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ABSTRACT Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2020 the updated recommendations for the diagnosis and treatment of HCC. Since then, new data have emerged in the literature, including new drugs approved for the systemic treatment of HCC that were not available at the time. The SBH board conducted an online single-topic meeting to discuss and review the recommendations on the systemic treatment of HCC. The invited experts were asked to conduct a systematic review of the literature on each topic related to systemic treatment and to present the summary data and recommendations during the meeting. All panelists gathered together for discussion of the topics and elaboration of the updated recommendations. The present document is the final version of the reviewed manuscript containing the recommendations of SBH and its aim is to assist healthcare professionals, policy-makers, and planners in Brazil and Latin America with systemic treatment decision-making of patients with HCC.

RESUMO O carcinoma hepatocelular (CHC) é uma das principais causas de mortalidade relacionada a câncer no Brasil e no mundo. A Sociedade Brasileira de Hepatologia (SBH) publicou em 2020 a atualização das recomendações da SBH para o diagnóstico e tratamento do CHC. Desde então, novas evidências científicas sobre o tratamento sistêmico do CHC foram relatadas na literatura médica, incluindo novos medicamentos aprovados que não estavam disponíveis na época do último consenso, levando a diretoria da SBH a promover uma reunião monotemática on-line para discutir e rever as recomendações sobre o tratamento sistêmico do CHC. Um grupo de experts foi convidado para realizar uma revisão sistemática da literatura e apresentar uma atualização, baseada em evidências científicas, sobre cada tópico relacionado ao tratamento sistêmico e a apresentar os dados e recomendações resumidas durante a reunião. Todos os painelistas se reuniram para discutir os tópicos e elaborar as recomendações atualizadas. O presente documento é a versão final do manuscrito revisado, contendo as recomendações da SBH, e seu objetivo é auxiliar os profissionais de saúde, formuladores de políticas e planejadores no Brasil e na América Latina na tomada de decisões sobre o tratamento sistêmico de pacientes com CHC.

https://doi.org/10.1590/s0004-2803.202301000-14

Genetic diversity of Mycoplasma hyopneumoniae in finishing pigs in Minas Gerais
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Andrade, Mariana R.

; Daniel, Amanda G.S.

; Zarate, Javier B.

; Sato, José P.H.

; Santos, Lucas F.

; Guedes, Roberto M.C.

Pesquisa Veterinária Brasileira

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2023, Volume 43 elocation e07155

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

ABSTRACT: Mycoplasma hyopneumoniae is one of the most challenging respiratory pathogens involved with swine pneumonia worldwide, responsible for a chronic infection with high morbidity, which predisposes secondary bacterial infections in growing and finishing pigs. Advances in diagnostic techniques allowed identification of genetic characteristics associated with high antigenic and proteomic variability among bacterial strains. This study aimed to evaluate the genetic diversity of M. hyopneumoniae strains in lungs with pneumonic lesions obtained from 52 pig farms located in Minas Gerais, one of the largest swine production states in Brazil. Genotyping was performed using multilocus variable number of tandem repeat (VNTR) analysis (MLVA), targeting two loci encoding P97 and P146 adhesins VNTR. The results showed that this agent is widely disseminated in pig farms and there is a high polymorphism of M. hyopneumoniae variants circulating in the state of Minas Gerais. Different M. hyopneumoniae genotypes are randomly distributed in several regions of the state, with no specific geographic population structure pattern. M. hyopneumoniae association with viral agents was sporadic (3.17% with Influenza A and 1.9% with PCV2).

RESUMO: Mycoplasma hyopneumoniae é um dos patógenos respiratórios mais desafiadores envolvidos com pneumonia suína em todo o mundo. É responsável por uma infecção crônica de alta morbidade, que predispõe a infecções bacterianas secundárias nas fases de crescimento e terminação. Avanços nas técnicas diagnósticas permitiram a identificação de características genéticas do agente, associadas à alta variabilidade antigênica e proteômica entre cepas. Este estudo teve como objetivo examinar a ocorrência e diversidade genética de cepas de M. hyopneumoniae em pulmões com lesões pneumônicas em 52 granjas de suínos no estado de Minas Gerais, um dos maiores estados produtores de suínos do Brasil. A genotipagem foi realizada utilizando a técnica de “multilocus variable number of tandem repeat analysis” (VTNR/MLVA), usando dois loci que codificam VNTR das adesinas P97 e P146. Os resultados mostraram que esse agente está amplamente disseminado em granjas de suínos e que existe alto polimorfismo das variantes de M. hyopneumoniae circulando no estado de Minas Gerais. Diferentes genótipos de M. hyopneumoniae estão distribuídos aleatoriamente em várias regiões do estado, sem um padrão de estrutura populacional e geográfica específico. Associação de M. hyopneumoniae e agentes virais foi esporádica (3,17% com Influenza A e 1,9% com PCV2).

