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Abstract: Bone quality is an important issue in dentistry. Low bone density may be associated with more severe periodontitis, and may influence implant therapy success. Recent evidence suggests that physical activity can improve alveolar bone quality. Irisin is an exercise-mediated peptide that might be involved in this process. We assessed the effect of exercise and that of intra-peritoneal irisin administration on bone quality in healthy and osteoporosis-induced rodents. This study was registered at PROSPERO (CRD42020184140), and followed PRISMA guidelines. A search by two independent examiners was conducted in five databases and gray literature up to July 2021, without restrictions regarding language or date of publication. Initially, they analyzed retrieved titles and abstracts (n=3,844) based on eligibility criteria. Of this total, 19 studies remained for full-text reading, and 16 proceeded to the data extraction and quality assessment phases. Meta-analyses were conducted (n= 6 studies) to establish the effects of irisin administration on cancellous bone mineral density (BMD). Exercise or irisin administration enhanced bone quality, but the meta-analysis showed that BMD increased only slightly in osteoporotic rodents (BMD: mean difference 0.03 mg/cm3 - 95% CI 0.01-0.05). This indicates that they had no significant benefits on the bones of healthy animals. Implications of key findings evidence the potential of irisin as an agent able to mitigate bone loss caused by osteoporosis, an outcome that could favor dental rehabilitation. More studies investigating the effect of irisin on alveolar bone are needed to elucidate its therapeutic viability and implications.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0055

Canopy openness and soil conditions explain community structure and diversity in a tropical seasonal forest in south-eastern Brazil
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Barreto, Tiago Egydio

; Ivanauskas, Natália Macedo

; Lima, Renato Augusto Ferreira de

; Toniato, Maria Teresa Zugliani

; Souza, Flaviana Maluf

; Rodrigues, Ricardo Ribeiro

Acta Botanica Brasilica

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dec 2021, Volume 35 N. 4 Pages 638 - 652

Abstract: En | Text: En | PDF: En

ABSTRACT In tropical semi-deciduous forests, where 20-50 % of canopy trees shed their leaves in the dry season, species with varying degrees of leaf deciduousness share the same space and resources. Here, we describe the tree community in a 10.24-ha plot to assess whether small-scale variation in canopy structure and soil conditions are associated with changes in tree community structure, diversity, and composition. We sampled 11,585 individuals with diameter at breast height ≥ 4.8 cm belonging to 146 species. Plot density (1,129 trees ha-1) and basal area (24.81 m2 ha-1) were smaller than other similar forests, which may be due to an old wind disturbance. For 8.96 ha, we evaluated the relationship between abiotic factors and community descriptors using regression models. Results varied within size classes, but canopy openness was associated with changes in the community structure and diversity, and soil fertility did not affect species diversity. Tree density, basal area, and diversity were smaller in areas with more canopy gaps. Tree density and basal area increase with phosphorus availability, while the density of deciduous trees increased with canopy openness and base saturation. Thus, we found evidence that canopy openness and soil can explain small-scale variations of forest structure and diversity.

https://doi.org/10.1590/0102-33062020abb0280

Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de

; Hammond, Naomi

; Li, Yang

; Azevedo, Luciano Cesar Pontes de

; Cavalcanti, Alexandre Biasi

; Taniguchi, Leandro

; Gobatto, André

; Japiassú, André Miguel

; Bafi, Antonio Tonete

; Mazza, Bruno Franco

; Noritomi, Danilo Teixeira

; Dal-Pizzol, Felipe

; Bozza, Fernando

; Salluh, Jorge Ibrahin Figueira

; Westphal, Glauco Adrieno

; Soares, Márcio

; Assunção, Murillo Santucci César de

; Lisboa, Thiago

; Lobo, Suzana Margarete Ajeje

; Barbosa, Achilles Rohlfs

; Ventura, Adriana Fonseca

; Souza, Ailson Faria de

; Silva, Alexandre Francisco

; Toledo, Alexandre

; Reis, Aline

; Cembranel, Allan

; Rea Neto, Alvaro

; Gut, Ana Lúcia

; Justo, Ana Patricia Pierre

; Santos, Ana Paula

; Albuquerque, André Campos D. de

; Scazufka, André

; Rodrigues, Antonio Babo

; Fernandino, Bruno Bonaccorsi

; Silva, Bruno Goncalves

; Vidal, Bruno Sarno

; Pinheiro, Bruno Valle

; Pinto, Bruno Vilela Costa

; Feijo, Carlos Augusto Ramos

; Abreu Filho, Carlos de

; Bosso, Carlos Eduardo da Costa Nunes

; Moreira, Carlos Eduardo Nassif

; Ramos, Carlos Henrique Ferreira

; Tavares, Carmen

; Arantes, Cidamaiá

; Grion, Cintia

; Mendes, Ciro Leite

; Kmohan, Claudio

; Piras, Claudio

; Castro, Cristine Pilati Pileggi

; Lins, Cyntia

; Beraldo, Daniel

; Fontes, Daniel

; Boni, Daniela

; Castiglioni, Débora

; Paisani, Denise de Moraes

; Pedroso, Durval Ferreira Fonseca

; Mattos, Ederson Roberto

; Brito Sobrinho, Edgar de

; Troncoso, Edgar M. V.

