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RESUMEN Objetivos: evaluar el conocimiento de los Agentes Comunitarios de Salud sobre la demencia antes y después de un taller de capacitación para la detección de signos de la enfermedad. Métodos: estudio cuasi experimental con 33 agentes comunitarios, en el que se recopilaron datos sociodemográficos y conocimiento sobre la demencia, evaluados mediante la Escala de Conocimiento de la Enfermedad de Alzheimer, antes y después del taller. Hubo 10 sesiones semanales en línea y sincrónicas. Se utilizó la prueba t de Student para muestras relacionadas y se calculó el tamaño del efecto. Resultados: mientras que la puntuación promedio en la evaluación inicial a través del instrumento de medición fue de 16,3, en la evaluación final fue de 21,24. Se observó un aumento en la puntuación de instrumento después de participar en el taller, con un valor de 4,94. Conclusiones: es urgente invertir en la educación continua de estos profesionales para aumentar la conciencia en la detección oportuna de casos de demencia en atención primaria y la concienciación sobre factores potencialmente modificables.

RESUMO Objetivos: avaliar o conhecimento dos Agentes Comunitários de Saúde sobre demência antes e após a oficina de capacitação para detecção de sinais da doença. Métodos: estudo quase-experimental com 33 agentes comunitários, no qual foram coletadas informações sociodemográficas e de conhecimento sobre demência, avaliadas pela Alzheimer’s Disease Knowledge Scale, no pré e pós-oficina. Houve 10 encontros semanais, online e síncronos. Utilizou-se o teste t de Student para amostras relacionadas e calculou-se o tamanho do efeito. Resultados: enquanto a média de pontos na avaliação inicial, por meio do instrumento de medida, foi de 16,3, na avaliação final foi de 21,24. Observou-se aumento na pontuação na escala após a participação na oficina, com um valor de 4,94. Conclusões: é urgente investir na educação permanente desses profissionais para maior conscientização na detecção oportuna de casos de demência ainda na atenção básica e conscientização de fatores potencialmente modificáveis.

ABSTRACT Objectives: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. Methods: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer’s Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student’s t-test for related samples was used, and the effect size was calculated. Results: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. Conclusions: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

https://doi.org/10.1590/0034-7167-2023-0027

Effects of training Community Health Agents on dementia: a quasi-experimental study
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Coelho, Aline Cristina Ramos

; Cruz, Edmir Batista da Silva

; Radicchi, Helena Zacharias

; Mattos, Emanuela Bezerra Torres

; Novelli, Marcia Maria Pires Camargo

; Souza, Felipe Granado de

; Goulart, Rubens

; Ribeiro, Corina Lopes

Revista Brasileira de Enfermagem

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2024, Volume 77 N. 1 elocation e20230027

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

https://doi.org/10.1590/0034-7167-2023-0027

Application of artificial intelligence in predicting malignancy risk in breast masses on ultrasound
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Wanderley, Mariah Carneiro

; Soares, Cândida Maria Alves

; Morais, Marina Marcondes Moreira

; Cruz, Rachel Malheiros

; Lima, Isadora Ribeiro Monteiro

; Chojniak, Rubens

; Bitencourt, Almir Galvão Vieira

Radiologia Brasileira

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sep 2023, Volume 56 N. 5 Pages 229 - 234

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

Abstract Objective: To evaluate the results obtained with an artificial intelligence-based software for predicting the risk of malignancy in breast masses from ultrasound images. Materials and Methods: This was a retrospective, single-center study evaluating 555 breast masses submitted to percutaneous biopsy at a cancer referral center. Ultrasonographic findings were classified in accordance with the BI-RADS lexicon. The images were analyzed by using Koios DS Breast software and classified as benign, probably benign, low to intermediate suspicion, high suspicion, or probably malignant. The histological classification was considered the reference standard. Results: The mean age of the patients was 51 years, and the mean mass size was 16 mm. The radiologist evaluation had a sensitivity and specificity of 99.1% and 34.0%, respectively, compared with 98.2% and 39.0%, respectively, for the software evaluation. The positive predictive value for malignancy for the BI-RADS categories was similar between the radiologist and software evaluations. Two false-negative results were identified in the radiologist evaluation, the masses in question being classified as suspicious by the software, whereas four false-negative results were identified in the software evaluation, the masses in question being classified as suspicious by the radiologist. Conclusion: In our sample, the performance of artificial intelligence-based software was comparable to that of a radiologist.

