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ABSTRACT Cardiovascular disease is the main cause of death in patients with chronic kidney disease (CKD). Several heart conditions have been associated with CKD, including myocardial and pericardial diseases. This paper describes a case of Dialysis-related constrictive pericarditis in a patient diagnosed with sudden hypotension during a hemodialysis session. A 65-year-old man diagnosed with hypertension, diabetes, obesity, and cirrhosis on hemodialysis for two years complained of symptoms during one of his sessions described as malaise, lipothymia, and confusion. The patient had a record of poor compliance with the prescribed diet and missed dialysis sessions. He was sluggish during the physical examination, and presented hypophonetic heart sounds, a blood pressure of 50/30mmHg, and a prolonged capillary refill time. The patient was referred to the intensive care unit and was started on antibiotics and vasoactive drugs. His workup did not show signs of infection, while electrocardiography showed low QRS-wave voltage. His echocardiogram showed signs consistent with a thickened pericardium without pericardial effusion. Cardiac catheterization showed equalization of diastolic pressures in all heart chambers indicative of constrictive pericarditis. The patient underwent a pericardiectomy. Examination of surgical specimens indicated he had marked fibrosis and areas of dystrophic calcification without evidence of infection, consistent with Dialysis-related constrictive pericarditis. Hypotension for unknown causes must be considered in the differential diagnosis of dialysis patients.

RESUMO A doença cardiovascular é a principal causa de morte em pacientes com doença renal crônica (DRC). Várias formas de acometimento cardíaco têm sido associadas. à DRC, incluindo doenças miocárdicas e pericárdicas. Este artigo descreve um caso de pericardite constritiva relacionada a em um paciente diagnosticado com hipotensão súbita durante uma sessão de hemodiálise. Um homem de 65 anos com diagnósticos prévios de hipertensão, diabetes, obesidade e cirrose em hemodiálise por dois anos queixou-se de sintomas durante uma de suas sessões, descritos como mal-estar, lipotímia e confusão mental. Apresentava histórico de baixa adesão à dieta prescrita e faltas frequentes às sessões de diálise. Ele estava fraco durante o exame físico e apresentava bulhas cardíacas hipofonéticas, pressão arterial de 50/30mmHg e tempo de enchimento capilar prolongado. O paciente foi encaminhado para a unidade de terapia intensiva e iniciou o tratamento com antibióticos e drogas vasoativas. Investigação laboratorial não mostrou sinais de infecção, enquanto o eletrocardiograma mostrou baixa voltagem de complexo QRS. Seu ecocardiograma evidenciou sinais consistentes com um pericárdio espessado, sem derrame pericárdico. O cateterismo cardíaco mostrou equalização das pressões diastólicas em todas as câmaras cardíacas, indicativo de pericardite constritiva. O paciente foi submetido a uma pericardiectomia. O exame anatomopatológico mostrou sinais de acentuada fibrose acentuada fibrose e áreas de calcificação distrófica sem evidência de infecção, consistente com pericardite constritiva relacionada a por diálise. A hipotensão por causas desconhecidas deve ser considerada no diagnóstico diferencial de pacientes em diálise.

https://doi.org/10.1590/2175-8239-jbn-2020-0252

Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil
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Bensenor, Isabela M.

; Goulart, Alessandra C.

; Pereira, Alexandre C.

; Brunoni, André R.

; Alencar, Airlane

; Santos, Raul D.

; Bittencourt, Márcio S.

; Telles, Rosa W.

; Machado, Luciana Andrade Carneiro

; Barreto, Sandhi Maria

; de Almeida-Pititto, Bianca

; Janovsky, Carolina Porto Silva

; Sgarbi, José Augusto

; Tebar, William R.

; Meneghini, Vandrize

; Barbosa Junior, Fernando

; Ribeiro, Ana Cristina de Medeiros

; Pasoto, Sandra Gofinet

; Pereira, Rosa Maria R.

; Bonfá, Eloísa

; Sipahi, Aytan M.

