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Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

https://doi.org/10.1055/s-0042-1757692

The reasons why the Regression Tree Method is more suitable than General Linear Model to analyze complex educational datasets
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Gomes, Cristiano Mauro Assis

; Lemos, Gina C.

; Jelihovschi, Enio G.

Revista Portuguesa de Educação

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dec 2021, Volume 34 N. 2 Pages 42 - 64

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

Resumo Qualquer método quantitativo é formatado por certas regras ou postulados que constituem a sua própria racionalidade. Não fortuitamente, esses postulados determinam as condições e constrangimentos segundo os quais as evidências podem ser construídas. Neste artigo, argumentamos por que a racionalidade do Método de Regressão em Árvore é mais apropriada do que a do Modelo Linear Geral para analisar dados educacionais complexos. Ademais, aplicamos o algoritmo CART do Método de Regressão em Árvore, assim como a Regressão Linear Múltipla, num modelo com 53 preditores, tomando como desfecho as pontuações dos estudantes em leitura da edição de 2011 do Exame Nacional do Ensino Médio (ENEM; N = 3.670.089), o qual é um dado educacional complexo. Esta comparação empírica ilustra como o Método de Regressão em Árvore é superior ao Modelo Linear Geral para fornecer evidências sobre relações não lineares, assim como para lidar com variáveis nominais com muitas categorias, e variáveis ordinais. Concluímos que o Método de Regressão em Árvore constrói melhores evidências sobre as relações entre os preditores e o desfecho em dados complexos.

Resumen Cualquier método cuantitativo está conformado por ciertas reglas o postulados que constituyen su propia racionalidad. No por casualidad, estos postulados determinan las condiciones y restricciones sobre las cuales se puede construir la evidencia En este artículo, argumentamos por qué la racionalidad del Método de Árbol de Regresión es más apropiada que el Modelo Lineal General para analizar datos educativos complejos. Además, se aplicó el algoritmo CART del Método de Regresión de Árbol, así como la Regresión Linear Múltiple, en un modelo con 53 predictores, tomando como variable de respuesta el desempeño de los estudiantes en lectura de la edición 2011 del Examen Nacional de Educación Secundaria (ENEM; N = 3.670.089), que es un dato educativo complejo. Esta comparación empírica ilustra cómo el Método de Árbol de Regresión es superior al Modelo Linear General al proporcionar evidencia de relaciones no lineales, así como al tratar con variables nominales con muchas categorías y variables ordinales. Llegamos a la conclusión de que el Método de Árbol de Regresión genera mejores evidencias sobre las relaciones entre los predictores y el variable de respuesta en datos complejos.

Abstract Any quantitative method is shaped by certain rules or assumptions which constitute its own rationale. It is not by chance that these assumptions determine the conditions and constraints which permit the evidence to be constructed. In this article, we argue why the Regression Tree Method’s rationale is more suitable than General Linear Model to analyze complex educational datasets. Furthermore, we apply the CART algorithm of Regression Tree Method and the Multiple Linear Regression in a model with 53 predictors, taking as outcome the students’ scores in reading of the 2011’s edition of the National Exam of Upper Secondary Education (ENEM; N = 3,670,089), which is a complex educational dataset. This empirical comparison illustrates how the Regression Tree Method is better suitable than General Linear Model for furnishing evidence about non-linear relationships, as well as, to deal with nominal variables with many categories and ordinal variables. We conclude that the Regression Tree Method constructs better evidence about the relationships between the predictors and the outcome in complex datasets.

https://doi.org/10.21814/rpe.18044 11 downloads

Impact of COVID-19 on education, health and lifestyle behaviour of Brazilian urology residents
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Prezotti, José Antonio

; Henriques, João Victor T.

; Favorito, Luciano A.

; Canalini, Alfredo F.

; Machado, Marcos G.

; Brandão, Thulio B. V.

; Barbosa, Akemi M. V.

; Moromizato, Julyana K. M.

; Anzolch, Karin M. J.

; Fernandes, Roni de C.