Resumo Objetivo: O objetivo deste trabalho foi avaliar os resultados de um software baseado em algoritmo de inteligência artificial para predição do risco de malignidade em nódulos mamários. Materiais e Métodos: Estudo retrospectivo e unicêntrico que avaliou 555 nódulos mamários submetidos a biópsia percutânea em um centro de referência oncológico. Os achados ultrassonográficos foram classificados de acordo com o léxico do BI-RADS. As imagens foram analisadas pelo software Koios DS Breast e divididas em benigna ou provavelmente benigna, suspeita baixa ou intermediária, suspeita alta ou provavelmente maligna. O resultado histopatológico foi considerado como padrão ouro. Resultados: A média de idade das pacientes foi de 51 anos e o tamanho médio dos nódulos foi de 16 mm. A sensibilidade e a especificidade foram de 99,1% e 34,0% para o radiologista e 98,2% e 39,0% para o software, respectivamente. O valor preditivo positivo para malignidade para as categorias BIRADS foi semelhante para o radiologista e para o software. Foram identificados dois resultados falso-negativos na avaliação pelo radiologista que foram classificados como suspeitos pelo software, e quatro resultados falso-negativos na avaliação pelo software que foram classificados como suspeitos pelo radiologista. Conclusão: Na nossa amostra, o software de inteligência artificial demonstrou resultados comparáveis à avaliação pelo radiologista.

https://doi.org/10.1590/0100-3984.2023.0034

Study on the Tribological Behavior of Wear and Friction Coefficient on AISI M35 High-Speed Steel with and without DLC Coating
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Martins, Paulo Sérgio

; Carneiro, José Rubens Gonçalves

; Ba, Elhadji Cheikh Talibouya

; Vieira, Vitor Ferreira

; Amaral, Diego Boaventura Cruz, Nilson Cristino da

Materials Research

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2022, Volume 25 elocation e20200577

Abstract: En | Text: En | PDF: En

Abstract To improve the wear resistance of cutting tools made of high-speed steel, the Diamond-Like Carbon (DLC) coating appears as a promising alternative. There are several methods to assess wear, however, it is a challenge for manufacturing engineering to work with thin films, due to the uncertainty in the boundary of the substrate and the coating. Based on this concern, this study proposed the evaluation of the tribological behavior of the DLC coating deposited on AISI M35 steel, seeking to predict its behavior in machining conditions based on characterizations, nano-indentation, micro-abrasion and ball-on-disc test. Results showed that the DLC coating produced for this study consists mainly of sp2 hybridizations. The results of the nano-indentation showed that DLC coating may have a better wear resistance when compared to high-speed steel, and the nano-hardness and Young's modulus do not necessarily obey a positive correlation. Compared to high-speed steel, DLC provided reductions of 71% and 69% without micro-abrasive wear and without friction coefficient during sliding, respectively.

https://doi.org/10.1590/1980-5373-mr-2020-0577 63 downloads

Compondo temporalidades: o colonial e a ditadura nas narrativas brasileiras do século XXI
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Cruz, Lua Gill da

Estudos de Literatura Brasileira Contemporânea

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2022, N. 65 elocation e6507

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

Resumo Contar um período histórico está diretamente relacionado a questões políticas, sociais, históricas, culturais e temporais. No caso da ditadura militar brasileira, “o que foi” (ou o que é) ainda está sendo produzido, seja na historiografia ou na literatura. Muitas dessas histórias, entretanto, ainda não foram contadas e permanecem esquecidas, excluídas e/ou ignoradas. Neste artigo, atentaremos para os pontos cegos da história, observando a relação e composição das temporalidades coloniais e ditatoriais e discutindo quais histórias de violência e de resistência foram contadas, como foram escritas e mobilizadas, mesmo anos depois dos processos de justiça de transição e de reparação, no presente e na literatura, a partir das narrativas Nem tudo é silêncio (2010), de Sonia Bischain, a chamada Trilogia infernal, composta pelos livros Aqui, no coração do inferno (2016), O peso do coração do homem (2017), e O amor, esse obstáculo (2018), de Micheliny Verunschk, em maior medida, e, em menor medida, as obras Ainda estou aqui (2015), de Marcelo Rubens Paiva, e Antes do passado (2012), de Liniane Brum.

