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1.
Revisiting the orbital complications of acute rhinosinusitis
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Anselmo-Lima, Wilma T.
; Soares, Mateus R.
; Fonseca, Jefferson P.
; Garcia, Denny M.
; Cruz, Antonio A. Velasco e
; Tamashiro, Edwin
; Valera, Fabiana CP.
.
Abstract Objective: The present study revisited three classification systems of orbital complications of acute rhinosinusitis (ARS) (Chandler, Mortimore & Wormald, and Velasco e Cruz & Anselmo-Lima) and observed which of them presented the best clinical applicability. Methods: Clinical data and CT scan findings of patients with orbital infection were retrospectively collected. To compare the three classification systems, we revised and graded all CT images accordingly, and divided the patients into four groups: Eyelid cellulitis (EC), orbital cellulitis (OC), subperiosteal abscess (SA), and orbital abscess (OA). The groups were compared regarding the presence of sinus opacification, the need for hospitalization and/or surgical treatment, and the presence of further complications/sequelae. Results: 143 patients were included. The median number of sinuses involved in patients in the OC, SA, and OA groups was 2.0. ARS was rarely associated with signs of EC (present in both Chandler’s and Mortimore & Wormald’s classifications. The hospitalization rate was significantly lower in the EC group compared to the other three groups. Surgery was performed in all cases in the OA group, in 58.1% in the SA group, 19.4% in the OC group, and 12.5% in the EC group (p-value < 0.0001 ). Complications were present at higher rates in the OA group compared to the other three groups. Conclusions: ARS was rarely associated with Eyelid Cellulitis. The stratification in the other three groups showed to be clinically relevant. Velasco e Cruz & Anselmo-Lima's classification system proved valid, simple, and effective for categorizing orbital complications of ARS. Level of evidence: 3.
2.
[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães
Barroso, Weimar Kunz Sebba
Mion Júnior, Décio
Nobre, Fernando
Mota-Gomes, Marco Antonio
Jardim, Paulo Cesar Brandão Veiga
Amodeo, Celso
Camargo, Adriana
Alessi, Alexandre
Sousa, Ana Luiza Lima
Brandão, Andréa Araujo
Pio-Abreu, Andrea
Sposito, Andrei Carvalho
Pierin, Angela Maria Geraldo
Paiva, Annelise Machado Gomes de
Spinelli, Antonio Carlos de Souza
Machado, Carlos Alberto
Poli-de-Figueiredo, Carlos Eduardo
Rodrigues, Cibele Isaac Saad
Forjaz, Cláudia Lúcia de Moraes
Sampaio, Diogo Pereira Santos
Barbosa, Eduardo Costa Duarte
Freitas, Elizabete Viana de
Cestário , Elizabeth do Espírito Santo
Muxfeldt, Elizabeth Silaid
Lima Júnior, Emilton
Campana, Erika Maria Gonçalves
Feitosa, Fabiana Gomes Aragão Magalhães
Consolim-Colombo, Fernanda Marciano
Almeida, Fernando Antônio de
Silva, Giovanio Vieira da
Moreno Júnior, Heitor
Finimundi, Helius Carlos
Guimarães, Isabel Cristina Britto
Gemelli, João Roberto
Barreto Filho, José Augusto Soares
Vilela-Martin, José Fernando
Ribeiro, José Marcio
Yugar-Toledo, Juan Carlos
Magalhães, Lucélia Batista Neves Cunha
Drager, Luciano Ferreira
Bortolotto, Luiz Aparecido
Alves, Marco Antonio de Melo
Malachias, Marcus Vinícius Bolívar
Neves, Mario Fritsch Toros
Santos, Mayara Cedrim
Dinamarco, Nelson
Moreira Filho, Osni
Passarelli Júnior, Oswaldo
Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira
Miranda, Roberto Dischinger
Bezerra, Rodrigo
Pedrosa, Rodrigo Pinto
Paula, Rogério Baumgratz de
Okawa, Rogério Toshiro Passos
Póvoa, Rui Manuel dos Santos
Fuchs, Sandra C.
Inuzuka, Sayuri
Ferreira-Filho, Sebastião R.
Paffer Fillho, Silvio Hock de
Jardim, Thiago de Souza Veiga
Guimarães Neto, Vanildo da Silva
Koch, Vera Hermina
Gusmão, Waléria Dantas Pereira
Oigman, Wille
Nadruz, Wilson
Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population.
Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care.
It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations.
Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced.
Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM).
Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance.
Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.
La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial.
La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización.
Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones.
Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA.
La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA).
Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia.
Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.