; Rodrigues, Fransber R. A.

; Bellucci, Carlos H. S.

; Silva, Caroline S.

; Pompeo, Antonio Carlos L.

; Bessa Jr., Jose de

; Gomes, Cristiano M.

International braz j urol

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aug 2021, Volume 47 N. 4 Pages 753 - 776

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. Materials and Methods: A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE). Results: Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. Conclusions: COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.

https://doi.org/10.1590/s1677-5538.ibju.2021.99.09 170 downloads

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists
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Gomes, Cristiano M.

; Favorito, Luciano A.

; Henriques, João Victor T.

; Canalini, Alfredo F.

; Anzolch, Karin M. J.

; Fernandes, Roni de C.

; Bellucci, Carlos H. S.

; Silva, Caroline S.

; Wroclawski, Marcelo L.

; Pompeo, Antonio Carlos L.

; Bessa Jr., Jose de

International braz j urol

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dec 2020, Volume 46 N. 6 Pages 1042 - 1071

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists’ clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 – 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions COVID-19 produced massive disturbances in Brazilian urologists’ practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians’ income, health and personal lives. These findings are probably applicable to other medical specialties.

https://doi.org/10.1590/s1677-5538.ibju.2020.99.15 3190 downloads

Characterization of biochemical compounds and antioxidant activity of “dedo-de-moça” chili pepper accessions
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Gomes, Gisely Paula

; Constantino, Leonel Vinicius

; Corte, Ligia Erpen-Dalla

; Riger, Cristiano Jorge

; Chaves, Douglas S de A

; Gonçalves, Leandro SA

Horticultura Brasileira

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oct 2019, Volume 37 N. 4 Pages 429 - 436

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

RESUMO Capsicum baccatum é uma das principais espécies de pimenta cultivadas e consumidas na América do Sul. No Brasil, C. baccatum var. pendulum é amplamente cultivada, especialmente a pimenta do tipo “dedo-de-moça”. Para a maioria das culturas hortícolas, incluindo as espécies de Capsicum, a diversidade genética permanece subexplorada para características relacionadasà qualidade dos frutos, uma vez que nos últimos anos os esforços dos programas de melhoramento têm concentrado principalmente no bom desempenho agronômico. Assim, o investimento na avaliação de características como sabor, compostos nutricionais e características de promoção da saúde, como o teor de antioxidantes em variedades tradicionais, é muito importante para apoiar os esforços de melhoramento para a qualidade dos frutos. Assim, o objetivo deste estudo foi acessar as variações nos teores de sólidos solúveis, acidez, capsaicinoides, vitamina C, compostos fenólicos totais e atividade antioxidante (in vitro e in vivo) de cinco acessos de pimentas “dedo-de-moça”. Os resultados indicaram que os acessos UEL111 e UEL112 apresentaram os maiores valores de sólidos solúveis totais (TSS) e relação (TSS/acidez total titulável). Os acessos UEL110 e UEL112 apresentaram maior concentração de vitamina C e conteúdo fenólico total e o acesso UEL113 apresentou maior concentração de capsaicinoides. Ensaios antioxidantes in vitro sugerem UEL114 com maior atividade antioxidante. Ensaios antioxidantes in vivo não identificaram diferenças entre os acessos e provaram o efeito antioxidante dos extratos de pimenta na proteção celular contra o agente de estresse. Estes resultados permitiram identificar acessos que podem ser explorados em programas de melhoramento de pimenta para qualidade de frutos.

