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ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Analysis of pH, calcium ion release, and energy dispersive spectroscopy of a bioceramic root canal dressing
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Capitanio, Bárbara Luzia

; Hashizume, Lina Naomi

; Kuga, Milton Carlos

; Oliveira, Eliane Cristina Gulin de

; Rosa, Ricardo Abreu da

; Só, Gabriel Barcelos

; Só, Marcus Vinicius Reis

Brazilian Dental Journal

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aug 2023, Volume 34 N. 4 Pages 54 - 61

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

Abstract This study compared the pH and calcium ion release of calcium silicate- (Bio-C Temp) and calcium hydroxide-based (Ultracal XS) medications. Intracanal remnants of both medications were also evaluated using SEM-EDS after the removal protocol. Thirty-five bovine teeth were prepared. Fifteen were filled with Bio-C Temp and 15 with Ultracal XS. Five remained without intracanal medication (control group). Five samples from each experimental time (i.e.. 24, 72, and 168 hours) were used to measure pH and calcium ions release using a digital pH meter and microplate reader, respectively. Afterward, the peaks of the chemical elements composing both medications were analyzed in SEM-EDS. One-way ANOVA and Tukey's post hoc test analyzed the pH and calcium ion release data. Student's t-test compared the medications in each experimental time. SEM-EDS described the percentage of chemical elements in the samples. Bio-C Temp and Ultracal XS showed a significant pH increase from 24 to 168 hours (p<0.05). Ultracal XS showed a higher pH value at 24 hours than Bio-C Temp (p<0.05) but were similar at 72 and 168h (p > 0.05). Calcium ion release did not depend on the experimental period (p > 0.05). Bio-C Temp showed lower calcium ions release than Ultracal XS at 24 hours (p<0.05). SEM-EDS analyses showed the remains of both medications, but the concentration of Si, Al, and W ions was present only in the calcium silicate-based medication. Bio-C Temp presented alkaline pH and a satisfactory calcium ion release over the time. The remaining of both medications were present after the protocols for paste removal.

Resumo Este estudo comparou o pH e a liberação de íons cálcio de medicações intracanais a à base de silicato de cálcio (Bio-C Temp) e à base de hidróxido de cálcio (Ultracal XS). Remanescentes de ambas as medicações também foram avaliados usando microscopia eletrônica de varredura e espectroscopia de dispersão de energia após o protocolo de remoção. Trinta e cinco dentes bovinos foram preparados. Quinze dentes foram preenchidos com Bio-C Temp e 15 com Ultracal XS. Cinco permaneceram sem medicação intracanal (grupo controle). Cinco amostras de cada tempo experimental (ou seja, 24, 72 e 168 horas) foram usadas para medir o pH e a liberação de íons de cálcio usando um medidor de pH digital e um leitor de microplacas, respectivamente. Em seguida, os picos dos elementos químicos que compõem os dois medicamentos foram analisados em microscopia eletrônica de varredura e por espectroscopia de dispersão de energia. Os testes One-way ANOVA e post hoc de Tukey analisaram os dados de pH e liberação de íons cálcio. O teste t de Student comparou as medicações em cada tempo experimental. A microscopia eletrônica de varredura e a espectroscopia de dispersão de energia descreveu a porcentagem de elementos químicos nas amostras. O Bio-C Temp e o Ultracal XS mostraram um aumento significativo de pH de 24 a 168 horas (p<0,05). O Ultracal XS apresentou um valor de pH mais alto em 24 horas do que o Bio-C Temp (p<0,05), mas foi semelhante em 72 e 168h (p > 0,05). A liberação de íons cálcio não dependeu do período experimental (p> 0,05). O Bio-C Temp apresentou menor liberação de íons de cálcio do que Ultracal XS em 24 horas (p<0,05). As análises de microscopia eletrônica de varredura e espectroscopia de dispersão de energia mostraram remanescentes de ambas as medicações, mas a concentração de íons Si, Al e W estavam presentes apenas na medicação à base de silicato de cálcio. O Bio-C Temp apresentou pH alcalino e maior liberação de íons cálcio. Remanescentes de ambas as medicações estiveram presentes após os protocolos de remoção da pasta.

https://doi.org/10.1590/0103-6440202305506

Brote de histoplasmosis en el contexto de la pandemia por COVID-19
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Abreu La Rosa, Idioel

; García Gómez, Carlos

; Fragoso Marchante, María Caridad

; Cruz de los Santos, Héctor Javier

; Cuéllar Oramas, Yanisleydi

Revista Cubana de Medicina Tropical

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apr 2023, Volume 75 N. 1 elocation e942

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

ABSTRACT Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated.