A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial.
A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização.
Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações.
Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA.
A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA).
Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz).
Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.
3.
Ganglio centinela positivo en melanoma: factores predictivos y resultados del vaciamiento ganglionar
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Magraht, Carolina
; Mazzei, Fabiana B.
; Verna, Silvina
; Paradeda, María Eugenia
; Paes de Lima, Andrea
; Montesinos, Manuel R.
.
ABSTRACT Background: Sentinel lymph node (SLN) biopsy is the technique accepted to determine the prognosis of early cutaneous melanomas. The advantage of lymph node dissection (LND) when SLN biopsy is positive has recently been questioned. Objective: The aim of this study is to describe the percentages and factors associated with SLN and non-sentinel node (NSN) metastases in LNDs of SLN-positive patients. Material and methods: The clinical records and pathology reports of 139 patients undergoing surgery for cutaneous melanoma between January 2012 and December 2019 were retrospectively reviewed. Results: Ninety-six (69%) patients underwent SLN biopsy. Mean age was 61.7 ± 17.5 years (19-93) and 53 (55.2%) were men. The primary lesion was located in the extremities in 47 (49%) cases, in the trunk in 39 (40.6%), and in the head and neck in 10 (10.4%). Mean Breslow thickness was 5.01 mm (1.05-50 mm) and ulceration was found in 35 cases (36.4%). The SLN was identified in all the cases and was positive in 39 (40.6%). There was an association with thickness ≥ 3 mm (p = 0.000017) and ulceration (p = 0.0011). Those patients with positive SLN biopsy underwent LND of the territory involved: axillary in 23, inguinal in 10 and cervical in 6. Twenty-three (59%) presented NSLN metastases and were associated with thickness (p = 0.022) and ulceration (p = 0.019). Conclusion: There was a high percentage of positive NSLN in the population studied which was associated with thickness and ulceration. These characteristics and the difficulty to achieve strict follow-up are the reasons for completion LND in SLN-positive patients.
RESUMEN Antecedentes: la biopsia del ganglio centinela (GC) es la técnica aceptada para determinar el pronóstico en estadios iniciales de melanoma cutáneo. La ventaja del vaciamiento ganglionar (VG) cuando el GC resulta positivo ha sido recientemente cuestionada. Objetivo: describir los porcentajes y factores asociados a metástasis en el GC, y en los ganglios no centinela (GnC) en los VG de pacientes con GC positivo. Material y métodos: se llevó a cabo un estudio retrospectivo de los registros clínicos y patológicos de 139 pacientes operados por melanoma cutáneo entre enero de 2012 y diciembre de 2019. Resultados: a 96 (69%) pacientes se les realizó biopsia de GC. El promedio de edad fue 61,7 años ± 17,5 (19-93); 53 (55,2%) fueron hombres. La lesión primaria estuvo ubicada en: extremidades 47 (49%), tronco 39 (40,6%), cabeza y cuello 10 (10,4%). El promedio de espesor de Breslow fue 5,01 mm (1,05- 50 mm) y se encontró ulceración en 35 casos (36,4%). El GC fue identificado en todas las oportunidades y en 39 (40,6%) fue positivo. Hubo asociación con el espesor ≥ 3 mm (p = 0,000017) y con la ulceración (p = 0,0011). A los pacientes con GC positivo se les efectuó el VG del territorio afectado: 23 axilar, 10 inguinal y 6 cervical. Veintitrés (59%) presentaron metástasis en GnC. Se asoció con el espesor (p = 0,022) y la ulceración (p = 0,019). Conclusión: existió un alto porcentaje de GnC positivos en la población estudiada, vinculado al espesor y la ulceración. Estas características, así como la dificultad de un estricto seguimiento, inducen a no abandonar el VG en pacientes con GC positivo.
4.
Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (CRSwNP) in Brazil
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Anselmo-Lima, Wilma T.
; Tamashiro, Edwin
; Romano, Fabrizio R.
; Miyake, Marcel M.
; Roithmann, Renato
; Kosugi, Eduardo M.
; Nakanishi, Márcio
; Fornazieri, Marco A.
; Bezerra, Thiago F.P.
; Mello Jr., João F.
; Lessa, Marcus M.
; Voegels, Richard L.
; Piltcher, Otávio B.
; Sakano, Eulalia
; Valera, Fabiana C.P.
.