ABSTRACT Capsicum baccatum is one of the main chili pepper species grown and consumed in South America. In Brazil, C. baccatum var. pendulum is widely cultivated, especially “dedo-de-moça” type. For most horticultural crops, including Capsicum species their diversity remains under-explored for traits related to fruit quality, since over the past half century breeding efforts have focused mainly on good agronomic performances. The investment in screening traits such as flavor, nutritional compounds and antioxidant content in traditional varieties is very important to support fruit quality breeding efforts. Thus, the objective of this study was accessing the variations into content of soluble solid, acidity, capsaicinoid, vitamin C, total phenolic compounds and antioxidant activity (in vitro and in vivo) of five “dedo-de-moça” peppers accessions. The results evidenced that UEL111 and UEL112 accessions showed highest TSS and ratio. Accessions UEL110 and UEL112 showed highest concentration of vitamin C and total phenolic content and UEL113 accession showed highest concentration of capsaicinoids. In vitro antioxidant assays suggest the UEL114 with highest antioxidant activity. In vivo antioxidant assays have not identified differences among the accessions and proved the antioxidant effect of chili pepper extracts on cell protection against stress agent. The results highlighted accessions that can be exploited in chili pepper breeding programs.

https://doi.org/10.1590/s0102-053620190411 1153 downloads

Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations
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Fratini, Letícia M.

; Gomes, Cristiano

; Queiroga, Luciana

; Santos, Fabiane R.

; Fantinatti, Alexandra P.

; Pavarini, Saulo P.

; Gerardi, Daniel G.

; Beck, Carlos Afonso C.

Pesquisa Veterinária Brasileira

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nov 2018, Volume 38 N. 11 Pages 2117 - 2123

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

RESUMO: As afecções pulmonares são comuns na rotina clínica de pequenos animais, todavia, por apresentarem sintomas inespecíficos, muitas vezes o diagnóstico dessas doenças torna-se limitado. Recursos de imagem como a radiografia e a ultrassonografia torácica são válidos como exames de triagem, mas somente a biopsia pulmonar pode possibilitar um diagnóstico específico da doença. A toracoscopia fornece um meio minimamente invasivo de diagnóstico para as doenças torácicas e oferece os benefícios de melhor iluminação e ampliação da imagem, quando comparado com a toracotomia. O presente estudo teve como objetivo avaliar as técnicas de biópsia pulmonar por meio da agulha cortante guilhotinada e da pinça de biopsia, guiadas por toracoscopia, pelo acesso transdiafragmático em cães que apresentavam imagem sugestiva de nódulo pulmonar em exame radiográfico prévio. Foram utilizados 14 cães, independente de raça, sexo, idade e peso corporal. Somente caninos com nódulos visíveis na radiografia torácica e que apresentaram condições clínicas e laboratoriais de serem anestesiados foram incluídos no estudo. Os cães foram posicionados em decúbito dorsal e foram realizados dois acessos à cavidade torácica: um primeiro portal intercostal, para introdução dos dispositivos de biopsia; e outro portal paraxifoide transdiafragmático para introdução do endoscópio. Com cada instrumento de biopsia foram coletadas três amostras do mesmo nódulo ou de nódulos macroscopicamente semelhantes e próximos quando o tamanho destes era inferior a um centímetro. Posteriormente as amostras foram encaminhadas para exame histopatológico. O tempo cirúrgico foi cronometrado da incisão ao fechamento da ferida, etodas as informações foram registradas. No pós-operatório os cães foram avaliados quanto à presença de enfisema subcutâneo, hematoma, seroma, infecção local e deiscência de pontos. Não foi necessário converter os procedimentos toracoscópicos para cirurgia convencional em nenhum dos caninos. Concluiu-se tratar de uma técnica segura, rápida sem complicações trans e pós-operatórias. Ambos dispositivos permitiram aquisição de material suficiente para análise histopatológica das alterações pulmonares, no entanto a agulha cortante guilhotinada apresentou maior eficácia, principalmente, em nódulos pulmonares de maior diâmetro. O acesso transdiafragmático mostrou-se eficiente para exploração de ambos os hemitórax.

