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[SciELO Preprints] - Crisis, fiscal austerity and food insecurity: associated factors, trends and spatial distribution via PNAD and POF
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Amaral, Marcelo Rubens dos Santos do Silva, Pedro Luis do Nascimento Leon, Antonio Carlos Monteiro Ponce de

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Publication date: 2023-03-28

Abstract: Es En Pt

Este estudio tiene como objetivo identificar y analizar los factores asociados a la Inseguridad Alimentaria (IF), tendencias y distribución espacial por estratos geográficos. Se investigó la hipótesis de empeoramiento del resultado de la IF severa, medida por la Escala Brasileña de Inseguridad Alimentaria (EBIA), en los hogares como efecto de la crisis y/o de la política de austeridad. El artículo trata de estudios con diseño transversal para análisis ecológicos transversales y mixtos de tendencias espacio-temporales, a partir de 4 encuestas nacionales del IBGE. Se adoptó un procedimiento de calibración de peso de acuerdo con la distribución por sexo y grupo de edad y métodos de estimación y modelado que incorporan efectos del diseño de la muestra. Se utilizó la regresión de Poisson con estimación robusta de la varianza para estimar los índices de prevalencia de la IA grave a nivel etiológico. Para el nivel ecológico, se emplearon dos enfoques de modelado multinivel para medidas repetidas de estratos: regresión logarítmica múltiple para asociaciones; y modelado de splines para la estimación de tendencias. Los hallazgos apuntan a impactos de la actual austeridad, con cambios de tendencia en el Programa Bolsa Família y reflejos sobre el aumento de la IF severa. Se proyecta un aumento de la IA y distancia de la consecución del objetivo nº 2 de los ODS en 2030 por parte de Brasil, a pesar del éxito obtenido en 2014 para el ODM nº 1.

This study aims to identify and analyze factors associated with Food Insecurity (FI), trends and spatial distributions for geographical strata. The hypothesis of worsening of the outcome of severe FI, measured by the Brazilian Food Insecurity Scale (EBIA), in households as an effect of the crisis and/or the austerity policy, was investigated. The article involves studies with cross-sectional design and mixed ecological of spatio-temporal trends, based on 4 national IBGE surveys. It was adopted a weight calibration procedure according to population distribution by gender and age group, as well as estimation and modeling methods that incorporate effects of the sample design. Poisson regression with robust estimation of variance was used to estimate prevalence ratios of severe FI at the etiological level. For the ecological level, two multilevel modeling approaches were employed for repeated measures of strata: multiple log-log regression for associations; and, modeling of splines for trend estimation. The findings point to impacts of the current austerity, with changes in trends in the Bolsa Família Program and reflections on the increase in severe FI. It is projected an increase in FI and distance from the achievement of the SDG nº 2 in 2030 by Brazil, despite the success obtained in 2014 for MDG nº 1.

Este estudo visa identificar e analisar fatores associados à Insegurança Alimentar (IA), tendências e distribuição espacial para estratos geográficos. Investigou-se a hipótese de piora do desfecho de IA grave, medido pela Escala Brasileira de Insegurança Alimentar (EBIA), nos domicílios como efeito da crise e/ou da política de austeridade. O artigo envolve estudos com desenho transversal para análises seccionais e ecológico misto de tendências espaço-temporais, a partir de 4 inquéritos nacionais do IBGE. Adotou-se procedimento de calibração dos pesos segundo distribuição por sexo e faixa etária e métodos de estimação e modelagem que incorporam efeitos do desenho amostral. A regressão de Poisson com estimação robusta de variância foi empregada para estimar razões de prevalências de IA grave em nível etiológico. Para o nível ecológico, empregou-se duas abordagens de modelagem multinível para medidas repetidas de estratos: regressão múltipla log-log para associações; e, modelagem de splines para estimação de tendências. Os achados apontam impactos da austeridade vigente, com mudanças de tendências no Programa Bolsa Família e reflexos sobre o aumento da IA grave. Projeta-se o aumento da IA e afastamento do alcance do objetivo nº 2 dos ODS em 2030 pelo Brasil, a despeito do sucesso obtido em 2014 para o ODM nº 1.

https://doi.org/10.1590/SciELOPreprints.5737

Wort disinfection treatment with electron beam for bioethanol production
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Calegari, Rubens Perez