Resumo Introdução A rinossinusite crônica com pólipos nasais grave não controlada impacta negativamente na qualidade de vida do indivíduo. Para esses casos, novos imunobiológicos têm surgido, para uso em fenótipos específicos da rinossinusite crônica, e mudaram os paradigmas de seu tratamento. Objetivo Revisar o estado atual das indicações de imunobiológicos em rinossinusite crônica. Método A Academia Brasileira de Rinologia reuniu diferentes especialistas para sugerir uma conduta que considerasse suas particularidades e seus aspectos relacionados à realidade nacional. Resultados De particular interesse para a tomada de decisão serão a identificação dos subgrupos de pacientes refratários às opções de tratamento pré-existentes e a construção de uma estratégia que realmente melhore a qualidade de vida deles, dentro da melhor relação custo-benefício. Conclusão O uso de imunobiológicos é uma opção válida para tratamento em casos mais graves. Essa estratégia deve ser mais bem compreendida e aprimorada no futuro, com mais estudos e maior experiência clínica.
Abstract Introduction Severe uncontrolled chronic rhinosinusitis with nasal polyps has a negative impact on an individual’s quality of life. Therefore, new biologics have emerged for use in specific phenotypes of chronic rhinosinusitis, changing the paradigms of its treatment. Objective To review the current status of biologic treatment indications in chronic rhinosinusitis. Methods The Brazilian Academy of Rhinology brought together different specialists to suggest a course of action, considering its particularities and aspects related to the national reality. Results Of particular interest for decision making will be the identification of subgroups of patients refractory to pre-existing treatment options and the construction of a strategy that improves their quality of life, with the best cost-benefit ratio. Conclusion The use of biologics is a valid option for treatment in more severe cases. This strategy must be better understood and improved in the future, with more studies and greater clinical experience.
5.
COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience
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Gomes, Walter J.
; Rocco, Isadora
; Pimentel, Wallace S.
; Pinheiro, Aislan H. B.
; Souza, Paulo M. S.
; Costa, Luiz A. A.
; Teixeira, Marjory M. P.
; Ohashi, Leonardo P.
; Bublitz, Caroline
; Begot, Isis
; Moreira, Rita Simone L
; Hossne Jr, Nelson A.
; Vargas, Guilherme F.
; Branco, João Nelson R.
; Teles, Carlos A.
; Medeiros, Eduardo A. S.
; Sáfadi, Camila
; Rampinelli, Amândio
; Moratelli Neto, Leopoldo
; Rosado, Anderson Rosa
; Mesacasa, Franciele Kuhn
; Capriata, Ismael Escobar
; Segalote, Rodrigo Coelho
; Palmieri, Deborah Louize da Rocha Vianna
; Jardim, Amanda Cristina Mendes
; Vianna, Diego Sarty
; Coutinho, Joaquim Henrique de Souza Aguiar
; Jazbik, João Carlos
; Coutinho, Henrique Madureira da Rocha
; Kikuta, Gustavo
; Almeida, Zely Sant'Anna Marotti de
; Feguri, Gibran Roder
; Lima, Paulo Ruiz Lucio de
; Franco, Anna Carolina
; Borges, Danilo de Cerqueira
; Cruz, Felipe Ramos Honorato De La
; Croti, Ulisses Alexandre
; Borim, Bruna Cury
; Marchi, Carlos Henrique De
; Goraieb, Lilian
; Postigo, Karolyne Barroca Sanches
; Jucá, Fabiano Gonçalves
; Oliveira, Fátima Rosane de Almeida
; Souza, Rafael Bezerra de
; Zilli, Alexandre Cabral
; Mas, Raul Gaston Sanchez
; Bettiati Junior, Luiz Carlos
; Tranchesi, Ricardo
; Bertini Jr, Ayrton
; Franco, Leandro Vieira
; Fernandes, Priscila
; Oliveira, Fabiana
; Moraes Jr, Roberto
; Araújo, Thiago Cavalcanti Vila Nova de
; Braga, Otávio Penna
; Pedrosa Sobrinho, Antônio Cavalcanti
; Teixeira, Roberta Tavares Barreto
; Camboim, Irla Lavor Lucena
; Gomes, Eduardo Nascimento
; Reis, Pedro Horigushi
; Garcia, Luara Piovan
; Scorsioni, Nelson Henrique Goes
; Lago, Roberto
; Guizilini, Solange
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.
6.
Association of interleukin 22 receptor subunit alpha 1 gene polymorphisms with chronic rhinosinusitis
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Dinarte, Vanessa R. Pires
; Silva Jr., Wilson A.
; Baccarin, Anemari R.D.
; Tamashiro, Edwin
; Valera, Fabiana C.
; Anselmo-Lima, Wilma T.
.
