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1.
Carcass characteristics and pork quality of pigs fed diets containing crude glycerin and ractopamine
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BARROS, Imara Guimarães Lima
; GARBOSSA, Cesar Augusto Pospissil
; ALBUQUERQUE, Tatiane Mendonça Nogueira Carneiro de
; COUTO, Claudiana Esteves
; SILVA JUNIOR, Sudário Roberto
; PINTO, Adriana Brasil Ferreira
; FARIA, Peter Bitencourt
; NAVES, Luciana de Paula
.








Abstract An experiment was conducted to evaluate the effects of increasing concentrations of crude glycerin, with or without ractopamine, in the diet of finishing barrows on carcass characteristics and pork quality. The experimental design was a randomized complete block, in a 4 x 2 factorial scheme, with four concentrations of crude glycerin (0, 100, 150, or 200 g/kg) and two concentrations of ractopamine (0 or 10 mg/kg). There was no interaction between the crude glycerin concentrations and the ractopamine use as well as there was no isolated effect of the dietary crude glycerin concentration for all the evaluated traits. However, the dietary ractopamine increased the hot (p = 0.021) and cold (p=0.020) carcass weight, the hot carcass yield (p = 0.038), the shear force (p = < 0.0001), lightness (L* index) (p = 0.043), hue angle (h*) (p = 0.026), and C16:1 (p = 0.023) concentration in the loin. Moreover, the dietary ractopamine decreased the red content (a* value) (p = 0.043), the activity of C16-C18 elongase (p = 0.037) and the C18:0 (p = 0.021) concentration in the loin. The inclusion of up to 200 g/kg crude glycerin in the diet of finishing pigs may be used as a partial substitute for dietary corn, combined or not with 10 mg/kg ractopamine, without impair the evaluated carcass characteristics and the quality of the loin.
2.
Carcass characteristics and pork quality of pigs fed diets containing crude glycerin and ractopamine
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BARROS, Imara Guimarães Lima
; GARBOSSA, Cesar Augusto Pospissil
; ALBUQUERQUE, Tatiane Mendonça Nogueira Carneiro de
; COUTO, Claudiana Esteves
; SILVA JUNIOR, Sudário Roberto
; PINTO, Adriana Brasil Ferreira
; FARIA, Peter Bitencourt
; NAVES, Luciana de Paula
.








Abstract An experiment was conducted to evaluate the effects of increasing concentrations of crude glycerin, with or without ractopamine, in the diet of finishing barrows on carcass characteristics and pork quality. The experimental design was a randomized complete block, in a 4 x 2 factorial scheme, with four concentrations of crude glycerin (0, 100, 150, or 200 g/kg) and two concentrations of ractopamine (0 or 10 mg/kg). There was no interaction between the crude glycerin concentrations and the ractopamine use as well as there was no isolated effect of the dietary crude glycerin concentration for all the evaluated traits. However, the dietary ractopamine increased the hot (p = 0.021) and cold (p=0.020) carcass weight, the hot carcass yield (p = 0.038), the shear force (p = < 0.0001), lightness (L* index) (p = 0.043), hue angle (h*) (p = 0.026), and C16:1 (p = 0.023) concentration in the loin. Moreover, the dietary ractopamine decreased the red content (a* value) (p = 0.043), the activity of C16-C18 elongase (p = 0.037) and the C18:0 (p = 0.021) concentration in the loin. The inclusion of up to 200 g/kg crude glycerin in the diet of finishing pigs may be used as a partial substitute for dietary corn, combined or not with 10 mg/kg ractopamine, without impair the evaluated carcass characteristics and the quality of the loin.
3.
Ediacaran-Cambrian microbialites of the Southern Amazon Craton: relation with the metazoan rise, sea-level changes, and global tectonics
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Nogueira, Afonso César Rodrigues
; Santos, Renan Fernandes dos
; Romero, Guilherme Raffaeli
; Bandeira, José
; Riccomini, Claudio
; Barrera, Ivan Alfredo Romero
; Silva, Pedro Augusto Santos da
; Soares, Joelson Lima
; Fairchild, Thomas
; Nogueira, Anna Andressa Evangelista
; Góes, Ana Maria
; Oliveira, Rick Souza de
; Medeiros, Renato Sol Paiva de
; Andrade, Luiz Saturnino de
; Brito, Ailton da Silva
; Oliveira, Pedro Guilherme Assunção
; Sodré, Argel de Assis Nunes
; Carvalho, Davi Ferreira de
; Truckenbrodt, Werner
.



















