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1.
INCIDENCIA DEL AIRE ACONDICIONADO AUTOMOTRIZ EN EL ÍNDICE DE CONSUMO DE COMBUSTIBLE EN VEHÍCULO DE ENCENDIDO PROVOCADO EN UNA RUTA DE LA AMAZONÍA ECUATORIANA
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Llanes-Cedeño, Edilberto Antonio
; Grefa Shiguango, Shayan Fredy
; Molina-Osejos, Jaime Vinicio
; Rocha-Hoyos, Juan Carlos
.
Abstract In recent years the environment has been affected by pollution produced by vehicles. The objective of this research project was to determine the incidence of air conditioning (A/C) in the vehicular fuel consumption index in the Shushufindi canton, through real traffic tests, Efficient driving mode and the use of Extra and Super gasoline, for the selection of the best alternative. The study was carried out on a route with a greater flow of vehicles, especially during normal (9:00 am) and beak (5:00 pm) hours, which comprises 16.17 km; for which used gasoline Extra (85 octane) and Super (92 octane). Data collection was carried out using an OBD2 ELM 327 system. The results obtained in the characterization of the representative mixed cycle at 9:00 am, a maximum speed of 81 km/h and an average speed of 39 km/h were obtained in a time of 1446 s route; while the mixed cycle at 5:00 pm the maximum speed is 70 km/h and an average speed of 37 km/h with a travel time of 1632 s. The lowest fuel consumption index was evidenced in normal hours, without A/C and Extra fuel (T3) with values between 0.0584 - 0.060 (L/km), and in normal hours, without A/C and super fuel (T7) that are between 0.0561-0.0585 (L/km).
Resumen En los últimos años, el ambiente se ha visto afectado a causa de la contaminación producida por los vehículos. El presente proyecto de investigación tuvo como objetivo determinar la incidencia del aire acondicionado (A/C) en el índice de consumo de combustible vehicular en el cantón Shushufindi, por medio de pruebas reales de tráfico, modo de conducción eficiente y empleo de gasolina extra y súper, para la selección de la mejor alternativa. El estudio se realizó en una ruta de mayor flujo de vehículos, especialmente en la hora normal (9 a. m.) y pico (5 p. m.) que comprende 16.17 km, para ello se utilizó el combustible Extra (85 octanos) y Súper (92 octanos). La toma de datos se ejecutó mediante un sistema OBD2 ELM 327. Los resultados obtenidos en la caracterización del ciclo mixto representativo de 9 a. m. se obtuvo una velocidad máxima de 81 km/h y una velocidad media de 39 km/h en un tiempo de recorrido de 1446 s; mientras que el ciclo mixto de 5 p. m. la velocidad máxima es de 70 km/h y una velocidad media de 37 km/h con un tiempo de recorrido de 1632 s. El menor índice de consumo de combustible se evidenció en el horario normal, sin A/C y combustible extra (T3) siendo sus valores entre 0.0584 - 0.060 (L/km), y en el horario normal, sin A/C y combustible súper (T7) que se encuentran entre 0.0561-0.0585 (L/km).
2.
ChEVAR technique for emergent aneurysm repair - a retrospective case series
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Vetera, Carlos
; Pinto, Pedro Sá
; Pereira, Carlos
; Martins, Joana
; Mendes, Daniel A.
; Rocha, Henrique
; Pinelo, Andreia
; Machado, Rui
.