https://doi.org/10.1590/1678-5150-pvb-7155

Minor psychiatric disorders among university students during the COVID-19 pandemic
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Kantorski, Luciane Prado

; Guedes, Ariane da Cruz

; Brum, Aline Neutzling

; Treichel, Carlos Alberto dos Santos

; Santos, Vinícius Boldt dos

; Gonçalves, Bianca Albuquerque

; Almeida, Mariana Dias

Revista Gaúcha de Enfermagem

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2023, Volume 44 elocation e20220064

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

ABSTRACT Objective: To identify the prevalence and factors associated with the manifestation of Minor Psychiatric Disorders (MPD) among university students in southern Brazil during the COVID-19 pandemic. Method: Cross-sectional study, conducted in August and September 2020, with 464 university students. The Self-Reporting Questionnaire (SRQ-20) was used with a cut-off point ≥ 7, and associated factors were identified through crude and adjusted analyses using logistic regression. Results: The prevalence of MPD was 76.5%. Factors positively associated with the outcome were female gender, job loss during the pandemic, use of psychoactive substances, and difficulties in following online classes. Being in social distancing for seven months or more was negatively associated with the outcome. Conclusion: High prevalence of MPD among the studied sample, as well as a relationship between this outcome and the consequences of the COVID-19 pandemic.

RESUMEN Objetivo: Identificar la prevalencia y los factores asociados a la manifestación de trastornos psiquiátricos menores en estudiantes universitarios del sur de Brasil durante la pandemia del COVID-19. Método: Estudio realizado en 2020, con 464 alumnos vinculados a una disciplina optativa de Salud Mental. Para el resultado se utilizó el Self-Reporting Questionnaire (SRQ-20), con el punto de corte ≥ 7. La identificación de los factores asociados se realizó mediante regresión logística, precedida de selección de factores de confusión. Resultados: Prevalencia de trastornos psiquiátricos menores correspondiente al 76,5% entre los participantes. Factores asociados positivamente con este resultado: sexo femenino, la pérdida de empleo durante la pandemia, el consumo de sustancias psicoactivas y las dificultades para seguir las clases en línea. Estar socialmente distante durante siete meses o más se asoció negativamente con el resultado. Conclusión: Alta prevalencia de malestar emocional entre la muestra, así como una relación entre este resultado y la pandemia.

RESUMO Objetivo: Identificar a prevalência e os fatores associados à manifestação de Transtornos Psiquiátricos Menores (TPM) em estudantes universitários do Sul do Brasil durante a pandemia da COVID-19. Método: Estudo transversal, realizado nos meses de agosto e setembro de 2020, com 464 estudantes universitários. Foi utilizado o Self-Reporting Questionnaire (SRQ-20) com o ponto de corte ≥ 7, e identificados os fatores associados por meio de análises brutas e ajustadas com emprego de regressão logística. Resultados: A prevalência de TPM foi de 76,5%. Os fatores positivamente associados ao desfecho foram as pessoas do sexo feminino, perda de emprego durante a pandemia, uso de substâncias psicoativas e dificuldades para acompanhar as aulas on-line. Esteve negativamente associado ao desfecho, estar em distanciamento social por período igual ou superior a sete meses. Conclusão: O estudo sugere alta prevalência de TPM entre os universitários e a relação entre esse desfecho e os desdobramentos da pandemia da COVID-19.

https://doi.org/10.1590/1983-1447.2023.20220064.en

Intraoperative assessment of surgical margins using ‟en face” frozen sections in the management of cutaneous carcinomas
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Otsuka, Ana Carolina Vasconcellos Guedes

