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ABSTRACT Bulk density (BD) is a soil physical property used as a soil quality indicator and variations in this measurement influence soil water content and carbon stock estimates. This study aims to compile a database of samples of bulk density, textural fractions, and organic carbon values, as well as evaluate the accuracy of published pedotransfer functions (PTF) that predict bulk density, and propose a hierarchical PTF to predict the bulk density of Brazilian Soils. The performance of eleven PTFs and the newly proposed PTFs were evaluated and compared using the root mean square error (RMSE) and coefficient of determination (R2) based on a testing soil database collected from the literature. We noticed a slight improvement in accuracy when organic carbon and coarse and fine sand fractions were included as predictors alongside silt and clay. The best results with existing PTFs were obtained by PTF-A in Tomasella and Hodnett (1998) (RMSE = 0.20 g cm–3) and PTF-F in Benites et al. (2007) (RMSE = 0.17 g cm–3). Our proposed PTFs use textural fractions and organic carbon as predictors in a hierarchical form. The proposed PTF-4, which uses fine sand, coarse sand, clay, and organic carbon, presented the lowest value for RMSE (0.14 g cm–3) for BD prediction.

https://doi.org/10.1590/1678-992x-2022-0255

Fatores associados aos sintomas depressivos em agentes comunitários de saúde
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Barbosa, Mariane Silveira

; Brito, Maria Fernanda Santos Figueiredo

; Rossi-Barbosa, Luiza Augusta Rosa

; Santos, Gustavo Ribeiro dos

; Moreira, Kênia Souto

PsychTech & Health Journal

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sep 2023, Volume 7 N. 1 Pages 30 - 40

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

Abstract The objective of the present study was to answer the question, “What are the factors associated with the prevalence of depressive symptoms in community health agents”. This cross-sectional, quantitative, and analytical study used a Patient Health Questionnaire - 9 to check the depressive symptoms and a questionnaire on the socio-demographic and occupational conditions. A Poisson multiple regression with robust variance was performed, considering a significance level of 5% (p < .05). Six hundred seventy-three community health agents participated in the study. The depressive symptoms prevalence was 19.0% (N = 128). There was an association with females (RP:1.09; IC:1.03-1.05), working time as a community health agent over six years (RP:1.12; IC:1.06-1.17), job dissatisfaction (RP:1.13; IC:1.07-1.19) and the variable being religious (RP:.90; IC:.84-.97) as a protection factor. There was high depressive symptoms prevalence among the community health agents associated with socio-demographic factors.

Resumo O objetivo do presente estudo foi responder à pergunta “Quais são os fatores associados à prevalência de sintomas depressivos em agentes comunitários de saúde”. É um estudo transversal, quantitativo e analítico no qual utilizou instrumento Patient Health Questionnaire - 9 para verificar os sintomas depressivos e um questionário sobre as condições sociodemográficas e ocupacionais. Realizou-se regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < .05). Participaram do estudo 673 agentes comunitários de saúde. A prevalência para os sintomas depressivos foi de 19.0% (N = 128). Houve associação com o sexo feminino (RP:1.09; IC:1.03-1.05), tempo de trabalho como agente comunitário de saúde acima de 6 anos (RP:1.12; IC:1.06-1.17), insatisfação no trabalho (RP:1.13; IC:1.07-1.19) e a variável ser religioso (RP:.90; IC:.84-.97) como fator de proteção. Verificou-se alta prevalência de sintomas depressivos entre agentes comunitários de saúde havendo associação com fatores sociodemográficos e ocupacionais.

https://doi.org/10.26580/pthj.art56-2023

Response to the letter to the editor "Commentary on the COVID-19 mRNA vaccine reactogenicity study"
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Inglés-Torruella, Joan

; Gil-Soto, Rosa

; Sabaté, Esther

; Garcia-Grau, Mercé

; Pons-Boronat, Nina

; Rubio-Civit, Adelaida

; Bandera-Baez, Miriam

; Moreno-Martín, Gustavo

Archivos de Prevención de Riesgos Laborales

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sep 2023, Volume 26 N. 3 Pages 217 - 220

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

https://doi.org/10.12961/aprl.2022.26.03.05

Análisis comparativo de las características clínicas, evolución y mortalidad de pacientes hospitalizados por COVID-19 durante la primera y segunda ola de la pandemia (REGISTRO ECCOVID)
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Córdova, Ezequiel

; Mykietiuk, Analia

; de Vedia, Lautaro

; Bacelar, Brenda

; Cáceres, María Florencia

; Nemirovsky, Corina

; Contreras, Rosa

; Alzogaray, Maria Fernanda

; Nannini, Esteban

; Consalvo, María Fernanda

; Soler Puy, Lucrecia

; Scapellato, Pablo G.

; Barcelona, Laura

; Golikow, Mariana L.

; Piñeiro, María Florencia

; Miño, Hugo J.

; Cabral, Myrna

; Lamponi Tappata, Lucía

; Lopardo, Gustavo

; Sued, Omar

; Stryjewski, Martín E.