; Rodrigues Filho, Edison Moraes

; Nogueira, Eduardo Enrico Ferrari

; Ferreira, Eduardo Leme

; Pacheco, Eduardo Souza

; Jodar, Euzebio

; Ferreira, Evandro L. A.

; Araujo, Fabiana Fernandes de

; Trevisol, Fabiana Schuelter

; Amorim, Fábio Ferreira

; Giannini, Fabio Poianas

; Santos, Fabrício Primitivo Matos

; Buarque, Fátima

; Lima, Felipe Gallego

; Costa, Fernando Antonio Alvares da

; Sad, Fernando Cesar dos Anjos

; Aranha, Fernando G.

; Ganem, Fernando

; Callil, Flavio

; Costa Filho, Francisco Flávio

; Dall´Arto, Frederico Toledo Campo

; Moreno, Geovani

; Friedman, Gilberto

; Moralez, Giulliana Martines

; Silva, Guilherme Abdalla da

; Costa, Guilherme

; Cavalcanti, Guilherme Silva

; Betônico, Gustavo Navarro

; Reis, Hélder

; Araujo, Helia Beatriz N.

; Hortiz Júnior, Helio Anjos

; Guimaraes, Helio Penna

; Urbano, Hugo

; Maia, Israel

; Santiago Filho, Ivan Lopes

; Farhat Júnior, Jamil

; Alvarez, Janu Rangel

; Passos, Joel Tavares

; Paranhos, Jorge Eduardo da Rocha

; Marques, José Aurelio

; Moreira Filho, José Gonçalves

; Andrade, Jose Neto

; Sobrinho, José Onofre de C

; Bezerra, Jose Terceiro de Paiva

; Alves, Juliana Apolônio

; Ferreira, Juliana

; Gomes, Jussara

; Sato, Karina Midori

; Gerent, Karine

; Teixeira, Kathia Margarida Costa

; Conde, Katia Aparecida Pessoa

; Martins, Laércia Ferreira

; Figueirêdo, Lanese

; Rezegue, Leila

; Tcherniacovsk, Leonardo

; Ferraz, Leone Oliveira

; Cavalcante, Liane

; Rabelo, Ligia

; Miilher, Lilian

; Garcia, Lisiane

; Tannous, Luana

; Hajjar, Ludhmila Abrahão

; Paciência, Luís Eduardo Miranda

; Cruz Neto, Luiz Monteiro da

; Bley, Macia Valeria

; Sousa, Marcelo Ferreira

; Puga, Marcelo Lourencini

; Romano, Marcelo Luz Pereira

; Nobrega, Marciano

; Arbex, Marcio

; Rodrigues, Márcio Leite

; Guerreiro, Márcio Osório

; Rocha, Marcone

; Alves, Maria Angela Pangoni

; Rosa, Maria Doroti

; Dias, Mariza D’Agostino

; Martins, Miquéias

; Oliveira, Mirella de

; Moretti, Miriane Melo Silveira

; Matsui, Mirna

; Messender, Octavio

; Santarém, Orlando Luís de Andrade

; Silveira, Patricio Júnior Henrique da

; Vassallo, Paula Frizera

; Antoniazzi, Paulo

; Gottardo, Paulo César

; Correia, Paulo

; Ferreira, Paulo

; Torres, Paulo

; Silva, Pedro Gabrile M. de Barros e

; Foernges, Rafael

; Gomes, Rafael

; Moraes, Rafael

; Nonato filho, Raimundo

; Borba, Renato Luis

; Gomes, Renato V

; Cordioli, Ricardo

; Lima, Ricardo

; López, Ricardo Pérez

; Gargioni, Ricardo Rath de Oliveira

; Rosenblat, Richard

; Souza, Roberta Machado de

; Almeida, Roberto

; Narciso, Roberto Camargo

; Marco, Roberto

; waltrick, Roberto

; Biondi, Rodrigo

; Figueiredo, Rodrigo

; Dutra, Rodrigo Santana

; Batista, Roseane

; Felipe, Rouge

; Franco, Rubens Sergio da Silva

; Houly, Sandra

; Faria, Sara Socorro

; Pinto, Sergio Felix

; Luzzi, Sergio

; Sant’ana, Sergio

; Fernandes, Sergio Sonego

; Yamada, Sérgio

; Zajac, Sérgio

; Vaz, Sidiner Mesquita

; Bezerra, Silvia Aparecida Bezerra

; Farhat, Tatiana Bueno Tardivo

; Santos, Thiago Martins

; Smith, Tiago

; Silva, Ulysses V. A.

