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ABSTRACT Objective: To translate, cross-culturally adapt and validate the Sickle Cell Self-Efficacy Scale for application in the Brazilian cultural context. Methods: This is a methodological study performed in 6 steps: 1- Forward translation; 2- Translation synthesis; 3- Back-translation; 4- Assessment by expert committee, with computation of the Content Validity Index (CVI); 5- Cultural adequacy (pre-test); 6- Reproducibility. A pre-test was performed with the participation of 10 adolescents/young adults with sickle cell disease through a telephone call and their responses were recorded on a form in a web platform. The instrument validation step was carried out with 55 adolescents/young adults with sickle cell disease, 43 of them having participated in the retest. The analysis of internal consistency and reproducibility was calculated using the Cronbach’s alpha coefficient and the Intraclass Correlation Coefficient (ICC), in the R statistical programming environment. Results: The translated instrument had good acceptance among the experts, reaching an average CVI of 1.0. In assessing reliability, the scale showed acceptable internal consistency, with a Cronbach’s alpha of 0.84. In the agreement analysis, the ICC was 0.923 (95% CI: 0.857 to 0.958), which indicates good temporal reproducibility. Conclusions: Following the process of translation, cross-cultural adaptation and validation, we obtained the Brazilian version of the Sickle Cell Self-Efficacy Scale, considered valid and reliable to be applied to adolescents and young adults with sickle cell disease in Brazil.

https://doi.org/10.1016/j.htct.2022.02.010

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease,
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Ferreira, Maristela Mian

; Lopes, Karen de Carvalho

; Grigol, Thaís Alvares de Abreu e Silva

; Ganança, Maurício Malavasi

; Caovilla, Heloisa Helena

Brazilian Journal of Otorhinolaryngology

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jun 2023, Volume 89 N. 3 Pages 485 - 493

Abstract: En | Text: En | PDF: En

Abstract Objective To evaluate otolith function by comparing the findings of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential tests in patients in the inter-crisis period of unilateral definite Meniere's disease. Methods The sample consisted of an experimental group (n = 22; 10 men and 12 women, mean age 47.32 ± 12.82 years) with definite unilateral Meniere's disease and a control group (n = 14; 5 men and 9 women, with a mean age of 41.64 ± 13.45 years). They all underwent vestibular evaluation by means of Subjective Visual Vertical with the bucket method and, cervical and ocular Vestibular Evoked Myogenic Potential tests. The data were collected and subjected to statistical analysis. Results The results of the comparison of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential, the ocular Vestibular Evoked Myogenic Potential and, the association of cervical Vestibular Evoked Myogenic Potential with the ocular Vestibular Evoked Myogenic Potential showed no significant difference, indicating concordance among the tests. Conclusion The identified abnormalities and the concordance between the combined proportion of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential findings indicate that the association of these three tests contributes to the identification of sustained and transient otolith dysfunction in the inter-crisis of unilateral definite Meniere’s disease. Level of evidence 2.

https://doi.org/10.1016/j.bjorl.2022.11.005

Avaliação do programa comportamental em diabetes mellitus tipo 2: ensaio clínico randomizado
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Nunes, Laura Barbosa

; Santos, Jéssica Caroline dos

; Reis, Ilka Afonso

; Torres, Heloísa de Carvalho

Ciência & Saúde Coletiva

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mar 2023, Volume 28 N. 3 Pages 851 - 862

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

Resumo O objetivo deste artigo é avaliar o efeito do programa comportamental educação em grupo e intervenção telefônica na modificação das atitudes psicológicas, melhora do empoderamento e das práticas de autocuidado visando à melhora do controle clínico em diabetes mellitus tipo 2. Trata-se de um ensaio clínico com cluster randomizado, realizado em 199 pessoas com diabetes. Para realizar as comparações intragrupos (tempos final e inicial) e entre grupos quanto aos valores das variáveis atitudes psicológicas, empoderamento, autocuidado e medidas da hemoglobina glicada, foi utilizada a abordagem das Generalizing Estimating Equations (GEE). Em todas as análises, utilizou-se um nível de significância de 5% e intervalos de 95% de confiança. Quando comparado ao GC, o GI apresentou uma redução significativa nos valores médios de hemoglobina glicada (IC95%: -1,49 a - 0,45), aumento estatisticamente significativo na modificação dos escores de atitudes psicológicas (IC95%: 9,70 a 15,40), na escala do empoderamento (IC95%: 0,81 a 2,72) e na adesão às práticas de autocuidado (IC95%: 1,44 a 2,10) ao final do estudo. O programa comportamental se mostrou capaz de modificar as atitudes psicológicas, melhorar o empoderamento, as práticas de autocuidado e o controle clínico.