; Bertolli, Eduardo

; Macedo, Mariana Petaccia de

; Pinto, Clovis Antonio Lopes

; Duprat Neto, João Pedreira

Anais Brasileiros de Dermatologia

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oct 2022, Volume 97 N. 5 Pages 583 - 591

Abstract: En | Text: En | PDF: En

Abstract Background: Basal cell and squamous cell carcinomas (BCC and SCC) are the most common types of cancer worldwide. Intraoperative assessment of surgical margins by frozen section has been widely used to ensure disease-free margins. The intraoperative ‟en face” freezing technique evaluates all peripheral and deep margins. Objective: To report the results of the ‟en face” freezing technique in relation to tumor recurrence and agreement with paraffin-embedded tissue examination. Methods: Retrospective analysis of patients undergoing surgical excision of BCC and SCC at the A. C. Camargo Cancer Center, Brazil. Results: This study included 542 skin carcinomas, which were excised from 397 patients. A total of 201 male patients (50.6%), and 196 female patients (49.4%) were assessed, whose mean age was 64 years. The tumors were mostly located on the head and neck region (87.8%). BCC corresponded to 79.7% of the cases. The mean follow-up was 38 months. Tumor relapse occurred in 0.86% of the primary tumors and 3.7% of recurrent tumors. The result of the intraoperative ‟en face” frozen section evaluation was in agreement with the final result of the anatomopathological examination (paraffin test) in 98% of the lesions. Study limitations: Not having a minimum follow-up time of 5 years for all patients. Conclusion: The ‟en face” freezing technique shows low tumor relapse, being reliable and safe to guarantee negative surgical margins of the tumor.

https://doi.org/10.1016/j.abd.2021.09.013

What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review
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Guedes Neto, Henrique Jorge

; Kuramoto, Danielle Akemi Bergara

; Correia, Rebeca Mangabeira

; Santos, Brena Costa

; Borges, Amanda da Cunha

; Pereda, Mariana Raffo

; Aidar, Ana Laura e Silva

; Pereira Júnior, Francisco Amadeu

; Amaral, Fabio Cabral de Freitas

; Vasconcelos, Vladimir Tonello de

; Lustre, Wellington Gianoti

; Amorim, Jorge Eduardo de

; Flumignan, Ronald Luiz Gomes

; Nakano, Luis Carlos Uta

; Baptista-Silva, José Carlos Costa

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 2 Pages 320 - 327

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients’ lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.

https://doi.org/10.1590/1516-3180.2021.0374.r2.15092021

Health impacts caused by excessive sodium consumption in Brazil: results of the GBD 2019 study
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Guedes, Larissa Fernanda Fonseca

; Felisbino-Mendes, Mariana Santos

; Vegi, Aline Siqueira Fogal

; Meireles, Adriana Lúcia

; Menezes, Mariana Carvalho de

; Malta, Deborah Carvalho

; Machado, Ísis Eloah

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Suppl. 1 elocation e0266-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Excessive sodium consumption is associated with increased blood pressure, which is an important risk factor for non-communicable diseases (NCDs). This study therefore aimed to describe the burden of NCDs attributable to excessive sodium consumption among Brazilians. METHODS: This observational study used mortality and Disability Adjusted Life Years (DALY) rates, and their respective uncertainty intervals (UI), from the Global Burden of Disease Study 2019 (GBD 2019). The burden was obtained by the population attributable fraction of each NCD, considering the minimum theoretical value of risk (intake of 0-3g of sodium/day); the excessive consumption proportion in the population, obtained through population inquiries; and the relative risks obtained through meta-analyses. RESULTS: Excessive sodium consumption was the third highest dietary risk contributing to deaths (30,814; 95% UI = 2,034 - 84,130) and DALYs (699,119; 95% UI= 43,130 - 1,914,066) in 2019. States from the Northeast region had the highest age-standardized rates of deaths and DALYs, and the male population was more affected by NCDs caused by excessive sodium consumption. Cardiovascular diseases were the main contributing factors in the burden attributable to excessive sodium consumption. CONCLUSIONS: Regardless of the progress in addressing NCDs related to this risk factor, the impact remains high, especially among men and in the Northeast region. More effective measures are needed to reduce sodium in industrialized products, such as health promotion actions to combat sodium consumption, in order to prevent and control NCDs in Brazil.