Abstract Introduction: Chimney EVAR (ChEVAR) for the treatment of complex abdominal aortic aneurysm (AAA) has been largely relegated for when fenestrated endografts are unavailable, especially due to durability concerns. However, the off-the-shelf nature of ChEVAR makes it a good option for emergent AAA repair. We report our institutional experience in ChEVAR in an urgent setting. Methods: ChEVAR procedures were collected f rom 2019 to 2023 in a tertiary hospital, and a retrospective analysis was performed. This includes gathered information f rom electronic medical records, surgical reports and the picture archiving system. Descriptive statistics were applied. The main endpoints were technical success,30-day and 1-year survival. Results: Five patients were submitted to urgent aneurysm repair using the chEVAR technique. Average age was 73,4 years and all patients were male. Arterial hypertension was present in 100% patients and all patients were ASA 4. Indications for surgery were post EVAR type 1a endoleak with associated rupture or abdominal pain in two patients; symptomatic/contained rupture of pararenal AAA in two patients; and contained rupture of a thoracoabdominal aneurysm in one patient. A total of eight target vessels were catheterized: two patients required single-vessel chimney and the remainder two-vessel chimney. Target vessels were two superior mesenteric arteries and six renal arteries. Technical success rate was 100% and 30-day mortality was 0%. There were no major complications. Follow-up time is 20.2 months (4.7-38). Target vessel patency during the follow-up period was 87.5%. Three patients (60%) died due to non-aortic related pathologies, on average 18 months after surgery (4.7-38), with a 1-year survival of 80%. Conclusion: Our experience with ChEVAR for emergent AAA repair is satisfactory, with high technical success rates and low short-term mortality. Sac regression, low rates of target vessel occlusion and type 1a endoleaks reveal a favourable profile for aneurysm exclusion. ChEVAR is a viable option in emergent setting for patients unfit for open repair.
3.
Outcomes of kidney autotransplantation technique in the treatment of different vascular disorders: an updated narrative review
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Mendes, Daniel A.
; Machado, Rui
; Veterano, Carlos
; Rocha, Henrique
; Castro, João
; Pinelo, Andreia
; Almeida, Henrique
; Almeida, Rui
.
Abstract Introduction: Kidney autotransplantation (KAT) is a versatile surgical technique used to treat multiple diseases affecting the kidney. This procedure allows the reconstruction of the renal artery or vein with optimal surgical exposure reducing warm ischemia time compared to open direct repair. Although infrequently reported nowadays and despite the growing use of endovascular treatments, KAT still has a place in treating complex kidney vascular conditions. Methods: We performed a literature review using the MEDLINE®, SCOPUS, and Web of Science databases with the combination of the terms: “kidney autotransplantation,” “renal artery,” “renal vein,” “aorta,” “aneurysm,” and “nutcracker syndrome.” All relevant English-language studies published between January 1990 and June 2022 reporting the outcomes of the KAT technique in vascular disorders were included. Results: A total of 32 articles were included. Ex-vivo repair and KAT is widely described in treating renal artery aneurysms (RAA), with a reported technical success rate of 99.9%, a complication rate ranging from 6.9 to 9.4%, and a graft loss rate of up to 4.1%. The use of the laparoscopic technique for harvesting the kidney was variable throughout the series published, and heterotopic KAT was performed in most treated patients. Ex-vivo repair and KAT was successfully used after failed endovascular therapy and is a viable option in women of childbearing age with bilateral complex RAA. Concerning renal artery stenosis associated with different etiologies (fibromuscular dysplasia, Takayasu's arteritis, and neurofibromatosis type 1), significant reduction of blood pressure and the number of anti-hypertensive drugs have been reported in most patients after KAT. Results of arterial hypertension improvement associated with RAA after KAT are more variable. The use of KAT in treating nutcracker syndrome is reported with good results, even after left renal vein transposition or venous stenting failure. Other reports exist on the successful use of KAT for treating renal vein aneurysms and as an adjunct in open surgical or hybrid aortic reconstructions. Conclusion: Renal autotransplantation is a useful technique in the treatment of kidney vascular disorders with good overall results reported in the literature. It may be an essential adjunct in open surgical or hybrid treatments for abdominal and thoracoabdominal aortic diseases. Defining the patients who would benefit from this technique as a preferential treatment choice in different renal vessel disorders would be necessary.
4.
Evaluation of the properties of natural rubber bio composite and guava residue (Psidium guajava L.) as sustainable application
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Hiranobe, Carlos T.
; Silva, Alex R. da
; Cruz, Marco A. G.
; Canhada, João C. S.
; Araújo, Samara S.
; Rocha, José A.
; Santos, Harison F. dos
; Ribeiro, Gabriel D.
; Tolosa, Gabrieli R.
; Santos, Gleyson T. A.
; Budemberg, Eduardo R.
; Azevedo, Cláudia G. de
; Santos, Renivaldo J. dos
.