; Silva, Eric Alberto da

; Silva, Ana Paula Maria da

; Gomes, Marcelo Pego

; Mota, Layna Amorim

; Arthur, Valter

; Baptista, Antonio Sampaio

Scientia Agricola

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2023, Volume 80 elocation e20210260

Abstract: En | Text: En | PDF: En

ABSTRACT Microbial contamination of the wort during the fermentation process causes significant losses in ethanol production worldwide and creates a dependence of the industry on chemicals and antibiotics to control contamination. Therefore, this study used electron beam (e-beam) to disinfect wort from sugarcane (Saccharum officinarum L.) molasses and investigate the bioethanol fermentation. Four treatments (T0 – T3) were carried out using ionizing doses of radiation through the electron accelerator: 0 (control), 10, 20, and 40 kGy. Total mesophiles, total bacteria, sucrose, glucose, fructose, phenolics, flavonoids, hydroxymethylfurfural (5-HMF), and Furfural were measured. An alcoholic fermentation assay was performed after the irradiation process. The irradiated treatments showed no inversion of sugars and formation of the inhibitory by-products flavonoids, furfural and 5-HMF, except for the phenolic compounds. The lower dose tested (10 kGy) reduced more than 99.9 % of the total mesophiles and more than 99.99 % of the total bacteria in the substrate. In the fermentation, the irradiated worts presented similar (p > 0.05) yields (92, 93, and 94 %) and ethanol productivity levels (0.89, 0.88, and 0.87 g L–1 h–1, for T1, T2, and T3 respectively). However, all treatments presented higher yields and productivity (p < 0.05) when compared to the control (88 % and 0.85 g L–1 h–1), highlighting the possible use of e-beam in wort fermentation at a lower dose (10 kGy). This allows reduction in losses caused by microbial contamination, besides increasing fermentation yield and productivity with lower energy consumption.

https://doi.org/10.1590/1678-992x-2021-0260

Comparative assessment of TiN thin films created by plasma deposition technique on the surface features of NiCr alloys for dental applications
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Cerqueira, Nicole da Costa

; Balica, Naasson Matheus Pereira

; Borges, Wênio Fhará Alencar

; Sousa, Gabriel Melo Reis de

; Pupim, Denise

; Radi, Polyana Alves

; Nascimento, Rubens Maribondo do

; Silva, António Ramos

; Silva, Lucas Filipe Martins da

; Costa, Thércio Henrique de Carvalho

; Silva, Heurison de Sousa e

; Nunes, Lívio César Cunha

; Sousa, Rômulo Ribeiro Magalhães de

; Santos, Rafaela Luiz Pereira

Matéria (Rio de Janeiro)

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2023, Volume 28 N. 1 elocation e20220257

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Surface treatment is an important technique to increase adhesion between implants and bones, improving its mechanical characteristics and consequently the patient’s comfort. Objectives: Ni-Cr alloys were the object of study in this work, with the purpose of analyzing and evaluating the effect of thin films deposition of titanium nitride via plasma, on its surface and comparing with cathodic cage (CC) and hollow cathode (HC) methods, for dental applications. Methods: Eighteen samples were prepared and the experiment was conducted in two steps: the pre-sputtering (1h, 350 °C, gases: Ar and H) and sputtering (4h, 450 °C, gases: Ar, Ni, and H). To characterize and compare the samples with those of reference, the Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), Vickers Microhardness and wettability tests were used. Results: The results presented by SEM showed that during the surface treatment using CC, voids were formed, and using HC, the samples showed a more homogenous behavior. In microhardness tests, using a 25gf load, it was possible to observe that the HC method allowed an increase of 87% when compared to the reference and treated samples. Significance: Lastly, it can be concluded that both methods are suitable for Ni-Cr alloy surface treatment, and the HC technique, a method already used by dental professionals, presents better results due to the formation of a thicker film layer.

https://doi.org/10.1590/1517-7076-rmat-2022-0257

Glycemic and nonglycemic mechanisms of congenital malformations in hyperglycemic pregnancies: a narrative review
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Negrato, Carlos Antonio

; Marques Júnior, Paulo Rubens

; Leite, Heloisa Barreto

; Torigoe, Carolina Naomi

; Silva, Beatriz Fernandes

; Costa, Kessy

; Kamei, Júlia Marchatto

; Zampa, Cárian Leoz

; Toni, Ana Clara Rocha Gomes

; Pereira, Izabella Carolina Gomes Santana

; Heinzelmann, Gabryel Luz

; Zajdenverg, Lenita

Archives of Endocrinology and Metabolism

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dec 2022, Volume 66 N. 6 Pages 908 - 918