Resumo Introdução: A rinossinusite crônica é uma doença multifatorial cuja patogênese, influenciada por fatores genéticos e ambientais, ainda é incerta. Estudos genéticos anteriores mostraram que pacientes com rinossinusite crônica têm expressão reduzida do gene da Interleucina-22 (IL-22). Objetivo: Identificar e comparar a frequência de polimorfismos no gene IL22RA1 (receptor subunidade alfa 1 da interleucina 22) entre os pacientes com rinossinusite crônica com ou sem pólipos nasais. Método: Amostras de sangue periférico foram coletadas de 70 pacientes com rinossinusite crônica com pólipos nasais, 14 pacientes com rinossinusite crônica sem pólipos nasais e 68 indivíduos sem rinossinusite crônica, seguido por extração de DNA e análise da sequência do gene IL22RA1. Resultados: Dos dez polimorfismos identificados no gene IL22RA1, três não foram encontrados em alguma banco de dados genético analisado. Pacientes com rinossinusite crônica apresentaram maior frequência da inserção frameshift c.113_114insA, possivelmente patogênica. Por outro lado, no grupo controle, o polimorfismo c.435A>C mostrou predominância significativa do alelo mutado, talvez relacionado a uma proteção potencial contra o fenótipo da rinossinusite crônica. O polimorfismo c.770C> T, caracterizado como uma variante não sinônima, foi encontrado exclusivamente em pacientes negros com rinossinusite crônica com pólipos nasais. Conclusões: Embora nenhuma relação causal direta possa ser estabelecida entre os polimorfismos do gene IL22RA1 e a fisiopatologia da rinossinusite crônica, variações genéticas como c.113_114insA e c.435A>C podem estar envolvidas na suscetibilidade ou proteção contra o fenótipo da rinossinusite crônica, respectivamente. Testar essa hipótese exigirá estudos com coortes maiores.
Abstract Introduction: Chronic rhinosinusitis is a multifactorial disease whose pathogenesis, influenced rhinosinusitis; by both genetic and environmental factors, is still unclear. Previous genetic studies have shown that patients with chronic rhinosinusitis have reduced expression of the Interleukin-22 (IL-22) gene. Objective: Identify and compare the frequency of polymorphisms in the IL22RA1 gene (IL22 alpha-1 subunit receptor) among chronic rhinosinusitis patients – either with or without nasal polyps. Methods: Peripheral blood samples were collected from 70 chronic rhinosinusitis with polyps patients, 14 chronic rhinosinusitis without polyps patients and 68 subjects without chronic rhinosinusitis, followed by DNA extraction and IL22RA1 gene sequence analysis. Results: Among ten polymorphisms identified in the IL22RA1 gene, three were not found in any of the genetic databases analyzed. Chronic rhinosinusitis patients displayed higher frequency of the c.113_114insA frameshift insertion, possibly pathogenic. Conversely, in the control group, polymorphism c.435A > C had a significant predominance of the mutated allele, perhaps related to a potential protection against the chronic rhinosinusitis phenotype. Polymorphism c.770C > T, characterized as a non-synonymous variant, was exclusively found in Black chronic rhinosinusitis with polyps patients. Conclusions: Although no direct causal relationship could be established between IL22RA1 gene polymorphisms and the pathophysiology of chronic rhinosinusitis, genetic variations such as c.113_114insA and c.435A > C may be involved in the susceptibility to or protection against the chronic rhinosinusitis phenotype, respectively. Testing this hypothesis will require studies with larger cohorts.
https://doi.org/10.1016/j.bjorl.2019.10.006
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7.
Synthesis and Biological Evaluation of Benzo[f]indole-4,9-diones N-Linked to Carbohydrate Chains as New Type of Antitumor Agents
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Dias, Flaviana R. F.
; Guerra, Fabiana S.
; Lima, Fernanda A.
; Castro, Yasmin K. C. de
; Ferreira, Vitor F.
; Campos, Vinícius R.
; Fernandes, Patrícia D.
; Cunha, Anna C.
.
In this work, we report the synthesis of three series of carbohydrate-based benzo[f]indole-4,9-diones and amino-1,4-naphthoquinone derivatives and evaluated their cytotoxic activity against eight human cancer cell lines. Several compounds showed a promising cytotoxic activity toward the tumor cell lines (half maximal inhibitory concentration (IC50) < 10.0 μM). The importance of the substitution pattern of the quinone derivatives on the antitumor activity was also discussed. 3-Carboethoxy-2-methyl-benzo[f]indole-4,9-dione derivatives were more cytotoxic than their parent compounds and amino-1,4-naphthoquinones. Unlike clinically useful anticancer agent doxorubicin, the majority of synthesized compounds did not exhibit any lytic effects against erythrocytes or normal human leukocytes.
https://doi.org/10.21577/0103-5053.20200202
219 downloads
8.
