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1.
To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis B B2 positive outcomes
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Resende, Gustavo Gomes
; Saad, Carla Goncalves Schahin
Marques, Claudia Diniz Lopes
Ribeiro, Sandra Lúcia Euzébio
Gavi, Maria Bernadete Renoldi de Oliveira
Yazbek, Michel Alexandre
Marinho, Adriana de Oliveira
Menin, Rita de Cássia
Ochtrop, Manuella Lima Gomes
Soares, Andressa Miozzo
Cavalcanti, Nara Gualberto
Carneiro, Jamille Nascimento
Werner de Castro, Glaucio Ricardo
Fernandes, José Mauro Carneiro
Souza, Elziane da Cruz Ribeiro E
Alvarenga, Corina Quental de Menezes
Vieira, Rejane Maria Rodrigues de Abreu
Machado, Natalia Pereira
Ximenes, Antônio Carlos
Gazzeta, Morgana Ohira
Albuquerque, Cleandro Pires de
Skare, Thelma Larocca
Keiserman, Mauro Waldemar
Kohem, Charles Lubianca
Benacon, Gabriel Sarkis
Rocha, Vítor Florêncio Santos
Lage, Ricardo da Cruz
Malheiro, Olivio Brito
Golebiovski, Rywka Tenenbaum Medeiros
Oliveira, Thauana Luiza
Duque, Ruben Horst
Londe, Ana Carolina
Pinheiro, Marcelo de Medeiros
Sampaio-Barros, Percival Degrava

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±
2.
New formulations of fermented milk drinks with fruit pulp added: Physicochemical characteristics during storage and nutritional profile
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Souza, Handray Fernandes de
; Borges, Lara Aguiar
; Mendes, Gabriela da Rocha Lemos
; Durães, Carla Adriana Ferreira
; Fonseca, Hugo Calixto
; Boitrago, Sarah Caroline Oliveira de Souza
; Leal, Jéssica Santos
; Ferreira, Sildimar Rodrigues
; Lima, William James Nogueira
; Kamimura, Eliana Setsuko
; Brandi, Igor Viana
.











ABSTRACT The aim of this study was to evaluate the nutritional profile and the physicochemical characteristics during storage of newly developed formulations of fermented milk drinks with added pineapple, mango and passion fruit pulp. The fermented drinks showed a high content of protein, iron, and calcium. The passion fruit milk drink had the lowest pH (4.13) and highest acidity (0.95%, expressed in % of lactic acid), which was significantly different (p<0.05) from the pineapple and mango drinks. As for syneresis and sedimentation, the pineapple milk drink had the highest rates at 14 days storage, with 34.33% and 6.50%, respectively and was significantly different (p≤0.05) when compared to the mango and passion fruit milk drinks. In conclusion, newly developed fermented milk drinks with added fruit pulp were a source of several nutrients. We observed physical-chemical characteristics suitable for a fermented milk product during storage.
RESUMEN El objetivo de este estudio fue el desarrollo de nuevas formulaciones de bebidas lácteas fermentadas adicionadas de piña, mango y maracuyá, para evaluar el perfil nutricional y las características fisicoquímicas durante el almacenamiento. Las bebidas fermentadas mostraron un alto contenido en proteínas, hierro y calcio. En cuanto a las características fisicoquímicas durante el almacenamiento, la bebida láctea de maracuyá presentó el pH más bajo (4,13) y la acidez más alta (0,95%, expresada en % de ácido láctico), con una diferencia significativa (p < 0,05), en comparación con las bebidas de piña y mango. En cuanto a sinéresis y sedimentación, la bebida láctea de piña presentó los mayores índices a los 14 días de almacenamiento, con 34,33% y 6,50%, respectivamente, y con diferencia significativa (p ≤ 0,05) al compararla con las bebidas lácteas de mango y maracuyá. En conclusión, las bebidas lácteas fermentadas con adición de pulpa de fruta son una fuente de varios nutrientes, y de características físico-químicas adecuadas para un producto lácteo fermentado durante el almacenamiento.
3.
Lesão Miocárdica e Prognóstico em Pacientes Hospitalizados com COVID-19 no Brasil: Resultados do Registro Nacional de COVID-19 COVID19 COVID 19 COVID-1 Brasil COVID1 1 COVID-
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Barbosa, Hannah Cardoso
; Martins, Maria Auxiliadora Parreiras
; Jesus, Jordana Cristina de
; Meira, Karina Cardoso
; Passaglia, Luiz Guilherme
; Sacioto, Manuela Furtado
; Bezerra, Adriana Falangola Benjamin
; Schwarzbold, Alexandre Vargas
; Maurílio, Amanda de Oliveira
; Farace, Barbara Lopes
; Silva, Carla Thais Cândida Alves da
; Cimini, Christiane Corrêa Rodrigues
; Silveira, Daniel Vitorio
; Carazai, Daniela do Reis
; Ponce, Daniela
; Costa, Emanuel Victor Alves
; Manenti, Euler Roberto Fernandes
; Cenci, Evelin Paola de Almeida
; Bartolazzi, Frederico
; Madeira, Glícia Cristina de Castro
; Nascimento, Guilherme Fagundes
; Velloso, Isabela Vasconcellos Pires
; Batista, Joanna d’Arc Lyra
; Morais, Júlia Drumond Parreiras de
; Carvalho, Juliana da Silva Nogueira
; Ruschel, Karen Brasil
; Martins, Karina Paula Medeiros Prado
; Zandoná, Liege Barella
; Menezes, Luanna Silva Monteiro
; Kopittke, Luciane
; Castro, Luís César de
; Nasi, Luiz Antônio