https://doi.org/10.1590/0037-8682-0266-2021

Burden of non-communicable diseases attributable to dietary risks in Brazil, 1990-2019: an analysis of the Global Burden of Disease Study 2019
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Machado, Ísis Eloah

; Parajára, Magda do Carmo

; Guedes, Larissa Fernanda Fonseca

; Meireles, Adriana Lúcia

; Menezes, Mariana Carvalho de

; Felisbino-Mendes, Mariana Santos

; Verly-Junior, Eliseu

; Malta, Deborah Carvalho

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Suppl. 1 elocation e0282-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: An unhealthy diet is a modifiable risk factor for non-communicable diseases (NCDs), one of the most important public health problems in Brazil. This study aimed to analyze the burden of NCDs attributable to dietary risks in Brazil between 1990-2019. METHODS: Secondary data from the Global Burden of Disease Study were used to estimate the burden attributable to fifteen dietary risks in Brazil. The main sources of data for Brazil were national surveys and international databases. A comparative risk assessment was used to obtain the population attributable fraction. We described the intake of each dietary risk and the distribution of number and rates of deaths and Disability-adjusted life years (DALYs) attributable to diet by sex, age, state, and year from 1990-2019. RESULTS: Cardiovascular diseases, diabetes mellitus, and neoplasms were the main NCDs attributable to an unhealthy diet. Age-standardized mortality and DALYs rates attributable to unhealthy diet decreased between 1990-2019 (-51.5% and -48.8, respectively). Diet high in red meat and sodium, and low in whole grains were the three main risk factors contributing to the burden of NCDs both in 1990 and 2019. The burden of NCDs was higher among males in the middle-aged population (around 50 years), as well as in the states of Maranhão, Rio de Janeiro, and Alagoas. CONCLUSIONS: The present study found a suboptimum diet among the Brazilian population. The major contributors to this burden were diet high in red meat and sodium and low in whole grains. This study supports priorities in public policies on food and nutrition to reduce the burden of NCDs.

https://doi.org/10.1590/0037-8682-0282-2021

Currículo informal singular: eletividade na formação médica durante a pandemia
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Cruz, Walter Gabriel Neves

; Camelier-Mascarenhas, Mariana

; Queirós, Vitória Oliveira de

; Ferreira, Gustavo Henrique Mendes

; Guedes, Jorge Carvalho

Revista Brasileira de Educação Médica

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2022, Volume 46 N. 2 elocation e080

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

Resumo: Introdução: A interrupção das atividades de ensino imposta pela pandemia de Sars-CoV-2 ofereceu uma oportunidade ímpar de analisar os hábitos de estudo extracurriculares dos estudantes de Medicina, buscando compreender como a inexistência de um direcionamento institucional temático impactou a formação médica durante esse período de isolamento social. Objetivo: Este estudo teve como objetivo avaliar a ocorrência, as temáticas e as principais fontes dos estudos durante o período de suspensão de aulas na pandemia. Método: Trata-se de um estudo analítico e descritivo com dados colhidos a partir de um questionário virtual aplicado a estudantes de Medicina de uma instituição de ensino superior. Resultado: A partir da suspensão total das aulas, dos 310 participantes, 152 (49,0%) discentes alegaram ter estudado temas relacionados à área de ciências da saúde e 93 (30,0%) estudaram temas não relacionados à área de ciências da saúde. Estatisticamente, houve preferência exclusiva por uma área outra (p < 0,001), indicando dois perfis de estudo no período. Os interesses temáticos mais abundantes foram aqueles abordados em eventos médicos virtuais, como congressos ou simpósios, bem como os relacionados à Covid-19. Entre os temas mais citados, destacaram-se: fisiologia, clínica médica e geral ou especializada, anatomia, idiomas, finanças e filosofia. Conclusão: A despeito da suspensão das atividades acadêmicas curriculares, os estudantes buscaram novos aprendizados de acordo com suas demandas intelectivas, denotando o desenvolvimento de um currículo informal singularizado.

