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1.
Impact of vertical positioning on lung aeration among mechanically ventilated intensive care unit patients: a randomized crossover clinical trial
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Neves, Douglas
; Marques Filho, Paulo Ricardo
; Townsend, Raquel da Silva
; Rodrigues, Cristiano dos Santos
; Tagliari, Luciana
; Madeira, Laura Cordeiro
; Mattioni, Mariana Fensterseifer
; Camillis, Márcio Luiz Ferreira de
; Leães, Clarissa Garcia Soares
; Andrade, Juliana Mara Stormovski de
; Robinson, Caroline Cabral
; Sganzerla, Daniel
; Drehmer, Laura
; Costa, Denis Fernandes Madruga da
; Machado, André Sant’Ana
; Rosa, Regis Goulart
; Lago, Pedro Dal
.
ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445
RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445
2.
Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023
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Oliveira, Gláucia Maria Moraes de
; Almeida, Maria Cristina Costa de
; Rassi, Daniela do Carmo
; Bragança, Érika Olivier Vilela
; Moura, Lidia Zytynski
; Arrais, Magaly
; Campos, Milena dos Santos Barros
; Lemke, Viviana Guzzo
; Avila, Walkiria Samuel
; Lucena, Alexandre Jorge Gomes de
; Almeida, André Luiz Cerqueira de
; Brandão, Andréa Araujo
; Ferreira, Andrea Dumsch de Aragon
; Biolo, Andreia
; Macedo, Ariane Vieira Scarlatelli
; Falcão, Breno de Alencar Araripe
; Polanczyk, Carisi Anne
; Lantieri, Carla Janice Baister
; Marques-Santos, Celi
; Freire, Claudia Maria Vilas
; Pellegrini, Denise
; Alexandre, Elizabeth Regina Giunco
; Braga, Fabiana Goulart Marcondes
; Oliveira, Fabiana Michelle Feitosa de
; Cintra, Fatima Dumas
; Costa, Isabela Bispo Santos da Silva
; Silva, José Sérgio Nascimento
; Carreira, Lara Terra F.
; Magalhães, Lucelia Batista Neves Cunha
; Matos, Luciana Diniz Nagem Janot de
; Assad, Marcelo Heitor Vieira
; Barbosa, Marcia M.
; Silva, Marconi Gomes da
; Rivera, Maria Alayde Mendonça
; Izar, Maria Cristina de Oliveira
; Costa, Maria Elizabeth Navegantes Caetano
; Paiva, Maria Sanali Moura de Oliveira
; Castro, Marildes Luiza de
; Uellendahl, Marly
; Oliveira Junior, Mucio Tavares de
; Souza, Olga Ferreira de
; Costa, Ricardo Alves da
; Coutinho, Ricardo Quental
; Silva, Sheyla Cristina Tonheiro Ferro da
; Martins, Sílvia Marinho
; Brandão, Simone Cristina Soares
; Buglia, Susimeire
; Barbosa, Tatiana Maia Jorge de Ulhôa
; Nascimento, Thais Aguiar do
; Vieira, Thais
; Campagnucci, Valquíria Pelisser
; Chagas, Antonio Carlos Palandri
.
3.
Herpetofauna of protected areas in the Caatinga VIII: An updated checklist for the Serra das Confusões region with new data from Serra Vermelha, Piauí, Brazil
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Marques, Ricardo
; Garda, Adrian A.
; Furtado, Adriana P.
; Bruinjé, Andre C.
; Protázio, Arielson dos S.
; de Carvalho, Breno F.
; Vieira, Cecília R.
; Gomes, Dandara
; Pantoja, Davi L.
; Figueiredo, Diainara da S.
; Shepard, Donald B.
; Camurugi, Felipe
; Coelho, Felipe E. A.
; Magalhães, Felipe M.
; Caetano, Gabriel H. O.
; Colli, Guarino R.
; Paulino, Henrique M.
; Carvalho, Izabelle T. S.
; Graciene, Joedma
; Alvarenga, Júlio M.
; Clay, Natalie A.
; Albuquerque, Ralph L.
; Bosque, Renan J.
; Faria, Renato
; da Silveira-Filho, Ricardo R.
; Mângia, Sarah
; Cavalcante, Vitor H. G. L.
; Vieira, Washington L. S.
; da Silva, Willianilson P.