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
.
https://doi.org/10.36660/abc.20201238
10948 downloads
9.
Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine
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Helito, Alberto C.
; Lindoso, Livia
; Sieczkowska, Sofia M.
; Astley, Camilla
; Queiroz, Ligia B.
; Rose, Natalia
; Santos, Claudia Renata P.
; Bolzan, Thalis
; Peralta, Rita María I.A.
; Franco, Ruth R.
; Cominato, Louise
; Pereira, Rosa Maria R.
; Tannuri, Uenis
; Campos, Lucia Maria A.
; Lourenço, Benito
; Toma, Ricardo K.
; Medeiros, Karina
; Watanabe, Andréia
; Grangeiro, Patricia Moreno
; Farhat, Sylvia C.
; Casella, Caio B.
; Polanczyk, Guilherme V.
; Gualano, Bruno
; Silva, Clovis A.
; Sallum, Adriana M. E.
; Iraha, Amanda Y.
; Ihara, Bianca P.
; Mazzolani, Bruna C.
; Martinez, Claudia A.
; Strabelli, Claudia A. A.
; Fonseca, Claudia B.
; Lima, Dandara C. C.
; Setoue, Debora N. D.
; Roz, Deborah F. P.
; Smaira, Fabiana I.
; Roschel, Hamilton
; Miyatani, Helena T.
; Marques, Isabela G.
; Oba, Jane
; Ferreira, Juliana C. O.
; Simon, Juliana R.
; Kozu, Katia
; Saccani, Ligia P.
; Martiniano, Lorena V. M.
; Miranda, Luana C. A.
; Silva, Luiz E. V.
; Laurentino, Moisés F.
; Aikawa, Nadia E.
; Sakita, Neusa K.
; Tanigava, Nicolas Y.
; Pereira, Paulo R. A.
; Palmeira, Patrícia
; Angelo, Simone S.
; Lavorato, Sofia S. M.
; Bernardes, Tamires M.
; Franco, Tathiane C.
; Viana, Vivianne S. L.
; Barros, Vera P. M. F. R.
; Zheng, Yingying
.
OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality.
10.
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
; Brentani, Alexandra V. M.
; Neto, Álvaro José S.
; Ihara, Amanda
; Santos, Andrea R.
; Canton, Ana Pinheiro M.
; Watanabe, Andreia
; Santos, Angélica C. dos
; Pastorino, Antonio C.
; Franco, Bernadette D. G. M.
; Caruzo, Bruna
; Ceneviva, Carina
; Martins, Carolina C. M. F.
; Prado, Danilo
; Abellan, Deipara M.
; Benatti, Fabiana B.
; Smaria, Fabiana
; Gonçalves, Fernanda T.
; Penteado, Fernando D.
; Castro, Gabriela S. F. de
; Gonçalves, Guilherme S.
; Roschel, Hamilton
; Disi, Ilana R.
; Marques, Isabela G.
; Castro, Inar A.
; Buscatti, Izabel M.
; Faiad, Jaline Z.
; Fiamoncini, Jarlei
; Rodrigues, Joaquim C.
; Carneiro, Jorge D. A.
; Paz, Jose A.
; Ferreira, Juliana C.
; Ferreira, Juliana C. O.
; Silva, Katia R.
; Bastos, Karina L. M.
; Kozu, Katia
; Cristofani, Lilian M.
; Souza, Lucas V. B.
; Campos, Lucia M. A.
; Silva Filho, Luiz Vicente R. F.
; Sapienza, Marcelo T.
; Lima, Marcos S.
; Garanito, Marlene P.
; Santos, Márcia F. A.
; Dorna, Mayra B.
; Aikawa, Nadia E.
; Litvinov, Nadia
; Sakita, Neusa K.
; Gaiolla, Paula V. V.
; Pasqualucci, Paula
; Toma, Ricardo K.
; Correa-Silva, Simone
; Sieczkowska, Sofia M.
; Imamura, Marta
; Forsait, Silvana
; Santos, Vera A.
; Zheng, Yingying
.
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
11.
Vascularization of the Alouatta belzebul brain base
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Sabec-Pereira, Dayane Kelly
; Lima, Fabiano C.
; Melo, Fabiano R.
; Melo, Fabiana Cristina S.A.
; Pereira, Kleber Fernando
; Vulcani, Valcinir Aloisio S.