In juice and pulp extraction, about 10% of fruit waste is generated, which often ends up in landfills that can cause environmental damage, serve as food for insects and rodents, and cause health problems for humans. In this work, micronized guava waste was used as a filler in vulcanized compounds in natural rubber. Mechanical properties such as hardness, tensile strength, tear resistance, and abrasion resistance were evaluated, as well as thermal properties such as thermogravimetric analysis, in addition to scanning electron microscopy, X-ray fluorescence, elemental analysis, and infrared spectroscopy. According to the results of the mechanical properties tests, the addition of up to 20 phr of the filler tends to improve the tensile strength of the composites, resulting in an increase in the density of cross-links obtained through the Flory-Rehner method. The thermal behavior analyzed by TGA and FTIR spectra were not affected by the incorporation of fillers.
5.
The historical ecology of the world’s largest tropical country uniquely chronicled by its municipal coat-of-arms symbology
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BOGONI, JULIANO A.
; CONCONE, HENRIQUE VILLAS BOAS
; CARVALHO-ROCHA, VÍTOR
; FERRAZ, KATIA M.P.M.B.
; PERES, CARLOS A.
.
Anais da Academia Brasileira de Ciências
- Journal Metrics
Abstract Coats-of-arms representing municipal counties express local patterns of rural economics, natural resource and land use, features of the natural capital, and the cultural heritage of either aborigines or colonists. We reconstruct the subnational economic and political timeline of the world’s largest tropical country using municipal coats-of-arms to reinterpret Brazil’s historical ecology. We assessed all natural resource, biophysical, agricultural, and ethnocultural elements of 5,197 coats-of-arms (93.3%) distributed throughout Brazil. We extracted socioenvironmental co-variables for any municipality to understand and predict the relationships between social inequality, environmental degradation, and the historical ecology symbology. We analyzed data via ecological networks and structural equation models. Our results show that the portfolio of political-administrative symbology in coats-of-arms is an underutilized tool to understand the history of colonization frontiers. Although Brazil is arguably Earth’s most species-rich country, generations of political leaders have historically failed to celebrate this biodiversity, instead prioritizing a symbology depicted by icons of frontier conquest and key natural resources. Brazilian historical ecology reflects the relentless depletion of the natural resource capital while ignoring profound social inequalities. Degradation of natural ecosystems is widespread in Brazilian economy, reflecting a legacy of boom-and-bust rural development that so far has failed to deliver sustainable socioeconomic prosperity.
6.
Comparative analysis of the biocompatibility of endothelial cells on surfaces treated by thermal plasma and cold atmospheric plasma
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SOUZA, ALAN MAX T. DE
; BRAZ, JANINE KARLA F. DA SILVA
; MARTINS, GABRIEL M.
; VITORIANO, JUSSIER DE OLIVEIRA
; G.A. NETO, AURÉLIO
; NERY, DAVID M.
; SABINO, VLADIMIR G.
; LUCENA, EUDES E. DE SOUZA
; ROCHA, HUGO ALEXANDRE DE OLIVEIRA
; BARBOZA, CARLOS AUGUSTO G.
; A. JÚNIOR, CLODOMIRO
; MOURA, CARLOS EDUARDO B. DE
.
Abstract In recent years, cold atmospheric plasma (CAP) is used for surface disinfection. However, little is known about its ability to improve biocompatibility of metallic surfaces when compared to thermal plasma methods. In this context, the study aimed to evaluate the response of human endothelial cells (Ea.hy926) on titanium surfaces treated by non-thermal plasma method and thermal plasma method under nitriding atmosphere. The wettability was characterized by the sessile drop method, the topography and roughness were evaluated by atomic force microscopy (AFM), and the microstructure by grazing angle X-ray diffraction (GIXRD). Endothelial cells were cultured and evaluated for morphology by scanning electron microscopy and viability by an MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. CAP treatment reduced the contact angle of the Ti surface (13.43° ± 1.48; p<0.05), increasing hydrophilicity. Rz roughness was higher on the nitrided surface (220.44±20.30; p< 0.001) compared to the CAP treated surfaces (83.29 ± 11.61; p< 0.001) and polished (75.98 ±34.21a); p<0.001). The different applied plasma treatments created different titanium surfaces improving the biocompatibility of endothelial cells, however CAP results demonstrate its potential for biomedical applications, considering the low cost and ease of use of the technique, allowing surface treatments before clinical procedures.