; Soares, Yan F. F.
; Mesquita, Daniel O.
.
Abstract It is repeatedly stressed the need to characterize the extant biodiversity in tropical ecosystems. However, inventory studies are still progressing slowly in dry ecosystems, leading to the underestimation of their true biodiversity and hindering conservation efforts. In this study, we present primary and secondary data, along with an updated list of amphibians and reptiles from two localities in the São Francisco-Gurguéia region in Piauí. Additionally, we compare the species composition between nine areas within the Caatinga, which were sampled using standardized methods over the past ten years, to examine broader spatial patterns of community composition. To survey reptiles and amphibians, we employed similar methods and sampling efforts in two areas within the Serra das Confusões National Park (SCNP) region. Our surveys recorded a total of 73 species of amphibians and reptiles, of which 24 are new distribution records for the SCNP region. Consequently, our findings increase the known herpetofauna in the region to 94 species. Despite their proximity, the two sites in the SCNP region exhibited only 42% similarity in species composition, and they differed significantly from other areas within the Caatinga. Furthermore, even the closer Caatinga areas presented differences in species composition, highlighting the necessity to evaluate biodiversity across the landscape and contribute to understanding biogeographic patterns.
Resumo É repetidamente enfatizada a necessidade de caracterizar a biodiversidade vivente em ecossistemas tropicais. No entanto, os estudos de inventário ainda estão progredindo lentamente em ecossistemas secos, levando à subestimação de sua verdadeira biodiversidade e dificultando os esforços de conservação. Neste estudo, apresentamos dados primários e secundários, juntamente com uma lista atualizada de anfíbios e répteis de duas localidades na região de São Francisco-Gurguéia, do Piauí. Além disso, comparamos a composição de espécies entre nove áreas dentro da Caatinga, que foram amostradas usando métodos padronizados nos últimos dez anos, para examinar padrões espaciais mais amplos de composição da comunidade. Para estudar répteis e anfíbios, utilizamos métodos e esforços de amostragem semelhantes em duas áreas na região do Parque Nacional da Serra das Confusões (PNSC). Nossos levantamentos registraram um total de 73 espécies de anfíbios e répteis, das quais 24 são novos registros de distribuição para a região do PNSC. Consequentemente, nossos resultados aumentam a herpetofauna conhecida na região para 94 espécies. Apesar da proximidade, os dois locais na região do PNSC exibiram apenas 42% de similaridade na composição de espécies e diferiram significativamente de outras áreas dentro da Caatinga. Mesmo áreas mais próximas da Caatinga apresentaram diferenças na composição de espécies, destacando a necessidade de avaliar a biodiversidade em toda a paisagem e contribuir para a compreensão de padrões biogeográficos.
4.
Production and characterization of a new mango distilled beverage
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Oliveira, Patrícia Natielly de
; Alcarde, André Ricardo
; Bortoletto, Aline Marques
; Abud, Ana Karla de Souza
; Oliveira Júnior, Antonio Martins de
.
ABSTRACT The large scale of mango production allows for the application of immediate technologies to minimize post-harvest losses and add even more value to the fruit chain. As a consequence of feasible applications, the production of alcoholic beverages through fermentation and distillation has been elaborated, resulting in a supply of products with different characteristics. This study aimed to monitor the development of a distilled mango beverage and its profile for consumption. The mangoes were selected, pulped and subjected to physicochemical characterization and, subsequently, to fermentation and distillation processes where the kinetics were monitored, and the beverage obtained was compared to similar products found in the literature. During column distillation, the relationship between the temperature profile and the alcohol content was observed, allowing for careful selection of each fraction of the distillate and the establishment of a standard for future distillations. As regards the fraction of interest, good results were obtained in terms of composition with compounds such as methanol and acetaldehyde in minimal quantities, indicating a product that can be consumed without health risks. The small amount of studies following the same line of research confirms the potential mango pulp named Tommy Atkins for the formulation of alcoholic products.
https://doi.org/10.1590/1678-992x-2020-0149
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5.
Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes
; Melo, Ana Karla Guedes de
; Cruz, Vítor Alves
; Souza, Viviane Angelina de
; Carvalho, Joana Starling de
; Machado, Ketty Lysie Libardi Lira
; Valadares, Lilian David de Azevedo
; Reis Neto, Edgard Torres dos
; Rezende, Rodrigo Poubel Vieira de
; Guimarães, Maria Fernanda Brandão de Resende
; Ferreira, Gilda Aparecida
; Braz, Alessandra de Sousa
; Vieira, Rejane Maria Rodrigues de Abreu
; Pinheiro, Marcelo de Medeiros
; Ribeiro, Sandra Lúcia Euzébio
; Bica, Blanca Elena Gomes Rios
; Baptista, Kátia Lino
; Costa, Izaias Pereira da
; Marques, Claudia Diniz Lopes
; Lopes, Maria Lúcia Lemos
; Martinez, José Eduardo
; Giorgi, Rina Dalva Neubarth
; Mota, Lícia Maria Henrique da
; Loures, Marcos Antônio Araújo da Rocha
; Paiva, Eduardo dos Santos
; Monticielo, Odirlei André
; Xavier, Ricardo Machado
; Kakehasi, Adriana Maria
; Pileggi, Gecilmara Cristina Salviato
.
Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.
6.
O Futuro do turismo no Brasil a partir da análise crítica do período 2000-2019
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Lohmann, Gui
; Lobo, Heros Augusto Santos
; Trigo, Luiz Gonzaga Godoi
; Valduga, Vander
; Castro, Rafael
; Coelho, Mariana de Freitas
; Cyrillo, Marina Wöhlke
; Dalonso, Yona
; Gimenes-Minasse, Maria Henriqueta
; Gosling, Marlusa de Sevilha
; Lanzarini, Ricardo
; Leal, Sergio Rodrigues
; Marques, Osiris
; Mayer, Verônica Feder
; Moreira, Jasmine Cardozo Moreira
; Moraes, Lauro Almeida de
; Panosso Netto, Alexandre
; Perinotto, André Riani Costa
; Queiroz Neto, Ambrozio
; Raimundo, Sidnei
; Sanovicz, Eduardo
; Trentin, Fábia
; Uvinha, Ricardo Ricci
.
Resumo O presente artigo oferece uma perspectiva sobre o turismo no Brasil, analisando os principais desdobramentos com foco no período de 2000-2019. Trata-se de um artigo de opinião com reflexões de acadêmicos do turismo brasileiro. Os tópicos relacionados ao turismo, cobertos neste artigo, incluem economia, política e planejamento, marketing, transporte, meio ambiente, gastronomia, hospitalidade, lazer, entre outros. Como principal conclusão, considera-se que o Brasil não conseguiu se posicionar como destino de renome internacional, já que desde a década de 1990 os esforços para apoiar o desenvolvimento do turismo regional obtiveram sucesso apenas moderado. As crises econômicas, a instabilidade política, a violência e a corrupção foram entraves que afetaram consideravelmente o setor de turismo. A falta de uma abordagem coordenada entre os vários níveis de governo, a escassez de dados de turismo e uma campanha de marketing supra-governamental de longo prazo, entre outros fatores, fizeram com que o país perdesse várias oportunidades importantes na década de 2010 para se estabelecer como um dos principais destinos turísticos no mercado global.
Abstract This article provides a perspective on tourism in Brazil, analyzing the main developments focusing on the period 2000-2019. This opinion paper provides a reflection made by academics with expertise in tourism in Brazil. Tourism-related topics covered in this paper include economics, politics and planning, marketing, transportation, environment, gastronomy, hospitality, leisure, among others. As the main conclusion, it is argued that Brazil has not managed to position itself as an internationally renowned destination. The efforts in the 1990s to support the development of regional tourism have had only moderate success. Economic crises, political instability, violence and corruption were obstacles that considerably affected the tourism sector. The lack of a coordinated approach between the various levels of government, the shortage of tourism data and a long-term supra-governmental marketing campaign, among other factors, meant that the country missed several opportunities in the 2010s to become established as one of the top tourist destinations in the global market.