.
RESUMO: Estudamos o círculo arterial no encéfalo de cinco espécimes do primata Alouatta belzebul. O material teve o sistema arterial perfundido (água a 40°C), injetado com látex corado (Neoprene 650), fixado em solução aquosa de formaldeído (10%) e dissecado para verificação dos vasos. O círculo arterial deste primata é composto por dois sistemas vasculares: vértebro-basilar e o sistema carotídeo, que se anastomosam para fechar o circuito arterial. Na porção caudal do círculo arterial encontra-se as artérias vertebrais e seus ramos: artéria espinal rostral e a cerebelar inferior caudal. A anastomose das artérias vertebrais dá origem a artéria basilar. Esta apresentou uma variação anatômica no início do seu trajeto, formando uma dupla artéria basilar, denominada ilha arterial. Em seu trajeto emitiu ramos dando origem a artéria cerebelar inferior rostral, as artérias pontinas, as artérias cerebelares rostrais, as artérias cerebelares rostrais satélites e o seu ramo terminal, a artéria cerebral caudal, que apresentou-se em dois segmentos: o pré-comunicante e pós-comunicante, unindo-se a artéria carótida interna e originando a artéria comunicante caudal. Este grupo de artérias e anastomoses encerram a porção caudal do círculo arterial. Das artérias carótidas internas direita e esquerda, inicia-se a porção rostral do círculo arterial, ao qual é constituído pelas artérias cerebrais rostrais direita e esquerda e as artérias cerebrais médias direita e esquerda. As artérias cerebrais rostrais se anastomosam em um tronco único dando origem a artéria inter-hemisférica e em A. belzebul e Sapajus libidinosus, a artéria comunicante rostral se encontra ausente. A artéria inter-hemisférica segue para região média do encéfalo e no joelho do corpo caloso se divide em artéria pericalosa e artéria calosomarginal, que vão suprir as regiões pré e pós-central dos hemisférios cerebrais desta espécie, assim como outros primatas não humanos e humano. Nota-se que na primeira parte da artéria cerebral rostral esquerda, ocorre uma inosculação direta entre o ramo recorrente da artéria cerebral rostral e artéria cerebral média esquerda para suprir a região entorrinal, esse fato também ocorre em Pongo spp. A artéria cerebral média segue seu trajeto pelo sulco lateral onde emite vários ramos superficiais para irrigar as regiões corticais supero e ínfero lateral do lobo frontal, parietal e temporal, esta não faz parte do círculo arterial mas é o ramo terminal da artéria carótida interna. Pode-se considerar que A. belzebul depende de duas fontes de suprimento para o encéfalo: os sistemas vértebro-basilar e carotídeo, contribuindo na intervenção de médicos veterinários durante os procedimentos clínicos e cirúrgicos em outros primatas, assim como na preservação de animais silvestres.
ABSTRACT: We studied the arterial circle in the brain of five specimens of the Alouatta belzebul primate. The material had the arterial system perfused (water at 40°C), injected with stained latex (Neoprene 650), fixed in aqueous formaldehyde solution (10%) and dissected for vessel verification. The arterial circle of this primate is composed of two vascular systems: the vertebra-basilar and the carotid ones, which anastomose to close the arterial circuit. In the caudal portion of the arterial circle, there are the vertebral arteries and their branches: the rostral spinal artery and the caudal inferior cerebellar artery. The anastomosis of the vertebral arteries gives rise to the basilar artery. It presented an anatomical variation at the beginning of its path, forming a double basilar artery, called arterial island. In its course, it emitted branches giving rise to the rostral inferior cerebellar artery, the pontine arteries, the rostral cerebellar arteries, the satellite rostral cerebellar arteries and its terminal branch, the caudal cerebral artery, which presented itself in two segments: the pre-communicating one and post-communicating, joining the internal carotid artery and originating the caudal communicating artery. This group of arteries and anastomoses enclose the caudal portion of the arterial circle. From the right and left internal carotid arteries begins the rostral portion of the arterial circle, which consists of the right and left rostral cerebral arteries and the right and left middle cerebral arteries. The rostral cerebral arteries anastomose into a single trunk, giving rise to the interhemispheric artery, and in A. belzebul and Sapajus libidinosus, the rostral communicating artery is absent. The interhemispheric artery goes to the midbrain region and the corpus callosum knee divides into pericalous artery and callosarginal artery, which will supply the pre and post-central regions of the cerebral hemispheres of this species, as well as other non-human and human primates. It is noted that in the first part of the left rostral cerebral artery, there is a direct inosculation between the recurrent branch of the rostral cerebral artery and left middle cerebral artery to supply the entorhinal region. This fact also occurs in Pongo spp. The middle cerebral artery travels along the lateral sulcus where it emits several superficial branches to irrigate the superior and inferior lateral cortical regions of the frontal, parietal and temporal lobes. It is not part of the arterial circle but is the terminal branch of the internal carotid artery. A. belzebul can be considered to depend on two sources of supply to the brain: the vertebra-basilar and carotid systems, contributing to the intervention of veterinarians during clinical and surgical procedures in other primates, as well as the preservation of wild animals.
