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au:MENDES, MARIA CAROLINA SANTOS

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Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies
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Ferreira, Juliana Carvalho

; Vianna, Arthur Oswaldo de Abreu

; Pinheiro, Bruno Valle

; Maia, Israel Silva

; Baldisserotto, Sérgio Vasconcellos

; Isola, Alexandre Marini

; Cavalcanti, Alexandre Biasi Gama, Ana Maria Casati Nogueira da Rocha, Angelo Roncalli Miranda Oliveira, Antonio Gonçalves de Serpa Neto, Ary Farias, Augusto Manoel de Carvalho Orlando, Bianca Rodrigues Esteves, Bruno da Costa Mazza, Bruno Franco Silveira, Camila de Freitas Martins Soares Carvalho, Carlos Roberto Ribeiro de Toufen Junior, Carlos Barbas, Carmen Silvia Valente Teixeira, Cassiano Silveira, Débora Dutra da Medeiros, Denise Machado Parolo, Edino Costa, Eduardo Leite Vieira Caser, Eliana Bernadete Oliveira, Ellen Pierre de Banholzer, Eric Grieger Carvalho, Erich Vidal Amorim, Fabio Ferreira Saddy, Felipe Gonçalves, Fernanda Alves Ferreira Galas, Filomena Regina Barbosa Gomes Zanatta, Giovanna Carolina Gardini Silva, Gisele Sampaio Westphal, Glauco Adrieno Matos, Gustavo Faissol Janot de Souza, João Claudio Emmerich de Silva Junior, João Manoel Valiatti, Jorge Luis dos Santos Nascimento Junior, José Ribamar do Rocco, Jose Rodolfo Hajjar, Ludhmila Abrahão Forgiarini Junior, Luiz Alberto Malbuisson, Luiz Marcelo Sá Holanda, Marcelo Alcantara Amato, Marcelo Britto Passos Park, Marcelo Oliveira, Marco Antonio da Rosa e Reis, Marco Antonio Soares Tavares, Marcos Soares Souza, Mario Henrique Dutra de Damasceno, Marta Cristina Pauleti Lira-Batista, Marta Maria da Silva Pattacini, Max Morais Assunção, Murillo Santucci Cesar de Oliveira, Neymar Elias de Franzosi, Oellen Stuani Rocco, Patricia Rieken Macedo Caruso, Pedro Silva, Pedro Leme Mendes, Pedro Vitale Duarte, Pericles Almeida Delfino Santa Neto, Renato Fabio Alberto Della Rodrigues, Ricardo Goulart Cordioli, Ricardo Luiz Palazzo, Roberta Fittipaldi Goldwasser, Rosane Pinheiro, Sabrina dos Santos Justino, Sandra Regina Nemer, Sergio Nogueira Oliveira, Vanessa Martins de Silva, Vinicius Zacarias Maldaner da Nedel, Wagner Luis Bellissimo-Rodrigues, Wanessa Teixeira Oliveira Filho, Wilson de

Critical Care Science

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2025, Volume 37 elocation e20250242en

Abstract: En | Text: En | PDF: En

ABSTRACT Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.

https://doi.org/10.62675/2965-2774.20250242-en

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio

; Rassi Jr, Anis

; Oliveira, Gláucia Maria Moraes

; Correia, Luís Claudio Lemos

; Ramos Júnior, Alberto Novaes

; Luquetti, Alejandro Ostermayer

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Paola, Angelo Amato Vincenzo de

