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ABSTRACT Objective: To evaluate adult height and identify the factors contributing to its achievement in patients born small for gestational age (SGA) treated with recombinant human growth hormone (rhGH). Subjects and methods: This retrospective study includes data of SGA children treated at a pediatric endocrinology center. Inclusion criteria were SGA birth (birth length and/or weight < -1.28 standard deviation score (SDS), absence of catch-up growth by the age of four years, rhGH treatment for more than 12 months, and recorded adult height. Birth size SDS was calculated using Intergrowth-21st (gestational age ≥ 33 weeks) or Fenton (<33 weeks) standards. Patients with uncontrolled chronic diseases, genetic syndromes, or growth hormone deficiency were excluded. An increase of 0.6 SDS or more was considered a positive response. Results: Twenty-four patients (14 boys) were included, with an average gestational age of 38.0 (range: 33.0-40.0) weeks, birth weight of -1.3 ± 0.9 SDS, and birth length of -2.4 ± 0.7 SDS. They were treated with rhGH starting at an average age of 10.3 ± 2.6 years for a duration of 5.4 ± 2.3 years. Height SDS increased from -2.6 ± 0.4 SDS to -1.2 ± 0.6 SDS, which was comparable to the target height SDS (-1.3 ± 0.9; p = 0.3). Although 18 children were classified as good responders, 6 did not achieve a final height SDS > -2.0. Adult height was correlated with the increment in height SDS and growth velocity during the first year of treatment. No significant differences were observed between children classified as SGA by birth weight or length < 10th percentile and those by weight or length < -2.0 SDS. Conclusion: In this cohort of children born SGA with short stature, rhGH treatment effectively improved adult height. Given the diverse causes of being born SGA, the response to rhGH therapy may vary.

https://doi.org/10.20945/2359-4292-2023-0513

Chromium propionate or calcium salts of palm oil in the diets of ewes in late pregnancy and lactation and the effects on the offspring
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Gallo, Sarita Bonagurio

; Oliveira, Giuliana Micai de

; Oliveira, Mariluce Cardoso

; Santos, Fernanda Ferreira dos

; Brochine, Luciano

; Silva, Mônica Márcia da

; Negrão, João Alberto

; Delgado, Eduardo Francisquine

Scientia Agricola

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2025, Volume 82 elocation e20230248

Abstract: En | Text: En | PDF: En

ABSTRACT Ruminants in late gestation and lactation have high energy requirements, which can be effectively met with diets that include chromium and protected fat. This study aimed to compare the effects of chromium propionate and rumen-protected fat supplementation in the diet of ewes in late gestation and lactation and to evaluate their impact on the performance, metabolism, carcass, and meat quality of the offspring. The study population consisted of 25 mixed-breed ewes, aged 3 ± 1 years, with a body weight (BW) of 57 ± 10 kg, and a single gestation. All ewes in the study gave birth to males. The experimental design was a randomized block design with three dietary treatments: a control diet (CTL; n = 8) consisting of corn as the primary energy source; a chromium propionate treatment (CRPR; n = 9) consisting of the CTL diet plus 0.5 mg of chromium propionate per kg of dry matter (DM); and a calcium-salts from palm oil treatment (FAT; n = 8) - CTL diet plus calcium salts from palm oil. The ewes were fed the diets for 50 days of gestation and 70 days of lactation. Following weaning, the lambs were confined for of 60 days and subsequently slaughtered. The means were compared using Tukey’s test with a statistical probability of 5 %. The maternal diets of CRPR and FAT resulted in lambs with higher BW at weaning and slaughter, greater chest and leg width, and higher aspartate aminotransferase (AST) and insulin values, as well as lower cholesterol and low-density lipoprotein (LDL) levels. The FAT treatment reduced cooking losses and alterations in lambs’ sarcomere length (SL) and muscle fiber area. It can be concluded that the inclusion of CRPR and FAT in the diet of pregnant and lactating ewes has beneficial effects on the offspring.

https://doi.org/10.1590/1678-992x-2023-0248

Physiologically Based Pharmacokinetic and Physiologically Based Biopharmaceutic models research in Latin America: A regional level bibliometric analysis, 2011-2023
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Ribeiro, Marx

; Cardoso, Juliana Cordeiro

; Martins, José Eduardo Severino

; Pinto, Aline Ferreira

; Souto, Eliana Maria Barbosa

; Severino, Patricia

Brazilian Journal of Pharmaceutical Sciences

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2025, Volume 61 elocation e24422