; Damasceno, Valnei Bento

; Nobre, Vandack

; Dantas, Vicente Cés de Souza

; Irineu, Vivian Menezes

; Bogado, Viviane

; Nedel, Wagner

; Campos Filho, Walther

; Dantas, Weidson

; Viana, William

; Oliveira Filho, Wilson de

; Delgadinho, Wilson Martins

; Finfer, Simon

; Machado, Flavia Ribeiro

Revista Brasileira de Terapia Intensiva

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apr 2021, Volume 33 N. 2 Pages 206 - 218

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

Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.

RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.

https://doi.org/10.5935/0103-507x.20210028

Determinants of minute ventilation-carbon dioxide production relationship in Chagas cardiomyopathy
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Oliveira, Lucas Frois Fernandes

; Andrade, Janaina Martins

; Figueiredo, Pedro Henrique Scheidt

; Ávila, Matheus Ribeiro

; Silva, Whesley Tanor

; Vianna, Marcus Vinicius Accetta

; Trede Filho, Renato Guilherme

; Costa, Henrique Silveira

; Rocha, Manoel Otávio Costa

; Lima, Vanessa Pereira

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0047-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) is among the main prognostic factors of Chagas cardiomyopathy whose determinants remain unknown. METHODS: Seventy-eight patients with Chagas cardiomyopathy were evaluated using clinical assessment, cardiopulmonary exercise test, echocardiography, and International Physical Activity Questionnaire. RESULTS: Age, functional class, International Physical Activity Questionnaire score, and dilated cardiomyopathy with systolic dysfunction were independent determinants of VE/VCO2 slope, and these variables explained 63% of its variance. CONCLUSIONS: The VE/VCO2 slope was related to age, functional class, physical activity level, and dilated cardiomyopathy with systolic dysfunction in patients with Chagas cardiomyopathy.

https://doi.org/10.1590/0037-8682-0047-2021

Identification and characterisation of SARS-CoV-2 and Human alphaherpesvirus 1 from a productive coinfection in a fatal COVID-19 case
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Herlinger, Alice Laschuk

; Monteiro, Fábio Luís Lima

; D’arc, Mirela

; Moreira, Filipe Romero Rebello

; Westgarth, Harrison James

; Galliez, Rafael Mello

; Mariani, Diana

; da Costa, Luciana Jesus

; de Almeida, Luiz Gonzaga Paula

; Voloch, Carolina Moreira

; Melo, Adriana Suely de Oliveira

; Aguiar, Renato Santana de

; dos Santos, André Felipe Andrade

; Castiñeiras, Terezinha Marta Pereira Pinto

; de Vasconcelos, Ana Tereza Ribeiro

; João Filho, Esaú Custódio

; Escosteguy, Claudia Caminha

; Ferreira Junior, Orlando da Costa

; Tanuri, Amilcar

; Higa, Luiza Mendonça

Memórias do Instituto Oswaldo Cruz

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2021, Volume 116 elocation e210176

Abstract: En | Text: En | PDF: En

BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.