Abstract: En | Text: En | PDF: En

ABSTRACT Congenital malformations are more frequently found among children born to mothers with diabetes than in the background population. There are several complex mechanisms involved in the development of congenital malformations in the offspring of mothers with hyperglycemia, such as the overexpression of glucose transporters (GLUTs) 1 and 2, the increased activity of the hexosamine biosynthetic pathway and the reduced expression of the PAX3 gene with a consequent increase in p53 protein expression. These alterations can lead to increased glucose and free radical concentrations in the embryo, thus promoting the process of apoptosis and causing malformation. The most frequent malformations found in the offspring of mothers with diabetes are heart and neural tube defects, urinary tract and kidney malformations, and cleft lip with or without cleft palate. Strict glycemic control should be obtained before and during pregnancy, aiming to avoid or minimize the risk of congenital malformations in the offspring. Beyond hyperglycemia, several factors may also be associated with increased risks of malformations in the offspring of these women, such as obesity, multiple pregnancies, advanced maternal age, folic acid deficiency, use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, assisted reproduction techniques, and exposure to different types of environmental pollutants.

https://doi.org/10.20945/2359-3997000000521

Linear AC Three-Phase OPF Model for Active Distribution Networks with Unbalanced ZIP Loads
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Pinto, Rafael Silva

; Unsihuay-Vila, Clodomiro

; Fernandes, Thelma Solange Piazza

; Baran Junior, Antonio Rubens

Brazilian Archives of Biology and Technology

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2022, Volume 65 elocation e22220061

Abstract: En | Text: En | PDF: En

Abstract: Although nonlinear Alternating Current (AC) Optimal Power Flow (OPF) may provide more accurate results compared to linearized OPF models, many ACOPF problems are complex and may require high, sometimes infeasible, computational time. The linear Direct Current OPF (DCOPF) has been widely used in power system analysis; however, it has limitations regarding reactive power analysis, and it may cause significant error in distribution networks with a high R/X ratio of feeders. Moreover, most of the existing formulations for the linear ACOPF do not consider mutual impedance for the lines and simplify the network as a single-phase system, which does not significantly represent unbalanced loads. This paper proposes a novel linear AC three-phase OPF formulation for unbalanced ZIP loads using current injection and considering delta and wye loads. The formulation is extended to include shunt capacitors, voltage regulators, and mutual impedance. The proposed methodology is illustrated using the IEEE 123-bus test system in case studies including/not-including voltage regulators, distributed generation, high R/X ratio, and mutual impedance. The results are very accurate compared with a nonlinear three-phase ACOPF model. The high computational performance and the accuracy of the proposed model considering distributed generation and high R/X ratio show its effectiveness in active distribution networks.

https://doi.org/10.1590/1678-4324-2022220061

Acesso e direito à saúde para migrantes bolivianos em uma metrópole brasileira
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Carneiro Junior, Nivaldo

; Aith, Fernando

; Silva, Rubens Antonio da

; Wanderley, Dalva Marli Valério

; Luna, Expedito José

; Shikanai-Yasuda, Maria Aparecida

Saúde e Sociedade

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2022, Volume 31 N. 3 elocation e210761pt

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

Resumo Este artigo analisa as condições de acesso do imigrante boliviano ao sistema de saúde brasileiro e a percepção do direito à saúde. É um estudo transversal de metodologia quantitativa e qualitativa, realizado de 2013 a 2015. Foi elaborado um questionário com perguntas fechadas respondidas por 633 bolivianos, e em relação ao acesso à saúde por 472 indivíduos bolivianos maiores de 18 anos. A abordagem qualitativa foi feita por meio da análise de conteúdo de entrevistas semiestruturadas com 55 sujeitos (bolivianos, profissionais de saúde, representantes de Secretarias de Saúde, Consulado da Bolívia, Defensoria Pública da União, Ministério Público Federal e Organizações Não Governamentais). Os bolivianos conhecem o Sistema Único de Saúde (SUS) e utilizam com frequência a Atenção Primária à Saúde (APS). Todavia, barreiras de acesso são descritas, como falta de documentação, condições de trabalho, procedimentos de média e/ou alta complexidades, dificuldades para entenderem o que é dito assim como para serem compreendidos, entre outras. Sobressai-se a obtenção do Cartão Nacional de Saúde (CNS) como porta de entrada para o acesso à saúde, desempenhando papel de integração social. O reconhecimento da Saúde como direito social destaca-se entre os entrevistados, apontado como valor humano e solidário. A garantia desse reconhecimento fica ameaçada quando não se apoia na consolidação de políticas sociais que visem o fortalecimento da proteção social universal.

