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1.
Factors associated with the use of cannabis by students at a public university
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Bernardino, Isadora Laroca
; Boska, Gabriella de Andrade
; Zanott, Daniela Viganó
; Cavalcante, Marilia Daniella Machado Araújo
; Fernandes, Heloísa Garcia Claro
; Luz, Priscilla de Oliveira
; Malaquias, Tatiana da Silva Melo
; Oliveira, Márcia Aparecida Ferreira de
.








RESUMO Objetivo: Identificar a frequência e os fatores associados ao uso de cannabis entre estudantes de uma universidade pública do estado do Paraná. Método: Estudo transversal realizado com 168 estudantes de uma universidade pública do centro do Paraná, Brasil. Os dados foram coletados entre agosto e novembro de 2022 pela plataforma RedCap contendo variáveis sociodemográficas sobre o uso de cannabis, problemas relacionados ao consumo e a Escala de Depressão, Ansiedade e Estresse. Realizou-se análise descritiva e modelos de regressão múltipla de mínimos quadrados ordinários. A pesquisa foi aprovada pelo Comitê de Ética. Resultados: O uso de cannabis foi relatado por 84,5% dos estudantes e 13,7% apresentaram algum problema relacionado ao consumo. Os fatores orientação sexual (homossexual p-valor=0,02/assexual p-valor =0,01), residir com colegas de faculdades (p-valor=0,03) e ter maior renda (p-valor <0,001), associaram-se tanto a mais dias de consumo como aos problemas. O uso de tabaco nos últimos 30 dias associou-se a mais dias de consumo (p-valor=0,02) e índices mais elevados de estresse aos problemas com o uso (p-valor=0,05). Conclusão: O uso de cannabis é frequente entre os estudantes e identificou-se que as características sociodemográficas, o uso de outras substâncias e o estresse associaram-se tanto aos dias de consumo como aos problemas relatados.
RESUMEN Objetivo: Identificar frecuencia y factores asociados al uso de cannabis entre estudiantes de una universidad pública del estado de Paraná. Método: Estudio transversal, realizado con 168 estudiantes de una universidad pública del centro de Paraná, Brasil. Los datos fueron recolectados entre agosto y noviembre de 2022 por la plataforma RedCap que contiene variables sociodemográficas, sobre el uso de cannabis y la Escala de Depresión, Ansiedad y Estrés. Se realizaron análisis descriptivos y modelos de regresión múltiple de mínimos cuadrados ordinarios. La investigación fue aprobada por el comité de ética. Resultados: El consumo de cannabis fue reportado por el 84,5% de los estudiantes y el 13,7% tuvo algún problema relacionado con el consumo. Los factores orientación sexual (valor p homosexual = 0,02/valor p asexual = 0,01), vivir con amigos de la universidad (valor p = 0,03) y tener mayores ingresos (valor p <0,001), se asociaron con más días de consumo y problemas. El consumo de tabaco en los últimos 30 días se asoció con más días de consumo de cannabis (valor p=0,02) y mayores niveles de estrés y problemas con el consumo (valor p=0,05). Conclusión: El consumo de cannabis es frecuente entre los estudiantes y se identificó que las características sociodemográficas, el uso de otras sustancias y lo estrés, inherentes al contexto universitario, se asociaron tanto con los días de consumo como con los problemas reportados.
ABSTRACT Objective: To identify frequency and factors associated with the use of cannabis among students at a public university in the state of Paraná. Method: Cross-sectional study, conducted with 168 students from a public university in central Paraná, Brazil. Data were collected between August and November 2022 through the RedCap platform containing sociodemographic variables, on the use of cannabis, problems related to consumption, and the Depression, Anxiety and Stress Scale. Descriptive analysis and ordinary least squares multiple regression models were performed. The research was approved by the Ethics Committee. Results: Cannabis use was reported by 84.5% of students and 13.7% had some problem related to consumption. The factors sexual orientation (homosexual p-value=0.02/asexual p-value =0.01), living with college friends (p-value=0.03) and higher income (p-value <0.001), were associated with both more days of consumption and problems. Tobacco use in the last 30 days was associated with more days of cannabis consumption (p-value=0.02) and higher levels of stress linked to consumption-related problems (p-value=0.05). Conclusion: Cannabis use is frequent among students, and sociodemographic characteristics, the use of other substances, and stress were associated with both the number of consumption days and reported problems.
2.
Invasive infections by group A Streptococcus infections in Brazil: a pediatric case series
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Russo, Daniela Otoni
; Moreira, Marina Melo
; Bentes, Aline Almeida
; Marques, Bárbara Araujo
; Carellos, Ericka Viana Machado
; Nogueira, Flávia Duarte
; Romanelli, Roberta Maia de Castro
; Jimenez, Ana Luisa Lodi
; Souza, Carolina Campos Vieira de
; Moreira, Luana Casilho
; Parreira, Milena Pereira
; Avendanha, Renata Araujo
; Santos, Renata Campos Correa dos
; Arantes Junior, Márcio Antônio Ferreira
; Diniz, Lilian Martins Oliveira
.















RESUMO Objetivo: Streptococcus do grupo A (SGA) são cocos gram-positivos que colonizam a nasofaringe e/ou a pele e em casos raros podem causar infecções graves. Embora essas infecções tenham diminuído durante a pandemia da COVID-19, alguns países observaram um aumento no número de doenças invasivas pelo SGA nos últimos anos. O objetivo deste estudo foi descrever uma série de doenças invasivas pelo S. pyogenes em crianças internadas em um hospital de referência para tratamento de doenças infecciosas em Minas Gerais, Brasil, entre setembro de 2022 e agosto de 2023. Os dados foram obtidos dos prontuários médicos. O SGA foi isolado do sangue, líquido pleural, cerebrospinal ou fluido articular. Descrição do caso: O total de nove pacientes, quatro do sexo masculino e cinco do sexo feminino, com idade entre oito meses e dez anos, foram admitidos. Ao todo, três (33%) tiveram pneumonia, três (33%) síndrome do choque tóxico, três (33%) artrite séptica, um (11%) osteomielite, dois (22%) meningite e dois (22%) celulite. A maioria dos pacientes (5) apresentou complicações, incluindo derrame pleural, choque séptico, vasculite cerebral e amputações de membros. Ao todo, sete (75%) pacientes foram admitidos na unidade de terapia intensiva, e um paciente morreu. Comentários: É importante estar atento à possibilidade de infeção por S. pyogenes em crianças com infecções pulmonares, neurológicas, osteoarticulares, cutâneas ou em casos graves de choque séptico. Diante da ausência de sinais clínicos específicos, dados epidemiológicos que demonstrem o aumento da incidência da doença são de grande importância e devem servir de alerta para o diagnóstico da doença.