ABSTRACT: Lung diseases are common in small animal clinical routine. Diagnosis is usually affected due to nonspecific symptoms. Imaging features such as radiography and chest ultrasound are acceptable screening tests, although lung biopsy can provides a precise diagnosis. Thus thoracoscopy provides a minimally invasive diagnostic assessment for chest diseases and offers the benefits such as improved illumination and magnification of the image when compared with thoracotomy. In this study we evaluated the transdiaphragmatic thoracoscopic-assisted techniques of lung biopsy with a the guillotine cutting needle and biopsy forceps, in dogs presenting radiographic suspicion on pulmonary tumors. Fourteen dogs regardless of breed, gender, age and body weight admitted at the Hospital of Veterinary Clinics (HCV) of the Veterinary College (FAVET) of Universidade Federal do Rio Grande do Sul (UFRGS), were assessed. Inclusion criteria were presence of nodules on chest radiography and triage tests without changes that could hinder general anesthesia and surgical approach. The animals were positioned in dorsal recumbence and two thoracoscopic ports were established: the first port for working instruments; the second paraxyphoid port for the telescope. Three samples were collected using each sampling method from each lesion or from tumors macroscopically similar whenever their size was less than one centimeter. The samples were sent for histopathological examination in the Veterinary Pathology Laboratory of FAVET/UFRGS. Surgical time was recorded from first incision to wound closure and surgical complications were reported. The dogs were evaluated for the presence of subcutaneous emphysema, hematoma, seroma, local infection and dehiscence. No conversion to open surgery was necessary during the thoracoscopic procedure in any patient. Thoracoscopic assisted biopsy using guillotine needle and biopsy forceps was a safe and fast technique, without perioperative complications. Both devices provided good quality samples for histopathological analysis of lung abnormalities. However the cutting guillotine needle was more efficient especially in larger pulmonary nodules. The transdiaphragmatic access provided optimal approach for both hemithoraces.

https://doi.org/10.1590/1678-5150-pvb-5648 1055 downloads

Linfonodo axilar como sentinela de neoplasia mamária em cadelas
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Bianchi, Simone P.

; Gomes, Cristiano

; Pavarini, Saulo P.

; Mombach, Verônica S.

; Santos, Fabiane R.

; Vieira, Luciane C.

; Oliveira, Luciana O.

; Contesini, Emerson A.

Pesquisa Veterinária Brasileira

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apr 2018, Volume 38 N. 4 Pages 692 - 695

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

RESUMO: Linfonodo axilar como sentinela de neoplasia mamária em cadelas. O estudo dos tumores de mama em cadelas é de grande importância devido à alta frequência com que surgem na clínica de pequenos animais. O presente estudo teve como objetivo avaliar a importância do linfonodo axilar como sentinela em neoplasias mamárias de cadelas. Foram avaliadas 49 fêmeas com neoplasia mamária, submetidas à mastectomia unilateral total, utilizando o corante azul patente para a identificação do linfonodo axilar, o qual foi submetido à análise histopatológica com a coloração de hematoxilina-eosina e imuno-histoquímica (IHQ) com anticorpo citoqueratina (AE1/AE3) para procura de metástase. Oito cadelas apresentaram metástases em linfonodo axilar, sendo sete detectadas por histopatologia e por IHQ e uma somente pela IHQ (micrometástase). Uma paciente que apresentava tumor em mamas abdominal caudal e inguinal tinha metástase no linfonodo axilar e inguinal. Assim, observa-se que o tumor pode causar alteração na drenagem linfática provocando metástase em linfonodos que normalmente não drenam determinadas mamas, por isso a retirada do linfonodo axilar deve ser incluída como técnica de rotina para permitir melhor estadiamento das neoplasias mamárias de cadelas.

