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ABSTRACT: The Amazonian manatee (Trichechusinunguis) is an aquatic mammal threatened with extinction. However, few studies have investigated the pathogens in this species, which may affect both animal and human health. This study aimed to evaluate the frequency, distribution, and patterns of antimicrobial susceptibility of Staphylococcus spp. and Escherichiacoli colonizing the nasal and rectal cavities of Amazonian manatees kept in captivity at the National Institute for Amazonian Research (INPA) in the state of Amazonas, Brazil. Rectal and nasal swabs from 44 manatees of different ages were used in this study. The genus Staphylococcus was isolated from the nasal swabs of 32 (72.7%) animals, with two individuals harboring more than one species of Staphylococcus. S. sciuri was the most commonly isolated species. Resistance to penicillin was observed in 13 (40.6%) isolates, more frequent than the other antimicrobials tested (P = 0.01). E. coli was isolated from the rectal swabs of all animals, with phylogroup B1 being the most frequent among the strains obtained (P = 0.0008). Four isolates (6.8%) were positive for virulence factors, three of which were classified as enterotoxigenicE. coli (ETEC) and one as enteropathogenicE. coli (EPEC). To our knowledge, this is the first study to evaluate Staphylococcus spp. and E. coli in Amazonian manatee samples. This study revealed nasal colonization by Staphylococcus spp., mainly S. sciuri, and diarrheagenicE. coli isolates, including antimicrobial-resistant strains. ABSTRACT Trichechusinunguis (Trichechusinunguis extinction However health frequency distribution spp INPA (INPA Amazonas Brazil 4 3 72.7% 727 72 7 (72.7% animals S 1 40.6% 406 40 6 (40.6% P 0.01. 001 0.01 . 0 01 0.01) E B 0.0008. 00008 0.0008 0008 0.0008) 6.8% 68 8 (6.8% factors enterotoxigenicE ETEC (ETEC enteropathogenicE EPEC. EPEC (EPEC) knowledge samples diarrheagenicE antimicrobialresistant resistant 72.7 (72.7 40.6 (40.6 00 0.0 0000 0.000 000 6.8 (6.8 (EPEC 72. (72. 40. (40. 0. 0.00 6. (6. (72 (40 (6 (7 (4 (

RESUMO: O peixe-boi amazônico (Trichechus inunguis) é um mamífero aquático ameaçado de extinção. Apesar disso, poucos estudos investigaram patógenos nessa espécie que podem impactar a saúde animal e humana. O objetivo deste estudo foi avaliar a frequência, distribuição e padrões de suscetibilidade antimicrobiana de Staphylococcus sp. e Escherichia coli pertencentes à microbiota nasal e retal de peixes-bois da Amazônia mantidos em cativeiro no Instituto Nacional de Pesquisas da Amazônia (INPA) (Amazonas, Brasil). Foram utilizados suabes retais e nasais de 44 peixes-boi de diferentes idades. O gênero Staphylococcus foi isolado do swab nasal de 32 (72,7%) animais, sendo que dois indivíduos apresentaram mais de uma espécie de Staphylococcus. S. sciuri foi a espécie mais comumente isolada. A resistência à penicilina foi observada em 13 (40,6%) isolados, sendo mais frequente do que os outros antimicrobianos testados (P = 0,01). Escherichia coli foi isolada dos suabes retais de todos os animais, sendo o filogrupo B1 o mais frequente entre as cepas obtidas (P = 0,0008). Quatro isolados (6,8%) foram positivos para fatores de virulência, três dos quais foram classificados como E. coli enterotoxigênica (ETEC) e um isolado como E. coli enteropatogênica (EPEC). Este é o primeiro estudo a avaliar Staphylococcus spp. e E. coli de amostras de peixe-boi da Amazônia. O estudo revelou colonização nasal por Staphylococcus sp., principalmente S. sciuri, e por isolados diarreiogênicos de E. coli, incluindo cepas resistentes a antimicrobianos. RESUMO peixeboi peixe boi Trichechus inunguis extinção disso humana frequência sp peixesbois peixes bois INPA (INPA Amazonas, Amazonas (Amazonas Brasil. Brasil . Brasil) 4 peixesboi idades 3 72,7% 727 72 7 (72,7% animais S 1 40,6% 406 40 6 (40,6% P 0,01. 001 0,01 0 01 0,01) B 0,0008. 00008 0,0008 0008 0,0008) 6,8% 68 8 (6,8% virulência E ETEC (ETEC EPEC. EPEC (EPEC) spp 72,7 (72,7 40,6 (40,6 00 0,0 0000 0,000 000 6,8 (6,8 (EPEC 72, (72, 40, (40, 0, 0,00 6, (6, (72 (40 (6 (7 (4 (

https://doi.org/10.1590/0103-8478cr20230140

[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Data de publicação: 2024-04-08

