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Sodium Intake Targets in Peritoneal Dialysis Patients: A Real-Life Challenge
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Castro, Pedro Almiro e

; Correia, Ana Luísa

; Mira, Filipe

; Cerqueira, Sofia

; Oliveira, Nuno Afonso

; Maia, Pedro

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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dec 2023, Volume 37 N. 4 Pages 207 - 211

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Optimal fluid balance in peritoneal dialysis requires adequate urinary and peritoneal water and sodium removal and restriction of dietary sodium intake (<2 g/day). We aim to study the relationship between sodium intake, blood pressure control and medication burden in peritoneal dialysis patients. Methods: Observational, cross-sectional study of chronic peritoneal dialysis patients followed in our hospital in March 2022. We estimated patient’s sodium intake according to the equations proposed by Kim et al. Mean ambulatory blood pressure was categorized in controlled, stage one, stage two and stage three hypertension. A qualitative evaluation of sodium intake was done by asking patients about their compliance with a low-salt diet. Results: Eighty-two patients: mostly men, with a mean age of 54.1±14.7 years and dialysis vintage of 26.2±18.7 months. Most patients were on continuous ambulatory peritoneal dialysis (63.4%) and the mean weekly Kt/V was 2.2±0.4. A percentage of 85.4% of our patients had residual diuresis, averaged at 1257±867 mL/day. Mean dietary sodium intake was 3.5±1.1 g; it was higher in men and patients with uncontrolled hypertension, regardless of age, dialysis vintage and other comorbidities. We found a strong correlation between dietary sodium intake and residual diuresis, systolic blood pressure, diastolic blood pressure and the number of anti-hypertensive drugs. Patients with a sodium intake ≥ 3.3 g had higher risk of uncontrolled BP and higher medication burden. Qualitative evaluation of this sub-population revealed that only 2.3% (n=1) admitted non-compliance with a low-sodium diet. Conclusion: We found a strong correlation between estimated dietary sodium consumption, blood pressure control and medication burden. Most importantly, there was a striking difference between patient’s perception of sodium consumption and the actual results. Our results highlight the importance of dietary salt restriction in blood pressure control and reinforce the need for a dietary consultation in peritoneal dialysis patients.

https://doi.org/10.32932/pjnh.2023.11.265

Life and Sleep Quality amongst Peritoneal Dialysis Patients: A Comparative Study
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Castro, Pedro Almiro e

; Correia, Ana Luísa

; Mira, Filipe

; Cerqueira, Sofia

; Oliveira, Nuno Afonso

; Maia, Pedro

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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mar 2023, Volume 37 N. 1 Pages 21 - 24

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Sleep disorders affect up to 70% of peritoneal dialysis (PD) patients and appear to have significant negative effects on their quality of life (QoL). We compared life and sleep quality between patients on automated PD (APD) and continuous ambulatory PD (CAPD). Material and Methods: Cross-sectional study in chronic PD patients followed in our Dialysis Unit in February 2022. We evaluated sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) and QoL with EUROHIS-QOL-8. Results: Fifty-two patients, mostly men (65.4%, n=32), with a mean age of 52.7±14.2 years and PD vintage of 24.3±17.1 months. Our sample had similar distribution between APD and CAPD; we found no difference between groups regarding demographic data, PD-related quality parameters or prevalence of previous sleep disturbances. Mean QoL index was 69.9%±9.3% and similar between APD and CAPD patients; EUROHIS-QOL-8 negatively correlated with the scores on ESS (p=0.004) and PSQI (p=0.011). Regarding sleep quality, the mean ESS was 8.8±4.2 and PSQI was 7.6±3.6. APD patients had similar scores on ESS, but higher prevalence of severe daytime sleepiness (ESS≥18) (p=0.04) and higher scores on PSQI (p=0.002). Within the PSQI, sleep’ latency (p=0.003), duration (p=0.002) and efficiency (p=0.013) were the most affected parameters. Higher PSQI scores also correlated with worse blood pressure control; a cut-off value for PSQI of 6 was found to increase the risk of uncontrolled hypertension. Conclusion: In our series, APD patients had worse global sleep quality (PSQI) when compared to ACPD patients. This difference was mainly due to worse sleep latency, duration and efficiency. The assessment of the quality of life showed no difference between groups, however there was a clear link between quality of life and sleep quality.

https://doi.org/10.32932/pjnh.2023.02.223

Neurocritical care management supported by multimodal brain monitoring after acute brain injury
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Monteiro, Elisabete

; Ferreira, António

; Mendes, Edite Raquel

; Silva, Sofia Rocha e

; Maia, Isabel

; Dias, Cláudia Camila

; Czosnyka, Marek

; Paiva, José Artur

; Dias, Celeste

Critical Care Science

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2023, Volume 35 N. 2 Pages 196 - 202