7.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
8.
Eating disorders are associated with adverse obstetric and perinatal outcomes: a systematic review
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das Neves, Maila de C.
; Teixeira, Ananda A.
; Garcia, Flávia M.
; Rennó, Joel
; da Silva, Antônio G.
; Cantilino, Amaury
; Rosa, Carlos E.
; Mendes-Ribeiro, Jeronimo de A.
; Rocha, Renan
; Lobo, Hewdy
; Gomes, Igor E.
; Ribeiro, Christiane C.
; Garcia, Frederico D.
.
Objective: To systematically review the literature focusing on obstetric and perinatal outcomes in women with previous or current eating disorders (EDs) and on the consequences of maternal EDs for the offspring. Methods: The study was performed following the systematic review and meta-analysis (PRISMA) statement. PubMed, SciELO, and Cochrane databases were searched for non-interventional studies published in English or Portuguese from January 1980 to December 2020. Risk of bias was assessed using the Methods guide for effectiveness and comparative effectiveness reviews (American Agency for Healthcare Research and Quality). Results: The search yielded 441 records, and 30 articles were included. The psychiatric outcome associated with EDs in women was mainly perinatal depression. The most prevalent obstetric outcomes observed in women with EDs were vomiting, hyperemesis, bleeding, and anemia. Most studies found maternal anorexia nervosa and bulimia nervosa to be associated with low birth weight and slow fetal growth. Women with binge EDs delivered children with increased birth weight. Of the 30 studies included, methodological quality was good in seven, fair in eight, and poor in 15 studies. Conclusion: A considerable body of evidence was reviewed to assess obstetric and perinatal outcomes in EDs. Acute and lifetime EDs, especially if severe, correlated with poor perinatal, obstetric, and neonatal outcomes. Obstetricians and general practitioners should be vigilant and screen for EDs during pregnancy.
9.
Phenolic substances and cyanogenesis in galled and non-galled tissue of the fern species Microgramma vacciniifolia
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Resumo Galhas são estruturas vegetais neo-formadas que ocorrem em diferentes órgãos. Elas são geradas por uma interação espécie-específica com um organismo indutor. Os indutores manipulam o metabolismo do hospedeiro. Microgramma vacciniifolia (Langsd. & Fisch.) Copel. é uma samambaia epífita neotropical que hospeda duas galhas caulinares, uma induzida por uma espécie de mosquito (Diptera) e outra por uma micromariposa (Lepidoptera). O objetivo deste estudo foi avaliar o impacto desses dois insetos indutores de galhas na bioquímica dos ácidos fenólicos e da cianogênese em galhas, caules e folhas de M. vacciniifolia. Em análise de cromatografia líquida de alta eficiência (CLAE) foi possível indicar a presença de um total de 14 derivados fenólicos, incluindo ácido cafeico e ácido cumárico. Análise das Coordenadas Principais (ACoP) indicou três grupos (1) caules não galhados e galhas induzidas pela micromariposa; (2) galhas induzidas pelo mosquito; (3) galhas induzidas pelo mosquito com parasitoides. Em relação a frequência da cianogênese analisada com o teste do papel picrato, o teste do qui-quadrado apresentou diferença significativa entre as folhas férteis (8,3%), folhas estéreis (27,7%), caules não galhados (0%) e galhas. Entre as galhas, somente aquelas induzidas pelo mosquito foram cianogênicas (15%). Os resultados encontrados indicam, ao menos para as substâncias fenólicas, que os insetos indutores de galha (mosquito e micromariposa) promovem alterações espécie-específica na composição química da samambaia hospedeira.