; Sousa, Antônio Carlos Sobral

; Ribeiro, Antonio Luiz Pinho

; Correia Filho, Dalmo

; Souza, Dilma do Socorro Moraes de

; Cunha-Neto, Edecio

; Ramires, Felix Jose Alvarez

; Bacal, Fernando

; Nunes, Maria do Carmo Pereira

; Martinelli Filho, Martino

; Scanavacca, Maurício Ibrahim

; Saraiva, Roberto Magalhães

; Oliveira Júnior, Wilson Alves de

; Lorga-Filho, Adalberto Menezes

; Guimarães, Adriana de Jesus Benevides de Almeida

; Braga, Adriana Lopes Latado

; Oliveira, Adriana Sarmento de

; Sarabanda, Alvaro Valentim Lima

; Pinto, Ana Yecê das Neves

; Carmo, Andre Assis Lopes do

; Schmidt, Andre

; Costa, Andréa Rodrigues da

; Ianni, Barbara Maria

; Markman Filho, Brivaldo

; Rochitte, Carlos Eduardo

; Macêdo, Carolina Thé

; Mady, Charles

; Chevillard, Christophe

; Virgens, Cláudio Marcelo Bittencourt das

; Castro, Cleudson Nery de

; Britto, Constança Felicia De Paoli de Carvalho

; Pisani, Cristiano

; Rassi, Daniela do Carmo

; Sobral Filho, Dário Celestino

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Mesquita, Evandro Tinoco

; Mendes, Fernanda de Souza Nogueira Sardinha

; Gondim, Francisca Tatiana Pereira

; Silva, Gilberto Marcelo Sperandio da

; Peixoto, Giselle de Lima

; Lima, Gustavo Glotz de

; Veloso, Henrique Horta

; Moreira, Henrique Turin

; Lopes, Hugo Bellotti

; Pinto, Ibraim Masciarelli Francisco

; Ferreira, João Marcos Bemfica Barbosa

; Nunes, João Paulo Silva

; Barreto-Filho, José Augusto Soares

; Saraiva, José Francisco Kerr

; Lannes-Vieira, Joseli

; Oliveira, Joselina Luzia Menezes

; Armaganijan, Luciana Vidal

; Martins, Luiz Cláudio

; Sangenis, Luiz Henrique Conde

; Barbosa, Marco Paulo Tomaz

; Almeida-Santos, Marcos Antonio

; Simões, Marcos Vinicius

; Yasuda, Maria Aparecida Shikanai

; Moreira, Maria da Consolação Vieira

; Higuchi, Maria de Lourdes

; Monteiro, Maria Rita de Cassia Costa

; Mediano, Mauro Felippe Felix

; Lima, Mayara Maia

; Oliveira, Maykon Tavares de

; Romano, Minna Moreira Dias

; Araujo, Nadjar Nitz Silva Lociks de

; Medeiros, Paulo de Tarso Jorge

; Alves, Renato Vieira

; Teixeira, Ricardo Alkmim

; Pedrosa, Roberto Coury

; Aras Junior, Roque

; Torres, Rosalia Morais

; Povoa, Rui Manoel dos Santos

; Rassi, Sergio Gabriel

; Alves, Silvia Marinho Martins

; Tavares, Suelene Brito do Nascimento

; Palmeira, Swamy Lima

; Silva Júnior, Telêmaco Luiz da

; Rodrigues, Thiago da Rocha

; Madrini Junior, Vagner

; Brant, Veruska Maia da Costa

; Dutra, Walderez Ornelas

; Dias, João Carlos Pinto

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 6 elocation e20230269

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20230269

The association among the consumption of ultra-processed food and body image, nutritional status and physical activity of pregnant women at the primary health care
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Rodrigues, Carolina Amaral Oliveira

; Leão, Giselle Mara Mendes Silva

; Andrade, Ruth Emanuele Silva

; Freire, Rafael Silveira

; Crivellenti, Lívia Castro

; Silveira, Marise Fagundes

; Silva, Rosângela Ramos Veloso

; Brito, Maria Fernanda Santos Figueiredo

; Pinho, Lucinéia de

Revista Brasileira de Saúde Materno Infantil

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2023, Volume 23 elocation e20220362

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

Abstract Objectives: to analyze the consumption of ultra-processed food and its association with body image, physical activity, nutritional status and self-assessment on food of pregnant women enrolled in the Primary Health Care. Methods: this is a cross-sectional study carried out with pregnant women enrolled in the Family Health Strategy in the city of Montes Claros, Minas Gerais. Data were collected through a questionnaire. The dependent variable was the consumption of ultra-processed food, and the independent ones addressed body appearance, physical activity, nutritional status, self-assessment on food and food consumption. Descriptive analysis was carried out and for association of analysis, the linear regression model was used with crude and adjusted associations. Results: 1,185 pregnant women participated in the study. Caloric intake from ultra-processed food represented 32.0% of these women’s daily diet. There was an association between consumption of ultra-processed food and physical activity (β=-0.08; p<0.01), pre-gestional nutritional status (β=-0,12; p<0.01) and body image (β =0.08; p=0.01). Conclusion: the pregnant women presented high consumption of ultra-processed food. Having a negative body image, the lowest level of physical activity, and high pre-gestational nutritional status are conditions that influenced the consumption of these food.

Resumo Objetivos: analisar o consumo de alimentos ultraprocessados e sua associação com imagem corporal, atividade física, estado nutricional e autoavaliação alimentar de gestantes cadastradas na Atenção Primária à Saúde. Métodos: trata-se de um estudo transversal, realizado com gestantes cadastradas na Estratégia Saúde da Família do município de Montes Claros, Minas Gerais. Os dados foram coletados por meio de um questionário. A variável dependente foi consumo de alimentos ultraprocessados, e as independentes abordaram aspecto corporal, atividade física, estado nutricional, autoavaliação alimentar e consumo alimentar. Realizou-se análise descritiva e para análise de associação, utilizou-se o modelo de regressão linear com associações brutas e ajustadas. Resultados: participaram do estudo 1.185 gestantes. O consumo calórico proveniente dos ultraprocessados representou 32,0% da dieta diária dessas mulheres. Verificou-se associação entre consumo de ultraprocessados com atividade física (β=-0,08; p<0,01), estado nutricional pré-gestacional (β=-0,12; p<0,01) e imagem corporal (β=0,08; p=0,01). Conclusão: as gestantes apresentaram alto consumo de alimentos ultraprocessados. Ter imagem corporal negativa, menor nível de atividade física, estado nutricional pré-gestacional elevado são condições que influenciaram o consumo desses alimentos.