ABSTRACT Objective: Group A Streptococcus (GAS) are Gram-positive cocci that colonize the nasopharynx and/or skin and in rare cases may cause severe invasive infections. Although these infections decreased during the COVID-19 pandemic, some countries have observed an increased number of invasive GAS (iGAS) diseases in recent years. The objective of this study was to describe a series of iGAS diseases in a referral hospital for the treatment of pediatric infectious disease in Minas Gerais State, Brazil, between September 2022 and August 2023. The data were obtained from medical records, and GAS was isolated from blood, pleural, cerebrospinal, or joint fluid. Case description: A total of nine patients, four male and five female, between eight months and ten years of age, were admitted. Of the patients observed, three (33%) had pneumonia, three (33%) had toxic shock syndrome, three (33%) had septic arthritis, one (11%) had osteomyelitis, two (22%) had meningitis, and two (22%) cellulitis. The majority of patients (5) experienced complications, including pleural effusion, septic shock, cerebral vasculitis, and limb amputations. In total, seven (75%) patients were admitted to the intensive care unit, and one patient died. Comments: It is important to be aware of the possibility of S. pyogenes infection in children with pulmonary, neurological, osteoarticular, skin infections or in severe cases of septic shock. Given the absence of specific clinical signs, epidemiological data showing an increase in the local incidence of S. pyogenes infections is of great importance and should serve as an alert for the diagnosis of the disease.
3.
Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia – 2024
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Gualandro, Danielle Menosi
; Fornari, Luciana Savoy
; Caramelli, Bruno
; Abizaid, Alexandre Antonio Cunha
; Gomes, Brenno Rizerio
; Tavares, Caio de Assis Moura
; Fernandes, Caio Julio Cesar dos Santos
; Polanczyk, Carisi Anne
; Jardim, Carlos
; Vieira, Carolina Leticia Zilli
; Pinho, Claudio
; Calderaro, Daniela
; Schreen, Dirk
; Marcondes-Braga, Fabiana Goulart
; Souza, Fábio de
; Cardozo, Francisco Akira Malta
; Tarasoutchi, Flavio
; Carmo, Gabriel Assis Lopes
; Kanhouche, Gabriel
; Lima, José Jayme Galvão de
; Bichuette, Luciana Dornfeld
; Sacilotto, Luciana
; Drager, Luciano Ferreira
; Vacanti, Luciano Janussi
; Gowdak, Luis Henrique Wolff
; Vieira, Marcelo Luiz Campos
; Martins, Marcelo Luiz Floriano Melo
; Lima, Márcio Silva Miguel
; Lottenberg, Marcos Pita
; Aliberti, Márlon Juliano Romero
; Marchi, Mauricio Felippi de Sá
; Paixão, Milena Ribeiro
; Oliveira Junior, Mucio Tavares de
; Yu, Pai Ching
; Cury, Patricia Ramos
; Farsky, Pedro Silvio
; Pessoa, Ranna Santos
; Siciliano, Rinaldo Focaccia
; Accorsi, Tarso Augusto Duenhas
; Correia, Vinícius Machado
Mathias Junior, Wilson







































4.
Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024
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Fernandes, Fabio
; Simões, Marcus V.
; Correia, Edileide de Barros
; Marcondes-Braga, Fabiana Goulart
; Coelho-Filho, Otavio Rizzi
; Mesquita, Cláudio Tinoco
; Mathias Junior, Wilson
; Antunes, Murillo de Oliveira
; Arteaga-Fernández, Edmundo
; Rochitte, Carlos Eduardo
; Ramires, Felix José Alvarez
; Alves, Silvia Marinho Martins
; Montera, Marcelo Westerlund
; Lopes, Renato Delascio
; Oliveira Junior, Mucio Tavares de
; Scolari, Fernando Luis
; Avila, Walkiria Samuel
; Canesin, Manoel Fernandes
; Bocchi, Edimar Alcides
; Bacal, Fernando
; Moura, Lidia Zytynski
; Saad, Eduardo Benchimol
; Scanavacca, Mauricio Ibrahim
; Valdigem, Bruno Pereira
; Cano, Manuel Nicolas
; Abizaid, Alexandre Antonio Cunha
; Ribeiro, Henrique Barbosa
; Lemos Neto, Pedro Alves
; Ribeiro, Gustavo Calado de Aguiar
; Jatene, Fabio Biscegli
; Dias, Ricardo Ribeiro
; Beck-da-Silva, Luis
; Rohde, Luis Eduardo Paim
; Bittencourt, Marcelo Imbroinise
; Pereira, Alexandre da Costa
; Krieger, José Eduardo
; Villacorta Junior, Humberto
; Martins, Wolney de Andrade
; Figueiredo Neto, José Albuquerque de
; Cardoso, Juliano Novaes
; Pastore, Carlos Alberto
; Jatene, Ieda Biscegli
; Tanaka, Ana Cristina Sayuri
; Hotta, Viviane Tiemi
; Romano, Minna Moreira Dias
; Albuquerque, Denilson Campos de
; Mourilhe-Rocha, Ricardo
; Hajjar, Ludhmila Abrahão
; Brito Junior, Fabio Sandoli de
; Caramelli, Bruno
; Calderaro, Daniela
; Farsky, Pedro Silvio
; Colafranceschi, Alexandre Siciliano
; Pinto, Ibraim Masciarelli Francisco
; Vieira, Marcelo Luiz Campos
; Danzmann, Luiz Claudio
; Barberato, Silvio Henrique
; Mady, Charles
; Martinelli Filho, Martino
; Torbey, Ana Flavia Malheiros
; Schwartzmann, Pedro Vellosa
; Macedo, Ariane Vieira Scarlatelli
; Ferreira, Silvia Moreira Ayub
; Schmidt, Andre
; Melo, Marcelo Dantas Tavares de
; Lima Filho, Moysés Oliveira
; Sposito, Andrei C.
; Brito, Flávio de Souza
; Biolo, Andreia
; Madrini Junior, Vagner
; Rizk, Stephanie Itala
; Mesquita, Evandro Tinoco
.








































































5.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
Slipinski, Adam
Linzmeier, Adelita M.
Calor, Adolfo R.
Garda, Adrian A.
Kury, Adriano B.
Fernandes, Agatha C.S.
Agudo-Padrón, Aisur I.
Akama, Alberto
Silva Neto, Alberto M. da
Burbano, Alejandro L.
Menezes, Aleksandra
Pereira-Colavite, Alessandre
Anichtchenko, Alexander
Lees, Alexander C.
Bezerra, Alexandra M.R.
Domahovski, Alexandre C.
Pimenta, Alexandre D.
Aleixo, Alexandre L.P.
Marceniuk, Alexandre P.
Paula, Alexandre S. de
Somavilla, Alexandre
Specht, Alexandre
Camargo, Alexssandro
Newton, Alfred F.
Silva, Aline A.S. da
Santos, Aline B. dos
Tassi, Aline D.