; Santos, Itamar de S.

; Lotufo, Paulo A.

Clinics

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2022, Volume 77 elocation 100013

Abstract: En | Text: En | PDF: En

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

https://doi.org/10.1016/j.clinsp.2022.100013

Persistent SARS-CoV-2 antigen presence in multiple organs of a naturally infected cat from Brazil
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Jarrah, Samar Afif

; Kmetiuk, Louise Bach

; Carvalho, Otávio Valério de

; Sousa, Alessandra Tammy Hayakawa Ito de

; Souza, Valeria Regia Franco

; Nakazato, Luciano

; Colodel, Edson Moleta

; Santos, Andrea Pires dos

; Pettan-Brewer, Christina

; Hahn, Rosane Christine

; Slhessarenko, Renata Dezengrini

; Ubiali, Daniel Guimarães

; Pereira, Asheley Henrique Barbosa

; Morais, Helio Autran de

; Biondo, Alexander Welker

; Dutra, Valéria

Journal of Venomous Animals and Toxins including Tropical Diseases

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2022, Volume 28 elocation e20210074

Abstract: En | Text: En | PDF: En

Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of the disease coronavirus 2019 (COVID-19) in humans. SARS-CoV-2 has been identified in cats with or without clinical signs. Case presentation: We describe the pathological and molecular findings in a six-month-old asymptomatic cat with SARS-CoV-2 infection from Brazil, belonging to a human family with COVID-19 cases. The pool of nasopharynx and oropharynx swabs at day zero tested positive by RT-qPCR for SARS-CoV-2. No amplification resulted from molecular testing performed on days 7 and 14. The cat was hit by a car and died 43 days after the molecular diagnosis. Immunohistochemistry at post-mortem examination demonstrated nucleocapsid protein in samples from the lungs, kidneys, nasal conchae, trachea, intestine, brain and spleen. Conclusion: The present study has highlighted the possibility that viral antigens can be detected by immunohistochemistry in multiple organs six weeks after infection, although the same tissues tested negative by RT-PCR.

https://doi.org/10.1590/1678-9199-jvatitd-2021-0074

Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
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Becker, Jefferson

