RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
Abstract Brazil’s Midwest is composed of four biomes: the Cerrado, predominant in the region; the Pantanal, the largest wetland in the world; the Amazon, which occupies part of Mato Grosso; and the Atlantic Forest. The objective of this study was to identify the evolution of occupation and use of land in the rural settlements of the Brazilian Midwest depending on the biome of location. A total of 54 settlements distributed in the four biomes of the region were analyzed using direct observation and Landsat images from the years 2004 and 2014. Using the software QGIS 2.8 Wien, the vegetation indices NDVI and NDWI were used to classify agricultural, pasture and forest areas by biome. Native vegetation is declining in most of the analyzed settlements and pastures, for milk production, occupied the largest area. Between 2004 and 2014, pasture areas expanded to the detriment of forests. Although they have the highest percentage of environmental preservation areas, the settlements we analyzed in the Amazon biome do not comply with legislation. Part of the forest in these settlements was transformed into areas of bushy cerrado. However, there was an increase in forests in the settlements of the Atlantic Forest biome.
Abstract The Midwest region of Brazil has a high concentration of land and is the primary producer of grains and livestock in the country, activities with a negative impact on environment. Agrarian reform allows redistribution of land and reinforces family agriculture, which is considered to be favorable to environmental protection. The aim of this study was to use field and remote observations to verify the evolution of environmental preservation and land use in rural settlements in the Midwest region of Brazil. 54 settlements distributed in the region were analyzed. We used images from Landsat 5 satellite obtained by the Thematic Mapper sensor in 2004 and images from Landsat 8 satellite from 2014. The NDVI and NDWI vegetation indexes were used to classify urban, agricultural, pasture, savannah and forest areas. Forests declined in all states, however Mato Grosso, the only one with Amazonian forest, where settlements presented lowest compliance with environmental legislation. The evolution indicates the transformation of forest areas into savannah. Settlers predominantly engage in dairy farming, which requires large areas of land and thus exerts significant pressure on the environment. Productive areas are poorly exploited, and better technical assistance could have a significant impact on environmental protection.
Abstract Brazil’s Midwest is composed of four biomes, the Cerrado (Brazilian savannah), predominant in the region; the Pantanal, the largest irrigated plain on the planet; the Amazon biome; and the Atlantic Forest. The Midwest is the largest producer of grains and livestock in Brazil, activities that have a negative impact on environmental preservation. Agrarian reform redistributes land and reinforces small family farming, which many authors consider as favorable to environmental protection. The objective of this study is to characterize the impact of agrarian reform on environmental preservation and agriculture on each biome of the Brazilian Midwest. Fifty-four settlements were surveyed using direct observation and Landsat images available for the year 2014. QGIS software 2.8 Wien was applied to calculate NDVI and NDWI vegetation indices to classify areas of agriculture, pasture, and environmental preservation. Pasture and savannah land occupy the largest areas in all biomes, with the main human activity based on livestock. Most settlements in the Midwest lead to small-scale activities such as dairy farming and polyculture, practices that differ from large-scale farming based on monoculture, and are more favorable to environmental protection.
Abstract: Characterized by fluvio-alluvial sedimentation processes, the heterogeneity in the Pantanal Basin allows its division in several sub-regions, which present natural characteristics of their own. It is possible to find in the literature different proposals to subdivide the Pantanal plain, which vary in total area and number of sub-regions. Each author uses specific criteria – mainly vegetation, soil and humidity – in his delimitation, but does not consider the tectonic aspects of the basin. In this sense, we intend to analyze three Pantanal delimitations from the literature and to relate them to the neotectonic context of the Pantanal plain by comparing the boundaries proposed in the delimitations to structural lineaments present in the basin. As a result, we observe that the comparison of the Pantanal boundaries with the lineaments shows a high compatibility between them, suggesting the influence of these structures in the development of the sub-regions.