; Floriani, Maiara Anschau
; Souza, Maíra Dias
; Carneiro, Marcelo
; Bicalho, Maria Aparecida Camargos
; Lima, Maria Clara Pontello Barbosa
; Godoy, Mariana Frizzo de
; Guimarães-Júnior, Milton Henriques
; Mendes, Paulo Mascarenhas
; Delfino-Pereira, Polianna
; Ribeiro, Raquel Jaqueline Eder
; Finger, Renan Goulart
; Menezes, Rochele Mosmann
; Francisco, Saionara Cristina
; Araújo, Silvia Ferreira
; Oliveira, Talita Fischer
; Oliveira, Thainara Conceição de
; Polanczyk, Carisi Anne
Marcolino, Milena Soriano
















































Resumo Fundamento As complicações cardiovasculares da COVID-19 são aspectos importantes da patogênese e do prognóstico da doença. Evidências do papel prognóstico da troponina e da lesão miocárdica em pacientes hospitalizados com COVID-19 na América Latina são ainda escassos. Objetivos Avaliar a lesão miocárdica como preditor independente de mortalidade hospitalar e suporte ventilatório mecânico em pacientes hospitalizados, do registro brasileiro de COVID-19. Métodos Este estudo coorte é um subestudo do registro brasileiro de COVID-19, conduzido em 31 hospitais brasileiros de 17 cidades, de março a setembro de 2020. Os desfechos primários incluíram mortalidade hospitalar e suporte ventilatório mecânico invasivo. Os modelos para os desfechos primários foram estimados por regressão de Poisson com variância robusta, com significância estatística de p<0,05. Resultados Dos 2925 pacientes [idade mediana de 60 anos (48-71), 57,1%], 27,3% apresentaram lesão miocárdica. A proporção de pacientes com comorbidades foi maior nos pacientes com lesão miocárdica [mediana 2 (1-2) vs. 1 (0-20)]. Os pacientes com lesão miocárdica apresentaram maiores valores medianos de peptídeo natriurético cerebral, lactato desidrogenase, creatina fosfoquinase, N-terminal do pró-peptídeo natriurético tipo B e proteína C reativa em comparação a pacientes sem lesão miocárdica. Como fatores independentes, proteína C reativa e contagem de plaquetas foram relacionados com o risco de morte, e neutrófilos e contagem de plaquetas foram relacionados ao risco de suporte ventilatório mecânico invasivo. Os pacientes com níveis elevados de troponina apresentaram um maior risco de morte (RR 2,03, IC95% 1,60-2,58) e suporte ventilatório mecânico (RR 1,87;IC95% 1,57-2,23), em comparação àqueles com níveis de troponina normais. Conclusão Lesão cardíaca foi um preditor independente de mortalidade hospitalar e necessidade de suporte ventilatório mecânico em pacientes hospitalizados com COVID-19. COVID19 COVID 19 COVID-1 doença escassos COVID19. 19. COVID19, 19, 3 cidades 2020 invasivo robusta p005 p 0 05 p<0,05 292 idade 6 4871, 4871 48 71 , (48-71) 57,1%, 571 57,1% 57 57,1%] 273 27 27,3 12 (1-2 vs 020. 020 20 . (0-20)] cerebral desidrogenase fosfoquinase Nterminal N terminal própeptídeo pró independentes RR 203 03 2,03 IC95 IC 1,602,58 160258 1,60 2,58 58 1,60-2,58 1,87IC95% 187IC95 1,87 87 1,87;IC95 1,572,23, 157223 1,57 2,23 23 1,57-2,23) normais COVID1 COVID- 202 p00 p<0,0 29 487 4 7 (48-71 57,1 5 27, (1- 02 (0-20) 2,0 IC9 602 1,602,5 16025 160 1,6 258 2,5 1,60-2,5 87IC95 1,87IC95 187IC9 187 1,8 8 1,87;IC9 572 1,572,23 15722 157 1,5 223 2,2 1,57-2,23 p0 p<0, (48-7 57, (1 (0-20 2, 1,602, 1602 16 1, 25 1,60-2, 87IC9 1,87IC9 187IC 18 1,87;IC 1,572,2 1572 15 22 1,57-2,2 p<0 (48- ( (0-2 1,602 1,60-2 87IC 1,87IC 1,572, 1,57-2, p< (48 (0- 1,60- 1,572 1,57-2 (4 (0 1,57-
Abstract Background Cardiovascular complications of COVID-19 are important aspects of the disease’s pathogenesis and prognosis. Evidence on the prognostic role of troponin and myocardial injury in Latin American hospitalized COVID-19 patients is still scarce. Objectives To evaluate myocardial injury as independent predictor of in-hospital mortality and invasive mechanical ventilation support in hospitalized patients, from the Brazilian COVID-19 Registry. Methods This cohort study is a substudy of the Brazilian COVID-19 Registry, conducted in 31 Brazilian hospitals of 17 cities, March-September 2020. Primary outcomes included in-hospital mortality and invasive mechanical ventilation support. Models for the primary outcomes were estimated by Poisson regression with robust variance, with statistical significance of p<0.05. Results Of 2,925 patients (median age of 60 years [48-71], 57.1% men), 27.3% presented myocardial injury. The proportion of patients with comorbidities was higher among patients with cardiac injury (median 2 [1-2] vs. 1 [0-2]). Patients with myocardial injury had higher median levels of brain natriuretic peptide, lactate dehydrogenase, creatine phosphokinase, N-terminal pro-brain natriuretic peptide, and C-reactive protein than patients without myocardial injury. As independent predictors, C-reactive protein and platelet counts were related to the risk of death, and neutrophils and platelet counts were related to the risk of invasive mechanical ventilation support. Patients with high troponin levels presented a higher risk of death (RR 2.03, 95% CI 1.60-2.58) and invasive mechanical ventilation support (RR 1.87, 95% CI 1.57-2.23), when compared to those with normal troponin levels. Conclusion Cardiac injury was an independent predictor of in-hospital mortality and the need for invasive mechanical ventilation support in hospitalized COVID-19 patients. COVID19 COVID 19 COVID-1 diseases disease s prognosis scarce inhospital hospital Registry 3 cities MarchSeptember March September 2020 variance p005 p 0 05 p<0.05 2925 925 2,92 6 4871, 4871 48 71 , [48-71] 571 57 57.1 men, men men) 273 27 27.3 12 [1-2 vs 02. 