https://doi.org/10.1590/1806-9304202300000362-en

[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio Rassi Jr., Anis Moraes Oliveira, Gláucia M. Lemos Correia, Luís Claudio Novaes Ramos Jr., Alberto Hasslocher-Moreno, Alejandro Marcel Luquetti Ostermayer, Alejandro Sousa, Andréa Silvestre de Amato Vincenzo de Paola, Angelo Sobral de Sousa, Antonio Carlos Pinho Ribeiro, Antonio Luiz Correia Filho, Dalmo Moraes de Souza, Dilma do Socorro Cunha-Neto, Edecio J. A. Ramires, Felix Bacal, Fernando Pereira Nunes, Maria do Carmo Martinelli Filho, Martino Ibrahim Scanavacca, Maurício Magalhães Saraiva, Roberto Alves de Oliveira Júnior, Wilson M. Lorga-Filho, Adalberto de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Adriana V. L. Sarabanda, Alvaro Yecê das Neves Pinto, Ana Assis Lopes do Carmo, André Schmidt, André Costa, Andréa Rodrigues da Ianni, Barbara Maria Markman Filho, Brivaldo Eduardo Rochitte, Carlos Thé Macedo, Carolina Mady, Charles Chevillard, Christophe Bittencourt das Virgens, Cláudio Marcelo Nery de Castro, Cleudson De Paoli de Carvalho Britto, Constança Felícia Pisani, Cristiano do Carmo Rassi, Daniela C. Sobral Filho, Dario Rodrigues Almeida, Dirceu A. Bocchi, Edimar T. Mesquita, Evandro de Souza Nogueira Sardinha Mendes, Fernanda Pereira, Francisca Tatiana Sperandio da Silva, Gilberto Marcelo de Lima Peixoto, Giselle Glotz de Lima, Gustavo H. Veloso, Henrique Turin Moreira, Henrique Bellotti Lopes, Hugo Masciarelli Francisco Pinto, Ibraim Pinto Dias, João Carlos Bemfica, João Marcos Silva-Nunes, João Paulo Soares Barreto-Filho, José Augusto Kerr Saraiva, José Francisco Lannes-Vieira, Joseli Menezes Oliveira, Joselina Luzia V. Armaganijan, Luciana Martins, Luiz Cláudio C. Sangenis, Luiz Henrique Barbosa, Marco Paulo Almeida-Santos, Marcos Antônio Simões, Marcos Vinicius Shikanai-Yasuda, Maria Aparecida Vieira Moreira, Maria da Consolação Higuchi, Maria de Lourdes Costa Monteiro, Maria Rita de Cássia Felix Mediano, Mauro Felippe Maia Lima, Mayara T. Oliveira, Maykon Moreira Dias Romano , Minna Nitz, Nadjar de Tarso Jorge Medeiros, Paulo Vieira Alves, Renato Alkmim Teixeira, Ricardo Coury Pedrosa, Roberto Aras, Roque Morais Torres, Rosália dos Santos Povoa, Rui Manoel Rassi, Sérgio Gabriel Salles Xavier, Sérgio Marinho Martins Alves , Silvia B. N. Tavares, Suelene Lima Palmeira, Swamy da Silva Junior, Telêmaco Luiz da Rocha Rodrigues, Thiago Madrini Junior, Vagner Maia da Costa , Veruska Dutra, Walderez

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Publication date: 2022-10-11

Abstract: En Pt

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.

Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;

https://doi.org/10.1590/SciELOPreprints.4820

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports
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Cavalcante, Thalitta Mendes

; Gubert, Vanessa Terezinha

; Lima, Carolina de Deus Luciano, Larissa Anjos Croda, Mariana Garcia Venturini, James Gasparoto, Antonio Luiz Dal Bello Santiago, Wellyngton Matheus Souza Motta-Castro, Ana Rita Coimbra Reis, Fernanda Paes Marques, Ana Paula da Costa Lorenz, Aline Pedroso Fava, Wellington Santos Zardin, Marina Castilhos Souza Umaki Chaves, Cláudia Elizabeth Volpe Braga, Gabriel Pereira Paniago, Anamaria Mello Miranda Oliveira, Sandra Maria do Valle Leone de

