography for the quantification of renal allograft stiffness. Results: We evaluated 55 patients, of whom 9 (16.4%) had an RI defined as abnormal (≥ 0.79) and 46 (83.6%) had an RI defined as normal (< 0.79). The mean age was higher in the abnormal RI group than in the normal RI group (68.0 ± 8.6 years vs. 42.6 ± 14.1 years; p < 0.001), as was the mean shear wave velocity (2.6 ± 0.4 m/s vs. 2.2 ± 0.4 m/s; p = 0.013). Multivariate analysis identified two independent predictors of arterial resistance: age (OR = 1.169; 95% CI: 1.056 to 1.294; p = 0.003) and shear wave velocity (OR = 17.1; 95% CI: 1.137 to 257.83; p = 0.040). Conclusion: We observed an association between rigidity in the cortex of the transplanted kidney, as evaluated by shear wave elastography, and arterial resistance, as evaluated by color Doppler, in kidney transplant recipients.

https://doi.org/10.1590/0100-3984.2020.0148

Whole-body magnetic resonance imaging for the diagnosis of metastasis in children and adolescents: a systematic review and meta-analysis
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Valduga, Simone Gianella

; Forte, Gabriele Carra

; Paganin, Ricardo Pessini

; Abreu, Diego Gomez

; Medeiros, Tássia Machado

; Irion, Klaus

; Hochhegger, Bruno

; Mattiello, Rita

Radiologia Brasileira

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oct 2021, Volume 54 N. 5 Pages 329 - 335

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

Resumo A ressonância magnética de corpo inteiro (WB-MRI) é um método de imagem não invasivo que pode ser usado para diagnosticar, estadiar e avaliar a resposta terapêutica em oncologia. O objetivo desta meta-análise foi avaliar a precisão do diagnóstico de WB- MRI no diagnóstico de metástases em crianças. Foram pesquisadas as seguintes bastes de dados: Medline, Embase, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin-American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and ClinicalTrials.gov. Todos os estudos incluíram crianças e adolescentes com prova histopatológica de um tumor original. Os estudos selecionados incluíram 118 pacientes com idade variando de 7 meses a 19 anos. A sensibilidade e especificidade combinadas de WB-MRI foram, respectivamente, 0,964 (IC 95%: 0,944-0,978; I2 = 0%) e 0,902 (IC 95%: 0,882-0,919; I2 = 98,4%), com AUC de 0,991. A WB-MRI tem uma boa precisão para o diagnóstico de metástases em pediatria e pode potencialmente fornecer um método alternativo não ionizante mais seguro para completar o estadiamento da doença maligna em crianças.

Abstract Whole-body magnetic resonance imaging (WB-MRI) is a noninvasive imaging method that can be used to diagnose and stage tumors, as well as to assess therapeutic responses in oncology. The objective of this meta-analysis was to evaluate the accuracy of WB-MRI for the diagnosis of metastases in pediatric patients. The following electronic databases were searched: Medline, Embase, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin-American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and ClinicalTrials.gov. All of the selected studies included children and adolescents with histopathological confirmation of a primary tumor. Collectively, the studies included 118 patients ranging in age from 7 months to 19 years. The pooled sensitivity and specificity of WB-MRI were, respectively, 0.964 (95% CI: 0.944-0.978; I2 = 0%) and 0.902 (95% CI: 0.882-0.919; I2 = 98.4%), with an area under the curve (AUC) of 0.991. We found that WB-MRI had good accuracy for the diagnosis of metastases in pediatric patients and could therefore provide an alternative to complete the staging of tumors in such patients, being a safer option because it does not involve the use of ionizing radiation.

https://doi.org/10.1590/0100-3984.2020.0183 153 downloads

10.

Ethephon as a potential tool to manage alternate bearing of ‘Fuji’ apple trees
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Pasa, Mateus da Silveira

; Carra, Bruno

; Brighenti, Alberto Fontanella

; Pinto, Felipe Augusto Moretti Ferreira

; Mello-Farias, Paulo Celso de

; Herter, Flávio Gilberto

Revista Ceres

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jun 2021, Volume 68 N. 3 Pages 180 - 184

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to investigate the effect of different rates of ethephon on return bloom and yield, and fruit quality of ‘Fuji’ apple trees. The experiment was performed during the 2014/2015 and 2015/2016 growing seasons. Eighteen-year-old Fuji Standard apple trees grafted on M.9 were sprayed with different rates of ethephon (300 mg L-1, 400 mg L-1, and 500 mg L-1) 30 days after full bloom (DAFB) and compared to an unsprayed control. Yield components (number of fruit per tree, yield, fruit weight, and estimated yield) and fruit quality attributes (fruit firmness, total soluble solids and starch-iodine index) were evaluated in both seasons. Return bloom (percentage of flowering spurs and 1-year-shoots) was assessed only the year following the application. Our results show that ethephon increases return bloom and yield of ‘Fuji Standard’ apple trees, without affecting fruit quality attributes.

https://doi.org/10.1590/0034-737x202168030003 108 downloads

11.