https://doi.org/10.1590/0074-02760210176

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa

; Pereira, Maria Fernanda Badue

; Santos, Angélica Carreira dos

; Fink, Thais Toledo

; Paula, Camila Sanson Yoshino de

; Litvinov, Nadia

; Schvartsman, Claudio

; Delgado, Artur Figueiredo

; Gibelli, Maria Augusta Bento Cicaroni

; Carvalho, Werther Brunow de

; Odone Filho, Vicente

; Tannuri, Uenis

; Carneiro-Sampaio, Magda

; Grisi, Sandra

; Duarte, Alberto José da Silva

; Antonangelo, Leila

; Francisco, Rossana Pucineli Vieira

; Okay, Thelma Suely

; Batisttella, Linamara Rizzo

; Carvalho, Carlos Roberto Ribeiro de

; Brentani, Alexandra Valéria Maria

; Silva, Clovis Artur

; Eisencraft, Adriana Pasmanik

; Rossi Junior, Alfio

; Fante, Alice Lima

; Cora, Aline Pivetta

; Reis, Amelia Gorete A. de Costa

; Ferrer, Ana Paula Scoleze

; Andrade, Anarella Penha Meirelles de

; Watanabe, Andreia

; Gonçalves, Angelina Maria Freire

; Waetge, Aurora Rosaria Pagliara

; Silva, Camila Altenfelder

; Ceneviva, Carina

; Lazari, Carolina dos Santos

; Abellan, Deipara Monteiro

; Santos, Emilly Henrique dos

; Sabino, Ester Cerdeira

; Bianchini, Fabíola Roberta Marim

; Alcantara, Flávio Ferraz de Paes

; Ramos, Gabriel Frizzo

; Leal, Gabriela Nunes

; Rodriguez, Isadora Souza

; Pinho, João Renato Rebello

; Carneiro, Jorge David Avaizoglou

; Paz, Jose Albino

; Ferreira, Juliana Carvalho

; Ferranti, Juliana Ferreira

; Ferreira, Juliana de Oliveira Achili

; Framil, Juliana Valéria de Souza

; Silva, Katia Regina da

; Kanunfre, Kelly Aparecida

; Bastos, Karina Lucio de Medeiros

; Galleti, Karine Vusberg

; Cristofani, Lilian Maria

; Suzuki, Lisa

; Campos, Lucia Maria Arruda

; Perondi, Maria Beatriz de Moliterno

; Diniz, Maria de Fatima Rodrigues

; Fonseca, Maria Fernanda Mota

; Cordon, Mariana Nutti de Almeida

; Pissolato, Mariana

; Peres, Marina Silva

; Garanito, Marlene Pereira

; Imamura, Marta

; Dorna, Mayra de Barros

; Luglio, Michele

; Rocha, Mussya Cisotto

; Aikawa, Nadia Emi

; Degaspare, Natalia Viu

; Sakita, Neusa Keico

; Udsen, Nicole Lee

; Scudeller, Paula Gobi

; Gaiolla, Paula Vieira de Vincenzi

; Severini, Rafael da Silva Giannasi

; Rodrigues, Regina Maria

; Toma, Ricardo Katsuya

; Paula, Ricardo Iunis Citrangulo de

; Palmeira, Patricia

; Forsait, Silvana

; Farhat, Sylvia Costa Lima

; Sakano, Tânia Miyuki Shimoda

; Koch, Vera Hermina Kalika

; Cobello Junior, Vilson

Clinics

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2021, Volume 76 elocation e3488

Abstract: En | Text: En | PDF: En

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

https://doi.org/10.6061/clinics/2021/e3488

Acesso à fisioterapia de crianças e adolescentes com deficiência física em instituições públicas
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Silva, Verônica Andrade da

; Busnello, Adson Renato Rodrigues

; Cavassin, Renata Cristina

; Loureiro, Ana Paula Cunha

; Moser, Auristela Duarte de Lima

; Carvalho, Deborah Ribeiro

Ciência & Saúde Coletiva

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jul 2020, Volume 25 N. 7 Pages 2859 - 2870

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

Abstract This study aims to identify the factors that hinder physically disabled children and adolescent’s access to physiotherapy in establishments accredited by the Unified Health System in Curitiba, Paraná, Brazil. This is a cross-sectional study that interviewed managers, physiotherapists, parents or guardians of children with physical disabilities. The perception of difficulties of each interviewed group was compared through descriptive statistics, considering the following realms: availability, purchasing power, information and acceptability. Considering the realm of availability, we identified the following hindrances: distance between the physiotherapy location and user’s residence, inadequate supply of services and waiting list. Regarding the purchasing power, we observed the lack of financial resources among parents. Regarding information and acceptability, the lack of information about diagnosis and denial were reported by participants. We can conclude that the physiotherapy service has not been timely assured to children’s motor development, so it is necessary to review the organization and distribution of services, and effective policies are required to ensure their use.

Resumo Este estudo objetiva identificar os fatores que dificultam o acesso de crianças e adolescentes com deficiência física ao tratamento fisioterapêutico, em estabelecimentos credenciados ao Sistema Único de Saúde em Curitiba, Paraná, Brasil. Trata-se de um estudo transversal que entrevistou gestores, fisioterapeutas, pais e/ou responsáveis por crianças com deficiência física. A percepção de dificuldades de cada um dos grupos de entrevistados foi comparada por meio de estatísticas descritivas, considerando as dimensões: disponibilidade, poder de pagamento, informação e aceitabilidade. Considerando a dimensão disponibilidade, identificaram-se como dificuldades: distância entre o estabelecimento e a residência dos usuários, pouca oferta de serviços e fila de espera. Em relação ao poder de pagamento, observou-se a falta de recursos financeiros entre os pais. Nas dimensões informação e aceitabilidade, a falta de informação acerca do diagnóstico e a negação foram referidas pelos participantes. Conclui-se que o serviço de fisioterapia não tem sido garantido em tempo favorável ao desenvolvimento motor das crianças, de modo que se faz necessário rever a organização e distribuição dos serviços, bem como são essenciais políticas efetivas que garantam a sua utilização.

https://doi.org/10.1590/1413-81232020257.12682018 1760 downloads

Acesso à fisioterapia de crianças e adolescentes com deficiência física em instituições públicas
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Silva, Verônica Andrade da

; Busnello, Adson Renato Rodrigues

; Cavassin, Renata Cristina

; Loureiro, Ana Paula Cunha

; Moser, Auristela Duarte de Lima

; Carvalho, Deborah Ribeiro

Ciência & Saúde Coletiva

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jul 2020, Volume 25 N. 7 Pages 2859 - 2870

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

https://doi.org/10.1590/1413-81232020257.12682018

Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol
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Ferreira, Juliana C.

