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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre 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 P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, 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, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli 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, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

Managing chronic obstructive pulmonary disease in primary health care: the impact of pulmonary rehabilitation
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Oliveira, Guilherme

; Félix, Rita

; Santos, Pedro Ruivo dos

; Monteiro, Luís

; Tejo, Cristina

Revista Portuguesa de Medicina Geral e Familiar

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feb 2024, Volume 40 N. 1 Pages 58 - 67

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

Resumo Introdução: A doença pulmonar obstrutiva crónica (DPOC) é a terceira causa de mortalidade a nível global. O tratamento foca-se na melhoria da qualidade de vida, atraso da progressão da doença e redução das exacerbações. Neste contexto, o benefício da reabilitação respiratória tem vindo a ser verificado. Esta medida não farmacológica pode ser implementada na comunidade, no contexto dos cuidados de saúde primários. Objetivos: Esta revisão sistemática propôs-se a fazer um levantamento da evidência atual sobre o impacto da reabilitação pulmonar na qualidade de vida dos doentes com DPOC, num contexto de cuidados de saúde primários. Métodos: Foram pesquisados estudos randomizados controlados em três bases de dados. Foi incluída a reabilitação pulmonar realizada na comunidade e excluídas intervenções em contexto hospitalar. Foi considerado como resultado primário a qualidade de vida relacionada com a saúde comparando com a terapêutica padrão da DPOC. A extração e triagem de dados foi efetuada por três autores, de forma independente. Avaliou-se o viés pela Cochrane Risk of Bias Tool. Resultados: Quatro estudos corresponderam aos critérios de pesquisa. Três estudos reportaram benefício em pelo menos um dos resultados. A frequência e duração da reabilitação pareceram ter algum impacto nos resultados. A mortalidade foi mais alta nos grupos de controlo. Os estudos incluídos tinham limitações importantes, nomeadamente a incapacidade de realizar intervenções cegas. Conclusões: A reabilitação pulmonar em cuidados de saúde primários melhora a qualidade de vida e capacidade funcional na DPOC. A duração, frequência e modalidade ótimas da intervenção não estão definidas e poderão depender de características individuais. Embora o paradigma não se altere, espera-se que esta revisão fomente o interesse na intervenção.

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and its management involves improving quality of life, delaying progression, and minimizing exacerbations. The benefit of pulmonary rehabilitation in COPD has been documented in the literature. This intervention can be applied to a primary healthcare setting, using community resources. Objectives: This systematic review sought to compile current evidence implying the impact of pulmonary rehabilitation in a primary healthcare setting on the quality of life of patients with COPD. Methods: Three databases were searched for randomized controlled trials. We included community-based pulmonary rehabilitation and excluded interventions in a hospital setting. The primary outcome was health-related quality of life; secondary outcomes were functional exercise capacity and mortality. Data extraction and triage were performed independently by three authors, and bias was evaluated using the Cochrane Risk of Bias Tool. Results: Four studies met the search criteria. Three studies reported benefits in at least one of the outcomes; a fourth reported no differences between groups. Rehabilitation frequency and duration seemed to have some impact on all outcomes. Mortality was higher in the control groups when available. The included studies had important limitations, namely the inability to blind interventions. Conclusions: Pulmonary rehabilitation in a primary health care setting benefits the quality of life and functional exercise capacity in COPD patients. Optimal treatment modality, frequency, and duration are yet to be defined and are perhaps reliant on individual patient attributes. Though unable to add to previous findings, we hope this review fosters interest in this potentially life-changing intervention in a primary healthcare context.

https://doi.org/10.32385/rpmgf.v40i1.13749

SARS-CoV-2 and the ocular surface: test accuracy and viral load
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Santoro, Dalton de Freitas

; Hirai, Flavio Eduardo

; Tochetto, Lucas Baldissera

; Conte, Danielle Dias

; Lima, Ana Luísa Hofling

; Sousa, Luciene Barbosa de

; Bellei, Nancy Cristina Junqueira

; Freitas, Denise

; Oliveira, Lauro Augusto de

Arquivos Brasileiros de Oftalmologia

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2024, Volume 87 N. 5 elocation e2022-0172