ABSTRACT: Mammary tumors research in bitches is important due to their high incidence. The aim of this study was to evaluate the importance of the axillary lymph node as a sentinel lymph node for mammary neoplasms in female dogs. Forty-nine bitches with mammary neoplasia were submitted to total unilateral mastectomy, and the axillary lymph node was identified using the patent blue dye. This lymph node was processed routinely for histopathological analysis and stained with hematoxylin-eosin and by immunohistochemistry (IHC) with cytokeratin antibody (AE1/AE3) to search for metastasis. Eight dogs had axillary lymph node metastases, seven of which were detected by histopathology and by IHC and only one by IHC (micrometastasis). One dog who presented tumor in caudal and inguinal abdominal mammary glands had metastases in the axillary and inguinal lymph nodes. It is concluded that the mammary tumor can cause alteration in lymphatic drainage leading to metastases in lymph nodes which normally do not drain certain glands; so the removal of the axillary lymph node should be included as a routine technique to allow better staging of mammary neoplasms of bitches.

https://doi.org/10.1590/1678-5150-pvb-5482 4483 downloads

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months
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PARREIRA, JOSÉ GUSTAVO

; CAMPOS, TÉRCIO DE

; PERLINGEIRO, JACQUELINE A. GIANINNI

; SOLDÁ, SILVIA C.

; ASSEF, JOSÉ CESAR

; GONÇALVES, AUGUSTO CANTON

; ZUFFO, BRUNO MALTEZE

; FLORIANO, CAIO GOMES

; OLIVEIRA, ERIK HARUK DE

; OLIVEIRA, RENATO VIEIRA RODRIGUES DE

; OLIVEIRA, AMANDA LIMA

; MELO, CAIO GULLO DE

; BELOW, CRISTIANO

; MIRANDA, DINO R. PÉREZ

; SANTOS, GABRIELLA COLASUONNO

; ALMEIDA, GABRIELE MADEIRA DE

; BRIANTI, ISABELA CAMPOS

; VOTTO, KARINA BARUEL DE CAMARGO

; SCHUES, PATRICK ALEXANDER SAUER

; SANTOS, RAFAEL GOMES DOS

; FIGUEREDO, SÉRGIO MAZZOLA POLI DE

; ARAUJO, TATIANI GONÇALVES DE

; SANTOS, BRUNA DO NASCIMENTO

; FERREIRA, LAURA CARDOSO MANDUCA

; TANAKA, GIULIANA OLIVI

; MATOS, THIARA

; SOUSA, MARIA DAIANA DA

; AUGUSTO, SAMARA DE SOUZA

Revista do Colégio Brasileiro de Cirurgiões

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aug 2015, Volume 42 N. 4 Pages 265 - 272

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

RESUMOObjetivo:analisar a implantação de registro de trauma em hospital universitário com atendimento ao SUS, bem como, sua capacidade em identificar pontos para melhorada qualidade no atendimento.Métodos:o grupo de coleta de dados foi composto por alunos dos cursos de medicina e enfermagem, orientados pelos coordenadores do projeto. Utilizamos o software itreg (ECO Sistemas-RJ/SBAIT) como ferramenta de banco de dados. Vários "filtros" de qualidade foram propostos no intuito de selecionar os casos a serem revistos no processo de controle de qualidade.Resultados:entre março e novembro de 2014, foram inseridos no itreg dados de 1344 vítimas de trauma. Cerca de 87% foram vítimas de trauma fechado, 59,6% apresentaram RTS>7,0 e, 67%, ISS<9. Os registros foram completos em 292 casos, que foram selecionados para a revisãono programa de qualidade. Os filtros de auditoria mais frequentemente anotadosforam a laparotomia após quatro horas da admissão e a drenagem dos hematomas subdurais agudos após quatro horas da admissão. Identificamos vários pontos a serem desenvolvidos, como o controle da "supertriagem" de doentes, a necessidade de diminuição do número de exames de imagem negativos, o desenvolvimento de protocolos para passagem de acessos venosos centrais e tratamento de trauma craniencefálico grave.Conclusão:o Registro de Trauma traz uma visão clara dos pontos a serem melhorados no atendimento ao traumatizado, contudo, há características específicas na implantação desta ferramenta.

ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

https://doi.org/10.1590/0100-69912015004012 4149 downloads

10.