Abstract Microbialites are the most abundant life evidence in Precambrian sedimentary rocks. They are produced by microbial interaction activity and sedimentary processes reflecting paleoenvironmental conditions. The Ediacaran-Cambrian carbonate and siliciclastic successions in the Southern Amazon Craton in Central Brazil, provide a key opportunity to understand how the metazoan life coexisted with the microbial communities. The spatial and temporal distribution of microbialites as well as morphological and paleoenvironmental changes have been assessed, reinterpreting previous works and including new data from the Araras-Alto Paraguai and Corumbá basins. The deposition was controlled by subsidence and sea-level changes that affected these basins, considered extensions of epicontinental seas during the Gondwana assembly. The stromatolites are restricted to coastal deposits and experienced thriving flourishment intervals after the Marinoan Glaciation (635 Ma). Post-glacial transgression was marked by microbial colonization in shallow platforms represented by stratiform and giant domical stromatolites in the Araras-Alto Paraguai Basin. The continuity of the transgression generated a moderately deep aragonite sea at about 622 Ma. A progressive sea-level fall caused the implantation of coastal environments under greenhouse conditions with tidal flat and sabkha settings colonized by centimetric-scale stromatolites. The sea retreat was accompanied by progressive uplift, causing a moderate inversion of the basin and erosion of the succession until ~560 Ma with the deposition of the last preserved tidal flat deposits with the occurrence of thrombolites. The subsiding Corumbá Basin was the site of microbially-induced deposition of carbonates in a shallow platform connected to an offshore setting with the proliferation of metazoan straddling the Ediacaran-Cambrian boundary. Microbial communities were restricted to lagoon deposits during the Lower Cambrian transgression in the Araras-Alto Paraguai Basin and the last phase refers to the sea retreat towards southeast, developing a fluvial system connected with the arid and evaporitic tidal flats colonized by microbialites that lasted until the upper Cambrian. Except for the post-glacial stromatolites, the columnar and domal microbialite indicate that the coastal settings dominated the Ediacaran-Cambrian transition. The preservation of microbialites in the post-glacial intervals can be associated with the Mg-Ca-CO3 oversaturation in dolomitic platforms. The rapid calcification and ability to resist the dissolution and replacement have increased the stromatolites’ preservation potential reported here, where its well-preserved occurrence in tidal flats and sabkha occurs due to intense early diagenetic silicification. The change from carbonate accumulation to siliciclastic-rich environments contributed to the demise of microbially-induced strata. In general, the scarce coexistence between coastal stromatolite and metazoan-bearing marine deposits makes it challenging to establish a competitive relationship between these organisms, as previously postulated.
4.
Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
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Becker, Jefferson
; Ferreira, Lis Campos
; Damasceno, Alfredo
; Bichuetti, Denis Bernardi
; Christo, Paulo Pereira
; Callegaro, Dagoberto
; Peixoto, Marco Aurélio Lana
; Sousa, Nise Alessandra De Carvalho
; Almeida, Sérgio Monteiro De
; Adoni, Tarso
; Santiago-Amaral, Juliana
; Junqueira, Thiago
; Pereira, Samira Luisa Apóstolos
; Gomes, Ana Beatriz Ayroza Galvão Ribeiro
; Pitombeira, Milena
; Paolilo, Renata Barbosa
; Grzesiuk, Anderson Kuntz
; Piccolo, Ana Claudia
; D´Almeida, José Arthur Costa
; Gomes Neto, Antonio Pereira
; Oliveira, Augusto Cesar Penalva De
; Oliveira, Bianca Santos De
; Tauil, Carlos Bernardo
; Vasconcelos, Claudia Ferreira
; Kaimen-Maciel, Damacio
; Varela, Daniel
; Diniz, Denise Sisterolli
; Oliveira, Enedina Maria Lobato De
; Malfetano, Fabiola Rachid
; Borges, Fernando Elias
; Figueira, Fernando Faria Andrade
; Gondim, Francisco De Assis Aquino
; Passos, Giordani Rodrigues Dos
; Silva, Guilherme Diogo
; Olival, Guilherme Sciascia Do
; Santos, Gutemberg Augusto Cruz Dos
; Ruocco, Heloisa Helena
; Sato, Henry Koiti
; Soares Neto, Herval Ribeiro
; Cortoni Calia, Leandro
; Gonçalves, Marcus Vinícius Magno
; Vecino, Maria Cecilia Aragón De
; Pimentel, Maria Lucia Vellutini
; Ribeiro, Marlise De Castro
; Boaventura, Mateus
; Parolin, Mônica Koncke Fiuza
; Melo, Renata Brant De Souza
; Lázaro, Robson
; Thomaz, Rodrigo Barbosa
; Kleinpaul, Rodrigo
; Dias, Ronaldo Maciel
; Gomes, Sidney
; Lucatto, Simone Abrante
; Alves-Leon, Soniza Vieira
; Fukuda, Thiago
; Ribeiro, Taysa Alexandrino Gonsalves Jubé
; Winckler, Thereza Cristina D’ávila
; Fragoso, Yara Dadalti
; Nascimento, Osvaldo José Moreira Do
; Ferreira, Maria Lucia Brito
; Mendes, Maria Fernanda
; Brum, Doralina Guimarães
; Glehn, Felipe Von
.































































ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.
RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.
5.
Metabolic assessment in pure struvite stones formers: is it necessary?
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Danilovic, Alexandre
; Ferreira, Thiago Augusto Cunha
; Gomes, Samirah Abreu
; Wei, Isabela Akemi
; Vicentini, Fabio Carvalho
; Torricelli, Fabio Cesar Miranda
; Marchini, Giovanni Scala
; Mazzucchi, Eduardo
; Srougi, Miguel
; Nahas, William Carlos
.










Abstract Background and objective: Magnesium ammonium phosphate stones (MAP), also known as struvite stones, are associated with urinary infection and impairment of renal unit. The aim of this study is to evaluate the urinary metabolic risk factors for recurrence of renal calculi in patients submitted to nephrectomy due to MAP stones. Methods: We retrospectively reviewed the charts of patients > 18 years old submitted to total nephrectomy due to pure MAP stones and pure calcium oxalate (CaOx) stones from July 2006 to July 2016. Urinary metabolic parameters were assessed through 24-hour urine exams ≥ 3 months after nephrectomy. Urinary metabolic parameters and new event related to lithiasis were compared. Results: Twenty-eight and 39 patients were included in MAP and CaOx group, respectively. Abnormalities in 24-hour urine samples were similar between groups. Hypercalciuria occurred in 7.1 and 10.3% of patients in MAP and CaOx group, respectively (p = 0.66), whereas hypocitraturia was present in 65.2 and 59.0% of patients with MAP and CaOx group, respectively (p = 0.41). No significant difference in new events was found between MAP and CaOx groups (17.9 vs. 23.1%, respectively; p = 0.60). Conclusion: A 24-hour urine evaluation should be offered to patients submitted to nephrectomy due to pure MAP stones in order to detect metabolic risk, improve treatment, and prevent stone recurrence.
Resumo Contexto e objetivo: Cálculos de fosfato de amônio e magnésio (FAM), também conhecidos como cálculos de estruvita, estão associados à infecção urinária e ao comprometimento da unidade renal. O objetivo deste estudo é avaliar os fatores de risco metabólico-urinários para recorrência de cálculos renais em pacientes submetidos à nefrectomia devido a cálculo de FAM. Métodos: Revisamos retrospectivamente os prontuários de pacientes > 18 anos submetidos à nefrectomia total devido a cálculos de FAM puro e cálculos de oxalato de cálcio puro (OxCa) de julho de 2006 a julho de 2016. Os parâmetros metabólicos urinários foram avaliados através de exames de urina de 24 horas ≥ 3 meses após a nefrectomia. Os parâmetros metabólicos urinários e um novo evento relacionado à litíase foram comparados. Resultados: Vinte e oito e 39 pacientes foram incluídos nos grupos FAM e OxCa, respectivamente. As anormalidades em amostras de urina de 24 horas foram similares entre os grupos. A hipercalciúria ocorreu em 7,1 e 10,3% dos pacientes nos grupos FAM e OxCa, respectivamente (p = 0,66), enquanto a hipocitratúria esteve presente em 65,2 e 59,0% dos pacientes nos grupos FAM e OxCa, respectivamente (p = 0,41). Nenhuma diferença significativa em novos eventos foi encontrada entre os grupos FAM e OxCa (17,9 vs. 23,1%, respectivamente; p = 0,60). Conclusão: Uma avaliação de urina de 24 horas deve ser oferecida aos pacientes submetidos à nefrectomia devido a cálculos de FAM puro, a fim de detectar risco metabólico, melhorar o tratamento e prevenir a recorrência de cálculos.
6.
Geophysical-Structural Framework in a Mineralized Region of Northwesternmost Camaquã Basin, Southern Brazil
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Pereira, Henrique Garcia
; Ferreira, Francisco José Fonseca
; Moreira, César Augusto
; Silva, Vinicius Antunes Ferreira da
.