Abstract: Introduction: The interruption of teaching activities imposed by the Sars-CoV-2 pandemic offered a unique opportunity to analyze the extracurricular study habits of medical students, seeking to understand how the lack of a thematic institutional targeting impacted on medical training during the period of social isolation. Objective: This study aimed to evaluation of the occurrence, themes, and main sources of studies during the period of suspension of classes in the pandemic. Method: Analytical and descriptive study with data collected from a virtual questionnaire applied to medical students of a higher education institution. Result: From the complete suspension of local activities, of the 310 participants, 152 (49.0%) students claimed to have studied topics related to the health sciences and 93 (30.0%) studied topics not related to the health sciences area. Statistically, there was an exclusive preference for one area to another (p < 0.001), indicating two study profiles in the period. The most abundant thematic interests were those addressed in virtual medical events, such as conferences or symposia, as well as those related to Covid-19. It stands out as the most cited themes: physiology, medical and general or specialized clinic, anatomy, languages, finance and philosophy. Conclusion: Despite the suspension of academic activities, students sought new learning habits according to their intellectual demands, denoting the development of a singularized informal curriculum.

https://doi.org/10.1590/1981-5271v46.2-20210366

Influence of silver nanoparticles on the tissue reaction of polyacrylic acid-based gel
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Bonete, Jéssica Mariana

; Tamashiro, Jacqueline Roberta

; Paiva, Fábio Friol Guedes de

; Queiroz-Fernandes, Geisiany Maria de

; Guidelli, Éder

; Baffa, Oswaldo

; Kinoshita, Angela

Acta Cirúrgica Brasileira

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2022, Volume 37 N. 5 elocation e370504

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To study the influence of silver nanoparticles (AgNP) on tissue reaction when incorporated into a polymeric matrix of polyacrylic acid-based (Carbopol®) gel as a proposal for a new low-cost type of biomaterial that is simple to manufacture for use as an antimicrobial and antioxidative dressing. Methods: In-vivo tests of implantation in the subcutaneous tissue of the back of rats were performed using polyethylene tubes in three situations: empty, only the gel, and gel incorporated with AgNP. Then, the tissue reaction was studied by counting inflammatory cells. Additionally, in-vitro tests of the antioxidative and antimicrobial activity of AgNP were performed. The radical 2,2 diphenyl-1 picrylhydrazyl (DPPH) was used to test the antioxidative activity of AgNP using electron spin resonance. The antimicrobial activity of AgNP was determined by minimum inhibitory concentration against the microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Results: The results indicated that AgNP presents antioxidative activity and was able to inhibit the growth of the microorganisms tested. The addition of AgNP in Carbopol® did not alter the tissue inflammatory response (p>0.05, Kruskal-Wallis’s test). Conclusions: The new biomaterial is promising for future use as a dressing for its beneficial properties for regenerative processes.

https://doi.org/10.1590/acb370504

10.

Functional ambulation decline and factors associated in amyotrophic lateral sclerosis
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Alencar, Mariana Asmar

; Guedes, Maria Clara Batista

; Pereira, Tayná Amaral Leite

; Rangel, Marcela Ferreira de Andrade

; Abdo, Juliana Silva

; Souza, Leonardo Cruz de

Fisioterapia em Movimento

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2022, Volume 35 elocation e35127

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

Resumo Introdução: A esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa incapacitante, que compromete a locomoção e a independência funcional. Como o objetivo da fisioterapia é manter a capacidade de locomoção e independência do indivíduo pelo maior tempo possível, é necessário conhecer melhor os possíveis fatores associados à perda dessa capacidade. Objetivo: Avaliar a deambulação funcional em pacientes com ELA e possíveis fatores associados ao seu declínio. Métodos: Realizou-se um estudo transversal com ELA esporádica. Aspectos demográficos e clínicos/funcionais foram avaliados. A Escala Funcional de ELA (ALSFRS-R), a Escala de Categoria de Deambulação Funcional (FAC), a Medical Research Council Scale e a Escala de Severidade de Fadiga (FSS) foram usadas. Foram realizadas análises descritivas e comparativas dos grupos capazes e incapazes de deambulação funcional. A regressão logística binária (método stepwise forward) foi realizada para determinar os potenciais fatores associados à perda da deambulação funcional. Resultados: Entre os 55 pacientes (média de idade: 56,9 ± 11,2 anos), 74,5% eram capazes de deambular funcionalmente. Encontraram-se diferenças entre os grupos quanto ao tempo de diagnóstico, número de quedas, dor, uso de ventilação não invasiva, gastrostomia, capacidade de se virar no leito, auxiliares de locomoção, adaptações domiciliares, desempenho funcional, força muscular e fadiga. Os possíveis preditores de incapacidade de locomoção foram força muscular geral (OR = 0,837; p = 0,003) e fadiga (OR = 1,653; p = 0,034). Conclusão: A força muscular e a fadiga estão associadas ao declínio da capacidade de deambulação em pacientes com ELA. Diante da complexidade dos elementos envolvidos na caminhada, são necessários mais estudos que investiguem a influência desses aspectos nessa população.