; Ho, Yeh-Li

; Besen, Bruno A.M.P.

; Malbuisson, Luiz M.S.

; Taniguchi, Leandro U.

; Mendes, Pedro V.

; Costa, Eduardo L.V.

; Park, Marcelo

; Daltro-Oliveira, Renato

; Roepke, Roberta M.L.

; Silva Jr, João M.

; Carmona, Maria José C.

; Carvalho, Carlos Roberto Ribeiro

; Hirota, Adriana

; Kanasiro, Alberto Kendy

; Crescenzi, Alessandra

; Fernandes, Amanda Coelho

; Miethke-Morais, Anna

; Bellintani, Arthur Petrillo

; Canasiro, Artur Ribeiro

; Carneiro, Bárbara Vieira

; Zanbon, Beatriz Keiko

; Batista, Bernardo Pinheiro De Senna Nogueira

; Nicolao, Bianca Ruiz

; Besen, Bruno Adler Maccagnan Pinheiro

; Biselli, Bruno

; Macedo, Bruno Rocha De

; Toledo, Caio Machado Gomes De

; Pompilio, Carlos Eduardo

; Carvalho, Carlos Roberto Ribeiro De

; Mol, Caroline Gomes

; Stipanich, Cassio

; Bueno, Caue Gasparotto

; Garzillo, Cibele

; Tanaka, Clarice

; Forte, Daniel Neves

; Joelsons, Daniel

; Robira, Daniele

; Costa, Eduardo Leite Vieira

; Silva Júnior, Elson Mendes Da

; Regalio, Fabiane Aliotti

; Segura, Gabriela Cardoso

; Marcelino, Gustavo Brasil

; Louro, Giulia Sefrin

; Ho, Yeh-Li

; Ferreira, Isabela Argollo

; Gois, Jeison de Oliveira

; Silva Junior, Joao Manoel Da

; Reusing Junior, Jose Otto

; Ribeiro, Julia Fray

; Ferreira, Juliana Carvalho

; Galleti, Karine Vusberg

; Silva, Katia Regina

; Isensee, Larissa Padrao

; Oliveira, Larissa dos Santos

; Taniguchi, Leandro Utino

; Letaif, Leila Suemi

; Lima, Lígia Trombetta

; Park, Lucas Yongsoo

; Chaves Netto, Lucas

; Nobrega, Luciana Cassimiro

; Haddad, Luciana

; Hajjar, Ludhmila

; Malbouisson, Luiz Marcelo

; Pandolfi, Manuela Cristina Adsuara

; Park, Marcelo

; Carmona, Maria José Carvalho

; Andrade, Maria Castilho Prandini H De

; Santos, Mariana Moreira

; Bateloche, Matheus Pereira

; Suiama, Mayra Akimi

; Oliveira, Mayron Faria de

; Sousa, Mayson Laercio

; Louvaes, Michelle

; Huemer, Natassja

; Mendes, Pedro

; Lins, Paulo Ricardo Gessolo

; Santos, Pedro Gaspar Dos

; Moreira, Pedro Ferreira Paiva

; Guazzelli, Renata Mello

; Reis, Renato Batista Dos

; Oliveira, Renato Daltro De

; Roepke, Roberta Muriel Longo

; Pedro, Rodolpho Augusto De Moura

; Kondo, Rodrigo

; Rached, Samia Zahi

; Fonseca, Sergio Roberto Silveira Da

; Borges, Thais Sousa

; Ferreira, Thalissa

; Cobello Junior, Vilson

; Sales, Vivian Vieira Tenório

; Ferreira, Willaby Serafim Cassa

Clinics

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2020, Volume 75 elocation e2294

Abstract: En | Text: En | PDF: En

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital’s electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

https://doi.org/10.6061/clinics/2020/e2294

10.

Fatores associados ao letramento funcional em saúde da pessoa idosa em tratamento pré-dialítico
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Lima, Monique de Freitas Gonçalves

; Vasconcelos, Eliane Maria Ribeiro de

; Borba, Anna Karla de Oliveira Tito

; Santos, Carlos Renato dos

; Carvalho, Juliana Cordeiro

; Zimmermann, Rogerio Dubosselard

Revista Brasileira de Geriatria e Gerontologia

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2020, Volume 23 N. 4 elocation e200114

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

Abstract Objective To evaluate the factors associated with functional health literacy in the elderly undergoing pre-dialysis treatment. Method This is a cross-sectional study, carried out with 60 elderly people diagnosed with chronic kidney disease and assisted in the conservative treatment outpatient clinic of a public hospital in the city of Recife, Pernambuco, Brazil. Data were collected using the instrument of Test of Health Literacy in Adults, an abbreviated version and a structured questionnaire, which were subsequently analyzed using descriptive and inferential statistics. Result Functional health literacy was insufficient 43(71.7%) and was associated with lower education (p-value=0.000) and non-white race (p-value=0.040). Conclusion The educational level and race are factors that interfere in functional health literacy, serving as subsidies for the elaboration of educational actions adjusted to the reality of this public.