02 . [0-2]) peptide dehydrogenase phosphokinase Nterminal N terminal probrain pro Creactive C reactive predictors RR 203 03 2.03 95 1.602.58 160258 1.60 2.58 58 1.60-2.58 187 87 1.87 1.572.23, 157223 1.57 2.23 23 1.57-2.23) COVID1 COVID- 202 p00 p<0.0 292 92 2,9 487 4 7 [48-71 5 57. 27. [1- [0-2] 20 2.0 9 602 1.602.5 16025 160 1.6 258 2.5 1.60-2.5 18 8 1.8 572 1.572.23 15722 157 1.5 223 2.2 1.57-2.23 p0 p<0. 29 2, [48-7 [1 [0-2 2. 1.602. 1602 16 1. 25 1.60-2. 1.572.2 1572 15 22 1.57-2.2 p<0 [48- [ [0- 1.602 1.60-2 1.572. 1.57-2. p< [48 [0 1.60- 1.572 1.57-2 [4 1.57-
4.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
Jesuíno, Isabella de Andrade
Reis, Luiz Fernando Lima
Mattos, Renata Rodrigues de
Pinheiro, Carla Cristina Gomes
Luz, Mariane Nascimento
Spadoni, Clayse Carla da Silva
Moro, Elisângela Emilene
Bueno, Flávia Regina
Sampaio, Camila Santana Justo Cintra
Silva, Débora Patrício
Baldassare, Franca Pellison
Silva, Ana Cecilia Alcantara
Veiga, Thabata
Barbante, Leticia
Lambauer, Marianne
Campos, Viviane Bezerra
Santos, Elton
Santos, Renato Hideo Nakawaga
Laranjeiras, Ligia Nasi
Valeis, Nanci
Santucci, Eliana
Miranda, Tamiris Abait
Patrocínio, Ana Cristina Lagoeiro do
Carvalho, Andréa de
Sousa, Eduvirgens Maria Couto de
Sousa, Ancelmo Honorato Ferraz de
Malheiro, Daniel Tavares
Bezerra, Isabella Lott
Rodrigues, Mirian Batista
Malicia, Julliana Chicuta
Silva, Sabrina Souza da
Gimenes, Bruna dos Passos
Sesin, Guilhermo Prates
Zavascki, Alexandre Prehn
Sganzerla, Daniel
Medeiros, Gregory Saraiva
Santos, Rosa da Rosa Minho dos
Silva, Fernanda Kelly Romeiro
Cheno, Maysa Yukari
Abrahão, Carolinne Ferreira
Oliveira Junior, Haliton Alves de
Rocha, Leonardo Lima
Nunes Neto, Pedro Aniceto
Pereira, Valéria Chagas
Paciência, Luis Eduardo Miranda
Bueno, Elaine Silva
Caser, Eliana Bernadete
Ribeiro, Larissa Zuqui
Fernandes, Caio Cesar Ferreira
Garcia, Juliana Mazzei
Silva, Vanildes de Fátima Fernandes
Santos, Alisson Junior dos
Machado, Flávia Ribeiro
Souza, Maria Aparecida de
Ferronato, Bianca Ramos
Urbano, Hugo Corrêa de Andrade
Moreira, Danielle Conceição Aparecida
Souza-Dantas, Vicente Cés de
Duarte, Diego Meireles
Coelho, Juliana
Figueiredo, Rodrigo Cruvinel
Foreque, Fernanda
Romano, Thiago Gomes
Cubos, Daniel
Spirale, Vladimir Miguel
Nogueira, Roberta Schiavon
Maia, Israel Silva
Zandonai, Cassio Luis
Lovato, Wilson José
Cerantola, Rodrigo Barbosa
Toledo, Tatiana Gozzi Pancev
Tomba, Pablo Oscar
Almeida, Joyce Ramos de
Sanches, Luciana Coelho
Pierini, Leticia
Cunha, Mariana
Sousa, Michelle Tereza
Azevedo, Bruna
Dal-Pizzol, Felipe
Damasio, Danusa de Castro
Bainy, Marina Peres
Beduhn, Dagoberta Alves Vieira
Jatobá, Joana D’Arc Vila Nova
Moura, Maria Tereza Farias de
Rego, Leila Rezegue de Moraes
Silva, Adria Vanessa da
Oliveira, Luana Pontes
Sodré Filho, Eliene Sá
Santos, Silvana Soares dos
Neves, Itallo de Lima
Leão, Vanessa Cristina de Aquino
Paes, João Lucidio Lobato
Silva, Marielle Cristina Mendes
Oliveira, Cláudio Dornas de
Santiago, Raquel Caldeira Brant
Paranhos, Jorge Luiz da Rocha
Wiermann, Iany Grinezia da Silva
Pedroso, Durval Ferreira Fonseca
Sawada, Priscilla Yoshiko
Prestes, Rejane Martins
Nascimento, Glícia Cardoso
Grion, Cintia Magalhães Carvalho
Carrilho, Claudia Maria Dantas de Maio
Dantas, Roberta Lacerda Almeida de Miranda
Silva, Eliane Pereira
Silva, Antônio Carlos da
Oliveira, Sheila Mara Bezerra de
Golin, Nicole Alberti
Tregnago, Rogerio
Lima, Valéria Paes
Silva, Kamilla Grasielle Nunes da
Boschi, Emerson
Buffon, Viviane
Machado, André Sant’Ana
Capeletti, Leticia
Foernges, Rafael Botelho
Carvalho, Andréia Schubert de
Oliveira Junior, Lúcio Couto de
Oliveira, Daniela Cunha de
Silva, Everton Macêdo
Ribeiro, Julival
Pereira, Francielle Constantino
Salgado, Fernanda Borges
Deutschendorf, Caroline
Silva, Cristofer Farias da
Gobatto, Andre Luiz Nunes
Oliveira, Carolaine Bomfim de
Dracoulakis, Marianna Deway Andrade
Alvaia, Natália Oliveira Santos
Souza, Roberta Machado de
Araújo, Larissa Liz Cardoso de
Melo, Rodrigo Morel Vieira de
Passos, Luiz Carlos Santana
Vidal, Claudia Fernanda de Lacerda
Rodrigues, Fernanda Lopes de Albuquerque
Kurtz, Pedro
Shinotsuka, Cássia Righy
Tavares, Maria Brandão
Santana, Igor das Virgens
Gavinho, Luciana Macedo da Silva
Nascimento, Alaís Brito
Pereira, Adriano J
Cavalcanti, Alexandre Biasi










RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
5.