Plant growth regulators to increase fruit set and yield of ‘Rocha’ pear trees in Southern Brazil
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CARRA, BRUNO

; PASA, MATEUS S.

; ABREU, EVERTON S.

; DINI, MAXIMILIANO

; PASA, CARINA P.

; CIOTTA, MARLISE N.

; HERTER, FLAVIO G.

; MELLO-FARIAS, PAULO

Anais da Academia Brasileira de Ciências

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2021, Volume 93 N. 3 elocation e20180680

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to evaluate the effect of different aminoethoxyvinilglycine (AVG), thidiazuron (TDZ) and prohexadione calcium (P-Ca) rates sprayed at different timings on fruit set, yield, and fruit quality of ‘Rocha’ pear trees in different climatic conditions of Southern Brazil. The study was performed in two commercial orchards located in São Joaquim, SC (2015/2016) and Antônio Prado, RS (2016/2017). Plant material consisted of ‘Rocha’ pear trees grafted onto Pyrus calleryana and quince rootstock ‘BA29’ in São Joaquim and Antônio Prado, respectively. Treatments consisted of AVG, TDZ and P-Ca sprayed at different rates and timings. Trunk cross-sectional area increase, fruit set, thinned fruit, fruit per tree, yield, average fruit weight, projected yield, yield efficiency, fruit length, fruit diameter, L/D ratio, seed number, flesh firmness, and soluble solids content were assessed. Fruit set and yield were consistently increased by AVG in all experiments. Fruit set was not affected by P-Ca and was significantly decreased by TDZ. However, yield was positively affected by P-Ca 100 mg L–1 sprayed at full bloom + 7 days after full bloom and TDZ 10 mg L–1 at full bloom. Fruit size was consistently increased by TDZ.

https://doi.org/10.1590/0001-3765202120180860 1203 downloads

12.

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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STUDART-NETO, Adalberto

; GUEDES, Bruno Fukelmann

; TUMA, Raphael de Luca e

; CAMELO FILHO, Antonio Edvan

; KUBOTA, Gabriel Taricani

; IEPSEN, Bruno Diógenes

; MOREIRA, Gabriela Pantaleão

; RODRIGUES, Júlia Chartouni

; FERRARI, Maíra Medeiros Honorato

; CARRA, Rafael Bernhart

; SPERA, Raphael Ribeiro

; OKU, Mariana Hiromi Manoel

; TERRIM, Sara

; LOPES, Cesar Castello Branco

; PASSOS NETO, Carlos Eduardo Borges

; FIORENTINO, Matheus Dalben

; DE SOUZA, Julia Carvalhinho Carlos

; BAIMA, José Pedro Soares

; DA SILVA, Tomás Fraga Ferreira

; MORENO, Cristiane Araujo Martins

; SILVA, Andre Macedo Serafim

; HEISE, Carlos Otto

; MENDONÇA, Rodrigo Holanda

; FORTINI, Ida

; SMID, Jerusa

; ADONI, Tarso

; GONÇALVES, Marcia Rubia Rodrigues

; PEREIRA, Samira Luisa Apóstolos

; PINTO, Lecio Figueira

; GOMES, Helio Rodrigues

; ZANOTELI, Edmar

; BRUCKI, Sonia Maria Dozzi

; CONFORTO, Adriana Bastos

; CASTRO, Luiz Henrique Martins

; NITRINI, Ricardo

Arquivos de Neuro-Psiquiatria

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aug 2020, Volume 78 N. 8 Pages 494 - 500

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

RESUMO Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomas neurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doenças neurológicas prévias podem exigir tratamento especial e estar associadas a piores desfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmente pouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitar consultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com 900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico de COVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas as interconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foram analisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dados disponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionais conforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões de consenso. Após o diagnóstico, os neurologistas participaram da condução dos casos. Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) em pacientes internados por COVID-19 durante o período. Os principais diagnósticos neurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%), doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornos neuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomas leves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em um hospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetar o desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecer sintomas neurológicos. Os neurologistas são membros importantes da equipe médica no atendimento hospitalar à COVID-19.

ABSTRACT Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

https://doi.org/10.1590/0004-282x20200089 2651 downloads

13.

[SciELO Preprints] - Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
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Studart-Neto, Adalberto Guedes, Bruno Fukelmann Tuma, Raphael De Luca E Camelo Filho, Antonio Edvan Kubota, Gabriel Taricani Iepsen, Bruno Diógenes Moreira, Gabriela Pantaleão Rodrigues, Júlia Chartouni Ferrari, Maíra Medeiros Honorato Carra, Rafael Bernhard Spera, Raphael Ribeiro Oku, Mariana Hiromi Manoel Terrim, Sara Lopes, Cesar Castello Branco Passos Neto, Carlos Eduardo Borges Dalben, Matheus De Souza, Julia Carvalhinho Carlos Baima, José Pedro Soares Da Silva, Tomás Fraga Ferreira Moreno, Cristiane Araujo Martins Silva, Andre Macedo Serafim Heise, Carlos Otto Mendonça, Rodrigo Holanda Fortini, Ida Smid, Jerusa Adoni, Tarso Gonçalves, Marcia Rubia Rodrigues Pereira, Samira Luisa Apóstolos Pinto, Lecio Figueira Gomes, Helio Rodrigues Zanotelli, Edmar Brucki, Sonia Maria Dozzi Conforto, Adriana Bastos Castro, Luiz Henrique Martins Nitrini, Ricardo

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Publication date: 2020-07-16

Abstract: En Pt

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.

Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomasneurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doençasneurológicas prévias podem exigir tratamento especial e estar associadas a pioresdesfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmentepouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitarconsultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico deCOVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas asinterconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foramanalisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dadosdisponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionaisconforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões deconsenso. Após o diagnóstico, os neurologistas participaram da condução dos casos.Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) empacientes internados por COVID-19 durante o período. Os principais diagnósticosneurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%),doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornosneuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomasleves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em umhospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetaro desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecersintomas neurológicos. Os neurologistas são membros importantes da equipe médica noatendimento hospitalar à COVID-19.

https://doi.org/10.1590/0004-282X20200089

14.

Thidiazuron (TDZ) increases fruit set and yield of ‘Hosui’ and ‘Packham’s Triumph’ pear trees
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PASA, MATEUS S.

; SILVA, CARINA P. DA

; CARRA, BRUNO

; BRIGHENTI, ALBERTO F.

; SOUZA, ANDRÉ LUIZ K. DE

; PETRI, JOSÉ LUIZ

Anais da Academia Brasileira de Ciências

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dec 2017, Volume 89 N. 4 Pages 3103 - 3110

Abstract: En | Text: En | PDF: En

ABSTRACT The low fruit set is one of the main factors leading to poor yield of pear orchards in Brazil. The exogenous application of thidiazuron (TDZ) and aminoethoxyvinilglycine (AVG) has shown promising results in some pear cultivars and other temperate fruit trees. The objective of this study was to evaluate the effect of TDZ and AVG on fruit set, yield, and fruit quality of ‘Hosui’ and ‘Packham’s Triumph’ pears. The study was performed in a commercial orchard located in São Joaquim, SC. Plant material consisted of ‘Hosui’ and ‘Packham’s Triumph’ pear trees grafted on Pyrus calleryana. Treatments consisted on different rates of TDZ (0 mg L-1, 20 mg L-1, 40 mg L-1 and 60 mg L-1) sprayed at full bloom for both cultivars. An additional treatment of AVG 60 mg L-1 was sprayed one week after full bloom in ‘Hosui’. The fruit set, number of fruit per tree, yield, fruit weight, seed number, and fruit quality attributes were assessed. Fruit set and yield of both cultivars are consistently increased by TDZ, within the rates of 20 to 60 mg L-1. Besides, its application increased fruit size of ‘Hosui’ and did not negatively affect fruit quality attributes of both cultivars.

https://doi.org/10.1590/0001-3765201720170644 1235 downloads

15.

Prohexadione calcium reduces vegetative growth and increases fruit set of ‘Smith’ pear trees, in Southern Brazil
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Carra, Bruno

; Spagnol, Daniel

; Abreu, Everton Sozo de

; Pasa, Mateus da Silveira

; Silva, Carina Pereira da

; Hellwig, Cristiano Geremias

; Fachinello, José Carlos

Bragantia

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jul 2017, Volume 76 N. 3 Pages 360 - 371

Abstract: En | Text: En | PDF: En

ABSTRACT Prohexadione calcium (P-Ca) has been reported to effectively control shoot growth in several pear cultivars, but with a few reports about its efficiency under the climatic conditions of southern Brazil. Therefore, the objective of this study was to evaluate vegetative growth, production, and fruit quality of ‘Smith’ pear trees in response to the use of different rates of P-Ca in the climatic conditions of southern Brazil. The experiment was conducted during the 2013/2014 and 2014/2015 seasons, in a 6-year-old ‘Smith’ pear orchard, trained to a central-leader system, with spacing of 1.5 × 4.8 m, grafted onto Pyrus calleryana Decne. Different P-Ca rates were applied (100, 200, 300, and 400 mg∙L–1) in different stages: first, in early spring for all treatments, and the others when shoot growth resumed (GR), but only for some treatments. Variables for vegetative growth, yield components and fruit quality at harvest and post-harvest were evaluated. The use of P-Ca was effective to control vegetative growth in both seasons, at different rates. Yield components were not affected by P-Ca applications in 2013/2014, except return bloom and return yield. In 2014/2015 season, P-Ca applications positively affected yield components, except average fruit weight and return bloom. P-Ca applications did not alter the qualitative attributes of the fruits of ‘Smith’ pear trees at harvest and after a period of cold storage. These results implicate P-Ca as a potential tool to manage vigor of ‘Smith’ pear trees in climatic conditions of southern Brazil.

https://doi.org/10.1590/1678-4499.298 1401 downloads

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