Abstract Narrating a historical period is directly related to political, social, historical, cultural and temporal issues. In the case of the Brazilian military dictatorship “what was” (or what is) is still being produced, whether in historiography or literature. Many of these stories, however, have yet to be told and remain forgotten, excluded or ignored. In this text, we will observe the blind spots of this history, observing the relationship and composition of colonial and dictatorial temporalities and seeking to observe which stories of violence and resistance were told, and how they were written and mobilized, even years after the transitional justice and reparation processes, in the present and in literature, looking at the narratives Nem tudo é silêncio (2010), by Sonia Bischain, the so-called Trilogia infernal, composed by the books Aqui, no coração do inferno (2016), O peso do coração do homem (2017), O amor, esse obstáculo (2018), by Micheliny Verunschk, to a greater extent, and, to a lesser extent, the works Ainda estou aqui (2015), by Marcelo Rubens Paiva, and Antes do passado (2012), by Liniane Brum.

Resumen Contar un período histórico está directamente relacionado con cuestiones políticas, sociales, históricas, culturales y temporales. En el caso de la dictadura militar brasileña se sigue produciendo “lo que fue” (o lo que es), ya sea en la historiografía o en la literatura. Sin embargo, muchas de estas historias aún no se han contado y siguen olvidadas, excluidas o ignoradas. En este texto examinaremos los puntos ciegos de esta historia, discutiendo la relación y la composición de las temporalidades coloniales y dictatoriales y observando qué historias de violencia y resistencia se contaron, y cómo se escribieron y movilizaron, incluso años después de los procesos de justicia transicional y reparación, en el presente y en la literatura, desde las narrativas Nem tudo é silêncio (2010, de Sonia Bischain, la llamada Trilogia Infernal, compuesta por los libros Aqui, no coração do inferno (2016), O peso do coração do homem (2017), y O amor, esse obstáculo (2018), de Micheliny Verunschk, en mayor medida, y, en menor medida, las obras Ainda estou aqui (2015), de Marcelo Rubens Paiva y Antes do passado (2012), de Liniane Brum.

https://doi.org/10.1590/2316-40186507

Educating diabetic patients through an SMS intervention: a randomized controlled trial at a Brazilian public hospital
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Aceti, Viviane Moura

; Santoro, Rodolpho Vianna

; Velarde, Luis Guillermo Coca

; Brandão, Diego Nunes

; Cruz Filho, Rubens Antunes da

; Taboada, Giselle F.

Archives of Endocrinology and Metabolism

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dec 2021, Volume 65 N. 6 Pages 695 - 703

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Diabetes mellitus (DM) has a high healthcare system cost worldwide. Educational strategies are important to improve self-care and control this disease. This study aimed to evaluate satisfaction and clinical efficacy of a Short Message Service (SMS) educational intervention in self-care and nutrition at a Brazilian university hospital. Materials and methods: We conducted a trial of educational intervention and assigned eligible patients with DM to either receive weekly educational SMS for 6 months (intervention group [IG]) or no SMS at all (control group). A satisfaction questionnaire was applied before and after the intervention in both groups. Laboratory (fasting glucose, hemoglobin [Hb] A1c, total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein) and clinical (blood pressure) data were also collected. Data were analyzed using nonparametric tests with the Statistical Package for the Social Sciences. Results: We included 128 patients (64 in each group). Responses to the satisfaction questionnaire with self-care and healthcare professionals from 112 patients revealed an improvement in the perception of receiving information regarding helpful eating habits and in healthy eating behavior and an improvement in satisfaction with their diabetes care in the IG. In the post-intervention period, improved systolic blood pressure and HbA1c levels were observed in the IG as illustrated by delta % (post-intervention minus pre-intervention data divided by pre-intervention data multiplied by 100) reductions of 2.3% and 3.9%, respectively Conclusion: SMS intervention was useful as an educational tool for improving satisfaction and glycemic and blood pressure control of patients with DM observed at a Brazilian university hospital.

https://doi.org/10.20945/2359-3997000000390 2 downloads

Screening of Alkaloid-Producing Endophytic Penicillium Strains from Amazon Medicinal Plants by Electrospray Ionization Mass Spectrometry (ESI-MS) and Principal Component Analysis (PCA)
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Silva-Filho, Francinaldo A. da

; Souza, Marjory M. M. de

; Rezende, Gabriel O.