Medicina (Buenos Aires)

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aug 2023, Volume 83 N. 4 Pages 551 - 557

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

Resumen Introducción : Las características clínicas y evolutivas de los pacientes con diagnóstico de COVID-19 pueden diferir entre las distintas olas de la pandemia. El objetivo de este estudio fue comparar las características clínicas, evolución y mortalidad de pacientes hospitalizados por COVID-19 durante la primera y segunda ola en Argentina. Métodos : Registro multicéntrico y prospectivo de pacientes ≥ 18 años con diagnóstico confirmado de COVID-19 internados en 18 hospitales de Argentina durante la primera (marzo a octubre 2020) y la segunda ola (marzo a julio 2021) de la pandemia. Se compararon variables demográficas, características clínicas, y evolu ción a 30 días. Resultados : Se incluyeron un total de 1691 pacien tes (primera ola n = 809, segunda ola n = 882). Los pa cientes hospitalizados durante la segunda ola tenían mayor edad (mediana 53 años vs. 61 años, p < 0.001), comorbilidades (71% vs. 77%, p = 0.007) y requerimiento de oxígeno (21% vs. 62%, p < 0.001). Durante la hospi talización, los pacientes de la segunda ola requirieron más oxigenoterapia (49% vs. 85%, p < 0.001), asistencia mecánica respiratoria (12% vs. 22%, p <0,001) y presen taron mayor mortalidad (11% vs. 26%, p < 0.001). Compa rando únicamente a los que requirieron oxigenoterapia durante la hospitalización, la mortalidad a los 30 días fue de 20% y 30% p < 0.001 en la primera y segunda ola respectivamente. Conclusión : Comparados con los pacientes interna dos durante la primera ola, los internados durante la segunda ola de SARS-CoV-2 en Argentina presentaron mayor gravedad y mortalidad.

Abstract Introduction : Clinical features and outcomes of SARS-CoV-2 infections may change between different waves of the pandemic. The objective of this study was to compare clinical characteristics and outcomes between two cohorts of patients hospitalized for COVID-19 during the first and second waves in Argentina. Methods : Multicenter and prospective registry of patients ≥18 years old with a confirmed diagnosis of COVID-19 admitted to 18 hospitals in Argentina during the first wave (March to October 2020) and second wave (March to July 2021) of the pandemic. Demographics, clinical characteristics, and outcomes of these patients were compared. Results : A total of 1691 patients were included (first wave n = 809, second wave n = 882). Hospitalized pa tients during the second wave were older (median 53 years vs. 61 years, p < 0.001), had more comorbidities (71% vs. 77%, p=0.007) and required more supplemental oxygen at admission (21% vs 62%, p < 0.001). During hos pitalization, patients of the second wave required more supplemental oxygen (49% vs. 85%, p < 0.001), invasive ventilation (12% vs. 22%, p < 0.001) and had higher 30- day mortality (11% vs. 26%, p < 0.001). Comparing only patients who required supplemental oxygen during hos pitalization, 30-day mortality was 20% and 30% p < 0.001 for the first and second wave, respectively. Conclusion : Compared to patients admitted during the first wave, patients admitted with SARS-CoV2 dur ing the second wave in Argentina were more seriously ill and had a higher mortality.

Estudio de reactogenicidad en las vacunas mRNA frente a la COVID-19
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Inglés-Torruella, Joan

; Gil-Soto, Rosa

; Sabaté, Esther

; Garcia-Grau, Mercé

; Pons-Boronat, Nina

; Rubio-Civit, Adelaida

; Bandera-Baez, Miriam

; Moreno-Martín, Gustavo

Archivos de Prevención de Riesgos Laborales

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jun 2023, Volume 26 N. 2 Pages 106 - 126

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

Abstract Objective: To compare the reactogenicity between the types of mRNA Commirnaty® (Pfizer) and Spikevax® (Moderna) vaccines against COVID-19 in a healthcare population. Methods: Cross sectional study of short-term adverse effects and their consequences (sick leave, limitations of daily life, etc.) after the administration of the first and second doses of both vaccines in professionals and students of a health institution. A questionnaire on symptoms and their consequences was administered seven days after each vaccination dose. The prevalence and 95% confidence interval (95%CI) were calculated. Differences between vaccines were quantified using the odds ratio (OR) and its 95%CI. Results: The questionnaire was completed by 1924 and 1170 healthcare providers (response rates 62.2% and 39.1%) after the first and second doses, respectively, of the Commirnaty® vaccine, and 410 (56.0%) and 107 (15.0%) of Spikevax®. After the first dose of Comirnaty®, 67.4% presented some adverse effect, and 76.1% for Spikevax® (OR 1.5 95%CI 1.2-1.9). In general, women and young people showed greater reactogenicity and differences between vaccines. Consequences of adverse effects were more frequent for Spikevax®. The reactogenicity was higher after the second than the first dose, for both vaccines (Comirnaty®: 67.4% vs. 75.6%; Spikevax®: 76.1% vs. 87.9%. Conclusions: The greater reactogenicity and its consequences, for the first and second dose of the Spikevax® vaccine compared to Comirnaty®, and of the second dose compared to the first dose of both vaccines, provides useful knowledge for planning vaccination against COVID-19 campaigns in healthcare settings.