; Ferreira, Lis Campos

; Damasceno, Alfredo

; Bichuetti, Denis Bernardi

; Christo, Paulo Pereira

; Callegaro, Dagoberto

; Peixoto, Marco Aurélio Lana

; Sousa, Nise Alessandra De Carvalho

; Almeida, Sérgio Monteiro De

; Adoni, Tarso

; Santiago-Amaral, Juliana

; Junqueira, Thiago

; Pereira, Samira Luisa Apóstolos

; Gomes, Ana Beatriz Ayroza Galvão Ribeiro

; Pitombeira, Milena

; Paolilo, Renata Barbosa

; Grzesiuk, Anderson Kuntz

; Piccolo, Ana Claudia

; D´Almeida, José Arthur Costa

; Gomes Neto, Antonio Pereira

; Oliveira, Augusto Cesar Penalva De

; Oliveira, Bianca Santos De

; Tauil, Carlos Bernardo

; Vasconcelos, Claudia Ferreira

; Kaimen-Maciel, Damacio

; Varela, Daniel

; Diniz, Denise Sisterolli

; Oliveira, Enedina Maria Lobato De

; Malfetano, Fabiola Rachid

; Borges, Fernando Elias

; Figueira, Fernando Faria Andrade

; Gondim, Francisco De Assis Aquino

; Passos, Giordani Rodrigues Dos

; Silva, Guilherme Diogo

; Olival, Guilherme Sciascia Do

; Santos, Gutemberg Augusto Cruz Dos

; Ruocco, Heloisa Helena

; Sato, Henry Koiti

; Soares Neto, Herval Ribeiro

; Cortoni Calia, Leandro

; Gonçalves, Marcus Vinícius Magno

; Vecino, Maria Cecilia Aragón De

; Pimentel, Maria Lucia Vellutini

; Ribeiro, Marlise De Castro

; Boaventura, Mateus

; Parolin, Mônica Koncke Fiuza

; Melo, Renata Brant De Souza

; Lázaro, Robson

; Thomaz, Rodrigo Barbosa

; Kleinpaul, Rodrigo

; Dias, Ronaldo Maciel

; Gomes, Sidney

; Lucatto, Simone Abrante

; Alves-Leon, Soniza Vieira

; Fukuda, Thiago

; Ribeiro, Taysa Alexandrino Gonsalves Jubé

; Winckler, Thereza Cristina D’ávila

; Fragoso, Yara Dadalti

; Nascimento, Osvaldo José Moreira Do

; Ferreira, Maria Lucia Brito

; Mendes, Maria Fernanda

; Brum, Doralina Guimarães

; Glehn, Felipe Von

Arquivos de Neuro-Psiquiatria

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nov 2021, Volume 79 N. 11 Pages 1049 - 1061

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

RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.

ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

https://doi.org/10.1590/0004-282x-anp-2021-0162 1 downloads

Performance of cover crops under two irrigation regimes in the Coastal Tablelands region of Brazil
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Nicole, Lucas Rodrigues

; Cardoso, Dione Pereira

; Pires, Fábio Ribeiro

; Bonomo, Robson

; Netto, Benedicto Barbosa

; Belo, Alessandra Ferreira

Revista Ceres

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aug 2021, Volume 68 N. 4 Pages 301 - 309

Abstract: En | Text: En | PDF: En

ABSTRACT There is currently a lack of information regarding the performance of cover crops grown in the Coastal Tablelands region in the North of the Brazilian state of Espírito Santo, where zero tillage is increasingly being adopted. The objective of this study was to evaluate the agronomic performance of six cover crops (ruzi grass, jack bean, and the millets ADR 300, ADR 500, ADRf 6010, and BRS 1501) under two irrigation regimes. A field experiment setup was based on randomized blocks with split plots and four repetitions. Shoot dry matter content, plant height, leaf area, chlorophyll fluorescence, and root growth of the cover crops were evaluated. The irrigation regime influences the agronomic performance of most of the cover crops, with the exception of jack bean and ADRf 6010 millet, which were tolerant to water deficiency, based on our evaluations of the variables shoot dry matter, plant height, and leaf area. In terms of biomass production, ADRf 6010 millet is the most suitable crop for use in conservation systems under conditions of water stress in this region.

https://doi.org/10.1590/0034-737x202168040007 20 downloads

Covid-19 and Metabolic Syndrome
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Chocair, Pedro Renato

; Neves, Precil Diego Miranda de Menezes

; Pereira, Leonardo Victor Barbosa

; Mohrbacher, Sara

; Oliveira, Erico Souza

; Nardotto, Luciana Loureiro

; Bales, Alessandra Martins

; Sato, Victor Augusto Hamamoto

; Ferreira, Bernadete Maria Coelho

; Cuvello Neto, Américo Lourenço

Revista da Associação Médica Brasileira

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jul 2020, Volume 66 N. 7 Pages 871 - 875

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.66.7.871 1504 downloads

Tradução para a língua portuguesa e análise das propriedades psicométricas do instrumento Patient Generated Index (PGI) para pacientes com doença pulmonar obstrutiva crônica: avaliação individualizada de qualidade de vida
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Cardoso, Renato Fleury

