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au:Pereira, Alexandre Alves

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Consensus of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy (ABHH) and the Brazilian Ministry of Health - General management of blood and blood products on the tests necessary for the release of exceptional medicines for sickle cell disease
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Lobo, Clarisse

; Araújo, Aderson Antunes, Alexandre de Albuquerque Pinto, Ana Cristina Silva Godinho, Ariadne Carvalho Pires, Cassia Silvestre Mariano Matheus, Cinthia Cristina Albuquerque, Xerez de Neves, Daniele Campos Fontes Moreno, Fábio de Lima Baldanzi, Giorgio Siufi, Grazziella Curado Miranda, Heloisa Helena Pereira Hankins, Jane Aragão, Joice Braga, Josefina Aparecida Pellegrini Martins, Juliana Touguinha Neves Souza, Luciana Campos Costa Machado de Figueiredo, Maria Stella Oliveira, Mirella Rodrigues Cardoso, Patricia Santos Resende Pinto, Patricia Costa Alves Moura, Patricia Gomes Cançado, Rodolfo Delfini Araujo, Paulo Ivo Cortez de Saad, Sara Olalla Loggetto, Sandra Regina Fonseca, Teresa Cristina Cardoso

Hematology, Transfusion and Cell Therapy

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mar 2024, Volume 46 N. 1 Pages 67 - 71

Abstract: En | Text: En | PDF: En

Abstract To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety.

https://doi.org/10.1016/j.htct.2024.01.001

IgG4-related disease—rare but you should not forget it
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Pinheiro, Frederico Augusto Gurgel

; Pereira, Ivanio Alves de Souza, Alexandre Wagner Silva Giardini, Henrique Ayres Mayrink Cordeiro, Rafael Alves

Advances in Rheumatology

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2024, Volume 64 elocation 35

Abstract: En | Text: En | PDF: En

Abstract Immunoglobulin G4-related disease is a systemic immune-mediated disease with insidious evolution characterized by fibroinflammatory lesions over virtually any organ system. Despite the remarkable progression of knowledge, its etiology remains undefined. Due to its relapse-remitting pattern, it could accumulate irreversible damage, increasing comorbidities and mortality. This paper emphasizes key concepts for diagnosing and treating patients with this condition.

https://doi.org/10.1186/s42358-024-00374-y

Position statement of the Brazilian society of Rheumatology on mesna use as a preventive therapy for bladder disease in patients with systemic autoimmune diseases and systemic vasculitis under cyclophosphamide treatment
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de Souza, Alexandre Wagner S.

; Dantas, João Gabriel Montandon, Ana Carolina de Oliveira e Silva Calich, Ana Luísa Alverne, Andrea Rocha de Saboia Mont' Gasparin, Andrese Aline Bianchi, Dante Yuki, Emily Figueiredo Neves Sacilotto, Nathalia Reis Neto, Edgard Torres dos Monticielo, Odirlei André Pereira, Ivanio Alves

Advances in Rheumatology

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2024, Volume 64 elocation 41

Abstract: En | Text: En | PDF: En

Abstract Objective To review current literature to support the use of mesna as a preventive therapy for hemorrhagic cystitis and bladder cancer in patients with systemic autoimmune diseases and systemic vasculitis treated with cyclophosphamide. Materials and methods The search for articles was conducted systematically through MEDLINE, LILACS, Cochrane Library, and Embase databases. Only articles in English were selected. For available records, titles and abstracts were selected independently by two investigators. Results Eighteen studies were selected for analysis. The known adverse effects of cyclophosphamide were hematological toxicity, infections, gonadal toxicity, teratogenicity, increased risk for malignancy and hemorrhagic cystitis. Long-term toxicity was highly dependent on cyclophosphamide cumulative dose. The risk of bladder cancer is especially higher in long-term exposure and with cumulative doses above 36 g. The risk remains high for years after drug discontinuation. Hemorrhagic cystitis is highly correlated with cumulative dose and its incidence ranges between 12 and 41%, but it seems to be lower with new regimens with reduced cyclophosphamide dose. No randomized controlled trials were found to analyze the use of mesna in systemic autoimmune rheumatic diseases and systemic vasculitis. Retrospective studies yielded conflicting results. Uncontrolled prospective studies with positive results were considered at high risk of bias. No evidence was found to support the use of mesna during the treatment with cyclophosphamide for autoimmune diseases or systemic vasculitis to prevent hemorrhagic cystitis and bladder cancer. In the scenarios of high cumulative cyclophosphamide dose (i.e., > 30 g), patients with restricted fluid intake, neurogenic bladder, therapy with oral anticoagulants, and chronic kidney disease, mesna could be considered. Conclusion The current evidence was found to be insufficient to support the routine use of mesna for the prophylaxis of hemorrhagic cystitis and bladder cancer in patients being treated for systemic autoimmune diseases and systemic vasculitis with cyclophosphamide. The use may be considered for selected cases.