Abstract The scope of this article was to evaluate the effect of the behavioral group education program and telephone intervention in modifying psychological attitudes, enhancing empowerment, and self-care practices aimed at improving clinical control in type 2 diabetes mellitus. It involved a randomized cluster clinical trial, carried out with 199 people with diabetes. In order to perform intragroup comparisons (final and initial phases) and between groups with respect to the indices of the psychological attitude, empowerment, self-care and glycated hemoglobin level variables, the Generalizing Estimating Equation (GEE) approach was used. In all analyses, a 5% significance level and 95% confidence interval were used. When compared to the CG, the IG showed a significant reduction in the mean values of glycated hemoglobin (95%CI: -1.49 to -0.45), a statistically significant increase in the change in psychological attitude scores (95%CI: 9.70 to 15.40), on the empowerment scale (95%CI: 0.81 to 2.72) and adherence to self-care practices (95%CI: 1.44 to 2.10) at the end of the study. The behavioral program proved to be capable of modifying psychological attitudes, improving empowerment, self-care practices and clinical control.

https://doi.org/10.1590/1413-81232023283.10102022

Avaliação do programa comportamental em diabetes mellitus tipo 2: ensaio clínico randomizado
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Nunes, Laura Barbosa

; Santos, Jéssica Caroline dos

; Reis, Ilka Afonso

; Torres, Heloísa de Carvalho

Ciência & Saúde Coletiva

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mar 2023, Volume 28 N. 3 Pages 851 - 862

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

https://doi.org/10.1590/1413-81232023283.10102022

Sociodemographic and economic characteristics of families and health and education conditions of children in the BRISA cohort during the COVID-19 pandemic
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Teixeira, Julia Hannah

; Rocha, Paulo Ricardo Higassiaraguti

; Veiga, Eduardo Carvalho de Arruda

; Salomão, Karina Bezerra

; Barbieri, Manuela Ramos

; Oliveira, Mariana Moraes de

; Cardoso, Viviane Cunha

; Cavalli, Ricardo de Carvalho

; Barbieri, Marco Antonio

; Saraiva, Maria da Conceição Pereira

; Bettiol, Heloisa

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230036

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

RESUMO Objetivo: Descrever as alterações nas características sociodemográficas, econômicas e variáveis relacionadas à caracterização da família, saúde e educação durante a pandemia da COVID-19, em uma coorte de nascimento avaliada aos 10–11 anos de idade. Métodos: Estudo transversal envolvendo 1.033 crianças de uma coorte de nascidos em 2010/2011, na cidade de Ribeirão Preto, SP, Brasil. Os dados foram obtidos por meio de entrevistas por telefone ou videochamada com o responsável pela criança, no período de julho a outubro de 2021. Os questionários abordaram informações sobre a organização familiar, comportamento e saúde da criança, acompanhamento escolar, avaliação socioeconômica e ocorrência da COVID-19 durante o período de isolamento social. Foi realizada estatística descritiva. O teste qui-quadrado foi utilizado para verificar diferenças de grupos por salários-mínimos (SM). Resultados: Dos entrevistados, 47,6% relataram piora na condição financeira durante a pandemia, sendo a piora econômica mais frequente no grupo de renda familiar <3 SM em comparação ao grupo de >6 SM (59,1 vs. 15,7%; p<0,001). Segundo os responsáveis, 62% das crianças apresentaram mudança de comportamento durante o período, sendo a ansiedade relatada com mais frequência. Ainda, 61,4% das crianças apresentaram dificuldades de aprendizagem, e o prejuízo foi mais acentuado naquelas de menor renda familiar em comparação às de maior renda (74,7 vs. 45,1%; p<0,001). Conclusão: A pandemia da COVID-19 alterou diferentes aspectos econômicos das famílias, assim como indicadores educacionais, de saúde e de comportamento das crianças. As famílias de menor renda foram as mais prejudicadas tanto do ponto de vista econômico como nos demais indicadores.

