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ABSTRACT BACKGROUND: Peritoneal carcinomatosis in gastric cancer is considered a fatal disease, without expectation of definitive cure. As systemic chemotherapy is not sufficient to contain the disease, a multimodal approach associating intraperitoneal chemotherapy with surgery may represent an alternative for these cases. AIMS: The aim of this study was to investigate the role of intraperitoneal chemotherapy in stage IV gastric cancer patients with peritoneal metastasis. METHODS: This study is a single institutional single-arm prospective clinical trial phase II (NCT05541146). Patients with the following inclusion criteria undergo implantation of a peritoneal catheter for intraperitoneal chemotherapy: Stage IV gastric adenocarcinoma; age 18–75 years; Peritoneal carcinomatosis with peritoneal cancer index<12; Eastern Cooperative Oncology Group 0/1; good clinical status; and lab exams within normal limits. The study protocol consists of four cycles of intraperitoneal chemotherapy with paclitaxel associated with systemic chemotherapy. After treatment, patients with peritoneal response assessed by staging laparoscopy undergo conversion gastrectomy. RESULTS: The primary outcome is the rate of complete peritoneal response. Progression-free and overall survivals are other outcomes evaluated. The study started in July 2022, and patients will be screened for inclusion until 30 are enrolled. CONCLUSIONS: Therapies for advanced gastric cancer patients have been evaluated in clinical trials but without success in patients with peritoneal metastasis. The treatment proposed in this trial can be promising, with easy catheter implantation and ambulatory intraperitoneal chemotherapy regime. Verifying the efficacy and safety of paclitaxel with systemic chemotherapy is an important progress that this study intends to investigate.

RESUMO RACIONAL: A carcinomatose peritoneal no câncer gástrico é considerada uma doença fatal, sem expectativa de cura definitiva. Como a quimioterapia sistêmica não é suficiente para conter a doença, uma abordagem multimodal associando a quimioterapia intraperitoneal à cirurgia pode representar uma alternativa para esses casos. OBJETIVOS: Investigar o papel da quimioterapia intraperitoneal em pacientes com câncer gástrico estágio IV com metástases peritoneais. MÉTODOS: Trata-se de um ensaio clínico prospectivo unicêntrico, braço único, fase II (NCT05541146). Pacientes com os seguintes critérios de inclusão serão submetidos à implantação de cateter peritoneal para quimioterapia intraperitoneal: adenocarcinoma gástrico estágio IV; idade 18-75 anos; carcinomatose peritoneal com índice de câncer peritoneal<12; ECOG 0/1; bom estado clínico e exames laboratoriais dentro da normalidade. O protocolo do estudo consiste em 4 ciclos de quimioterapia intraperitoneal com Paclitaxel associado à quimioterapia sistêmica. Após o tratamento, os pacientes com resposta peritoneal avaliada por laparoscopia serão submetidos à gastrectomia de conversão. RESULTADOS: O desfecho primário é a taxa de resposta peritoneal completa. A sobrevida livre de progressão e global são outros desfechos avaliados. O estudo foi iniciado em julho de 2022 e os pacientes serão selecionados para inclusão até que 30 sejam inscritos. CONCLUSIONS: Terapias para pacientes com câncer gástrico avançado foram avaliadas em ensaios clínicos, mas sem sucesso em pacientes com metástase peritoneal. O tratamento proposto neste estudo pode ser promissor, com fácil implantação do cateter e regime de quimioterapia intraperitoneal ambulatorial. Verificar a eficácia e segurança do Paclitaxel associado à quimioterapia sistêmica é um progresso importante que o presente estudo pretende investigar.

https://doi.org/10.1590/0102-672020230026e1744

Oral findings in children on liver transplantation programming: a scoping review
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Santos, Catielma Nascimento

; Gallegos, Claudia Jacqueline Lopez

; Caminha, Raquel D’Aquino Garcia

; Porta, Gilda

; Soares Junior, Luiz Alberto Valente

; Bönecker, Marcelo

; Santos, Paulo Sérgio da Silva

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2022095

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

Abstract Objective: To identify oral characteristics found in children with liver disease in programming for liver transplantation. Data source: The methodology was written according to PRISMA-ScR. We adopted the methodological framework and recommendations for this type of review by Arksey and O’Malley and the Joanna Briggs Institute. The protocol was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). A systematic search (Medline/PubMed, Scopus, Web of Science, and ProQuest) was conducted to identify studies that met the inclusion criteria: systematic reviews; prospective clinical trials (parallel or crossover group designs); observational studies (cohort, case-control, and cross-sectional studies); clinical case series; and case reports evaluating children with liver disease in preparation for transplantation. The last search was conducted in July 2021, and no restrictions were imposed as to language or year of publication. Studies presenting mixed data with post-transplant evaluation, and studies evaluating not only liver transplantation but also other solid organs were excluded. Screening, inclusion, and data extraction were performed by two reviewers independently. A narrative synthesis was conducted to describe the findings of the study. Data synthesis: The bibliographic search identified 830 references. A total of 21 articles were read in their entirety after the inclusion criteria assessment. Finally, after evaluating the exclusion criteria, only 3 studies were considered for the qualitative analysis. Conclusions: Children with liver disease in preparation for transplantation may present enamel defects, tooth pigmentation, caries, gingivitis, and opportunistic infections such as candidiasis.