Resumo: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

ENDOSONOGRAPHY-GUIDED RESCUE PROCEDURES AFTER FAILED ERCP IN A PATIENT WITH PANCREATIC DUCTAL ADENOCARCINOMA ENDOSONOGRAPHYGUIDED ENDOSONOGRAPHY GUIDED
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ARDENGH, José Celso

; ORSINI-ARMAN, Anna Carolina

; HAUEISEN-FIGUEIREDO, Bruna

; OLIVEIRA-CANEJO, Guilherme Camarotti de

; MICELLI-NETO, Otávio

Arquivos de Gastroenterologia

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2024, Volume 61 elocation e23152

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s0004-2803.24612023-152

Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio

; Simões, Marcus V.

; Correia, Edileide de Barros

; Marcondes-Braga, Fabiana Goulart

; Coelho-Filho, Otavio Rizzi

; Mesquita, Cláudio Tinoco

; Mathias Junior, Wilson

; Antunes, Murillo de Oliveira

; Arteaga-Fernández, Edmundo

; Rochitte, Carlos Eduardo

; Ramires, Felix José Alvarez

; Alves, Silvia Marinho Martins

; Montera, Marcelo Westerlund

; Lopes, Renato Delascio

; Oliveira Junior, Mucio Tavares de

; Scolari, Fernando Luis

; Avila, Walkiria Samuel

; Canesin, Manoel Fernandes

; Bocchi, Edimar Alcides

; Bacal, Fernando

; Moura, Lidia Zytynski

; Saad, Eduardo Benchimol

; Scanavacca, Mauricio Ibrahim

; Valdigem, Bruno Pereira

; Cano, Manuel Nicolas

; Abizaid, Alexandre Antonio Cunha

; Ribeiro, Henrique Barbosa

; Lemos Neto, Pedro Alves

; Ribeiro, Gustavo Calado de Aguiar

; Jatene, Fabio Biscegli

; Dias, Ricardo Ribeiro

; Beck-da-Silva, Luis

; Rohde, Luis Eduardo Paim

; Bittencourt, Marcelo Imbroinise

; Pereira, Alexandre da Costa

; Krieger, José Eduardo

; Villacorta Junior, Humberto

; Martins, Wolney de Andrade

; Figueiredo Neto, José Albuquerque de

; Cardoso, Juliano Novaes

; Pastore, Carlos Alberto

; Jatene, Ieda Biscegli

; Tanaka, Ana Cristina Sayuri

; Hotta, Viviane Tiemi

; Romano, Minna Moreira Dias

; Albuquerque, Denilson Campos de

; Mourilhe-Rocha, Ricardo

; Hajjar, Ludhmila Abrahão

; Brito Junior, Fabio Sandoli de

; Caramelli, Bruno

; Calderaro, Daniela

; Farsky, Pedro Silvio

; Colafranceschi, Alexandre Siciliano

; Pinto, Ibraim Masciarelli Francisco

; Vieira, Marcelo Luiz Campos

; Danzmann, Luiz Claudio

; Barberato, Silvio Henrique

; Mady, Charles

; Martinelli Filho, Martino

; Torbey, Ana Flavia Malheiros

; Schwartzmann, Pedro Vellosa

; Macedo, Ariane Vieira Scarlatelli

; Ferreira, Silvia Moreira Ayub

; Schmidt, Andre

; Melo, Marcelo Dantas Tavares de

; Lima Filho, Moysés Oliveira

; Sposito, Andrei C.