ABSTRACT Objective: To describe changes in sociodemographic, economic and variables related to the characterization of family, health and education during the COVID-19 pandemic in a birth cohort evaluated at 10–11 years of age. Methods: Cross-sectional study involving 1,033 children from a cohort of children born in 2010/2011, in the city of Ribeirão Preto, SP, Brazil. Data were collected from July to October 2021 by telephone or video interview held with the person responsible for the child. The questionnaires discussed family organization, child behavior and health, school attendance, socioeconomic assessment and occurrence of COVID-19 during the period of social isolation due to the pandemic. Descriptive statistics were used to describe the data. The chi-square test was used to verify group differences by minimum wages (MW). Results: Of the respondents, 47.6% reported worsening of their financial situation during the pandemic, which was more frequent in the group with a household income <3 MW compared to the group with >6 MW (59.1 vs. 15.7%; p<0.001). According to the respondents, 62% of the children exhibited behavioral changes during the period and anxiety was the most frequently reported condition. In addition, 61.4% of the children had learning difficulties and these problems were more prevalent among children from households with lower incomes compared to those with higher incomes (74.7 vs. 45.1%; p<0.001). Conclusion: The COVID-19 pandemic has changed different economic aspects of families, as well as educational, health and behavioral indicators of children. Lower-income families were the most affected both economically and in terms of other indicators.

https://doi.org/10.1590/1980-549720230036

Carbohydrase inclusion in a corn-soybean diet improves broiler growth performance
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Simões, Flávio Eduardo de Souza

; Mello, Heloisa Helena de Carvalho

; Stringhini, José Henrique

; Leandro, Nadja Susana Mogyca

; Mascarenhas, Alessandra Gimenez

; Martins, Julyana Machado da Silva

; Café, Marcos Barcellos

Acta Scientiarum. Animal Sciences

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2023, Volume 45 elocation e58738

Abstract: En | Text: En | PDF: En

ABSTRACT. An experiment was conducted to evaluate the effect of diets with reduced energy level content, supplemented with carbohydrase, on broiler performance and the coefficient of metabolizability of nutrients. A total of 720 one-day-old male Cobb-500 chicks were distributed in a completely randomized design, with six treatments, eight repetitions of 15 birds each. The treatments were: (1) a positive control, basal diet to meet the requirements of broiler chickens (PC); (2) a negative control, basal diet with a reduction of 80 kcal kg-1 (NC); (3) NC + alphagalactosydase; (4) NC + xylanase; (5) NC + xylanase and alphagalactosydase, and (6) NC + enzymatic blend (alphagalactosydase, xylanase, pectinase and amylase). The nutrient digestibility was not improved by use of enzymes. At 7 days of age, the broilers which were fed diets supplemented with enzymes showed a lower feed intake (FI) and better feed conversion ratio (FCR) than the broilers fed on PC. Both the NC and enzymatic blend resulted in a worse performance of the broilers at 21, 35 and 42 days old. The use of alphagalactosydase and xylanase, isolated or in combination, in a corn-soybean meal-based diet is effective in improving the growth performance of broilers fed energy-reduced diets.

https://doi.org/10.4025/actascianimsci.v45i1.58738

Major discrepancy between clinical diagnosis of death and anatomopathological findings in adolescents with chronic diseases during 18-years
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Ribeiro, Maira P.

; Duarte Neto, Amaro N.

; Dolhnikoff, Marisa

; Lindoso, Livia

; Lourenco, Benito

; Marques, Heloisa H.

; Pereira, Maria F.B.

; Cristofani, Lilian M.

; Odone Filho, Vicente

; Campos, Lucia M.A.

; Sallum, Adriana M.E.

; Carneiro-Sampaio, Magda

; Delgado, Artur F.

; Carvalho, Werther B.

; Mauad, Thais

; Silva, Clovis A.