; Ruta, Danny

; Oliveira, Thessália Miranda de

; Costa, Maria Carolina Barbosa

; Fonseca, Alenice Aliane

; Figueiredo, Pedro Henrique Scheidt

; Bastone, Alessandra de Carvalho

; Alcântara, Marcus Alessandro de

; Lacerda, Ana Cristina Rodrigues

; Lima, Vanessa Pereira

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 6 elocation e20190272

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

RESUMO Objetivo Traduzir, adaptar e validar o Patient Generated Index (PGI) para brasileiros com doença pulmonar obstrutiva crônica (DPOC). Métodos 50 voluntários com DPOC, em sua maioria homens (74%), com 73,1 ± 8,9 anos de idade, VEF1 de 52,3 ± 14,5% do previsto e VEF1/CVF de 56,2 ± 8,6% do previsto, responderam ao PGI e ao Saint George Respiratory Questionnaire (SGRQ) e realizaram teste Glittre Activities of Daily Living (Glittre ADL). Após o período de 7-14 dias, o PGI foi novamente aplicado para análise da confiabilidade relativa e absoluta. Resultados A tradução ocorreu sem alterações no questionário. A pontuação obtida no PGI apontou fraca correlação com a pontuação total do SGRQ (r = −0,44; p < 0,001) e com o domínio impacto (r = −0,40; p < 0,05), moderada correlação com o domínio sintomas do SGRQ (r = −0,55; p < 0,001) e fraca correlação com o domínio atividades (r = −0,31; p < 0,05). Foram observadas fraca correlação entre o PGI e o Glittre ADL (r = −0,30; p < 0,05) e alta confiabilidade entre as medidas do PGI (CCIr = 0,94). Conclusão Este estudo mostra que a versão brasileira do PGI é um instrumento confiável e válido para medir a qualidade de vida relacionada à saúde em pacientes com DPOC. Trata-se de uma nova forma individualizada de avaliação de qualidade de vida centrada no paciente com DPOC.

ABSTRACT Objective To translate, adapt and validate the Patient Generated Index (PGI) for Brazilians with chronic obstructive pulmonary disease (COPD). Methods 50 volunteers with COPD, mostly men (74%), with 73.1 ± 8.9 years of age, FEV1 of 52.3 ± 14.5% of predicted and FEV1 / FVC of 56.2 ± 8.6% of predicted responded to PGI, to the Saint George Respiratory Questionnaire (SGRQ) and to perform Glittre Activities of Daily Living test (Glittre ADL). After 1-2 weeks, PGI was again applied for the analysis of relative and absolute reliability. Results The translation occurred without changes in the questionnaire. The score obtained in PGI had weak correlation with the SGRQ total score (r = -0.44, p <0.001) and with the impact domain (r = -0.40, p <0.05), presented a moderate correlation with the symptoms domain of the SGRQ (r = -0.55, p <0.001) and weak correlation with the activity domain (r = -0.31, p <0.05). A weak correlation was observed between PGI and Glittre ADL (r = -0.30; p <0.05). It was observed high reliability among the measures of PGI (ICCr = 0.94). Conclusion This study shows that the Brazilian version of PGI is a reliable and valid instrument to measure health-related quality of life (HRQL) in patients with COPD. It is a new and individualized form of evaluation of COPD patient-centered quality of life.

https://doi.org/10.36416/1806-3756/e20190272 851 downloads

Transference of multiple resistance to peanut through the development of cross-compatible complex hybrids of wild Arachis
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Fávero, Alessandra Pereira

; Custodio, Adriana Regina

; Dinato, Naiana Barbosa

; Godoy, Ignácio José de

; Seijo, José Guillermo

; Michelotto, Marcos Doniseti

Genetics and Molecular Biology

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2020, Volume 43 N. 2 elocation e20190099

Abstract: En | Text: En | PDF: En

Abstract Peanut (Arachis hypogaea L.) is a tetraploid species with an A and B genome, while the majority of wild Arachis species are diploid with distinct genomes. In pre-breeding programs, one way to introgress interesting wild genes into peanut is by producing amphidiploids. This study aimed at the hybridization between distinct amphidiploids and their characterization, to combine high crossability with peanut, observed in some amphidiploids, with high pest and disease resistances observed in others. These new hybrids were called complex hybrids. Four amphidiploids previously obtained were crossed at four different combinations, and the derived complex hybrids were crossed with four peanut cultivars. Morphological, reproductive, chromosome complement, molecular markers for hybrid identification, phytopatological, and entomological characterizations were performed on the complex hybrids. All cross combinations resulted in complex hybrids. One complete complement of each diploid progenitor was confirmed in each hybrid. Plants of six distinct hybrid combinations were obtained between the complex hybrids and peanut. Based on morphological characterization, differences among progenies from distinct cross combinations were observed. Complex hybrids were considered more resistant to all diseases and pests than peanut cultivars. The simultaneous introgression of genes from four wild Arachis species into peanut was possible through the development of complex hybrids.