Abstract Airborne and ground magnetic and gravimetric maps provide important information about the spatial distribution of causative sources in the geological substrate. These sources normally have different physical properties and geometric shapes and are located at different depths, making it difficult to identify the geological features that correspond to the sources. Filtering and enhancement techniques can be used to highlight features in potential field anomalies (such as center and edges of sources). Also, these techniques remove associated noise, isolate shallow from deep sources, and estimate depths. We applied enhancement and depth estimation techniques in airborne and ground potential field data to delineate a subsurface structural framework of two copper occurrences (Victor Teixeira and Capão Grande) in the northwestern border of Camaquã Basin with the Sul-Riograndense Shield. Our results confirmed previously recognized structures and revealed an interconnected structural framework, which has an estimated depth of 170 m by Euler solutions. This configuration suggests a possible connection between the two mineralization outcrops, which are separated by a distance of 2,300 m.
Resumen Los mapas magnéticos y gravimétricos (aéreos y/o terrestres) suministran información importante sobre la distribución espacial de las fuentes del sustrato geológico, las cuales normalmente tienen propiedades físicas y geometrías diferentes. Estas fuentes también pueden estar localizadas a distintas profundidades, complicando la identificación de las correspondientes estructuras geológicas. Técnicas de filtrado y de realce de anomalías potenciales, pueden ser utilizadas para realzar ciertas características de interés (como el centro y el borde de las fuentes), para remover aquellas características asociadas a ruidos, para separar las anomalías de las fuentes superficiales y profundas, así como estimar sus profundidades. En este trabajo se analizan los resultados de la utilización de técnicas de realce y estimación de profundidad de las fuentes con datos geofísicos aéreos y terrestres potenciales, con el objetivo de delinear una imagen estructural del subsuelo en un área con dos ocurrencias de cobre en el límite noroeste, entre las rocas del Escudo Sul-Riograndense y la Cuenca del Camaquã. Los resultados confirman estructuras que han sido reconocidas previamente y revelan otras estructuras geológicas que integran una malla estructural interconectada, cuya profundidad, estimada por las soluciones de Euler, alcanzan los 170 m. Esta configuración sugiere una probable conexión entre las mineralizaciones de cobre observadas en los afloramientos, separados por un intervalo de 2,300 m.
7.
Arteriopathy in pediatric stroke: an underestimated clinical entity
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PIZZATTO, Ronaldo
; RESENDE, Lucas Lopes
; LOBO, Carlos Felipe Teixeira
; NEVES, Yuri Costa Sarno
; PAZ, José Albino da
; ALVES, César Augusto Pinheiro Ferreira
; LEITE, Claudia da Costa
; LUCATO, Leandro Tavares
.








ABSTRACT Background: Pediatric arterial ischemic stroke (AIS), which was thought to be a rare disorder, is being increasingly recognized as an important cause of neurological morbidity, thanks to new advances in neuroimaging. Objective: The aim of this study was to review the main etiologies of stroke due to arteriopathy in children. Methods: Using a series of cases from our institution, we addressed its epidemiological aspects, physiopathology, imaging findings from CT, MR angiography, MR conventional sequences and MR DWI, and nuclear medicine findings. Results: Through discussion of the most recent classification for childhood AIS (Childhood AIS Standardized Classification and Diagnostic Evaluation, CASCADE), we propose a modified classification based on the anatomical site of disease, which includes vasculitis, varicella, arterial dissection, moyamoya, fibromuscular dysplasia, Takayasu's arteritis and genetic causes (such as ACTA-2 mutation, PHACE syndrome and ADA-2 deficiency). We have detailed each of these separately. Conclusions: Prompt recognition of AIS and thorough investigation for potential risk factors are crucial for a better outcome. In this scenario, neurovascular imaging plays an important role in diagnosing AIS and identifying children at high risk of recurrent stroke.
RESUMO Introdução: O acidente vascular cerebral (AVC) pediátrico, considerado um distúrbio raro, está sendo cada vez mais reconhecido como importante causa de morbidade neurológica, graças aos novos avanços na neuroimagem. Objetivo: Revisar as principais etiologias do AVC por arteriopatia em crianças. Métodos: Utilizando-se de uma série de casos de nossa instituição, abordamos seus aspectos epidemiológicos, fisiopatológicos e de imagem na angiotomografia computadorizada e angiorressonância magnética, sequências convencionais e avançadas de ressonância magnética e medicina nuclear. Resultados: Com base na classificação mais recente de AVC na infância (Classificação Padronizada e Avaliação Diagnóstica do AVC na Infância - CASCADE) propusemos uma classificação modificada com base no local anatômico da doença, que inclui vasculite, varicela, dissecção arterial, Moyamoya, displasia fibromuscular, arterite de Takayasu e causas genéticas (como mutação ACTA-2, síndrome PHACE e deficiência de ADA-2), detalhando cada uma separadamente. Conclusões: O reconhecimento imediato do AVC na infância e a investigação minuciosa de possíveis fatores de risco são cruciais para um melhor resultado. Nesse cenário, a imagem neurovascular desempenha papel importante no diagnóstico de AVC e na identificação de crianças com alto risco de recorrência.
8.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.









































































































































































































Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
9.
Predicting the potential distribution of aquatic herbaceous plants in oligotrophic Central Amazonian wetland ecosystems
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Lopes, Aline
; Demarchi, Layon Oreste
; Franco, Augusto Cesar
; Ferreira, Aurélia Bentes
; Ferreira, Cristiane Silva
; Wittmann, Florian
; Santiago, Ivone Neri
; Cruz, Jefferson da
; Silva, Jeisiane Santos da
; Schöngart, Jochen
; Souza, Sthefanie do Nascimento Gomes de
; Piedade, Maria Teresa Fernandez
.












ABSTRACT Aquatic herbaceous plants are especially suitable for mapping environmental variability in wetlands, as they respond quickly to environmental gradients and are good indicators of habitat preference. We describe the composition of herbaceous species in two oligotrophic wetland ecosystems, floodplains along black-water rivers (igapó) and wetlands upon hydromorphic sand soils (campinarana) in the Parque Nacional do Jaú and the Reserva de Desenvolvimento Sustentável Uatumã in Central Amazonia, both protected areas. We tested for the potential distribution range (PDR) of the most frequent species of these ecosystems, which are the ones that occurred in at least two of the sampled wetlands, using species distribution models (SDMs). In total, 98 aquatic herbaceous species were recorded, of which 63 occurred in igapós and 44 in campinaranas. Most igapó species had ample PDRs across the Neotropics, while most campinarana species were restricted to the Amazon Basin. These results are congruent with studies that described similar distribution patterns for tree and bird species, which emphasizes a high degree of endemism in Amazonian campinaranas. However, we also found differences in the potential distribution of species between the two protected areas, indicating high environmental variability of oligotrophic ecosystems that deserve further investigation to develop effective measures for their conservation and protection.
10.
Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba
; Rodrigues, Cibele Isaac Saad
; Bortolotto, Luiz Aparecido
; Mota-Gomes, Marco Antônio
; Brandão, Andréa Araujo
; Feitosa, Audes Diógenes de Magalhães
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Amodeo, Celso
; Mion Júnior, Décio
; Barbosa, Eduardo Costa Duarte
; Nobre, Fernando
; Guimarães, Isabel Cristina Britto
; Vilela-Martin, José Fernando
; Yugar-Toledo, Juan Carlos
; Magalhães, Maria Eliane Campos
; Neves, Mário Fritsch Toros
; Jardim, Paulo César Brandão Veiga
; Miranda, Roberto Dischinger
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C
; Alessi, Alexandre
; Lucena, Alexandre Jorge Gomes de
; Avezum, Alvaro
; Sousa, Ana Luiza Lima
; Pio-Abreu, Andrea
; Sposito, Andrei Carvalho
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Nogueira, Armando da Rocha
; Dinamarco, Nelson
; Eibel, Bruna
; Forjaz, Cláudia Lúcia de Moraes
; Zanini, Claudia Regina de Oliveira
; Souza, Cristiane Bueno de
; Souza, Dilma do Socorro Moraes de
; Nilson, Eduardo Augusto Fernandes
; Costa, Elisa Franco de Assis
; Freitas, Elizabete Viana de
; Duarte, Elizabeth da Rosa
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Cesarino, Evandro José
; Marques, Fabiana
; Argenta, Fábio
; Consolim-Colombo, Fernanda Marciano
; Baptista, Fernanda Spadotto
; Almeida, Fernando Antonio de
; Borelli, Flávio Antonio de Oliveira
; Fuchs, Flávio Danni
; Plavnik, Frida Liane
; Salles, Gil Fernando
; Feitosa, Gilson Soares
; Silva, Giovanio Vieira da
; Guerra, Grazia Maria
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Back, Isabela de Carlos
; Oliveira Filho, João Bosco de
; Gemelli, João Roberto
; Mill, José Geraldo
; Ribeiro, José Marcio
; Lotaif, Leda A. Daud
; Costa, Lilian Soares da
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano Ferreira
; Martin, Luis Cuadrado
; Scala, Luiz César Nazário
; Almeida, Madson Q.
; Gowdak, Marcia Maria Godoy
; Klein, Marcia Regina Simas Torres
; Malachias, Marcus Vinícius Bolívar
; Kuschnir, Maria Cristina Caetano
; Pinheiro, Maria Eliete
; Borba, Mario Henrique Elesbão de
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Coelho, Otavio Rizzi
; Vitorino, Priscila Valverde de Oliveira
; Ribeiro Junior, Renault Mattos
; Esporcatte, Roberto
; Franco, Roberto
; Pedrosa, Rodrigo
; Mulinari, Rogerio Andrade
; Paula, Rogério Baumgratz de
; Okawa, Rogério Toshiro Passos
; Rosa, Ronaldo Fernandes
; Amaral, Sandra Lia do
; Ferreira-Filho, Sebastião R.
; Kaiser, Sergio Emanuel
; Jardim, Thiago de Souza Veiga
; Guimarães, Vanildo
; Koch, Vera H.
; Oigman, Wille
; Nadruz, Wilson
.

































































