Resumen Objetivo: Comparar la reactogenicidad entre los tipos de vacuna RNAm Commirnaty® (Pfizer) y Spikevax® (Moderna) frente a la COVID-19 en población sanitaria. Métodos: Estudio de prevalencia de los efectos adversos a corto plazo y sus consecuencias tras la administración de la primera y segunda dosis de ambas vacunas en profesionales y estudiantes de una institución sanitaria. Se administró un cuestionario de síntomas y sus consecuencias (incapacidad temporal, dificultades en la vida diaria, etc.) a los 7 días de la vacunación. Se calculó la prevalencia e intervalo de confianza del 95% (IC95%). Las diferencias entre vacunas se cuantificaron mediante las odds ratio (OR) e IC95%. Resultados: Completaron el cuestionario 1924 y 1170 sanitarios (tasas de respuesta 62.2% y 39.1%) tras la primera y la segunda dosis, respectivamente, de la vacuna Commirnaty®, y 410 (56.0%) y 107 (15.0%), de Spikevax®. Después de la primera dosis de Comirnaty® un 67,4% presentó algún efecto adverso, y un 76,1% para Spikevax® (OR 1,5 IC95% 1,2-1,9). En general mujeres y jóvenes mostraron mayor reactogenicidad y diferencias entre vacunas. Las consecuencias de los efectos adversos fueron más frecuentes para Spikevax®. La reactogenicidad fue superior tras la segunda dosis que tras la primera, para las dos vacunas (Comirnaty® 67,4% vs. 75,6%; Spikevax® 76,1% vs. 87,9%). Conclusiones: La mayor reactogenicidad y sus consecuencias, para la primera y segunda dosis de la vacuna Spikevax® respecto a Comirnaty®, y de la segunda dosis respecto a la primera dosis de ambas vacunas, aporta conocimiento útil para la planificación de campañas de vacunación frente a la COVID-19 en el entorno sanitario.

https://doi.org/10.12961/aprl.2022.26.02.02

Impact of COVID-19 pandemic on prostate cancer outcomes at an uro-oncology referral center
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Andrade, Guilherme Miranda

; Sesconetto, Lucas

; Silva, Rafael Benjamim Rosa da

; Santos, Gabriela Guimarães Rodrigues dos

; Kayano, Paulo Priante

; Baccaglini, Willy

; Bezerra, Murilo Borges

; Bianco, Bianca

; Lemos, Gustavo Caserta

; Carneiro, Arie

International braz j urol

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apr 2023, Volume 49 N. 2 Pages 233 - 242

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction To evaluate the possible effects of the coronavirus disease 2019 (COVID-19) pandemic on the oncologic results of patients with prostate cancer regarding clinical staging, presence of adverse pathological outcomes, and perioperative complications. Materials and methods This retrospective study included patients who underwent radical prostatectomy. The time between biopsy and surgery, staging tests, final histopathological evaluation after surgery, lymphadenectomy rate, postoperative complications, and prostatic specific antigen (PSA) levels (initial and 30 days after surgery) were analyzed and compared in a group of patients before and during the pandemic period. Results We included 226 patients: 88 in the pre-pandemic period and 138 during the pandemic period. There was no statistically significant difference in mean age, body mass index, ASA, pathological locally advanced disease, the proportion of patients who underwent lymphadenectomy, and ISUP grade in the biopsy between the groups. Positive surgical margins, prostatic extracapsular extension, and PSA levels at 30 days were also similar between the groups. The mean time between medical consultation and surgery was longer in the pandemic period than in the pre-pandemic (124 vs. 107 days, p<0.001), and the mean time between biopsy and medical consultation (69.5 days vs. 114 days, p<0.001) and between biopsy and surgery (198.5 days vs. 228 days, p=0.013) was shorter during the pandemic. The incidence of severe early and late perioperative complications was similar between the periods. Conclusions There was no delay between diagnosis and treatment at our institution during the COVID-19 pandemic period. No worsening of the prostate cancer features was observed.

https://doi.org/10.1590/s1677-5538.ibju.2022.0393

Using the cell phone while standing or walking affects balance and mobility in people with Parkinson’s disease
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Lino, Tayla Borges

; Silva, Milena Nunes de Oliveira da

; Paula, Isabela Corrêa de

; Melo, Sarah Jane Lemos de

; Barbosa, Suzi Rosa Miziara

; Christofoletti, Gustavo

Arquivos de Neuro-Psiquiatria

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apr 2023, Volume 81 N. 4 Pages 377 - 383