https://doi.org/10.1590/1678-4685-gmb-2019-0099 775 downloads

Characterization of diploid Arachis interspecific hybrids for pest resistance
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Paula, Ailton Ferreira de

; Dinato, Naiana Barbosa

; Vigna, Bianca Baccili Zanotto

; Fávero, Alessandra Pereira

Bragantia

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mar 2019, Volume 78 N. 1 Pages 96 - 108

Abstract: En | Text: En | PDF: En

ABSTRACT In Brazil, the thrips (Enneothrips flavens Moulton) and rednecked peanutworm (Stegasta bosquella Chambers) are considered key pests for the peanut crop. Wild species show resistance to both of these pests, and can be used in breeding programs. The production of the sterile interspecific hybrids is necessary, which could be colchicine treated to get a synthetic amphidiploid with the same or similar genomic configuration of cultivated peanut. In this context, this study proposed the hybridization of wild pest-resistant species in 18 distinct combinations, obtaining the interspecific hybrids of Arachis and completing their characterization by (i) the reproductive characterization through pollen stainability with 2% acetocarmine (AC) solution with glycerin and 0.25% tetrazolium solution (TZ), (ii) the molecular certification of hybridization using microsatellite markers, and (iii) the morphological characterization using 61 morphological traits with Principal Component Analysis. Using reproductive, morphological and molecular characterizations, we identified six hybrid plants of the following crosses: three fromA. magna V 13751 × A. kuhlmannii V 9243, two from A. magna V 13751 × A. kempff-mercadoi V 13250, and one from A. magna K 30097 ×A. kuhlmannii V 7639. Amphidiploids can be reached based on these diploid plants and they can be used in breeding programs aiming pest resistance introgression.

https://doi.org/10.1590/1678-4499.2018130 763 downloads

10.

Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis
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Marques, Vanessa Daccach

; Passos, Giordani Rodrigues dos

; Mendes, Maria Fernanda

; Callegaro, Dagoberto

; Lana-Peixoto, Marco Aurélio

; Comini-Frota, Elizabeth Regina

; Vasconcelos, Cláudia Cristina Ferreira

; Sato, Douglas Kazutoshi

; Ferreira, Maria Lúcia Brito

; Parolin, Mônica Koncke Fiuza

; Damasceno, Alfredo

; Grzesiuk, Anderson Kuntz

; Muniz, André

; Matta, André Palma da Cunha

; Oliveira, Bianca Etelvina Santos de

; Tauil, Carlos Bernardo

; Maciel, Damacio Ramón Kaimen

; Diniz, Denise Sisteroli

; Corrêa, Eber Castro

; Coronetti, Fernando

; Jorge, Frederico M. H.

; Sato, Henry Koiti

; Gonçalves, Marcus Vinícius Magno

; Sousa, Nise Alessandra de C.

; Nascimento, Osvaldo J. M.

; Gama, Paulo Diniz da

; Domingues, Renan

; Simm, Renata Faria

; Thomaz, Rodrigo Barbosa

; Morales, Rogério de Rizo

; Dias, Ronaldo Maciel

; Apóstolos-Pereira, Samira dos

; Machado, Suzana Costa Nunes

; Junqueira, Thiago de Faria

; Becker, Jefferson

Arquivos de Neuro-Psiquiatria

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aug 2018, Volume 76 N. 8 Pages 539 - 554

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

RESUMO O crescent arsenal terapêutico na esclerose múltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que é melhor para cada paciente, com base em evidências e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratégias de tratamento na EM.

ABSTRACT The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS.

https://doi.org/10.1590/0004-282x20180078 8891 downloads

11.