Abstract: En | Text: En | PDF: En

Abstract The landscape of scientific research in Latin America (LA), particularly in the realms of the Physiologically Based Pharmacokinetic (PBPK) and Physiologically Based Biopharmaceutic models (PBPM), is a mosaic of varied contributions, collaborations, and specializations. This study examines research production in the region using data from the Scopus and PubMed databases collected between 2011 and 2023. Brazil stands out as a prominent country in terms of the quantity of publications. When considering thematic specialization, Colombia cones first as the country with the greatest Relative Specialization Index (RSI), followed by Brazil, Cuba, Uruguay, Mexico, and Argentina. Regarding internationalization, Brazil and Mexico are currently exerting significant influence, particularly through their increasing cooperation with the United States and Europe. Interestingly, there is a lack of cooperation inside Latin America at the regional level. Regarding the contribution of Latin-American institutions, the State University of Maringá leads in number of publications, followed by the University of São Paulo and the Federal University of São Paulo. In this work, we analyzed the strengths and weaknesses of LA’s scientific contributions, offering a roadmap for future collaborative and specialized efforts in the field of PBPK and PBBM.

https://doi.org/10.1590/s2175-97902025e24422

Diversity of Chemical Composition and Antibacterial Activity of Cinnamomum verum and Ocotea catharinensis (Lauraceae) Essential Oils
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Costa, Erica R.

; Coutinho, Eduardo J. Silva, Jaqueline C. M. da Facco, Janaina T. Vaz, Márcia S. M. Simionatto, Simone Cardoso, Cláudia A. L. Paula-Silva, Michele C. de Simionatto, Euclésio

Journal of the Brazilian Chemical Society

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2025, Volume 36 N. 6 elocation e-20250041

Abstract: En | Text: En | PDF: En

The chemical composition of the essential oils isolated from the leaves and barks of Cinnamomum verum and Ocotea catharinensis (Lauraceae) species was characterized by gas chromatography-flame ionization detection (GC-FID) and gas chromatography-mass spectrometry (GC-MS) analyses. In C. verum essential oils, 14 and 21 chemical compounds were identified in the oils from the leaves and bark, representing 85.3 and 85.9% of the total composition of the oils, respectively. For O. catharinensis, 30 and 32 compounds were characterized in the essential oils from the leaves and bark, equivalent to 87.7 and 89.2% of the oil composition, respectively. It was observed that C. verum oils are considerably rich in monoterpenes (> 77%), while O. catharinensis oils present a predominance of sesquiterpenes, with emphasis on the content of these compounds in the oil obtained from the leaves of this species (60.5%), while in the bark there is a predominance of monoterpenes (47.8%). The main compounds characterized in C. verum oil from the leaves were cymene (21.2%) and 1,8-cineole (eucalyptol) (24.7%), while in the oil from the bark the major compounds were 1,8-cineole (38.9%), α-terpineol (12.9%) and terpine-4-ol (11.7%). In the O. catharinenses leaves oil, spathulenol (13.2%), α-pinene (10.2%) and β-pinene (8.4%) were the major components, while in the O. catharinenses barks oil, α-pinene (12.4%), 1,8-cineole (eucalyptol) (8.9%) and rosifoliol (9.4%) were the main constituents. The C. verum essential oil from leaves showed activity against the bacteria Serratia marcescens (minimum inhibitory concentration, MIC, 1.12 mg mL 1). The seasonality study with essential oils from the leaves of O. catharinensis and C. verum demonstrated great variation in the terpene composition, with summer being the most discrepant season.

https://doi.org/10.21577/0103-5053.20250041

Modifiable risk factors associated with the risk of developing Parkinson's disease: a critical review
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Tumas, Vitor

; Aureliano, Marcelo Jhonatan

; Rieder, Carlos Roberto de Melo

; Schuh, Artur Francisco Schumacher

; Ferraz, Henrique Ballalai

; Borges, Vanderci

; Soares, Maria Carolina

; Boone, Dayany Leonel

; Silva, Carolina Candeias da

; Costa, Mariana Cavalcanti

; Silva, Delson José da

; Carmo, Aracelle Victor do

; Mikael, Luana de Rezende

; Santos-Lobato, Bruno Lopes

; Rosso, Ana Lucia Zuma

; Vilaça, Celmir de Oliveira

; Braga-Neto, Pedro

; Gomes, André Borges Ferreira

; Carvalho, Camila Gonçalves Monteiro

; Letro, Grace Helena

; Nicaretta, Denise Hack

; Coletta, Marcus Vinicius Della

; Barbosa, Egberto Reis

; Cury, Rubens Gisbert

; Cardoso, Francisco Eduardo Costa

; Camargos, Sarah Teixeira

; Mata, Ignacio Fernandez

Arquivos de Neuro-Psiquiatria

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2025, Volume 83 N. 3 elocation s00451805075