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

Abstract Background Cell phones are part of peoples’ lives. The literature indicates risks when cell phones are used during a secondary motor task. Studies addressing this topic in people with Parkinson’s disease are still scarce. Objective To investigate the impact of daily dual tasks with cell phone on balance and mobility in people with Parkinson’s disease, compared to healthy control peers. Methods Participants with Parkinson’s disease and controls underwent three motor tasks: (1) Standing and walking without using a cell phone; (2) Standing and walking while talking on the phone; and (3) Standing and walking while texting messages on the phone. Assessments involved balance and mobility tests. Statistical analysis was performed with multivariate analysis of variance, comparing main effect for group (Parkinson’s disease × control), task (using × not using cell phone) and interactions (group × task). Significance was set at 5%. Effect sizes are reported. Results Participants with Parkinson’s disease showed worse balance (p = 0.001, effect size of 0.471) and mobility (p = 0.001, effect size of 0.472) than control peers. The use of cell phone while performing a secondary motor task affected both groups (p = 0.005, effect size of 0.673 for balance and p = 0.001, effect size of 0.549 for mobility). The dual task impact, however, was higher in the Parkinson’s disease group (p = 0.009, effect size of 0.407 for mobility). Conclusion Daily dual tasks with cell phones increase imbalance and mobility risks in Parkinson’s disease. People should be careful when using their cell phone while standing or walking.

Resumo Antecedentes Aparelhos celulares fazem parte da vida das pessoas. A literatura aponta riscos quando o uso do celular está associado a uma tarefa motora. Estudos abordando esse tema na doença de Parkinson são escassos. Objetivo Investigar o impacto de tarefas-duplas com o celular sobre equilíbrio e mobilidade de pessoas com doença de Parkinson, na comparação com controles saudáveis. Métodos Participantes com e sem doença de Parkinson foram submetidos a três tarefas: (1) Ficar em pé e caminhar sem o celular; (2) Ficar em pé e caminhar enquanto conversa ao celular; e (3) Ficar em pé e caminhar enquanto digita mensagens. As avaliações envolveram testes de equilíbrio e mobilidade. Os procedimentos estatísticos envolveram testes de análise múltipla de variâncias, com análise de efeito principal para os fatores grupo (doença de Parkinson x controle), tarefa (com celular × sem celular) e interação (grupo × tarefa). Significância foi estipulada em 5%. Tamanhos de efeito foram reportados. Resultados Participantes com doença de Parkinson apresentaram pior equilíbrio (p = 0,001; tamanho do efeito: 0,471) e mobilidade (p = 0,001; tamanho do efeito: 0,472) que controles. O uso do celular afetou ambos os grupos (p = 0,005, tamanho do efeito de 0,673 para equilíbrio e p = 0,001, tamanho do efeito de 0,549 para mobilidade). O impacto da tarefa-dupla, contudo, foi maior no grupo Parkinson (p = 0,009; tamanho do efeito de 0,407 para mobilidade). Conclusão Tarefas simultâneas com o celular causam desequilíbrio e problemas de mobilidade na doença de Parkinson. As pessoas devem ter cuidado ao utilizar celulares durante atividades em pé e ao caminhar.

https://doi.org/10.1055/s-0043-1767825

Brote de histoplasmosis en el contexto de la pandemia por COVID-19
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Abreu La Rosa, Idioel

; García Gómez, Carlos

; Fragoso Marchante, María Caridad

; Cruz de los Santos, Héctor Javier

; Cuéllar Oramas, Yanisleydi

Revista Cubana de Medicina Tropical

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apr 2023, Volume 75 N. 1 elocation e942

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

RESUMEN La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas.

ABSTRACT Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated.

Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?
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Urbanetz, Lorena Ana Mercedes Lara

; Soares Junior, José Maria

; Maciel, Gustavo Arantes Rosa

; Simões, Ricardo dos Santos

; Baracat, Maria Cândida Pinheiro

; Baracat, Edmund Chada

Clinics

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2023, Volume 78 elocation 100310

Abstract: En | Text: En | PDF: En

Abstract PCOS is an endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Its etiology is uncertain. It is debated whether BPA would be a component of the environmental factor in the etiology of PCOS. Contamination by BPA can occur from food packaging (exposure during the diet) and through skin absorption and/or inhalation. It can be transferred to the fetus via the placenta or to the infant via breast milk, and it can be found in follicular fluid, fetal serum, and amniotic fluid. The phenolic structure of BPA allows it to interact with Estrogen Receptors (ERs) through genomic signaling, in which BPA binds to nuclear ERα or Erβ, or through nongenomic signaling by binding to membrane ERs, prompting a rapid and intense response. With daily and constant exposure, BPA's tendency to bioaccumulate and its ability to activate nongenomic signaling pathways can alter women's metabolic and reproductive function, leading to hyperandrogenism, insulin resistance, obesity, atherogenic dyslipidemia, chronic inflammatory state, and anovulation and favoring PCOS. The harmful changes caused by BPA can be passed on to future generations without the need for additional exposure because of epigenetic modifications. Not only high BPA levels can produce harmful effects, but at low levels, BPA may be harmful when exposure occurs during the most vulnerable periods, such as the fetal and neonatal periods, as well as during the prepubertal age causing an early accumulation of BPA in the body. Learning how BPA participates in the pathogenesis of PCOS poses a challenge and further studies should be conducted.

https://doi.org/10.1016/j.clinsp.2023.100310

10.