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

ABSTRACT Purpose: This study aimed to evaluate the pre-sence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in the ocular surface of individuals clinically suspected of coronavirus disease 2019 (COVID-19) and determine the accuracy of different approaches of molecular testing on the ocular surface based on the nasopharyngeal positivity status for COVID-19. Methods: A total of 152 individuals with suspected COVID-19 symptoms who simultaneously underwent nasopharyngeal and two different tear film collection techniques for quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) were included. Tears were collected and randomized: one eye had the filter strip for the Schirmer test and the contralateral eye had conjunctival swab/cytology in the inferior fornix. All patients underwent slit lamp biomicroscopy. The accuracy of various ocular surface collection techniques used for the detection of SARS-CoV-2 RNA was determined. Results: Of the 152 patients enrolled in the study, 86 (56.6%) had COVID-19 confirmed by nasopharyngeal PCR. Both tear film collection techniques detected viral particles: the Schirmer test was positive in 16.3% (14/86) and the conjunctival swab/cytology in 17.4% (15/86), with no statistically significant differences. No positive ocular tests were found among those with negative nasopharyngeal PCR tests. The overall agreement of the ocular tests was 92.7%, and in combination, the sensitivity would increase to 23.2%. The mean cycle threshold values in the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests were 18.2 ± 5.3, 35.6 ± 1.4, and 36.4 ± 3.9, respectively. Compared with the nasopharyngeal test, the Schirmer (p=0.001) and conjunctival swab/cytology (p<0.001) tests had significantly different Ct values. Conclusion: The Schirmer (16.3%) and conjunctival swab (17.4%) tests were comparably capable of detecting SARS-CoV-2 RNA in the ocular surface by RT-PCR accurately based on nasopharyngeal status and demonstrated indistinct sensitivity and specificity. Simultaneous specimen sampling and processing from the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests demonstrated significantly lower viral load in both ocular surface approaches than in the nasopharyngeal test. Ocular manifestations detected by slit lamp biomicroscopy were not associated with ocular RT-PCR positivity.

RESUMO Objetivo: Avaliar a presença de RNA de coronavírus 2 causador de síndrome respiratória aguda grave (SARS-CoV-2) na superfície ocular de indivíduos clinicamente suspeitos com COVID-19 e determinar a precisão de diferentes abordagens de testes moleculares na superfície ocular com base no status de positividade do RT-qPCR de nasofaringe para COVID-19. Métodos: 152 indivíduos com sintomas suspeitos para a COVID-19 foram submetidos a coleta de reação em cadeia da polimerase de nasofaringe simultaneamente a duas técnicas diferentes de coleta de filme lacrimal para RT-qPCR: aleatoriamente, um olho com a tira filtro do teste de Schirmer e, o olho contralateral, com citologia (swab) conjuntival no fórnice inferior. Todos os indivíduos foram submetidos à biomicroscopia com lâmpada de fenda. Resultados: Dos 152 pacientes, 86 (56,6%) tiveram a COVID-19 confirmada por PCR de nasofaringe. Ambas as técnicas de coleta detectaram partículas virais: o teste de Schirmer foi positivo em 16,3% (14/86) e a citologia conjuntival em 17,4% (15/86), sem diferenças estatisticamente significativas. Não houve testes oculares positivos entre aqueles com reação em cadeia da polimerase de nasofaringe negativo. A concordância geral dos testes oculares foi de 92,7% e, em combinação, a sensibilidade aumentaria para 23,2%. Os valores médios do limiar de ciclo nos testes de nasofaringe, Schirmer e citologia conjuntival foram 18,2 ± 5,3, 35,6 ± 1,4 e 36,4 ± 3,9, respectivamente. Conclusão: Os testes de Schirmer (16,3%) e swab conjuntival (17,4%) foram igualmente capazes de detectar RNA de SARS-CoV-2 na superfície ocular por RT-PCR e demonstraram sensibilidade e especificidade indistintas. A coleta simultânea de amostras ao processamento dos testes de RT-PCR de nasofaringe, Schirmer e citologia (swab) conjuntival demonstraram carga viral significativamente menor em ambas as abordagens da superfície ocular em comparação com o teste de nasofaringe. As manifestações oculares detectadas pela biomicroscopia com lâmpada de fenda não foram claramente associadas à positividade do RT-PCR ocular.

https://doi.org/10.5935/0004-2749.2022-0172

Occurrence of avian reovirus and picobirnavirus in wild birds from an environmental protection area in the Brazilian Amazon
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PEREIRA, Diego

; SOUTO, Lizandra Caroline dos Santos

; GUERRA, Sylvia de Fátima dos Santos

; PENHA-JÚNIOR, Edvaldo Tavares da

; LOBO, Patrícia dos Santos

; SOARES, Luana da Silva

; PINHEIRO, Helder Henrique Costa

; CHAGAS, Elaine Hellen Nunes

; GUIMARÃES, Ricardo José de Paula Souza e

; RAMOS, Bruna Alves

; CHAGAS, Liliane Leal das

; FREITAS, Maria Nazaré Oliveira

; FURTADO, Erilene Cristina da Silva

; RODRIGUES, Jéssica Cecília Pinheiro

; CASSEB, Alexandre do Rosário

; MARTINS, Lívia Caricio

; MASCARENHAS, Joana D’Arc Pereira

Acta Amazonica

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2024, Volume 54 N. 1 elocation e54hs23012

