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1.
Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters
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Barcelos, Rafaela N.
; Camacho, Cléber P.
; Mamone, Maria da Conceição de O. C.
; Ikejiri, Elza S.
; Vanderlei, Felipe A. B.
; Yang, Ji H.
; Padovani, Rosália P.
; Martins, Leandro A. L.
; Biscolla, Rosa Paula M.
; Macellaro, Danielle
; Lindsey, Susan C.
; Maciel, Rui M. B.
; Martins, João Roberto M.
.
ABSTRACT Objective: The risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy (FNAB) of thyroid nodules (TN) with diameters ≥ 3-4 cm remains controversial. However, some groups have indicated surgical treatment in these patients regardless of the FNAB results. We aimed to evaluate the diagnostic accuracy of the FNAB in systematically resected ≥4 cm TN and if the risk of malignancy is higher in these patients. Subjects and methods: We retrospectively evaluated 138 patients (142 nodules) with TN with diameters ≥4 cm who underwent thyroidectomy. Results: The FNAB results were nondiagnostic/unsatisfactory (ND/UNS) in 2.1% of the cases and benign in 51.4%. They indicated atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) in 23.9% of cases, follicular neoplasia/suspicious for a follicular neoplasm (FN/SFN) in 9.2%, suspicion of malignancy (SUS) in 8.5%, and malignant in 4.9%. The histopathological analysis after thyroidectomy revealed a thyroid cancer rate of 100% in the FNABs classified as malignant, 33.3% in SUS cases, 7.7% in FN/SFN, 17.6% in AUS/FLUS, and 4.1% in benign FNABs. None of the ND/UNS FNABs were malignant. The global malignancy diagnosis was 14.8% (n = 21). However, the rate of false negatives for FNAB was low (4.1%). Conclusion: We showed that the risk of malignancy in nodules with diameters ≥4 cm was higher compared to the risk of thyroid cancer in TN in general. However, we found a low rate of false-negative cytological results; therefore, our data do not justify the orientation of routine resection for these larger nodules.
2.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
3.
Influence of Neuropeptide Y and Neuropeptide Y 2 Receptor Variants in Acute Coronary Syndrome
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Soares, Fábia C. S.
; Araújo, Romário M.
; Werkhauser, Roberto P.
; Diniz, George T.
; Bhaskar, Lakkakula V.K.S
; Carvalho, Viviane D. C. V.
; Tashiro, Tetsuo
; Amorim, Ester A. S.
; Silva, Lilian C. A.
; Montenegro, Sergio Tavares
; Neco, Heytor V. P. C.
; Moraes, Clarice N. L.
; Martins, Danyelly B. G.
; Montenegro, Silvia M. L.
.
International Journal of Cardiovascular Sciences
- Journal Metrics
Abstract Background The neuropeptide Y (NPY) is one of the most abundant neurotransmitters in the nervous system. NPY acts as a potent stimulator of angiogenesis, inflammation, and adipogenesis, through the NPY 2 receptor (NPY2R). Changes in the NPY signaling pathway have been linked to Acute Coronary Syndrome (ACS). Objectives The purpose of this study is to determine the association between variants in the NPY and NPY2R genes, as well as the severity of acute coronary syndrome (ACS). Methods Approximately 221 ACS patients and 278 healthy controls were selected for this study. Four variants in NPY and two variants in NPY2R genes were genotyped using Taqman allelic discrimination and sequencing. The Chi-square and Fisher's exact tests were used to verify the genotype frequencies. The logistic regression analyses were used for the evaluation of the studied variables. Haplotype analysis was used to evaluate the linkage disequilibrium (LD) between the variants (p<0.05). Results An association of NPY c.20T>C variant was found with the ACS group when compared to the healthy group. In the analysis between variants and risk factors in the ACS group, NPY c.84G>A was associated with hypertension. The analysis between TIMI risk showed a significance for NPY c.20T>C between the low and intermediate/high TIMI risk groups. In the haplotype analysis, strong linkage disequilibrium (LD) was found between the variants NPY c.150G>A and NPY c.-485T>C. Conclusion The NPY c.20T>C variant appears to contribute to the development of ACS. The NPY2R c.-1116A>G variant may contribute to the early development of ACS and the NPY c.84G>A variant appears to contribute to the development of hypertension. In addition, the NPY c.20T>C is associated with a protective effect in ACS severity.