; Brito, Flávio de Souza

; Biolo, Andreia

; Madrini Junior, Vagner

; Rizk, Stephanie Itala

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 Nº 7 elocation e202400415

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

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

Organic residues and Parachlorella microalgae favor the growth and gas exchange of cedar
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Santos, Cleberton Correia

; Oliveira, Mauricio Lacerda de

; Ribeiro, Dágon Manoel

; Scalon, Silvana de Paula Quintão

; Linné, Jéssica Aline

; Silverio, Juliana Milene

; Figueiredo, Vanda Maria de Aquino

; Silva, Otávio Henrique Medina da

Scientia Agricola

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2024, Volume 81 elocation e20230077

Resumo: En | Texto: En | PDF: En

ABSTRACT Using organic residues and bioinputs is a promising and sustainable practice to produce seedlings with forest essences, such as Cedrela fissilis Vell. (cedar), a vulnerable species close to extinction due to intensive exploitation in native areas. Thus, we aimed to evaluate the effect of different substrates based on organic residues associated with or without the application of Parachlorella sp. microalgae in the emergence and morphophysiology of C. fissilis seedlings. Sowing was carried out on six substrates: Oxisol with a clayey texture; Oxisol + Parachlorella sp.; Oxisol with sheep manure (3:1, v v–1); Oxisol with sheep manure + Parachlorella sp.; Oxisol with cattle manure (3:1, v v–1); and Oxisol with cattle manure + Parachlorella sp. The addition of organic residues to the soil, especially cattle manure, contributes to increasing the percentage of emergence, plant height, chlorophyll index, CO2 assimilation rate, and instantaneous carboxylation efficiency of Rubisco due to the superior chemical attributes in the substrate, which promote greater physiological efficiency. Organic residues increased the water use efficiency of seedlings. The application of Parachlorella sp. microalgae contributes to increases in the CO2 assimilation rate and stomatal conductance when seedlings are grown only in Oxisol. C. fissilis seedlings produced in the substrate with sheep and cattle manure showed better growth and gas exchange characteristics. essences Vell cedar, cedar , (cedar) areas Thus sp C texture 31, 31 3 1, 1 (3:1 v–1 v1 v–1) soil height index CO characteristics (cedar (3: v– (3 (

https://doi.org/10.1590/1678-992x-2023-0077

Slope position controls prescribed fire effects on soil: a case study in the high-elevation grassland of Itatiaia National Park soil highelevation high elevation
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Oliveira, Ana Paula Pessim de

; Silva Neto, Eduardo Carvalho da

; Marcondes, Robson Altiellys Tosta

; Pereira, Marcos Gervasio

; Motta, Marcelo Souza

; Diniz, Yan Vidal de Figueiredo Gomes

; Fagundes, Hugo de Souza

; Delgado, Rafael Coll

; Santos, Otavio Augusto Queiroz dos

; Anjos, Lúcia Helena Cunha dos

Revista Brasileira de Ciência do Solo

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2023, Volume 47 elocation e0230009

Resumo: En | Texto: En | PDF: En

ABSTRACT There is a need for greater knowledge about the medium- and long-term effects of prescribed fire management on soil in ecosystems prone to wildfires and more vulnerable to climate change. This study examined the short- and medium-term effects of prescribed fire on soil chemical properties and chemical fractions of soil organic matter (SOM) in two positions of the landscape in a high-elevation grassland environment. The ecosystem is located in the mountain peaks of southeastern Brazil associated with the Atlantic Forest biome. Prescribed fire was conducted in 2017 to reduce understory vegetation and thus prevent potential severe wildfires. Soil samples were collected at the layers of 0.00-0.10, 0.10-0.20, and 0.20-0.40 m, at eight composite sampling. The composite samples were collected on five different occasions: before the prescribed fire, and 10, 30, 90, and 240 days after the prescribed fire. Soil chemical properties, total organic carbon, labile C, and chemical fractionation of SOM were analyzed. All soil properties investigated were affected by the prescribed fire, with variations in landscape position, duration of effect, and soil layer. In the backslope area, the medium-term effect of fire was negative and induced soil degradation and induced soil degradation. In the footslope area, the system showed greater resilience to the effects of fire, as indicated by the recovery of the soil’s chemical properties. These results can help assess the suitability of controlled burning of vegetation for managing risks of fire in mountainous regions, such as high-elevation grasslands. medium longterm long term change short mediumterm (SOM highelevation high elevation environment biome 201 0.000.10, 000010 0.00 0.10, 0 00 10 0.00-0.10 0.100.20, 010020 0.10 0.20, 20 0.10-0.20 0.200.40 020040 0.20 0.40 40 0.20-0.4 m sampling occasions 30 90 24 carbon C analyzed position layer area soils s regions grasslands 000 0.000.10 00001 0.0 010 1 0.00-0.1 100 0.100.20 01002 0.1 020 2 0.10-0.2 200 0.200.4 02004 0.2 040 0.4 4 0.20-0. 3 9 0.000.1 0000 0. 01 0.00-0. 0.100.2 0100 02 0.10-0. 0.200. 0200 04 0.20-0 0.000. 0.00-0 0.100. 0.10-0 0.200 0.20- 0.000 0.00- 0.100 0.10-

https://doi.org/10.36783/18069657rbcs20230009

Endoscopic Holmium Laser harvesting of bladder mucosal graft for substitution urethroplasty
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Figueiredo, Felipe C. A.