Aragão, Allan C.
Santos, Allan P.M.
Migotto, Alvaro E.
Mendes, Amanda C.
Cunha, Amanda
Chagas Júnior, Amazonas
Sousa, Ana A.T. de
Pavan, Ana C.
Almeida, Ana C.S.
Peronti, Ana L.B.G.
Henriques-Oliveira, Ana L.
Prudente, Ana L.
Tourinho, Ana L.
Pes, Ana M.O.
Carmignotto, Ana P.
Wengrat, Ana P.G. da Silva
Dornellas, Ana P.S.
Molin, Anamaria Dal
Puker, Anderson
Morandini, André C.
Ferreira, André da S.
Martins, André L.
Esteves, André M.
Fernandes, André S.
Roza, André S.
Köhler, Andreas
Paladini, Andressa
Andrade, Andrey J. de
Pinto, Ângelo P.
Salles, Anna C. de A.
Gondim, Anne I.
Amaral, Antonia C.Z.
Rondón, Antonio A.A.
Brescovit, Antonio
Lofego, Antônio C.
Marques, Antonio C.
Macedo, Antonio
Andriolo, Artur
Henriques, Augusto L.
Ferreira Júnior, Augusto L.
Lima, Aurino F. de
Barros, Ávyla R. de A.
Brito, Ayrton do R.
Romera, Bárbara L.V.
Vasconcelos, Beatriz M.C. de
Frable, Benjamin W.
Santos, Bernardo F.
Ferraz, Bernardo R.
Rosa, Brunno B.
Sampaio, Brunno H.L.
Bellini, Bruno C.
Clarkson, Bruno
Oliveira, Bruno G. de
Corrêa, Caio C.D.
Martins, Caleb C.
Castro-Guedes, Camila F. de
Souto, Camilla
Bicho, Carla de L.
Cunha, Carlo M.
Barboza, Carlos A. de M.
Lucena, Carlos A.S. de
Barreto, Carlos
Santana, Carlos D.C.M. de
Agne, Carlos E.Q.
Mielke, Carlos G.C.
Caetano, Carlos H.S.
Flechtmann, Carlos H.W.
Lamas, Carlos J.E.
Rocha, Carlos
Mascarenhas, Carolina S.
Margaría, Cecilia B.
Waichert, Cecilia
Digiani, Celina
Haddad, Célio F.B.
Azevedo, Celso O.
Benetti, Cesar J.
Santos, Charles M.D. dos
Bartlett, Charles R.
Bonvicino, Cibele
Ribeiro-Costa, Cibele S.
Santos, Cinthya S.G.
Justino, Cíntia E.L.
Canedo, Clarissa
Bonecker, Claudia C.
Santos, Cláudia P.
Carvalho, Claudio J.B. de
Gonçalves, Clayton C.
Galvão, Cleber
Costa, Cleide
Oliveira, Cléo D.C. de
Schwertner, Cristiano F.
Andrade, Cristiano L.
Pereira, Cristiano M.
Sampaio, Cristiano
Dias, Cristina de O.
Lucena, Daercio A. de A.
Manfio, Daiara
Amorim, Dalton de S.
Queiroz, Dalva L. de
Queiroz, Dalva L. de
Colpani, Daniara
Abbate, Daniel
Aquino, Daniel A.
Burckhardt, Daniel
Cavallari, Daniel C.
Prado, Daniel de C. Schelesky
Praciano, Daniel L.
Basílio, Daniel S.
Bená, Daniela de C.
Toledo, Daniela G.P. de
Takiya, Daniela M.
Fernandes, Daniell R.R.
Ament, Danilo C.
Cordeiro, Danilo P.
Silva, Darliane E.
Pollock, Darren A.
Muniz, David B.
Gibson, David I.
Nogueira, David S.
Marques, Dayse W.A.
Lucatelli, Débora
Garcia, Deivys M.A.
Baêta, Délio
Ferreira, Denise N.M.
Rueda-Ramírez, Diana
Fachin, Diego A.
Souza, Diego de S.
Rodrigues, Diego F.
Pádua, Diego G. de
Barbosa, Diego N.
Dolibaina, Diego R.
Amaral, Diogo C.
Chandler, Donald S.
Maccagnan, Douglas H.B.
Caron, Edilson
Carvalho, Edrielly
Adriano, Edson A.
Abreu Júnior, Edson F. de
Pereira, Edson H.L.
Viegas, Eduarda F.G.
Carneiro, Eduardo
Colley, Eduardo
Eizirik, Eduardo
Santos, Eduardo F. dos
Shimbori, Eduardo M.
Suárez-Morales, Eduardo
Arruda, Eliane P. de
Chiquito, Elisandra A.
Lima, Élison F.B.
Castro, Elizeu B. de
Orlandin, Elton
Nascimento, Elynton A. do
Razzolini, Emanuel
Gama, Emanuel R.R.
Araujo, Enilma M. de
Nishiyama, Eric Y.
Spiessberger, Erich L.
Santos, Érika C.L. dos
Contreras, Eugenia F.
Galati, Eunice A.B.
Oliveira Junior, Evaldo C. de
Gallardo, Fabiana
Hernandes, Fabio A.
Lansac-Tôha, Fábio A.
Pitombo, Fabio B.
Dario, Fabio Di
Santos, Fábio L. dos
Mauro, Fabio
Nascimento, Fabio O. do
Olmos, Fabio
Amaral, Fabio R.
Schunck, Fabio
Godoi, Fábio S. P. de
Machado, Fabrizio M.
Barbo, Fausto E.
Agrain, Federico A.
Ribeiro, Felipe B.
Moreira, Felipe F.F.
Barbosa, Felipe F.
Silva, Fenanda S.
Cavalcanti, Fernanda F.
Straube, Fernando C.
Carbayo, Fernando
Carvalho Filho, Fernando
Zanella, Fernando C.V.
Jacinavicius, Fernando de C.
Farache, Fernando H.A.
Leivas, Fernando
Dias, Fernando M.S.
Mantellato, Fernando
Vaz-de-Mello, Fernando Z.
Gudin, Filipe M.
Albuquerque, Flávio
Molina, Flavio B.
Passos, Flávio D.
Shockley, Floyd W.
Pinheiro, Francielly F.
Mello, Francisco de A.G. de
Nascimento, Francisco E. de L.
Franco, Francisco L.
Oliveira, Francisco L. de
Melo, Francisco T. de V.
Quijano, Freddy R.B.
Salles, Frederico F.
Biffi, Gabriel
Queiroz, Gabriel C.
Bizarro, Gabriel L.
Hrycyna, Gabriela
Leviski, Gabriela
Powell, Gareth S.
Santos, Geane B. dos
Morse, Geoffrey E.
Brown, George
Mattox, George M.T.
Zimbrão, Geraldo
Carvalho, Gervásio S.
Miranda, Gil F.G.
Moraes, Gilberto J. de
Lourido, Gilcélia M.
Neves, Gilmar P.