Pollen morphology of Rubiaceae Juss. species occurring in an area of caatinga (dryland) vegetation in Bahia State, Brazil
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Silveira Júnior, Cristiano Eduardo Amaral

; Saba, Marileide Dias

; Jardim, Jomar Gomes

Acta Botanica Brasilica

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jun 2012, Volume 26 N. 2 Pages 444 - 455

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

Rubiaceae foi representada na flora de Brejinho das Ametistas por dezesseis espécies, as quais foram tratadas palinologicamente no presente estudo: Coccocypselum hirsutum Bartl. ex DC., Cordiera rigida Kuntze, Coutarea hexandra K.Schum., Declieuxia fruticosa Kuntze, Diodella apiculata (Willd. ex Roem. & Schult.) Delprete, D. radula (Willd. ex Roem. & Schult.) Delprete, D. teres Small., Emmeorhiza umbellata K.Schum., Leptoscela ruellioides Hook. f., Mitracarpus baturitensis Sucre., Mitracarpus villosus Cham. & Schltdl., Palicourea rigida Kunth, Psyllocarpus asparagoides Mart., Richardia grandiflora Steud., Staelia aurea K. Schum., Staelia galioides DC. Para análise sob microscopia de luz e eletrônica de varredura, os grãos de pólen foram acetolisados, mensurados, descritos, foto e eletromicrografados. Os grãos de pólen variaram de pequenos a grandes; suboblatos a subprolatos. Inaperturados em P. rigida, colpados, e colporados na maioria das espécies, com número de aberturas variável de três a várias. Exina predominantemente microrreticulada entre as espécies, sendo reticulada (C. hirsutum, C. rigida, P. rigida), birreticulada (D. fruticosa), microequinada-perfurada (C. hexandra), equinado-granulada (R. grandiflora), equinado-granulado-perfurada (D. apiculata e D. teres), e psilada (P. asparagoides). Os resultados mostraram que as espécies são palinologicamente distintas.

The palynology of the following 16 species of Rubiaceae, from Brejinho das Amestistas, was investigated: Coccocypselum hirsutum Bartl. ex DC., Cordiera rigida Kuntze, Coutarea hexandra K.Schum., Declieuxia fruticosa Kuntze, Diodella apiculata (Willd. ex Roem. & Schult.) Delprete, D. radula (Willd. ex Roem. & Schult.) Delprete, D. teres Small., Emmeorhiza umbellata K.Schum., Leptoscela ruellioides Hook. f., Mitracarpus baturitensis Sucre., Mitracarpus villosus Cham. & Schltdl., Palicourea rigida Kunth, Psyllocarpus asparagoides Mart., Richardia grandiflora Steud., Staelia aurea K. Schum., and Staelia galioides DC. The pollen grains were acetolysed to and their morphological characters were analyzed using light and scanning electron microscopy. They varied in size from small to large; were suboblate to subprolate; inaperturate (P. rigida), colpate and colporate in the remaining species, with an aperture number that varied from three to several. The exines were microreticulate in most species, reticulate (C. hirsutum, C. rigida and P. rigida), bireticulate (D. fruticosa), microechinate-perforated (C. hexandra), echinate-granulate (R. grandiflora), echinate-granulate-perforate (D. apiculata and D. teres), and psilate (P. asparagoides). Based on the results, palynological data can be used to distinguish these species.

https://doi.org/10.1590/S0102-33062012000200020 5561 downloads

11.

Assessment of the genetic risks of a metallic alloy used in medical implants
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Gomes, Cristiano C.

; Moreira, Leonardo M.

; Santos, Vanessa J.S.V.

; Ramos, Alfeu S.

; Lyon, Juliana P.

; Soares, Cristina P.

; Santos, Fabio V.