LIVER TRANSPLANT FOR METASTATIC NEUROENDOCRINE TUMORS: A SINGLE-CENTER REPORT
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Sampaio, Raquel Lima

; Coelho, Gustavo Rego

; Quidute, Ana Rosa Pinto

; Rocha Filho, Duilio Reis da

; Soares, Carlos Eduardo Lopes

; Garcia, José Huygens Parente

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2023, Volume 36 elocation e1750

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

ABSTRACT BACKGROUND: Neuroendocrine tumors are rare neoplasms of uncertain biological behavior. The liver is one of the most common sites of metastases, occurring in 50% of patients with metastatic disease. AIMS: To analyze a clinical series in liver transplant of patients with neuroendocrine tumors metastases. METHODS: A retrospective descriptive study, based on the review of medical records of patients undergoing liver transplants due to neuroendocrine tumor metastases in a single center in northeast Brazil, over a period of 20 years (January 2001 to December 2021). RESULTS: During the analyzed period, 2,000 liver transplants were performed, of which 11 were indicated for liver metastases caused by neuroendocrine tumors. The mean age at diagnosis was 45.09±14.36 years (26–66 years) and 72.7% of cases were females. The most common primary tumor site was in the gastrointestinal tract in 64% of cases. Even after detailed investigation, three patients had no primary tumor site identified (27%). Overall survival after transplantation at one month was 90%, at one year was 70%, and five year, 45.4%. Disease-free survival rate was 72.7% at one year and 36.3% at five years. CONCLUSIONS: Liver transplantation is a treatment modality with good overall survival and disease-free survival results in selected patients with unresectable liver metastases from neuroendocrine tumors. However, a rigorous selection of patients is necessary to obtain better results and the ideal time for transplant indication is still a controversial topic in the literature.

RESUMO RACIONAL: Os tumores neuroendócrinos são neoplasias raras de comportamento biológico incerto. O fígado é um local comum de metástase, ocorrendo em 50% dos pacientes com doença metastática. OBJETIVOS: Analisar casuística de transplante hepático por metástases de tumores neuroendócrinos. MÉTODOS: Estudo descritivo retrospectivo com revisão de prontuários de pacientes submetidos a transplante hepático por metástases de tumores neuroendócrinos em um único centro no Nordeste do Brasil durante 20 anos (janeiro de 2001 a dezembro de 2021). RESULTADOS: Durante o período analisado, foram realizados 2.000 transplantes hepático, sendo 11 indicados por metástases hepáticas de tumores neuroendócrinos. A média de idade ao diagnóstico foi de 45,09±14,36 anos (26–66 anos) e 72,7% dos casos eram do sexo feminino. O local do tumor primário mais comum foi o trato gastrointestinal (64% dos casos). Após detalhada investigação, três pacientes não tiveram o local do tumor primário identificado (27%). A sobrevida global um mês e após um ano do transplante foi de 90 e 70%, respectivamente. A sobrevida após 5 anos foi de 45,4%. A taxa de sobrevida livre de doença foi de 72,7% no primeiro ano e 36,3% em cinco anos. CONCLUSÕES: O transplante hepático é uma modalidade de tratamento com bons resultados de sobrevida global e sobrevida livre de doença, em pacientes selecionados com metástases hepáticas irressecáveis de tumores neuroendócrinos. No entanto, a seleção rigorosa dos pacientes é necessária para obter melhores resultados e o momento ideal para a indicação do transplante ainda é um tema controverso na literatura.

https://doi.org/10.1590/0102-672020230032e1750

11.

SARS-CoV-2 infection and COVID-19 and human reproduction – A changing perspective - A 2022 update
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Delamuta, Luciana C.

; Monteleone, Pedro A.A.

; Ferreira-Filho, Edson S.

; Heinrich-Oliveira, Vanessa

; Soares-Júnior, José Maria

; Baracat, Edmund C.

; Maciel, Gustavo Arantes Rosa

Clinics

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2023, Volume 78 elocation 100166

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.clinsp.2023.100166

12.

Rivaroxabana em Pacientes Ambulatoriais com COVID-19 Leve ou Moderada: Fundamentação e Desenho do Estudo CARE (CARE – Coalition COVID-19 Brazil VIII)
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Oliveira, Gustavo B. F.

; Neves, Precil Diego M. M.

; Oliveira, Haliton A.

; Catarino, Daniela Ghidetti Mangas

; Alves, Lucas B. O.

; Cavalcanti, Alexandre B.

; Rosa, Regis G.

; Veiga, Viviane C.

; Azevedo, Luciano C.P.