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

ABSTRACT Wild birds have great prominence in the transmission of diseases to humans, mainly due to their ease of access to human populations, raising concerns about the potential impact of that proximity on public health. The present study reports ARV and PBV occurrence in wild birds from an environmental protection area in the Amazon biome, in Pará state, Brazil. We obtained 155 fecal specimens from 47 species of wild birds for RNA extraction, ARV and PBV detection utilizing molecular methods, nucleotide sequencing, and phylogenetic analysis. ARV prevalence was 0.6% (1/155), being positive in an individual of Myrmotherula longipennis, and PBV prevalence was 1.29% (2/155), affecting two individuals of Guira guira. The PBV strains were assigned to genogroup I based on phylogenetic analysis, and they shared a strong phylogenetic link with strains isolated from different geographic locations. The ARV strain was more closely related to strains that had previously circulated in the same region. The presence of ARV and PBV in this habitat suggests that infection cycles of these agents occur naturally in the wild ecosystem, potentially triggering transmission events between bird species and humans. This is the first study on ARV detection in wild birds in Brazil and the first report on the occurrence of PBV in wild Guira guira. Additional studies are required to determine the epidemiology, origin, evolution, and emergence of new potentially pathogenic viruses in the Amazon.

RESUMO As aves silvestres têm grande destaque na transmissão de doenças ao homem, principalmente pela facilidade de acesso à população humana, levantando preocupações sobre o potencial impacto dessa proximidade no contexto da saúde pública. O presente estudo relata a ocorrência de ARV e PBV em aves silvestres de uma área de proteção ambiental no bioma Amazônico. Obtivemos 155 espécimes fecais de 47 espécies de aves silvestres, que foram submetidos a extração de RNA, detecção de ARV e PBV por técnicas moleculares, sequenciamento nucleotídico e análise filogenética. A prevalência de infecção por ARV foi 0,6% (1/155), sendo positivo em um indivíduo de Myrmotherula longipennis, e a prevalência de PBV foi 1,29% (2/155), afetando dois insdivíduos de Guira guira. A análise filogenética agrupou as cepas de PBV no genogrupo I, mostrando intensa relação filogenética com cepas isoladas de outras regiões geográficas. A cepa de ARV esteve mais relacionada filogeneticamente a cepas previamente circulantes na mesma região. Este é o primeiro estudo sobre detecção de ARV em aves silvestres no Brasil e o primeiro relato sobre a ocorrência de PBV em Guira guira. A circulação de ARV e PBV nesse ambiente demonstra que os ciclos desses agentes estão ocorrendo de forma natural no ecossistema silvestre, o que pode desencadear possíveis eventos de transmissão entre as espécies aviárias e humanos. Estudos adicionais são necessários para determinar a epidemiologia, origem, evolução e surgimento de novos vírus potencialmente patogênicos na Amazônia.

https://doi.org/10.1590/1809-4392202300120

Resistance Training Improves the Immune Response, Mainly Associated with CD8+ T Lymphocytes and B Lymphocytes, in Mice
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Pedro, Fernanda Cristina

; Oliveira, Marina Martins de

; Andrade, Rafaella Silva

; Costa, Anna Cecília Trolesi Reis Borges

; Pereira, Carine Rodrigues

; Oliveira, Pedro Felipe Rodrigues e

; Macari, Soraia

; Coimbra, Cândido Celso

; Dorneles, Elaine Maria Seles

; Pereira, Luciano José

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24220284

Abstract: En | Text: En | PDF: En

Abstract Studies investigating the effects of different modalities of exercises on the immune system are scarce. Therefore, the aim of this study was to compare the effects of eight weeks of resistance and aerobic training on the proliferation of T and B lymphocytes from mice. Eighteen male C56BL6/J mice were divided into groups (n=6), sedentary, aerobic, and resistance training. After 8 weeks, animals were euthanized, and their splenocytes were labeled and cultured with and without stimulation. Lymphocyte proliferation (CD4+, CD8+ and CD21/CD35+) was evaluated by flow cytometry. The mice subjected to resistance exercise exhibited greater proliferation for total, CD8+ and B lymphocytes (p<0.05), but not CD4+ cells (p>0.05), compared with their sedentary counterparts. We found significant correlations between maximum load and total, CD8+ and B lymphocytes proliferation rates (p<0.05). In conclusion, our results showed that resistance training promoted an improvement in the immune response associated with CD8+ and B lymphocytes.

https://doi.org/10.1590/1678-4324-2024220284

Production of Chives Using Organic Fertilizers before Planting and in Top Dressing
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Oliveira, Marcelo Munhoz Venâncio de