Moreira, Gilson R.P.
Montingelli, Giovanna G.
Maurício, Giovanni N.
Marconato, Gláucia
Lopez, Guilherme E.L.
Silva, Guilherme L. da
Muricy, Guilherme
Brito, Guilherme R.R.
Garbino, Guilherme S.T.
Flores, Gustavo E.
Graciolli, Gustavo
Libardi, Gustavo S.
Proctor, Heather C.
Gil-Santana, Helcio R.
Varella, Henrique R.
Escalona, Hermes E.
Schmitz, Hermes J.
Rodrigues, Higor D.D.
Galvão Filho, Hilton de C.
Quintino, Hingrid Y.S.
Pinto, Hudson A.
Rainho, Hugo L.
Miyahira, Igor C.
Gonçalves, Igor de S.
Martins, Inês X.
Cardoso, Irene A.
Oliveira, Ismael B. de
Franz, Ismael
Fernandes, Itanna O.
Golfetti, Ivan F.
S. Campos-Filho, Ivanklin
Oliveira, Ivo de S.
Delabie, Jacques H.C.
Oliveira, Jader de
Prando, Jadila S.
Patton, James L.
Bitencourt, Jamille de A.
Silva, Janaina M.
Santos, Jandir C.
Arruda, Janine O.
Valderrama, Jefferson S.
Dalapicolla, Jeronymo
Oliveira, Jéssica P.
Hájek, Jiri
Morselli, João P.
Narita, João P.
Martin, João P.I.
Grazia, Jocélia
McHugh, Joe
Cherem, Jorge J.
Farias Júnior, José A.S.
Fernandes, Jose A.M.
Pacheco, José F.
Birindelli, José L.O.
Rezende, José M.
Avendaño, Jose M.
Duarte, José M. Barbanti
Ribeiro, José R. Inácio
Mermudes, José R.M.
Pujol-Luz, José R.
Santos, Josenilson R. dos
Câmara, Josenir T.
Teixeira, Joyce A.
Prado, Joyce R. do
Botero, Juan P.
Almeida, Julia C.
Kohler, Julia
Gonçalves, Julia P.
Beneti, Julia S.
Donahue, Julian P.
Alvim, Juliana
Almeida, Juliana C.
Segadilha, Juliana L.
Wingert, Juliana M.
Barbosa, Julianna F.
Ferrer, Juliano
Santos, Juliano F. dos
Kuabara, Kamila M.D.
Nascimento, Karine B.
Schoeninger, Karine
Campião, Karla M.
Soares, Karla
Zilch, Kássia
Barão, Kim R.
Teixeira, Larissa
Sousa, Laura D. do N.M. de
Dumas, Leandro L.
Vieira, Leandro M.
Azevedo, Leonardo H.G.
Carvalho, Leonardo S.
Souza, Leonardo S. de
Rocha, Leonardo S.G.
Bernardi, Leopoldo F.O.
Vieira, Letícia M.
Johann, Liana
Salvatierra, Lidianne
Oliveira, Livia de M.
Loureiro, Lourdes M.A. El-moor
Barreto, Luana B.
Barros, Luana M.
Lecci, Lucas
Camargos, Lucas M. de
Lima, Lucas R.C.
Almeida, Lucia M.
Martins, Luciana R.
Marinoni, Luciane
Moura, Luciano de A.
Lima, Luciano
Naka, Luciano N.
Miranda, Lucília S.
Salik, Lucy M.
Bezerra, Luis E.A.
Silveira, Luis F.
Campos, Luiz A.
Castro, Luiz A.S. de
Pinho, Luiz C.
Silveira, Luiz F.L.
Iniesta, Luiz F.M.
Tencatt, Luiz F.C.
Simone, Luiz R.L.
Malabarba, Luiz R.
Cruz, Luiza S. da
Sekerka, Lukas
Barros, Lurdiana D.
Santos, Luziany Q.
Skoracki, Maciej
Correia, Maira A.
Uchoa, Manoel A.
Andrade, Manuella F.G.
Hermes, Marcel G.
Miranda, Marcel S.
Araújo, Marcel S. de
Monné, Marcela L.
Labruna, Marcelo B.
Santis, Marcelo D. de
Duarte, Marcelo
Knoff, Marcelo
Nogueira, Marcelo
Britto, Marcelo R. de
Melo, Marcelo R.S. de
Carvalho, Marcelo R. de
Tavares, Marcelo T.
Kitahara, Marcelo V.
Justo, Marcia C.N.
Botelho, Marcia J.C.
Couri, Márcia S.
Borges-Martins, Márcio
Felix, Márcio
Oliveira, Marcio L. de
Bologna, Marco A.
Gottschalk, Marco S.
Tavares, Marcos D.S.
Lhano, Marcos G.
Bevilaqua, Marcus
Santos, Marcus T.T.
Domingues, Marcus V.
Sallum, Maria A.M.
Digiani, María C.
Santarém, Maria C.A.
Nascimento, Maria C. do
Becerril, María de los A.M.
Santos, Maria E.A. dos
Passos, Maria I. da S. dos
Felippe-Bauer, Maria L.
Cherman, Mariana A.
Terossi, Mariana
Bartz, Marie L.C.
Barbosa, Marina F. de C.
Loeb, Marina V.
Cohn-Haft, Mario
Cupello, Mario
Martins, Marlúcia B.
Christofersen, Martin L.
Bento, Matheus
Rocha, Matheus dos S.
Martins, Maurício L.
Segura, Melissa O.
Cardenas, Melissa Q.
Duarte, Mércia E.
Ivie, Michael A.
Mincarone, Michael M.
Borges, Michela
Monné, Miguel A.
Casagrande, Mirna M.
Fernandez, Monica A.
Piovesan, Mônica
Menezes, Naércio A.
Benaim, Natalia P.
Reategui, Natália S.
Pedro, Natan C.
Pecly, Nathalia H.
Ferreira Júnior, Nelson
Silva Júnior, Nelson J. da
Perioto, Nelson W.
Hamada, Neusa
Degallier, Nicolas
Chao, Ning L.
Ferla, Noeli J.
Mielke, Olaf H.H.
Evangelista, Olivia
Shibatta, Oscar A.
Oliveira, Otto M.P.
Albornoz, Pablo C.L.
Dellapé, Pablo M.
Gonçalves, Pablo R.
Shimabukuro, Paloma H.F.
Grossi, Paschoal
Rodrigues, Patrícia E. da S.
Lima, Patricia O.V.
Velazco, Paul
Santos, Paula B. dos
Araújo, Paula B.
Silva, Paula K.R.
Riccardi, Paula R.
Garcia, Paulo C. de A.
Passos, Paulo G.H.
Corgosinho, Paulo H.C.
Lucinda, Paulo
Costa, Paulo M.S.
Alves, Paulo P.
Roth, Paulo R. de O.
Coelho, Paulo R.S.
Duarte, Paulo R.M.
Carvalho, Pedro F. de
Gnaspini, Pedro
Souza-Dias, Pedro G.B.