https://doi.org/10.1186/s42358-024-00380-0

Unveiling the clinical spectrum of relapsing polychondritis: insights into its pathogenesis, novel monogenic causes, and therapeutic strategies
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R G Bica, Blanca E

; de Souza, Alexandre Wagner S Pereira, Ivânio Alves

Advances in Rheumatology

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2024, Volume 64 elocation 29

Abstract: En | Text: En | PDF: En

Abstract Relapsing polychondritis is a rare multisystem disease involving cartilaginous and proteoglycan-rich structures. The diagnosis of this disease is mainly suggested by the presence of flares of inflammation of the cartilage, particularly in the ears, nose or respiratory tract, and more rarely, in the presence of other manifestations. The spectrum of clinical presentations may vary from intermittent episodes of painful and often disfiguring auricular and nasal chondritis to an occasional organ or even life-threatening manifestations such as lower airway collapse. There is a lack of awareness about this disease is mainly due to its rarity. In 2020, VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, a novel autoinflammatory syndrome, was described. VEXAS syndrome is attributed to somatic mutations in methionine-41 of UBA1, the major E1 enzyme that initiates ubiquitylation. This new disease entity connects seemingly unrelated conditions: systemic inflammatory syndromes (relapsing chondritis, Sweet's syndrome, and neutrophilic dermatosis) and hematologic disorders (myelodysplastic syndrome or multiple myeloma). Therefore, this article reviews the current literature on both disease entities.

https://doi.org/10.1186/s42358-024-00365-z

Construction and validation of a scenario for sedation training in the emergency room for pediatric surgical procedures by in-situ simulation
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SANTOS, MARCOS MACIEL CANDIDO JUSTINO DOS

; LIMA, SARA FITERMAN

; SLULLITEL, ALEXANDRE

; GIOVANAZZI, ROSEMEIRE SIMONE DELLACRODE

; LOPES NETO, FRANCISCO DIEGO NEGRÃO

; LIMA, MARJORIE DE ARAÚJO VIAN PINHEIRO

; SANTOS NETO, RENÉ SCALET DOS

; PEREIRA JÚNIOR, GERSON ALVES

Revista do Colégio Brasileiro de Cirurgiões

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2024, Volume 51 elocation e20243709

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

ABSTRACT Introduction: sedation and analgesia are fundamental procedures for children undergoing invasive interventions, and complications must be avoided during their implementation. In situ simulation allows, in turn, training in real practice environments to improve the technical and non-technical skills of professionals for such procedures. Although it is a very useful tool, it is often not used due to lack of preparation for its planning and application. Objective: develop and validate an in situ simulation scenario in pediatric emergency care using sedation to perform an invasive procedure. Method: descriptive study of construction and content validation of an in situ simulation scenario, using the Delphi method, following the following steps: 1) definition of the problem and selection of experts; 2) development of the initial document; 3) rounds for validation with analysis of responses and feedback (until consensus is reached by the Content Validation Index); 4) final report. Results: The experts indicated suggestions that were duly used and the scenario obtained, in all items, a CVI greater than 80.0%, demonstrating its high validity and reliability. By using experts to validate the scenario, their insights guarantee greater precision and reliability in scenario construction engineering. Conclusion: It is expected that this study will allow the replication of the scenario in different training contexts, facilitating and encouraging professional training based on a scenario model based on best evidence and practices.