; Alves, Thatiane Nepomuceno

; Cardoso, Antonio Ismael Inácio

; Luís, Débora Cristina Mastroleo

; Carvalho, Joseantonio Ribeiro de

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24230542

Abstract: En | Text: En | PDF: En

Abstract Chives are one of the most popular spice plants in world cuisine. It is usually produced by small producers, often in an organic farming system. However, research with chives in this production system is lacking. The purpose of this study was to evaluate the production of chives with the use of organic fertilizers before planting and in top dressing. Seven treatments were evaluated, resulting from the factorial 2x3+1, with two organic fertilizers (castor bean cake and hoof and horn powder) x 3 application modes (100% before planting; 100% in top dressing; 50% before planting and 50% in top dressing) + 1 control (without these organic fertilizers). The experimental design was in randomized blocks, with five replications and plots of 1 m2. The relative index of chlorophyll (“Spad” index), height, number of leaves, fresh and dry weight of the plants were evaluated. All treatments of the factorial were better than the control, showing that these organic fertilizers improve production in chives. It is recommended to use the hoof and horn powder in installments (50% before planting and 50% in top dressing) or 100% in top dressing, the latter option being more interesting for reducing the need for labor, with just one application moment.

https://doi.org/10.1590/1678-4324-2024230542

Itinerários terapêuticos de mulheres quilombolas do norte de Minas Gerais, Brasil
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Oliveira, Pâmela Scarlatt Durães

; Miranda, Sérgio Vinícius Cardoso de

; Queiroz, Patrícia de Sousa Fernandes

; Santos, Bruna Amorim

; Rodrigues Neto, João Felício

; Sampaio, Cristina Andrade

Ciência & Saúde Coletiva

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2024, Volume 29 N. 3 elocation e01762023

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

Abstract Quilombolas are ethnic-racial groups, of black ancestry, and had their territories consolidated in Brazil in regions with difficult access and far from large centers. The objective of this study is to know the therapeutic itinerary (IT) adopted by quilombola women in traditional communities located in the North of the state of Minas Gerais. This is a qualitative study with the theoretical model using the Arthur Kleinman health care system. The study scenario was 23 quilombola communities in northern Minas Gerais. Forty quilombola women aged between 25 and 89 years were interviewed. Data analysis was performed following the IT. Units of analysis emerged that were grouped into three categories: quilombola women and the meaning of health and care; the professional care system in quilombola communities; and route of care in situations experienced by women. The therapeutic itinerary of the communities is mainly related to the actions of popular medicine. It was also possible to observe that there are weaknesses in relation to health care due to factors such as difficulty of access to institutionalized services.

Resumo Os quilombolas são grupos étnico-raciais de ancestralidade negra e tiveram seus territórios consolidados no Brasil em regiões com acesso difícil e distante dos grandes centros. O objetivo desse estudo é conhecer o itinerário terapêutico (IT) adotado por mulheres quilombolas em comunidades tradicionais localizadas no norte do estado de Minas Gerais. Trata-se de um estudo com abordagem qualitativa com o modelo teórico utilizando o sistema de cuidados à saúde de Arthur Kleinman. O estudo se deu em 23 comunidades quilombolas do norte de Minas Gerais. Foram entrevistadas 40 mulheres quilombolas, com idades entre 25 e 89 anos. A análise dos dados foi realizada seguindo os IT. Emergiram unidades de análise que foram agrupadas em três categorias: as mulheres quilombolas e o significado da saúde e do cuidado; o sistema de cuidado profissional nas comunidades quilombolas; e itinerário de cuidados nas situações vivenciadas pelas mulheres. O itinerário terapêutico das comunidades se mostra relacionado principalmente às ações de medicina popular. Foi possível observar ainda que existem fragilidades em relação à atenção à saúde devido a fatores como dificuldade de acesso aos serviços institucionalizados.

https://doi.org/10.1590/1413-81232024293.01762023

Itinerários terapêuticos no cuidado em saúde em comunidades quilombolas
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Gomes, Rafael Fernandes

; Oliveira, Pâmela Scarlatt Durães

; Silva, Maria Luiza Oliveira

; Miranda, Sérgio Vinícius Cardoso de

; Sampaio, Cristina Andrade

Ciência & Saúde Coletiva

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2024, Volume 29 N. 3 elocation e01602023

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

Abstract This article aimed to map therapeutic itineraries in health care within rural Quilombola communities in the north of Minas Gerais, Brazil. This is a section of a qualitative research conducted in six visited communities. The data was collected through 18 individual interviews, analyzed using the theoretical-methodological framework of Therapeutic Itineraries, and organized into three empirical themes. The narratives allowed for understanding the paths taken in health care by the Quilombola population, identifying the components of the popular subsystem (natural resources, the use of teas and home remedies), the family subsystem (transmission of knowledge and cultural heritage of care), and the professional subsystem (hospital level, medical care, primary and specialized attention). The difficulties of access are not only due to geographical distances, but also broader aspects of social determination, such as institutional racism, low availability of services, the need for payment for transportation and medical procedures. In this sense, it is necessary to have an approach and interventions from public policies to address ethnic-racial, economic, and access inequalities in health care services.