Abstract: En | Text: En | PDF: En

Abstract The etiology of Parkinson's disease (PD) is complex and multifactorial, depending on interactions involving environmental/lifestyle and genetic factors. The genetic aspects of the disease are becoming well characterized, while the environmental factors still need further investigation. In the present narrative review, we have described the most concrete evidence of associations between environmental factors and the risk of developing PD. Physical activity, healthy dietary patterns, smoking, and caffeine intake are protective factors against PD. Head trauma, consumption of milk and dairy products, and pesticide exposure were associated with a higher risk of developing PD. The associations of alcohol consumption, living in rural areas, farming, and consumption of well water with PD are still controversial. Results of several studies strongly suggest that diabetes mellitus is a risk factor for the development of PD, as well as the pre-diabetic state. Lower serum levels of uric acid were associated with an increased risk of developing PD and with worse clinical features and faster progression of symptoms. The protective effects of nonsteroidal antiinflammatory drugs use are controversial. Several other factors were potentially associated with the risk of developing PD: environmental pollutants such as organic solvents, exposure to sunlight, vitamin D deficiency, bullous pemphigoid, bipolar disorder, inflammatory bowel disease, irritable bowel syndrome, certain infections and agents, and essential tremor. Environmental factors are important risk markers for the development of PD. Understanding these risks and protective factors could lead to the implementation of risk-modifying actions for PD.

https://doi.org/10.1055/s-0045-1805075

Risk of imbalanced glycemic pattern: diagnostic content validity
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Gonçalves, Letícia Mattos

; Lopes, Rafael Oliveira Pitta

; Gomes, Eduardo da Silva

; Silva, Thamiris da Silva e

; Cardoso, Rosane Barreto

; Brandão, Marcos Antônio Gomes

Revista da Escola de Enfermagem da USP

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2025, Volume 59 elocation e20240298

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

RESUMO Objetivo: Avaliar a evidência de validade de conteúdo da proposição diagnóstica “Risco de padrão glicêmico desequilibrado”. Método: Estudo de validade de conteúdo baseado na sabedoria coletiva, de abordagem quantitativa. Amostra composta por 51 participantes que avaliaram a relevância e precisão dos 13 fatores de risco, 10 populações em risco e 16 condições associadas. Para análise, foi utilizado o índice de validade de conteúdo, sendo excluídos os componentes diagnósticos que tenham atingido valor igual ou inferior a 0,5. Resultados: A etiqueta diagnóstica e sua definição alcançaram um índice de validade de conteúdo de 0,98 e 0,94, respectivamente. Os fatores de risco com maiores índices foram monitoramento inadequado da glicemia, conhecimento inadequado do manejo da doença, regularidade inadequada do consumo de refeições, obesidade e sobrepeso. Nenhum componente diagnóstico foi excluído, pois todos apresentaram evidência de validade de conteúdo. Conclusão: A proposição diagnóstica Risco de padrão glicêmico desequilibrado atingiu adequados valores para a consideração de evidência de validade de conteúdo.

ABSTRACT Objective: To assess evidence of content validity of the diagnostic proposition “Risk of imbalanced glycemic pattern”. Method: Content validity study based on collective wisdom, with a quantitative approach. Sample composed of 51 participants who assessed the relevance and accuracy of 13 risk factors, 10 at-risk populations, and 16 associated conditions. For analysis, the content validity index was used, excluding diagnostic components that reached a value equal to or less than 0.5. Results: The diagnostic label and its definition achieved a content validity index of 0.98 and 0.94, respectively. The risk factors with the highest rates were inadequate blood glucose monitoring, inadequate knowledge of disease management, inadequate regularity of meal consumption, obesity, and overweight. No diagnostic component was excluded, as all of them presented evidence of content validity. Conclusion: The diagnostic proposition Risk of imbalanced glycemic pattern reached adequate values for consideration of evidence of content validity.

RESUMEN Objetivo: Evaluar la evidencia de validez de contenido de la propuesta diagnóstica “Riesgo de patrón glucémico desequilibrado”. Método: Estudio de validez de contenido basado en la sabiduría colectiva, con un enfoque cuantitativo. Muestra compuesta por 51 participantes que evaluaron la relevancia y precisión de 13 factores de riesgo, 10 poblaciones en riesgo y 16 afecciones asociadas. Para el análisis se utilizó el índice de validez de contenido, excluyendo los componentes diagnósticos que alcanzaron un valor igual o menor a 0,5. Resultados: La etiqueta diagnóstica y su definición alcanzaron un índice de validez de contenido de 0,98 y 0,94, respectivamente. Los factores de riesgo con tasas más altas fueron el control inadecuado de la glucemia, conocimientos inadecuados sobre el manejo de la enfermedad, regularidad inadecuada en el consumo de comidas, obesidad y sobrepeso. No se excluyó ningún componente diagnóstico, ya que todos presentaron evidencia de validez de contenido. Conclusión: La propuesta diagnóstica Riesgo de patrón glucémico desequilibrado alcanzó valores adecuados para ser considerada evidencia de validez de contenido.

https://doi.org/10.1590/1980-220x-reeusp-2024-0298en

Benefits of Re-sintering on the Properties of Al2O3-based Ceramics Obtained by Extrusion 3D Printing
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Silva, Bruno M.

; Baltazar, Joana

; Cardoso, Ronald P.

; Amarante, José Eduardo V.