Clinics

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2023, Volume 78 elocation 100184

Abstract: En | Text: En | PDF: En

Abstract Objectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases. Methods: A cross-sectional study including a sample of adolescents’ autopsies who died in a pediatric and adolescent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59). Results: Median age at death (13.5 [10‒19] vs. 13 [10‒19] years, p = 0.495) and disease duration (22 [0‒164] vs. 20 [0‒200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018). Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies.

https://doi.org/10.1016/j.clinsp.2023.100184

Use of Images and Clinical Experience to Calibrate Dental Surgeons for the Diagnosis of Molar Incisor Hypomineralization
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Vieira, Heloisa Aparecida Orsini

; Araújo, Lisa Danielly Curcino

; Carvalho, Fabrício Kitazono de

; Queiroz, Alexandra Mussolino de

; Paula-Silva, Francisco Wanderley Garcia

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2023, Volume 23 elocation e220040

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate an imaging protocol for use as a diagnostic and calibration tool for dentists before and after practical activity. Material and Methods: Thirty photos of children's teeth with or without changes in dental enamel were selected and evaluated by a group of experienced dentists previously calibrated to establish the diagnosis defined as the gold standard. After instructions, the images were shown to a group of postgraduate dentists for free identification of dental changes. Subsequently, a lecture on molar incisor hypomineralization (MIH) was carried out, and, at 14 days and all calibration was performed using the criteria previously. The retest was performed at 28 days. After experience in clinical activity in the following two weeks, the post-test was performed at 49 days. Data were analyzed using Cohen's kappa coefficient. Results: Theoretical learning on the subject showed low inter-examiner agreement when the diagnosis of defects was made from images obtained from intraoral photographs. After clinical practice, there was greater intra-examiner agreement. After theoretical training, dentists started to identify different types of enamel alteration, although with low agreement between them. Conclusion: Clinical experience in theoretical and imaging training favored the identification of defects. However, it is necessary to improve the protocol to establish a reliable and viable diagnostic method for calibration in MIH.

https://doi.org/10.1590/pboci.2023.026

Qualidade de vida do cuidador familiar de paciente em hemodiálise
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Jardim, Viviane Rodrigues

; Reis, Ilka Afonso

; Amaral, Samantha Vieira Alves

; Torres, Heloisa de Carvalho

Acta Paulista de Enfermagem

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2023, Volume 36 elocation eAPE00372

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

Abstract Objective To analyze the quality of life of family caregivers of patients under hemodialysis and the existence of an association with their sociodemographic and clinics characteristics. Methods This is a cross-sectional study conducted with 75 family caregivers in two hemodialysis centers. Caregivers’ quality of life was measured using the World Health Organization Quality of Life – BREF instrument, and its association with sociodemographic characteristics was assessed using the Kruskal-Wallis test (significance level equal to 5%). Results Most family caregivers were women (84%), spouses (41.3%), children (38.7%), housewives (38.7%) and had a family income of one to three minimum wages (85.4 %). The variable working outside the home had a positive influence on overall quality of life (p=0.014), psychological domains (p=0.009) and social relationships (p≤0.001). Being male (p=0.016), not having diseases (p=0.002) and not using medications (p=0.007) positively interfered with the physical domain. The absence of financial help from other people and/or family members had a negative influence on the social relationships (p=0.050) and environment (p=0.001) domains. Conclusion Male family caregivers, or those who work outside the home or receive financial help from other people and/or family members had better quality of life levels. On the other hand, clinical conditions such as using a drug or having diseases have negatively influenced quality of life levels.