Resumo Este artigo teve como objetivo mapear os itinerários terapêuticos no cuidado em saúde em comunidades quilombolas rurais no norte de Minas Gerais, Brasil. Trata-se de um recorte de uma pesquisa qualitativa realizada em seis comunidades visitadas. Os dados foram produzidos por meio de 18 entrevistas individuais, analisados pelo referencial teórico-metodológico dos itinerários terapêuticos e organizados em três temas empíricos. As narrativas permitiram a compreensão dos percursos trilhados no cuidado em saúde pela população quilombola, a identificação dos componentes do subsistema popular (recursos naturais, o uso de chás e remédios caseiros), do subsistema familiar (transmissão de conhecimentos e herança cultural de cuidados), e do subsistema profissional (nível hospitalar, cuidados médicos, atenção primária e especializada). As dificuldades de acesso não decorrem apenas das distâncias geográficas, envolvem aspectos mais amplos da determinação social, como o racismo institucional, a baixa oferta de serviços, a necessidade de pagamento para deslocamentos e procedimentos médicos. Nesse sentido, fazem-se necessárias uma abordagem e intervenções das políticas públicas frente às desigualdades étnico-raciais, econômicas e de acesso aos serviços de cuidado em saúde.

https://doi.org/10.1590/1413-81232024293.01602023

Assessing a cut-off point for the diagnosis of abnormal uterine bleeding using the Menstrual Bleeding Questionnaire (MBQ): a validation and cultural translation study with Brazilian women
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Rezende, Gabriela Pravatta

; Brito, Luiz Gustavo Oliveira

; Gomes, Daniela Angerame Yela

; Souza, Leticia Mansano de

; Polo, Sergio

; Benetti-Pinto, Cristina Laguna

Sao Paulo Medical Journal

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2024, Volume 142 N. 1 elocation e2022539

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment. OBJECTIVES: To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese. DESIGN AND SETTING: Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center. METHODS: MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life – abbreviated version (WHOQOL-BREF) were applied. RESULTS: Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%. CONCLUSION: The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB.

https://doi.org/10.1590/1516-3180.2022.0539.r2.100423

10.

Steps of cryopreservation of coffee seeds: physiological responses and antioxidant systems
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Souza, Ana Cristina de

; Costa, Marina Chagas

; Figueiredo, Madeleine Alves de

; Pereira, Cristiane Carvalho

; Coelho, Stefânia Vilas Boas

; Vilela, Ana Luiza Oliveira

; Pereira, Diego de Souza

; Rosa, Sttela Dellyzete Veiga Franco da

Ciência Rural

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2024, Volume 54 N. 2 elocation e20220480

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

ABSTRACT: The cryopreservation of plant germplasm at ultralow temperatures is an alternative technique for the long-term storage of seeds of the genus Coffea sp. However, for this technique to be successful, cell integrity must be maintained at all stages of the process on the basis of scientific research. The present study investigated validated cryopreservation protocols for Coffea arabica L. seeds and evaluate the effects on the physiological and biochemical characteristics of the seeds at each stage of the process. Seeds were dried on silica gel or with saturated saline solution, precooled or not in a biofreezer, immersed in nitrogen, and reheated in a water bath. After each of these steps, the physiological and biochemical quality of the seeds was determined. Pre-cooling is a step that can be dispensed with in the cryopreservation of Coffea arabica seeds, direct immersion in liquid nitrogen being more indicated. Coffea arabica L. seeds tolerate cryopreservation after rapid drying in silica gel up to water contents of 17 or 20% (wb), with greater survival at 17%. The enzyme activities of catalase, polyphenol oxidase and peroxidase are indicators of the quality of C. arabica L. seeds subjected to cryopreservation.

RESUMO: A criopreservação de germoplasma vegetal em temperaturas ultrabaixas é uma alternativa para o armazenamento em longo prazo de sementes do gênero Coffea sp. Entretanto, para que essa técnica apresente sucesso, a realização de pesquisas que garantam a manutenção da integridade celular em todas as etapas do processo é de fundamental importância. O objetivo com o presente trabalho foi investigar protocolos de criopreservação validados para sementes de Coffea arabica L., avaliando separadamente, os efeitos sobre as características fisiológicas e bioquímicas das sementes, em cada etapa do processo. As sementes foram secadas em sílica gel ou em solução salina saturada, submetidas ou não ao pré-resfriamento em biocongelador, em seguida imersas no nitrogênio e reaquecidas em banho-maria. Após cada uma dessas etapas, a qualidade fisiológica e bioquímica das sementes foi determinada. O pré-resfriamento é uma etapa que pode ser dispensada na criopreservação de sementes de Coffea arabica, sendo mais indicada a imersão direta em nitrogênio líquido. Sementes de Coffea arabica L. toleram a criopreservação após secagem rápida em sílica gel até teores de água de 17 ou 20% (wb), com maior sobrevivência a 17%. A atividade das enzimas catalase, polifenoloxidase e peroxidase são indicadoras da qualidade de sementes de Coffea arabica L. submetidas à criopreservação.

https://doi.org/10.1590/0103-8478cr20220480

11.