Programas de Controle de Infecção Hospitalar: avaliação de indicadores de estrutura e processo
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Giroti, Alessandra Lyrio Barbosa

; Ferreira, Adriano Menis

; Rigotti, Marcelo Alessandro

; Sousa, Álvaro Francisco Lopes de

; Frota, Oleci Pereira

; Andrade, Denise de

Revista da Escola de Enfermagem da USP

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2018, Volume 52 elocation e03364

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

RESUMO Objetivo Avaliar Comissões de Controle de Infecção Hospitalar quanto aos indicadores de estrutura e processo dos Programas de Controle de Infecção Hospitalar. Método Estudo transversal e descritivo, realizado com Comissões de hospitais registrados no Cadastro Nacional de Estabelecimentos de Saúde. A coleta de dados primários e secundários foi realizada por meio de entrevista estruturada, utilizando-se de instrumentos validados e verificação de documentos, respectivamente. Resultados Participaram da pesquisa 14 Comissões. Evidenciaram-se médias de conformidade de 80,58% para o indicador de avaliação da estrutura técnico-operacional, 60,77% para o indicador das diretrizes operacionais de prevenção e controle de infecção, 81,59% para o indicador de avaliação do sistema de vigilância epidemiológica e 63,44% para o indicador de avaliação das atividades de controle e prevenção de infecção hospitalar. Conclusão Entre os quatro instrumentos aplicados para a avaliação dos Programas de Controle de Infecção Hospitalar, apenas dois deles apresentaram resultado superior a 80,0% de conformidade, os relativos às avaliações da estrutura técnico-operacional e à vigilância epidemiológica.

ABSTRACT Objective To assess hospital infection control committees in relation to structure and process indicators of hospital infection control programs. Method Descriptive, cross-sectional study conducted with hospital committees registered in the National Registry of Healthcare Facilities. Primary and secondary data collection was conducted through structured interview using validated instruments and verification of documents, respectively. Results Fourteen committees participated in the research. Mean values of conformity of 80.58% were evidenced for the technical-operational structure assessment indicator, 60.77% for the infection control and prevention operational guidelines indicator, 81.59% for the epidemiological surveillance system assessment indicator, and 63.44% for hospital infection control and prevention activities assessment indicator. Conclusion Among the four instruments applied to assess hospital infection control programs, only two presented results with more than 80.0% of conformity: those related to the epidemiological surveillance and technical-operational structure assessments.

RESUMEN Objetivo Evaluar comisiones de Control de Infección Hospitalaria en cuanto a los indicadores de estructura y proceso de los Programas de Control de Infección Hospitalaria. Método Estudio transversal y descriptivo, realizado con Comisiones de hospitales inscritos en el Registro Nacional de Establecimientos Sanitarios. La recolección de datos primarios y secundarios se llevó a cabo mediante entrevista estructura utilizándose instrumentos validados y verificación de documentos, respectivamente. Resultados Participaron en la investigación 14 Comisiones. Se evidenciaron promedios de conformidad del 80,58% para el indicador de evaluación de la estructura técnica y operativa, el 60,77% para el indicador de las directrices operativas de prevención y control de infección, el 81,59% para el indicador de evaluación del sistema de vigilancia epidemiológica y el 63,44% para el indicador de evaluación de las actividades de control y prevención de infección hospitalaria. Conclusión Entre los cuatro instrumentos aplicados para la evaluación de los Programas de Control de Infección Hospitalaria, solo dos de ellos presentaron resultado superior al 80,0% de conformidad, los relativos a las evaluaciones de la estructura técnica y operativa y a la vigilancia epidemiológica.

https://doi.org/10.1590/s1980-220x2017039903364 14317 downloads

12.