; Carvalho, Luiz Augusto Westin

; Pinto, Luís Otávio

; Teloken, Patrick Ely

; Favorito, Luciano Alves

International braz j urol

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Abr 2022, Volume 48 Nº 2 Páginas 371 - 372

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Tissue transfer has been used in urethral reconstruction for decades, and several grafts have been described (1, 2). The ideal graft would have optimal tissue characteristics and lead to minimal morbidity at the donor site. Urethroplasty using bladder mucosa was first described by Memmelaar in 1947 (3). The main limitation in using bladder mucosal grafts has been the invasiveness of open harvesting (4). We describe an endoscopic technique using Holmium: YAG laser to harvest bladder mucosal graft for substitution urethroplasty. Methodology: A 33-year-old male with no history of urethral instrumentation, trauma, or infection presented with obstructive lower urinary tract symptoms. On retrograde urethrogram a 6cm bulbar urethral stricture was identified. Several options were discussed, and the patient opted for a one-sided onlay dorsal urethroplasty (5) using a bladder mucosal graft. Equipment used to harvest the graft included an 18.5Fr continuous flow laser endoscope with a Kuntz working element (RZ) and a 60W Holmium Laser (Quanta) with 550μm laser fiber. The procedure was started by making a perineal incision, urethral mobilization and incision of the stricture segment. The laser endoscope was then introduced via the perineum. Settings of 0.5J, 30 Hz, and long pulse were used and a 7 x 2.5cm graft was harvested from the posterior bladder wall. Hemostasis of the harvest site was performed. The bladder mucosal graft was thinned in similar fashion to a buccal mucosal graft and sutured as per previously described techniques. Conclusion: Endoscopic Holmium Laser harvesting of bladder mucosal graft is feasible and may allow this graft to become an alternative to buccal mucosa. Further studies are required to define its role in urethral reconstruction.

https://doi.org/10.1590/s1677-5538.ibju.2022.99.09

SPECIAL ARTICLE COVID-19: Safety for the Rhinologist in the Age of COVID-19: Mask Use, Nasal Corticosteroids, Saline Irrigation, and Endoscopic Procedures - Literature Review
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Kosugi, Eduardo Macoto

; Villa, Jonatas Figueiredo

; Ramos, Henrique Faria

; Luz-Matsumoto, Gabriela Ricci

; Serrano, Thiago Luis Infanger

; Campos, Carlos Augusto Correia de

; Barreto, Carolina Cincurá

; Lima, Clara Mônica

; Fornazieri, Marco Aurélio

; Piltcher, Otavio

; Lessa, Marcus Miranda

; Romano, Fabrizio Ricci

International Archives of Otorhinolaryngology

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Mar 2022, Volume 26 Nº 1 Páginas 137 - 147

Resumo: En | Texto: En | PDF: En

Abstract Introduction Coronavirus disease 2019 (COVID-19) has claimed millions of lives. Adequate protection of the professionals involved in patient care is essential in the battle against this disease. However, there is much uncertainty involving safety-relarted topics that are of particular interest to the rhinologist in the context of COVID-19. Objective To evaluate the current evidence regarding three safety-related topics: mask and respirator use, performance of nasal endoscopic procedures, and use of topical nasal and intranasal medications (saline irrigation and nasal corticosteroids). Methods A literature review was performed on the PubMed, Scopus, and Cochrane databases, with standardized search queries for each of the three topics of interest. Results In total, 13 articles on mask use, 6 articles on the safety of nasal corticosteroids, 6 articles on the safety of nasal endoscopic procedures, and 1 article on nasal irrigation with saline solution were included in the final analysis. Conclusion N95 respirators are essential for the adequate protection of otolaryngologists. If reuse is necessary, physical methods of sterilization must be employed. No evidence was found to contraindicate the use of nasal corticosteroids, whether acute (in the management of sinonasal inflammatory conditions) or continued (in patients who use them chronically). Nasal irrigation with saline solution apparently does not increase the risk in the context of COVID-19. Nasal endoscopic procedures should only be performed after testing the patient for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the surgical team must wear full personal protective equipment to prevent aerosol exposure.