Abstract Galls, neo-formed plant structures that can occur in different organs, are generated by species-specific interaction with an inducing organism. Inducers manipulate the metabolism of its host. Microgramma vacciniifolia (Langsd. & Fisch.) Copel. is a Neotropical epiphytic fern that hosted two stem galls, one induced by a midge species (Diptera) and other by a micromoth species (Lepidoptera). The aim of this study was to evaluate the impact of these two gall-inducing insects on the biochemistry of phenolic acids and the cyanogenesis in galls, stems and leaves of M. vacciniifolia. High performance liquid chromatography (HPLC) indicated a total of 14 phenol derivatives, including caffeic and coumaric acid. Principal Coordinates Analysis (PCoA) of the phenolic substances indicated three groups consisting (1) non-galled stems and micromoth-induced galls; (2) midge-induced galls; (3) midge-induced galls with parasitoids. Regarding the frequency of cyanogenesis assessed by the picrate paper test, the chi-squared test showed significant difference between fertile leaves (8.3%), sterile leaves (27.7%), non-galled stems (0%) and galls. Among galls, only the midge-induced galls analyzed were cyanogenic (15%). Our results indicated that the different gall-inducers (midge and micromoth) promote species-specific alterations to the phenolic substance composition of the host fern.
https://doi.org/10.1590/1519-6984.236151
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10.
Natural history museums and zoological collections of São Paulo State
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Percequillo, Alexandre Reis
; Barbosa, Marina F. C.
; Bockmann, Flávio A.
; Bogoni, Juliano A.
; Esguícero, André L. H.
; Lamas, Carlos
; Moraes, Gilberto José de
; Pinto-da-Rocha, Ricardo
; Silveira, Luís Fábio
.
Abstract Scientific collections constitute a valuable source for contributions to scientific research and the training of human resources in systematics, but also other areas of biological knowledge. In this contribution, we intend to discuss these advancements in collections and the role played by FAPESP in sponsoring them, as well as a general overview of the zoological collections in São Paulo state. We also aim to stress the importance of zoological collections and the need for continuous logistic and financial support from institutions and research agencies to maintain and develop these unique repositories of biodiversity. From 1980 to the present, FAPESP supported 118 research projects focused on several areas of zoology that are directly or indirectly associated with collections. There is a constant growth in the number of projects, and the financial support provided by FAPESP through the Biota Program was paramount for the advancement of our knowledge of biodiversity in Brazil. Parallel to the scientific advances, but not less important, this support allowed curators to increase the number of specimens, and to organize, maintain and digitize them in these valuable and irreplaceable collections. Regarding the lack of new taxonomists, it is essential that FAPESP and universities in São Paulo encourage the formation of new academics in zoological groups where specialists are rare. Considering the investment provided by FAPESP, it is quite important that the institutions that benefited from these resources took greater responsibility to safeguard these collections, and they should consider including resources on their budgets to obtain safety certificates, ensuring their permanence for many generations to come. Zoological collections are a heritage of humanity and are essential not only for the improvement of our knowledge of biodiversity but also with direct applications, among other services provided by these biological resources. It is important that research and teaching institutions in São Paulo that house specimens under their care start to value more this important patrimony and this heritage, as these collections represent the most valuable testimony of our impressive biodiversity, records of our past, and windows to our future, essential to our academic, scientific, cultural and social sovereignty.
Resumo As coleções científicas constituem uma fonte valiosa para contribuições à pesquisa científica e para a formação de recursos humanos em sistemática, mas também em outras áreas do conhecimento biológico. Nesta contribuição, pretendemos discutir esses avanços nas coleções e o papel desempenhado pela FAPESP no seu patrocínio, bem como um panorama geral das coleções zoológicas do estado de São Paulo. Também pretendemos enfatizar a importância das coleções zoológicas e a necessidade de apoio logístico e financeiro contínuo de instituições e agências de pesquisa para manter e desenvolver esses repositórios únicos de biodiversidade. Ao longo de 1980 até os dias atuais, a FAPESP apoiou 118 projetos de pesquisa focados em diversas áreas da zoologia, direta ou indiretamente associados a coleções. Há um crescimento constante no número de projetos, e o apoio financeiro da FAPESP por meio do Programa Biota foi fundamental para o avanço do nosso conhecimento sobre a biodiversidade no Brasil. Paralelamente aos avanços científicos, mas não menos importante, este apoio permitiu aos curadores aumentar o número de exemplares, e organizá-los, mantê-los e digitalizá-los nestas valiosas e insubstituíveis coleções. Em relação à falta de novos taxonomistas, é fundamental que a FAPESP e as universidades paulistas estimulem a formação de novos acadêmicos em grupos zoológicos onde os especialistas são raros. Considerando o investimento realizado pela FAPESP, é de suma importância que as instituições beneficiadas com esses recursos tenham maior responsabilidade na salvaguarda desses acervos, devendo considerar a inclusão de recursos em seus orçamentos para obtenção de certificados de segurança, garantindo sua permanência por muitas gerações. As coleções zoológicas são patrimônio da humanidade, e são essenciais não apenas para o aprimoramento do nosso conhecimento sobre a biodiversidade, mas também com aplicações diretas, entre outros serviços prestados por esses recursos biológicos. É importante que as instituições de pesquisa e ensino paulistas que abrigam exemplares sob seus cuidados passem a valorizar mais esse importante patrimônio e essa herança, pois essas coleções representam o testemunho mais valioso de nossa impressionante biodiversidade, registros do nosso passado e janelas para o nosso futuro, essenciais à nossa soberania acadêmica, científica, cultural e social.