RESUMO Objetivo: Identificar características bucais em crianças hepatopatas em programação para o transplante hepático. Fontes de dados: A metodologia foi descrita de acordo com o PRISMA-ScR. Adotamos a estrutura metodológica e recomendações para este tipo de revisão por Arksey e O’Malley e o Instituto Joanna Briggs. O protocolo foi registrado no Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). Uma pesquisa sistemática (Medline/PubMed, Scopus, Web of Science e ProQuest) foi conduzida para identificar estudos que preenchessem os critérios de inclusão: revisões sistemáticas; ensaios clínicos prospectivos (desenhos de grupos paralelos ou cruzados); estudos observacionais (coorte, caso-controle e estudos transversais); séries de casos clínicos; e relatos de casos que avaliam crianças com doenças hepáticas em preparação para o transplante. A última busca foi conduzida em julho de 2021, e não foram impostas restrições quanto ao idioma ou ano de publicação. Foram excluídos estudos que apresentavam dados mistos com avaliação pós-transplante e estudos que avaliavam não só o transplante de fígado, mas também de outros órgãos sólidos. O rastreio, inclusão e extração de dados foram realizados por dois revisores independentemente. Foi conduzida uma síntese narrativa para identificar os resultados do estudo. Síntese dos dados: A pesquisa bibliográfica identificou 830 referências. Foram lidos 21 artigos na íntegra após avaliação dos critérios de inclusão. Finalmente, após a avaliação dos critérios de exclusão, apenas três estudos foram considerados para análise. Conclusões Crianças com doença hepática em preparação para o transplante podem apresentar defeitos de esmalte, pigmentação dentária, cárie, gengivite além de infecções oportunistas como a candidíase.

https://doi.org/10.1590/1984-0462/2023/41/2022095

Tree species used in urban forestry in Brazil: a scientometric review
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Vidal-Couto, Daniela Baldez

; Brito, Carolina Reis de

; Andrade, Isis Leite Medeiros Mascarenhas

; Cerqueira, Amanda Freitas

; Reis, Igor Pires

; Tomasini, Sergio Luiz Valente

; Dalmolin, Ândrea Carla

; Mielke, Marcelo Schramm

Rodriguésia

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2023, Volume 74 elocation e01162022

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

Abstract We conducted a scientometric review based on urban floristic inventories published in Brazilian scientific journals between 2000 and 2020 to determine the diversity and conservation status of trees used in urban forestry in Brazil. The floristic inventories were divided according to five Brazilian geographic regions. Tree species were divided into native and exotic species. We identified 71 floristic inventories of urban forestry, most of which were concentrated in the South and Southeast regions. In total, 473 species and 125 botanical families were identified. The largest number of species and families was found in the Southeast region, but most species/inventories were found in the North and Central-West regions. The ratio of native to exotic tree species was approximately 1:1; however, when the five most commonly used species were analyzed, the ratio of native to exotic species was less than 0.6, regardless of the geographic region. Regarding vulnerability, most of the species included in this study were not assessed for threat (86%), whereas only 1.7% of the species were vulnerable and 1% were endangered. We emphasize the urgent need to increase the number of tree species included in the IUCN Red List Categories and Criteria in urban forestry programs in Brazil.

Resumo Realizamos uma revisão cienciométrica baseada em inventários florísticos urbanos publicados em revistas científicas brasileiras entre 2000 e 2020 visando determinar a diversidade e o estado de conservação de árvores utilizadas na arborização urbana no Brasil. Os inventários florísticos foram divididos de acordo com cinco regiões geográficas brasileiras. As espécies arbóreas foram divididas em nativas e exóticas. Identificamos 71 inventários florísticos de arborização urbana, a maioria concentrada nas regiões Sul e Sudeste. No total, foram identificadas 473 espécies e 125 famílias botânicas. O maior número de espécies e famílias foi encontrado na região Sudeste, mas a maioria das espécies/inventários foi encontrada nas regiões Norte e Centro-Oeste. A proporção de espécies arbóreas nativas e exóticas foi de aproximadamente 1:1; no entanto, quando analisadas as cinco espécies mais utilizadas, a proporção de espécies nativas para exóticas foi inferior a 0,6, independentemente da região geográfica. Em relação à vulnerabilidade, a maioria das espécies incluídas neste estudo não foram avaliadas como ameaçadas (86%), enquanto apenas 1,7% das espécies estavam vulneráveis e 1% estavam ameaçadas. Enfatizamos a necessidade urgente de aumentar o número de espécies arbóreas incluídas nas categorias e critérios da Lista Vermelha da IUCN em programas de arborização urbana no Brasil.