4.
Root exudation of oxalic acid in Lotus corniculatus in response to aluminum toxicity
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Santos, Armando Martins dos
; Pedrazza, Graziele Pereira Ramos
; Zuanazzi, José Angelo Silveira
; Dall’Agnol, Miguel
; Weiler, Roberto Luis
; Brunes, André Pich
; Antoniolli, Júlio
; Silveira, Diógenes Cecchin
.
ABSTRACT The objective of this research was to identify the existence of root exudation of organic acid in Lotus corniculatus germplasms subjected to toxic aluminum (Al) levels and investigate the effect of this mechanism on the Al content in the root tissue and in morphological parameters of plant development. Two experiments were performed in nutrient solution to evaluate the Al accumulation and exudation of organic acids, using cultivars INIA Draco and São Gabriel and genotypes UFRGS and UF-T2. The plants were cultivated in Al-free solution, which was applied on the 45th day in half of the pots of each genotype. Root exudation was highly correlated with the reduced accumulation of Al in the root tissue (r2 = 0.75 at 72 h). Genotype UF-T2, selected for Al tolerance, extruded 80% more oxalic acid in the presence of Al compared with the other germplasms, indicating that this mechanism is involved with Al tolerance in L. corniculatus. This experiment showed strong evidence that L. corniculatus exhibits Type I tolerance, in which anionic channels are rapidly activated by Al exposure. Exudation of oxalic acid is likely a crucial mechanism that allows the maintenance of L. corniculatus growth when exposed to toxic Al conditions, and this characteristic should be used to identify tolerant genotypes in the future.
5.
Severe visceral leishmaniasis and COVID-19 coinfection in an immunosuppressed patient
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Martins, Luciamáre Perinetti Alves
; Fukasawa, Josianne Thomazini
; Messias, Mirella Beni Balbino Ferreira
; Castanho, Roberto Esteves Pires
; Andrade, Leticia Abrantes
; Sperança, Márcia Aparecida
; Suzuki, Rodrigo Buzinaro
.
Revista do Instituto de Medicina Tropical de São Paulo
- Journal Metrics
ABSTRACT Visceral leishmaniasis (VL) is an opportunistic disease in immunosuppressed individuals, who may present severe clinical conditions, such as the ones described in this patient. She lived in an endemic region for VL, and was possibly infected with L. (L.) infantum chagasi through the bite of a contaminated sand fly. This initial infection has triggered a pemphigus vulgaris condition by immunogenic proteins present in the mosquito's saliva. The immunosuppression caused by the use of high doses of corticosteroids to control the disease promoted a severe VL condition, with hepatosplenomegaly, thrombocytopenia and hemorrhages, requiring hospitalization and the onset of a subsequent SARS-CoV-2 infection. Due to the intensity of clinical manifestations related to VL, aggravated by COVID-19, she died two days after admission to the Clinical Hospital of Marilia Medical School (HC–Famema).
6.
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
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7.
Validation of ELISA with recombinant antigens in serological diagnosis of canine Leishmania infantum infection
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Fujimori, Mahyumi
; de Almeida, Arleana do Bom Parto Ferreira
; Barrouin-Melo, Stella Maria
; Cortez, Luiz Ricardo Paes de Barros
; Duthie, Malcolm Scott
; Hiramoto, Roberto Mitsuyoshi
; de Pinho, Flaviane Alves
; Reed, Steven Gregory
; Sousa, Valéria Régia Franco
; Souza, Nazaré Fonseca
; Soares, Rodrigo Martins
; Tolezano, José Eduardo
; Sanchez, Maria Carmen Arroyo
; Goto, Hiro
.