; Daguano, Juliana Kelmy Macario Faria Santos, Claudinei

Materials Research

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2025, Volume 28 elocation e20240492

Abstract: En | Text: En | PDF: En

In this study, Al2O3-based ceramics were obtained by 3D extrusion printing using an ink containing carboxymethylcellulose (CMC) and polyethyleneimine (PEI) as additives. The-ceramic pieces were printed using syringes with nozzles of either 0.25 mm or 0.41 mm diameter at a printing speed of 10 mm/s. After drying, the samples were sintered at 1600 °C for 2 hours and characterized for relative density, microstructure, and crystalline phases. The mechanical properties, including Vickers hardness and fracture toughness, were also evaluated. After sintering, groups of samples were re-sintered at 1610 °C with an isothermal plateau of 0 h, 2 h, or 6 h and then characterized. A group of Al2O3 samples, the control group, was processed conventionally (uniaxial pressing→sintering at 1600 °C for 2 hours) for comparative analysis. The results indicate that, under all manufacturing conditions, α-Al2O3 was the only crystalline phase observed. Additionally, the results showed improvements in the mechanical properties of the samples printed by Robocasting after the re-sintering process, regardless of the extrusion nozzle diameter. The relative density increased from 95.3 ±0.4% to 97.4 ±0.3%, Vickers hardness improved from 1322 ±62 HV to 1526 ±45 HV, and fracture toughness increased from 2.3 ±0.4 MPa.m1/2 to 3.2 ±0.6 MPa.m1/2.

https://doi.org/10.1590/1980-5373-mr-2024-0492

Use of nicosulfuron in the management of Megathyrsus maximus ‘BRS Zuri’ intercropped with maize
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Silva, Carlos Henrique de Lima e

; Mello, Carlos Eduardo Leite

; Silva, Jaqueline Oliveira da

; Jakelaitis, Adriano

; Marques, Renata Pereira

; Cruz, Dayana Cardoso

Revista Ciência Agronômica

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2025, Volume 56 elocation e202394128

Abstract: En | Text: En | PDF: En

ABSTRACT Intercropping maize with tropical forages is common in production systems but must be correctly managed during the early stages to avoid a loss in crop yield due to interspecific competition. Applying subdoses of selective herbicides to the maize is a possible way of suppressing forage growth and avoiding this competition. The aim of this study was to evaluate the effects of subdoses of nicosulfuron herbicide on the development of Megathyrsus maximus ‘BRS Zuri’ when intercropped with maize, and how this simultaneous cultivation affects the weed population and the biometric and production variables of the maize and forage. The design was of randomised blocks with four replications and treatments consisting of six subdoses of nicosulfuron herbicide (0, 2.5, 5, 12.5, 25 and 50 g ha−1) in addition to a single crop of maize. The results show that the forage, BRS Zuri, suppressed the growth and development of the weeds. The dose of 50 g ha−1 caused phytotoxicity in the B2360PW maize hybrid. The presence of the forage had a negative effect on grain yield. The herbicide did not suppress the growth of the forage since both its height and biomass were significant. The results show the need for adjusting the dose, the choice of maize hybrid and the time of herbicide application, with a view to minimising possible interference from the forage in the performance of the maize crop.

https://doi.org/10.5935/1806-6690.20250059

Integration of smart glasses in telementoring for simulated medical procedures
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Zubiolo, Tiago Francisco Meleiro

; Marques, Vlaudimir Dias

; Massago, Miyoko

; Machado, Aline Cardoso

; Ueda, Felipe Hideaki

; Aboboreira, Mateus de Amorim

; Damasceno, Eduardo Filgueiras

; Gurgel, Sanderland José Tavares

; Fontes, Carlos Edmundo Rodrigues

; Andrade, Luciano de

Acta Cirúrgica Brasileira

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2025, Volume 40 elocation e403625

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To demonstrate the complete process of telementoring implementation using augmented-reality smart glasses for performing a simulated medical procedure. Methods: Fifteen participants, including physicians and medical students, were recruited to participate in a telementoring session with an educational focus during simulated thoracostomy with closed pleural drainage. A questionnaire assessing technology usability and usefulness was administered, and the results were analyzed by Cronbach’s alfa and multiple correspondence analysis (MCA). Results: The mean age of the participants was 28.8 and 66.67% of them were women. The test results indicated a Cronbach’s alpha of 78% and an MCA of 49.48% for the first three dimensions. Conclusion: The results showed that smart glasses are easy to use and facilitate communication among the professionals involved, providing comfort and safety to participants of care simulations. Additionally, smart glasses were considered to have perceived usefulness.

https://doi.org/10.1590/acb403625

10.