11.
Diretrizes brasileiras para o manejo de potenciais doadores de órgãos em morte encefálica. Uma força-tarefa composta por Associação de Medicina Intensiva Brasileira, Associação Brasileira de Transplantes de Órgãos, Brazilian Research in Critical Care Network e Coordenação Geral do Sistema Nacional de Transplantes
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Westphal, Glauco Adrieno
; Robinson, Caroline Cabral
; Cavalcanti, Alexandre Biasi
; Gonçalves, Anderson Ricardo Roman
; Guterres, Cátia Moreira
; Teixeira, Cassiano
; Stein, Cinara
; Franke, Cristiano Augusto
; Silva, Daiana Barbosa da
; Pontes, Daniela Ferreira Salomão
; Nunes, Diego Silva Leite
; Abdala, Edson
; Dal-Pizzol, Felipe
; Bozza, Fernando Augusto
; Machado, Flávia Ribeiro
; Andrade, Joel de
; Cruz, Luciane Nascimento
; Azevedo, Luciano César Pontes
; Machado, Miriam Cristine Vahl
; Rosa, Regis Goulart
; Manfro, Roberto Ceratti
; Nothen, Rosana Reis
; Lobo, Suzana Margareth
; Rech, Tatiana Helena
; Lisboa, Thiago Costa
; Colpani, Verônica
; Falavigna, Maicon
.



























Abstract Objective: To contribute to updating the recommendations for brain-dead potential organ donor management. Methods: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, answered questions related to the following topics were divided into mechanical ventilation, hemodynamics, endocrine-metabolic management, infection, body temperature, blood transfusion, and checklists use. The outcomes considered were cardiac arrests, number of organs removed or transplanted as well as function / survival of transplanted organs. The quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system to classify the recommendations. Results: A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong, 11 as weak and 1 was considered a good clinical practice. Conclusion: Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak.
RESUMO Objetivo: Fornecer recomendações para nortear o manejo clínico do potencial doador em morte encefálica. Métodos: O presente documento foi formulado em dois painéis compostos por uma força tarefa integrada por 27 especialistas de diferentes áreas que responderam a questões dirigidas aos seguintes temas: ventilação mecânica, hemodinâmica, suporte endócrino-metabólico, infecção, temperatura corporal, transfusão sanguínea, e uso de checklists. Os desfechos considerados foram: parada cardíaca, número de órgãos retirados ou transplantados e função/sobrevida dos órgãos transplantados. A qualidade das evidências das recomendações foi avaliada pelo sistema Grading of Recommendations Assessment, Development, and Evaluation. Resultados: Foram geradas 19 recomendações a partir do painel de especialistas. Dessas, 7 foram classificadas como fortes, 11 fracas e uma foi considerada boa prática clínica. Conclusão: Apesar da concordância entre os membros do painel em relação à maior parte das recomendações, o grau de recomendação é fraco em sua maioria.
12.
Envelhecimento e dependência no Brasil: características sociodemográficas e assistenciais de idosos e cuidadores
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Ceccon, Roger Flores
; Vieira, Luiza Jane Eyre de Souza
; Brasil, Christina César Praça
; Soares, Konrad Gutterres
; Portes, Virgínia de Menezes
; Garcia Júnior, Carlos Alberto Severo
; Schneider, Ione Jayce Ceola
; Carioca, Antonio Augusto Ferreira
.