11.
Sterile, recurrent, and bilateral corneal perforation related to primary biliary cirrhosis complicated by secondary Sjögren syndrome and vitamin A deficiency
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Martín, Leyre Lloreda
; Rocha-de-Lossada, Carlos
; Marín-Martínez, Sara
; Peraza-Nieves, Jorge Ernesto
.
RESUMO A cirrose biliar primária é uma doença hepática autoimune progressiva rara que causa colestase crônica. 75% dos pacientes com Cirrose Biliar Primária desenvolvem Síndrome de Sjögren Secundária, e podem também desenvolver deficiência de vitamina A. Aqui, relatamos um paciente com Cirrose Biliar Primária que desenvolveu Síndrome de Sjögren Secundária e deficiência de vitamina A, levando a envolvimento ocular grave e incomum com perfurações espontâneas múltiplas e recorrentes da córnea. Perfurações da córnea em pacientes com Cirrose Biliar Primária e Síndrome de Sjögren Secundária são complicações raras, mas devastadoras, em contraste com outras manifestações clínicas oculares da doença.
ABSTRACT Primary biliary cirrhosis is a rare progressive autoimmune liver disease that causes chronic cholestasis. Of patients with primary biliary cirrhosis, 75% develop secondary Sjogren syndrome and could develop vitamin A deficiency. Here, we report the case of a patient with primary biliary cirrhosis who developed a secondary Sjogren syndrome and vitamin A deficiency, which led to severe and unusual eye involvement with multiple and recurrent spontaneous corneal perforations. Corneal perforations in patients with primary biliary cirrhosis and secondary Sjogren syndrome are rare but devastating complications, in contrast to other eye clinical manifestations of the disease.
https://doi.org/10.5935/0004-2749.20210100
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12.
COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience
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Gomes, Walter J.
; Rocco, Isadora
; Pimentel, Wallace S.
; Pinheiro, Aislan H. B.
; Souza, Paulo M. S.
; Costa, Luiz A. A.
; Teixeira, Marjory M. P.
; Ohashi, Leonardo P.
; Bublitz, Caroline
; Begot, Isis
; Moreira, Rita Simone L
; Hossne Jr, Nelson A.
; Vargas, Guilherme F.
; Branco, João Nelson R.
; Teles, Carlos A.
; Medeiros, Eduardo A. S.
; Sáfadi, Camila
; Rampinelli, Amândio
; Moratelli Neto, Leopoldo
; Rosado, Anderson Rosa
; Mesacasa, Franciele Kuhn
; Capriata, Ismael Escobar
; Segalote, Rodrigo Coelho
; Palmieri, Deborah Louize da Rocha Vianna
; Jardim, Amanda Cristina Mendes
; Vianna, Diego Sarty
; Coutinho, Joaquim Henrique de Souza Aguiar
; Jazbik, João Carlos
; Coutinho, Henrique Madureira da Rocha
; Kikuta, Gustavo
; Almeida, Zely Sant'Anna Marotti de
; Feguri, Gibran Roder
; Lima, Paulo Ruiz Lucio de
; Franco, Anna Carolina
; Borges, Danilo de Cerqueira
; Cruz, Felipe Ramos Honorato De La
; Croti, Ulisses Alexandre
; Borim, Bruna Cury
; Marchi, Carlos Henrique De
; Goraieb, Lilian
; Postigo, Karolyne Barroca Sanches
; Jucá, Fabiano Gonçalves
; Oliveira, Fátima Rosane de Almeida
; Souza, Rafael Bezerra de
; Zilli, Alexandre Cabral
; Mas, Raul Gaston Sanchez
; Bettiati Junior, Luiz Carlos
; Tranchesi, Ricardo
; Bertini Jr, Ayrton
; Franco, Leandro Vieira
; Fernandes, Priscila
; Oliveira, Fabiana
; Moraes Jr, Roberto
; Araújo, Thiago Cavalcanti Vila Nova de
; Braga, Otávio Penna
; Pedrosa Sobrinho, Antônio Cavalcanti
; Teixeira, Roberta Tavares Barreto
; Camboim, Irla Lavor Lucena
; Gomes, Eduardo Nascimento
; Reis, Pedro Horigushi
; Garcia, Luara Piovan
; Scorsioni, Nelson Henrique Goes
; Lago, Roberto
; Guizilini, Solange
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.