https://doi.org/10.1590/2175-7860202374047

Epidural morphine for chronic pain in a patient with peripheral neuropathy and DRESS syndrome. Case report
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Valente, Julie Azevedo Araújo

; Siqueira, Bárbara Caroline

; Martins, Marcelo de Jesus

; Sampaio Filho, Antonio Argolo

BrJP

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sep 2022, Volume 5 N. 3 Pages 298 - 300

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

RESUMO JUSTIFICATIVA E OBJETIVOS: Neuropatia periférica é uma condição rara, de etiologia multifatorial. Dormência, parestesia, redução de força muscular e dor neuropática são sintomas comuns. O tratamento consiste em uso de anticonvulsivantes e antidepressivos. O objetivo deste estudo foi relatar o caso de dor crônica refratária a diversas terapias de uma paciente com contraindicação absoluta para uso de todos os fármacos anticonvulsivantes e antidepressivos. RELATO DO CASO: Paciente do sexo feminino, 40 anos, com história de neuralgia do trigêmeo abordada previamente com cirurgia, com cefaleia occipital crônica refratária à radiofrequência e polineuropatia bilateral T4 sensorial e motora após meningite viral. No curso do tratamento, apresentou grave farmacodermia (Drug Rash with Eosinophilia and Systemic Symptoms - Síndrome DRESS) após o uso de carbamazepina e outros anticonvulsivantes, além de reação alérgica a todos analgésicos e opioides, exceto morfina. Optou-se por analgesia teste por via peridural, durante 5 dias, com bolus intermitentes e diários de morfina para avaliação de possibilidade de implante de bomba de morfina. CONCLUSÃO: O teste foi considerado bem-sucedido e a paciente encaminhada para neurocirurgia. No seguimento de 6 meses após implante de bomba por via subaracnoidea, esta estratégia se mostrou eficaz no controle da dor secundária à polineuropatia.

ABSTRACT BACKGROUND AND OBJECTIVES: Peripheral neuropathy is a rare condition with many etiologies. Common symptoms are numbness, paresthesia, weakness and neuropathic pain. Treatment consists in frst-line agents such as anticonvulsants and some antidepressants. Te aim of this study was to report a case of chronic pain refractory to several therapies in a patient with absolute contraindication to the use of all anticonvulsants and antidepressants drugs. CASE REPORT: Female patient, a 40-year-old treated for trigeminal neuralgia with decompression that developed chronic occipital pain refractory to radiofrequency and onset of transient and bilateral T4 sensory and motor polyneuropathy after viral meningitis. In addition, she showed a severe pharmacodermy (Drug Rash with Eosinophilia and Systemic Symptoms- DRESS Syndrome) after using carbamazepine and other anticonvulsants, as well as allergy to all analgesics and opioids except morphine. Epidural puncture with insertion of a catheter was performed aiming at a 5-day test through intermittent epidural morphine bolus to assess the possibility of morphine pump implantation. CONCLUSION: The test was successful and the patient referred to the neurosurgery team. At the 6-month follow-up after the insertion of the morphine intrathecal pump, the strategy has proven to be efective in controlling pain secondary to polyneuropathy.

https://doi.org/10.5935/2595-0118.20220041-en

Clinical, radiological, and transbronchial biopsy findings in patients with long COVID-19: a case series
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Baldi, Bruno Guedes

; Fabro, Alexandre Todorovic

; Franco, Andreia Craveiro

; Machado, Marília Helena C

; Prudente, Robson Aparecido

; Franco, Estefânia Thomé

; Marrone, Sergio Ribeiro

; Vale, Simone Alves do

; Cezare, Talita Jacon

; Moraes, Marcelo Padovani de Toledo

; Ferreira, Eloara Vieira Machado

; Albuquerque, André Luis Pereira

; Sawamura, Marcio Valente Yamada

; Tanni, Suzana Erico

Jornal Brasileiro de Pneumologia

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2022, Volume 48 N. 3 elocation e20210438