Nutritional interventions in children and adolescents with cerebral palsy: systematic review
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Silva, Danielle Cristina Guimarães da

; Cunha, Marcela de Sá Barreto da

; Santana, Amanda de Oliveira

; Alves, Augusto Matheus dos Santos

; Santos, Marcos Pereira

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2022107

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

ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: “children” OR “childhood” AND “nutritional therapy” OR “nutritional intervention” OR “nutrition” OR “nutritional support” OR “diet” AND “cerebral palsy” OR “cerebral injury”. Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.

RESUMO Objetivo: Revisar sistematicamente a literatura em busca das intervenções e indicações nutricionais mais adequadas e eficazes para o tratamento nutricional de crianças e adolescentes com paralisia cerebral (PC). Fontes de dados: Esta revisão foi conduzida de acordo com as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses — PRISMA. Os artigos foram selecionados em sete bases de dados (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Foram incluídos estudos de um grupo pediátrico (zero a 18 anos) com diagnóstico de PC e a estratégia de busca incluiu os descritores: “children” OR “childhood” AND “nutritional therapy” OR “nutritional intervention” OR “nutrition” OR “nutritional support” OR “diet” AND “cerebral palsy” OR “cerebral injury”. A qualidade metodológica foi avaliada utilizando a lista de verificação para estudos transversais analíticos, escala Newcastle-Ottawa ou ferramenta da Cochrane Collaboration, para ensaios clínicos. Síntese dos dados: Quinze estudos (n=658) publicados de 1990 a 2020 preencheram os critérios de inclusão. Todos tiveram baixo risco de viés. Os dados mostraram que crianças e adolescentes com PC apresentam pior estado nutricional do que os normalmente desenvolvidos. Aqueles que receberam suplementação nutricional hipercalórica e hiperproteica beneficiaram-se de seu uso. Estudos demonstram que a nutrição enteral deve ser considerada quando as necessidades nutricionais não são supridas pela dieta oral, principalmente nos casos em que as funções oromotoras estão prejudicadas. Além disso, houve relação direta entre a consistência dos alimentos, o nível de função motora e o estado nutricional. Conclusões: Crianças e adolescentes com PC têm maior risco de desnutrição. O uso de suplementação nutricional pode auxiliar no ganho de peso desses pacientes. Além disso, a nutrição enteral e a modificação da textura dos alimentos têm sido artifícios utilizados para a melhora do estado nutricional neste grupo.

https://doi.org/10.1590/1984-0462/2024/42/2022107

12.

Association between iron deficiency anemia and sleep duration in the first year of life
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Rodrigues Junior, José Israel

; Mecenas, Victória Gabriella Fidelix de

; de Oliveira Lima, Márcia

; Menezes, Risia Cristina Egito de

; Oliveira, Priscilla Márcia Bezerra de

; Longo-Silva, Giovana

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2022173

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

Abstract Objective: The aim of this study was to investigate the association between iron deficiency anemia and sleep duration in the first year of life. Methods: A total of 123 infants were investigated, with sleep being evaluated at 3, 6, and 12 months of age and anemia at birth and 6 months. The cutoff points for anemia and short sleep duration were hemoglobin <11 g/dL (at birth and/or 6 months) and <10 h (at 3, 6, and 12 months), respectively. The comparison of the average sleep time between infants with and without anemia was performed using the Student’s t-test, and logistic regression models were also used to verify differences in the sleep duration (short/not short) between the groups. Linear regression analyses were conducted to determine the association between sleep duration and hemoglobin values. The analyses were adjusted for potential confounders. Results: Children with anemia were more likely to be short sleepers [odds ratio (95% confidence interval (CI)): 4.02 (1.02–15.76); p≤0.05], and for each unit increase in hemoglobin values, the sleep duration increased by 16.2 min [β (95%CI): 0.27 (0.00–0.55); p≤0.05), regardless of family income, maternal schooling, gender, and body mass index at birth. Conclusions: Our results suggest that iron deficiency anemia is associated with short sleep duration in the first year of life and indicate the need for longitudinal investigations, with longer follow-up, to verify the impact of anemia on sleep duration at subsequent ages.