Abstract This paper aims to identify sociodemographic and care characteristics of dependent older adults, formal and family caregivers in municipalities from different Brazilian regions. A cross-sectional study was carried out with a sample of 175 people, of whom 64 were older adults, 27 formal caregivers, and 84 family caregivers. Semi-structured interviews were conducted with specific questions for each group on the theme of care and dependence. Most older adults were female, aged 80 years or older, with low education and have been dependent for four years or more. Older adults reported feelings of loneliness, pointed out difficulties in medical care, and 29% had only access to Primary Health Care actions. Inequalities, burden, illnesses, and social problems were found among family caregivers. Black females with no formal employment, little or no training for the function, and low remuneration predominated among formal caregivers, and care was associated with domestic chores. We can conclude that gender and race inequalities persist in the care of dependent older adults, and we observed that the rigid social roles assigned to men and women in Brazil persist in the family and work dynamics in caring for the dependent older adults.
Resumo O artigo tem como objetivo identificar características sociodemográficas e assistenciais de idosos dependentes, cuidadores formais e familiares em municípios de diferentes regiões brasileiras. Realizou-se um estudo transversal com amostra de 175 pessoas, sendo 64 idosos, 27 cuidadores formais e 84 cuidadores familiares. Foram realizadas entrevistas semiestruturadas, com questões específicas para cada grupo sobre a temática do cuidado e dependência. A maioria dos idosos era do sexo feminino, com idade igual ou maior a 80 anos, com baixa escolaridade e dependente há quatro anos ou mais. Os idosos relataram sentimentos de solidão, apontaram dificuldades na assistência médica e 29% tinham acesso apenas a ações da Atenção Primária à Saúde. Entre os cuidadores familiares, encontrou-se desigualdades, sobrecargas, adoecimentos e problemas sociais. Entre os formais predominou o sexo feminino, a raça negra, sem vínculo legal de trabalho, pouca ou nenhuma formação para a função e baixa remuneração; o cuidado associou-se aos afazeres domésticos. Conclui-se que perduram as desigualdades de gênero e raça no cuidado às pessoas idosas em situação de dependência. Observou-se também que a rigidez dos papeis sociais atribuídos a homens e mulheres no Brasil persistem nas dinâmicas familiares e laborais no cuidado ao idoso dependente.
13.
Metabolic assessment in pure struvite stones formers: is it necessary?
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Danilovic, Alexandre
; Ferreira, Thiago Augusto Cunha
; Gomes, Samirah Abreu
; Wei, Isabela Akemi
; Vicentini, Fabio Carvalho
; Torricelli, Fabio Cesar Miranda
; Marchini, Giovanni Scala
; Mazzucchi, Eduardo
; Srougi, Miguel
; Nahas, William Carlos
.










Resumo Contexto e objetivo: Cálculos de fosfato de amônio e magnésio (FAM), também conhecidos como cálculos de estruvita, estão associados à infecção urinária e ao comprometimento da unidade renal. O objetivo deste estudo é avaliar os fatores de risco metabólico-urinários para recorrência de cálculos renais em pacientes submetidos à nefrectomia devido a cálculo de FAM. Métodos: Revisamos retrospectivamente os prontuários de pacientes > 18 anos submetidos à nefrectomia total devido a cálculos de FAM puro e cálculos de oxalato de cálcio puro (OxCa) de julho de 2006 a julho de 2016. Os parâmetros metabólicos urinários foram avaliados através de exames de urina de 24 horas ≥ 3 meses após a nefrectomia. Os parâmetros metabólicos urinários e um novo evento relacionado à litíase foram comparados. Resultados: Vinte e oito e 39 pacientes foram incluídos nos grupos FAM e OxCa, respectivamente. As anormalidades em amostras de urina de 24 horas foram similares entre os grupos. A hipercalciúria ocorreu em 7,1 e 10,3% dos pacientes nos grupos FAM e OxCa, respectivamente (p = 0,66), enquanto a hipocitratúria esteve presente em 65,2 e 59,0% dos pacientes nos grupos FAM e OxCa, respectivamente (p = 0,41). Nenhuma diferença significativa em novos eventos foi encontrada entre os grupos FAM e OxCa (17,9 vs. 23,1%, respectivamente; p = 0,60). Conclusão: Uma avaliação de urina de 24 horas deve ser oferecida aos pacientes submetidos à nefrectomia devido a cálculos de FAM puro, a fim de detectar risco metabólico, melhorar o tratamento e prevenir a recorrência de cálculos.
Abstract Background and objective: Magnesium ammonium phosphate stones (MAP), also known as struvite stones, are associated with urinary infection and impairment of renal unit. The aim of this study is to evaluate the urinary metabolic risk factors for recurrence of renal calculi in patients submitted to nephrectomy due to MAP stones. Methods: We retrospectively reviewed the charts of patients > 18 years old submitted to total nephrectomy due to pure MAP stones and pure calcium oxalate (CaOx) stones from July 2006 to July 2016. Urinary metabolic parameters were assessed through 24-hour urine exams ≥ 3 months after nephrectomy. Urinary metabolic parameters and new event related to lithiasis were compared. Results: Twenty-eight and 39 patients were included in MAP and CaOx group, respectively. Abnormalities in 24-hour urine samples were similar between groups. Hypercalciuria occurred in 7.1 and 10.3% of patients in MAP and CaOx group, respectively (p = 0.66), whereas hypocitraturia was present in 65.2 and 59.0% of patients with MAP and CaOx group, respectively (p = 0.41). No significant difference in new events was found between MAP and CaOx groups (17.9 vs. 23.1%, respectively; p = 0.60). Conclusion: A 24-hour urine evaluation should be offered to patients submitted to nephrectomy due to pure MAP stones in order to detect metabolic risk, improve treatment, and prevent stone recurrence.
14.
Predicting the potential distribution of aquatic herbaceous plants in oligotrophic Central Amazonian wetland ecosystems
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Lopes, Aline
; Demarchi, Layon Oreste
; Franco, Augusto Cesar
; Ferreira, Aurélia Bentes
; Ferreira, Cristiane Silva
; Wittmann, Florian
; Santiago, Ivone Neri
; Cruz, Jefferson da
; Silva, Jeisiane Santos da
; Schöngart, Jochen
; Souza, Sthefanie do Nascimento Gomes de
; Piedade, Maria Teresa Fernandez
.