Abstract This paper analyzes the health care accessibility conditions afforded to Bolivian immigrants in the Brazilian health system and their perception of the right to health. This was a cross-sectional, quantitative and qualitative study carried out from 2013 to 2015. Data were collected by a questionnaire with closed questions answered by 633 Bolivian individuals; questions regarding access to health were answered by 472 immigrants over 18 years old. Semi-structured interviews conducted with 55 subjects (Bolivians, health professionals, representatives of Health Departments, Consulate of Bolivia, Public Defender’s Office, Federal Public Prosecutor’s Office and Non-Governmental Organizations) underwent content analysis. Most Bolivian immigrants know the Brazilian National Health System (SUS) and often use Primary Health Care; however, they described structural and systemic barriers to health accessibility, such as lack of documentation, working conditions, medium and high complexity procedures, language barriers, among others. The National Health Card (CNS) is an important gateway to access health care, playing a role of social integration. Interviewees recognize health as a social right, pointing it out as a human and solidary value. Ensuring this recognition, when not based on the consolidation of social policies aimed at strengthening universal social protection, is threatened.

https://doi.org/10.1590/s0104-12902022210761pt

Monitoring Rhodnius neglectus (Lent, 1954) populations’ susceptibility to insecticide used in controlling actions in urban areas northwest of São Paulo state
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Silva, Rubens Antonio da

; Maldonado, Lis Adriana

; Pessoa, Grasielle Caldas D’Ávila

; Diotaiuti, Liléia

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0553-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Chagas disease (CD) is caused by the flagellate protozoan Trypanosoma cruzi and can be carried by different species of triatomines, including Rhodnius neglectus, which is wild, well distributed in Brazil, and has formed colonies in palm trees located in urban areas of municipalities in the state of São Paulo. Chemical control has been routinely used to reduce population density, but each year, there has been an increase in species dispersion and density. This study aimed to evaluate the susceptibility of insects to insecticides used in control. Methods: The reference population was collected from Araçatuba municipality, Nilce Maia. Dilutions of deltamethrin were prepared and applied to the back of the first-stage nymphs, which were biologically synchronized. The control group received pure acetone only. Mortality was assessed after 72 h. Results: The mortality rate with respect to diagnostic dose was 100%. The susceptibility profile observed for this population showed RR50 ranging from 1.76 to 3.632. Conclusions: The populations were susceptible to the insecticides tested. It is possible that the insecticide residual effect on this ecotope has decreased the lifespan, and controlling failures may be the cause of recolonization in this environment.

https://doi.org/10.1590/0037-8682-0553-2021

Mabea dalyana (Euphorbiaceae-Hippomaneae): a new subshrub with xylopodia endemic to the savannas of the Brazilian Amazon
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Bigio, Narcisio C.

; Secco, Ricardo de S.

; Esser, Hans-Joachim

; Alves, Daniel Borini

; Silveira, Antônio Laffayete Pires da

; Ramos, Rubens Sousa

; Anjos, Cassiane Barroso dos

; Gonçalves, Késia da Silva

Acta Botanica Brasilica

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2022, Volume 36 elocation e2021abb0039

Abstract: En | Text: En | PDF: En

ABSTRACT During fieldwork in the Campos Amazônicos National Park, Amazonas state, Brazil, a new endemic species of Mabea was collected in savanna areas. Field collections and specimens in RON, MG, and HRCB were analyzed. To understand the species distribution and verify possible areas of occurrence, niche modeling was conducted using the sdm package in R. Mabea dalyana, the new species is a subshrub with xylopodia and reduced size (less than 1 m height) and small, yellow thyrses. There are several allopatric species of Mabea growing in Amazonian savannas, some widespread but others locally restricted, such as M. uleana from central Amazonia that has some superficial resemblance in leaves and inflorescences but can be distinguished from M. dalyana by pubescent adaxial leaf surface (vs. glabrous), 12-21 submarginal glands (vs. 10 submarginal glands), thyrse brownish to red (vs. yellow thyrse) and conspicuous caruncle (vs. caruncle inconspicuous). M. dalyana is endemic to hyperseasonal savanna, very well adapted to savanna, and fire tolerant. It has notable characteristics, such as a subshrub habit, a xylopodium, glabrous leaves, and sepals noticeably larger than the ovary.