Brazilian Academy of Neurology practice guidelines for stroke rehabilitation: part I
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Minelli, Cesar
; Bazan, Rodrigo
; Pedatella, Marco Túlio Araújo
; Neves, Luciana de Oliveira
; Cacho, Roberta de Oliveira
; Magalhães, Sheila Cristina Sayuri Abe
; Luvizutto, Gustavo José
; Moro, Carla Heloísa Cabral
; Lange, Marcos Christiano
; Modolo, Gabriel Pinheiro
; Lopes, Bruna Correia
; Pinheiro, Elisandra Leites
; Souza, Juli Thomaz de
; Rodrigues, Guilherme Riccioppo
; Fabio, Soraia Ramos Cabette
; Prado, Gilmar Fernandes do
; Carlos, Karla
; Teixeira, Juliana Junqueira Marques
; Barreira, Clara Monteiro Antunes
; Castro, Rodrigo de Souza
; Quinan, Thalita Dayrell Leite
; Damasceno, Eduardo
; Almeida, Kelson James
; Pontes-Neto, Octávio Marques
; Dalio, Marina Teixeira Ramalho Pereira
; Camilo, Millene Rodrigues
; Tosin, Michelle Hyczy de Siqueira
; Oliveira, Bianca Campos
; Oliveira, Beatriz Guitton Renaud Baptista de
; Carvalho, João José Freitas de
; Martins, Sheila Cristina Ouriques
.































RESUMO As Diretrizes Brasileiras para Reabilitação do AVC são fruto de um esforço conjunto do Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia com o objetivo de orientar os profissionais envolvidos no processo de reabilitação para a redução da incapacidade funcional e aumento da autonomia dos indivíduos. Membros do grupo acima participaram de fóruns de discussão na web com pré-temas, seguidos de reuniões por videoconferência em que as controvérsias foram discutidas, levando a um consenso. Essas diretrizes, divididas em duas partes, focam as implicações de recentes ensaios clínicos, revisões sistemáticas e metanálises sobre reabilitação do AVC. O objetivo principal é servir de orientação a médicos, fisioterapeutas, fonoaudiólogos, terapeutas ocupacionais, enfermeiros, nutricionistas e demais profissionais envolvidos no cuidado pós-AVC. As recomendações e níveis de evidência foram adaptados de acordo com a literatura disponível atualmente. Aqui é apresentada a Parte I sobre tópicos de reabilitação na fase aguda, prevenção e tratamento de doenças e comorbidades frequentes após o AVC.
ABSTRACT The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature. The main objective was to guide physicians, physiotherapists, speech therapists, occupational therapists, nurses, nutritionists, and other professionals involved in post-stroke care. Recommendations and levels of evidence were adapted according to the currently available literature. Part I discusses topics on rehabilitation in the acute phase, as well as prevention and management of frequent conditions and comorbidities after stroke.
6.
The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA
; BACCARO, FABRICIO
; CRONEMBERGER, CECILIA
; HIPÓLITO, JULIANA
; BARROS, CLAUDIA FRANCA
; RODRIGUES, DOMINGOS DE JESUS
; NECKEL-OLIVEIRA, SELVINO
; OVERBECK, GERHARD E.
; DRECHSLER-SANTOS, ELISANDRO RICARDO
; ANJOS, MARCELO RODRIGUES DOS
; FERREGUETTI, ÁTILLA C.
; AKAMA, ALBERTO
; MARTINS, MARLÚCIA BONIFÁCIO
; TOMAS, WALFRIDO MORAES
; SANTOS, SANDRA APARECIDA
; FERREIRA, VANDA LÚCIA
; CUNHA, CATIA NUNES DA
; PENHA, JERRY
; PINHO, JOÃO BATISTA DE
; SALIS, SUZANA MARIA
; DORIA, CAROLINA RODRIGUES DA COSTA
; PILLAR, VALÉRIO D.
; PODGAISKI, LUCIANA R.
; MENIN, MARCELO
; BÍGIO, NARCÍSIO COSTA
; ARAGÓN, SUSAN
; MANZATTO, ANGELO GILBERTO
; VÉLEZ-MARTIN, EDUARDO
; SILVA, ANA CAROLINA BORGES LINS E
; IZZO, THIAGO JUNQUEIRA
; MORTATI, AMANDA FREDERICO
; GIACOMIN, LEANDRO LACERDA
; ALMEIDA, THAÍS ELIAS
; ANDRÉ, THIAGO
; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA
; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA
; MESSIAS, MARILUCE REZENDE
; MARQUES, MARCIA C.M.
; PADIAL, ANDRE ANDRIAN
; MARQUES, RENATO
; BITAR, YOUSZEF O.C.
; SILVEIRA, MARCOS
; MORATO, ELDER FERREIRA
; PAGOTTO, RUBIANI DE CÁSSIA
; STRUSSMANN, CHRISTINE
; MACHADO, RICARDO BOMFIM
; AGUIAR, LUDMILLA MOURA DE SOUZA
; FERNANDES, GERALDO WILSON
; OKI, YUMI
; NOVAIS, SAMUEL
; FERREIRA, GUILHERME BRAGA
; BARBOSA, FLÁVIA RODRIGUES
; OCHOA, ANA C.
; MANGIONE, ANTONIO M.
; GATICA, AILIN
; CARRIZO, MARÍA CELINA
; RETTA, LUCÍA MARTINEZ
; JOFRÉ, LAURA E.
; CASTILLO, LUCIANA L.
; NEME, ANDREA M.