; Silva, Felipe M. A. da

; Cruz, Jeferson C. da

; Silva, Gilvan F. da Souza, Afonso D. L. de Souza, Antonia Q. L. de

Journal of the Brazilian Chemical Society

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sep 2021, Volume 32 N. 9 Pages 1832 - 1839

Abstract: En | Text: En | PDF: En

The genus Penicillium is among the most promising alkaloid-producing fungal and therefore plays an important role in terms of producing molecules with biotechnological potential. Thus, in order to identify alkaloid-producing fungi, 25 endophytic Penicillium strains previously isolated from Amazon medicinal plants were subject to an integrative approach based on direct infusion positive electrospray ionization mass spectrometry (ESI-MS) and principal component analysis (PCA). The multivariate analysis pointed paxiline (1), glandicoline B (2), roquefortine C (3), and oxaline (5) as responsible for the segregation of three promising alkaloid-producing groups, been these groups constituted for P. chrysogenum, P. oxalicum, P. paxilli, and P. rubens strains. These alkaloids and the glandicoline A (4) were tentatively identified by multiple-stage mass spectrometry. In addition, compounds 1 and 2 were isolated and confirmed by using 1D and 2D nuclear magnetic resonance (NMR) spectroscopy. Overall, the chemical profile analysis by ESI-MS along with PCA provided a simple and effective approach to screening alkaloid-producing Penicillium strains for biotechnological applications.

https://doi.org/10.21577/0103-5053.20210074 20 downloads

Acesso à Terapia de Reperfusão e Mortalidade em Mulheres com Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST: Registro VICTIM
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Oliveira, Jussiely Cunha

; Barros, Mayse Pereira Souza

; Barreto, Ikaro Daniel de Carvalho

; Silva Filho, Rubens Cruz

; Andrade, Volfanio Araújo

; Oliveira, André de Melo

; Lima, Ticiane Clair Remacre Munareto

; Oliveira, Jeferson Cunha

; Arcelino, Larissa Andreline Maia Oliveira, Laís Costa Souza Santana-Santos, Eduesley Almeida-Santos, Marcos Antônio Sousa, Antônio Carlos Barreto Filho, José Augusto Soares

Arquivos Brasileiros de Cardiologia

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apr 2021, Volume 116 N. 4 Pages 695 - 703

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

Resumo Fundamento: A reperfusão miocárdica é parte fundamental do tratamento para infarto agudo do miocárdio com supradesnivelamento de ST (IAMCSST) e é responsável por reduzir morbimortalidade no paciente acometido. No entanto, as taxas de reperfusão são geralmente mais baixas e as taxas de mortalidade mais altas em mulheres que em homens. Objetivos: Avaliar a prevalência do uso de terapias de reperfusão em mulheres e homens com IAMCSST nos hospitais com capacidade para realizar intervenção coronariana percutânea (ICP) no estado de Sergipe. Métodos: Trata-se de estudo transversal que utilizou dados do Registro VICTIM. Foram avaliados pacientes com diagnóstico de IAMCSST admitidos nos quatro hospitais com capacidade para realizar ICP no estado de Sergipe, sendo um público e três privados, no período de dezembro de 2014 a junho de 2018. Foi aplicada análise multivariada com modelo ajustado utilizando mortalidade como variável dependente. Em todas as análises, o nível de significância adotado foi de 5% (p<0,05). Resultados: Foram incluídos 878 voluntários com diagnóstico confirmado de IAMCSST, dos quais 33,4% eram mulheres. Apenas 53,3% dos pacientes foram submetidos à reperfusão miocárdica (134 mulheres versus 334 homens). A fibrinólise foi realizada somente em 2,3% de todos os pacientes (1,7% das mulheres versus 2,6% dos homens; p=0,422). Nas mulheres, a taxa de ICP primária foi menor (44% versus 54,5%; p=0,003) e a mortalidade hospitalar foi maior (16,1% versus 6,7%; p<0,001) que nos homens. Conclusão: As mulheres apresentam taxas significativamente menores de ICP primária e significativamente maiores de mortalidade hospitalar que os homens. A taxa de reperfusão em ambos os gêneros foi baixa e houve nítida subutilização de agentes trombolíticos.