Abstract Introduction: Amyotrophic lateral sclerosis (ALS) is a disabling neurodegenerative disease, which compromises locomotion and functional independence. As the goal of physical therapy is to maintain the individual's locomotion capacity and independence as long as possible, it is necessary to gain a better understanding of the possible factors associated with the loss of this capacity. Objective: To evaluate functional ambulation in patients with ALS and possible factors associated with its decline. Methods: A cross-sectional study was conducted with sporadic ALS patients. Demographic and clinical/functional aspects were evaluated. ALS Functional Rating Scale-Revised (ALSFRS-R), Functional Ambulation Category, Medical Research Council scale and Fatigue Severity Scale were used. Descriptive and comparative analyses were conducted of the groups capable and incapable of functional ambulation. Binary logistic regression (stepwise forward method) was performed to determine potential factors associated with the loss of functional ambulation. Results: Among the 55 patients (mean age: 56.9 ± 11.2 years), 74.5% were able to walk functionally. Differences were found between groups regarding time of diagnosis, number of falls, pain, use of noninvasive ventilation, gastrostomy, ability to turn in bed, mobility aids, home adaptations, functional performance, muscle strength and fatigue. The possible predictors of walking disability were overall muscle strength (OR = 0.837; p = 0.003) and fatigue (OR =1.653; p = 0.034). Conclusion: Muscle strength and fatigue are associated with the decline in ambulation capacity in patients with ALS. In view of the complexity of elements involved in walking, further studies are needed to investigate the influence of these aspects in this population.

https://doi.org/10.1590/fm.2022.35127

11.

Desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais: revisão integrativa
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Brito, Eva Anny Wélly de Souza

; Martins, Mariana Cavalcante

; Guedes, Nirla Gomes

; Oriá, Mônica Oliveira Batista

; Castro, Régia Christina Moura Barbosa

; Sousa, Weslley Monteiro Amora

; Silva, Leonardo Alexandrino da

; Carneiro, Thais Aquino

Acta Paulista de Enfermagem

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2022, Volume 35 elocation eAPE03397

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

Resumo Objetivo Analisar as evidências científicas de práticas de desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais. Métodos Revisão integrativa de literatura, realizada de junho a julho de 2020, nas bases de dados: LILACS, SciELO, CINAHL, SCOPUS, Web of Science e MEDLINE. Os achados foram organizados conforme o fluxograma PRISMA e discutidos de acordo com a literatura pertinente. Resultados Dos 780 artigos encontrados, apenas cinco contemplaram os critérios de inclusão. Os saneantes utilizados foram: cloreto de didecildimetilamônio, polihexametilenobiguanida e Peróxido de Hidrogênio (VHP); cloreto de didecildimetilamônio; N-(3-aminopropyl)-N-dodécylpropane-1,3-diamine; cloreto de didecildimetilamônio e limpeza a vapor; água com detergente para limpeza no balde e água sanitária (200mg/L) e desinfectante Umonium38® a 2,5%. Há diversidade de opções para desinfecção das incubadoras, com variação de métodos e frequência de limpeza. Os saneantes utilizados foram eficazes, apontando para redução da carga microbiana. Conclusão Observou-se uma variedade de procedimentos e produtos que podem ser utilizados para limpeza e desinfecção das incubadoras. Os procedimentos de desinfecção favoreceram a redução da contaminação da superfície. No entanto, a presença de micro-organismos, mesmo que reduzida, alerta sobre o risco à segurança do paciente.