UMA ONTOLOGIA PARA INTEGRAR DADOS DE EVASÃO ESCOLAR, DESEMPENHO ACADÊMICO E DISTRIBUIÇÃO DE AUXÍLIOS SOCIOECONÔMICOS: ESTUDO DE CASO NO IFMG
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Melo, Eduardo Cardoso

; Bax, Marcello Peixoto

Perspectivas em Ciência da Informação

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2025, Volume 30 elocation e-51965

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

RESUMO O emprego massivo de tecnologias computacionais por organizações dos mais variados ramos de atuação está ligado, em especial, com o surgimento cada vez mais frequente de ambientes que requerem dos gestores extrema capacidade decisória, mesclando qualidade e agilidade. Em cenários marcados por decisões subsidiadas por dados, é fundamental o apoio de artefatos que contribuam para integrar fontes heterogêneas de dados nas organizações, tais como as ontologias. Este artigo apresenta uma ontologia de domínio elaborada para organizar o conhecimento relacionado com evasão escolar, desempenho acadêmico e distribuição de auxílios socioeconômicos em uma Instituição Federal de Ensino Superior, bem como integrar os dados de tais construtos. A metodologia empregada, com destaque para a abordagem SABiO em conjunto com a linguagem de modelagem OntoUML, forneceu o suporte necessário para todo o processo de desenvolvimento da ontologia de domínio. Como principais resultados, houve a integração dos dados de quatro fontes heterogêneas em conformidade com a ontologia especificada, permitindo a recuperação de informações que responderam as questões de competência que indicam a coerência entre o propósito da ontologia e a realidade do seu escopo. Quanto aos dados institucionais analisados, ficou evidente a importância dos auxílios socioeconômicos distribuídos para a redução da evasão escolar e aumento do desempenho acadêmico dos estudantes.

ABSTRACT The massive use of computing technologies by organizations from the most varied fields of activity is linked, in particular, to the increasingly frequent emergence of environments that require extreme decision-making capacity from managers, combining quality and agility. In scenarios marked by decisions supported by data, the support of artifacts that contribute to integrating heterogeneous data sources in organizations, such as ontologies, is essential. This article presents how to develop a domain ontology to organize knowledge related to school dropout, academic performance and distribution of socioeconomic aid in a Federal Higher Education Institution, as well as integrating data from such constructs. The methodology used, with emphasis on the SABiO approach, provided the necessary support for the entire domain ontology development process. As main results, there was the integration of data from four heterogeneous sources in accordance with the specified ontology, allowing the recovery of information that answered the competence questions that indicate the coherence between the purpose of the ontology and the reality of its scope. Regarding the institutional data analyzed, the importance of the socioeconomic aid distributed for reducing school dropouts and increasing students' academic performance was evident.

https://doi.org/10.1590/1981-5344/51965

11.

Diretriz Brasileira de Ergometria em Crianças e Adolescentes – 2024
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Carvalho, Tales de

; Freitas, Odilon Gariglio Alvarenga de

; Chalela, William Azem

; Hossri, Carlos Alberto Cordeiro

; Milani, Mauricio

; Buglia, Susimeire

; Falcão, Andréa Maria Gomes Marinho

; Costa, Ricardo Vivacqua Cardoso

; Ritt, Luiz Eduardo Fonteles

; Pfeiffer, Maria Eulália Thebit

; Silva, Odwaldo Barbosa e

; Imada, Rodrigo

; Pena, José Luiz Barros

; Avanza Júnior, Antônio Carlos

; Sellera, Carlos Alberto Cyrillo

; Ferreira, Ana Luíza Guimarães

Arquivos Brasileiros de Cardiologia

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aug 2024, Volume 121 N. 8 elocation e20240525

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

Classes of Recommendation Class I: Conditions for which there is conclusive evidence and, failing that, general agreement that a given procedure is safe and useful/effective. Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the safety and usefulness/efficacy of a procedure. Class IIa: Weight or evidence/opinion in favor of the procedure. Most approve. Class IIb: Safety and usefulness/efficacy less well established, with divergence of opinions. Class III: Conditions for which there is evidence and/or general agreement that a procedure is not useful/effective and, in some cases, may be harmful. Levels of Evidence Level A: Data derived from multiple large, concordant randomized trials and/or robust meta-analyses of randomized trials. Level B: Data derived from less robust meta-analyses, from a single randomized trial and/or from observational studies. Level C: Data derived from consensus opinion of experts.

Classes de Recomendação Classe I: Condições para as quais há evidências conclusivas e, na sua falta, consenso geral de que o procedimento é seguro e útil/eficaz. Classe II: Condições para as quais há evidências conflitantes e/ou divergência de opinião sobre a segurança e utilidade/eficácia do procedimento. Classe IIa: Peso ou evidência/opinião a favor do procedimento. A maioria aprova. Classe IIb: Segurança e utilidade/eficácia menos estabelecidas, havendo opiniões divergentes. Classe III: Condições para as quais há evidências e/ou consenso de que o procedimento não é útil/eficaz e, em alguns casos, pode ser prejudicial. Níveis de Evidência Nível A: Dados obtidos a partir de múltiplos estudos randomizados de bom porte, concordantes e/ou de metanálise robusta de estudos randomizados. Nível B: Dados obtidos a partir de metanálise menos robusta, a partir de um único estudo randomizado e/ou de estudos observacionais. Nível C: Dados obtidos de opiniões consensuais de especialistas.

https://doi.org/10.36660/abc.20240525

12.