Abstract Background: Myocardial reperfusion is a fundamental part of the treatment for ST elevation myocardial infarction (STEMI) and is responsible for reducing morbidity and mortality in affected patients. However, reperfusion rates are usually lower and mortality rates higher in women compared to men. Objectives: To evaluate the prevalence of the use of reperfusion therapies among women and men with STEMI in hospitals where percutaneous coronary intervention (PCI) is available in the state of Sergipe. Methods: This is a cross-sectional study that used data from the VICTIM Register. Patients diagnosed with STEMI admitted to the four hospitals (one public and three private) where PCI is available in the state of Sergipe were evaluated, from December 2014 to June 2018. A multivariate analysis with adjusted model using mortality as a dependent variable was made. In all analyses, the level of significance adopted was 5% (p < 0.05). Results: A total of 878 volunteers with a confirmed diagnosis of STEMI, of which 33.4% were women, were included in the study. Only 53.3% of the patients underwent myocardial reperfusion (134 women versus 334 men). Fibrinolysis was performed only in 2.3% of all patients (1.7% of women versus 2.6% of men; p = 0.422). The rate of primary PCI was lower (44% versus 54.5%; p = 0.003) and hospital mortality was higher (16.1% versus 6.7%; p < 0.001) in women than in men. Conclusion: Women have significantly lower rates of primary PCI and higher hospital mortality. Reperfusion rates were low in both sexes and there was a clear underutilization of thrombolytic agents.