BACKGROUND Dogs are the main peridomiciliary reservoir of Leishmania infantum thus the correct diagnosis of infection is essential for the control of the transmission and treatment as well. However, the diagnosis is based on serological assays that are not fully effective. OBJECTIVE We aimed to establish an effective serological assay for the diagnosis of L. infantum infected dogs using Leishmania-derived recombinant antigens. METHODS Leishmania derived rK39-, rK28-, rKR95-based enzyme-linked immunosorbent assay (ELISA) was standardized using symptomatic and asymptomatic L. infantum-infected dogs. Then 2,530 samples from inquiry in endemic areas for VL were evaluated and the results compared with recommended assays by the Brazilian Ministry of Health (MH algorithm). Further samples from a cohort of 30 dogs were searched. FINDINGS For rK39-, rK28- and rKR95-ELISA the sensitivity was around 97% and specificity 100%. The positivity of these three ELISA in the inquiry samples was 27-28%, around 10% higher than the assays currently in use. When cohort samples were searched, we observed likely false-negative results (> 65%) with supposedly negative samples that turned positive six months later with the assays in use (MH algorithm). MAIN CONCLUSIONS For the diagnosis of L. infantum-infected dogs, rK39-based ELISA showed better diagnostic performance than other assays in use in Brazil and worldwide.
https://doi.org/10.1590/0074-02760200428
516 downloads
8.
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
; Brentani, Alexandra V. M.
; Neto, Álvaro José S.
; Ihara, Amanda
; Santos, Andrea R.
; Canton, Ana Pinheiro M.
; Watanabe, Andreia
; Santos, Angélica C. dos
; Pastorino, Antonio C.
; Franco, Bernadette D. G. M.
; Caruzo, Bruna
; Ceneviva, Carina
; Martins, Carolina C. M. F.
; Prado, Danilo
; Abellan, Deipara M.
; Benatti, Fabiana B.
; Smaria, Fabiana
; Gonçalves, Fernanda T.
; Penteado, Fernando D.
; Castro, Gabriela S. F. de
; Gonçalves, Guilherme S.
; Roschel, Hamilton
; Disi, Ilana R.
; Marques, Isabela G.
; Castro, Inar A.
; Buscatti, Izabel M.
; Faiad, Jaline Z.
; Fiamoncini, Jarlei
; Rodrigues, Joaquim C.
; Carneiro, Jorge D. A.
; Paz, Jose A.
; Ferreira, Juliana C.
; Ferreira, Juliana C. O.
; Silva, Katia R.
; Bastos, Karina L. M.
; Kozu, Katia
; Cristofani, Lilian M.
; Souza, Lucas V. B.
; Campos, Lucia M. A.
; Silva Filho, Luiz Vicente R. F.
; Sapienza, Marcelo T.
; Lima, Marcos S.
; Garanito, Marlene P.
; Santos, Márcia F. A.
; Dorna, Mayra B.
; Aikawa, Nadia E.
; Litvinov, Nadia
; Sakita, Neusa K.
; Gaiolla, Paula V. V.
; Pasqualucci, Paula
; Toma, Ricardo K.
; Correa-Silva, Simone
; Sieczkowska, Sofia M.
; Imamura, Marta
; Forsait, Silvana
; Santos, Vera A.
; Zheng, Yingying
.
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
9.
An Overview on the Development of Electrochemical Capacitors and Batteries – Part I
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MARTINS, VITOR L.
; NEVES, HERBERT R.
; MONJE, IVONNE E.
; LEITE, MARINA M.
; OLIVEIRA, PAULO F.M. DE
; ANTONIASSI, RODOLFO M.