Análise Comparativa do ECG com o Holter na avaliação da Frequência Cardíaca na Insuficiência Cardíaca com Fração de Ejeção Reduzida e Ritmo Sinusal
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Camazzola, Fabio Eduardo

; Schwartzmann, Pedro Vellosa

; Sabedotti, Marcelo

; Massuti, Rafael Zortea, Tulio Chen, Vitoria Maggi, Ana Carolina Guimarães Souza, Francine Fonseca de Cardoso, Andressa da Silva Selistre, Luciano da Silva

Arquivos Brasileiros de Cardiologia

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aug 2024, Volume 121 N. 8 elocation e20230771

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

Abstract Background Heart rate (HR) has shown prognostic value in patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm. However, the method of measurement is debated in the literature. Objectives To compare HR on Holter with 3 resting electrocardiograms (ECG1, ECG2, and ECG3) in patients with HFrEF and sinus rhythm. Methods This was a cross-sectional study with 135 patients with heart failure with ejection fraction ≤ 40% and sinus rhythm. HR was assessed by ECG and Holter. Analyses included intraclass correlation coefficient (ICC), robust regression, root mean squared error, Bland-Altman, and area under the receiver operating characteristic (ROC) curve. A significance level of 0.05 and Bonferroni-Holm adjustment were adopted to minimize type I errors. Results The median [interquartile range] age and ejection fraction were 65 years [16] and 30% [11], respectively. The ICC of the 3 ECGs was 0.922 (95% confidence interval: 0.892; 0.942). The robust regression coefficients for ECG1 and ECG3 were 0.20 (95% confidence interval: 0.12; 0.29) and 0.21 (95% confidence interval: 0.06; 0.36). The robust R2 was 0.711 (95% confidence interval: 0.628; 0.76). In the Bland-Altman agreement analysis, the limits of agreement were −17.0 (95% confidence interval: −19.0; −15.0) and 32.0 (95% confidence interval: 30.0; 34.0). The area under the ROC curve was 0.896 (95% confidence interval: 0.865; 0.923). Conclusion The HR on ECG showed high agreement with the HR on Holter, validating its clinical use in patients with HFrEF and sinus rhythm. However, agreement was suboptimal in one third of patients with HR below 70 bpm on ECG; thus, 24-hour Holter monitoring should be considered in this context.

Resumo Fundamento A frequência cardíaca (FC) na insuficiência cardíaca com fração de ejeção reduzida (ICFEr) e ritmo sinusal apresenta valor prognóstico. Entretanto, o método de mensuração é debatido na literatura. Objetivos Comparar em pacientes com ICFEr e ritmo sinusal a FC no Holter com três eletrocardiogramas de repouso: ECG1, ECG2 e ECG3. Metodologia Estudo transversal com 135 pacientes portadores de insuficiência cardíaca com fração de ejeção ≤ 40% e ritmo sinusal. A FC foi avaliada por ECG e Holter. Análises incluíram o coeficiente de correlação intraclasse (CCI), regressão robusta, raiz do erro quadrático médio, Bland-Altman e a área sobre a curva ROC. Adotou-se nível de significância de 0,05 e o ajuste de Bonferroni-Holm para minimizar erros tipo I. Resultados As medianas [intervalo interquartil] de idade e fração de ejeção foram de 65 anos [16] e 30% [11], respectivamente. O CCI dos 3 ECG foi de 0,922 (intervalo de confiança de 95%: 0,892; 0,942). Os coeficientes de regressão robusta para ECG1 e ECG3 foram 0,20 (intervalo de confiança de 95%: 0,12; 0,29) e 0,21 (intervalo de confiança de 95%: 0,06; 0,36). O R2 robusto foi de 0,711 (intervalo de confiança de 95%: 0,628; 0,76). Na análise de concordância de Bland-Altman, os limites de concordância foram de −17,0 (intervalo de confiança de 95%: −19,0; −15,0) e 32,0 (intervalo de confiança de 95%: 30,0; 34,0). A área sob a curva ROC foi de 0,896 (intervalo de confiança de 95%: 0,865; 0,923). Conclusão A FC do ECG mostrou alta concordância com a FC do Holter, validando seu uso clínico em pacientes com ICFEr e ritmo sinusal. Contudo, a concordância foi subótima em um terço dos pacientes com FC inferior a 70 bpm pelo ECG, devendo ser considerada a realização de Holter neste contexto.

https://doi.org/10.36660/abc.20230771

13.