Resumo Objetivo Avaliar os fatores associados ao letramento funcional em saúde da pessoa idosa em tratamento pré-dialítico. Método Estudo seccional, realizado com 60 idosos com diagnóstico de doença renal crônica e assistidos no ambulatório de tratamento conservador de um hospital público, na cidade do Recife, Pernambuco, Brasil. Os dados foram coletados por meio do instrumento Test of Health Literacy in Adults versão abreviada e questionário estruturado, sendo posteriormente analisados por estatística descritiva e inferencial. Resultado: O letramento funcional em saúde foi insuficiente 43(71,7%) e esteve associado a menor escolaridade (p-valor=0,000) e raça não branca (p-valor=0,040). Conclusão O nível instrucional e a raça são fatores que interferem no letramento funcional em saúde, servindo de subsídios para a elaboração de ações educativas ajustadas à realidade desse público.

https://doi.org/10.1590/1981-22562020023.200114

11.

Application of Films Based on Chitosan and Xanthan Gum in Refrigerated Fish Conservation
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Lima, Maria de Morais

; Carneiro, Lucia Cesar

; Machado, Mírian Ribeiro Galvão

; Dias, Alvaro Renato Guerra

; Zavareze, Elessandra da Rosa

; Prentice, Carlos

; Moreira, Angelita da Silveira

Brazilian Archives of Biology and Technology

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2020, Volume 63 elocation e20190046

Abstract: En | Text: En | PDF: En

Abstract This research aims to determine the efficiency of chitosan and xanthan gum films in conservation of croaker fillets kept in refrigeration for 9 days. Proximal composition, loss of mass, color, pH, TVB-N (Total Volatile Bases) and microbiological profile were assessed. The films were prepared with chitosan and xanthan gum in varying mass proportions 100:0, m:m (C100XG0); 60:40, m:m (C60XG40); 50:50, m:m (C50XG50). They presented the respective values for moisture content, water solubility, thickness and water vapor permeability: 24.59%, 19.50%, 0.086 mm and 11.45gm-1.s-1.Pa-1for C100XG0; 24.58%; 20.27%, 0.091 mm and 10.41 gm-1.s-1.Pa-1for C60XG40; 22.11%, 22.06%, 0.089 mm and 10.68 gm-1.s-1.Pa-1 forC50XG50.The films were made in small bags format capable to hold about 20 g of fish fillets. A control sample was prepared in parallel, using polyethylene bags under the same storage conditions. The results showed that the chitosan films combined with xanthan gum had excellent antimicrobial properties, capable of preserving the quality of chilled fish fillets during the studied period, since it inhibited the growth of Staphylococcus coagulase-positive, Salmonella spp and coliforms at 45 ° C. Mass loss of the croaker fillets was not significantly affected by xanthan gum addition to the films. On the other hand, xanthan gum addition affected pH and color parameters of the corvina fillets. It was also verified that the combination of these two polymers promoted the reduction of N-BVT, being the C50XG50 film that presented the best response.

https://doi.org/10.1590/1678-4324-2020190046

12.

Human Epidermal Growth Factor Receptor-2 gene polymorphism and breast cancer risk in women from the Northeastern region of Brazil
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Escórcio-Dourado, Carla Solange

; Alves-Ribeiro, Francisco Adelton

; Lima-Dourado, Jose Charles

; dos Santos, Alesse Ribeiro

; de Oliveira Pereira, Renato

; Tavares, Cleciton Braga

; Silva, Vladimir Costa

; Costa, Pedro Vitor Lopes

; Soares-Júnior, José Maria

; da Silva, Benedito Borges

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2020, Volume 75 elocation e2360