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

ABSTRACT Objective: To evaluate the association between different intensive care units and levels of brain monitoring with outcomes in acute brain injury. Methods: Patients with traumatic brain injury and subarachnoid hemorrhage admitted to intensive care units were included. Neurocritical care unit management was compared to general intensive care unit management. Patients managed with multimodal brain monitoring and optimal cerebral perfusion pressure were compared with general management patients. A good outcome was defined as a Glasgow outcome scale score of 4 or 5. Results: Among 389 patients, 237 were admitted to the neurocritical care unit, and 152 were admitted to the general intensive care unit. Neurocritical care unit management patients had a lower risk of poor outcome (OR = 0.228). A subgroup of 69 patients with multimodal brain monitoring (G1) was compared with the remaining patients (G2). In the G1 and G2 groups, 59% versus 23% of patients, respectively, had a good outcome at intensive care unit discharge; 64% versus 31% had a good outcome at 28 days; 76% versus 50% had a good outcome at 3 months (p < 0.001); and 77% versus 58% had a good outcome at 6 months (p = 0.005). When outcomes were adjusted by SAPS II severity score, using good outcome as the dependent variable, the results were as follows: for G1 compared to G2, the OR was 4.607 at intensive care unit discharge (p < 0.001), 4.22 at 28 days (p = 0.001), 3.250 at 3 months (p = 0.001) and 2.529 at 6 months (p = 0.006). Patients with optimal cerebral perfusion pressure management (n = 127) had a better outcome at all points of evaluation. Mortality for those patients was significantly lower at 28 days (p = 0.001), 3 months (p < 0.001) and 6 months (p = 0.001). Conclusion: Multimodal brain monitoring with autoregulation and neurocritical care unit management were associated with better outcomes and should be considered after severe acute brain injury.

RESUMO Objetivo: Avaliar a associação entre diferentes tipos de unidades de cuidados intensivos e os níveis de monitorização cerebral com desfechos na lesão cerebral aguda. Métodos: Foram incluídos doentes com traumatismo craniencefálico e hemorragia subaracnoide internados em unidades de cuidados intensivos. A abordagem na unidade de cuidados neurocríticos foi comparada à abordagem na unidade de cuidados intensivos polivalente geral. Os doentes com monitorização cerebral multimodal e pressão de perfusão cerebral ótima foram comparados aos que passaram por tratamento geral. Um bom desfecho foi definido como pontuação de 4 ou 5 na Glasgow outcome scale. Resultados: Dos 389 doentes, 237 foram admitidos na unidade de cuidados neurocríticos e 152 na unidade de cuidados intensivos geral. Doentes com abordagem em unidades de cuidados neurocríticos apresentaram menor risco de um mau desfecho (Odds ratio = 0,228). Um subgrupo de 69 doentes com monitorização cerebral multimodal (G1) foi comparado aos demais doentes (G2). Em G1 e G2, respectivamente, 59% e 23% dos doentes apresentaram bom desfecho na alta da unidade de cuidados intensivos; 64% e 31% apresentaram bom desfecho aos 28 dias; 76% e 50% apresentaram bom desfecho aos 3 meses (p < 0,001); e 77% e 58% apresentaram bom desfecho aos 6 meses (p = 0,005). Quando os desfechos foram ajustados para o escore de gravidade do SAPS II, usando o bom desfecho como variável dependente, os resultados foram os seguintes: para o G1, em comparação ao G2, a odds ratio foi de 4,607 na alta da unidade de cuidados intensivos (p < 0,001), 4,22 aos 28 dias (p = 0,001), 3,250 aos 3 meses (p = 0,001) e 2,529 aos 6 meses (p = 0,006). Os doentes com abordagem da pressão de perfusão cerebral ótima (n = 127) apresentaram melhor desfecho em todos os momentos de avaliação. A mortalidade desses doentes foi significativamente menor aos 28 dias (p = 0,001), aos 3 meses (p < 0,001) e aos 6 meses (p = 0,001). Conclusão: A monitorização cerebral multimodal com autorregulação e abordagem na unidade de cuidados neurocríticos foi associado a melhores desfechos e deve ser levado em consideração após lesão cerebral aguda grave.

https://doi.org/10.5935/2965-2774.20230036-en

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis

; Pujol-Luz, José Roberto

; Rafael, José Albertino

; Riccardi, Paula Raile

; Rodrigues, João Paulo Vinicios

; Roque, Fabio de Oliveira

; Sallum, Maria Anice Mureb

; Santis, Marcelo Domingos de

; Santos, Charles Morphy Dias dos

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Shimabukuro, Paloma Helena Fernandes

; Silva, Vera Cristina

; Schelesky-Prado, Daniel de Castro

; Silva-Neto, Alberto Moreira da

; Camargo, Alexssandro

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Wiedenbrug, Sofia

; Yamaguchi, Carolina

; Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

https://doi.org/10.1590/1806-9665-rbent-2023-0051

PATENT DUCTUS ARTERIOSUS CLOSURE: EXPERIENCE FROM A TERTIARY REFERRAL CENTER
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Faim, Diogo Remi Oliveira

; Tiago, Joaquim António Maia

; Castelo, Rui Jorge Simões

; Francisco, Andreia Sofia Santos

; Alves, Rosa Ramalho

; Pires, António Manuel Guerra Santos

Revista Paulista de Pediatria

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2021, Volume 39 elocation e2020013