; RUEDA, CARLA
; TOLEDO, JOSÉ JULIO DE
; GRELLE, CARLOS EDUARDO VIVEIROS
; VALE, MARIANA M.
; VIEIRA, MARCUS VINICIUS
; CERQUEIRA, RUI
; HIGASHIKAWA, EMÍLIO MANABU
; MENDONÇA, FERNANDO PEREIRA DE
; GUERREIRO, QUÊZIA LEANDRO DE MOURA
; BANHOS, AUREO
; HERO, JEAN-MARC
; KOBLITZ, RODRIGO
; COLLEVATTI, ROSANE GARCIA
; SILVEIRA, LUÍS FÁBIO
; VASCONCELOS, HERALDO L.
; VIEIRA, CECÍLIA RODRIGUES
; COLLI, GUARINO RINALDI
; CECHIN, SONIA ZANINI
; SANTOS, TIAGO GOMES DOS
; FONTANA, CARLA S.
; JARENKOW, JOÃO A.
; MALABARBA, LUIZ R.
; RUEDA, MARTA P.
; ARAUJO, PUBLIO A.
; PALOMO, LUCAS
; ITURRE, MARTA C.
; BERGALLO, HELENA GODOY
; MAGNUSSON, WILLIAM E.
.
























































































Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.
https://doi.org/10.1590/0001-3765202120201604
1034 downloads
7.
Maintenance of venomous snakes in captivity for venom production at Butantan Institute from 1908 to the present: a scoping history
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Grego, Kathleen Fernandes
; Vieira, Samira Emanuela Maria
; Vidueiros, Jarbas Prado
; Serapicos, Eliana de Oliveira
Barbarini, Cibele Cíntia
Silveira, Giovanni Perez Machado da
Rodrigues, Fabíola de Souza
Alves, Lucas de Carvalho Francisco
Stuginski, Daniel Rodrigues
Rameh-de-Albuquerque, Luciana Carla
Furtado, Maria de Fátima Domingues
Tanaka-Azevedo, Anita Mitico
Morais-Zani, Karen de
Rocha, Marisa Maria Teixeira da
Fernandes, Wilson
Sant’Anna, Sávio Stefanini



Journal of Venomous Animals and Toxins including Tropical Diseases
- Journal Metrics
Abstract Maintenance of snakes at Butantan Institute started in the last century, intending to produce a different antivenom serum to reduce death caused by snakebites. Through a successful campaign coordinated by Vital Brazil, farmers sent venomous snakes to Butantan Institute by the railway lines with no cost. From 1908 to 1962, the snakes were kept in an outdoor serpentarium, where venom extraction was performed every 15 days. During this period, the snake average survival was 15 days. In 1963, the snakes were transferred to an adapted building, currently called Laboratory of Herpetology (LH), to be maintained in an intensive system. Although the periodicity of venom extraction remained the same, animal average survival increased to two months. With the severe serum crisis in 1983, the Ministry of Health financed remodeling for the three public antivenom producers, and with this support, the LH could be improved. Air conditioning and exhausting systems were installed in the rooms, besides the settlement of critical hygienic-sanitary managements to increase the welfare of snakes. In the early 1990s, snake survival was ten months. Over the years to the present day, several improvements have been made in the intensive serpentarium, as the establishment of two quarantines, feeding with thawed rodents, an interval of two months between venom extraction routines, and monitoring of snake health through laboratory tests. With these new protocols, average snake survival increased significantly, being eight years for the genus Bothrops, ten years for genus Crotalus and Lachesis, and four years for the genus Micrurus. Aiming the production of venoms of good quality, respect for good management practices is essential for the maintenance of snakes in captivity. New techniques and efficient management must always be sought to improve animal welfare, the quality of the venom produced, and the safety of those working directly with the venomous snakes.
https://doi.org/10.1590/1678-9199-jvatitd-2020-0068
1418 downloads
8.
Acute effects of 2D exergame on cognitive functions and frontal cortical activity
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Souza, Osmano Tavares de
; Machado, Frederico Sander Mansur
; Carneiro, Lara Sofia Rodrigues de Sousa Fernandes
; Rodrigues, Vinicius Dias
; Silva, Carla Silvana de Oliveira e
; Leão, Luana Lemos
; Monteiro-Junior, Renato Sobral
.







RESUMO Este estudo tem como objetivo avaliar o efeito de um exercício com sessão de realidade virtual 2D na cognição e atividade cortical de jovens do sexo masculino. Trata-se de um ensaio controlado randomizado com dez homens de 18 a 23 anos. Os participantes foram distribuídos aleatoriamente em duas condições: 1) sessão de exercícios com jogos de realidade virtual 2D e 2) controle, que consistia em assistir a um vídeo de dois episódios de um programa de TV. A cognição e a atividade cortical frontal foram avaliadas imediatamente antes e após a intervenção, por meio do Mindset, realização do Digit Span Test, fluência verbal e função executiva. A função executiva melhorou com a sessão de exergame (p=0,025). Exergames promove parcialmente um aumento imediato na função executiva dos jovens.
ABSTRACT This study aims to evaluate the effect of an exercise with a 2D virtual reality session on the cognition and cortical activity of young males. This is a randomized controlled trial with ten men aged 18 to 23 years. They were randomly assigned under two conditions: 1) exercise session with 2D virtual reality games and 2) control, which consisted of watching a two-episode video of a comic TV show. Cognition and frontal cortical activity were assessed immediately before and after the intervention, using the Mindset, performing the Digit Span Test, semantic verbal fluency, and executive function. Executive function improved with the exergame session (p=0.025). Exergames partially promote an immediate increase in the executive function of young people.