RESUMO Introdução: a sedação e analgesia são procedimentos fundamentais para crianças submetidas a intervenções invasivas, devendo-se evitar complicações durante sua realização. A simulação in situ permite, por sua vez, capacitações nos ambientes reais de prática para aprimorar as competências técnicas e não técnicas dos profissionais para tais procedimentos. Embora seja uma ferramenta de grande utilidade, muitas vezes não é aproveitada pelo despreparo para seu planejamento e aplicação. Objetivo: elaborar e validar um cenário de simulação in situ no atendimento de urgências pediátricas com uso de sedação para realização de procedimento invasivo. Método: estudo descritivo de construção e validação de conteúdo de um cenário de simulação in situ, por meio do método Delphi, seguindo os seguintes passos: 1) definição do problema e seleção de especialistas; 2) desenvolvimento do documento inicial; 3) rodadas para validação com análise das respostas e feedback (até obtenção do consenso pelo Índice de Validação de Conteúdo); 4) relatório final. Resultados: Os especialistas indicaram sugestões devidamente aproveitadas e o cenário obteve, em todos os itens, um IVC maior que 80,0% demonstrando sua alta validade e confiabilidade. Ao usar especialistas para validar o cenário, seus insights garatem maior precisão e confiabilidade à engenharia de construção dos cenários. Conclusão: espera-se, que este estudo permita a replicação do cenário em diferentes contextos de formação facilitando e incentivando a capacitação profissional a partir de um modelo de cenário baseado em melhores evidências e práticas.

https://doi.org/10.1590/0100-6991e-20243709-en

Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024
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Fernandes, Fabio

; Simões, Marcus V.

; Correia, Edileide de Barros

; Marcondes-Braga, Fabiana Goulart

; Coelho-Filho, Otavio Rizzi

; Mesquita, Cláudio Tinoco

; Mathias Junior, Wilson

; Antunes, Murillo de Oliveira

; Arteaga-Fernández, Edmundo

; Rochitte, Carlos Eduardo

; Ramires, Felix José Alvarez

; Alves, Silvia Marinho Martins

; Montera, Marcelo Westerlund

; Lopes, Renato Delascio

; Oliveira Junior, Mucio Tavares de

; Scolari, Fernando Luis

; Avila, Walkiria Samuel

; Canesin, Manoel Fernandes

; Bocchi, Edimar Alcides

; Bacal, Fernando

; Moura, Lidia Zytynski

; Saad, Eduardo Benchimol

; Scanavacca, Mauricio Ibrahim

; Valdigem, Bruno Pereira

; Cano, Manuel Nicolas

; Abizaid, Alexandre Antonio Cunha

; Ribeiro, Henrique Barbosa

; Lemos Neto, Pedro Alves

; Ribeiro, Gustavo Calado de Aguiar

; Jatene, Fabio Biscegli

; Dias, Ricardo Ribeiro

; Beck-da-Silva, Luis

; Rohde, Luis Eduardo Paim

; Bittencourt, Marcelo Imbroinise

; Pereira, Alexandre da Costa

; Krieger, José Eduardo

; Villacorta Junior, Humberto

; Martins, Wolney de Andrade

; Figueiredo Neto, José Albuquerque de

; Cardoso, Juliano Novaes

; Pastore, Carlos Alberto

; Jatene, Ieda Biscegli

; Tanaka, Ana Cristina Sayuri

; Hotta, Viviane Tiemi

; Romano, Minna Moreira Dias

; Albuquerque, Denilson Campos de

; Mourilhe-Rocha, Ricardo

; Hajjar, Ludhmila Abrahão

; Brito Junior, Fabio Sandoli de

; Caramelli, Bruno

; Calderaro, Daniela

; Farsky, Pedro Silvio

; Colafranceschi, Alexandre Siciliano

; Pinto, Ibraim Masciarelli Francisco

; Vieira, Marcelo Luiz Campos

; Danzmann, Luiz Claudio

; Barberato, Silvio Henrique

; Mady, Charles

; Martinelli Filho, Martino

; Torbey, Ana Flavia Malheiros

; Schwartzmann, Pedro Vellosa

; Macedo, Ariane Vieira Scarlatelli

; Ferreira, Silvia Moreira Ayub

; Schmidt, Andre

; Melo, Marcelo Dantas Tavares de

; Lima Filho, Moysés Oliveira

; Sposito, Andrei C.