Resumen El artículo ofrece una perspectiva del turismo en Brasil, analizando los principales desarrollos con un enfoque en el período 2000-2019. Es un artículo de opinión con reflexiones de investigadores del turismo brasileño. Los temas relacionados con el turismo que se tratan en este artículo incluyen economía, política y planificación, marketing, transporte, medio ambiente, gastronomía, hostelería, ocio, entre otros. Como conclusión principal, se considera que Brasil no ha logrado posicionarse como un destino de renombre internacional, ya que desde la década de los noventa los esfuerzos para apoyar el desarrollo del turismo regional solo han tenido un éxito moderado. Las crisis económicas, la inestabilidad política, la violencia y la corrupción fueron obstáculos que afectaron considerablemente al sector turístico. La falta de un enfoque coordinado entre los distintos niveles de gobierno, la escasez de datos turísticos y una campaña de marketing supra gubernamental a largo plazo, entre otros factores, hicieron que el país perdiera varias oportunidades importantes en la década de 2010 para establecerse como uno de los principales destinos turísticos del mercado mundial.
7.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
8.
Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis
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Lage, Ricardo da Cruz
; Marques, Claudia Diniz Lopes
; Oliveira, Thauana Luiza
; Resende, Gustavo Gomes
; Kohem, Charles Lubianca
; Saad, Carla Gonçalves
; Ximenes, Antônio Carlos
; Gonçalves, Célio Roberto
; Bianchi, Washington Alves
; Meirelles, Eduardo de Souza
; Keiserman, Mauro Waldemar
; Chiereghin, Adriano
; Campanholo, Cristiano Barbosa
; Lyrio, André Marun
; Schainberg, Cláudia Goldenstein
; Pieruccetti, Lenise Brandao
; Yazbek, Michel Alexandre
; Palominos, Penelope Esther
; Goncalves, Rafaela Silva Guimarães
; Assad, Rodrigo Luppino
; Bonfiglioli, Rubens
; Lima, Sônia Maria Alvarenga Anti Loduca
; Carneiro, Sueli
; Azevedo, Valderílio Feijó
; Albuquerque, Cleandro Pires
; Bernardo, Wanderley Marques
; Sampaio-Barros, Percival Degrava
; Pinheiro, Marcelo de Medeiros
.
Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.
https://doi.org/10.1186/s42358-020-00160-6
505 downloads
9.
The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA
; BACCARO, FABRICIO
; CRONEMBERGER, CECILIA
; HIPÓLITO, JULIANA
; BARROS, CLAUDIA FRANCA
; RODRIGUES, DOMINGOS DE JESUS
; NECKEL-OLIVEIRA, SELVINO
; OVERBECK, GERHARD E.
; DRECHSLER-SANTOS, ELISANDRO RICARDO
; ANJOS, MARCELO RODRIGUES DOS
; FERREGUETTI, ÁTILLA C.
; AKAMA, ALBERTO
; MARTINS, MARLÚCIA BONIFÁCIO
; TOMAS, WALFRIDO MORAES
; SANTOS, SANDRA APARECIDA
; FERREIRA, VANDA LÚCIA
; CUNHA, CATIA NUNES DA
; PENHA, JERRY
; PINHO, JOÃO BATISTA DE
; SALIS, SUZANA MARIA
; DORIA, CAROLINA RODRIGUES DA COSTA
; PILLAR, VALÉRIO D.
; PODGAISKI, LUCIANA R.
; MENIN, MARCELO
; BÍGIO, NARCÍSIO COSTA
; ARAGÓN, SUSAN
; MANZATTO, ANGELO GILBERTO
; VÉLEZ-MARTIN, EDUARDO
; SILVA, ANA CAROLINA BORGES LINS E
; IZZO, THIAGO JUNQUEIRA
; MORTATI, AMANDA FREDERICO
; GIACOMIN, LEANDRO LACERDA
; ALMEIDA, THAÍS ELIAS
; ANDRÉ, THIAGO
; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA
; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA
; MESSIAS, MARILUCE REZENDE
; MARQUES, MARCIA C.M.
; PADIAL, ANDRE ANDRIAN
; MARQUES, RENATO
; BITAR, YOUSZEF O.C.
; SILVEIRA, MARCOS
; MORATO, ELDER FERREIRA
; PAGOTTO, RUBIANI DE CÁSSIA
; STRUSSMANN, CHRISTINE
; MACHADO, RICARDO BOMFIM
; AGUIAR, LUDMILLA MOURA DE SOUZA
; FERNANDES, GERALDO WILSON
; OKI, YUMI
; NOVAIS, SAMUEL
; FERREIRA, GUILHERME BRAGA
; BARBOSA, FLÁVIA RODRIGUES
; OCHOA, ANA C.
; MANGIONE, ANTONIO M.