RESUMEN La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas.

Burnout risk among anesthesiology residents in Brazil during the second wave of COVID-19: a cross-sectional survey
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Pietroski dos Santos, Natanael

; Biseo Henriques, Luisa Emanuela

; Pivovar De Camargo Rosa, Rafael

; Midory Marques Monteiro, Rebecca

; Vicente Sanches Gonçalves, Rafael

; Canga, José Carlos

; Callegari, Desiré Carlos

; Rocha, Esther Alessandra

Brazilian Journal of Anesthesiology

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jan 2023, Volume 73 N. 1 Pages 120 - 122

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.08.001

IAC Herculândia - a Coffea canephora rootstock multiresistant to Meloidogyne species
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Guerreiro Filho, Oliveiro

; Fazuoli, Luiz Carlos

; Braghini, Masako Toma

; Gallo, Paulo Boller

; Oliveira, Claúdio Marcelo Gonçalves

; Padilha, Lilian

; Fatobene, Barbhara Joana dos Reis

; Andrade, Vinicius Teixeira

; Vasconcelos, Larissa de Brito Caixeta

; Rosa, Juliana Magrinelli Osório

Crop Breeding and Applied Biotechnology

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2023, Volume 23 N. 3 elocation e46322339

Abstract: En | Text: En | PDF: En

Abstract IAC Herculândia is a Coffea canephora cultivar multiresistant to Meloidogyne exigua, M. incognita, and M. paranaensis to be used as a rootstock for Coffea arabica cultivars. It is a synthetic cultivar resulting from recombination among the clonal cultivars IAC WG, IAC FEBS, IAC PM, IAC LCCBF, and IAC ARM.

https://doi.org/10.1590/1984-70332023v23n3c32

Production of ethanol and xylitol from D-xylose by four strains of Candida (Spathaspora) materiae
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MOURA, MARINA ELIZABETH F. DE

; PALLADINO, FERNANDA

; CADETE, RAQUEL M.

; BARROS, KATHARINA O.

; LARA, CARLA A.

; SILVA, FERNANDA G.S.

; ROSA, CARLOS A.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 N. 4 elocation e20200278

Abstract: En | Text: En | PDF: En

Abstract Xylose is the most abundant pentose sugar in lignocellulosic biomass and can be biologically converted into economically important products by microorganisms such as yeasts. This study aimed to characterize the bioconversion of xylose into xylitol and ethanol using four strains of Candida materiae belonging to the Spathaspora clade, which includes yeast species with the potential to convert D-xylose to xylitol and ethanol. Fermentation assays were performed in YPX medium (yeast extract, peptone, xylose 5%) under two oxygen-limiting conditions at inoculum concentrations of 1, 5 and 10 g L-1. The best results were obtained using a 5 g L-1 inoculum under moderate oxygen-limiting conditions. C. materiae UFMG-CM-Y480 produced 32.23 g L-1 of xylitol, yielding 0.743 g g-1 within 36 h. Different combinations of xylose and glucose (25/25 g L-1, 40/10 g L-1, 10/40 g L-1) were also used to verify the influence of sugars on C. materiae metabolism. Xylitol was preferentially produced in medium containing 40 g L-1 xylose. C. materiae UFMG-CM-Y480 produced 26.20 g L-1 of xylitol with a yield of 0.646 g g-1 in 36 h. Our results showed that C. materiae UFMG-CM-Y480 may convert D-xylose to xylitol with a better fermentative performance than other xylitol-producing yeasts.

https://doi.org/10.1590/0001-3765202320200278

Influência da época de Semeadura sobre o Estabelecimento e Desenvolvimento do Arroz Irrigado
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Grohs, Mara

; Wolter, Roberto Carlos Doring

; Cera, Jossana

; Silveira, Rodrigo de Moura

; Bergmann, Cristiele

; Pohlmann, Valeria

; Rosa, Caren Alessandra da

Revista Brasileira de Meteorologia

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sep 2022, Volume 37 N. 3 Pages 365 - 372