https://doi.org/10.1055/s-0041-1740988

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations
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Silva, Whesley Tanor

; Oliveira, Lucas Frois Fernandes

; Xavier, Diego Mendes

; Figueiredo, Pedro Henrique Scheidt

; Lacerda, Ana Cristina Rodrigues

; Mendonça, Vanessa Amaral

; Ávila, Matheus Ribeiro

; Ferreira Júnior, Cláudio Luiz

; Lima, Márcia Maria Oliveira

; Mediano, Mauro Felippe Felix

; Rocha, Manoel Otávio da Costa

; Costa, Henrique Silveira

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0377-2022

Resumo: En | Texto: En | PDF: En

ABSTRACT Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

https://doi.org/10.1590/0037-8682-0377-2022

10.

The health-related quality of life in patients with post-COVID-19 after hospitalization: a systematic review
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Figueiredo, Eduardo Augusto Barbosa

; Silva, Whesley Tanor

; Tsopanoglou, Sabrina Pinheiro

; Vitorino, Débora Fernandes de Melo

; Oliveira, Luciano Fonseca Lemos de

; Silva, Keity Lamary Souza

; Luz, Hiago Daniel Herédia

; Ávila, Matheus Ribeiro

; Oliveira, Lucas Fróis Fernandes de

; Lacerda, Ana Cristina Rodrigues

; Mendonça, Vanessa Amaral

; Lima, Vanessa Pereira

; Mediano, Mauro Felippe Felix

; Figueiredo, Pedro Henrique Scheidt

; Rocha, Manoel Otávio Costa

; Costa, Henrique Silveira

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0741-2021

Resumo: En | Texto: En | PDF: En

ABSTRACT Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.

https://doi.org/10.1590/0037-8682-0741-2021

11.

The health-related quality of life in patients with Chagas disease: the state of the art
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Almeida, Igor Lucas Geraldo Izalino de

; Oliveira, Luciano Fonseca Lemos de

; Figueiredo, Pedro Henrique Scheidt

; Oliveira, Rafael Dias de Brito

; Damasceno, Thayrine Rosa

; Silva, Whesley Tanor

; Oliveira, Lucas Frois Fernandes de

; Ávila, Matheus Ribeiro

; Lima, Vanessa Pereira

; Lages, Ana Thereza Chaves

; Mediano, Mauro Felippe Felix

; Rocha, Manoel Otávio Costa

; Costa, Henrique Silveira

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2022, Volume 55 elocation e0657-2021

Resumo: En | Texto: En | PDF: En

ABSTRACT Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

https://doi.org/10.1590/0037-8682-0657-2021

12.

Determinantes da Capacidade Funcional em Pacientes com Doença de Chagas
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Silva, Whesley Tanor

; Costa, Henrique Silveira

; Figueiredo, Pedro Henrique Scheidt

; Lima, Márcia Maria Oliveira

; Lima, Vanessa Pereira

; Costa, Fábio Silva Martins da

; Ávila, Matheus Ribeiro

; Mendonça, Vanessa Amaral

; Lacerda, Ana Cristina Rodrigues

; Nunes, Maria Carmo Pereira

; Rocha, Manoel Otávio Costa

Arquivos Brasileiros de Cardiologia

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Nov 2021, Volume 117 Nº 5 Páginas 934 - 941