Programas de Controle de Infecção Hospitalar: avaliação de indicadores de estrutura e processo
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Giroti, Alessandra Lyrio Barbosa

; Ferreira, Adriano Menis

; Rigotti, Marcelo Alessandro

; Sousa, Álvaro Francisco Lopes de

; Frota, Oleci Pereira

; Andrade, Denise de

Revista da Escola de Enfermagem da USP

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2018, Volume 52 elocation e03364

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

https://doi.org/10.1590/s1980-220x2017039903364 171 downloads

13.

Dose vocal em professores: correlação com a presença de disfonia
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Gama, Ana Cristina Côrtes

; Santos, Juliana Nunes

; Pedra, Elisângela de Fátima Pereira

; Rabelo, Alessandra Terra Vasconcelos

; Magalhães, Max de Castro

; Casas, Estevam Barbosa de Las

CoDAS

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apr 2016, Volume 28 N. 2 Pages 190 - 192

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

RESUMO Professores são profissionais com alta prevalência de disfonia, para a qual os principais fatores de risco são as longas jornadas de trabalho em salas de aula com presença de ruído ambiental. O objetivo da pesquisa foi calcular o tempo de fonação e a dose cíclica de professoras com disfonia e de professoras sem alteração de voz durante a atividade letiva. Para o estudo, dois grupos foram analisados: cinco professoras com disfonia funcional constituíram o grupo de professores disfônicos, e cinco professoras sem alteração de voz constituíram o segundo grupo. Para a coleta dos dados foi utilizado o dosímetro marca VoxLog® e os parâmetros analisados foram: intensidade; frequência fundamental; tempo de fonação e dose cíclica. Na análise estatística foram utilizados os testes Anova, T de Student e Kruskal-Wallis. Observou-se que professores disfônicos apresentaram um maior tempo de fonação e de dose cíclica quando comparados com professores sem alteração vocal. A disfonia associa-se com um tempo maior de fonação e uma exposição maior do tecido da prega vocal a fonotraumas.

ABSTRACT Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal–Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma.

https://doi.org/10.1590/2317-1782/20162015156 3192 downloads

14.

Processo de implantação da política nacional de humanização em hospital público
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Pereira, Alessandra Barbosa

; Ferreira Neto, João Leite

Trabalho, Educação e Saúde

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apr 2015, Volume 13 N. 1 Pages 67 - 88

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

O artigo analisa a experiência de implantação da Política Nacional de Humanização em uma instituição hospitalar pública de Belo Horizonte, Minas Gerais. Focalizam-se os avanços e limites da gestão participativa proposta pela política de humanização no cenário hospitalar. Trata-se de uma abordagem qualitativa, por meio de um estudo de caso no qual se utilizam pesquisa documental, entrevistas e observação. Os dados foram tratados mediante a análise temática de conteúdo, construindo-se categorias temáticas numa perspectiva da história do processo de implantação da Política Nacional de Humanização. O esforço da fase de implantação e o apoio do Ministério da Saúde não se sustentaram a médio prazo no hospital. A Política Nacional de Humanização apresenta inovação em relação às práticas do setor privado, ao superar um modelo de humanização centrado na 'satisfação do cliente', associando as práticas de cuidado às de gestão. Contudo, o maior desafio é transpor essa lógica e instaurar uma nova forma de se relacionar e atuar na saúde. Para que isso ocorra, é necessário intervir sobre a totalidade da conjuntura institucional.

This article analyzes the experience of deploying the National Humanization Policy at a public hospital in Belo Horizonte, state of Minas Gerais, Brazil. The focus is on the progress made and on the limitations of the participatory management proposed by the humanization policy in the hospital setting. It is a qualitative approach based on a case study that uses documentary research, interviews, and observation. Data were treated by means of thematic content analyses, building theme categories from the perspective of the history of the process of deploying the National Humanization Policy. Neither the efforts made during the deployment phase or the support provided by the Ministry of Health were sustained over the medium term at the hospital. The National Humanization Policy represents an innovation in relation to private sector practices by overcoming a humaniza-tion model focused on 'customer satisfaction,' associating care and management practices. However, the biggest challenge is implementing this logic and introducing a new way to relate to and act on health. Action is needed on the institutional panorama as a whole in order for this to occur.