RESUMEN Este estudio tiene como objetivo evaluar el efecto de un ejercicio con sesión de realidad virtual 2D sobre la cognición y la actividad cortical de varones jóvenes. Este es un ensayo controlado aleatorio con diez hombres de 18 a 23 años. Fueron asignados aleatoriamente bajo dos condiciones: 1) sesión de ejercicios con juegos de realidad virtual 2D y 2) control, que consistía en ver dos episodios de un programa de televisión. Se evaluó la cognición y la actividad cortical frontal inmediatamente antes y después de la intervención, utilizando el Mindset, realizando el Digit Span Test, la fluidez verbal y la función ejecutiva. La función ejecutiva mejoró con la sesión de exergame (p=0.025). Exergames promueven parcialmente un aumento de la función ejecutiva de los jóvenes.
https://doi.org/10.1590/rbce.43.e011720
24 downloads
9.
COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves
; Ximenez, João Paulo Bianchi
; Seiva, Fábio Rodrigues Ferreira
; Panis, Carolina
; Bezerra, Rafael dos Santos
; Ferrasa, Adriano
; Cecchini, Alessandra Lourenço
; Medeiros, Alexandra Ivo de
; Almeida, Ana Marisa Fusco
; Ramão, Anelisa
; Boldt, Angelica Beate Winter
; Moya, Carla Fredrichsen
Chin, Chung Man
Paula, Daniel de
Rech, Daniel
Gradia, Daniela Fiori
Malheiros, Danielle
Venturini, Danielle
Tavares, Eliandro Reis
Carraro, Emerson
Ribeiro, Enilze Maria de Souza Fonseca
Pereira, Evani Marques
Tuon, Felipe Francisco
Follador, Franciele Aní Caovilla
Fernandes, Glaura Scantamburlo Alves
Volpato, Hélito
Cólus, Ilce Mara de Syllos
Oliveira, Jaqueline Carvalho de
Rodrigues, Jean Henrique da Silva
Santos, Jean Leandro dos
Visentainer, Jeane Eliete Laguila
Brandi, Juliana Cristina
Serpeloni, Juliana Mara
Bonini, Juliana Sartori
Oliveira, Karen Brajão de
Fiorentin, Karine
Lucio, Léia Carolina
Faccin-Galhardi, Ligia Carla
Ferreto, Lirane Elize Defante
Lioni, Lucy Megumi Yamauchi
Consolaro, Marcia Edilaine Lopes
Vicari, Marcelo Ricardo
Arbex, Marcos Abdo
Pileggi, Marcos
Watanabe, Maria Angelica Ehara
Costa, Maria Antônia Ramos
Giannini, Maria José S. Mendes
Amarante, Marla Karine
Khalil, Najeh Maissar
Lima Neto, Quirino Alves de
Herai, Roberto H.
Guembarovski, Roberta Losi
Shinsato, Rogério N.
Mainardes, Rubiana Mara
Giuliatti, Silvana
Yamada-Ogatta, Sueli Fumie
Gerber, Viviane Knuppel de Quadros
Pavanelli, Wander Rogério
Silva, Weber Claudio da
Petzl-Erler, Maria Luiza
Valente, Valeria
Soares, Christiane Pienna
Cavalli, Luciane Regina
Silva Jr, Wilson Araujo











Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.
10.
COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro
; Uchôa, Caroline Louise Mesquita
; Mazzoco, Marina Flaborea
; Cruz, Isabella D'Andrea Garcia da
; Echegaray, Mariana V.F.
; Humes, Eduardo de Castro
; Silveira, Júlia Belizário
; Santi, Talita Di
; Miguel, Euripedes Constantino
; Corchs, Felipe
; Fatori, Daniel
Campello, Guilherme
Oliveira, Gabriel M. de
Argolo, Felipe C.
Ferreira, Felipe de M.
Machado, Gustavo
Argeu, Adriana
Oliveira, Graça Maria Ramos de
Serafim, Antônio de Pádua
Siqueira, Luciana de Lima
Rossi, Luciane de
Rios, Izabel Cristina
Oliveira, Talita Rodrigues de
Antoniazzi, Leilane C. K.
Gagliotti, Daniel Augusto Mori
Abelama Neto, Emílio
Oliveira Junior, Paulo Novais de
Correia, Aline Villalobo
Gonçalves, Luca Schilling
Tortato, Liana Silva
Busato, Wagner Machado Moraes
Guimarães-Fernandes, Flávio
Alves, Marcos
Leite Netto, Oswaldo Ferreira
Schoueri, Patrícia de Campos Lindenberg
Roque, Márcio de Assis
Merlin, Silvia Stahl
Boer, Giovana Cardoso Machado
Sallet, Paulo Clemente
Malbergier, André
Spedo, Mariana Abrahão
Kamitsuji, Carla Satie
Faria, Elizabeth de
Moreira, Moacyr Vergara de Godoy
Kaufman, Arthur
Abdo, Carmita
Scanavino, Marco de Tubino
Lancman, Selma
Tavares, Hermano
Polanczyk, Guilherme
Brunoni, André R.
Forlenza, Orestes V.
Barros-Filho, Tarcísio Eloy Pessoa de










OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.
11.
Uncommon oral manifestations of dengue viral infection
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https://doi.org/10.1016/j.bjorl.2016.10.001
687 downloads
12.
Survey on connectivity and cloud computing technologies: State-of-the-art applied to Agriculture 4.0
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Simionato, Rafael
; Torres Neto, José Rodrigues
; Santos, Carla Julciane dos
; Ribeiro, Bruno Silva
; Araújo, Fernando Cesar Britto de
; Paula, Antonio Robson de
; Oliveira, Pedro Augusto de Lima
; Fernandes, Paulo Silas
; Yi, Jin Hong
.









RESUMO Nos últimos anos, a agricultura tem enfrentado muitos desafios, desde uma crescente população global a ser alimentada, a evasão da força de trabalho no setor, até requisitos de sustentabilidade e restrições ambientais. Para satisfazer as partes interessadas cada vez mais exigentes, o setor agrícola tem procurado novas formas de lidar com essas questões. Nesse contexto, as Tecnologias da Informação e Comunicação (TICs) têm sido aplicadas para ajudar o setor agrícola a superar esses desafios. Este artigo investiga como duas TICs - conectividade e computação em nuvem - podem alavancar e explorar outras TICs, como Internet das Coisas e inteligência artificial, permitindo que todo o setor produtivo seja apoiado por sistemas de tomada de decisão, que por sua vez são baseados em modelos orientados por dados. Além disso, é apresentado um estudo de caso de sucesso sobre como a computação em nuvem ajudou um dos maiores clientes da SiDi - uma empresa global - a melhorar seu desempenho operacional ao obter insights a partir de seus dados.