; GATICA, AILIN
; CARRIZO, MARÍA CELINA
; RETTA, LUCÍA MARTINEZ
; JOFRÉ, LAURA E.
; CASTILLO, LUCIANA L.
; NEME, ANDREA M.
; RUEDA, CARLA
; TOLEDO, JOSÉ JULIO DE
; GRELLE, CARLOS EDUARDO VIVEIROS
; VALE, MARIANA M.
; VIEIRA, MARCUS VINICIUS
; CERQUEIRA, RUI
; HIGASHIKAWA, EMÍLIO MANABU
; MENDONÇA, FERNANDO PEREIRA DE
; GUERREIRO, QUÊZIA LEANDRO DE MOURA
; BANHOS, AUREO
; HERO, JEAN-MARC
; KOBLITZ, RODRIGO
; COLLEVATTI, ROSANE GARCIA
; SILVEIRA, LUÍS FÁBIO
; VASCONCELOS, HERALDO L.
; VIEIRA, CECÍLIA RODRIGUES
; COLLI, GUARINO RINALDI
; CECHIN, SONIA ZANINI
; SANTOS, TIAGO GOMES DOS
; FONTANA, CARLA S.
; JARENKOW, JOÃO A.
; MALABARBA, LUIZ R.
; RUEDA, MARTA P.
; ARAUJO, PUBLIO A.
; PALOMO, LUCAS
; ITURRE, MARTA C.
; BERGALLO, HELENA GODOY
; MAGNUSSON, WILLIAM E.
.
Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.
https://doi.org/10.1590/0001-3765202120201604
1034 downloads
10.
Instrument to evaluate the behavioral intention of hypertensive people when taking anti-hypertensives
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Almeida, Taciana da Costa Farias
; Sousa, Mailson Marques de
; Gouveia, Bernadete de Lourdes André
; Olinda, Ricardo Alves de
; Freire, Maria Eliane Moreira
; Oliveira, Simone Helena dos Santos
.
RESUMO Objetivos: construir e analisar a validade de conteúdo de um instrumento para avaliar a intenção comportamental de indivíduos com hipertensão de tomar comprimidos anti-hipertensivos. Métodos: estudo metodológico fundamentado na teoria do comportamento planejado, desenvolvido em três etapas: elaboração do instrumento, validação de conteúdo e pré-teste com o público-alvo. O conteúdo foi validado por seis especialistas. Aplicou-se o Índice de Validade de Conteúdo. Resultados: participaram cinco enfermeiros e um psicólogo, com experiências em hipertensão arterial sistêmica e/ou teoria do comportamento planejado. A primeira versão do instrumento continha 40 itens. Após análise, originou-se a segunda versão, com 36 itens. Obteve-se concordância de 100% para abrangência dos constructos. O pré-teste evidenciou clareza e compreensão dos itens pelo públicoalvo. Conclusões: o instrumento configura-se um produto tecnológico confiável e inovador para utilização em populações com hipertensão arterial sistêmica e crenças semelhantes às identificadas no grupo pesquisado.
ABSTRACT Objectives: to build and analyze the validity of an instrument to assess the behavioral intention of individuals with hypertension to take antihypertensive pills. Methods: methodological study based on the theory of planned behavior, developed in three stages: preparation of the instrument, validation of content and pre-test with the target audience. The content has been validated by six experts. The Content Validity Index was applied. Results: five nurses and one psychologist participated, with experiences in systemic arterial hypertension and/or planned behavior theory. The first version of the instrument contained 40 items. After analysis, the second version originated, with 36 items. 100% agreement was obtained for the scope of the constructions. The pre-test showed clarity and understanding of the items by the target audience. Conclusions: the instrument is a reliable and innovative technological product for use in populations with systemic arterial hypertension and beliefs similar to those identified in the surveyed group.