; CHAUQUE, SUSANA
; MORAIS, WILLIAM G.
; MELO, EDUARDO C.
; OBANA, THIAGO T.
; SOUZA, BRENO L.
; TORRESI, ROBERTO M.
.
Abstract The Nobel Prize in Chemistry 2019 recognized the importance of Li-ion batteries and the revolution they allowed to happen during the past three decades. They are part of a broader class of electrochemical energy storage devices, which are employed where electrical energy is needed on demand and so, the electrochemical energy is converted into electrical energy as required by the application. This opens a variety of possibilities on the utilization of energy storage devices, beyond the well-known mobile applications, assisting on the decarbonization of energy production and distribution. In this series of reviews in two parts, two main types of energy storage devices will be explored: electrochemical capacitors (part I) and rechargeable batteries (part II). More specifically, we will discuss about the materials used in each type of device, their main role in the energy storage process, their advantages and drawbacks and, especially, strategies to improve their performance. In the present part, electrochemical capacitors will be addressed. Their fundamental difference to batteries is explained considering the process at the electrode/electrolyte surface and the impact in performance. Materials used in electrochemical capacitors, including double layer capacitors and pseudocapacitive materials will be reviewed, highlighting the importance of electrolytes. As an important part of these strategies, synthetic routes for the production of nanoparticles will also be approached (part I).
https://doi.org/10.1590/0001-3765202020200796
1490 downloads
10.
An Overview on the Development of Electrochemical Capacitors and Batteries – part II
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MARTINS, VITOR L.
; NEVES, HERBERT R.
; MONJE, IVONNE E.
; LEITE, MARINA M.
; OLIVEIRA, PAULO F.M. DE
; ANTONIASSI, RODOLFO M.
; CHAUQUE, SUSANA
; MORAIS, WILLIAM G.
; MELO, EDUARDO C.
; OBANA, THIAGO T.
; SOUZA, BRENO L.
; TORRESI, ROBERTO M.
.
Abstract In the second part of the review on electrochemical energy storage, the devolvement of batteries is explored. First, fundamental aspects of battery operation will be given, then, different materials and chemistry of rechargeable batteries will be explored, including each component of the cell. In negative electrodes, metallic, intercalation and transformation materials will be addressed. Examples are Li or Na metal batteries, graphite and other carbonaceous materials (such as graphene) for intercalation of metal-ions and transition metal oxides and silicon for transformation. In the positive electrode section, materials for intercalation and transformation will be reviewed. The state-of-the-art on intercalation as lithium cobalt oxide and nickel containing oxides will be approached for intercalation materials, whereas sulfur and metal-air will also be explored for transformation. Alongside, the role of electrolyte will be discussed concerning performance and safety, with examples for the next generation devices. Finally, a general future perspective will address both electrochemical capacitors and batteries.
https://doi.org/10.1590/0001-3765202020200800
1498 downloads
11.
TEMPORAL VARIATION AND SPATIAL DISTRIBUTION OF RELATIVE INDICES OF LEAF CHLOROPHYLL IN GRAPEVINE cv. CHARDONNAY
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ABSTRACT Variation in the spatial distribution of leaf chlorophyll content associated with the progression of the phenological cycle of crops may occur in cultivated areas as a result of the variability of environmental conditions and of the intrinsic properties of the plants. The objective of the present study was to model the trend in variation and assess the temporal stability of index of chlorophyll a, b, and total chlorophyll (Chla, Chlb, and Chlt, respectively), and to characterize the spatial distribution of Chlt index in grapevine cv. ‘Chardonnay’. The assessments consisted of in situ measurements made with a portable meter in a commercial vineyard located in the municipality of Espírito Santo do Pinhal, state of São Paulo, Brazil, in the period between flowering and fruit maturation. Descriptive statistics were applied to the indices and regression models were fitted to ascertain the relationship of their mean variation with time. The temporal stability of Chlt index was estimated using Spearman's rank correlation analysis and thematic maps were created using geostatistical analysis and spatial estimation by ordinary kriging. The Chlb and Chlt indices were non-linearly associated with cycle progression and their decrease after the start of maturation was estimated. The temporal stability of the Chlt index was low and variation in its spatial distribution was observed over the assessed period.