ABSTRACT Aquatic herbaceous plants are especially suitable for mapping environmental variability in wetlands, as they respond quickly to environmental gradients and are good indicators of habitat preference. We describe the composition of herbaceous species in two oligotrophic wetland ecosystems, floodplains along black-water rivers (igapó) and wetlands upon hydromorphic sand soils (campinarana) in the Parque Nacional do Jaú and the Reserva de Desenvolvimento Sustentável Uatumã in Central Amazonia, both protected areas. We tested for the potential distribution range (PDR) of the most frequent species of these ecosystems, which are the ones that occurred in at least two of the sampled wetlands, using species distribution models (SDMs). In total, 98 aquatic herbaceous species were recorded, of which 63 occurred in igapós and 44 in campinaranas. Most igapó species had ample PDRs across the Neotropics, while most campinarana species were restricted to the Amazon Basin. These results are congruent with studies that described similar distribution patterns for tree and bird species, which emphasizes a high degree of endemism in Amazonian campinaranas. However, we also found differences in the potential distribution of species between the two protected areas, indicating high environmental variability of oligotrophic ecosystems that deserve further investigation to develop effective measures for their conservation and protection.
15.
Apparent digestibility of juveniles of matrinxã Brycon amazonicus fed diets with different protein levels
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Gonçalves, Cesar Augusto Alves
; Pantoja-Lima, Jackson
; Machado-Bussons, Márcia Regina Fragoso
; Rufino, João Paulo Ferreira
.




ABSTRACT. The objective of the present study was to determine the apparent digestibility of juveniles of matrinxã Brycon amazonicus fed diets with different levels of protein. The experimental design was completely randomized, where the treatments consisted of four levels of protein in the diets (28, 32, 36 and 40%) and five replicates (water boxes) with 10 juveniles of matrinxã each. Diets were offered four times a day, and feces were collected twice a week, along 28 days, for digestibility analysis. Data collected were subjected to polynomial regression at 5% significance. Differences (p<0.05) were observed in dry matter digestibility, with higher digestibility according to increasing levels of protein in the diets. This behavior was directly expressed in the digestibility of nutrients by juveniles of matrinxã, such as % ash, % crude protein, apparent digestible energy, % digestibility of apparent digestible energy and energy: protein ratio. However, this was not observed (p > 0.05) in the digestibility of % ether extract. Digestibility of N, P, Ca, Mg, Cu and Zn presented linear positive (p < 0.05) behavior, in which the use of these minerals increased with the increase in the level of protein in the diets. However, the digestibility of K, Fe and Mn reduced (p < 0.05) with increasing protein levels in the diets. Thus, it can be concluded that the rise in protein level in diets for juveniles of matrinxã improves nutrient digestibility. The results of this study indicated that 40% crude protein in the diets provided better results.
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