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

RESUMO Objetivo: Caraterizar o número e métodos de fechamento de canal arterial durante 16 anos numa maternidade de nível terciário. Métodos: Estudo retrospetivo de nascidos entre 01 de janeiro de 2003 a 31 de dezembro de 2018 submetidos a fechamento do canal arterial por métodos farmacológico, cirúrgico e/ou percutâneo. Avaliaram-se idade gestacional, sexo, peso ao nascimento, número de fechamentos por ano e método utilizado. Aferiram-se as taxas de sucesso de método farmacológico e de mortalidade e sua associação com peso ao nascer, fármaco utilizado e insucesso do fechamento. Resultados: Verificaram-se 47.198 recém-nascidos, 5.156 prematuros, dos quais 325 com canal arterial patente, sendo 106 com indicação para fechamento (idade gestacional mediana 27 semanas, peso <1000 g em 61%). Verificou-se diminuição do número de fechamentos ao longo dos anos, sobretudo a partir de 2010. O fechamento ocorreu em 62% após primeiro ciclo de tratamento farmacológico e em 74% após segundo. Após insucesso farmacológico, 12 realizaram ligadura cirúrgica e dois, fechamento percutâneo. Houve indicação de ligadura cirúrgica exclusiva em quatro. O ibuprofeno substituiu a indometacina em 2010. O acetaminofen foi usado em três doentes. A mortalidade nos 106 pacientes foi de 12%, associando-se ao peso ao nascer (13/65 <1000 vs. 0/41 >1000 g; p=0,002) e à falha do primeiro ciclo de tratamento farmacológico (13/27 com falha vs. 0/75 com sucesso; p<0,001). Conclusões: Consenso nacional de 2010 para diagnóstico e tratamento do canal arterial nos prematuros levou à diminuição do número de fechamentos desse canal. O fechamento farmacológico foi o método mais utilizado, seguido da ligadura cirúrgica. Peso <1000 g e falha no primeiro ciclo de fechamento farmacológico se associaram à maior mortalidade.

ABSTRACT Objective: To characterize the number and methods of closure of Persistent Ductus Arteriosus (PDA) over a span of 16 years in a third level maternity hospital. Methods: Retrospective study of neonates born between January 2003 and Deccember 2018, who underwent ductus arteriosus closure by pharmacological, surgical and/or transcatheter methods. Gestational age, birth weight, number and methods of closures per year were evaluated. The success rate of the pharmacologic method was calculated, as well as the mortality rate. The association between mortality and birthweight, treatment used and treatment failure was explored. Results: There were 47,198 births, 5,156 were preterm, 325 presented PDA and 106 were eligible for closure (median gestational age - 27 weeks, birthweight <1000 g - 61%). Frequency of PDA closure decreased during the study period, especially starting in 2010. Success rate with pharmacologic treatment was 62% after the first cycle and 74% after the second. After drug failure, 12 underwent surgical ligation and two underwent transcatheter closure. Exclusive surgical ligation was indicated in four infants. Ibuprofen replaced indomethacin in 2010, and acetaminophen was used in three infants. Among the 106 infants, hospital mortality was 12% and it was associated with birthweight <1000 g (13/65 <1000 vs. 0/41 >1000 g; p=0.002) and with failure in the first pharmacologic treatment cycle (13/27 with failure, vs. 0/75 without failure; p<0.001). Conclusions: The national consensus published in 2010 for the diagnosis and treatment of PDA in preterm infants led to a decrease in the indication for closure. Pharmacological closure was the method of choice, followed by surgical ligation. Birthweight <1000 g and first cycle of pharmacologic treatment failure were associated with higher mortality.

https://doi.org/10.1590/1984-0462/2021/39/2020013 1155 downloads

Treatment of mycobacteriosis in a patient with compatible symptoms after a cesarean delivery
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Maia, Carina Scanoni

; Araújo, Paulo Sérgio Ramos de

; Schindler, Haiana Charifker

; Soares, Jardel Pereira

; Cruz, Ana Sofia

; Queiroz Júnior, José Reginaldo Alves de

; Tenorio, Fernanda das Chagas Angelo Mendes

; Medeiros, Juliana Pinto de

; Tenorio, Bruno Mendes

; Maciel, Gyl Everson de Souza

; Amorim, Rosa Valéria da Silva

; Hinrichsen, Sylvia Lemos

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e37

Abstract: En | Text: En | PDF: En

ABSTRACT This study aims to report the diagnostic course and treatment of a fast-growing mycobacteria infection after cesarean delivery. We report the case of a 37-year-old woman admitted to the Infectious Diseases’ Clinic of the Hospital das Clinicas da Universidade Federal de Pernambuco, Pernambuco State, Brazil, four months after a cesarean section, presenting with healing difficulties and located pain outside the surgical site. The first diagnosis was a probable rejection of the sutures that were not absorbed, but based on the clinical signs, reported history, complementary laboratory tests and no response to treatment with the conventional antibiotic therapy (cephalosporins/quinolones) prescribed, the ultimate diagnosis was a mycobacteriosis caused by Micobacterium fortuitum. Since fast-growing mycobacteria do not easily penetrate host tissues, they is mainly related to post-trauma or post-surgical procedures. It is extremely important to call attention to these occurrences in the gynecological-obsthetric field. Treatment for mycobacteriosis is often complicated because of the side effects of antibiotics, especially the ototoxicity of amikacin.

https://doi.org/10.1590/s1678-9946202163037 329 downloads

A comparative study of temporal variation of two epiphytic bryophytes in a central Amazonian white-sand forest, Brazil
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Pereira, Marta Regina

; Sierra, Adriel M

; Maia, Jair Max Furtunato

; Holanda, Ana Sofia Sousa de

Hoehnea

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2021, Volume 48 elocation e1352020