RESUMO Objetivo: Investigar a associação entre a anemia por deficiência de ferro e a duração do sono no primeiro ano de vida. Métodos: Foram avaliadas 123 crianças, sendo o sono investigado aos três, seis e 12 meses de idade e a anemia ao nascimento e aos seis meses. Utilizaram-se como pontos de corte para anemia e curta duração de sono, respectivamente, hemoglobina<11 g/dL (nascimento e/ou seis meses) e tempo total <10 h (3, 6 e/ou 12 meses). A comparação do tempo médio de sono entre as crianças com e sem anemia foi realizada pelo teste t de Student e modelos de regressão logística foram usados para verificar diferenças na duração do sono (curta/não curta) entre os grupos. Análises de regressão linear foram conduzidas para determinar a associação entre a duração do sono e valores de hemoglobina. As análises foram ajustadas para potenciais confundidores. Resultados: As crianças com anemia tiveram maior chance de apresentar curta duração do sono [odds ratio — OR (intervalo de confiança — IC95%): 4,02 (1,02–15,76); p≤0,05]. Para cada unidade de aumento nos valores da hemoglobina, o tempo de sono aumentou em 16,2 min [β (IC95%): 0,27 (0,00–0,55); p≤0,05), independentemente de renda familiar, escolaridade materna, sexo e índice de massa corporal ao nascimento. Conclusões: Nossos resultados sugerem que a anemia ferropriva está associada à curta duração do sono no primeiro ano de vida e indicam a necessidade de investigações longitudinais, com maior tempo de seguimento, para verificar o impacto da anemia na duração do sono em idades subsequentes.

https://doi.org/10.1590/1984-0462/2024/42/2022173

13.

Stress level and quality of life following pediatric cataract surgery
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Koch, Camila Ribeiro

; Parahyba, Marcelle Oliveira

; Barros, Adriana Nascimento Alves de

; Leite, Marcela Macedo

; Souza, Ângela Cristina Santana

; Bastos, Joana Anjos

Arquivos Brasileiros de Oftalmologia

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2024, Volume 87 N. 3 elocation e2021-0493

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

ABSTRACT Purpose: To evaluate the quality of life and stress level related to visual function following pediatric cataract surgery in a Brazilian public hospital. Methods: This prospective study analyzed children aged 6-14 years old who underwent cataract surgery. The Childhood Stress Scale and Children’s Visual Function Questionnaire (CVFQ) were used to assess stress levels and quality of life, respectively. Both instruments were applied by two psychologists before and after the surgery. Eye examination was performed by two ophthalmologists. Preoperative and postoperative data were compared. Results: In total, 23 children (32 eyes) were enrolled in the study, of which 9 had bilateral cataracts. The average age group at the time of surgery was 9.65 ± 2.26 (6-14) years old. One month after the surgery, the spherical equivalent was -0.90 ± 1.66D, and the corrected distance visual acuity was 0.13 ± 0.10 (0-0.3) LogMAR in bilateral cases and 0.50 ± 0.39 (0-1.3) LogMAR in unilateral cases (p<0.01). According to the Childhood Stress Scale, 77.7% of the bilateral cases and 57.1% of the unilateral cases had stable stress levels, and 34.7% of the children improved their stress level. The analysis of the CVFQ was based on scores for general health, general vision health, competence, personality, and treatment. After cataract surgery, 78.2% of the patients had improved or maintained CVFQ scores in the general health domain; 82.6%, general vision health; 95.6%, competence; 56.5%, personality; and 78.2%, treatment. Conclusion: Pediatric cataract surgery improves the visual function and the quality of life even in patients undergoing surgical procedures, without increasing the stress levels.

RESUMO Objetivo: Avaliar a qualidade de vida e o nível de estresse relacionada à função visual após a cirurgia de catarata pediátrica em um hospital público brasileiro. Métodos: Estudo prospectivo em crianças de seis a 14 anos submetidas à cirurgia de catarata. A Escala de Stresse Infantil e o Questionário de Função Visual em Crianças foram usados para avaliar o nível de estresse e a qualidade de vida, respectivamente. Ambos os instrumentos foram aplicados por duas psicólogas antes e após a cirurgia. O exame oftalmológico foi realizado por dois oftalmologistas. Os dados coletados no pré e pós-operatório foram comparados. Resultados: Vinte e três crianças (32 olhos) foram incluídas no estudo, nove delas apresentavam catarata bilateral. A média de idade na cirurgia foi de 9,65±2,26 (6 a 14) anos. Um mês após a cirurgia, o equivalente esférico foi de -0,90 ± 1,66D e a acuidade visual corrigida a distância foi de 0,13 ± 0,10 (0-0,3) LogMAR em casos bilaterais e 0,50 ± 0,39 (0-1,3) LogMAR em casos unilaterais (p<0.01). De acordo com a Escala de Stresse Infantil, 77,7% dos casos de catarata bilaterais, e 57,1% dos casos unilaterais mantiveram o nível de estresse e 34,7% das crianças melhoraram o nível de estresse. A análise do Questionário de Função Visual em Crianças foi baseada em pontuações para saúde geral, saúde geral da visão, competência, personalidade e tratamento. Após a cirurgia de catarata, 78,2% dos pacientes melhoraram ou mantiveram o escore do Questionário de Função Visual em Crianças na saúde geral, 82,6% na saúde geral da visão, 95,6% na competência, 56,5% na personalidade e 78,2% no tratamento. Conclusão: A cirurgia de catarata pediátrica melhora a função visual e a qualidade de vida em pacientes submetidos a procedimento cirúrgico, sem aumentar o nível de estresse.

https://doi.org/10.5935/0004-2749.2021-0493

14.