Journal of Venomous Animals and Toxins including Tropical Diseases

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2022, Volume 28 elocation e20220020

Abstract: En | Text: En | PDF: En

Abstract Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

https://doi.org/10.1590/1678-9199-jvatitd-2022-0020

Spatial analysis of leisure-time physical activity in an urban area
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Gomes, Crizian Saar

; Vieira, Carolina Santiago

; Rocha, Fabiana Lucena

; Temponi, Hanrieti Rotelli

; Vieira, Maria Alice Souza

; Mendes, Mayara Santos

; Tiensoli, Sabrina Daros

; Costa, Marcelo Azevedo

; Velasquez-Melendez, Gustavo

Revista Brasileira de Epidemiologia

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2021, Volume 24 Suppl. 1 elocation e210012

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

RESUMO: Objetivo: Analisar a distribuição espacial da prevalência da prática de atividade física (AF) no lazer suficiente em uma área urbana brasileira, no período de 2008 a 2010, e verificar se ela é influenciada por características dos ambientes físico e social. Métodos: Estudo transversal com dados do sistema de Vigilância de Fatores de Risco para doenças crônicas não transmissíveis, realizado em Belo Horizonte (MG), entre os anos 2008 e 2010. O desfecho foi a realização de AF no lazer e as exposições foram densidade residencial e populacional, densidade de locais de prática de AF no lazer, taxa de homicídio, renda familiar média e índice de vulnerabilidade da saúde. Foi empregada a técnica de varredura espacial para identificar clusters de alta prevalência de AF no lazer. Utilizou-se o teste de Mann-Whitney para comparar variáveis ambientais dentro e fora do cluster. Resultados: A amostra foi constituída de 5.779 participantes, dos quais 33,3% referiram praticar AF no lazer suficientemente. Identificou-se um cluster significativo de alta prevalência de prática de AF no lazer. Após ajustes, ele apresentou raio de 3.041,99 m e 603 indivíduos, dos quais 293 (48,6%) realizavam AF no lazer suficiente. A probabilidade de um indivíduo praticar AF no lazer suficiente no cluster foi 27% maior (razão de prevalência — RP = 1,27; p = 0,002) do que nas áreas de abrangência das unidades básicas de saúde não pertencentes a ele. Esse cluster teve maior densidade de locais para a prática de AF no lazer, maior densidade populacional e residencial e maior renda familiar. Conclusão: Constatou-se cluster de alta prevalência de AF no lazer em um contexto físico e econômico privilegiado de Belo Horizonte, o que demonstra que diminuir desigualdades pode aumentar a prática de AF no lazer.

ABSTRACT: Objective: To analyze the spatial distribution of the prevalence of leisure-time physical activity (LTPA) in a Brazilian urban area and its association with the characteristics of the physical and social environments. Methods: A cross-sectional study conducted with data from the Surveillance System for Risk and Protective Factors for Chronic Diseases from the years 2008–2010, in Belo Horizonte, state of Minas Gerais, Brazil. The outcome was the practice of LTPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, and health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of PA at leisure time. The Mann-Whitney test was used to compare variables inside and outside the cluster. Results: The sample included 5,779 participants, 33.3% (SE = 0.73) of whom reported sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LTPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, and 293 (48.6%) of them reported sufficient LTPA. The probability of performing sufficient LTPA in the cluster was 27% higher (PR = 1.27; p = 0.002) than in the coverage areas of primary healthcare units outside the cluster. There was a higher density of places for LTPA practice, higher population and residential density, and higher family income in the cluster. Conclusion: The results evidenced a cluster of high prevalence of LTPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LTPA.

https://doi.org/10.1590/1980-549720210012.supl.1 638 downloads

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen Chin, Chung Man Paula, Daniel de Rech, Daniel Gradia, Daniela Fiori Malheiros, Danielle Venturini, Danielle Tavares, Eliandro Reis Carraro, Emerson Ribeiro, Enilze Maria de Souza Fonseca Pereira, Evani Marques Tuon, Felipe Francisco Follador, Franciele Aní Caovilla Fernandes, Glaura Scantamburlo Alves Volpato, Hélito Cólus, Ilce Mara de Syllos Oliveira, Jaqueline Carvalho de Rodrigues, Jean Henrique da Silva Santos, Jean Leandro dos Visentainer, Jeane Eliete Laguila Brandi, Juliana Cristina Serpeloni, Juliana Mara Bonini, Juliana Sartori Oliveira, Karen Brajão de Fiorentin, Karine Lucio, Léia Carolina Faccin-Galhardi, Ligia Carla Ferreto, Lirane Elize Defante Lioni, Lucy Megumi Yamauchi Consolaro, Marcia Edilaine Lopes Vicari, Marcelo Ricardo Arbex, Marcos Abdo Pileggi, Marcos Watanabe, Maria Angelica Ehara Costa, Maria Antônia Ramos Giannini, Maria José S. Mendes Amarante, Marla Karine Khalil, Najeh Maissar Lima Neto, Quirino Alves de Herai, Roberto H. Guembarovski, Roberta Losi Shinsato, Rogério N. Mainardes, Rubiana Mara Giuliatti, Silvana Yamada-Ogatta, Sueli Fumie Gerber, Viviane Knuppel de Quadros Pavanelli, Wander Rogério Silva, Weber Claudio da Petzl-Erler, Maria Luiza Valente, Valeria Soares, Christiane Pienna Cavalli, Luciane Regina Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