El artículo analiza la experiencia de implantación de la Política Nacional de Humanización en una institución hospitalaria pública de Belo Horizonte, Minas Gerais, Brasil. El estudio se concentra en los avances y límites de la gestión participativa propuesta por la política de humanización en el escenario hospitalario. Se trata de un enfoque cualitativo, por medio de un estudio de caso en el cual se utiliza investigación documental, entrevistas y observación. Los datos se trataron mediante análisis temático de contenido, construyendo categorías temáticas desde una perspectiva de la historia del proceso de implantación de la Política Nacional de Humanización. El esfuerzo de la fase de implantación y el apoyo del Ministerio de la Salud no se sustentaron a medio y largo plazo en el hospital. La Política Nacional de Humanización innova con relación a las prácticas del sector privado, al superar un modelo de humanización centrado en la 'satisfacción del cliente', asociando las prácticas de cuidado a las de gestión. No obstante, el mayor desafío es transponer esta lógica e instaurar una nueva forma de relacionarse y de actuar en la salud. Para que ello ocurra, hay que intervenir sobre la totalidad de la coyuntura institucional.

https://doi.org/10.1590/1981-7746-sip00024 8932 downloads

15.

Selectivity of Annona (Annonaceae) extract on egg parasitoid Trissolcus urichi (Hymenoptera: Platygastridae)
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Morais Turchen, Leonardo

; Golin, Vanessa

; Regina Butnariu, Alessandra

; Barbosa Pereira, Mônica Josene

Revista Colombiana de Entomología

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dec 2014, Volume 40 N. 2 Pages 176 - 180

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Se evaluó el efecto del extracto de Annona crassiflora sobre el parasitoide de huevos Trissolcus urichi, enemigo natural de Euschistus heros, principal plaga de la soya en Brasil. Para esto, se realizaron dos bioensayos utilizando concentraciones de 0,5%, 1,0%, 2,0% y 4,0% y como controles agua y dimetilsulfóxido (10%). En el primer bioensayo, huevos de E. heros no parasitados fueron sumergidos en el extracto de A. crassiflora y ofrecidos a las hembras de T. urichi. En el segundo bioensayo, huevos previamente parasitados fueron sometidos a tratamientos en tres diferentes edades de T. urichi (huevo, larva y pupa). Las variables evaluadas fueron el número de huevos parasitados y parasitoides emergidos. El porcentaje de reducción del parasitismo fue calculado y clasificado de acuerdo con la IOBC. El extracto de A. crassiflora aplicado antes de ser ofrecido a las hembras redujo el parasitismo en concentraciones superiores al 0,5%, y cuando aplicado después del parasitismo no interfirió en las etapas de desarrollo del parasitoide. Este resultado puede ser útil tanto para una prueba de campo como para la toma de decisiones sobre las fechas de aplicación y liberación de las avispas.

The effect of the Annona crassiflora (Annonaceae) extract was evaluated on the egg parasitoid Trissolcus urichi (Hymenoptera: Platygastridae), natural enemy of Euschistus heros (Heteroptera: Pentatomidae), major pest of soybean in Brazil. For this two bioassays were conducted with extract concentrations 0.5%, 1.0%, 2.0% and 4.0% and controls (distilled water and DMSO). In the first bioassay, unparasitized eggs of E. heros were treated with the extract of A. crassiflora and offered to T. urichi females. In second bioassay, parasitized eggs were treated in three stages in order to achieve different development stages of T. urichi (egg, larvae and pupae). The variables evaluated were the number of eggs parasitized and parasitoids emerged. The percentage of parasitism was calculated and classified according to IOBC. The extract of A. crassiflora reduced parasitism in concentrations higher than 0.5% when applied on unparasitized eggs and when applied on parasitized eggs, it did not affected the developmental stages of the parasitoid indicating the selectivity of the extract on the development of the parasitoid. This is an important result to be considered in a field test, useful as for decisions on the moment of application and the release of the wasps.

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