Abstract: En | Text: En | PDF: En

OBJECTIVES: In the Human Epidermal Growth Factor Receptor-2 (HER2) rs1136201 variant, the presence of the G allele may promote cellular alterations and increase breast cancer risk, in addition to enhanced cellular proliferation, tumor aggressiveness, and metastases. The aim of this study was to investigate the presence of the single-nucleotide polymorphism (SNP) variant, rs1136201, within the HER2 gene in women from the Northeastern region of Brazil and breast cancer risk. METHODS: The study included 140 women who were divided into two groups, case (breast cancer) and control (without breast cancer), with 70 women in each group. Peripheral blood of each woman was drawn for the study of genomic Deoxyribonucleic acid (DNA) extracted from leukocytes using the genotyping technique by real-time polymerase chain reaction. RESULTS: The GG genotype occurred in 1 woman in both groups (1.4%) (p=0.32), while the AG genotype occurred in 19 (27.2%) and 13 (18.6%) women in the case and control (p=1.00) groups, respectively. No statistically significant difference in GG and AG genotypes was observed between the case and control groups in premenopausal women (p=1.00). Furthermore, no significant difference in genotypes was observed between the groups, among postmenopausal women (p=0.14). CONCLUSION: In this study, the HER2 rs1136201 polymorphism did not show any statistically significant association with breast cancer, both in premenopausal and postmenopausal women. Nevertheless, further studies with a larger sample size should be performed to assess the association of HER2 polymorphism with breast cancer risk in women from the Northeastern region of Brazil.

https://doi.org/10.6061/clinics/2020/e2360

13.

Effects of flushing with rehydrated corn grain silage on follicular development in tropical Santa Inês ewes
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Figueira, Lucas Machado

; Faria, Letícia Rodrigues

; Campos, João Pedro Araújo

; Silva, Débora Regina da

; Furusho-Garcia, Iraides Ferreira

; Leite, Rafael Fernandes

; Lima, Renato Ribeiro de

; Alves, Nadja Gomes

Revista Brasileira de Zootecnia

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2020, Volume 49 elocation e20200041

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to evaluate the effect of replacing ground corn (402 g kg−1 of dry matter) with rehydrated corn grain silage (RCGS; 425 g kg−1 of dry matter) in a flushing diet on follicular development in tropical Santa Inês ewes. Fifteen ewes were randomly assigned to one of two treatment groups: a diet with ground corn (control, n = 7) or a diet with RCGS (n = 8). The first day of the diets was designated d0, and the diets were fed for 30 days, up to two days after the end of the estrus synchronization protocol. The estrus synchronization protocol (intravaginal progestogen sponge for 11 days plus 300 IU eCG and 37.5 µg d-cloprostenol IM two days before sponge removal) started on d17 of the diets. The number and diameters of ovarian follicles ≥3 mm were assessed by ultrasound on the day before the diets were provided (d−1), on d14, and then daily from two days before sponge removal until ovulation or up to the eighth day after sponge removal. Blood samples were collected on days −1, 0, 6, 12, 18, 24, and 30 for glucose and urea analyses. There was no effect of the treatments on dry matter intake, plasma glucose, and urea nitrogen concentrations, or on the percentage of ewes that ovulated and on the number of ovulations. The number of follicles ≥3 mm did not differ between treatment groups; the number increased between d−1 and d14 and did not differ between d14 and d28. The diameter of ovulatory follicles at sponge removal, the interval from sponge removal to estrus, and the growth rate of the ovulatory follicles were greater in the RCGS group than in the control group, resulting in larger follicles at ovulation. Replacement of ground corn by RCGS in the flushing diet does not increase the number of ovulations but results in delayed onset of estrus and ovulation of larger follicles.

https://doi.org/10.37496/rbz4920200041

14.

Brazilian guidelines for the pharmacological treatment of idiopathic pulmonary fibrosis. Official document of the Brazilian Thoracic Association based on the GRADE methodology
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Baddini-Martinez, José

; Ferreira, Juliana

; Tanni, Suzana

; Alves, Luis Renato

; Cabral Junior, Benedito Francisco

; Carvalho, Carlos Roberto Ribeiro

; Cezare, Talita Jacon

; Costa, Claudia Henrique da

; Gazzana, Marcelo Basso

; Jezler, Sérgio

; Kairalla, Ronaldo Adib

; Kawano-Dourado, Leticia

; Lima, Mariana Silva

; Mancuzo, Eliane

; Moreira, Maria Auxiliadora Carmo

; Rodrigues, Marcelo Palmeira

; Rodrigues, Silvia Carla Sousa

; Rubin, Adalberto Sperb

; Rufino, Rogério Lopes

; Steidle, Leila John Marques

; Storrer, Karin

; Baldi, Bruno Guedes

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 2 elocation e20190423

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

ABSTRACT Idiopathic pulmonary fibrosis (IPF) is a form of chronic interstitial lung disease of unknown cause, which predominantly affects elderly men who are current or former smokers. Even though it is an uncommon disease, it is of great importance because of its severity and poor prognosis. In recent decades, several pharmacological treatment modalities have been investigated for the treatment of this disease, and the classic concepts have therefore been revised. The purpose of these guidelines was to define evidence-based recommendations regarding the use of pharmacological agents in the treatment of IPF in Brazil. We sought to provide guidance on the practical issues faced by clinicians in their daily lives. Patients of interest, Intervention to be studied, Comparison of intervention and Outcome of interest (PICO)-style questions were formulated to address aspects related to the use of corticosteroids, N-acetylcysteine, gastroesophageal reflux medications, endothelin-receptor antagonists, phosphodiesterase-5 inhibitors, pirfenidone, and nintedanib. To formulate the PICO questions, a group of Brazilian specialists working in the area was assembled and an extensive review of the literature on the subject was carried out. Previously published systematic reviews with meta-analyses were analyzed for the strength of the compiled evidence, and, on that basis, recommendations were developed by employing the Grading of Recommendations Assessment, Development and Evaluation approach. The authors believe that the present document represents an important advance to be incorporated in the approach to patients with IPF, aiming mainly to improve its management, and can become an auxiliary tool for defining public policies related to IPF.