Linardi, Pedro M.
Bartholomay, Pedro R.
Demite, Peterson R.
Bulirsch, Petr
Boll, Piter K.
Pereira, Rachel M.M.
Silva, Rafael A.P.F.
Moura, Rafael B. de
Boldrini, Rafael
Silva, Rafaela A. da
Falaschi, Rafaela L.
Cordeiro, Ralf T.S.
Mello, Ramon J.C.L.
Singer, Randal A.
Querino, Ranyse B.
Heleodoro, Raphael A.
Castilho, Raphael de C.
Constantino, Reginaldo
Guedes, Reinaldo C.
Carrenho, Renan
Gomes, Renata S.
Gregorin, Renato
Machado, Renato J.P.
Bérnils, Renato S.
Capellari, Renato S.
Silva, Ricardo B.
Kawada, Ricardo
Dias, Ricardo M.
Siewert, Ricardo
Brugnera, Ricaro
Leschen, Richard A.B.
Constantin, Robert
Robbins, Robert
Pinto, Roberta R.
Reis, Roberto E. dos
Ramos, Robson T. da C.
Cavichioli, Rodney R.
Barros, Rodolfo C. de
Caires, Rodrigo A.
Salvador, Rodrigo B.
Marques, Rodrigo C.
Araújo, Rodrigo C.
Araujo, Rodrigo de O.
Dios, Rodrigo de V.P.
Johnsson, Rodrigo
Feitosa, Rodrigo M.
Hutchings, Roger W.
Lara, Rogéria I.R.
Rossi, Rogério V.
Gerstmeier, Roland
Ochoa, Ronald
Hutchings, Rosa S.G.
Ale-Rocha, Rosaly
Rocha, Rosana M. da
Tidon, Rosana
Brito, Rosangela
Pellens, Roseli
Santos, Sabrina R. dos
Santos, Sandra D. dos
Paiva, Sandra V.
Santos, Sandro
Oliveira, Sarah S. de
Costa, Sávio C.
Gardner, Scott L.
Leal, Sebastián A. Muñoz
Aloquio, Sergio
Bonecker, Sergio L.C.
Bueno, Sergio L. de S.
Almeida, Sérgio M. de
Stampar, Sérgio N.
Andena, Sérgio R.
Posso, Sergio R.
Lima, Sheila P.
Gadelha, Sian de S.
Thiengo, Silvana C.
Cohen, Simone C.
Brandão, Simone N.
Rosa, Simone P.
Ribeiro, Síria L.B.
Letana, Sócrates D.
Santos, Sonia B. dos
Andrade, Sonia C.S.
Dávila, Stephane
Vaz, Stéphanie
Peck, Stewart B.
Christo, Susete W.
Cunha, Suzan B.Z.
Gomes, Suzete R.
Duarte, Tácio
Madeira-Ott, Taís
Marques, Taísa
Roell, Talita
Lima, Tarcilla C. de
Sepulveda, Tatiana A.
Maria, Tatiana F.
Ruschel, Tatiana P.
Rodrigues, Thaiana
Marinho, Thais A.
Almeida, Thaís M. de
Miranda, Thaís P.
Freitas, Thales R.O.
Pereira, Thalles P.L.
Zacca, Thamara
Pacheco, Thaynara L.
Martins, Thiago F.
Alvarenga, Thiago M.
Carvalho, Thiago R. de
Polizei, Thiago T.S.
McElrath, Thomas C.
Henry, Thomas
Pikart, Tiago G.
Porto, Tiago J.
Krolow, Tiago K.
Carvalho, Tiago P.
Lotufo, Tito M. da C.
Caramaschi, Ulisses
Pinheiro, Ulisses dos S.
Pardiñas, Ulyses F.J.
Maia, Valéria C.
Tavares, Valeria
Costa, Valmir A.
Amaral, Vanessa S. do
Silva, Vera C.
Wolff, Vera R. dos S.
Slobodian, Verônica
Silva, Vinícius B. da
Espíndola, Vinicius C.
Costa-Silva, Vinicius da
Bertaco, Vinicius de A.
Padula, Vinícius
Ferreira, Vinicius S.
Silva, Vitor C.P. da
Piacentini, Vítor de Q.
Sandoval-Gómez, Vivian E.
Trevine, Vivian
Sousa, Viviane R.
Sant’Anna, Vivianne B. de
Mathis, Wayne N.
Souza, Wesley de O.
Colombo, Wesley D.
Tomaszewska, Wioletta
Wosiacki, Wolmar B.
Ovando, Ximena M.C.
Leite, Yuri L.R.








ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others.
6.
Root Temperature Variation during Gutta-Percha Removal Using Stainless Steel and NiTi Instruments
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Suassuna, Fernanda Clotilde Mariz
; Amorim, Ana Marly Araújo Maia
; Melo, Saulo Leonardo Sousa
; Silva, Diego Filipe Bezerra
; Lopes, Layrlla Kateriny Moura Oliveira
; Bento, Patrícia Meira
; Melo, Daniela Pita de
.







Pesquisa Brasileira em Odontopediatria e Clínica Integrada
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ABSTRACT Objective: To assess the temperature variation of gutta-percha removal with stainless steel and two NiTi instruments using infrared thermography and thermocouples. Material and Methods: 45 single-rooted teeth were divided into three groups (n = 15) according to the following gutta-percha removal instruments: Largo Peeso (L), Protaper Retreatment (PR), and Reciproc (R). Thermal analysis was conducted using a FLIR T650sc infrared thermography camera and three thermocouples. For infrared thermography assessment, the infrared camera was programmed to acquire thermograms every 15 seconds before the gutta-percha removal started until temperature normalization. Root temperature was assessed in the thermograms using FLIR tools software v6.4 with the straight-line tool along the long axis of the tooth and in the cervical, middle, and apical thirds of each tooth. The temperature from the thermocouples was recorded and registered for each root third. Inferential statistical analysis Kruskal-Wallis and post hoc Tukey tests were used. Results: For the infrared thermography camera, the highest median temperature value was found 15 seconds after guttapercha removal for the L technique (20.3°C), which presented the highest temperatures at all studied times. For thermocouples, the highest temperature was found in the middle third during gutta-percha removal with L (20.7°C). PR and R presented similar patterns of root temperature. Conclusion: Stainless-steel L temperature reaches values above 10°C; however, the exposure time was too short to cause injuries to the periodontium.
7.