12.
Efeito do cultivo de feijão com co-inoculação (Rhizobium tropici e Azospirillum brasilense) e lâminas de irrigação sobre a qualidade fisiológica das sementes produzidas
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Ribeiro Peres, Amanda
; Portugal, José Roberto
; Ferreira Rodrigues, Ricardo Antônio
; Sá, Marco Eustáquio de
; Arf, Orivaldo
; Franco, Aline Aparecida
; Martins Garé, Lucas
.
ABSTRACT During seed production, nutrients (nitrogen) and climatic conditions (water) can affect their physiological quality. Therefore, the influence of common bean cultivation with the use of more sustainable techniques such as co-inoculation with nitrogen-fixing bacteria and the reduction of the irrigation depth on the quality of the seed produced should be analyzed. The objective of this study was to evaluate the physiological quality of seeds coming from the common bean cultivation submitted to inoculation and co-inoculation with Rhizobium tropici and Azospirillum brasilense under two irrigation depths. The experiment conducted in the field consisted of randomized blocks with a split-plot design with two irrigation depths as plots (recommended and 75% of the recommended) and five forms of nitrogen supply as subplots (control non-inoculated with 40 kg ha- 1 of nitrogen in topdressing; control non-inoculated with 80 kg ha- 1 of N in topdressing; A. brasilense inoculation with 40 kg ha-1 of N in topdressing; R. tropici inoculation with 40 kg ha-1 of N in topdressing; and co-inoculation of A. brasilense and R. tropici with 40 kg ha- 1 of N in topdressing). Common bean cultivation with 40 kg ha-1 of N in topdressing without inoculation provides satisfactory physiological quality of seeds, and there is no need to apply higher doses of nitrogen and inoculation. Bean seeds can be produced with the recommended 75% depth, without decrease their quality.
RESUMO Durante a produção de sementes, os nutrientes (nitrogênio) e condições climáticas (água) podem afetar a sua qualidade fisiológica. A influência do cultivo do feijoeiro com a utilização de técnicas mais sustentáveis como a co-inoculação com bactérias fixadoras de nitrogênio e a redução da lâmina de irrigação sobre a qualidade da semente produzida deve ser analisada. Objetivou-se avaliar a qualidade fisiológica de sementes oriundas do cultivo de feijão submetido à inoculação e co-inoculação com Rhizobium tropici e Azospirillum brasilense sob duas lâminas de irrigação. O delineamento experimental em campo foi em blocos casualizados com tratamentos dispostos em esquema de parcelas subdivididas. Nas parcelas foram alocadas as duas lâminas de irrigação (recomendada para o feijão e 75% da recomendada) e nas subparcelas foram alocadas as cinco formas de fornecimento de nitrogênio (testemunha sem inoculação com 40 kg ha-1 de N em cobertura; 80 kg ha-1 de N em cobertura sem inoculação; inoculação de A. brasilense com 40 kg ha-1 de N em cobertura; inoculação de R. tropici com 40 kg ha-1 de N em cobertura; e co-inoculação de A. brasilense e R. tropici com 40 kg ha-1 de N em cobertura), com quatro repetições. O cultivo do feijoeiro com aplicação de 40 kg ha-1 de N em cobertura sem inoculação proporciona qualidade fisiológica de sementes satisfatória, não havendo a necessidade de aplicação de maiores doses de nitrogênio e inoculação. As sementes de feijoeiro podem ser produzidas com a lâmina de 75% da recomenda, sem diminuição da sua qualidade.
https://doi.org/10.18004/investig.agrar.2018.junio.11-21
372 downloads
13.