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

Resumo Há uma grande variação climática regional no RS, maior estado produtor de arroz do Brasil, o que ocasiona diferentes respostas em produtividade de grãos, tornando a época de semeadura, o fator determinante da produção anual. O objetivo do trabalho foi avaliar cultivares de arroz irrigado, com diferentes ciclos de desenvolvimento, em função da época de semeadura. Dois experimentos foram conduzidos na região central e zona sul do RS, avaliando a produtividade de grãos em oito épocas de semeadura (a partir de 01/09 até 15/12) com cultivares distintas em função do ciclo: super precoce, precoce, médio e tardio. Foram quantificados a soma térmica, bem como a velocidade de estabelecimento. As semeaduras antecipadas (até 01/10) podem prejudicar o estande inicial e o estabelecimento da cultura é atrasado conforme a antecipação da semeadura. A diferença da necessidade de acúmulo de soma térmica entre os ciclos é mais contrastante do subperíodo emergência-diferenciação da panícula e a época de semeadura para o RS variam conforme o ciclo, sendo 15/09 a 01/10 para o melhor período para semeadura de cultivares tardias, 01/10 a 15/10 para ciclo médio, 01/10 a 15/11 para precoce e 15/11 para super precoce e a temperatura apresenta tanto impacto quanto a radiação solar, na produtividade da cultura.

Abstract There is a great regional climatic variation in RS, the largest rice producing state in Brazil, which causes different responses in grain yield, making the sowing time, the determining factor of the annual production of this cereal. This study aimed to evaluate flooded rice cultivars with different development cycles as a function of sowing date and the agroecological sub-region of RS. Two experiments were carried out in the Central and Southern region of RS, evaluating grain yield in eight sowing dates (from 09/01 to 12/15) with cultivars from four different maturation cycles: super short, short, medium and long. The thermal sum was quantified for the main stages of the crop, as well as the speed of establishment at all dates. Early sowing (until 10/01) can harm the initial stand and the establishment of the culture is delayed according to the anticipation of sowing. The difference in the need for thermal sum accumulation between cycles is more contrasting from the emergence- panicle differentiation subperiod and the sowing date for RS, differs according to the cycle being 09/15 to 10/01 for long cultivars, 10/01 to 10/15 for medium, 10/1 to 11/15 for short and 11/15 for super short.

https://doi.org/10.1590/0102-77863730048

Desfechos clínicos e características da mecânica pulmonar entre a síndrome do desconforto respiratório agudo associada à COVID-19 e a não associada à COVID-19: uma análise de escore de propensão de dois importantes ensaios randomizados
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Tomazini, Bruno Martins

; Costa, Eduardo Leite Vieira

; Besen, Bruno Adler Maccagnan Pinheiro

; Zampieri, Fernando Godinho

; Carvalho, Carlos Roberto Ribeiro de

; Caser, Eliana Bernardete

; Souza-Dantas, Vicente Cés de

; Boschi, Emerson

; Fumis, Renata Rego Lins

; Alencar Filho, Meton Soares de

; Maia, Israel Silva

; Oliveira Filho, Wilson de

; Veiga, Viviane Cordeiro

; Avezum, Alvaro

; Lopes, Renato Delascio

; Machado, Flávia Ribeiro

; Berwanger, Otávio

; Rosa, Regis Goulart

; Cavalcanti, Alexandre Biasi

; Azevedo, Luciano César Pontes de

Revista Brasileira de Terapia Intensiva

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jul 2022, Volume 34 N. 3 Pages 335 - 341