https://doi.org/10.36660/abc.20190468 386 downloads

Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de

; Hammond, Naomi

; Li, Yang

; Azevedo, Luciano Cesar Pontes de

; Cavalcanti, Alexandre Biasi

; Taniguchi, Leandro

; Gobatto, André

; Japiassú, André Miguel

; Bafi, Antonio Tonete

; Mazza, Bruno Franco

; Noritomi, Danilo Teixeira Dal-Pizzol, Felipe Bozza, Fernando Salluh, Jorge Ibrahin Figueira Westphal, Glauco Adrieno Soares, Márcio Assunção, Murillo Santucci César de Lisboa, Thiago Lobo, Suzana Margarete Ajeje Barbosa, Achilles Rohlfs Ventura, Adriana Fonseca Souza, Ailson Faria de Silva, Alexandre Francisco Toledo, Alexandre Reis, Aline Cembranel, Allan Rea Neto, Alvaro Gut, Ana Lúcia Justo, Ana Patricia Pierre Santos, Ana Paula Albuquerque, André Campos D. de Scazufka, André Rodrigues, Antonio Babo Fernandino, Bruno Bonaccorsi Silva, Bruno Goncalves Vidal, Bruno Sarno Pinheiro, Bruno Valle Pinto, Bruno Vilela Costa Feijo, Carlos Augusto Ramos Abreu Filho, Carlos de Bosso, Carlos Eduardo da Costa Nunes Moreira, Carlos Eduardo Nassif Ramos, Carlos Henrique Ferreira Tavares, Carmen Arantes, Cidamaiá Grion, Cintia Mendes, Ciro Leite Kmohan, Claudio Piras, Claudio Castro, Cristine Pilati Pileggi Lins, Cyntia Beraldo, Daniel Fontes, Daniel Boni, Daniela Castiglioni, Débora Paisani, Denise de Moraes Pedroso, Durval Ferreira Fonseca Mattos, Ederson Roberto Brito Sobrinho, Edgar de Troncoso, Edgar M. V. Rodrigues Filho, Edison Moraes Nogueira, Eduardo Enrico Ferrari Ferreira, Eduardo Leme Pacheco, Eduardo Souza Jodar, Euzebio Ferreira, Evandro L. A. Araujo, Fabiana Fernandes de Trevisol, Fabiana Schuelter Amorim, Fábio Ferreira Giannini, Fabio Poianas Santos, Fabrício Primitivo Matos Buarque, Fátima Lima, Felipe Gallego Costa, Fernando Antonio Alvares da Sad, Fernando Cesar dos Anjos Aranha, Fernando G. Ganem, Fernando Callil, Flavio Costa Filho, Francisco Flávio Dall´Arto, Frederico Toledo Campo Moreno, Geovani Friedman, Gilberto Moralez, Giulliana Martines Silva, Guilherme Abdalla da Costa, Guilherme Cavalcanti, Guilherme Silva Cavalcanti, Guilherme Silva Betônico, Gustavo Navarro Betônico, Gustavo Navarro Reis, Hélder Araujo, Helia Beatriz N. Hortiz Júnior, Helio Anjos Guimaraes, Helio Penna Urbano, Hugo Maia, Israel Santiago Filho, Ivan Lopes Farhat Júnior, Jamil Alvarez, Janu Rangel Passos, Joel Tavares Paranhos, Jorge Eduardo da Rocha Marques, José Aurelio Moreira Filho, José Gonçalves Andrade, Jose Neto Sobrinho, José Onofre de C Bezerra, Jose Terceiro de Paiva Alves, Juliana Apolônio Ferreira, Juliana Gomes, Jussara Sato, Karina Midori Gerent, Karine Teixeira, Kathia Margarida Costa Conde, Katia Aparecida Pessoa Martins, Laércia Ferreira Figueirêdo, Lanese Rezegue, Leila Tcherniacovsk, Leonardo Ferraz, Leone Oliveira Cavalcante, Liane Rabelo, Ligia Miilher, Lilian Garcia, Lisiane Tannous, Luana Hajjar, Ludhmila Abrahão Paciência, Luís Eduardo Miranda Cruz Neto, Luiz Monteiro da Bley, Macia Valeria Sousa, Marcelo Ferreira Puga, Marcelo Lourencini Romano, Marcelo Luz Pereira Nobrega, Marciano Arbex, Marcio Rodrigues, Márcio Leite Guerreiro, Márcio Osório Rocha, Marcone Alves, Maria Angela Pangoni Alves, Maria Angela Pangoni Rosa, Maria Doroti Dias, Mariza D’Agostino Martins, Miquéias Oliveira, Mirella de Moretti, Miriane Melo Silveira Matsui, Mirna Messender, Octavio Santarém, Orlando Luís de Andrade Silveira, Patricio Júnior Henrique da Vassallo, Paula Frizera Antoniazzi, Paulo Gottardo, Paulo César Correia, Paulo Ferreira, Paulo Torres, Paulo Silva, Pedro Gabrile M. de Barros e Foernges, Rafael Gomes, Rafael Moraes, Rafael Nonato filho, Raimundo Borba, Renato Luis Gomes, Renato V Cordioli, Ricardo Lima, Ricardo López, Ricardo Pérez Gargioni, Ricardo Rath de Oliveira Rosenblat, Richard Souza, Roberta Machado de Almeida, Roberto Narciso, Roberto Camargo Marco, Roberto waltrick, Roberto Biondi, Rodrigo Figueiredo, Rodrigo Dutra, Rodrigo Santana Batista, Roseane Felipe, Rouge Franco, Rubens Sergio da Silva Houly, Sandra Faria, Sara Socorro Pinto, Sergio Felix Luzzi, Sergio Sant’ana, Sergio Fernandes, Sergio Sonego Yamada, Sérgio Zajac, Sérgio Vaz, Sidiner Mesquita Bezerra, Silvia Aparecida Bezerra Farhat, Tatiana Bueno Tardivo Santos, Thiago Martins Smith, Tiago Silva, Ulysses V. A. Damasceno, Valnei Bento Nobre, Vandack Dantas, Vicente Cés de Souza Irineu, Vivian Menezes Bogado, Viviane Nedel, Wagner Campos Filho, Walther Dantas, Weidson Viana, William Oliveira Filho, Wilson de Delgadinho, Wilson Martins Finfer, Simon Machado, Flavia Ribeiro

Revista Brasileira de Terapia Intensiva

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apr 2021, Volume 33 N. 2 Pages 206 - 218

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

RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.

Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.

https://doi.org/10.5935/0103-507x.20210028 273 downloads

10.