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

RESUMO Esta comunicação breve demonstra a correlação de sintomas respiratórios persistentes com achados funcionais, tomográficos e de biópsia pulmonar transbrônquica em pacientes com COVID-19 que tiveram um longo período de acompanhamento. Relatamos uma série de seis pacientes com COVID-19 com acometimento pulmonar que apresentavam dispneia persistente após 4-15 meses da alta. Realizamos biópsias transbrônquicas, e o padrão histopatológico consistentemente demonstrou remodelação peribrônquica com fibrose pulmonar intersticial. Portanto, a biópsia pulmonar pode ser útil na abordagem de pacientes com COVID-19 prolongada, embora o tipo de procedimento, suas indicações precisas e o momento de sua realização ainda não estejam esclarecidos. (Registro Brasileiro de Ensaios Clínicos - ReBEC; número de identificação: RBR-8j9kqy [http://www.ensaiosclinicos.gov.br])

ABSTRACT This brief communication demonstrates the correlation of persistent respiratory symptoms with functional, tomographic, and transbronchial pulmonary biopsy findings in patients with COVID-19 who had a long follow-up period. We report a series of six COVID-19 patients with pulmonary involvement who presented with persistent dyspnea within 4-15 months of discharge. We performed transbronchial biopsies, and the histopathological pattern consistently demonstrated peribronchial remodeling with interstitial pulmonary fibrosis. Therefore, lung biopsy may be useful in the approach of patients with long COVID-19, although the type of procedure, its precise indication, and the moment to perform it are yet to be clarified. (Brazilian Registry of Clinical Trials-ReBEC; identifier: RBR-8j9kqy [http://www.ensaiosclinicos.gov.br])

https://doi.org/10.36416/1806-3756/e20210438

Snakebites caused by the genera Bothrops and Lachesis in the Brazilian Amazon: a study of factors associated with severe cases and death
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Magalhães, Samara Freire Valente

; Peixoto, Henry Maia

; Freitas, Lúcia Rolim Santana de

; Monteiro, Wuelton Marcelo

; Oliveira, Maria Regina Fernandes de

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0558-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Snakebites are a major problem in developing countries owing to their high morbidity rates, severity, and sequelae. In Brazil, most cases of envenomation are caused by Bothrops and Lachesis snakes. The present study aimed to evaluate variables associated with death, systemic complications, and amputations in victims of envenomation due to Bothrops or Lachesis snake. Methods: An analytical epidemiological study was performed with data from the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação [SINAN]) relating to the Brazilian Amazon for the period 2010-2015. A hierarchical Poisson regression analysis was performed with three aspects, namely, individual characteristics, sociodemographic characteristics, and clinical conditions. Results: The following associations were observed: i) advanced age (>65 years), sepsis, renal failure, and hemorrhagic manifestations were related to two outcomes - death due to snakebite and death from all causes; ii) more advanced age (≥46 years), time to health care longer than 6 hours, renal and hemorrhagic manifestations, and region of occurrence being rural areas were associated with systemic complications; and iii) children (up to 12 years old) were associated with amputations. Conclusions: Knowledge of the characteristics associated with severe outcomes in snakebites may help identify patients who will require more intensive care or longer follow-up and may provide the physician with counseling rationale for their possible prognosis.

https://doi.org/10.1590/0037-8682-0558-2021

Epidural morphine for chronic pain in a patient with peripheral neuropathy and DRESS syndrome. Case report
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Valente, Julie Azevedo Araújo

; Siqueira, Bárbara Caroline

; Martins, Marcelo de Jesus

; Sampaio Filho, Antonio Argolo

BrJP

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2022, N. ahead

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

https://doi.org/10.5935/2595-0118.20220041-en

Salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus
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BRAGARD, Loreley Carlos Agostinho

; SETE, Manuela Rubim Camara

; FREITAS-FERNANDES, Liana Bastos

; SZTAJNBOK, Flavio Roberto

; FIGUEREDO, Carlos Marcelo

; VALENTE, Ana Paula

; FIDALGO, Tatiana Kelly da Silva

; SILVA, Fernanda de Brito

Brazilian Oral Research

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2022, Volume 36 elocation e0128

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to characterize the salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus (jSLE). A total of 24 adolescents with jSLE (15.92 ± 2.06 years) and 12 systemically healthy controls (15.25 ± 2.7 years) were included in the study. Participants underwent rheumatologic testing and periodontal examination, with the recording of plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing index (BPI). Unstimulated whole saliva was collected from both groups and stored at -80 ºC. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a spectrometer operating at 500 MHz. Partial least squared discriminant analysis (PLS-DA) and orthogonal PLS-DA (O-PLS-DA) were used for statistical analysis. Mean CAL and PI were significantly increased in the group with jSLE (p < 0.01). Patients with jSLE presented a significantly different salivary metabolic profile (accuracy = 0.54; R2 = 0.86; Q2 = -0.293), significantly higher salivary levels of N-acetyl sugars, and significantly reduced levels of phenylalanine, glycine, taurine, hydroxybutyrate, and valerate compared with healthy controls (p < 0.05). It is suggested that the salivary metabolomic profile analyzed by 1H NMR in patients with jSLE presents a different fingerprint that the systemically healthy subjects. Integrating the variation of metabolites with the identification of the metabolic pathways involved seems to provide a better understanding of the influence of systemic disease on salivary metabolites.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0128