Resumen Objetivo Analizar la calidad de vida de los cuidadores familiares de pacientes en hemodiálisis y la existencia de asociación con las características demográficas y clínicas. Métodos Estudio transversal, realizado con 75 cuidadores familiares en dos centros de diálisis. La calidad de vida de los cuidadores fue medida a través del instrumento World Health Organization Quality of Life – BREF, y su relación con las características sociodemográficas fue evaluada mediante la prueba de Kruskal-Wallis (nivel de significación igual a 5 %). Resultados La mayoría de los cuidadores familiares era mujer (84 %), cónyuge (41,3 %), hijo (38,7 %), del hogar (38,7 %) y poseía ingresos familiares de uno a tres salarios mínimos (85,4 %). La variable trabajar fuera de casa tuvo influencia positiva en la calidad de vida general (p=0,014), en los dominios psicológicos (p=0,009) y en las relaciones sociales (p≤0,001). Ser de sexo masculino (p=0,016), no tener enfermedades (p=0,002) y no usar medicamentos (p=0,007) interfirieron positivamente en el dominio físico. La ausencia de ayuda financiera de otras personas o familiares influyó de manera negativa en los dominios de las relaciones sociales (p=0,050) y del medio ambiente (p=0,001). Conclusión Los cuidadores familiares de sexo masculino, o que trabajan fuera de casa o reciben ayuda financiera de otras personas o familiares presentaron mejores niveles de calidad de vida. En contraste, las condiciones clínicas, tales como hacer uso de algún medicamento o padecer enfermedades, influyeron de forma negativa en los niveles de calidad de vida.

Resumo Objetivo Analisar a qualidade de vida do cuidador familiar do paciente em hemodiálise e a existência de associação com suas características clínicas e sociodemográficas. Métodos Estudo transversal, realizado com 75 cuidadores familiares em dois centros de diálise. A qualidade de vida do cuidador foi medida por meio do instrumento World Health Organization Quality of Life – BREF, e sua associação com as características sociodemográficas foi avaliada pelo teste de Kruskal-Wallis (nível de significância igual a 5%). Resultados A maioria dos cuidadores familiares era mulher (84%), cônjuge (41,3%), filho (38,7%), do lar (38,7%) e possuía renda familiar de um a três salários mínimos (85,4%). A variável trabalhar fora de casa teve influência positiva na qualidade de vida geral (p=0,014), nos domínios psicológicos (p=0,009) e nas relações sociais (p≤0,001). Ser do sexo masculino (p=0,016), não ter doenças (p=0,002) e não usar medicamentos (p=0,007) interferiram positivamente no domínio físico. A ausência de ajuda financeira de outras pessoas e/ou familiares influenciou de forma negativa nos domínios das relações sociais (p=0,050) e meio ambiente (p=0,001). Conclusão O cuidador familiar do sexo masculino, ou que trabalha fora de casa ou recebe ajuda financeira de outras pessoas e/ou familiares apresentaram melhores níveis de qualidade de vida. Em contrapartida, as condições clínicas tais como fazer uso de algum medicamento ou ter doenças influenciaram de forma negativa nos níveis de qualidade de vida.

https://doi.org/10.37689/acta-ape/2023ao00372

10.

Sociodemographic and economic characteristics of families and health and education conditions of children in the BRISA cohort during the COVID-19 pandemic
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Teixeira, Julia Hannah

; Rocha, Paulo Ricardo Higassiaraguti

; Veiga, Eduardo Carvalho de Arruda

; Salomão, Karina Bezerra

; Barbieri, Manuela Ramos

; Oliveira, Mariana Moraes de

; Cardoso, Viviane Cunha

; Cavalli, Ricardo de Carvalho

; Barbieri, Marco Antonio

; Saraiva, Maria da Conceição Pereira

; Bettiol, Heloisa

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230036

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

https://doi.org/10.1590/1980-549720230036

11.

Dados de Vida Real sobre o Uso da Hidroxicloroquina ou da Cloroquina Combinadas ou Não à Azitromicina em Pacientes com Covid-19: Uma Análise Retrospectiva no Brasil
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Souza-Silva, Maíra Viana Rego