Genetics and Molecular Biology

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2011, Volume 34 N. 1 Pages 116 - 121

Abstract: En | Text: En | PDF: En

The use of artificial implants provides a palliative or permanent solution for individuals who have lost some bodily function through disease, an accident or natural wear. This functional loss can be compensated for by the use of medical devices produced from special biomaterials. Titanium alloy (Ti-6Al-4V) is a well-established primary metallic biomaterial for orthopedic implants, but the toxicity of the chemical components of this alloy has become an issue of concern. In this work, we used the MTT assay and micronucleus assay to examine the cytotoxicity and genotoxicity, respectively, of an extract obtained from this alloy. The MTT assay indicated that the mitochondrial activity and cell viability of CHO-K1 cells were unaffected by exposure to the extract. However, the micronucleus assay revealed DNA damage and an increase in micronucleus frequency at all of the concentrations tested. These results show that ions released from Ti-6Al-4V alloy can cause DNA and nuclear damage and reinforce the importance of assessing the safety of metallic medical devices constructed from biomaterials.

3201 downloads

12.

Intoxicação por Baccharis megapotamica var. weiriiem ovinos
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Pedroso, Pedro M.O.

; Bandarra, Paulo M.

; Feltrin, Cristiano

; Gomes, Danilo C.

; Watanabe, Tatiana T.N.

; Ferreira, Hugo H.

; Driemeier, David

Pesquisa Veterinária Brasileira

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may 2010, Volume 30 N. 5 Pages 403 - 405

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

As intoxicações por Baccharis coridifolia afetam especialmente animais de fazenda famintos ou curiosos e que não haviam tido contato prévio com a planta. B. coridifolia ocorre usualmente em terrenos secos de coxilhas no Rio Grande do Sul e estados ou países vizinhos. Uma forma indistinguível e esporádica da doença tem sido associada com a ingestão de Baccharis megapotamica que ocorre em áreas úmidas. Relata-se a intoxicação natural de quatro cordeiros após ingestão de Baccharis megapotamica var. weirii. A doença foi observada em uma propriedade localizada em Barra do Ribeiro, Rio Grande do Sul. O rebanho era composto por 220 ovinos, os quais eram mantidos em área de pastagem nativa sem qualquer suplementação. Uma rápida doença clínica caracterizada por anorexia, cólica, diarréia e desidratação causou a morte de três cordeiros em um período de 8 a 24 horas, o outro foi encontrado morto. A necropsia revelou alterações significativas no rúmen, no qual havia edema de serosa e hemorragias equimóticas na submucosa. Microscopicamente, o rúmen apresentou edema de submucosa, além de edema, tumefação, vacuolização e necrose de mucosa. O diagnóstico foi fundamentado nos achados clínicos, patológicos e epidemiológicos.

Spontaneous poisoning of livestock by Baccharis coridifolia affects mostly hungry or curious animals that have not entered in contact with the plant previously. The plant occurs usually in dried hilly soils of Rio Grande do Sul and neighboring states or countries. An indistinguishable and sporadic form of the disease has been associated with the ingestion of Baccharis megapotamica, a species occurring in moist areas. This communication reports the spontaneous poisoning of four lambs after ingestion of B. megapotamica var. weirii. Clinical signs were observed in three lambs, the other was found dead. A rapid clinical disease characterized by anorexia, colic, dehydration, and diarrhea resulted in death after 8-24 hours. Necropsy revealed significant changes in the rumen, in which serosal edema, and submucosal echimotic hemorrhages were observed. Microscopically, the rumen showed submucosal edema and mucosal tumefaction, vacuolization, and necrosis. Diagnosis was based on clinical, pathological and epidemiological findings.

2181 downloads

13.

Prostate specific antigen levels following transurethral resection of the prostate
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Fonseca, Roberto C.

; Gomes, Cristiano M.

; Meireles, Elton B.

; Freire, Geraldo C.

; Srougi, Miguel

International braz j urol

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feb 2008, Volume 34 N. 1 Pages 41 - 48