https://doi.org/10.1590/0102-33062021abb0039

Acesso e direito à saúde para migrantes bolivianos em uma metrópole brasileira
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Carneiro Junior, Nivaldo

; Aith, Fernando

; Silva, Rubens Antonio da

; Wanderley, Dalva Marli Valério

; Luna, Expedito José

; Shikanai-Yasuda, Maria Aparecida

Saúde e Sociedade

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2022, Volume 31 N. 3 elocation e210761pt

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

https://doi.org/10.1590/s0104-12902022210761pt

10.

Videolaparoscopic prostatectomy in porcine model for training residents
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Suartz, Caio Vinicius

; Pedrenho Neto, Rubens

; Pellanda, Anderson Bruno

; Andrade, Hiury Silva

; Srougi, Victor

; Arap, Marco Antonio

; Mitre, Anuar Ibrahim

; Srougi, Miguel

; Nahas, William Carlos

; Duarte, Ricardo Jordão

International braz j urol

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dec 2021, Volume 47 N. 6 Pages 1274 - 1276

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Surgical training models prepare the resident for a more ethical surgical practice as well as providing a less steep learning curve. In urology, there are well-known models of pyeloplasty simulation, urethro-vesical anastomosis and nephrectomy, which have helped in the training of urology residents (1–3). Learning laparoscopic prostatectomy is a difficult surgery and requires advanced surgical skill from the surgeon (4), requires operate without a direct view of the surgical field in a two-dimensional space and with longer instruments (5). Laparoscopic prostatectomy step by step makes the surgeon's learning curve less difficult, lead to less intraoperative complications, such as blood loss, while also enabling shorter operative time and less positive surgical margins (6). The objective of surgical models is to simulate surgical procedures in a reliable way thus preparing the surgeon for his daily practice, surgical simulations in animal models have been described to compensate for inadequate clinical exposure (7). The canine model of prostate cancer has many similarities with humans. Despite trying to develop a model that is as credible as possible, there are ethical issues in several countries, such as Brazil, that do not allow the use of live dogs for scientific experimentation and there is a difficulty in not standardizing the animals used (8, 9). The swine surgical training model is widely known, accepted and used as a valuable tool in the teaching of new surgeons (10). The porcine video laparoscopic prostatectomy model allows the urologist in training to exercise the skills required in a real surgical situation, practicing them in a single session (10). We will present an experimental model in pigs for training urology residents in laparoscopic radical prostatectomy with current techniques (11–13). The limitations found are that the prostate has no limits as well defined as in humans, the urethra is long and coiled, the fat surrounding the pelvic organs is scarce and there is no postoperative follow-up for evaluating functionality after the procedure, as well as the effectiveness of the surgery with surgical margins. However, it is similar in surgical model presented, it is reproducible and can provide a realistic simulation environment to the beginner surgeon. Material and Methods: In this paper, according to the institutional protocol approved by the institutional ethics and research committee FMUSP n° 964/2017 and protocol was in accordance with current international regulations for the use of animals in Research: Reporting In Vivo Experiments (ARRIVE) guide. Ten male pigs weighing 20 to 22kg were used. The animals were anesthetized with a combination of Telazol (5mg/kg), Xylazine (1.5mg/kg), Cetamine (22mg/kg) and Atropine (0.04mg/kg) for orotracheal intubation followed by Isoflurane (2%). Animals were euthanized at the end of the procedure with a lethal dose of KCl (2mEq/kg). The trocar insertion points were marked using the epigastric vessels and umbilical region as reference points. Initially, urethral catheterization was performed using a hydrophilic Nitinol guidewire, followed by a perineal incision to dissect the tortuous urethra of the porcine model. A malleable urethral catheter 8Fr was inserted into their bladder. The animal was placed in the Trendelenburg position inserted and 12mm trocars were inserted in its umbilical region, utilizing 10mm in the surgeon's dominant hand, 5mm in his non-dominant hand of the surgeon, and 5mm in the first assistant's trocar. The surgeon replicates the steps performed in a laparoscopic radical prostatectomy in humans, including the bladder catheterization, dissection of the anterior bladder plane, the vesicular and prostatic dissection, the suture of the dorsal venous plexus, a prostatectomy, an urethral vesical anast omosis, as well as the waterproof test, even including the performing of surgical steps using current concepts of anterior urethral suspension as the reconstruction of the posterior plane of the rhabdosphincter. Results: All steps of surgery could be reproduced in all ten porcine cases. No significant bleeding was observed and the surgical time was gradually reduced fifty percent from case one to last cases. Conclusions: The porcine model allowed the surgeon to replicate all the steps usually performed in a laparoscopic radical prostatectomy. The junior surgeons are better prepared to such difficult surgery. However, further studies will be necessary to prove the impact of the animal model presented in urological clinical practice.