Spatial analysis of leisure-time physical activity in an urban area
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Gomes, Crizian Saar

; Vieira, Carolina Santiago

; Rocha, Fabiana Lucena

; Temponi, Hanrieti Rotelli

; Vieira, Maria Alice Souza

; Mendes, Mayara Santos

; Tiensoli, Sabrina Daros

; Costa, Marcelo Azevedo

; Velasquez-Melendez, Gustavo

Revista Brasileira de Epidemiologia

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2021, Volume 24 Suppl. 1 elocation e210012

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

https://doi.org/10.1590/1980-549720210012.supl.1

[SciELO Preprints] - Spatial analysis of leisure-time physical activity in an urban area
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Gomes , Crizian Saar Vieira, Carolina Santiago Rocha , Fabiana Lucena Temponi , Hanrieti Rotelli Vieira, Maria Alice Souza Mendes, Mayara Santos Tiensoli , Sabrina Daros Costa , Marcelo Azevedo Velasquez-Melende, Gustavo

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Publication date: 2020-12-15

Abstract: En Pt

Objective: analyze the spatial distribution of the prevalence of leisure-time physical activity (LPA) in a Brazilian urban area and its association with the characteristics of the physical and social environment. Method: a cross-sectional study with data from the Risk Factors Surveillance system for chronic non-communicable diseases from the years 2008-2010, in Belo Horizonte, MG. The outcome was the performance of LPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of LPA at leisure. The Mann-Whitney test was used to compare variables inside and outside the cluster. Results: the sample included 5,779 participants, 33.26% (EP = 0.73) of whom reported practicing sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, 293 (48.6%) of who practiced sufficient LPA. The probability of practicing sufficient LPA in the cluster was 32% higher (PR= 1.32; p= 0.0016) than in the AAUBS that do not belong to the cluster. There was a higher density of places for LPA practice, higher population and residential density and higher family income in the cluster. Conclusions: The results evidenced a cluster of a high prevalence of LPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LPA.

Objetivo: analisar a distribuição espacial da prevalência da prática de atividade física suficiente no lazer (AFL) em uma área urbana brasileira, no período de 2008 a 2010, e verificar se esta é influenciada por características do ambiente físico e social. Método: estudo transversal com dados do sistema de Vigilância de Fatores de Risco para doenças crônicas não transmissíveis entre os anos 2008 e 2010, em Belo Horizonte, MG. O desfecho foi a realização de AFL e as exposições foram densidade residencial e populacional, densidade de locais de prática de AFL, taxa de homicídio, renda familiar média e índice de vulnerabilidade à saúde. Foi realizada técnica de varredura espacial para identificar clusters de alta prevalência de AFL. Utilizou-se o teste Mann-Whitney para comparar variáveis ambientais dentro e fora do cluster. Resultados: a amostra foi de 5.779 participantes, dos quais 33,26% referiram praticar AFL suficientemente. Foi identificado um cluster significativo de alta prevalência de prática de AFL. Após ajustes, o cluster apresentou raio de 3.041,99 metros e 603 indivíduos, sendo que 293 destes (48,6%) realizavam AFL suficiente. A probabilidade de um indivíduo praticar AFL suficiente no cluster foi 32% maior (RP=1,32; p=0,0016) do que nas AAUBS não pertencentes ao cluster. Esse cluster teve maior densidade de locais para prática de AFL, maior densidade populacional e residencial e maior renda familiar. Conclusões: foi evidenciado cluster de alta prevalência de AFL em um contexto físico e econômico privilegiado em Belo Horizonte, demonstrando que diminuir desigualdades pode aumentar prática de AF no lazer.

https://doi.org/10.1590/1980-549720210012.supl.1

10.