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A doença de Chagas leva à redução da capacidade funcional. Entretanto, o estágio em que o comprometimento funcional é detectável permanece obscuro. Objetivos: O presente estudo teve como objetivo comparar a capacidade funcional de pacientes em diferentes estágios da doença de Chagas e de indivíduos saudáveis e verificar os determinantes do consumo de oxigênio de pico (VO2pico). Métodos: Em um estudo transversal, foram selecionados 160 indivíduos, 35 saudáveis e 125 com doença de Chagas. No grupo chagásico, 61 (49%) estavam na forma indeterminada da doença, 45 (36%) com cardiomiopatia chagásica (CC) e função cardíaca preservada e 19 (15%) com disfunção cardíaca e CC dilatada. Os dados foram analisados por meio de análise de regressão univariada e multivariada. A significância estatística foi fixada em 5%. Resultados: Pacientes na forma indeterminada da doença apresentaram capacidade funcional semelhante a indivíduos saudáveis (p> 0,05). Pacientes com ChC e função cardíaca preservada apresentaram VO2pico menor que os pacientes na forma indeterminada (p <0,05), mas apresentaram valores de VO2pico semelhantes ao ChC dilatado (p = 0,46). A idade, sexo masculino, classe funcional da NYHA, pressão arterial diastólica, razão entre a velocidade do fluxo transmitral diastólico precoce e a velocidade anular mitral diastólica precoce, a fração de ejeção do ventrículo esquerdo (FEVE) e o diâmetro diastólico final do ventrículo esquerdo foram associados à capacidade funcional. Porém, apenas idade, sexo masculino, FEVE e classe funcional da NYHA permaneceram associados ao VO2pico no modelo final (R2 ajustado = 0,60). Conclusão: Pacientes com CC apresentam menor capacidade funcional do que pacientes na forma indeterminada. FEVE, idade, sexo masculino e classe funcional da NYHA foram determinantes do VO2pico em pacientes com doença de Chagas.

Abstract Background: Chagas disease leads to reduced functional capacity. However, the stage at which functional impairment is detectable remains unclear. Objectives: The present study was addressed to compare the functional capacity of patients at different stages of Chagas disease and healthy individuals and to verify the determinants of peak oxygen uptake (VO2peak). Methods: In a cross-sectional study, 160 individuals were selected, 35 healthy and 125 with Chagas disease. In the Chagasic group, 61 (49%) were in the indeterminate form of the disease, 45 (36%) with Chagas cardiomyopathy (ChC) and preserved cardiac function and 19 (15%) with cardiac dysfunction and dilated ChC. The data were analyzed using univariate and multivariate regression analysis. Statistical significance was set at 5%. Results: Patients in the indeterminate form of disease showed similar functional capacity to healthy individuals (p>0.05). Patients with ChC and preserved cardiac function had lower VO2peak than patients in the indeterminate form (p<0.05), but showed similar VO2peak values than dilated ChC (p=0.46). The age, male sex, NYHA functional class, diastolic blood pressure, ratio of the early diastolic transmitral flow velocity to early diastolic mitral annular velocity, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter were associated with functional capacity. However, only age, male sex, LVEF and NYHA functional class, remained associated with VO2peak in the final model (adjusted R2=0.60). Conclusion: Patients with ChC had lower functional capacity than patients in the indeterminate form. LVEF, age, male sex and NYHA functional class were determinants with VO2peak in patients with Chagas disease.

https://doi.org/10.36660/abc.20200462 3 downloads

13.

Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021
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Marcondes-Braga, Fabiana G.

; Moura, Lídia Ana Zytynski

; Issa, Victor Sarli

; Vieira, Jefferson Luis

; Rohde, Luis Eduardo

; Simões, Marcus Vinícius

; Fernandes-Silva, Miguel Morita

; Rassi, Salvador

; Alves, Silvia Marinho Martins

; Albuquerque, Denilson Campos de

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Ramires, Felix José Alvarez

; Bacal, Fernando

; Rossi Neto, João Manoel

; Danzmann, Luiz Claudio

; Montera, Marcelo Westerlund

; Oliveira Junior, Mucio Tavares de

; Clausell, Nadine

; Silvestre, Odilson Marcos

; Bestetti, Reinaldo Bulgarelli

; Bernadez-Pereira, Sabrina

; Freitas Jr, Aguinaldo F.

; Biolo, Andréia

; Barretto, Antonio Carlos Pereira

; Jorge, Antônio José Lagoeiro

; Biselli, Bruno

; Montenegro, Carlos Eduardo Lucena

; Santos Júnior, Edval Gomes dos

; Figueiredo, Estêvão Lanna

; Fernandes, Fábio

; Silveira, Fabio Serra

; Atik, Fernando Antibas

; Brito, Flávio de Souza

; Souza, Germano Emílio Conceição

; Ribeiro, Gustavo Calado de Aguiar

; Villacorta, Humberto

; Souza Neto, João David de

; Goldraich, Livia Adams

; Beck-da-Silva, Luís

; Canesin, Manoel Fernandes

; Bittencourt, Marcelo Imbroinise

; Bonatto, Marcely Gimenes

; Moreira, Maria da Consolação Vieira

; Avila, Mônica Samuel

; Coelho Filho, Otavio Rizzi

; Schwartzmann, Pedro Vellosa

; Mourilhe-Rocha, Ricardo

; Mangini, Sandrigo

; Ferreira, Silvia Moreira Ayub

; Figueiredo Neto, José Albuquerque de

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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Jun 2021, Volume 116 Nº 6 Páginas 1174 - 1212

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210367 3168 downloads

14.

Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba

; Rodrigues, Cibele Isaac Saad

; Bortolotto, Luiz Aparecido

; Mota-Gomes, Marco Antônio

; Brandão, Andréa Araujo

; Feitosa, Audes Diógenes de Magalhães

; Machado, Carlos Alberto

; Poli-de-Figueiredo, Carlos Eduardo

; Amodeo, Celso

; Mion Júnior, Décio

; Barbosa, Eduardo Costa Duarte

; Nobre, Fernando

; Guimarães, Isabel Cristina Britto

; Vilela-Martin, José Fernando

; Yugar-Toledo, Juan Carlos

; Magalhães, Maria Eliane Campos

; Neves, Mário Fritsch Toros

; Jardim, Paulo César Brandão Veiga

; Miranda, Roberto Dischinger

; Póvoa, Rui Manuel dos Santos

; Fuchs, Sandra C

; Alessi, Alexandre

; Lucena, Alexandre Jorge Gomes de

; Avezum, Alvaro

; Sousa, Ana Luiza Lima

; Pio-Abreu, Andrea

; Sposito, Andrei Carvalho

; Pierin, Angela Maria Geraldo

; Paiva, Annelise Machado Gomes de

; Spinelli, Antonio Carlos de Souza

; Nogueira, Armando da Rocha

; Dinamarco, Nelson

; Eibel, Bruna

; Forjaz, Cláudia Lúcia de Moraes

; Zanini, Claudia Regina de Oliveira

; Souza, Cristiane Bueno de

; Souza, Dilma do Socorro Moraes de

; Nilson, Eduardo Augusto Fernandes

; Costa, Elisa Franco de Assis

; Freitas, Elizabete Viana de

; Duarte, Elizabeth da Rosa

; Muxfeldt, Elizabeth Silaid

; Lima Júnior, Emilton

; Campana, Erika Maria Gonçalves

; Cesarino, Evandro José

; Marques, Fabiana

; Argenta, Fábio

; Consolim-Colombo, Fernanda Marciano

; Baptista, Fernanda Spadotto

; Almeida, Fernando Antonio de

; Borelli, Flávio Antonio de Oliveira

; Fuchs, Flávio Danni

; Plavnik, Frida Liane

; Salles, Gil Fernando

; Feitosa, Gilson Soares

; Silva, Giovanio Vieira da

; Guerra, Grazia Maria

; Moreno Júnior, Heitor

; Finimundi, Helius Carlos

; Back, Isabela de Carlos

; Oliveira Filho, João Bosco de

; Gemelli, João Roberto

; Mill, José Geraldo

; Ribeiro, José Marcio

; Lotaif, Leda A. Daud

; Costa, Lilian Soares da

; Magalhães, Lucélia Batista Neves Cunha

; Drager, Luciano Ferreira

; Martin, Luis Cuadrado

; Scala, Luiz César Nazário

; Almeida, Madson Q.

; Gowdak, Marcia Maria Godoy

; Klein, Marcia Regina Simas Torres

; Malachias, Marcus Vinícius Bolívar

; Kuschnir, Maria Cristina Caetano

; Pinheiro, Maria Eliete

; Borba, Mario Henrique Elesbão de

; Moreira Filho, Osni

; Passarelli Júnior, Oswaldo

; Coelho, Otavio Rizzi

; Vitorino, Priscila Valverde de Oliveira

; Ribeiro Junior, Renault Mattos

; Esporcatte, Roberto

; Franco, Roberto

; Pedrosa, Rodrigo

; Mulinari, Rogerio Andrade

; Paula, Rogério Baumgratz de

; Okawa, Rogério Toshiro Passos

; Rosa, Ronaldo Fernandes

; Amaral, Sandra Lia do

; Ferreira-Filho, Sebastião R.

; Kaiser, Sergio Emanuel

; Jardim, Thiago de Souza Veiga

; Guimarães, Vanildo

; Koch, Vera H.