; Pereira, Daniella Nunes

; Pires, Magda Carvalho

; Vasconcelos, Isabela Muzzi

; Schwarzbold, Alexandre Vargas

; Vasconcelos, Diego Henrique de

; Pereira, Elayne Crestani

; Manenti, Euler Roberto Fernandes

; Costa, Felício Roberto

; Aguiar, Filipe Carrilho de

; Anschau, Fernando

; Bartolazzi, Frederico

; Nascimento, Guilherme Fagundes

; Vianna, Heloisa Reniers

; Batista, Joanna d’Arc Lyra

; Machado-Rugolo, Juliana

; Ruschel, Karen Brasil

; Ferreira, Maria Angélica Pires

; Oliveira, Leonardo Seixas de

; Menezes, Luanna Silva Monteiro

; Ziegelmann, Patricia Klarmann

; Tofani, Marcela Gonçalves Trindade

; Bicalho, Maria Aparecida Camargos

; Nogueira, Matheus Carvalho Alves

; Guimarães-Júnior, Milton Henriques

; Aguiar, Rúbia Laura Oliveira

; Rios, Danyelle Romana Alves

; Polanczyk, Carisi Anne

; Marcolino, Milena Soriano

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 9 elocation e20220935

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

Abstract Background Despite no evidence showing benefits of hydroxychloroquine and chloroquine with or without azithromycin for COVID-19 treatment, these medications have been largely prescribed in Brazil. Objectives To assess outcomes, including in-hospital mortality, electrocardiographic abnormalities, hospital length-of-stay, admission to the intensive care unit, and need for dialysis and mechanical ventilation, in hospitalized COVID-19 patients who received chloroquine or hydroxychloroquine, and to compare outcomes between those patients and their matched controls. Methods A retrospective multicenter cohort study that included consecutive laboratory-confirmed COVID-19 patients from 37 Brazilian hospitals from March to September 2020. Propensity score was used to select matching controls by age, sex, cardiovascular comorbidities, and in-hospital use of corticosteroid. A p-value <0.05 was considered statistically significant. Results From 7,850 COVID-19 patients, 673 (8.6%) received hydroxychloroquine and 67 (0.9%) chloroquine. The median age in the study group was 60 years (46 - 71) and 59.1% were women. During hospitalization, 3.2% of patients presented side effects and 2.2% required therapy discontinuation. Electrocardiographic abnormalities were more prevalent in the chloroquine/hydroxychloroquine group (13.2% vs. 8.2%, p=0.01), and the long corrected QT interval was the main difference (3.6% vs. 0.4%, p<0.001). The median hospital length of stay was longer in the HCQ/CQ + AZT group than in controls (9.0 [5.0, 18.0] vs. 8.0 [4.0, 14.0] days). There was no statistical differences between groups in intensive care unit admission (35.1% vs. 32.0%; p=0.282), invasive mechanical ventilation support (27.0% vs. 22.3%; p=0.074) or mortality (18.9% vs. 18.0%; p=0.682). Conclusion COVID-19 patients treated with chloroquine or hydroxychloroquine had a longer hospital length of stay, when compared to matched controls. Intensive care unit admission, invasive mechanical ventilation, dialysis and in-hospital mortality were similar.

Resumo Fundamento Apesar da ausência de evidência mostrando benefícios da hidroxicloroquina e da cloroquina combinadas ou não à azitromicina no tratamento da covid-19, esses medicamentos têm sido amplamente prescritos no Brasil. Objetivos Avaliar desfechos, incluindo moralidade hospitalar, alterações eletrocardiográficas, tempo de internação, admissão na unidade de terapia intensiva, e necessidade de diálise e de ventilação mecânica em pacientes hospitalizados com covid-19 que receberam cloroquina ou hidroxicloroquina, e comparar os desfechos entre aqueles pacientes e seus controles pareados. Métodos Estudo multicêntrico retrospectivo do tipo coorte que incluiu pacientes com diagnóstico laboratorial de covid-19 de 37 hospitais no Brasil de março a setembro de 2020. Escore de propensão foi usado para selecionar controles pareados quanto a idade, sexo, comorbidades cardiovasculares, e uso de corticosteroides durante a internação. Um valor de p<0,05 foi considerado estatisticamente significativo. Resultados Dos 7850 pacientes com covid-19, 673 (8,6%) receberam hidroxicloroquina e 67 (0,9%) cloroquina. A idade mediana no grupo de estudo foi 60 (46-71) anos e 59,1% eram mulheres. Durante a internação, 3,2% dos pacientes apresentaram efeitos adversos e 2,2% necessitaram de interromper o tratamento. Alterações eletrocardiográficas foram mais prevalentes no grupo hidroxicloroquina/cloroquina (13,2% vs. 8,2%, p=0,01), e o prolongamento do intervalo QT corrigido foi a principal diferença (3,6% vs. 0,4%, p<0,001). O tempo mediano de internação hospitalar foi maior no grupo usando CQ/HCQ em relação aos controles (9,0 [5,0-18,0] vs. 8,0 [4,0-14,0] dias). Não houve diferenças estatisticamente significativas entre os grupos quanto a admissão na unidade de terapia intensiva (35,1% vs. 32,0%; p=0,282), ventilação mecânica invasiva (27,0% vs. 22,3%; p=0,074) ou mortalidade (18,9% vs. 18,0%; p=0,682). Conclusão Pacientes com covid-19 tratados com cloroquina ou hidroxicloroquina apresentaram maior tempo de internação hospitalar, em comparação aos controles. Não houve diferença em relação a admissão em unidade de terapia intensiva, necessidade de ventilação mecânica e mortalidade hospitalar.