Vanishing bone metastasis: pictorial essay
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Fukamizu, Erina Megumi Nagaya

; Seabra, Adriano

; Otto, Deborah Yukiko

; Sawamura, Marcio Valente Yamada

; Bordalo-Rodrigues, Marcelo

; Helito, Paulo Victor Partezani

Radiologia Brasileira

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oct 2021, Volume 54 N. 5 Pages 336 - 340

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

Resumo Vanishing bone metastasis é um pitfall na tomografia computadorizada (TC) com contraste em pacientes com obstrução das veias torácicas, principalmente das veias cava superior e braquiocefálica, geralmente ocasionada por tumores malignos. Na TC, aparece como um realce pseudopatológico do corpo vertebral e pode ser erroneamente interpretado como metástase óssea esclerótica, levando a tratamento desnecessário. Embora não seja raro, esse achado geralmente é subdiagnosticado pelos radiologistas. O objetivo deste estudo é revisar a fisiopatologia desse fenômeno, ilustrando as vias venosas colaterais mais comuns na obstrução da veia torácica e correlacionar com os achados da TC.

Abstract Vanishing bone metastasis (pseudopathological vertebral body enhancement) is a pitfall in the interpretation of contrast-enhanced computed tomography (CT) scans of patients with thoracic vein obstruction, mainly in the superior vena cava and brachiocephalic veins, typically being related to thrombosis due to malignant tumors. On the basis of the CT findings, pseudopathological vertebral body enhancement can be misdiagnosed as sclerotic bone metastasis, leading to unnecessary treatment. Although not rare, pseudopathological vertebral body enhancement is usually underdiagnosed by radiologists. The aim of this study is to review the pathophysiology of this phenomenon, illustrating the most common collateral venous pathways in thoracic vein obstruction and making the correlation with the CT findings.

https://doi.org/10.1590/0100-3984.2020.0124 200 downloads

10.

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

11.

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil
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Martins Neto, Francisco

; Moura Júnior, Luiz Gonzaga de

; Rocha, Hermano Alexandre Lima

; Castro Neto, Josué Viana de

; Lima, Alexandre Marcelo Rodrigues

; Siqueira, Rafael Pontes de

; Castillo, Daniela Lima Chow

; Moura, Régis Luiz Sabiá de

; Valente, Acrísio Sales

Acta Cirúrgica Brasileira

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2021, Volume 36 N. 5 elocation e360508

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose To develop and validate a chest cavity simulator for teaching video-assited thoracic surgery (VATS). Methods The first phase of the study consisted of developing a chest cavity simulator. A quasi-experimental study was performed in the second phase, and 25 surgeons and residents participated in a three-stage pulmonary suture experiment. The videos were recorded and timed. Generalized linear regression models for repeated measures were used to analyze the outcome change over time. Results The chest cavity simulator consists of a console simulating the left hemithorax. Among the participants, 96% rated the design, visual aspect, positioning ergonomics, and triangulation of the portals as very good or excellent (face validity). There was a decrease in suturing time in step 1 from 435.7 ± 105 to 355.6 ± 76.8 seconds compared to step 3 (p = 0.001). The evaluation of the simulation effectiveness and performance (content validity) was rated as very good or excellent by 96% ofparticipants. The most experienced surgeon showed significant reduction in procedure time (p = 0.021) (construct validity). Conclusions The thoracic cavity simulator is realistic, showing content and construct validity, and can be used in VATS training. The simulation model allowed skill gain in the endoscopic suture.

https://doi.org/10.1590/acb360508 149 downloads

12.