Authentic leadership among nursing professionals: knowledge and profile
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Mondini, Cleide Carolina da Silva Demoro

; Cunha, Isabel Cristina Kowal Olm

; Trettene, Armando dos Santos

; Fontes, Cassiana Mendes Bertoncello

; Bachega, Maria Irene

; Cintra, Flávia Maria Ravagnani

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 4 elocation e20180888

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

RESUMO Objetivos: identificar o conhecimento dos profissionais de enfermagem sobre modelos de liderança e avaliar o perfil de liderança autêntica entre eles. Métodos: estudo analítico, realizado entre agosto e dezembro de 2015, que envolveu 84 profissionais de enfermagem atuantes em um hospital público e terciário. Utilizaram-se dois instrumentos: Questionário Sociodemográfico com questões sobre liderança e o Authentic Leadership Questionnaire. Resultados: tanto enfermeiros quanto técnicos de enfermagem desconheciam a liderança autêntica. Ambos apontaram a comunicação, o planejamento e a organização como competências do líder (n = 58, 95%). Referente ao perfil de liderança autêntica, observou-se que o escore foi “alto” entre enfermeiros e “baixo” entre os técnicos. Exercer cargo de liderança e atualizar-se influenciou positivamente o maior perfil de liderança autêntica. Conclusões: os enfermeiros demonstraram conhecer a liderança comportamental, enquanto os técnicos de enfermagem mostraram conhecimento sobre a liderança situacional. Os enfermeiros apresentaram escore alto de comportamentos de liderança autêntica, ao passo que os técnicos de enfermagem apresentaram escore baixo, contudo, não se evidenciou diferença significante entre eles. Exercer cargo de liderança e atualizar-se influenciou positivamente o comportamento de liderança autêntica.

ABSTRACT Objectives: to identify the knowledge of nursing professionals about leadership models and evaluate the authentic leadership profile among them. Methods: analytical study, conducted between August and December 2015, involving 84 nursing professionals working in a public and tertiary hospital. We used two instruments: Sociodemographic Questionnaire with questions about leadership and the Authentic Leadership Questionnaire. Results: both nurses and nursing technicians were unaware of authentic leadership. Both pointed to communication, planning, and organization as competencies of the leader (n = 58, 95%). Regarding the authentic leadership profile, we observed that the score was “high” among nurses and “low” among technicians. Holding a leadership position and professionally upgrading has positively influenced the highest-profile of authentic leadership. Conclusions: nurses demonstrated to know behavioral leadership, while nursing technicians showed knowledge about situational leadership. Nurses had a high score of authentic leadership behaviors, while nursing technicians had a low score, but we found no significant difference between them. Holding a leadership position and professionally upgrading has positively influenced the highest profile of authentic leadership.

RESUMEN Objetivos: identificar el conocimiento de los profesionales de enfermería sobre los modelos de liderazgo y evaluar el perfil de liderazgo auténtico entre ellos. Métodos: estudio analítico, realizado entre agosto y diciembre de 2015, que involucró 84 profesionales de enfermería actuantes en un hospital público y terciario. Se ha utilizado dos instrumentos: Cuestionario Sociodemográfico con cuestiones sobre liderazgo y el Authentic Leadership Questionnaire. Resultados: tanto enfermeros cuanto técnicos de enfermería desconocían el liderazgo auténtico. Ambos apuntaron la comunicación, el planeamiento y la organización como competencias del líder (n = 58, 95%). Referente al perfil de liderazgo auténtico, se observó que el escore ha sido “alto” entre enfermeros y “bajo” entre los técnicos. Ejercer cargo de liderazgo y actualizarse influenció positivamente el mayor perfil de liderazgo auténtico. Conclusiones: los enfermeros demostraron conocer el liderazgo del comportamiento, mientras los técnicos de enfermería mostraron conocimiento sobre el liderazgo situacional. Los enfermeros presentaron escore alto de comportamientos de liderazgo auténtico, a la vez que los técnicos de enfermería presentaron escore bajo, sin embargo, no se evidenció diferencia significante entre ellos. Ejercer cargo de liderazgo y actualizarse influenció positivamente el comportamiento de liderazgo auténtico.

https://doi.org/10.1590/0034-7167-2018-0888 3416 downloads

11.

Authentic leadership among nursing professionals: knowledge and profile
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Mondini, Cleide Carolina da Silva Demoro

; Cunha, Isabel Cristina Kowal Olm

; Trettene, Armando dos Santos

; Fontes, Cassiana Mendes Bertoncello

; Bachega, Maria Irene

; Cintra, Flávia Maria Ravagnani

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 4 elocation e20180888

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

https://doi.org/10.1590/0034-7167-2018-0888 48 downloads

12.

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes
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dos Santos, Samira Fernandes Morais

; Soares, Fernanda Valente Mendes

; de Abranches, Andrea Dunshee

; da Costa, Ana Carolina Carioca

; Gomes-Júnior, Saint Clair dos Santos

; Fonseca, Vania de Matos

; Moreira, Maria Elisabeth Lopes

Clinics

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2019, Volume 74 elocation e798

Abstract: En | Text: En | PDF: En

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.

https://doi.org/10.6061/clinics/2019/e798 719 downloads

13.