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

RESUMO Objetivo: Comparar a mecânica pulmonar e os desfechos entre a síndrome do desconforto respiratório agudo associada à COVID-19 e a síndrome do desconforto respiratório agudo não associada à COVID-19. Métodos: Combinamos dados de dois ensaios randomizados sobre a síndrome do desconforto respiratório agudo, um incluindo apenas pacientes com COVID-19 e o outro incluindo apenas pacientes sem COVID-19, para determinar se a síndrome do desconforto respiratório agudo associada à COVID-19 está associada à maior mortalidade aos 28 dias do que a síndrome do desconforto respiratório agudo não associada à COVID-19 e também examinar as diferenças na mecânica pulmonar entre esses dois tipos de síndrome do desconforto respiratório agudo. Resultados: Foram incluídos na análise principal 299 pacientes com síndrome do desconforto respiratório agudo associada à COVID-19 e 1.010 pacientes com síndrome do desconforto respiratório agudo não associada à COVID-19. Os resultados mostraram que os pacientes sem COVID-19 utilizaram pressão positiva expiratória final mais alta (12,5cmH2O; DP 3,2 versus 11,7cmH2O; DP 2,8; p < 0,001), foram ventilados com volumes correntes mais baixos (5,8mL/kg; DP 1,0 versus 6,5mL/kg; DP 1,2; p < 0,001) e apresentaram menor complacência respiratória estática ajustada para o peso ideal (0,5mL/cmH2O/kg; DP 0,3 versus 0,6mL/cmH2O/kg; DP 0,3; p = 0,01). Não houve diferença entre os grupos quanto à mortalidade aos 28 dias (52,3% versus 58,9%; p = 0,52) ou à duração da ventilação mecânica nos primeiros 28 dias entre os sobreviventes (13 [IQ 5 - 22] dias versus 12 [IQ 6 - 26] dias; p = 0,46). Conclusão: Esta análise mostrou que os pacientes com síndrome do desconforto respiratório agudo não associada à COVID-19 têm mecânica pulmonar diferente, mas desfechos semelhantes aos dos pacientes com síndrome do desconforto respiratório agudo associada à COVID-19. Após pareamento por escore de propensão, não houve diferença na mecânica pulmonar e nem nos desfechos entre os grupos.

ABSTRACT Objective: To compare the lung mechanics and outcomes between COVID-19-associated acute respiratory distress syndrome and non-COVID-19-associated acute respiratory distress syndrome. Methods: We combined data from two randomized trials in acute respiratory distress syndrome, one including only COVID-19 patients and the other including only patients without COVID-19, to determine whether COVID-19-associated acute respiratory distress syndrome is associated with higher 28-day mortality than non-COVID-19 acute respiratory distress syndrome and to examine the differences in lung mechanics between these two types of acute respiratory distress syndrome. Results: A total of 299 patients with COVID-19-associated acute respiratory distress syndrome and 1,010 patients with non-COVID-19-associated acute respiratory distress syndrome were included in the main analysis. The results showed that non-COVID-19 patients used higher positive end-expiratory pressure (12.5cmH2O; SD 3.2 versus 11.7cmH2O SD 2.8; p < 0.001), were ventilated with lower tidal volumes (5.8mL/kg; SD 1.0 versus 6.5mL/kg; SD 1.2; p < 0.001) and had lower static respiratory compliance adjusted for ideal body weight (0.5mL/cmH2O/kg; SD 0.3 versus 0.6mL/cmH2O/kg; SD 0.3; p = 0.01). There was no difference between groups in 28-day mortality (52.3% versus 58.9%; p = 0.52) or mechanical ventilation duration in the first 28 days among survivors (13 [IQR 5 - 22] versus 12 [IQR 6 - 26], p = 0.46). Conclusion: This analysis showed that patients with non-COVID-19-associated acute respiratory distress syndrome have different lung mechanics but similar outcomes to COVID-19-associated acute respiratory distress syndrome patients. After propensity score matching, there was no difference in lung mechanics or outcomes between groups.

https://doi.org/10.5935/0103-507x.20220040-pt

Efecto del ejercicio en la memoria de adultos mayores con sobrepeso u obesidad: Revisión sistemática
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Curilem Gatica, Cristian

; Guandalini Valdete, Regina

; Liabeuf Altamirano, Gianella

; Bahamondes Ávila, Carlos

; Bruneau-Chávez, José

; Berral de la Rosa, Francisco José

Revista del Nacional (Itauguá)

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jun 2022, Volume 14 N. 1 Pages 58 - 74

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

RESUMEN La obesidad y el sobrepeso en adultos mayores se asocia con un mayor riesgo de enfermedades cognitivas, lo que contribuye a la disminución del rendimiento funcional. El objetivo de esta revisión es analizar el efecto del ejercicio en la memoria de adultos mayores con obesidad o sobrepeso. La metodología utiliza las palabras MESH: Población = envejecido, sobrepeso, obesidad; Intervención = ejercicio; Comparación = grupo control; Resultado = memoria; Diseño: ensayo clínico aleatorio. Buscando hasta diciembre de 2021 en: PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE Y MEDLINE. Se identifican 6.832 artículos. Se analizan cinco estudios, con 214 participantes. El índice de masa corporal medio es 28,6 ± 1,1 kg/m2 y el Mini mental medio inicial es 23,6 ± 2,1 puntos. La intervención con ejercicio es de doce a veintiséis semanas. En el modelo de efectos aleatorios el ejercicio mejora el Mini mental medio en MD = 2,6 puntos (1,7 a 3,4) p < 0,01. Heterogeneidad (87,7 %). El ejercicio mejora la función cognitiva (memoria) en adultos mayores con sobrepeso u obesidad.