https://doi.org/10.36660/abc.20220935

12.

Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina
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Barbosa, Hannah Cardoso

; Torres, Heloisa de Carvalho

; Oliveira, João Antônio de Queiroz

; Santos, Rebeca Priscila de Melo

; Costa, Josiane Moreira da

; Miranda, Leonardo Gonçalves

; Pagano, Adriana Silvina

; Praxedes, Marcus Fernando da Silva

; Martins, Maria Auxiliadora Parreiras

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 6 elocation e20220576

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

Abstract Background Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy. Objective The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients. Methods The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population. Results Relevance, adequacy, clarity, and internal reliability of the instrument’s items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96. Conclusion EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings.

Resumo Fundamento A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia. Objetivo Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina. Métodos As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo. Resultados Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96. Conclusão O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde.

https://doi.org/10.36660/abc.20220576

13.

History of radiotherapy in the treatment of uterine cervix cancer: an overview cancer
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Carvalho, Heloisa de Andrade

; Mauro, Geovanne Pedro

Revista da Associação Médica Brasileira

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2023, Volume 69 Suppl. 1 elocation e2023S126

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.2023s126

14.

Redes sociais de trabalho entre agricultores de um município do estado do Ceará
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Martins, José Wilton Lima

; Braga, Natalia Lopes

; Baião, Darli Chahine

; Matos, Tereza Glaucia Rocha

; Carvalho, Renata Guimarães de

; Maciel, Regina Heloísa

Interações (Campo Grande)

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dec 2022, Volume 23 N. 4 Pages 1235 - 1253

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

Resumo: Este artigo tem o objetivo de descrever e analisar redes sociais de trabalho entre agricultores de um município do estado do Ceará. Para isso, foram mapeadas as redes sociais de dois agricultores e seus contatos, totalizando oito participantes. Para a coleta de dados, foi utilizada entrevista, observação e a técnica do gerador de nomes para mapeamento das redes sociais. Para a análise dos dados, foram utilizados indicadores de redes com o auxílio dos softwares Ucinet e NetDraw e de Análise de Conteúdo. Os resultados mostraram que as duas redes de trabalho fazem uso de laços de amizade e parentesco para o seu funcionamento, mobilizando capital social para viabilizar a produção rural em uma configuração semelhante a redes socioprodutivas. Contudo, apresentam diferenças, já que uma das redes é mais desenvolvida, com laços mais diversificados e uma maior quantidade de relações de trabalho remunerado e hierarquia. Conclui-se que as redes fazem parte da organização do trabalho dos agricultores e tornam viável a produção dos bens agrícolas, seja por meio de ajuda para a realização das atividades, seja pelo acesso a informações e recursos mais variados. Resumo Ceará isso contatos participantes dados entrevista Conteúdo funcionamento socioprodutivas Contudo diferenças desenvolvida hierarquia Concluise Conclui se agrícolas atividades variados