Abstract Objective To analyze the scientific evidence of incubator disinfection practices used in Neonatal Intensive Care Units. Methods This is an integrative literature review, conducted from June to July 2020, in the LILACS, SciELO, CINAHL, Scopus, Web of Science and MEDLINE databases. The findings were organized according to the PRISMA flowchart and discussed according to pertinent literature. Results Of the 780 articles found, only five met the inclusion criteria. The sanitizers used were: didecyldimethylammonium chloride, PHMB and vaporized hydrogen peroxide (VHP); didecyldimethylammonium chloride; N-(3-aminopropyl)-N-dodecylpropane-1,3-diamine; didecyldimethylammonium chloride and steam cleaning; water with detergent for cleaning in the bucket and bleach (200 mg/L) and 2.5% Umonium38® disinfectant. There is a diversity of options for disinfection of incubators, with variation of methods and frequency of cleaning. The sanitants used were effective, pointing to reduction of microbial load. Conclusion A variety of procedures and products were observed that can be used for cleaning and disinfection of incubators. Disinfection procedures favored the reduction of surface contamination. However, the presence of microorganisms, even if reduced, alerts about the risk to patient safety.

Resumen Objetivo Analizar las evidencias científicas de prácticas de desinfección de incubadoras usadas en Unidades de Cuidados Intensivos Neonatales. Métodos Revisión integradora de literatura, realizada de junio a julio de 2020, en las bases de datos: LILACS, SciELO, CINAHL, SCOPUS, Web of Science y MEDLINE. Los resultados fueron organizados de acuerdo con el diagrama de flujo PRISMA y discutidos de acuerdo con la literatura pertinente. Resultados De los 780 artículos encontrados, solamente cinco contemplaron los criterios de inclusión. Los desinfectantes utilizados fueron: cloruro de didecildimetilamonio, polihexametilen biguanida y peróxido de hidrógeno (VHP); cloruro de didecildimetilamonio; N-(3-aminopropil)-N-dodecilpropano-1,3-diamina; cloruro de didecildimetilamonio y limpieza a vapor; agua con detergente para limpieza en el balde y cloro (200mg/L) y desinfectante Umonium38® al 2,5 %. Existe una diversidad de opciones para la desinfección de las incubadoras, con variación de métodos y frecuencia de limpieza. Los desinfectantes utilizados fueron eficaces, lo que indica una reducción de la carga microbiana. Conclusión Se observó una variedad de procedimientos y de productos que se pueden utilizar para la limpieza y la desinfección de las incubadoras. Los procedimientos de desinfección favorecieron la reducción de la contaminación de la superficie. Sin embargo, la presencia de microorganismos, aunque reducida, alerta respecto al riesgo a la seguridad del paciente.

https://doi.org/10.37689/acta-ape/2022ar003397

12.

The use of occlusive dressings: influence on excisional wound healing in animal model
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Guillen, Mariana Raquel Soares

; Borges, Eline Lima

; Amorim, Gilmara Lopes

; Vieira, Puebla Cassini

; Guedes, Antônio Carlos Martins

; Barcelos, Luciola Silva

Acta Cirúrgica Brasileira

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2022, Volume 37 N. 12 elocation e371206

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To analyze the influence of occlusive dressing on the healing of excisional skin wounds in mice. Methods: Pre-clinical, comparative, and translational study. Mice were divided into three experimental groups: wounds occluded with hydrocolloid (HD) dressings, transparent polyurethane film (TF) dressings, and without occlusion (WO), monitored at three, six and 14 days, with eight animals each. Closure rate, infiltration of neutrophils and macrophages, measurement of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) and, histologically, angiogenesis were evaluated. Results: Wound closure was accelerated in the occlusive groups. There was a decrease in TNF-α levels in the HD group when compared to the WO and TF groups. Neutrophils accumulation decreased in the HD group. Increased dosages of macrophages were evidenced in the HD group, compared to the WO and TF groups. Levels of VEGF were increased in the TF and HD groups. Conclusions: It is suggested that the occlusion of wounds modulates the inflammatory response.

https://doi.org/10.1590/acb371206

13.