Recommendations from the Brazilian Society of Anesthesiology (SBA) for difficult airway management in pediatric care
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Lima, Luciana Cavalcanti
; Cumino, Débora de Oliveira
Vieira, Alex Madeira
Silva, Cláudia Helena Ribeiro da
Neville, Mariana Fontes Lima
Marques, Felipe Oliveira
Quintão, Vinicius Caldeira
Carlos, Ricardo Vieira
Fujita, Ana Carla Giosa
Barros, Hugo Ítalo Melo
Garcia, Daniela Biachi
Ferreira, Cynthia Beatriz Tostes
Barros, Guilherme Antonio Moreira de
Modolo, Norma Sueli Pinheiro

Abstract Difficult airway management in pediatrics during anesthesia represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report containing updated recommendations for the management of difficult airways in children and neonates. These recommendations have been developed based on the consensus of a panel of experts, with the objective of offering strategies to overcome challenges during airway management in pediatric patients. Grounded in evidence published in international guidelines and expert opinions, the report highlights crucial steps for the appropriate management of difficult airways in pediatrics, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and, paramountly, the maintenance of arterial oxygenation. The report also delves into additional strategies involving the use of advanced tools, such as video laryngoscopy, flexible intubating bronchoscopy, and supraglottic devices. Emphasis is placed on the simplicity of implementing the outlined recommendations, with a focus on the significance of continuous education, training through realistic simulations, and familiarity with the latest available technologies. These practices are deemed essential to ensure procedural safety and contribute to the enhancement of anesthesia outcomes in pediatrics.
8.
Origin and properties of kaolinites from soils of a toposequence in Southern Brazil
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Ferreira, Daniela Nicole
; Melo, Vander de Freitas
; Testoni, Samara Alves
; Vidal-Torrado, Pablo
; Oliveira Junior, Jairo Calderari de
.





ABSTRACT Kaolinite is the main clay mineral in most soils around the world and has been widely used for industrial purposes. This research aimed to study chemical, morphological and crystallographic characteristics of kaolinite, and establish the origin of kaolinitic samples on Serra do Mar and kaolinitic layers on peatlands, located at Southern Brazil. Samples were collected on different geomorphological positions: two samples at Serra do Mar (kaolinitic saprolite – SAP, and kaolinitic layers - KL); and two cores at the peatland with Sapric Histosols from Quaternary sedimentary basin. Granulometry and total organic carbon (TOC) were determined in soil samples. Kaolinite in silt and clay fractions was studied by chemical extractions, X-ray diffraction (XRD), thermal analysis (DTA/TG), and scanning electron microscopy with energy dispersive spectroscopy – SEM/EDS. Chemical and mineralogical characteristics of kaolinite were divided into two groups, according to the particle size and the location of the deposit in the relief. Silt fraction: i) SAP – genesis mainly derived from mica weathering; ii) peatland, containing pseudomorph crystals smaller than those found in Serra do Mar; Clay fraction: i) Serra do Mar – there was a larger contribution of K-feldspar weathering in the genesis of kaolinite from KL in relation to SAP; ii) peatland – the stronger weathering and the hydromorphic conditions resulted in less neoformed crystalline kaolinites. For both environments, the substitution of Al3+ by Fe3+ into the octahedral sheet led to a reduction in the mineral thickness and also increased the occurrence of structural deformations in clay kaolinite. Kaolinite in peatland is a combination of the following genesis processes: transportation from Serra do Mar (mainly in the silt fraction) and; formation in situ through neogenesis process (dominant in the clay fraction).
9.
Síndrome de Guillain-Barré Secundária à Infecção por Citomegalovírus em Paciente Pediátrico Transplantado Renal
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Lopes, Daniela Saraiva Guerra
; Araujo, Iracy de Oliveira
; Gallindo, Rodrigo Melo
; Ribeiro, Cassio Tâmara
; Genesio, Paula Andréa dos Santos
.





ABSTRACT The association between Guillain-Barré syndrome (GBS) and cytomegalovirus (CMV) is already well established in the literature, first reported in 1967. However, this association is rare in solid organ transplant patients, although the incidence of symptomatic CMV infection is higher in this population. Due to its potential severity, high morbidity and mortality, the possibility of GBS cannot be ruled out in the case of neurological complications in transplant patients. In this report, a case of GBS secondary to CMV is described in an eight-year-old kidney transplant patient in the pediatric age group, an interval with an even greater scarcity of reports on this association. The patient had negative antibodies (IgG and IgM) for CMV in pre-transplant tests, while the donor had positive IgG antibodies, meaning a higher risk of developing the disease. The clinical condition began approximately two months after the transplant, with classic symptoms and the evolution of GBS. The clinical aspects, diagnosis, treatment and evolution of the disease are discussed, in addition to the evidence in the world literature.
RESUMO A associação entre síndrome de Guillain-Barré (SGB) e citomegalovírus (CMV) já é bem estabelecida na literatura, tendo sido primeiramente relatada em 1967. Porém, essa associação é rara em pacientes transplantados de órgãos sólidos, apesar da incidência de infecção sintomática por CMV ser maior nesta população. Devido ao seu potencial de gravidade, alta morbidade e mortalidade, a possibilidade de SGB não pode ser afastada em caso de complicação neurológica em pacientes transplantados. Neste relato, é descrito um caso de SGB secundária a CMV em um paciente transplantado renal de 8 anos de idade, na faixa etária pediátrica, intervalo com ainda maior escassez de relatos sobre essa associação. O paciente apresentava sorologia (IgG e IgM) negativa para CMV em exames pré-transplante, enquanto o doador possuía IgG positiva, havendo dessa forma alto risco de desenvolvimento da doença. A abertura do quadro clínico ocorreu cerca de dois meses após a realização do transplante, com sintomas e evolução clássicos de SGB. São discutidos os aspectos clínicos, diagnósticos, de tratamento e de evolução da doença, além da relação com as evidências presentes na literatura mundial.
10.
Usefulness of prolactin levels in predicting the etiology of hyperprolactinemia in a cohort of 770 patients
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Vilar, Lucio
; Vilar, Clarice Freitas
; Lyra, Ruy
; Albuquerque, Luciano
; Garrido, Ana Carolina Thé
; Gadelha, Patrícia Sampaio
; Diniz, Erik Trovão
; Almeida, Marcos
; Cordeiro, Lucia Helena
; Carvalho, Erico Higino de
; Melo, Ana Teresa Bezerra de
; Medeiros, Karoline Matias
; Ferreira, Gabriel Rodrigues de Assis
; Mororó Neto, José Coelho
; Ximenes, Daniela Zago
; Madruga, Camila Ribeiro Coutinho
; Nunes, Rosália de Oliveira
; Sá, Yanna Queiroz Pereira de
; Naves, Luciana Ansaneli
.



















ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients (<2%) with microprolactinomas or drug-induced hyperprolactinemia. Conclusion Despite considerable overlap in prolactin levels among the different etiologies of hyperprolactinemia, values > 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas.
11.
Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023
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Almeida, André Luiz Cerqueira
; Melo, Marcelo Dantas Tavares de
; Bihan, David Costa de Souza Le
; Vieira, Marcelo Luiz Campos
; Pena, José Luiz Barros
; Del Castillo, José Maria
; Abensur, Henry
; Hortegal, Renato de Aguiar
; Otto, Maria Estefania Bosco
; Piveta, Rafael Bonafim
; Dantas, Maria Rosa
; Assef, Jorge Eduardo
; Beck, Adenalva Lima de Souza
; Santo, Thais Harada Campos Espirito
; Silva, Tonnison de Oliveira
; Salemi, Vera Maria Cury
; Rocon, Camila
; Lima, Márcio Silva Miguel
; Barberato, Silvio Henrique
; Rodrigues, Ana Clara
; Rabschkowisky, Arnaldo
; Frota, Daniela do Carmo Rassi
; Gripp, Eliza de Almeida
; Barretto, Rodrigo Bellio de Mattos
; Silva, Sandra Marques e
; Cauduro, Sanderson Antonio
; Pinheiro, Aurélio Carvalho
; Araujo, Salustiano Pereira de
; Tressino, Cintia Galhardo
; Silva, Carlos Eduardo Suaide
; Monaco, Claudia Gianini
; Paiva, Marcelo Goulart
; Fisher, Cláudio Henrique
; Alves, Marco Stephan Lofrano
; Grau, Cláudia R. Pinheiro de Castro
; Santos, Maria Veronica Camara dos
; Guimarães, Isabel Cristina Britto
; Morhy, Samira Saady
; Leal, Gabriela Nunes
; Soares, Andressa Mussi
; Cruz, Cecilia Beatriz Bittencourt Viana
; Guimarães Filho, Fabio Villaça
; Assunção, Bruna Morhy Borges Leal
; Fernandes, Rafael Modesto
; Saraiva, Roberto Magalhães
; Tsutsui, Jeane Mike
; Soares, Fábio Luis de Jesus
; Falcão, Sandra Nívea dos Reis Saraiva
; Hotta, Viviane Tiemi
; Armstrong, Anderson da Costa
; Hygidio, Daniel de Andrade
; Miglioranza, Marcelo Haertel
Camarozano, Ana Cristina
Lopes, Marly Maria Uellendahl
Cerci, Rodrigo Julio
Siqueira, Maria Eduarda Menezes de
Torreão, Jorge Andion
Rochitte, Carlos Eduardo
Felix, Alex



















































12.
Analysis of reported adverse liver reactions associated with drugs used to treat patients with coronavirus disease 2019
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Abstract Hepatic injury has been documented in patients with coronavirus disease 2019 (COVID-19). However, pharmacotherapy can frequently impact liver alterations, given the known hepatotoxic potential of drugs not effective to treat COVID-19. The objective of the present study was to evaluate reports of suspected liver reactions to drugs used for treating COVID-19, compare their use for other indications among patients with COVID-19, and assess possible interactions between them. We obtained reports on drugs used to treat COVID-19 (tocilizumab, remdesivir, hydroxychloroquine, and/or lopinavir/ritonavir), registered on June 30, 2020, from the Food and Drug Administration Adverse Event Reporting System (FAERS) Public Dashboard. We then analyzed the risk of developing liver events with these drugs by calculating the reported odds ratios (ROR). We identified 662, 744, and 1381 reports related to tocilizumab, lopinavir/ ritonavir, and hydroxychloroquine use, respectively. The RORs (95% confidence intervals) were 6.32 (5.28-7.56), 6.12 (5.22-7.17), and 9.07 (8.00-10.29), respectively, demonstrating an increased risk of liver events among patients with COVID-19 when compared with uninfected patients. The elevated risk of reporting adverse liver events in patients with COVID-19 who receive these drugs, alone or in combination, highlights the need for careful drug selection and efforts to reduce drug combinations without notable benefits. Similar to any other condition, the use of drugs without established efficacy should be avoided.
13.
Potential kidney damage associated with the use of remdesivir for COVID-19: analysis of a pharmacovigilance database
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Silva, Nayara Aparecida de Oliveira
; Zara, Ana Laura de Sene Amâncio
; Figueras, Albert
; Melo, Daniela Oliveira de
.




Resumen: La Agencia Americana de Control de Alimentos y Medicamentos (FDA) ha destacado que la prescripción de remdesivir debe ser prudente con pacientes con tasa de filtración glomerular estimada (TGFe) < 30; además, algunos estudios informaron del riesgo de reacciones adversas renales. La información disponible sobre el perfil de seguridad renal, en el caso del remdesivir, es limitada. Por ello, analizamos las reacciones adversas renales y urinarias atribuidas al remdesivir e notificadas en una extensa base de datos abierta de farmacovigilancia. Obtuvimos las notificaciones de remdesivir y otros medicamentos usados para tratar la COVID-19 (tocilizumab, hidroxicloroquina, lopinavir/ritonavir) registrados el 30 de septiembre de 2020 por el Sistema de Notificación de Eventos Adversos de la FDA (FAERS). Analizamos las odds ratios informadas (RORs) en el caso de informes de eventos adversos renales y urinarios adversos relacionados con el remdesivir y otros medicamentos. En el FAERS, encontramos 2.922 notificaciones de remdesivir registradas como medicament sospechoso usado en COVID-19. De estos, habían 493 con efectos renales y urinarios adversos (16,9%). Los efectos adversos más frecuentes fueron lesiones renales agudas (338; 11,6%), insuficiencia renal (86; 2,9%), y fallo renal (53; 1,8%). Frente a hidroxicloroquina, lopinavir/ritonavir, o tocilizumab, el uso de remdesivir se asoció con un riesgo mayor de notificar alteraciones renales y urinarios, independientemente del género y edad de los pacientes (2,53; IC95%: 2,10-3,06). La ROR permaneció significativo al restringir el análisis a la hidroxicloroquina (4,31; IC95%: 3,25-5,71) o tocilizumab (3,92; IC95%: 2,51-6,12). Nuestros resultados corroboran datos previos, algo que podría ser extremadamente útil para los profesionales de la salud que decidan usar este nuevo antiviral para tratar la COVID-19, sobre todo conociendo su baja eficacia.
Resumo: De acordo com a Agência de Controle de Alimentos e Medicamentos dos Estados Unidos (FDA), a prescrição do remdesivir deve ser feita com cautela em pacientes com taxa de filtração glomerular estimada (TFGe) < 30, sendo que diversos estudos relatam risco de eventos adversos renais. São limitados os dados disponíveis sobre o perfil de segurança renal do remdesivir. Assim, analisamos as reações adversas renais e urinárias atribuídas ao remdesivir e notificadas em um grande base de dados abertos de farmacovigilância. Obtivemos notificações sobre remdesivir e outros medicamentos usados para tratar a COVID-19 (tocilizumabe, hidroxicloroquina, lopinavir/ritonavir) registradas até 30 de setembro de 2020 do Sistema de Notificação de Eventos Adversos da FDA (FAERS). Analisamos as razões de chances de notificação (RORs) para notificações de eventos adversos renais e urinários referentes ao remdesivir e outros medicamentos. Encontramos 2.922 notificações sobre remdesivir registradas no FAERS para COVID-19. Entre esses casos, foram notificados 493 efeitos adversos renais e urinários (16,9%). Os eventos mais frequentes foram lesão renal aguda (338; 11,6%), comprometimento renal (86; 2,9%) e insuficiência renal (53; 1,8%). Comparado com a hidroxicloroquina, lopinavir/ritonavir ou tocilizumabe, o uso do remdesivir esteve associado com um aumento das chances de notificação de transtornos renais e urinários, independentemente do sexo e idade dos pacientes (2,53; IC95%: 2,10-3,06). A ROR permaneceu significativo quando limitamos a análise à hidroxicloroquina (4,31; IC95%: 3,25-5,71) ou ao tocilizumabe (3,92; IC95%: 2,51-6,12). Nossos resultados corroboram outros estudos e destacam a utilidade para profissionais da saúde que usam esse novo antiviral para tratar a COVID-19, sobretudo em função de sua baixa eficácia.