ABSTRACT Obesity and overweight in older adults are associated with an increased risk of cognitive diseases, contributing to decreased functional performance. The objective of this review is to analyze the effect of exercise on memory in older adults with obesity or overweight. The methodology uses the words MESH: Population = aged, overweight, obesity; Intervention = exercise; Comparison = control groups; Result = Memory; Design: randomized controlled trial. Searching until December 2021 in PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE, and MEDLINE. Six thousand eight hundred thirty-two items are identified. We analyzed five studies with 214 participants. The mean body mass index is 28.6 ± 1.1 kg/m2, and the initial average Mini mental is 23.6 ± 2.1 points. The intervention with exercise is from twelve to twenty-six weeks. In the random-effects model, exercise improves the mean Mini Mental by MD = 2.6 points (1.7 to 3.4) p < 0.01. Heterogeneity (87.7 %). Exercise improves cognitive function (memory) in older adults who are overweight or obese.

https://doi.org/10.18004/rdn2022.jun.01.058.074

10.

O direito à indenização do consumidor pelo tempo perdido, em razão do defeito no produto ou no serviço
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Goiabeira Rosa, Luiz Carlos

; Oliveira de Aguiar Borges, Gabriel

; Salviano Alves, Dionis

Prolegómenos

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jun 2022, Volume 25 N. 49 Pages 87 - 100

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

Resumo: este trabalho tem como finalidade analisar a possibilidade de se indenizar o tempo desperdiçado pelo consumidor por má conduta do fornecedor ao impossibilitar ou dificultar a reparação pelo defeito no produto ou no serviço, o que a doutrina alcunhou de “desvio do tempo produtivo do consumidor", e o dever de reparar daí decorrente. Adotou-se o método dedutivo, partindo-se do direito fundamental à proteção do consumidor e um de seus corolários, o princípio da vulnerabilidade do consumidor, chegando-se à responsabilidade do fornecedor pela colocação de produtos e serviços defeituosos no mercado de consumo, e ao final constatando-se o dever de reparar em razão do tempo tomado do consumidor e da não resolução do problema, por exclusiva desídia do fornecedor.

Summary: this work aims to analyze the possibility of indemnifying the time wasted by the consumer due to the supplier's misconduct by making it impossible or difficult to repair the defect in the product or service, which the doctrine called "deviation of the consumer's productive time", and the resulting duty to repair. The deductive method was adopted, starting from the fundamental right to consumer protection and one of its corollaries, the principle of consumer vulnerability, arriving at the supplier's responsibility for placing defective products and services in the consumer market, and at the end, the duty to repair is verified due to the time taken by the consumer and the failure to solve the problem, due to the exclusive negligence of the supplier.

Resumen: este trabajo tiene como objetivo analizar la posibilidad de indemnizar el tiempo perdido por el consumidor debido a la mala conducta del proveedor al hacer imposible o difícil reparar el defecto en el producto o servicio, que la doctrina denominaba “desviación del tiempo productivo del consumidor", y el consiguiente deber de reparación. Se adoptó el método deductivo, partiendo del derecho fundamental a la protección del consumidor y uno de sus corolarios, el principio de vulnerabilidad del consumidor, llegando a la responsabilidad del proveedor por colocar productos y servicios defectuosos en el mercado de consumo, y al final, al deber de la reparación se verifica por el tiempo empleado por el consumidor y la falta de solución del problema, por negligencia exclusiva del proveedor.

https://doi.org/10.18359/prole.5629

11.

Eating disorders are associated with adverse obstetric and perinatal outcomes: a systematic review
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das Neves, Maila de C.

; Teixeira, Ananda A.

; Garcia, Flávia M.

; Rennó, Joel

; da Silva, Antônio G.

; Cantilino, Amaury

; Rosa, Carlos E.

; Mendes-Ribeiro, Jeronimo de A.

; Rocha, Renan

; Lobo, Hewdy

; Gomes, Igor E.

; Ribeiro, Christiane C.