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

RESUMO Avaliamos a dinâmica populacional local de duas espécies epífitas, Syrrhopodon helicophyllus e Thysananthus amazonicus, ao longo de seis anos de 2014-2020, tanto antes quanto depois do incêndio que ocorreu na Campinarana localizada na Amazônia Central. Não observamos diferenças gerais na abundância de colônias na árvore hospedeira ao longo do tempo antes do evento de incêndio em 2019. No entanto, a abundância de colônias muda ao longo do gradiente vertical em direção ao microambiente mésico, o que permite persistir durante o evento El Niño de 2015-2016, e recuperado nos anos seguintes. Além disso, observamos que as colônias de ambas as espécies de briófitas diminuíram drasticamente após o incêndio em 2019, levando à perda completa das espécies em algumas das árvores hospedeiras estudadas Os impactos diretos das mudanças climáticas com o aumento de incêndios e secas nas florestas da Amazônia Central resultarão na perda da biodiversidade local epífita, especialmente nas florestas isoladas como as Campinaranas.

ABSTRACT We evaluated the local population dynamic of two epiphytic species, Syrrhopodon helicophyllus and Thysananthus amazonicus, over six years from 2014-2020, both before and after the fire event which occurred in the white-sand forest (Campinarana) located in Central Amazon. We did not observed an overall differences on colony abundance on the host tree over time before the fire event in 2019. However, colony abundances shifts along the vertical gradient towards mesic microenvironment which allow to persist during the El Niño event of 2015-2016, and recovered in the following years. Moreover, we observed that colonies of both bryophyte speciesdrastically declined after the fire event in 2019, leading to a complete loss of the species in some of the host tree studied. The direct impacts of climate change with an increased fire and drought events in Central Amazon forests will result in the loss of epiphyte local biodiversity, especially in the unique isolated white-sand forests.

https://doi.org/10.1590/2236-8906-135/2020 1 downloads

Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
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Jácome, Cristina

; Amaral, Rita

; Almeida, Rute

; Pereira, Ana Margarida

; Couto, Mariana

; Araújo, Luís

; Alves-Correia, Magna

; Pereira, Mariana

; Ferreira-Magalhães, Manuel

; Loureiro, Cláudia Chaves

; Catarata, Maria Joana

; Santos, Lília Maia

; Cabral, Sara

; Pereira, João

; Ramos, Bárbara

; Lopes, Cristina

; Mendes, Ana

; Lopes, Anabela

; Rodrigues, José Carlos Cidrais

; Oliveira, Georgeta

; Aguiar, Ana Paula

; Afonso, Ivete

; Carvalho, Joana

; Arrobas, Ana Maria

; Costa, José

; Valério, Margarida

; Pereira, Marta

; Almeida, Teresa

; Dias, Joana

; Bom, Ana Todo

; Azevedo, João

; Ribeiro, Carmelita

; Alves, Marta

; Pinto, Paula Leiria

; Neuparth, Nuno

; Neves, Ana Castro

; Palhinha, Ana

; Marques, João Gaspar

; Martins, Pedro

; Trincão, David Pina

; Todo-Bom, Filipa

; Santos, Maria Alvarenga

; Branco, Joana

; Costa, Alberto

; Neto, Armandina Silva

; Santalha, Marta

; Lozoya, Carlos

; Santos, Natacha

; Silva, Diana

; Vasconcelos, Maria João

; Barata, Luís Taborda

; Teixeira, Maria Fernanda

; Pinto, Diana

; Alves, Rodrigo Rodrigues

; Moreira, Ana Sofia

; Pinto, Cláudia Sofia

; Silva, Pedro Morais

; Alves, Carlos

; Câmara, Raquel

; Coelho, Didina

; Bordalo, Diana

; Carvalho, Fernanda

; Fernandes, Ricardo

; Ferreira, Rosário

; Oliveira, José Ferraz de

; Menezes, Fernando

; Gomes, Ricardo

; Calix, Maria José

; Marques, Ana

; Cardoso, João

; Emiliano, Madalena

; Gerardo, Rita

; Nunes, Carlos

; Ferreira, José Alberto

; Lopes, Inês

; Alves, Adelaide

; Fonseca, João Almeida

Revista Portuguesa de Imunoalergologia

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dec 2020, Volume 28 N. 4 Pages 231 - 240

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

Objetivos: Identificar clusters de controlo da asma baseados no Teste de Controlo da Asma e Rinite Alérgica (CARAT) e comparar as características dos doentes nos diferentes clusters. Métodos: Adultos e adolescentes (≥13 anos) com asma persistente foram recrutados em 29 centros no contexto de 2 estudos observacionais do projeto INSPIRERS. Foram recolhidos dados relativos a características demográficas e clínicas, adesão ao inalador, crenças sobre a medicação, sintomas de ansiedade e depressão, qualidade de vida e controlo da asma (CARAT, >24 bom controlo). Foi efetuada uma análise hierárquica de clusters usando a pontuação total do CARAT (CARAT-T).Resultados: Foram analisados 410 doentes (68% adultos), com uma idade mediana (percentil 25-percentil 75) de 28 (16-46) anos. Foram identificados três clusters [média CARAT-T(min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] e cluster 3 [10(2-13)]. Os doentes no cluster 1 (34%) apresentavam melhor controlo da asma, melhor qualidade de vida, maior adesão aos inaladores e usavam um único inalador. Os doentes nos clusters 2 (50%) e 3 (16%) tinham a asma não controlada, menor adesão aos inaladores, mais sintomas de ansiedade e depressão e mais de metade reportavam pelo menos uma exacerbação no último ano. Adicionalmente, os doentes no cluster 3 eram predominantemente mulheres, tinham mais consultas médicas não agendadas, apresentavam mais sintomas de ansiedade, percebiam uma maior necessidade dos inaladores, mas também uma maior preocupação associada ao seu uso. Não se verificaram diferenças na idade, índice de massa corporal, função pulmonar, hábitos tabágicos, hospitalizações ou tempo de seguimento pelo médico especialista. Conclusões: Um método não supervisionado baseado no CARAT-T, identificou 3 clusters de doentes com diferentes características clínicas. O cluster com melhor controlo apresenta um ponto de corte semelhante ao estabelecido no estudo de validação do CARAT. Este estudo sugere ainda a existência de um ponto de corte adicional para distinguir doença mais grave. Mais investigação é necessária para validar os clusters identificados

Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25-percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT-T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.

https://doi.org/10.32932/rpia.2020.12.046 633 downloads

Avaliação de domínios gerais e específicos na discalculia do desenvolvimento: que investigar?
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Batista, Luana

; Maia, Luis

; Silva, Sofia

Psicologia, Saúde & Doenças

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dec 2020, Volume 21 N. 3 Pages 956 - 966

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

Resumen La discalculia del desarrollo es parte de trastornos de aprendizaje específicos y afecta del 3 al 5% de la población en edad escolar. Se caracteriza por una dificultad en el procesamiento numérico y cálculos básicos con manifestación temprana y persistente durante todo el desarrollo. La evaluación neuropsicológica y sus herramientas son útiles para establecer un diagnóstico clínico. La discalculia afecta los dominios generales y específicos de la cognición. En dominios generales, es importante evaluar las representaciones verbales, las habilidades visoespaciales, las funciones ejecutivas y la memoria de trabajo. En los dominios específicos, es necesario investigar representaciones no simbólicas, transcodificaciones, operadores, conceptos, procedimientos, hechos aritméticos y problemas formulados verbalmente. Además, los niños con discapacidades de aprendizaje son susceptibles al desarrollo de problemas emocionales y de comportamiento, y su investigación es muy necesaria. Comprender los mecanismos subyacentes al trastorno facilita la comprensión de las habilidades preservadas y deterioradas en el individuo.

Resumo A Discalculia do Desenvolvimento faz parte dos transtornos específicos de aprendizagem e afeta de 3 a 5% da população em idade escolar. É caracterizada por uma dificuldade no processamento numérico e em cálculos básicos com manifestação precoce e persistente ao longo do desenvolvimento. A avaliação neuropsicológica e suas ferramentas são úteis no estabelecimento do diagnóstico clínico. A Discalculia afeta domínios gerais e específicos da cognição. Nos domínios gerais, é importante a avaliação das representações verbais, habilidades visuoespaciais, funções executivas e memória de trabalho. Já nos domínios específicos é necessária a investigação das representações não simbólicas, transcodificação, operadores, conceitos, procedimentos, fatos aritméticos e problemas verbalmente formulados. Além disso, crianças com transtorno de aprendizagem estão suscetíveis ao desenvolvimento de problemas emocionais e comportamentais, sendo sua investigação altamente necessária. O entendimento dos mecanismos subjacentes ao transtorno facilita a compreensão das habilidades preservadas e prejudicadas no indivíduo.

Abstract Developmental dyscalculia is part of specific learning disorders and affects 3 to 5% of the school-age population. It is characterized by a difficulty in numerical processing and basic calculations with early and persistent manifestation throughout development. Neuropsychological assessment and its tools are useful in establishing a clinical diagnosis. Dyscalculia affects general and specific domains of cognition. In general domains, it is important to evaluate verbal representations, visuospatial skills, executive functions and working memory. In the specific domains, it is necessary to investigate non-symbolic representations, transcoding, operators, concepts, procedures, arithmetic facts and verbally formulated problems. In addition, children with learning disabilities are susceptible to the development of emotional and behavioural problems, and their investigation is highly necessary. Understanding the mechanisms underlying the disorder facilitates the understanding of the skills preserved and impaired in the individual.

https://doi.org/10.15309/20psd210334 216 downloads

10.

Transtorno do espectro autista: o Síndrome de Savant
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Rodrigues, Vânia

; Nascimento, Sofia

; Maia, Luis

Psicologia, Saúde & Doenças

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aug 2020, Volume 21 N. 2 Pages 387 - 394

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

O transtorno do Espectro Autista expressa-se na infância, sendo sua característica um atraso no desenvolvimento do individuo, interacções sociais anómalas, e ainda pode estar presente uma deficiência intelectual. Neste transtorno pode estar incluído o Síndrome de Savant, onde o presente artigo tem como principal objectivo reflectir e abordar esse mesmo tema, uma situação rara na qual uma pessoa com défice intelectual tem um grande grau de genialidade e sabedoria, tendo muitas habilidades através da sua extraordinária memória. Assim a principal característica do Síndrome de Savant é o desenvolvimento de uma capacidade extraordinária, estando essa capacidade relacionada com a memorização, cálculo, habilidade musical/artística e por fim linguística.