RESUMO A fibrose pulmonar idiopática (FPI) é uma forma de pneumopatia intersticial crônica fibrosante de causa desconhecida, que acomete preferencialmente homens idosos, com história atual ou pregressa de tabagismo. Mesmo sendo uma doença incomum, ela assume grande importância devido a sua gravidade e prognóstico reservado. Nas últimas décadas, diversas modalidades terapêuticas farmacológicas foram investigadas para o tratamento dessa doença, de tal modo que conceitos clássicos vêm sendo revisados. O objetivo destas diretrizes foi definir recomendações brasileiras baseadas em evidências em relação ao emprego de agentes farmacológicos no tratamento da FPI. Procurou-se fornecer orientações a questões de ordem prática, enfrentadas pelos clínicos no seu cotidiano. As perguntas PICO (acrônimo baseado em perguntas referentes aos Pacientes de interesse, Intervenção a ser estudada, Comparação da intervenção e Outcome [desfecho] de interesse) abordaram aspectos relativos ao uso de corticosteroides, N-acetilcisteína, tratamento medicamentoso do refluxo gastroesofágico, inibidores dos receptores da endotelina, inibidores da fosfodiesterase-5, pirfenidona e nintedanibe. Para a formulação das perguntas PICO, um grupo de especialistas brasileiros atuantes na área foi reunido, sendo realizada uma extensa revisão bibliográfica sobre o tema. As revisões sistemáticas com meta-análises previamente publicadas foram analisadas quanto à força das evidências compiladas e, a partir daí, foram concebidas recomendações seguindo a metodologia Grading of Recommendations Assessment, Development and Evaluation. Os autores acreditam que o presente documento represente um importante avanço a ser incorporado na abordagem de pacientes com FPI, objetivando principalmente favorecer seu manejo, e pode se tornar uma ferramenta auxiliar na definição de políticas públicas relacionadas à FPI.

https://doi.org/10.36416/1806-3756/e20190423 1799 downloads

15.

Committee neural network and weighted multiple regression to predict the energetic values of poultry feedstuffs
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Mariano, Flávia Cristina Martins Queiroz

; Lima, Renato Ribeiro de

; Alvarenga, Renata Ribeiro

; Rodrigues, Paulo Borges

Pesquisa Agropecuária Brasileira

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2020, Volume 55 elocation e01199

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

Abstract: The objective of this work was to compare the committee neural network (CNN) and weighted multiple linear regression (WMLR) models, in order to estimate the nitrogen-corrected apparent metabolizable energy (AMEn) of poultry feedstuffs. The prediction equation was adjusted by using a WMLR model and the meta-analysis principle. The models were compared by considering the correct prediction percentages, based on the classic prediction intervals and on the highest-probability density intervals, and by using a comparison test for proportions. The accuracy of the models was evaluated based on the values of the mean squared error, coefficient of determination, mean absolute deviation, mean absolute percentage error, and bias. Data from metabolic trials were used to compare the selected models. The committee neural network is the model that showed the highest accuracy of prediction, being recommended as the most accurate model to predict AMEn values for energetic concentrate feedstuffs used by the poultry feed industry.

Resumo: O objetivo deste trabalho foi comparar o modelo comitê de redes neurais e o modelo de regressão linear múltipla ponderada (RLMP), para estimar a energia metabolizável aparente corrigida por nitrogênio (EMAn) de alimentos para aves. A equação de predição foi ajustada por RLMP e pelo princípio da meta-análise. Os modelos foram comparados tendo-se considerando as percentagens de acerto de predição, com base em intervalos de predição clássicos e intervalos de credibilidade da máxima densidade de probabilidade, e utilizado um teste para comparação de proporções. A acurácia dos modelos foi avaliada com base nos valores de erro médio quadrático, coeficiente de determinação, desvio médio absoluto, erro percentual absoluto médio e viés. Dados provenientes de ensaios metabólicos foram utilizados na comparação dos modelos selecionados. O comitê de redes neurais é o modelo que forneceu predições mais acuradas, sendo recomendado como o de maior acurácia, para prever os valores de EMAn de alimentos concentrados utilizados na indústria alimentícia para aves.

https://doi.org/10.1590/s1678-3921.pab2020.v55.001199 536 downloads

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