; Garcia, Frederico D.

Brazilian Journal of Psychiatry

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apr 2022, Volume 44 N. 2 Pages 201 - 214

Abstract: En | Text: En | PDF: En

Objective: To systematically review the literature focusing on obstetric and perinatal outcomes in women with previous or current eating disorders (EDs) and on the consequences of maternal EDs for the offspring. Methods: The study was performed following the systematic review and meta-analysis (PRISMA) statement. PubMed, SciELO, and Cochrane databases were searched for non-interventional studies published in English or Portuguese from January 1980 to December 2020. Risk of bias was assessed using the Methods guide for effectiveness and comparative effectiveness reviews (American Agency for Healthcare Research and Quality). Results: The search yielded 441 records, and 30 articles were included. The psychiatric outcome associated with EDs in women was mainly perinatal depression. The most prevalent obstetric outcomes observed in women with EDs were vomiting, hyperemesis, bleeding, and anemia. Most studies found maternal anorexia nervosa and bulimia nervosa to be associated with low birth weight and slow fetal growth. Women with binge EDs delivered children with increased birth weight. Of the 30 studies included, methodological quality was good in seven, fair in eight, and poor in 15 studies. Conclusion: A considerable body of evidence was reviewed to assess obstetric and perinatal outcomes in EDs. Acute and lifetime EDs, especially if severe, correlated with poor perinatal, obstetric, and neonatal outcomes. Obstetricians and general practitioners should be vigilant and screen for EDs during pregnancy.

https://doi.org/10.1590/1516-4446-2020-1449

12.

Antivirais para pacientes adultos hospitalizados com infecção por SARS-CoV-2: Um estudo de Fase II/III, randomizado, multicêntrico, controlado por placebo, adaptativo, com múltiplos braços e estágios. COALITION COVID-19 BRAZIL IX - REVOLUTIOn: protocolo e plano de análise estatística
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Maia, Israel Silva

; Marcadenti, Aline

; Zampieri, Fernando Godinho

; Damiani, Lucas Petri

; Santos, Renato Hideo Nakagawa

; Negrelli, Karina Leal

; Gomes, Samara Pinheiro do Carmo

; Gomes, Jaqueline Oliveira

; Carollo, Mariana Barbosa dos Santos

; Miranda, Tamiris Abait

; Santucci, Eliana

; Valeis, Nanci

; Laranjeira, Ligia Nasi

; Westphal, Glauco Adrieno

; Horta, Jacques Gabriel Alvares

; Flato, Uri Adrian Prync

; Fernandes, Camilo

; Barros, Waldemar Carlos

; Bolan, Renata S

; Gebara, Otávio Celso Eluf

; Alencar Filho, Meton Soares de

; Hamamoto, Victor Augusto

; Hernandes, Mauro Esteves

; Golin, Nicole Alberti

; Olinda, Ronald Torres de

; Machado, Flávia Ribeiro

; Rosa, Régis Goulart

; Veiga, Viviane Cordeiro

; Azevedo, Luciano César Pontes de

; Avezum, Alvaro

; Lopes, Renato Delascio

; Souza, Tiago Moreno L

; Berwanger, Otávio

; Cavalcanti, Alexandre Biasi

Revista Brasileira de Terapia Intensiva

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mar 2022, Volume 34 N. 1 Pages 44 - 55

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

RESUMO Os medicamentos reaproveitados são importantes em contextos de recursos limitados porque as intervenções estão mais rapidamente disponíveis, já foram testadas com segurança em outras populações e são, em geral, mais baratas. Os medicamentos reaproveitados são uma solução eficaz, especialmente para doenças emergentes, como a COVID-19. O estudo REVOLUTIOn visa avaliar três medicamentos antivirais reaproveitados: atazanavir, daclatasvir e sofosbuvir, já utilizados em pacientes infectados pelo HIV ou pelo vírus da hepatite C, em um estudo randomizado, controlado por placebo, adaptativo, multibraço e em múltiplos estágios. Os medicamentos serão testados simultaneamente em um ensaio de Fase II para primeiro identificar se algum deles, isoladamente ou em combinação, reduz a carga viral. Se reduzirem, será iniciado um estudo de Fase III para investigar se tais medicamentos são capazes de aumentar o número de dias sem suporte respiratório. Os participantes devem ser adultos hospitalizados com idade ≥ 18 anos com início dos sintomas ≤ 9 dias e saturação de oxigênio ≤ 94% em ar ambiente ou necessidade de oxigênio suplementar para manter saturação de oxigênio > 94%. O tamanho total esperado da amostra varia entre 252 e 1.005 participantes, dependendo do número de estágios que serão concluídos no estudo. Assim, o protocolo é aqui descrito em detalhes, juntamente do plano de análise estatística. Em conclusão, o estudo REVOLUTIOn foi concebido para fornecer evidências se o atazanavir, o daclatasvir ou o sofosbuvir reduzem a carga viral de SARS-CoV-2 em pacientes com COVID-19 e aumentam o número de dias em que os pacientes ficam sem suporte respiratório. Neste artigo de protocolo, descrevem-se a fundamentação, o desenho e a situação do ensaio. Identificador do ClinicalTrials.gov:NCT04468087