ABSTRACT Pantanal da Nhecolândia is one of the most well-preserved areas in the State of Mato Grosso do Sul. Located in the southern part of the Taquari River megafan, it is in tectonic contact with the fault escarpments of the Maracaju-Campo Grande plateaus to the east and with the fault escarpments of the Bodoquena plateau to the west, which continue to north. To the south and to the north, the limits are marked respectively by the lineaments of the Negro and Taquari Rivers. Nhecolândia is characterized by the existence of at least 17,631 lagoons, 17,050 (96.70 %) of which are of fresh water (baías) and 577 (3.3 %) of salty water (salinas). Studies based on (Landsat) satellite images and use of free software (QGIS, version 2.8.3) and GIS (Geographic Information Systems) revealed that the major axes of the lagoons are aligned along two directions, NE (62.49 %) and NW (37.51 %), with modes concentrated between N30-40E and N30-40W, suggesting in both cases the role played by tectonic control (neotectonics) in their formation. Evidences of fluvial origin are presented for these groups of lagoons, as well as for their tectonic alignment.
ABSTRACT The present study aimed to perform an epidemiological survey on the prevalence rate of oral lesions diagnosed in a referral center in Brazil and to establish association between the lesions and the age and gender of the affected patients. This analytical observational study analyzed 3521 medical records of anatomopathological exams of the Pathological Anatomy and Cytopathology Laboratory of the Cancer Hospital of the state of Mato Grosso (Brazil), from December 2011 to September 2015. A total of 1550 relevant medical records was detected. Patients aging between 41 and 60 consisted of 42.84% of the sample. Males were more affected than females (60.13%). Inflammatory processess consisted of the most prevalent diagnosis (43.29%), followed by squamous cell carcinoma (6.06%), and periapical granuloma (5.23%). Oral health public policies must give major attention to Brazilian males aged between the fourth and sixth decades of life in order to improve their quality of life.
ABSTRACT The main goal of this paper is to characterize the Coxim earthquake occurred in June 15th, 2009 in the Pantanal Basin and to discuss the relationship between its faulting mechanism with the Transbrasiliano Lineament. The earthquake had maximum intensity MM V causing damage in farm houses and was felt in several cities located around, including Campo Grande and Goiânia. The event had an mb 4.8 magnitude and depth was 6 km, i.e., it occurred in the upper crust, within the basement and 5 km below the Cenozoic sedimentary cover. The mechanism, a thrust fault mechanism with lateral motion, was obtained by P-wave first-motion polarities and confirmed by regional waveform modelling. The two nodal planes have orientations (strike/dip) of 300°/55° and 180°/55° and the orientation of the P-axis is approximately NE-SW. The results are similar to the Pantanal earthquake of 1964 with mb 5.4 and NE-SW compressional axis. Both events show that Pantanal Basin is a seismically active area, under compressional stress. The focal mechanism of the 1964 and 2009 events have no nodal plane that could be directly associated with the main SW-NE trending Transbrasiliano system indicating that a direct link of the Transbrasiliano with the seismicity in the Pantanal Basin is improbable.
Este trabalho apresenta um estudo dos lineamentos estruturais extraídos manualmente a partir de imagens de satélite (CBERS-2B, sensor WFI, uma imagem gratuita disponível na internet) da região do Pantanal e faz uma comparação com os lineamentos estruturais de rochas Pré-Cambrianas e Paleozóicas que circundam a bacia Cenozóica do Pantanal. Usando software livre para análise de imagens de satélite, a fotointerpretação mostrou que as direções NS, NE e NW observadas no Pantanal são as mesmas registradas nas rochas mais antigas que circundam a bacia, sugerindo reativação destas mesmas direções estruturais durante o Quaternário. Logo, a Bacia do Pantanal possui uma tectônica ativa e sua evolução parece estar ligada às mudanças relacionadas com a subducção Andina.
This paper presents a study of the structural lineaments of the Pantanal extracted visually from satellite images (CBERS-2B satellite, Wide Field Imager sensor, a free image available in INTERNET) and a comparison with the structural lineaments of Precambrian and Paleozoic rocks surrounding the Cenozoic Pantanal Basin. Using a free software for satellite image analysis, the photointerpretation showed that the NS, NE and NW directions observed on the Pantanal satellite images are the same recorded in the older rocks surrounding the basin, suggesting reactivation of these basement structural directions during the Quaternary. So the Pantanal Basin has an active tectonics and its evolution seems to be linked to changes that occurred during the Andean subduction.