13.
Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos
; Feitosa Filho, Gilson Soares
; Petriz, João Luiz
; Furtado, Remo Holanda de Mendonça
; Précoma, Dalton Bertolim
; Lemke, Walmor
; Lopes, Renato Delascio
; Timerman, Ari
; Marin Neto, José A.
; Bezerra Neto, Luiz
; Gomes, Bruno Ferraz de Oliveira
; Santos, Eduardo Cavalcanti Lapa
; Piegas, Leopoldo Soares
; Soeiro, Alexandre de Matos
; Negri, Alexandre Jorge de Andrade
; Franci, Andre
; Markman Filho, Brivaldo
; Baccaro, Bruno Mendonça
; Montenegro, Carlos Eduardo Lucena
; Rochitte, Carlos Eduardo
; Barbosa, Carlos José Dornas Gonçalves
; Virgens, Cláudio Marcelo Bittencourt das
; Stefanini, Edson
; Manenti, Euler Roberto Fernandes
; Lima, Felipe Gallego
; Monteiro Júnior, Francisco das Chagas
; Correa Filho, Harry
; Pena, Henrique Patrus Mundim
; Pinto, Ibraim Masciarelli Francisco
; Falcão, João Luiz de Alencar Araripe
; Sena, Joberto Pinheiro
; Peixoto, José Maria
; Souza, Juliana Ascenção de
; Silva, Leonardo Sara da
; Maia, Lilia Nigro
; Ohe, Louis Nakayama
; Baracioli, Luciano Moreira
; Dallan, Luís Alberto de Oliveira
; Dallan, Luis Augusto Palma
; Mattos, Luiz Alberto Piva e
; Bodanese, Luiz Carlos
; Ritt, Luiz Eduardo Fonteles
; Canesin, Manoel Fernandes
; Rivas, Marcelo Bueno da Silva
; Franken, Marcelo
; Magalhães, Marcos José Gomes
; Oliveira Júnior, Múcio Tavares de
; Filgueiras Filho, Nivaldo Menezes
; Dutra, Oscar Pereira
; Coelho, Otávio Rizzi
; Leães, Paulo Ernesto
; Rossi, Paulo Roberto Ferreira
; Soares, Paulo Rogério
; Lemos Neto, Pedro Alves
; Farsky, Pedro Silvio
; Cavalcanti, Rafael Rebêlo C.
; Alves, Renato Jorge
; Kalil, Renato Abdala Karam
; Esporcatte, Roberto
; Marino, Roberto Luiz
; Giraldez, Roberto Rocha Corrêa Veiga
; Meneghelo, Romeu Sérgio
; Lima, Ronaldo de Souza Leão
; Ramos, Rui Fernando
; Falcão, Sandra Nivea dos Reis Saraiva
; Dalçóquio, Talia Falcão
; Lemke, Viviana de Mello Guzzo
; Chalela, William Azem
; Mathias Júnior, Wilson
.
https://doi.org/10.36660/abc.20210180
3052 downloads
14.
Use of non-invasive stimulation in movement disorders: a critical review
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Godeiro, Clecio
; França, Carina
; Carra, Rafael Bernhart
; Saba, Felipe
; Saba, Roberta
; Maia, Débora
; Brandão, Pedro
; Allam, Nasser
; Rieder, Carlos R. M.