; Brito, Flávio de Souza

; Biolo, Andreia

; Madrini Junior, Vagner

; Rizk, Stephanie Itala

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e202400415

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

https://doi.org/10.36660/abc.20240415

Injectable supplementation of butaphosphan through differents pharmaceutical forms on postpartum metabolism and milk production in dairy cows
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Silva, Thais Casarin da

; Bilhalva, Alexandre Ferreira

; Bugoni, Milena

; Machado, Mauricio Cardozo

; Pereira, Rubens Alves

; Feijó, Josiane de Oliveira

; Corrêa, Marcio Nunes

; Rabassa, Viviane Rohrig

; Schmitt, Eduardo

; Pino, Francisco Augusto Burkert Del

Ciência Animal Brasileira

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2024, Volume 25 elocation 77593E

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

Abstract The aim of this study was to evaluate the effects of different pharmaceutical forms of Butaphosphan on milk production and the metabolism in dairy cows during the postpartum period. After in vitro and pharmacokinetic assays, thirty-six multiparous cows belonging to the Holstein breed, were randomly divided into three groups: Group BUT (n=12), that received an aqueous solution of Butaphosphan (150 mg/mL); Group BUTSR (n=12), that received a sustained-release formulation of Butaphosphan (150 mg/mL) and Group Control (CL ; n=12), that received saline solution (NaCl 0.9 %). All the groups received three subcutaneous doses of 30 mL in the neck region, on the day of parturition (day 0) and 3 and 7 days after parturition. Blood samples were collected on days 0, 3, 7 and 10, postpartum. Daily milk production was evaluated from day 11 to 60, postpartum. The animals of the BUTSR group presented greater (P=0.01) milk production than the other groups. It was observed that the BUTSR and BUT groups showed higher blood levels of calcium (P=0.01) than the animals in the CL group. The BUTSR group obtained higher milk production compared to other groups, demonstrating that this pharmaceutical form has great potential for a future product and could be an alternative for the market. More studies are needed to better understand the action of Butaphosphan on the metabolism of dairy cows in the recent postpartum period.

Resumo O objetivo deste estudo foi avaliar os efeitos das diferentes formas farmacêuticas contendo Butafosfan sob a produção de leite e o metabolismo de vacas leiteiras durante o pós-parto. A partir de ensaios in vitro e in vivo, duas formas farmacêuticas foram testadas em animais de produção. Trinta e seis vacas da raça Holandês, foram divididas aleatoriamente em três grupos: Grupo BUT (n=12), que recebeu solução aquosa de Butafosfan (150 mg mL-1); BUTSR (n=12), que recebeu uma formulação de liberação prolongada de Butafosfan (150 mg mL-1) e o Grupo CL (Controle; n=12), que recebeu solução fisiológica de cloreto de sódio. Todos os grupos, tiveram administração de três doses subcutâneas de 30 mL. A aplicação foi realizada no dia do parto (dia 0) e nos dias 3 e 7 após o parto. Amostras de sangue foram coletadas nos dias 0, 3, 7 e 10 para avaliação de parâmetros metabólitos e a produção de leite foi avaliada do dia 11 aos 60 dias pós-parto. O grupo BUTSR apresentou maior produção de leite (P=0.01), em comparação aos demais grupos. Observou-se que os grupos BUTSR e BUT apresentaram maiores níveis sanguíneos de cálcio (P=0.01) que os animais do grupo CL. O grupo BUTSR obteve maior produção de leite em comparação aos demais grupos, demonstrando que essa forma farmacêutica possui grande potencial, podendo ser uma alternativa para o mercado. Mais estudos são necessários para melhor compreender a ação do Butafosfan no metabolismo de vacas leiteiras no pós-parto recente.

https://doi.org/10.1590/1809-6891v25e-77593e

Feasibility of replacing the viral isolation technique in mice with RT-qPCR for the diagnosis of rabies
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Marinho, Karina Miranda

; Magalhães Júnior, Cássio Alexandre Costa

; Amorim Júnior, Lúcio André

; Vianna, Lucas Alves

; Tobias, Fernando Luiz

; Langoni, Hélio

; Braga, Fabio Ribeiro

; Rossi, Gabriel Augusto Marques

; Vieira, Luiz Fernando Pereira

Ciência Rural

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2024, Volume 54 N. 8 elocation e20230229

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

ABSTRACT: Rabies is a viral encephalitis that affects mammals, including humans. Rapid and effective laboratory diagnosis of the rabies virus is critical for public health. This study evaluated the operational, technical, and financial viability of the RT-qPCR in replacement of inoculation in mice for diagnosing rabies in the laboratory routine. A total of 316 samples of mammalian brains were analyzed, 121 positives and 195 negatives, previously diagnosed by direct immunofluorescence (DIF) and mouse inoculation test (MIT). The samples were submitted to the duplex TaqMan RT-qPCR technique. The accuracy, sensitivity, and specificity of RT-qPCR were analyzed. We analyzed the costs for performing the RT-qPCR technique and compared it with the cost of MIT. The results showed 99.37% accuracy, 99.17% sensitivity, and 99.49% specificity by RT-qPCR when related to DIF and MIT results, which proved to be a robust and repeatable technique. The minimum time for a positive diagnosis was reduced in RT-qPCR (1 day) if compared to MIT (9.64 days), with a 17.7% reduction in the cost of the molecular technique. The present study demonstrated that the molecular biology technique is an efficient tool to diagnose rabies in the laboratory routine, being able to replace MIT.