Resumen: Este artículo tiene como objetivo describir y analizar las redes sociales de trabajo entre los agricultores de un municipio del estado de Ceará. Para ello, se mapearon las redes sociales de dos agricultores y sus contactos, totalizando ocho participantes. Para la recolección de datos, se utilizó la entrevista, la observación y la técnica generadora de nombres para el mapeo de redes sociales. Para el análisis de datos, se utilizaron indicadores de red con la ayuda de los softwares Ucinet y NetDraw y Análisis de Contenido. Los resultados mostraron que las dos redes de trabajo hacen uso de lazos de amistad y parentesco para su funcionamiento, movilizando capital social para viabilizar la producción rural en una configuración similar a las redes socioproductivas. Sin embargo, presentan diferencias, ya que una de las redes es más desarrollada, con vínculos más diversificados y con mayor número de relaciones laborales remuneradas y jerarquizadas. La conclusión es que las redes son parte de la organización del trabajo de los agricultores y viabilizan la producción de bienes agrícolas, ya sea a través de la ayuda para la realización de actividades, o mediante el acceso a información y recursos más variados. Resumen Ceará ello contactos participantes datos entrevista Contenido funcionamiento socioproductivas embargo diferencias desarrollada jerarquizadas agrícolas actividades variados

Abstract: This article aims to describe and analyze social networking among farmers in a municipality in the state of Ceará. For this, the social networking of two farmers and their contacts were mapped, totaling eight participants. For data collection, interviews, observation and the name generator technique for mapping social networking were used. For data analysis, network indicators were used with the help of Ucinet and NetDraw softwares and Content Analysis. The results showed that the two work networks make use of friendship and kinship ties for their functioning, mobilizing social capital to make rural production viable in a configuration similar to socio-productive networks. However, they present differences, since one of the networks is more developed, with more diversified ties and a greater number of paid work relationships and hierarchy. The conclusion is that the networks are part of the organization of the work of farmers and make the production of agricultural goods viable, either through help to carry out activities, or through access to more varied information and resources. Abstract Ceará this mapped participants collection interviews analysis Analysis functioning socioproductive socio productive However differences developed hierarchy activities resources

https://doi.org/10.20435/inter.v23i4.3589

15.

Autonomic and cardiorespiratory responses to the active tilt test in individuals with Parkinson disease: cross-sectional study
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Valente, Heloisa Balotari

; Gervazoni, Natacha de Lima

; Laurino, Maria Júlia Lopez

; Vanzella, Laís Manata

; Stoco-Oliveira, Mileide Cristina

; Rodrigues, Mariana Viana

; André, Larissa Borba

; Ribeiro, Felipe

; Carvalho, Augusto Cesinando de

; Vanderlei, Luiz Carlos Marques

Arquivos de Neuro-Psiquiatria

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jul 2022, Volume 80 N. 7 Pages 689 - 698

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

Abstract Background The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. Objective To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. Methods A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. Results At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. Conclusion Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.

Resumo Antecedentes A doença de Parkinson (DP) está frequentemente associada a disfunções autonômicas. Porém, dados sobre a influência da DP nas respostas autonômicas às mudanças posturais são limitados. Objetivos Analisar e comparar as respostas autonômicas, avaliadas por métodos lineares e não lineares de variabilidade da frequência cardíaca e parâmetros cardiorrespiratórios em dois grupos: DP (GDP) e controle (CG), em repouso e durante o tilt test ativo. Métodos Foram analisados 48 participantes (GDP: n = 25;73,40 ± 7,01 anos/GC: n = 23; 70,17 ± 8,20 anos). A modulação autonômica e os parâmetros cardiorrespiratórios foram avaliados em repouso e durante o tilt test ativo. Para avaliar a modulação autonômica foram calculados os índices lineares, nos domínios do tempo (rMSSD, SDNN) e frequência (LF, HF, LF/HF), e os índices não lineares, obtidos através do plot de Poincaré (SD1, SD2, SD1/SD2). Os parâmetros cardiorrespiratórios avaliados foram frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD), saturação periférica de oxigênio (SpO2) e frequência respiratória. Resultados Em repouso, o GDP apresentou valores menores de rMSSD, SDNN, LF, HF, SD1, SD2 e PAD, e maiores valores de SpO2. No teste, foram observadas modificações na FC e na PAS, redução da resposta parassimpática e aumento da modulação global no GDP. A análise qualitativa do plot de Poincaré mostrou que o GDP apresentou menor dispersão dos intervalos RR no repouso e no tilt test ativo. Conclusão Indivíduos com DP apresentam redução da variabilidade global e modulação parassimpática em repouso, redução da resposta parassimpática e prejuízo na regulação da FC ao realizar o tilt test ativo, em comparação aos controles.

https://doi.org/10.1055/s-0042-1755225

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