Características dos primeiros casos de microcefalia possivelmente relacionados ao vírus Zika notificados na Região Metropolitana de Recife, Pernambuco
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Vargas, Alexander Saad, Eduardo Dimech, George Santiago Santos, Roselene Hans Sivini, Maria Auxiliadora Vieira Caldas Albuquerque, Luciana Carolina Lima, Patricia Michelly Santos Barreto, Idalacy de Carvalho Andrade, Michelly Evangelista de Estima, Nathalie Mendes Carvalho, Patrícia Ismael de Azevedo, Rayane Souza de Andrade Vasconcelos, Rita de Cássia de Oliveira Assunção, Romildo Siqueira Frutuoso, Lívia Carla Vinhal Carmo, Greice Madeleine Ikeda do Souza, Priscila Bochi de Wada, Marcelo Yoshito Oliveira, Wanderson Kleber de Henriques, Cláudio Maierovitch Pessanha Percio, Jadher

Epidemiologia e Serviços de Saúde

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dec 2016, Volume 25 N. 4 Pages 691 - 700

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

Resumo OBJETIVO: descrever os primeiros casos de microcefalia possivelmente relacionados ao vírus Zika em nascidos vivos notificados na Região Metropolitana do Recife, Pernambuco, Brasil. MÉTODOS: estudo descritivo de tipo série de casos (notificados de 1º de agosto a 31 de outubro de 2015), com dados obtidos dos registros médicos e de questionário aplicado às mães. RESULTADOS: foram confirmados 40 casos com microcefalia, distribuídos em oito municípios da Região Metropolitana do Recife, com maior concentração no Recife (n=12); a mediana do perímetro cefálico foi de 29 cm, do perímetro torácico, 31 cm, e do peso, 2.628 gramas; 21/25 casos apresentaram calcificação cerebral, ventriculomegalia ou lisencefalia; entre as 40 mães, 27 referiram exantema na gestação, 20 no primeiro trimestre e sete no segundo, além de prurido, cefaleia, mialgia e ausência de febre. CONCLUSÃO: a maioria dos casos apresentou características de infecção congênita; a maioria das mães apresentou quadro sugestivo de infecção pelo vírus Zika na gestação.

Abstract OBJECTIVE: to describe the first cases of microcephaly possibly related to Zika virus in live born babies reported in the Metropolitan Region of Recife, Pernambuco State, Brazil. METHODS: this was a descriptive case series study (cases reported between August 1st and October 31st 2015), using medical record data and data from a questionnaire answered by the mothers of the babies. RESULTS: 40 microcephaly cases were confirmed, distributed in eight municipalities within the Metropolitan Region, with Recife itself having the highest concentration of cases (n=12); median head circumference was 29 cm, median chest girth was 31 cm and median weight was 2,628 grams; 21/25 cases had brain calcification, ventriculomegaly or lissencephaly; 27 of the 40 mothers reported rash during pregnancy, 20 in the first trimester and 7 in the second trimester, as well as itching, headache, myalgia and absence of fever. CONCLUSION: the majority of the cases bore the characteristics of congenital infection; the clinical condition of the majority of mothers suggested Zika virus infection during pregnancy.

Resumen OBJETIVO: describir los primeros casos de microcefalia en nacidos vivos reportados al Departamento de Salud del Estado de Pernambuco, en la región metropolitana de Recife, Pernambuco, 2015. MÉTODOS: estudio epidemiológico descriptivo de serie de casos (reportados de 1 de agosto a 31 de octubre de 2015), con datos obtenidos de registros médicos y cuestionarios aplicados a las madres. RESULTADOS: 40 casos fueron confirmados con microcefalia, en ocho municipios de la región metropolitana de Recife, con mayor concentración de casos en Recife (n=12); la circunferencia media de la cabeza fue 29 cm, perímetro torácico 31 cm y peso 2.628 gramos; exámenes revelaron que 21/25 casos mostraron calcificación, dilatación ventricular o lisencefalia; de las 40 madres, 27 (68%) informan exantema durante la gestación, 20 (74%) en el primer trimestre y siete (26%) en la segunda, además de prurito, dolor de cabeza, mialgia y ausencia de fiebre. CONCLUSIÓN: la mayoría de los casos presenta características de infección congénita; la mayoría de las madres mostró características que sugieren infección por el virus Zika en el embarazo.

https://doi.org/10.5123/s1679-49742016000400003 22574 downloads

14.

Características dos primeiros casos de microcefalia possivelmente relacionados ao vírus Zika notificados na Região Metropolitana de Recife, Pernambuco
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Epidemiologia e Serviços de Saúde

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dec 2016, Volume 25 N. 4 Pages 691 - 700

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

https://doi.org/10.5123/s1679-49742016000400003

15.