RESUMO: A raiva é uma encefalite viral que acomete os mamíferos, incluindo humanos. O diagnóstico laboratorial rápido e eficaz do vírus da raiva é importante para a saúde pública. Este estudo teve como objetivo avaliar a viabilidade operacional, técnica e financeira da RT-qPCR em substituição à inoculação em camundongos para o diagnóstico da raiva na rotina laboratorial. Foram analisadas 316 amostras de cérebros de mamíferos, 121 positivas e 195 negativas, previamente diagnosticadas por imunofluorescência direta (IFD) e isolamento viral em camundongos, por inoculação intracerebral em camundongos. As amostras foram submetidas à técnica duplex TaqMan RT-qPCR. A precisão, sensibilidade e especificidade da RT-qPCR foram analisadas. Os custos para realizar a técnica de RT-qPCR foram analisados e comparados com o custo do isolamento viral em camundongos. Os resultados demostraram 99,37% de acurácia, 99,17% de sensibilidade e 99,49% de especificidade pela RT-qPCR quando relacionada aos resultados de IFD e isolamento viral em camundongos, que se mostrou uma técnica robusta e com repetibilidade. O tempo mínimo para diagnóstico positivo foi reduzido na RT-qPCR (1 dia) quando comparado ao isolamento viral em camundongos (9,64 dias), e com redução de 17,7% no custo pela técnica molecular. O presente estudo demonstrou que a técnica de biologia molecular é uma ferramenta eficiente para o diagnóstico da raiva na rotina laboratorial, podendo substituir o isolamento viral em camundongos.

https://doi.org/10.1590/0103-8478cr20230229

Results of the Last 5 Years (2018-2022) of the Specialist Title Exam of The Brazilian College of Surgeons
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PEREIRA JÚNIOR, GERSON ALVES

; HAMAMOTO-FILHO, PEDRO TADAO

; RASSLAN, ROBERTO

; BENEVENUTO, DYEGO SÁ

; SILVA, EDUARDO NACUR

; OLIVEIRA, ALEXANDRE FERREIRA

; PORTARI FILHO, PEDRO EDER

Revista do Colégio Brasileiro de Cirurgiões

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2024, Volume 51 elocation e20243749

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

ABSTRACT The article discusses the evolution of the Brazilian College of Surgeons (CBC) specialist title exam, highlighting the importance of evaluating not only theoretical knowledge, but also the practical skills and ethical behavior of candidates. The test was instituted in 1971, initially with only the written phase, and later included the oral practical test, starting with the 13th edition in 1988. In 2022, the assessment process was improved by including the use of simulated stations in the practical test, with the aim of assessing practical and communication skills, as well as clinical reasoning, in order to guarantee excellence in the assessment of surgeons training. The aim of this study is to demonstrate the performance of candidates in the last five years of the Specialist Title Test and to compare the performance results between the different surgical training groups of the candidates. The results obtained by candidates from the various categories enrolled in the test in the 2018 to 2022 editions were analyzed. There was a clear and statistically significant difference between doctors who had completed three years of residency recognized by the Ministry of Education in relation to the other categories of candidates for the Specialist Title..

RESUMO O artigo aborda a evolução da prova de título de especialista do Colégio Brasileiro de Cirurgiões (CBC), destacando a importância de avaliar não apenas o conhecimento teórico, mas também as habilidades práticas e o comportamento ético dos candidatos. A prova foi instituída em 1971, inicialmente com apenas a fase escrita, e posteriormente foi incluída a prova prática oral, a partir da 13ª edição em 1988. Em 2022, foi aprimorado o processo de avaliação, incluindo na prova prática o uso de estações simuladas, visando avaliar habilidades práticas e de comunicação, além do raciocínio clínico, buscando garantir a excelência da avaliação da formação dos cirurgiões. O objetivo deste estudo é demonstrar o desempenho dos candidatos nos últimos cinco anos da Prova de Título de Especialista e comparar os resultados dos desempenhos entre os diferentes grupos de formação cirúrgica dos candidatos. Foram analisados os resultados obtidos pelos candidatos das diversas categorias inscritas na prova nas edições de 2018 a 2022. Ficou evidente e estatisticamente significativa a diferença entre os médicos que fizeram três anos de residência reconhecida pelo MEC em relação aos demais categorias de candidatos ao Título de Especialista.

https://doi.org/10.1590/0100-6991e-20243749-en

10.