Brazilian legislation on genetic heritage harms Biodiversity Convention goals and threatens basic biology research and education
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ALVES, RUY JOSÉ V.
; WEKSLER, MARCELO
; OLIVEIRA, JOÃO A.
; BUCKUP, PAULO A.
; POMBAL JR., JOSÉ P.
; SANTANA, HÉLCIO R.G.
; PERACCHI, ADRIANO LÚCIO
; KELLNER, ALEXANDER W.A.
; ALEIXO, ALEXANDRE
; LANGGUTH, ALFREDO
; ALMEIDA, ALZIRA MARIA P. DE
; ALBERNAZ, ANA LUISA
; RIBAS, CAMILA C.
; ZILBERBERG, CARLA
; GRELLE, CARLOS EDUARDO V.
; ROCHA, CARLOS F.D.
; LAMAS, CARLOS JOSÉ E.
; HADDAD, CÉLIO F.B.
; BONVICINO, CIBELE R.
; PRADO, CYNTHIA P.A.
; LIMA, DANIELA O. DE
; ROSSA-FERES, DENISE C.
; SANTOS, FABRÍCIO R. DOS
; SALIMENA, FÁTIMA REGINA G.
; PERINI, FERNANDO A.
; BOCKMANN, FLÁVIO A.
; FRANCO, FRANCISCO LUÍS
; GIUDICE, GISELE M.L. DEL
; COLLI, GUARINO R.
; VIEIRA, IMA CÉLIA G.
; MARINHO-FILHO, JADER
; WERNECK, JANE M.C.F.
; SANTOS, JORGE A.D. DOS
; NASCIMENTO, JORGE LUIZ DO
; NESSIMIAN, JORGE LUIZ
; CORDEIRO, JOSÉ LUIS P.
; CLARO, KLEBER DEL
; SALLES, LEANDRO O.
; CASATTI, LILIAN
; PY-DANIEL, LUCIA HELENA R.
; SILVEIRA, LUÍS FÁBIO
; TOLEDO, LUÍS FELIPE
; OLIVEIRA, LUIZ F. DE
; MALABARBA, LUIZ ROBERTO
; SILVA, MARCELO D. DA
; COURI, MÁRCIA S.
; MARTINS, MÁRCIO
; TAVARES, MARCOS D.S.
; SOBRAL, MARCOS EDUARDO G.
; VIEIRA, MARCUS VINÍCIUS
; OLIVEIRA, MARIA DE LOURDES A.
; PINNA, MÁRIO DE
; HOPKINS, MICHAEL J.G.
; SOLÉ, MIRCO
; MENEZES, NAÉRCIO A.
; PASSOS, PAULO
; D’ANDREA, PAULO SERGIO
; PINTO, PEDRO C.E.A.
; VIANA, PEDRO L.
; TOLEDO, PETER M.
; REIS, ROBERTO E.
; VILELA, ROBERTO
; BASTOS, ROGÉRIO P.
; COLLEVATTI, ROSANE G.
; CERQUEIRA, RUI
; CASTROVIEJO-FISHER, SANTIAGO
; CARAMASCHI, ULISSES
.
https://doi.org/10.1590/0001-3765201820180460
7311 downloads
14.
Ocimum basilicum essential oil combined with deltamethrin to improve the management of Spodoptera frugiperda
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Silva, Sérgio Macedo
; Cunha, João Paulo Arantes Rodrigues da
; Carvalho, Stephan Malfitano de
; Zandonadi, César Henrique Souza
; Martins, Rafael Castro
; Chang, Roberto
.