Diretriz Brasileira de Cardio-oncologia – 2020
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Hajjar, Ludhmila Abrahão

; Costa, Isabela Bispo Santos da Silva da

; Lopes, Marcelo Antônio Cartaxo Queiroga

; Hoff, Paulo Marcelo Gehm

; Diz, Maria Del Pilar Estevez

; Fonseca, Silvia Moulin Ribeiro

; Bittar, Cristina Salvadori

; Rehder, Marília Harumi Higuchi dos Santos

; Rizk, Stephanie Itala

; Almeida, Dirceu Rodrigues

; Fernandes, Gustavo dos Santos

; Beck-da-Silva, Luís

; Campos, Carlos Augusto Homem de Magalhães

; Montera, Marcelo Westerlund

; Alves, Sílvia Marinho Martins

; Fukushima, Júlia Tizue

; Santos, Maria Verônica Câmara dos

; Negrão, Carlos Eduardo

; Silva, Thiago Liguori Feliciano da

; Ferreira, Silvia Moreira Ayub

; Malachias, Marcus Vinicius Bolivar

; Moreira, Maria da Consolação Vieira

; Valente Neto, Manuel Maria Ramos

; Fonseca, Veronica Cristina Quiroga

; Soeiro, Maria Carolina Feres de Almeida

; Alves, Juliana Barbosa Sobral

; Silva, Carolina Maria Pinto Domingues Carvalho

; Sbano, João

; Pavanello, Ricardo

; Pinto, Ibraim Masciarelli F.

; Simão, Antônio Felipe

; Dracoulakis, Marianna Deway Andrade

; Hoff, Ana Oliveira

; Assunção, Bruna Morhy Borges Leal

; Novis, Yana

; Testa, Laura

; Alencar Filho, Aristóteles Comte de

; Cruz, Cecília Beatriz Bittencourt Viana

; Pereira, Juliana

; Garcia, Diego Ribeiro

; Nomura, Cesar Higa

; Rochitte, Carlos Eduardo

; Macedo, Ariane Vieira Scarlatelli

; Marcatti, Patricia Tavares Felipe

; Mathias Junior, Wilson

; Wiermann, Evanius Garcia

; Val, Renata do

; Freitas, Helano

; Coutinho, Anelisa

; Mathias, Clarissa Maria de Cerqueira

; Vieira, Fernando Meton de Alencar Camara

; Sasse, André Deeke

; Rocha, Vanderson

; Ramires, José Antônio Franchini

; Kalil Filho, Roberto

Arquivos Brasileiros de Cardiologia

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nov 2020, Volume 115 N. 5 Pages 1006 - 1043

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

https://doi.org/10.36660/abc.20201006 4180 downloads

13.

Seasonal variation of vitamin D among healthy adult men in a subtropical region
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Fontanive, Tiago Oselame

; Dick, Nidea Rita Michels

; Valente, Mariana Costa Silva

; Laranjeira, Vani dos Santos

; Antunes, Marina Venzon

; Corrêa, Marcelo de Paula

; Alves, Rita de Cássia Marques

; Linden, Rafael

; Furlanetto, Tania Weber

Revista da Associação Médica Brasileira

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oct 2020, Volume 66 N. 10 Pages 1431 - 1436

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

RESUMO OBJETIVOS: Avaliar a sazonalidade da 25(OH)vitamina D3 [25(OH)D3] e fatores associados em homens adultos saudáveis, que se exercitavam ao ar livre pelo menos 50 min duas vezes por semana, das 10 às 16h, em uma região subtropical. MÉTODOS: Sangue foi colhido no fim das estações para medir 25(OH)D3, por cromatografia líquida em tandem com espectroscopia de massas. A radiação ultravioleta foi estimada por radiômetro, calculando diariamente a resposta fotobiológica para sintetizar vitamina D na pele humana (D-VitD). RESULTADOS: A prevalência de 25(OH)D3 <20ng/mL foi sazonal (p=0.000): 8.7% (n=6/69), 1.5% (n=1/66), 0% (n= 0/64), e 21.7% (n=13/60), respectivamente, no final do inverno, primavera, verão e outono. A prevalência, ajustada para comparações múltiplas, foi maior no inverno do que no verão (p=0.026) e no outono do que na primavera (p=0.001) e verão (p=0.000). A 25(OH)D3 não se associou com o índice de massa corporal (p=0.207), gordura corporal (p=0.064) ou fototipo (p=0.485), na análise univariada. Associou-se à D-VitD nos 30 dias antes da coleta de sangue (p=0.000), ajustada para gordura corporal. Houve sazonalidade na prevalência de 25(OH)D3 <30ng/mL (p=0.000): 69.6% (n=48/69), 68.2% (n=45/66), 43.8% (n=28/64), e 88.4% (n=53/60), respectivamente, no inverno, primavera, verão e outono. CONCLUSÕES: Em uma região subtropical, houve sazonalidade na 25(OH)D3 em homens adultos, saudáveis, embora se exercitassem ao ar livre pelo menos 50 minutos duas vezes por semana, usando shorts e camiseta. 25(OH)D3 <20ng/mL foi 21.7% no outono e a D-vitD 30 dias antes da coleta do sangue foi o único fator associado de modo independente à 25(OH)D3.