https://doi.org/10.1590/s1677-5538.ibju.2021.0139 99 downloads

11.

Acesso à Terapia de Reperfusão e Mortalidade em Mulheres com Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST: Registro VICTIM
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Oliveira, Jussiely Cunha

; Barros, Mayse Pereira Souza

; Barreto, Ikaro Daniel de Carvalho

; Silva Filho, Rubens Cruz

; Andrade, Volfanio Araújo

; Oliveira, André de Melo

; Lima, Ticiane Clair Remacre Munareto

; Oliveira, Jeferson Cunha

; Arcelino, Larissa Andreline Maia

; Oliveira, Laís Costa Souza

; Santana-Santos, Eduesley

; Almeida-Santos, Marcos Antônio

; Sousa, Antônio Carlos

; Barreto Filho, José Augusto Soares

Arquivos Brasileiros de Cardiologia

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apr 2021, Volume 116 N. 4 Pages 695 - 703

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

Resumo Fundamento: A reperfusão miocárdica é parte fundamental do tratamento para infarto agudo do miocárdio com supradesnivelamento de ST (IAMCSST) e é responsável por reduzir morbimortalidade no paciente acometido. No entanto, as taxas de reperfusão são geralmente mais baixas e as taxas de mortalidade mais altas em mulheres que em homens. Objetivos: Avaliar a prevalência do uso de terapias de reperfusão em mulheres e homens com IAMCSST nos hospitais com capacidade para realizar intervenção coronariana percutânea (ICP) no estado de Sergipe. Métodos: Trata-se de estudo transversal que utilizou dados do Registro VICTIM. Foram avaliados pacientes com diagnóstico de IAMCSST admitidos nos quatro hospitais com capacidade para realizar ICP no estado de Sergipe, sendo um público e três privados, no período de dezembro de 2014 a junho de 2018. Foi aplicada análise multivariada com modelo ajustado utilizando mortalidade como variável dependente. Em todas as análises, o nível de significância adotado foi de 5% (p<0,05). Resultados: Foram incluídos 878 voluntários com diagnóstico confirmado de IAMCSST, dos quais 33,4% eram mulheres. Apenas 53,3% dos pacientes foram submetidos à reperfusão miocárdica (134 mulheres versus 334 homens). A fibrinólise foi realizada somente em 2,3% de todos os pacientes (1,7% das mulheres versus 2,6% dos homens; p=0,422). Nas mulheres, a taxa de ICP primária foi menor (44% versus 54,5%; p=0,003) e a mortalidade hospitalar foi maior (16,1% versus 6,7%; p<0,001) que nos homens. Conclusão: As mulheres apresentam taxas significativamente menores de ICP primária e significativamente maiores de mortalidade hospitalar que os homens. A taxa de reperfusão em ambos os gêneros foi baixa e houve nítida subutilização de agentes trombolíticos.