RESUMEN Objetivos: construir y analizar la validez de contenido de un instrumento para evaluar la intención del comportamiento de individuos hipertensos de tomar comprimidos antihipertensivos. Métodos: estudio metodológico fundamentado en la teoría del comportamiento planeado, desarrollado en tres etapas: elaboración del instrumento, validez de contenido y pretest con el público objetivo. El contenido ha validado por seis especialistas. Se aplicó el Índice de Validez de Contenido. Resultados: participaron cinco enfermeros y un psicólogo, con experiencias en hipertensión arterial sistémica y/o teoría del comportamiento planeado. La primera versión del instrumento contenía 40 ítems. Después del análisis, se originó la segunda, con 36 ítems. Se obtuvo concordancia de 100% para inclusión de los constructos. El pretest evidenció claridad y comprensión de los ítems por el público objetivo. Conclusiones: el instrumento se configura un producto tecnológico confiable e innovador para utilización en poblaciones con hipertensión arterial sistémica y creencias semejantes a las identificadas en el equipo investigado.
https://doi.org/10.1590/0034-7167-2020-0192
500 downloads
11.
Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato
; Ferreira, Gilda Aparecida
; Gomides Reis, Ana Paula Monteiro
; Reis Neto, Edgard Torres
; Abreu, Mirhelen Mendes
; Albuquerque, Cleandro Pires
; Araújo, Nafice Costa
; Bacchiega, Ana Beatriz
; Bianchi, Dante Valdetaro
; Bica, Blanca
; Bonfa, Eloisa Duarte
; Borba, Eduardo Ferreira
; Brito, Danielle Christinne Soares Egypto
; Duarte, Ângela Luzia Branco Pinto
; Santo, Rafaela Cavalheiro Espírito
; Fernandes, Paula Reale
; Guimarães, Mariana Peixoto
; Gomes, Kirla Wagner Poti
; Kakehasi, Adriana Maria
; Klumb, Evandro Mendes
; Lanna, Cristina Costa Duarte
; Marques, Claudia Diniz Lopes
; Monticielo, Odirlei André
; Mota, Licia Maria Henrique
; Munhoz, Gabriela Araújo
; Paiva, Eduardo Santos
; Pereira, Helena Lucia Alves
; Provenza, José Roberto
; Ribeiro, Sandra Lucia Euzébio
; Rocha Junior, Laurindo Ferreira
; Sampaio, Camila Santana Justo Cintra
; Sampaio, Vanderson Souza
; Sato, Emília Inoue
; Skare, Thelma
; de Souza, Viviane Angelina
; Valim, Valeria
; Lacerda, Marcus Vinícius Guimarães
; Xavier, Ricardo Machado
; Pinheiro, Marcelo Medeiros
.
Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).
https://doi.org/10.1186/s42358-021-00217-0
22 downloads
12.
Brazilian Society of Rheumatology 2020 guidelines for psoriatic arthritis
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Carneiro, Sueli
; Palominos, Penelope Esther
; Anti, Sônia Maria Alvarenga
; Assad, Rodrigo Luppino
; Gonçalves, Rafaela Silva Guimarães
; Chiereghin, Adriano
; Lyrio, Andre Marun
; Ximenes, Antônio Carlos
; Saad, Carla Gonçalves
; Gonçalves, Célio Roberto
; Kohem, Charles Lubianca
; Marques, Cláudia Diniz Lopes
; Schainberg, Cláudia Goldenstein
; Meirelles, Eduardo de Souza
; Resende, Gustavo Gomes
; Pieruccetti, Lenise Brandao
; Keiserman, Mauro Waldemar
; Yazbek, Michel Alexandre
; Sampaio-Barros, Percival Degrava
; Lage, Ricardo da Cruz
; Bonfiglioli, Rubens
; Oliveira, Thauana Luíza
; Azevedo, Valderílio Feijó
; Bianchi, Washington Alves
; Bernardo, Wanderley Marques
; Simões, Ricardo dos Santos
; Pinheiro, Marcelo de Medeiros
; Campanholo, Cristiano Barbosa
.
Abstract Psoriatic arthritis (PsA) is a chronic and systemic immune disease characterized by inflammation of peripheral and/ or axial joints and entheses in patients with psoriasis (PsO). Extra-articular and extracutaneous manifestations and numerous comorbidities can also be present. These recommendations replace the previous version published in May 2013. A systematic review of the literature retrieved 191 articles that were used to formulate 12 recommendations in response to 12 clinical questions, divided into 4 sections: diagnosis, non-pharmacological treatment, conventional drug therapy and biologic therapy. These guidelines provide evidence-based information on the clinical management for PsA patients. For each recommendation, the level of evidence (highest available), degree of strength (Oxford) and degree of expert agreement (interrater reliability) are reported.
13.