SUMMARY OBJECTIVE: To evaluate seasonal variation of 25(OH)vitamin D [25(OH)D3] levels, and factors associated with it, in healthy adult men, who exercised outdoors for 50 min., at least twice a week, from 10AM to 4PM, in a Brazilian semitropical region. METHODS: Blood samples were collected at the end of each season for 25(OH)D3, measured by liquid chromatography with tandem mass spectrometry. Ultraviolet irradiation was estimated by radiometer, calculating the daily photobiological response to vitamin D synthesis in human skin (D-VitD). The prevalence of 25(OH)D3 <20ng/mL changed with the seasons (p=0.000): 8.7% (n=6/69), 1.5% (n=1/66), 0 (n=0/64), and 21.7% (n=13/60), respectively, at the end of winter, spring, summer, and autumn. The prevalence, adjusted for multiple comparisons, was higher in winter than summer (p=0.026), and in autumn than spring (p=0.001) and summer (p=0.000). There were no associations of 25(OH) D3 levels with BMI (p=0.207), body fat (p=0.064), and phototype (p=0.485), in univariate analysis. It was associated with D-VitD in the 30 days before blood sampling (p=0.000), after adjustment to body fat. The prevalence of 25(OH)D3 <30ng/mL varied seasonally (p=0.000): 69.6% (n=48/69), 68.2% (n=45/66), 43.8% (n=28/64), and 88.4% (n=53/60), respectively, in winter, spring, summer, and autumn. CONCLUSIONS: In a Brazilian subtropical region, a seasonal variation in 25(OH)D3 was observed in healthy adult males, although they spent at least 50 min outdoors twice a week, wearing shorts and T-shirts. 25(OH)D3 <20ng/mL was 21.7% in autumn; D-vitD 30 days prior to blood sampling was the only factor independently associated with 25(OH)D3 levels.

https://doi.org/10.1590/1806-9282.66.10.1431 612 downloads

14.

Intensive support recommendations for critically-ill patients with suspected or confirmed COVID-19 infection
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Corrêa, Thiago Domingos

; Matos, Gustavo Faissol Janot de

; Bravim, Bruno de Arruda

; Cordioli, Ricardo Luiz

; Garrido, Alejandra del Pilar Gallardo

; Assuncao, Murillo Santucci Cesar de

; Barbas, Carmen Silvia Valente

; Timenetsky, Karina Tavares

; Rodrigues, Roseny dos Reis

; Guimarães, Hélio Penna

; Rabello Filho, Roberto

; Lomar, Frederico Polito

; Scarin, Farah Christina de La Cruz

; Batista, Carla Luciana

; Pereira, Adriano José

; Guerra, João Carlos de Campos

; Carneiro, Bárbara Vieira

; Nawa, Ricardo Kenji

; Brandão, Rodrigo Martins

; Pesaro, Antônio Eduardo Pereira

; Silva Júnior, Moacyr

; Carvalho, Fabricio Rodrigues Torres de

; Silva, Cilene Saghabi de Medeiros

; Almeida, Ana Claudia Ferraz de

; Franken, Marcelo

; Pesavento, Marcele Liliane

; Eid, Raquel Afonso Caserta

; Ferraz, Leonardo José Rolim

einstein (São Paulo)

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2020, Volume 18 elocation eAE5793

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

RESUMO Em dezembro de 2019, uma série de pacientes com pneumonia grave foi identificada em Wuhan, província de Hubei, na China. Esses pacientes evoluíram para síndrome respiratória aguda grave e síndrome do desconforto respiratório agudo. Posteriormente, a COVID-19 foi atribuída a um novo betacoronavírus, o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2). Cerca de 20% dos pacientes com diagnóstico de COVID-19 desenvolvem formas graves da doença, incluindo insuficiência respiratória aguda hipoxêmica, síndrome respiratória aguda grave, síndrome do desconforto respiratório agudo e insuficiência renal aguda e requerem admissão em unidade de terapia intensiva. Não há nenhum ensaio clínico randomizado controlado que avalie potenciais tratamentos para pacientes com infecção confirmada pela COVID-19 no momento da publicação destas recomendações de tratamento. Dessa forma, essas recomendações são baseadas predominantemente na opinião de especialistas (grau de recomendação de nível C).

ABSTRACT In December 2019, a series of patients with severe pneumonia were identified in Wuhan, Hubei province, China, who progressed to severe acute respiratory syndrome and acute respiratory distress syndrome. Subsequently, COVID-19 was attributed to a new betacoronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Approximately 20% of patients diagnosed as COVID-19 develop severe forms of the disease, including acute hypoxemic respiratory failure, severe acute respiratory syndrome, acute respiratory distress syndrome and acute renal failure and require intensive care. There is no randomized controlled clinical trial addressing potential therapies for patients with confirmed COVID-19 infection at the time of publishing these treatment recommendations. Therefore, these recommendations are based predominantly on the opinion of experts (level C of recommendation).

https://doi.org/10.31744/einstein_journal/2020ae5793 23244 downloads

15.