ABSTRACT In recent years, agriculture has faced many challenges, from a growing global population to be fed, the work power evasion in the sector, to sustainability requirements and environmental constraints. To satisfy the increasingly demanding stakeholders, the agricultural sector has looked for new ways to tackle these issues. In this context, Information and Communications Technologies (ICTs) have been applied to help the agricultural sector overcome these challenges. This article investigates how two ICTs - connectivity and cloud computing - can leverage and traverse other ICTs, such as Internet of Things and artificial intelligence, enabling the entire productive sector to be supported by decision-making systems, which in turn are based on data-driven models. Moreover, a successful case study on how cloud computing has helped one of SiDi’s biggest customers - a global company - improve its operational performance by obtaining insights from its data is presented.
https://doi.org/10.5935/1806-6690.20200085
101 downloads
13.
Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach
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Ribeiro, Sabrina Varão Oliveira
; Batista, Rosângela Fernandes Lucena
; Ribeiro, Marizélia Rodrigues Costa
; Pessoa, Kivania Carla
; Simões, Vanda Maria Ferreira
; Figueiredo, Felipe Pinheiro de
; Bettiol, Heloisa
.







Revista Brasileira de Saúde Materno Infantil
- Journal Metrics
Resumo Objetivos: analisar associações entre violência contra gestantes, sintomas de depressão na gestação e sintomas de depressão materna. Métodos: estudo em uma coorte de pré-natal no município de São Luís (Brasil) com amostra de 1.139 mães. Violência psicológica e violência física contra gestantes foram medidas pelo instrumento World Health Organization Violence against woman. Sintomas de depressão na gestação foram medidos pela Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) e sintomas de depressão materna foram medidos pela Escala de Depressão materna de Edimburgo (EPDS). O modelo conceitual, por modelagem de equações estruturais, teve situação socioeconômica, suporte social, violência psicológica, física e depressão na gestação como determinantes de sintomas de depressão materna. Resultados: Sintomas de depressão materna foram relatados por gestantes que mais frequentemente sofreram violência psicológica (Coeficiente Padronizado, CP=0.256; p-valor, p<0.001), violência física (CP=0.221 p<0.001) e apresentavam sintomas de depressão na gestação (CP=0.322 p<0.001). Sintomas de depressão na gestação mediaram efeitos das violências física e psicológica na depressão materna. Conclusões: gestantes submetidas à violência psicológica e física e que apresentaram sintomas de depressão na gestação relataram com mais frequência sintomas de depressão materna.
Abstract Objectives: to analyze associations among violence against pregnant women, depressive symptoms during pregnancy and maternal depression symptoms. Methods: a sample of 1,139 mothers was conducted on a prenatal cohort study in the municipality of São Luís in Brazil. Psychological and physical violence against pregnant women were measured by the World Health Organization Violence Against Woman. Depressive symptoms during pregnancy were measured by the Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) (Depression Scale for Epidemiological Studies Center) and maternal depression symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS). The conceptual model of the structural equation modeling contained socioeconomic situation, social support, psychological and physical violence and depression during pregnancy as determinants of the maternal depression symptoms. Results: maternal depression symptoms were more frequently reported by pregnant women who suffered psychological violence (Standardized Coefficient, SC=0.256; p-value, p<0.001), physical violence (SC=0.221 p<0.001) and those who presented depressive symptoms during pregnancy SC=0.322, p<0.001). Depressive symptoms during pregnancy mediated the effects on physical and psychological violence on maternal depression. Conclusions: pregnant women who were submitted to psychological and physical violence and presented depressive symptoms during pregnancy frequently reported more of having maternal depression symptoms.
https://doi.org/10.1590/1806-93042019000100010
2070 downloads
14.
Outcomes of the Conversion of the Fontan-Kreutzer Operation to a Total Cavopulmonary Connection for the Failing Univentricular Circulation
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Fernandes, Gabriel Carmona
; Silva, Guilherme Viotto Rodrigues da
Caneo, Luiz Fernando
Tanamati, Carla
Turquetto, Aida Luiza Ribeiro
Jatene, Marcelo Biscegli

Resumo Fundamento: O procedimento de Fontan-Kreutzer (FK) foi amplamente realizado no passado, mas a longo prazo gerou muitas complicações, resultando em falha na circulação univentricular. A conversão para conexão cavopulmonar total (CCPT) é uma das opções de tratamento. Objetivo: Avaliar os resultados da conversão de FK para CCPT. Métodos: Revisão retrospectiva de prontuários de pacientes submetidos à conversão de FK para CCPT no período de 1985 a 2016. Significância p < 0,05. Resultados: Operações do tipo Fontan foram realizadas em 420 pacientes durante este período: CCPT foi realizada em 320, técnica de túnel lateral em 82 e FK em 18. Dez casos do grupo FK foram eleitos para conversão em CCPT. Todos os pacientes submetidos à conversão de Fontan foram incluídos neste estudo. Em nove pacientes, a indicação deveu-se a arritmia não controlada e em um devido à enteropatia perdedora de proteínas. A morte foi observada nos dois primeiros casos. O tempo médio de internação na unidade de terapia intensiva (UTI) foi de 13 dias e o tempo médio de internação hospitalar foi de 37 dias. Uma classe funcional pela melhora da New York Heart Association (NYHA) foi observada em 80% dos pacientes em NYHA I ou II. Cinquenta e sete por cento das conversões devido a arritmias tiveram melhora das arritmias; quatro casos foram curados. Conclusões: A conversão é um procedimento complexo e requer que um hospital terciário experiente seja realizado. A conversão melhorou a classe funcional da NYHA, apesar de uma resolução insatisfatória da arritmia.