; Berwanger, Otávio

; Lopes, Renato D.

; Avezum, Álvaro

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 3 elocation e20220431

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

Abstract Background Previous studies have demonstrated a high risk of arterial and venous thromboembolic events as a consequence of direct viral damage to endothelial cells by SARS-CoV-2 and a procoagulant milieu due to increased biomarkers, such as D-dimer, fibrinogen, and factor VIII. Although randomized controlled trials of antithrombotic therapies have been conducted in hospitalized patients, few have evaluated the role of thromboprophylaxis in an outpatient setting. Objective To assess whether antithrombotic prophylaxis with rivaroxaban reduces the risk of venous or arterial thrombotic events, invasive ventilatory support, and death in COVID-19 outpatients. Methods The COVID Antithrombotic Rivaroxaban Evaluation (CARE) study, a multicenter, randomized, open-label, controlled trial of rivaroxaban 10 mg once daily for 14 days or local standard treatment alone to prevent adverse outcomes, is registered in clinicaltrials.gov (NCT04757857). The inclusion criteria are adults with confirmed or suspected SARS-CoV-2 infection and mild or moderate symptoms without indication for hospitalization, within 7 days of symptom onset, and 1 risk factor for COVID-19 complication (> 65 years, hypertension, diabetes mellitus, asthma, chronic obstructive pulmonary disease or other chronic lung diseases, smoking, immunosuppression, or obesity). The primary composite endpoint, which includes venous thromboembolism, invasive mechanical ventilation, major acute cardiovascular events, and mortality within 30 days of randomization, will be assessed according to the intention-to-treat principle. All patients will provide informed consent. A significance level of 5% will be used for all statistical tests. Results Major thrombotic and bleeding outcomes, hospitalizations, and deaths will be centrally adjudicated by an independent clinical events committee blinded to the assigned treatment groups. Conclusion The CARE study will provide relevant and contemporary information about the potential role of thromboprophylaxis in outpatients with COVID-19.

Resumo Fundamento Estudos anteriores revelaram alto risco de eventos tromboembólicos arteriais e venosos como consequência de danos virais diretos do SARS-CoV-2 em células endoteliais e um meio procoagulante devido ao aumento de biomarcadores como o D-dímero, fibrinogênio, fator VIII. Foram realizados ensaios controlados randomizados de terapias antitrombóticas em pacientes internados, no entanto, poucos estudos avaliaram o papel da tromboprofilaxia no ambiente ambulatorial. Objetivo Avaliar se a profilaxia antitrombótica com rivaroxabana reduz o risco de eventos trombóticos venosos ou arteriais, suporte ventilatório invasivo e morte em pacientes ambulatoriais com COVID-19. Métodos O estudo CARE é um ensaio randomizado, aberto, multicêntrico e controlado por rivaroxabana 10 mg uma vez por dia durante 14 dias ou tratamento local padrão isolado, para a prevenção de resultados adversos, registrado no Clinicaltrials.gov (NCT04757857). Os critérios de inclusão são adultos com infecção confirmada ou suspeita do SARS-CoV-2, com sintomas leves ou moderados, sem indicação de hospitalização, no prazo de 7 dias após o início dos sintomas e um fator de risco de complicação da COVID-19 (>65 anos, hipertensão, diabetes, asma, doença pulmonar obstrutiva crônica ou outras doenças pulmonares crônicas, tabagismo, imunossupressão ou obesidade). O desfecho primário composto inclui tromboembolismo venoso, necessidade de ventilação mecânica invasiva, eventos cardiovasculares agudos maiores e mortalidade no prazo de 30 dias após a randomização, sendo avaliado segundo o princípio da intenção de tratar. Todos os pacientes assinaram termo de consentimento. Foi estabelecido um nível de significância de 5% para todos os testes estatísticos. Resultados Os principais desfechos trombóticos e hemorrágicos, hospitalizações e mortes serão avaliados centralmente por um comitê de eventos clínicos independente, sob a condição cega para a alocação dos grupos de tratamento. Conclusão O estudo CARE fornecerá informação relevante e contemporânea sobre o possível papel da tromboprofilaxia em pacientes ambulatoriais com COVID-19.

https://doi.org/10.36660/abc.20220431

13.

Hidroxicloroquina para Pacientes com COVID-19 não Hospitalizados: Uma Revisão Sistemática e Metanálise de Ensaios Clínicos Randomizados
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Lucchetta, Rosa

; Matuoka, Jessica Y.