Abstract: En | Text: En | PDF: En

OBJECTIVE: Determine how serum prostate-specific antigen (t-PSA) levels and free PSA (f/t PSA) ratio change following transurethral resection of the prostate (TURP). MATERIALS AND METHODS: Thirty men with a mean age of 67.0 + 4.2 years (range 46 to 84 years) underwent TURP for BPH between May 2005 and October 2005. Preoperative assessment included symptom evaluation with the International Prostate Symptom Score (I-PSS) and the prostate volume estimation by transrectal ultrasound. Total PSA and f/t PSA ratio were assessed before the procedure, as well as 30, 60 and 180 days after the TURP. RESULTS: Clinical improvement after TURP, reflected by I-PSS score, was demonstrated as early as 30 days and remained stable until the end of the follow-up. Mean t-PSA declined 71% after TURP and 60 days after surgery the reduction reached its peak, stabilizing afterwards. It varied from 6.19 + 7.06 ng/mL before surgery to 1.75 + 1.66 ng/mL on day 60 (p < 0.001). The mean baseline f/t PSA ratio was 18.2% + 3.4% and was not significantly changed at any given time point in the postoperative period (p = 0.91). There were also no statistically significant differences in t-PSA or f/t PSA between patients with and without prostatitis at any time point (p = 0.23). Resected prostate fragments weighed 29.9 + 19.6 g, corresponding to 39.1% of the estimated preoperative prostate volume. Each gram of tissue resected decreased PSA by 0.15 + 0.11 ng/mL, while 1% prostate volume resected led to a reduction of 2.4% + 0.4% in serum PSA from baseline. CONCLUSIONS: PSA decreases drastically in patients who undergo TURP. These low levels stabilize within 60 days after surgery. The f/t PSA ratio did not change, and the finding of chronic prostatitis did not affect the levels of these variables.

9481 downloads

14.

Urogenital involvement in the Klippel-Trenaunay-Weber syndrome: treatment options and results
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Vicentini, Fabio C.

; Denes, Francisco T.

; Gomes, Cristiano M.

; Danilovic, Alexandre

; Silva, Frederico A.

; Srougi, Miguel

International braz j urol

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dec 2006, Volume 32 N. 6 Pages 697 - 704

Abstract: En | Text: En | PDF: En

OBJECTIVE: Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital condition characterized by vascular malformations of the capillary, venous and lymphatic systems associated to soft tissue and bone hypertrophy in the affected areas. This syndrome may involve bladder, kidney, urethra, ureter and genitals. We report the treatment of 7 KTWS patients with urogenital involvement. MATERIALS AND METHODS: From 1995 to 2005, 7 patients with KTWS were evaluated and the charts of these patients were reviewed. RESULTS: Patients’ median age was 19-years (range 4 to 46-years) and only 1 was female. The clinical presentation included genital deformities in 3 cases, hematuria in 2 and urethrorragia in 2, one of which associated with cryptorchidism and phimosis. Three patients had an association of pelvic and genital malformations, including 2 patients with hematuria due to vesical lesions and 1 patient with left ureterohydronephrosis due to a pelvic mass. Two patients had urethral lesions. Treatment included endoscopic laser coagulation for 1 patient with recurrent hematuria and 1 patient with urethrorrhagia, pelvic radiotherapy for 1 patient with hematuria and circumcision in 2 patients with genital deformities. One patient required placement of a double-J catheter to relieve obstruction. Hematuria and urethrorragia were safely and effectively controlled with laser applications. Circumcision was also effective. The patient treated with radiotherapy developed a contracted bladder and required a continent urinary diversion. CONCLUSIONS: Urogenital involvement in patients with KTWS is not rare and must be suspected in the presence of hematuria or significant cutaneous deformity of the external genitalia. Surgical treatment may be warranted in selected cases.

10038 downloads

15.

Concurrent validity, internal consistency and responsiveness of the portuguese version of the king's health questionnaire (KHQ) in women after stress urinary incontinence surgery
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Tamanini, Jose T. N.

; Dambros, Miriam

; D'ancona, Carlos A. L.

; Palma, Paulo C. R.

; Botega, Neury J.

; Rios, Luis A. S.

; Gomes, Cristiano M.

; Baracat, Fabio

; Bezerra, Carlos A.

; Netto Jr, Nelson R.

International braz j urol

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dec 2004, Volume 30 N. 6 Pages 479 - 486

Abstract: En | Text: En | PDF: En

OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73%) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.

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