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

11.

Manure application enhances the biomass production, phytochemical contents, antioxidant, and essential oil of Lippia dulcis
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Ribeiro, Fernanda Naiara Santos

; Rocha, Taina Teixeira

; Medeiros, Ana Paula Ribeiro

; Germano, Carolina Mesquita

; Assis, Rafael Marlon Alves de

; Carvalho, Alexandre Alves de

; Bertolucci, Suzan Kelly Vilela

; Pinto, José Eduardo Brasil Pereira

Revista Ciência Agronômica

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2024, Volume 55 elocation e20238873

Abstract: En | Text: En | PDF: En

ABSTRACT Lippia dulcis is a medicinal species used by communities in the Amazon region for the control of diabetes and as a tranquilizer. The objective of this study was to evaluate the plant biomass production, antioxidant defense, and chemical profiles of the phenolic compounds and essential oil of plants grown under different doses of cattle, quail, and chicken manure. Chicken and quail manure at a dose of 6 kg m-2 reached the highest values of dry weight and essential oil yield of the leaves and positively influenced bisabolol production. Cattle manure affected the content and yield of the essential oil of the inflorescences, the antioxidant defense performance, and the chemical composition of phenolic compounds and essential oil. Plants grown with cattle manure showed a linear increase in the amounts of these substances with increasing dose. Chicken and quail manure led to the highest values of these components at doses between 0 and 3 kg m-2. The evaluation of phenolic compounds and antioxidant defense showed the highest values at doses of 0, 1.5, and 3 kg m-2, regardless of the manure used. The essential oil concentration was higher in the inflorescences, and its total yield was higher in the leaves. The chemical composition varied between these vegetative organs.

https://doi.org/10.5935/1806-6690.20240026

12.

Physical and chemical attributes of beans damaged by the coffee berry borer at different levels of infestation
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Silva, Sabrina Alves

; Pereira, Rosemary Gualberto Fonseca Alvarenga

; Chalfoun, Sara Maria

; Teixeira, Alexandre Resende

Bragantia

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2024, Volume 83 elocation e20230251

Abstract: En | Text: En | PDF: En

ABSTRACT The physical and chemical attributes of coffee beans have a direct relation with the sensory quality of the beverage and the commodity’s market value. The coffee berry borer is a pest that causes a worldwide harm, and its infestation compromises bean health and composition. The objective of this study was to analyze the effect of infestation levels on beans physical and chemical parameters. Coffee samples were collected, and the damaged beans present in the samples were classified as to infestation level. The centesimal composition, color, quantification of bioactive compounds, and organic acids were evaluated. The L* and b* parameters of the CIELab color system were found to be significantly different between infestation levels. For chemical parameters, beans with major levels of infestation were found to differ from the others in the content of sugars, lipids, soluble solids, total titratable acidity, electrical conductivity, potassium leaching, succinic acid, and acetic acid. The presence of pests did not affect the bioactive compounds present in the coffee beans.

https://doi.org/10.1590/1678-4499.20230251

13.

Translation and cross-cultural adaptation of the Mayo High Performance Team Scale (MHPTS) into Brazilian Portuguese
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SANTOS, MARCOS MACIEL CANDIDO JUSTINO DOS

; LIMA, SARA FITERMAN

; SLULLITEL, ALEXANDRE

; OLIVEIRA, NELSON GONÇALVES DE

; SANTOS, ELAINE CRISTINA NEGRI

; ARAÚJO, EDUARDO CRUZ

; BRUGINSKI, DANIELLE

; PEREIRA JÚNIOR, GERSON ALVES

Revista do Colégio Brasileiro de Cirurgiões

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2024, Volume 51 elocation e20243740

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

ABSTRACT Objective: describe the process of translation and cross-cultural adaptation of the Mayo High Performance Team Scale into Brazilian Portuguese. Method: descriptive study of validation and cross-cultural adaptation of the scale, carried out virtually, following assumptions proposed by Beaton and collaborators. It had a sample of 40 experts, and carried out two rounds, one for validation and one for final assessment. Results: after following all translation steps, the scale was presented to the committee of experts who reached a consensus (IVC between 0.9 and 1.0) that there was no discrepancy, after evaluating the semantic, idiomatic, experiential and conceptual equivalences between the original scale and the translated version. Conclusion: The Brazilian Portuguese version of the MHPTS was adequately translated and validated, revealing excellent potential for use in clinical simulation contexts for multidisciplinary scenarios.