; Freitas, Fernando Cini
; Capato, Tamine
; Spitz, Mariana
; Faria, Danilo Donizete de
; Cordellini, Marcela
; Veiga, Beatriz A. A. G.
; Rocha, Maria Sheila G.
; Maciel, Ricardo
; Melo, Lucio B. De
; Möller, Patricia D. S.
; R. R. Júnior, Magno
; Fornari, Luís H. T.
; Mantese, Carlos E.
; Barbosa, Egberto Reis
; Munhoz, Renato P.
; Coletta, Marcus Vinicius Della
; Cury, Rubens Gisbert
.
Resumo Introdução: A estimulação não-invasiva tem sido amplamente utilizada nos últimos 30 anos no estudo e no tratamento de um grande número de doenças neurológicas, incluindo distúrbios do movimento. Objetivos: Nesta revisão crítica, discutimos o embasamento científico do uso da estimulação não-invasiva em distúrbios do movimento e as evidências científicas dos principais ensaios clínicos realizados. Métodos: Um grupo de especialistas realizou uma revisão crítica abrangente da literatura a fim de analisar as principais aplicações da estimulação magnética transcraniana (EMT) e da estimulação transcraniana por corrente contínua (ETCC) em distúrbios do movimento. As classes de evidência e de recomendação foram descritas para cada doença. Resultados: Apesar da grande variabilidade da metodologia e baixo efeito clínico, a EMT é provavelmente eficaz para o tratamento dos sintomas motores e da depressão na doença de Parkinson. A eficácia em outros distúrbios do movimento ainda é incerta. A EMT é possivelmente eficaz para o tratamento da distonia focal da mão, do tremor essencial e da ataxia cerebelar. No entanto, é provavelmente ineficaz na redução dos tiques na síndrome de Tourette. Finalmente, a ETCC é provavelmente eficaz na melhora da marcha na doença de Parkinson. Conclusões: As evidências até o momento sugerem que a estimulação não-invasiva pode ser benéfica para o alívio de alguns sintomas em determinados distúrbios do movimento como a doença de Parkinson, o tremor essencial, a distonia e a ataxia. Os protocolos de aplicação e paradigmas de estimulação ainda precisam ser investigados em ensaios clínicos maiores, assim como os seus efeitos a longo prazo.
Abstract Background: Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. Objective: In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinical trials performed to date. Methods: A nationally representative group of experts performed a comprehensive review of the literature in order to analyze the key clinical decision-making factors driving transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in movement disorders. Classes of evidence and recommendations were described for each disease. Results: Despite unavoidable heterogeneities and low effect size, TMS is likely to be effective for treating motor symptoms and depression in Parkinson’s disease (PD). The efficacy in other movement disorders is unclear. TMS is possibly effective for focal hand dystonia, essential tremor and cerebellar ataxia. Additionally, it is likely to be ineffective in reducing tics in Tourette syndrome. Lastly, tDCS is likely to be effective in improving gait in PD. Conclusions: There is encouraging evidence for the use of noninvasive stimulation on a subset of symptoms in selected movement disorders, although the means to optimize protocols for improving positive outcomes in routine clinical practice remain undetermined. Similarly, the best stimulation paradigms and responder profile need to be investigated in large clinical trials with established therapeutic and assessment paradigms that could also allow genuine long-term benefits to be determined.
https://doi.org/10.1590/0004-282x-anp-2020-0381
427 downloads
15.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
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.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
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ti | article title |
au | author |
kw | article keywords |
subject | subject (title words, abstract and keywords) |
ab | abstract |
ta | journal short title (e.g. Cad. Saúde Pública) |
journal_title | journal full title (e.g. Cadernos de Saúde Pública) |
la | publication language code (e.g. pt - Portuguese, es - Spanish) |
type | document type |
pid | publication identifier |
publication_year | publication year of publication |
sponsor | sponsor |
aff_country | country code of the author's affiliation |
aff_institution | author affiliation institution |
volume | article volume |
issue | article issue |
elocation | elocation |
doi | DOI number |
issn | journal ISSN |
in | SciELO colection code (e.g. scl - Brasil, col - Colômbia) |
use_license | article usage license code |