Autism Spectrum Disorder is expressed in childhood, its characteristic being a delay in the development of the individual, anomalous social interactions, and an intellectual deficiency may still be present. This disorder may include Savant Syndrome, where the main purpose of this article is to reflect and address the same theme, a rare situation in which a person with intellectual deficit has a great degree of genius and wisdom, having many skills through his extraordinary memory. Thus the main characteristic of the Savant Syndrome is the development of an extraordinary capacity, being this capacity related to the memorization, calculation, musical/artistic ability and finally linguistic.

https://doi.org/10.15309/20psd210213 4640 downloads

11.

Inclusión y diferenciación pedagógica: dos estudios cualitativos en el sistema educativo portugués
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Maia Ferreira, Marco Paulo

; da Veiga Gonçalves, Cláudia Sofia

; Cruz da Silva, Cláudia Beatriz

; Oleína Sempere, Gustau

Revista Colombiana de Educación

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apr 2020, N. 78 Pages 321 - 342

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

Resumen Este artículo de investigación ha sido elaborado a partir de dos estudios empíricos realizados en el sistema educativo portugués durante el año escolar 2017-2018. El objetivo es comprender y discutir las concepciones y percepciones de los docentes acerca de la inclusión. La organización de los entornos educativos inclusivos está influenciada por las actitudes y las prácticas que los docentes tienen para promover una verdadera escuela para todos. Creemos que los desafíos a los que se enfrenta la educación en la actualidad colocan al maestro en el centro de la acción pedagógica para el desarrollo de la educación inclusiva. En estos estudios, se utilizó una metodología cualitativa basada en una recolección de datos a partir de guiones de entrevista semiestructurada. Fueron entrevistados 9 educadores de infancia y 14 profesores del primer ciclo. Los datos muestran que los participantes tienen concepciones apropiadas acerca de la inclusión, valorando, por ejemplo, la importancia de la interacción entre todos los alumnos, pero también revelan que la falta de recursos y la inadecuada formación de los docentes son barreras para implementar en sus rutinas pedagógicas metodologías y estrategias que valoren la inclusión y la pedagogía diferenciada.

Abstract This article is based on two empirical studies carried out in the Portuguese education system during the 2017-2018 school year. The aim is to understand and discuss the conceptions and representations of teachers about inclusion. The organization of inclusive educational environments goes with the attitudes and practices of teachers in promoting a sincere school for all. We firmly believe that the currently teaching challenges place the teacher at the core of the pedagogical action for the development of an inclusive education. In these studies, a qualitative methodology was used, based on a data collection from semi-structured interview protocol. 9 preschool teachers and 14 primary teachers were interviewed. The data shows that the participants in the studies have adequate conceptions about inclusion, emphasizing, for example, the relevance of the interaction between all the students, but also reveals that lack of resources and the inadequate teacher training are barriers for implementing in their pedagogical routines, methodologies and strategies that value inclusion and differentiated pedagogy.

Resumo Este artigo é elaborado a partir de dois estudos empíricos realizados no sistema de ensino português durante o ano letivo 2017-2018. O objetivo é compreender e discutir as conceções e representações dos docentes acerca da inclusão. A organização de contextos educativos inclusivos é influenciada pelas atitudes e práticas dos professores para promover uma verdadeira escola para todos. Acreditamos, que os desafios atuais do ensino, colocam o professor no centro da ação pedagógica para o desenvolvimento da educação inclusiva. Nestes estudos, utilizou-se uma metodologia qualitativa, baseada numa recolha de dados a partir de guiões de entrevista semiestruturada. Foram entrevistados 9 educadores de infância e 14 professores do 1° ciclo. Os dados apurados mostram que os participantes têm conceções adequadas acerca da inclusão, enfatizando, por exemplo, a relevância da interação entre todos os alunos, mas também revela que a falta de recursos e a inadequada formação docente são barreiras para implementarem nas suas rotinas pedagógicas, metodologias e estratégias que valorizem a inclusão e a pedagogia diferenciada.

https://doi.org/10.17227/rce.num78-9922 598 downloads

12.

Freshwater fishes of the Bahia State, Northeastern Brazil
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Silva, André Teixeira

; Chagas, Ricardo Jucá

; Santos, Alexandre Clistenes de Alcântara

; Zanata, Angela Maria

; Rodrigues, Beatriz Kawamura

; Polaz, Carla Natacha Marcolino

; Alves, Carlos Bernardo Mascarenhas

; Vieira, Cristiana Souza

; Souza, Fabiane Barreto

; Vieira, Fábio

; Sampaio, Francisco Alexandre Costa

; Ferreira, Harildon

; Alves, Hilda Susele Rodrigues

; Sarmento-Soares, Luisa Maria

; Pinho, Marianna

; Martins-Pinheiro, Ronaldo Fernando

; Lima, Sergio Maia Queiroz

; Campiolo, Sofia

; Camelier, Priscila

Biota Neotropica

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2020, Volume 20 N. 4 elocation e20200969