; Oliveira Junior, Haliton Alves de

; Oliveira, Gustavo

; Cavalcanti, Alexandre Biasi

; Azevedo, Luciano

; Berwanger, Otavio

; Lopes, Renato Delascio

; Rosa, Regis Goulart

; Veiga, Viviane Cordeiro

; Avezum, Álvaro

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 4 elocation e20220380

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

Abstract Background: Previous systematic reviews have identified no benefit of hydroxychloroquine and chloroquine in non-hospitalized COVID-19 patients. After publication of these reviews, the results of COPE, the largest randomized trial conducted to date, became available. Objectives: To conduct a systematic review and meta-analyses of randomized clinical trials (RCTs) to synthesize the evidence on the efficacy and safety of hydroxychloroquine and chloroquine for non-hospitalized COVID-19 patients compared to placebo or standard of care. Methods: Searches were conducted in PubMed, Embase, The Cochrane Library, and ClinicalTrials.gov complemented by manual search. Pairwise meta-analyses, risk of bias, and evidence certainty assessments were conducted, including optimal information size analysis (OIS). A level of significance of 0.05 was adopted in the meta-analysis. PROSPERO: CRD42021265427. Results: Eight RCTs with 3,219 participants were included. COVID-19 hospitalization and any adverse events rates were not significantly different between hydroxychloroquine (5.6% and 35.1%) and control (7.4% and 20.4%) (risk ratio, RR, 0.77, 95% confidence interval, CI, 0.57-1.04, I2: 0%; RR 1.78, 95%-CI 0.90; 3.52, I2: 93%, respectively). The OIS (7,880) was not reached for COVID-19 hospitalization, independently of the simulation for anticipated event rate and RR reduction estimate. Conclusion: Evidence of very low certainty showed lack of benefit with hydroxychloroquine in preventing COVID-19 hospitalizations. Despite being the systematic review with the largest number of participants included, the OIS, considering pre-vaccination response to infection, has not yet been reached.

Resumo Fundamento: Revisões sistemáticas anteriores não identificaram benefício do uso da hidroxicloroquina ou da cloroquina em pacientes com COVID-19 não hospitalizados. Após a publicação dessas revisões, os resultados do COPE, o maior ensaio clínico randomizado até hoje, tornaram-se disponíveis. Objetivos: Conduzir uma revisão sistemática e metanálise de ensaios clínicos randomizados (ECRs) para sintetizar as evidências sobre a eficácia e a segurança da hidroxicloroquina e da cloroquina em pacientes com COVID-19 não hospitalizados em comparação a controle ou tratamento padrão. Métodos: As buscas foram conduzidas nos bancos de dados PubMed, Embase, The Cochrane Library e ClinicalTrials.gov, e complementadas por busca manual. Foram realizadas metanálises diretas e avaliações de risco de viés e certeza da evidência, incluindo análise do tamanho ótimo da informação (OIS, optimal information size). Um nível de significância de 0,05 foi adotado na metanálise. PROSPERO: CRD42021265427. Resultados: Oito ECRs com 3219 participantes foram incluídos. As taxas de internação por COVID-19 e de eventos adversos não foram significativamente diferentes entre hidroxicloroquina (5,6% e 5,1%) e controle (7,4% e 20,4%) [risco relativo (RR) 0,77, intervalo de confiança 95% (IC95%), 0,57-1,04, I2: 0%; RR 1,78, IC95% 0,90; 3,52, I2: 93%, respectivamente)]. O OIS (7880) não foi alcançado para hospitalização por COVID-19, independentemente da simulação para a taxa de evento e redução do RR estimados. Conclusão: A evidência de muito baixa qualidade indicou falta de benefício com hidroxicloroquina em prevenir internações por COVID-19. Apesar de ser a revisão sistemática com o maior número de participantes incluídos, o OIS, considerando a resposta à infecção anterior à vacinação, não foi atingido.

https://doi.org/10.36660/abc.20220380

14.

Panorama das Intervenções Coronárias Percutâneas em Oclusões Totais Crônicas em Centros Participantes do LATAM CTO Registry no Brasil
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Silva, Antonio Carlos Botelho da

; Paula, João Eduardo Tinoco de

; Campos, Carlos M.

; Ribeiro, Marcelo Harada

; Martins Filho, Evandro

; Oliveira, Marcos Danillo Peixoto

; Côrtes, Leandro Assumpção

; Abelin, Aníbal Pereira

; Zukowski, Cleverson Neves

; Martinelli, Gustavo Cervino

; Brito, Fábio Sândoli de

; Muniz, Antônio José

; Cantarelli, Marcelo José de Carvalho

; Andrade, Pedro Beraldo de

; Medeiros, César Rocha

; Falcão, Breno de Alencar Araripe

; Fuchs, Felipe Costa

; Silva, Leonardo Sinnott

; Fattah, Tammuz

; Degrazia, Ramiro Caldas

; Mangione, José Armando

; Bezerra, Cristiano Guedes

; Baradel, Sandra

; Silveira, João Brum

; Ybarra, Luiz Fernando

; Weillenmann, Daniel

; Gottschall, Carlos

; Lemke, Viviana

; Silva, Franciele Rosa da

; Schmidt, Marcia Moura

; Belli, Karlyse Claudino

; Oliveira, Pedro Piccaro de

; Quadros, Alexandre Schaan de

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 4 elocation e20210462

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

Abstract Background Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries. Objectives To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil. Methods Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months. Results Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%. Conclusions CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centers.