RESUMO Objetivo: descrever o processo de tradução e adaptação transcultural da escala Mayo High Performance Team Scale para o português brasileiro. Método: estudo descritivo de validação e adaptação transcultural da escala, realizado de maneira virtual, seguindo pressupostos propostos por Beaton e colaboradores. Contou com uma amostra de 40 especialistas, e realizou duas rodadas, sendo uma de validação e uma de apreciação final. Resultados: após seguir todas as etapas de tradução a escala foi apresentada ao comitê de especialistas que chegou a um consenso (IVC entre 0,9 e 1,0) sobre não haver qualquer discrepância, após avaliação das equivalências semântica, idiomática, experiencial e conceitual entre a escala original e a versão traduzida. Conclusão: A versão em português brasileiro da MHPTS foi adequadamente traduzida e validada, revelando excelente potencial de utilização em contextos de simulação clínica para cenários multiprofissionais.

https://doi.org/10.1590/0100-6991e-20243740-en

14.

Nutrological therapy in oncology: from prevention to nutritional support during treatment
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Matos, Alexandre Nogueira

; Silvestre, Simone Chaves de Miranda

; Fernandes, Sandra Lúcia

; Pereira, Aritana Alves

; Pimentel, Rodrigo Fernandes Weyll

; Carvalho-Rassbach, Marina

; Albuquerque, Ligia Carvalho de

; Iucif Junior, Nelson

Revista da Associação Médica Brasileira

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2024, Volume 70 Suppl. 1 elocation e2024S123

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.2024s123

15.

Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan
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Maia, Israel Silva

; Medrado Jr, Fernando Azevedo

; Tramujas, Lucas

; Tomazini, Bruno Martins

; Oliveira, Júlia Souza

; Sady, Erica Regina Ribeiro

; Barbante, Letícia Galvão

; Nicola, Marina Lazzari

; Gurgel, Rodrigo Magalhães

; Damiani, Lucas Petri

; Negrelli, Karina Leal

; Miranda, Tamiris Abait

; Santucci, Eliana

; Valeis, Nanci

; Laranjeira, Ligia Nasi

; Westphal, Glauco Adrieno

; Fernandes, Ruthy Perotto

; Zandonai, Cássio Luis

; Pincelli, Mariangela Pimentel

; Figueiredo, Rodrigo Cruvinel

; Bustamante, Cíntia Loss Sartori

; Norbin, Luiz Fernando

; Boschi, Emerson

; Lessa, Rafael

; Romano, Marcelo Pereira

; Miura, Mieko Cláudia

; Alencar Filho, Meton Soares de

; Dantas, Vicente Cés de Souza

; Barreto, Priscilla Alves

; Hernandes, Mauro Esteves

; Grion, Cintia Magalhães Carvalho

; Laranjeira, Alexandre Sanches

; Mezzaroba, Ana Luiza

; Bahl, Marina

; Starke, Ana Carolina

; Biondi, Rodrigo Santos Dal-Pizzol, Felipe Caser, Eliana Bernadete Thompson, Marlus Muri Padial, Andrea Allegrini Veiga, Viviane Cordeiro Leite, Rodrigo Thot Araújo, Gustavo Guimarães, Mário Martins, Priscilla de Aquino Lacerda, Fábio Holanda Hoffmann Filho, Conrado Roberto Melro, Livia Pacheco, Eduardo Ospina-Táscon, Gustavo Adolfo Ferreira, Juliana Carvalho Freires, Fabricio Jocundo Calado Machado, Flávia Ribeiro Cavalcanti, Alexandre Biasi Zampieri, Fernando Godinho

Critical Care Science

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2024, Volume 36 elocation e20240210en

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

ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial.

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo.

https://doi.org/10.62675/2965-2774.20240210-en

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