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

Resumo: Este trabalho foi realizado a partir da avaliação do estado de conservação da ictiofauna de água doce do Estado da Bahia. Os dados de inventário e distribuição das espécies foram obtidos a partir da literatura científica especializada e de coleções ictiológicas representativas. Um total de 281 espécies nativas foi registrado no Estado da Bahia, distribuídas nas ecorregiões de água doce Mata Atlântica Nordeste (NMA) e São Francisco (SFR). A riqueza de espécies foi maior na NMA (187 spp.), composta por diversas bacias costeiras, do que na SFR (134 spp.), composta pela bacia do rio São Francisco. Das 30 famílias registradas, as mais representativas foram Characidae e Rivulidae, com 53 e 48 espécies, respectivamente. O estado de conservação de 214 espécies foi avaliado e 33 (15%) destas foram classificadas em alguma categoria de ameaça da IUCN. Destas, 11 foram classificadas como vulneráveis (VU), 12 em perigo (EN) e 10 criticamente em perigo (CR). A maioria das espécies ameaçadas (n = 14) pertence à família Rivulidae. O elevado número de espécies ameaçadas na NMA: (n = 23) está associado ao alto endemismo das espécies com distribuição restrita e aos impactos da ocupação humana ao longo da região costeira. Na SFR, a maioria das espécies ameaçadas é de peixes anuais, que estão localmente desaparecendo devido à degradação crescente de seus habitats temporários.

Abstract: This work was carried out from the assessment of the conservation status of the freshwater ichthyofauna from Bahia State. The inventory data and species distribution were obtained from the specialized scientific literature and representative ichthyological collections. A total of 281 native species was recorded in Bahia State, distributed in the Northeastern Mata Atlantica (NMA) and São Francisco (SFR) freshwater ecoregions. There was a larger number of species in the NMA (187 spp.), composed by several coastal basins, than in the SFR (134 spp.), composed by São Francisco river basin. Among the 30 families recorded, Characidae and Rivulidae were the most representative, with 53 and 48 species, respectively. The conservation status of 214 species was assessed and 33 of them (15%) were included in the IUCN threat categories. Of these, 11 species were classified as vulnerable (VU), 12 as endangered (EN), and 10 as critically endangered (CR). Most threatened species (n = 14) belongs to the family Rivulidae. The larger number of threatened species in the NMA: (n = 23) is mainly related to the high endemism of restricted-range species associated with the human occupation impacts along the coastal regions. In the SFR, most of threatened species are annual killifishes, which are locally disappearing due to increasing degradation of their temporary habitats.

https://doi.org/10.1590/1676-0611-bn-2020-0969 1667 downloads

13.

Análise das relações das variáveis logísticas com a organização e estratégia das empresas de construção
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Maia, Sofia Gauginski

; Iarozinski Neto, Alfredo

; Costa, Sergio Edurado Gouvea da

; Romano, Cezar Augusto

Ambiente Construído

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dec 2019, Volume 19 N. 4 Pages 135 - 153

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

Resumo A necessidade de construir de forma eficiente, com prazos curtos e com menos custos, é uma das características para as construtoras sobreviverem num mercado cada vez mais competitivo. Devido à importância da logística na organização, o presente artigo tem como objetivo entender como os mecanismos das variáveis relacionadas à logística afetam o funcionamento de uma organização e impactam a estratégia das empresas de construção. Para tanto foi desenvolvido um estudo aplicado, descritivo, de natureza quantitativa e tempo transversal. Como procedimento principal foi escolhido o método Survey com análise de correlação entre as variáveis com base no Método da Matriz de Impacto Cruzado - Multiplicação Aplicada a uma Classificação (Micmac). Os resultados mostraram que as organizações têm predisposição a contratos de parcerias, com busca de informações junto aos fornecedores e frequentes ações conjuntas para a redução dos prazos de execução. Também procuram ter uma relação mais próxima com os clientes. Os resultados da pesquisa indicam ainda que a logística tem pouca influência na dinâmica do sistema e que as variáveis estratégicas se destacam como um papel importante no processo de desenvolvimento da empresa.

Abstract Building efficiently with short deadlines and lower costs is an objective that builders strive to achieve in order to survive in an increasingly competitive market. Due to the importance of logistics in any organisation, this article aims to understand how the mechanisms by which variables related to logistics affect the functioning of an organisation and influence the strategy of construction companies. For this purpose, an applied, descriptive study of qualitative and transverse time was developed. The main procedure chosen for the study was the Survey method with a correlation analysis between variables based on Micmac. The results showed that organisations have a predisposition to establish partnership contracts, seeking information from suppliers and frequent joint actions to reduce execution deadlines. They also seek to have a closer relationship with clients.The results of the research project also indicate that logistics has little influence on the dynamics of the system and that the strategic variables stand out as an important role in the process of development of the company.

https://doi.org/10.1590/s1678-86212019000400347 1742 downloads

14.

IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT
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Pires, Sofia Alexandra Pereira

; Lemos, Ana Pereira

; Pereira, Ester Preciosa Maio Nunes

; Maia, Paulo Alexandre da Silva Vilar

; Agro, João Patrício de Sousa e Alvim Bismarck do

Revista Paulista de Pediatria

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sep 2019, Volume 37 N. 3 Pages 382 - 385

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

RESUMO Objetivo: Descreve-se o caso de um adolescente do sexo masculino com diagnóstico de meningite asséptica por ibuprofeno. Discutem-se as causas de meningite asséptica induzida por medicamentos (MAIM) e a importância do reconhecimento precoce dessa situação, para que a medicação envolvida seja suspensa e as recorrências prevenidas. Poucos casos foram descritos em idade pediátrica. Descrição do caso: Adolescente de 15 anos, gênero masculino, saudável, procurou o serviço de urgência por cefaleia, náuseas, tonturas, febre, hiperemia conjuntival e visão desfocada 30 minutos após o uso de ibuprofeno. Durante a internação, iniciou vômitos e rigidez na nuca. A análise do líquido cefalorraquidiano excluiu causas infeciosas, e considerou-se como diagnóstico mais provável a MAIM. A recuperação foi total após a suspensão do medicamento. Comentários: A MAIM é rara, mas deve ser considerada no diagnóstico diferencial de meningite asséptica. A principal causa são os anti-inflamatórios não esteroides, principalmente o ibuprofeno. A suspeita clínica é evocada pela relação temporal entre o uso do medicamento e o início dos sintomas, mas as causas infeciosas devem ser sempre excluídas.