Abstract Background: The Fontan-Kreutzer procedure (FK) was widely performed in the past, but in the long-term generated many complications resulting in univentricular circulation failure. The conversion to total cavopulmonary connection (TCPC) is one of the options for treatment. Objective: To evaluate the results of conversion from FK to TCPC. Methods: A retrospective review of medical records for patients who underwent the conversion of FK to TCPC in the period of 1985 to 2016. Significance p < 0,05. Results: Fontan-type operations were performed in 420 patients during this period: TCPC was performed in 320, lateral tunnel technique in 82, and FK in 18. Ten cases from the FK group were elected to conversion to TCPC. All patients submitted to Fontan Conversion were included in this study. In nine patients the indication was due to uncontrolled arrhythmia and in one, due to protein-losing enteropathy. Death was observed in the first two cases. The average intensive care unit (ICU) length of stay (LOS) was 13 days, and the average hospital LOS was 37 days. A functional class by New York Heart Association (NYHA) improvement was observed in 80% of the patients in NYHA I or II. Fifty-seven percent of conversions due to arrhythmias had improvement of arrhythmias; four cases are cured. Conclusions: The conversion is a complex procedure and requires an experienced tertiary hospital to be performed. The conversion has improved the NYHA functional class despite an unsatisfactory resolution of the arrhythmia.
https://doi.org/10.5935/abc.20180256
3772 downloads
15.
CONHECIMENTO DOS PROFISSIONAIS DE ENFERMAGEM SOBRE DERMATITE ASSOCIADA A INCONTINÊNCIA E LESÃO POR PRESSÃO
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Alcoforado, Carla Lucia Goulart Constant
; Lopes, Fabiana Onesio
; Fernandes, Raquel de Araújo
; Carvalho, Rafael Lima Rodrigues de
; Guillen, Mariana Raquel Soares
; Ercole, Flavia Falci
; Chianca, Tânia Couto Machado
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ABSTRACT Incontinence-associated dermatitis (IAD) and pressure injury (PI) are problems that affect the skin, especially in the case of hospitalized individuals in critical situations. These events may have a similar clinical presentation and it is essential that health professionals know how to differentiate them. This study aims to evaluate the knowledge of the nursing team about PI in stages 1 and 2 and of IAD regarding the concept, identification, prevention and treatment. This is a descriptive, exploratory, cross-sectional study with quantitative analysis performed with 76 nursing professionals. The data were collected in October 2017 and professionals were first approached to pass on information about the research and the questionnaire. The instrument was distributed to participants during working hours, and they filled it out and returned it to the researchers. The questionnaire applied had questions on definition, evaluation, prevention and treatment of IAD and PI. The study revealed that, with respect to skin changes caused by IAD and PI, the correct answers were more frequent in questions about IAD. Regarding evaluation, the rate of correct answers was close to the average (56.58%). In the prevention and treatment category, the highest percentage of correct answers was found in questions that referred to the importance of professional qualification and direct care measures to patients. The study led to the conclusion that, among the skin conditions IAD and PI in early stages, the professionals showed less knowledge about the latter.
RESUMEN La dermatitis asociada a la incontinencia (DAI) y lesión por presión (LP) afectan la piel, principalmente de pacientes hospitalizados en situación crítica. La presentación clínica de ambos trastornos es parecida y por ello es imprescindible que los profesionales de salud sepan distinguirlos. El presente estudio busca evaluar el conocimiento del equipo de enfermería en LP en las etapas 1 y 2 y en concepto, identificación, prevención y tratamiento de DAI. Investigación descriptiva, exploratoria, transversal con análisis cuantitativa, llevada a cabo con 76 profesionales de enfermería. La recogida de datos se realizó en octubre de 2017; antes se les informó a los profesionales sobre la investigación y el cuestionario. Durante el horario de trabajo, los participantes recibieron un cuestionario con preguntas sobre definición, evaluación, y prevención y tratamiento de DAI y LP, que completaron y devolvieron a los investigadores. A través de la prueba de conocimiento, el estudio reveló que, en los trastornos cutáneas de DAI y LP, había más respuestas correctas referentes a DAI. En la categoría evaluación, el índice de respuestas correctas fue equilibrado (56%). En prevención y tratamiento, el mayor porcentaje de respuestas correctas era sobre la importancia de la capacitación profesional y medidas de cuidados directos al paciente. Se concluye que, entre los trastornos de la piel DAI y LP en las primeras etapas, los profesionales demuestran tener menos conocimiento en LP.
RESUMO A dermatite associada a incontinência (DAI) e lesão por pressão (LP) é dano que acomete a pele, principalmente de indivíduos hospitalizados em situações críticas. Esses eventos podem ter apresentação clínica semelhante, sendo fundamental que os profissionais de saúde saibam diferenciá-los. Este estudo visa avaliar o conhecimento da equipe de Enfermagem quanto à LP nos estágios 1 e 2 e da DAI em relação ao conceito, identificação, prevenção e tratamento. É pesquisa descritiva exploratória, transversal, com análise quantitativa, realizada com 76 profissionais de Enfermagem. Os dados foram coletados no mês de outubro de 2017 e foi realizada abordagem prévia com os profissionais para informá-los sobre a pesquisa e o questionário. O instrumento foi distribuído aos participantes durante o horário de trabalho, e estes o preencheram e retornaram aos pesquisadores. Foi aplicado questionário com questões sobre definição, avaliação e prevenção e tratamento da DAI e LP. O estudo revelou no teste de conhecimento que, entre as alterações cutâneas de DAI e LP, os acertos foram maiores naquelas questões sobre a DAI. Em relação à categoria avaliação, o índice de acertos foi próximo do médio (56,58%). Na categoria prevenção e tratamento, o maior percentual de acertos foi entre questões que envolviam a importância da capacitação dos profissionais e medidas de cuidados diretos ao paciente. Concluiu-se que, entre as afecções cutâneas DAI e LP nos estágios iniciais, os profissionais demonstraram menos conhecimento sobre a LP.
https://doi.org/10.5935/1415-2762.20190014
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