ABSTRACT Repurposed drugs are important in resource-limited settings because the interventions are more rapidly available, have already been tested safely in other populations and are inexpensive. Repurposed drugs are an effective solution, especially for emerging diseases such as COVID-19. The REVOLUTIOn trial has the objective of evaluating three repurposed antiviral drugs, atazanavir, daclatasvir and sofosbuvir, already used for HIV- and hepatitis C virus-infected patients in a randomized, placebo-controlled, adaptive, multiarm, multistage study. The drugs will be tested simultaneously in a Phase II trial to first identify whether any of these drugs alone or in combination reduce the viral load. If they do, a Phase III trial will be initiated to investigate if these medications are capable of increasing the number of days free respiratory support. Participants must be hospitalized adults aged ≥ 18 years with initiation of symptoms ≤ 9 days and SpO2 ≤ 94% in room air or a need for supplemental oxygen to maintain an SpO2 > 94%. The expected total sample size ranges from 252 to 1,005 participants, depending on the number of stages that will be completed in the study. Hence, the protocol is described here in detail together with the statistical analysis plan. In conclusion, the REVOLUTIOn trial is designed to provide evidence on whether atazanavir, daclatasvir or sofosbuvir decrease the SARS-CoV-2 load in patients with COVID-19 and increase the number of days patients are free of respiratory support. In this protocol paper, we describe the rationale, design, and status of the trial. ClinicalTrials.gov identifier:NCT04468087

https://doi.org/10.5935/0103-507x.20220002-pt

13.

Incidence of fever and bleeding after percutaneous nephrolithotomy: a prospective cohort study
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Sierra-Diaz, Erick

; Dávila-Radilla, Fernando

; Espejo-Vázquez, Analía

; Ruiz-Velasco, Carlos B.

; Gaxiola-Perez, Efren

; Celis-De la Rosa, Alfredo de Jesús

Cirugía y cirujanos

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feb 2022, Volume 90 N. 1 Pages 57 - 63

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

Abstract Objective: Despite relative agreement on the need for immediate peri-operative antibiotic prophylaxis in percutaneous nephrolithotomy (PCNL), there is no consensus regarding antibiotic use the days leading up to PCNL. This study aimed to report the incidence of complications during and after PCNL based on a cohort study design. Material and methods: We included 101 patients in a prospective schedule for PCNL. Patients were divided into 2 groups. In the exposed patients (positive urine culture) the antibiotic was indicated according to the antibiogram report, 7 days before surgery, and 7 days after surgery, and in the non-exposed patient’s intravenous antibiotic empirically was administered 8 h and 1 h before surgery. Results: The incidence of complications for both groups was 19%. The exposed group presented complications in 27%, and 16% for the non-exposed. The relative risk of complications, in general, was 1.68 (95% CI, 0.77-3.6), the attributable risk was 11.09, and the percentage of attributable risk was 40.68%. Conclusions: The presence of positive urine culture is the main risk factor for the development of post-PCNL fever. Each treatment center needs to standardize its protocols to reduce the morbidity associated with surgery and to identify the main risk factors.