Abstract Background: Myocardial reperfusion is a fundamental part of the treatment for ST elevation myocardial infarction (STEMI) and is responsible for reducing morbidity and mortality in affected patients. However, reperfusion rates are usually lower and mortality rates higher in women compared to men. Objectives: To evaluate the prevalence of the use of reperfusion therapies among women and men with STEMI in hospitals where percutaneous coronary intervention (PCI) is available in the state of Sergipe. Methods: This is a cross-sectional study that used data from the VICTIM Register. Patients diagnosed with STEMI admitted to the four hospitals (one public and three private) where PCI is available in the state of Sergipe were evaluated, from December 2014 to June 2018. A multivariate analysis with adjusted model using mortality as a dependent variable was made. In all analyses, the level of significance adopted was 5% (p < 0.05). Results: A total of 878 volunteers with a confirmed diagnosis of STEMI, of which 33.4% were women, were included in the study. Only 53.3% of the patients underwent myocardial reperfusion (134 women versus 334 men). Fibrinolysis was performed only in 2.3% of all patients (1.7% of women versus 2.6% of men; p = 0.422). The rate of primary PCI was lower (44% versus 54.5%; p = 0.003) and hospital mortality was higher (16.1% versus 6.7%; p < 0.001) in women than in men. Conclusion: Women have significantly lower rates of primary PCI and higher hospital mortality. Reperfusion rates were low in both sexes and there was a clear underutilization of thrombolytic agents.

https://doi.org/10.36660/abc.20190468 386 downloads

12.

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

; 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

; 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

Revista Brasileira de Terapia Intensiva

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apr 2021, Volume 33 N. 2 Pages 206 - 218

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

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

13.

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis
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Lage, Ricardo da Cruz

; Marques, Claudia Diniz Lopes

; Oliveira, Thauana Luiza

; Resende, Gustavo Gomes

; Kohem, Charles Lubianca

; Saad, Carla Gonçalves

; Ximenes, Antônio Carlos

; Gonçalves, Célio Roberto

; Bianchi, Washington Alves

; Meirelles, Eduardo de Souza

; Keiserman, Mauro Waldemar

; Chiereghin, Adriano

; Campanholo, Cristiano Barbosa

; Lyrio, André Marun

; Schainberg, Cláudia Goldenstein

; Pieruccetti, Lenise Brandao

; Yazbek, Michel Alexandre

; Palominos, Penelope Esther

; Goncalves, Rafaela Silva Guimarães

; Assad, Rodrigo Luppino

; Bonfiglioli, Rubens

; Lima, Sônia Maria Alvarenga Anti Loduca

; Carneiro, Sueli

; Azevedo, Valderílio Feijó

; Albuquerque, Cleandro Pires

; Bernardo, Wanderley Marques

; Sampaio-Barros, Percival Degrava

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 4

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

https://doi.org/10.1186/s42358-020-00160-6

14.

Colonization by Panstrongylus megistus (Hemiptera, Reduviidae, Triatominae) in an urban park in the city of São Paulo
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Silva, Rubens Antonio da

; Estevão, Vera Aparecida Oliveira

; Duarte, Agnaldo Nepomuceno

; Maria, Priscilla Cipolini

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e03302020

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: This communication reports on the occurrence of colonization by Panstrongylus megistus in an urban park in the municipality of São Paulo, Brazil. METHODS: Entomological research includes active search for vectors based on notifications by the population and identification and examination of insects. RESULTS: A colony of triatomines was found to be associated with enclosed birds. CONCLUSIONS: The occurrence of P. megistus has already been reported in the city of São Paulo; however, reports of colonization by this species provide evidence of its potential for the occupation of artificial ecotopes, which may pose a risk to the human population.

https://doi.org/10.1590/0037-8682-0330-2020

15.

Colonization of Panstrongylus megistus (Hemiptera:Reduvidae:Triatominae) in an urban area and its association with Didelphis marsupialis in the metropolitan region of São Paulo
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Silva, Rubens Antonio da

; Zaicaner, Raquel

; Rosa, Mariangela Palma

; Aun, Graciela Cristina Granizo

; Muniz, Júlio César

; Magalhães, Alon Carlos

; Pereira, Creusa

; Pena, Amanda Rosa

; Santos, Maysa Flexa dos

; Estevão, Vera Aparecida Oliveira

; Duarte, Agnaldo Nepomuceno

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0471-2020

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: This communication reports the colonization of Panstrongylus megistus in an urban area of the municipality of Taboão da Serra in the metropolitan region of São Paulo. METHODS: After receiving a notification from the population, entomological research comprising active search, collection, identification, and examination of triatomines was conducted. Wild animals were captured and examined. RESULTS: A colony of triatomines was found to be associated with dogs in the backyard of the property. CONCLUSIONS: The colonization of P. megistus shows the potential for their occupation of artificial ecotopes, which may pose a risk to the human population.

https://doi.org/10.1590/0037-8682-0471-2020

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