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis
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Lage, Ricardo da Cruz

; Marques, Claudia Diniz Lopes Oliveira, Thauana Luiza Resende, Gustavo Gomes Kohem, Charles Lubianca Saad, Carla Gonçalves Ximenes, Antônio Carlos Gonçalves, Célio Roberto Bianchi, Washington Alves Meirelles, Eduardo de Souza Keiserman, Mauro Waldemar Chiereghin, Adriano Campanholo, Cristiano Barbosa Lyrio, André Marun Schainberg, Cláudia Goldenstein Pieruccetti, Lenise Brandao Yazbek, Michel Alexandre Palominos, Penelope Esther Goncalves, Rafaela Silva Guimarães Assad, Rodrigo Luppino Bonfiglioli, Rubens Lima, Sônia Maria Alvarenga Anti Loduca Carneiro, Sueli Azevedo, Valderílio Feijó Albuquerque, Cleandro Pires Bernardo, Wanderley Marques Sampaio-Barros, Percival Degrava Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 4

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

https://doi.org/10.1186/s42358-020-00160-6 505 downloads

11.

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; DIAS, André Roncon

; FORONES, Nora Manoukian

; CARVALHO, Marineide Prudêncio de

; CASTRO, Osvaldo Antonio Prado

; KASSAB, Paulo

; COSTA-JÚNIOR, Wilson Luiz da

; WESTON, Antônio Carlos

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira ZeideCharruf, Amir Brandalise, André Silva, André Maciel da Alves, Barlon Marins, Carlos Augusto Martinez Malheiros, Carlos Alberto Leite, Celso Vieira Bresciani, Claudio José Caldas Szor, Daniel Mucerino, Donato Roberto Wohnrath, Durval R. JirjossIlias, Elias Martins Filho, Euclides Dias PinatelLopasso, Fabio Coimbra, Felipe José Fernandez Felippe, Fernando E. Cruz Tomasisch, Flávio Daniel Saavedra Takeda, Flavio Roberto Ishak, Geraldo Laporte, Gustavo Andreazza Silva, Herbeth José Toledo Cecconello, Ivan Rodrigues, Joaquim José Gama Grande, José Carlos Del Lourenço, Laércio Gomes Motta, Leonardo Milhomem da Ferraz, Leonardo Rocha Moreira, Luis Fernando Lopes, Luis Roberto Toneto, Marcelo Garcia Mester, Marcelo Rodrigues, Marco Antônio Gonçalves Franciss, Maurice Youssef AdamiAndreollo, Nelson Corletta, Oly Campos Yagi, Osmar Kenji Malafaia, Osvaldo Assumpção, Paulo Pimentel Savassi-Rocha, Paulo Roberto Colleoni Neto, Ramiro Oliveira, Rodrigo Jose de AissarSallun, Rubens Antonio Weschenfelder, Rui Oliveira, Saint Clair Vieira de Abreu, Thiago Boechat de Castria, Tiago Biachi de Ribeiro Junior, Ulysses Barra, Williams Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 1 elocation e1563

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

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.

ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

https://doi.org/10.1590/0102-672020210001e1563 768 downloads

12.

Brazilian Society of Rheumatology 2020 guidelines for psoriatic arthritis
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Carneiro, Sueli

; Palominos, Penelope Esther Anti, Sônia Maria Alvarenga Assad, Rodrigo Luppino Gonçalves, Rafaela Silva Guimarães Chiereghin, Adriano Lyrio, Andre Marun Ximenes, Antônio Carlos Saad, Carla Gonçalves Gonçalves, Célio Roberto Kohem, Charles Lubianca Marques, Cláudia Diniz Lopes Schainberg, Cláudia Goldenstein Meirelles, Eduardo de Souza Resende, Gustavo Gomes Pieruccetti, Lenise Brandao Keiserman, Mauro Waldemar Yazbek, Michel Alexandre Sampaio-Barros, Percival Degrava Lage, Ricardo da Cruz Bonfiglioli, Rubens Oliveira, Thauana Luíza Azevedo, Valderílio Feijó Bianchi, Washington Alves Bernardo, Wanderley Marques Simões, Ricardo dos Santos Pinheiro, Marcelo de Medeiros Campanholo, Cristiano Barbosa

Advances in Rheumatology

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2021, Volume 61 elocation 69

Abstract: En | Text: En | PDF: En

Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.

https://doi.org/10.1186/s42358-021-00219-y

13.

Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study
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Mattos, Ana Carolina Musser Tavares de

; Campos, Yuri Sofiati

; Fiorini, Vitória Oliveira

; Sab, Yasmin

; Tavares, Bruna Landeiro

; Velarde, Luis Guillermo Coca

; Lima, Giovanna Aparecida Balarini

; Cruz Filho, Rubens Antunes da

Archives of Endocrinology and Metabolism

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aug 2020, Volume 64 N. 4 Pages 412 - 417

Abstract: En | Text: En | PDF: En

ABSTRACT Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg-1.min-1;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.

https://doi.org/10.20945/2359-3997000000228 778 downloads

14.

Diabetes Mellitus, Insulin Use, and Infective Endocarditis
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Cruz Filho, Rubens Antunes

International Journal of Cardiovascular Sciences

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feb 2020, Volume 33 N. 1 Pages 12 - 13

Abstract: En | Text: En | PDF: En

https://doi.org/10.5935/2359-4802.20190087 174 downloads

15.

BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP
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BARCHI, Leandro Cardoso

; RAMOS, Marcus Fernando Kodama Pertille

; YAGI, Osmar Kenji

; MUCERINO, Donato Roberto

; BRESCIANI, Claudio José Caldas

; RIBEIRO JÚNIOR, Ulysses

; ANDREOLLO, Nelson Adami

; ASSUMPÇÃO, Paulo Pimentel

; WESTON, Antônio Carlos

; COLLEONI NETO, Ramiro

; ZILBERSTEIN, Bruno

; Ferraz, Álvaro Antônio Bandeira Charruf, Amir Zeide Dias, André Roncon Brandalise, André Silva, André Maciel da Alves, Barlon Malheiros, Carlos Alberto Marins, Carlos Augusto Martinez Leite, Celso Vieira Szor, Daniel Wohnrath, Durval R. Ilias, Elias Jirjoss Martins Filho, Euclides Dias Lopasso, Fabio Pinatel Coimbra, Felipe José Fernandez Felippe, Fernando E. Cruz Tomasisch, Flávio Daniel Saavedra Takeda, Flavio Roberto Ishak, Geraldo Laporte, Gustavo Andreazza Silva, Herbeth José Toledo Cecconello, Ivan Rodrigues, Joaquim José Gama Grande, José Carlos Del Lourenço, Laércio Gomes Motta, Leonardo Milhomem da Ferraz, Leonardo Rocha Moreira, Luis Fernando Lopes, Luis Roberto Toneto, Marcelo Garcia Mester, Marcelo Rodrigues, Marco Antônio Gonçalves Carvalho, Marineide Prudêncio de Franciss, Maurice Youssef Forones, Nora Manoukian Corletta, Oly Campos Castro, Osvaldo Antonio Prado Malafaia, Osvaldo Kassab, Paulo Savassi-Rocha, Paulo Roberto Oliveira, Rodrigo Jose de Sallun, Rubens Antonio Aissar Weschenfelder, Rui Oliveira, Saint Clair Vieira de Abreu, Thiago Boechat de Castria, Tiago Biachi de Barra, Williams Costa Júnior, Wilson Luiz da Freitas Júnior, Wilson Rodrigues de

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2020, Volume 33 N. 3 elocation e1535

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

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico (ABCG) foi recentemente publicado. Nesta ocasião, inúmeros especialistas que atuam no tratamento desta doença expressaram sua opinião diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 1) quanto ao diagnóstico, estadiamento, tratamento endoscópico e seguimento dos pacientes com câncer gástrico. Métodos: Para formulação destas Diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO com os seguintes descritores: câncer gástrico, estadiamento, tratamento endoscópico e seguimento. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 24 declarações, duas (8,3%) foram classificadas com nível de evidência A, 11 (45,8%) B e 11 (45,8%) C. Quanto ao grau de recomendação, seis (25%) declarações obtiveram grau de recomendação 1, nove (37,5%) grau 2a, seis (25%) 2b e três (12,5%) 3. Conclusão: As diretrizes aqui presentes têm a finalidade de auxiliar os profissionais que atuam no combate ao câncer gástrico com informações relevantes e atuais, permitindo que sejam aplicadas na prática médica diária.

ABSTRACT Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.

https://doi.org/10.1590/0102-672020200003e1535 2100 downloads

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