First known case of human bertiellosis in a child in Paraná, Brazil
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Kishi, Nathália Mitsue

; Godoy, Amanda Parteka de

; Afonso, Bárbara Luiza Viana

; Mattar, Cristina Alvarez

; Matos, Gabriela Riter Martins de

; Prado, Lucas Müller

; Kormann, Maria Augusta

; Barbosa, Raphael Ferreira

; Barros, Rodolfo Corrêa de

; Rossoni, Andrea Maciel de Oliveira

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2023077

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

ABSTRACT Objective: To describe the first known case of human Bertiellosis in Paraná (Brazil). Case description: A 6-year-old male residing in the Brazilian state of Paraná was suffering from intermittent nonspecific abdominal pain and abdominal distension, associated with expulsion of live tapeworms in his feces for 7 months. He had a history of interaction with monkeys on an island. His first feces analysis was inconclusive, with an initial hypothesis of an atypical Taenia. However, after additional research, the parasitologist identified pregnant proglottids of Bertiella sp. The patient was initially treated with an unknown dosage of albendazole and nitazoxanide, as it was believed he had been infected with Taenia sp. Since the symptoms persisted, praziquantel 10 mg/kg was prescribed without further proglottids elimination. Comments: Human Bertiellosis is a rare zoonosis, with less than one hundred cases reported. However, it is a cause of chronic abdominal pain and should be kept as a differential diagnosis, especially in cases reporting recurrent tapeworm expulsion in feces and refractory treatment with albendazole.

RESUMO Objetivo: Descrever o primeiro caso conhecido de bertielose humana no Paraná, Brasil. Descrição do caso: Criança de seis anos do sexo masculino, residente no Paraná, Brasil, apresentava dor abdominal inespecífica intermitente e distensão abdominal, associadas à expulsão de helmintos vivos em suas fezes havia sete meses. Tinha um histórico de interação com macacos em uma ilha. Sua primeira análise de fezes foi inconclusiva, com hipótese inicial de uma Taenia atípica. No entanto, após pesquisas adicionais, o parasitologista identificou proglótides gravídicas de Bertiella sp. O paciente foi inicialmente tratado com uma dosagem desconhecida de albendazol e nitazoxanida, pois se acreditava que havia sido infectado por Taenia sp. Diante da persistência dos sintomas, foi prescrito praziquantel 10 mg/kg, sem mais eliminação de proglótides. Comentários: A bertielose humana é uma zoonose rara, com menos de cem casos relatados. No entanto, é uma causa de dor abdominal crônica e deve ser mantida como diagnóstico diferencial, principalmente nos casos que relatam expulsão recorrente de helmintos nas fezes e que são refratários ao tratamento com albendazol.

https://doi.org/10.1590/1984-0462/2024/42/2023077

15.

Estimating sugarcane productivity: an approach using fuzzy logic
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Gabriel Filho, Luís Roberto Almeida

; Amorim, Fernando Rodrigues de

; Cremasco, Camila Pires

; Presumido Júnior, Márcio

; Oliveira, Sandra Cristina de

Revista Ciência Agronômica

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2024, Volume 55 elocation e20228392

Abstract: En | Text: En | PDF: En

ABSTRACT Brazil is a benchmark in sugarcane production, with the state of São Paulo standing out as the largest Brazilian producer. However, for sugarcane suppliers and mills to sustain this activity, there is a need to improve productivity per hectare and reduce production costs. In this regard, this study aimed to propose fuzzy systems to estimate sugarcane productivity based on planted area (Area) and total cost of soil tillage (TCST) for raw material suppliers and mills. To this end, two fuzzy inference systems were constructed for the output variable (productivity) from two input variables (Area and TCST), considering five membership functions (very low, low, medium, high, and very high). Additionally, a survey on 42 sugarcane suppliers and 31 mills in the state of São Paulo was used for model construction. The results showed that the relationship between Area and TCST reflects on the productivity of sugarcane suppliers and mills in distinct ways. For suppliers, an increase in productivity is observed when there is an almost negative relationship between both input variables. For mills, productivity rises when these variables fluctuate in the same direction. Therefore, the proposed method is viable and provides relevant information for conjecturing survival strategies for agents in the sugarcane energy sector.

https://doi.org/10.5935/1806-6690.20240012

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Glossary and search help

You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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