Serological occurrence for tick-borne agents in beef cattle in the Brazilian Pantanal
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Ramos, Inalda Angélica de Souza

; Mello, Victória Valente Califre de

; Mendes, Natalia Serra

; Zanatto, Diego Carlos de Souza

; Campos, João Bosco Vilela

; Alves, João Vitor Almeida

; Macedo, Gabriel Carvalho de

; Herrera, Heitor Miraglia

; Labruna, Marcelo Bahia

; Pereira, Gener Tadeu

; Machado, Rosangela Zacarias

; André, Marcos Rogério

Revista Brasileira de Parasitologia Veterinária

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2020, Volume 29 N. 1 elocation e014919

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

Resumo Este estudo teve como objetivo determinar a co-soropositividade para agentes transmitidos por carrapatos, como Anaplasma marginale, Babesia bovis, Babesia bigemina, Coxiella burnetii, Anaplasma phagocytophilum, e Trypanosoma vivax em bovinos de corte do Pantanal Brasileiro. Amostras de soro foram colhidas de 400 animais (200 vacas; 200 bezerros) e submetidas a Ensaios Imunoenzimáticos Indiretos (iELISA) para detecção de anticorpos IgG anti- A. marginale, anti- B. bovis, anti- B. bigemina e anti- T. vivax, e à Reação de Imunofluorescência Indireta (RIFI) para detecção de anticorpos IgG anti -C. burnetii e anti- A. phagocytophilum. Ausência de correlação foi vista entre os animais soropositivos para C. burnetii e A. phagocytophilum com os outros agentes e correlação moderada ocorreu entre A. marginale x B. bigemina x B. bovis. Vacas foram mais soropositivas que bezerros para T. vivax e bezerros mais soropositivos que vacas para B. bovis e B. bigemina. Maior número de animais soropositivos para um único agente foi visto para T. vivax (15,2%). Vacas demonstraram maior co-soropositividade para T. vivax + A. marginale (25,5%) e bezerros para T. vivax + B. bovis + B. bigemina + A. marginale (57,5%). A alta correlação entre a soropositividade para A. marginale x B. bovis x B. bigemina é provavelmente devida à presença do vetor biológico, o carrapato Rhipicephalus microplus, nas fazendas estudadas. As vias de transmissão comuns, mediadas por dípteros hematófagos e fômites, podem explicar a alta co-soropositividade das vacas para A. marginale e T. vivax. A baixa soropositividade para C. burnetii é provavelmente devida ao tipo de sistema de criação empregado (extenso). A soropositividade para A. phagocytophilum em apenas um animal sugere a ocorrência de reação sorológica cruzada com outro agente do gênero Anaplasma.

Abstract This study investigated the seropositivity for five different tick-borne agents, namely Anaplasma marginale, Babesia bovis, Babesia bigemina, Coxiella burnetii, Anaplasma phagocytophilum, and Trypanosoma vivax in beef cattle in the Brazilian Pantanal. The serum samples collected from animals (200 cows; 200 calves) were used in indirect enzyme-linked immunosorbent assays (iELISA) to detect IgG antibodies against A. marginale, B. bovis, B. bigemina, and T. vivax, and Indirect Fluorescent Antibody Test (IFAT) for detecting IgG antibodies against C. burnetii and A. phagocytophilum. No correlation was observed between seropositivity for C. burnetii and A. phagocytophilum with other agents whereas moderate correlation was observed for A. marginalexB. bigemina x B. bovis. Cows were more seropositive for T. vivax whereas calves were more seropositive for B. bovis and B. bigemina. The highest number of seropositive animals by a single agent was observed for T. vivax (15.2%). Co-seropositivity for T. vivax + A. marginale was higher in cows (25.5%) and for T. vivax + B. bovis + B. bigemina + A. marginale was higher in calves (57.5%). The high seropositivity correlation for A. marginale x B. bovis x B. bigemina is probably due to the presence of the tick biological vector, Rhipicephalus microplus, in the studied farms. Common transmission pathways, mediated by hematophagous dipterans and fomites, may explain the high co-seropositivity of cows for A. marginale and T. vivax. Low seropositivity to C. burnetii is probably due to the type of breeding system employed (extensive). Seropositivity for A. phagocytophilum in only one animal suggests the occurrence of a cross-serological reaction with another agent of the genus Anaplasma.

https://doi.org/10.1590/s1984-29612020007 933 downloads

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