Agenesia isolada do corpo caloso - que prognóstico neurológico?
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Torrinha, Mariana Camanho Lencastre Fleming

; Seco, Inês Maria Moreira Guedes Maia Nunes de Melo

; Monteiro, Cristina Maria Conceição Dias

Acta Obstétrica e Ginecológica Portuguesa

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dec 2021, Volume 15 N. 4 Pages 362 - 369

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

Abstract Corpus Callosum Agenesis (CCA) is a rare clinical entity. The diagnosis of CCA is mostly made in the prenatal period and includes genetic factors as one of the main causes for its development. Parental counseling is extremely difficult particularly in cases of isolated malformation due to the wide variety of possible clinical presentations. The article reviews this pa-thology with a particular focus on isolated agenesis of corpus callosum and its associated neurological prognosis. The analysis is essential so that parental counseling can be adequately given when this diagnosis is made in the prenatal period.

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14.

Infarto Agudo do Miocárdio com Trombose Coronária em um Paciente com Covid-19 sem Fatores de Risco para Doença Cardiovascular
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Viana, Tainá

; Bezerra, Mariana Lins Baptista Guedes

; Melo, Rodrigo Morel Vieira de

; Bezerra, Cristiano Guedes

; Mamédio, Vítor

; Dourado, Gabriela Pio

; Figueiredo, Clara Salles

; Passos, Luiz Carlos Santana

Arquivos Brasileiros de Cardiologia

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mar 2021, Volume 116 N. 3 Pages 511 - 515

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

https://doi.org/10.36660/abc.20200972 841 downloads

15.

Domestic violence against women amidst the pandemic: coping strategies disseminated by digital media
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Fornari, Lucimara Fabiana

; Lourenço, Rafaela Gessner

; Oliveira, Rebeca Nunes Guedes de

; Santos, Danyelle Leonette Araújo dos

; Menegatti, Mariana Sbeghen

; Fonseca, Rosa Maria Godoy Serpa da

Revista Brasileira de Enfermagem

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2021, Volume 74 Suppl. 1 elocation e20200631

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

RESUMO Objetivo: conhecer as estratégias de enfrentamento da violência doméstica contra a mulher divulgadas pelas mídias digitais no início da pandemia de COVID-19. Métodos: estudo documental de abordagem qualitativa. A busca aconteceu de 11 de março a 30 de abril de 2020, em quatro fontes: jornais e portais online, rede social, páginas oficiais governamentais e portais do terceiro setor. Realizou-se análise de conteúdo temática dos achados. Resultados: foram identificadas 77 estratégias na imprensa jornalística, 93 na rede social, 45 nos portais governamentais e 40 nas organizações do terceiro setor. Da análise, emergiram três categorias empíricas: Estratégias para comunicação com as mulheres; Estratégias adotadas pelos serviços de atendimento; Estratégias para informar a população. Considerações finais: a maior parte das estratégias foram adaptações de serviços já existentes, centradas na denúncia da violência pelas mulheres.

ABSTRACT Objective: to know the strategies to cope with domestic violence against women disseminated by digital media at the beginning of the COVID-19 pandemic. Methods: a documentary study with a qualitative approach. The search took place from March 11 to April 30, 2020, from four sources: newspapers and online portals, social network, official government pages and third sector portals. Thematic content analysis of the findings was performed. Results: seventy-seven strategies were identified in the journalistic press, 93 in the social network, 45 in government portals and 40 in third sector organizations. From analysis, three empirical categories emerged: Strategies for communication with women; Strategies adopted by customer service; Strategies to inform the population. Final considerations: most of strategies were adaptations of existing services, centered on the reporting of violence by women

RESUMEN Objetivo: conocer las estrategias para enfrentar la violencia doméstica contra las mujeres difundidas por los medios digitales al inicio de la pandemia de COVID-19. Métodos: estudio documental con enfoque cualitativo. La búsqueda se realizó del 11 de marzo al 30 de abril de 2020, a partir de cuatro fuentes: periódicos y portales en línea, red social, páginas oficiales del gobierno y portales del tercer sector. Se realizó un análisis de contenido temático de los hallazgos. Resultados: se identificaron 77 estrategias en la prensa periodística, 93 en la red social, 45 en portales gubernamentales y 40 en organizaciones del tercer sector. Del análisis surgieron tres categorías empíricas: Estrategias de comunicación con las mujeres; Estrategias adoptadas por el servicio al cliente; Estrategias para informar a la población. Consideraciones finales: la mayoría de las estrategias fueron adaptaciones de servicios existentes, centradas en la denuncia de violencia por parte de mujeres.

https://doi.org/10.1590/0034-7167-2020-0631 9763 downloads

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