Aromatic profiling of flavor active compounds in sugarcane spirits aged in tropical wooden barrels
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Resumo A produção de bebidas destiladas de qualidade envolve um período de envelhecimento em barris de madeira, durante o qual diversas reações físico-químicas ocorrem entre a madeira e o destilado. O carvalho é a principal madeira empregada mundialmente no processo de envelhecimento de bebidas alcoólicas. Entretanto, no Brasil, o uso de espécies de madeiras tropicais pode ser uma opção viável por permitir inovação nas características de destilados. O objetivo deste estudo foi determinar o perfil aromático de compostos de aromas em aguardente de cana (cachaça) envelhecida por 12 meses em barris novos de 225 L, com e sem tosta, construídos com espécies de madeiras tropicais: cerejeira [Amburana cearensis (Fr. Allem.) A.C. Smith], castanheira (Bertholletia excelsa Humboldt & Bonpland) e cabreúva (Myrocarpus frondosus Allemão). A caracterização química foi realizada por meio de cromatografia gasosa/espectrometria de massas, no modo scan, visando identificar compostos de aromas (ésteres, álcoois, ácidos orgânicos, compostos fenólicos e terpenos). Tanto os barris tostados quanto os sem tosta aumentaram a concentração de compostos fenólicos nas cachaças. Os destilados envelhecidos em cerejeira apresentaram maior complexidade aromática, principalmente devido aos ácidos orgânicos e aos compostos fenólicos. Os barris de cabreúva forneceram maiores teores de terpenos aromáticos aos destilados. Esta pesquisa apresenta um novo enfoque no perfil aromático de compostos de aroma em cachaça envelhecida em barris de madeiras tropicais.
Abstract The production of high quality spirits implies an aging period in wooden barrels, resulting in numerous physicochemical reactions between the wood and the beverage. Oak is the main wood used in the aging process of alcoholic beverages worldwide. However, in Brazil, the use of tropical wood species can be a viable option, allowing for innovation in the characteristics of spirits. This study aimed to determine the aromatic profiling of flavor active compounds in Brazilian sugarcane spirit (cachaça) after a 12-month aging period in new 225-L toasted and non-toasted barrels made from the tropical wood species cerejeira [Amburana cearensis (Fr. Allem.) A.C. Smith], castanheira (Bertholletia excelsa Humboldt & Bonpland), and cabreúva (Myrocarpus frondosus Allemão). The chemical characterization was carried out using the Gas-Chromatography/Mass Spectroscopy (GC/MS) scan mode, and the identification targeted on flavor active compounds (esters, alcohols, organic acids, phenolic compounds, and terpenes). Toasted and non-toasted cerejeira barrels intensified the contents of phenolic compounds in cachaça. The samples aged in cerejeira barrels exhibited the most complex profile, mainly related to organic acids and phenolic compounds. However, cabreúva barrels transferred significant aromatic terpenes to cachaça. This research presented a novel focus on the aromatic profiling of flavor active compounds in cachaça aged in barrels made from tropical wood species.
https://doi.org/10.1590/1981-6723.07119
168 downloads
14.
Patterns of radioiodine use for differentiated thyroid carcinoma in Brazil: insights and a call for action from a 20-year database
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Schwengber, Wallace Klein
; Mota, Laís Marques
; Nava, Carla Fernanda
; Rodrigues, João Antônio Paim
; Zanella, André B.
; Kuchenbecker, Ricardo De Souza
; Scheffel, Rafael Selbach
; Maia, Ana Luiza
; Dora, Jose Miguel
.
ABSTRACT Objective: This study aimed to explore the patterns of radioactive iodine (RAI) use for differentiated thyroid cancer (DTC) in Brazil over the past 20 years. Materials and methods: A retrospective analysis of the DTC-related RAI prescriptions, from 2000 to 2018, retrieved from the Department of Informatics of the Unified Health System (Datasus) and National Supplementary Health Agency (ANS) database was performed. RAI activities prescriptions were re-classified as low (30-50 mCi), intermediate (100 mCi), or high activities (>100 mCi). Results: The number of DTC-related RAI prescriptions increased from 0.45 to 2.28/100,000 inhabitants from 2000 to 2015, declining onwards, closing 2018 at 1.87/100,000. In 2018, population-adjusted RAI prescriptions by state ranged from 0.07 to 4.74/100,000 inhabitants. Regarding RAI activities, in the 2000 to 2008 period, the proportion of high-activities among all RAI prescriptions increased from 51.2% to 74.1%. From 2009 onwards, there was a progressive reduction in high-activity prescriptions in the country, closing 2018 at 50.1%. In 2018, the practice of requesting high-activities varied from 16% to 82% between Brazilian states. Interestingly, variability of RAI use do not seem to be related to RAI referral center volume nor state socio-economic indicators. Conclusion: In recent years, there has been a trend towards the lower prescription of RAI, and a reduction of high-activity RAI prescriptions for DTC in Brazil. Also, significative inter-state and inter-institutional variability on RAI use was documented. These results suggest that actions to advance DTC healthcare quality surveillance should be prioritized.