ABSTRACT Objective: To report a case of a male adolescent with the diagnosis of ibuprofen-induced meningitis. We discuss themain causes of drug-induced aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented. Only few DIAM cases have been reported in pediatric age. Case description: A healthy 15-year-old boy presented to the emergency department with headache, nausea, dizziness, fever, conjunctival hyperemia and blurred vision 30 minutes after ibuprofen-intake. During his stay, he developed emesis and neck stiffness. Cerebrospinal ﬂuid analysis excluded infectious causes, and DIAM was considered. He totally recovered after drug withdrawal. Comments: DIAM is a rare entity, that should be considered in the differential diagnosis of an aseptic meningitis. The major causative agents are nonsteroidal anti-inflammatory drugs, particularly ibuprofen. Suspicion is made by the chronologic link between drug intake and the beginning of symptoms, but infectious causes should always be ruled out.

https://doi.org/10.1590/1984-0462/;2019;37;3;00016 2572 downloads

15.

Aplicação do modelo WINROP no rastreio de Retinopatia de Prematuridade (ROP) numa amostra de prematuros portugueses
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Malheiro, Luísa

; Falcão, Inês

; Neiva, Luísa

; Almeida, Alexandra

; Maia, Sofia

; Miranda, Vasco

; Parreira, Ricardo

; Menéres, Pedro

Revista Brasileira de Oftalmologia

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feb 2019, Volume 78 N. 1 Pages 30 - 36

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

Resumo Objetivo: Avaliar a sensibilidade e especificidade do algoritmo WINROP na deteção de retinopatia de prematuridade (ROP) numa amostra de prematuros portugueses. Métodos: Estudo retrospetivo que incluiu todos os recém-nascidos prematuros (RN) submetidos a rastreio de ROP no Centro Hospital Universitário do Porto entre Janeiro de 2010 a Maio de 2016. A idade gestacional (IG), peso à nascença e os pesos semanais dos RN, até uma idade pós-menstrual de 35-36 semanas, foram introduzidos na aplicação online do WINROP, que sinaliza com uma mensagem de alarme os RN em risco de desenvolver ROP tipo 1, que requer tratamento. Resultados: De um total de 496 RN submetidos a rastreio de ROP, 20 foram excluídos do estudo por registos incompletos e 101 por IG≥32 semanas. Dos RN com uma IG≥ 32 semanas, um desenvolveu ROP tipo 1 e foi submetido a tratamento. Dos 375 RN introduzidos no modelo WINROP, 231 (62%) registaram um sinal de alarme. Todos os RN com ROP tipo 1 foram identificados pelo sinal de alarme. O tempo médio entre o sinal de alarme e o tratamento foi de 11 semanas. O algoritmo WINROP apresentou uma sensibilidade e um valor preditivo negativo de 100% e uma especificidade de 42%. Conclusão: O modelo WINROP demonstrou ser sensível na deteção de prematuros com necessidade de tratamento. Embora com um valor de especificidade menor, a aplicação do algoritmo pode ajudar a reduzir substancialmente o número de exames realizados. Uma das limitações do modelo consiste na exclusão de RN com IG≥32 semanas.

Abstract Objective: To evaluate the sensitivity and specificity of the WINROP algorithm for predicting retinopathy of prematurity (ROP) in a population of Portuguese preterm infants. Methods: Retrospective study of all newborns who underwent ROP screening at Hospital Universitário do Porto from January 2010 to May 2016. Gestational age (GA), birthweight and weekly postnatal weight measurements of the newborns, up to a postmenstrual age of 35-36 weeks, were entered in the online application of WINROP, which signals with an alarm the newborns who are at risk of developing ROP type 1, which requires treatment. Results: Of a total of 496 RN undergoing ROP screening, 20 were excluded from the study by incomplete records and 101 by GA ≥32 weeks. Of the newborns with a GA≥32 weeks, one developed ROP type 1 and was treated. Of the 375 newborns introduced in the WINROP application, 231 recorded an alarm signal. All the newborns with type 1 ROP were identified by the alarm signal. The WINROP algorithm presented a sensitivity and a negative predictive value of 100% and a specificity of 41%. The mean time between the alarm signal and the treatment was 10 weeks plus 6 days. Conclusion: The WINROP model was 100% sensitive in the detection of preterm infants requiring treatment for ROP. Besides its lower specificity, WINROP application can reduce substantially the number of exams in ROP screening. One of the limitations of the model is the exclusion of newborns with GA≥32 weeks.

https://doi.org/10.5935/0034-7280.20190007 953 downloads

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elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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