; Oigman, Wille

; Nadruz, Wilson

Arquivos Brasileiros de Cardiologia

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Mar 2021, Volume 116 Nº 3 Páginas 516 - 658

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20201238 10948 downloads

15.

Avaliação do Seguimento de 1 Ano dos Pacientes Incluídos no Registro da Prática Clínica em Pacientes de Alto Risco Cardiovascular (REACT)
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Silva, Pedro Gabriel Melo de Barros e

; Berwanger, Otavio

; Precoma, Dalton Bertolim

; Cavalcante, Margaret Assad

; Vilela-Martin, José Fernando

; Figueiredo, Estêvão Lanna

; Lopes, Renato Delascio

; Bodanese, Luiz Carlos

; Guimarães, Jorge Ilha

; Andrade, Jadelson Pinheiro de

; Paola, Angelo Amato Vincenzo de

; Malachias, Marcus Vinicius Bolivar

; Mattos, Luiz Alberto Piva e

; Bacal, Fernando

; Dutra, Oscar Pereira

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Jan 2021, Volume 116 Nº 1 Páginas 108 - 116

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento Na prática clínica, há evidências de falhas na prescrição de terapias baseadas em evidências para pacientes de alto risco cardiovascular. Entretanto, no Brasil, ainda são insuficientes os dados sobre a evolução ao longo de 1 ano desses pacientes. Objetivos Descrição no acompanhamento de 12 meses da utilização de terapias baseadas em evidência e da ocorrência de desfechos cardiovasculares maiores e seus principais preditores em um registro brasileiro multicêntrico de pacientes de alto risco cardiovascular. Métodos Estudo observacional prospectivo que documentou a prática clínica ambulatorial de indivíduos acima de 45 anos e de alto risco cardiovascular tanto em prevenção primária como secundária. Os pacientes foram seguidos por 1 ano e avaliou-se a prescrição de terapias baseadas em evidência e a ocorrência de eventos cardiovasculares maiores (infarto agudo do miocárdio [IAM], acidente vascular cerebral [AVC], parada cardíaca e mortalidade por causa cardiovascular). Valores de p < 0,05 foram considerados estatisticamente significantes. Resultados De julho de 2010 até agosto de 2014, 5.076 indivíduos foram incluídos em 48 centros, sendo 91% dos 4.975 pacientes elegíveis acompanhados em centros de cardiologia e 68,6% em prevenção secundária. Em 1 ano, o uso concomitante de antiplaquetários, estatinas e inibidores da enzima conversora de angiotensina (IECA) reduziu de 28,3% para 24,2% (valor de p < 0,001). A taxa de eventos cardiovasculares maiores foi de 5,46%, e os preditores identificados foram: idade, pacientes em prevenção secundária e nefropatia diabética. Conclusões Neste grande registro nacional de pacientes de alto risco cardiovascular, foram identificados preditores de risco semelhantes aos registros internacionais, porém a adesão da prescrição médica a terapias baseadas em evidência esteve abaixo dos dados da literatura internacional e apresentou piora significativa em 1 ano. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Background In clinical practice, there is evidence of failure to prescribe evidence-based therapies for patients at high cardiovascular risk. However, in Brazil, data on 1-year outcomes of these patients remain insufficient. Objectives To describe the use of evidence-based therapies and the occurrence of major cardiovascular outcomes and their major predictors in a 12-month follow-up of a Brazilian multicenter registry of patients at high cardiovascular risk. Methods This prospective observational study documented the outpatient clinical practice of managing patients over 45 years of age and of high cardiovascular risk in both primary and secondary prevention. Patients were followed-up for 1 year, and the prescription of evidence-based therapies and the occurrence of major cardiovascular events (myocardial infarction, stroke, cardiac arrest, and cardiovascular death) were assessed. P-values < 0.05 were considered statistically significant. Results From July 2010 to August 2014, a total of 5076 individuals were enrolled in 48 centers, 91% of the 4975 eligible patients were followed-up in cardiology centers, and 68.6% were in secondary prevention. At 1 year, the concomitant use of antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors reduced from 28.3% to 24.2% (p < 0.001). Major cardiovascular event rate was 5.46%, and the identified predictors were age, patients in secondary prevention, and diabetic nephropathy. Conclusions In this large national registry of patients at high cardiovascular risk, risk predictors similar to those of international registries were identified, but medical prescription adherence to evidence-based therapies was inferior and significantly worsened at 1 year. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

https://doi.org/10.36660/abc.20190885 528 downloads

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