RESUMO Para uma cultura importante e expressiva como o milho, a resistência de Spodoptera frugiperda J.E. Smith a vários inseticidas atraiu a atenção no mundo para pesquisar o potencial inseticida de compostos naturais. Para o manejo da resistência, os compostos naturais associados a inseticidas sintéticos podem ser uma ferramenta promissória por reduzirem a aplicação das moléculas sintéticas para que não percam sua eficácia, além de promover o controle das pragas. O linalol é um terpenoide considerado como inseticida potencial, pode ser facilmente obtido naturalmente uma vez que é encontrado em alta concentração no óleo essencial de Ocimum basilicum. Portanto, o presente estudo teve como objetivo avaliar a toxicidade deste óleo essencial e sua combinação com deltametrina no controle de Spodoptera frugiperda. Através do ensaio de dose-resposta, foi estimada a toxicidade aguda (DL50) do óleo essencial e da deltametrina. Adicionalmente, foi também avaliada a combinação entre ambos, alcançando uma redução de 80% da DL50 de deltametrina para se obter o mesmo resultado quando o piretroide foi administrado sozinho. A partir dos nossos resultados, espera-se que uma combinação de uso de compostos naturais e inseticidas sintéticos possa ser uma prática promissora, auxiliando no manejo da resistência de pragas e principalmente reduzindo os impactos ambientais de compostos tóxicos.
ABSTRACT For an important and expensive crop such as corn, the resistance of Spodoptera frugiperda J.E. Smith to various pesticides has led to research throughout the world for a potential insecticide from a natural source. For the management of pest resistance, natural compounds associated with synthetic insecticides can be a promising tool because they can reduce the application of the synthetics molecules while maintaining their effectiveness and promoting the control of the pests. Linalool is a potential insecticide that is easily obtained because it is found in high concentrations in the essential oil of Ocimum basilicum L. Therefore, the present study aimed to evaluate the toxicity of this essential oil and its combination with deltamethrin to control S. frugiperda. Through dose response assays, the acute toxicities (LD50) of the essential oil and deltamethrin were estimated. Additionally, the combination of these materials was also assessed, attaining a reduction of 80% of the LD50 of deltamethrin while obtaining the same result as when the pyrethroid was administered alone. From these results, it is expected that the combination of natural compounds and synthetic insecticides will be a promising practice, helping to manage resistance while reducing the environmental impact of toxic compounds.
https://doi.org/10.1590/1413-70542017416016317
33611 downloads
15.
Physiologic parameters in female Red-billed curassows (Crax blumenbachii) in rehabilitation
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Marietto-Gonçalves, Guilherme A.
; Martins, Mayra T.A.
; Souza, Katiane L.
; Takahira, Regina K.
; Gonçalves, Roberto C.
; Andreatti Filho, Raphael L.
.
Resumo: O presente artigo reporta dados inéditos de análise hemogasométrica, hematológica e bacteriológica de quatro fêmeas de Mutum do Sudeste, resgatadas do tráfico ilegal de animais silvestres e em processo de habilitação e reintrodução para vida-livre pelo Projeto Centrofauna, Botucatu/SP. Na literatura há uma falta de dados fisiológicos sobre esta espécie, endêmica da região da Mata Atlântica e ameaçada de extinção. Esta falta de informação faz com que avaliações clínicas nesta espécie aviária sejam muito difíceis de interpretar, causando um efeito direto e negativo nestas aves para a realização de tratamento médico em hospitais, clínicas veterinárias, centros de pesquisa e/ou conservação, bem como centros de reintrodução.
Abstract: The present paper reports blood gas analysis, hematologic and micro bacteriologic information on four female Red-billed curassows, rescued from illegal wild animal trading, that were undergoing habilitation for reintroduction into the wild through Projeto Centrofauna/Botucatu-SP. There is a lack of physiological data on this species, endemic to the region of Atlantic Forest (Mata Atlântica), now under threat of extinction. This lack of information makes the clinical evaluation of these birds very difficult and has a direct and adverse effect on any of these birds received for medical treatment in hospitals, veterinary clinics and centers for research and conservation, as well as in reintroduction centers.
https://doi.org/10.1590/S0100-736X2016000200011
1062 downloads
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