Difference in fatty acids composition of breast adipose tissue in women with breast cancer and benign breast disease
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Lopes da Conceição, Lisiane Moura e Dias, Mariana de Pessoa, Milene Cristine Graças Pena, Geórgia das Santos Mendes, Maria Carolina Vilas Boas Neves, Cristiane Miranda Hermsdorff, Helen Hermana Nascimento de Freitas, Renata Gouveia Peluzio, Maria do Carmo

Nutrición Hospitalaria

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dec 2016, Volume 33 N. 6 Pages 1354 - 1360

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

Introducción: el cáncer de mama (CM) es el segundo cáncer más común en el mundo, y el cáncer más frecuente entre las mujeres. Por otra parte, hay factores que influyen en el riesgo de padecer CM, entre los que se encuentran la edad, factores genéticos y endocrinos, y el estilo de vida. Objetivos: evaluar el consumo de ácidos grasos; comparar la composición de ácidos grasos en el tejido adiposo de mama de las mujeres con CM y enfermedad benigna de mama (EBM), así como los posibles factores de riesgo; y describir la frecuencia genotípica del polimorfismo Pro12Ala PPARγ. Material y métodos: se llevó a cabo un estudio caso-control basado en hospitales, incluyendo casos incidentes (n = 38 cáncer de mama, n = 75 enfermedad benigna de mama, n = 166 control). Se evaluaron las características del estilo de vida, las cuestiones socioeconómicas, la ingesta dietética, la antropometría y los datos de sangre y tejidos. Resultados: no se observaron diferencias para la ingesta de ácidos grasos. Curiosamente, ácido láurico (p = 0,001), ácido mirístico (p = 0,036), ácido esteárico (p = 0,031) y los ácidos grasos totales saturados (AGS) (p = 0,048) tenían concentraciones más bajas en CM que en mujeres EBM, mientras ácido palmitoleico (p = 0,022), ácido erúcico (p = 0,002), los ácidos totales grasos monoinsaturados (MUFA) (p = 0,039) y la relación ácido oleico/ácido esteárico (p = 0,015) aumentó. No hubo asociación significativa entre el polimorfismo PPAR gamma y los grupos de estudio (p = 0,977). La edad al primer embarazo (p = 0,004) se asoció de forma significativa con el desarrollo de CM, mientras que el IMC (p = 0,005), porcentaje de grasa corporal (p = 0,024), la actividad física (p = 0,036) y la edad de la menarquia (p = 0,008), al primer embarazo (p < 0,001), y de la primera mamografía (p = 0,018), fueron significativamente asociados con el desarrollo de EBM. Conclusiones: los resultados sugieren una composición diferente de ácidos grasos del tejido adiposo de la mama, un biomarcador de la ingesta dietética a largo plazo, particularmente para SFA, MUFA y 18: 1 n-9/18: 00. Nuestros hallazgos también muestran que existen diferencias en los factores relacionados con el desarrollo de CM y EBM.

Introduction: Breast cancer is the second most common cancer in the world, and the most frequent cancer among women. Moreover, there are factors that influence the risk for breast cancer including the age, genetic and endocrine factors, and lifestyle. Objectives: To evaluate the consumption of fatty acids; compare the fatty acids composition in the breast adipose tissue of women with breast cancer and benign breast disease as well as potential risk factors; and describe the genotypic frequency of the Pro12Ala PPARγ polymorphism. Material and methods: A hospital-based case-control study was conducted including incident cases (n = 38 breast cancer; n = 75 benign breast disease; n = 166 control). Lifestyle features, socioeconomic issues, dietary intake, anthropometry, and blood and tissue data were assessed. Results: No differences were observed for fatty acids intake. Interestingly, lauric acid (p = 0.001), myristic acid (p = 0.036), stearic acid (p = 0.031), and total saturated fatty acids (SFAs) (p = 0.048) had lower concentrations in BC than in BBD women, while palmitoleic acid (p = 0.022), erucic acid (p = 0.002), total monounsaturated fatty acids (MUFAs) (p = 0.039) and oleic acid/stearic acid ratio (p = 0.015) increased. There was no significant association between PPARγ polymorphism and studied groups (p = 0.977). The age at first full pregnancy (p = 0.004) was significantly associated with the development BC, whereas BMI (p = 0.005); percentage of body fat (p = 0.024); physical activity (p = 0.036); and age at menarche (p = 0.008), at first full pregnancy (p < 0.001), and of first mammogram (p = 0.018) were significantly associated with the development of BBD. Conclusion: The results suggest a different fatty acids composition of breast adipose tissue, a biomarker of long-term dietary intake, particularly for SFAs, MUFA and 18: 1 n-9/18: 00 ratio. Our findings also show that are differences in the factors related to the development of BC and BBC.

https://doi.org/10.20960/nh.795

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