https://doi.org/10.1590/1678-5150-pvb-6536
663 downloads
12.
Statistical association of rs2243250 polymorphism of IL4 gene and hemorrhagic stroke in Brazilian population
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Rolim, Ângelo M.
; Borges, Felipe S. A.
; Barros, Aline R.
; Lima, Jonathan D.
; Silva, Fabiana B. A.
; Souza, Hélia Carla de
; Freire, Daniel O.
; Ferreira, Luzitano B.
; Silva, Izabel Cristina R.
.
Jornal Brasileiro de Patologia e Medicina Laboratorial
- Journal Metrics
RESUMO A interleucina-4 (IL-4) tem grande importância nos processos inflamatórios em casos de acidente vascular cerebral (AVC), uma vez que ela é capaz de polarizar micróglias para o fenótipo anti-inflamatório chamado M2. Este estudo analisou se a variação entre o genótipo TT e os demais genótipos (CT e CC), no polimorfismo -589 (rs2243250) do gene IL4, possui associação com o prognóstico de AVC hemorrágico e com aspectos clínicos que são fatores de risco para doenças cerebrovasculares. O resultado deste estudo mostra que não há associação estatística do polimorfismo do IL4 nem com prognóstico nem com os aspectos clínicos dos pacientes com AVC hemorrágico.
ABSTRACT Interleukin-4 (IL-4) has great significance in inflammatory processes in cases of stroke, since it is able to polarize microglia to the antiinflammatory phenotype called M2. This study analyzed if the variation between TT genotype and the other genotypes (CT and CC), in -589 (rs2243250) polymorphism of IL4 gene, has association with the prognosis of hemorrhagic stroke (HS) and with clinical aspects which are risk factors for cerebrovascular diseases. The result of this study shows that there is no statistical association of the IL4 polymorphism with either prognosis or clinical aspects in HS patients.
RESUMEN La interleucina-4 (IL-4) tiene gran importancia en los procesos inflamatorios en casos de accidente cerebrovascular (ACV), puesto que hace que las microglías sean polarizadas hacia el fenotipo antiinflamatorio M2. Este estudio analizó si la variación entre el genotipo TT y los demás genotipos (CT y CC), en el polimorfismo -589 (rs2243250) del gen IL4, posee asociación con el pronóstico de ACV hemorrágico y con aspectos clínicos que son factores de riesgo para enfermedades cerebrovasculares. El resultado de este estudio enseña que no hay asociación estadística del polimorfismo del IL4 ni con el pronóstico ni con los aspectos clínicos de pacientes con ACV hemorrágico.
https://doi.org/10.5935/1676-2444.20200031
1106 downloads
13.
THE TYPOLOGY OF BROILER HOUSE AND THE IMPACT IN THE LOCOMOTION OF BROILERS
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Garcia, Rodrigo G.
; Lima, Nilsa D. da S.
; Naas, Irenilza de A.
; Caldara, Fabiana R.
; Sgavioli, Sarah
.
ABSTRACT The large majority of broiler houses use two types of systems: dark-house system - DHP, and tunnel with curtain system - ATC. The objective of the present study was to evaluate the association and the prevalence of locomotion issues in the broiler commercial farming systems (DHP and ATC). For assessing the thermal environment and the litter quality, a completely random design was adopted using two factors (broiler houses, DHP and ATC) with 12 repetitions. To study the surface temperature of the broiler breast, and the locomotion ability (gait score) a completely randomized design was adopted in a double factorial scheme 2 × 2 (two houses typology vs. sex) with 24 repetitions. To verify whether the type of house and the sex were associated to broiler locomotion problems due to the lack in walking ability, and the presence of medular compression (spondylolisthesis) the logistic regression was applied to the analysis: odds ratio and relative risk. The chance of the poultry to present inability of walking was 3.80 times higher in the male population. The risk factor associated with the lack of walking ability of the poultry was correlated to the tunnel house with curtains, presenting a relative risk 1.58 times higher when compared to the dark-house with walls. There was not the relative risk of medular compression (spondylolisthesis) neither was found an association between the poultry’ sex and the type of house. The reduction in the male broiler locomotion ability might be associated with the rearing in the housing tunnel with curtains.