Abstract: The U.S. Food and Drug Administration (FDA) has stated that the prescription of remdesivir should be cautious for patients with estimated glomerular filtration rate (eGFR) < 30 and some studies reported risk of adverse renal events. The available information on the renal safety profile for remdesivir is limited, thus we analyzed the renal and urinary adverse reactions attributed to remdesivir reported in a large open pharmacovigilance database. We obtained reports of remdesivir and other drugs used to treat COVID-19 (tocilizumab, hydroxychloroquine, lopinavir/ritonavir) registered by September 30 2020, from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS). We analyzed the reporting odds ratios (RORs) for reports of adverse renal and urinary events for remdesivir and other drugs. We found 2,922 reports with remdesivir registered in FAERS for COVID-19. Among these, 493 renal and urinary adverse effects (16.9%) were reported. The most frequent events were acute kidney injury (338; 11.6%), renal impairment (86; 2.9%), and renal failure (53; 1.8%). Versus hydroxychloroquine, lopinavir/ritonavir, or tocilizumab, the use of remdesivir was associated with an increased chance of reporting renal and urinary disorders regardless of gender and age of patients (2.53; 95%CI: 2.10-3.06). The ROR remained significant when we restricted the analysis to hydroxychloroquine (4.31; 95%CI: 3.25-5.71) or tocilizumab (3.92; 95%CI: 2.51-6.12). Our results reinforce this already reported signal, emphasizing that it could be extremely useful for health professionals who prescribe this new antiviral to treat COVID-19, mainly knowing its low efficacy.
14.
COVID-19 e doença hipertensiva no Brasil: possibilidade de uma tempestade perfeita
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Melo, Daniela Oliveira de
; Ribeiro, Tatiane Bonfim
; Grezzana, Guilherme Brasil
; Stein, Airton Tetelbom
.




15.
Avaliação da resposta inicial de desenvolvimento de ensaios clínicos para COVID-19 no Brasil
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Ribeiro, Tatiane Bomfim
; Mazotti, Talita Aona
; Silva, Nayara Aparecida de Oliveira
; Stein, Airton Tetelbom
; Diaz-Quijano, Fredi Alexander
; Melo, Daniela Oliveira de
.






RESUMO: Objetivo: Descrever as características metodológicas e de boas práticas em pesquisa dos estudos de intervenção para COVID-19 desenvolvidos no Brasil nos primeiros meses da pandemia. Métodos: Revisamos o boletim da Comissão Nacional de Ética em Pesquisa - edição especial Coronavírus (CONEP-COVID) (28 de maio de 2020) e as bases International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov e Registro Brasileiro de Ensaios Clínicos (ReBEC) para identificar estudos registrados no Brasil que avaliassem intervenções de tipo de medicamento, terapia biológica ou vacinas. Descrevemos as características metodológicas e calculamos o poder para diferentes magnitudes de efeito. Resultados: Foram incluídos 62 estudos, 55 identificados no site da CONEP e mais sete nas bases de registro. As intervenções medicamentosas mais frequentemente testadas nesses estudos foram: cloroquina/hidroxicloroquina, azitromicina, plasma convalescente, tocilizumabe, sarilumabe, eculizumabe, vacina, corticoides, anticoagulantes, n-acetilcisteína, nitazoxanida, ivermectina e lopinavir/ritonavir. De 22 protocolos publicados até maio de 2020 nas bases de registro, 18 (82%) eram ensaios clínicos randomizados e 13 (59%) tinham grupo controle adequado. Entretanto, nove (41%) eram mascarados e somente cinco (24%) incluíam pacientes diagnosticados com teste de laboratório específico (por exemplo, transcrição reversa seguida de reação em cadeia da polimerase - RT-PCR). A maioria desses trabalhos teria poder > 80% apenas para identificar grandes tamanhos de efeito. Em seguimento prospectivo, observamos que 60% dos estudos disponíveis na CONEP até maio de 2020 não estavam em nenhuma das plataformas de registro (ICTRP/ReBEC/ClinicalTrials) até o dia 21 de julho de 2020. Conclusão: As intervenções avaliadas durante a resposta brasileira em pesquisa refletem iniciativas internacionais, porém com distribuição diferente, tendo número elevado de estudos que avaliam hidroxicloroquina/cloroquina. Limitações no delineamento metodológico e planejamento amostral representam desafios que podem afetar o alcance dos trabalhos.
ABSTRACT: Objective: To describe the methodological characteristics and good research practices of COVID-19 interventional studies developed in Brazil in the first months of the pandemic. Methods: We reviewed the bulletin of the National Research Ethics Committee - Coronavirus Special Edition (Comissão Nacional de Ética em Pesquisa - CONEP-COVID) (May 28, 2020) and the databases of the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clínicos - ReBEC) to identify interventional studies registered in Brazil that assessed drug type, biological therapy, or vaccines. We described their methodological characteristics and calculated their power for different effect magnitudes. Results: A total of 62 studies were included, 55 retrieved from the CONEP website, and 7 from registry databases. The most tested pharmacological interventions in these studies were: chloroquine/hydroxychloroquine, azithromycin, convalescent plasma, tocilizumab, sarilumab, eculizumab, vaccine, corticosteroids, anticoagulants, n-acetylcysteine, nitazoxanide, ivermectin, and lopinavir/ritonavir. Out of 22 protocols published on registry databases until May 2020, 18 (82%) were randomized clinical trials, and 13 (59%) had an appropriate control group. However, 9 (41%) of them were masked, and only 5 (24%) included patients diagnosed with a specific laboratory test (for example, reverse transcription polymerase chain reaction - RT-PCR). Most of these studies had power > 80% only to identify large effect sizes. In the prospective follow-up, 60% of the studies available at CONEP until May 2020 had not been published on any registry platform (ICTRP/ReBEC/ClinicalTrials) by July 21, 2020. Conclusion: The interventions evaluated during the Brazilian research response reflect those of international initiatives, but with a different distribution and a large number of studies assessing hydroxychloroquine/chloroquine. Limitations in methodological design and sample planning represent challenges that could affect the research outreach.
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