O Pantanal da Nhecolândia é o maior e mais diversificado campo de lagos da região tropical do planeta, com cerca de 10.000 lagos de variadas salinidade, pH, alcalinidade, cor, fisiografia e atividade biológica dispostos em uma área de 24.000 km². Os lagos hipossalinos têm pH variável, baixa alcalinidade, macrófitas e baixa densidade de fitoplâncton. Os lagos salinos tem pH acima de 9 ou 10, elevada alcalinidade, alta densidade de fitoplâncton e praias de areia. A causa da diversidade desses lagos é uma questão ainda em aberto que é abordada nesta pesquisa. Propõe-se como principal causa um processo híbrido, geoquímico e biológico, baseado em (1) clima com um déficit hídrico importante e pobreza em Ca2+na água superficial e do freático e (2) na elevação do pH durante florações de cianobactérias. Estes dois aspectos desestabilizam a tendência geral de pH neutro para as águas superficiais da Terra. Este desequilíbrio resulta em aumento do pH e dissolução da areia quartzosa do fundo dos lagos salino-alcalinos. Durante secas extremas há precipitação de sílica amorfa nos espaços inter-granulares dos sedimentos de fundo destes lagos, aumentando seu isolamento do freático. O artigo discute este processo biogeoquímico, à luz de dados físico-químicos, químicos, fitoplânctonicos e de altimetria de precisão.
The Pantanal of Nhecolândia, the world's largest and most diversified field of tropical lakes, comprises approximately 10,000 lakes, which cover an area of 24,000 km² and vary greatly in salinity, pH, alkalinity, colour, physiography and biological activity. The hyposaline lakes have variable pHs, low alkalinity, macrophytes and low phytoplankton densities. The saline lakes have pHs above 9 or 10, high alkalinity, a high density of phytoplankton and sand beaches. The cause of the diversity of these lakes has been an open question, which we have addressed in our research. Here we propose a hybrid process, both geochemical and biological, as the main cause, including (1) a climate with an important water deficit and poverty in Ca2+ in both superficial and phreatic waters; and (2) an elevation of pH during cyanobacteria blooms. These two aspects destabilise the general tendency of Earth's surface waters towards a neutral pH. This imbalance results in an increase in the pH and dissolution of previously precipitated amorphous silica and quartzose sand. During extreme droughts, amorphous silica precipitates in the inter-granular spaces of the lake bottom sediment, increasing the isolation of the lake from the phreatic level. This paper discusses this biogeochemical problem in the light of physicochemical, chemical, altimetric and phytoplankton data.
O ecocardiograma sob estresse com dobutamina é um método bem estabelecido para avaliar doença arterial coronária, cuja sensibilidade tem sido potencializada pela adição de atropina no final do protocolo. Indivíduos com glaucoma, doença com alta prevalência em pacientes cardiopatas com mais de 40 anos, não podem se beneficiar do uso de atropina por ser contra-indicada neste grupo. Além disso, estes indivíduos são tratados freqüentemente com betabloqueadores tópicos (colírios), que podem exercer efeitos sistêmicos diminuindo a freqüência cardíaca, pressão arterial e capacidade pulmonar. O objetivo do nosso trabalho foi verificar se a ocorrência de um possível efeito sistêmico causado por estes colírios, causando baixa resposta cronotrópica, poderia determinar resultados inconclusivos no ecocardiograma sob estresse pela dobutamina nestes pacientes com glaucoma.
Dobutamine stress echocardiography is a well-established method to assess coronary artery disease, of which sensitivity has been enhanced by adding atropine at the end of the protocol. Individuals with glaucoma, a disease with a high prevalence in patients with cardiac diseases older than 40 years, cannot benefit from the use of atropine as it is contraindicated for this group of patients. Additionally, these individuals are often treated with topical betablockers (eye drops), which can have systemic effects by decreasing cardiac frequency, blood pressure and pulmonary capacity. The aim of our study was to verify whether a possible systemic effect caused by the use of these eye drops, yielding a low chronotropic response, could result in inconclusive dobutamine stress echocardiography in patients with glaucoma.