https://doi.org/10.20945/2359-3997000000302
520 downloads
15.
Psychosocial Determinants of the Intention to Take Oral Antihypertensive Drugs: A Cross-sectional Study
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Almeida, Taciana da Costa Farias
; Sousa, Mailson Marques de
; Gouveia, Bernadete de Lourdes André
; Olinda, Ricardo Alves de
; Lamas, José Luiz Tatagiba
; Oliveira, Simone Helena dos Santos
.
RESUMEN Objetivo: identificar los predictores psicosociales que influyen la intención comportamental de tomar los antihipertensivos orales. Materiales y métodos: estudio transversal, fundamentado en la teoría de la conducta planeada. Se aplicó un cuestionario construido y validado a 220 individuos con hipertensión arterial sistémica en seguimiento ambulatorio en un hospital público. Se emplearon las pruebas de Cui-cuadrado y exacto de Fisher, correlación de Spearman y regresión logística múltiple para analizar los datos. Resultados: los participantes presentaron alta intención de tomar los antihipertensivos. Las creencias comportamentales (ß = 0,0432; p = 0,0364), la norma subjetiva (ß = -1,5708; p < 0,01) y el control comportamental percibido (ß = 2,2809; p = 0,0028) explicaron la intención comportamental en el 33 %. Conclusiones: creencias comportamentales, norma subjetiva y control comportamental percibido son predictores psicosociales significativos de la tomada de los antihipertensivos y deben valorarse, de forma individual y conjunta, en las acciones de salud hacia esta población.
ABSTRACT Objective: To identify the psychosocial predictors that influence the behavioral intention to take oral antihypertensive drugs. Materials and methods: A cross-sectional study, based on the theory of planned behavior. A questionnaire constructed and validated was applied to 220 individuals with systemic arterial hypertension in outpatient follow-up at a public hospital. The chi-square and Fisher's exact tests, Spearman's correlation and multiple logistic regression were used for data analysis. Results: The participants presented a high intention of taking antihypertensive drugs. The behavioral beliefs (ß = 0.0432; p = 0.0364), subjective norm (ß = -1.5708; p < 0.01) and perceived behavioral control (ß = 2.2809; p = 0.0028) explained the behavioral intention in 33 %. Conclusions: The behavioral beliefs, the subjective norm, and the perceived behavioral control are significant psychosocial predictors of taking antihypertensive drugs and must be valued, individually and jointly, in the health actions targeted at this population.
RESUMO Objetivo: identificar os preditores psicossociais que influenciam a intenção comportamental de tomar os anti-hipertensivos orais. Materiais e métodos: estudo transversal, fundamentado na teoria do comportamento planejado. Aplicou-se um questionário construído e validado a 220 indivíduos com hipertensão arterial sistêmica em acompanhamento ambulatorial em um hospital público. Utilizaram-se os testes qui-quadrado e exato de Fisher, correlação de Spearman e regressão logística múltipla para as análises dos dados. Resultados: os participantes apresentaram alta intenção de tomar os anti-hipertensivos. As crenças comportamentais (ß = 0,0432; p = 0,0364), a norma subjetiva (ß = -1,5708; p < 0,01) e o controle comportamental percebido (ß = 2,2809; p = 0,0028) explicaram a intenção comportamental em 33 %. Conclusões: crenças comportamentais, norma subjetiva e controle comportamental percebido são preditores psicossociais significativos da tomada dos anti-hipertensivos e devem ser valorizados, de forma individual e conjunta, nas ações de saúde direcionadas a essa população.
https://doi.org/10.5294/aqui.2020.20.4.6
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