Resumen Objetivo: El objetivo de este estudio es reportar la incidencia de complicaciones durante y después de la nefrolitotomía percutánea (NLP) con base en un diseño de cohorte prospectivo. Material y métodos: Se incluyeron 101 pacientes de forma prospectiva programados para NLP. Los pacientes fueron divididos en 2 grupos. En el grupo de expuestos (cultivo de orina positivo) el antibiótico se indicó según el reporte del antibiograma, 7 días antes y 7 días después de la cirugía. En los pacientes no expuestos (cultivo de orina negativo) se administró empíricamente antibiótico intravenoso 8 h y 1 h antes de la cirugía. Resultados: La incidencia de complicaciones para ambos grupos fue del 19%. El grupo de expuestos presentó complicaciones en 27% mientras que para los no expuestos fue de 16%. El riesgo relativo de complicaciones en general fue de 1.68 (IC 95%, 0.77-3.6), el riesgo atribuible fue de 11.09 y el porcentaje de riesgo atribuible fue de 40.68%. Conclusiones: la presencia de urocultivo positivo es el principal factor de riesgo para el desarrollo de fiebre post-NLP. Es importante que cada centro de tratamiento estandarice sus protocolos para reducir la morbilidad asociada con la cirugía e identificar los principales factores de riesgo.

https://doi.org/10.24875/ciru.20001130 17 downloads

14.

Energy supplementation as strategy of pasture management
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Santos, Alyce Raiana Monteiro

; Cabral, Carla Heloísa Avelino

; Cabral, Carlos Eduardo Avelino

; Barros, Lívia Vieira de

; Pires, Deborah França

; Rosa, Altieres dos Santos

; Alves, Guilherme Ribeiro

; Coutinho, Marina Pereira Souza

Acta Scientiarum. Animal Sciences

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2022, Volume 44 elocation e55761

Abstract: En | Text: En | PDF: En

ABSTRACT. This study evaluated the effect of increased energy via supplementation on the performance, ingestive behavior, nutrient digestibility, and nitrogen metabolism of grazing heifers fed tropical forage in the rainy-dry transition season. Treatments consisted of mineral supplementation ad libitum (control) and multiple supplements formulated to provide different energy levels and the same amount of protein (300 g CP animal d-1) and were denominated as low (LE; 340 g TDN animal d-1), medium (ME; 780 g TDN animal d-1) and high (HE; 1220 g TDN animal d-1) energy. Animals supplemented with ME, and HE had a greater average daily gain in relation to the control treatment, with an increase of 41 and 46%, respectively. Greater values for total apparent digestibility of neutral detergent fiber were observed for the treatment HE. Lesser values of urinary urea N were observed for the control and HE treatments. Our results define the use of energy levels in the supplement as a tool for pasture management. If the purpose of the production system is to enhance forage intake, the option is to supply supplements with less energy levels. In contrast, if the purpose is to increase the stocking rate, supplements with greater energy levels should be used.

https://doi.org/10.4025/actascianimsci.v44i1.55761

15.

Effect of alpha-humulene incorporation on the properties of experimental light-cured periodontal dressings
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ROSSATO, Tharsis Christini de Almeida

; ALVES, Tomaz

; CUEVAS-SUÁREZ, Carlos Enrique

; ROSA, Wellington Luiz de Oliveira da

; SILVA, Adriana Fernandes da

; PIVA, Evandro

; ZANCHi, Cesar Henrique

; LUND, Rafael Guerra

Brazilian Oral Research

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2022, Volume 36 elocation e091

Abstract: En | Text: En | PDF: En

Abstract The objective of this study was to formulate an experimental light-cured periodontal dressing containing alpha-humulene and to compare its physical, antimicrobial, and cytotoxicity properties with commercial gold standards (Barricaid® and Periobond®). Two periodontal dressing formulations were developed (a and b). The formulations were divided into 5 groups according to the alpha-humulene concentration as follows: Ea - control group, Ea1 - 1%, Ea5 - 5%, Ea10 - 10%, and Ea20 - 20%; Eb - control group, Eb1 - 1%, Eb5 - 5%, Eb10 - 10%, and Eb20 - 20%. Materials characterization was performed using the degree of conversion, cohesive strength, sorption, and solubility assays. Antimicrobial assay was performed using the modified direct contact test against E. faecalis and S. aureus. Cytotoxicity was assessed by the cell viability experiment using L929 fibroblasts. In general, the cohesive strength values of materials decreased as the alpha-humulene concentration increased. All the experimental dressings showed antimicrobial activity against both bacteria tested. Cell viability results for the Ea, Ea1, Eb, and Eb1 groups showed moderate cytotoxic effect. The formulations containing alpha-humulene showed similar behavior to the commercial references. Thus, formulations containing alpha-humulene have potential to be used as periodontal dressing.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0091

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