Marco zero: As origens da guerra cibernética orquestrada pelos Estados Unidos para atingir a República Islâmica do Irã (2007-2010)
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Casalunga, Fernando H. Svartman, Eduardo Munhoz Reis, Bruno Cardoso

Relações Internacionais (R:I)

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jul 2024, N. 82 Pages 77 - 92

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

Resumo Neste artigo realizamos um estudo de caso-único do conflito desencadeado entre os Estados Unidos e a República Islâmica do Irã (2007-2010), sob a perspectiva dos retornos estratégicos auferidos em função do uso da tecnologia da informação para atingir setores de infraestrutura crítica. Nossa análise destaca as condições que permitiram aos norte-americanos ampliarem as capacidades de projeção de poder sobre o seu adversário, fatores significativos para explicar a origem e o impacto da guerra cibernética nos dias atuais. A partir da coleta de evidências que revelam o funcionamento do mecanismo das operações orquestradas por atores estatais e não estatais para conter o programa nuclear iraniano, verificamos como o ciberespaço se tornou um domínio chave para a consecução de objetivos estratégicos nacionais. Por este prisma, com base em fontes primárias e secundárias utilizamos técnicas de análise qualitativa para responder à seguinte questão: como os Estados Unidos utilizaram o ciberespaço para atingir o programa nuclear iraniano?

Abstract In this article, we conduct a single-case study of the conflict between the United States and the Islamic Republic of Iran (2007-10), from the perspective of the strategic returns obtained through the use of information technology to achieve criticism of infrastructure sectors. Our analysis highlights the conditions that allowed the North Americans to expand their power projection capabilities over their adversary, significant factors in explaining the origin and impact of cyber warfare today. By collecting evidence that reveals the functioning of the operational mechanism orchestrated by state and non-state actors to contain the Iranian nuclear program, we verify how cyberspace has become a key domain for achieving national strategic objectives. From this perspective, based on primary and secondary sources, we use qualitative analysis techniques to answer the following question: how did the United States use cyberspace to target the Iranian nuclear program?

https://doi.org/10.23906/ri2024.82a06

14.

Clinical Characteristics of Genuine Acute Autoimmune Hepatitis
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Oliveira, Elze Maria Gomes

; Amaral, Ana Cristina de Castro

; Oliveira, Patricia Marinho Costa

; Lanzoni, Valéria Pereira

; Perez, Renata Mello

; Narciso-Schiavon, Janaína Luz Whale, Raul Carlos Carvalho-Filho, Roberto José Silva, Antonio Eduardo Benedito Ferraz, Maria Lucia Cardoso Gomes

GE-Portuguese Journal of Gastroenterology

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jun 2024, Volume 31 N. 3 Pages 21 - 29

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

Resumo Introdução: A hepatite autoimune (HAI) apresenta um espectro de sintomas que varia de doença assintomática a hepatite aguda grave, hepatite crónica e cirrose descompensada. A apresentação aguda não é rara e pode representar hepatite autoimune aguda genuína (HAIAG) ou exacerbação aguda de hepatite autoimune crónica (EAHAIC). O nosso objetivo foi identiﬁcar a prevalência, caraterísticas clínicas e fatores prognósticos associados à HAIAG, e comparar esses casos com EAHAIC. Métodos: Estudo observacional, transversal, incluindo doentes com apresentação aguda de HAI, deﬁnida como bilirrubina total > 5 vezes o limite superior da normalidade (xLSN) e/ou ALT > 10 xLSN, e sem história prévia de doença hepática. HAIAG foi deﬁnida pela presença de achados histológicos de doença aguda. Análises bivariadas foram realizadas para identiﬁcar fatores associados à HAIAG, quando comparado com o EAHAIC. Resultados: Foram incluídos setenta e dois doentes com apresentação agu-da de HAI, dos quais seis (8.3%) com HAIAG. A análise comparativa entre doentes com HAIAG e doentes com EAHAIC mostrou que a atividade de protrombina (96%(74-100) versus 61% (10-100; p=0.003) e os níveis de albumina (3,9 ± 0,2 g/dL vs. 3,4 ± 0,5 g/dL; p < 0,001) foram signiﬁcativamente mais elevados em pacientes com HAIAG. O score do Grupo Internacional de Hepatite Autoimune foi mais elevado em doentes com EAHAIC (18.5 (8-23) versus 16.5 (15-17); p=0.010). A resposta terapêutica completa ao tratamento foi alcançada em 66.7% dos casos de HAIAG (vs. 15,2% na EAHAIC, p=0,018). Conclusões: A HAIAG é rara (8.3%), e os doentes com esta apresentação mostraram testes de função hepática mais preservados, sugerindo que a maioria dos casos com perda de função são EAHAIC. Além disso, os doentes com HAIAG tiveram maior taxa de resposta terapêutica completa, sugerindo que uma função hepática mais preservada na apresentação e o diagnóstico precoce tem uma implicação terapêutica positiva.