14.
Extended-time of Noninvasive Positive Pressure Ventilation Improves Tissue Perfusion after Coronary Artery Bypass Surgery: a Randomized Clinical Trial
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Nasrala, Mara L. S.
; Bolzan, Douglas W.
; Lage, Yumi G.
; Prado, Fabiana S.
; Arena, Ross
; Lima, Paulo R. L.
; Feguri, Gibran
; Silva, Ageo M. C.
; Marcondi, Natasha O.
; Hossne, Nelson
; Guizilini, Solange
; Gomes, Walter J.
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
Abstract Objective: To compare the effects of extended- versus short-time noninvasive positive pressure ventilation on pulmonary function, tissue perfusion, and clinical outcomes in the early postoperative period following coronary artery bypass surgery in patients with preserved left ventricular function. Methods: Patients were randomized into two groups according to noninvasive positive pressure ventilation intensity: short-time noninvasive positive pressure ventilation n=20 (S-NPPV) and extended-time noninvasive positive pressure ventilation n=21 (E-NPPV). S-NPPV was applied for 60 minutes during immediate postoperative period and 10 minutes, twice daily, from postoperative days 1-5. E-NPPV was performed for at least six hours during immediate postoperative period and 60 minutes, twice daily, from postoperative days 1-5. As a primary outcome, tissue perfusion was determined by central venous oxygen saturation and blood lactate level measured after anesthetic induction, immediately after extubation and following noninvasive positive pressure ventilation protocols. As a secondary outcome, pulmonary function tests were performed preoperatively and in the postoperative days 1, 3, and 5; clinical outcomes were recorded. Results: Significant drop in blood lactate levels and an improvement in central venous oxygen saturation values in the E-NPPV group were observed when compared with S-NPPV group after study protocol (P<0.01). The E-NPPV group presented higher preservation of postoperative pulmonary function as well as lower incidence of respiratory events and shorter postoperative hospital stay (P<0.05). Conclusion: Prophylactic E-NPPV administered in the early postoperative period of coronary artery bypass surgery resulted in greater improvements in tissue perfusion, pulmonary function and clinical outcomes than S-NPPV, in patients with preserved left ventricular function. Trial Registration: Brazilian Registry of Clinical trial - RBR7sqj78 - http://www.ensaiosclinicos.gov.br
https://doi.org/10.21470/1678-9741-2017-0232
886 downloads
15.
3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology
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Gualandro, Danielle Menosi
; Yu, Pai Ching
; Caramelli, Bruno
; Marques, André Coelho
; Calderaro, Daniela
; Fornari, Luciana Savoy
; Pinho, Claudio
; Feitosa, Alina Coutinho Rodrigues
; Polanczyk, Carisi Anne
; Rochitte, Carlos Eduardo
; Jardim, Carlos
; Vieira, Carolina L. Z.
; Nakamura, Debora Y. M.
; Iezzi, Denise
; Schreen, Dirk
; Adam, Eduardo Leal
; D’Amico, Elbio Antonio
; Lima, Emerson Q. de
; Burdmann, Emmanuel de Almeida
; Mateo, Enrique Indalecio Pachón
; Marcondes-Braga, Fabiana Goulart
; Machado, Fabio S.
; Paula, Flavio J. de
; Carmo, Gabriel Assis Lopes do
; Feitosa-Filho, Gilson Soares
; Prado, Gustavo Faibischew
; Lopes, Heno Ferreira
; Fernandes, João R. C.
; Lima, José J. G. de
; Sacilotto, Luciana
; Drager, Luciano Ferreira
; Vacanti, Luciano Janussi
; Rohde, Luis Eduardo Paim
; Prada, Luis F. L.
; Gowdak, Luis Henrique Wolff
; Vieira, Marcelo Luiz Campos
; Monachini, Maristela Camargo
; Macatrão-Costa, Milena Frota
; Paixão, Milena Ribeiro
; Oliveira Junior, Mucio Tavares de
; Cury, Patricia
; Villaça, Paula R.
; Farsky, Pedro Silvio
; Siciliano, Rinaldo F.
; Heinisch, Roberto Henrique
; Souza, Rogerio
; Gualandro, Sandra F.M.
; Accorsi, Tarso Augusto Duenhas
; Mathias Júnior, Wilson
.
https://doi.org/10.5935/abc.20170140
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