Resumo Fundamento Tem sido observado um grande avanço nas técnicas e nos dispositivos para a realização de intervenções coronárias percutâneas (ICP) em oclusões totais coronarianas crônicas (OTC), mas existem poucos dados da prática do mundo real em países em desenvolvimento. Objetivos Relatar as características clínicas e angiográficas, os aspectos dos procedimentos e os resultados clínicos da ICP de OTC em centros dedicados a esse procedimento no Brasil. Métodos Os pacientes incluídos foram submetidos à ICP de OTC em centros participantes do LATAM CTO Registry, um registro multicêntrico latino-americano dedicado à coleta prospectiva desses dados. Os critérios de inclusão foram procedimentos realizados no Brasil, idade acima de 18 anos e presença de OTC com tentativa de ICP. A definição de OTC foi lesão de 100% em uma artéria coronária epicárdica, conhecida ou estimada como tendo pelo menos 3 meses de evolução. Resultados Foram incluídos dados de 1.196 ICPs de OTC. Os procedimentos foram realizados principalmente para controle da angina (85%) e/ou tratamento de uma grande área isquêmica (24%). A taxa de sucesso técnico foi de 84% e foi alcançada com técnicas de fios anterógrados em 81%, dissecção/reentrada anterógrada em 9% e retrógrada em 10% dos procedimentos. Os eventos cardiovasculares adversos intra-hospitalares ocorreram em 2,3% dos casos, sendo a mortalidade de 0,75%. Conclusões As OTC podem ser tratadas no Brasil por intervenção coronária percutânea de forma efetiva e com baixas taxas de complicações. O desenvolvimento científico e tecnológico observado nessa área na última década reflete-se na prática clínica de centros brasileiros dedicados a essa técnica.

https://doi.org/10.36660/abc.20210462

15.

Carbon stocks and lability in land use and management systems in southwestern Goiás, Brazil
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Ribeiro, Diego Oliveira

; Gonçalves, Gabriel Rosa

; Rubio, Giovana Oliveira

; Castoldi, Gustavo

; Vendruscolo, Eduardo Pradi

; Souza, Zaqueu Henrique de

Pesquisa Agropecuária Tropical

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2023, Volume 53 elocation e74416

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

ABSTRACT The southwest region of the Goiás state, Brazil, is suitable for several agricultural activities, even in more fragile soils such as Typic Quartzipsamments. This study aimed to evaluate the carbon stocks and lability of a Typic Quartzipsamment under land use and management systems in southwestern Goiás. The experiment was conducted in a completely randomized design and consisted of areas subjected to five land use and management systems [native Cerrado vegetation (Brazilian Savanna), pasture under intensive grazing, pasture under extensive grazing, soybean and maize rotation, and eucalyptus]. Soil samples were collected at the 0-0.1 and 0.1-0.2 m layers. The land use and management systems affected the carbon stocks and quality. In the 0-0.2 m layer, the carbon stocks ranged between 15.9 and 29.2 Mg ha−1. The areas with eucalyptus and under intensive grazing promoted increases in the carbon stocks that ranged between 72 and 84 %, when compared to the areas with Cerrado vegetation and soybean and maize rotation. The carbon contents in the F1, F2 and F4 fractions were higher in the areas with eucalyptus and under intensive grazing. In the 0-0.1 m soil layer, the areas with eucalyptus and under intensive grazing had an increase in the carbon management index by 33 and 36 %, respectively, when compared to the reference area with native Cerrado vegetation.

RESUMO O sudoeste do estado de Goiás apresenta elevada vocação para diversas atividades agropecuárias, mesmo em solos considerados mais frágeis, como os Neossolos Quartzarênicos. Objetivou-se avaliar os estoques e a labilidade de carbono em sistemas de uso e manejo de um Neossolo Quartzarênico, no sudoeste goiano. Utilizou-se delineamento inteiramente causualizado, constando de áreas submetidas a cinco sistemas de uso e manejo do solo (Cerrado nativo, pastagem intensiva, pastagem extensiva, plantio de soja com sucessão de milho, e eucalipto). Foram coletadas amostras nas profundidades de 0-0,1 e 0,1-0,2 m. Os sistemas de uso e manejo do solo alteraram os estoques e a qualidade do carbono. Na camada de 0-0,2 m, os estoques de carbono variaram entre 15,9 e 29,2 Mg ha−1. As áreas com eucalipto e sob pastejo intensivo proporcionaram incrementos variando entre 72 e 84 % nos estoques de carbono, em relação às áreas de Cerrado e soja-milho. Os teores de carbono nas frações F1, F2 e F4 foram superiores nas áreas com eucalipto e sob pastejo intensivo. Na camada de 0-0,1 m, as áreas com cultivo de eucalipto e sob pastejo intensivo incrementaram o índice de manejo de carbono em 33 e 36 %, respectivamente, quando comparadas à área de referência com Cerrado nativo.

https://doi.org/10.1590/1983-40632023v5374416

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