Abstract Introduction: Autoimmune hepatitis (AIH) has a spectrum of symptoms ranging from asymptomatic disease to acute severe hepatitis, chronic hepatitis, and decompensated cirrhosis. The acute presentation is not rare and could represent genuine acute AIH (GAAIH) or acute exacerbation of chronic autoimmune hepatitis. We aimed to identify the prevalence, clinical features, and prognostic factors associated with GAAIH and compare these cases with acute exacerbation of chronic AIH. Methods: This cross-sectional observational study evaluated patients with acute AIH presentation, deﬁned as total bilirubin >5 times the upper limit of normality (xULN) and/or alanine aminotransferase >10 xULN, and no prior history of liver disease. Histology ﬁndings of acute disease deﬁned GAAIH. Bivariate analyses were performed to identify factors associated with the GAAIH, when compared with acute exacerbation of chronic AIH. Results: Seventy-two patients with acute presentation of AIH were included and six (8.3%) of them presented GAAIH. Comparative analysis between patients with GAAIH and patients with acute exacerbation of chronic AIH revealed that prothrombin activity (96% [74-100] vs. 61% [10-100]; p = 0.003) and albumin levels (3.9 ± 0.2 g/dL vs. 3.4 ± 0.5 g/dL; p < 0.001) were higher in patients with GAAIH. The International Autoimmune Hepatitis Group score was higher in patients with acute exacerbation of chronic AIH (18.5 [8-23] vs. 16.5 [15-17]; p = 0.010). Compared to 15.2% of acute exacerbation of chronic AIH, complete therapeutic response to treatment was achieved in 67.7% of cases with GAAIH (p = 0.018). Conclusions: GAAIH was rare (8.3%), and patients with this presentation exhibited more preserved liver function tests, suggesting that most cases presenting with loss of function are acute exacerbation of chronic AIH. Additionally, patients with GAAIH had a better complete therapeutic response, suggesting a more preserved liver function at presentation, and early diagnosis has a positive therapeutic implication.

https://doi.org/10.1159/000531018

15.

Construção e Estudos Psicométricos da Bateria de Avaliação do Estado Mental (BAEM)
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Corrêa, Dionne Rayssa Cardoso Oliveira, Sérgio Eduardo Silva de

Avaliação Psicológica

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2024, Volume 23 N. 4 Pages 380 - 393

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

RESUMEN El examen del estado mental es una práctica clínica consolidada en el área de la salud mental y puede entenderse como un procedimiento para el mapeo de una variedad de dominios del funcionamiento psicológico. El objetivo de esta investigación fue investigar las evidencias de validez y confiabilidad de una batería de 11 escalas desarrolladas para la evaluación del estado mental a través del autoinforme. Se examinaron evidencias de validez factorial y la relación con otras variables, a saber, los síntomas de los trastornos mentales comunes y la calidad de vida relacionada con la salud. También se verificó la capacidad de las escalas para diferenciar participantes con y sin indicadores de trastornos mentales. Un total de 654 adultos de todas las regiones de Brasil participaron en este estudio. Los resultados obtenidos indicaron evidencias adecuadas de validez y confiabilidad para los 39 factores que componen las 11 escalas de la batería, sugiriendo la pertinencia de su uso para la evaluación dimensional de los trastornos en el funcionamiento mental.

RESUMO O exame do estado mental é uma prática clínica consolidada na área da saúde mental e pode ser entendido como um procedimento de mapeamento de uma variedade de domínios do funcionamento psicológico. O objetivo desta pesquisa foi investigar evidências de validade e fidedignidade para uma bateria de 11 escalas desenvolvidas para a avaliação do estado mental por meio do autorrelato. Foram examinadas evidências de validade fatorial e na relação com outras variáveis, a saber, sintomas de transtornos mentais comuns e qualidade de vida relacionada à saúde. Também, verificou-se a capacidade das escalas em diferenciar participantes com e sem indicadores de transtornos mentais. Participaram deste estudo 654 adultos de todas as regiões do Brasil. Os resultados obtidos indicaram adequadas evidências de validade e fidedignidade para 39 fatores que compõem as 11 escalas da bateria, sugerindo a pertinência de seu uso para a avaliação dimensional de distúrbios no funcionamento mental.

ABSTRACT Mental status examination is an established clinical practice in the field of mental health and is understood as a procedure for mapping various domains of psychological functioning. This study aimed to investigate evidence of validity and reliability for a battery of 11 scales developed to assess mental status through self-report. Evidence of factor validity, as well as validity related to other variables, namely, symptoms of common mental disorders and health-related quality of life, was examined. Additionally, the ability of the scales to differentiate participants with and without indicators of mental disorders was verified. A total of 654 adults from all regions of Brazil participated in this study. The results indicated adequate evidence of validity and reliability for 39 factors comprising the 11 scales of the battery, supporting its use for the dimensional assessment of disorders in mental functioning.

https://doi.org/10.15689/ap.2024.2304.02

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